(P26-54-26) Chinese Healthy Eating Index-2022 (CHEI) Prediction of Cardiovascular Risk Factors Among American Adults by NHANES 2017–2020 Pre-pandemic

Objectives: Previous evidence shows that associations between commonly used diet quality assessment tools, including the Healthy Eating Index and the Mediterranean Diet Score, and cardiovascular disease (CVD) risk factors differ by race/ethnicity. This study examined associations between the CHEI (a 0–100 diet quality score based on traditional Chinese healthy eating patterns, where higher scores reflect better adherence) and major CVD risk factors, and whether these varied by race/ethnicity among U.S. adults.

Methods: We analyzed NHANES 2017-2020 pre-pandemic data among non-pregnant adults ≥18 years with complete two-day dietary recalls. Diet quality was assessed using the CHEI. Overweight/obesity was BMI ≥ 23 kg/m² for Asian Americans and ≥ 25 kg/m² for all others, hypertension was SBP ≥ 130 mmHg or DBP ≥ 80 mmHg, diabetes was self-reported, and dyslipidemia was abnormal total cholesterol, triglycerides, LDL, or HDL. Survey-weighted logistic regression models examined associations between standardized diet scores and CVD risk factors across Hispanic, non-Hispanic White, non-Hispanic Black, and Asian adults, adjusting for age and gender (partially adjusted), as well as other sociodemographic and behavioral covariates (fully adjusted) and testing interactions by race/ethnicity.

Results: The analytic sample included 4,624 adults (22.0% Hispanic, 37.6% non-Hispanic White, 29.3% non-Hispanic Black, 11.0% non-Hispanic Asian). Higher CHEI scores were associated with lower odds of overweight/obesity in both the partially adjusted model (OR=0.88, 95% CI: 0.80–0.98) and the fully adjusted model (OR=0.84, 95% CI: 0.74–0.97). Higher CHEI was associated with lower odds of hypertension (OR=0.87, 95% CI: 0.77–0.99) and with lower odds of dyslipidemia (OR=0.89, 95% CI: 0.80-0.99) in the partially adjusted model, but these were attenuated after full adjustment. No significant associations were observed for diabetes, and no significant interactions by race/ethnicity were detected. (p >0.10).

Conclusions: The CHEI may serve as a useful alternative diet quality index, given its consistent inverse association with overweight/obesity across racial/ethnic groups in a representative sample of U.S. adults.

Funding Sources: N/A