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Dietary patterns in middle-aged Irish men and women defined by cluster analysis.

OBJECTIVES: To identify and characterise dietary patterns in a middle-aged Irish population sample and study associations between these patterns, sociodemographic and anthropometric variables and major risk factors for cardiovascular disease. DESIGN: A cross-sectional study. SUBJECTS AND METHODS: A group of 1473 men and women were sampled from 17 general practice lists in the South of Ireland. A total of 1018 attended for screening, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and provided a fasting blood sample for glucose, lipids and homocysteine. Dietary intake was assessed using a standard food-frequency questionnaire adapted for use in the Irish population. The food-frequency questionnaire was a modification of that used in the UK arm of the European Prospective Investigation into Cancer study, which was based on that used in the US Nurses' Health Study. Dietary patterns were assessed primarily by K-means cluster analysis, following initial principal components analysis to identify the seeds. RESULTS: Three dietary patterns were identified. These clusters corresponded to a traditional Irish diet, a prudent diet and a diet characterised by high consumption of alcoholic drinks and convenience foods. Cluster 1 (Traditional Diet) had the highest intakes of saturated fat (SFA), monounsaturated fat (MUFA) and percentage of total energy from fat, and the lowest polyunsaturated fat (PUFA) intake and ratio of polyunsaturated to saturated fat (P:S). Cluster 2 (Prudent Diet) was characterised by significantly higher intakes of fibre, PUFA, P:S ratio and antioxidant vitamins (vitamins C and E), and lower intakes of total fat, MUFA, SFA and cholesterol. Cluster 3 (Alcohol & Convenience Foods) had the highest intakes of alcohol, protein, cholesterol, vitamin B(12), vitamin B(6), folate, iron, phosphorus, selenium and zinc, and the lowest intakes of PUFA, vitamin A and antioxidant vitamins (vitamins C and E). There were significant differences between clusters in gender distribution, smoking status, physical activity, body mass index, waist circumference and serum homocysteine concentrations. CONCLUSION: In this general population sample, cluster analysis methods yielded two major dietary patterns: prudent and traditional. The prudent dietary pattern is associated with other health-seeking behaviours. Study of dietary patterns will help elucidate links between diet and disease and contribute to the development of healthy eating guidelines for health promotion.

Alcohol Drinking↗

Living arrangements and dietary patterns of older adults in the United States.

Living arrangements and dietary patterns were examined for 3,477 adults aged 65 to 74 from the first National Health and Nutrition Examination Survey 1971 to 1974 (NHANES I). Several indicators of dietary variety, diet composition, and energy and nutrient intake from both the 24-hour recall, and the dietary frequency questionnaires were analyzed. Dietary patterns of older men were associated more strongly with type of living arrangement and income compared with older women. Men living with a spouse consistently had more favorable dietary patterns than either those living alone or those living with someone other than a spouse. Low income men who were not living with a spouse were at highest risk of poor dietary intake. Income was associated more consistently with the dietary indicators than type of living arrangement for women. Income, however, was still a less consistent influence on dietary patterns of older women compared to older men.

Aged↗

Dietary patterns and further survival in Japanese centenarians.

We have previously reported that centenarians (persons > or = 100 y old) in Tokyo prefer dairy products. Dietary preferences may be associated with longevity. The aim of the present study was to investigate the relationship between dietary patterns and further survival in centenarians. During 1992-1999, we examined the dietary practices of 104 centenarians (29 men and 75 women; mean age, 100.3 +/- 0.9 y) who lived in the Tokyo metropolitan area. Dietary patterns were classified by kappa-means cluster analysis. As clinical co-variables, we considered activities of daily living, cognitive function, nutritional status, presence of important disease, gender, and age at the time of the initial survey. Survival data were recorded yearly until 2001, and then tested with Kaplan-Meier analysis and the log rank statistic. Four dietary patterns were identified: a pattern preferring vegetables (n = 33), a pattern preferring dairy products (n = 26), a pattern preferring beverages (n = 10), and a pattern preferring cereals (n = 35). No clinical variables differed between the four dietary patterns. In 2001, 28 centenarians were still alive. The survival rate for those preferring dairy products was the highest of the four dietary patterns; in particular, being significantly higher than the pattern preferring beverages (p = 0.048). A dietary pattern preferring dairy products was associated with increased survival in Tokyo-area centenarians.

