A Diet Pattern with More Dairy and Nuts, but Less Meat Is Related to Lower Risk of Developing Hypertension in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population
2.2. Data Collection
2.3. Dietary Assessment
2.4. Blood Pressure Measurement
2.5. Statistical Methods
3. Results
ARIC participants | All (n = 9913) | Black men (n = 700) | White men (n = 3759) | Black women (n = 1092) | White women (n = 4362) |
---|---|---|---|---|---|
Systolic/diastolic BP at baseline, mmHg * | n = 9913 114 ± 12/70 ± 9 | n = 700 116 ± 0.7/73 ± 0.5 | n = 3759 115 ± 0.2/72 ± 0.2 | n = 1092 116 ± 0.7/70 ± 0.5 | n = 4362 112 ± 0.2/68 ± 0.2 |
Systolic/diastolic BPat Exam 4, mmHg * | n = 7736 123 ± 17/70 ± 10 | n = 461 125 ± 1.3/71 ± 0.7 | n = 2974 122 ± 0.4/71 ± 0.2 | n = 751 127 ± 1.2/70 ± 0.7 | n = 3550 122 ± 0.4/68 ± 0.2 |
Incident high-normal BP, n (%) † | 2642(42.9) | 132(43.0) | 988(47.7) | 232(44.1) | 1290(42.5) |
Incident hypertension, n (%) ‡ | 2853(28.8) | 242(34.6) | 1027(27.3) | 445(40.8) | 1139(26.1) |
Healthy Food Score (HFscore) Quintiles | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Characteristics | Q1 (n = 2127) | Q2 (n = 1568) | Q3 (n = 2582) | Q4 (n = 1662) | Q5 (n=1974) | |||||
Mean HFscore | ||||||||||
Age, year (SD) | 52.6 | (5.5) | 53.4 | (5.6) | 53.4 | (5.7) | 53.8 | (5.7) | 54.1 | (5.7) |
Blacks, n (%) | 567 | (26.7) | 317 | (20.2) | 447 | (17.3) | 256 | (15.4) | 205 | (10.4) |
Females, n (%) | 1197 | (56.3) | 833 | (53.1) | 1380 | (53.4) | 939 | (56.5) | 1105 | (56.0) |
<High school, n (%) | 619 | (29.1) | 350 | (22.3) | 459 | (17.8) | 231 | (13.9) | 233 | (11.8) |
Current smoking, n (%) | 699 | (32.9) | 430 | (27.5) | 672 | (26.0) | 409 | (24.6) | 475 | (24.1) |
Physical activity score (SD) | 2.3 | (0.7) | 2.4 | (0.8) | 2.5 | (0.8) | 2.6 | (0.8) | 2.7 | (0.8) |
Body Mass Index, kg/m2 (SD) | 27.2 | (5.0) | 26.8 | (4.8) | 26.8 | (4.8) | 26.6 | (4.7) | 26.1 | (4.4) |
Systolic blood pressure, mmHg (SD) | 114.2 | (12.3) | 113.6 | (12.6) | 113.7 | (12.5) | 113.6 | (12.1) | 113.0 | (12.2) |
Diastolic blood pressure, mmHg (SD) | 70.7 | (8.8) | 70.0 | (8.6) | 69.9 | (8.7) | 69.8 | (8.5) | 69.3 | (8.5) |
Nutrient intake, unit per day (SD) | ||||||||||
Energy (kcal) | 1322 | (528) | 1478 | (523) | 1632 | (575) | 1773 | (571) | 2013 | (596) |
% kcal from fat | 35.1 | (7.5) | 34.1 | (6.5) | 33.0 | (6.4) | 32.2 | (6.3) | 31.5 | (5.9) |
Dietary fiber (g) | 10.9 | (5.0) | 14.3 | (5.2) | 17.2 | (6.8) | 20.1 | (7.3) | 24.5 | (8.8) |
