Dietary Patterns Associated with Lower 10-Year Atherosclerotic Cardiovascular Disease Risk among Urban African-American and White Adults Consuming Western Diets

Abstract

The study’s objective was to determine whether variations in the 2013 American College of Cardiology/American Heart Association 10-year risk for atherosclerotic cardiovascular disease (ASCVD) were associated with differences in food consumption and diet quality. Findings from the baseline wave of Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study 2004–2009, revealed participants consumed a Western diet. Diet quality measures, specifically the Healthy Eating Index (HEI)-2010, Dietary Approaches to Stop Hypertension (DASH) diet and the Mean Adequacy Ratio (MAR), based on two 24-h recalls collected during follow-up HANDLS studies from 2009–2013, were used. Reported foods were assigned to 27 groups. In this cross-sectional analysis, the participants (n = 2140) were categorized into tertiles based on their 10-year ASCVD risk. Lower and upper tertiles were used to determine significantly different consumption rates among the food groups. Ten groups were used in hierarchical case clustering to generate four dietary patterns (DPs) based on group energy contribution. The DP with the highest HEI-2010 score included sandwiches along with vegetables and cheese/yogurt. This DP, along with the pizza/sandwiches DP, had significantly higher DASH and MAR scores and a lower 10-year ASCVD risk, compared to the remaining two DPs–meats/sandwiches and sandwiches/bakery products; thus, Western dietary patterns were associated with different levels of ASCVD 10-year risk.

Association of DASH and Depressive Symptoms with BMI over Adulthood in Racially and Socioeconomically Diverse Adults Examined in the HANDLS Study

“…However, the protective effects of the DASH dietary pattern from an increase in BMI with age were observed in the HANDLS study participants. Similarly, in this sample an inverse relationship between DASH score and 10 year atherosclerotic cardiovascular risk has also been reported [33].…”

“…Results of multiple mixed-effects linear regression models indicated an inverse cross-sectional relationship between DASH (mean) and BMI (mean) , mainly in women and participants with incomes <125% of poverty. Previous research found that the food intake of this sample tended to resemble the Western diet, with low adherence to the DASH diet [33]. However, the protective effects of the DASH dietary pattern from an increase in BMI with age were observed in the HANDLS study participants.…”

Food processing: criteria for dietary guidance and public health?

“…Further, there are significant concerns about NOVA's actionability and practicality for various lifestyles, skill sets and resource availability. Studies comparing NOVA implementation with vetted plans such as DASH or MyPLATE are needed to show that nutrient intakes and health outcomes are at least equivalent to those from plans that promote the right balance of foods from all levels of processing (2,(72)(73)(74)(75)(76)(166)(167)(168)(169) .…”

Dietary Flavonoid Intakes Are Associated with Race but Not Income in an Urban Population

“…Disparate intake of flavonoid classes by race could be a reflection of cultural food habits [ 11 , 58 ]. Previous research of HANDLS data has revealed food selections varied by race [ 39 , 54 ], which contributed to observed differences in dietary patterns with different 10-year atherosclerotic cardiovascular disease risk [ 39 ]. When compared to AA, W had higher mean Healthy Eating Index (HEI)-2010 scores for the total vegetables and whole fruits components [ 59 ], which would be consistent with W’s observed higher intakes of flavones and flavonols (both found primarily in vegetables) and anthocyanidins (found primarily in fruits, particularly berries and grapes).…”

“…Previously published research indicates the prevalence of risky health behaviors, including a nutrient-poor diet, is high among participants in HANDLS. For instance, Kuczmarski et al found that most HANDLS participants consume a pro-inflammatory Westernized diet [ 39 ]. The Westernized diet is characterized by high intakes of saturated fat, proteins (derived from processed meats), and sugars and low intakes of dietary fiber [ 40 ].…”