Abstract
Background
The Reversing the Negative cardiovascular Effects on Weight (ReNEW) Clinic is a prospective cohort study in children and adolescents (≤21 years) at the Johns Hopkins Children’s Center.
Methods
Cross-sectional analysis between diet quality using the Alternative Healthy Eating Index (AHEI-2010), pro-inflammatory potential using the Children’s Dietary Inflammatory Index (C-DII), and cardiometabolic outcomes. AHEI-2010 and C-DII scores were assessed by median intake determined from the sample distribution and associated with cardiometabolic measures using linear regression models. Changes in measures were evaluated in a sub-sample of participants invited to attend follow-up visits due to the presence of hypertensive blood pressure (n = 33).
Results
Participants (n = 90) reported an average energy intake of 1790 kcal/day (SD ± 734), AHEI-2010 score of 55.04 (SD ± 9.86) (range: 0 to 110) and C-DII score of −0.12 (±0.86) (range −5 to 5). Participants with higher quality/anti-inflammatory diets trended towards more favorable cardiometabolic measures at baseline. Among the sub-sample (n = 33), there was a significant reduction in total energy (m = −302 kcal/day; p-value= 0.03) but no change in AHEI-2010 (p-value = 0.73) or C-DII score (p-value = 0.85) over follow-up.
Conclusions
Despite stable diet quality scores, outpatient dietary and behavioral counseling may be an effective tool to reduce energy intake in youth with overweight/obesity and elevated blood pressure.
Impact
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Diet quality scores among obese, hypertensive, African American adolescents were low and reflect a pro-inflammatory diet.
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Reported intake was negligible for fruits, whole grains, nuts, and legumes, and well above the daily limit for sodium and saturated fat.
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Participants with high quality/anti-inflammatory diet quality scores trended toward improved cardiometabolic measures.
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Outpatient dietary counseling resulted in reduced total energy intake.
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Contributions
K.D.-S., T.M.B., and V.G.L. conceptualized the analyzes. K.D.-S. analyzed data and wrote the first draft of the manuscript. T.M.B. is the PI of the ReNEW Clinic Cohort Study, enrolls participants, and delivers medical care to individuals in the study. D.V. is the research dietitian for the ReNEW Clinic Cohort Study, educates patients on dietary choices, collects dietary data, inputs data into NDSR, and provided dietary data linked to clinic visits. V.G.L. was involved in the manuscript preparation and oversaw all aspects, including the analyses and writing. L.E.C, N.M, and S.R. gave feedback to the analyses, and contributed to interpreting the findings. All authors approved the final manuscript
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The ReNEW Clinic Cohort Study (NCT03816462) is human subjects research that has been approved by the Johns Hopkins IRB (IRB00056175). Participants in the cohort study agree to have their clinical data abstracted from the electronic medical record (EMR) and entered into a longitudinal clinic registry. The study is discussed with participants in the presence of their parent or legal guardian and those who agree to participant sign consent (≥18 years) or assent (<18 years) as appropriate.
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Ducharme-Smith, K., Brady, T.M., Vizthum, D. et al. Diet quality scores associated with improved cardiometabolic measures among African American adolescents. Pediatr Res 92, 853–861 (2022). https://doi.org/10.1038/s41390-021-01893-w
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DOI: https://doi.org/10.1038/s41390-021-01893-w
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