|Camhi, Sarah - University Of Massachusetts|
|Evans, E. Whitney - Brown University|
|Hayman, Laura - University Of Massachusetts|
|Lichtenstein, Alice - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Must, Aviva - Tufts University|
Submitted to: Preventive Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/27/2015
Publication Date: 5/1/2015
Citation: Camhi, S.M., Evans, E., Hayman, L.L., Lichtenstein, A.H., Must, A. 2015. Healthy eating index and metabolically healthy obesity in U.S. adolescents and adults. Preventive Medicine. 77:23-27. https://doi.org/10.1016/j.ypmed.2015.04.023.
DOI: https://doi.org/10.1016/j.ypmed.2015.04.023 Interpretive Summary: Our objective is to determine whether dietary quality differs between metabolically-healthy-obesity (MHO) and metabolically-abnormal-obesity (MAO) in a nationally representative sample. NHANES data were used to identify obese adolescents and adults. MHO was defined as fewer than 2 abnormal cardiometabolic risk factors (elevated blood pressure, triglycerides, glucose, low HDL-C; or on medications). Healthy Eating Index 2005 (HEI-2005) scores were calculated from 24-hour recall data. A higher HEI-2005 score indicates greater compliance with current dietary recommendations. Compared to MAO, MHO women and men age 12-18 years had higher total HEI-2005 scores and milk scores, as well as higher scores from calories from solid fats, alcoholic beverages and added sugars. The overall HEI-2005 score suggested MHO participants exhibited better compliance with the Dietary Guidelines for Americans than MAO participants. Compared with MAO, MHO women age 19-44 years had higher total HEI-2005 scores, and whole fruit, whole grain and meat and bean scores, which also suggests better compliance with the Dietary Guidelines for Americans. No significant differences were observed between MHO and MAO for total HEI-2005 scores in men age 19-44 years, or either women or men age 45-85 years. These data suggest potential intervention targets to improve cardiometabolic risk, particularly in those who have experienced excess weight gain.
Technical Abstract: Objective. To determine whether dietary quality differs between metabolically-healthy-obese (MHO) and metabolically-abnormal-obesity (MAO) in a nationally representative sample. Methods. National Health and Nutrition Examination Survey (NHANES) data (2007-2008; 2009-2010) were used to identify obese adolescents (>/=95th body mass index (BMI) %tile) and adults (>/=30 kg/m^2). MHO was defined as <2 abnormal cardiometabolic risk factors (elevated blood pressure, triglycerides, glucose, low high density lipoprotein cholesterol (HDL-C); or on medications). Healthy Eating Index 2005 (HEI-2005) scores were calculated from 24-hour recall data. General linear regression models determined whether HEI-2005 scores differed between MHO and MAO after controlling for age, race, gender, NHANES wave, BMI, physical activity and health status by age group (12-18; 19-44; 45-85 years). Results. Compared with MAO, MHO adolescents (n = 133) had higher total HEI-2005 score, higher milk scores, and higher scores from calories from solid fats, alcohol beverages and added sugars. MHO women 19-44 years (n = 240) had higher total HEI-2005, higher whole fruit, higher whole grain and higher meat and bean scores compared with MAO. No significant differences were observed between MHO and MAO for HEI-2005 total scores in men 19-44 years, or adults 45-85 years. Conclusion. MHO adolescents and women 19-44 years have better dietary compliance to the U.S. guidelines when compared with MAO, suggesting potential intervention targets to improve cardiometabolic risk within obesity.