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Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
Circulation 2015; 132(9):804-14Circ

Abstract

BACKGROUND

The association of overall diet, as characterized by dietary patterns, with risk of incident acute coronary heart disease (CHD) has not been studied extensively in samples including sociodemographic and regional diversity.

METHODS AND RESULTS

We used data from 17 418 participants in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national, population-based, longitudinal study of white and black adults aged ≥45 years, enrolled from 2003 to 2007. We derived dietary patterns with factor analysis and used Cox proportional hazards regression to examine hazard of incident acute CHD events - nonfatal myocardial infarction and acute CHD death - associated with quartiles of consumption of each pattern, adjusted for various levels of covariates. Five primary dietary patterns emerged: Convenience, Plant-based, Sweets, Southern, and Alcohol and Salad. A total of 536 acute CHD events occurred over a median (interquartile range) 5.8 (2.1) years of follow-up. After adjustment for sociodemographics, lifestyle factors, and energy intake, highest consumers of the Southern pattern (characterized by added fats, fried food, eggs, organ and processed meats, and sugar-sweetened beverages) experienced a 56% higher hazard of acute CHD (comparing quartile 4 with quartile 1: hazard ratio, 1.56; 95% confidence interval, 1.17-2.08; P for trend across quartiles=0.003). Adding anthropometric and medical history variables to the model attenuated the association somewhat (hazard ratio, 1.37; 95% confidence interval, 1.01-1.85; P=0.036).

CONCLUSIONS

A dietary pattern characteristic of the southern United States was associated with greater hazard of CHD in this sample of white and black adults in diverse regions of the United States.

Authors+Show Affiliations

From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.). jshikany@uabmc.edu.From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.).From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.).From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.).From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.).From Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham (J.M.S., M.M.S., R.W.D.); Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University and Program in Environmental Studies, Harvard University, Boston, MA (P.K.N.); Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham (T.M.B.); and Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (S.E.J.).

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26260732

Citation

Shikany, James M., et al. "Southern Dietary Pattern Is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study." Circulation, vol. 132, no. 9, 2015, pp. 804-14.
Shikany JM, Safford MM, Newby PK, et al. Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Circulation. 2015;132(9):804-14.
Shikany, J. M., Safford, M. M., Newby, P. K., Durant, R. W., Brown, T. M., & Judd, S. E. (2015). Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Circulation, 132(9), pp. 804-14. doi:10.1161/CIRCULATIONAHA.114.014421.
Shikany JM, et al. Southern Dietary Pattern Is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Circulation. 2015 Sep 1;132(9):804-14. PubMed PMID: 26260732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. AU - Shikany,James M, AU - Safford,Monika M, AU - Newby,P K, AU - Durant,Raegan W, AU - Brown,Todd M, AU - Judd,Suzanne E, Y1 - 2015/08/10/ PY - 2014/11/19/received PY - 2015/06/15/accepted PY - 2015/8/12/entrez PY - 2015/8/12/pubmed PY - 2015/12/15/medline KW - coronary disease KW - diet KW - epidemiology KW - follow-up studies KW - nutrition assessment SP - 804 EP - 14 JF - Circulation JO - Circulation VL - 132 IS - 9 N2 - BACKGROUND: The association of overall diet, as characterized by dietary patterns, with risk of incident acute coronary heart disease (CHD) has not been studied extensively in samples including sociodemographic and regional diversity. METHODS AND RESULTS: We used data from 17 418 participants in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national, population-based, longitudinal study of white and black adults aged ≥45 years, enrolled from 2003 to 2007. We derived dietary patterns with factor analysis and used Cox proportional hazards regression to examine hazard of incident acute CHD events - nonfatal myocardial infarction and acute CHD death - associated with quartiles of consumption of each pattern, adjusted for various levels of covariates. Five primary dietary patterns emerged: Convenience, Plant-based, Sweets, Southern, and Alcohol and Salad. A total of 536 acute CHD events occurred over a median (interquartile range) 5.8 (2.1) years of follow-up. After adjustment for sociodemographics, lifestyle factors, and energy intake, highest consumers of the Southern pattern (characterized by added fats, fried food, eggs, organ and processed meats, and sugar-sweetened beverages) experienced a 56% higher hazard of acute CHD (comparing quartile 4 with quartile 1: hazard ratio, 1.56; 95% confidence interval, 1.17-2.08; P for trend across quartiles=0.003). Adding anthropometric and medical history variables to the model attenuated the association somewhat (hazard ratio, 1.37; 95% confidence interval, 1.01-1.85; P=0.036). CONCLUSIONS: A dietary pattern characteristic of the southern United States was associated with greater hazard of CHD in this sample of white and black adults in diverse regions of the United States. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/26260732/Southern_Dietary_Pattern_is_Associated_With_Hazard_of_Acute_Coronary_Heart_Disease_in_the_Reasons_for_Geographic_and_Racial_Differences_in_Stroke__REGARDS__Study_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.114.014421?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -