Development and Use of a Traditional Mexican Diet Score in Relation to Systemic Inflammation and Insulin Resistance among Women of Mexican Descent.

BACKGROUND Women of Mexican descent are disproportionally affected by obesity, systemic inflammation, and insulin resistance (IR). Available approaches used to give scores to dietary patterns relative to dietary guidelines may not effectively capture traditional diets of Mexicans, who comprise the largest immigrant group in the United States. OBJECTIVES We characterized an a priori traditional Mexican diet (MexD) score high in corn tortillas, beans, soups, Mexican mixed dishes (e.g., tamales), fruits, vegetables, full-fat milk, and Mexican cheeses and low in refined grains and added sugars and evaluated the association of the MexD score with systemic inflammation and IR in 493 postmenopausal participants in the Women's Health Initiative (WHI) who are of Mexican ethnic descent. METHODS The MexD score was developed from the baseline (1993-1998) WHI food frequency questionnaire, which included Hispanic foods and was available in Spanish. Body mass index (BMI) was computed from baseline measured weight and height, and ethnicity was self-reported. Outcome variables were high sensitivity C-reactive protein (hsCRP), glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and triglyceride concentrations measured at follow-up (2012-2013). Multivariable linear and logistic regression models were used to test the associations of the MexD score with systemic inflammation and IR. RESULTS The mean ± SD MexD score was 5.8 ± 2.1 (12 maximum points) and was positively associated with intakes of carbohydrates, vegetable protein, and dietary fiber and inversely associated with intakes of added sugars and total fat (P < 0.01). Women with high compared with low MexD scores, consistent with a more-traditional Mexican diet, had 23% and 15% lower serum hsCRP (P < 0.05) and insulin concentrations, respectively (P < 0.05). Baseline BMI modified these associations such that lower MexD scores were associated with higher insulin and HOMA-IR in overweight/obese women (P-interaction <0.05). CONCLUSION These findings suggest that greater adherence to a traditional Mexican diet could help reduce the future risk of systemic inflammation and IR in women of Mexican descent.

[1]  J. Manson,et al.  Mediterranean and DASH Diet Scores and Mortality in Women With Heart Failure: The Women’s Health Initiative , 2013, Circulation. Heart failure.

[2]  E. White,et al.  Lifestyle Factors and Inflammation: Associations by Body Mass Index , 2013, PloS one.

[3]  V. McCormack,et al.  Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study , 2013, International journal of cancer.

[4]  T. Buchanan,et al.  High-fat diet is associated with obesity-mediated insulin resistance and β-cell dysfunction in Mexican Americans. , 2013, The Journal of nutrition.

[5]  S. Kirkpatrick,et al.  Update of the Healthy Eating Index: HEI-2010. , 2013, Journal of the Academy of Nutrition and Dietetics.

[6]  J. Manson,et al.  Determinants of Racial/Ethnic Disparities in Incidence of Diabetes in Postmenopausal Women in the U.S. , 2012, Diabetes Care.

[7]  Ahmad Esmaillzadeh,et al.  Legume consumption is inversely associated with serum concentrations of adhesion molecules and inflammatory biomarkers among Iranian women. , 2012, The Journal of nutrition.

[8]  Katherine M Flegal,et al.  Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. , 2012, JAMA.

[9]  A. Schwartz,et al.  The relation of acculturation to overweight, obesity, pre-diabetes and diabetes among U.S. Mexican-American women and men. , 2012, Ethnicity & disease.

[10]  Judith,et al.  Determinants of Racial/Ethnic Disparities in Incidence of Diabetes in PostmenopausalWomen in the U.S. The Women’s Health Initiative 1993–2009 , 2012 .

[11]  M. Siervo,et al.  Obesity and energy balance: is the tail wagging the dog? , 2011, European Journal of Clinical Nutrition.

[12]  B. Popkin,et al.  Food acculturation drives dietary differences among Mexicans, Mexican Americans, and Non-Hispanic Whites. , 2011, The Journal of nutrition.

[13]  K. Tucker,et al.  Differences in diet pattern adherence by nativity and duration of US residence in the Mexican-American population. , 2011, Journal of the American Dietetic Association.

[14]  A. González-Angulo,et al.  Triple‐negative breast cancer in Hispanic patients , 2011, Cancer.

