Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis
Open accessAbstract
Background Empirically derived dietary patterns show strong cross-sectional associations with cardiovascular disease (CVD) risk factors in the Multi-Ethnic Study of Atherosclerosis (MESA).Objective We investigated associations between dietary patterns and risk of incident CVD in 5316 men and women.Design White, black, Hispanic, and Chinese adults aged 45-84 y and free of CVD and diabetes completed food-frequency questionnaires at baseline. Dietary patterns were derived by using principal components analysis. Incident CVD events (n = 207) identified over a median of 4.6 y were verified by death certificates and medical records.Results The Fats and Processed Meat dietary pattern was associated with a greater risk (hazard ratio quintile 5 compared with quintile 1: 1.82; 95% CI: 0.99, 3.35), and the Whole Grains and Fruit dietary pattern was associated with a lower risk (0.54; 0.33, 0.91) of CVD after adjustment for demographic and lifestyle confounders. Associations between CVD and the Whole Grains and Fruit dietary pattern remained strong after adjustment for waist circumference, blood pressure, lipids, or inflammatory markers.Conclusions Data from this multiethnic cohort reinforce findings from predominantly white cohorts, ie, that "healthy" and "unhealthy" dietary patterns empirically exist and that these patterns are important lifestyle predictors of CVD incidence.
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Healthful dietary patterns have been positively associated with cardiovascular health in observational epidemiological studies.
“Furthermore, healthful dietary patterns have been positively associated with CVH in observational epidemiological studies.[99][100][101][102][103][104]”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [100]
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- Authors
- Nettleton, J. A., Polak, J. F., Tracy, R., Burke, G. L., & Jacobs, D. R.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Nettleton, Jennifer A
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 90
- Issue
- 3
- Pages
- 647-654
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC2728647
- OpenAlex
- W2160611992
- Cited by
- 138
- References
- 16
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 4 · 2020: 9 · 2019: 4 · 2018: 4 · 2017: 10 · 2016: 10 · 2015: 14 · 2014: 11 · 2013: 16 · 2012: 11
- FWCI
- 9.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc95164-17-0-1, n01hc95165-34-0-1, n01hc95161-24-0-1, n01hc95166-21-0-1, n01hc95162-31-0-1, n01hc95160-18-0-1, n01hc95163-22-0-1, n01hc95159-40-0-1)
- National Heart, Lung, and Blood Institute (N01 HC-95159, N01-HC-95160, (N01-HC-95163, N01 HC-95161, N01 HC95165, N01HC95164, N01‐HC‐95166, N01-HC-95159 through N01-HC-95166, N01 HC-95162)
- National Center for Research Resources (N01-HC-95166, N01-HC-95159, M01RR000645, M01 RR00645)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Keywords
- dietary habits, cardiovascular disease incidence, healthy eating, unhealthy diet, Multi-Ethnic Study of Atherosclerosis, multi-ethnic cohort, cardiovascular risk factors
- MeSH terms
- Animals, Black or African American, Cardiovascular Diseases, Edible Grain, Diet, Diet Surveys, Dietary Fats, Female, Fruit, Hispanic or Latino, Humans, Male, Meat, Middle Aged, Risk Factors, United States, Health Behavior, Incidence, White People, Asian People, Atherosclerosis
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