Association of eating patterns with blood pressure and body mass index: the INTERMAP study

Abstract

Background Epidemiologic evidence is sparse on the role of dietary patterns that may be important drivers of high blood pressure (BP) and body mass index (BMI) levels. Additionally, dietary fibre intake in association with BP and BMI yielded inconsistent results. Objective Investigate the relationships of eating frequency, dietary energy density, diet quality, evening energy intake, GI, GL, and dietary fibre to BP, BMI using cross-sectional data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) of 4680 men and women aged 40–59 y from Japan, China, the United Kingdom, and the United States of America. Methods During 4 visits, eight BP, four weight and height measures, four 24-hour dietary recalls, and two 24-hour urine samples were collected. Consumption of all solid foods was aggregated into eating occasions. Nutrient density is expressed using the Nutrient Rich Food index. Multivariable adjusted linear regression models were used to estimate BP and BMI differences per 2SD higher intakes of eating occasions, dietary energy density, Nutrient Rich Food index, evening energy intake, GI, GL, and dietary fibre. Results Compared to participants with <4 eating occasions/24-hours, those with ≥6 eating occasions/24-hours had lower average: systolic BP: 116.4 vs. 121.4 mm Hg; BMI: 27.3 vs. 29.0 kg/m2; total energy: 2127 vs. 2521 kcal/24-hours; dietary energy density: 1.5 vs. 2.2 kcal/g; and higher Nutrient Rich Food index score: 35.1 vs. 26.8. Additionally, insoluble fibre higher by 4 g/1000 was inversely associated with systolic BP (p<0.05), while soluble fibre and GI, GL showed no associations with BP and BMI. Conclusions Results suggest that higher meal frequency may be associated with improved diet quality and lower BP and BMI. Higher intakes of insoluble fibre may contribute to lower BP and BMI. This may have implications for behavioural approaches to controlling high BP levels and the obesity epidemic.