Skip to main content Accessibility help
×
Home

Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults

  • Christin Heidemann (a1), Christa Scheidt-Nave (a1), Almut Richter (a2) and Gert B. M. Mensink (a1)

Abstract

Studies that investigated complex actual eating behaviours of the general population and their relation to cardiometabolic risk markers are sparse. We aimed to identify dietary patterns within a nationally representative sample of 4025 German adults by factor analysis based on validated dietary history interviews. Furthermore, we evaluated associations of the derived dietary patterns with abnormalities clustered within the metabolic syndrome and related metabolic markers by logistic regression models and ANCOVA. A high adherence to the ‘processed foods’ pattern reflected a high intake of refined grains, processed meat, red meat, high-sugar beverages, eggs, potatoes, beer, sweets and cakes, snacks and butter, whereas a high adherence to the ‘health-conscious’ pattern represented a high intake of vegetables, vegetable oils, legumes, fruits, fish and whole grains. For subjects in the highest compared with those in the lowest quintile of the processed foods pattern, the occurrence of abdominal obesity was 88 (95 % CI 31, 169) % higher, hypertension was 34 (95 % CI − 4, 86) % higher, hypertriacylglycerolaemia was 59 (95 % CI 11, 128 ) % higher and the metabolic syndrome was 64 (95 % CI 10, 143) % higher when adjusted for age, sex, energy intake, socio-economic status, sport activity and smoking. Furthermore, subjects in the highest quintile had statistically significantly higher uric acid concentrations and lower folate concentrations (P for trend < 0·05). In contrast, subjects in the highest quintile of the health-conscious pattern had a 30 (95 % CI 10, 46) % lower occurrence of hypertension, higher folate concentrations and lower homocysteine and fibrinogen concentrations (P for trend < 0·05). These data strengthen the findings from non-representative studies and emphasise the importance of healthy overall food patterns for preventing metabolic disturbances.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Dr. G. B. M. Mensink, fax +49 30 18754 3211, email mensinkg@rki.de

