Cardiometabolic health, socioeconomic status, and 2019 Canada’s Food Guide Food Choices Assessment Score: findings from the Canadian Health Measures Survey

Suboptimal diets are linked to higher cardiometabolic risks and influenced by socioeconomic status. In 2019, Health Canada released an updated Canda's Food Guide (CFG) supported with Canada's Dietary Guidelines (CDG) to help Canadians achieve healthy diet. This study aims to investigate the association between food choices assessed by a Food Choices Assessment Score (FCAS) according to 2019 CFG/CDG, and socioeconomic status and cardiometabolic risk factors among Canadian adults. Dietary choices of Canadian adults (<i>n</i> = 6352) from the food frequency questionnaire data of the Canadian Health Measures Survey cycles 5 and 6 (2016-2019) were used. Canadian adults with post-secondary education and high household income were associated with higher FCAS (+6.2; 95%CI 4.2, 8.2) and (+2.1; 95%CI 0.3, 3.8), respectively. Compared with the lowest quintile of the FCAS, Canadians in the highest quintile of the FCAS had lower odds of elevated BMI (0.63; 95%CI 0.44, 0.91), elevated WC (0.51; 95%CI 0.27, 0.97) in females but not in males, elevated systolic (0.69; 95%CI 0.48, 0.97), diastolic blood pressure (0.69; 95%CI 0.50, 0.96), TC (0.59; 95%CI 0.39, 0.89), non-HDL-C (0.51; 95%CI 0.31, 0.86), LDL-C (0.60; 95%CI 0.38, 0.95), Apo-B (0.62; 95%CI 0.39, 0.96), HbA1C (0.53; 95%CI 0.31, 0.93), FBG (0.62; 95%CI 0.4, 0.94), HOMA-IR (0.60; 95%CI 0.39, 0.91), and hs-CRP (0.59; 95%CI 0.36, 0.96). HDL-C and TG were not associated with FCAS. These analyses suggest strong associations between dietary choices, aligned with 2019 CFG/CDG as measured by the FCAS, and socioeconomic status and better cardiometabolic health among Canadian adults.