Activities of Daily Living↗

Dietary patterns and subsequent colorectal cancer risk by subsite: a prospective cohort study.

In order to investigate the associations between dietary patterns and the risk of colorectal cancer by subsite in Japan, the baseline data from a population-based cohort study of 20,300 men and 21,812 women were analyzed. We conducted factor analysis and identified 3 major dietary patterns, "healthy," "traditional" and "Western," and calculated the factor scores of each pattern for individuals. During 10 years of follow-up, 370 colorectal cancer cases were identified. We found a positive association between the traditional pattern and colon cancer risk in women [rate ratio for highest quartile (RR) = 2.06; 95% CI = 1.10-3.84; p for trend = 0.11], but not in men. This positive association was slightly stronger for proximal colon cancer (RR = 2.07; 95% CI = 0.84-5.12) than for distal colon cancer (RR = 1.84; 95% CI = 0.75-4.50). After multivariate adjustment, the Western dietary pattern was also positively associated with colon cancer risk in females (RR = 2.21; 95% CI = 1.10-4.45), with the strongest associations being observed for females with distal colon cancer (RR = 3.48; 95% CI = 1.25-9.65). We did not observe any significant association between the healthy dietary pattern and colon cancer risk. For rectal cancer, no significant associations were found for the 3 dietary patterns. In conclusion, we found that the traditional and the Western dietary patterns were positively associated with colon cancer risk in females.

Adult↗

A dietary pattern derived to explain biomarker variation is strongly associated with the risk of coronary artery disease.

BACKGROUND: In previous studies, dietary patterns were derived in different populations without regard to a specific outcome. OBJECTIVE: The objective was to apply a new statistical method to construct a specific dietary pattern that is strongly associated with the risk of coronary artery disease (CAD). DESIGN: We applied reduced rank regression to a sample of 200 cases and 255 controls from the Coronary Risk Factors for Atherosclerosis in Women (CORA) Study. The CAD-specific dietary pattern was constructed by choosing intake data for 49 food groups as predictors and 5 established biomarkers for CAD as responses. RESULTS: A high score for the constructed dietary pattern was characterized by high intakes of meat, margarine, poultry, and sauce and low intakes of vegetarian dishes, wine, vegetables, and whole-grain cereals. After adjustment for known CAD risk factors, the relative risks from the lowest to the highest quintiles of the pattern score were 1.0, 1.1, 3.6, 6.2, and 12.3 (95% CI: 4.9, 30.9; P for trend < 0.0001). There was an approximate 4.5-fold difference in C-reactive protein and a 2-fold difference in C-peptide between the highest and lowest score quintiles of the study population. HDL-cholesterol concentrations ranged from 70 mg/dL in the lowest quintile to 49 mg/dL in the highest quintile of dietary pattern score. CONCLUSION: The new statistical method, reduced rank regression, may be a useful tool for identifying dietary patterns that simultaneously affect the concentrations of known CAD biomarkers and the risk of developing CAD.

Adult↗

Dietary patterns and risk of prostate cancer in Ontario, Canada.