References

Hide All
1 Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
2 Newby, PK & Tucker, KL (2004) Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 62, 177203.
3 Gidding, SS, Lichtenstein, AH, Faith, MS, et al. (2009) Implementing American Heart Association pediatric and adult nutrition guidelines: a scientific statement from the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular Disease in the Young, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Nursing, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research. Circulation 119, 11611175.
4 Graham, I, Atar, D, Borch-Johnsen, K, et al. (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur Heart J 28, 23752414.
5 Esmaillzadeh, A, Kimiagar, M, Mehrabi, Y, et al. (2007) Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 85, 910918.
6 Lopez-Garcia, E, Schulze, MB, Fung, TT, et al. (2004) Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 80, 10291035.
7 Fung, TT, Rimm, EB, Spiegelman, D, et al. (2001) Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 73, 6167.
8 Lee, S, Cai, H, Yang, G, et al. (2010) Dietary patterns and blood pressure among middle-aged and elderly Chinese men in Shanghai. Br J Nutr 104, 265275.
9 Delavar, MA, Lye, MS, Khor, GL, et al. (2009) Dietary patterns and the metabolic syndrome in middle aged women, Babol, Iran. Asia Pac J Clin Nutr 18, 285292.
10 Esmaillzadeh, A & Azadbakht, L (2008) Food intake patterns may explain the high prevalence of cardiovascular risk factors among Iranian women. J Nutr 138, 14691475.
11 Perozzo, G, Olinto, MT, Dias-da-Costa, JS, et al. (2008) Association between dietary patterns and body mass index and waist circumference in women living in Southern Brazil. Cad Saude Publica 24, 24272439.
12 McNaughton, SA, Mishra, GD, Stephen, AM, et al. (2007) Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate. J Nutr 137, 99105.
13 Sadakane, A, Tsutsumi, A, Gotoh, T, et al. (2008) Dietary patterns and levels of blood pressure and serum lipids in a Japanese population. J Epidemiol 18, 5867.
14 Williams, DE, Prevost, AT, Whichelow, MJ, et al. (2000) A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br J Nutr 83, 257266.
15 Centritto, F, Iacoviello, L, di Giuseppe, R, et al. (2009) Dietary patterns, cardiovascular risk factors and C-reactive protein in a healthy Italian population. Nutr Metab Cardiovasc Dis 19, 697706.
16 Panagiotakos, DB, Pitsavos, C, Skoumas, Y, et al. (2007) The association between food patterns and the metabolic syndrome using principal components analysis: The ATTICA Study. J Am Diet Assoc 107, 979987.
17 Newby, PK, Muller, D & Tucker, KL (2004) Associations of empirically derived eating patterns with plasma lipid biomarkers: a comparison of factor and cluster analysis methods. Am J Clin Nutr 80, 759767.
18 Noel, SE, Newby, PK, Ordovas, JM, et al. (2009) A traditional rice and beans pattern is associated with metabolic syndrome in Puerto Rican older adults. J Nutr 139, 13601367.
19 Lutsey, PL, Steffen, LM & Stevens, J (2008) Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation 117, 754761.
20 Nettleton, JA, Steffen, LM, Mayer-Davis, EJ, et al. (2006) Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 83, 13691379.
21 Kerver, JM, Yang, EJ, Bianchi, L, et al. (2003) Dietary patterns associated with risk factors for cardiovascular disease in healthy US adults. Am J Clin Nutr 78, 11031110.
22 Lee, JW, Hwang, J & Cho, HS (2007) Dietary patterns of children and adolescents analyzed from 2001 Korea National Health and Nutrition Survey. Nutr Res Pract 1, 8488.
23 Mensink, GB & Beitz, R (2004) Food and nutrient intake in East and West Germany, 8 years after the reunification – The German Nutrition Survey 1998. Eur J Clin Nutr 58, 10001010.
24 Mensink, GB, Haftenberger, M & Thamm, M (2001) Validity of DISHES 98, a computerised dietary history interview: energy and macronutrient intake. Eur J Clin Nutr 55, 409417.
25 Dehne, LI, Klemm, C, Henseler, G, et al. (1999) The German Food Code and Nutrient Data Base (BLS II.2). Eur J Epidemiol 15, 355359.
26 Drescher, LS, Thiele, S & Mensink, GB (2007) A new index to measure healthy food diversity better reflects a healthy diet than traditional measures. J Nutr 137, 647651.
27 Hatcher, L (1994) A Step-by-Step Approach to using SAS® for Factor Analysis and Structural Equation Modeling. Cary, NC: SAS Institute, Inc..
28 Winkler, J & Stolzenberg, H (1999) Social class index in the Federal Health Survey. Gesundheitswesen 61, S178S183.
29 Friedewald, WT, Levy, RI & Fredrickson, DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18, 499502.
30 Executive summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) (2001) JAMA 285, 24862497.
31 Neuhauser, H & Ellert, U (2008) Estimation of the metabolic syndrome prevalence in the general population in Germany. J Public Health 16, 221227.
32 Esmaillzadeh, A, Kimiagar, M, Mehrabi, Y, et al. (2007) Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr 137, 992998.
33 van Dam, RM, Grievink, L, Ocke, MC, et al. (2003) Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population. Am J Clin Nutr 77, 11561163.
34 Gittelsohn, J, Wolever, TM, Harris, SB, et al. (1998) Specific patterns of food consumption and preparation are associated with diabetes and obesity in a Native Canadian community. J Nutr 128, 541547.
35 Hamer, M & Mishra, GD (2009) Dietary patterns and cardiovascular risk markers in the UK Low Income Diet and Nutrition Survey. Nutr Metab Cardiovasc Dis 20, 491497.
36 Hu, FB (2008) Globalization of food patterns and cardiovascular disease risk. Circulation 118, 19131914.
37 Joint WHO/FAO Expert Consultation (2003) Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser, i–viii 916, 1149.
38 Martinez, ME, Marshall, JR & Sechrest, L (1998) Invited Commentary: factor analysis and the search for objectivity. Am J Epidemiol 148, 1719.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed