Relationship between Dietary Quality and Cardiometabolic Risk in a College Population

OBJECTIVES: Early adulthood plays a key role in the development of healthy eating habits, however, the association between dietary indices and cardiometabolic risk is not well investigated in younger adults. This study assessed diet quality and its relationship with cardiometabolic risk of university students. METHODS: Between 2007–21 students (18–24 years) were recruited from a northeast university as part of the ongoing College Health and Nutrition Assessment Survey. All participants were enrolled in a semester-long nutrition course. Students completed a 3-day dietary food record; nutrient intake was calculated using online analysis software. A modified Healthy Eating Index (mHEI) score was assigned (0–100) based on HEI-2005, -2010, and -2015 categories using daily intakes of fruit, vegetables, grains, meat and beans, fatty acids, protein, milk, saturated fat, sodium, and empty calories. After excluding cases with missing data and stratifying for sex, mHEI scores were grouped into quartiles. Chi-square analyses assessed the relationship between ascending mHEI quartiles (Q1-4) with prevalence of metabolic syndrome (MetS) and individual MetS criterion. RESULTS: The final sample (n = 6,214) of students included mostly first- or second-year students (85%) but only 6% were nutrition majors (n = 455). About a third (29%) of students met 1 criterion for MetS and 14.5% met ≥ 2 (n = 1,167.) More men than women met 1 or 2 MetS criteria (43.3% vs. 35.5%, 17.1% vs. 12.9%, respectively, both p < .001). Mean mHEI score was 64.4 ± 12.6. Participants in mHEI Q1 vs. Q4 were more likely to meet ≥ 2 MetS criteria (22.7% vs. 15.0%, X2 = 30.0, p < 0.0001). Moreover, a higher proportion of mHEI Q1 v. Q4 met the criteria for fasting plasma glucose (7.4% v. 4.0%, X(2)( )= 29.0, p < 0.001) and blood pressure (22.8% v. 19.1%, X(2)( )= 8.8, p = 0.04). CONCLUSIONS: Findings support a relationship between dietary quality and cardiometabolic risk in the college population and suggest a need for further research on the dietary habits of young adults for disease prevention earlier in the life cycle. FUNDING SOURCES: New Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1,010,738.