N° 42 | February 2010

Healthy Eating Index and abdominal obesity

More than one billion adults worldwide are overweight with about one-third of them obese1. Overweight and obesity are associated with increased risk of multiple chronic diseases and potentially reduced length and quality of life. Environmental, genetic, and behavioural patterns are key contributors to this epidemic. However, the ultimate Reason for the disease is a progressive, positive energy balance. Diet is a modifiable risk factor for obesity. This article2 focused on studying relationships between abdominal adiposity and dietary quality. A secondary data analysis was conducted with the third National Health and Nutrition Examination Survey (NHANES III) data for this purpose.

Measuring abdominal adiposity and the Healthy Eating Index (HEI) and HEI component scores among US adults

Standardized interviews that collected 24 hour recalls and physical examinations that recorded Waist Circumference (WC) measures were conducted by trained professionals during NHANES III. This study included non-pregnant NHANES III participants 20 years and older with HEI and WC data (n 15 658). The HEI data were based on 24 hour recall data and are publically available at http://www.cdc.gov/nchs/nhanes.htm. The total HEI score and ten HEI component scores were studied in relation to abdominal adiposity. The component scores were the following nutrition measures: (1) dairy, (2) fruit, (3) grain, (4) meat, (5) vegetable, (6) total fat, (7) saturated fat, (8) sodium, (9) dietary cholesterol, and (10) variety. WC values were utilized to measure abdominal adiposity, with abdominal obesity defined as a WC > 102 cm for men and > 88 cm for women.

Dietary measures related to abdominal obesity risk

The composite HEI score, saturated fat component score, variety component score, and fruit component score were related with risk of abdominal obesity. The rates of abdominal obesity were higher among women compared with men in this study, with more than one-third of the total sample with abdominal obesity. Improved overall dietary quality, measured by the composite HEI score, was related to reduced risk of abdominal obesity for both men and women. Lower saturated fat intake and greater dietary variety were associated with reduced abdominal obesity risk for men and higher fruit intake and was related to reduced abdominal obesity risk for women. Thus, overall dietary quality, as well as specific nutrition measures are related to abdominal adiposity and risk of abdominal obesity based on this study.

Implications for practice

Although the ultimate defense against abdominal adiposity is a diet and physical activity that result in energy balance, this study indicates that food consumption associated with improved dietary quality may be one mechanism to fight abdominal obesity. Further, gender differences appear to exist, with men benefiting from reduced saturated fat intake and greater dietary variety, and women benefiting from fruit intake that meets recommendations. Dietary intake that follows dietary recommendations appears to protect against abdominal obesity based on this study. These results are important because abdominal obesity has been associated with several chronic diseases and increased mortality risk3.

  1. Obesity and Overweight. World Health Organization. Global strategy on diet, physical activity and health. Available at: http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/print.html.
  2. Tande DL, Magel R, Strand BN. Healthy Eating Index and a bdominal obesity. Public Health Nutrition. Public Health Nutrition. 2009 August 5:1-7. [Epub ahead of print]
  3. Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and risk of all-cause, cardiovascular, and cancer mortality: Sixteen years of follow-up in US women. Circulation. 2008; 117:1658-1667.
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