Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population

The association between dietary patterns and cardiovascular disease risk factors in Iranian adults: a cross-sectional study

BACKGROUND

Dietary patterns are important factors associated with cardiovascular diseases (CVDs). We examined the association between dietary patterns derived from factor analysis and CVD risk factors.

METHODS

In the present cross-sectional study, a total of 3,687 adults (aged 40 to 70 years) with one or more types of CVDs were enrolled as participants. A validated semi-quantitative food-frequency questionnaire was utilized to assess food intakes, and then dietary patterns were extracted by factor analysis. Fasting blood sugar (FBS), lipid profile, anthropometric indices, and blood pressure (BP) were measured. Multivariable-adjusted logistic regression analysis was employed to ascertain the odds ratio (OR) of CVD risk factors associated with posteriori dietary patterns. In this study, healthy and unhealthy dietary patterns were identified.

RESULTS

Adherence to a healthy dietary pattern was associated with a decrease in systolic BP (SBP) (OR = 0.78; 95% confidence interval (CI): 0.62-0.99) and high-density lipoprotein cholesterol (HDL-C) levels (OR = 1.32; 95% CI: 1.06-1.64). Additionally, greater adherence to the unhealthy dietary pattern was positively associated with SBP (OR = 1.43; 95% CI: 1.13-1.80) and diastolic BP (DBP) (OR = 1.33; 95% CI: 1.01-1.76).

CONCLUSIONS

We concluded that greater adherence to an unhealthy dietary pattern was associated with an increase in SBP and DBP. On the other hand, greater adherence to a healthy dietary pattern could be effective in reducing SBP. Further investigation is recommended to validate these findings.

Lifestyle patterns, nutritional, and metabolic syndrome determinants in a sample of the older Iranian population

BACKGROUND

Chronic diseases and metabolic disorders are prevalent health concerns that often escalate with increasing age and thus affect older individuals. The proportion of the elderly population in Iran increased from 7.22% in 2006 to 12.0% in 2023. The current study aimed to evaluate lifestyle patterns and lifestyle risk factors among patients with metabolic syndrome (MetS) based on dietary, physical activity, and smoking, as well as MetS components.

METHODS

This cross-sectional study included 582 older people with MetS living in Yazd, Iran. Latent class analysis (LCA) was used to determine the lifestyle behaviors of diet patterns, smoking, and physical activity. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were identified using principal component analysis (PCA). Clinical measurements of MetS components were examined using relevant guidelines.

RESULTS

The mean age of the participants was 72.71 years (SD = 5.57). Using PCA, two dietary patterns were identified: traditional patterns (e.g., fruits, fish, poultry, vegetables, meats, salt, and sugar sweetened beverages) and high-fat patterns (e.g., high-fat dairy). Applying LCA identified two classes of lifestyle patterns. About 35% (n = 204) of the participants were categorized in a low-risk class (I) and characterized by physical activity (0.93%, n = 190), a traditional pattern for diet (61%, n = 122), and zero probability of smoking. About 65% (n = 378) of the patients were categorized in high-risk class (II) and characterized by low physical activity levels (69%, n = 261), cigarette smoking (71.6%, n = 271), and a high-fat dietary pattern (56.9%, n = 215).

CONCLUSION

The results of our study indicated two distinct classes within the patients. In class I, aging patients with MetS exhibited characteristics such as engagement in physical activity and having a traditional pattern for diet. Class II, with a higher prevalence of lifestyle risk factors, included individuals who engaged in cigarette smoking, displayed low physical activity (69%), and having a high-fat diet. The combination of these lifestyle factors exposed them to a heightened risk of developing MetS. The findings could guide healthcare professionals to be aware of the associations between different lifestyle risk factors and to focus on multiple behaviors at the same time.

Association between Dietary Patterns and Serum Low Density Lipoprotein Cholesterol in Japanese Women and Men: The Japan Multi-Institutional Collaborative Cohort (J-MICC) Study

AIMS

The association between dietary patterns and serum low density lipoprotein (LDL) cholesterol would be changing in recent dietary habits in Japan. We investigated the relationship between dietary patterns and serum LDL cholesterol in a large general population.

METHODS

From the baseline survey of Japan Multi-Institutional Collaborative Cohort Study between 2005 and 2013, 27,237 participants (13,994 were women) aged 35-69 years were cross-sectionally analyzed. Using a semi-quantitative food frequency questionnaire, five major sex-specific dietary patterns were identified using factor analysis. We assessed serum LDL cholesterol by quintiles of dietary pattern factor score.

RESULTS

We identified dietary patterns; "vegetable rich pattern" , "meat and fried food rich pattern" and "high bread and low rice pattern" in women and men; "fish and shellfish rich pattern" and "high confectioneries and low alcohol pattern" in men; "healthy Japanese diet pattern" and "high alcohol and low rice pattern" in women. Serum LDL cholesterol in men was associated with "high bread and low rice pattern" score (Q5 was 4.2 mg/dL higher than Q1, p for trend ＜0.001) and "high confectioneries and low alcohol pattern" scores (Q5 was 9.5 mg/dL higher than Q1, p for trend ＜0.001). In women, serum LDL cholesterol was associated with "high bread and low rice pattern" score (Q5 was 7.1 mg/dL higher than Q1, p for trend ＜0.001).

CONCLUSION

Some recent dietary patterns in Japan were associated with serum LDL cholesterol. Serum LDL cholesterol was associated with high bread and low rice pattern in both sex, and high confectioneries and low alcohol pattern in men.

Dietary Patterns in Association With Hypertension: A Community-Based Study in Eastern China

Objective

This study aimed to explore the association between dietary patterns and hypertension based on a community–based survey in Suzhou, Eastern China.

Methods

This cross–sectional analysis was undertaken from the subset of the Suzhou Food Consumption and Health State Survey in 2018–2019. Adults aged ≥ 18 years were invited to participate in this survey. Dietary intake was collected by a 24–h dietary recall and a weighing method over three consecutive days (including two weekdays and one weekend day). Dietary patterns were defined using factor analysis. Association between the dietary patterns and hypertension was examined by multivariable logistic regression models with adjustment for covariates. Moreover, sensitivity analysis was used to reinforce our findings.

Results

A total of 2,718 participants were included in the final analysis. Rice-vegetable pattern, fast food pattern, fruit-dairy pattern, and wheat-meat pattern were identified. We observed that the fruit-dairy pattern was inversely associated with hypertension after adjustment for all the covariates (OR = 0.55; 95% CI: 0.40, 0.75; P = 0.002). The association between the wheat-meat pattern and hypertension was attenuated and became statistically nonsignificant in sensitivity analyses. The other two patterns were not significantly associated with hypertension (P > 0.05).

Conclusion

The fruit-dairy pattern was inversely associated with the risk of hypertension among Chinese adults. Our findings further emphasize the important role of optimal diet combination in the prevention of hypertension.

Long-Term High-Fat High-Fructose Diet Induces Type 2 Diabetes in Rats through Oxidative Stress

Long-term consumption of a Western diet is a major cause of type 2 diabetes mellitus (T2DM). However, the effects of diet on pancreatic structure and function remain unclear. Rats fed a high-fat, high-fructose (HFHF) diet were compared with rats fed a normal diet for 3 and 18 months. Plasma biochemical parameters and inflammatory factors were used to reflect metabolic profile and inflammatory status. The rats developed metabolic disorders, and the size of the islets in the pancreas increased after 3 months of HFHF treatment but decreased and became irregular after 18 months. Fasting insulin, C-peptide, proinsulin, and intact proinsulin levels were significantly higher in the HFHF group than those in the age-matched controls. Plasmatic oxidative parameters and nucleic acid oxidation markers (8-oxo-Gsn and 8-oxo-dGsn) became elevated before inflammatory factors, suggesting that the HFHF diet increased the degree of oxidative stress before affecting inflammation. Single-cell RNA sequencing also verified that the transcriptional level of oxidoreductase changed differently in islet subpopulations with aging and long-term HFHF diet. We demonstrated that long-term HFHF diet and aging-associated structural and transcriptomic changes that underlie pancreatic islet functional decay is a possible underlying mechanism of T2DM, and our study could provide new insights to prevent the development of diet-induced T2DM.

Dietary Pattern Extraction Using Natural Language Processing Techniques

In this study, we observed the changes in dietary patterns among Korean adults in the previous decade. We evaluated dietary intake using 24-h recall data from the fourth (2007–2009) and seventh (2016–2018) Korea National Health and Nutrition Examination Survey. Machine learning-based methodologies were used to extract these dietary patterns. Particularly, we observed three dietary patterns from each survey similar to the traditional and Western dietary patterns in 2007–2009 and 2016–2018, respectively. Our results reveal a considerable increase in the number of Western dietary patterns compared with the previous decade. Thus, our study contributes to the use of novel methods using natural language processing (NLP) techniques for dietary pattern extraction to obtain more useful dietary information, unlike the traditional methodology.

