title: Dietary patterns, cardiometabolic risk factors, and the incidence of cardiovascular disease in severe obesity.
abstract: OBJECTIVE
  The longitudinal associations between a dietary pattern (DP) and cardiometabolic risk factors and cardiovascular disease (CVD) incidence were investigated in a cohort of adults with severe obesity.
  
  
  METHODS
  The analysis included 2,037 individuals with severe obesity (>34 and >38 kg/m(2) for men and women, respectively) from the Swedish Obese Subjects study repeatedly followed up for 10 years. Reduced rank regression was used to identify a DP characterized by dietary energy density, saturated fat intake, and fiber density. Mixed models examined relationships between repeated measures of DP z-scores and cardiometabolic risk factors. Cox proportional hazards models assessed relationships between DP scores and CVD incidence.
  
  
  RESULTS
  An energy-dense, high-saturated-fat, and low-fiber DP was derived. A one-unit increase in the DP z-score between follow-ups was associated with an increase in weight [β (SE)] (1.71 ± 0.10 kg), waist circumference (1.49 ± 0.07 cm), BMI (0.60 ± 0.34 kg/m2), serum cholesterol (0.06 ± 0.01 mmol/l), and serum insulin (1.22 ± 0.17 mmol/l; all P < 0.0001), as well as in serum triglycerides (0.05 ± 0.02 mmol/l; P < 0.05), systolic blood pressure (1.05 ± 0.27 mmHg; P < 0.001), and diastolic blood pressure (0.55 ± 0.16 mmHg; P < 0.05). No significant association was observed between repeated measures of the DP z-scores and CVD incidence (HR = 0.96; 95% CI = 0.83-1.12).
  
  
  CONCLUSIONS
  An energy-dense, high-saturated-fat, and low-fiber DP was longitudinally associated with increases in cardiometabolic risk factors in severe obesity but not with CVD incidence.
authors: Diet and Obesity Research, Medical Research Council, Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
authors: David J
authors: DJ
authors: Johns
authors: Anna-Karin
authors: AK
authors: Lindroos
authors: Susan A
authors: SA
authors: Jebb
authors: Lars
authors: L
authors: Sjöström
authors: Lena M S
authors: LM
authors: Carlsson
authors: Gina L
authors: GL
authors: Ambrosini
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D015897:Comorbidity; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D008055:Lipids