Dietary patterns derived from principal component- and k-means cluster analysis: long-term association with coronary heart disease and stroke.
OBJECTIVE
Studies comparing dietary patterns derived from different a posteriori methods in view of predicting disease risk are scarce. We aimed to explore differences between dietary patterns derived from principal component- (PCA) and k-means cluster analysis (KCA) in relation to their food group composition and ability to predict CHD and stroke risk.


RESULTS
The study was conducted in the EPIC-NL cohort that consists of 40,011 men and women. Baseline dietary intake was measured using a validated food-frequency questionnaire. Food items were consolidated into 31 food groups. Occurrence of CHD and stroke was assessed through linkage with registries. After 13 years of follow-up, 1,843 CHD and 588 stroke cases were documented. Both PCA and KCA extracted a prudent pattern (high intakes of fish, high-fiber products, raw vegetables, wine) and a western pattern (high consumption of French fries, fast food, low-fiber products, other alcoholic drinks, soft drinks with sugar) with small variation between components and clusters. The prudent component was associated with a reduced risk of CHD (HR for extreme quartiles: 0.87; 95%-CI: 0.75-1.00) and stroke (0.68; 0.53-0.88). The western component was not related to any outcome. The prudent cluster was related with a lower risk of CHD (0.91; 0.82-1.00) and stroke (0.79; 0.67-0.94) compared to the western cluster.


CONCLUSIONS
PCA and KCA found similar underlying patterns with comparable associations with CHD and stroke risk. A prudent pattern reduced the risk of CHD and stroke.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
M D
MD
Stricker
N C
NC
Onland-Moret
J M A
JM
Boer
Y T
YT
van der Schouw
W M M
WM
Verschuren
A M
AM
May
P H M
PH
Peeters
J W J
JW
Beulens
D000368:Aged; D000428:Alcohol Drinking; D000434:Alcoholic Beverages; D016000:Cluster Analysis; D003327:Coronary Disease / Q000150:complications / Q000517:prevention & control*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000517:prevention & control*; D011795:Surveys and Questionnaires