Alternative Healthy Eating Index as a predictor of cardiovascular disease

Evaluation of the Alternative Healthy Eating Index as a predictor of 10-year cardiovascular disease risk in a group of Iranian employees

Hariri et al., JHND Early View


Noncommunicable diseases, of which almost half are some form of cardiovascular disease (CVD), have overtaken communicable diseases as the world’s major disease burden. There is growing evidence that indices of diet quality could have an association with a decreased risk of CVD in several countries. We aimed to examine the association between diet quality, as measured by the Alternative Healthy Eating Index (AHEI), and 10-year predicted CVD risk based on the Framingham Risk Score (FRS) in a group of Iranian employees.


A cross-sectional descriptive study was conducted on 296 (232 male, 64 female) employees aged ≥30 years selected by nonrandom sampling. AHEI was calculated according to a food frequency questionnaire with complementary questions on intake of cooking fats and oils among households. The 10-year risk of CVD was calculated based on FRS. Total and high-density lipoprotein-cholesterol, fasting blood sugar and blood pressure were measured to help in the calculation of FRS.


AHEI did not have a significant relationship with FRS (r = −0.02, P = 0.67). However, some of its components, such as the intake of nuts and soy groups (r = −0.11, P = 0.04) and fruits (r = −0.14, P= 0.01), had a significant relationship with a reduced risk of CVD. According to stepwise multiple linear regression results, for every single increase in the intake of fruit servings, there would be a 0.14 reduction in the 10-year CVD risk score (β = −0.14, P = 0.01).


The present study showed no significant relationship between AHEI and the 10-year predicted risk of CVD among Iranian employees.


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