scholarly journals Pasta meal intake in relation to risks of type 2 diabetes and atherosclerotic cardiovascular disease in postmenopausal women : findings from the Women’s Health Initiative

2021 ◽  
pp. bmjnph-2020-000198
Author(s):  
Mengna Huang ◽  
Kenneth Lo ◽  
Jie Li ◽  
Matthew Allison ◽  
Wen-Chih Wu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Women's Health ◽  
Postmenopausal Women ◽  
Diabetes Risk ◽  
Atherosclerotic Cardiovascular Disease ◽  
White Bread ◽  
Health Initiative ◽  
Meal Intake ◽  
Reduced Risk

ObjectiveTo evaluate the association between pasta meal intake and long-term risk of developing diabetes or atherosclerotic cardiovascular disease (ASCVD, including coronary heart disease (CHD) and stroke) in postmenopausal women.DesignProspective cohort study.SettingWomen’s Health Initiative (WHI) in the USA.Participants84 555 postmenopausal women aged 50–79 in 1994, who were free of diabetes, ASCVD and cancer at baseline who were not in the dietary modification trial of the WHI, completed a validated food frequency questionnaire, and were evaluated for incident diabetes and ASCVD outcomes during the follow-up until 2010.Main outcome measureDiabetes and ASCVD.ResultsCox proportional hazards models were used to estimate the association (HR) between quartiles of pasta meal consumption (residuals after adjusting for total energy) and the risk of incidence diabetes, CHD, stroke or ASCVD, accounting for potential confounding factors, with testing for linear trend. We then statistically evaluated the effect of substituting white bread or fried potato for pasta meal on disease risk. When comparing the highest to the lowest quartiles of residual pasta meal intake, we observed significantly reduced risk of ASCVD (HR=0.89, 95% CI 0.83 to 0.96, p trend=0.002), stroke (HR=0.84, 95% CI 0.75 to 0.93, p trend=0.001), CHD (HR=0.91, 95% CI 0.83 to 1.00, p trend=0.058) and no significant alteration in diabetes risk (HR=1.02, 95% CI 0.96 to 1.07, p trend=0.328). Replacing white bread or fried potato with pasta meal was statistically associated with decreased risk of stroke and ASCVD.ConclusionsPasta meal intake did not have adverse effects on long-term diabetes risk and may be associated with significant reduced risk of stroke and ASCVD. The potential benefit of substituting pasta meal for other commonly consumed starchy foods on cardiometabolic outcomes warrants further investigation in additional high-quality and large prospective studies of diverse populations.

Abstract P511: Adherence to the Dietary Portfolio is Associated With Lower Cardiovascular Disease Risk in the Women's Health Initiative Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Andrea J Glenn ◽  
Kenneth Lo ◽  
Beatrice A Boucher ◽  
Mara Z Vitolins ◽  
Joann E Manson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Women's Health ◽  
Postmenopausal Women ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Women's Health Initiative ◽  
Health Initiative ◽  
Dietary Portfolio ◽  
The Women’S Health Initiative

Introduction: The Dietary Portfolio is a plant-based dietary pattern of a combination of recognized cholesterol-lowering foods and has been shown to lower a number of cardiovascular disease (CVD) risk factors, including low-density lipoprotein cholesterol, blood pressure and C-reactive protein. However, no studies have assessed if following the Portfolio results in fewer CVD events. Hypothesis: Higher adherence to the Portfolio will be associated with fewer CVD events. Methods: We included 125,389 postmenopausal women from the Women’s Health Initiative Observational Study and Clinical Trials (from 1993 to 2017) who were free of CVD at baseline. Adherence to the Portfolio was assessed using an a priori diet index based on 6 food categories (high in plant protein [soy & pulses], nuts, viscous fiber, plant sterols and monounsaturated fat, and low in saturated fat) that were found to lower CVD risk factors in the Portfolio trials. Adjusted hazard ratios (HRs) and 95% confidence intervals [CIs] for CVD were calculated using Cox regressions. We adjusted for CVD risk & lifestyle factors and potential confounders (see Table 1). Results: During 1,826,176 person-years of follow-up, we documented 11,370 total CVD cases, including 5,739 coronary heart disease (CHD) cases, 4,451 stroke cases, 1,946 heart failure (HF) cases and 935 atrial fibrillation (AF) cases. Comparing the highest to the lowest quartile in the fully adjusted model, higher adherence to the Portfolio was associated with a reduced risk of total CVD (HR=0.89 [95% CI 0.84-0.95]), CHD (0.87 [0.79-0.95]) and HF (0.83 [0.70-0.98]). No association was found with stroke (0.97 [0.87-1.08]) and AF (1.09 [0.87-1.38]). Conclusions: In postmenopausal women, higher adherence to the Portfolio was inversely associated with total CVD, CHD and HF but not stroke or AF. These findings suggest that the Portfolio may assist with CVD, CHD and HF prevention and warrants further investigation. Table 1: Association of the Dietary Portfolio and risk of CVD in Postmenopausal Women

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