Traditional Dietary Pattern Is Associated with Elevated Cholesterol among the Inuit of Nunavik

Our cross-sectional study assessed the associations between dietary patterns and cardiovascular disease (CVD) risk factors among Nunavik Inuit. This study was conducted as part of the 2004 Nunavik Inuit Health Survey, which included the collection of clinical measurements, plasma samples, and diet information from a food frequency questionnaire. A sample of 666 Inuit aged 18 years and older was included in our analyses. Dietary patterns were generated by principal component analysis. Multivariate general linear models adjusting for sex, age, waist circumference, and other potential confounders were used to examine associations between dietary patterns and CVD risk factors. Four distinct patterns were identified, namely the traditional, Western, nutrient-poor food, and healthy patterns. The traditional pattern showed positive associations with plasma total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B100, LDL peak particle diameter, and oxidized LDL (all P values for trend≤0.04), but showed no association with the total cholesterol:high-density lipoprotein cholesterol ratio or with inflammatory biomarkers (all P values for trend ≥0.19). The nutrient-poor food pattern was positively associated with oxidized LDL (P=0.04), but inversely associated with high-sensitivity C-reactive protein (P<0.0001). The Western and healthy patterns showed no association with any CVD risk factor. Our data show that high adherence to a traditional pattern among Nunavik Inuit is not associated with important changes in CVD risk factors, with the exception of a slight elevation in cholesterol concentrations, most likely attributable to increased n-3 fatty acid intake. Dietary patterns reflecting the recent introduction of market foods in the Inuit diet appear to exert a trivial influence on CVD risk factors.     

Dietary Patterns Associated with the Prevalence of Cardiovascular Disease Risk Factors in Kuwaiti Adults

BackgroundKuwaiti adults have experienced a rapid increase in cardiovascular disease (CVD) and its risk factors. Dietary patterns in the Kuwaiti diet associated with the increasingly higher CVD burden have not been adequately evaluated.ObjectiveThe objective of this study was to identify the major dietary patterns in Kuwaiti adults and examine their associations with CVD risk factors.DesignThis cross-sectional study examined data from the 2008-2009 National Nutrition Survey of the State of Kuwait.Participants/settingThe study included 555 Kuwaiti adults aged ≥20 years who completed a 24-hour dietary recall.Main outcome measuresThe outcome measures included CVD risk factors such as obesity (body mass index), abdominal obesity (waist circumference), elevated blood pressure, dyslipidemia (blood lipid levels), diabetes (glucose and glycated hemoglobin levels), and metabolic syndrome.Statistical analysisDietary patterns were identified using principal component analysis. The associations between dietary patterns and CVD risk factors were analyzed using survey-weighted multivariable linear and logistic regression models.ResultsThree dietary patterns were identified: vegetable-rich, fast food, and refined grains/poultry. Younger adults had higher adherence to the fast-food or refined-grains/poultry dietary patterns, whereas older adults had higher adherence to the vegetable-rich dietary pattern. The fast-food dietary pattern was positively associated with body mass index (β=.94, 95% CI 0.08 to 1.79), waist circumference (β=2.05, 95% CI 0.20 to 3.90 cm), and diastolic blood pressure (β=1.62, 95% CI 0.47 to 2.77 mm Hg). The refined grains/poultry dietary pattern was positively associated with plasma glucose levels (β=1.02, 95% CI 1.002 to 1.04 mg/dL [0.056 to 0.058 mmol/L]). Individuals in the highest tertile of the fast-food or refined-grains/poultry dietary patterns had higher odds of metabolic syndrome than those in the lowest tertile.ConclusionsThe fast-food and refined grains/poultry dietary patterns were associated with high prevalence of CVD risk factors among Kuwaiti adults. The current findings underscore the need for prospective studies to further explore dietary pattern and CVD risk factor relationships among at-risk Kuwait adults.     

