Dietary Quality Assessed by the HEI-2010 and Biomarkers of Cardiometabolic Disease: An Exploratory Analysis

Abstract

Objectives: This study explores relationships between cardiometabolic measures of antioxidant capacity or inflammation and diet quality assessed by the Healthy Eating Index (HEI)-2010 which measures conformity to Dietary Guidelines for Americans. This cross-sectional study was an ancillary analysis of baseline data for a randomized controlled trial with older adults at risk for cardiometabolic disease (ClinicalTrials.gov #NCT00955903).

Methods: Community-dwelling older adults (n = 133, 49% male, 70.4 ± 4.8 years) with a body mass index of 30–40 kg/m² provided a fasted blood sample for measurement of antioxidant capacity, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6. Dietary data were generated from the mean of three 24-hour recalls.

Results: After adjustment for potential confounders, HEI-2010 composite scores were not significantly associated with decreased inflammation or greater antioxidant capacity. In analysis of the 12 components composing the HEI-2010, significant positive association was observed between total dairy and total serum antioxidant capacity (0.043; 95% CI, 0.008–0.069). Significant associations observed in inflammatory markers were between total vegetable and tumor necrosis factor-alpha (−0.078; 95% CI, −0.151 to −0.005), sodium and interleukin-6 (0.091; 95% CI, 0.023–0.158), and scores for combined calories from solid fats, alcoholic beverages, and added sugars and interleukin-6 (0.139; 95% CI, 0.027–0.252). In models adjusting for HEI-2010 composite score when significant associations were observed between component scores and biomarkers, two of six associations were strengthened by adding the composite score as a potential confounder.

Conclusions: Largely null findings along with those inconsistent with scientific expectations suggest caution in extrapolating adherence to the HEI-2010 with an individual’s inflammatory or antioxidant status. Results merit additional investigation with other biomarkers of chronic disease and emphasis on dietary patterns given potential synergy within food combinations.

Keywords:

• Healthy Eating Index
• Dietary Guidelines for Americans
• antioxidant capacity
• inflammation
• cardiometabolic
• oxidative stress

Acknowledgements

The authors would like to acknowledge Hunter Allman for assisting with statistical analysis as well as Navneet Baidwan and Fuchenchu Wang for independently replicating these analyses.

Disclosure statement

This research received no specific grant from any funding agency or commercial or not-for-profit sectors. The authors have no conflicts of interest to report.