Abstract
Abstract only Introduction: Dietary acculturation, defined as diet adaptation after migration, is related to human health. However, the influence of dietary acculturation on cardiovascular disease (CVD) is largely unknown, nor is the potential mechanism clear. Hypothesis: Dietary acculturation (diet reflecting U.S. exposure - years in the U.S. and nativity [U.S. 50 states/DC vs. foreign-born]) is associated with altered gut microbiota and related metabolites, which may contribute to CVD risk. Methods: A dietary acculturation score was derived from 14172 participants with two 24-hr dietary recalls at baseline (2008-11) using LASSO regression (29 food groups as predictors of U.S. exposure). We evaluated associations of dietary score with incident CVD over 7 years follow-up (including coronary heart disease, stroke and heart failure, n=14172/211 total/cases) and gut microbiota (shotgun sequencing, n=2349, 2014-17). Further, we identified serum metabolites associated with diet-related microbiome (n=694, 2014-17) and examined associations of baseline metabolites with incident CVD (n=5256/108 total/cases). Results: We identified a dietary acculturation pattern (Fig1A) which increased with years in the U.S. and was highest in U.S.-born adults (Fig1B). Higher dietary acculturation was associated with risk of incident CVD (HR per SD, 1.33 [95%CI: 1.13-1.57]), adjusting for sociodemographic, lifestyle, and clinical factors. We identified 69 diet-related species (17 enriched and 52 depleted, mainly from Clostridium , Prevotella and Eubacterium , Fig1C), and 25 metabolites associated with both diet-related microbiome score and incident CVD (Fig1D). Proxy association analysis based on these metabolites suggested a positive relationship between diet-related microbiome and incident CVD (r=0.70, p<0.001) (Fig1E). Conclusions: Among U.S. Hispanics/Latinos, greater dietary acculturation was associated with increased risk of CVD, possibly via diet-related alterations in gut microbiota and related serum metabolites.