Dietary patterns reflect combinations of dietary exposures, and here we examine these in relation to prostate cancer risk. In a case-control study, 80 incident primary prostate cancer cases and 334 urology clinic controls were enrolled from 1997 through 1999 in Kingston, Ontario, Canada. Food-frequency questionnaires were completed prior to diagnosis and assessed intake in the 1-year period 2-3 years prior to enrollment. Among controls, dietary intake was used in principal components analyses to identify patterns that were then evaluated with all subjects in relation to prostate cancer risk using unconditional logistic regression, controlling for age. Four dietary patterns were identified: Healthy Living, Traditional Western, Processed and Beverages. Increased prostate cancer risk is apparent in relation to the Processed pattern, composed of processed meats, red meats, organ meats, refined grains, white bread, onions and tomatoes, vegetable oil and juice, soft drinks and bottled water. The OR for the highest tertile compared to baseline is 2.75 (95% CI 1.40-5.39), with a dose-response pattern (trend test p < 0.0035). Our results suggest that a dietary pattern including refined grain products, processed meats and red and organ meats contributes to increased prostate cancer risk. Since dietary information was collected before subjects knew their diagnosis, recall bias was avoided.

Aged↗

Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial.

OBJECTIVE: To determine the effects of dietary patterns on blood pressure in subgroups. METHODS: Dietary Approaches to Stop Hypertension (DASH) was a randomized controlled feeding study conducted at 4 academic medical centers. Participants were 459 adults with untreated systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg. For 3 weeks, participants were fed a "control" diet. They were then randomized to 8 weeks of (1) control diet; (2) a diet rich in fruits and vegetables; or (3) a combination diet rich in fruits, vegetables, and low-fat dairy foods, and reduced in saturated fat, total fat, and cholesterol (the DASH combination diet). Weight and salt intake were held constant. Change in diastolic blood pressure was the primary outcome variable, and systolic blood pressure a secondary outcome. Subgroups analyzed included race, sex, age, body mass index, years of education, income, physical activity, alcohol intake, and hypertension status. RESULTS: The combination diet significantly lowered systolic blood pressure in all subgroups (P<.008), and significantly lowered diastolic blood pressure (P<.01) in all but 2 subgroups. The fruits-and-vegetables diet also reduced blood pressure in the same subgroups, but to a lesser extent. The combination diet lowered systolic blood pressure significantly more in African Americans (6.8 mm Hg) than in whites (3.0 mm Hg), and in hypertensive subjects (11.4 mm Hg) than in nonhypertensive subjects (3.4 mm Hg) (P<.05 for both interactions). CONCLUSIONS: The DASH combination diet, without sodium reduction or weight loss, significantly lowered blood pressure in virtually all subgroups examined, and was particularly effective in African Americans and those with hypertension. The DASH combination diet may be an effective strategy for preventing and treating hypertension in a broad cross section of the population, including segments of the population at highest risk for blood pressure-related cardiovascular disease.

Adult↗

Dietary pattern is associated with homocysteine and B vitamin status in an urban Chinese population.

To identify existing dietary patterns and examine associations between these patterns and plasma homocysteine and B vitamin concentrations in an urban Chinese population living in Beijing (n = 119), dietary information was collected with a food frequency questionnaire designed for this population. Plasma homocysteine and B vitamin concentrations were examined. Food group variables, expressed as percentages of total energy intake, were entered into cluster analysis to define three distinct dietary pattern groups. The prevalence of high homocysteine (>11 micromol/L for women and 12 micromol/L for men), was 31.9%; of low folate (<6.8 nmol/L), 36.2%; of low vitamin B-12 (<221 pmol/L), 36.9%; and of low vitamin B-6 (<30 nmol/L), 16.0%. The three dietary patterns derived were defined by relatively greater intake of 1) fruit and milk, 2) red meat and 3) refined cereals. More than 40% of subjects in the refined cereals group had high plasma homocysteine and low plasma folate concentrations, and 67% had low plasma vitamin B-12 concentrations. Those following the refined cereals pattern were 4 and 5.2 times more likely to have high homocysteine and low vitamin B-12 concentrations, respectively, relative to the fruit and milk dietary pattern group (P < 0.01), after adjustment for potential confounders. High intake of refined cereals was associated with low B vitamin and high homocysteine concentrations, whereas the pattern high in fruit and milk was associated with the lowest homocysteine. Dietary patterns appear to play an important role in the micronutrient and homocysteine status of these Chinese adults.

