Potato Consumption and Risk of Cardiovascular Mortality and Type 2 Diabetes After Myocardial Infarction: A Prospective Analysis in the Alpha Omega Cohort

Abstract

Background: Higher potato intake, especially French fries, was unfavorably associated with cardiometabolic endpoints in population-based studies. Little is known about this in patients with ischemic heart disease (IHD).

Objective: Total and boiled potatoes and French fries intake were examined in relation to cardiovascular disease (CVD) mortality, all-cause mortality, and type 2 diabetes mellitus (T2DM) risk in Dutch post-myocardial infarction (MI) patients of the Alpha Omega Cohort.

Methods: We analyzed 3,401 patients (60-80 years, 78% male), free from T2DM at baseline, with an MI ≤ 10 years before enrolment. Diet was assessed at baseline (2002-2006) using a 203-item validated Food Frequency Questionnaire (FFQ) that includes potato preparation methods. Cause-specific mortality was monitored through December 2018, and T2DM incidence (self-reported physician diagnosis and/or prescribed anti-diabetes medication) was monitored during the first 40 months of follow-up. Multivariable Cox models were used to obtain hazard ratios (HRs) for fatal endpoints and incident T2DM in tertiles of potato intake.

Results: Patients had a median total potato intake (mainly boiled) of 111 g/d, 96% consumed >1 serving (200 g) per week. French fries were consumed by 48% of the patients (median of 6 g/d among consumers). During >12 years of follow-up (38,987 person-years), 1,476 deaths occurred of which 641 were from CVD, 394 were from IHD, and 119 were from a stroke. Total and boiled potatoes were not associated with CVD mortality, but a higher risk of all-cause mortality was observed (HR: 1.07; 95% CI: 1.01, 1.14; per 50 g/d). Potato consumption tended to be positively associated with incident T2DM (186 cases; HR: 1.11, 95% CI: 0.94, 1.32; per 50 g/d). Results for French fries were inconsistent for all outcomes.

Conclusion: In Dutch post-MI patients, potatoes (mainly boiled) were not associated with CVD mortality but possibly adversely associated with all-cause mortality and T2DM risk. These findings warrant confirmation in other IHD patient cohorts. The Alpha Omega Cohort is registered at ClinicalTrials.gov as NCT03192410.

Keywords: French fries; cardiovascular disease; ischemic heart disease; mortality; patients; potatoes; type 2 diabetes mellitus.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Cruijsen, Indyk, Simon, Busstra and Geleijnse.

Figures

Figure 1

Associations of total potato intake with CVD mortality (A) and all-cause mortality (B) in 3,401 patients from the Alpha Omega Cohort. Lines are restricted cubic splines, showing continuous associations, with 3 knots located at the 5th, 50th, and 95th percentiles. The y-axis shows the predicted hazard ratios (HRs) for mortality for any value of total potato intake, compared to the reference value set at 0 g/d. HRs are adjusted for age, sex, energy intake, education level, smoking, physical activity level, alcohol intake, whole and refined grains, fish, red and processed meat, milk, yogurt and custard, vegetables, fruits, mayonnaise, saturated fatty acids, polyunsaturated fatty acids, sugar-sweetened beverages, sweet and sour snacks and nuts, seeds, and legumes. CVD, cardiovascular disease; HR, hazard ratio.