title: Adherence index based on the AHA 2006 diet and lifestyle recommendations is associated with select cardiovascular disease risk factors in older Puerto Ricans.
abstract: In 2006, the AHA released diet and lifestyle recommendations (AHA-DLR) for cardiovascular disease (CVD) risk reduction. The effect of adherence to these recommendations on CVD risk is unknown. Our objective was to develop a unique diet and lifestyle score based on the AHA-DLR and to evaluate this score in relation to available CVD risk factors. In a cross-sectional study of Puerto Rican adults aged 45-75 y living in the greater Boston area, information was available for the following variables: diet (semiquantitative FFQ), blood pressure, waist circumference (WC), 10-y risk of coronary heart disease (CHD) (Framingham risk score), and fasting plasma lipids, serum glucose, insulin, and C-reactive protein (CRP) concentrations. We developed a diet and lifestyle score (AHA-DLS) based on the AHA-DLR. The AHA-DLS had both internal consistency and content validity. It was associated with plasma HDL cholesterol (P = 0.001), serum insulin (P = 0.0003), and CRP concentrations (P = 0.02), WC (P < 0.0001), and 10-y risk of CHD score (P = 0.01 in women). The AHA-DLS was inversely associated with serum glucose among those with a BMI < 25 (P = 0.01). Women and men in the highest quartile of the AHA-DLS had lower serum insulin (P-trend = 0.0003) and CRP concentrations (P-trend = 0.002), WC (P-trend = 0.0003), and higher HDL cholesterol (P-trend = 0.008). The AHA-DLS is a useful tool to measure adherence to the AHA-DLR and may be used to examine associations between diet and lifestyle behaviors and CVD risk.
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Bhupathiraju
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.forename: Bess
authors.initials: B
authors.lastname: Dawson-Hughes
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
mesh_terms: D000069:Acculturation; D000368:Aged; D000572:American Heart Association; D001900:Boston / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005260:Female; D017408:Guidelines as Topic; D006293:Health Promotion; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010349:Patient Compliance; D011647:Puerto Rico / Q000208:ethnology; D012306:Risk; D014481:United States