(OR19-05-23) Longitudinal Associations Between the Mediterranean Diet and Dietary Approaches To Stop Hypertension Adherence With Cardiovascular Biomarkers

Objectives: Examine the associations between the Mediterranean Diet (MedDiet) and Dietary Approaches to Stop Hypertension (DASH) diet with coronary artery calcification (CAC) progression and pericardial adiposity volume (PAT) in adults with and without type 1 diabetes (T1D) over 6 years of follow-up.

Methods: We conducted a longitudinal analysis of data from Coronary Artery Calcification in Type 1 Diabetes study [n=1255; T1D: n=563; non-diabetic [non-DM]: n=692]. Participants completed a validated food frequency questionnaire, a physical exam, and fasting (12h overnight fast) biochemical analyses at each visit. CAC and PAT were measured using electron beam computed tomography. CAC progression was defined by the square root-transformed volume >2.5 mm. Mixed effect models were applied to examine the associations between the dietary pattern (DP) scores with PAT and CAC progression (logit function). All models included a random intercept to account for patient heterogeneity.

Results: Models were adjusted for age, sex, calories, visit, diabetes status (combined models only), body mass index, triglycerides, low-density lipoprotein, systolic blood pressure, and physical activity. A one-point increase in the MedDiet was associated with a significant -0.09 cm³ (95% CI -0.14, -0.03: p-value=0.0027) inverse association in PAT. A one-point increase in the DASH score was associated with a significant -0.26 cm³ (95% CI: -0.38, -0.14; p-value= < 0.0001) inverse association in PAT. When stratified by diabetes status, the DASH diet was only significant in the non-DM group for lower PAT (-0.34 cm³; 95% CI: -0.51, -0.17; p-value=0.0001). There was no difference by diabetes status for the MedDiet. In combined models, the DPs were not significantly associated with lower odds of CAC progression; however, both DPs had significant interactions by diabetes status for CAC. Only the DASH diet was associated with a lower odds of CAC progression in the non-DM group (OR: 0.96; 95% CI: 0.93, 0.99; p-value=0.0224).

Conclusions: The MedDiet was associated with lower PAT volume irrespective of diabetes status but was not associated with CAC progression in combined or stratified models. The DASH diet was only significant for lower PAT volume and lower odds of CAC progression in the non-DM group.

Funding Sources: NIH, American Diabetes Association