This competing renewal application represents a translational continuation of our long-standing research on dietary patterns and cardiovascular disease (CVD) that extends to the interconnections between dietary patterns, gut microbes, and metabolomic profiles. The recently released 2015-2020 Dietary Guidelines for Americans recommends three dietary patterns - the Healthy US-Style Eating Pattern, the Healthy Mediterranean-Style Eating Pattern, and the Healthy Vegetarian Eating Pattern. In this project, we will examine the associations between these three recommended dietary patterns and CVD risk in four large prospective US cohorts, with a particular focus on potential racial/ethnic differences.
In Aim 1, we will create updated indices for each dietary pattern (Healthy Eating Index [HEI]-2015, Mediterranean Diet Index [MDI], Healthful Plant-based Diet Index [hPDI]), and evaluate potential racial/ethnic differences in their associations with CVD in the Nurses' Health Study (NHS), NHSII, and Health Professionals Follow-up Study (HPFS), including 231,000 non-Hispanic whites, 3,600 African Americans, 3,000 Asians, and 2,400 Hispanics. We will also construct the three diet indices in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; n=13,000) and evaluate their associations with CVD during 12 years of follow-up. Secondarily, we will examine the associations of these diet indices with CVD in diverse Hispanic groups (Puerto Rican, Mexican, Central/South American, Cuban, and Dominican).
In Aim 2, we will evaluate the relationship between adherence to the three dietary patterns and plasma metabolic profiles (including CVD-related candidate metabolites and novel metabolic pathways based on >500 metabolites) in a subsample of 1,100 NHS/HPFS participants and 477 HCHS/SOL participants. In addition, we will identify and characterize gut microbiome markers, via shotgun metagenomic and metatranscriptomic sequencing, that are associated with the three dietary patterns among 621 NHSII/HPFS participants and 400 HCHS/SOL participants who provided or will provide stool samples. In secondary analyses, we will examine associations between the three dietary pattern scores and gut microbial features stratified by Hispanic sub-groups and compare them with non-Hispanic whites. The proposed study, with a unique prospective US Hispanic cohort, will be the first to assess adherence to dietary guidelines in relation to CVD risk in this population. Using state-of-the-art metabolomics and microbiome technologies, this study will also be among the first to explore potential mechanisms through which long-term adherence to recommended dietary patterns influences CVD risk in diverse racial/ethnic groups. Built on well-established long-term cohorts, archived biospecimens, and advanced -omics technology, this competing renewal will advance our understanding of the cardio-metabolic benefits associated with healthy dietary patterns, providing novel insight into the dietary prevention of CVD. !

Public Health Relevance

This study will be the first and largest of its kind to prospectively evaluate adherence to three recommended dietary patterns and cardiovascular disease risk in four large prospective US cohorts with diverse racial/ethnic groups. The study will also examine the interconnections between healthy eating patterns, plasma metabolite profiles, and gut microbes in Hispanic and non-Hispanic white populations. Our study will provide new insights into the relationship between diet and cardiovascular disease and inform evidence-based dietary recommendations and help to improve current guidelines. !

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Cancer, Heart, and Sleep Epidemiology A Study Section (CHSA)
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Boyington, Josephine
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Harvard University
Schools of Public Health
United States
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Satija, Ambika; Hu, Frank B (2018) Plant-based diets and cardiovascular health. Trends Cardiovasc Med 28:437-441
Li, Yanping; Pan, An; Wang, Dong D et al. (2018) Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. Circulation 138:345-355
Yu, Edward; Hu, Frank B (2018) Dairy Products, Dairy Fatty Acids, and the Prevention of Cardiometabolic Disease: a Review of Recent Evidence. Curr Atheroscler Rep 20:24
Pan, An; Lin, Xu; Hemler, Elena et al. (2018) Diet and Cardiovascular Disease: Advances and Challenges in Population-Based Studies. Cell Metab 27:489-496
Yu, Edward; Malik, Vasanti S; Hu, Frank B (2018) Cardiovascular Disease Prevention by Diet Modification: JACC Health Promotion Series. J Am Coll Cardiol 72:914-926
Mons, Ute; Müezzinler, Aysel; Schöttker, Ben et al. (2017) Leukocyte Telomere Length and All-Cause, Cardiovascular Disease, and Cancer Mortality: Results From Individual-Participant-Data Meta-Analysis of 2 Large Prospective Cohort Studies. Am J Epidemiol 185:1317-1326
Guasch-Ferré, Marta; Liu, Xiaoran; Malik, Vasanti S et al. (2017) Nut Consumption and Risk of Cardiovascular Disease. J Am Coll Cardiol 70:2519-2532
Li, Yanping; Willett, Walter C; Hu, Frank B (2017) Reply to DR Thomas. Am J Clin Nutr 106:324
Satija, Ambika; Bhupathiraju, Shilpa N; Spiegelman, Donna et al. (2017) Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. J Am Coll Cardiol 70:411-422
Buckley, Matthew T; Racimo, Fernando; Allentoft, Morten E et al. (2017) Selection in Europeans on Fatty Acid Desaturases Associated with Dietary Changes. Mol Biol Evol 34:1307-1318

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