Abstract
Background: Abnormal cardiac phenotypes, including left ventricular (LV) structure and function, are subclinical characteristics, detectable before experiencing heart failure (HF) symptoms. Identifying lifestyle risk factors of abnormal cardiac phenotypes can help to prevent or slow down the progression to HF and ultimately reduce the burden of the aging heart. Therefore, we aimed to identify the associations of carbohydrate (CHO) quality and fiber-rich foods with LV structure and function. Methods: We studied 3,171 Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Dietary intake was assessed via Diet History and averaged across years 0 (1985-86), 7, and 20. CHO:fiber ratio was created to define CHO quality (greater CHO:fiber ratio representing lower CHO quality). The fiber-rich food score was created based on the servings of whole grains, fruits, vegetables, nuts, and legumes. LV structure and function measures were assessed via echocardiography at years 25 and 30 and were the dependent variables in linear repeated measures models, including random intercepts for individuals. CHO:fiber ratio was treated as a fixed effect. Results: Study participants were 25.1 (range: 18-30, SD: 3.61) years old on average at baseline, 57% (1,807 of 3,171) female, and 53% (1,678 of 3,171) White. Higher CHO quality ratio was favorably associated with global longitudinal strain (GLS); while the fiber-rich food score was favorably associated with LV mass index, GLS, and E/e’ ratio after adjusting for demographic and lifestyle characteristics (see table). Conclusions: Our study finding suggests that higher CHO quality is associated with better systolic function and greater intake of fiber-rich foods is associated with better LV structure and function, which support the Dietary Guidelines for Americans and the Dietary Guidance to Improve Cardiovascular Health by the AHA that recommend intakes of high-quality CHO foods such as whole grains, fruit, and vegetables.
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