Background Some dietary patts are risk factors for acute myocardial infarction (AMI).Chinese traditional food and habits vary from other cultures.The present study determined whether different dietary patts were associated with AMI in Chinese people.Methods We conducted a case-control study.There were 1312 cases of first AMI and 2235 control subjects who did not have previous angina,diabetes mellitus,hypertension or stroke.Controls were matched to cases on age and gender.Diet was measured with a validated,19 item food frequency questionnaire.We identified three major dietary patts using factor analysis:vitamin and microelement patt (high intake of vegetables,fruits and tofu),carbohydrate patt (high in grain),and fat and protein patt (high in meat,fish,eggs and fried foods).Results After adjusting for all risk factors,the vitamin and microelement patt was inversely associated with AMI risk (global P value,0.0001).Compared with the first quartile,the adjusted ORs of AMI were 0.81 (95％ CI:0.66-1.00) for the second quartile,0.67 (95％ CI:0.54-0.82) for the third,and 0.70 (95％ CI:0.56-0.88) for the fourth.Several dietary frequencies (serves per week) including vegetables,fruits and tofu were closely associated with decrease of AMI risk.Carbohydrate patt showed weak relationship with AMI.We observed a U-shaped association between frequencies of fat and protein patt and AMI risk.Excessive fat intake increased the AMI risk.The adjusted OR of AMI associated with the higher level of green vegetables was 0.37 (95％ CI:0.24-0.57) in women and 0.65 (95％ CI:0.51-0.82) in men (P value for heterogeneity,0.0140).Conclusions Unhealthy dietary intake can increase the AMI risk.Improving intake of vegetables,fruits and tofu have the potential to partially prevent the rising epidemic of cardiovascular disease in China.