Overview

Abstract (English)

Cardiovascular disease (CVD) is second leading cause of death in Canada. Diabetes is a major risk factor for CVD, which is affecting more than 7.5% of Canadians. Prevention is important to reducing the burden of diabetes and CVD on the individual, society and health care sector. In order to prevent these diseases, identifying people at high risk and using modifiable factors in prevention of these diseases are the priority. The metabolic syndrome (MetS), CVD risk and cardiovascular age gap (CAG) are concepts, which have been recommended by national health organizations for identifying individuals with high risk of developing these diseases. Diet has been recognized as an important modifiable factor in the prevention of metabolic disorders, diabetes and CVD. The aim of the present thesis was to determine the prevalence of diabetes, MetS components, MetS and the mean risk of 10-year atherosclerotic cardiovascular disease (ASCVD) and CAG. Further, the association between MetS, 10-year ASCVD risk and CAG and dietary patterns among Canadian adults were determined. The Canadian Health Measures Survey (CHMS) combined Cycles 1 & 2 (2007-11) data were used to address these research objectives. In CHMS, the FFQ was used to determine the usual dietary intake among Canadians. Principal component analysis method was applied to extract the dietary patterns from 32 food/food groups available from CHMS data. Controlling for potential covariates, logistic and linear regression was used to determine the association between MetS, 10-year ASCVD risk and CAG and dietary patterns. To produce nationally representative results, weighting and bootstrapping were applied. The MetS prevalence was 16.9% among a sample representative of 26,038,108 Canadians aged 12-79 years. Four prevalent dietary patterns were extracted and the “Fast food” dietary pattern with positive loadings of hotdogs, sausage/bacon, chips, fries, and diet soft drinks, had a significant association with MetS (odds ratio=1.26; 95% CI: 1.016 to 1.55; p=0.035) for older adults aged 50-79 year. The mean 10-year ASCVD risk was 6.9% for a sample representative of 13,655,671 Canadians aged 40-79y. The mean vascular age for men was 4.1 years older and for females was 0.4 years younger than their chronological age. Four dietary patterns emerged from this population of 40-79 years. Of note, the “High carbohydrate and protein” dietary pattern, which included potatoes, red meat, sausage, egg and ice-cream/frozen yoghurt, was adversely associated with 10-year ASCVD (Ptrend=0.0128). Further, the “Healthy” and “Fast food” dietary patterns had an inverse (p<0.0001) and direct (p=0.005) association, respectively, with CAG adjusted for potential covariates. A considerable portion of Canadian adults had high relative and absolute ASCVD risk. Dietary patterns prevalent among the population that were associated with MetS, CAG and ASCVD 10-year risk were unhealthy. Thus, interventions with focus on educating Canadians, especially high-risk groups, with the aim of promoting a healthier balanced diet, along with increasing the physical activity and stop/preventing smoking, should be considered by researchers.

Abstract (French)

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