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Title: Body composition, dietary patterns, cardiovascular disease and mortality in older age
Author: Atkins, J. L.
ISNI:       0000 0004 8503 5711
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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Obesity and poor quality diet are major interrelated risk factors for cardiovascular disease (CVD) and mortality, which are well established in middle-aged populations. However, there is controversy on the effects of obesity on CVD and mortality in the elderly. Since body composition changes with age (visceral fat increases and muscle mass decreases) it may be important to also account for muscle mass in the elderly. However, few studies have examined the combined effects of adiposity and sarcopenia (low muscle mass) on CVD risk and mortality in the elderly. There is also a paucity of data on the associations between dietary patterns and CVD risk and mortality in older age. This thesis uses the British Regional Heart Study, a population based prospective cohort of men, to investigate the impact of body composition (obesity and sarcopenia) and dietary patterns on the risk of cardiovascular endpoints and all-cause mortality in older age (60-79 years). The main findings are that sarcopenic men (defined using mid-arm muscle circumference) and obese men (defined using waist circumference) had a significantly increased risk of CVD mortality and all-cause mortality. Men with both sarcopenia and obesity showed the highest all-cause mortality risk, and also an increased CVD mortality risk although non-significant. Adherence to an a priori defined dietary pattern (the Elderly Dietary Index, a modified Mediterranean-style diet) was associated with a lower risk of CVD mortality and all-cause mortality. Adherence to a 'high fat/low fibre' diet, identified by principal component analysis, was associated with an increased risk of all-cause mortality but not CVD mortality. Adherence to a 'high sugar' diet was associated with an increased risk of coronary heart disease (CHD) events and CVD events. Body composition and dietary patterns are therefore important risk factors for CVD and all-cause mortality which persist in older age.
Supervisor: Wannamethee, S. G. ; Whincup, P. H. ; Morris, R. W. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available