Adult↗

Dietary patterns and associated lifestyles in preconception, pregnancy and postpartum.

OBJECTIVE: To identify dietary patterns in women who are planning immediate pregnancy in preconception, weeks 6, 10, 26 and 38 of pregnancy, and 6 months postpartum, and to describe how particular lifestyles, the body mass index (BMI) and sociodemographic factors are associated to these patterns. DESIGN: Longitudinal study throughout the reproductive cycle of food consumption carried out in a Spanish Mediterranean city. SETTING: Faculty of Medicine and Health Sciences, Rovira i Virgili University. SUBJECTS: In total, 80 healthy female volunteers who were planning immediate pregnancy. INTERVENTIONS: A seven-consecutive-day dietary record was used to evaluate the dietary intake. Exploratory factor analysis was used to identify the main dietary patterns in each of the periods. Fitted multiple linear regression models were used to study the associations between the lifestyle and sociodemographic variables, and each dietary pattern. RESULTS: The 'sweetened beverages and sugars' pattern was identified from preconception to 6 months postpartum and the 'vegetables and meat' pattern to the end of pregnancy. The 'sweetened beverages and sugars' pattern is positively associated with smoking and negatively associated with physical activity before conception and in the first trimester of pregnancy. The 'vegetables and meat' pattern is negatively associated with the BMI during the preconception period and positively associated with age in weeks 10 and 38 of pregnancy. It is shown that the patterns do not change significantly throughout the period studied. CONCLUSIONS: We have identified two stable dietary patterns from preconception to postpartum. The 'sweetened beverages and sugars' pattern is associated with habits of risk for the health of the pregnant woman and her offspring. SPONSORSHIP: 'Comisión Interministerial de Ciencia y Tecnología' (CICYT: ALI89-0388) and 'Instituto de Salud Carlos III', RCMN (C03/08), Madrid, Spain'.

Adolescent↗

Dietary patterns using the Food Guide Pyramid groups are associated with sociodemographic and lifestyle factors: the multiethnic cohort study.

Dietary patterns have been used to identify typical combinations of foods that may be associated with disease risks. We defined dietary patterns among 195,298 participants of the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993-1996. Intakes of Food Guide Pyramid groups were calculated from a quantitative FFQ for subjects of 5 ethnic groups (African Americans, Hawaiians, Japanese Americans, Latinos, and whites). Three distinct dietary patterns, "Fat and Meat," "Vegetables," and "Fruit and Milk," were identified by exploratory factor analysis with a varimax rotation and validated by confirmatory factor analysis. Similar factor loadings were found for each of 10 ethnic-gender groups in stratified analyses. The odds ratios (OR) for being above the median scores for each factor were calculated. Age, gender, and ethnicity had relatively strong associations with dietary patterns whereas education showed only weak associations. BMI > or = 30 was strongly positively associated with the Fat and Meat pattern (OR = 2.14, 95% CI: 2.08-2.20, vs. BMI < 25). Current smokers showed a positive association with the Fat and Meat pattern (OR = 1.67, CI: 1.62-1.72, vs. nonsmokers) and inverse associations with the Vegetables (OR = 0.66, CI: 0.64-0.68) and Fruit and Milk patterns (OR = 0.53, CI: 0.52-0.55). Physical activity was positively associated with the Vegetables and Fruit and Milk patterns but not with the Fat and Meat pattern. These findings support the hypothesis that dietary patterns are influenced by interrelated sociocultural, demographic, and other lifestyle factors and may be useful in investigations of diet-disease relations.

Aged↗

Dietary patterns associated with male lung cancer risk in the Netherlands Cohort Study.

