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: Jiankang Liu, Aurelian Bidulescu, DeMarc A Hickson, Solomon K Musani, Sameera A Talegawkar, Teresa C Carithers, Katherine L Tucker, Caroline S Fox, Herman A Taylor
Journal: Circulation (2012)

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 &lt; 40 mg/dl in men and &lt; 50 mg/dl in women; MetS: metabolic syndrome; p: p-value; n: number of participants with condition.