Cardioprotective diet in Siberian residents: the PURE study
Authors: Tsygankova D , Bazdyrev E D , Indukaeva E V , Artamonova G V , Barbarash O L 
Published: October 2021

Abstract

Introduction
Nutrition plays an important role in the prevention of cardiovascular pathology. An appropriate diet helps to prevent the development of arterial hypertension (AH), hypercholesterolemia, obesity and diabetes mellitus (DM).

Aim
To identify dietary patterns and investigate the relationship between dietary patterns and risk factors for cardiovascular disease in healthy population of Siberia.

Materials and methods
1,600 people (age 35–70) were examined for the Prospective Urban and Rural Epidemiologic Study (PURE). Re-examination was carried out after 35.6±2.9 months. Subjects without chronic diseases, with normal blood pressure, lipid and glucose levels, body mass index (BMI) and waist circumference (WC) were selected for the analysis. They accounted for 5.2% of the total number of the responders. Dietary habits were assessed using principal component analysis.

Results
Three types of dietary patterns have been identified by factor analysis. The first type incorporates the consumption of vegetables, fruits throughout the year (“fruit/vegetable”). The second type includes the consumption of fatty meat, complex carbohydrates and sweets (“protein/carbohydrate”). The third type is comprised of persons who did not belong to any of the previous two types (“mixed”). Most of the responders adhered to the protein/carbohydrate type (42.2%), whereas the fruit/vegetable and mixed types accounted for 28.9% each.
Results of the second examination showed that in subjects following the fruit/vegetable diet-37.5% did not have any risk factors, 4.2% developed hypercholesterolemia, 4.2%-hypertriglyceridemia and general obesity, 12.5%-higher levels of low-density lipoprotein (LDL) and 16.7% had abdominal obesity. In protein/carbohydrate diet-71.4% of the responders remained healthy, 8.6% developed hypercholesterolemia, 2.8%-AH and 2.8%-abdominal obesity, 14.3%-a high LDL level. In the mixed diet-58.3% of the responders remained completely healthy, 8.3%-hypercholesterolemia, 12.5%-high LDL cholesterol levels, and 12.5%-abdominal obesity. Logistic regression analysis demonstrated that adherence to the fruit/vegetable type was associated with an higher risk of obesity according to BMI (OR=1.57, CI: 1.27–1.96, p&lt;0.001), WC (OR=1.43, CI: 1.1–1.9, p=0.006), DM (OR=1.27, CI: 1.2–2.2, p=0.046). Adherence to the protein/carbohydrate diet was associated with a lower risk of obesity according to BMI (OR=0.75, CI: 0.6–0.95, p=0.015), WC (OR=0.52, CI: 0.41–0.66, p&lt;0.001), DM (OR=0.66, CI: 0.47–0.93, p=0.018), hypercholesterolemia and hypertriglyceridemia (OR=0.66, CI: 0.52–0.83, p&lt;0.001).

Conclusion
Three types of diets have been prominent in Siberian residents. The fruit/vegetable diet has been associated with the development of obesity and diabetes, in contrast to the protein/carbohydrate diet. The findings suggest that it is necessary to further study the qualitative characteristics of each type of diet, depending on the physical activity of the respondents.

Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The study was supported by the Pfizer Inc