Suboptimal iron status and associated dietary patterns and practices in premenopausal women living in Auckland, New Zealand

Purpose

To investigate associations between dietary patterns and suboptimal iron status in premenopausal women living in Auckland, New Zealand.

Methods

Premenopausal women (n = 375; 18–44 years) were included in this cross-sectional analysis. Suboptimal iron status was defined as serum ferritin <20 μg/L. Participants completed a 144-item iron food frequency questionnaire (FeFFQ) and a questionnaire on dietary practices to assess dietary intake over the past month. Factor analysis was used to determine dietary patterns from the FeFFQ. Logistic regression was used to determine associations between these dietary patterns and iron status.

Results

Seven dietary patterns were identified: refined carbohydrate and fat; Asian; healthy snacks; meat and vegetable; high tea and coffee; bread and crackers; and milk and yoghurt. Logistic regression suggested that following a “meat and vegetable” dietary pattern reduced the risk of suboptimal iron status by 41 % (95 % CI: 18, 58 %; P = 0.002) and following a “milk and yoghurt” pattern increased the risk of suboptimal iron status by 50 % (95 % CI: 15, 96 %; P = 0.003).

Conclusions

These results suggest that dietary patterns characterized by either a low intake of meat and vegetables or a high intake of milk and yoghurt are associated with an increased risk of suboptimal iron status. Dietary pattern analysis is a novel and potentially powerful tool for investigating the relationship between diet and iron status.     

Dietary patterns and attention deficit hyperactivity disorder among Iranian children

ObjectiveThis study was conducted to assess the relation of major dietary patterns identified by factor analysis to attention-deficit/hyperactivity disorder (ADHD) in a group of Iranian school-age children.MethodsThis cross-sectional study was conducted in 375 school-age children in Tehran, Iran. We assessed usual dietary intakes by a semiquantitative food-frequency questionnaire. The presence of ADHD was diagnosed using the questionnaire of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Major dietary patterns were identified by factor analysis.ResultsThe prevalence of ADHD was 9.7% in this population. We identified four major dietary patterns: “healthy,” “Western,” “sweet,” and “fast food.” After controlling for potential confounders, children in the top quintile of the sweet dietary pattern score had greater odds for having ADHD compared with those in the lowest quintile (odds ratio 3.95, 95% confidence interval 1.16–15.31, P for trend = 0.03). Greater adherence to the fast-food dietary pattern was significantly associated with a higher risk of having ADHD (odds ratio 3.21, 95% confidence interval 1.05–10.90, P for trend = 0.03). No overall significant associations were seen between the healthy or Western dietary pattern and ADHD.ConclusionWe found significant independent associations between the sweet and fast-food dietary patterns and the prevalence of ADHD. Prospective studies are required to confirm these findings.     

Prevalence of Metabolic Syndrome and Associated Risk Factors in Asian Indians

OBJECTIVE: This study examined the association between metabolic syndrome, lifestyle behaviors, and perception and knowledge of current health and cardiovascular disease (CVD) among Asian Indians in the US. METHOD: The sample comprised of 143 adult Asian Indians recruited through health fairs for survey and bioclinical measures. RESULTS: The prevalence of metabolic syndrome was 32%, much higher than other ethnic groups, did not vary by gender but increased with age. Respondents had high physical inactivity and poor knowledge of CVD risk factors. Dietary behavior, age, number of years lived in the US, self-rated physical and mental health and BMI were significant predictors and explained 40.1% of variance in metabolic syndrome score. Poorer physical health status had the greatest predictive influence on metabolic syndrome. CONCLUSION: Asian Indians are a high risk group for CVD.     