Associations between empirically derived dietary patterns and cardiovascular risk factors among older adult men

Cardiovascular disease (CVD) remains the leading cause of death globally, and epidemiological studies have suggested a link between diet and cardiometabolic risk. Currently, the prevalence of CVD is rapidly increasing with an aging population and continues to contribute to the growing economic and public health burden. However, there is limited evidence available regarding dietary patterns and cardiometabolic risk factors in older adults. We conducted a cross-sectional study to assess dietary patterns and cardiometabolic risk factors in males ≥60 years. Factor analysis identified a "healthy" diet and an "unhealthy" diet as the two primary dietary patterns. Multivariable logistic regression was used for estimating the associations of identified dietary patterns and cardiometabolic risk factors including anthropometric measures, blood pressure, glycemic biomarkers, lipid profile, and inflammatory biomarkers. A healthy dietary pattern was significantly associated with decreased odds of high serum fasting blood sugar (FBS) (OR: 0.32; 95% CI: 0.15-0.67; P_trend=0.002), but increased odds of high serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.82; 95% CI: 1.02-3.24; P_trend=0.04). In comparison, an unhealthy diet was associated with increased odds of obesity (OR: 2.33; 95% CI: 1.31-4.15; P_trend=0.004) and high LDL-C (OR: 2.00; 95% CI: 1.10-2.61; P_trend=0.02). Thus, in older adults, adherence to an unhealthy dietary pattern has a significant impact on clinically relevant risk factors for cardiometabolic risk.

Association between type D personality and in-stent restenosis in patients treated with percutaneous coronary intervention: A mediation analysis of dietary patterns

OBJECTIVE

Type D personality is a psychosocial risk factor for cardiovascular events and in-stent restenosis (ISR), but the mechanisms involved are not well understood. This study aimed to evaluate the effects of dietary patterns on the association between Type D personality and ISR in patients with coronary artery disease treated with percutaneous coronary intervention (PCI).

METHODS

This cross-sectional study comprised a total of 230 post-PCI patients who were assessed for Type D personality, depression, dietary patterns, physical activity and medication adherence via self-administered questionnaires. ISR was assessed by coronary angiography.

RESULTS

Type D personality (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.05-10.71, p=0.042), low fruit intake (OR, 0.30; 95% CI, 0.12-0.68, p=0.008) and low vegetable intake (OR, 0.48, 95% CI, 0.27-0.91, p=0.021) were independent risk factors for ISR after adjustment for psychosocial, lifestyle and cardiovascular risk factors. Mediation analyses revealed that Type D personality had a significant direct effect on the development of ISR (p<0.05). In addition, nutrients in fruits and vegetables, including vitamin C, vitamin E and fiber, were important mediators of the relationship between Type D personality and ISR (p<0.05), the percentage of total indirect effect was 24.65%.

CONCLUSIONS

These findings suggested that the low intake of fruit and vegetables in Type D patients can predict ISR. The healthy dietary interventions to supply vitamin C, vitamin E and fiber may help to improve the prognosis in post-PCI patients with Type D personality.

The associations between dietary patterns and cardiovascular risk factors among adults: A cross-sectional study

OBJECTIVE

Cardiovascular diseases (CVDs) are the major causes of death, worldwide. Although for decades the associations between individual foods and nutrients and CVDs have been investigated, little attention has been paid to dietary patterns. Therefore, this study was conducted to examine the association between dietary patterns and CVD risk factors among Iranian adults.

METHODS

This cross-sectional study was performed on 236 adults who attended public health centers. Dietary intakes were collected using a valid food frequency questionnaire. Sociodemographic characteristics, anthropometric measures, and biochemical biomarkers were measured using standardized methods. Dietary patterns derived using the factor analysis. Logistic regression assessed the odds of CVD risk factors across tertiles of data-driven dietary patterns.

RESULTS

We identified three dietary patterns. After adjusting for possible confounders, we observed that participants in the third category of the healthy dietary pattern (HDP) had lower odds of low HDL-C (OR = 0.26; 95% CI: 0.10-0.64) compared to those in the first category. Adherence to the mixed pattern was associated with increased odds of high serum TC in men only (OR = 3.69; 95% CI: 1.06-12.81). However, women with higher adherence to the Western dietary pattern (WDP) had higher odds of high serum TG (OR = 5.61; 95% CI: 1.69-18.59), and those with a greater adherence to HDP had lower odds of low HDL-C (OR = 0.25; 95% CI: 0.07-0.98).

CONCLUSION

This study showed that adherence to HDP may protect against a low level of HDL-C, whereas mixed and Western-type diets may contribute to high serum TG levels. Future longitudinal studies are needed to assess the potential causality of the observed associations.

Major dietary patterns and predicted cardiovascular disease risk in an Iranian adult population

BACKGROUND

Limited data are available on the association of major dietary patterns and predicted risk of cardiovascular disease (CVD) using the Framingham Risk Score (FRS).

AIM

To investigate the association between major dietary patterns and the predicted 10-year CVD risk in an Iranian population.

METHODS

This cross-sectional study was conducted on 522 apparently healthy adults referred to health centers in Tehran. Usual dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. The association between dietary patterns and the predicted risk of development of CVD was evaluated using linear multiple regression. Principal component analysis was used to identify major dietary patterns.

RESULTS

In total, 41% of the men (n = 95) and 46% of women (n = 134) were in the low risk (<10%) and 6% of men (n = 14) and 1% of women (n = 3) were in the high risk (> 20%) category of the FRS. A significant decrease was found for body mass index (p < 0.001), systolic blood pressure (SBP) (p = 0.003), diastolic blood pressure (p = 0.005), and triglyceride (p = 0.02) in the higher tertile of healthy dietary pattern. Adherence to an unhealthy dietary pattern was associated with a significant increase in body weight (p = 0.03) and a significant decrease in high-density lipoprotein cholesterol (p < 0.001). The healthy dietary pattern score was negatively associated with SBP (p = 0.04) and FRS (p < 0.001).

CONCLUSION

Although we observed improvements in CVD risk factors with greater adherence to healthy dietary patterns, there was no association between identified dietary patterns and the predicted risk of 10-year CVD.

Dietary Patterns and Their Association with CVD Risk Factors among Bangladeshi Adults: A Cross-Sectional Study

PURPOSE

The objective of this study was to evaluate the association between dietary patterns and CVD risk factors among adults.

METHODS

Demographic data, knowledge, attitude, practices toward CVD related data, dietary data, and some biochemical data were collected from 250 participants at Coronary Care Unit of Jashore 250 bedded Sadar Hospital in Jashore district. A multinomial logit regression method was used to examine the association between LDL and TG levels with the dietary diversity of CVD risk patients.

RESULTS

According to the BMI, most of the respondents were overweight. The respondent's practice level was poor than their knowledge and attitude level toward CVD. A positive correlation was found among the respondents' knowledge, attitude, and practice. Most of the CVD patient's troponin value and BP level were found higher than the acceptable limit. Along with their lipid profile level was not good. Most of them were in borderline risk condition of CVD and some had high risk. The patients who consumed a higher amount of red meat, egg, cheese, fast food, soft drinks, and salty snacks had more probability of increasing LDL and TG level in blood which was the major risk factors of CVD than the patients who consumed fish, chicken, pulse, nuts, fruits, and vegetables in their diet regularly.

CONCLUSION

This study suggests that the consumption of fatty foods, fast foods, and soft drinks leads to the probability of increasing LDL and TG levels in CVD risk patients.

Dietary patterns associated with meeting the WHO free sugars intake guidelines

Objective:

Emerging evidence suggests that free sugars intake in many countries exceeds that recommended by the WHO. However, information regarding real-world dietary patterns associated with meeting the WHO free sugars guidelines is lacking. The current study aimed to determine dietary patterns associated with meeting the guidelines to inform effective free sugars reduction interventions in New Zealand (NZ) and similar high-income countries.

Design:

Dietary patterns were derived using principal component analysis on repeat 24-h NZ Adult Nutrition Survey dietary recall data. Associations between dietary patterns and the WHO guidelines (<5 and <10 % total energy intake) were determined using logistic regression analyses.

Setting:

New Zealand.

Participants:

NZ adults (n 4721) over 15 years old.

Results:

Eight dietary patterns were identified: ‘takeaway foods and alcohol’ was associated with meeting both WHO guidelines; ‘contemporary’ was associated with meeting the <10 % guideline (males only); ‘fast foods, sugar-sweetened beverages and dessert’, ‘traditional’ and ‘breakfast foods’ were negatively associated with meeting both guidelines; ‘sandwich’ and ‘snack foods’ were negatively associated with the <5 % guideline; and ‘saturated fats and sugar’ was negatively associated with the <10 % guideline.

Conclusions:

The majority of NZ dietary patterns were not consistent with WHO free sugars guidelines. It is possible to meet the WHO guidelines while consuming a healthier (‘contemporary’) or energy-dense, nutrient-poor (‘takeaway foods and alcohol’) diet. However, the majority of energy-dense patterns were not associated with meeting the guidelines. Future nutrition interventions would benefit from focusing on establishing healthier overall diets and reducing consumption and free sugars content of key foods.

Associations between dietary patterns and blood pressure in a sample of Australian adults

BACKGROUND

Investigating effects of whole diets on blood pressure (BP) can contribute to development of diet-based recommendations for health. Our aim was to assess the relationship between dietary patterns and BP in a sample of free-living Australian adults.

