Abstract 72: Association of Diet Quality and Physical Activity through Young Adulthood With Mid-Life Cardiovascular Health Trajectories: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Poor diet quality and inadequate higher intensity physical activity (PA) are associated with cardiovascular morbidity and mortality. However, no studies have assessed dietary quality and PA, or specifically the joint association of the two, through young adulthood and their associations with midlife cardiovascular health (CVH). Methods: CARDIA participants (enrolled in 1985-86) provided dietary data at exam years (Y) 0, 7 and 20, and PA information at Y0, 2, 5, 7, 10, 15, and 20. DASH diet and PA scores (in exercise units) were calculated from Y0 to Y20 (mean ages 25 to 45 yrs), and participants were stratified into groups using multiple latent class analysis based on similar patterns of joint DASH and PA score evolution from Y0 to Y20. CVH from Y20 onward (mean age 45 to 60 yrs) was quantified using the American Heart Association’s Life’s Essential 8 (LE8) score. LE8 trajectory groups from Y20 to Y35 (mean ages 45 to 60 yrs) were identified using trajectory modeling (SAS PROC TRAJ). Results: Data are from 2,806 participants (57% women, 43% Black).RI1 We identified four groups of joint DASH-PA patterns through young adulthood ( Figure 1A ): Group 1, low DASH/very low PA (10.9%); Group 2, low DASH/moderate-declining PA (25.6%); Group 3, moderate DASH/high-declining PA (41.5%); Group 4, high DASH/high-declining PA (22.0%). There were three distinct mid-life LE8 trajectories identified (low, moderate, and high CVH). Individually, diet and PA had significant associations with midlife CVH. Considering patterns of diet and PA jointly, participants in Groups 2, 3, and 4 had 4.8-, 8.6-, and 21.7-fold higher odds, respectively, of having high CVH compared to low CVH in midlife ( Figure 1B) . Participants in Groups 2, 3, and 4 had 1.4-, 1.6-, and 2.2-fold higher odds, respectively, of having moderate CVH compared to low CVH in midlife. Results were similar after additional adjustment for the Y0 LE8 score and with or without considering diet and PA in the midlife overall LE8 score trajectories. Conclusions: Our findings show the substantial importance of diet and PA, and particularly maintaining a combination of high-quality diet and greater PA, through young adulthood for mid-life CVH. These findings underscore the importance of initiating lifestyle prevention strategies early to achieve and sustain high mid-life cardiovascular health.