Abstract 4146587: The Healthy Eating Index as predictor of cardiovascular health among Asian populations in the United States

Introduction/Background: The Healthy Eating Index (HEI) is an important tool to assess diet quality in the U.S. Asian American populations (AA) have specific dietary patterns. Limited research exists to determine if HEI can adequately predict cardiovascular (CV) health among AA. Hypothesis: The HEI is with a better predictor of CV risk among non-Hispanic White persons (NHW) than among AA in the U.S. Goals/Aims: To assess if HEI predicts CV risk factors among AA and NHW using the National Health and Nutrition Examination Survey 2017-2020 pre-Pandemic (NHANES). Methods/Approach: We used data from 3,770 adults from NHANES 2017-2020 who identified as race/ethnicity AA (877) or NHW (2,893). The HEI-2015 was calculated from 2-day 24-hour recalls. We used multivariate linear and logistic regression models to test associations between HEI and CV risk outcomes. Outcome variables included Body Mass Index (BMI; kg/m 2 ), overweight status (BMI ≥ 24 kg/m 2 for AA and BMI ≥ 25 kg/m 2 for NHW), hypertension (SBP≥140 mmHg and DBP≥90 mmHg), and dyslipidemia (blood cholesterol > 200mg/dL, triglycerides > 150mg/dL, LDL-cholesterol > 100 mg/dL and/or HDL-cholesterol < 40 mmol/L). Adjusted models included age, gender, education, marital status, and alcohol intake. P-values < 0.05 were considered significant. Results/Data: Asian participants were on average 46.7 (±16.6) years and NHW were 53.7 (±19.9) years. Mean HEI were 58.6 (±14.0) among AA and 51.0 (±13.8) among NHW. Among AA, 61.9% were overweight or obese, and 72.2% among NHW. Approximately 5% had dyslipidemia in both groups. Prevalence of hypertension was 5.0% for AA and 4.0% for NHW. After adjusting for demographic variables, BMI (-0.45, 95% CI -0.62 to -0.29, p<0.001) and overweight status (0.99 95% CI 0.98 to 1.00 vs. normal weight, p=0.01) were significantly associated with HEI scores among NHW, while there were no significant associations among AA. Conclusion(s): Significant associations were observed between HEI scores with BMI and overweight status among NHW, but not among AA. A limitation of these analysis is clustering of various ethnic subgroups and national origins under AAs. Additionally, the effect of diet on weight may be less pronounced among AA compared to NHW particularly due to notable differences in waist circumference. Overall, these findings support the need for diet quality assessment tools that better reflect the dietary patterns associated with CV health among AA in the US.