Diet quality and metabolic risk factors among emerging adults

Authors: ALFARO HUDAK, KATELIN - Texas A&M Agrilife; ADEMU, LILIAN - Texas A&M Agrilife; Hess, Julie; RACINE, ELIZABETH - Texas A&M Agrilife

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 6/3/2025
Publication Date: N/A
Citation: N/A

Interpretive Summary: Adolescents and young adults in the U.S. tend to consume less nutritious diets than other population groups. This study compared the diet quality of "emerging adults" ( ages 18 to 23 years) who have Metabolic Syndrome (MetS) with the diet quality of emerging adults without Metabolic Syndrome using data from the National Health and Nutrition Examination Survey (NHANES). We defined MetS as having three or more of the following criteria: waist circumference over 40 inches (men) or 35 inches (women), blood pressure over 130/85 mmHg, fasting triglyceride (TG) level over 150 mg/dl, fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women) and fasting blood sugar over 100 mg/dl. Emerging adults with MetS had significantly lower diet quality than emerging adults who did not have MetS, and a better diet was associated with less chance of having MetS or a risk factor for MetS. Nutrition and diet quality is important across the lifespan, including during early adulthood.

Technical Abstract: Objectives: Recent evidence indicates that the diet quality of emerging adults is less optimal when compared to other adults. Poor diet quality is a key risk factor for diet-related diseases, including metabolic syndrome (MetS). Nutrition during youth shapes health behaviors and outcomes later in life. However, little is known about the prevalence of MetS during emerging adulthood. The objective of this study was to examine diet quality (measured via the Healthy Eating Index 2020 [HEI-2020]) among emerging adults (18-23 y) with MetS and those without. Our secondary objective was to examine the association of diet quality (HEI-2020) with MetS. Methods: We used NHANES 2013-2020 and defined MetS according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. We calculated HEI-2020 (range: 0-100, higher scores indicating higher diet quality) using the Multivariate Markov Chain Monte Carlo (MCMC) method for our primary objective. To address our secondary objective in a supplemental analysis, we calculated HEI-2020 using the simple scoring algorithm and used adjusted logistic regression to analyze the association between HEI-2020 and MetS. Results: The majority of our sample (n=853) were non-Hispanic White (57.6%) and had a high school degree (32.2%) or some college (38.6%) as their highest level of education. One third (32.6%) had abdominal obesity and 28.9% had low HDL cholesterol. Even in this young sample, 11.9% met criteria for MetS, and 59.6% had at least one risk factor. Mean HEI-2020 in those with MetS was 45.5 (standard error [SE]: 1.0) and was significantly lower (p<0.001) than those without MetS (48.6 SE: 0.9) In adjusted logistic regression (controlling for sex and race/ethnicity), a higher HEI-2020 was significantly associated with reduced odds of meeting criteria for MetS (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.96-1.00, p<0.05) and having at least one risk factor (OR: 0.98, 95% CI: 0.96-0.99, p<0.01). Conclusions: Emerging adulthood presents heightened risk of a lower diet quality which can contribute to increased risk for cardiometabolic disease. Our findings indicate that MetS risk factors occur even at young ages, and that diet quality is lower in those with MetS, warranting increased public health attention in the emerging adult age group.