4.7 Article

Association of macronutrients and dietary patterns with risk of systemic lupus erythematosus in the Black Women's Health Study

Journal

AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 114, Issue 4, Pages 1486-1494

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/ajcn/nqab224

Keywords

macronutrients; carbohydrates; fats; proteins; diet; reduced rank regression; systemic lupus erythematosus; African American; Black Women's Health Study

Funding

  1. National Cancer Institute [R01-CA058420, U01-CA164974]
  2. National Institute of Arthritis and Musculoskeletal and Skin Diseases [R01 AR0573727, K24 AR 066109]
  3. Rheumatology Research Foundation Scientist Development Award

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The study found that in African-American women, a diet high in carbohydrates and low in fats is associated with increased risk of SLE. Specifically, a dietary pattern rich in fruits and sugar-sweetened drinks, but low in margarines, red meats, processed meats, fried chicken, poultry, and eggs was linked to higher SLE risk.
Background: Systemic lupus erythematosus (SLE) affects African-American (AA) women disproportionately. The few prospective studies assessing dietary intake in relation to risk of SLE have been conducted in predominantly white populations and have been null. Objectives: The present study assessed associations of macronutrients and dietary patterns with risk of SLE in AA women. Methods: Data from the Black Women's Health Study was collected prospectively via biennial questionnaires starting in 1995. Participants completed a self-administered 68-item FFQ in 1995. Self-reported SLIP. was verified through medical record review. We used multivariable (MV) Cox regression models to estimate HRs and 95% CIs for macronutrients, carbohydrates, proteins, total fats, PUFAs, omega-3 fatty acids, omega-6 fatty acids, MUFAs, saturated fats, trans fatty acids. Alternative Healthy Eating Index score. vegetable/fruit and meat/fried food dietary patterns. and a reduced rank regression (RRR)-derived dietary pattern in relation to SLE risk. Results: We confirmed a total of 114 incident cases of SLE among 51,934 women during 1995-2015. MVHRs and 95% CIs for the highest quintile of intake versus the lowest were HR: 1.96, 95% CI: 1.02. 3.67 for carbohydrates: HR: 0.66, 95% CI: 0.37, 1.18 for protein; and HR: 0.54, 95% CI: 0.28. 1.01 for total fats. MUFAs, saturated fatty acids, and trans fatty acids were significantly associated with a lower risk of SLE. An RRR-derived factor, rich in fruits and sugar-sweetened drinks and low in margarines and butter, red and processed meats, fried chicken, poultry, and eggs, which explained 53.4% of the total variation of macronutrients, was the only food pattern associated with increased SLE risk (HR: 1.88, 95% CI: 1.06, 3.35). Conclusion: These analyses suggest that a diet high in carbohydrates and low in fats is associated with increased SLE risk in AA women.

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