Invited Commentary: Diet and Risk of Venous Thromboembolism—A Hard Nut to Crack

American Journal of Epidemiology, Jan 2012

Recently, there has been interest in determining whether diet is associated with the risk of venous thromboembolism. The article by Varraso et al. (Am J Epidemiol. 2012;175(2):114–126) published in this issue of the Journal is an important contribution to this literature. In this commentary, the author discusses the findings of Varraso et al. within the context of the existing literature and posits epidemiologic explanations for why investigators might have failed to identify strong associations between diet and venous thromboembolism.

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Invited Commentary: Diet and Risk of Venous Thromboembolism—A Hard Nut to Crack

Recently, there has been interest in determining whether diet is associated with the risk of venous thromboembolism. The article by Varraso et al. (Am J Epidemiol. Invited Commentary: Diet and Risk of Venous Thromboembolism-A Hard Nut to Crack Pamela L. Lutsey ) 0 0 Minnesota , 1300 South 2nd St., Suite 300, Minneapolis, MN 55454 ( American Journal of Epidemiology ª The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: . diet; food; pulmonary embolism; venous thrombosis A P (H T l S a o o ob tr a n ic eb eb e o lisce iteno ten linC lcap lcap lcap ohC tr rv sm .s .s .s A te s v v v d In es t t t he ry sA en en en lis ta r b ie o u D P , , , trya irsan lftoae d trya ,,fish ,) fttya ,B612 itede ie edg ,da ,12 an ide lse en sn ,B ly td it, n o B ,s n b mtra K1 t-s en fru rfie rsa in id re ta ow i,sd isn H d , mca t e ( S A l l l bl bl b o o o o o e h h h h h e o o o o o ff lc lc lc lc lc o A A A A A C emsde F i:t-311eenm i:t-ne61omittrcneaha iitthewm it-e3FFQm iitrsonnaee iitrsonnaee iitrsonnaee iitrsonnaee iitrsonnaee iitrsnnoaee C 3 u u u u u u 1 Q Q Q Q Q Q M M M M M M M F Q Q Q Q co .1 .5 .5 .1 0 2 2 4 .0 8 2 1 1 1 1 6 : : 1 : : : : n n : n n n n ia ia n ia ia a a d d a d d e e e e e e e 1 9 3 2 8 2 5 1 5 9 6 1 6 5 ,4 ,9 ,2 ,6 ,5 ,6 ,7 6 7 9 8 9 6 6 3 1 1 2 2 2 2 2 8 9 o 9 7 5 9 t . e 2 ,2 ,6 2 s d c 8 5 5 8 2 0 2 3 5 1 5 1 6 6 7 1 2 3 3 4 4 ) (1 1 0 ) 2 ) 01 (1 1 (1 09 ,e 15 1 n ( 2 6 ( 5 0 o ) , 9 2 0 2 r 4 1 lad 19 00 20 it,s -K (1 01 itrzge ,roha i,sa2 l,ynn ivnqd sanen 2011 ,ga2n F P T G L H E H te a )6 )7 ) S s in 9 A ju g 1 (1 ) 1 r ( 8 ( D d a 2010 ,2000 (801 0210 it:son itr-aea sam t, a 02 ,a ia a w pao am ,p da rve litv ree b u h B S P Y Aa b Diet and Venous Thromboembolism ACKNOWLEDGMENTS Author affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota. The author thanks Drs. Katie Meyer and Anna Prizment for reviewing a version of this commentary before submission. Conflict of interest: none declared. REFERENCES 1. Varraso R , Kabrhel C , Goldhaber SZ , et al. Prospective study of diet and venous thromboembolism in US women and men . Am J Epidemiol . 2012 ; 175 ( 2 ): 114 - 126 . 2. Jensen RA . Postoperative thrombosis-emboli; their frequency in the period 1940-1948 at the III department of Ulveva˚l Sykehus and the surgical department of Akers Sykehus . Acta Chir Scand . 1952 ; 103 ( 4 ): 263 - 275 . 3. Strom A. Examination into the diet of Norwegian families during the war-years 1942-45 . Acta Med Scand Suppl . 1948 ; 21 ( 1 ): 41 - 47 . 4. Glynn RJ , Ridker PM , Goldhaber SZ , et al. Effects of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism: report from the Women's Health Study . Circulation . 2007 ; 116 ( 13 ): 1497 - 1503 . 5. Ray JG , Kearon C , Yi Q , et al. Homocysteine-lowering therapy and risk for venous thromboembolism: a randomized trial . Heart Outcomes Prevention Evaluation 2 (HOPE-2) Investigators. Ann Intern Med . 2007 ; 146 ( 11 ): 761 - 767 . 6. den Heijer M , Willems HP , Blom HJ , et al. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: a randomized, placebo-controlled, double-blind trial . Blood . 2007 ; 109 ( 1 ): 139 - 144 . 7. Steffen LM , Folsom AR , Cushman M , et al. Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology . Circulation. 2007 ; 115 ( 2 ): 188 - 195 . 8. Lutsey PL , Steffen LM , Virnig BA , et al. Diet and incident venous thromboembolism: the Iowa Women's Health Study . Am Heart J . 2009 ; 157 ( 6 ): 1081 - 1087 . 9. Fitzgerald K , Chiuve S , Buring JE , et al. Comparison of associations of heart healthy diets with risks of cardiovascular disease and venous thromboembolism . Presented at the American Heart Association Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention Scientific Sessions , Atlanta, Georgia, March 22 - 25 , 2011 . 10. Pahor M , Guralnik JM , Havlik RJ , et al. Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons . J Am Geriatr Soc . 1996 ; 44 ( 9 ): 1030 - 1037 . 11. Tsai AW , Cushman M , Rosamond WD , et al. Cardiovascular risk factors and venous thromboembolism incidence: the Longitudinal Investigation of Thromboembolism Etiology . Arch Intern Med . 2002 ; 162 ( 10 ): 1182 - 1189 . 12. Glynn RJ , Rosner B. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism . Am J Epidemiol . 2005 ; 162 ( 10 ): 975 - 982 . 13. Lindqvist PG , Epstein E , Olsson H. The relationship between lifestyle factors and venous thromboembolism among women: a report from the MISS Study . Br J Haematol . 20 (...truncated)


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Pamela L. Lutsey. Invited Commentary: Diet and Risk of Venous Thromboembolism—A Hard Nut to Crack, American Journal of Epidemiology, 2012, pp. 127-130, 175/2, DOI: 10.1093/aje/kwr379