Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions

Clin Nutr. 2018 Aug;37(4):1332-1339. doi: 10.1016/j.clnu.2017.06.003. Epub 2017 Jun 8.


Background & aims: Diet quality may influence non-traditional cardiovascular disease (CVD) risk factors - namely, C-reactive protein (CRP) and the ankle-brachial index (ABI). Pre-existing traditional cardiometabolic conditions may confound this association. We aimed to determine whether diet quality was associated with high-risk CRP or ABI, independently from traditional cardiometabolic risk factors.

Methods: Baseline data were analyzed from US-Hispanics/Latinos aged 18-74 y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. Included were 14,623 participants with CRP data, and 7892 participants (≥45 y) with ABI data. Diet quality was measured with the Alternate Healthy Eating Index (AHEI).

Results: Nearly 35% of Hispanics/Latinos had high-risk CRP concentration and 6.3% had high-risk ABI (peripheral artery disease (PAD): 4.2%; arterial stiffness: 2.1%). After adjusting for sociodemographic and lifestyle factors, diabetes, hypertension, hypercholesterolemia, and obesity, the odds (95% confidence interval) of having high-risk ABI were 37% (5, 44%) lower per 10-unit increase in AHEI (p = 0.018). The association was marginally significant for PAD (0.77 (0.58, 1.00); p = 0.05), and non-significant for arterial stiffness (p = 0.16). Each 10-unit increase in AHEI was associated with 21% (10, 30%) lower odds of high-risk CRP (p = 0.0002) after similar adjustments. There were no significant interactions between AHEI and age, sex, ethnicity, smoking, or pre-existing cardiometabolic conditions for associations with ABI. The association between AHEI and high-risk CRP was stronger for those with diabetes (p-interaction < 0.0001), obesity (p-interaction = 0.005), or ages 45-74 y (p-interaction = 0.011).

Conclusions: Higher diet quality is associated with lower inflammation and less adverse ABI among Hispanics/Latinos, independently from traditional cardiometabolic risk factors.

Keywords: Ankle brachial blood pressure index; Diet quality; HCHS/SOL; Inflammation; Peripheral arterial disease; Subclinical vascular disease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ankle Brachial Index
  • Cohort Studies
  • Diet / statistics & numerical data*
  • Female
  • Humans
  • Inflammation* / complications
  • Inflammation* / epidemiology
  • Male
  • Middle Aged
  • Nutritive Value
  • Odds Ratio
  • Peripheral Arterial Disease* / complications
  • Peripheral Arterial Disease* / epidemiology
  • Young Adult