Associations between diet quality scores and central obesity among adults in Puerto Rico

Background Adults in Puerto Rico experience an excessive burden of central obesity. It remains unknown which dietary components are more strongly associated with central obesity in this high-risk group. We aimed to evaluate the relationship of the Mediterranean diet (MeDS) and Alternate Healthy Eating Index 2010 (AHEI) with central obesity in the Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) cross-sectional study. Methods Data from PRADLAD participants (ages 30-75 years) were used (n = 166). Dietary intake was assessed by food frequency questionnaire. The MeDS [nine components; range: 0 (lowest) to 9 (highest observance of a Mediterranean-like diet)] and AHEI [11 components; range: 0 (lowest) to 110 (highest diet quality)] were defined. Daily intake of foods and beverages within each MeDS component was ranked by contribution to total energy intake. Multivariable logistic regression was used to evaluate associations between MeDS and AHEI with central obesity (waist circumference > 102 cm males, > 88 cm females). Results Mean +/- SD MeDS was 4.46 +/- 1.77 and AHEI was 60.2 +/- 11.1. Traditional foods representative of the MeDS included potatoes, root vegetables, fruit juice, avocados, bread, oatmeal, beans, chicken, seafood, low-fat milk, cheese, eggs and beer. Adjusted odds ratios and 95% confidence intervals of central obesity were 0.78 (0.63-0.97) per unit increment of MeDS and 0.61 (0.42-0.90) per 10-unit increment of AHEI. Conclusions Higher adherence to MeDS or AHEI was associated with lower central obesity in adults in Puerto Rico. Consuming traditional foods reflecting these dietary patterns (i.e., Mediterranean-like) may reduce central obesity in high-risk populations.