title: Dietary patterns are associated with disease risk among participants in the Women's Health Initiative Observational Study.
abstract: Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women's Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infarct compared to 1224 WHI-OS controls matched for age, enrollment date, race/ethnicity, and absence of CHD at baseline or follow-up. The first six principal components explained >75% of variation in dietary intakes and K-mean analysis based on these six components produced three clusters. Diet cluster 1 was rich in carbohydrate, vegetable protein, fiber, dietary vitamin K, folate, carotenoids, α-linolenic acid [18:3(n-3)], linoleic acid [18:2(n-6)], and supplemental calcium and vitamin D. Diet cluster 2 was rich in total and animal protein, arachidonic acid [20:4(n-6)], DHA [22:6(n-3)], vitamin D, and calcium. Diet cluster 3 was rich in energy, total fat, and trans fatty acids (all P < 0.01). Conditional logistic regression analysis demonstrated diet cluster 1 was associated with lower CHD risk than diet cluster 2 (reference group) adjusted for smoking, education, and physical activity [OR = 0.79 (95% CI = 0.64, 0.99); P = 0.038]. This difference was not significant after adjustment for BMI and systolic blood pressure. Diet cluster 3 was associated with higher CHD risk than diet cluster 2 [OR = 1.28 (95% CI = 1.04, 1.57); P = 0.019], but this difference did not remain significant after adjustment for smoking, education, and physical activity. Within this WHI-OS cohort, distinct dietary patterns may be associated with subsequent CHD outcomes.
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, IL, USA. lvanhorn@northwestern.edu
authors.forename: Linda Van
authors.initials: LV
authors.lastname: Horn
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Linda
authors.initials: L
authors.lastname: Snetselaar
authors.forename: Nirupa R
authors.initials: NR
authors.lastname: Matthan
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
mesh_terms: D000368:Aged; D000375:Aging; D016022:Case-Control Studies; D016000:Cluster Analysis; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D004032:Diet / Q000009:adverse effects*; D005006:Ethnicity; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D025341:Principal Component Analysis; D012307:Risk Factors; D016387:Women's Health / Q000706:statistics & numerical data