Adherence to Dietary Patterns and Cardiovascular Disease Risk: A Cross-Sectional Study of Total Carotid Plaque Area in Argentina

Abstract

Objective: Assessing subclinical atherosclerosis (sAT) is crucial for preventing cardiovascular disease. The Mediterranean diet is considered the gold standard for cardiovascular protection, but cultural and economic barriers can hinder adherence to it. The prudent dietary pattern (DP) has been associated with protective effects against chronic diseases. However, its impact on primary cardiovascular prevention remains uncertain. This study examined adherence to various DPs and their effect on sAT, measured by total carotid plaque area (TPA).

Methods: This cross-sectional study included 116 adults enrolled in a cardiovascular prevention program. Demographic, clinical, laboratory, and TPA data were collected. Adherence to DPs was assessed using a food frequency questionnaire. Participants were categorized according to their adherence to 4 mutually exclusive DPs: prudent, traditional, sweet, and mixed. Generalized linear models were used to assess the effect of DPs on TPA, adjusting for relevant cardiovascular variables.

Results: The traditional, sweet, and mixed DPs were associated with higher TPA values than the prudent DP, with medians (interquartile range) of 27 (99), 39 (49), 27.5 (58), and 0 (36) mm², respectively. Gamma regression analysis found that the beta exponents for the traditional, sweet, and mixed DPs versus the prudent DP were 3.78 (p=0.046); 3.73 (p=0.013), and 2.20 (p=0.072), respectively. Systolic blood pressure values were higher for the sweet and mixed DPs than for the prudent DP (133.9±11.7; 132.5±13.9 and 122.7±8.8 mmHg, respectively; p<0.05).

Conclusion: These findings underscore the importance of additional research and targeted interventions to promote healthier DPs to promote improvements in cardiovascular health.

Keywords: Cardiovascular disease; Carotid atherosclerosis; Dietary patterns.

Fig. 1. Flow chart of participants included.

TPA, total carotid plaque area; DP, dietary pattern.

Fig. 2. Box plot between DPs and carotid total plaque area, expressed in mm². Values expressed as median (interquartile range). In the graphic, the line inside the box expresses the median TPA load for each DP. The bottom of the box is the 25th percentile, and the top is the 75th percentile. Note that in the prudent DP box, the line corresponding to the median value coincides with the lower one, being 0 mm².

TPA, total carotid plaque area; DP, dietary pattern. ^*p<0.05 vs. the prudent DP. There were no significant differences between the traditional, sweet, and mixed DPs.