Dietary Patterns and Colon Cancer Risk in Whites and African Americans in the North Carolina Colon Cancer Study

We examined associations of dietary patterns with colon cancer risk in African Americans and Whites from a case-control study in North Carolina. Incident colon cancer cases, 40 to 80 yr (n = 636), and matched controls (n = 1,042) were interviewed in person to elicit information on potential colon cancer risk factors. A validated food frequency questionnaire adapted to include regional foods captured diet over the year prior to diagnosis (cases) or interview date (controls). Three meaningful intake patterns were identified in both Whites and African Americans: “Western-Southern,” “fruit-vegetable,” and “metropolitan.” Compared to the Western-Southern pattern, the fruit-vegetable and metropolitan patterns were associated with more healthful dietary behaviors (e.g., higher vegetable intake and lower red meat consumption), and demographic/lifestyle characteristics typically correlated with low colon cancer risk, for example, lower BMI, higher education, and higher NSAID use. The fruit-vegetable pattern was significantly inversely associated with colon cancer risk in Whites (OR = 0.4, 95% CI = 0.3–0.6) and the metropolitan pattern with a nonsignificant 30% risk reduction in both Whites and African Americans after adjustment for education. The Western-Southern pattern was not associated with colon cancer risk. These findings may explain some of the racial differences in colon cancer incidence and underscore the importance of examining diet-cancer associations in different population subgroups.     

Understanding the role of depression and anxiety on cardiovascular disease risk, using structural equation modeling; the mediating effect of the Mediterranean diet and physical activity: the ATTICA study

PurposeTo evaluate the mediating role of behavioral patterns, such as adherence to the Mediterranean diet and physical activity status, in the relationship between depression, anxiety, and the cardiovascular disease (CVD) risk score HellenicSCORE.MethodsIn the context of the ATTICA study, a cross-sectional survey, 453 men (45 ± 13 years) and 400 women (44 ± 18 years), with complete psychological evaluation were studied. Participants were without any evidence of cardiovascular or other chronic disease. Depression was assessed with the Zung Self-Rating Depression Scale and anxious state by the Spielberger State Anxiety Inventory Scale. Physical activity was assessed using the International Physical Activity Questionnaire and adherence to the Mediterranean diet was assessed by the MedDietScore. Structural equation modeling methodology was implemented in the statistical analysis.ResultsFive latent depression and anxiety factors were revealed and associated with CVD risk score through mediation of physical activity status and adherence to the Mediterranean diet with very good fit to the data (χ²/df ratio = 2.34; root mean square error of approximation = 0.021; 90% confidence interval, 0.020–0.022; comparative fit index = 0.951). Significant total effect on CVD risk was found for the “anxiety–worry” latent factor, and this effect was through the inverse relationship of “anxiety–worry” with MedDietScore (P = .002). Moreover, “positive feelings” latent construct was associated with lower CVD risk, and this seems to be through the higher adherence to the Mediterranean diet (P = .01).ConclusionsAdherence to the Mediterranean diet seems to mediate the unfavorable effect of depression and anxiety on CVD risk.     

Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk

BACKGROUND: Although the effects of individual foods or nutrients on the development of diseases and their risk factors have been investigated in many studies, little attention has been given to the effect of overall dietary patterns. OBJECTIVE: Our objective was to examine the associations of 2 major dietary patterns, Western and prudent, with biomarkers of obesity and cardiovascular disease (CVD) risk. DESIGN: We used factor analysis to define major dietary patterns for a subsample of men (n = 466) from the Health Professionals Follow-up Study by using dietary information collected from food-frequency questionnaires (FFQs) in 1994. We calculated partial correlation coefficients between pattern scores and biomarker values adjusted for age, smoking status, energy and alcohol intake, physical activity, hours of television watching, and body mass index. RESULTS: We derived 2 major dietary patterns that were generally reproducible over time. The first pattern (prudent) was characterized by higher intakes of fruit, vegetables, whole grains, and poultry. The second pattern (Western) was characterized by higher intakes of red meats, high-fat dairy products, and refined grains. Using pattern scores from 1994 and adjusting for potential confounders, we found significant positive correlations between the Western pattern and insulin, C-peptide, leptin, and homocysteine concentrations, and an inverse correlation with plasma folate concentrations. The prudent pattern was positively correlated with plasma folate and inversely correlated with insulin and homocysteine concentrations. CONCLUSION: Major dietary patterns are predictors of plasma biomarkers of CVD and obesity risk, suggesting that the effect of overall diet on CVD risk may be mediated through these biomarkers.     