[15]  E. Denova-Gutiérrez,et al.  Dietary patterns are associated with different indexes of adiposity and obesity in an urban Mexican population. , 2011, The Journal of nutrition.

[16]  F. Clavel-Chapelon,et al.  Adherence to the Mediterranean Diet Is Associated with Lower Abdominal Adiposity in European Men and Women 1 – 3 , 2009 .

[17]  F. Rodríguez‐Artalejo,et al.  The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions , 2009, European Journal of Clinical Nutrition.

[18]  B. Popkin,et al.  Birthplace is associated with more adverse dietary profiles for US-born than for foreign-born Latino adults. , 2008, The Journal of nutrition.

[19]  J. Ockene,et al.  Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study. , 2008, Nutrition.

[20]  T. Byers,et al.  Diet patterns and breast cancer risk in Hispanic and non-Hispanic white women: the Four-Corners Breast Cancer Study. , 2008, The American journal of clinical nutrition.

[21]  J. Shaw,et al.  Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Risk of Diabetes in a Multiethnic Cohort of Women: the Women’s Health Initiative Observational Study , 2007, Diabetes Care.

[22]  K. Tucker,et al.  A study of dietary patterns in the Mexican-American population and their association with obesity. , 2007, Journal of the American Dietetic Association.

[23]  T. Byers,et al.  Diet composition and risk of overweight and obesity in women living in the southwestern United States. , 2007, Journal of the American Dietetic Association.

[24]  J. Manson,et al.  Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Risk of Diabetes in a Multiethnic Cohort of Women , 2007, Diabetes Care.

[25]  H. Juon,et al.  Factors Associated With Overweight and Obesity Among Mexican Americans and Central Americans: Results From the 2001 California Health Interview Survey , 2006, Preventing chronic disease.

[26]  D. Jacobs,et al.  Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). , 2006, The American journal of clinical nutrition.

[27]  C. Rochester,et al.  LOW-FAT DIETARY PATTERN AND RISK OF CARDIOVASCULAR DISEASE-THE WOMEN'S HEALTH INITIATIVE RANDOMIZED CONTROLLED DIETARY MODIFICATION TRIAL , 2006 .

[28]  J. Manson,et al.  Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. , 2006, JAMA.

[29]  J. Manson,et al.  Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. , 2005, The American journal of clinical nutrition.

[30]  H. Hubert,et al.  Health status, health behaviors, and acculturation factors associated with overweight and obesity in Latinos from a community and agricultural labor camp survey. , 2005, Preventive medicine.

[31]  J. Manson,et al.  Dietary pattern, inflammation, and incidence of type 2 diabetes in women. , 2005, The American journal of clinical nutrition.

[32]  J. Manson,et al.  Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. , 2004, The American journal of clinical nutrition.

[33]  R. Marfella,et al.  Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. , 2004, JAMA.

[34]  R. Turner,et al.  Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man , 1985, Diabetologia.

[35]  R. Langer,et al.  The Women's Health Initiative Observational Study: baseline characteristics of participants and reliability of baseline measures. , 2003, Annals of epidemiology.

[36]  Tina Costacou,et al.  Adherence to a Mediterranean diet and survival in a Greek population. , 2003, The New England journal of medicine.

[37]  Paul Knekt,et al.  Whole-grain and fiber intake and the incidence of type 2 diabetes. , 2003, The American journal of clinical nutrition.

[38]  P. Ridker.  Clinical application of C-reactive protein for cardiovascular disease detection and prevention. , 2003, Circulation.

[39]  S. Barquera,et al.  Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity , 2002, Public Health Nutrition.

[40]  T. Sellers,et al.  Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. , 2000, The American journal of clinical nutrition.

[41]  E. Parks,et al.  Carbohydrate-induced hypertriacylglycerolemia: historical perspective and review of biological mechanisms. , 2000, The American journal of clinical nutrition.

[42]  J. Manson,et al.  A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women. , 2000, American journal of public health.

[43]  A. Kristal,et al.  Measurement characteristics of the Women's Health Initiative food frequency questionnaire. , 1999, Annals of epidemiology.

[44]  JoAnn E. Manson,et al.  Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. , 1998, Controlled clinical trials.

[45]  A. Kristal,et al.  Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: the Women's Health Trial Feasibility Study in Minority Populations. , 1997, American journal of epidemiology.