The Relationship between Dietary Patterns and Different Level of Pro-oxidant - Antioxidant Balance, and Lipid Profile in Patients with Coronary Artery Diseases.

Abstract

Introduction: Globally, despite the many advances in prevention and treatment of cardiovascular disease, the absolute number of coronary artery disease (CAD) continues to rise. The dietary pattern approach has shown to be a powerful means for summarizing nutrient and food intake to depict the whole diet. Previous studies have demonstrated that healthy dietary pattern was associated with biomarkers of subclinical inflammation and proposed to protect individuals from oxidative stress, defined as the persistent imbalance between free radical formation and antioxidant defense, which in turn seems to play a crucial role in the development of CAD. Objectives: Mashhad stroke and atherosclerotic disorder (MASHAD) study investigated determinates risk factors of CAD in Iranian population including pro-oxidant antioxidant balance (PAB) and dietary pattern; and given the variety of cultures and dietary habits across the world, it is likely that much remains to be learned about dietary patterns and health outcomes in this area.

Materials and Methods: This is a prospective cohort study of 9704 men and women aged 35 – 65 y of MASHAD study population. Dietary patterns were derived from a 65-item validated food-frequency questionnaire (FFQ) and the factor analysis method was used to determine dietary patterns. Survival analysis was used to report the risk of CVDs incidence according to derived dietary patterns and serum PAB. Results: We identified two major dietary patterns using factor analysis: the "balanced pattern" and the "western pattern". The "balanced pattern," was characterized by higher intake of, fruits, vegetables, dairy products, other vegetables, red meat, sea foods, poultry and nuts, whereas the "Western pattern," was characterized by higher intake of potatoes, sweets, butter, snacks, eggs, carbonated beverages, organs meat, pickled foods, tea and fast foods. After adjustment for confounding factors, the hazard ratio from comparing the highest to the lowest tertiles of the balanced pattern score were 0.62 (95٪ CI: 0.39, 0.99; p for trend: 0.04). In contrast, the hazard ratio across increasing tertiles of the western pattern score were 2.02 (95٪ CI: 1.29, 3.16; p for trend: 0.002). Moreover, hazard ratio from comparing second tertile to lowest tertiles of PAB decreasing 0.66 (95٪ CI: 0.9, 0.48; p for trend: 0.01) Conclusion: The favorable effect of balanced dietary pattern on the prevention of CAD may be related to their higher content of fruits, vegetables, dairy products, other vegetables, red meat, sea foods, poultry and nut that provide enough vitamins, minerals and antioxidants. Moreover, PAB independently associated with CAD risk factors, since it could be considered as predictor of CAD in Iranian population.