Background:

Multiple dietary patterns haven been recommended by 2015-2020 Dietary Guidelines for Americans for the prevention of cardiovascular disease (CVD). The adherence to these patterns and its relationship with risk of CVD remain unclear in the US Hispanic/Latino population.

Objectives:

We aimed to evaluate three healthy eating patterns measured by three dietary pattern scores (the Alternate Mediterranean diet (aMED), the Healthy Eating Index (HEI)-2015, and the healthful Plant-based Diet Index (hPDI)) across different Hispanic/Latino backgrounds and generations. We further examined the associations of these dietary scores with incident CVD in US Hispanics/Latinos.

Methods:

We included 10,293 adult participants of US Hispanics/Latinos of six backgrounds (Mexican, Puerto Rican, Cuban, Dominican, Central American and South American), free of CVD or cancer at baseline, in the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores were derived at the baseline visit using two 24-hour dietary recalls. The primary outcome was the major incident CVD (n = 232), comprised of coronary heart disease and stroke, during an average 6-year follow-up.

Results:

Mean levels of all three dietary scores were significantly different across 6 Hispanic/Latino background groups (all P < 0.001), with highest (i.e., healthiest) in those of Mexican background and lowest in those of Puerto Rican background. Compared to non-mainland-US-born Hispanics/Latinos, mainland-US-born Hispanics/Latinos had significantly lower dietary scores (P < 0.001). Differences in dietary scores between mainland-US-born and non-mainland-US-born Hispanics/Latinos were majorly driven by differences in dietary intakes of healthy plant-based foods. After adjusting for multiple covariates, significantly lower risk ratios (95% CI) of CVD were observed for one standard deviation increment of the dietary scores, with 0.74 (0.60,0.91) for aMED, 0.80 (0.63,1.00) for HEI-2015, and 0.74 (0.60,0.93) for hPDI.

Conclusions:

Although adherence to healthy eating patterns varies by Hispanic/Latino backgrounds and generations, greater adherence to these eating patterns is associated with lower risk of CVD across diverse US Hispanics/Latinos.