(PTFS16-06-26) Diet Quality and Cardiometabolic Health Among Young Adults in the U.S.: Findings From NHANES 2011–2020

Objectives: Cardiometabolic risk factors often emerge in early adulthood but cluster heterogeneously. Building an understanding of relationships between risk clusters and dietary intake patterns may help to illuminate the potential for tailored nutritional strategies to support health. We evaluated cardiometabolic phenotypes among U.S. young adults (18–39 years) and examine associations with diet quality.

Methods: We conducted a cross-sectional study of young adults from NHANES 2011–2020, including participants with complete cardiometabolic and dietary data (initial n = 7,421; analytic n = 7,080). Latent class analysis was conducted using six indicators: obesity, central obesity, elevated blood pressure, prediabetes (HbA1c), high total cholesterol, and low HDL cholesterol to derive cardiometabolic phenotypes. Diet quality was assessed using the Healthy Eating Index 2020 (HEI-2020) scores from 24-hour dietary recalls. Survey-weighted multinomial regression estimated odds ratios (OR) with 95% confidence intervals (CI) for associations between HEI-2020 scores and phenotypes, adjusting for survey cycle, demographic, and lifestyle factors.

Results: 52.5% of young adults exhibited the metabolically favorable phenotype, characterized by low cardiometabolic risk and higher HDL levels. Three unfavorable phenotypes were observed in 47.5%: adiposity-predominant (20.9%), clustered metabolic risk (19.8%), and lipid-predominant (6.8%). A 10-point higher HEI-2020 score was associated with lower odds of the adiposity-predominant phenotype (OR, 0.87; 95% CI: 0.80–0.95) and the clustered metabolic risk phenotype (OR, 0.84; 95% CI:0.78–0.91) compared with the metabolically favorable phenotype. No association was observed for the lipid-predominant phenotype (OR, 0.94; 95% CI: 0.83–1.06). Higher intake of fruits, vegetables, whole grains, and seafood/plant proteins, as well as lower intake of saturated fats, were associated with lower odds of the clustered metabolic risk phenotype. In contrast, higher added sugar intake was associated with higher odds of this phenotype (OR = 1.06, 95% CI: 1.03–1.09).

Conclusions: Diet quality improvement in early adulthood may help to reduce cardiometabolic risk that is not predominantly related to lipid levels.

Funding Sources: None