Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions

Abstract

Diet quality may influence non-traditional cardiovascular disease (CVD) risk factors - namely, C-reactive protein (CRP) and the ankle-brachial index (ABI). Pre-existing traditional cardiometabolic conditions may confound this association. We aimed to determine whether diet quality was associated with high-risk CRP or ABI, independently from traditional cardiometabolic risk factors. Baseline data were analyzed from US-Hispanics/Latinos aged 18-74y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. Included were 14,623 participants with CRP data, and 7892 participants (≥45y) with ABI data. Diet quality was measured with the Alternate Healthy Eating Index (AHEI). Nearly 35% of Hispanics/Latinos had high-risk CRP concentration and 6.3% had high-risk ABI (peripheral artery disease (PAD): 4.2%; arterial stiffness: 2.1%). After adjusting for sociodemographic and lifestyle factors, diabetes, hypertension, hypercholesterolemia, and obesity, the odds (95% confidence interval) of having high-risk ABI were 37% (5, 44%) lower per 10-unit increase in AHEI (p=0.018). The association was marginally significant for PAD (0.77 (0.58, 1.00); p=0.05), and non-significant for arterial stiffness (p=0.16). Each 10-unit increase in AHEI was associated with 21% (10, 30%) lower odds of high-risk CRP (p=0.0002) after similar adjustments. There were no significant interactions between AHEI and age, sex, ethnicity, smoking, or pre-existing cardiometabolic conditions for associations with ABI. The association between AHEI and high-risk CRP was stronger for those with diabetes (p-interaction<0.0001), obesity (p-interaction=0.005), or ages 45-74y (p-interaction=0.011). Higher diet quality is associated with lower inflammation and less adverse ABI among Hispanics/Latinos, independently from traditional cardiometabolic risk factors.