A healthy diet can help attain hemoglobin HbA1c (A1C) , blood pressure (BP) , and cholesterol goals (ABC goals) in people with diabetes. We examined the association of diet quality with achievement of ABC goals (defined as A1C<8%, BP <140/90 mmHg, non-HDL cholesterol <130 mg/dL, and meeting all three goals) among adults with diabetes. Our analysis included non-pregnant adults aged ≥18 years with a self-reported diabetes diagnosis who had complete data on the 24-hour dietary recalls in the 2013-2018 National Health and Nutrition Examination Surveys. We used the Healthy Eating Index-2015 (HEI-2015) to measure diet quality. Overall, the median HEI-2015 among adults with diabetes was 51.1 points; a score larger than the median was positively associated with achievement of the A1C goal (Figure) . After adjusting for age, sex, race/ethnicity, education, marital status, health status, health insurance status, and smoking status using logistic regressions, we found that an interquartile increase in HEI-2015 (from 43.0 to 60.2 points) was significantly associated with 4.5 percentage points larger probability (74.3% compared with 78.8%, p=0.02) of meeting the A1C goal. No significant associations were found between HEI-2015 and achievement of BP, cholesterol, or combined ABC goals. Public health efforts to improve dietary quality among people with diabetes may help to increase the proportion of individuals with diabetes who achieve A1C goals.


K.R. Siegel: None. K.M. Bullard: None. D.B. Rolka: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.