Dietary patterns are associated with arterial stiffness and carotid atherosclerosis in postmenopausal women

Iliana Karagkouni; Dimitris Delialis; Mary Yannakoulia; Eleni Armeni; Christos Papavangelis; Areti Augoulea; Georgios Mavraganis; Dimitrios Bampatsias; Konstantinos Panoulis; Leon Aravantinos; Theodoros Panoskaltsis; Kimon Stamatelopoulos; Irene Lambrinoudaki

doi:10.1007/s12020-022-03152-2

Dietary patterns are associated with arterial stiffness and carotid atherosclerosis in postmenopausal women

Endocrine. 2022 Oct;78(1):57-67. doi: 10.1007/s12020-022-03152-2. Epub 2022 Aug 29.

Affiliations

¹ Menopause Clinic, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece.
² Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
⁴ Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. ilambrinoudaki@med.uoa.gr.

^# Contributed equally.

Abstract

Purpose: The increase in cardiovascular risk after the menopausal transition remains partly explained until today. Further research is needed to identify risk factors potentially modifiable by primary prevention practices. This cross-sectional study, part of a larger prospective project, aims to investigate possible associations between dietary patterns and indices of vascular structure and function among healthy postmenopausal women.

Methods: Postmenopausal women (n = 310) without clinically overt cardiovascular disease were recruited consecutively from a University Menopause Clinic over three years. Dietary intake was assessed by a validated food frequency questionnaire and the MedDietScore. In addition, we assessed anthropometric/biochemical parameters, including the Triglyceride-glucose index (TyG-Index), body fat distribution [triceps skinfold (TSF), mid-upper arm circumference (MUAC)] and physical activity. The vascular assessment included carotid-femoral pulse wave velocity (PWV), carotid and femoral-artery intima-media thickness (IMT) and atheromatous plaques presence.

Results: Consumption of non-refined cereals was associated with carotid-bulb IMT (R² = 5.5% b-coefficient = -0.142; p = 0.011), adjusting for age, physical activity, lipids, systolic blood pressure, smoking, body mass index, insulin resistance, and daily energy intake. PWV was associated with the intake of total dairy products (R² = 27.3%, b-coefficient = -0.117; p = 0.017). Higher red meat consumption was related to a greater TyG-index (Model 1, R² = 14.3%, b-coefficient=0.121; p = 0.048), an association mediated by total daily energy intake. Higher consumption of alcohol, as well as the MedDietScore, were inversely associated with TSF measurements, significant after Bonferroni correction.

Conclusion: Dietary patterns are associated with metabolic indices and subclinical atherosclerosis in postmenopausal women independently of traditional cardiovascular risk factors, total energy intake or physical activity.

Keywords: Arterial stiffness; Cardiovascular disease; Dietary patterns; Postmenopausal women; Subclinical atherosclerosis.

MeSH terms

Carotid Artery Diseases* / diagnostic imaging
Carotid Intima-Media Thickness
Cross-Sectional Studies
Female
Humans
Postmenopause
Prospective Studies
Pulse Wave Analysis
Risk Factors
Vascular Stiffness* / physiology