Adult women in Mexico city

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Nutrition Journal volume 17Article : 21 Cite this article. Metrics details. Research has found that diet and dietary patterns are associated with blood pressure and hypertension. Limited research in this area has been conducted in a Mexican population. Dietary patterns were categorized into quartiles and logistic regression models were fit. Participants were Between baseline and first follow-up — we identified incident cases of hypertension.

We identified three major components. The first was loaded heavily with vegetables, fruits and legumes; the second component was loaded heavily with processed meats, fast foods, and red meat; and finally the third component was loaded heavily with corn tortillas, hot peppers, and sodas. The Western pattern and the Modern Mexican pattern, which showcases an undergoing nutrition transition, may affect the incidence of hypertension, whereas the FV pattern was not associated with hypertension.

These findings are important in the prevention of hypertension and cardiovascular diseases in Mexico and possibly among Mexican people living in Adult women in Mexico city US. Peer Review reports. High blood pressure is a marker of cardiovascular risk and has important health impacts, such as on cardiovascular and cerebrovascular disease, renal failure, retinopathy and optic neuropathy. Diet is a modifiable risk factor for hypertension, however from studies on individual foods and nutrients i.

Evaluating dietary patterns has been proposed as a strategy that captures the overall manner in which individuals consume foods [ 91011 ]. Dietary patterns overcome the challenge of collinearity of studying single foods or nutrients and potentially considering their t effects [ 10 ]. Dietary patterns based on a priori indices have been associated to decreased risk of chronic disease. While there is robust scientific evidence on the benefits of the DASH diet Dietary Approaches to Stop Hypertension and the Mediterranean diet on lowering blood pressure [ 121314 ], these a priori indices have been generated from studies done mostly in Caucasian populations, with little representation of Mexicans, one of the largest minorities in the US.

It is questionable whether these indices are appropriate for the Hispanic population, specifically Mexicans, since evidence shows low adherence to these indices [ 15 ]. In contrast, empirically derived dietary patterns are data driven and allow for the examination of eating behaviors without prior knowledge or assumption of the existence of dietary patterns in the population.

There is a need to understand dietary patterns within the Mexican population and comprehend which of these patterns are associated with hypertension risk and subsequently target culturally appropriate public health messages of healthy diets. In this study we derived dietary patterns using principal component analysis to explore the association between the Mexican dietary patterns and incident hypertension in a population-based study. Women participate in a well-established voluntary economic incentives program and the study questionnaire was delivered and collected in collaboration with public education authorities from 12 states in Mexico [ 16 ].

All women ed an informed consent form to take part in the study. Between December and Februarya follow-up questionnaire was released. After a feasibility phase in, participants responded a questionnaire in that included a ly validated dietary questionnaire [ 17 ]. Finally, we excluded 12, participants for whom information after baseline was unavailable. The final study sample included 62, participants.

We collected dietary information with a item semi-quantitative food frequency questionnaire FFQ. Participants were asked to specify the average frequency of consumption over the year of each food item in a commonly used unit or portion size. The consumption frequencies were never, once a month or less, two to three times a month, once a week, two to four times a week, five to six times a week, once a day, two to three times a day, four to five times a day and six or more times a day.

With the USDA food-composition database [ 18 ] and the database used in the National Health and Nutrition Survey in Mexico we calculated nutrient and energy intakes by multiplying the nutrient Adult women in Mexico city of the pre-defined portion sizes by the frequency of consumption.

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A similar version of our FFQ was ly validated amongst Mexico City female residents in a month study [ 17 ]. Pearson correlation coefficients for total energy, carbohydrate, protein, and total fat intakes between the FFQ and four 4-day h recalls were 0. At follow-up, we asked participants to report whether a clinician had made a diagnosis of elevated blood pressure in the two years, if treatment was received, and the year of diagnosis. We defined hypertension as self-reported physician diagnosed elevated blood pressure under drug treatment.

We assessed the validity of self-reported hypertension diagnosis in a random subsample of participants who reported elevated blood pressure, using a structured phone interview to confirm the diagnosis, year of diagnosis and treatment. Food items in the FFQ were collapsed into 37 food groups Table 1 based on similarity of nutrient content by a trained dietitian.

Some individual foods were retained because they represented distinct dietary patterns or constituted a distinct item on their own e.

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Gram amounts of food groups were converted to calories and divided by total energy intake of each individual, resulting in food groups standardized as percent of total energy intake plus one and log transformed to normalize the distribution. We defined dietary patterns on the 37 food groups with principal component analysis PCA using the factor procedure in SAS.

PCA reduces the of observed variables to a smaller of principal components that for most of the variance of the observed variables. Components were rotated by an orthogonal transformation Varimax rotation function to achieve simpler structures with greater interpretation. We decided not use the percentage of variance explained to determine the of components to retain because this depends on the of variables entered into the analysis [ 2021 ].

There are two approaches to calculate the factor scores per participant, one is to compute the score by summing the observed intakes of the component food items weighted by its factor loading. The second approach is a simpler approach to sum only the factors that load higher than a certain value [ 19 ].

