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Brain & Heart The relationship between LE8 score and ASCVD

specifically on the initial day of the study. The Healthy diagnoses of any myocardial infarction, angina pectoris,
Eating Index-2015 (HEI-2015), serving as a metric for congestive heart failure, stroke, or CHD were reported.
diet quality, was computed with a scale ranging from
0 to 100, where elevated scores signify improved diet 2.5. Covariates
quality. The HEI-2015 scores were utilized as a surrogate During home interviews, demographic characteristics,
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for evaluating healthy dietary patterns, derived from a such as age, ethnicity, highest level of education, self-
1 -day 24-h dietary recall. HEI-2015 scores, constituting reported sex, race, marital status, and annual household
st
a 13-component index, spanned from 0 to 100, with income, were collected. Participants were categorized
elevated scores reflecting greater adherence to a healthy into four age groups: 20 – 39 (young adulthood), 31 – 50
diet. The components comprised various dietary elements, (middle age), 51-65, or ≥66 years (older age). Race and
including total fruit, whole fruit, grains, total vegetables, ethnicity information, as reported by the participants,
beans, dairy, whole grains, plant protein, total protein followed NHANES protocols and included categories, such
foods, seafood, fatty acids, refined grains, sodium, and as NH Asian, NH black, NH white, Mexican American,
empty calories. Participants were stratified based on or multiracial groups. Family income level was assessed
their HEI-2015 score: ≤50 for poor health, 51 – 80 for using a monthly poverty level index, where participants
intermediate health, and >80 for ideal health. Certain reported the total family income for the previous month
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variables necessary for calculating these components in dollars. This variable indicated the ratio of reported
were directly sourced from the Food Patterns Equivalents monthly income to the poverty threshold. Household
Database (FPED) and NHANES totals files. The FPED poverty status was established by comparing monthly
and NHANES Total Nutrient Intake datasets provided family income to poverty thresholds set by the Department
the following components directly used in computing of Health and Human Services and is classified into very
HEI-2015: data on total fruit, whole grains, dairy, refined low income (<1.0), low income (1.01 – 2.0), low middle
grains, and added sugars, as well as sodium and saturated income (2.01 – 3.0), middle income (3.01 – 4.0), and high
sats (Table S2).
income (>4.0).
Physical activity was assessed through a 3-day scale,
transforming activity duration into weekly minutes of 2.6. Statistical analysis
moderate- or higher-intensity physical activity. Sleep Descriptive statistics were utilized to summarize the
health was evaluated by self-reported usual sleep duration. frequency distributions, employing corresponding
Tobacco use, aligned with the AHA’s nicotine exposure weighted proportions and stratified by ASCVD and non-
definition, included inquiries about current/former/non- ASCVD status. The statistical analyses followed NHANES
cigarette-smoker status and cohabitation with regular analysis and reporting standards, incorporating sample
cigarette smokers (Table S1). 15 weights, stratification, and clustering considerations
as stipulated. Continuous variables were expressed as
2.3.2. Health factors assessment
mean (95% confidence interval [CI]), while categorical
Health factors underwent assessment following NHANES variables were delineated as counts (percentages). Baseline
protocols. BMI (kg/m²) was calculated by dividing characteristics between the two groups based on CVH were
the weight (kg) by the square of the standing height compared using a t-test for continuous variables and a χ
2
(m ). Systolic and diastolic blood pressure values were test for categorical variables, respectively. The relationship
2
determined as the mean of all available measurements between LE8 and ASCVD was assessed using multivariate
at the baseline assessment. Enzymatic methods were linear regression. All statistical analyses were performed
employed to measure serum cholesterol, while non-high- using Stata SE, version 18, and a two-sided p-value of <0.05
density lipoprotein (HDL) cholesterol was determined by was deemed statistically significant.
subtracting HDL cholesterol from the total cholesterol
value. Glycated hemoglobin levels were measured using 3. Results
high-performance liquid chromatography methods.
Comprehensive details regarding each CVH metric, 3.1. Characterization of the sample
including the scoring algorithm, are available in the The study population consisted of 5042 individuals,
supplementary file and in previous studies. 15 representing a total of 102,388,285 individuals, with
and without ASCVD. Within the ASCVD subgroup, the
2.4. Main outcome measure average age was 66.1 years (95% confidence interval [CI]:
The assessment of ASCVD prevalence involved participants 65.44 – 66.90), while in the non-ASCVD subgroups,
completing a self-administered questionnaire, where the it was 32.40 years (95% CI: 32.0 – 32.80), with females

Volume 2 Issue 2 (2024) 3 doi: 10.36922/bh.2915