scholarly journals Dietary Pattern Indices and Incident Peripheral Arterial Disease in Women: A Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 513-513
Author(s):  
Guochong Chen ◽  
Yasmin Mossavar-Rahmani ◽  
Xiaonan Xue ◽  
Bernhard Haring ◽  
Aladdin Shadyab ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Kidney Diseases ◽  
Healthy Eating Index ◽  
Cox Proportional Hazards ◽  
Processed Meat ◽  
Incident Cases

Abstract Objectives We aimed to evaluate diet quality as reflected by multiple a priori dietary pattern indices in relation to incident PAD. Methods We included 138,506 US postmenopausal women aged 50–79 years without known PAD at baseline (1993–1998) of the Women's Health Initiative. Score of 4 dietary pattern indices, including the alternate Mediterranean diet (aMED) index, the alternate Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet index, and the Healthy Eating Index (HEI)-2015, were derived using data collected by a validated food frequency questionnaire. Incident cases of symptomatic PAD in the lower extremities were ascertained and adjudicated through March 2019 by reviewing medical record. Hazard ratios (HR) and 95% confidence interval (CI) were estimated using Cox proportional hazards models, with adjustment for multiple potential confounders including known risk factors for PAD (i.e., smoking, high blood pressure, dyslipidemia, and diabetes). Results During a median 18.6 years of follow-up, 1036 incident cases of PAD were identified. All 4 dietary pattern indices were inversely associated with risk of PAD. The multivariable-adjusted HRs (95% CI) comparing the highest with the lowest score quartiles were 0.74 (0.61–0.91) for aMED index (P-trend across quartile = 0.010), 0.79 (0.65–0.95) for AHEI-2010 (P-trend < 0.001), 0.66 (0.55–0.80) for DASH index (P-trend < 0.001), and 0.68 (0.56–0.82) for HEI-2015 (P-trend < 0.001). Among major foods/nutrients contributing to these dietary patterns, intakes of whole grains (top vs. bottom quartile, HR = 0.81; P-trend = 0.01), legumes (HR = 0.77; P-trend = 0.004), dietary fiber (HR = 0.78; P-trend = 0.01), and vegetable protein (HR = 0.76; P-trend = 0.006) were associated with lower risk of PAD, whereas intakes of red meat (HR = 1.38; P-trend = 0.003), processed meat (HR = 1.36; P-trend = 0.004), and regular soft drinks (HR = 1.26; P-trend = 0.01) were associated with higher risk. Conclusions Adherence to various recommended dietary patterns is associated with lower risk of PAD in a nationwide cohort of US postmenopausal women. Our findings may extend the range of cardiovascular diseases that are potentially preventable by adopting a healthy dietary pattern. Funding Sources National Heart, Lung, and Blood Institute; and National Institute of Diabetes and Digestive and Kidney Diseases.

scholarly journals Healthy Eating Index 2015 and Major Dietary Patterns in Relation to Incident Hypertension; A Prospective Cohort Study

2021 ◽  
Author(s):  
Yahya Pasdar ◽  
Behrooz Hamzeh ◽  
Shima Moradi ◽  
Ehsan Mohammadi ◽  
Mitra Darbandi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Sodium Intake ◽  
Healthy Eating Index ◽  
Cox Proportional Hazards ◽  
Protective Effects ◽  
Using Data

Abstract Background: Since hypertension (HTN) is responsible for more than half of all deaths from cardiovascular disease, it is important to know the nutritional factors that reduce its risk. Although little information is known about it in the Kurdish population. This study was aimed to evaluate healthy eating index (HEI) 2015 and major dietary patterns in relation to incident HTN. Methods: This case- cohort study was designed using data from Ravansar non- communicable diseases (RaNCD) cohort study (294 participants with incident HTN and 1295 participants as representative random sub-cohort). HEI 2015 and major dietary patterns were extracted using data from their dietary intake and three major dietary patterns were identified including plant- based, high protein, and unhealthy dietary patterns. To analysis of association between HEI 2015 and major dietary patterns with incident HTN Cox proportional hazards regression models were applied. Results: There was a positive significant correlation between HEI 2015 and plant- based diet (r=0.492). The participants in the highest quartile of HEI-2015 had a 39% lower risk of incident HTN, compared to participants in first quartile in both crude and adjusted model (HR: 0.61; 95% CI: 0.46-0.82) and (HR: 0.7; 95% CI: 0.51–0.97), respectively. Furthermore, participants who were the highest tertile of plant- based dietary pattern were lower risk of incident HTN in both crude and adjusted models (HR: 0.69; 95% CI: 0.54–0.9) and (HR: 0.7; 95% CI: 0.53–0.94), respectively. However, other two identified dietary patterns had no significant association with incident HTN. Conclusions: We found evidence indicating higher adherence to HEI 2015 and plant- based diet had protective effects on incident HTN. The HEI 2015 emphasizes limited sodium intake and adequate intake of vegetables and fruits.

