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Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke

Published online by Cambridge University Press:  08 March 2007

Matthias B. Schulze*
Affiliation:
Department of Epidemiology,, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany,
Kurt Hoffmann
Affiliation:
Department of Epidemiology,, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany,
*
*Corresponding author: Dr Matthias B. Schulze, fax +49 33 200 88 721, email mschulze@mail.dife.de
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Abstract

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Dietary pattern analysis, which reflects the complexity of dietary intake, has received considerable attention by nutritional epidemiology. For a long time, two general approaches have been used to define these summary variables in observational studies. The exploratory approach is based only on the data of the study, whereas the hypothesis-oriented approach constructs pattern variables based on scientific evidence available before the study. Recently, a new statistical method, reduced rank regression, was applied to nutritional epidemiology that is exploratory by nature, but can use scientific evidence by focusing on disease-related dietary components or biomarkers. Several studies, both observational and clinical, suggest that dietary patterns may predict the risk of CHD and stroke. In the present review, we describe the results of these studies and the available evidence regarding the relationships between dietary patterns and risk of CVD and we discuss limitations and strengths of the statistical methods used toextract dietary patterns.

Type
Review Article
Copyright
Copyright © The Nutrition Society 2006

References

Appel, LJ, Moore, TJ, Obarzanek, E, et al., A clinical trial of the effects of dietary patternson blood pressure. DASH Collaborative Research Group. N Engl J Med 1997 336, 11171124.CrossRefGoogle Scholar
Bentler, PMMutivariate analysis with latent variables: causal modeling. Annu Rev Psychol 1980 31, 1121.CrossRefGoogle Scholar
Bland, JM & Altman, DGCronbach's alpha. BMJ 1997 314, 572.CrossRefGoogle ScholarPubMed
de Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Delaye, J & Mamelle, NMediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart study. Circulation 1999 99, 779785.CrossRefGoogle ScholarPubMed
Diehr, P & Beresford, SAThe relation of dietary patterns to future survival, health, and cardiovascular events in older adults. J Clin Epidemiol 2003 56, 12241235.CrossRefGoogle ScholarPubMed
Esposito, K, Marfella, R, Ciotola, M, Di Palo, C, Giugliano, GD'Armiento, M, D'Andrea, F & Giugliano, DEffect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammationin the metabolic syndrome: a randomized trial. JAMA 2004 292, 14401446.CrossRefGoogle Scholar
Farchi, G, Mariotti, S, Menotti, A, Seccareccia, F, Torsello, S & Fidanza, FDiet and 20-y mortality in two rural population groups of middle-aged men in Italy. Am J Clin Nutr 1989 50, 10951103.CrossRefGoogle ScholarPubMed
Fung, TT, Hu, FB, Holmes, MD, Rosner, BA, Hunter, DJ, Colditz, GA & Willett, WCDietary patterns and the risk of postmenopausal breast cancer. Int J Cancer 2005a 116, 116121.CrossRefGoogle ScholarPubMed
Fung, TT, McCullough, ML, Newby, P, Manson, JE, Meigs, JB, Rifai, N, Willett, WC & Hu, FBDiet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 2005b 82, 163173.CrossRefGoogle ScholarPubMed
Fung, TT, Rimm, EB, Spiegelman, D, Rifai, N, Tofler, GH, Willett, WC & Hu, FBAssociation between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 2001a 73, 6167.CrossRefGoogle ScholarPubMed
Fung, TT, Schulze, M, Manson, JE, Willett, WC & HU, FBpatterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med 2004a 164, 22352240.CrossRefGoogle ScholarPubMed
Fung, TT, Stampfer, MJ, Manson, JE, Rexrode, KM, Willett, WC & Hu, FBProspective study of major dietary patterns and stroke risk in women. Stroke 2004b 35, 20142019.CrossRefGoogle ScholarPubMed
Fung, TT, Willett, WC, Stampfer, MJ, Manson, JE & Hu, FBDietary patterns and the risk of coronary heart disease in women. Arch Intern Med 2001b 1857, 1862–.Google Scholar
Gittelsohn, J, Wolever, TM, Harris, SB, Harris-Giraldo, R, Hanley, AJ & Zinman, BSpecific patterns of food consumption and preparation are associated with diabetes and obesity in a Native Canadian community. J Nutr 1998 128, 541547.CrossRefGoogle Scholar
Heidemann, C, Hoffmann, K, Spranger, J, Klipstein-Grobusch, K, Mohlig, M, Pfeiffer, AF & Boeing, HA dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study cohort. Diabetologia 2005 48, 11261134.CrossRefGoogle ScholarPubMed
