Differing Diets May Explain Differing CVD Rates in US Hispanics, Latinos

Megan Brooks

March 28, 2022

Differing dietary patterns might help explain the different rates of heart disease and stroke among Hispanic and Latino populations in the United States, new research suggests.

On the basis of multiple measures of diet quality, Hispanic adults of Mexican origin have the most heart-healthy diet, whereas Puerto Rican adults have the least heart-healthy diet.

Yet, place of birth matters, with Hispanic/Latino adults born outside the United States consuming more heart-healthy diets than those born in the United States.

"Compared to the first-generation Hispanics/Latinos, those born in the US consumed more US-American style foods, as expected," lead investigator Crystal Chen, MD, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, told Medscape Medical News.

"This reflects the influence of acculturation on dietary pattern change toward to an unhealthy western dietary pattern in US Hispanics/Latinos," Chen said.

The findings were presented at the Epidemiology and Prevention/Lifestyle Cardiometabolic Health (EPI/Lifestyle) 2022 conference sponsored by the American Heart Association.

More Precise Data

"The results are, overall, in line with what we know about healthy dietary patterns and lower risk of CVD, adding important precision for the people identifying as Hispanic/Latinx," Marie-France Hivert, MD, program committee cochair, told Medscape Medical News.

They also highlight "some subgroups that deserve further attention, and maybe consideration for messaging that would be culturally appropriate to promote inclusion of more fresh vegetables and other elements of healthy diet patterns," said Hivert, from the Department of Population Medicine at Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston.

Several healthy eating patterns are recommended by the Dietary Guidelines for Americans from the Department of Health and Human Services for the prevention of cardiovascular disease (CVD).

Chen and colleagues measured adherence to three of these healthy eating patterns and their relation to CVD risk:

  • Alternative Mediterranean diet (aMED), an eating plan that emphasizes consumption of fruits, vegetables, olive oil, beans, nuts, whole grains, and seeds.

  • Healthy Eating Index (HEI-2015), which assesses the extent to which a person's diet aligns with the 2015–2020 Dietary Guidelines for Americans.

  • The healthful plant-based diet index (hPDI), which assesses consumption of healthy plant food, unhealthy plant food and animal food.

Participants were 10,766 adults (mean age, 46 years; 63% women) from the Hispanic Community Health Study/Study of Latinos. None had cancer or CVD at enrollment.

All participants completed 24-hour dietary recall questionnaires at enrollment and roughly a month later. The researchers used this information to determine average adherence to the healthy eating plans.

During an average follow-up of 6 years, 248 participants (2.3%) suffered a heart attack or stroke.

The researchers found that average adherence to each of the three dietary quality measures was significantly different across the six Hispanic/Latino background groups: Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American descent.

Mexican adults had the healthiest diets, followed by people from the Dominican Republic, South America, Central America, Cuba, and Puerto Rico.

In the overall sample and after multivariable adjustment, when comparing the highest to lowest dietary adherence, the risk for CVD was reduced 46% with aMED, 36% with HEI-2015, and 44% with hPDI.

The associations between dietary quality scores and CVD risk were not significantly different across Hispanic/Latino backgrounds or for US-born status.

Hispanic and Latinos born outside the United States, however, had significantly better adherence to the heart-healthy diets than those born in the United States. This was mainly driven by greater intake of plant-based foods, such as whole grains, fruits, vegetables, legumes, and nuts.

"Since the greater adherence to three healthy dietary patterns was associated with lower risk of CVD, we would suggest increasing consumption of healthy plant-based food would help the younger generation reach a better cardiovascular health than their older relatives," Chen told Medscape Medical News.

She noted that, despite commonly being aggregated as one ethnic group, the US Hispanic/Latino population is composed of diverse cultural backgrounds noted to have distinct dietary patterns.

"Understanding each group's particular dietary habits and its effects on diseases can have considerable public health relevance," Chen said.

The study was funded by grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Chen and Hivert have no relevant disclosures.

EPI/Lifestyle 2022. Oral Abstract. Presented March 3, 2022.

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