(P17-078-25) Brief Diet Screener for Cardiovascular Risk Reduction and Stroke Recurrence Prevention: Development and Validation

Objectives: Diet quality is an important cardiovascular diseases (CVD) determinant that is rarely comprehensively measured in CVD trials due to cost and time constraints. This study aimed to develop a Dietary Approaches to Stop Hypertension (DASH) diet screener using questions from the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis trial (SAMMPRIS), and to assess its construct validity in 3 two-year cycles of National Health and Nutrition Examination Survey (NHANES, 2009-2014).

Methods: Two DASH scores were created in a NHANES subset of 14651 adults aged ≥20 with ≥1 reliable 24-h diet recall and plausible energy intakes. The validated DASH score used established methods to create a total score ranging from 8 to 40. The DASH screener used 11 non-validated diet questions from the SAMPPRIS trial to create 8 components. Each component was multiplied by a weight to mimic the weighting scheme as the validated DASH score and summed to obtain an overall score (0-100), with higher values indicating better adherence. Construct validity was examined by analyzing correlations, comparing groups with known adherence differences, and testing concordance between the two total scores using weighted Cohen’s κ.

Results: Participants were on average 47.6 (±16.9) years, 68% Non-Hispanic White, 53% female, 56% nonsmokers, 31% had > college degrees, and with a BMI of 28.9 kg/m². The mean (SD) of the DASH screener score and validated DASH score were 46.8(13.8) and 23.8(5.2). Correlation between the total scores was 0.70 (p < 0.0001). Most components were strongly correlated (r=0.62 to 1, p< 0.0001), except for sodium (r=0.05). Smokers had significantly lower screener scores (41) than former or nonsmokers (48); younger adults had lower scores (44) than older adults (50), with no differences by sex. For concordance, the total screener score had substantial agreement across the total DASH score tertiles (κ=0.62, p< 0.0001).

Conclusions: Preliminary analyses show that the screener is strongly correlated with the validated DASH score. It distinguished between some groups with known adherence differences and was concordant with the DASH score. The sodium component requires correction to improve screener validity along with research incorporating multivariable adjustment and evaluation of predictive validity in diverse samples.

Funding Sources: N/A