title: Dietary Patterns Are Associated with Predicted Cardiovascular Disease Risk in an Urban Mexican Adult Population.
abstract: BACKGROUND
  Dietary patterns may predict cardiovascular disease (CVD) risk more accurately than does consumption of specific nutrients or foods.
  
  
  OBJECTIVE
  We evaluated the association between Mexican adults' dietary patterns and development of a >10% risk of 10-y CVD (using the Framingham risk score) over 7 y of follow-up.
  
  
  METHODS
  This prospective cohort study included 1196 men and women aged 20-80 y with a 10-y predicted risk <10% and without a CVD diagnosis at baseline in 2004-2007. Data on sociodemographic, lifestyle, and medical history factors were collected with a self-administered questionnaire. Dietary intake was evaluated by using a semiquantitative food-frequency questionnaire. The relations between dietary patterns and predicted CVD were analyzed by using pooled logistic regression models.
  
  
  RESULTS
  With the use of factor analysis, we identified 3 major dietary patterns in participants' dietary data. The "prudent" pattern was characterized by high positive loadings for the consumption of fresh fruit, vegetables, and whole grains. The "meat/fish" pattern showed positive loadings for the consumption of red meat, processed meat, eggs, fats, fish, and poultry. Finally, the "refined foods" pattern featured positive loadings for corn tortillas, refined grains, soft drinks, and alcohol. After adjustment for potential confounders, compared with participants in the lowest quintile of the prudent pattern, those in the highest quintile had a lower RR of 10-y CVD (RR: 0.40; 95% CI: 0.20, 0.79; P-trend = 0.006). In contrast, participants in the highest quintile of the refined-foods pattern had a greater risk of elevated 10-y CVD (RR: 2.98; 95% CI: 1.46, 6.10; P-trend = 0.020) than did those in the lowest quintile. Finally, the meat/fish dietary pattern was not significantly associated with 10-y CVD.
  
  
  CONCLUSIONS
  Our data suggest that the prudent pattern is associated with a reduced risk of 10-y CVD, whereas the refined-foods pattern may increase 10-y CVD in Mexican adults.
authors.affiliation: Health Services and Epidemiological Investigation Unit, Mexican Institute of Social Security, Cuernavaca, Mexico; Center of Research in Nutrition and Health and Geriatric Epidemiology Research Center, National Institute of Geriatrics, Mexico City, Mexico; and edenovag@gmail.com.
authors.forename: Edgar
authors.initials: E
authors.lastname: Denova-Gutiérrez
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
authors.affiliation: Center of Research in Nutrition and Health and.
authors.forename: Mario
authors.initials: M
authors.lastname: Flores
authors.affiliation: Center of Research in Nutrition and Health and.
authors.forename: Simón
authors.initials: S
authors.lastname: Barquera
authors.affiliation: Health Services and Epidemiological Investigation Unit, Mexican Institute of Social Security, Cuernavaca, Mexico; Population Research Center, National Institute of Public Health, Cuernavaca, Mexico;
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004032:Diet; D002149:Energy Intake; D005260:Female; D005638:Fruit; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D011446:Prospective Studies; D000069466:Red Meat; D012307:Risk Factors; D017747:Seafood; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014675:Vegetables; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Health Workers Cohort Study; Mexico; adult population; dietary patterns; factor analysis; predicted cardiovascular disease risk