Diet Quality Assessment and the Relationship between Diet Quality and Cardiovascular Disease Risk

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the U.S. and globally. Dietary risk factors contribute to over half of all CVD deaths and CVD-related disability. The aim of this narrative review is to describe methods used to assess diet quality and the current state of evidence on the relationship between diet quality and risk of CVD. The findings of the review will be discussed in the context of current population intake patterns and dietary recommendations. Several methods are used to calculate diet quality: (1) a priori indices based on dietary recommendations; (2) a priori indices based on foods or dietary patterns associated with risk of chronic disease; (3) exploratory data-driven methods. Substantial evidence from prospective cohort studies shows that higher diet quality, regardless of the a priori index used, is associated with a 14–29% lower risk of CVD and 0.5–2.2 years greater CVD-free survival time. Limited evidence is available from randomized controlled trials, although evidence shows healthy dietary patterns improve risk factors for CVD and lower CVD risk. Current dietary guidance for general health and CVD prevention and management focuses on following a healthy dietary pattern throughout the lifespan. High diet quality is a unifying component of all dietary recommendations and should be the focus of national food policies and health promotion.     

Smoking cessation and prevention: an urgent public health priority for American Indians in the Northern Plains

OBJECTIVE: The purpose of this study was to compare the prevalence of cigarette smoking and smoking cessation among American Indians living on or near Montana's seven reservations to those of non-Indians living in the same geographic region. METHODS: Data for Montana Behavioral Risk Factor Surveillance System (BRFSS) respondents (n = 1,722) were compared to data from a BRFSS survey of American Indians living on or near Montana's seven reservations in 1999 (n = 1,000). Respondents were asked about smoking and smoking cessation as well as cardiovascular disease (CVD) and selected risk factors. Quit ratios were calculated for both groups. RESULTS: American Indians were more likely to report current smoking (38%) than non-Indians (19%; p < 0.001). Thirty-seven percent of Indian respondents with CVD risk factors reported current smoking, compared with 17% of non- Indians with CVD risk factors. However, there was no significant difference in reported smoking rates between Indians (21%) and non-Indians (27%) with a history of CVD. Indian smokers were more likely to report quitting for one or more days in the past year (67%), compared with non-Indians (43%). Quit ratios were significantly lower among Indians (43%) than among non-Indians (65%). CONCLUSIONS: High smoking rates in Indians, particularly among those with other CVD risk factors, demonstrate an urgent need for culturally sensitive smoking cessation interventions among Northern Plains Indians and highlight the need for the Surgeon General's focus on smoking in minority populations.     

Measuring dietary acculturation in Japanese Americans with the use of confirmatory factor analysis of food-frequency data

BACKGROUND: Epidemiologic evidence suggests that dietary changes associated with acculturation to a Western diet may increase the risk of type 2 diabetes in Japanese Americans. OBJECTIVE: We hypothesized that dietary acculturation patterns could be measured by confirmatory factor analysis (CFA) by using a culturally sensitive food-frequency questionnaire (FFQ). We examined the utility of the estimated factor scores by testing for associations with diabetes and 2 risk factors for diabetes-body mass index (BMI; in kg/m(2)) and C-reactive protein (CRP). DESIGN: By using cross-sectional data from a sample of 219 Nisei (second-generation Japanese American; mean age 70 y) and 277 Sansei (third-generation Japanese American; mean age 42 y) participants in the Japanese American Family Study, we conducted CFA on 5 items characteristic of a Japanese diet and 4 items characteristic of a Western diet. The resulting factor scores were examined for associations with diabetes by using logistic regression and for associations with BMI and CRP by using linear regression. RESULTS: CFA confirmed the presence of Japanese and Western food factors. The Nisei had a significantly higher average factor score for the Japanese food factor and significantly lower average factor score for the Western food factor than did the Sansei. In Sansei persons, but not in Nisei persons, the Western food factor score was significantly associated with plasma CRP concentration (P = 0.02), BMI (P = 0.02), and diabetes (P = 0.001). CONCLUSIONS: In this Japanese American sample, dietary acculturation can be estimated by using CFA on FFQ data. Future studies should investigate the effects of dietary acculturation on disease risk independent of other lifestyle factors.     

