Twenty-year trends in the total diet quality for coronary heart disease prevention among adults in the Minneapolis-St. Paul metropolitan area

This study was carried out to examine trends in overall diet quality with specific focus on coronary heart disease during the past two decades. Dietary data were drawn from the Minnesota Heart Survey (MHS), repeated surveillance surveys to examine trends in risk factors for coronary vascular disease within geographically defined independent probability samples of residents in a metropolitan area.; A Heart Disease Prevention Eating Index (HDPEI) was developed to measure the overall dietary healthfulness by the level of compliance with the latest American Heart Association Dietary Guidelines. Investigations to evaluate surrogate markers of whole grain and fruit and vegetable intake included in the HDPEI were undertaken based on dietary data from the most recent MHS study period. Results indicated that phytic acid and the composite of various carotenoids and pectin may have utility as proxy measures of whole grain and fruit and vegetable consumption, respectively. Additionally, the overall performance level of the HDPEI appears satisfactory, successfully reflecting each element within the index and some demographic and behavioral characteristics in accord with the literatures.; Findings on dietary trends indicated an overall improvement in the total diet quality in relation to CHD. The improvement was particularly driven by changes in total grain including whole grain, total fat, saturated fatty acid, trans-fatty acid, and cholesterol intake. Energy balance, sodium intake, and fish intake were observed to change unfavorably or stay at a low level compliance, suggesting efforts for CHD prevention should include a focus on moderating energy and sodium intake while encouraging fish consumption. Of concern is it that improvements with respect to the fatty acid composition and whole grain intake have leveled off during the last five years. The public health message regarding the importance of the types of fatty acids and grain-based foods in the diet for CHD prevention may need to be reinforced in light of recent messages to the public which may be imparting the incorrect impression that dietary fat, regardless of types, is unimportant for CHD prevention and intake of all types of grain-based foods should be reduced.