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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #366729
Title: Diet indices reflecting changes to Dietary Guidelines for Americans from 1990 to 2015 are more strongly associated with risk of coronary heart disease

Author
item REBHOLZ, CASEY - Johns Hopkins University
item KIM, HYUNJU - Johns Hopkins University
item MA, JIANTAO - National Heart, Lung And Blood Institute(NHLBI, NIH)
item JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item LEVY, DANIEL - National Institutes Of Health (NIH)
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/24/2019
Publication Date: 11/5/2019
Citation: Rebholz, C.M., Kim, H., Ma, J., Jacques, P.F., Levy, D., Lichtenstein, A.H. 2019. Diet indices reflecting changes to Dietary Guidelines for Americans from 1990 to 2015 are more strongly associated with risk of coronary heart disease. Current Developments in Nutrition. https://doi.org/10.1093/cdn/nzz123.
DOI: https://doi.org/10.1093/cdn/nzz123

Interpretive Summary: The Dietary Guidelines for Americans (DGAs) are updated every 5 years and are intended to provide dietary recommendations for the general population. An underlying goal is to reduce the risk of developing chronic diseases such as cardiovascular disease. An evaluation of whether updated versions of the DGAs accomplish this goal is lacking. To address this issue, dietary data collected using a food frequency questionnaire in the Framingham Heart Study Offspring cohort was used to assess adherence to sequential versions of the Healthy Eating Index (1990, 2005, 2010, and 2015) and Alternative Healthy Eating Index (2000 and 2010). We found that an adherence to any dietary index was inversely associated with risk of overall cardiovascular disease, coronary heart disease, and heart failure, but not stroke. Compared to earlier diet indices versions, scores for the more recent versions were more strongly associated with coronary heart disease risk, but not overall cardiovascular disease, heart failure, or stroke. The results of these analyses indicate that more recent iterations of diet indices, reflecting updates to the Dietary Guidelines for Americans over the past 25 years, are associated with lower incident coronary heart disease risk.

Technical Abstract: Background: The US Dietary Guidelines for Americans (DGAs) provide dietary recommendations for the general population with the intent of preventing chronic disease risk such as cardiovascular disease. An evaluation of whether updated versions of the DGAs accomplish this goal is lacking. Methods and Results: Dietary data collected using a food frequency questionnaire in the Framingham Heart Study Offspring cohort was used to assess adherence to sequential versions of the Healthy Eating Index (1990, 2005, 2010, and 2015) and Alternative Healthy Eating Index (2000 and 2010) (N=3,267). We conducted prospective analyses using Cox regression to estimate the association between diet indices and incident cardiovascular disease outcomes. Among the 3,267 study participants, 54% were female, mean age was 55 years, and mean body mass index was 27 kg/m^2. There were a total of 544 cardiovascular disease events (324 coronary heart disease events, 153 stroke events, and 187 heart failure events). Adherence to any dietary index was inversely associated with risk of overall cardiovascular disease, coronary heart disease, and heart failure, but not stroke. Compared to HEI-1990, scores for the more recent diet indices were more strongly associated with coronary heart disease risk, but not overall cardiovascular disease, heart failure, or stroke. Conclusions: More recent iterations of diet indices, reflecting updates to the DGAs over time, are more strongly associated with risk of incident coronary heart disease than the original diet index (HEI-1990).