Healthy eating index and cardiovascular risk factors among Iranians

To determine the associations between Healthy Eating Index (HEI) and cardiometabolic risk factors among Iranian population.

This cross-sectional study was conducted on 9568 Iranians who participated in Isfahan Healthy Heart program (IHHP). Dietary intakes were assessed using a 48-item food frequency questionnaire (FFQ). HEI scores were calculated based on the number of food groups, different kinds of fat intakes, sodium intake, and dietary diversity score in 10 separate components. The assessment of anthropometric and biochemical variables was done using standard protocols.

Mean ± SD of the HEI score was 39.1 ± 5.2. Those in the highest quintile of HEI consumed more fruits, vegetables, and dairy products and had lower total fat, saturated fatty acid, cholesterol, and sodium intakes. HEI scores were inversely associated with serum C-reactive protein (CRP) levels in both women and men (β = -0.07 for both men and women; p < 0.001). Women in the highest quintile of HEI had the lowest mean values of systolic blood pressure and apolipoprotein B (mean ± SD = 112.7 ± 20.2, 112.6 ± 20.5, 110.6 ± 19.5 mmHg; p = 0.001 and mean ± SD = 99.3 ± 26.0, 100.1 ± 26.6, 97.7 ± 23.1 (mg/dL); p = 0.04, respectively). HEI weakly correlated with various cardiovascular risk factors.

The low mean of HEI scores in this sample indicates the need to improve diet quality. Higher HEI scores were associated with healthier dietary habits and a weak inverse association was found between HEI scores and serum levels of CRP, apolipoprotein B, and systolic blood pressure.