Eating behaviors and their relationship with cardiovascular disease. A case/case-control study

• The overall effect of eating behaviors on cardiovascular health was examined
• Unhealthier eating practices increase the likelihood of acute coronary syndromes
• Unhealthier eating practices were not associated with ischemic stroke presence
• Evaluation of eating practices deserves a place in everyday clinical practice

The aim of the present work was to evaluate the combined role of eating behaviors and to investigate their effect on the likelihood of developing an acute coronary syndrome (ACS) or an ischemic stroke. During 2009–2010, 1000 participants were enrolled; 250 consecutive patients with a first ACS (83% males, 60 ± 12 years) and 250 control subjects, as well as 250 consecutive patients with a first ischemic stroke (56% males, 77 ± 9 years) and 250 controls. The controls were population-based and age–sex matched with the patients. Detailed information regarding their anthropometric data, medical records and lifestyle characteristics (dietary and smoking habits, physical activity, psychological state and eating practices -using a special questionnaire-) were recorded. Five eating behaviors were selected to compose an eating behavior score for the purposes of this work: adherence to the Mediterranean diet (using the MedDietScore), frequency of breakfast consumption, eating while being stressed, eating while working and skipping meals. Eating behaviors with beneficial health effects were scored with 0, while those with negative effects were assigned score 1. The total range of the score was between 0 and 5. Higher scores reveal “unhealthier” eating practices. After controlling for potential confounding factors, each unit increase of the eating behavior score was associated with 70% (95%CI: 1.29–2.22) higher likelihood of developing an ACS. Insignificant associations were observed regarding ischemic stroke. The overall adoption of specific “unhealthy” eating practices seems to have a detrimental effect on cardiovascular health, and especially coronary heart disease.