Prevalence of metabolic syndrome risk factors among young adult Asian Indians

Metabolic syndrome has a high prevalence within the U.S population. Asian Indians have a greater prevalence of the chronic diseases associated with this syndrome compared to Caucasians. This study aimed to determine the prevalence of risk factors of metabolic syndrome in young adult Asian Indians. Behavioral risk factors, dietary intake, and anthropometric measurements were assessed on all study participants (n = 50). The mean BMI was 23.2 and 20.4, waist circumference was 87 and 79 cm, and percent body fat was 16 and 26% for males and females, respectively. Macronutrient contributions to the total energy intake were: carbohydrate 55% for males and females, protein 14 and 12% for males and females respectively, and total fat 31 and 33% for males and females, respectively. Using the definition of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, ATP III), these Asian Indians did not appear to be at high risk for developing metabolic syndrome. However, using the newly proposed recommendations for Asian Indians, the results suggest that this group may be at risk for developing metabolic syndrome.     

Cardiovascular risk factors in Montana American Indians with and without diabetes

BACKGROUND: Cardiovascular disease (CVD) and diabetes are prevalent and of major concern for American-Indian communities in the United States. Health professional counseling is effective in increasing patient awareness and inducing lifestyle modification. The objective of this study was to compare the prevalence of CVD, modifiable risk factors and counseling for smoking cessation, physical activity, and a healthy diet in adult American Indians with and without diabetes. METHODS: A random sample of adult American Indians living on or near the seven Montana reservations was interviewed through an adapted Behavioral Risk Factor Surveillance System telephone survey in 1999 (N=1000) and 2001 (N=1006). RESULTS: Respondents with diabetes, compared to those without, had a significantly higher prevalence of CVD (27% vs 8%); overweight (89% vs 71%); high blood pressure (57% vs 24%); and high cholesterol (44% vs 22%). There were no differences for insufficient physical activity (60% vs 51%) or smoking (34% vs 41%) after adjustment for age, gender, and survey year. Respondents with diabetes, compared to respondents without diabetes, were significantly more likely to report health professional counseling for smoking cessation (83% vs 58%); physical activity (73% vs 37%); and reduced fat consumption (57% vs 24%). CONCLUSIONS: The prevalence of modifiable CVD risk factors was alarmingly high among adult American Indians with and without diabetes. Strategies to increase health professional counseling for healthy diet and smoking cessation are needed.     

The relationship among cardiovascular risk factors, diet patterns, alcohol consumption, and ethnicity among women aged 50 years and older