Calcium (mg) | 418.3 | (234.0) | 558.7 | (306.9) | 671.8 | (344.8) | 785.0 | (366.5) | 929.2 | (397.2) |
Vitamin D (IU) | 131.4 | (89.5) | 183.6 | (126.4) | 220.5 | (129.6) | 258.3 | (132.9) | 311.5 | (155.0) |
Alcohol (g) | 4.8 | (15.0) | 4.7 | (11.6) | 5.6 | (12.1) | 6.5 | (13.0) | 8.3 | (12.1) |
Food Intake, servings/day (SD) | ||||||||||
Dairy | 0.96 | (0.85) | 1.38 | (1.15) | 1.72 | (1.31) | 2.04 | (1.35) | 2.43 | (1.47) |
Meat | 1.42 | (0.81) | 1.40 | (0.79) | 1.38 | (0.83) | 1.37 | (0.79) | 1.38 | (0.81) |
Fish and seafood | 0.18 | (0.19) | 0.25 | (0.29) | 0.30 | (0.28) | 0.36 | (0.30) | 0.49 | (0.36) |
Nuts | 0.05 | (0.12) | 0.08 | (0.17) | 0.12 | (0.29) | 0.16 | (0.27) | 0.26 | (0.36) |
Fruit and vegetables | 2.04 | (1.24) | 2.80 | (1.37) | 3.50 | (1.80) | 4.15 | (1.97) | 5.15 | (2.26) |
Fruit juice | 0.24 | (0.43) | 0.39 | (0.51) | 0.51 | (0.58) | 0.64 | (0.61) | 0.81 | (0.71) |
Legumes | 0.20 | (0.21) | 0.24 | (0.24) | 0.27 | (0.31) | 0.30 | (0.28) | 0.37 | (0.35) |
Whole grain products | 0.61 | (0.75) | 0.98 | (1.03) | 1.27 | (1.15) | 1.67 | (1.35) | 1.98 | (1.30) |
Refined grain products | 2.10 | (1.67) | 2.30 | (1.70) | 2.43 | (1.82) | 2.46 | (1.69) | 2.65 | (1.67) |
Sugar-sweetened beverage | 0.79 | (1.20) | 0.57 | (0.91) | 0.50 | (0.82) | 0.43 | (0.77) | 0.37 | (0.72) |
Diet soda | 0.56 | (1.07) | 0.56 | (1.00) | 0.51 | (0.96) | 0.52 | (0.93) | 0.46 | (0.87) |
Healthy food score (HFscore) quintiles | ||||||
---|---|---|---|---|---|---|
Q1 (n = 1107) | Q2 (n = 860) | Q3 (n = 1333) | Q4 (n = 879) | Q5 (n = 1081) | p for trend † | |
Mean HFscore | 15.4 | 20.1 | 23.5 | 27.0 | 31.7 | |
Model 1 HR (95% CI) | 1.0 | 1.04 (0.89–1.23) | 1.11 (0.95–1.31) | 1.03 (0.86–1.23) | 1.06 (0.89–1.25) | 0.63 |
Model 2 HR (95% CI) | 1.0 | 1.04 (0.88–1.22) | 1.11 (0.94–1.31) | 1.04 (0.87–1.24) | 1.06 (0.89–1.26) | 0.63 |
Model 3 HR (95% CI) | 1.0 | 1.04 (0.88–1.22) | 1.11 (0.94–1.31) | 1.03 (0.87–1.23) | 1.08 (0.91–1.29) | 0.90 |
Healthy food score (HFscore) quintiles | ||||||
---|---|---|---|---|---|---|
Q1 (n = 2127) | Q2 (n = 1568) | Q3 (n = 2582) | Q4 (n = 1662) | Q5 (n = 1974) | p for trend † | |
Mean HFscore | 15.4 | 20.0 | 23.5 | 27.0 | 31.7 | |
FullHealth foodscore models | ||||||
Model 1 HR (95% CI) | 1.0 | 0.97 (0.87–1.09) | 0.91 (0.81–1.02) | 0.90 (0.79–1.02) | 0.85 (0.74–0.96) | 0.006 |
Model 2 HR (95% CI) | 1.0 | 0.97 (0.87–1.09) | 0.91 (0.81–1.02) | 0.91 (0.80–1.03) | 0.86 (0.75–0.98) | 0.01 |
