Women with a so-called empty calorie diet—high in sweetened beverages, red meat, and desserts—had significantly elevated intima-media thickness, compared with women who followed other dietary patterns, including diets high in fat.
The finding comes from an analysis of the Framingham Heart Offspring/Spouse Study that was presented during a poster session at the annual scientific sessions of the American Heart Association.
“Any diet that consists of regular intake of a lot of fatty food, a lot of sugary food including sugary drinks, and not a lot of low-fat dairy, fruits, or vegetables is probably setting a woman up for cardiovascular problems,” lead study author Lisa S. Brown said in an interview.
Ms. Brown and her associates analyzed data from 1,278 women with a mean age of 58 years who participated in the Framingham Offspring/Spouse Study and who completed the Framingham food frequency questionnaire during 1984–1988, underwent intima-media thickness measurement via ultrasound at exam 6 (1996–1998), and were free of cardiovascular disease at exam 6.
“A lot of intima-media thickness and diet work has looked at specific nutrients—especially antioxidants and different types of fats,” noted Ms. Brown, a registered dietitian who is a doctoral candidate in medical nutrition sciences at Boston University. “None have looked at diet in such a comprehensive manner.”
Based on how the women responded to a validated Framingham food frequency questionnaire, the researchers placed them into one of five dietary patterns:
▸ Heart healthy. The 250 women in this group eat more fruits and vegetables than women in the other groups. “We think this is a group that changed their diet some time in their adult life and that they make an effort to be health conscious,” she said.
▸ Light eating. The 612 women in this group are chronic dieters who consume the least amount of sweets and take in the least amount of calories. “But they tend to be a little heavier than we would expect them to be based on their dietary intake,” she said.
▸ Wine and moderate eating. The 45 women in this group consume about two alcoholic drinks per day. Their diet also is highest in cholesterol and lowest in calcium consumption.
▸ High fat. The 266 women in this group “get a lot of their calories from refined grains and vegetable fats both hard and soft, so they get a lot of margarine and oils,” Ms. Brown said. “Their saturated fat is the highest [among] all the groups but for some reason they are also the least likely to be overweight or obese. We don't know why, and we are still trying to figure out what makes this group different from what we expect.”
▸ Empty calorie. The 105 women in this group consume seven to eight times more soda and other sweetened beverages, compared with their counterparts. They also consume more red meat and desserts and eat fewer fruits, vegetables, and micronutrients than women in the other groups. In addition, empty calorie dieters are likely to smoke and have a higher body mass index than women in the other groups.
Women in the empty calorie group had maximum carotid intima-media thickness of 1.46 mm, which was significantly higher than that of women in the heart healthy group (1.18 mm), light eating group (1.22 mm), wine and moderate eating group (1.27 mm), and high fat group (1.17 mm). This relationship remained significant even after controlling for smoking, systolic blood pressure, cholesterol, body mass index, and other risk factors.
“We suspect that the intima-media thickness of the empty calorie group is so high because intima-media thickness is a really good indicator of lifetime exposure to all the things that cause heart disease risk including poor diet, high blood pressure, high cholesterol, smoking, and physical inactivity,” Ms. Brown said.