Abstract 13: Adherence to Various Dietary Patterns and Risk of Recurrent Coronary Heart Disease and Mortality in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
James M Shikany ◽  
Monika M Safford ◽  
Joanna Bryan ◽  
PK Newby ◽  
Joshua S Richman ◽  
...  
Keyword(s):  
Racial Differences ◽  
Mediterranean Diet ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Mediterranean Diet Score ◽  
The Mediterranean ◽  
Diet Score

Background: We have shown that the Southern dietary pattern, characterized by added fats, fried foods, organ and processed meats, and sugar-sweetened beverages, is associated with a greater risk of incident CHD in REGARDS, a national, population-based, longitudinal cohort. We sought to determine if the Southern pattern, other dietary patterns, and the Mediterranean diet score were associated with CHD events and mortality in REGARDS participants who previously reported CHD. Methods: REGARDS enrolled white and black adults aged ≥45 years between 2003-2007. Data were analyzed from 3,562 participants with CHD at baseline. Participants completed an FFQ at baseline, from which 5 dietary patterns were derived through factor analysis (Table). The Mediterranean diet score was calculated for each participant. Expert-adjudicated CHD events included myocardial infarction and CHD death. Cox proportional hazards regression was used to model the association of the dietary patterns and score with CHD events and death, adjusting for sociodemographics, lifestyle factors, energy intake, anthropometrics, and medical conditions. Results: Over 7 years of follow-up, there were 581 recurrent CHD events and 1,098 deaths. In fully-adjusted analyses, the highest quartile of adherence to the alcohol/salads pattern and highest group of the Mediterranean diet score were associated with lower risk of recurrent CHD compared to the lowest quartile/group (HR: 0.76; 95% CI: 0.59 – 0.98, HR: 0.78; 95% CI: 0.62 – 0.98, respectively). The highest quartile of adherence to the Southern pattern was associated with higher mortality (HR: 1.57; 95% CI: 1.28 – 1.91), while the highest group of the Mediterranean diet score was associated with lower mortality (HR: 0.80; 95% CI: 0.68 – 0.95). Conclusions: While the Southern dietary pattern was not related to risk of recurrent CHD, it was associated with higher mortality in REGARDS participants with existing CHD. Greater adherence to a Mediterranean diet was associated with lower risk of recurrent CHD and mortality.

scholarly journals Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study

2019 ◽  
Vol 110 (3) ◽  
pp. 713-721 ◽  
Author(s):  
Emily A Hu ◽  
Lyn M Steffen ◽  
Morgan E Grams ◽  
Deidra C Crews ◽  
Josef Coresh ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Healthy Eating Index ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Dietary Score

ABSTRACTBackgroundAdherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined.ObjectiveWe aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD.MethodsWe conducted a prospective analysis in 12,155 participants aged 45–64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 accompanied by ≥25% decline in estimated glomerular filtration rate, a kidney disease–related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017.ResultsThere were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk (P-trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1.ConclusionHigher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.

scholarly journals Dietary Patterns and Risk of Chronic Kidney Disease Progression and All-Cause Mortality: Findings from the CRIC study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1415-1415
Author(s):  
Emily Hu ◽  
Josef Coresh ◽  
Cheryl Anderson ◽  
Lawrence Appel ◽  
Morgan Grams ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Ckd Progression ◽  
Adjusted Risk ◽  
All Cause Mortality

