Journal article
Eating Pattern Response to a Low-Fat Diet Intervention and Cardiovascular Outcomes in Normotensive Women: The Women's Health Initiative
Current developments in nutrition, Vol.4(3), pp.nzaa021-nzaa021
03/01/2020
DOI: 10.1093/cdn/nzaa021
PMCID: PMC7056819
PMID: 32159070
Abstract
Background: Women without cardiovascular disease (CVD) or hypertension at baseline assigned to intervention in the Women's Health Initiative Dietary Modification (DM) trial experienced 30% lower risk of coronary heart disease (CHD), whereas results in women with hypertension or prior CVD could have been confounded by postrandomization use of statins.
Objectives: Intervention participants reported various self-selected changes to achieve the 20% total fat goals. Reviewed are intervention compared with comparison group HRs for CHD, stroke, and total CVD in relation to specific dietary changes in normotensive participants.
Methods: Dietary change was assessed by comparing baseline with year 1 FFQ data in women (n = 10,371) without hypertension or CVD at baseline with intake of total fat above the median to minimize biases due to use of the FFQ in trial eligibility screening.
Results: Intervention participants self-reported compensating reduced energy intake from total fat by increasing carbohydrate and protein. Specifically they increased plant protein, with those in the upper quartile (increased total protein by >= 3.3% of energy) having a CHD HR of 0.39 (95% CI: 0.22, 0.71), compared with 0.92 (95% CI: 0.57, 1.48) for those in the lower quartile of change (decreased total protein >= 0.6% of energy), with P-trend of 0.04. CHD HR did not vary significantly with change in percentage energy from carbohydrate, and stroke HR did not vary significantly with any macronutrient changes. Scores reflecting adherence to recommended dietary patterns including the Dietary Approaches to Stop Hypertension Trial and the Healthy Eating Index showed favorable changes in the intervention group.
Conclusions: Intervention group total fat reduction replaced with increased carbohydrate and some protein, especially plant-based protein, was related to lower CHD risk in normotensive women without CVD who reported high baseline total fat intake.
Details
- Title: Subtitle
- Eating Pattern Response to a Low-Fat Diet Intervention and Cardiovascular Outcomes in Normotensive Women: The Women's Health Initiative
- Creators
- Linda Van Horn - Northwestern UniversityAaron K. Aragaki - Fred Hutch Cancer CenterBarbara Howard - Georgetown UniversityMatthew A. Allison - University of California San DiegoCarmen R. Isasi - Albert Einstein College of MedicineJoAnn E. Manson - Harvard UniversityMarian L. Neuhouser - Northwestern UniversityYasmin Mossavar-Rahmani - Albert Einstein College of MedicineCynthia A. Thomson - University of ArizonaMara Z. Vitolin - Wake Forest UniversityRobert B. Wallace - University of IowaRoss L. Prentice - Fred Hutch Cancer CenterWHI Investigators
- Resource Type
- Journal article
- Publication Details
- Current developments in nutrition, Vol.4(3), pp.nzaa021-nzaa021
- DOI
- 10.1093/cdn/nzaa021
- PMID
- 32159070
- PMCID
- PMC7056819
- NLM abbreviation
- Curr Dev Nutr
- ISSN
- 2475-2991
- eISSN
- 2475-2991
- Publisher
- Oxford Univ Press
- Number of pages
- 11
- Grant note
- N01WH22110; 24152; 32100-2; 32105-6; 32108-9; 32111-13; 32115; 32118-32119; 32122; 42107-26; 42129-32; 44221 / National Heart, Lung, and Blood Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
- Language
- English
- Date published
- 03/01/2020
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984364420902771
Metrics
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