The objective of this article was to study the association between dietary patterns and lung cancer incidence in the Netherlands Cohort Study on Diet and Cancer. The baseline measurement of this prospective case cohort study that was completed by 58,279 men in 1986 included a self-administered questionnaire on dietary intake, smoking habits, and other covariates. Follow-up was established by computerized record linkage to cancer registries and a pathology register. After 9.3 years of follow-up, 1,426 confirmed cases of incident male lung cancer were detected. Five dietary patterns were identified by exploratory factor analysis in a randomly sampled subcohort (n = 2,190). The dietary pattern labeled "salad vegetables" was associated with decreased risk of lung cancer [rate ratios (RR)(Q5), 0.75; 95% confidence interval (CI), 0.55-1.01], after multivariate adjustment. This inverse association was most evident among current and former smokers. A dietary pattern labeled "sweet foods" was also inversely associated with lung cancer risk (RR(Q5), 0.62; 95% CI, 0.43-0.89). However, the higher intake of monosaccharides and disaccharides, fruits, and lower consumption of alcohol associated with this pattern could not account for its full protective effect. The "pork, processed meat, and potatoes" pattern was nonsignificantly associated with increased risk (RR(Q5), 1.44; 95% CI, 0.99-2.09), and this positive association was most evident among current smokers. The other dietary patterns characterized by brown/white bread substitution and by consumption of cooked vegetables were not associated with lung cancer risk. These results show how studying both single factors and dietary patterns gives more insight into the complex, and often seemingly inconsistent, associations between diet and cancer.

Aged↗

Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study.

BACKGROUND: Several nutrients are known to affect bone mineral density (BMD). However, these nutrients occur together in foods and dietary patterns, and the overall effects of dietary choices are not well understood. OBJECTIVE: We evaluated associations between dietary patterns and BMD in older adults. DESIGN: Of the original Framingham Heart Study subjects, 907 aged 69-93 y completed food-frequency questionnaires as part of an osteoporosis study. We defined dietary patterns by cluster analysis. BMD was measured at the proximal right femur (femoral neck, trochanter, Ward's area) with a dual-photon absorptiometer and at the 33% radial shaft with a single-photon absorptiometer. We regressed BMD measures onto the cluster variable, adjusting for potential confounders. RESULTS: Six dietary patterns were identified, with relatively greater proportions of intake from meat, dairy, and bread; meat and sweet baked products; sweet baked products; alcohol; candy; and fruit, vegetables, and cereal. After adjustment for multiple comparisons, men in the last group had significantly (P = 0.05) greater BMD than did 2-4 other groups at the hip sites and the candy group at the radius. Men in the candy group had significantly (P < 0.05) lower BMD than did those in the fruit, vegetables, and cereal group for 3 of the 4 sites. Women in the candy group had significantly (P < 0.01) lower BMD than did all but one other group at the radius. CONCLUSIONS: Dietary pattern is associated with BMD. High fruit and vegetable intake appears to be protective in men. High candy consumption was associated with low BMD in both men and women.

Aged↗

Dietary patterns and risk for type 2 diabetes mellitus in U.S. men.

BACKGROUND: The role of diet in the development of type 2 diabetes mellitus remains unsettled. OBJECTIVE: To examine the association between major dietary patterns and risk for type 2 diabetes mellitus. DESIGN: Prospective cohort study. SETTING: United States. PARTICIPANTS: 42 504 male health professionals, 40 to 75 years of age, without diagnosed diabetes, cardiovascular disease, or cancer at baseline. MEASUREMENTS: Using factor analysis based on data from food-frequency questionnaires, we identified and validated two major dietary patterns that we labeled "prudent" (characterized by higher consumption of vegetables, fruit, fish, poultry and whole grains) and "western" (characterized by higher consumption of red meat, processed meat, French fries, high-fat dairy products, refined grains, and sweets and desserts). Relative risks and 95% CIs were adjusted for potential confounders, including body mass index (BMI), physical activity, and cigarette smoking. RESULTS: During 12 years of follow-up (466 508 person-years), we documented 1321 cases of type 2 diabetes. The prudent dietary pattern score was associated with a modestly lower risk for type 2 diabetes (relative risk for extreme quintiles, 0.84 [CI, 0.70 to 1.00]). In contrast, the western dietary pattern score was associated with an increased risk for type 2 diabetes (relative risk, 1.59 [CI, 1.32 to 1.93]; P < 0.001 for trend). A high score for the western dietary pattern combined with low physical activity (relative risk comparing extreme quintiles of dietary pattern score and physical activity, 1.96 [CI, 1.35 to 2.84]) or obesity (relative risk for BMI > or = 30 kg/m2 vs. <25 kg/m2, 11.2 [CI, 8.07 to 15.6]) was associated with a particularly high risk for type 2 diabetes. CONCLUSION: Our findings suggest that a western dietary pattern is associated with a substantially increased risk for type 2 diabetes in men.

