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J Am Heart Assoc. 2019 Oct;8(19):e013249. doi: 10.1161/JAHA.119.013249. Epub 2019 Sep 19.

Diet Quality and Cardiovascular Disease Risk in Postmenopausal Women With Type 2 Diabetes Mellitus: The Women's Health Initiative.

Author information

1
Department of Epidemiology School of Medicine University of California Irvine CA.
2
Division of Preventive Medicine School of Medicine University of Alabama Birmingham AL.
3
Department of Family Medicine and Epidemiology Alpert Medical School Brown University Providence RI.
4
Department of Family Medicine and Public Health University of California San Diego CA.
5
Division of Cardiology George Washington University School of Medicine and Healthcare Sciences Washington DC.
6
Public Health Sciences-Division of Epidemiology School of Medicine University of California Davis CA.
7
Department of Biobehavioral Nursing and Health Informatics School of Nursing University of Washington Seattle WA.

Abstract

Background Dietary patterns are associated with cardiovascular disease (CVD) risk in the general population, but diet-CVD association in populations with diabetes mellitus is limited. Our objective was to examine the association between diet quality and CVD risk in a population with type 2 diabetes mellitus. Methods and Results We analyzed prospective data from 5809 women with prevalent type 2 diabetes mellitus at baseline from the Women's Health Initiative. Diet quality was defined using alternate Mediterranean, Dietary Approach to Stop Hypertension, Paleolithic, and American Diabetes Association dietary pattern scores calculated from a validated food frequency questionnaire. Multivariable Cox's proportional hazard regression was used to analyze the risk of incident CVD. During mean 12.4 years of follow-up, 1454 (25%) incident CVD cases were documented. Women with higher alternate Mediterranean, Dietary Approach to Stop Hypertension, and American Diabetes Association dietary pattern scores had a lower risk of CVD compared with women with lower scores (Q5 v Q1) (hazard ratio [HR]aMed 0.77, 95% CI 0.65-0.93; HRDASH 0.69, 95% CI 0.58-0.83; HRADA 0.71, 95% CI 0.59-0.86). No association was observed between the Paleolithic score and CVD risk. Conclusions Dietary patterns that emphasize higher intake of fruits, vegetables, whole grains, nuts/seeds, legumes, a high unsaturated:saturated fat ratio, and lower intake of red and processed meats, added sugars, and sodium are associated with lower CVD risk in postmenopausal women with type 2 diabetes mellitus.

KEYWORDS:

cardiovascular disease prevention; diabetes mellitus; diet; nutrition; women

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