Longitudinal associations of the alternative healthy eating index with coronary artery calcification and pericardial adiposity in US adults with and without type 1 diabetes

BACKGROUND AND AIM

Long-term associations between the alternative healthy eating index (AHEI) score and two predictive indicators for CVD, pericardial adipose tissue (PAT) and coronary artery calcification (CAC) volume, are lacking. Our study aims to investigate the longitudinal associations of the AHEI score with measures of CAC and PAT in adults with and without type 1 diabetes (T1D).

METHODS AND RESULTS

The prospective Coronary Artery Calcification in T1D (CACTI) study included 652 people with T1D and 764 people without diabetes (non-DM) (19-56 years old) and was conducted in 2000-2002, 2003-2004, and 2006-2007. At each visit, food frequency questionnaires were collected and PAT and CAC were measured using electron beam computed tomography. Two variables were used for CAC analyses: a continuous variable for the square-root tranformed volume (SRV) for each visit and a second variable identified CAC progression from baseline to visit 3. Mixed effect models and a logistic regression model were used to conduct statistical analyses. A one-point increase in the AHEI score was significantly associated with a -0.12 cm3 (95% CI: -0.17, -0.08; p-value<0.0001) decrease in PAT volume in combined analyses, a -0.16 cm3 (95% CI: -0.22, -0.09; p-value<0.0001) decrease in the non-DM group, a marginally significant -0.07 cm3 (95% CI: -0.14, 0.002; p-value = 0.0571) decrease in the T1D group, and was not associated with either CAC outcome.

CONCLUSION

The AHEI score is inversely associated with PAT; the association revealed greater magnitude of PAT reduction in the non-DM group. The AHEI score did not associate with CAC progression.

The association of healthy lifestyle score and risk of non-alcoholic fatty liver disease

BACKGROUND

The combined role of important environmental factors as a single lifestyle index in predicting non-alcoholic fatty liver disease (NAFLD) risk is not fully assessed. Therefore, we aimed to investigate the association of healthy lifestyle factor score (HLS) with the odds of NAFLD in Iranian adults.

METHODS

This case-control study was conducted on 675 participants, aged ≥ 20-60 years, including 225 new NAFLD cases and 450 controls. We measured dietary intake information using a validated food frequency questionnaire and determined diet quality based on the alternate healthy eating index-2010(AHEI-2010). The score of HLS was calculated based on four lifestyle factors, including a healthy diet, normal body weight, non-smoking, and high physical activity. An ultrasound scan of the liver was used to detect NAFLD in participants of the case group. Logistic regression models were used to determine the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of HLS and AHEI.

RESULTS

Mean ± SD age of the participants were 38.13 ± 8.85 years. The Mean ± SD HLS in the case and control groups was 1.55 ± 0.67 and 2.53 ± 0.87, respectively. Also, the Mean ± SD AHEI in the case and control groups was 48.8 ± 7.7 and 54.1 ± 8.1, respectively. Based on the age and sex-adjusted model, the odds of NAFLD were decreased across tertiles of AHEI (OR:0.18;95%CI:0.16-0.29,P_trend<0.001) and HLS(OR:0.03;95%CI:0.01-0.05,P_trend<0.001). Also, in the multivariable model, the odds of NAFLD were decreased across tertiles AHEI (OR:0.12;95%CI:0.06-0.24,P_trend<0.001) and HLS(OR:0.02;95%CI:0.01-0.04,P_trend<0.001).

CONCLUSIONS

Our findings reported that higher adherence to lifestyle with a higher score of HLS was associated with decreased odds of NAFLD. Also, a diet with a high AHEI score can reduce the risk of NAFLD in the adult population.

Alternate healthy eating index and risk of depression: A meta-analysis and systemematic review

Objective: The alternate healthy eating index has been associated with depression. However, results reported in the literature are inconsistent. The present meta-analysis determined the association between the AHEI or AHEI-2010 and depression in adults without chronic disease.Methods: Nine electronic databases and the reference lists of identified studies were systematically searched for studies published up to December 2016. Articles examining the association between depression and the AHEI or AHEI-2010 in adults were included.Results: We identified eight observational studies with 10 effect sizes involving a total of 38,360 participants. When both the AHEI and AHEI-2010 were considered, the dietary index score was associated with a significant reduction in depression risk (odds ratio OR=0.70, 95% confidence interval CI=0.57-0.87). However, the subgroup analysis indicated that the AHEI-2010 (OR=0.69, 95% CI=0.56-0.89), but not the AHEI (OR=0.60, 95% CI=0.30-1.17), was significantly associated with reduced odds of depression. The heterogeneity among the included studies was significantly high (Q=48.9, P<0.01, I²=81.60%).Discussion: Our findings suggest that the AHEI-2010 is associated with a reduction in depression risk. However, well-designed randomized controlled trials must be conducted to confirm the causal relationship between the AHEI-2010 and depression.