Association between a social-business eating pattern and early asymptomatic atherosclerosis

Authors: PENALVO, JOSE - TUFTS UNIVERSITY; FERNANDEZ-FRIERA, LETICIA - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); LOPEZ-MELGAR, BEATRIZ - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); UZHOVA, IRINA - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); OLIVA, BELEN - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); FERNANDEZ-ALVIRA, JUAN - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); LACLAUSTRA, MARTIN - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); POCOCK, STUART - LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE; MOCOROA, AGUSTIN - BANCO DE SANTANDER; MENDIGUREN, JOSE - BANCO DE SANTANDER; SANZ, GINES - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); GUALLAR, ELISEO - JOHNS HOPKINS UNIVERSITY; BANSILAL, SAMEER - THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI; VEDANTHAN, RAJESH - THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI; JIMENEZ-BORREGUERO, LUIS - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); IBANEZ, BORJA - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); ORDOVAS, JOSE - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY; FERNANDEZ-ORTIZ, ANTONIO - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); BUENO, HECTOR - NATIONAL CENTER FOR CARDIOVASCULAR RESEARCH(CNIC); FUSTER, VALENTIN - THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Submitted to: Journal of the American College of Cardiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/21/2016
Publication Date: 8/23/2016
Citation: Penalvo, J.L., Fernandez-Friera, L.L., Lopez-Melgar, B., Uzhova, I., Oliva, B., Fernandez-Alvira, J.M., Laclaustra, M., Pocock, S., Mocoroa, A., Mendiguren, J.M., Sanz, G., Guallar, E., Bansilal, S., Vedanthan, R., Jimenez-Borreguero, L.J., Ibanez, B., Ordovas, J.M., Fernandez-Ortiz, A., Bueno, H., Fuster, V. 2016. Association between a social-business eating pattern and early asymptomatic atherosclerosis. Journal of the American College of Cardiology. doi: 10.1016/j.jacc.2016.05.080.

Interpretive Summary: The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies. This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults. For this purpose we used the information provided by participants in the PESA (Progression of Early Subclinical Atherosclerosis) Study (n = 4,082 asymptomatic participants, mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis. A fundamental objective of this cohort study was to evaluate the life-style-related determinants, including diet, on atherosclerosis onset and development. Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern and was characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, sugar-sweetened beverages, and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile as well as increased odds of presenting subclinical atherosclerosis compared to participants following a Mediterranean diet. In summary, a newly described social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages and also by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis.

Technical Abstract: BACKGROUND: The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies. OBJECTIVES: This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults. METHODS: The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the life-style-related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall life-style and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information. RESULTS: Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet. CONCLUSIONS: A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis.