Identifying groups at risk for atherosclerotic cardiovascular disease (ASCVD) and improving prevention strategies are important due to the high rates of these diseases in the world. We aimed to determine the 10-year ASCVD risk and cardiovascular age gap (CAG) of Canadians 40–79 and the association between prevalent dietary patterns and ASCVD risk, and CAG.
Health measures and dietary intake information were obtained from 2088 respondents representative of 13,655,671 Canadians 40–79 years in the cross-sectional Canadian Health Measures Survey Cycles 1 and 2 (2007–11). The estimated 10-year ASCVD risk and CAG were determined for 40–79 years adults across different levels of sociodemographic/lifestyle factors. Dietary patterns emerged using the principal component analysis from 32 food groups collected using food frequency questionnaire. The association between 10-year ASCVD risk, and CAG, with dietary patterns was investigated controlling for potential covariates. Survey data were weighted and bootstrapped to be nationally representative.
The mean 10-year ASCVD risk of 40–79 years was 6.9%. The mean CAG for men was −4.1 years (older) and for females was +0.4 years (younger). Four dietary patterns emerged. Of note, the “High carbohydrate and protein” dietary pattern, which included potatoes, red meat, sausage, egg and ice-cream/frozen yoghurt was positively associated with 10-year ASCVD (Ptrend = 0.013). The “Healthy like” and “Fast food” dietary patterns had an inverse (p < 0.0001) and positive (p = 0.005) association, respectively, with CAG.
Dietary patterns prevalent among this population were associated with CAG and ASCVD risk. Interventions for promoting healthy dietary patterns may be beneficial to reduce ASCVD in Canada.
Subscribe to Journal
Get full journal access for 1 year
only $41.58 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Statistics Canada. Table 13-10-0394-01. Leading causes of death, total population, by age group. Ottawa, ON, Canada: Statistics Canada; 2012. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401.
Reiner Ž, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818. https://doi.org/10.1093/eurheartj/ehr158.
Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2935–59. https://doi.org/10.1016/j.jacc.2013.11.005.
D’agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circ J. 2008;117:743–53. https://circ.ahajournals.org/content/117/6/743.ful.
Cuende JI. Vascular age versus cardiovascular risk: clarifying concepts. Rev Esp Cardiol (English edition). 2016;69:243–6.
Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13:3–9.
Sonnenberg L, Pencina M, Kimokoti R, Quatromoni P, Nam BH, D’Agostino R, et al. Dietary patterns and the metabolic syndrome in obese and non-obese Framingham women. Obes Res. 2005;13:153–62.
Expert Panel on Detection, E. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486.
Freeland-Graves J, Nitzke S. Position of the American Dietetic Association: total diet approach to communicating food and nutrition information. J Am Diet Assoc. 2002;102:100–8.
Statistics Canada. Canadian Health Measures Survey—data user guide: cycle 1, definitions, data sources and methods. Ottawa, ON, Canada: Statistics Canada; 2012. http://www23.statcan.gc.ca/imdb-bmdi/document/5071_D2_T1_V1-eng.htm.
Statistics Canada. Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 2. Ottawa, ON, Canada: Statistics Canada; 2012. http://data.library.utoronto.ca/datapub/codebooks/cstdli/chms/CHMS_User_Guide_Cycle2_E.pdf.
Statistics Canada. Canadian Health Measures Survey (CHMS): instructions for combining cycle 1 and cycle 2 data. Ottawa, ON, Canada: Statistics Canada; 2014. Available at Research Data Center.
Hosseini Z, Whiting SJ, Vatanparast H. Type 2 diabetes prevalence among Canadian adults—dietary habits and sociodemographic risk factors. Appl Physiol Nutr Metab. 2019;44:1099–104.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circ J. 2009;120:1640–5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644.
Hennessy DA, Bushnik T, Manuel DG, Anderson TJ. Comparing guidelines for statin treatment in Canada and the United States. JAMA. 2015;4:e001758.
Tucker KL. Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab. 2010;35:211–8.
Statistics Canada. Canadian Health Measures Survey—Data Dictionary: Cycle 1. Ottawa, ON, Canada: Statistics Canada; 2010. http://www.library.carleton.ca/sites/default/files/find/data/surveys/pdf_files/chms-c1-07-09-dic.pdf.
Yang Q, Zhong Y, Ritchey M, Cobain M, Gillespie C, Merritt R, et al. Vital signs: predicted heart age and racial disparities in heart age among US adults at the state level. MMWR Morb Mortal Wkly Rep. 2015;64:950–8.
Hosseini Z, Whiting SJ, Vatanparast H. Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective. Nutr Res Rev. 2016;29:152–62.
Movassagh EZ, Vatanparast H. Current evidence on the association of dietary patterns and bone health: a scoping review. Adv Nutr. 2017;8:1–6.
Nettleton JA, Polak JF, Tracy R, Burke GL, Jacobs DR Jr. Dietary patterns and incident cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2009;90:647–54.
Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM, et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2006;83:1369–79.
Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr. 2000;72:912–21.
Fung TT, Stampfer MJ, Manson JE, Rexrode KM, Willett WC, Hu FB. Prospective study of major dietary patterns and stroke risk in women. Stroke. 2004;35:2014–9.
Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006;354:1601–13.
Deshmukh-Taskar PR, O’Neil CE, Nicklas TA, Yang SJ, Liu Y, Gustat J, et al. Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study. Public Health Nutr. 2009;12:2493–503.
Adlercreutz H. Western diet and Western diseases: some hormonal and biochemical mechanisms and associations. Scand J Clin Lab Investig. 1990;50:3–23.
Hosseini Z, Whiting SJ, Vatanparast H. Canadians’ Dietary Intake from 2007 to 2011 and across Different Sociodemographic/Lifestyle Factors Using the Canadian Health Measures Survey Cycles 1 and 2. J Nutr Metab. 2019. https://doi.org/10.1155/2019/28319.
Authors of this study acknowledge Saskatchewan Research Data Centre at the University of Saskatchewan for providing opportunity to access the nationally representative CHMS datasets.
This paper is supported by University of Saskatchewan and a contribution from the Dairy Research Cluster Initiative (Dairy Farmers of Canada, Agriculture and Agri-Food Canada, the Canadian Dairy Network and the Canadian Dairy Commission) (grant number AIP-CL04). The funders had no contribution in any part of this research or any part of the preparation of this paper.
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Hosseini, Z., Rostami, M., Shamloo, A. et al. Association between the 10-year predicted risk of atherosclerotic cardiovascular disease and dietary patterns among Canadian adults 40–79 years. Eur J Clin Nutr (2020). https://doi.org/10.1038/s41430-020-00763-8