Relationship between dietary stereotypes and arterial hypertension among residents of Siberia

Objective to evaluate the dynamics and identify the relationship between empirically obtained dietary stereotypes and the presence of arterial hypertension (AH) according to a prospective study among the population of a large region of Siberia.

Design and methods. A clinical and epidemiological prospective group study of the population aged 35 to 70 years was carried out. The baseline study included 1124 women (70,3%) and 476 men (29,7%). The mean age was 54,9 ± 9,75 years and 52,6 ± 10,0 years, respectively, p < 0,001. The followup period was 3 years from the first visit of the respondent. An adapted questionnaire (Questionnaire Food Frequency (FFQ)) was used to assess the frequency of food consumption. To identify latent factors (stereotypes of eating behavior), we used factor analysis (method of principal components). The association of eating habits with the presence of AH was assessed using logistic regression analysis. The critical level of significance when testing statistical hypotheses in the study was taken to be ≤ 0,05.

Results. In men, the prevalence of AH was the highest among those who adhered to the fruit and vegetable dietary stereotype (75,0%), the minimum was in men who followed the mixed stereotype (60,1 %, p = 0,034). Among women, as well as among men, the maximum prevalence of AH was observed in people with a fruit and vegetable diet (71,1 %), and the minimum was observed in those with a protein-carbohydrate diet (63,2 %, p = 0,049). Among those who followed the fruit and vegetable stereotype, new cases of AH were identified in 30,9 %, protein-carbohydrate — 33,3 %, mixed — 35,7 % (p = 0,846). The structure of nutrition of the population has undergone changes during the observation period. So, 5 main stereotypes of eating behavior were determined: vegetable, protein-carbohydrate, fruit, dairy and mixed. The prevalence of AH did not differ statistically significantly among individuals with different nutritional stereotypes at the prospective stage (p = 0,337): the maximum prevalence of AH was observed among individuals who followed the vegetable stereotype (77,6%), and the minimum — fruit (67,6%). When conducting a logistic regression analysis, after leveling the influence of gender and age, no statistically significant associations were found between nutritional stereotypes and the development of AH.

Conclusions. 1. Over three years of observation, the prevalence of AH among residents of a large industrial region of Siberia increased from 66,4% to 72,0%. 2. With the help of factor analysis, three nutrition stereotypes were identified: fruit and vegetable, protein and carbohydrate, and mixed. During the three-year period of observation, the diet of the inhabitants of Siberia has changed: 5 main stereotypes of eating behavior have been identified — vegetable, protein-carbohydrate, fruit, dairy and mixed. 3. At the basic stage, AH was more common among people who followed the fruit and vegetable diet, especially among young men. During the prospective phase of the study — in individuals who preferred the vegetable stereotype.

1. Ramezankhani A, Hosseini-Esfahani F, Mirmiran P, Azizi F, Hadaegh F. The association of priori and posteriori dietary patterns with the risk of incident hypertension: Tehran Lipid and Glucose Study. J Transl Med. 2021;19(1):44. doi:10.1186/s12967-021-02704-w

2. Monge A, Lajous M, Ortiz-Panozo E, Rodríguez BL, Góngora JJ, López-Ridaura R. Western and Modern Mexican dietary patterns are directly associated with incident hypertension in Mexican women: a prospective follow-up study. Nutr J. 2018; 17(1):21. doi:10.1186/s12937–018–0332–3

3. Kerimi A, Williamson G. The cardiovascular benefits of dark chocolate. Vascul Pharmacol. 2015;71:11–15.

4. Stamler J, Brown IJ, Daviglus ML, Chan Q, Miura K, Okuda N et al. Dietary glycine and blood pressure: the International Study on Macro/Micronutrients and Blood Pressure. Am J Clin Nutr. 2013;98(1):136–145. doi:10.3945/ajcn.112.043000

5. Jannasch F, Riordan F, Andersen LF, Schulze MB. Exploratory dietary patterns: a systematic review of methods applied in pan-European studies and of validation studies. Br J Nutr. 2018;120(6):601–611.

6. Roberts K, Cade J, Dawson J, Holdsworth M. Empirically derived dietary patterns in UK adults are associated with sociodemographic characteristics, lifestyle, and diet quality. Nutrients. 2018;10(2): E177.

7. Maksimov SA, Karamnova NS, Shalnova SA, Drapkina OM. Empirical patterns of nutrition and their impact on health status in epidemiological studies. Nutrit Iss. 2020;89(1):6–18. In Russian.

8. Nissensohn M, Roman-Vinas B, Sanchez-Villegas A, Piscopo S, Serra-Majem L. The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis. J Nutr Educ Behav. 2016;48(1):42–53.e1. doi:10.1016/j.jneb.2015.08.023

9. Gay HC, Rao SG, Vaccarino V, Ali MK. Effects of different dietary interventions on blood pressure: systematic review and meta-analysis of randomized controlled trials. Hypertension. 2016; 67(4):733–739. doi:10.1161/HYPERTENSIONAHA.115.06853

10. Harmon BE, Boushey CJ, Shvetsov YB, Ettienne R, Reedy J, Wilkens LR et al. Associations of key diet-quality indexes with mortality in the multiethnic cohort: the dietary patterns methods project. Am J Clin Nutr. 2015;101(3):587–597. doi:10.3945/ajcn.114.090688

11. Kish L. Survey Sampling. New York. John Wiley and Sons. 1965. Р. 643.

12. Tsygankova DP, Bazdyrev ED, Indukaeva EV, Artamonova GV, Barbarash OL. Eating behavior stereotypes and risk factors for cardiovascular pathology in residents of a large industrial region of Siberia. Atherosclerosis. 2020:16(4):18–26. In Russian.

13. Tsygankova DP, Krivoshapova KE, Maksimov SA, Indukaeva EV, Shapovalova EB, Artamonova GV et al. Obesity and arterial hypertension: the role of criteria. Syst Hypertens. 2019:16(1):32–36. In Russian.

14. Shi Z, Papier K, Yiengprugsawan V, Kelly M, Seubsman SA, Sleigh AC. Dietary patterns associated with hypertension risk among adults in Thailand: 8-year findings from the Thai Cohort Study. Public Health Nutr. 2019;22(2):307–313. doi:10.1017/S1368980018002203