Abstract 15791: Higher Diet Quality Associates With Lower Inflammation in Black Adults With Heart Failure

Abstract

Introduction: Heart failure (HF) is associated with a chronic inflammatory state. Diet-derived metabolites, such as trimethylamine-N-oxide (TMAO), may be associated with chronic inflammation. Most Americans consume a pro-inflammatory diet with high intakes of sugar and processed foods, but adherence to high quality diet patterns may be beneficial in HF-associated inflammation. The Healthy Eating Index (HEI) and the Alternative Healthy Eating Index (AHEI) measure adherence to the Dietary Guidelines for Americans with greater adherence associated with lower inflammation and better HF outcomes but is understudied in Black adults. Hypothesis: Higher adherences to the HEI or the AHEI is inversely associated with TMAO and inflammation measured by TNF-α. Methods: Participants included Black adults living with HF (N=36, mean age 57 years, 64% women); HEI and AHEI diet scores were derived from a food frequency questionnaire (FFQ). TMAO and TNF-α were analyzed with dried blood spots and immunoassays. A lifestyle factor (LIS) score consisting of alcohol intake, body mass index, physical activity, and smoking was measured. Analyses included correlational and regression analyses. Results: Regression models explained the variance of TMAO and TNF-α levels. HEI and related covariates (AHEI, LIS) explained 15.9% change in TMAO levels: F(3,30)=3.09, p<.042. Standardized beta coefficients were at least 0.3 and higher. HEI scores and related covariates explained 17.2% change in TNF-α levels: F(4,29)=2.71, p<.050. There was an inverse correlation between AHEI scores and TNF-α: r=-.36, p=.031. Conclusions: Higher diet quality, as measured by the HEI/AHEI, was associated with lower levels of TNF-α. The anti-inflammatory benefits of adherence to healthy eating patterns are important in the self-management of HF, yet these foods may include precursors for TMAO levels. Thus, healthy eating should be balanced with an overall dietary plan that attends to the quantity and nature of foods consumed by those with HF. Interventions which promote adherence to high quality diet patterns are needed in adults with HF, particularly in Black adults who bear an excess burden of disease. More research to understand which specific diet components decrease inflammation in HF are warranted.