Could the Wheel of Cardiovascular Health Diet Be a Tool for Diet Quality in Nutritional Counseling? Comparison with Healthy Eating Index-2020

Abstract

Objective

The Wheel of Cardiovascular Health Diet was recently elaborated based on current nutritional recommendations for healthy eating and was made for person-centered nutritional counseling, thus it may be an interesting tool to improve food awareness. However, its validity is yet to be tested. We hypothesized that the self-perception of patients diagnosed with chronic diseases, evaluated by the Wheel of Cardiovascular Health Diet, is satisfactory in assessing the quality of their diets, compared with the Healthy Eating Index-2020.

Methods

This is a cross-sectional analysis of adults with uncontrolled hypertension or type 2 diabetes. The patients answered the Wheel of Cardiovascular Health Diet, and then, based on the food frequency questionnaire, we analyzed the Healthy Eating Index-2020.

Results

A total of 330 patients were included in the study: 91.5% had hypertension, 58.5% had type 2 diabetes, and the median age was 58 (50–65) years. The mean difference observed between the percentage of the graphic area assessed by the patients’ self-perception from the Wheel of Cardiovascular Health Diet and Healthy Eating Index-2020 was −10.0% (95%CI −35.3 to 15.3), and a moderate correlation was observed. Linear Regression models showed that a 10-point increase in patients’ self-perception in the Wheel of Cardiovascular Health Diet is associated with a 2.9% increase (95%CI 2.08 to 3.70) in the diet quality by the Healthy Eating Index-2020 and is associated with lower BMI values: β = −0.42 kg/m² (95%CI −0.83 to −0.01).

Conclusion

The Wheel of Cardiovascular Health Diet performed satisfactorily regarding validity and reliability by BMI and was associated with higher overall dietary quality, with the Healthy Eating Index-2020 as a relative reference.

Keywords:

• Diet quality
• diabetes mellitus
• type 2
• hypertension
• self care

Acknowledgments

The authors would like to thank the Programa de Financiamento e Incentivo à Pesquisa e Evento (FIPE/HCPA) of the Hospital de Clínicas de Porto Alegre, Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil, and the following investigation sites of the NUGLIC and NUPRESS studies: Hospital do Coração; Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul; Hospital Comunitário São Peregrino Lazziozi; Instituto de Cardiologia do Rio Grande do Sul; Fundação Edson Queiroz; Universidade Federal de Goiás; Associação Educacional Luterana Bom Jesus/IELUSC; Universidade Federal de Tocantins; Escola de Enfermagem de Ribeirão Preto/Universidade de São Paulo; Hospital Escola/Universidade Federal de Pelotas; Escola de Nutrição/Universidade Federal da Bahia; Instituto Estadual de Cardiologia Aloysio de Castro; Irmandade da Santa Casa de Misericórdia de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Universidade Federal de Juiz de Fora – Campus Governador Valadares; Universidade Federal de Lavras; Universidade Federal de Viçosa.

Author contributions

AM, ACB-F, RHVM, DMLM, and JCA contributed to the elaboration and development of the Wheel of Cardiovascular Health Diet. TAS and ACB-F contributed to the data collection and interpretation. VCS contributed to the interpretation of the Wheel of Cardiovascular Health Diet. TAS, BPR, VCS, and JCA contributed to the statistical analysis and interpretation of results. TAS wrote the manuscript and JCA did the mentoring. TAS, BPR, and JCA critically reviewed the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

NUGLIC and NUPRESS studies were funded by Hcor in partnership with the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS/Brazilian Ministry of Health). This study was partly financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil [CAPES; Finance Code 001], Edital 05/2019 Pesquisador Gaúcho FAPERGS [19/2551-0001858-4], and by the Fundo de Incentivo à Pesquisa e Evento (FIPE/HCPA) of the Hospital de Clínicas de Porto Alegre [ID 2019-0644].