Compliance with expert population-based dietary guidelines and lower odds of carotid atherosclerosis in women: the Framingham Nutrition Studies.

Background: Carotid stenosis, an indicator of subclinical atherosclerosis, predicts future coronary artery disease (CAD) and stroke and provides a noninvasive method to identify candidates for primary prevention. The relation between diet and stenosis is relatively unexplored, particularly in women.

Objective: We evaluated in women the association between nutrient intakes that were consistent with expert population-based dietary guidelines and carotid stenosis.

Design: We used prospective logistic regression analyses to evaluate relations between baseline nutrient intake and the presence of carotid stenosis at 4-y follow-up in 1123 women from the Framingham Offspring-Spouse study, after control for multiple CAD risk factors. We also developed multivariate models that were stratified by compliance with expert population-based dietary guidelines and smoking status.

Results: Baseline nutrient and risk factor profiles differed by women's compliance and smoking status. Dietary noncompliance and smoking were each associated with odds for stenosis that were 2.5-fold those of dietary compliance and nonsmoking. Odds were highest for dietary noncompliance in combination with smoking (odds ratio: 3.49; 95% CI: 1.67, 7.27).

Conclusions: Nutrient intake consistent with current expert population-based dietary guidelines and smoking abstinence are associated with lower odds of carotid atherosclerosis in women. Unique dietary and risk factor profiles of at-risk women suggest areas for targeted primary CAD prevention.