Adult↗

Dietary patterns among older Europeans: the EPIC-Elderly study.

Overall dietary patterns have been associated with health and longevity. We used principal component (PC) and cluster analyses to identify the prevailing dietary patterns of 99 744 participants, aged 60 years or older, living in nine European countries and participating in the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort) and to examine their socio-demographic and lifestyle correlates. Two PC were identified: PC1 reflects a 'vegetable-based' diet with an emphasis on foods of plant origin, rice, pasta and other grain rather than on margarine, potatoes and non-alcoholic beverages. PC2 indicates a 'sweet- and fat-dominated' diet with a preference for sweets, added fat and dairy products but not meat, alcohol, bread and eggs. PC1 was associated with a younger age, a higher level of education, physical activity, a higher BMI, a lower waist:hip ratio and never and past smoking. PC2 was associated with older age, less education, never having smoked, a lower BMI and waist:hip ratio and lower levels of physical activity. Elderly individuals in southern Europe scored positively on PC1 and about zero on PC2, whereas the elderly in northern Europe scored negatively on PC1 and variably on PC2. The results of cluster analysis were compatible with the indicated dietary patterns. 'Vegetable-based' and a 'sweet- and fat-dominated' diets are prevalent among the elderly across Europe, and there is a north-south gradient regarding their dietary choices. Our study contributes to the identification of groups of elderly who are likely to have different prospects for long-term disease occurrence and survival.

Age Distribution↗

Socioeconomic differences in dietary patterns among middle-aged men and women.

The aim of the study is to (i) identify common dietary patterns, (ii) study socioeconomic differences in these dietary patterns, and (iii) assess whether they contribute to socioeconomic differences in biological risk factors. The data come from the Whitehall II study of London civil servants, who participated in the third phase (1991-1993) and were 39-63-years old (N=8004). Food frequency questionnaire and socioeconomic background information was from a questionnaire, and biological risk factors from a medical screening. Six dietary patterns were identified. In reference to high employment grade men, the odds ratios of low grade men consuming the 'unhealthy' or the 'very unhealthy' diet were 1.26 and 3.34, respectively, while the odds for the 'French' diet was 0.13. Among women the corresponding odds were 2.98, 6.19 and 0.25. Adjusting for spouse's socioeconomic status and to a lesser extent smoking and exercise as well as job control attenuate these grade differences somewhat. Among men and women adjusting for dietary patterns accounted for about 25-50 per cent of grade differences in HDL and serum triglyceride levels.

Adult↗

Dietary patterns are associated with body mass index in multiethnic women.

This cross-sectional study investigated the relationship between dietary patterns and body mass index among 514 women with different ethnic backgrounds who completed a validated food-frequency questionnaire. An exploratory factor analysis with orthogonal rotation started with 23 food items and resulted in four factors that accounted for 93% of the total variance. Confirmatory factor analysis with the 16 items that had factor loadings of at least 0.60 validated the four dietary patterns. The most significant dietary pattern, "meat," was characterized by high intake of processed and red meats, fish, poultry, eggs, fats and oils, and condiments. The "vegetable" pattern loaded high on different vegetables, whereas the third pattern named "bean" was high in legumes, tofu and soy protein. The major components of the "cold foods" pattern were fruit, fruit juice and cold breakfast cereals. Although the "meat" pattern was predominant among Hawaiians and the "bean" pattern very common among Chinese and Japanese women, factors two and four were not related to ethnicity. After adjustment for daily energy intake, the "meat" pattern was positively associated with body mass index (r = 0.17, P: = 0.0001), whereas the other three patterns showed negative relationships to body mass index (r = -0.076, P: = 0.084, r = -0.13, P: = 0.003, and r = -0.13, P: = 0.003) for vegetables, beans and cold foods, respectively. The associations were similar in direction and magnitude for all ethnic groups. The study results support the ideas that choosing the right foods may be important in weight control and that food-based dietary patterns may be useful in dietary counseling.

