Dietary intake of folate equivalents and risk of myocardial infarction in the European Prospective Investigation into Cancer and Nutrition (EPIC) - Potsdam study

Objective: To assess the relationship between intake of dietary folate equivalents and risk of myocardial infarction in a German cohort. Design: Intake of dietary folate equivalents was assessed by a validated food-frequency questionnaire. Cox proportional hazard models were used to evaluate the association between intake of dietary folate equivalents and risk of myocardial infarction. Setting: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, Germany. Subjects: Subjects were 22 245 apparently healthy non-users of vitamin supplements aged 35-64 years. Results: During 4.6 years of follow-up, 129 incident cases of myocardial infarction were identified. Compared with intake below the median (103 μg), higher intake of dietary folate equivalents was associated with a multivariate-adjusted hazard ratio (HR) of 0.57 (95% confidence interval (CI) 0.36-0.91). The inverse association of folate intake and myocardial infarction risk was stronger in participants with an ethanol intake equal to or above the sex-specific median (HR = 0.37, 95% CI 0.18-0.79) and attenuated in those with a low ethanol intake (HR = 0.67, 95% CI 0.37-1.22). Conclusion: An increased intake of dietary folate equivalents was observed to be associated with decreased risk of myocardial infarction in a German study population, pointing towards the importance of folate intake with respect to primary prevention of myocardial infarction. © The Authors 2006.