Abstract
Background Multimorbidity is considered a major challenge for current health care. Lifestyle interventions, as a broad and generic approach, may have the potential to improve the management of care among patients with multimorbidity. The objective of this study was to evaluate the association of multimorbidity defined within the cardiometabolic disease domains with dietary patterns, representing habitual dietary intake. Design We studied 129 369 participants from the Lifelines Cohort study (42% male, 45±13 years (range 18–93)) in which diet was assessed using a 110-item food frequency questionnaire. A composite morbidity score was applied in multivariable ordered logistic regression to test the association with dietary patterns derived by principal components analysis, based on sex-specific dietary pattern scores. Results Four dietary patterns were retained, accounting for 26.6% of the variation in overall diet. After control for potential confounders, men and women in the highest quintile of “meat, alcohol and potato pattern” and “snack pattern” had a higher likelihood of having higher morbidity scores than those in the lowest quintile (e.g. men: OR = 1.83(95% CI:1.71–1.97), OR = 1.18(95% CI 1.11–1.27 respectively). The opposite was observed with respect to the “bread and sweets pattern” and “vegetable, fish and fruit pattern” (e.g. women: OR = 0.88 (95% CI: 0.81–0.96), OR = 0.86(95% CI 0.81–0.92 respectively). The association partially attenuated after adjusting for BMI, but the associations remained significant among men. Conclusions Robust associations between dietary patterns and multimorbidity within the cardiometabolic domain, in particular a “meat, alcohol and potato pattern”, suggest an important opportunity of dietary interventions in multimobidity prevention. Generic prevention strategies based on population derived dietary patterns may have the potential to enhance lifestyle management among people with multimorbidity.
| Original language | English |
|---|---|
| Article number | e0220368 |
| Journal | PLoS ONE |
| Volume | 14 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 1 Aug 2019 |
| Externally published | Yes |
Bibliographical note
Funding Information:The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord Nederland) and REP (Ruimtelijk Economisch Programma). LHD participates in projects funded by De Friesland Zorgverzekeraar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. None of the authors reported any conflicts of interest related to the study. The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord Nederland) and REP (Ruimtelijk Economisch Programma). LHD participates in projects funded by De Friesland Zorgverzekeraar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all study participants.
Publisher Copyright:
© 2019 Dekker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.