Dietary patterns and cardiovascular disease are closely linked, yet the relationships among healthy diets, blood metabolite profiles, and heart conditions in U.S. Hispanic/Latino adults are not well-understood. Healthy dietary patterns are recommended to prevent cardiovascular disease (CVD), yet the relationships among healthy dietary patterns, blood metabolite profile, and incident CVD are not well-understood.

Objective:

This study aimed to assess the associations of healthy dietary patterns and related serum metabolite profile with incident CVD in US Hispanic/Latino adults.

Methods:

The study included 13,922 participants aged 18-74 years from the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores, including Healthy Eating Index (HEI)-2020, healthful Plant-based Diet Index (hPDI), and alternate Mediterranean diet score (aMED), were constructed at baseline (2008-2011) based on two 24-hour dietary recalls. The primary outcome was incident CVD, encompassing myocardial infarction, heart failure, and stroke. Dietary-pattern-associated metabolites were identified in a subsample of participants free of diabetes at baseline (n=4,096). Associations of dietary pattern scores, individual metabolites and metabolite scores with incident CVD were evaluated using multivariable Cox regression.

Results:

During a median 9.7-year follow-up period, 260 CVD events occurred among 13,922 participants. After adjusting for demographic, socioeconomic and behavioral factors, higher dietary pattern scores were associated with lower risk of CVD (hazard ratios [HRs]=0.53 [95% confidence interval: 0.30, 0.92], 0.50 [0.27, 0.91] and 0.62 [0.36, 1.07] for HEI-2020, hPDI and aMED, respectively, by comparing the highest tertile to the lowest tertile). A total of 60 metabolites were identified to be associated with all three dietary pattern scores, including 45 metabolites positively and 15 metabolites negatively associated with dietary pattern scores. A total metabolite score based on these 60 dietary-pattern-associated metabolites was negatively associated with risk of CVD after multivariable adjustment (HR=0.57 [0.35, 0.92] by comparing the highest tertile to the lowest tertile).

Conclusions:

Healthier diet patterns and related serum metabolite profile were associated with lower risk of CVD in US Hispanic/Latino adults.