Nur Ain Fatinah Abu Bakar1, Aryati Ahmad1,2*, Wan Zulaika Wan Musa1 Mohd Razif Shahril3, Wan Arfah Nadiah Wan Abdul Jamil1, Hazreen Abdul Majid4, Carmen Piernas2, Ahmad Wazi Ramli5, Nyi Nyi Naing6
1Faculty of Health Sciences, University Sultan Zainal Abidin (UniSZA), 21300 Kuala Nerus, Terengganu, Malaysia
2Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, Oxford OX2 6GG, United Kingdom
3Faculty of Health Sciences, University Kebangsaan Malaysia (UKM), 43600 Bangi, Selangor, Malaysia
4Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
5Medical Department, Hospital Sultanah Nur Zahirah (HSNZ), 20400 Kuala Terengganu, Malaysia
6Faculty of Medicine, University Sultan Zainal Abidin (UniSZA), 20400 Kuala Terengganu, Terengganu, Malaysia
This study aimed to derive potential dietary patterns (DPs) and to determine its association with coronary heart disease (CHD) risk.
This multicentre retrospective cross-sectional study involved 365 participants (CHD = 178; non-CHD = 187) who were recruited from selected hospitals and health clinics. Dietary intake was measured using 189-item semi-quantitative foods frequency questionnaire (FFQ) whilst clinical data including diagnosis of CHD and lipid profile were obtained from medical record. Reduced rank regression method (RRR) was used to derived DPs scores and binary logistic regression was used to assess association between identified DPs with CHD risk.
Results & Discussion
Dietary pattern “High saturated fatty acid (SFA), high dietary energy density (DED), high sodium” which is characterized by high consumption of seasoning sauce, salted and processed foods, coconut-based dishes, fast foods and snacks, rice dishes, fat spread and low intake for fruits, green leafy vegetables, white rice and other vegetables was associated with CHD risk (OR:1.315, 95% CI:1.029, 1.681; p = 0.029), adjusted for age, sex, race, education level, income, family history, marital status, smoking status, physical activity, and stress level. The link between this DP and CHD risk is predicated upon its effects on cardiometabolic risk factors including dyslipidaemia, abdominal obesity and hypertension. Although further longitudinal prospective studies with larger sample size are required to confirm this association, the findings from this study has provided an important insight on the link between dietary patterns and CHD risk among Malaysian.
Individuals with a DP of high SFA, energy-dense, and sodium have significantly higher risk of getting CHD compared to the individuals without the DP. This finding contributes new evidence to the current CHD prevention guideline whereby dietary recommendation in form of DP is more practical and translatable to the real setting of population dietary intake.