Z Asadi 1 2, M Shafiee 3, F Sadabadi 4 5, A Heidari-Bakavoli 6, M Moohebati 6, M S Khorrami 4, S Darroudi 4 5, S Heidari 7, T Hoori 7, M Tayefi 8, F Mohammadi 1, H Esmaeily 9, M Safarian 1, M Ghayour-Mobarhan 5, G A Ferns 10
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Modern Sciences and Technologies, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran.
Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran.
Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Brighton & Sussex Medical School, Division of Medical Education, Brighton, Sussex, UK.
Background: Cardiovascular disease (CVD) is the principal cause of mortality and disability in Iranian adults. We aimed to evaluate the relationship between dietary patterns and CVD incidence in a large sample of adults in northeastern Iran.
Methods: The present study comprised a prospective study of 5706 CVD-free men and women aged 35-65 years who participated in a cohort study. All of the participants were followed up for a 6-year period. Dietary patterns were derived from a 65-item validated food frequency questionnaire and the factor analysis method was used to determine dietary patterns.
Results: We identified two major dietary patterns: (i) a Balanced dietary pattern (a high intake of green leafy vegetables, other vegetables, fruits, dairy products, red meats, poultry, seafoods, legumes and nuts, as well as a low intake of sugar) and (ii) a Western dietary pattern (a high intake of sugar, tea, egg, snacks, fast foods, potato, carbonated beverages, pickled foods, organs meat and butter) by factor analysis. The hazard ratio (HR) and 95% confidence intervals (CIs) of total CVD in the highest versus lowest tertiles of the Balanced pattern were 1.29 (95% CI = 0.67-2.47; P = 0.44). The HR and 95% CIs of CVD in the highest versus lowest tertiles of Western pattern were 2.21 (95% CI = 1.08-4.45; P = 0.03).
Conclusions: During the 6-year follow-up, we found that adherence to a Balanced dietary pattern was not significantly associated with CVD events. However, adherence to a Western dietary pattern was associated with a significantly increased risk of CVD events and its associated risk.
Keywords: Western dietary pattern; cardiovascular diseases; dietary patterns; factor analysis.
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