Dietary Patterns in a Population Cohort in Uruguay and Associations with Markers of Cardiovascular Disease Risk

Abstract

Abstract Objectives The impact of habitual diet on chronic diseases has not been extensively characterized in South America. We aimed to identify major dietary patterns (DP) in a population adult cohort in Uruguay (Genotype Phenotype and Environment of Hypertension Study - GEFA-HT-UY) and to assess associations with metabolic and anthropometric markers of cardiovascular disease risk. Methods In a subsample (n = 295), DP were derived by principal component analysis based on 27 food groups (food frequency questionnaire). Total cholesterol, triglycerides (TG), low and high-density lipoproteins cholesterol (LDL, HDL), fasting glucose and insulin (HOMA), 25(OH)D, neutrophils and lymphocytes were measured in blood. Body weight, height, waist and blood pressure (BP) were measured. Multivariable linear regression models were used to estimate by tertile of DP load the adjusted changes of each outcome variable (relative to tertile 1), according to age (splitting by median age, 54 y). The models included sex, smoking, alcohol drinking, BMI, and season for 25(OH)D, as covariables. Results Three DP were identified: Meat (MDP), Prudent (PDP), and Cereal and Mate (CMDP), explaining 22.6% of total variance. MDP was characterized by higher loads for red, processed and barbecued meat; PDP by higher loads for vegetables, fish and nuts; and CMDP by higher loads for cereals and mate (traditional infused drink). Protein, sodium and alcohol intake increased, and fibre, mono and polyunsaturated fatty acids (MUFA, PUFA) intake decreased, by MDP tertile. Protein, fat (MUFA), fibre and calcium intake increased by PDP tertile. Carbohydrate, sodium and energy intake increased, and PUFA and calcium intake decreased, by CMDP tertile. MDP was associated with lower HDL (−3.1 mg/dl) and 25(OH)D (−3.5 ng/ml), and higher TG/HDL ratio (0.8) and HOMA (0.5), in the older group (P < 0.05). PDP was associated with higher 25(OH)D in both age groups (2.9 and 7.7 ng/ml; P < 0.002). CMDP was associated with higher neutrophils/lymphocytes ratio (0.35) in the younger group, and higher LDL (18.2 mg/dl), systolic BP (5.9 mm Hg) and waist/height ratio (0.024) in the older group (P < 0.05). Conclusions Meat DP was associated with worse blood lipid profile in younger adults, Cereal and Mate DP with worse cardiovascular risk markers in older adults, and Prudent DP with higher 25(OH)D in both age groups. Funding Sources CSIC, ANII, Uruguay.