All ETDs from UAB

Advisory Committee Chair

Suzanne E Judd

Advisory Committee Members

David J Becker

Paula C Chandler-Laney

W Timothy Garvey

James M Shikany

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Despite the invaluable contributions that both randomized controlled trials and longitudinal studies have made to our understanding of the relationships between diet and cardiovascular disease (CVD), a comprehensive understanding of these relationships does not yet exist from birth to death. Furthermore, the longest running of these longitudinal studies have not included a representative portion of racial minority participants. Lastly, given the financial impacts of CVD, as well as how socioeconomic status (SES) can influence diet, the interplay between these three merits consideration. Therefore, the objective of this dissertation was to evaluate the associations between diet and cardiovascular disease (CVD): 1) in diverse populations 2) over stages of the life course 3) reflexive of the etiology of CVD 4) using various methods of defining diet 5) while examining how socioeconomic status may impact diet selection, and 6) considering how diet-mediated CVD may impact healthcare costs. In the first paper we observed positive associations between added sugars in the diets of children aged 7-12 y and diastolic blood pressure and triglycerides. In the second paper, adherence to the USDA Dietary Guidelines was associated with lower risk of atherosclerosis in a middle aged population as assessed by Carotid Artery Intima-Media thickness (CIMT) and Coronary Artery Calcification (CAC) at a time point 20 years into the study; however, this finding was not statistically robust. Finally, adherence to dietary patterns (previously shown to be associated with incident CVD) was shown to be associated with socioeconomic status and race in an older population (45+ y). These studies contribute to the broader work of nutrition sciences, as well as our corporate understanding of the manifold ways in which diet is interwoven with such themes as policy, sociology, economics, and medicine.