(P14-021-23) Diet Quality Is Associated With Elevated Blood Pressure in Adults of São Paulo, Brazil: A Population-Based Study

Objectives: We examined the association between elevated blood pressure (BP) and four established dietary quality indexes – 2015 Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index (AHEI), Brazilian Healthy Eating Index (BHEI).

Methods: The sample was composed of adults aged ≥ 18 years (n=1253) from the 2015 Health Survey of São Paulo, a cross-sectional population-based study in São Paulo city, Brazil. Dietary intake was assessed from 24-hour recalls and overall diet quality by adherence to the HEI, DASH, AHEI, and BHEI scores. The National Cancer Institute method was used to estimate the usual intake of food and nutrients. Multiple logistic regression models were estimated to investigate associations of diet quality with BP, sociodemographic, lifestyle, and dietetic variables. Analyses were performed in Stata 14.2, considering complex sample design and statistical significance p< 0.05.

Results: Better scores of the diet quality indexes investigated were associated with being ≥ 60 years of age, female, self-identifying as White or Asian, having a per capita family income with ≥1 minimum wage, classified as under-reporter, and with excess body weight. HEI and BHEI total scores were inversely related to elevated BP (HEI: OR 0.94, 95% CI 0.89, 0.99; BHEI: OR 0.95, 95% CI 0.91, 0.99). Individuals at the second quartile (OR 0.33, 95% CI 0.12, 0.90) and fourth quartile of BHEI (OR 0.34, 95% CI 0.13, 0.87) also presented lower odds for the occurrence of elevated BP, suggesting that measuring diet quality with a population-specific index may better represent the association of their diet quality with BP outcomes in adults.

Conclusions: The diet quality of adults from São Paulo needs improvement with disparities across sociodemographic factors. Associations of diet quality and elevated BP differ according to the index used. Higher diet quality was associated with lower odds of high BP in Brazilian, mainly using BHEI score.

Funding Sources: The 2015 Health Survey of São Paulo was supported by the São Paulo Municipal Health Department, the São Paulo Research Foundation, and the National Council for Scientific and Technological Development. PVF received a doctoral scholarship from the São Paulo Research Foundation and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil.