Abstract Body (Do not enter title and authors here): Introduction Black adults with heart failure (HF) have issues with dietary preferences that warrant further study to achieve optimal self- and culturally-congruent care. Greater knowledge of dietary patterns and behaviors is essential to understanding barriers with improving diet quality. Aging in Black populations with HF may also affect diet, inflammation, and lifestyle choices. Metabolites like trimethylamine N-oxide (TMAO) are linked to inflammation which contributes to deterioration in HF, especially with renal involvement. More research is needed to ascertain the impact of diet quality, lifestyle factors, and inflammatory biomarkers in this population.

Research Question What factors are associated with diet quality,TMAO, and lifestyles in Black adults with HF?

Methods Thirty-one participants were recruited from a cardiac center (mean age 57 years, 65% women). Measures included age, diet quality (Healthy Eating Index [HEI]); lifestyle factors (Lifestyle Score [LIS] from smoking, alcohol, activity, body mass index [BMI]); comorbidities (Charlson Comorbidity Index [CCI]]; creatinine measures, and TMAO. Analyses included descriptive, correlational, and inferential statistics.

Results HEI score (range:47-87; mean 64+ 10) out of a possible ideal score of 100, was positively correlated with age (r=.368, p=.054). TMAO level (mean 6.3+ 0.7) was negatively correlated with LIS (r= -.470, p=.008). The mean LIS was 2 +0.9 and the mean for CCI was 3+2. There was a positive correlation with age and comorbidities (r= .423, p=.018). A multiple regression model with creatinine levels and LIS as predictors of TMAO accounted for 16.6% of the variance (F(2,27)=3.89, p=.033). LIS was the key predictor related to TMAO levels. T-tests were performed for each component of the LIS variable and notably TMAO concentrations of those who consumed alcohol were lower than those who did not (mean difference 0.41 ± 0.18, p=.026, d=0.66).

Conclusion Black persons with HF have a high number of comorbidities with increasing age. The greater the age in this sample, the higher the HEI diet quality score. However, HEI scores were in the range for needing improvement. The LIS in relation to TMAO has a counterintuitive result but suggests that BMI, smoking, exercise ability, and alcohol use may influence metabolite levels that are linked to the diet. Findings suggest that diet quality is a strong intervention target for older Black adults with HF, especially for those with high comorbidities.