METHODS

Usual dietary patterns of participants recruited to dietary intervention studies were assessed using factor analysis (two 24-h recalls). The mean of seven days of daily, seated BP measurements were used.

RESULTS

Complete data from 251 participants (112 males; mean age 55.1(9.1) (SD) years; body mass index (BMI) 29.5(3.9) kg/m²) was included. Three dietary patterns were identified. Only Dietary Pattern 2 was positively associated with home systolic BP (β = 1.88, 95% CI 0.16, 3.60) after adjusting for age, sex, BMI, anti-hypertensive medication, smoking, education, physical activity and energy intake. This dietary pattern was characterised by high consumption of low-fibre bread, pasta, noodles and rice, meat dishes, poultry dishes and egg dishes, mixed cereal dishes, salted nuts and low consumption of milk and yoghurt (low-fat), vegetable juice, vegetables and high-fibre bread. Dietary Pattern 2 was also positively associated with intakes of energy (P = 0.002) and sodium (P = 0.005) and inversely associated with potassium intake (P = 0.002). After adjustment for energy, only the inverse association with potassium remained (P <  0.001).

CONCLUSIONS

In this sample of Australian adults, Dietary Pattern 2 was associated with higher BP and thus chronic disease risk, supporting the evidence that diets high in energy and sodium, and low in potassium from vegetables and dairy, are detrimental to cardiovascular health.

Sociodemographic and Regional Determinants of Dietary Patterns in Russia

An empirical assessment of diets using a posteriori analysis allows us to define actual dietary patterns (DPs) in the food consumption structure of a population. This study represents an a posteriori assessment of DPs for the Russian population in general as well as their dependence on socio-demographic and regional parameters. The data were obtained from 21,923 individuals aged 25-64 years old from a Russian multicenter study of "Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation" conducted in 2013-2014. Cross-sectional study subjects were interviewed face-to-face in order to obtain data on their diet. DPs were defined using principal component analysis. Four DPs were specified as "Rational", "Salt", "Meat", and "Mixed"; all these variants together accounted for 55.9% of variance. Diets in gender and age groups corresponded to those for an all-Russian population; in several regions, the defined diets differed from the all-Russian ones. More favorable diet trends were observed among women, people with no family, people not working, and urban dwellers, and diet trends were more favorable with an increase in age, level of education, and material wealth. Thus, a posteriori DPs were defined for the Russian population, which were stable in sex/age groups and were mediated by the socio-demographic characteristics of the population.

Identification of dietary patterns associated with elevated blood pressure among Lebanese men: A comparison of principal component analysis with reduced rank regression and partial least square methods

BACKGROUND

To examine the associations of dietary patterns with odds of elevated Blood Pressure (BP) among Lebanese adult males using principal component analysis (PCA), and compare the results to two other data reduction methods, including reduced rank regression (RRR) and partial least-squares (PLS) regression.

METHODS

Data from the National Nutrition and Non-Communicable Disease Risk Factor Survey conducted in Lebanon between years 2008 and 2009 were used. Dietary intake data were collected by a 61-item food frequency questionnaire (FFQ). In addition, anthropometric and blood pressure measurements were obtained following standard techniques. For the purpose of this study, data of males older than 20 years with no history of chronic diseases were selected (n = 673). Elevated BP was indicated if the systolic blood pressure was > = 130mm Hg and/or the diastolic blood pressure > = 85 mm Hg. Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with elevated BP. For PLS and RR, the response variables were BMI, waist circumference and percent body fat. Multiple logistic regression was used to evaluate the associations between the dietary pattern scores of each method and risk of elevated BP.

RESULTS

Three dietary patterns were identified using PCA: Western, Traditional Lebanese, and Fish and alcohol. Both the Western and the Traditional Lebanese patterns were associated with higher odds of elevated BP in the study population (OR = 1.23, CI 1.03, 1.46; OR = 1.29, CI 1.09, 1.52 respectively). The comparison among the three methods for dietary patterns derivation showed that PLS and RRR derived patterns explained greater variance in the outcome (PCA: 1.2%; PLS: 14.1%; RRR: 15.36%) and were significantly associated with elevated BP, while the PCA dietary patterns were descriptive of the study population's real dietary habits (PCA: 23.6%; PLS: 19.8%; RRR: 11.3%).

CONCLUSIONS

The Western and Traditional Lebanese dietary patterns were associated with higher odds of elevated BP among Lebanese males. The findings of this study showed that, compared to PCA, the use of RRR method resulted in more significant associations with the outcome while the PCA-derived patterns were more related to the real habits in the study population.

The Associations between Meat Group Consumption and Acute Myocardial Infarction Risks in an Iranian Population: a Case-Control Study

Acute myocardial infraction (AMI) is a highly frequent cause of mortality and disability around the world. The aim of the present study was to evaluate the associations between meat group intake levels and AMI risks in an adult Iranian population. This case-control study was conducted on 200 first AMI cases and 200 healthy individuals matched by age, sex, and body mass index. A Food Frequency Questionnaire validated for Iranian populations was used to assess usual dietary intake levels over the previous year. Data was extracted regarding the meat group-including meat (red and processed), fish, poultry, eggs, nuts, and legumes. The associations between meat group items and AMI were calculated by multivariable logistic regression. Red meat consumption was significantly positively associated with increased risk of AMI. After adjustment for potential confounders, a positive association was found between higher frequency of processed and red meat intake, and increased risk of AMI (processed meat consumption: odds ratio [OR], 1.71; 95% confidence interval [CI], 1.31-2.23 and red meat consumption: OR, 2.51; 95% CI, 1.84-5.11). In addition, the results indicated an inverse association between the frequency of nuts consumption and AMI (OR, 0.52; 95% CI, 0.31-0.92). There were no associations seen between poultry, fish, eggs and beans intake levels, and the odds of AMI. The current study suggested a direct association between the frequency of processed/red meat consumption and increased AMI risks. In addition, an inverse relation was observed between frequency of nuts consumption and the risks of AMI.

Dietary patterns in relation to lipid profiles among Iranian adults

Introduction: Lipid metabolism is one of the main concerns of cardiovascular disease and atherosclerosis. Little is known about the association between dietary patterns and dyslipidemia. Therefore, the present study aimed to determine such association among Iranian adults. Methods: This cross-sectional study was conducted on 1433 Iranian adults in Isfahan Healthy Heart Program (IHHP). Usual dietary intakes were assessed with the use of a 48 items food frequency questionnaire (FFQ). Factor analysis was used to identify dietary patterns. Three major dietary patterns were identified: western, semi healthy and healthy fat patterns. Results: After adjustment, subjects in the upper quartiles of western dietary pattern were more likely to have high total cholesterol concentrations than those in the first quartile (odds ratio [OR]: 2.07; 95% CI: 1.25-3.42). Individuals with greater adherence to western dietary pattern had greater odds of having high low-density lipoprotein-cholesterol (LDL-C) levels compared with those in the lowest quartiles (2.53; 1.45-4.40). Conclusion: Semi healthy dietary pattern was not associated with cardiovascular disease (CVD) risk factors. Same trend was observed for healthy fat dietary pattern. Significant association was found between western dietary pattern and dyslipidemia among Iranian adults.

Dietary patterns are positively associated with semen quality

OBJECTIVE

To study association of semen quality with a priori whole dietary pattern indexes, which reflect real-world dietary practices and the numerous combinations by which foods are consumed: Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet score (aMED), and Alternative Healthy Eating Index (AHEI).

DESIGN

A cross-sectional single-center study.

SETTING

Hospital fertility center and university.

PATIENT(S)

A total of 280 men attending fertility center from 2012 to 2015.

INTERVENTION(S)

Food frequency questionnaire (FFQ) and semen and sperm analysis.

MAIN OUTCOME MEASURE(S)

Food consumption with the use of FFQ and HEI, AHEI, aMED, DASH nutritional individual scoring indexes. Semen parameters, including semen volume, sperm concentration, motility, total count, and morphology.

RESULT(S)

Comparing the highest and lowest quartiles of the nutritional indexes, men in the highest quartiles of HEI, AHEI, aMed, and DASH indexes had significantly higher adjusted means of sperm concentration (by 10%, 45%, and 24% for HEI, AHEI, and DASH, respectively), normal sperm morphology (by 21% and 8% for AHEI and DASH, respectively), total sperm count (by 29% for AHEI), and sperm motility (by 6% and 11% for aMed and HEI, respectively).

CONCLUSION(S)

Adherence to any of the four dietary indexes is associated with better overall sperm quality, with AHEI best associated. Following our novel findings, we recommend using AHEI as a clinical and practical tool for public whole nutritional recommendation for semen quality.

