Dietary Quality Evidenced by the Healthy Eating Index and Cardiovascular Disease Risk Factors in Kuwaiti Schoolchildren

Abdulaziz Kh Al-Farhan; Lorraine J Weatherspoon; Karin A Pfeiffer; Wei Li; Joseph J Carlson

doi:10.3390/nu16081243

Dietary Quality Evidenced by the Healthy Eating Index and Cardiovascular Disease Risk Factors in Kuwaiti Schoolchildren

Nutrients. 2024 Apr 22;16(8):1243. doi: 10.3390/nu16081243.

Authors

Abdulaziz Kh Al-Farhan^{1

2}, Lorraine J Weatherspoon¹, Karin A Pfeiffer³, Wei Li⁴, Joseph J Carlson^{1

5}

Affiliations

¹ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
² The Public Authority for Applied Education and Training, The College of Nursing, Shuwaikh 23167, Kuwait.
³ Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA.
⁴ Department of Dietetics & Nutrition, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
⁵ Department of Radiology, Michigan State University, East Lansing, MI 48824, USA.

Abstract

Background: Poor dietary quality is associated with adiposity and other risks of cardiovascular disease (CVD) in children. In Kuwait, although children's food choices are a concern, no studies have evaluated dietary quality relative to the risk of CVD in Kuwaiti schoolchildren. This study hypothesized that dietary quality using the Healthy Eating Index (HEI) is associated with CVD risk factors in children and that there are associated sex differences.

Objective: Our main objective was to evaluate the dietary quality of schoolchildren and investigate whether poor HEI scores are associated with CVD risk and if there are sex differences.

Methods: This was a cross-sectional study of Kuwaiti fifth graders (n = 313; 53% girls; mean age = 10.4 ± 0.4 years) who completed an adapted Block Kids 2004 food frequency questionnaire. Anthropometric, blood pressure, and biochemical data were also measured. HEI-2010 and HEI-2015 scores were calculated.

Statistics: A general linear model and logistic regression were applied, controlling for moderate-vigorous physical activity (MVPA) and screen time (ST).

Results: The total HEI-2010 and HEI-2015 scores were 58 and 52 points, respectively; a trend analysis indicated that more girls than boys had poor (≤50 points) HEI-2015 scores (p < 0.063). The maximum scores for total vegetables (p < 0.001), dairy (p < 0.034), and fatty acids (p < 0.01) were significantly higher in girls, while the maximum scores for whole grains (p < 0.046) and protein (p < 0.006), but not sodium (p < 0.009), were higher in boys. Obesity was inversely associated with poor total HEI 2010 and HEI 2015 scores (OR: 0.347, 95% CI: 0.234 - 0.516, p < 0.001 and OR: 0.561, 95% CI: 0.391-0.805, p < 0.002, respectively). However, the correlation was lost after adjustment for possible confounding factors.

Conclusions: Dietary quality for children overall in this study was low, and there was only a weak association between poor scores and elevated blood pressure and none between scores and obesity. These findings have public health implications and warrant further investigation and attention.

Keywords: CVD risk factors; diet quality; schoolchildren.

MeSH terms

Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / etiology
Child
Cross-Sectional Studies
Diet / statistics & numerical data
Diet, Healthy* / statistics & numerical data
Exercise
Female
Heart Disease Risk Factors*
Humans
Kuwait / epidemiology
Male
Risk Factors
Sex Factors

Grants and funding

This research received no external funding.