Examining Generalizability of Nutrient-Based Food Patterns and Their Cross-Sectional Associations with Cardiometabolic Health for Hispanic/Latino Adults in the US: Results from the National Health and Nutrition Examination Survey (NHANES) and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Background. Ethnicity, cultural background, and geographic location differ significantly amongst the US Hispanic/Latino population. These characteristic differences can greatly define measured diet and its relationship with cardiometabolic disease, thus influencing generalizability of results. Objective. We aimed to examine dietary patterns of Hispanic/Latino adults and their association with cardiometabolic risk factors (high cholesterol, hypertension, obesity, diabetes) across two representative studies with differing sampling strategies. Methods. Data were collected from Mexican or Other Hispanic adult participants from 2007-2012 National Health and Nutrition Examination Survey (NHANES, n=3,209) and 2007-2011 Hispanic Community Health Survey/Study of Latinos (HCHS/SOL, n=13,059). Nutrient-based food patterns (NBFPs) were derived using factor analysis on nutrient intake data estimated from 24-hour dietary recalls and interpreted using common foods prominent in these nutrients. Cross-sectional association between NBFPs (quintiles) and cardiometabolic risk factors, defined by clinical measures and self-report, were estimated using survey-weighted logistic regression. Results. Five NBFPs were identified in both studies: (1) meats, (2) grains/legumes, (3) fruits/vegetables, (4) dairy, and (5) fats/oils. Association to cardiometabolic risk factors differed by NBFP and study. In HCHS/SOL, persons in the highest quintile of meats NBFP had higher odds of diabetes (OR=1.43, 95%CI: 1.10, 1.86) and obesity (OR=1.36, 95%CI: 1.14, 1.63). Those in the lowest quintile of grains/legumes NBFP (OR=1.22, 95%CI: 1.02, 1.47) and the highest quintile of fats/oils (OR=1.26, 95%CI: 1.03, 1.53) also had higher odds of obesity. In NHANES, NBFPs associated with higher odds of diabetes included those in the lowest quintile of dairy (OR=1.66, 95%CI: 1.01, 2.72) and highest quintile of grains/legumes (OR=2.10, 95%CI: 1.26, 3.50). Persons in the fourth quintile of meats (OR=0.68, 95%CI: 0.47, 0.99) had lower odds of cholesterol. Conclusion. Diet-disease relationships among Hispanic/Latino adults vary according to two representative studies. These differences have research and practical implications when generalizing inferences on heterogeneous underrepresented populations.