Examining socioeconomic disparities in the diet quality and the association with cardiometabolic outcomes among Mexican adults

There are limited studies about the association of diet quality with cardiometabolic outcomes among Mexican adults, and still less is known about whether socioeconomic status (SES) modifies this association. With a higher burden of obesity and many untreated cardiometabolic diseases among low SES individuals, understanding this relationship is important. Using data from the Mexican National Health and Nutrition Survey 2012, our primary aim was to examine the association of diet quality with body mass index (BMI), waist circumference (WC), and cardiometabolic risk. We evaluated the diet quality using the total Mexican Diet Quality Index and Mexican Healthy Eating Index and defined cardiometabolic risk as diabetes, atherogenic dyslipidemia, and inflammatory risk. We found that diet quality was not associated with BMI, WC, or cardiometabolic risk in the overall population for either index. Our secondary aim was to examine the association between diet quality and cardiometabolic outcomes by SES, specifically education level. We found that poor diet quality was associated with higher predicted BMI and WC for men with lower but not higher education level. Among women, education level did not modify the association of diet quality with BMI and WC. Education level did not modify the association between diet quality and cardiometabolic risk in men. Among women, the probability of diabetes and atherogenic dyslipidemia risk was lower for each 10 units increase in the diet quality score in women with low but not high education level. Finally, we examined the association between SES (using education level and assets index) and diet quality. We found that education level was inversely associated with diet quality in women, but not in men, while a household assets index was inversely associated with diet quality in men, but not in women. In conclusion, a higher diet quality was associated with lower BMI and WC in lower-educated men, and lower diabetes and atherogenic dyslipidemia risk in lower-educated women. Lower SES was inversely associated with diet quality in Mexican adults. Longitudinal analyses are needed to confirm our results and identify the utility of improving dietary quality as a strategy for reducing cardiometabolic disease in this population.Doctor of Philosoph