Abstract P049: Principal Component Analysis of Dietary Patterns and the Risk of Cardiovascular Disease and Mortality in Older British Men

Abstract

Background: Diet quality is a major risk factor for morbidity and mortality, but few studies have examined the relationship between dietary patterns and the risk of cardiovascular disease (CVD) and mortality in older adults. We examined prospective associations between dietary patterns defined using principal component analysis and the risk of CVD and all-cause mortality in older British men. Methods: 3226 men aged 60-79 years from the British Regional Heart Study, free from CVD at baseline, were followed-up for 11 years. Baseline food frequency questionnaire data were used to generate dietary intake data on 34 food groups. Principal component analysis identified dietary patterns which were then categorised according to quartiles of adherence. Cox proportional hazards regression examined associations between dietary patterns and risk of all-cause mortality, CVD mortality, CVD events and coronary heart disease (CHD) events, adjusting for confounders. Results: Principal component analysis identified three interpretable dietary patterns, which explained 20.8% of the total variance. An ‘unhealthy’ dietary pattern explained the greatest single proportion of the variance (7.9%) and was characterised by consumption of red meat, meat products, white bread, fried potato and eggs. A ‘healthy’ dietary pattern was characterised by consumption of poultry, fish, fruit, vegetables, legumes, pasta, rice, wholemeal bread, eggs and olive oil and explained 7.1% of the variance. Finally, a ‘sweet’ dietary pattern was characterised by consumption of biscuits, puddings, chocolate, sweets, sweet spreads and breakfast cereal and explained 5.8% of the variance. There were 899 deaths, 316 CVD deaths, 569 CVD events and 301 CHD events during follow-up. An ‘unhealthy’ dietary pattern was associated with a graded increase in risk of all-cause mortality, after adjustment for sociodemographic, behavioural and cardiovascular risk factors (highest vs. lowest quartile; HR: 1.44, 95% CI: 1.13-1.84, p-trend = 0.007). No significant associations were seen between the risk of all-cause mortality and the ‘healthy’ diet (highest vs. lowest quartile; HR: 0.83, 95% CI: 0.66-1.04, p-trend = 0.28) or the ‘sweet’ diet (highest vs. lowest quartile; HR: 1.00, 95% CI: 0.77-1.29, p-trend = 0.71). None of the dietary patterns were significantly associated with cardiovascular outcomes (CVD mortality, CVD events or CHD events). Conclusions: Dietary patterns are an important risk factor for all-cause mortality in the elderly. Older adults should avoid a high consumption of components of an ‘unhealthy’ dietary pattern to reduce the risk of all-cause mortality.