The Associations between Dietary Patterns and Sedentary Behaviors in Polish Adults (LifeStyle Study)

Sedentary behavior, a low physical activity level, and unhealthy dietary patterns are risk factors for major chronic diseases, including obesity. The aim of this study was to assess the associations of dietary patterns (DPs) with sedentary behaviors (SB) and self-reported physical activity (PA). The data was collected in November 2016 through a cross-sectional quantitative survey amongst 1007 Polish adults. Principal components analysis (PCA) was conducted to derive DPs. Logistic regression analysis was used to verify associations between PA and SD (independent variables), and DPs (dependent variables). Five DPs ('Fast foods & sweets'-FF&S; 'Meat & meat products'-M&MP; 'Fruit & vegetable'-F&V; 'Wholemeal food'-WF; 'Fruit & vegetable juices'-F&VJ) were identified. Representing M&MP independently increased the chance of watching TV at least once a day (by 73%). There was no such relationship between the FF&S and sedentary behaviors. Being in the upper tertiles of pro-health DPs increased the chance of reading books (by 177%-F&V, 149%-WF, 54%-F&VJ) and watching TV (by 71%-F&V). On the other hand, belonging to the upper tertile of WF reduced the chance of using the computer for more than 4 h a day. Belonging to the upper tertile of healthy DPs (WF and F&VJ) increased the chances of moderate or high physical activity, both at work/school and during leisure time. Within F&V, there was a lower chance of moderate or high physical activity at work/school. Being in the upper tertile of unhealthy DPs (FF&S and M&MP) did not show any significant association with physical activity. The study indicated the associations between both healthy and unhealthy DPs and some sedentary behaviors. Association between F&V and watching TV and reading books/newspapers should be recognized as potentially efficient in education. Association between M&MP and watching television can be indicative of the mutual overlap of a negative lifestyle resulting in the development of overweight and obesity, especially since the extent of occurrence of sedentary behaviors is high.

ABO Genotype Does Not Modify the Association between the "Blood-Type" Diet and Biomarkers of Cardiometabolic Disease in Overweight Adults

Background

Although 7 million copies of Eat Right 4 Your Type have been sold in >60 languages, there has been a lack of evidence supporting the "blood-type" diet hypothesis.

Objective

The present study aimed to examine the validity of this diet in overweight adults.

Methods

A total of 973 adults [mean ± SEM age: 44.6 ± 0.4 y; mean ± SEM body mass index (BMI; kg/m2): 32.5 ± 0.2; 758 women, 215 men] were participants of the Toronto Healthy Diet Study. A 1-mo, 196-item food-frequency questionnaire was used to determine dietary intakes before and after a 6-mo dietary intervention. Diet scores were calculated to determine relative adherence to each of the 4 blood-type diets as a secondary analysis. ABO blood group was determined by genotyping rs8176719 and rs8176746. ANCOVA was used to compare cardiometabolic risk factors across tertiles of diet scores.

Results

At baseline, individuals with a higher adherence score to the type A diet had lower diastolic blood pressure (tertile 3 compared with tertile 1: 70.9 ± 1.1 compared with 73.3 ± 1.1 mm Hg; P < 0.01). Lower waist circumference was observed in individuals with higher adherence to the type B (tertile 3 compared with tertile 1: 100.8 ± 1.8 compared with 105.4 ± 1.7 cm; P < 0.01) and type AB (tertile 3 compared with tertile 1: 101.2 ± 1.8 compared with 104.8 ± 1.7 cm; P < 0.01) diets. After a 6-mo dietary intervention, individuals with increased adherence to the type A and type B diets had greater reductions in BMI and waist circumference, respectively (P < 0.01). Individuals with an increase in type O diet adherence showed decreases in both BMI and waist circumference (P < 0.01). However, matching the diets with the corresponding ABO genotype of each individual did not change the effect size of any of these associations either at baseline or at 6 mo.

Conclusions

ABO genotype does not modify any association between blood-type diets and biomarkers of cardiometabolic disease in overweight adults, suggesting that the theory behind this diet is not valid This study was based on the data of a trial that was registered at www.clinicaltrials.gov as NCT00516620.

Dietary patterns and physical activity in the metabolically (un)healthy obese: the Dutch Lifelines cohort study

BACKGROUND

Diversity in the reported prevalence of metabolically healthy obesity (MHO), suggests that modifiable factors may be at play. We evaluated differences in dietary patterns and physical activity between MHO and metabolically unhealthy obesity (MUO).

METHODS

Cross-sectional data of 9270 obese individuals (30-69 years) of the Lifelines Cohort Study was used. MHO was defined as obesity and no metabolic syndrome risk factors and no cardiovascular disease history. MUO was defined as obesity and ≥2 metabolic syndrome risk factors. Sex-specific associations of dietary patterns (identified by principal component analysis) and physical activity with MHO were assessed by multivariable logistic regression (reference group: MUO). Analyses were adjusted for multiple covariates.

RESULTS

Among 3442 men and 5828 women, 10.2% and 24.4% had MHO and 56.9% and 35.3% MUO, respectively. We generated four obesity-specific dietary patterns. Two were related to MHO, and in women only. In the highest quartile (Q) of 'bread, potatoes and sweet snacks' pattern, odds ratio (OR) (95% CI) for MHO was 0.52 (0.39-0.70). For the healthier pattern 'fruit, vegetables and fish', an OR of 1.36 (1.09-1.71) in Q3 and 1.55 (1.21-1.97) in Q4 was found for MHO. For physical activity, there was a positive association between moderate physical activity and vigorous physical activity in the highest tertile and MHO in women and men, respectively (OR 1.19 (1.01-1.41) and OR 2.02 (1.50-2.71)).

CONCLUSION

The healthier diet -characterized by 'fruit, vegetables and fish'- and moderate physical activity in women, and vigorous physical activity in men may be related to MHO. The (refined) carbohydrate-rich 'bread, potatoes and sweet snacks' dietary pattern was found to counteract MHO in women.

Food Patterns and Framingham Risk Score in Iranian Adults: Tehran Lipid and Glucose Study: 2005-2011

BACKGROUND

Healthy dietary habits can prevent cardiovascular diseases (CVD). The aim of this study was to investigate the association between dietary patterns and predicted risk of CVD development using Framingham Risk Score (FRS) in Iranian population over 6 years of follow-up.

METHODS

In this prospective study, 2333 individuals aged 30-74 years with a 10-year predicted risk <10% and without a CVD diagnosis at baseline were recruited from participants in the third survey of Tehran Lipid and Glucose Study. Usual dietary intake was assessed using a validated semiquantitative food frequency questionnaire. Dietary patterns were identified using factor analysis. The risk of developing CVD was evaluated using FRS questionnaire. The association between dietary patterns and risk of development of CVD was evaluated using binary logistic regression models.

RESULTS

Three major dietary patterns were identified, which explained 32% of total variance in dietary intake of participants. The healthy dietary pattern was characterized by high intake of fruits, fruit juices, vegetables, liquid oils, and nuts and lower intake of refined grains. The western dietary pattern was characterized by high intake of fast foods, soft drinks, sweets and sugars, and red meat, organ meat, and egg. The traditional dietary pattern was characterized by high intake of legumes and vegetables and low intake of high-fat dairy products. After adjustment for all confounding factors, participants in the highest tertile of the healthy dietary pattern had a lower risk of CVD development (odds ratio [OR]: 0.67; 95% CI: 0.51-0.87, P-trend: 0.003).

CONCLUSION

Our findings in a large cohort of Iranian population confirm the current recommendation regarding consuming healthy dietary pattern for primary prevention of CVDs.

Joint associations of dietary pattern and television viewing with CVD risk factors among urban men and women in China: a cross-sectional study

The purpose of this study was to investigate the joint associations of dietary pattern and television viewing with risk factors of CVD among urban adults in China. A community-based cross-sectional study was conducted among urban adults in Nanjing, China. Five dietary patterns were identified based on a FFQ. Television time was obtained from a standard questionnaire and further classified into two categories (≤7, >7 h/week). Multiple logistic regression was used to calculate the OR and 95 % CI for the separate and joint associations of dietary patterns and television viewing with CVD risk factors. Compared with other dietary patterns, participants who followed the healthy traditional pattern had a lower likelihood of abdominal obesity (AO) (OR 0·52; 95 % CI 0·41, 0·67). Participants watching television no more than 7 h/week presented a 19 and 21 % lower likelihood for hypertension (HT) and elevated total cholesterol (ETC) than those with television time >7 h/week. Individuals who had less television time and a healthy dietary pattern had a lower OR for the presence of AO (OR 0·48; 95 % CI 0·36, 0·65), HT (OR 0·71; 95 % CI 0·66, 0·77), ETC (OR 0·72; 95 % CI 0·57, 0·91) and elevated TAG (OR 0·76; 95 % CI 0·61, 0·95), compared with those who followed other dietary patterns and television time >7 h/week. In conclusion, both healthy traditional pattern and less television time are jointly associated with reduced levels of CVD risk factors. It has important public health implications regarding the precision prevention of CVD at population level.

Convenience-based food purchase patterns: identification and associations with dietary quality, sociodemographic factors and attitudes

OBJECTIVE

The present study aimed to derive food purchase patterns considering the convenience level of foods. Associations between identified patterns and dietary quality were analysed, as well as household characteristics associated with the dietary patterns.

DESIGN

A Convenience Food Classification Scheme (CFCS) was developed. After classifying basic food groups into the CFCS, the formed groups were used to apply a factor analysis to identify convenience-based food purchase patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between the adherence to the patterns and household characteristic and attitude variables were analysed.

SUBJECTS

The study used representative German food purchase data from 2011. Approximately 12 million purchases of 13 131 households were recorded in these data.

