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This Article Full Text Full Text (PDF) All Versions of this Article: 90/3/647    most recent ajcn.2009.27597v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Nettleton, J. A Articles by Jacobs, D. R PubMed PubMed Citation Articles by Nettleton, J. A Articles by Jacobs, D. R, Jr Agricola Articles by Nettleton, J. A Articles by Jacobs, D. R

Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis^1,2,3

¹ From the Division of Epidemiology, University of Texas Health Sciences Center School of Public Health, Houston, TX (JAN); the Department of Radiology, Tufts Medical Center, Boston, MA (JFP); the Department of Pathology and Biochemistry, University of Vermont, School of Medicine, Burlington, VT (RT); and the Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (GLB); the Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN and the Department of Nutrition, University of Oslo, Oslo, Norway (DRJ).

² Supported by contracts N01-HC-95159 through N01-HC-95166 from the National Heart, Lung, and Blood Institute and by General Clinical Research Center grant M01-RR00645 from the National Center for Research Resources.

³ Address correspondence to JA Nettleton, Division of Epidemiology, School of Public Health, University of Texas Health Sciences Center, 1200 Herman Pressler, RAS E-641, Houston, TX 77030. E-mail: jennifer.a.nettleton{at}uth.tmc.edu.

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.