Diet quality scores associated with improved cardiometabolic measures among African American adolescents

Kirstie Ducharme-Smith; Tammy M Brady; Diane Vizthum; Laura E Caulfield; Noel T Mueller; Summer Rosenstock; Vanessa Garcia-Larsen

doi:10.1038/s41390-021-01893-w

Diet quality scores associated with improved cardiometabolic measures among African American adolescents

Pediatr Res. 2022 Sep;92(3):853-861. doi: 10.1038/s41390-021-01893-w. Epub 2021 Dec 16.

Authors

Kirstie Ducharme-Smith¹, Tammy M Brady², Diane Vizthum³, Laura E Caulfield¹, Noel T Mueller⁴, Summer Rosenstock⁵, Vanessa Garcia-Larsen⁶

Affiliations

¹ Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Pediatric Hypertension Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ The Institute for Clinical and Translational Research, The Johns Hopkins Hospital, Baltimore, MD, USA.
⁴ Program in Cardiovascular and Clinical Epidemiology, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Social and Behavioral Interventions, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁶ Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. vgla@jhu.edu.

Abstract

Background: The Reversing the Negative cardiovascular Effects on Weight (ReNEW) Clinic is a prospective cohort study in children and adolescents (≤21 years) at the Johns Hopkins Children's Center.

Methods: Cross-sectional analysis between diet quality using the Alternative Healthy Eating Index (AHEI-2010), pro-inflammatory potential using the Children's Dietary Inflammatory Index (C-DII), and cardiometabolic outcomes. AHEI-2010 and C-DII scores were assessed by median intake determined from the sample distribution and associated with cardiometabolic measures using linear regression models. Changes in measures were evaluated in a sub-sample of participants invited to attend follow-up visits due to the presence of hypertensive blood pressure (n = 33).

Results: Participants (n = 90) reported an average energy intake of 1790 kcal/day (SD ± 734), AHEI-2010 score of 55.04 (SD ± 9.86) (range: 0 to 110) and C-DII score of -0.12 (±0.86) (range -5 to 5). Participants with higher quality/anti-inflammatory diets trended towards more favorable cardiometabolic measures at baseline. Among the sub-sample (n = 33), there was a significant reduction in total energy (m = -302 kcal/day; p-value= 0.03) but no change in AHEI-2010 (p-value = 0.73) or C-DII score (p-value = 0.85) over follow-up.

Conclusions: Despite stable diet quality scores, outpatient dietary and behavioral counseling may be an effective tool to reduce energy intake in youth with overweight/obesity and elevated blood pressure.

Impact: Diet quality scores among obese, hypertensive, African American adolescents were low and reflect a pro-inflammatory diet. Reported intake was negligible for fruits, whole grains, nuts, and legumes, and well above the daily limit for sodium and saturated fat. Participants with high quality/anti-inflammatory diet quality scores trended toward improved cardiometabolic measures. Outpatient dietary counseling resulted in reduced total energy intake.

Trial registration: ClinicalTrials.gov NCT03816462.

MeSH terms

Adolescent
Black or African American*
Cardiovascular Diseases*
Child
Cross-Sectional Studies
Diet
Humans
Obesity
Prospective Studies
Sodium

Substances

Sodium

Associated data

ClinicalTrials.gov/NCT03816462