Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique.

BACKGROUND: Hybrid methodologies have gained continuing interest as unique data reduction techniques for establishing a direct link between dietary exposures and clinical outcomes. OBJECTIVES: We aimed to compare partial least squares (PLS) and reduced rank regression (RRR) in identifying a dietary pattern associated with a high cardiovascular disease (CVD) risk in Canadian adults, construct PLS- and RRR-based simplified dietary patterns, and assess associations between the 4 dietary pattern scores and CVD risk. METHODS: Data were collected from 24-h dietary recalls of adult respondents in the 2 cycles of the nationally representative Canadian Community Health Survey (CCHS)-Nutrition: CCHS 2004 linked to health administrative databases (n = 12,313) and CCHS 2015 (n = 14,020). Using 39 food groups, PLS and RRR were applied for identification of an energy-dense (ED), high-saturated-fat (HSF), and low-fiber-density (LFD) dietary pattern. Associations of the derived dietary pattern scores with lifestyle characteristics and CVD risk were examined using weighted multivariate regression and weighted multivariable-adjusted Cox proportional hazard models, respectively. RESULTS: PLS and RRR identified highly similar ED, HSF, and LFD dietary patterns with common high positive loadings for fast food, carbonated drinks, salty snacks, and solid fats, and high negative loadings for fruit, dark green vegetables, red and orange vegetables, other vegetables, whole grains, and legumes and soy (≥|0.17|). Food groups with the highest loadings were summed to form simplified pattern scores. Although the dietary patterns were not significantly associated with CVD risk, they were positively associated with 402-kcal/d higher energy intake (P-trends < 0.05) and higher obesity risk (PLS: OR: 2.09; 95% CI: 1.62, 2.70; RRR: OR: 1.76; 95% CI: 1.44, 2.17) (P-trends < 0.0001) in the fourth quartiles. CONCLUSIONS: PLS and RRR were shown to be equally effective for the derivation of a high-CVD-risk dietary pattern among Canadian adults. Further research is warranted on the role of major dietary components in cardiovascular health.

Adherence to emerging plant-based dietary patterns and its association with cardiovascular disease risk in a nationally representative sample of Canadian adults.

BACKGROUND: Little is known about the role of emerging plant-based dietary patterns in cardiovascular disease (CVD) risk at the national population level. OBJECTIVES: The objectives of this research were to assess the validity and reliability of newly established plant-based dietary indices, and to evaluate their associations with CVD risk among Canadian adults. METHODS: Data were obtained from repeated 24-h dietary recalls of adult participants in the cross-sectional, nationally representative Canadian Community Health Survey cycle 2004 linked to health administrative databases (n = 12,323) and cycle 2015 (n = 14,026). Plant-based diet quality was assessed with a revised Plant-based Dietary Index (PDI), EAT-Lancet Reference Diet (ERD) score, and the latest Dietary Guidelines for Americans Adherence Index (DGAI) 2020. Weighted multivariate analyses were used for testing associations between diet quality and lifestyle characteristics, and weighted multivariable-adjusted Cox proportional hazards models for associations with CVD risk. RESULTS: Construct validity was confirmed for the revised PDI and DGAI 2020 (but not the ERD) because participants in the highest (healthiest) quartile, compared to those in the lowest (least healthy), were more likely to be female (mean ± SE: 52.63% ± 1.27% compared with 44.80% ± 1.65% for revised PDI; 59.37% ± 2.01% compared with 40.84% ± 1.71% for DGAI 2020), older (mean ± SE: 50.55 ± 0.39 y compared with 45.56 ± 0.43 y for revised PDI; 51.57 ± 0.39 y compared with 46.35 ± 0.54 y for DGAI 2020), to have postsecondary education (mean ± SE: 32.36% ± 1.55% compared with 21.12% ± 1.31% for revised PDI; 34.17% ± 2.69% compared with 17.87% ± 0.98% for DGAI 2020), and less likely to be daily smokers (mean ± SE: 8.21% ± 1.0% compared with 17.06% ± 1.45% for revised PDI; 7.36% ± 1.71% compared with 21.53% ± 1.58% for DGAI 2020) (P-trend < 0.0001). No significant associations were observed between dietary index scores and CVD risk. CONCLUSIONS: The revised PDI and DGAI 2020 provided valid and meaningful measures of plant-based eating among Canadians, whereas the validity of the ERD was not directly confirmed. Adherence to the plant-based dietary patterns was not associated with CVD risk. Future large-scale studies are necessary to further evaluate the role of plant-based eating in CVD prevention.

Acute effect of oat ß-glucan on the bioavailability of orange juice flavanones.

The impact of ß-glucan on the bioavailability of orange juice (OJ) flavanones was investigated in a randomised controlled trial. Volunteers consumed 500 mL of OJ without or with either 3 g (OB-3) or 6 g (OB-6) of ß-glucan. Urine samples, collected 12 h before and over a 0-24 h period post-supplementation, were analysed by high-performance liquid chromatography-high resolution mass spectrometry. The overall 0-24 h urinary excretion of the 17 flavanone metabolites identified and quantified in urine after OJ ingestion corresponded to 29.7 µmol, and 25.0 and 9.3 µmol, respectively, after OB-3 and OB-6 intake. This corresponds to 9.3, 7.9, and 2.9% recoveries of the 318 µmol of the ingested flavanones. The acute ingestion of OJ with 6 g, but not 3 g of ß-glucan led to a significant reduction (p < 0.05) in the excretion of flavanone metabolites compared with consumption of OJ alone.