Abstract 020: Healthy Dietary Patterns And Risk Of Cardiovascular Disease In Us Hispanics/latinos: The Hispanic Community Health Study/study Of Latinos (HCHS/SOL)

Abstract

Introduction: Multiple healthy eating patterns have been recommended by the Dietary Guidelines for Americans (2015-2020) for the prevention of cardiovascular disease (CVD). However, adherence to these dietary patterns and its relationship with risk of CVD remains unclear among US Hispanic/Latinos. Hypothesis: We aimed to evaluate three healthy eating patterns measured by three dietary quality indices (the Alternate Mediterranean diet (aMED), the Healthy Eating Index (HEI)-2015, and the healthful Plant-based Diet Index (hPDI)), and assessed the hypothesis that higher adherence to healthy eating patterns is associated with lower risk of CVD in US Hispanic/Latinos. Methods: We included 10,766 adult participants representing six Hispanic/Latino backgrounds (Mexican, Puerto Rican, Cuban, Dominican, Central American and South American), free of CVD or cancer at baseline, from the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores were derived using information collected by two 24-hour dietary recalls at baseline (2008-11). The primary outcome was major incident CVD (n=248), comprised of coronary heart disease and stroke, during an average 6-year follow-up period. Relative risks for CVD were estimated using survey Poisson regression after adjustment for demographic, socioeconomic, and behavioral variables and sampling weights. Results: Mean scores of all three dietary quality indices were significantly different across six Hispanic/Latino background groups (all P <0.001), with the highest (healthier) in Mexicans and lowest in Puerto Ricans. Compared to Hispanics/Latinos who were born outside the mainland US, US-born Hispanics/Latinos had significantly lower dietary quality scores (all P <0.001), especially in Mexican, Dominican, and Central American background groups. The differences in dietary scores between the non-US-born and US-born Hispanics/Latinos were primarily driven by intakes of healthy plant-based foods (e.g., whole grains, fruits, vegetables, legumes and nuts). We found significant inverse associations across tertiles of the three dietary indices with risk of CVD. After multivariable adjustment, the relative risk of CVD was 0.54 (95% CI 0.37-0.81; P -trend=0.002) for aMED, 0.64 (95% CI 0.39-1.05; P -trend=0.033) for HEI-2015, and 0.56 (95% CI, 0.35-0.88; P -trend=0.009) for hPDI when comparing highest to lowest tertiles in the overall sample. The associations between dietary quality scores and risk of CVD were not different across Hispanic/Latino backgrounds (all P for interaction ≥0.24) or not by US-born status (all P for interaction ≥0.25). Conclusions: Adherence to healthy eating patterns reflected by three diet quality indices varied by Hispanic/Latino background and immigrant generation, and higher compliance to healthy eating patterns was associated with lower risk of CVD risk in the US Hispanic/Latino population.