Model 3 HR (95% CI) | 1.0 | 0.98 (0.88–1.10) | 0.92 (0.82–1.04) | 0.92 (0.81–1.05) | 0.90 (0.79–1.02) | 0.06 |
Partial Healthy food score models (Model 2) | ||||||
(a) HFscore without meat | ||||||
Partial HFscore | 1 | 1.00 (0.89–1.13) | 0.96 (0.85–1.08) | 0.94 (0.83–1.07) | 0.95 (0.83–1.09) | 0.33 |
Meat ** | 1 | 1.01 (0.9–1.14) | 0.90 (0.79–1.02) | 0.88 (0.77–1.01) | 0.82 (0.71–0.94) | 0.002 |
(b) HFscore without dairy | ||||||
Partial HFscore | 1.0 | 0.99 (0.88–1.11) | 0.94 (0.82–1.07) | 0.92 (0.82–1.04) | 0.92 (0.81–1.06) | 0.14 |
Dairy | 1.0 | 0.96 (0.85–1.07) | 0.95 (0.84–1.07) | 0.92 (0.81–1.04) | 0.85 (0.75–0.97) | 0.01 |
(c) HFscore without nuts | ||||||
Partial HFscore | 1.0 | 0.95 (0.85–1.07) | 0.88 (0.78–1.00) | 0.94 (0.82–1.07) | 0.89 (0.78–1.02) | 0.10 |
Nuts | 1.0 | 1.11 (0.98–1.27) | 0.96 (0.87–1.07) | 0.92 (0.81–1.04) | 0.87 (0.77–0.97) | 0.002 |
(d) HFscore without dairy, meat, & nuts | ||||||
Partial HFscore | 1.0 | 0.98 (0.87–1.10) | 0.93 (0.82–1.04) | 0.97 (0.86–1.10) | 1.03 (0.90–1.18) | 0.90 |
Meat | 1.0 | 1.03 (0.91–1.16) | 0.92 (0.81–1.04) | 0.90 (0.78–1.02) | 0.84 (0.73–0.97) | 0.009 |
Dairy | 1.0 | 0.96 (0.85–1.07) | 0.95 (0.84–1.07) | 0.92 (0.82–1.04) | 0.86 (0.75–0.98) | 0.02 |
Nuts | 1.0 | 1.12 (0.98–1.27) | 0.96 (0.87–1.07) | 0.91 (0.81–1.03) | 0.86 (0.77–0.97) | 0.002 |
4. Discussion
5. Conclusions
Acknowledgements
Conflict of Interest
References
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Weng, L.-C.; Steffen, L.M.; Szklo, M.; Nettleton, J.; Chambless, L.; Folsom, A.R. A Diet Pattern with More Dairy and Nuts, but Less Meat Is Related to Lower Risk of Developing Hypertension in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study. Nutrients 2013, 5, 1719-1733. https://doi.org/10.3390/nu5051719
Weng L-C, Steffen LM, Szklo M, Nettleton J, Chambless L, Folsom AR. A Diet Pattern with More Dairy and Nuts, but Less Meat Is Related to Lower Risk of Developing Hypertension in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study. Nutrients. 2013; 5(5):1719-1733. https://doi.org/10.3390/nu5051719
Chicago/Turabian StyleWeng, Lu-Chen, Lyn M. Steffen, Moyses Szklo, Jennifer Nettleton, Lloyd Chambless, and Aaron R. Folsom. 2013. "A Diet Pattern with More Dairy and Nuts, but Less Meat Is Related to Lower Risk of Developing Hypertension in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study" Nutrients 5, no. 5: 1719-1733. https://doi.org/10.3390/nu5051719