RESULTS

Three convenience-based patterns were identified: a low-convenience, a semi-convenience and a ready-to-eat food pattern. Tighter adherence to the semi-convenience pattern was shown to result in the lowest nutrient and highest energy densities. Important factors influencing adherence to the patterns were household size, presence of children and attitudes. Working full-time was negatively associated with adherence to the low-convenience pattern and positively with the ready-to-eat pattern.

CONCLUSIONS

Convenience foods were an important part of households' food baskets which in some cases led to lower nutritional quality. Therefore, it is important to offer convenience foods higher in nutrient density and lower in energy density. Interventions targeted on enhancing cooking skills could be an effective strategy to increase purchases of unprocessed foods, which, in turn, could also contribute to an improved diet quality.

Heart healthy diet and risk of myocardial infarction and venous thromboembolism

Prudent dietary patterns are associated with reduced risk of arterial cardiovascular diseases (CVD). Limited data exist on the relation between diet and venous thromboembolism (VTE). The aim of our prospective, population based study was to investigate the association of a heart healthy diet on risk of myocardial infarction (MI) and VTE. Information on dietary habits was available in 18,062 subjects, aged 25–69, who participated in the fourth Tromsø study, 1994–1995. Dietary patterns were assessed by a slightly modified version of the validated SmartDiet score; a 13-item questionnaire producing a diet score based on the intakes of fat, fibre, fruit and vegetables. Incident events of MI (n=518) and VTE (n=172) were recorded to the end of follow-up December 31, 2005 (median follow-up 10.8 years). Cox-regression models were used to calculate hazard ratios (HR). A healthy diet score of >27 points (upper tertile) was associated with 17% reduced risk of MI (HR: 0.83, 95% confidence interval [CI]: 0.66–1.06), and no association with VTE (HR: 1.01; 95%CI: 0.66–1.56), compared to <24 points (lower tertile) in multivariable analysis. High intake of fish, fruit, vegetables and polyunsatured fat had a 23% reduced risk of MI (HR 0.77; 95%CI: 0.60–0.98), but no association with VTE (HR 0.95; 95%CI: 0.64–1.40). A heart healthy diet showed an even more favourable association with MI in obese subjects (HR: 0.62; 95%CI: 0.41–0.95), but not with VTE. Our findings suggest that a heart healthy dietary pattern is associated with moderately reduced risk of MI, but not related to risk of VTE.

Food purchase patterns: empirical identification and analysis of their association with diet quality, socio-economic factors, and attitudes

Background

Empirically derived food purchase patterns provide information about which combinations of foods were purchased from households. The objective of this study was to identify what kinds of patterns exist, which level of diet quality they represent and which factors are associated with the patterns.

Methods

The study made use of representative German consumption data in which approximately 12 million food purchases from 13,125 households are recorded. In accordance with healthy diet criteria the food purchases were assigned to 18 food groups of the German Food Pyramid. Based on these groups a factor analysis with a principal component technique was applied to identify food patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between pattern scores and socio-economic as well as attitude variables, reflecting personal statements about healthy eating, were analyzed.

Results

In total, three food purchase patterns could be identified: a natural, a processed and a traditional one. The first one was characterized by a higher purchasing of natural foods, the second by an increased purchasing of processed foods and the third by a meat-oriented diet. In each pattern there were specific diet quality criteria that could be improved whereas others were in line with actual dietary guidelines. In addition to socio-demographic factors, attitudes were significantly associated with the purchase patterns.

Conclusions

The findings of this study are interesting from a public health perspective, as it can be assumed that measures focusing on specific aspects of diet quality are more promising than general ones. However, it is a major challenge to identify the population groups with their specific needs of improvement. As the patterns were associated with both socio-economic and attitude variables these grouping criteria could be used to define target groups.

Food intake patterns and cardiovascular risk factors in Japanese adults: analyses from the 2012 National Health and nutrition survey, Japan

BACKGROUND

There is an increasing global interest in the role of Japanese diet as a possible explanation for the nation's healthy diet, which contributes to the world's highest life-expectancy enjoyed in Japan. However, nationwide studies on current food intake status among general Japanese population have not been established yet. This study examined the association between food intake patterns and cardiovascular risk factors (CVRF) such as waist circumference (WC), body mass index (BMI), blood pressure (SBP, DBP), HbA1c and blood lipid profiles among general Japanese adults.

METHODS

De-identified data on the Japan National Health and Nutrition Survey (NHNS) 2012 with a total of 11,365 subjects aged 20-84 years were applied. Food intake patterns were derived by principal component analysis (PCA) based on 98 food groups. Generalized linear regression analysis was used to assess the relation between the food intake patterns and CVRF.

RESULTS

We identified three food intake patterns: traditional Japanese, Westernized, and meat and fat patterns. Traditional Japanese pattern was significantly related to high WC and BMI in men, and high DBP in women. Westernized pattern was associated with lower SBP, but high total cholesterol and LDL cholesterol in both men and women. Meat and fat pattern was associated with high WC, high BMI, high blood pressure and blood lipid profiles in both men and women (trend P < 0.001).

CONCLUSION

The significant association between cardiovascular disease risks and three food intake patterns derived from the NHNS, showed a similar tendency to other dietary survey methods.

Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases

Diet and lifestyle play a significant role in the development chronic diseases; however the full complexity of this relationship is not yet understood. Dietary pattern investigation, which reflects the complexity of dietary intake, has emerged as an alternative and complementary approach for examining the association between diet and chronic diseases. Literature on this association has largely focused on individual nutrients, with conflicting outcomes, but individuals consume a combination of foods from many groups that form dietary patterns. Our objective was to systematically review the current findings on the effects of dietary patterns on chronic diseases. In this review, we describe and discuss the relationships between dietary patterns, such as the Mediterranean, the Dietary Approach to Stop Hypertension, Prudent, Seventh-day Adventists, and Western, with risk of obesity, type-2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenearive diseases. Evidence is increasing from both observational and clinical studies that plant-based dietary patterns, which are rich in fruits, vegetables, and whole grains, are valuable in preventing various chronic diseases, whereas a diet high in red and processed meat, refined grains and added sugar seems to increase said risk. Dietary pattern analysis might be especially valuable to the development and evaluation of food-based dietary guidelines.

A comparison of principal component analysis, partial least-squares and reduced-rank regressions in the identification of dietary patterns associated with bone mass in ageing Australians

PURPOSE

The relative advantages of dietary analysis methods, particularly in identifying dietary patterns associated with bone mass, have not been investigated. We evaluated principal component analysis (PCA), partial least-squares (PLS) and reduced-rank regressions (RRR) in determining dietary patterns associated with bone mass.

METHODS

Data from 1182 study participants (45.9% males; aged 50 years and above) from the North West Adelaide Health Study (NWAHS) were used. Dietary data were collected using a food frequency questionnaire (FFQ). Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with bone mineral density (BMD) and content (BMC).

RESULTS

PCA, PLS and RRR identified two, four and four dietary patterns, respectively. All methods identified similar patterns for the first two factors (factor 1, "prudent" and factor 2, "western" patterns). Three, one and none of the patterns derived by RRR, PLS and PCA were significantly associated with bone mass, respectively. The "prudent" and dairy (factor 3) patterns determined by RRR were positively and significantly associated with BMD and BMC. Vegetables and fruit pattern (factor 4) of PLS and RRR was negatively and significantly associated with BMD and BMC, respectively.

CONCLUSIONS

RRR was found to be more appropriate in identifying more (plausible) dietary patterns that are associated with bone mass than PCA and PLS. Nevertheless, the advantage of RRR over the other two methods (PCA and PLS) should be confirmed in future studies.

Associations between dietary patterns and serum lipids, apo and C-reactive protein in an adult population: evidence from a multi-city cohort in South America

Several previous epidemiological studies from developed countries have shown that an unhealthy dietary pattern affects plasma lipid levels and inflammation biomarkers. We assessed the cross-sectional associations between dietary patterns and cardiovascular risk factors among 961 adults from a multi-city cohort in South America. We conducted a principal component analysis to derive dietary patterns. As outcomes, we examined plasma levels of apo A-I, apo B, high-sensitivity C-reactive protein (hs-CRP), LDL-, HDL- and serum total cholesterol and TAG. The crude and adjusted changes in each outcome were estimated for quartiles of dietary patterns using multivariable linear regression models. The prudent pattern (PP) characterised by higher intake of fruits, vegetables, fish, seafood, whole cereal and low-fat dairy products was associated with reduced plasma concentrations of apo B (-8·5 mg/l), total cholesterol (-18·8 mg/dl) and LDL-cholesterol (-16·5 mg/dl) and hs-CRP (-1·6 mg/l) in men. In women also reduced plasma concentrations of apo B (-6·6 mg/l), total (-12·0 mg/dl) and LDL (-9·3 mg/dl). The 'Western-like' pattern characterised by higher intake of eggs, pastry and cakes, pizza, snacks, refined grains, red meat, vegetable oils and poultry was not significantly associated with any of the selected serum lipid or inflammatory biomarkers. The explained variances were 10·3 and 7·4 %, respectively. The PP was associated with better lipid profile, mainly lower atherogenic particles (apo B) and LDL-cholesterol and serum total cholesterol. This study provides possible evidence of a prudent diet in South American populations to help reduce the burden of CVD.