Adult↗

Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire.

BACKGROUND: Recently, the analysis of dietary patterns has emerged as a possible approach to examining diet-disease relations. OBJECTIVE: We examined the reproducibility and validity of dietary patterns defined by factor analysis using dietary data collected with a food-frequency questionnaire (FFQ). DESIGN: We enrolled a subsample of men (n = 127) from the Health Professionals Follow-up Study in a diet-validation study in 1986. A 131-item FFQ was administered twice, 1 y apart, and two 1-wk diet records and blood samples were collected during this 1-y interval. RESULTS: Using factor analysis, we identified 2 major eating patterns, which were qualitatively similar across the 2 FFQs and the diet records. The first factor, the prudent dietary pattern, was characterized by a high intake of vegetables, fruit, legumes, whole grains, and fish and other seafood, whereas the second factor, the Western pattern, was characterized by a high intake of processed meat, red meat, butter, high-fat dairy products, eggs, and refined grains. The reliability correlations for the factor scores between the 2 FFQs were 0.70 for the prudent pattern and 0.67 for the Western pattern. The correlations (corrected for week-to-week variation in diet records) between the 2 FFQs and diet records ranged from 0.45 to 0.74 for the 2 patterns. In addition, the correlations between the factor scores and nutrient intakes and plasma concentrations of biomarkers were in the expected direction. CONCLUSIONS: These data indicate reasonable reproducibility and validity of the major dietary patterns defined by factor analysis with data from an FFQ.

Adult↗

Food group sources of nutrients in the dietary patterns of the DASH-Sodium trial.

The aim of this paper is to identify major food group sources of several essential nutrients in the two dietary patterns used in the DASH-Sodium trial: a control diet and the DASH dietary pattern. The DASH-Sodium trial was a multicenter, randomized, controlled-feeding trial comparing the effects of three levels of sodium and two dietary patterns on blood pressure. Nutrient contents of all the menus for both the control and the DASH diets were analyzed and examined for their dietary sources from 13 food groups. Contributions of all foods within each food group to each nutrient were averaged then weighted to reflect the actual distribution of energy levels in the study. Nutrient contents across the three sodium levels are very similar within each diet. Refined grains and whole grains are the major energy sources for the control and the DASH diet, providing 35% and 23% to the total intake, respectively. Nutrient-dense whole grains contributed greatly, ranging from 11% to 46%, to the higher intakes of protein, fiber, calcium, magnesium, potassium, zinc, and folate in the DASH diet. Vegetables, in addition to being a good source for fiber, vitamins A, C, E, and folate, also contributed an average of 15% to the intakes of magnesium, potassium, and calcium in the DASH diet. Differences in nutrient contents between the control and the DASH diets were accomplished by varying the selection of food items (eg, refined grains vs whole grains) and quantities of certain food groups (eg, less red meats and higher amounts of fruits and vegetables). The DASH dietary pattern recommends four to five servings of fruits; four to five servings of vegetables; two to three servings of low-fat dairy products; seven to eight servings of grain products (preferably whole grains); two or less servings of meats, poultry, and fish per day; and four to five servings of nuts, seeds, and legumes per week for a 2,000 kcal diet. Each of these food groups contributes critical nutrients across various sodium levels. It is important to emphasize all food groups when trying to follow this proven dietary pattern.

Blood Pressure↗