Better adherence to the Chinese Healthy Eating Index is associated with a lower prevalence of metabolic syndrome and its components

The Chinese Healthy Eating Index (CHEI) was built on Dietary Guidelines for Chinese-2016 and has been confirmed as a valid measuring instrument to evaluate the diet quality of the Chinese population. Studies have shown that healthy dietary patterns were associated with reduced metabolic syndrome (MS) risk. Here, we hypothesized a better adherence to CHEI was effective in preventing MS. Therefore, we performed a cross-sectional study (n = 704; 298 males and 406 females) in Hubei. Dietary data were collected by 3-day 24-hour dietary recalls. MS was diagnosed using Guidelines for the Prevention and Control of type 2 Diabetes in China (2017 edition). Logistic regression and propensity and restricted cubic splines analysis were used to evaluate the associations of CHEI with MS and its components. In a comparison of the adjusted risk of MS in participants in the third and first tertile of CHEI, a 47% lower risk was observed for MS in females, especially for those who were middle-aged. However, no significant association of CHEI was exhibited with MS in males. Propensity analysis validated the findings in females, presenting a 58% lower MS risk and 71% lower risk of central obesity. It exhibited a linear association of CHEI score with MS and abdominal obesity. The associations were consistent after excluding those with prior hypertension or diabetes mellitus. In conclusion, a negative linear association was identified between CHEI score and MS and central obesity, which was pronounced in females.