Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis.
BACKGROUND
Empirically derived dietary patterns show strong cross-sectional associations with cardiovascular disease (CVD) risk factors in the Multi-Ethnic Study of Atherosclerosis (MESA).


OBJECTIVE
We investigated associations between dietary patterns and risk of incident CVD in 5316 men and women.


METHODS
White, black, Hispanic, and Chinese adults aged 45-84 y and free of CVD and diabetes completed food-frequency questionnaires at baseline. Dietary patterns were derived by using principal components analysis. Incident CVD events (n = 207) identified over a median of 4.6 y were verified by death certificates and medical records.


RESULTS
The Fats and Processed Meat dietary pattern was associated with a greater risk (hazard ratio quintile 5 compared with quintile 1: 1.82; 95% CI: 0.99, 3.35), and the Whole Grains and Fruit dietary pattern was associated with a lower risk (0.54; 0.33, 0.91) of CVD after adjustment for demographic and lifestyle confounders. Associations between CVD and the Whole Grains and Fruit dietary pattern remained strong after adjustment for waist circumference, blood pressure, lipids, or inflammatory markers.


CONCLUSIONS
Data from this multiethnic cohort reinforce findings from predominantly white cohorts, ie, that "healthy" and "unhealthy" dietary patterns empirically exist and that these patterns are important lifestyle predictors of CVD incidence.
Nettleton
Jennifer A
JA
University of Texas Health Sciences Center School of Public Health, Houston, 77030, USA. a.nettleton@uth.tmc.edu
Polak
Joseph F
JF
Tracy
Russell
R
Burke
Gregory L
GL
Jacobs
David R
DR
D001741:Black or African American; D000818:Animals; D044466:Asian People; D050197:Atherosclerosis / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology; D004032:Diet; D004034:Diet Surveys; D004041:Dietary Fats; D002523:Edible Grain; D005260:Female; D005638:Fruit; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008297:Male; D008460:Meat; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People
D004041:Dietary Fats