|Van Horn, Linda|
Submitted to: Nutrition, Physical Activity and Metabolism Conference
Publication Type: Abstract Only
Publication Acceptance Date: 12/13/2007
Publication Date: 4/1/2008
Citation: Lichtenstein, A.H., Tian, L., Matthan, N., Neuhouser, M., Van Horn, L. 2008. Dietary Patterns Predict Subsequent Coronary Heart Disease Risk In Postmenopausal Women : The Women’s Health Initiative Observational Cohort Study. Nutrition, Physical Activity and Metabolism Conference. EPI-08-A-345-AHA. Interpretive Summary:
Technical Abstract: Background: Evidence suggests that dietary patterns predispose to the development of coronary heart disease (CHD). The relationship between dietary patterns and CHD risk was assessed in postmenopausal women participating in the Women’s Health Initiative Observational Study (WHI-OS). Methods: Case-control study, matching criteria were age, date of enrollment, race/ethnicity and absence of CHD at baseline. A total of 2448 women with complete dietary data were studied, 1224 cases with centrally confirmed CHD, fatal or non-fatal MI, and 1224 controls free of CHD or MI, angina, CABG/PTCA, CHF, stroke or peripheral vascular disease. Baseline data for 43 nutrient/food intakes from the WHI Food Frequency Questionnaire were analyzed. Subjects were clustered into groups based on constructed principal components analysis using K-mean method. CHD risk was compared across the groups based on odds ratios using conditional logistic regression. Results: The first five principal components accounted for >60% of the variance in the 43 nutrient/food group intakes of the cases and controls. Three major eating patterns (groups) were formed driven mainly by the value of the first principal component, a weighted sum of the 43 nutrient/food intakes. Using cluster 2 (n=1122) as the reference group, the odds ratio of CHD for clusters 1 (n=674) and 3 (n=652) were 1.27 and 0.76, respectively (p <0.01). Comparisons of the average intakes and risk of CHD among the three dietary patterns are shown in the table. Conclusion: In this case-control study of free-living postmenopausal women participating in the WHI-OS, distinct dietary patterns reported at baseline were associated with subsequent CHD risk. The pattern associated with lowest risk (group 3) was characterized by a diet rich in vegetables, fruits and fish, and is consistent with current dietary recommendations for CHD prevention.