Dietary patterns and the risk of coronary heart disease in women

Background: Although substantial information on individual nutrients or foo ds and risk of coronary heart disease (CHD) is available, little is known a bout the role of overall eating pattern. Methods: Using dietary information from a food frequency questionnaire in 1 984 from the Nurses' Health Study, we conducted factor analysis and identif ied 2 major dietary pattems - "prudent" and "Western" - and calculated fact or scores of each pattern for individuals in the cohort. We used logistic r egression to examine prospectively the associations between dietary pattern s and CHD risk among 69017 women aged 38 to 63 years in 1984 without histor y of major chronic diseases. Results: The prudent pattern was characterized by higher intakes of fruits, vegetables, legumes, fish, poultry, and whole grains, while the Western pa ttern was characterized by higher intakes of red and processed meats, sweet s and desserts, french fries, and refined grains. Between 1984 and 1996, we documented 821 CHD cases. After adjusting for coronary risk factors, the p rudent diet score was associated with a relative risk (RR) of 0.76 (95% con fidence interval (CI), 0.60-0.98; P for trend test,.03) comparing the highe st with lowest quintile. Extreme quintile comparison yielded,an RR of 1.46 (95% CI, 1.07-1.99; P for trend test,.02) for the Western pattern. Those wh o were jointly in the highest prudent diet quintile and lowest Western diet quintile had an RR of 0.64 (95% CI, 0.44-0.92) compared with those with th e opposite pattern profile. Conclusion: A diet high in fruits, vegetables, whole grains, legumes, poult ry, and fish and low in refined grains, potatoes, and red and processed mea ts may lower risk of CHD.