Dietary patterns and cardiovascular risk factors among Brazilians: A population-based study in Viçosa, Minas Gerais

The aim of this study was to identify dietary patterns (DPs) and analyze their association with cardiovascular risk factors including metabolic biomarkers and markers of inflammation and oxidative stress in a cross-sectional population-based study with 959 Brazilian adults from Viçosa.

Food consumption was assessed by food frequency questionnaire, and DPs were identified by principal component analysis. A self-administered questionnaire was applied to assess sociodemographic and behavioral variables.

Four distinct DPs were identified: Western, Snacks and Processed Food, Healthy, and Traditional Brazilian. Comparing the highest to the lowest tertile of each DP: Snacks and Processed Food DP was associated with a significantly higher diastolic blood pressure (β = 2.81; 95% confidence interval [CI], 0.48-5.14), waist circumference (β = 4.75; 95% CI, 2.77-6.73), body mass index (β = 1.65; 95% CI, 0.63-2.67), neck circumference (β = 0.74; 95% CI, 0.15-1.34), uric acid (β = 0.32; 95% CI, 0.13-0.51), and C-reactive protein (β = 0.31; 95% CI, 0.07-0.55). The Healthy DP was associated with lower Homeostatic Model Assessment of Insulin Resistance (HOMA-IR; β = -0.17; 95% CI, -0.34 to -0.008), lower tumor necrosis factor-α (odds ratio [OR] = 0.46; 95% CI, 0.26-0.84), lower interleukin (IL)-8 (OR = 0.50; 95% CI, 0.28-0.91), and lower catalase (OR = 0.36; 95% CI, 0.16-0.78). The Traditional Brazilian DP was associated with lower high-density lipoprotein (HDL) cholesterol (β = -5.04; 95% CI, -7.60 to -2.48), non-HDL cholesterol (β: -10.25; 95% CI, -19.07 to -1.43), and superoxide dismutase (OR = 0.52; 95% CI, 0.32-0.87), and higher uric acid (β = 0.24; 95% CI, 0.01-0.48), IL-12p70 (OR = 2.55; 95% CI, 1.23-5.32), IL-1β (OR = 2.22; 95% CI, 1.01-4.89), IL-10 (OR = 2.03; 95% CI, 1.05-3.93), and ferric reducing ability of plasma (OR = 2.23; 95% CI, 1.16-4.27).

The Snacks and Processed Food DP was associated with increases in several risk factors for cardiovascular disease, and the Healthy DP with lower HOMA-IR scores, tumor necrosis factor-α, IL-8, and catalase. A diet based on rice and beans (Traditional Brazilian) may have a protective role against non-HDL cholesterol while presenting other risks related to inflammation and oxidative stress, as shown by a direct association with the interleukins IL-12p70, IL-1β, and IL-10 and an inverse association with superoxide dismutase.