British Journal of Nutrition

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British Journal of Nutrition (2010), 103:1471-1479 Cambridge University Press
Copyright © The Authors 2009

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Human and Clinical Nutrition

Food intake patterns associated with carotid artery atherosclerosis in the Insulin Resistance Atherosclerosis Study

Angela D. Liesea1 c1, Michele Nicholsa1, Denise Hodoa1, Philip B. Mellena2, Mandy Schulza3, David C. Goff Jra4 and Ralph B. D'Agostino Jra4

a1 Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, USA
a2 Hypertension Center, Hattiesburg Clinic, Hattiesburg, MS, USA
a3 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
a4 Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Article author query
liese ad [PubMed]  [Google Scholar]
nichols m [PubMed]  [Google Scholar]
hodo d [PubMed]  [Google Scholar]
mellen pb [PubMed]  [Google Scholar]
schulz m [PubMed]  [Google Scholar]
goff dc [PubMed]  [Google Scholar]
d'agostino rb [PubMed]  [Google Scholar]


We aimed to identify food intake patterns that operate via haemostatic and inflammatory pathways on progression of atherosclerosis among 802 middle-aged adults with baseline and 5-year follow-up ultrasound measurements of common (CCA) and internal carotid artery (ICA) intimal medial thickness (IMT). Food intake was ascertained with an FFQ. We derived food patterns using reduced rank regression (RRR) with plasminogen activator inhibitor 1 and fibrinogen as response variables. We explored the impact of various food pattern simplification approaches. We identified a food pattern characterised by higher intakes of less healthful foods (low-fibre bread and cereal, red and processed meat, cottage cheese, tomato foods, regular soft drinks and sweetened beverages) and lower intakes of more healthful foods (wine, rice and pasta, meal replacements and poultry). The pattern was positively associated with mean CCA IMT at follow-up (P = 0·0032), a 1 sd increase corresponding to an increase of 13 μm higher CCA IMT at follow-up, adjusted for demographic and cardiovascular risk factors. With increasing pattern quartile (Q), the percentage change in CCA IMT increased significantly: Q1 0·8 %; Q2 3·2 %; Q3 8·6 %; Q4 7·9 % (P = 0·0045). No clear association with ICA IMT was observed. All simplification methods yielded similar results. The present results support the contention that a pro-inflammatory and pro-thrombotic dietary pattern increases the rate of coronary artery atherosclerosis progression, independent of traditional cardiovascular risk factors. RRR is a promising and robust tool for moving beyond the previous focus on nutrients or foods into research on the health effects of broader dietary patterns.

(Received June 22 2009)

(Revised October 27 2009)

(Accepted November 11 2009)

(Online publication January 22 2010)

Key Words:Dietary patterns; Inflammation; Haemostasis; Nutrition; Atherosclerosis


c1 Corresponding author: Angela D. Liese, fax +1 803 777 2524, email


Abbreviations: CCA, common carotid artery; FS, full food pattern score; ICA, internal carotid artery; IMT, intimal medial thickness; IRAS, Insulin Resistance Atherosclerosis Study; PAI-1, plasminogen activator inhibitor 1; RRR, reduced rank regression; SI, insulin sensitivity