Abstract P259: Improvements in Diet Quality Are Associated With Reduced Abdominal Adiposetissue: A Prospective Study

Abstract

Objectives: Visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) are associated with cardiometabolic diseases. The relationship between diet quality and abdominal fat accumulation, however, has not been well studied. We aimed to examine the long-term association of change in diet quality and change in abdominal adipose tissue. Methods: In 1,677 participants who attended two consecutive Framingham Heart Study examinations, we measured the volume of VAT and SAT using multi-detector computed tomography at two time-points (median interval of 6 years). The ratio of VAT/SAT was calculated to reflect the relative abundance of these two fat stores, i.e., abdominal fat distribution. We created two scores to represent overall diet quality, the Mediterranean-style diet score (MDS) and the Alternative Healthy Eating Index (AHEI) score, using food frequency questionnaires at baseline and follow-up exams. We analyzed the association between change in the dietary scores and change in VAT, SAT, and VAT/SAT ratio with adjustment for baseline covariates including sex, age, dietary score, VAT, SAT, or VAT/SAT ratio, BMI, energy intake, smoking status, physical activity score, and change in energy intake, smoking status, and physical activity. Results: For each standard deviation increase in ΔMDS (diet quality improved), VAT volume reduced by 53±19 cm 3 (P=0.005) and SAT volume declined by 52±20 cm 3 (P=0.01). Similarly, for each standard deviation increase in ΔAHEI (diet quality improved), VAT volume declined by 45±18 cm 3 (P=0.01) and SAT volume fell by 57±19 cm 3 (P=0.003). In addition, an increased MDS was associated with a decline in VAT/SAT ratio (P=0.04), but there was no association between ΔAHEI and change in VAT/SAT ratio (P=0.06). We also observed that improved intake of nuts (P=0.04), whole grains (P=0.02), and meat (P=0.005) for MDS and fruits (P=0.02) and meat (P=0.03) for AHEI were associated with a decline in VAT/SAT ratio. Conclusions: The present study demonstrates that longitudinal improvements in diet quality were associated with reduced abdominal fat accumulation, both VAT and SAT. In addition, improved dietary intake of fruits, nuts, whole grains, and meat may affect abdominal fat distribution, i.e., more likely to reduce fat accumulation in VAT relative to SAT.