(P14-060-23) Association of Baseline Diet Quality Scores with Cardiometabolic Risk Factors and Visceral Adiposity Measures in the Habitual Diet and Avocado Trial (HAT)

Objectives: Several healthy eating patterns are recommended for CVD risk reduction. We determined adherence to three of these healthy eating patterns: Alternative Mediterranean Diet (AMED); the Healthy Eating Index_2015 (HEI); and the Dietary Approaches to Stop Hypertension (DASH) and evaluated its relationship to cardiometabolic risk factors (CMRFs) and visceral adiposity measures in participants from the Habitual Diet and Avocado Trial (HAT).

Methods: Cross-sectional analysis of diet quality was assessed using baseline 24-hour diet recalls administered to 992 HAT participants. Scoring was based on the (i) AMED, which emphasizes consumption of fruits, vegetables, olive oil, beans, nuts, whole grains and seeds [0-9 score], (ii) HEI, which assesses adherence to the 2015-2020 Dietary Guidelines for Americans [0-100 score], and (iii) DASH, which emphasizes consumption of fruits, vegetables and whole-grains, and limits full-fat dairy foods and sugar sweetened beverages [8-40 score]. Multivariable-adjusted linear regression was used to determine the associations between Quintile 1 and 5 (Q1 vs. Q5) scores for each dietary pattern and CMRFs (waist circumference, BMI, blood pressure, plasma lipid profile, glucose, insulin, hsCRP), visceral adiposity volume (VAT) and hepatic fat content (HFF).

Results: Participants were 72% female, ages 50 ±14 years with a BMI of 33 ± 6 kg/m². Total diet quality scores (median [min, max]) were 3 [0, 9] for AMED, 53 [16, 97] for HEI and 24 [12, 37] for DASH. Participants with higher adherence to any of the three heart-healthy dietary patterns had significantly lower BMI and waist circumference compared to those with lower adherence (Q5 vs. Q1). After adjustment for covariates and multiple testing, only HFF was significantly lower in DASH Q5 compared to Q1 participants. Among the DASH components, participants in Q5 compared to Q1, had higher fruit and lower sugar sweetened beverage scores. These scores were significantly associated with lower glucose and LDL-cholesterol levels. No significant associations were observed between CMRFs and AMED or HEI food components.

Conclusions: Adherence to the three dietary patterns was suboptimal among HAT participants. However, participants with higher adherence to the DASH dietary pattern had lower HFF and more favorable.

Funding Sources: Hass Avocado Board and USDA agreement No. 58-1950-4-401