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Prospective association between the Cardiovascular Health Diet Index and subclinical atherosclerosis: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort study

Published online by Cambridge University Press:  11 November 2024

Leandro Teixeira Cacau Open the ORCID record for Leandro Teixeira Cacau [Opens in a new window] ,
Mariane de Almeida Alves Open the ORCID record for Mariane de Almeida Alves [Opens in a new window] ,
Itamar de Souza Santos ,
Giuliano Generoso ,
Márcio Sommer Bittencourt ,
Paulo Andrade Lotufo ,
Isabela Martins Benseñor  and
Dirce Maria Lobo Marchioni Open the ORCID record for Dirce Maria Lobo Marchioni [Opens in a new window]
Leandro Teixeira Cacau*
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
Mariane de Almeida Alves
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
Itamar de Souza Santos
Affiliation:
Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Giuliano Generoso
Affiliation:
Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
Márcio Sommer Bittencourt
Affiliation:
Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
Paulo Andrade Lotufo
Affiliation:
Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Isabela Martins Benseñor
Affiliation:
Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Dirce Maria Lobo Marchioni
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
*
Corresponding author: Leandro Teixeira Cacau; Email: [email protected]
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Abstract

The Cardiovascular Health Diet Index (CHDI) is a diet quality score based on the dietary guidelines of the American Heart Association for cardiovascular health but with some adaptations, such as red meat, dairy products, beans and ultra-processed foods in its components. The CHDI has shown good relative validity parameters; however, its association with health outcomes is still unclear. Thus, our aim was to investigate the association between the CHDI score with subclinical atherosclerosis. Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort were used. Subclinical atherosclerosis was assessed by measuring coronary artery calcification at baseline (2008–2010) and second wave (2012–2014) and carotid intima-media thickness at baseline and at the third wave (2017–2019). The CHDI score (ranges from 0 to 110 points) was applied to dietary data obtained from an FFQ at baseline. Poisson regression with robust variance, linear regression and linear mixed-effects models were used to evaluate the association of the CHDI score with coronary artery calcification incidence (n 2224), coronary artery calcification progression (n 725) and changes in carotid intima-media thickness (n 7341) over time, respectively. After a median 8-year follow-up period, a 10-point increase in the CHDI score was associated with a decrease in carotid intima-media thickness of 0·002 mm (95 % CI –0·005, –0·001). No association was observed between the CHDI score and coronary artery calcification incidence and progression after a 4-year follow-up period. Higher scores in the CHDI were prospectively associated with decreased subclinical atherosclerosis after an 8-year follow-up period.

Keywords

Diet qualityDietary patternCardiovascular healthSubclinical atherosclerosisCohort study
Type
Research Article
Information
British Journal of Nutrition , Volume 132 , Issue 12 , 28 December 2024 , pp. 1637 - 1644
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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