title: Dietary intake and peripheral arterial disease incidence in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: Background:Peripheral arterial disease (PAD) is a costly source of morbidity and mortality among older persons in the United States. Dietary intake plays a role in the development of atherosclerotic cardiovascular disease; however, few studies have examined the relation of food intake or dietary patterns with PAD.Objective:We examined the relation between habitual dietary intake at midlife and incident PAD over ∼20 y of follow-up.Design:Among 14,082 participants enrolled in the ARIC (Atherosclerosis Risk in Communities) Study initially free of PAD, dietary intake was assessed at baseline in 1987-1989 by using a modified Harvard food-frequency questionnaire. Food groups were created, and principal components analysis was used to develop "healthy" and "Western" dietary patterns; both were categorized into quintiles or quartiles. Incident PAD was determined by an ankle-brachial index <0.9 assessed at 2 subsequent examinations and hospital discharge codes through 2012. Multivariate-adjusted Cox proportional hazards regression was used.Results:During a mean follow-up of 19.9 y, 1569 participants developed incident PAD. In models adjusted for demographic characteristics, behaviors, and food groups, the HRs (95% CIs) for incident PAD increased across quintiles of meat consumption [quintile 1: reference, quintile 2: 1.38 (1.16, 1.65), quintile 3: 1.38 (1.16, 1.65), quintile 4: 1.45 (1.20, 1.74), quintile 5: 1.66 (1.36, 2.03);P-trend <0.001]. Compared with those who drank no alcohol, those who had 1-6 drinks/wk had a lower risk of incident PAD [0.78 (0.68, 0.89)]. For coffee, ≥4 cups/d compared with none was inversely associated with incident PAD [quintile 5 compared with quintile 1: 0.84 (0.75, 1.00);P-trend = 0.014]. There was no association between other food groups or patterns and incident PAD.Conclusions:In this prospective cohort study, greater meat consumption was associated with a higher risk, and moderate alcohol consumption was associated with a lower risk of incident PAD. Whether these associations are causal remains to be seen. This trial was registered at clinicaltrials.gov as NCT00005131.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and ogilv019@umn.edu.
authors.forename: Rachel P
authors.identifier: 0000-0002-7643-7175
authors.initials: RP
authors.lastname: Ogilvie
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and.|University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and.
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
mesh_terms: D000428:Alcohol Drinking; D050197:Atherosclerosis; D003069:Coffee; D004032:Diet; D004034:Diet Surveys; D000072001:Diet, Healthy; D066273:Diet, Western; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000209:etiology / Q000517:prevention & control; D025341:Principal Component Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D003069:Coffee; D000431:Ethanol
keywords: alcohol; cardiovascular disease; dietary patterns; food groups; meat; peripheral arterial disease