(P21-27-26) Reported Dietary Intake and Diet Quality Correlate With Diurnal Blood Pressure Patterns in Adolescents With Overweight and Obesity

Objectives: The relationship between diet quality and diurnal blood pressure (BP) patterns in adolescents with overweight and obesity (OW/OB) remains uncharacterized. This study evaluated the correlation of reported dietary intake and diet quality with BP measured using 24-hour blood pressure monitoring (ABPM) in adolescents with OW/OB.

Methods: Children (n=37; 13–17 years) were enrolled in a randomized trial at the Arkansas Children’s Nutrition Center. ABPM outcomes included mean 24-hour, daytime, night-time systolic and diastolic BP (SBP/DBP, mmHg), and SBP/DBP nocturnal dipping (%). Dietary intake was assessed using a food frequency questionnaire. Diet quality was evaluated using the Total Healthy Eating Index (HEI, max score = 100) and the scores for each of its 13 individual components (higher scores = greater adherence to dietary recommendations). Associations between dietary intake, HEI and BP outcomes were examined using Spearman correlations (rho) adjusted for age, sex, and BMI z-score.

Results: Adolescents (Mean±SD: 15.6±1.3 years old) were predominantly White non-Hispanic (68%) with a BMI z-score of 1.8±0.4. The mean omega-6 to omega-3 fatty acid ratio was 10:1 (range 6:1–16:1). Omega-3 fatty acid intake (g/d, 1.0±0.5) positively correlated with SBP dipping (rho = 0.38, p = 0.027). Omega-6 fatty acid intake (g/d, 10.9±7.6) positively correlated with daytime SBP (rho = 0.37, p = 0.033). Trans-fat intake (g/d, 5.1±2.1) directly correlated with daytime SBP (rho = 0.53, p = 0.001). The mean total HEI score was 52.8±7.7 (range: 35.3–71.2) and did not correlate with ABPM measures. However, the HEI score for the consumption of dairy products inversely correlated with 24-h SBP (rho = -0.35, p = 0.045), 24-h DBP (rho = -0.36, p = 0.037), night-time SBP (rho = -0.44, p = 0.009), and night-time DBP (rho = -0.47, p = 0.005).

Conclusions: In this group of adolescents with OW/OB, overall dietary quality was suboptimal, with intake patterns marked by elevated omega-6 and with high trans-fat consumption, both of which were positively correlated with daytime SBP. In contrast, higher omega-3 fatty acid intake was associated with improved blood pressure dipping, and greater adherence to dairy product recommendations was linked to better 24-hour and nighttime blood pressure control.

Funding Sources: NIH-NIGMS P20GM109096, USDA-ARS 6026-10700-001-000D