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14-02-2011 | Cardiometabolic | Article

Novel tool measures AHA-DLR adherence


Free abstract

MedWire News: US researchers have developed a tool for measuring individuals' adherence to the American Heart Association's diet and lifestyle recommendations for cardiovascular disease (CVD) risk reduction.

"We developed the AHA Diet and Lifestyle Score (AHA-DLS) to assess the relationship between adherence to the American Heart Association's Diet and Lifestyle Recommendations (AHA-DLR) and CVD risk," explain Katherine Tucker (Tufts University, Boston, Massachusetts) and colleagues who performed their study on a group of Puerto Ricans adults, aged 45-75 years.

"The AHA-DLS appears to be a useful instrument for assessing adherence to the AHA-DLR in this group of adults, and to assess relationships with diet and lifestyle behaviors and health outcomes," say the authors.

Using data on 1500 Boston Puerto Rican Health Study participants, the researchers tested the validity of the AHA-DLS by looking for associations between the AHA-DLS, nutrient intake, blood pressure, waist circumference, CVD risk factors, and Framingham risk score (FRS).

The team found that even a relatively modest adherence to AHA-DLR was associated with a significantly lower FRS, waist circumference, and concentrations of serum insulin and C-reactive protein (CRP), and with higher concentrations of high-density lipoprotein (HDL) cholesterol.

Out of a maximum possible score of 110, the mean AHA-DLS was 32.1, with overall adherence to the AHA-DLR being poor; only 3% of the population had a score of more than 55.

HDL cholesterol levels increased across quartiles of AHA-DLS, while serum insulin, waist circumference, CRP concentrations and FRS (in women) decreased across quartiles.

Furthermore, the team says that individuals in the highest quartile of AHA-DLS (38.6-72.2) were more likely to be physically active, consumers of alcohol, acculturated, users of supplements, report less perceived stress, have a lower body mass index, and to have greater education and household income, compared with those in the lowest quartile (AHA-DLS 4.8-23.1).

Writing in The Journal of Nutrition, the researchers say the positive association between AHA-DLS and HDL cholesterol in older Puerto Ricans is an important finding because a high prevalence of low HDL cholesterol has previously been identified in this population.

The team concludes that the Puerto Rican population appears to be at high risk for chronic disease, and suggests that diet and lifestyle interventions, based on the AHA-DLR, may provide substantial benefits to these individuals.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Nikki Withers