Dietary patterns associated with the incidence of hypertension: Application of machine learning to a cohort study

Abstract

Abstract Background: Previous studies have focused on the relationship between specific dietary factors (such as sodium intake or consumption of fruits and vegetables) and the development of hypertension. However, less is known about the role of overall dietary patterns (food intake, dietary behaviors, and cooking methods) in the development of hypertension. This study aims to address this gap in the literature by using unsupervised machine-learning techniques to identify dietary patterns associated with the incidence of hypertension. Methods: Data were obtained from Japanese participants enrolled in a prospective cohort study between August 2008 and August 2010. A total of 447 male participants were included in the analysis. Dimension reduction using Uniform Manifold Approximation and Projection (UMAP) and subsequent K-means clustering was used to derive dietary patterns. In addition, multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) to evaluate the association between dietary patterns and the incidence of hypertension. Results: We identified four dietary patterns: ‘Sweet Tooth,’ ‘Herbivorous,’ ‘Meat-based healthy,’ and ‘Seafood and Alcohol.’ Approximately 13.4% of the cohort study participants developed hypertension in the following two years. Compared with ‘Seafood and Alcohol’ as a reference, the protective dietary patterns for hypertension were ‘Herbivorous’ (OR = 0.39, 95% CI = 0.19–0.80, p = 0.013) and the ‘Meat-based healthy’ (OR = 0.37, 95% CI = 0.16–0.86, p = 0.022) after adjusting for potential confounding factors, including age, body mass index, smoking, education, physical activity, dyslipidemia, and diabetes. An age-matched sensitivity analysis confirmed this finding. Conclusions:From a methodological perspective, we successfully identified clear dietary patterns by clustering using the UMAP and K-means algorithms in an epidemiological dataset with a small sample size. The ‘Herbivorous’ and ‘Meat-based healthy’ dietary patterns were associated with a lower risk of hypertension in Japanese males than the ‘Seafood and Alcohol’ pattern. These findings provide helpful insights into hypertension-preventive interventions in Japanese males through dietary pattern regulation.