Abstract Objectives Current dietary guidelines recommend that chronic kidney disease (CKD) patients reduce intake of individual nutrients, such as sodium, potassium, phosphorus, and protein. This approach can be difficult for patients to implement and ignores important nutrient interactions. Our objective was to define the association of healthy dietary patterns with risk of CKD progression and all-cause mortality among people with CKD. Methods We analyzed data from 2403 participants aged 21–74 years with an estimated glomerular filtration rate (eGFR) of 20–70 mL/min/1.73 m2 and dietary data in the Chronic Renal Insufficiency Cohort (CRIC) study. Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMed), and Dietary Approaches to Stop Hypertension (DASH) diet scores were calculated using data collected from food frequency questionnaires. We analyzed the association between these dietary patterns and two main outcomes: 1) CKD progression defined as ≥50% eGFR decline, kidney transplantation, or dialysis, and 2) all-cause mortality. Cox proportional hazards regression models adjusted for demographic, lifestyle, and clinical covariates were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results There were 855 cases of CKD progression and 773 deaths over a maximum of 14 years. Compared with participants with the lowest adherence, the most highly adherent tertile of AHEI-2010, aMed, and DASH had lower adjusted risk of CKD progression with the strongest association for aMed (HR: 0.75, 95% CI: 0.62–0.90). Nuts and legumes were independently associated with lower risk of CKD progression. Compared with participants with the lowest adherence, the highest adherence tertiles for all four scores had a 24–31% lower adjusted risk of all-cause mortality. Conclusions Greater adherence to a healthy dietary pattern is associated with a lower risk of CKD progression and all-cause mortality among people with CKD. Guidance to adopt healthy dietary patterns should be incorporated into guidelines for individuals with CKD. Funding Sources NIH (NHLBI, NIDDK).

scholarly journals Adherence to Dietary Patterns and Risk of Incident Dementia: Findings from the Atherosclerosis Risk in Communities Study

2020 ◽  
Vol 78 (2) ◽  
pp. 827-835
Author(s):  
Emily A. Hu ◽  
Aozhou Wu ◽  
Jennifer L. Dearborn ◽  
Rebecca F. Gottesman ◽  
A. Richey Sharrett ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Cox Regression ◽  
Healthy Eating Index ◽  
Atherosclerosis Risk In Communities ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Previous studies have suggested that adherence to healthy dietary patterns during late life may be associated with improved cognition. However, few studies have examined the association between healthy dietary patterns during midlife and incident dementia. Objective: Our study aimed to determine the association between adherence to healthy dietary patterns at midlife and incident dementia. Methods: We included 13,630 adults from the Atherosclerosis Risk in Communities (ARIC) Study in our prospective analysis. We used food frequency questionnaire responses to calculate four dietary scores: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension (DASH). Participants were followed until the end of 2017 for incident dementia. Cox regression models adjusted for covariates were used to estimate risk of incident dementia by quintile of dietary scores. Results: Over a median of 27 years, there were 2,352 cases of incident dementia documented. Compared with participants in quintile 1 of HEI-2015, participants in quintile 5 (healthiest) had a 14% lower risk of incident dementia (hazard ratio, HR: 0.86, 95% confidence interval, CI: 0.74–0.99). There were no significant associations of incident dementia with the AHEI-2010, aMed, or DASH scores. There were no significant interactions by sex, age, race, education, physical activity, hypertension, or obesity. Conclusion: Adherence to the HEI-2015, but not the other dietary scores, during midlife was associated with lower risk of incident dementia. Further research is needed to elucidate whether timing of a healthy diet may influence dementia risk.

scholarly journals Identification of Dish-Based Dietary Patterns for Breakfast, Lunch, and Dinner and Their Diet Quality in Japanese Adults

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 67
Author(s):  
Nana Shinozaki ◽  
Kentaro Murakami ◽  
Keiko Asakura ◽  
Shizuko Masayasu ◽  
Satoshi Sasaki
Keyword(s):  
Cluster Analysis ◽  
Healthy Eating ◽  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Healthy Eating Index ◽  
Japanese Adults ◽  
Dietary Record ◽  
Dietary Data

