Food patterns, inflammation markers and incidence of cardiovascular disease: the Malmo Diet and Cancer study

Objectives. To examine the associations between food patterns constructed using cluster analysis and markers of systemic and vascular inflammation, and incident cardiovascular disease (CVD) after 13 years of follow-up. Design. Population-based, prospective cohort study. Setting and subjects. Cluster analysis identified six food patterns from 43 food group variables among 4999 subjects, aged 45-68 years, who participated in the Malmo Diet and Cancer cardiovascular programme between 1991 and 1994. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), C-reactive protein concentration and white blood cell (WBC) count were measured using blood samples at baseline. Incidence of CVD (coronary events and ischaemic stroke) was monitored over 13 years of follow-up. Results. The fibre-rich bread pattern was associated with favourable effects on WBC count in women, and the low-fat and high-fibre pattern with favourable effects on Lp-PLA(2) mass in women, and on Lp-PLA(2) activity in men. However, the milk fat and sweets and cakes patterns were both associated with adverse effects; the former on WBC count in women and on Lp-PLA(2) mass in men, and the latter on WBC count and Lp-PLA(2) mass in women. The milk fat and sweets and cakes patterns were associated with increased CVD risk in women. Conclusions. The results of this study support the present Nordic dietary recommendations indicating that diets rich in high-fibre, low-fat and low-sugar foods are favourably associated with markers of inflammation and, potentially, with CVD risk.