Abstract
Objectives
Our goal was to examine the relationship between diet quality, cardiovascular disease risk, and changes in diet quality over time. We hypothesized that diets lacking in nutrients for ideal cardiovascular health would be conserved from childhood to adulthood. This would be reflected as increased rates of hypertension, diabetes, dyslipidemia, and obesity.
Methods
Diet data was analyzed from the Princeton Lipid Research study (24 hour recall in the 70’s; Block Food Frequency Questionnaire in 1998). Diet quality at each visit was assessed as a ranking of 15 different macro/micronutrients and by a modified Dietary Approaches to Stop Hypertension (DASH) index based on 9 nutrient targets and adapted for children. Outcomes for childhood/adulthood included: glucose intolerance/diabetes, high blood pressure/hypertension (HTN), dyslipidemia/hyperlipidemia (HLD), and obesity. Linear and logistic regression models were performed with adjustment for age, race, sex, body mass index, occupation and education of self or head of household, and marital status.
Results
Analysis included 221 total individuals in Generation 1 (parents at initial visit; 39% male, mean age 38.9 ± 6.5 followed up at 66.6 ± 6.6 years) and 606 individuals in Generation 2 (45% male, mean age 11.9 ± 3.23 at initial visit and 38.5 ± 3.6 years at follow up). Generation 1 increased in total DASH score from initial visit to follow-up (1.74 ± 0.95 → 2.11 ± 1.33) while Generation 2 decreased (1.91 ± 0.80 → 1.64 ± 1.13). Overall DASH score was not significantly associated with baseline or follow up outcomes in childhood or adulthood. However, in Generation 2 at follow-up, fiber, potassium, iron, niacin, and vitamin A were associated with HTN; fiber, potassium, and sugar with HLD; cholesterol with obesity; and saturated fat with diabetes in Generation 1.
Conclusions
Overall diet quality was poor in both generations and changed little over time. No relationship was detected between DASH diet accordance and disease outcomes, however certain nutrients are associated with and may contribute to higher cardiovascular disease risk.
Funding Sources
Supported by the NIH grant for the University of Cincinnati's Medical Student Summer Research Program.
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