Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort
Hye A h Lee, The American Journal of Clinical Nutrition,2020
Background
Dietary patterns (DPs) provide a comprehensive picture of the foods consumed by an individual.
Objectives
Using 12-y follow-up data from the Korean Genome Epidemiology Study (KoGES), we determined the associations of DPs with incident cardiovascular disease (CVD) using reduced rank regression (RRR).
Methods
This study analyzed the data of 7354 CVD-free subjects aged 40–69 y drawn from the community-based KoGES cohort. Based on the daily intake of 26 food groups at baseline, we identified DPs based on retinol, vitamin B-2 (riboflavin), and vitamin B-3 (niacin) intakes using RRR. The effects of the DPs on incident CVD were assessed using HRs with 95% CIs. Furthermore, using a marginal structural model, the association between DPs and incident CVD was evaluated after adjusting for time-varying confounders.
Results
The incidence of CVD during the follow-up period was 3.7 per 1000 person-years (n = 274). The identified DP accounted for 28.99% of the variation in the response variables (i.e., the intake amounts of all 3 nutrients) and was characterized by high intakes of eggs, fish, milk, and dairy products. The effect of DP quintile on incident CVD differed by sex (Pinteraction = 0.03); the highest DP quintile was associated with a protective effect against the development of CVD in women (HR: 0.44; 95% CI: 0.22, 0.89), but not in men (HR: 1.57; 95% CI: 0.82, 3.00), compared with the lowest quintile. Even after adjusting for time-dependent variables, the effect of DP on incident CVD was significant in women (HR: 0.43; 95% CI: 0.22, 0.84), but not in men (HR: 1.49; 95% CI: 0.71, 3.10).
Conclusions
In this study, we identified DPs related to CVD, and a DP characterized by high intakes of eggs, fish, milk, and dairy products protected against incident CVD in women.