TY - JOUR
T1 - Prospective investigation of major dietary patterns and risk of cardiovascular mortality in Bangladesh
AU - Chen, Yu
AU - McClintock, Tyler R.
AU - Segers, Stephanie
AU - Parvez, Faruque
AU - Islam, Tariqul
AU - Ahmed, Alauddin
AU - Rakibuz-Zaman, Muhammad
AU - Hasan, Rabiul
AU - Sarwar, Golam
AU - Ahsan, Habibul
N1 - Funding Information:
The research is supported by the US National Institute of Health funding. The National Institute of Environmental Health Sciences and the National Cancer Institute provide support under the following grants: P42ES010349 , R01ES017541 , R01CA102484 , R01CA107431 , R01ES017541 , R01ESO11601 , P30ES09089 , CA016087 , ES000260 , and CA014599 .
PY - 2013/8/20
Y1 - 2013/8/20
N2 - Background: Dietary pattern analysis is emerging as a practical, effective tool for relating comprehensive dietary intake to risk of cardiovascular disease mortality. However, no studies have applied this technique to a population outside of the developed world. Methods: We conducted prospective cohort analyses in 11,116 participants enrolled in the Health Effects of Arsenic Study in Araihazar, Bangladesh, measuring deaths attributable to disease of circulatory system, heart disease, and cerebrovascular disease. Participants were enrolled in 2000 and followed up for an average of 6.6 years. Dietary information was obtained through a previously validated food-frequency questionnaire at baseline. Results: Principal component analysis based on our comprehensive, 39 item FFQ yielded 3 dietary patterns: (i) a balanced pattern, comprised of steamed rice, red meat, fish, fruit and vegetables; (ii) an animal protein diet, which was more heavily weighted towards eggs, milk, red meat, poultry, bread, and vegetables; and (iii) a gourd and root vegetable diet that heavily relied on a variety of gourds, radishes, pumpkin, sweet potato, and spinach. We observed a positive association between increasing adherence to the animal protein diet and risk of death from both disease of the circulatory system and heart disease; the hazard ratios were 1.13 (95% CI, 1.00-1.28, p = 0.05) and 1.17 (95% CI, 0.99-1.38, p = 0.07), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern, after controlling for age, sex, body mass index, smoking status, and energy intake. The positive association was more significant among ever smokers; the hazard ratios (95% CI) for deaths from disease of the circulatory system and heart disease were 1.17 (1.02-1.34) and 1.20 (1.00-1.45), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern. Conclusions: An animal protein-rich diet in rural Bangladesh may increase risk of heart disease mortality, especially among smokers. This emphasizes the need to further explore and address the impact of dietary patterns on cardiovascular disease in populations undergoing epidemiologic transition.
AB - Background: Dietary pattern analysis is emerging as a practical, effective tool for relating comprehensive dietary intake to risk of cardiovascular disease mortality. However, no studies have applied this technique to a population outside of the developed world. Methods: We conducted prospective cohort analyses in 11,116 participants enrolled in the Health Effects of Arsenic Study in Araihazar, Bangladesh, measuring deaths attributable to disease of circulatory system, heart disease, and cerebrovascular disease. Participants were enrolled in 2000 and followed up for an average of 6.6 years. Dietary information was obtained through a previously validated food-frequency questionnaire at baseline. Results: Principal component analysis based on our comprehensive, 39 item FFQ yielded 3 dietary patterns: (i) a balanced pattern, comprised of steamed rice, red meat, fish, fruit and vegetables; (ii) an animal protein diet, which was more heavily weighted towards eggs, milk, red meat, poultry, bread, and vegetables; and (iii) a gourd and root vegetable diet that heavily relied on a variety of gourds, radishes, pumpkin, sweet potato, and spinach. We observed a positive association between increasing adherence to the animal protein diet and risk of death from both disease of the circulatory system and heart disease; the hazard ratios were 1.13 (95% CI, 1.00-1.28, p = 0.05) and 1.17 (95% CI, 0.99-1.38, p = 0.07), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern, after controlling for age, sex, body mass index, smoking status, and energy intake. The positive association was more significant among ever smokers; the hazard ratios (95% CI) for deaths from disease of the circulatory system and heart disease were 1.17 (1.02-1.34) and 1.20 (1.00-1.45), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern. Conclusions: An animal protein-rich diet in rural Bangladesh may increase risk of heart disease mortality, especially among smokers. This emphasizes the need to further explore and address the impact of dietary patterns on cardiovascular disease in populations undergoing epidemiologic transition.
KW - Bangladesh
KW - Cardiovascular disease
KW - Coronary heart disease
KW - Dietary patterns
KW - Epidemiologic transition
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U2 - 10.1016/j.ijcard.2012.04.041
DO - 10.1016/j.ijcard.2012.04.041
M3 - Article
C2 - 22560940
AN - SCOPUS:84881481060
SN - 0167-5273
VL - 167
SP - 1495
EP - 1501
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 4
ER -