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Original Research Communication |
1 From the Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; the Department of Laboratory Medicine, Children's Hospital, Harvard Medical School, Boston; and the Cardiology Department, Royal North Shore Hospital, St Leonards, Australia.
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.
Key Words: Dietary patterns • biomarker • cardiovascular disease • leptin • Western diet • prudent diet • Health Professionals Follow-up Study • food-frequency questionnaire
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W. Willett, M. Stampfer, N.-F. Chu, D. Spiegelman, M. Holmes, and E. Rimm Assessment of Questionnaire Validity for Measuring Total Fat Intake using Plasma Lipid Levels as Criteria Am. J. Epidemiol., December 15, 2001; 154(12): 1107 - 1112. [Abstract] [Full Text] [PDF]
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E. Wirfalt, B. Hedblad, B. Gullberg, I. Mattisson, C. Andren, U. Rosander, L. Janzon, and G. Berglund Food Patterns and Components of the Metabolic Syndrome in Men and Women: A Cross-sectional Study within the Malmo Diet and Cancer Cohort Am. J. Epidemiol., December 15, 2001; 154(12): 1150 - 1159. [Abstract] [Full Text] [PDF]
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E. Giovannucci Insulin, Insulin-Like Growth Factors and Colon Cancer: A Review of the Evidence J. Nutr., November 1, 2001; 131(11): 3109S - 3120. [Abstract] [Full Text] [PDF]
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T. T. Fung, W. C. Willett, M. J. Stampfer, J. E. Manson, and F. B. Hu Dietary Patterns and the Risk of Coronary Heart Disease in Women Arch Intern Med, August 13, 2001; 161(15): 1857 - 1862. [Abstract] [Full Text] [PDF]
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G. L Blackburn The public health implications of the Dietary Approaches to Stop Hypertension Trial Am. J. Clinical Nutrition, July 1, 2001; 74(1): 1 - 2. [Full Text] [PDF]
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