Reference Number: 539
Year: 2021
Link: Link to original paper
Health: Cardiometabolic diseases | Cholesterol | Heart Disease | Lower Inflammation | Non-communicable diseases
Nutrition: Fibre | Whole grain
Summary
Background
Traditionally, studies investigating diet and health associations have focused on single nutrients. However, key nutrients co-exist in many common foods, and studies focusing solely on individual nutrients may obscure their combined effects on cardiovascular disease (CVD) and all-cause mortality. We aimed to identify food-based dietary patterns which operate through excess energy intake and explain high variability in energy density, free sugars, saturated fat, and fiber intakes and to investigate their association with total and fatal CVD and all-cause mortality.
Methods
Detailed dietary data was collected using a 24-h online dietary assessment on two or more occasions (n =?116,806). We used reduced rank regression to derive dietary patterns explaining the maximum variance. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD.
Results
Over an average of 4.9?years of follow-up, 4245 cases of total CVD, 838 cases of fatal CVD, and 3629 cases of all-cause mortality occurred. Two dietary patterns were retained that jointly explained 63% of variation in energy density, free sugars, saturated fat, and fiber intakes in total. The main dietary pattern was characterized by high intakes of chocolate and confectionery, butter and low-fiber bread, and low intakes of fresh fruit and vegetables. There was a positive linear association between the dietary pattern and total CVD [hazard ratio (HR) per z-score 1.07, 95% confidence interval (CI) 1.04–1.09; HRtotal CVD 1.40, 95% CI 1.31–1.50, and HRall-cause mortality 1.37, 95% CI 1.27–1.47 in highest quintile]. A second dietary pattern was characterized by a higher intakes of sugar-sweetened beverages, fruit juice, and table sugar/preserves. There was a non-linear association with total CVD risk and all-cause mortality, with increased risk in the highest quintile [HRtotal CVD 1.14, 95% CI 1.07–1.22; HRall-cause mortality 1.11, 95% CI 1.03–1.19].
Conclusions
We identified dietary patterns which are associated with increased risk of CVD and all-cause mortality. These results help identify specific foods and beverages which are major contributors to unhealthy dietary patterns and provide evidence to underpin food-based dietary advice to reduce health risks.
Significance of this study to the baker:
This large study clearly identifies the dietary patterns associated with increased risk of CVD and lower health span. Through our sourdough bakes, we are increasing our intake of dietary fibre and when we combine our bakes with healthy fats, fruit and vegetables, we are naturally controlling our blood sugar levels. For example, to lower the risk of CVD and improve health span, you may like to try these recipes to combine with your sourdough bread: cultured anchovy butter and cauliflower & chickpea soup.
Our 7 core principles are in line with following these healthier dietary patterns.