We identified dish-based dietary patterns for breakfast, lunch, and dinner and assessed the diet quality of each pattern. Dietary data were obtained from 392 Japanese adults aged 20–69 years in 2013, using a 4 d dietary record. K-means cluster analysis was conducted based on the amount of each dish group, separately for breakfasts (n = 1462), lunches (n = 1504), and dinners (n = 1500). The diet quality of each dietary pattern was assessed using the Healthy Eating Index 2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3). The extracted dietary patterns were as follows: ‘bread-based’ and ‘rice-based’ for breakfast; ‘bread’, ‘rice-based’, ‘ramen’, ‘udon/soba’, and ‘sushi/rice bowl dishes’ for lunch; and ‘miscellaneous’, ‘meat dish and beer’, and ‘hot pot dishes’ for dinner. For breakfast, the HEI-2015 and NRF9.3 total scores were higher in the ‘rice-based’ pattern than the ‘bread-based’ pattern. For lunch, the HEI-2015 and NRF9.3 total scores were relatively high in the ‘rice-based’ pattern and low in the ‘ramen’ pattern. For dinner, the HEI-2015 total score was the highest in the ‘meat dish and beer’ pattern, and the NRF9.3 total score was higher in the ‘hot pot dishes’ than the ‘miscellaneous’ pattern. These results suggested that breakfast, lunch, and dinner have distinctive dietary patterns with different diet qualities.

scholarly journals Mediterranean, DASH, and Alternate Healthy Eating Index Dietary Patterns and Risk of Death in the Physicians’ Health Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1893
Author(s):  
Yash R. Patel ◽  
Jeremy M. Robbins ◽  
J. Michael Gaziano ◽  
Luc Djoussé
Keyword(s):  
Healthy Eating ◽  
Dietary Patterns ◽  
Cancer Mortality ◽  
Lower Risk ◽  
Cox Regression ◽  
Total Mortality ◽  
Healthy Eating Index ◽  
Health Study ◽  
Risk Of Death ◽  
All Cause Mortality

Objective: Our primary objective was to examine the associations of the Mediterranean (MED), the Dietary Approaches to Stop Hypertension (DASH), and the Alternate Healthy Eating Index (AHEI) diet with total mortality. Our secondary objective was to examine the association of these three dietary patterns with cardiovascular disease (CVD) and cancer mortality. Research: Design and Methods: We prospectively studied 15,768 men from the Physicians’ Health Study who completed a semi-quantitative food-frequency questionnaire. Scores from each dietary pattern were divided into quintiles. Multivariable Cox regression models were used to estimate hazard ratio’s (95% confidence intervals) of mortality. Results: At baseline, average age was 65.9 ± 8.9 years. There were 1763 deaths, including 488 CVD deaths and 589 cancer deaths. All diet scores were inversely associated with risk for all-cause mortality: Hazard ratios (95% CI) of all-cause mortality from lowest to highest quintile for MED diet were 1.0 (reference), 0.85 (0.73–0.98), 0.80 (0.69–0.93), 0.77 (0.66–0.90), and 0.68 (0.58–0.79); corresponding values were 1.0 (reference), 0.96 (0.82–1.12), 0.95 (0.82–1.11), 0.88 (0.75–1.04), and 0.83 (0.71–0.99) for DASH diet and 1.0 (reference), 0.88 (0.77–1.02), 0.82 (0.71–0.95), 0.69 (0.59, 0.81), and 0.56 (0.47–0.67) for AHEI diet, after adjusting for age, energy, smoking, exercise, BMI, hypertension, coronary heart disease, congestive heart failure, diabetes, and atrial fibrillation. For cause-specific mortality, MED and AHEI scores were inversely associated with lower risk for CVD mortality, whereas AHEI and MED scores were inversely associated with lower risk for cancer mortality. Conclusion: Within this cohort of male physicians, AHEI, MED, and DASH scores were each inversely associated with mortality from all causes.

scholarly journals Ketogenic Ratio of Macronutrients and Risk of Diabetes Among Postmenopausal Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 459-459
Author(s):  
Tyler Titcomb ◽  
Buyun Liu ◽  
Linda Snetselaar ◽  
Terry Wahls ◽  
Wei Bao
Keyword(s):  
Postmenopausal Women ◽  
Ketogenic Diet ◽  
Kidney Diseases ◽  
Cox Proportional Hazards ◽  
Diabetes Research ◽  
Total Carbohydrate ◽  
Ketogenic Diets ◽  
Increased Risk ◽  
Incident Cases

