Higher diet quality associated with lower CVD risk in adults with normal, overweight BMI
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Higher diet quality was associated with lower risk for incident CVD in U.S. adults with normal weight and overweight, but not in those with obesity, researchers reported in the American Journal of Preventive Cardiology.
“While diet quality is known to be associated with lower BMI, which our results also support, data are sparse on the associations of diet quality with incident CVD within and across BMI strata,” Nathan W. Kong, MD, internist in the department of preventive medicine at Northwestern University Feinberg School of Medicine, and colleagues wrote. “To our knowledge, this is one of the first large, diverse cohort studies to examine the independent association between diet quality and CVD incidence stratified by BMI.”
Researchers evaluated prospective cohort data from 30,219 participants (mean age, 53.5 years; 55.3% women) from the Lifetime Risk Pooling Project and diet data from six U.S. cohorts. Using the alternative Healthy Eating Index-2010, researchers calculated a diet quality score for each participant; participants were then divided into quintiles based on their scores (1: n = 6,041; 2: n = 6,045; 3: n = 6,045; 4: n = 6,045; 5: n = 6,043).
The primary outcome was a composite of the incidence of CVD, which included CHD, stroke, HF and CVD death.
During a median follow-up of 16.2 years, 7,021 CVD events occurred.
Diet quality quintiles and BMI category showed a significant interaction with the primary outcome (P = .0009).
Among participants with normal weight, CVD events were increased with lower diet quality score: 7.1 events per 1,000 participant-years in the highest quintile of diet quality score compared with 11.5 CVD events per 1,000 participant-years in the lowest quintile of diet quality score, according to the results. The researchers reported a similar finding among patients with overweight: 13.2 CVD events per 1,000 participant-years in the highest quintile of diet quality score compared with 17.3 events per 1,000 participant-years in the lowest quintile.
Researchers reported an inverse association between participants’ diet quality score and incident CVD among those with normal weight (adjusted HR = 0.57; 95% CI, 0.5-0.66) and those with overweight (aHR = 0.69; 95% CI, 0.61-0.77), according to the results.
Diet quality score was not associated with incident CVD among participants with obesity (aHR = 0.97; 95% CI, 0.84-1.13). Participants in the highest diet quality quintile experienced 18.2 CVD events per 1,000 participant-years compared with 16.8 CVD events per 1,000 participant-years in the lowest diet quality quintile.
“On a societal level, improving diet quality is a safe intervention with profound public health implications for the entire population,” the researchers wrote. “From a clinical perspective, counseling of a healthy diet should be initiated early in life and sustained regardless of weight category.”
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