Abstract
Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile. This was a cross-sectional study of 1862 men and women aged 46-73 years, randomly selected from a large primary care centre in Ireland. DASH, HEI-2015, MD and E-DII scores were derived from food frequency questionnaires. Lipoprotein subclass particle concentrations and size were determined using nuclear magnetic resonance spectroscopy. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with lipoprotein particle subclasses. In fully adjusted models, higher diet quality or a more anti-inflammatory diet was associated with less large and medium very low-density lipoprotein (VLDL) (DASH and HEI-2015), intermediate-density lipoprotein (IDL) (DASH, MD and E-DII) and small high-density lipoprotein (HDL) (DASH, HEI-2015 and E-DII) particles. After accounting for multiple testing, relationships with large VLDL (DASH: β=-0.102, p=.037), IDL (DASH: β=-0.089, p=.037) and small HDL (DASH: β=-0.551, p=.014 and E-DII: β=0.483, p=.019) concentrations persisted. These findings provide evidence that better diet quality, determined by the DASH score, may be more closely associated with a more favourable lipoprotein particle subclass profile in middle-to older-aged adults than the HEI-2015, MD and E-DII scores. A less pro-atherogenic lipoprotein status may be a potential mechanism underlying the cardioprotective effects of higher dietary quality.
Highlights
Chronic Diseases Expert Group revealed increased consumption of healthy foods over those 20 years
A more pro-inflammatory diet indicated by a higher E-dietary inflammatory index (DII) score was positively correlated with triglycerides, total triglyceride-rich lipoprotein (TRL), large very low-density lipoprotein (VLDL), medium VLDL, total low-density lipoprotein (LDL), intermediate-density lipoprotein (IDL), small LDL, small high-density lipoprotein (HDL), the Lipoprotein Insulin Resistance score (LP-IR) score, and was inversely correlated with HDL cholesterol, large LDL, total, large and medium HDL and both LDL and HDL particle size
In fully adjusted analyses which accounted for multiple testing, higher diet quality or a more anti-inflammatory diet was significantly associated with less large VLDL (DASH only), IDL (DASH only) and small HDL (DASH and E-DII) particle concentrations
Summary
Chronic Diseases Expert Group revealed increased consumption of healthy foods over those 20 years. Studies have highlighted the importance of characterising the relationship between diet and cardiometabolic health through assessment of dietary patterns and numerous dietary scores have been developed. The Dietary Approaches to Stop Hypertension (DASH) diet emphasises consumption of fruits, vegetables, nuts, beans, wholegrains and low-fat dairy and restricting intake of red meat, sugar, sweetened beverages, total fat and saturated fat [6]. Our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DIITM) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more antiinflammatory) would be associated with a more favourable lipoprotein profile. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with lipoprotein particle subclasses. After accounting for multiple testing, relationships with large VLDL
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