Dietary patterns and the risk of cardiovascular diseases in Jiangsu Province, China: a nested case-control study

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BackgroundDietary patterns are reported to be influential to the risk of cardiovascular disease, but few studies have explored this among Chinese people. We aimed to examine the relationship between dietary patterns and the risk of cardiovascular diseases among the general population in Jiangsu Province, China. MethodsIn this nested case-control study, representative adults without a history of cardiovascular disease were recruited from Jiangsu Province. Face-to-face interviews were used to assess dietary intake using a validated food frequency questionnaire, in which more than 85% of foods consumed in Jiangsu were covered. From December, 2010, to December, 2014, incident cases of cardiovascular disease were collected through the Jiangsu population-based cardiovascular disease registry system, supplemented by door-to-door follow-up interviews. A subset of controls, frequency matched by age (plus or minus 5 years), sex, and area of residence, were randomly selected from participants who did not have a cardiovascular disease event or death during follow-up. Dietary patterns were identified by principal component analysis. We estimated multivariate odds ratios (ORs) and 95% CIs for quartiles of component scores (ie, factor scores ranging from low [first quartile] to high [fourth quartile]) for each dietary pattern using unconditional logistic regression. This research has been approved by the ethical committee of Jiangsu Provincial Center for Disease Control and Prevention. Participants were well informed of the whole procedure and all gave informed consent. FindingsBetween January and December, 2010, we recruited 8400 adults, 8215 of whom did not have a history of cardiovascular disease at baseline. 96 incident cases of cardiovascular disease occurred during follow-up, and 480 matched controls were selected. Four dietary patterns were identified: meaty (characterised by consumption of various animal products and alcohol), healthy (vegetables, fruit, milk, and fish), high-energy (high-energy food, but comparatively low vegetable consumption), and traditional Chinese (wholegrain, vegetables, soy, and meat). After adjusting for potential confounders, people in the third quartile of the traditional Chinese dietary pattern had a decreased risk of cardiovascular disease relative to the lowest quartile (OR 0·28, 95% CI 0·11–0·72, ptrend=0·008). High consumption of the healthy dietary pattern was associated with a lower risk of cardiovascular disease (fourth vs first quartile: OR 0·37, 95% CI 0·18–0·76, ptrend=0·007). InterpretationThese results indicate that diets characterised by high consumption of wholegrain, vegetables, soy, and meat or high consumption of vegetables, fruit, milk, and fish are associated with a decreased risk of cardiovascular disease among the general population in Jiangsu Province, China. FundingJiangsu Provincial Preventive Medicine Grant (Y2013052).