Relationship among dietary patterns, apolipoproteins, C-reactive protein and other lipids in adult populations in four cities of the Southern Cone of Latin America

ROSANA POGGIO, MD, MSC ; LAURA GUTIERREZ, MHSC; NATALIA ELORRIAGA, MHSC; VILMA IRAZOLA, MD, MSC; ADOLFO RUBINSTEIN MD, MSC, PHD

San Francisco

Congreso; EPIDEMIOLOGY AND PREVENTION/ NUTRITION, PHYSICAL ACTIVITY AND METABOLISM; 2014

American Heart Association

Background In the last decades, there has been a nutrition transition in Latin America to diets with higher total caloric intake and lower consumption of vegetables, cereals and fruits. An unhealthy dietary pattern affects plasma levels of apolipoprotein (Apo) AI, Apo B and C-reactive protein (CRP) which are independently associated with the incidence of coronary heart disease and stroke). There is no data regarding these biomarkers in relation to dietary patterns from the Southern Cone of Latin America. Therefore, the objective of this study is to analyze these biomarkers in relation to our traditional dietary patterns. Methods CESCAS I study is an observational prospective cohort study with a multistage probabilistic sample of 7524 participants from general population of 4 sites in Argentina, Chile and Uruguay. We conducted a cross-sectional analysis in a randomly selected subsample of 985 subjects. Subjects with previous cardiovascular events or under lipid lowering agents were excluded. Diet was assessed using a previously validated 126-item food frequency questionnaire. We used a factor analysis to derive the major dietary patterns by gender. Linear regression models were used to examine the associations among Apo AI, Apo B, CRP and other lipids (dependent variables) and quartiles (Q) of dietary pattern scores (independent variables). Linear trends tests were conducted to assess the associations with multiple regression analysis. Results The population sample included 418 men and 570 women. The ?Prudent pattern? (PP) was characterized by intake of fruits, vegetables, low fat dairy products, whole cereal, fish and seafood. In men, higher scores of PP (Q4) showed a significant reduction in mean adjusted values of: Apo B (-9.29 mg/dl), total cholesterol (TC) (-22.4 mg/dl), low density lipoprotein (LDL) (-19.0 mg/dl), high density lipoprotein (HDL) (-3.3 mg/dl) compared to the lowest scores (Q1). In normal weight subjects, higher scores of PP also reduced CRP levels (-3.12 g/l). In women, higher scores of PP showed significant reduction in Apo B (-6.51 mg/dl), total cholesterol (TC) (-14.4 mg/dl) and low density lipoprotein (LDL) (-11.3 mg/dl). The ?Western like pattern? (WLP) was characterized by intake of meat, processed foods, pizza, empanadas, sweets and desserts, refined grains, vegetable oils and other fats. In men, higher scores of WLP showed a trend to increase LDL (+27.1 mg/dl) while in women they showed a trend to increase values of triglycerides (+27.1 mg/dl, p 0.08), LDL (+7.4 mg/dl) and TC (+9.2 mg/dl). Apo AI level was not associated with any dietary pattern. Conclusion Prudent dietary pattern was associated with a healthier lipid profile in both genders and better inflammatory profile in normal weight men, while the WLP showed a trend to increase plasma lipids, especially in women.