Association Between a Social-Business Eating Pattern and Early Asymptomatic Atherosclerosis

J Am Coll Cardiol. 2016 Aug 23;68(8):805-14. doi: 10.1016/j.jacc.2016.05.080.


Background: The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies.

Objectives: This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults.

Methods: The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the life-style-related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall life-style and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information.

Results: Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet.

Conclusions: A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).

Keywords: cardiovascular disease; dietary patterns; plaque; subclinical atherosclerosis.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Atherosclerosis / epidemiology
  • Atherosclerosis / etiology
  • Atherosclerosis / prevention & control*
  • Cross-Sectional Studies
  • Diet / methods*
  • Feeding Behavior*
  • Female
  • Follow-Up Studies
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Morbidity / trends
  • Prevalence
  • Primary Prevention / methods*
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Time Factors

Associated data