Diet quality and weight gain among black and white young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985–2005)

Introduction: There is growing data regarding the potential for plant-centered diets to reduce risk for cardiovascular disease (CVD) and mortality. However, additional investigation is needed to strengthen and address inconsistencies in the existing evidence base. We examined the association between cumulative consumption of a plant-centered diet and a shift toward a more plant-centered diet and onset of CVD and all-cause mortality. Hypothesis: Nutritionally-rich plant-centered diets will be related to decreased risk of CVD and mortality. Methods: We included 4,926 black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, ages 18-30 years and free of CVD at baseline (1985-1986, exam year [Y0]) and followed until 2018. Diet was assessed through an interviewer-administered diet history at Y0, Y7, and Y20. A Priori Diet Quality Score (APDQS) was used to assess plant-centered diet quality, and high index scores were characterized by higher consumption of nutritionally-rich plant foods with limited consumption of meats and less healthful plant foods. Proportional hazards regression estimated the association of time-varying APDQS, which were cumulatively averaged over follow-up and 13-year change in APDQS (Y7-Y20) with CVD and all-cause mortality. The model was adjusted for sociodemographic factors, energy intake, parental history of CVD, smoking, and physical activity. Results: We documented 289 new CVD cases and 445 all-cause deaths during the median 32-years of follow up. In multivariable analysis, the highest quintile of cumulative APDQS was associated with a 52% lower risk of CVD (hazard ratio [HR]: 0.48, 95% CI: 0.28-0.81) compared with the lowest quintile of cumulative APDQS. Increased APDQS over 13 years was related to a 62% lower subsequent 12-year risk of CVD (95% CI: 0.18-0.78) when comparing extreme quintiles. The association for all-cause mortality was only apparent among high educational groups. Conclusions: Following a plant-centered, high-quality diet staring from young adulthood was associated with a lower risk of developing CVD and death by middle age. Our findings support the concept that a plant-centered diet may help prevent early CVD and death.

Download Full-text

Age-Related Development of Cardiac Remodeling and Dysfunction in Young Black and White Adults: The Coronary Artery Risk Development in Young Adults Study

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2020.11.002 ◽

2020 ◽

Author(s):

Amanda M. Perak ◽

Sadiya S. Khan ◽

Laura A. Colangelo ◽

Samuel S. Gidding ◽

Anderson C. Armstrong ◽

...

Keyword(s):

Young Adults ◽

Coronary Artery ◽

Cardiac Remodeling ◽

Black And White ◽

Age Related ◽

Related Development ◽

White Adults

Download Full-text

Life Course Change Towards a Plant-Centered Diet and Incidence of Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study (OR33-03-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.or33-03-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Yuni Choi ◽

David Jacobs ◽

Kristin Hirahatake ◽

Nicole Larson ◽

Andrew Odegaard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Coronary Artery ◽

