BACKGROUND AND AIMS: Rates of cardiovascular disease (CVD) are disproportionately high in American Indians (AI), and changes in lifestyle may be responsible. It is not known whether diverse dietary patterns exist in this population and whether the patterns are associated with CVD risk factors. This article describes the relationships between dietary patterns and CVD risk factors in this high-risk population. METHODS AND RESULTS: Nutrition data were collected via food frequency questionnaire from 3438 Strong Heart Study (SHS) participants, ≥ age 15 y. All participants were members of 94 extended families. The final sample consisted of 3172 men and women. Diet patterns were ascertained using factor analysis with the principal component factoring method. We derived four predominant dietary patterns: Western, traditional AI/Mexican, healthy, and unhealthy. Participants following the Western pattern had higher LDL cholesterol (LDL-C) (p < 0.001), slightly higher systolic blood pressure (BP) (p < 0.001), lower HDL cholesterol (HDL-C) (p < 0.001), and slightly lower homeostasis model assessment estimates of insulin resistance (HOMA-IR) in the lowest vs. highest deciles of adherence to this pattern (p < 0.001). The traditional diet was associated with higher HDL-C (p < 0.001), but higher body mass index (BMI) (p < 0.001) and HOMA-IR (p < 0.001). Followers of the healthy pattern had lower systolic BP, LDL-C, BMI, and HOMA-IR in increasing deciles (p < 0.001). The unhealthy pattern was associated with higher LDL-C. CONCLUSIONS: Dietary patterns reflect the changing lifestyle of AI and several of the patterns are associated with CVD risk factors. Evolving methods of food preparation have made the traditional pattern less healthy.
BACKGROUND AND AIMS: Rates of cardiovascular disease (CVD) are disproportionately high in American Indians (AI), and changes in lifestyle may be responsible. It is not known whether diverse dietary patterns exist in this population and whether the patterns are associated with CVD risk factors. This article describes the relationships between dietary patterns and CVD risk factors in this high-risk population. METHODS AND RESULTS: Nutrition data were collected via food frequency questionnaire from 3438 Strong Heart Study (SHS) participants, ≥ age 15 y. All participants were members of 94 extended families. The final sample consisted of 3172 men and women. Diet patterns were ascertained using factor analysis with the principal component factoring method. We derived four predominant dietary patterns: Western, traditional AI/Mexican, healthy, and unhealthy. Participants following the Western pattern had higher LDL cholesterol (LDL-C) (p < 0.001), slightly higher systolic blood pressure (BP) (p < 0.001), lower HDL cholesterol (HDL-C) (p < 0.001), and slightly lower homeostasis model assessment estimates of insulin resistance (HOMA-IR) in the lowest vs. highest deciles of adherence to this pattern (p < 0.001). The traditional diet was associated with higher HDL-C (p < 0.001), but higher body mass index (BMI) (p < 0.001) and HOMA-IR (p < 0.001). Followers of the healthy pattern had lower systolic BP, LDL-C, BMI, and HOMA-IR in increasing deciles (p < 0.001). The unhealthy pattern was associated with higher LDL-C. CONCLUSIONS: Dietary patterns reflect the changing lifestyle of AI and several of the patterns are associated with CVD risk factors. Evolving methods of food preparation have made the traditional pattern less healthy.
Authors: B V Howard; T K Welty; R R Fabsitz; L D Cowan; A J Oopik; N A Le; J Yeh; P J Savage; E T Lee Journal: Diabetes Date: 1992-10 Impact factor: 9.461
Authors: Clive Rosendorff; Henry R Black; Christopher P Cannon; Bernard J Gersh; Joel Gore; Joseph L Izzo; Norman M Kaplan; Christopher M O'Connor; Patrick T O'Gara; Suzanne Oparil Journal: Circulation Date: 2007-05-14 Impact factor: 29.690
Authors: Jiaqiong Xu; Sigal Eilat-Adar; Catherine Loria; Uri Goldbourt; Barbara V Howard; Richard R Fabsitz; Ellie M Zephier; Claudia Mattil; Elisa T Lee Journal: Am J Clin Nutr Date: 2006-10 Impact factor: 7.045
Authors: Lisa A Strycker; Susan C Duncan; Nigel R Chaumeton; Terry E Duncan; Deborah J Toobert Journal: Int J Behav Nutr Phys Act Date: 2007-02-17 Impact factor: 6.457
Authors: Robert H Eckel; John M Jakicic; Jamy D Ard; Janet M de Jesus; Nancy Houston Miller; Van S Hubbard; I-Min Lee; Alice H Lichtenstein; Catherine M Loria; Barbara E Millen; Cathy A Nonas; Frank M Sacks; Sidney C Smith; Laura P Svetkey; Thomas A Wadden; Susan Z Yanovski; Karima A Kendall; Laura C Morgan; Michael G Trisolini; George Velasco; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Maggie Li; Markus Hilpert; Jeff Goldsmith; Jada L Brooks; Jenni A Shearston; Steven N Chillrud; Tauqeer Ali; Jason G Umans; Lyle G Best; Joseph Yracheta; Aaron van Donkelaar; Randall V Martin; Ana Navas-Acien; Marianthi-Anna Kioumourtzoglou Journal: Am J Public Health Date: 2022-04 Impact factor: 9.308
Authors: Heather D Gibbs; Christina Pacheco; Hung-Wen Yeh; Christine Daley; K Allen Greiner; Won S Choi Journal: Am J Prev Med Date: 2016-07-21 Impact factor: 5.043
Authors: Rohaid Ali; Elisa T Lee; Allen W Knehans; Ying Zhang; Jeunliang Yeh; Everett R Rhoades; Jared B Jobe; Tauqeer Ali; Melanie R Johnson Journal: Int J Health Nutr Date: 2013-05-14
Authors: Li Gang Yang; Zhi Xiu Song; Hong Yin; Yan Yan Wang; Guo Fang Shu; Hui Xia Lu; Shao Kang Wang; Gui Ju Sun Journal: Lipids Date: 2015-11-02 Impact factor: 1.880
Authors: Ana Navas-Acien; Miranda J Spratlen; Ahlam Abuawad; Nancy J LoIacono; Anne K Bozack; Mary V Gamble Journal: Curr Diab Rep Date: 2019-11-22 Impact factor: 4.810