Stability-based validation of dietary patterns obtained by cluster analysis

Background

Cluster analysis is a data-driven method used to create clusters of individuals sharing similar dietary habits. However, this method requires specific choices from the user which have an influence on the results. Therefore, there is a need of an objective methodology helping researchers in their decisions during cluster analysis. The objective of this study was to use such a methodology based on stability of clustering solutions to select the most appropriate clustering method and number of clusters for describing dietary patterns in the NESCAV study (Nutrition, Environment and Cardiovascular Health), a large population-based cross-sectional study in the Greater Region (N = 2298).

Methods

Clustering solutions were obtained with K-means, K-medians and Ward’s method and a number of clusters varying from 2 to 6. Their stability was assessed with three indices: adjusted Rand index, Cramer’s V and misclassification rate.

Results

The most stable solution was obtained with K-means method and a number of clusters equal to 3. The “Convenient” cluster characterized by the consumption of convenient foods was the most prevalent with 46% of the population having this dietary behaviour. In addition, a “Prudent” and a “Non-Prudent” patterns associated respectively with healthy and non-healthy dietary habits were adopted by 25% and 29% of the population. The “Convenient” and “Non-Prudent” clusters were associated with higher cardiovascular risk whereas the “Prudent” pattern was associated with a decreased cardiovascular risk. Associations with others factors showed that the choice of a specific dietary pattern is part of a wider lifestyle profile.

Conclusion

This study is of interest for both researchers and public health professionals. From a methodological standpoint, we showed that using stability of clustering solutions could help researchers in their choices. From a public health perspective, this study showed the need of targeted health promotion campaigns describing the benefits of healthy dietary patterns.

Electronic supplementary material

The online version of this article (doi:10.1186/s12937-017-0226-9) contains supplementary material, which is available to authorized users.

Associations between explorative dietary patterns and serum lipid levels and their interactions with ApoA5 and ApoE haplotype in patients with recently diagnosed type 2 diabetes

Aims

In patients with type 2 diabetes (T2D), responsiveness of serum lipid concentrations to dietary patterns may vary by genotype. The aims of the present study were to identify explorative dietary patterns and to examine their independent associations with serum lipid levels and interactions with apolipoprotein (Apo)A5 and ApoE variants among patients recently diagnosed with T2D.

Methods

Within a cross-sectional analysis, participants of the German Diabetes Study (n = 348) with mean T2D duration of 6 months were investigated for fasting serum lipid levels, ApoA5 and ApoE genotypes; food consumption frequencies were assessed by a food propensity questionnaire. Dietary patterns were derived using principal component analysis (PCA) and reduced rank regression (RRR), which extracts patterns explaining variation in serum lipid concentrations.

Results

PCA yielded interpretable dietary patterns which were, however, not related to serum lipid levels. Relevance of the RRR patterns varied by genotype: a preferred consumption of fruit gum, fruit juice, and potato dumpling, whilst avoiding fruits and vegetables independently associated with higher triglyceride levels among ApoA5*2. Patients in the highest compared to the lowest tertile of pattern adherence had 99 % higher triglycerides. Lower consumption frequencies of butter, cream cake, French fries, or high-percentage alcoholic beverages were independently related to lower LDL-cholesterol among ApoE2 carriers, with those in the highest compared to the lowest tertile of pattern adherence having 40 % lower LDL-cholesterol (both P_interaction < 0.05).

Conclusions

Our explorative data analyses suggest that associations of dietary patterns with triglycerides and LDL-cholesterol differ by ApoA5 and ApoE haplotype in recently diagnosed T2D.

Trial registration Clinicaltrials.gov: NCT01055093. Date of registration: January 22, 2010 (retrospectively registered). Date of enrolment of first participant to the trial: September 2005

Electronic supplementary material

The online version of this article (doi:10.1186/s12933-016-0455-9) contains supplementary material, which is available to authorized users.

Associations between Dietary Patterns and Blood Pressure in a Clinical Sample of Overweight Adults

BACKGROUND

Dietary pattern analysis provides important evidence revealing diet-disease relationships. It may be especially useful in areas less well researched, such as diet and hypertension in clinical populations.

OBJECTIVE

The aim of this study was to identify the association between dietary patterns and blood pressure (BP) in a sample of overweight adults volunteering for a clinical trial for weight loss.

DESIGN

This cross-sectional analysis used baseline data from the HealthTrack study, a 12-month randomized controlled trial. Dietary intake was evaluated with 4-day food records.

PARTICIPANTS/SETTING

Participants were 328 adults recruited from the Illawarra region of New South Wales, Australia, between May 2014 and April 2015.

MAIN OUTCOME MEASURES

Resting BP and 24-hour urine sodium and potassium were measured.

STATISTICAL ANALYSIS

Dietary patterns were derived by principal component analysis from 21 food groups. Multiple regression analysis was performed to assess the association between the extracted dietary patterns and BP.

RESULTS

The participants' mean age was 43.6±8.0 years, mean body mass index was 32.4±4.2, and mean systolic BP/diastolic BP was 124.9±14.5/73.3±9.9 mm Hg. Six major dietary patterns were identified: "nuts, seeds, fruit, and fish," "milk and meat," "breads, cereals, and snacks," "cereal-based products, fats, and oils," "alcohol, eggs, and legumes," and "savoury sauces, condiments, and meat." The "nuts, seeds, fruit, and fish" dietary pattern was significantly and inversely associated with systolic BP (F [7,320]=15.248; P<0.0005; adjusted R²=0.234 and diastolic BP (F [7,320]=17.351; P<0.0005; adjusted R²=0.259) and sodium-to-potassium ratio (F [7,320]=6.210; P<0.0005; adjusted R²=0.100).

CONCLUSIONS

A dietary pattern rich in nuts, seeds, fruit, and fish was inversely associated with blood pressure in this clinical sample. The findings suggest that current dietary guidelines are relevant to an overweight clinical population and support the value of dietary pattern analysis when exploring the diet-disease relationship.

Association between dietary patterns and blood lipid profiles among Chinese women

OBJECTIVE

The present study aimed to identify dietary patterns and explore their associations with blood lipid profiles among Chinese women.

DESIGN

In a cross-sectional study, we identified dietary patterns using principal component analysis of data from three consecutive 24 h dietary recalls. The China Health and Nutrition Survey (CHNS) collected blood samples in the morning after an overnight fast and measured total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and TAG.

SETTING

Data were from the 2009 wave of the CHNS.

SUBJECTS

We studied 2468 women aged 18-80 years from the CHNS.

RESULTS

We identified three dietary patterns: traditional southern (high intakes of rice, pork and vegetables), snack (high intakes of fruits, eggs and cakes) and Western (high intakes of poultry, fast foods and milk). The traditional southern pattern was inversely associated with HDL-C (β=-0·68; 95 % CI -1·22, -0·14; P<0·05). The snack pattern was significantly associated with higher TAG (β=4·14; 95 % CI 0·44, 7·84; P<0·05). The Western pattern was positively associated with TC (β=2·52; 95 % CI 1·03, 4·02; P<0·01) and LDL-C (β=2·26; 95 % CI 0·86, 3·66; P<0·01).

CONCLUSIONS

We identified three dietary patterns that are significantly associated with blood lipid profiles. This information is important for developing interventions and policies addressing dyslipidaemia prevention among Chinese women.

Predictive role of the Mediterranean diet on mortality in individuals at low cardiovascular risk: a 12-year follow-up population-based cohort study

BACKGROUND

Adherence to the Mediterranean diet reduces the risk of all-cause and cardiovascular (CV) mortality and the incidence of CV events. However, most previous studies were performed in high-risk individuals. Our objective was to assess whether the adherence to the Mediterranean diet, evaluated by the MED score, was associated with all-cause and CV mortality and incidence of CV events in individuals at low CV risk from a population-based cohort, after a 12-year mean follow-up.

METHODS

A cohort of 1658 individuals completed a validated food-frequency questionnaire in 2001-2003. The MED score was calculated by a 0-9 scale. Anthropometric, laboratory measurements, and the vital status were collected at baseline and during 2014. The baseline CV risk was estimated by the Framingham risk score. Participants were divided into two groups: individuals at low risk (CV < 10) and individuals with CV risk ≥ 10.

RESULTS

During a 12-year mean follow-up, 220 deaths, 84 due to CV diseases, and 125 incident CV events occurred. The adherence to the Mediterranean diet was low in 768 (score 0-2), medium in 685 (score 4-5) and high in 205 (score > 6) individuals. Values of BMI, waist circumference, fasting glucose and insulin significantly decreased from low to high diet adherence only in participants with CV risk ≥ 10. In a Cox-regression model, the hazard ratios (HRs) in low-risk individuals per unit of MED score were: HR = 0.83 (95 % CI 0.72-0.96) for all-cause mortality, HR = 0.75 (95 % CI 0.58-0.96) for CV mortality, and HR = 0.79 (95 % CI 0.65-0.97) for CV events, after multiple adjustments. In individuals with CV risk ≥ 10, the MED score predicted incident CV events (HR = 0.85; 95 % CI 0.72-0.99), while the associations with all-cause (HR = 1.02; 95 % CI 0.90-1.15) and CV mortality (0.94; 95 % CI 0.76-1.15) were not significant.

