A new study published in The Journal of Nutrition concluded that higher diet quality scores among African American youths were associated with reduced risk of metabolic syndrome.

Diet quality among African American children and adolescents has been shown to be well below the dietary recommendations. From 1988 to 2000, the prevalence of metabolic syndrome increased from 2.0% to 5.1% in African American adolescents.  Dietary factors contributing to this trend include excess total energy intake, reduced intake of fresh fruits and vegetables, and frequent consumption of fried foods and sugar-sweetened beverages. Given the increasing health burden of obesity and metabolic syndrome in African American youth, there is a need to establish the relation of metabolic syndrome with diet quality.

To assess the association of diet quality with the prevalence of metabolic syndrome, Vanessa Garcia-Larsen (The John Hopkins Bloomberg School of Public Health) and colleagues conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES 2005-2016 cycles); a nationwide survey conducted in the United States to assess health and nutritional status. Dietary data were collected through self-reported 24-h recalls. Diet quality was determined using the Alternative Healthy Eating Index (AHEI) 2010 and the Dietary Approaches to Stop Hypertension (DASH) pattern score. Cardiometabolic characteristics included measures of weight, blood pressure, fasting blood glucose, and blood lipids. Metabolic syndrome was defined as having >2 cardiometabolic risk factors.

In this population-based study of nearly 2500 African American youths, nearly half of the sample classified as overweight or obese. Approximately one-third of participants had low family income or experienced household food insecurity. Diet quality was poor overall, with adolescents eating well below the recommended servings of healthy foods and above the daily limit of unhealthy foods. Greater adherence to a DASH pattern diet was associated with lower likelihood of having a hypertensive blood pressure.  The mean DASH pattern score of participants translated to 45% adherence to a DASH-style dietary pattern. By contrast, AHEI 2010 scores were not associated with hypertensive blood pressure but were associated with decreased risk of metabolic syndrome. The mean AHEI 2010 score of participants was equivalent to 35% meeting the recommendations to achieve an optimal diet quality.

This study underlines the importance of preventive diet and nutrition counseling, coupled with improved access to healthy affordable foods that would increase diet quality. A corresponding editorial by Katherine Arlinghaus and Jamie Stang (University of Minnesota) suggest that community-based peer and cross-age mentoring programs may help improve nutrition and physical activity behaviors of adolescents belonging to racial/ethnic minorities.


Ducharme-Smith K, Caulfield LE, Brady TM, Rosenstock S, Mueller NT, Garcia-Larsen V. Higher Diet Quality in African-American Adolescents Is Associated with Lower Odds of Metabolic Syndrome: Evidence from the NHANES. The Journal of Nutrition, Volume 151, Issue 6, June 2021, Pages 1609–1617, https://doi.org/10.1093/jn/nxab027.

Arlinghaus KR and Stang JS.  Population-Engaged Approaches to Improving Adolescent Nutrition. The Journal of Nutrition, Volume 151, Issue 6, June 2021, Pages 1371–1372, https://doi.org/10.1093/jn/nxab111.

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