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Dietary pattern, the metabolic syndrome, and left ventricular mass and systolic function: the Multi-Ethnic Study of Atherosclerosis^1,2,3

¹ From the Department of Epidemiology & Biostatistics, Drexel University School of Public Health, Philadelphia, PA (LL); the Department of Epidemiology, University of Texas Health Sciences Center, Houston, TX (JAN); the Department of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC (AGB); the National Institutes of Health/Clinical Center, Bethesda, MD (DAB); and the Departments of Cardiology (JAL) and Epidemiology (MS), Johns Hopkins University, Baltimore, MD.

² Supported by contracts N01-HC-95159 through N01-HC-95166, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute.

³ Address correspondence to L Liu, Drexel University School of Public Health, Department of Epidemiology & Biostatistics, 1505 Race Street, Philadelphia, PA 19102. E-mail: longjian.liu{at}drexel.edu.

Background: Little is known about the relations between dietary patterns, metabolic dysfunction, and left ventricular (LV) function.

Objective: The objective was to examine associations of dietary patterns with LV mass and function and to explore the potential role of metabolic dysfunction in the association between diet and LV function.

Design: Dietary patterns that maximally explained the variation in metabolic syndrome (MetSyn) components were derived by using reduced rank regression (RRR). LV mass, stroke volume, and LV ejection fraction (LVEF) were measured by magnetic resonance imaging. Associations between dietary pattern and LV indexes were analyzed cross-sectionally.

Results: A total of 4601 participants aged 45–84 y and free of clinical cardiovascular disease were studied. The primary RRR dietary pattern score was positively correlated with intake of foods with a high glycemic index, high-fat meats, cheeses, and processed foods and negatively correlated with low intakes of vegetables, soy, fruit, green and black tea, low-fat dairy desserts, seeds and nuts, and fish. Multivariate analyses showed that each 1-unit increase in the RRR dietary pattern score was associated with a 0.32-g/m² increase in LV mass/body surface area, a 0.43-mL/m² decrease in stroke volume/body surface area, and a 0.21% decrease in LVEF. The associations of the RRR dietary pattern score with LV mass and stroke indexes were attenuated and became nonsignificant after adjustment for all MetSyn components (P > 0.05).

Conclusions: The results suggest that the RRR dietary pattern is significantly associated with unfavorable LV function, and this association might be mediated by metabolic dysfunction. Given the cross-sectional nature of our study, these results must be confirmed with the use of longitudinal data.