Prospective Relations Between the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean Diet (MeDS) Scores and Self-Report Arthritis Among Puerto Rican Adults

Abstract

Abstract Objectives To investigate the prospective associations of DASH and MeDS with self-reported arthritis across three time points [baseline, 2y and 6y follow-up] among Puerto Rican older adults. Methods Data are from the Boston Puerto Rican Health Study, a prospective cohort of Puerto Rican adults aged 45 to 75 y. Individuals were included if they presented with diet and arthritis data at minimum 2/3 visits (n = 1210). Dietary quality indices (DASH and MeDS) were derived from dietary data assessed by FFQ. Participants self-reported arthritis. Generalized linear mixed modeling was used to estimate multivariable hierarchical logistic regression models, accounting for multiple time points (baseline, 2y and 6y). Models were adjusted for smoking, alcohol, physical activity, sex, estrogen, education, diabetes (y/n), BMI, and age. Results Among participants with data at all timepoints (n = 958), the mean time from baseline to last follow-up was 6.2 ± 0.97y. Mean age was 63 ± 7y (range 49–81y at follow-up), 72% were women, mean BMI was 31 ± 6 kg/m2, DASH score 24.0 ± 4.3 (10–37), and MeDS 5.0 ± 1.2 (0–9). MeDS was not predictive of arthritis at follow-up in crude (fixed effects estimate: −0.016, P = 0.70) nor adjusted (−0.016, P = 0.73) models. DASH score was inversely associated with arthritis in crude models (0.032, P = 0.01); but was no longer significantly associated after controlling for confounders, including age (0.013, P = 0.39). Age was significantly associated with DASH score in final models (fixed effects estimate: 0.08, P < 0.001). However, no significant interaction of DASH score with age was observed (P = 0.31). Conclusions The current results do not support a prospective association between MeDS or DASH score with self-reported arthritis among Puerto Rican adults. Previous studies suggest higher dietary quality is protective of arthritis, particularly in younger cohorts (<55y). Future studies are needed to determine if early intervention with DASH is more predictive of arthritis onset. Funding Sources P01 AG023394, P50 HL105185, R01 AG027087. SEN is supported by K01 AR067894.