Dietary patterns, serum metabolites, and risk of cardiovascular disease in United States Hispanic/Latino adults: a prospective analysis of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

BACKGROUND

Healthy dietary patterns are recommended to prevent cardiovascular disease (CVD), yet the relationships among healthy dietary patterns, blood metabolite profile, and incident CVD are not well understood.

OBJECTIVES

This study aimed to assess the associations of healthy dietary patterns and related serum metabolite profiles with incident CVD in United States Hispanic/Latino adults.

METHODS

The study included 13,922 participants aged 18-74 y from the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores, including Healthy Eating Index (HEI)-2020, healthful Plant-based Diet Index (hPDI), and alternate Mediterranean diet score (aMED), were constructed at baseline (2008-2011) based on 2 24-h dietary recalls. The primary outcome was incident CVD, encompassing myocardial infarction, heart failure, and stroke. Dietary-pattern-associated metabolites were identified in a subsample of participants free of diabetes at baseline (n = 4096). Associations of dietary pattern scores, individual metabolites, and metabolite scores with incident CVD were evaluated using multivariable Cox regression.

RESULTS

During a median 9.7-y follow-up period, 260 CVD events occurred among 13,922 participants. After adjusting for demographic, socioeconomic and behavioral factors, higher dietary pattern scores were associated with lower risk of CVD [hazard ratios (HRs) = 0.53 (95% confidence interval: 0.30, 0.92), 0.50 (0.27, 0.91) and 0.62 (0.36, 1.07) for HEI-2020, hPDI, and aMED, respectively, by comparing the highest tertile to the lowest tertile]. A total of 60 metabolites were identified to be associated with all 3 dietary pattern scores, including 45 metabolites positively and 15 metabolites negatively associated with dietary pattern scores. A total metabolite score based on these 60 dietary-pattern-associated metabolites was negatively associated with the risk of CVD after multivariable adjustment [HR = 0.57 (0.35, 0.92) by comparing the highest tertile to the lowest tertile].

CONCLUSIONS

Healthier diet patterns and related serum metabolite profiles are associated with a lower risk of CVD in United States Hispanic/Latino adults.