Abstract MP059: Direct Association of the US 'Southern' Dietary Pattern with Visceral Adipose Tissue and Cardiometabolic Risk Factors in African Americans: the Jackson Heart Study
Authors: Liu Jiankang , Bidulescu Aurelian , Hickson DeMarc A , Musani Solomon K , Talegawkar Sameera A , Carithers Teresa C , Tucker Katherine L , Fox Caroline S , Taylor Herman A 
Published: July 2021

Background:
The assessment of the individual's dietary pattern is innovative because of its focus on overall food and nutrient intake. The influence of specific dietary patterns on cardiovascular disease (CVD) risk for African Americans (AA) remains unclear. Thus, we investigated in AA the association of main dietary patterns and cardiometabolic risk factors (RFs) with the hypothesis that the US ‘southern’ dietary pattern increases CVD risk and fat accumulation in the abdomen.

Methods:
In the Jackson Heart Study cohort, we conducted a cross-sectional investigation among 1,775 AA participants without CVD and diabetes four years previously. With a validated ‘Deep South’ regional-specific food frequency questionnaire that queried the dietary intake characteristic of AA, we clustered dietary patterns based on ranked food groups using principal component analyses. Tertiles of ranked scores for each of the dietary patterns were analyzed across cardiometabolic RFs and abdominal visceral adipose tissue (VAT) categories (90th percentile).

Results:
Among the study participants (61% women; mean age, 47 ± 12 years), three major dietary patterns were identified: the ‘southern’, the ‘fast food’ and the ‘prudent’ patterns. The participants with a higher ‘southern’ pattern score had adverse risk factor profiles including larger waist circumference and VAT, elevated diastolic blood pressure, lower HDL-cholesterol and higher percentage of metabolic syndrome (
p range 0.007 - 0.0001 for trends
). After multivariable adjustment, participants with a higher ‘southern’ pattern score were significantly associated with increased odds ratios for cardiometabolic RFs and high VAT, similarly with those with the ‘fast food’ pattern (
Table
).

Conclusions:
The US ‘southern’ dietary pattern was directly associated with cardiometabolic RFs and visceral adiposity. Our findings highlight the importance of this dietary pattern in the development of cardiometabolic abnormalities in the African American populations in the Southeastern US.

Associations in JHS between Dietary Patterns and Cardiometabolic Risk Factors by Score Tertiles

‘Southern’ Diet
‘Fast Food’ Diet
‘Prudent’ Diet

Tertile 1
Tertile 2
Tertile 3
Tertile 1
Tertile 2
Tertile 3
Tertile 1
Tertile 2
Tertile 3

High VAT
Reference
1.39 (0.9-1.9)
1.80 (1.1-3.0)
Reference
1.38 (0.9-1.9)
1.52 (0.8-2.3)
Reference
1.13 (0.8-1.6)
0.91 (0.6-1.3)

p

0.05
0.02

0.06
0.14

0.47
0.61

n
130
130
121
134
137
113
112
140
132

HTN
Reference
1.42 (1.1-1.9)
1.14 (0.7-1.8)
Reference
1.35 (0.9-1.8)
1.67 (1.1-2.7)
Reference
0.75 (0.6-0.9)
0.69 (0.5-0.9)

p

0.02
0.60

0.05
0.03

0.04
0.02

n
172
189
137
177
173
148
167
167
164

Diabetes
Reference
2.03 (1.1-3.9)
1.55 (0.6-4.0)
Reference
2.46 (1.2-4.9)
2.86 (1.0-7.9)
Reference
0.88 (0.5-1.6)
0.88 (0.5-1.7)

p

0.03
0.36

0.01
0.04

0.66
0.71

n
21
33
25
20
32
27
25
25
29

High TRG
Reference
0.78 (0.5-1.2)
0.76 (0.4-1.3)
Reference
1.26 (0.8-1.9)
1.14 (0.6-1.9)
Reference
1.25 (0.9-1.8)
0.92 (0.6-1.4)

p

0.23
0.31

0.25
0.65

0.22
0.70

n
67
67
75
58
76
75
67
78
64

Low HDL
Reference
1.01 (0.8-1.3)
1.02 (0.7-1.5)
Reference
1.34 (1.0-1.7)
1.24 (0.8-1.9)
Reference
1.15 (0.8-1.5)
0.98 (0.7-1.3)

p

0.96
0.93

0.04
0.29

0.29
0.92

n
171
179
184
150
194
190
181
184
169

MetS
Reference
1.88 (1.3-2.7)
2.16 (1.3-3.6)
Reference
2.48 (1.7-3.6)
2.40 (1.4-4.2)
Reference
0.94 (0.7-1.3)
0.75 (0.5-1.1)

p

0.0005
0.004

0.0001
0.002

0.71
0.12

n
110
130
111
100
150
101
111
124
116

Odds ratio values adjusted for age, sex, smoking status, alcohol intake, dietary caloric intake, education levels and physical activity

JHS: Jackson Heart Study; HTN: hypertension (JNC7); High TRG: plasma triglycerides ≥ 150 mg/dl; Low HDL: plasma HDL-cholesterol < 40 mg/dl in men and < 50 mg/dl in women; MetS: metabolic syndrome; p: p-value; n: number of participants with condition.