Associations between dietary macronutrient intake and plasma lipids demonstrate criterion performance of the Multi-Ethnic Study of Atherosclerosis (MESA) food-frequency questionnaire

The validity of self-reported dietary intake is critical to the design and interpretation of diet-disease investigations. For many nutrients, there are no ideal methods to establish validity, given correlated error between reference and assessment tools, and constraints on time and resources available to perform such studies. Therefore, we quantified associations between macronutrient intakes and plasma HDL-cholesterol and TAG, relying on known associations between these factors to test the criterion validity of the FFQ used in the Multi-Ethnic Study of Atherosclerosis (MESA). Baseline dietary macronutrient intakes (derived from 120-item FFQ), and fasting plasma HDL and TAG were measured in 4510 MESA participants, aged 45-84 years. After adjusting for non-dietaxy factors known to affect plasma lipid concentrations, greater carbohydrate intake was associated with lower HDL and higher TAG (beta per 5-unit change in percentage energy intake from carbohydrate = -5 (SE 1) mg/l (P<0.001) for HDL and 15 (SE 6) mg/l (P=0.008) for TAG), whereas higher energy intake from fat was associated with higher HDL and lower TAG (P per 5-unit change in percentage energy from fat = 3.7 (SE 2) mg/l (P=0.01) for HDL and P = 19 (SE 7) mg/l (P=0.004) for TAG). Associations of dietary carbohydrate and fat intakes with HDL and TAG concentrations were consistent with previous studies, demonstrating criterion validity of these dietary measures in the MESA.