|Lichtenstein, A. H.|
|Tuckey, K. L.|
Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/1/2010
Publication Date: 1/3/2011
Citation: Bhupathiraju, S., Lichtenstein, A., Dawson-Hughes, B., Tuckey, K. 2011. Adherence index based on the American Heart Association 2006 diet and lifestyle recommendations: associations with cardiovascular disease risk factors in the Boston Puerto Rican health study. Journal of Nutrition. 141:460-469. PMID 21270369. Interpretive Summary: This manuscript looks at the lifestyle and diet recommendations for cardiovascular disease risk reduction (CVD) and a cross-sectional study of Puerto Rican adults ages 45-75 years living in the greater Boston area. By taking basic health measurements including blood pressure, waist circumference, and others, a diet and lifestyle score was developed (AHA-DLS). This is a useful tool to measure adhearence to the AHA-DRL and may be useful in the future examining associations between diet and lifestyle behaviors and CVD risk.
Technical Abstract: In 2006, the AHA released diet and lifestyle recommendations (AHA-DLR) for cardiovascular disease (CVD) risk reduction. The effect of adherence to these recommendations on CVD risk is unknown. Our objective was to develop a unique diet and lifestyle score based on the AHA-DLR and to evaluate this score in relation to available CVD risk factors. In a cross-sectional study of Puerto Rican adults aged 45–75 y living in the greater Boston area, information was available for the following variables: diet (semiquantitative FFQ), blood pressure, waist circumference (WC), 10-y risk of coronary heart disease (CHD) (Framingham risk score), and fasting plasma lipids, serum glucose, insulin, and C-reactive protein (CRP) concentrations. We developed a diet and lifestyle score (AHA-DLS) based on the AHA-DLR. The AHA-DLS had both internal consistency and content validity. It was associated with plasma HDL cholesterol (P = 0.001), serum insulin (P = 0.0003), and CRP concentrations (P = 0.02), WC (P < 0.0001), and 10-y risk of CHD score (P = 0.01 in women). The AHA-DLS was inversely associated with serum glucose among those with a BMI < 25 (P = 0.01). Women and men in the highest quartile of the AHA-DLS had lower serum insulin (P-trend = 0.0003) and CRP concentrations (P-trend = 0.002), WC (P-trend = 0.0003), and higher HDL cholesterol (P-trend = 0.008). The AHA-DLS is a useful tool to measure adherence to the AHA-DLR and may be used to examine associations between diet and lifestyle behaviors and CVD risk.