CONCLUSIONS

Greater adherence to the Mediterranean diet was associated with reduced fatal and non fatal CV events, especially in individuals at low CV risk, thus suggesting the usefulness of promoting this nutritional pattern in particular in healthier individuals.

Dietary patterns of women aged 50-69 years and associations with nutrient intake, sociodemographic factors and key risk factors for non-communicable diseases

OBJECTIVE

In women, the risk for non-communicable diseases increases after menopause. We aimed to identify major dietary patterns and study their associations with nutrient intake, sociodemographic factors and risk factors for non-communicable diseases among women aged 50-69 years.

DESIGN

A cross-sectional study. Food intake was recorded by a 253-item FFQ. Dietary patterns were identified using principal component analysis. The associations between the dietary patterns and nutrients were described by Pearson's correlation coefficients and multiple regression analysis was used to examine the associations between the dietary patterns and age, education, BMI, physical activity and smoking.

SETTING

The Norwegian Breast Cancer Screening Programme.

SUBJECTS

Women (n 6298) aged 50-69 years.

RESULTS

Three dietary patterns were identified: 'Prudent', 'Western' and 'Continental'. Adherence to the 'Prudent' pattern was related to older age, higher education, higher BMI, more physical activity (P trend<0·001) and being a non-smoker (P<0·001). Adherence to the 'Western' pattern was related to older age, lower education, higher BMI, less physical activity (0·001≤P trend≤0·006) and lower alcohol intake (r =-0·28). Adherence to the 'Continental' pattern was related to younger age, higher education, higher BMI, less physical activity, (P trend<0·001), being a smoker (P<0·001) and higher alcohol intake (r=0·36).

CONCLUSIONS

Three distinct dietary patterns were identified. High adherence to a 'Prudent' pattern was associated with a healthy lifestyle, while high adherence to a 'Western' or 'Continental' pattern was associated with an unhealthy lifestyle. These findings are valuable knowledge for health authorities when forming strategies to promote a healthier lifestyle among women.

Dietary Patterns Are Associated with Predicted Cardiovascular Disease Risk in an Urban Mexican Adult Population

BACKGROUND

Dietary patterns may predict cardiovascular disease (CVD) risk more accurately than does consumption of specific nutrients or foods.

OBJECTIVE

We evaluated the association between Mexican adults' dietary patterns and development of a >10% risk of 10-y CVD (using the Framingham risk score) over 7 y of follow-up.

METHODS

This prospective cohort study included 1196 men and women aged 20-80 y with a 10-y predicted risk <10% and without a CVD diagnosis at baseline in 2004-2007. Data on sociodemographic, lifestyle, and medical history factors were collected with a self-administered questionnaire. Dietary intake was evaluated by using a semiquantitative food-frequency questionnaire. The relations between dietary patterns and predicted CVD were analyzed by using pooled logistic regression models.

RESULTS

With the use of factor analysis, we identified 3 major dietary patterns in participants' dietary data. The "prudent" pattern was characterized by high positive loadings for the consumption of fresh fruit, vegetables, and whole grains. The "meat/fish" pattern showed positive loadings for the consumption of red meat, processed meat, eggs, fats, fish, and poultry. Finally, the "refined foods" pattern featured positive loadings for corn tortillas, refined grains, soft drinks, and alcohol. After adjustment for potential confounders, compared with participants in the lowest quintile of the prudent pattern, those in the highest quintile had a lower RR of 10-y CVD (RR: 0.40; 95% CI: 0.20, 0.79; P-trend = 0.006). In contrast, participants in the highest quintile of the refined-foods pattern had a greater risk of elevated 10-y CVD (RR: 2.98; 95% CI: 1.46, 6.10; P-trend = 0.020) than did those in the lowest quintile. Finally, the meat/fish dietary pattern was not significantly associated with 10-y CVD.

CONCLUSION

Our data suggest that the prudent pattern is associated with a reduced risk of 10-y CVD, whereas the refined-foods pattern may increase 10-y CVD in Mexican adults.

Dietary patterns in Swedish adults; results from a national dietary survey

Dietary patterns derived by statistical procedures is a way to identify overall dietary habits in specific populations. The aim of this study was to identify and characterise dietary patterns in Swedish adults using data from the national dietary survey Riksmaten adults 2010-11 (952 women, 788 men). Principal component analyses were used and two patterns were identified in both sexes: a healthy pattern loading positively on vegetables, fruits, fish and seafood, and vegetable oils, and negatively on refined bread and fast food, and a Swedish traditional pattern loading positively on potatoes, meat and processed meat, full-fat milk products, sweet bakery products, sweet condiments and margarine. In addition, a light-meal pattern was identified in women with positive loadings on fibre-rich bread, cheese, rice, pasta and food grain dishes, substitute products for meat and dairy products, candies and tea. The healthy pattern was positively correlated to dietary fibre (r 0·51-0·58) and n-3 (r 0·25-0·31) (all P<0·0001), and had a higher nutrient density of folate, vitamin D and Se. The Swedish traditional and the light-meal pattern were positively correlated to added sugar (r 0·20-0·25) and the Swedish traditional also to SFA (r 0·13-0·21) (all P<0·0001); both patterns were in general negatively correlated to micronutrients. Dietary pattern scores were associated with, for example, age, physical activity, education and income. In conclusion, we identified three major dietary patterns among Swedish adults. The patterns can be further used for examining the association between whole diet and health outcomes.

A Snack Dietary Pattern Increases the Risk of Hypercholesterolemia in Northern Chinese Adults: A Prospective Cohort Study

The evidence about the effect of dietary patterns on blood cholesterol from cohort studies was very scarce. The study was to identify the association of dietary patterns with lipid profile, especially cholesterol, in a cohort in north China. Using a 1-year food frequency questionnaire, we assessed the dietary intake of 4515 adults from the Harbin People’s Health Study in 2008, aged 20-74 years. Principle component analysis was used to identify dietary patterns. The follow-up was completed in 2012. Fasting blood samples were collected for the determination of blood lipid concentrations. Logistic regression models were used to evaluate the association of dietary patterns with the incidence of hypercholesterolemia, hypertriglyceridemia, and low-HDL cholesterolemia. Five dietary patterns were identified (“staple food”, “vegetable, fruit and milk”, “potato, soybean and egg”, “snack”, and “meat”). The relative risk (RR) between the extreme tertiles of the snack dietary pattern scores was 1.72 (95% CI = 1.14, 2.59, P = 0.004) for hypercholesterolemia, 1.39 (1.13, 1.75, P = 0.036) for hypertriglyceridemia, after adjustment for age, sex, education, body mass index, smoking, alcohol consumption, energy intake, exercise and baseline lipid concentrations. There was a significant positive association between the snack dietary pattern scores and fasting serum total cholesterol (SRC (standardized regression coefficient) = 0.262, P = 0.025), LDL-c (SRC = 0.324, P = 0.002) and triglycerides (SRC = 0.253, P = 0.035), after adjustment for the multiple variables above. Moreover, the adjusted RR of hypertriglyceridemia between the extreme tertiles was 0.73 (0.56, 0.94, P = 0.025) for the vegetable, fruit and milk dietary pattern, and 1.86 (1.33, 2.41, P = 0.005) for the meat dietary pattern. The snack dietary pattern was a newly emerged dietary pattern in northern Chinese adults. It appears conceivable that the risk of hypercholesterolemia can be reduced by changing the snack dietary pattern.

Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults

Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30-79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03-1.08) and central obesity (PR: 1.07, 95% CI: 1.06-1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02-1.09) and 1.17 (1.25-1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships.

Identifying cardiovascular risk factor-related dietary patterns with reduced rank regression and random forest in the EPIC-NL cohort

BACKGROUND

Several methods are used to determine dietary patterns. Hybrid methods incorporate information on nutrient intake or biological factors to extract patterns relevant to disease etiology.

OBJECTIVE

We explore differences between patterns derived with 2 hybrid methods with those obtained by a posteriori methods and compare associations of these patterns with coronary artery disease (CAD) and stroke risk.

DESIGN

Food-frequency questionnaires were used to estimate dietary intake in 34,644 participants of European Prospective Investigation into Cancer-Netherlands at baseline (1993-1997). Follow-up was complete until 31 December 2007. Hybrid methods to determine dietary patterns were reduced rank regression (RRR) and random forest with classification tree analysis (RF-CTA). Included risk factors were body mass index, total:high-density lipoprotein cholesterol ratio, and systolic blood pressure. Results were compared with those from principal component analysis (PCA) and k-means cluster analysis (KCA), respectively.

RESULTS

Both RRR and PCA derived a "Western," "prudent," and "traditional pattern." All RRR patterns were significantly associated with CAD risk [highest vs. lowest quartile factor score; HR: 1.45 (95% CI: 1.25, 1.69), 0.86 (0.74, 0.99), and 1.25 (1.07, 1.47), respectively]. Only the prudent RRR factor was statistically significant associated with stroke (HR: 0.76; 95% CI: 0.59, 0.97). From the PCA patterns, only the traditional pattern was associated with CAD (HR: 1.29; 95% CI: 1.11, 1.50). RF-CTA derived 7 dietary patterns that could be categorized as "Western-like," "prudent-like," and "traditional-like." KCA established a prudent and Western cluster. Compared with the RF-CTA "prudent-like 1" pattern, only the "traditional-like 1" pattern was associated with CAD (HR: 1.36; 955 CI: 1.12, 1.65). None of the RF-CTA groups were associated with stroke. Compared with the Western KCA cluster, the prudent cluster was not associated with CAD or stroke.

