The relationship between diet and subclinical atherosclerosis: results from the Asklepios Study.
OBJECTIVE
Nutritional epidemiology shifted its focus from effects of single foods/nutrients toward the overall diet. Food-based dietary guidelines (FBDGs) are promoted worldwide to stimulate a healthy diet, including a variety of foods, to meet nutrient needs and to reduce the risk for non-communicable diseases. The objective of this study was to investigate whether adherence to the FBDG is associated with reduced femoral/carotid atherosclerosis and/or inflammation.


METHODS
In October 2002, 2524 healthy men and women aged 35-55 years were recruited for the Belgian Asklepios cohort study. Subjects were extensively phenotyped, including echographic assessment of (carotid and femoral) atherosclerosis. A dietary index consisting of three subscores (dietary quality, diversity and equilibrium) was calculated to measure adherence to the Flemish FBDG, using data from a semi-quantitative food-frequency questionnaire. General linear models were used to investigate associations between these scores and cardiovascular (CV) risk factors and atherosclerosis and inflammation markers.


RESULTS
Women had better overall dietary scores than men (69 vs 59%). Participants with higher dietary scores showed better age-adjusted CV risk profiles (lower waist/hip ratio, blood pressure, non-high-density lipoprotein-cholesterol, blood triglycerides and homocystein), although most of these associations were only significant in men. Higher dietary scores were also inversely associated with inflammation makers (interleukin-6 and leukocyte count). Associations between diet and atherosclerosis were only found for femoral atherosclerosis and significance disappeared after adjustment for confounders.


CONCLUSIONS
Better adherence to the Flemish FBDG is associated with a better CV risk profile and less inflammation, mainly among men. There was no direct effect on the presence of carotid or femoral atherosclerosis.
Department of Public Health, Ghent University, Ghent, Belgium. inge.huybrechts@ugent.be
L I
LI
Hoebeeck
E R
ER
Rietzschel
M
M
Langlois
M
M
De Buyzere
D
D
De Bacquer
G
G
De Backer
L
L
Maes
T
T
Gillebert
I
I
Huybrechts
D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001530:Belgium / Q000453:epidemiology; D001794:Blood Pressure; D002318:Cardiovascular Diseases; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D004032:Diet; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007249:Inflammation; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D049629:Waist-Hip Ratio
D008055:Lipids; D006710:Homocysteine