Abstract 14: Diet Quality and Cardiovascular Disease Risk in Postmenopausal Women With Type 2 Diabetes: the Women’s Health Initiative

Abstract

Introduction: Both type 2 diabetes (T2D) and cardiovascular disease (CVD) are known to be influenced by dietary intake, however there is little evidence from large and well characterized cohort studies regarding the relationship between popular dietary patterns and CVD risk in populations with T2D. Understanding how common diet scores associate with CVD risk may provide better nutrition recommendations, education, and targeted interventions in the population with T2D. Hypothesis: We hypothesize that high diet quality as represented by higher scores on four different a priori diet indices is associated with a lower risk of developing CVD in postmenopausal women with T2D. Methods: We analyzed data of 6031 postmenopausal women with type 2 diabetes from the Women’s Health Initiative (WHI) cohort with no history of CVD at baseline. Dietary intake was assessed by a validated WHI food frequency questionnaire. Diet scores for four different diet patterns were calculated: Mediterranean (aMed), Dietary Approaches to Stop Hypertension (DASH), Paleolithic diet, and American Diabetes Association dietary recommendations (ADA). Multivariate Cox proportional hazards regression was used to estimate the hazard ratio of incident coronary heart disease (CHD) and stroke during study follow up for each dietary pattern score, adjusting for demographic, lifestyle and clinical measures. Results: Over 21 years of follow up 11.2% (675/6031) of women developed CHD and 6.7% (408/6031) had a stroke. There was a strong, monotonic inverse association between higher aMed, DASH, and ADA diet scores and risk of incident CHD and stroke; and no association between the Paleolithic dietary pattern score and CHD or stroke (Table 1). Conclusions: There are multiple dietary avenues to lower CVD risk in a population with T2D via the aMed, DASH, and ADA diets; whereas there was no evidence the Paleolithic diet score is associated with CVD risk in a population with T2D.