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among women of all races and ethnicities. The risk of developing the disease is greater in postmenopausal women. OBJECTIVE: The purpose of this study was to use cluster analysis to examine diet patterns and to examine the association between diet patterns and the presence of major cardiovascular disease risk factors. DESIGN: Data from the cross-sectional National Health and Nutrition Examination Survey (NHANES) 2001-2002 were used. SUBJECTS/SETTING: Women aged 50 years and older were included (n=1,313). MAIN OUTCOME MEASURES: The following major CVD risk factors were examined: being overweight or obese (body mass index >24.9), having elevated systolic blood pressure (>120 mm Hg), and having low levels of high-density lipoprotein cholesterol (<50 mg/dL [<1.30 mmol/L]). Dietary patterns were derived by cluster analysis using data from a 24-hour dietary recall. STATISTICAL ANALYSES PERFORMED: Odds Ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression to determine the probability of having a risk factor according to diet pattern while accounting for race/ethnicity, physical activity, age, and smoking. RESULTS: Cluster analysis generated six nonoverlapping diet patterns labeled: Pasta and Yellow Vegetables; Sweets; Beef, Starches, Fruits, and Milk; Frozen Meals, Burritos, and Pizza; Meat Dishes; and Soft Drinks and Poultry. The majority of the women were grouped in the Sweets diet pattern. Factors associated with adequate levels of high-density lipoprotein cholesterol included being non-Hispanic African American (OR 0.59, 95% CI 0.44 to 0.81; P<0.0001), alcohol consumption (OR 0.76, 95% CI 0.69 to 0.84; P<0.0001), and being assigned to the Sweets diet pattern (OR 0.27, 95% CI 0.14 to 0.50; P<0.0001) or Meat dishes diet pattern (OR 0.94, 95% CI 0.54 to 1.65; P<0.0075). The Sweets pattern was also associated with having normal systolic blood pressure levels (OR 0.51, 95% CI 0.34 to 0.76; P<0.0001). Individuals grouped in the Beef, Starches, and Milk diet pattern were more likely to have an adequate body mass index (OR 0.42, 95% CI 0.23 to 0.77; P<0.0032). CONCLUSIONS: Significant associations between dietary patterns and major CVD risk factors were observed. Food and nutrition professionals can use this information to assess unhealthful food choices observed in the dietary patterns to guide nutrition recommendations and help reduce the incidence of CVD risk factors. Future research should aim to evaluate dietary intake via complementary methods (ie, dietary patterns and nutrient assessment) to better understand diet-disease relationships.     

The Relationship Between Dietary Acculturation and Type 2 Diabetes Risk Among Asian Indians in the U.S.

Asian Indians have a high prevalence of type 2 diabetes in the U.S. (17.4–29 %). This study examined the relationship between dietary acculturation of Asian Indians in the U.S. and their future risk for type 2 diabetes. A validated Asian Indian Dietary Acculturation Measure (AIDAM) and the Finnish Diabetes Risk Score (FINDRISC) were completed by 153 Asian Indians in the U.S. via a cross-sectional web-survey. Correlations and relative risk ratios were used to examine the association between AIDAM and FINDRISC. A significantly larger proportion of Non-Indian Oriented participants (44.7 %) had higher FINDRISC scores (scores 7–26) compared to the Asian Indian Oriented group (27.9 %) (p = .024), and also had increased relative predictive risk for type 2 diabetes (relative risk ratio = 1.6). A positive association between dietary acculturation and diabetes risk was evident in our sample, which highlights the importance of assessing dietary acculturation in non-native groups when investigating type 2 diabetes risk factors.     

A healthy dietary pattern consisting of a variety of food choices is inversely associated with the development of metabolic syndrome

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.     

Dietary patterns associated with risk factors for cardiovascular disease in healthy US adults

BACKGROUND: Certain nutrients are well established as dietary risk factors for cardiovascular disease (CVD), but dietary patterns may be a better predictor of CVD risk. OBJECTIVE: This study tested the hypothesis that the complex dietary behaviors of US adults can be grouped into major dietary patterns that are related to risk factors for CVD. DESIGN: With the use of food-frequency questionnaire data from the third National Health and Nutrition Examination Survey, dietary patterns of healthy US adults (>/or =20 y old; n = 13 130) were identified by factor analysis. Log-transformed biomarker data were associated with major dietary patterns after control for confounding variables in regression analyses. All statistical analyses accounted for the survey design and sample weights. RESULTS: Of 6 dietary patterns identified, 2 patterns emerged as the most predominant: the Western pattern was characterized by high intakes of processed meats, eggs, red meats, and high-fat dairy products, and the American-healthy pattern was characterized by high intakes of green, leafy vegetables; salad dressings; tomatoes; other vegetables (eg, peppers, green beans, corn, and peas); cruciferous vegetables; and tea. The Western pattern was associated (P < 0.05) positively with serum C-peptide, serum insulin, and glycated hemoglobin and inversely with red blood cell folate concentrations after adjustment for confounding variables. The American-healthy pattern had no linear relation with any of the biomarkers examined. CONCLUSIONS: The identification of common dietary patterns among free-living persons is promising for characterizing high-risk groups at the US population level. The dietary patterns identified here are similar to those reported in other nonrepresentative samples and are associated with biomarkers of CVD risk, which confirms that dietary pattern analysis can be a valuable method for assessing dietary intakes when predicting CVD risk.     

