Abstract P192: Healthy Eating Index and Metabolically Healthy Obesity in U.S. Adolescents and Adults
Purpose: Studies of dietary intake between metabolically healthy obese (MHO) and metabolically abnormal obese (MAO) cardiometabolic profiles have been limited to macronutrient and micronutrient composition in postmenopausal women. Thus, the purpose of this study is to determine whether diet quality, measured by total and component Healthy Eating Index 2005 (HEI-2005), is different between MHO and MAO in a nationally representative sample.
Methods: Data from two National Health and Nutrition Examination Surveys (2007-2008; 2010-2011) were used to identify 133 obese (≥85th BMI %tile) adolescents 12-18 years, and 1164 obese (≥30kg/m2) adults 19-85 years. Adolescents and adults were classified as MAO if they had ≥2 cardiometabolic risk factors (adults: blood pressure ≥130/85 mmHg; triglycerides ≥150 mg/dL, HDL-C men <40, women <50 mg/dL; glucose ≥100 mg/dL; or on relevant medications; adolescents: triglycerides ≥150 mg/dL; HDL-C <40/50 mg/dL for boys/girls; blood pressure ≥90th %tile for age, gender, and height; glucose ≥100 mg/dL or on relevant medications), or MHO if they had <2 cardiometabolic risk factors. HEI-2005 scores were calculated from in-person 24-hour recall. Age group (12-18 years n=133, 19-44 years n=491; 45-85 years n=673) general linear regression models were used to determine whether total and component HEI-2005 scores differed between MHO and MAO after controlling for age, race, gender, NHANES wave, BMI and moderate to vigorous physical activity.
Results: MHO adolescents (n=45; 72%) had better quality diets as indicated by a higher total HEI-2005 score compared with MAO (MHO vs. MAO, mean ± SE; p-value for difference: 55.2 ± 1.2 vs. 47.8 ± 2.6; p=0.005), higher milk scores (5.2 ± 0.4 vs. 3.5 ± 0.7; p=0.03), and higher scores from calories from solid fats, alcohol beverages, and added sugars (SoFAAS) (15.5 ± 0.7 vs. 11.6 ± 1.0, p=0.007). The SoFAAS component score is reverse coded where a higher score indicates better adherence to diet recommendations (<20%). Adults 19-44 years with MHO profiles (n=229, 46%) had higher HEI-2005 scores compared with MAO (54.0 ± 1.0 vs. 51.3 ± 0.8; p=0.008) and higher whole grain scores (0.9 ± 0.1 vs. 0.4 ± 0.07, p=0.003). No significant differences between MHO (n=127; 23%) vs. MAO in HEI-2005 scores or its component scores were observed in adults 45-85 years of age.
Conclusion: MAO and MHO cardiometabolic profiles are characterized by differences in HEI-2005 total and component scores, though these differ by age group. Results suggest potential intervention targets which may improve cardiometabolic risk within obesity.
Author Disclosures: S.M. Camhi: None. E.W. Evans: None. L.L. Hayman: None. A.H. Lichtenstein: None. A. Must: None.
- © 2014 by American Heart Association, Inc.