Abstract
Introduction: South Asians (SA) are a growing population group in the US that remain understudied in research despite their high cardiometabolic risk. Compared to other ethnic groups, SA experience cardiometabolic disease onset at a younger age, and have higher abdominal, visceral and hepatic fat despite lower BMI. SA in the US have a unique dietary pattern characterized by a combination of traditional and western food items. Examining the dietary pattern of SA in relation to central adiposity may provide a tenable strategy for disease prevention and treatment. Hypothesis: We assessed the hypothesis that higher DASH diet score is associated with lower central adiposity, indicated by visceral fat area and hepatic attenuation measurements, among SA in the US. Methods: Using baseline data from 822 adults enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, we computed a Dietary Approaches to Stop Hypertension (DASH) concordance score from the FFQ validated to measure diet of South Asians in North America. Using an established method, score concordance was based on 8 components including high intake of fruit, vegetables, nuts/legumes, low-fat dairy products, whole grains; and low intake of sodium, sugar-sweetened beverages, and red/processed meats. We examined the association between the DASH score and its components with CT imaging of visceral fat area and hepatic attenuation (higher score indicates lower liver fat). Results: The overall DASH score among participants ranged from 13-35 (mean ± SD, 24.6 ± 4.4). Hepatic attenuation was 5 HU higher among participants in the highest category DASH score compared to the lowest (aβ (SE): 5 (1), 95% CI: 2, 7) in the age-adjusted model. The relationship was not significant in the fully adjusted model. Visceral fat area was 13.6 cm 2 lower among participants in the highest category of DASH score compared to the lowest (aβ (SE): -3.6 (5.1), 95% CI: -23.5, -3.7) in the model adjusted for age, sex, percent of life in US, education, BMI, physical activity, smoking, alcohol, and energy intake. When examining individual components of DASH, participants with the highest intake of low-fat dairy had hepatic attenuation 3 HU higher than those with the lowest intake, and those with the lowest intake of red/processed meat had hepatic attenuation 2 HU higher in the fully adjusted model. Participants with the lowest red/processed meat intake had visceral fat area that was 11 cm 2 lower in the fully adjusted model. Conclusions: In conclusion, our results indicate that greater adherence to DASH and some of its individual components is associated with favorable abdominal fat areas among a sample of SA adults in the US. These findings support the relationship between diet and abdominal fat accretion. Forthcoming analyses will use the DASH score to further elucidate the diet-disease relationship among SA in the US.
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