Dietary approaches to stop hypertension dietary pattern, physical activity, and risk of atherosclerotic cardiovascular disease

BACKGROUND: Atherosclerotic cardiovascular (ASCVD) disease is the leading cause of death in the United States. Longstanding poor nutrition habits and lack of exercise contribute to chronic inflammation and promote the development ASCVD. In clinical trials, the Dietary Approaches to Stop Hypertension (DASH) eating pattern, a diet rich in nutrients with anti-inflammatory and antioxidant properties, has been shown to reduce the risk of hypertension. Its role in overall cardiovascular (CV) health, both alone and in combination with an active lifestyle, is less clear. OBJECTIVES: The primary goal of this study is to examine the relationships between the DASH eating pattern, physical activity, the development of incident cardiovascular disease (CVD). Specifically, we will evaluate the independent and combined effects of DASH and moderate to vigorous physical activity (MVPA) on cardiovascular event risk among men and women in the Framingham Heart Study Offspring (FOS) cohort. METHODS: The DASH score was derived from two sets of three-day dietary records gathered during examination visits 3 and 5 in the prospective FOS cohort. Activity was self-reported and used to generate a composite score for MVPA. Scores were constructed for each individual by multiplying the number of hours spent during each day in sedentary, light, moderate, and vigorous activity by a standard weights reflecting the intensity of that activity. Subjects included 2503 individuals (1137 men and 1366 women), aged 30 years and older. Individuals were free of type II diabetes mellitus (T2DM), cancer, and cardiovascular disease at baseline. The DASH score was categorized according to adherence to the eating pattern, first as low, moderate, or high adherence and then dichotomized (DASH score <4.45 vs. ≥4.45). The MVPA score was classified into quintiles and also dichotomized (MVPA score