Diet Quality ◽

Proportional Hazards ◽

Dietary Quality ◽

Food Groups ◽

Incident Type

Abstract Objectives There has been limited study of long-term change towards a plant-centered diet in relation to incident type 2 diabetes (T2DM). We examined this question in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Methods Analyses included 2717 participants in CARDIA, a US multicenter, community-based prospective cohort study, currently with 30 years of follow-up. Participants were free of diabetes through year 20, with follow-up for incident T2DM through year 30. Dietary intake at years 0 and 20 was assessed by interviewer-administered diet history; overall dietary quality was assessed using a hypothesis-driven index based on 46 food groups, the A Priori Diet Quality Score (APDQS). The APDQS has possible scores 0 to 132 and increasing score is largely led by consumption of nutritionally rich plant foods–fruits and vegetables and plant-derived fats (e.g., seeds, nut, vegetable oils) and proteins (e.g., avocado, legume, soy). Change in diet quality (year 20 – year 0) and its quintiles were calculated. Diagnosis of T2DM was based on self-reported use of antidiabetic medication treatment or lab tests (fasting glucose, 2-hour glucose, or glycated hemoglobin). In proportional hazards regression, covariates included sociodemographics, baseline APDQS, and time-varying energy intake, smoking, and physical activity. Results Mean baseline age was 25.0 ± 3.6y, 43% were black, and 58% were women. During 10 years of follow-up after year 20, 206 cases of incident T2DM occurred. Mean year 0 APDQS was 64 ± 13 points and mean 20-year changes in APDQS was 7 ± 11. In multivariable-adjusted analysis, we found that the greatest increase in dietary quality over 20 years (median APDQS increased by 22 points) was associated with a 60% decrease in risk of T2DM as compared to a small decrease in diet quality (median APDQS decreased by 8 points); HRQ5 vs. Q1: 0.40; 95% CI:0.24–0.67). For every 10-point increase in APDQS over 20 years, there was a 23% decrease in risk of T2DM (95% CI: 0.67–0.88, P-trend = 0.0009). The pattern of findings persisted within below median and within above median year 0 APDQS. Conclusions Our finding suggests that young adults would benefit from improving diet quality by shifting toward a more plant-centered diet over time for the prevention of T2DM. Funding Sources This research was funded by an NHLBI contract and the University of Minnesota Healthy Food, Healthy Lives Institute. Supporting Tables, Images and/or Graphs

Download Full-text

A Plant-Centered Diet and Onset of Chronic Kidney Disease in 20 Years of Follow-Up: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Cohort

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_016 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1388-1388

Author(s):

Yuni Choi ◽

David Jacobs ◽

Haitao Chu ◽

Daniel Duprez ◽

Daniel Gallaher ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Young Adults ◽

Coronary Artery ◽

Kidney Disease ◽

Diet Quality ◽

Lower Risk ◽

Multivariable Analysis ◽

High Quality ◽

Quality Diet

Abstract Objectives Chronic kidney disease (CKD) is an increasing health problem in young adults and may be associated with dietary patterns. We examined the association of a plant-centered diet with incident moderate-to-very high risk CKD in young adults who were initially free of CKD. Methods We followed 3026 community-based participants (Black and White men and women) from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (1985–86 to 2015–16). Diet was assessed by an interviewer-administered diet history at exam years (Y) 0, 7, and 20. Higher plant-centered diet quality was judged by higher cumulative average value of the A Priori Diet Quality Score (APDQS, range 0–132), a hypothesis-driven index based on 46 food groups. A higher APDQS is characterized by high consumption of nutritionally rich plant foods and limited meat, added sugars, and other less nutritious foods. Kidney status, assessed at 5-year intervals from Y10 to Y30, was based on estimated glomerular filtration rate (eGFR) using CKD-EPI creatinine equation and spot urine albumin-to-creatinine ratio (ACR). CKD diagnosis included new onset of micro- or macro-albuminuria (ACR ≥30 mg/g), eGFR <60 mL/min/1.73m,2, or (hospitalized or fatal) end stage renal disease. Prevalent CKD cases throughout Y10 were excluded. Proportional hazards regression estimated the association of time-varying cumulative average APDQS with incident CKD, adjusted for age, sex, race, education, energy intake, % energy from protein, physical activity, and smoking. Results Mean Y10 age was 35.1 y (±3.6 y) and mean cumulative average APDQS was 65.0 (±11.4). We identified 358 incident CKD cases (59 of whom were severe cases) during mean follow-up of 17.7 years (±4.4) after Y10. Eating a plant-centered, high quality diet was associated with a lower risk of incident CKD. In multivariable analysis, participants in the highest quintile of the APDQS had 37% (95% confidence interval: 0.41–0.97) lower risk of CKD as compared with those in the lowest quintile of the APDQS. For each 11-point increment in APDQS, there was 15% lower risk of CKD (0.74–0.97). The association remained similar after further adjustment for prevalent cases of hypertension and diabetes. Conclusions A plant-centered, high quality diet was associated with a lower risk of developing CKD. Funding Sources CARDIA and MnDRIVE (University of Minnesota).

Download Full-text