Abstract

Introduction: Psychological and behavioral factors negatively impact cardiovascular health (CVH), defined by Life’s Simple 7. Few studies have investigated disordered eating and weight control behaviors and CVH, particularly outside of adolescence. Objective: To examine the cross-sectional and longitudinal associations of disordered eating and weight control behaviors with CVH among middle-aged adults. Methods: We studied CARDIA participants assessed between Y10 (1995-1996) and Y30 (2015-2016) excluding pregnant/breastfeeding individuals at Y10. The Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) was administered at Y10 and used to create the Problematic Relationship to Eating and Food (PREF) score, an aggregate measure (range 0-8) of eight disordered eating and weight-related behaviors (anxiety surrounding food, compensatory behaviors, overeating, loss of control, distress surrounding overeating, distress surrounding loss of control, shape concerns, time spent dieting). Diet, physical activity, smoking, blood pressure, cholesterol, glucose, and body mass index (BMI) were measured at Y10 and Y30 (except diet at Y7 and Y20) and used to define CVH categories Low-to-Moderate (0-9) or High (10-14). Logistic regression analyses were used to evaluate associations between PREF score and CVH category. Results: We included 2,040 participants (mean age 35.2 years, 55% female, 43% Black). At Y10, every 1-unit increment in PREF was associated with 19% higher odds of Low-to-Moderate vs. High CVH in adjusted models ( Table ). At Y30 after 20 years of follow-up (mean age 55.3 years), every 1-unit increment in PREF at Y10 was associated with 11% higher odds of Low-to-Moderate vs. High CVH at Y30 in adjusted models ( Table ). Further adjustment for Y10 BMI attenuated the relationship (OR=0.93, 95%CI: 0.87-0.99). Conclusion: Higher levels of problematic behaviors and attitudes towards eating are associated with less optimal CVH throughout middle-age, likely through weight increases.

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