Correlates of the “western” and “prudent” diet patterns in the us

PURPOSE: Underlying the diversity and changeability of US eating habits are fundamental dietary patterns shaped by common sociohistorical experiences. Currently, little is known of what patterns exist or their associations with sociodemographic/lifestyle factors. We examined these issues in third National Health and Nutrition Examination Survey data. METHODS: Analyses were based on 5,794 US-born, white participants. Interviews included a 60-item food frequency questionnaire (FFQ) and questions on sociodemographics and health behaviors. Dietary patterns were identified by principal components analysis on FFQ responses. Component scores representing intake level of each pattern were dichotomized at the median. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: We identified two primary dietary patterns—a “western” pattern characterized by processed and red meats, eggs, potatoes, and refined grains, and a “prudent” pattern characterized by cruciferous vegetables, greens, carrots, salads, and fresh fruits. The two patterns occurred across geographic regions and in both women and men. After age- and sex-adjustment, the “western” diet was associated with rural residence (OR = 1.9, 95% CI 1.7–2.2), working class status (OR = 1.4, 95% CI 1.2–1.6), and lack of high school completion (OR = 1.6, 95% CI 1.4–1.8). The “prudent” diet was associated with high school completion (OR = 2.8, 95% CI 2.5–3.3) and behaviors reflecting greater health awareness, such as daily physical activity (OR = 2.0, 95% CI 1.8–2.2), non-smoking (OR = 2.1, 95% CI 1.8–2.4), and supplement use (OR = 1.8, 95% CI 1.6–2.0). CONCLUSIONS: The two dietary patterns resemble those found in previous US studies. Findings regarding correlates agree with social histories describing the emergence of those patterns. Principal components analysis is potentially useful for identifying fundamental dietary patterns for future investigations of diet-disease associations.