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. 2023 Aug 11;15(16):3546.
doi: 10.3390/nu15163546.

Adherence to the 2015-2020 Dietary Guidelines for Americans Compared with the Mediterranean Diet in Relation to Risk of Prediabetes: Results from NHANES 2007-2016

Pengcheng Wu  1   2 , Lili Zhang  2 , Yan Zhao  2 , Miao Xu  3 , Quan Tang  3 , Guo-Chong Chen  2 , Liqiang Qin  2
Affiliations

Adherence to the 2015-2020 Dietary Guidelines for Americans Compared with the Mediterranean Diet in Relation to Risk of Prediabetes: Results from NHANES 2007-2016

Pengcheng Wu et al. Nutrients. .

Abstract

Prediabetes presents a high-risk state for the development of various diseases and is reversible by adhering to a healthy lifestyle. We conducted this analysis to explore the associations of the Healthy Eating Index-2015 (HEI-2015) and the Alternate Mediterranean Diet Index (aMed index) with the risk of prediabetes. The data were derived from the National Health and Nutrition Examination Survey, including 20,844 participants. Multivariable-adjusted odds ratios (OR) of prediabetes and 95% confidence intervals (CI) by tertile of diet quality scores were estimated using a weighted logistic regression. Compared to those in the lowest tertile, the multivariable-adjusted OR of prediabetes for the highest tertile was 0.82 (95% CI: 0.72, 0.94; p for trend = 0.005) for HEI-2015 and 0.87 (95% CI: 0.76, 0.98; p for trend = 0.02) for the aMed index. After mutual adjustment, the association for HEI-2015 (p for trend = 0.03) but not for the aMed index (p for trend = 0.59) remained significant. Among the component food groups and nutrients, higher intakes of red and processed meat, sodium, and total saturated fatty acids were associated with a higher risk of prediabetes, while moderate alcohol consumption was associated with a lower risk. In conclusion, adherence to the 2015-2020 Dietary Guidelines for Americans, as compared with the Mediterranean Diet, appeared to be more strongly associated with a lower risk of prediabetes among adults in the United States.

Keywords: Alternate Mediterranean Diet Index; Healthy Eating Index-2015; dietary components; dietary pattern; prediabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Relationship between diet quality scores and risk of prediabetes among US adults in NHANES 2007–2016. HEI, Healthy Eating Index; aMED, alternate Mediterranean diet. Model 1 was adjusted for age (years), sex, ethnicity (Non-Hispanic White, Non-Hispanic Black, Mexican American, other ethnicities), education (less than high school, high school or equivalent, college or above), marital status (married, previously married, never married), PIR (≤1.0, >1.0–3.0, >3.0), and total energy intake (kcal/d). Model 2 was adjusted for the covariates in model 1 plus smoking status (never, former, current), drinking status (never, former, non-excessive, excessive, only for HEI-2015), and physical activity (low, moderate, high). Model 3 was adjusted for the covariates in model 2 plus body mass index (kg/m2). Finally, both diet quality scores were mutually adjusted for each other in model 3. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated using multivariable logistic regression models, taking into account the complex sampling design; p for trend values were calculated by assigning the median value to each tertile of diet quality score as a continuous variable.
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