Hoffmann, K, Schulze, MB, Schienkiewitz, A, Nothlings, U & Boeing, HApplication of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol 2004a 159, 935944.CrossRefGoogle ScholarPubMed
Hoffmann, K, Zyriax, BC, Boeing, H & Windler, EA dietary pattern derived to explain biomarker variation is strongly associated with the risk of coronary artery disease. Am J Clin Nutr 2004b 80, 633640.CrossRefGoogle ScholarPubMed
Hu, FBDietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002 13, 39.CrossRefGoogle ScholarPubMed
Hu, FB, Rimm, E, Smith-Warner, SA, Feskanich, D, Stampfer, MJ, Ascherio, A, Sampson, L & Willett, WCReproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 1999 69, 243249.CrossRefGoogle ScholarPubMed
Hu, FB, Rimm, EB, Stampfer, MJ, Ascherio, A, Spiegelman, D & Willett, WCProspective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000 72, 912921.CrossRefGoogle ScholarPubMed
Hu, FB & Willett, WCOptimal diets for prevention of coronary heart disease. JAMA 2002 288, 25692578.CrossRefGoogle ScholarPubMed
Jacobs, DR jr & Steffen, LMNutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr Suppl 2003 3, (78)508S513S.CrossRefGoogle Scholar
Jacques, PF & Tucker, KLAre dietary patterns useful for understanding the role of diet in chronic disease?. Am J Clin Nutr 2001 73, 12.CrossRefGoogle ScholarPubMed
Kant, AKDietary patterns and health outcomes. J Am Diet Assoc 2004 104, 615635.CrossRefGoogle ScholarPubMed
Kant, KA, Schatzkin, A, Graubard, BI & Schairer, CA prospective study of diet quality and mortality in women. JAMA 2000 283, 21092115.CrossRefGoogle ScholarPubMed
Kennedy, ET, Ohls, J, Carlson, S & Fleming, KThe Healthy Eating Index: design and applications. J Am Diet Assoc 1995 95, 11031108.CrossRefGoogle ScholarPubMed
Kerver, JM, Yang, EJ, Bianchi, L & Song, WODietary patterns associated with risk factors for cardiovascular disease in healthy US adults. Am J Clin Nutr 2003 78, 11031110.CrossRefGoogle ScholarPubMed
Khani, BR, Ye, W, Terry, P & Wolk, AReproducibility and validity of major dietary patterns among Swedish women assessed with a food-frequency questionnaire. J Nutr 2004 134, 15411545.CrossRefGoogle ScholarPubMed
Knoops, KT, de Groot, LC, Kromhout, D, Perrin, AE, Moreiras-Varela, O, Menotti, A & van Staveren, WAMediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA 2004 292, 14331439.CrossRefGoogle ScholarPubMed
Leclercq, C, Valsta, LM & Turrini, AFood composition issues implications for the development of food-based dietary guidelines. Public Health Nutr 2001 4, 677682.CrossRefGoogle ScholarPubMed
Lopez-Garcia, E, Schulze, MB, Fung, TT, Meigs, JB, Rifai, N, Manson, JE & Hu, FBMajor dietary patterns are related to lasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 2004 80, 10291035.CrossRefGoogle Scholar
McCann, SE, Marshall, JR, Brasure, JR, Graham, S & Freudenheim, JLAnalysis of patterns of food intake in nutritional epidemiology: food classification in principal components analysis and the subsequent impact on estimates for endometrial cancer. Public Health Nutr 2001 4, 989997.CrossRefGoogle ScholarPubMed
McCullough, ML, Feskanich, D, Rimm, FB, Giovannucci, EL, Ascherio, A, Variyam, JN, Spiegelman, D, Stampfer, MJ & Willett, WCAdherence to the Dietary Guidelines for Americans and risk of major chronic disease in men. Am J Clin Nutr 2000a 72, 12231231.CrossRefGoogle ScholarPubMed
McCullough, ML, Feskanich, D, Stampfer, MJ, Giovannucci, EL, Rimm, EB, Hu, FB, Spiegelman, D, Hunter, DJ, Colditz, GA & Willett, WCDiet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 2002 76, 12611271.CrossRefGoogle ScholarPubMed
McCullough, ML, Feskanich, D, Stampfer, MJ, Rosner, BA, Hu, FB, Hunter, DJ, Variyam, JN, Colditz, GA & Willett, WCAdherence to the Dietary Guidelines for Americans and risk of major chronic disease in women. Am J Clin Nutr 2000b 72, 12141222.CrossRefGoogle ScholarPubMed
Margetts, BM, Beilin, LJ, Vandongen, R & Armstrong, BKVegetarian diet in mild hypertension: a randomised controlled trial.Br Med J (Clin Res Ed) 1986 293, 14681471.CrossRefGoogle ScholarPubMed
Martinez, ME, Marshall, JR & Sechrest, LInvited commentary: Factor analysis and the search for objectivity. Am J Epidemiol 1998 146, 1719.CrossRefGoogle Scholar
Maskarinec, G, Novotny, R & Tasaki, KDietary patterns are associated with body mass index in multiethnic women. J Nutr 2000 130, 30683072.CrossRefGoogle ScholarPubMed
Massari, M, Freeman, KM, Seccareccia, F, Menotti, A & Farchi, GAn index to measure the association between dietary patterns and coronary heart disease risk factors: findings from two Italian studies. Prev Med 2004 39, 841847.CrossRefGoogle ScholarPubMed
