Diet Quality and Its Association with Cardiometabolic Risk Factors Vary by Hispanic and Latino Ethnic Background in the Hispanic Community Health Study/Study of Latinos.
BACKGROUND
Healthful diet quality has been associated with a lower risk of metabolic syndrome (MetS) in several populations, but reports on Hispanic and Latino cohorts, grouped or by ethnic background, have been limited and inconsistent.


OBJECTIVE
We aimed to examine diet quality by using the 2010 Alternate Healthy Eating Index [(AHEI) range: 0-110, lowest to highest quality] and its cross-sectional association with MetS and its cardiometabolic components across 6 Hispanic and Latino backgrounds.


METHODS
We studied 12,406 US Hispanics and Latinos, aged 18-74 y and free of diabetes, from the multicenter, population-based Hispanic Community Health Study/Study of Latinos cohort. Food and nutrients were assessed from two 24-h recalls. MetS was defined by using the 2009 harmonized guidelines. Complex survey procedures were used in multivariable-adjusted linear regression models to test the association of the AHEI with continuous markers and in logistic regression models with MetS as an outcome.


RESULTS
The prevalence of MetS was 24.2%. Overall, Hispanics and Latinos had low scores for intakes of sugar-sweetened beverages and fruit juices, whole grains, and fruit and favorable scores for trans fats and nuts and legumes, according to AHEI criteria. Adjusted mean AHEI and its individual components differed by ethnic background (P < 0.001), ranging from 43.0 for Puerto Ricans to 52.6 for Mexicans. Overall, adjusted odds (95% CIs) of having MetS were 22% (9%, 33%) lower for each 10-unit increase in AHEI. This association was modified by ethnic background (P-interaction = 0.03), with significantly lower odds observed only for Mexicans (30%; 95% CIs: 13%, 44%) and Central Americans (42%; 95% CIs: 9%, 64%) for each 10-unit increase in AHEI. AHEI was inversely associated with waist circumference, blood pressure, and glucose among Mexicans and Puerto Ricans and with triglycerides among Mexicans only, and positively associated with HDL cholesterol among Puerto Ricans and Central Americans (all P < 0.05).


CONCLUSIONS
Diet quality differed by Hispanic or Latino background. Although healthier diet quality was associated with lower odds of MetS in the overall Hispanic and Latino cohort, the association of AHEI and cardiometabolic factors varied by ethnic background. Nutrition-related research and interventions among ethnically diverse groups should consider individual ethnic backgrounds to optimally address diet quality and cardiometabolic health. This trial was registered at clinicaltrials.gov as NCT02060344.
Departments of Nutrition and jmattei@hsph.harvard.edu.
Josiemer
http://orcid.org/0000-0001-5424-8245
J
Mattei
Collaborative Studies Coordinating Center, Department of Biostatistics, and.
Daniela
http://orcid.org/0000-0002-3226-6140
D
Sotres-Alvarez
Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL.
Martha L
http://orcid.org/0000-0002-6791-8727
ML
Daviglus
Department of Psychology, San Diego State University, San Diego, CA.
Linda C
LC
Gallo
Department of Psychology, University of Miami, Miami, FL.
Marc
M
Gellman
Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Frank B
FB
Hu
Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell, MA.
Katherine L
http://orcid.org/0000-0001-7640-662X
KL
Tucker
Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Walter C
http://orcid.org/0000-0003-1458-7597
WC
Willett
Departments of Epidemiology and Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Anna Maria
AM
Siega-Riz
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; and.
Linda
http://orcid.org/0000-0002-1362-5806
L
Van Horn
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
Robert C
RC
Kaplan
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008800:Mexico; D008875:Middle Aged; D015596:Nutrition Assessment; D015995:Prevalence; D011647:Puerto Rico; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference; D055815:Young Adult
D008055:Lipids
HCHS/SOL; Hispanics; Latinos; cardiometabolic risk factors; diet quality; health disparities; metabolic syndrome; minority health; race/ethnicity