Dietary patterns and the odds of carotid atherosclerosis in women: The framingham nutrition studies

Background. We prospectively examined the relationship between dietary patterns, assessed using cluster analysis and a food frequency questionnaire, and the presence of carotid artery stenosis, a subclinical marker of atherosclerotic disease. Methods. Analyses were conducted among 1,423 Framingham Study women without cardiovascular disease (CVD) at baseline (1984-1988). Carotid atherosclerosis (stenosis greater than or equal to 25%) was measured by ultrasound 12 years later. Results. Baseline differences in risk factor profiles were notable across five dietary subgroups. Compared to the more desirable profiles of women with Heart Healthy eating patterns, women who had Light Eating, High Fat, or Empty Calorie diets had higher rates of dyslipidemia and smoking and lower levels of physical activity. At follow-up, the prevalence of carotid atherosclerosis ranged from 6.8% in the Heart Health group to 17.8% in the Empty Calorie group. Compared with Heart Health women, all other groups displayed higher age-adjusted odds for carotid stenosis. In multivariate analyses, those with Empty Calorie diets had more than twofold increased odds of carotid atherosclerosis compared to Heart Health women (OR 2.28, 95% CI [1.12, 4.62]; P < 0.05). Conclusion. The association among unique dietary patterns, CVD risk factor profiles, and the presence of subclinical atherosclecosis identifies candidates and strategies for preventive behavioral interventions to promote the primary prevention of heart disease. (C) 2002 American Health Foundation and Elsevier Science (USA).