Michels, KB & Wolk, AA prospective study of variety of healthy foods and mortality in women.Int J Epidemiol 2002 31, 847854.CrossRefGoogle ScholarPubMed
Millen, BE, Quatromoni, PA, Nam, BH, O'Horo, CE, Polak, JF, Wolf, PA & D'Agostino, RBDietary patterns smoking, and subclinical heart disease in women: opportunities for primary prevention from the Framingham Nutrition Studies. J Am Diet Assoc 2004 104, 208214.CrossRefGoogle ScholarPubMed
Montonen, J, Knekt, P, Harkanen, T, Jarvinen, R, Heliovaara, M, Aromaa, A & Reunanen, ADietary patterns and the incidence of type 2 diabetes. Am J Epidemiol 2005 161, 219227.CrossRefGoogle ScholarPubMed
Newby, PK, Hu, FB, Rimm, EB, Smith-Warner, SA, Feskanich, D, Sampson, L & Willett, WCReproducibility and validity of the Diet Quality Index Revised as assessed by use of a food-frequency questionnaire. Am J Clin Nutr 2003 78, 941949.CrossRefGoogle ScholarPubMed
Newby, PK, Muller, D & Tucker, KLAssociations of empirically derived eating patterns with plasma lipid biomarkers: a comparison of factor and cluster analysis methods. Am J Clin Nutr 2004 80, 759767.CrossRefGoogle ScholarPubMed
Newby, PK & Tucker, KLEmpirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 2004 62, 177203.CrossRefGoogle ScholarPubMed
Osler, M, Heitmann, BL, Gerdes, LU, Jorgensen, LM & Scholl, MDietary patterns and mortality in Danish men and women: a prospective observational study. Br J Nutr 2001 85, 219225.CrossRefGoogle ScholarPubMed
Osler, M, Helms Andreasen, A, Heitmann, B, Hoidrup, S, Gerdes, U, Morch Jorgensen, L & Schroll, MFood intake patterns and risk of coronary heart disease: a prospective cohort study examining the use of traditional scoring techniques. Eur J Clin Nutr 2002 56, 568574.CrossRefGoogle ScholarPubMed
Petersen, S, Peto, V, Rayner, M, Leal, J, Luengo-Fernandez, R & Gray, AEuropean Cardiovascular Disease Statistics. London: British Heart Foundation. 2005Google Scholar
Rouse, IL, Beilin, LJ, Armstrong, BK & Vandongen, RBloodpressure-lowering effect of a vegetarian diet: controlled trial in normotensive subjects. Lancet 1983 i, 510.CrossRefGoogle Scholar
Schulze, MB, Hoffmann, K, Kroke, A & Boeing, HDietary patterns and their association with food and nutrient intake in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. Br J Nutr 2001 85, 363373.CrossRefGoogle ScholarPubMed
Schulze, MB, Hoffmann, K, Kroke, A & Boeing, HAn approach to construct simplified measures of dietary patterns from exploratory factor analysis. Br J Nutr 2003a 89, 409419.CrossRefGoogle ScholarPubMed
Schulze, MB, Hoffmann, K, Kroke, A & Boeing, HRisk of hypertension among women in the EPIC-Potsdam study: comparison of relative risk estimates for exploratory and hypothesisoriented dietary patterns. Am J Epidemiol 2003b 158, 365373.CrossRefGoogle ScholarPubMed
Schulze, MB, Hoffmann, K, Manson, JE, Willett, WC, Meigs, JBWeikert, CHeidemann, CColditz, GA & Hu, FBDietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr 2005 82, 675684.CrossRefGoogle ScholarPubMed
Schulze, MB & Hu, FBDietary patterns and risk of hypertension, type 2 diabetes mellitus, and coronary heart disease. Curr Atheroscler Rep 2002 4, 462467.CrossRefGoogle ScholarPubMed
Stampfer, MJ, Hu, FB, Manson, JE, Rimm, EB & Willett, WCPrimary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 2000 343, 1622.CrossRefGoogle ScholarPubMed
Trichopoulou, A, Costacou, T, Bamia, C & Trichopoulos, DAdherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003 348, 25992608.CrossRefGoogle Scholar
van Dam, RMNew approaches to the study of dietary patterns. Br J Nutr 2005 93, 573574.CrossRefGoogle Scholar
van Dam, RM, Grievink, L, Ocke, MC & Feskens, EJPatterns of food consumption and risk factors for cardiovascular disease in the general Dutch population. Am J Clin Nutr 2003 77, 11561163.CrossRefGoogle ScholarPubMed
van Dam, RM, Rimm, EB, Willett, WC, Stampfer, MJ & Hu, FBDietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med 2002 136, 201209.CrossRefGoogle ScholarPubMed
Weikert, C, Hoffmann, K, Dierkes, J, Zyriax, BC, Klipstein-Grobusch, K, Schulze, MB, Jung, R, Windler, E & Boeing, HA homocysteine metabolism-related dietary pattern and the risk of coronary heart disease in two independent German study populations. J Nutr 2005 135, 19811988.CrossRefGoogle ScholarPubMed
World Health Organization World Health Report: 2005, Make Every Mother and Child Count. Geneva: World Health Organization. 2003Google Scholar
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