A priori–defined dietary patterns and markers of cardiovascular disease risk in the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

BackgroundThe level of detail regarding the dietary intake necessary to characterize associations between diet and cardiovascular disease (CVD) risk is uncertain. ObjectiveWe evaluated a unique a priori–defined dietary pattern in relation to several traditional and novel CVD risk factors. DesignAt the baseline examination, diet (by food-frequency questionnaire), markers of inflammation, subclinical atherosclerosis, renal disease, vascular compliance, and other traditional risk factors were measured in 5089 men and women aged 45–84 y without clinical CVD or diabetes from the Multi-Ethnic Study of Atherosclerosis (MESA). We defined a Comprehensive Healthy Dietary Pattern by summing weighted categorical ranks of 36 narrowly defined food groups (21 rated favorably with categorical ranks × +1.0 and 15 rated unfavorably with categorical ranks × −1.0). We also defined a Simplified Healthy Dietary Pattern composed of 3 favorable (whole grains, fruit, and seeds and nuts) and 3 unfavorable (added fats and oils, processed meats, and fried potatoes) food groups using similar scoring techniques and determined the difference between the comprehensive and simplified scores. ResultsThe Comprehensive Healthy Dietary Pattern was associated with lower urinary albumin:creatinine ratios, common carotid intima-media thickness, measures of adiposity, and inflammatory marker, triacylglycerol, and insulin concentrations. The magnitudes of most of the associations were similar between the 2 dietary patterns, but some differences were observed between scores. Dietary patterns were not associated with blood pressure, coronary artery calcification, internal carotid intima-media thickness, or the ankle brachial index. ConclusionsMany food groups contribute to the characterization of relations with a variety of CVD risk markers, although only 6 food groups contribute much of the information in MESA.