Association between the healthy eating index 2020 and heart failure among the U.S. middle-aged and older adults from NHANES 2005-2020: a cross-sectional study

Objective: This study aims to shed light on the correlation between Healthy Eating Index-2020 (HEI-2020) and heart failure (HF) in American adults aged 50 or above.

Methods: Data were from the National Health and Nutrition Examination Survey 2005-2020, encompassing 13,105 participants with an age of 50 or above. HEI-2020 score was utilized for rating the dietary quality. The link of HEI-2020 to HF was assessed via logistic regression, restricted cubic splines (RCS), generalized additive models (GAM), weighted quantile sum (WQS) regression, as well as quantile g-computation (Qgcomp) models.

Results: A negative association between HEI-2020 and HF risk was uncovered in middle-aged and older Americans (OR = 0.99, 95% CI: 0.98-1.00, p = 0.006). The highest quartile (Q4) exhibited a markedly lower HF risk than the lowest quartile (Q1) (OR = 0.70, 95% CI: 0.55-0.89, p = 0.004). RCS and GAM analyses demonstrated a linear dose-response relationship between HEI-2020 and HF. Finally, WQS regression and Qgcomp models revealed a beneficial combined influence of 13 dietary components on HF risk, with dairy and whole fruits emerging as the most influential.

Conclusion: Elevated HEI-2020 scores are linked to decreased HF risks among Americans aged 50 or above, suggesting that adherence to the Dietary Guidelines for Americans can mitigate HF risk.