Eating Pattern Response to a Low-Fat Diet Intervention and Cardiovascular Outcomes in Normotensive Women: The Women's Health Initiative
AuthorVan Horn, Linda
Aragaki, Aaron K.
Howard, Barbara, V
Allison, Matthew A.
Isasi, Carmen R.
Manson, JoAnn E.
Neuhouser, Marian L.
Thomson, Cynthia A.
Vitolin, Mara Z.
Wallace, Robert B.
Prentice, Ross L.
AffiliationUniv Arizona, Dept Hlth Promot Sci, Mel & Enid Zuckerman Coll Publ Hlth
self-selected dietary change
MetadataShow full item record
PublisherOXFORD UNIV PRESS INC
CitationVan Horn, L., Aragaki, A. K., Howard, B. V., Allison, M. A., Isasi, C. R., Manson, J. E., ... & WHI Investigators. (2020). Eating pattern response to a low-fat diet intervention and cardiovascular outcomes in normotensive women: The Women's Health Initiative. Current developments in nutrition, 4(3), nzaa021.
Rights© The Author(s) 2020. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBackground: Women without cardiovascular disease (CVD) or hypertension at baseline assigned to intervention in the Women's Health Initiative Dietary Modification (DM) trial experienced 30% lower risk of coronary heart disease (CHD), whereas results in women with hypertension or prior CVD could have been confounded by postrandomization use of statins. Objectives: Intervention participants reported various self-selected changes to achieve the 20% total fat goals. Reviewed are intervention compared with comparison group HRs for CHD, stroke, and total CVD in relation to specific dietary changes in normotensive participants. Methods: Dietary change was assessed by comparing baseline with year 1 FFQ data in women (n = 10,371) without hypertension or CVD at baseline with intake of total fat above the median to minimize biases due to use of the FFQ in trial eligibility screening. Results: Intervention participants self-reported compensating reduced energy intake from total fat by increasing carbohydrate and protein. Specifically they increased plant protein, with those in the upper quartile (increased total protein by >= 3.3% of energy) having a CHD HR of 0.39 (95% CI: 0.22, 0.71), compared with 0.92 (95% CI: 0.57, 1.48) for those in the lower quartile of change (decreased total protein >= 0.6% of energy), with P-trend of 0.04. CHD HR did not vary significantly with change in percentage energy from carbohydrate, and stroke HR did not vary significantly with any macronutrient changes. Scores reflecting adherence to recommended dietary patterns including the Dietary Approaches to Stop Hypertension Trial and the Healthy Eating Index showed favorable changes in the intervention group. Conclusions: Intervention group total fat reduction replaced with increased carbohydrate and some protein, especially plant-based protein, was related to lower CHD risk in normotensive women without CVD who reported high baseline total fat intake.
NoteOpen access journal
VersionFinal published version
Except where otherwise noted, this item's license is described as © The Author(s) 2020. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).
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