The cardiovascular health diet index and incidence of metabolic syndrome: a prospective cohort study of Iranian adults

Emerging evidence suggests the that Cardiovascular Health Diet Index(CHDI) may serve as a predictor of cardiovascular diseases risk; Therefore, the current study aimed to investigate the association between CHDI score and the risk of metabolic syndrome(MetS). The present prospective cohort study included 4,628 adults (aged ≥ 18 years) with complete nutritional data from the 3rd and 4th phases of the Tehran Lipid and Glucose Study (TLGS), with follow up through 7th phase. Dietary intakes were collected using a validated 168-item food frequency questionnaire to compute the CHDI score. To estimate the risk of MetS across quartiles of CHDI scores, multivariable-adjusted Cox regression model were employed to report the hazard ratios (HRs) with 95% confidence intervals(95%CIs). The mean±standard deviation(SD) for age and body mass index of the study population(40.4% men) were 36.2 ± 12.8 years and 25.5 ± 4.28 kg/m2, respectively. Median (25th to 75th interquartile range) of CHDI score in the overall population was 71.0 (63.3–78.8). The incidence of MetS was 35.7% during 9.33 years of follow-up. In the multivariable model, after adjusting for age, sex, smoking, physical activity, energy intake, education status, marital status, occupation status, baseline values of fasting plasma glucose, waist circumference, blood pressure, and triglycerides/HDL-C the risk of MetS was reduced by 20% across the quartiles of CHDI score (HR = 0.80; 95%CI:0.70–0.93, P-trend = 0.003). Also, each one SD increment in CHDI score was inversely associated with the risk of MetS(HR = 0.92, 95%CI: 0.88–0.97, P-value = 0.003). Our results demonstrate that a higher adherence to a diet with greater CHDI score may be associated with reduced risk of MetS among Iranian adults.