Association between a social-business eating pattern and early asymptomatic atherosclerosis

José L Peñalvo, Leticia Fernández-Friera, Beatriz López-Melgar, Irina Uzhova, Belén Oliva, Juan Miguel Fernández-Alvira, Martín Laclaustra, Stuart Pocock, Agustín Mocoroa, José M Mendiguren, Ginés Sanz, Eliseo Guallar, Sameer Bansilal, Rajesh Vedanthan, Luis Jesús Jiménez-Borreguero, Borja Ibañez, José M Ordovás, Antonio Fernández-Ortiz, Héctor Bueno, Valentin Fuster

Research output: Contribution to journalA1: Web of Science-articlepeer-review


BACKGROUND: The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies.

OBJECTIVES: This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults.

METHODS: The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the life-style-related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall life-style and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information.

RESULTS: Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet.

CONCLUSIONS: A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).

Original languageEnglish
JournalJournal of the American College of Cardiology
Issue number8
Pages (from-to)805-14
Number of pages10
Publication statusPublished - 2016
Externally publishedYes


  • Adult
  • Asymptomatic Diseases
  • Atherosclerosis/epidemiology
  • Cross-Sectional Studies
  • Diet/methods
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Morbidity/trends
  • Prevalence
  • Primary Prevention/methods
  • Prospective Studies
  • Risk Factors
  • Spain/epidemiology
  • Time Factors


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