Poorer Diet Quality Observed Among US Adults With a Greater Number of Clinical Chronic Disease Risk Factors

Abstract

Background: Obesity and chronic disease risk are significantly related to healthy lifestyle behavior, including dietary intakes. Further, the interrelated etiology of many chronic conditions supports the comorbidity in US adults to manage multiple diagnoses. The purpose of this study was to assess diet quality across varying numbers of existing conditions, including obesity, hypercholesterolemia, hyperglycemia, and hypertension. Methods: Cross-sectional analysis of data from 17 356 adults aged 45 years and older from the 2005-2016 National Health and Nutrition Examination Survey were assessed for the presence of overweight or obesity (body mass index >25 kg/m2), hyperglycemia (glycated hemoglobin >5.7%), hypercholesterolemia (>200 mg/dL), and high blood pressure (>120/80 mm Hg). Overall diet quality was assessed using Healthy Eating Index 2015 scores computed from the intakes reported during the 24-hour dietary recall collected in the mobile examination center. The total score (range 0-100) is based on the sum of 13 subscales that represent concordance with the Dietary Guidelines for Americans. Results: Few adults presented with no markers of chronic disease (n = 407), with other presenting 1 indicator (n = 1978), 2 indicators (n = 4614), 3 indicators (n = 6319), and all 4 indicators (4038). While there was no significant difference in mean energy intakes on the day of intake, those with all 4 markers of chronic disease had a significantly poorer diet quality (P