Cardiovascular disease and risk factors in Montana American Indians and non-Indians

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death for both American Indian and non-Indian adults. Few published studies have compared the prevalence of CVD and related risk factors in Indians to that in non-Indians in the same geographic area. OBJECTIVE: To compare CVD and risk factors in American Indian and non-Indian populations in Montana. METHODS: Adult American Indians (n=1000) living on or near Montana's seven reservations and non-Indian (n=905) Montanans statewide were interviewed through the 1999 Behavioral Risk Factor Surveillance Survey (BRFSS). RESULTS: Indians aged > or =45 years reported a significantly higher prevalence of CVD compared to non-Indians (18% vs 10%). In persons aged 18-44 years, Indians were more likely to report hypertension (15% vs 10%), obesity (29% vs 12%), and smoking (42% vs 24%) compared to non-Indians. For persons aged > or =45 years, Indians reported higher rates of diabetes (24% vs 9%), obesity (38% vs 16%), and smoking (32% vs 13%) compared to non-Indians. Non-Indians aged > or =45 years reported having been diagnosed with high cholesterol more frequently than did Indians (32% vs 24%). CONCLUSIONS: Both Indians and non-Indians in Montana reported a substantial burden of CVD. The CVD risk patterns differ in the two populations. Prevention programs should be tailored to the risk burdens in these communities with particular emphasis on smoking cessation and the prevention of obesity.     

Dietary Patterns Are Differentially Associated with Atypical and Melancholic Subtypes of Depression

Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to (1) identify dietary patterns with exploratory factor analysis, (2) assess cross-sectional associations between dietary patterns and depression subtypes, and (3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009–2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.     

Associations Between Dietary Patterns and Longitudinal Quality of Life Changes in Colorectal Cancer Patients: The ColoCare Study

Quality of life (QoL) is an important clinical outcome in cancer patients. We investigated associations between dietary patterns and QoL changes in colorectal cancer (CRC) patients. The study included 192 CRC patients with available EORTC QLQ-C30 data before and 12 months post-surgery and food frequency questionnaire data at 12 months post-surgery. Principal component analysis was used to identify dietary patterns. Multivariate regression models assessed associations between dietary patterns and QoL changes over time. We identified four major dietary patterns: “Western” dietary pattern characterized by high consumption of potatoes, red and processed meat, poultry, and cakes, “fruit&vegetable” pattern: high intake of vegetables, fruits, vegetable oils, and soy products, “bread&butter” pattern: high intake of bread, butter and margarine, and “high-carb” pattern: high consumption of pasta, grains, nonalcoholic beverages, sauces and condiments. Patients following a “Western” diet had lower chances to improve in physical functioning (OR = 0.45 [0.21–0.99]), constipation (OR = 0.30 [0.13–0.72]) and diarrhea (OR: 0.44 [0.20–0.98]) over time. Patients following a “fruit&vegetable” diet showed improving diarrhea scores (OR: 2.52 [1.21–5.34]. A “Western” dietary pattern after surgery is inversely associated with QoL in CRC patients, whereas a diet rich in fruits and vegetables may be beneficial for patients' QoL over time.