Abstract
The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3%), lacto-ovo-vegetarians (44·3%), pesco-vegetarians (10·6%) and non-vegetarians (NV) (37·3%). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95% CI 0·45, 0·73), 0·72 (95% CI 0·59, 0·88) and 0·72 (95% CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95% CI 0·25, 0·83) and 0·62 (95% CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.
Highlights
The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied
The differing dietary patterns were associated with fatty acid intake[16], of which plant-based and seafood long-chain n-3 PUFA have been linked with lower CVD risk factors such as lower TAG, blood pressure (BP) and resting heart rate[17] and reduced risk of fatal CHD[18]
We found a lower adjusted non-HDL-C (TC minus HDL-C) level ranging from 3·53 to 3·66 mmol/l in the three vegetarian dietary patterns compared with 3·84 mmol/l among the NV which remained approximately the same after adjusting for BMI
Summary
The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Apart from our study among non-Hispanic blacks in the Adventist Health Study-2 (AHS-2) study[3] and three sub-studies among AHS-2 participants[4,5,6], very few other papers are available on the association between plant-based diets and outcomes[7,8,9,10,11,12] These studies have reported lower levels of both CVD risk factors (hypertension, obesity, abdominal adiposity, fasting blood glucose (FBG)) as well as prevalence of dyslipidaemia, CVD and type 2 diabetes mellitus (DM) among vegetarians compared with non-vegetarians (NV)(3–8). The aim of the present crosssectional study was to describe the association between selfreported dietary patterns at AHS-2 enrolment and clinical CVD risk factor data collected 1–3 years later among non-Hispanic white participants. Similar to a few studies of this association among vegans (VG) as a distinct group[3,5] we included three separate vegetarian dietary patterns, namely VG, lacto-ovo-vegetarian (LOV) and pesco-vegetarian (PV), to compare with NV
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