Dietary patterns associated with subclinical atherosclerosis: a cross-sectional analysis of the ELSA-Brasil study.

Objective To identify dietary patterns associated with subclinical atherosclerosis measured as coronary artery calcium (CAC). Design Cross-sectional analysis of data from the Brazilian Longitudinal Study of Adult Health. Dietary data were assessed using a food frequency questionnaire, and a principal component factor analysis was used to derive the dietary patterns. Scree plot, eigenvalues >1, and interpretability were considered to retain the factors. CAC was measured using a computed tomography scanner and an electrocardiography-gated prospective calcium score examination, and was categorized into three groups based on the CAC score: 0, 1-100, and >100 Agatston units. Multinomial regression models were conducted for dietary patterns and CAC severity categories. Setting Brazil, Sao Paulo, 2008-2010. Subjects Active and retired civil servants who lived in Sao Paulo and underwent a CAC exam were included (N = 4,025). Results Around 10% of participants (294 men, 97 women) had a detectable CAC (>0), 6.5% (182 men, 73 women) had a CAC of 1-100, and 3.5% (110 men, 23 women) had a CAC > 100. Three dietary patterns were identified: convenience food, which was positively associated with atherosclerotic calcification; plant-based and dairy food, which showed no association with CAC; and the traditional Brazilian food pattern (rice, legumes, and meats), which was inversely associated with atherosclerotic calcification. Conclusions Our results showed that a dietary pattern consisting of traditional Brazilian foods could be important to reducing the risk of atherosclerotic calcification, and prevent future cardiovascular events, whereas a convenience dietary pattern was positively associated with this outcome.