The Chain-Mediating Effect of Obesity, Depressive Symptoms on the Association between Dietary Quality and Cardiovascular Disease Risk

Abstract

In order to explore the relationship between the Healthy Eating Index (HEI-2015) and cardiovascular disease (CVD), and the mediating role of obesity and depressive symptoms, we used the data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) for further study. A total of 12,644 participants were included in the study. The HEI was derived using NHANES personal food data and USDA Food Pattern Equivalence Database (FPED) dietary data. The risk of cardiovascular disease was determined using the Framingham Heart Study’s multifactorial calculation tool. The weighted multiple logistic regression model was used to explore the association between the HEI-2015 and CVD, and the generalized structural equation was used to explore the mediating effects of obesity and depression, respectively and jointly. Higher HEI-2015 scores were associated with a lower risk of CVD compared to lower quartiles. Obesity, depressive symptoms, and their chain effects all played significant mediating roles in the association between the HEI-2015 and CVD, with proportional mediations of 9.03%, 2.23% and 0.25%, respectively. Our results suggest that higher dietary quality is associated with a lower risk of CVD, mediated by obesity, depressive symptoms, and the chain effect of obesity and depressive symptoms.

Healthy eating index-2015 and its association with the prevalence of stroke among US adults

“…The HEI is a measure of diet quality that assesses adherence to the United States Department of Agriculture’s (USDA) dietary guidelines 5 , 12 . The HEI is based on 13 components, including the intake of fruits, vegetables, whole grains, dairy, protein foods, seafood, and added sugars, as well as the ratio of unsaturated to saturated fats and sodium intake 13 , 14 . The HEI has been widely used in epidemiological studies to evaluate the association between diet quality and chronic disease outcomes, including cardiovascular disease, diabetes, and cancer 14 – 16 .…”

“…The HEI is based on 13 components, including the intake of fruits, vegetables, whole grains, dairy, protein foods, seafood, and added sugars, as well as the ratio of unsaturated to saturated fats and sodium intake 13 , 14 . The HEI has been widely used in epidemiological studies to evaluate the association between diet quality and chronic disease outcomes, including cardiovascular disease, diabetes, and cancer 14 – 16 . Although the association between diet quality and the risk of stroke has been investigated in several studies, the results have been inconsistent.…”

Oral Ionic Liquid for Transdermal Delivery and Obesity Treatment

“…It is estimated that the global economic burden used to control obesity, and its complications is two trillion U.S. dollars each year, accounting for 2.8% of global GDP . Various factors (diet, genetics, stress, sedentary, and social and environmental factors) are associated with the development of obesity. − …”