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Brain & Heart The relationship between LE8 score and ASCVD

Likewise, in a study conducted within a community prevalent among rural residents. Hence, adults continue to
setting, individuals characterized by a healthy lifestyle, as face a heightened risk of obesity. 29
denoted by an ideal LS7 score, exhibited a 55% decreased Our research also highlights the considerable health
risk of heart failure in comparison to those with an burdens posed by diet-related obesity and hyperlipidemia
inadequate LS7 score. Moreover, a separate investigation in ASCVD and the critical need to prioritize nutrition in
24
involving older British men illustrated the benefits of LS7 clinical care, health policy, and advocacy in research. In
30
indicators on the incidence of stroke. At present, only addition, considering previous research indicating a link
25
a few studies have utilized LE8 to assess CVH, and there between high-cholesterol diets and exogenous obesity, as
have been no investigations into the relationship between evidenced by elevated BMI, it is essential to emphasize
31
LE8 and ASCVD among pre-pandemic adults in the USA. nutritional strategies in the clinical management of
Many studies have focused on significant enhancements individuals at risk of ASCVD.
in LS7 or individual LS7 metrics with ASCVD, and our
findings are consistent with those of previous studies. 26,27 Our study possesses notable strengths and limitations.
The substantial sample size enhances the likelihood of
Using NHANES data and multivariate linear identifying statistically significant results and reduces
probability regression analysis, we revealed a negative the confidence intervals in our findings. In addition,
association between enhanced CVH, as defined by LE8, NHANES ensures rigorously conducted interviews and
and the prevalence of ASCVD in the NH white population study designs, incorporating multilevel verification of
subgroup. While the original LS7 metrics have been participant information. Continuous NHANES data
extensively utilized to examine the mechanisms, influences, collection is advantageous, allowing for the prompt
development, and outcomes of CVD across different addressing of emerging public health issues and offering
populations, subsequent evidence has highlighted the objective data on health conditions for the US population.
limitations of this score. Notably, compared to LS7 metrics, When interpreting our findings, it is essential to consider
LE8 offers increased sensitivity in the aggregate assessment the following limitations: our study, being cross-sectional
of adult CVH. Unlike LS7, LE8 metrics range from in nature, precludes the establishment of causal inferences
0 to 100 and include a refined assessment of components, between LE8 score and ASCVD events. Second, physical
such as adult physical activity, which now comprises seven activity, healthy diet, smoking habits, and sleep patterns
categories instead of the previous three. were self-reported and could be subject to recall bias. The
Moreover, HEI, employed for evaluating the alignment method of scoring utilized in our research may have been
of a food set with the Dietary Guidelines for Americans prone to errors due to a substantial number of individuals
(DGA), is regularly updated to correspond with each new not providing their glycated hemoglobin A1c values (90%).
edition of the DGA. For this study, the version linked As a result, assumptions were made to classify them into the
with the 2015 – 2020 DGA was utilized, where HEI-2015 <5.7% category (non-diabetic range). Importantly, these
maintains the same components as the HEI-2010, except errors could potentially lead to exposure misclassification
for the substitution of saturated sat and added sugars for bias toward null values, resulting in an underestimated
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empty calories. Thus, LE8 metrics have been established association between LE8 and ASCVD events.
as a new conceptualization of CVH, which expands on
the initial seven health behaviors and factors by including 5. Conclusion
sleep health, a component absent in the previous LS7 In this NHANES study (2017 – 2020), we identified an
construct. inverse association between the AHA-updated LE8 score
In a subsequent analysis, we illustrated that despite and prevalent ASCVD, particularly among young women
the NH white population showcasing commendable and college graduates. Therefore, enhancing the domains
efforts and displaying ideal metric scores in specific of the new LE8 score to maintain optimal CVH status
components related to sleep health, glycated hemoglobin carries considerable implications for preventing ASCVD
A1c, and physical activity, there are notable concerns. among the adult NH-white population in the USA. It is
Around 60% of this population, comprising individuals crucial to emphasize the importance of nutrition in clinical
without an ASCVD event, fall into the category of obesity practice, policy, and research, particularly for individuals
(BMI > 25 kg/m ). In addition, 34% follow a suboptimal at risk of acquiring an ASCVD event.
2
diet, and 32% have total cholesterol levels surpassing
222 mg/dL. These findings seem to tie in with findings by Acknowledgments
Trivedi et al., revealing that increased obesity rates, lack of We would like to thank Dr. Georgeta Vaidean for reviewing
physical activity, and inadequate dietary habits are more and making insightful suggestions for improving this article.

Volume 2 Issue 2 (2024) 7 doi: 10.36922/bh.2915