Compliance with expert population-based dietary guidelines and lower odds of carotid atherosclerosis in women: the Framingham Nutrition Studies.

BACKGROUND Carotid stenosis, an indicator of subclinical atherosclerosis, predicts future coronary artery disease (CAD) and stroke and provides a noninvasive method to identify candidates for primary prevention. The relation between diet and stenosis is relatively unexplored, particularly in women. OBJECTIVE We evaluated in women the association between nutrient intakes that were consistent with expert population-based dietary guidelines and carotid stenosis. DESIGN We used prospective logistic regression analyses to evaluate relations between baseline nutrient intake and the presence of carotid stenosis at 4-y follow-up in 1123 women from the Framingham Offspring-Spouse study, after control for multiple CAD risk factors. We also developed multivariate models that were stratified by compliance with expert population-based dietary guidelines and smoking status. RESULTS Baseline nutrient and risk factor profiles differed by women's compliance and smoking status. Dietary noncompliance and smoking were each associated with odds for stenosis that were 2.5-fold those of dietary compliance and nonsmoking. Odds were highest for dietary noncompliance in combination with smoking (odds ratio: 3.49; 95% CI: 1.67, 7.27). CONCLUSIONS Nutrient intake consistent with current expert population-based dietary guidelines and smoking abstinence are associated with lower odds of carotid atherosclerosis in women. Unique dietary and risk factor profiles of at-risk women suggest areas for targeted primary CAD prevention.