OBJECTIVES: To investigate the relationship between a heart-healthy dietary pattern and subclinical heart disease in women, and to identify potential opportunities for primary prevention. DESIGN: Prospective analysis in which dietary patterns and cardiovascular disease (CVD) risk factors were assessed at baseline. Presence of subclinical heart disease was assessed using carotid atherosclerosis (stenosis >or=25%) measured by ultrasound at 12-year follow-up. SUBJECTS\/SETTING: We studied 1,423 women in the population-based Framingham Offspring\/Spouse (FOS) Study cohort, Framingham, Massachusetts. Subjects did not have CVD at baseline. STATISTICAL ANALYSES: CVD risk factor differences among the dietary clusters were evaluated using analysis of covariance and logistic regression. The relationship between heart-healthy and less heart-healthy dietary patterns and the presence of subclinical heart disease at follow-up was examined using odds ratios calculated from multivariate logistic regressions; stratification by smoking status (current, former, never) was also explored. RESULTS: Women who ate a heart-healthy diet had more favorable baseline CVD risk factor profiles. The age-adjusted odds of subclinical heart disease at follow-up was 40% lower for heart-healthy women (OR 0.60, P=.02). Multivariate adjustment for BMI, blood lipid levels, and blood pressure only slightly attenuated these odds. The odds remained reduced after adding pack-years of smoking to the multivariate model, but statistical significance was attenuated (OR 0.74, P=.20). In analyses stratified by smoking status, women who consumed a heart-healthy diet and who had never smoked had more than 80% less odds for subclinical heart disease compared with smokers whose diets were less heart-healthy (adjusted OR 0.17; P=.0001). CONCLUSIONS: Women who achieve a heart-healthy eating pattern, in combination with the avoidance of smoking, have a lower odds of subclinical heart disease. Among former smokers, the avoidance of smoking seemed to have somewhat more influence than diet on stenosis risk. A public health priority for women to promote the primary prevention of heart disease is the adoption of positive lifestyle behaviors, especially healthful eating (dietary patterns rich in fruits, vegetables, low-fat dairy foods, leaner protein sources, and lower in fats) and the avoidance of smoking.<\/p>\n","protected":false},"template":"","mots_cles":[225],"class_list":["post-52811","resume","type-resume","status-publish","hentry","mots_cles-prevention"],"acf":{"adresse":"Department of Social and Behavioral Sciences at Boston University School of Public Health, MA 02118, USA. bmillen@bu.edu","annee":"2004","mois":"2","numero":"104:2","page":"208-14","auteurs":[{"ID":52806,"post_author":"0","post_date":"2018-12-04 06:09:13","post_date_gmt":"2018-12-04 05:09:13","post_content":"","post_title":"Ralph B 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