- © 2017 American Society for Nutrition
The Mediterranean Diet Score Is More Strongly Associated with Favorable Cardiometabolic Risk Factors over 2 Years Than Other Diet Quality Indexes in Puerto Rican Adults1,2,3
- Josiemer Mattei4,*,
- Mercedes Sotos-Prieto4,5,
- Sherman J Bigornia6,
- Sabrina E Noel6, and
- Katherine L Tucker6
- 4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;
- 5Department of Food and Nutrition Science, School of Applied Health Sciences and Wellness, Ohio University, Columbus, OH; and
- 6Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
- ↵*To whom correspondence should be addressed. E-mail: jmattei{at}hsph.harvard.edu.
Abstract
Background: Multiple diet quality scores have been used to evaluate adherence to specific dietary recommendations or to consumption of healthful foods and nutrients. It remains unknown which score can more strongly predict longitudinal changes in cardiometabolic risk factors.
Objective: We aimed to determine associations of 5 diet quality scores [AHA diet score (AHA-DS), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI)-2005, Mediterranean diet score (MeDS), and Alternative Healthy Eating Index (AHEI)] with 2-y changes in cardiometabolic risk factors in adults 45–75 y old.
Methods: Data from the Boston Puerto Rican Health Study were analyzed (n = 1194). Diet quality scores were calculated from a baseline-validated food-frequency questionnaire. Multivariable-adjusted, repeated-subjects, mixed-effects models, adjusted for baseline measures, estimated associations between each z score and 14 individual cardiometabolic factors measured at 2 y.
Results: MeDS was significantly associated with lower 2-y waist circumference (β coefficient ± SE: −0.52 ± 0.26, P = 0.048); body mass index (BMI; −0.23 ± 0.08, P = 0.005); log-insulin (−0.06 ± 0.02, P = 0.005); log–homeostasis model assessment of insulin resistance (HOMA-IR; −0.05 ± 0.02, P = 0.030), and log–C-reactive protein (−0.13 ± 0.03, P = 0.0002). Similar but weaker associations were observed for the AHEI with BMI, insulin, and HOMA-IR. The AHA-DS was inversely associated with BMI (−0.17 ± 0.08, P = 0.033). Neither the HEI-2005 nor DASH was significantly associated with any variable. Traditional Puerto Rican foods consumed by individuals with high MeDSs included vegetables and meats in homemade soups, orange juice, oatmeal, beans and legumes, fish, whole milk, corn oil, and beer.
Conclusions: The MeDS comprises food components and scores associated with a favorable cardiometabolic profile over 2 y in Puerto Rican adults. An overall healthy diet may be particularly beneficial for maintaining a lower BMI. These results can help identify suitable measures of diet quality in epidemiologic studies and craft meaningful nutritional messages and dietary recommendations for the intended population. This study was registered at clinicaltrials.gov as NCT01231958.
- diet quality
- diet quality scores
- diet quality indexes
- diet quality comparison
- cardiometabolic risk factors
- Puerto Ricans
- Hispanics/Latinos
- longitudinal studies
- Mediterranean diet
- traditional foods
Footnotes
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↵1 Supported by a Mentored Career Development Award to Promote Faculty Diversity in Biomedical Research (K01-HL120951) from the NIH/National Heart, Lung, and Blood Institute and by NIH grant K01-AR067894 (to SEN). The Boston Puerto Rican Health Study was funded by National Heart, Lung, and Blood Institute grant P50-HL105185 and National Institute on Aging grant P01-AG023394.
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↵2 Author disclosures: J Mattei, M Sotos-Prieto, SJ Bigornia, SE Noel, and KL Tucker, no conflicts of interest.
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↵3 Supplemental Tables 1 and 2 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://jn.nutrition.org.
- Manuscript received: December 2, 2016.
- Initial review completed: December 22, 2016.
- Revision accepted: February 7, 2017.
