Dietary patterns contribute to cardiovascular disease (CVD) risk. Asian Indians 
have earlier onset, more severe, and more prevalent CVD than many other 
racial/ethnic groups. We aimed to characterize dietary patterns in Asian Indians 
living in the United States and examine associations with cardiometabolic risk 
factors. One hundred fifty Asian Indians, aged 45 to 84 years, without known 
CVD, living in the San Francisco Bay, CA, area between August 2006 and October 
2007 were enrolled into the Metabolic syndrome and Atherosclerosis in South 
Asians Living in America study. A food frequency questionnaire validated in 
Asian Indians, fasting blood samples, and computed tomography scans were 
obtained for all participants. Principal component analysis with varimax 
rotation was used to determine prevalent dietary patterns. Linear regression 
analyses were performed for associations between dietary patterns and metabolic 
factors, adjusting initially for age and sex, then additionally for BMI, income, 
education, metabolic equivalent of task-minutes of exercise, alcohol 
consumption, and smoking. Two distinct dietary patterns were identified that we 
termed "Western," and "Vegetarian." Compared with the Western diet, the 
Vegetarian diet was associated with lower homeostasis model of 
assessment-insulin resistance (-1.12 mmol/L × mU/L; P=0.05) and lower 
high-density lipoprotein cholesterol (-4.77 mg/dL; P=0.09). Given that the 
Western and Vegetarian dietary patterns were each associated with adverse 
metabolic changes, healthful diet choices may help Asian Indians improve risk 
factors for CVD.