Abstract
BackgroundTo investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD).MethodsNational Health and Nutrition Examination Survey (NHANES) data for the years 1999–2002 were used. PAD was diagnosed by ankle brachial index assessment. Plasma concentrations of vitamins were measured using high performance liquid chromatography. Vitamin D levels were measured by radioimmunoassay. Analysis of covariance, principal components analysis (PCA) and adjusted logistic regression were applied, accounting for the survey design and sample weights.ResultsOf the 4864 eligible participants, 2482 (51.0%) were men and 269 (5.5%) had prevalent PAD. PCA uncovered three DPs which accounted for 56.8% of the variance in dietary nutrients consumption including DP1 (fatty acids and cholesterol), DP2 (minerals, vitamins and fiber), and DP3 (polyunsaturated fatty acids [PUFA]). PAD patients had a significantly higher serum concentrations of trans 9-octadecenoic acid and trans 9, trans 12-octadienoic acid as well as lower plasma levels of vitamin D, retinol, retinyl stearate and retinyl palmitate (p < 0.001 for all comparisons). In models adjusted for age, race, diabetes, cholesterol, hypertension, smoking and energy intake, individuals in the highest quartile of the DP1 had higher odds for PAD compared with those in the lowest quartile [(odds ratio (OR): 6.43, 95% confidence interval (CI): 2.00–20.63 p < 0.001], while those in the highest quartile of DP2 and DP3 had lower odds of PAD relative to those in the lowest quartile (OR:0.28, OR:0.44, respectively; p < 0.001 for both comparisons).ConclusionWe found that quality of diet, plasma vitamins and TFAs are associated with the likelihood of PAD. If confirmed in prospective studies, the possibility that dietary factors, plasma vitamins and TFAs might be valuable for preventing or delaying the clinical progression of PAD, should be investigated in intervention trials.
Highlights
To investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD)
Our findings revealed that individuals consuming a diet with a high intake of minerals, vitamins, fiber and [second DP (DP2)] polyunsaturated fatty acids (PUFA) [third DP (DP3)] had a lower likelihood of PAD, while diet rich in fatty acids [first DP (DP1)]) are associated with an increased likelihood of PAD
In line with our study, previous investigators showed that PAD diagnosis and the presence of claudication correlated with a diet rich in saturated fat, sodium, and cholesterol, and low in fiber, vitamin E, folate intake and lower levels of omega-3 PUFA [37,38,39]
Summary
To investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD). There are a few studies on PAD limited to specific nutrients, often of modest sample size [3,4,5,6] In this regard, vitamin C has been recognised to have an anti-atherogenic effect based on the association between PAD and subclinical vitamin C deficiency [7]. Available studies have mostly focused on a single nutrient or food/food group in relation with PAD [3,4,5,6] These common approaches have methodological and conceptual limitations [9, 10], in the sense that they can detect the effects of only a single nutrient or food on overall health but would not explain the interactions among nutrients and foods [11]. Such studies do not provide tangible practical dietary advice, as nobody normally consumes just a single food or nutrient [10, 12]
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