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We chose to use the more elaborate approach to calculate factor scores for this analysis were similar. Covariate information was based on self-reports from the baseline questionnaire. Responses to ownership of seven household assets phone, car, computer, vacuum cleaner, microwave oven, cell phone and internet were summed and classified into low, medium and high socioeconomic status tertile. Physical activity was defined as self-reported minutes per week spent on moderate and vigorous recreational physical activity calculated from responses to eight that ranged from none to more than 10 h per week.

Menopausal status was based on self-reported information related to last menstruation, hot flushes, hysterectomy, oophorectomy, and hormonal treatments; if these data were unknown then an algorithm using current age was used to determine status where possible. Smoking status was classified into never, past or current smokers. Adult women in Mexico city and hypercholesterolemia were defined by self-reported treated disease. Body mass index BMI was calculated as self-reported weight in kg over height in meters squared. Our main exposures were the three major dietary patterns derived from PCA.

We categorized individuals into quartiles of each dietary pattern using the lowest category as the referent. The median value for each quartile was used as a continuous variable to test for linear trend. A complete-case analysis was conducted. In sensitivity analyses we conducted the analyses among non-diabetics because diabetics could have altered their diet after diagnosis but they are still at a higher risk of hypertension. We also repeated analyses among never-smokers because smoking is a strong risk factor for hypertension and could mask the association between diet and hypertension.

The two component solution was used as an alternative exposure in sensitivity analyses. The mean age of participants was We identified incident cases of hypertension and three dietary patterns. The cumulative incidence of hypertension was 4.

Factor-loading matrixes for these patterns are shown in Fig. The first component was loaded positively with other vegetables, green vegetables, tomatoes, carrots and fruits, while pastries loaded negatively; the second component was loaded positively with processed meats, fast foods, and red meat, and negatively with fruit and corn tortilla; and finally the third component was loaded positively with corn tortillas, hot peppers and sodas, and negatively on whole grains, dairy and fruits. The first component explained 8.

PCA performed on the FFQs responded during the feasibility phase in resulted in similar dietary patterns. The first dietary pattern was named Fruits and Vegetables, the second Western, and the third Modern Mexican. The variability explained by each factor was 8. Age-adjusted baseline characteristics of participants according to quartiles of each dietary pattern are shown in Table 2. In the Western pattern, women with the highest category were less likely to be indigenous, more likely to be from Northern Mexico and less from the south and have a higher socioeconomic status and graduate education, they were also more likely to be current smokers and have a lower energy intake.

In contrast, women in the highest quartile of the Modern Mexican pattern were more likely to be indigenous, live in Northern and Southern Mexico, and be current smokers, however they were less likely to live in Mexico City, they had a lower socioeconomic status, and reported lower physical activity and energy intake.

Age-adjusted showed a statistically ificant direct association between the Western dietary pattern and the odds of hypertension Table 3. After adjustment for confounders the association between the Western pattern and the odds of hypertension remained ificant.

We also adjusted for BMI, a potential mediator of the association between the Western pattern and hypertension. As expected, the association was attenuated but remained ificant OR: 1. Adherence to the Modern Mexican pattern was directly associated with the odds of hypertension. After adjusting for BMI the association became null. However, there was an indication of a protective effect when the pattern score was modeled as a continuous variable OR: 0. To explore the consistency of the empirical dietary patterns we randomly divided the cohort into two groups and the dietary patterns derived in both groups resembled the three dietary patterns from the whole cohort.

When we used an oblique rotation method and ran a maximum likelihood method it resulted in similar dietary patterns and similar associations with hypertension data not shown. However, using all individual food items on the food frequency questionnaire resulted in slightly different dietary patterns. The first component was similar heavily loaded with fruits but also with nutsthe second component was different loading heavily on vegetablesand the third component was similar to the Western pattern loading heavily on processed meats and fast foods.

The variance Adult women in Mexico city by these three components was 6.

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The third component was directly associated with hypertension while the first two were not data not shown. In sensitivity analyses we ran the multivariable adjusted model only in non-diabetics and non-smokers to reduce confounding Additional file 1 : Table S1. We also ran the multivariable adjusted model using the dietary patterns derived from the two component solution as the exposure. Among non-diabetics and using the two factor solution as the exposure remained the same as in the main analyses.

When we used the less strict definition of hypertension, the associations with dietary patterns were stronger, in the same direction, and ificant with all dietary patterns without changes in our main conclusions. Moreover, after further adjustment by BMI, as in the main analysis, the association with the Modern Mexican dietary pattern lost ificance.

In this prospective study, the Western and Modern Mexican dietary patterns were directly associated with the incidence of hypertension in Mexican women. However, besides these two globally similar patterns we also derived a third pattern which exemplifies the nutritional transition in Mexicans, who have low adherence to dietary recommendations [ 26 ]. Adherence to this pattern is characterized by eating traditional foods i. The variance explained by the three dietary patterns 8.

Adult women in Mexico city

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General and Abdominal Adiposity and Mortality in Mexico City: A Prospective Study of Adults