Abstract Objectives To evaluate the association of the ketogenic ratio of macronutrients (KR) with incidence of diabetes (DM). Methods Dietary information was obtained at baseline from postmenopausal women enrolled in the Women's Health Initiative (WHI) clinical trials (not including the intervention arm of dietary modification trial) and observational study. Participants were excluded if they had prevalent diabetes or unknown status of diabetes at baseline or reported energy intakes &lt;600 or &gt;5000 kilocalories. The KR was calculated as follows: (0.9*grams fat + 0.46*grams protein) divided by (0.1*grams fat + 0.58*grams protein + grams total carbohydrate – grams total fiber). A KR value 1.5 is considered the minimum threshold to predict a ketogenic diet. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between KR and risk of DM. Follow-up time was the number of days from enrollment to the first instance of incident DM. Results Among 128 752 participants, there were 19 439 incident cases of DM with median follow-up time of 20.7 years. The median KR was 0.36 and 12 participants (&lt;0.0001%) exceeded the KR threshold for a ketogenic diet. After adjustment for age, race/ethnicity, comorbidities, education, income, marital status, health insurance, smoking, DM family history, hormone use, energy intake, HEI scores, physical activity, region, and WHI arm, each KR quintile was associated with increased risk of DM. Comparing extreme quintiles of KR, the adjusted HR (95% CI) for diabetes was 1.32 (1.26–1.39; Ptrend &lt; 0.0001). The association remained significant after further adjustment for BMI, with an adjusted HR (95% CI) of 1.22 (1.16–1.29; Ptrend &lt; 0.0001) comparing the highest with lowest quintile of KR. We were unable to show an association of exceeding the KR threshold with DM due to the small number of participants who exceeded the KR threshold. Conclusions The KR was positively associated with incidence of DM. However, we are unable to draw conclusions about ketogenic diets because the majority of participants were below the KR threshold for a ketogenic diet. Funding Sources This work was supported by the Fraternal Order of Eagles Diabetes Research Center with funding from the National Institutes of Diabetes and Digestive and Kidney Diseases.

scholarly journals Metabolomic markers of healthy dietary patterns in US postmenopausal women

2019 ◽  
Vol 109 (5) ◽  
pp. 1439-1451 ◽  
Author(s):  
Marjorie L McCullough ◽  
Maret L Maliniak ◽  
Victoria L Stevens ◽  
Brian D Carter ◽  
Rebecca A Hodge ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Partial Correlation ◽  
Healthy Eating Index ◽  
Healthy Diet ◽  
Diet Patterns ◽  
Diet Pattern ◽  
Risk Of Cancer ◽  
Diet Score

ABSTRACT Background Healthy diet patterns are associated with lower risk of cancer and other chronic diseases. Metabolomics has the potential to expand dietary biomarker development to include dietary patterns, which may provide a complement or alternative to self-reported diet. Objective This study examined the correlation of serum untargeted metabolomic markers with 4 diet pattern scores—the alternate Mediterranean diet score (aMED), alternate Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet, and the Healthy Eating Index (HEI)-2015—and used multivariate methods to identify discriminatory metabolites for each pattern. Methods Among 1367 US postmenopausal women with serum metabolomic data in the Cancer Prevention Study-II Nutrition Cohort, we conducted partial correlation analysis, adjusted for demographic and lifestyle variables, to examine cross-sectional correlations between serum metabolomic markers and healthy diet pattern scores. In a randomly selected “training” set (50%), we conducted orthogonal partial least-squares discriminant analysis to identify metabolites that discriminated the top from bottom diet score quintiles. Combinations of metabolites with a variable importance in projection (VIP) score ≥2.5 were tested for predictability in the “testing” set based on the use of receiver operating characteristic curves. Results Out of 1186 metabolites, 32 unique metabolites were considered discriminatory based on a VIP score ≥2.5 in the training dataset with some overlap across scores (aMED = 16; AHEI = 17; DASH = 13; HEI = 12). Spearman partial correlation analyses, applying a cut-point (|r| ≥ 0.15) and Bonferroni correction (P < 1.05 × 10−5), identified similar key metabolites. The top 5 metabolites for each pattern mostly distinguished high compared with low scores; 4 of the 5 (fish-derived) metabolites were the same for aMED and AHEI, 2 of which were identified for HEI; 4 DASH metabolites were unique. Conclusions Metabolomic methods that used a split-sample approach identified potential biomarkers for 4 healthy diet patterns. Similar metabolites across scores reflect fish consumption in healthy dietary patterns. These findings should be replicated in independent populations.

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