Determinants of Indigenous Diet Quality and Their Association with Inflammation and Biological Age in the NHLBI Strong Heart Family Study

Abstract

Chronic, systemic, low-grade tissue inflammation is a major etiologic component of metabolic dysfunction that has been positively associated with biological age and chronic noncommunicable disease (NCD) risk. Chronic systemic inflammation, biological age, and NCD risk are influenced by a wide range of factors, including certain modifiable lifestyle factors such as diet quality. We examined whether diet quality, assessed using the 2010 Alternative Healthy Eating Index, was associated with inflammation (serum interleukin-6 and C-reactive protein) and biological age (leukocyte telomere length) in a sample of American Indian adults in the NHLBI Strong Heart Family Study, a population with disproportionately high rates of NCDs. This analysis found that better diet quality at baseline was associated with lower levels of CRP during an 8-year follow-up. This relationship appeared to be driven by increases in whole grain and legume consumption. The analysis also found poor diet quality among study participants overall. This finding was expanded upon in a review of the historical and social determinants of Indigenous diet quality and identified the concept of Indigenous Food Sovereignty as a direction for future community and policy efforts aiming to improve the health and wellbeing of Indigenous populations.