Abstract P195: Metabolites Mediate the Association of the MIND Diet With Hypertension and Chronic Kidney Disease

The Mediterranean-DASH diet intervention for neurodegenerative delay (MIND), is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. The Mediterranean and DASH diets are associated with decreased risk of cardiometabolic disease; however, less is known regarding the association of the MIND diet with cardiometabolic disease. The objectives of this analysis were (1) to determine if the MIND diet is associated with prevalent hypertension and chronic kidney disease (CKD) and (2) to identify metabolites associated with the MIND diet and if these metabolites mediate the association of the MIND diet with hypertension and CKD. In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, we examined the association of the MIND diet with prevalent hypertension and CKD. Fully adjusted models included age, sex, race, calories, alcohol, smoking, education, exercise, income, region, BMI, lipidemia, history of coronary artery disease, and diabetes. In the REGARDS stroke case-cohort sub-study, 357 metabolites were measured in baseline plasma. Weighted linear regression models were used to test the association between MIND diet score and metabolites adjusting for age, sex, race, calories, alcohol, and smoking. Weighted logistic regression models were used to test the association between MIND-metabolites and hypertension and CKD adjusting for age, race, sex, BMI, alcohol, and smoking. Mediation analysis was conducted to examine metabolites mediating the association between MIND diet and hypertension and CKD. Sensitivity analyses were conducted in the cohort random controls. A higher MIND diet score was associated with lower odds of hypertension (odds ratio [OR] 0.97, 95% CI 0.96-0.99; p=0.01) and CKD (OR 0.88, 95% CI 0.86-0.91; p<0.0001). Fifty-one metabolites were associated with the MIND diet (MIND-metabolites). Three MIND-metabolites were associated with greater odds of hypertension; however, these associations were attenuated in the fully adjusted models. Twelve MIND-metabolites were associated with greater odds of CKD. Mediation analyses indicated dimethylguanidino valeric acid (DMGV), guanosine, and C7 carnitine to mediate the association between MIND diet and hypertension. DMGV, guanosine, gluconic acid, S-Adenosyl-L-homocysteine, C7 carnitine, and 5 triacylglycerols mediated the association between MIND diet and CKD. Higher adherence to the MIND diet is associated with a lower likelihood of hypertension and CKD. MIND diet-related metabolites were found to be associated with hypertension and CKD and may provide insight to metabolic pathways linking diet and disease.