(27-03-12) Dietary patterns matter: diet beverages and cardiometabolic risks in the longitudinal Coronary Artery Risk

Dietary patterns matter: diet beverages and cardiometabolic risks in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study1,2,3
1. Kiyah J Duffey,
2. Lyn M Steffen,
3. Linda Van Horn,
4. David R Jacobs Jr, and
5. Barry M Popkin
+Author Affiliations
1. 1From the Department of Nutrition, Gillings Global School of Public Health (KJD and BMP), and the Carolina Population Center (BMP), University of North Carolina at Chapel Hill, Chapel Hill, NC; the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (LVH); the Division of Epidemiology and Community Health (LMS) and the Department of Epidemiology (DRJ), School of Public Health, University of Minnesota, Minneapolis, MN; and the Department of Nutrition, University of Oslo, Oslo, Norway (DRJ).
+Author Notes
? ↵2 Supported by the NIH (R01 HL104580 and HL114091, R01-CA109831, R01-CA121152, K01-HD044263, R01-AA12162, and DK056350); the University of North Carolina at Chapel Hill (UNC-CH) Center for Environmental Health and Susceptibility (NIH P30-ES10126); the UNC-CH Clinic Nutrition Research Center (NIH DK56350); the Carolina Population Center; the University of Alabama at Birmingham, Coordinating Center (N01-HC-95095); the University of Alabama at Birmingham, Field Center (N01-HC-48047); the University of Minnesota, Field Center (N01-HC-48048); the Northwestern University, Field Center (N01-HC-48049); and the Kaiser Foundation Research Institute (N01-HC-48050 from the National Heart, Lung, and Blood Institute).
? ↵3 Address correspondence and reprint requests to KJ Duffey, Department of Nutrition, University of North Carolina at Chapel Hill, University Square, CB 8120, 123 West Franklin Street, Chapel Hill, NC 27516-3997. E-mail: [email protected].
Abstract
Background: Although diet beverages are typically consumed to promote weight control, positive associations with increased cardiometabolic risk have been reported.
Objective: The objective was to examine the joint and independent association between dietary pattern and diet beverage consumption with 20-y cardiometabolic risk.
Design: We analyzed a prospective 20-y cohort of young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. With the use of cluster analysis, we identified 2 baseline (year 0) dietary patterns [Prudent (higher intakes of fruit, whole grains, milk, and nuts and seeds; n = 1778) and Western (higher intakes of fast food, meat and poultry, pizza, and snacks; n = 2383)] and examined the interaction with diet beverage consumption (Consumers compared with Nonconsumers) by using proportional hazards regression models.
Results: Among Consumers, 66% were classified as having a Prudent diet. In fully adjusted models, being a Nonconsumer with a Prudent diet was independently associated with a lower risk of the metabolic syndrome through year 20. Lower risk in the Prudent than in the Western dietary pattern was maintained after stratification by diet beverage consumption: Prudent Nonconsumers had the lowest risk of high waist circumference (HR: 0.78; 95% CI: 0.62, 0.97), high triglycerides (HR: 0.72; 95% CI: 0.56, 0.93), and the metabolic syndrome (HR: 0.64; 95% CI: 0.50, 0.82) compared with Western Consumers.
Conclusions: Our results suggest that both overall dietary pattern and diet beverage consumption are important, to various degrees, for different metabolic outcomes. This covariation and interaction may partially explain differences in the relation between diet beverage consumption and cardiometabolic health observed in previous studies.

Source: Am J Clin Nutr April 2012 vol. 95 no. 4 909-915

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