Abstract P215: Adherence to the Healthy Eating Index-2015 May Reduce the Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality

Abstract

Background: The Healthy Eating Index-2015 (HEI-2015) score measures adherence to recommendations from the most recent Dietary Guidelines for Americans . The HEI-2015 was altered from the HEI-2010 by replacing the empty calories component with saturated fat and added sugar. Few studies have examined the association between the HEI-2015 score and incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. Hypothesis: We hypothesized that a higher HEI-2015 score, indicating better diet quality, would be associated with a lower risk of incident CVD, CVD mortality, and all-cause mortality. Methods: We conducted a prospective analysis of 12,135 participants aged 45-64 years from the Atherosclerosis Risk in Communities (ARIC) study. The HEI-2015 score (0-100) was computed using the average dietary intake assessed using food frequency questionnaires at visits 1 (1987-89) and 3 (1993-95) and divided into quintiles. Incident CVD, CVD mortality, and all-cause mortality were ascertained from baseline through December 31, 2016. We conducted Cox proportional hazards models adjusted for covariates to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 4,163 cases of incident CVD, 1,429 cases of CVD mortality, and 5,173 cases of all-cause mortality over a median of 25 years of follow-up. Compared to participants in the lowest quintile of HEI-2015 score, participants in the highest quintile had a 12% lower risk of incident CVD (HR: 0.88, 95% CI: 0.79-0.98), 41% lower risk of CVD mortality (HR: 0.59, 95% CI: 0.49-0.71), and 25% lower risk of all-cause mortality (HR: 0.75, 95% CI: 0.69-0.83) after adjusting for covariates ( Table ). There were significant trends across quintiles of HEI-2015 score for all three outcomes. Results were consistent by subgroups (sex, smoking, diabetes, hypertension). Conclusions: Higher adherence to the Dietary Guidelines for Americans 2015-2020 may reduce the risk of incident CVD, CVD mortality, and all-cause mortality among middle-aged adults in the U.S.