Dietary patterns and subclinical atherosclerosis incidence and progression: Results from ELSA-Brasil

Nutr Metab Cardiovasc Dis. 2023 Jan;33(1):47-55. doi: 10.1016/j.numecd.2022.09.021. Epub 2022 Oct 2.


Background and aims: Cardiovascular disease (CVD) is the main cause of disease burden worldwide. Coronary artery calcification (CAC) score is a subclinical atherosclerosis marker able to predict the risk of CVD in asymptomatic patients, and few studies have investigated the association between dietary patterns (DP) and CAC score prospectively. Thus, the aim of this study was to estimate the association between baseline DP and CAC score incidence and progression on the ELSA-Brasil cohort.

Methods and results: This study is a longitudinal prospective analysis of the ELSA-Brasil participants who underwent a CAC exam on baseline and follow-up (n = 2,824). CAC incidence was defined as a baseline CAC score equal to zero (n = 2,131) and subsequent follow-up CAC score greater than zero. CAC progression was defined according to the Hokanson method for the individuals who presented a CAC score greater than zero at the baseline (n = 639). Dietary data were assessed at the baseline using a food frequency questionnaire (FFQ), and factor analysis was applied to identify DP. Poisson regression models with robust variance and linear regression models were applied to estimate the association between baseline DP and CAC incidence and progression. The incidence of CAC was 14.6%, while 60.3% of the individuals presented CAC progression. Three DP were identified: convenience, Brazilian traditional, and prudent. We did not find a significant association between baseline DP and CAC incidence or progression.

Conclusion: Our findings from this longitudinal prospective analysis showed that baseline DP are not associated with CAC incidence or progression.

Keywords: CAC incidence; CAC progression; Dietary patterns (DP); Subclinical atherosclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Brazil / epidemiology
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / epidemiology
  • Disease Progression
  • Humans
  • Incidence
  • Risk Factors
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / epidemiology