A Traditional Mexican Diet Score, Diet Quality Scores, and Risk of Hypertension Among U.S. Adults of Mexican Heritage

Abstract

Despite the fact that existing dietary scores that capture the overall healthiness of the diet have extensively been used to study associations with risk factors for cardiovascular disease, it is questionable whether these scores are appropriate for the Hispanic/Latino U.S. population, since these metrics may not accurately capture the diet habits of ethnic/racial minority groups. In chapter 1, we adapted a traditional Mexican diet score (tMexS) based on an existing non-validated score, and we assessed its reproducibility and validity among U.S. adults of Mexican heritage in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The tMexS had satisfactory reproducibility and moderate validity correlations with nutrient intakes and biomarkers. Since the purpose of dietary scores is to assess and guide an individual’s dietary intake for the prevention of disease, the utility of the tMexS needed to be evaluated with disease endpoints. In chapter 2, we examined the association between the tMexS and risk of hypertension and changes in blood pressure (BP) among participants of Mexican heritage in HCHS/SOL. Greater adherence to a traditional Mexican diet was associated with a reduction of 0.21±0.11 mmHg in diastolic BP during a mean follow-up of 6 years, but not with the risk of hypertension. However, for tMexS components, we found 18% higher hypertension risk for each serving per day of red and processed meats, and 12% lower hypertension risk per serving per day of corn tortilla and 29% lower hypertension risk for grains. Associations between tMexS and BP were stronger among men and participants with overweight or obesity. To our knowledge, no studies have compared a diet score that measures adherence to a traditional diet against prevailing diet quality scores. In chapter 3, we compared the tMexS against three diet quality scores: the Mediterranean diet score (MeDS), the Alternate Healthy Eating Index 2010 (AHEI-2010), and the Dietary Approaches to Stop Hypertension (DASH) score in association with risk of hypertension and change in BP among U.S. adults of Mexican heritage in HCHS/SOL. We found that higher scores on AHEI-2010, but not DASH, MeDS, or tMexS, were associated with lower hypertension risk; however, tMexS reduced diastolic BP.