Adolescent Diet Quality, Cardiometabolic Risk, and Adiposity: A Prospective Cohort

Abstract

Objective: Examine the prospective association among diet with adolescent cardiometabolic risk (CMR) and anthropometrics.

Methods: Secondary analysis of an observational study of adolescents aged 10-16 years. Twenty-four-hour food recalls were used to calculate Healthy Eating Index-2015 (HEI-2015) scores. Anthropometrics were assessed using magnetic resonance imaging, dual-energy x-ray absorptiometry, and height/weight measurements. CMR included mean arterial pressure, homeostatic model assessment for insulin resistance, high-density lipoprotein cholesterol, and triglycerides. Associations between HEI-2015 score at baseline with follow-up adiposity and CMR were examined using regression models.

Results: A total of 192 adolescents were included. Baseline HEI-2015 scores were inversely associated with follow-up total CMR z-score (P = 0.01), homeostatic model assessment for insulin resistance (P < 0.01), waist circumference z-score (P = 0.02), body mass index percentile (P = 0.01), fat mass (P = 0.04), lean mass (P = 0.02), and visceral adipose tissue mass (P = 0.01).

Conclusions and implications: Adolescents with lower adherence to dietary guidelines and greater CMR and anthropometry measurements at baseline continued this trajectory across the observation.

Trial registration: ClinicalTrials.gov NCT02784509.

Keywords: HEI-2015; Nutrition; adiposity; adolescents; cardiometabolic risk.

Figure 1.

CONSORT Flow Diagram of Participants Included in Final Analyses

Figure 2.

HEI-2015 Component Mean Scores and Standard Deviations^a Scored out of 5(A) and 10(B) ^a Panel A components have a maximum score of 5, and Panel B components have a maximum score of 10. Higher scores indicate greater conformance with 2015–2020 Dietary Guidelines for Americans. HEI-2015 component scores of moderation are reverse scored and include refined grains, sodium, added sugars, and saturated fats.