CONCLUSION

Including risk factors in RRR and RF-CTA resulted in small differences in food groups, contributing to similar patterns that showed in general stronger associations with CAD than PCA and KCA, respectively.

Socio-economic status and ethnicity are independently associated with dietary patterns: the HELIUS-Dietary Patterns study

Background

Differences in dietary patterns between ethnic groups have often been observed. These differences may partially be a reflection of differences in socio-economic status (SES) or may be the result of differences in the direction and strength of the association between SES and diet.

Objective

We aimed to examine ethnic differences in dietary patterns and the role of socio-economic indicators on dietary patterns within a multi-ethnic population.

Design

Cross-sectional multi-ethnic population-based study.

Setting

Amsterdam, the Netherlands.

Subjects

Principal component analysis was used to identify dietary patterns among Dutch (n=1,254), South Asian Surinamese (n=425), and African Surinamese (n=784) participants. Levels of education and occupation were used to indicate SES. Linear regression analysis was used to examine the association between ethnicity and dietary pattern scores first and then between socio-economic indicators and dietary patterns within and between ethnic groups.

Results

‘Noodle/rice dishes and white meat’, ‘red meat, snacks, and sweets’ and ‘vegetables, fruit and nuts’ patterns were identified. Compared to the Dutch origin participants, Surinamese more closely adhered to the ‘noodle/rice dishes and white meat’ pattern which was characterized by foods consumed in a ‘traditional Surinamese diet’. Closer adherence to the other two patterns was observed among Dutch compared to Surinamese origin participants. Ethnic differences in dietary patterns persisted within strata of education and occupation. Surinamese showed greater adherence to a ‘traditional’ pattern independent of SES. Among Dutch participants, a clear socio-economic gradient in all dietary patterns was observed. Such a gradient was only present among Surinamese dietary oatterns to the ‘vegetables, fruit and nuts’ pattern.

Conclusions

We found a selective change in the adherence to dietary patterns among Surinamese origin participants, presumably a move towards more vegetables and fruits with higher SES but continued fidelity to the traditional diet.

Association of dietary pattern with biochemical blood profiles and bodyweight among adults with Type 2 diabetes mellitus in Tehran, Iran

Background

This study was conducted to identify dietary patterns and evaluated their association with biochemical blood profiles and body weight among adults with type 2 diabetes mellitus.

Methods

This was a cross sectional study conducted among 400 patients with type 2 diabetes mellitus in Tehran from March to August 2013. Biochemical blood profiles, socio-demographic, lifestyle, anthropometric measurements, and dietary data were obtained. Dietary data from food frequency questionnaire were used to derive dietary patterns. Factor analysis was conducted to ascertain the dietary patterns, and analysis of covariance was fitted to assess the relation between blood profiles, body weight and adherence to dietary patterns.

Results

Three dietary patterns by factor analysis were identified, Vegetable & Poultry, Western and Semi-healthy. After control for potential confounders, body mass index (b = −0/03, p < 0.05) were negatively associated with vegetable and poultry dietary pattern. Conversely, total cholesterol (b = 0.004, p < 0.01) and fasting blood glucose (b = 0.014, p < 0.05) were positively associated with western dietary pattern. A dietary pattern labeled as semi-healthy pattern was found to be positively related to HDL-cholesterol (b = 0.006 p < 0.01). Associations between semi-healthy pattern, LDL-cholesterol (b = −0.120 p < 0.05) and waist circumference (b = −0.020, p < 0.05) were negative.

Conclusion

Adherence to Vegetable & Poultry dietary pattern was favorably related to body weight, semi healthy related to lower LDL and higher HDL cholesterol whereas western related to higher fasting blood glucose and total cholesterol. Further studies are necessary to confirm the benefits of the dietary patterns for diabetes.

Greater adherence to a Mediterranean dietary pattern is associated with improved plasma lipid profile: the Aragon Health Workers Study cohort

INTRODUCTION AND OBJECTIVES

There is wide recognition of the importance of healthy eating in cardiovascular health promotion. The purpose of this study was to identify the main dietary patterns among a Spanish population, and to determine their relationship with plasma lipid profiles.

METHODS

A cross-sectional analysis was conducted of data from 1290 participants of the Aragon Workers Health Study cohort. Standardized protocols were used to collect clinical and biochemistry data. Diet was assessed through a food frequency questionnaire, quantifying habitual intake over the past 12 months. The main dietary patterns were identified by factor analysis. The association between adherence to dietary patterns and plasma lipid levels was assessed by linear and logistic regression.

RESULTS

Two dietary patterns were identified: a Mediterranean dietary pattern, high in vegetables, fruits, fish, white meat, nuts, and olive oil, and a Western dietary pattern, high in red meat, fast food, dairy, and cereals. Compared with the participants in the lowest quintile of adherence to the Western dietary pattern, those in the highest quintile had 4.6 mg/dL lower high-density lipoprotein cholesterol levels (P < .001), 8 mg/dL lower apolipoprotein A1 levels (P = .005) and a greater risk of having decreased high-density lipoprotein cholesterol (odds ratio = 3.19; 95% confidence interval, 1.36-7.5; P-trend = .03). Participants adhering to the Mediterranean dietary pattern had 3.3mg/dL higher high-density lipoprotein cholesterol levels (P < .001), and a ratio of triglycerides to high-density lipoprotein cholesterol that was 0.43 times lower (P = .043).

CONCLUSIONS

Adherence to the Mediterranean dietary pattern is associated with improved lipid profile compared with a Western dietary pattern, which was associated with a lower odds of optimal high-density lipoprotein cholesterol levels in this population.

Four major dietary patterns identified for a target-population of adults residing in Newfoundland and Labrador, Canada

Background

Very limited nutritional epidemiological studies conducted to explore the unique dietary exposure in Newfoundland and Labrador (NL). This study aims to identify and characterize major dietary patterns in the target-population from general adult NL residents and assess the associations with selected demographic factors.

Methods

A total of 192 participants, aged 35–70 years, completed and returned a food-frequency questionnaire (FFQ) and participated in a telephone interview to collect demographic information. Dietary patterns were identified by common factor analysis. Univariate and multivariate linear regression analyses were used to assess determinants of the different food consumption patterns. Pearson’s correlation coefficients were calculated for food scores of each pattern, total energy, and energy-adjusted nutrient intakes.

Results

Factor analyses identified four dietary patterns, which were labeled as “Meat”, “Vegetable/fruit”, “Fish”, and “Grain” patterns. In combination, the four dietary patterns explained 63% of the variance in dietary habits of the study population. Multivariate linear regression analysis indicated an increasing trend of factor scores for Meat and Grain pattern with age. Male participants were found to be more likely to choose the Meat and Fish patterns. Current smokers and those married/living together tend to choose the Grain pattern. Pearson’s correlation coefficients showed positive correlations between fat and cholesterol and the Meat pattern, fiber and the Vegetable/fruits pattern, protein and the Fish pattern, and carbohydrates and the Grain pattern.

Conclusion

This study derived four dietary patterns and obtained their significant associations with specific demographic characteristics in this population. It identified one dietary consumption pattern (Fish) not yet seen in other studied populations. These findings will update the current dietary-health information published in this province, and contribute to further research into the association between dietary practices and health.

Dietary patterns and hypertension: a population-based study with women from Southern Brazil

This study investigated the association between dietary pattern and hypertension using the rank reduced regression (RRR). It was a cross-sectional population-based study with a representative sample of 1,026 women living in the city of São Leopoldo, Rio Grande do Sul State, Brazil. In order to identify dietary patterns, dietary variables from a dietary frequency questionnaire were used as predictors and sodium, potassium and saturated fat consumption were selected as response variables. The RRR identified three dietary patterns: Factor 1, Factor 2 and Factor 3. The association between hypertension and factors 1, 2 and 3, after adjustment for socio-demographic, behavioral and obesity variables, was not significant. After stratification by age, the association between hypertension and factor 2 was present in 40-60 year-old women (tertile 2 compared to 3 RP = 0.62, 95%CI: 0.43-0.91; p = 0,05). The new statistical method (RRR), proved to be a useful tool for identifying dietary patterns. In this study, healthier dietary pattern was directly associated with hypertension in women between 40 and 60 years of age.

Association of dietary patterns with sociodemographic and health-related factors among coronary artery disease (CAD) patients

This study aimed to identify the association of dietary patterns with sociodemographic and health-related characteristics among coronary artery disease patients. In this cross-sectional study, the participants were 250 patients coronary artery disease aged ≥ 40 years old. Data collection was done using questionnaires related to sociodemographics, health-related factors, and food-frequency intake information. Three dietary patterns (traditional, western, and healthy) were obtained using principal component analysis. The result showed that dietary patterns were associated with sociodemographic and health-related factors. According to the result, all the factors were taken very seriously when planning a promotional program for healthy lifestyle in prevention of CAD.