Longitudinal Associations of Dietary Fructose and Psychological Stress with Vascular Aging Index and Incident Cardiovascular Disease in the CARDIA Cohort

ABSTRACT Background Cardiovascular disease (CVD) risk increases exponentially with age, largely due to vascular aging. We explored how dietary behaviors (sucrose, fructose, sodium, and potassium consumption) and endured psychological stress in young adult males and females impact the vascular aging index (VAI) and CVD risk by mid-life. Methods Data were obtained from the Coronary Artery Risk Development in Young Adults Study, an ongoing longitudinal study. Included participants (n=2,656) had undergone carotid artery ultrasound Doppler scans at year 20 allowing VAIs to be calculated. Demographics, dietary data and depression scale scores were obtained at the initial visit. Regression analyses were used to assess the predictors of VAI 20 years later. Cox regression analyses were conducted to assess the risk of fatal and non-fatal CVD, hypertensive CVD, and stroke. Results Predictors of vascular aging were found to be sex-specific. In females, CES-D scores at baseline were positively associated with VAI (B-weight=0.063, p=0.015). In males, sodium intake at year 20 positively predicted VAI (B-weight=0.145, p=0.003) and potassium intake inversely predicted VAI (B-weight=-0.160, p<0.001). On Cox regression analyses, BMI significantly predicted CVD, stroke, and death. In addition, fructose consumption at year 20 was a significant predictor of CVD risk while having blood pressure above 130/80 mmHg at baseline was significantly associated with stroke risk. Conclusion Our findings support the promotion of nutrient-specific behavior changes (specifically, limiting fructose consumption) to prevent vascular aging in early adulthood and CVD risk in mid-life.