Abstract P092: Relation of Nutrient-rich Diet to Blood Pressure and BMI: The INTERMAP Study
Objective The Nutrient Rich Food (NRF) index serves for measurement of nutrient quality of individual foods and can also be used to assess nutrient density of the overall diet. Unlike other methods to assess nutrient quality of the diet, the NRF index score reflects a composite of both foods to be encouraged and foods to be limited. For consumers, this may offer a comprehensive tool helpful for making better food choices. Whether a nutrient dense diet, assessed by the NRF index, is also associated with blood pressure (BP) and body mass index (BMI) is not yet known. The objective of this study is to explore whether a nutrient dense diet, based on a high NRF score, is associated with lower BP and BMI.
Methods Cross-sectional data were analyzed from the population-based INTERMAP Study, including 2,695 participants ages 40 to 59 from the United Kingdom (UK, n=501) and the United States (US, n=2,195). Data were averaged from four 24-hour dietary recalls, two 24-hour urine collections, and eight BP readings. Nutrient density was calculated per 100 kcal using the NRF9.3 algorithm. Participants were categorised into quintiles of NRF9.3 score; country specific linear regression analyses per 2 SD (29.53) higher NRF9.3 score were used to explore associations of dietary nutrient density with BP and BMI. Models were adjusted for total energy intake, gender, age, special diet, hours/day of physical activity, supplement intake, smoking, and years of education, also in analyses on NRF9.3 score and BP for BMI, cardiovascular disease, diabetes, family history of hypertension, and 24 h urinary NA/K.
Results Participants in the highest NRF9.3 quintile (median 58) were older, more educated, and had lower total energy intake per day, compared to those in the lowest quintile (median 22). Higher NRF9.3 score was associated with lower average BMI, systolic BP (SBP), and diastolic BP (DBP) (P for trend <0.0001 for BMI; 0.04 for SBP). Pearson correlations between NRF9.3 score and individual NRF9.3 score nutrients (adjusted for sex, gender, and sample) were strong with vitamins A, C, Mg, potassium, dietary fiber (r=0.75, 0.75, 0.71, 0.76, and 0.68 respectively), and saturated fatty acids (r= - 0.49), compared to other nutrients of the score e.g., iron, calcium, added sugar, and added salt (r=0.53, 0.34,-0.23, and -0.02 respectively). Multivariate linear regression analyses showed 2 SD higher NRF9.3 score to be associated with SBP, DBP, and BMI significantly lower - differences -3.00 mm Hg in SBP, -1.77 mm Hg in DBP, and -1.48 kg/m2 in BMI, all P values <0.0001 (BP differences were with control for BMI).
Conclusion Individual diets assessed as nutrient-rich based on a high NRF index score were associated with lower BP and BMI levels compared to levels of persons with a lower score, reflecting a less nutrient-rich diet.
- © 2013 by American Heart Association, Inc.