Introduction: Supplementation with key nutrients has been an effective strategy to meet nutritional requirements, particularly when diets alone are insufficient to fulfill needs or correct existing deficiencies. However, micronutrient deficiencies among women of childbearing age in Latin America remain a significant public health challenge, especially during the preconception period, when nutritional status critically influences maternal and fetal outcomes. Objective: This study aimed to analyze the micronutrient composition of commonly prescribed prenatal supplements in countries participating in the ELANS and compare it with dietary intake among women of childbearing age to identify relevant nutritional gaps relevant. Materials and methods. Commonly prescribed prenatal supplements in the ELANS countries were analyzed and compared with previously reported dietary intake data. A population-level model was used to estimate total micronutrient intake under a supplementation scenario. Results. Significant micronutrient gaps were identified, particularly for calcium, vitamin D, vitamin E, and choline. Choline intake was markedly inadequate, and none of the evaluated supplements contained this nutrient. While supplementation improved coverage for some micronutrients, it also led to potentially excessive intake of others, including iron and several B-complex vitamins. Substantial variability in supplement composition was observed across countries Conclusions. These findings reveal a mismatch between prenatal supplement composition and population nutritional needs, characterized by the coexistence of deficiencies and potential excesses. Tailored, evidence-based supplementation strategies are needed to better align regional nutritional gaps.

Background/Objectives: Strict adherence to a gluten-free diet (GFD) is the only effective treatment for celiac disease (CeD) but remains challenging due to structural and environmental barriers. Evidence on these determinants in Latin America is scarce. This study aimed to adapt and validate the Gluten-Free Perceived Nutrition Environment Measures Survey (NEMS-P-GF) for adults with CeD in Chile and examine its association with GFD adherence. Methods: A cross-sectional online survey (October 2023-January 2024) included adults (≥18 years) with biopsy- or serology-confirmed CeD (n = 233). The questionnaire collected sociodemographic and clinical data, assessed adherence using the Celiac Dietary Adherence Test (CDAT; good < 13, poor ≥ 13), and measured perceptions of home and supply food environments via the adapted NEMS-P-GF. Construct validity was tested using exploratory factor analysis and reliability with Cronbach's α and McDonald's ω. Associations with adherence were analyzed using Mann-Whitney U. Results: NEMS-P-GF domains showed adequate validity (KMO 0.71-0.81; Bartlett's p < 0.001) and acceptable-to-excellent reliability (α/ω = 0.70-0.90). Participants with good vs. poor adherence perceived more supportive environments, particularly at home (median 4.79 vs. 1.29; p < 0.01) and globally (1.72 vs. -7.25; p < 0.01). Supply environments were perceived as less supportive due to limited availability and high prices (median -3.68 and -7.78), with smaller differences between adherence groups (p = 0.018). Conclusions: Supportive home environments were strongly associated with better GFD adherence, while supply environments remained broadly restrictive, showing modest but significant differences between adherence groups. The NEMS-P-GF demonstrated preliminary evidence of good psychometric properties and offers a valid, context-sensitive tool to assess GF food environments and inform public health strategies for CeD populations.

Understanding diabetes heterogeneity across diverse populations is critical for advancing precision medicine. However, population-representative data on diabetes subphenotypes in South America are scarce. We examined Ahlqvist-derived diabetes clusters in nationally representative cohorts of Chilean adults and their associations with complications and mortality. This complex-sample analysis included 308 and 536 adults with diabetes from the Chilean National Health Survey (2009–2010 and 2016–2017). Participants were classified as Mild Age-Related Diabetes (MARD), Mild Obesity-Related Diabetes (MOD), Severe Insulin-Resistant Diabetes (SIRD), or Severe Insulin-Deficient Diabetes (SIDD) using the approach of Bello-Chavolla et al. Self-reported complications and all-cause mortality were assessed, with up to 13 years of follow-up. Subtype distributions were consistent across survey waves, with increasing MOD prevalence over time. SIDD was characterized by longer diabetes duration and poor glycaemic control. It exhibited up to threefold higher albuminuria, also among recently diagnosed individuals. In unadjusted analyses, SIDD showed higher mortality risk (HR 4.87, 95

BACKGROUND:Metabolic syndrome (MetS) is a significant public health issue in Chile, affecting approximately 40 % of the adult population and increasing the risk of chronic diseases. Although evidence from Mediterranean countries has shown benefits of the Mediterranean diet (MedDiet) improving metabolic parameters and reversing MetS, its impact in non-Mediterranean populations remains unclear. AIM:The CHILEan MEDiterranean (CHILEMED) study is evaluating MetS reversal effectiveness of a MedDiet, with or without well-being support, compared to a low-fat diet. METHODOLOGY:CHILEMED is an ongoing 1-year, parallel-group randomized controlled trial, and this report presents an interim analysis with preliminary findings at 6 months of follow-up. A total of 246 participants (men and women, middle-aged, with comparable baseline cardiometabolic risk profiles) diagnosed with MetS have been assigned to low-fat diet (control), MedDiet, or MedDiet with psychological well-being interventions. Participants received face-to-face and online nutritional counseling specific to their assigned dietary intervention. Clinical assessments, including anthropometry, biochemical parameters, and dietary adherence, were performed at baseline and 6 months. The primary outcome was MetS reversal, while secondary outcomes included changes in dietary adherence and MetS components. RESULTS:Preliminary analyses of 156 participants completing the 6-month follow-up showed a significantly greater increase in MedDiet adherence in the combined MedDiet (with and without psychological well-being intervention) groups compared with the low-fat diet group. Participants in the MedDiet group exhibited greater reduction in waist circumference, triglycerides, and glucose levels compared to the low-fat diet group. Notably, 36 % of individuals in the MedDiet intervention experienced MetS reversal, compared to only 11 % in the low-fat diet group (p < 0.01), with an adjusted hazard ratio of 3.84 for MetS reversal in the MedDiet versus the control group. CONCLUSIONS:These preliminary 6-month results from the ongoing 1-year randomized CHILEMED trial provides evidence supporting MedDiet's effectiveness in improving metabolic health and reversing MetS in Chilean adults. Given changing dietary patterns and rising prevalence of MetS-related conditions, promoting adherence to MedDiet may be a key strategy for chronic disease management and public health policies in Chile.

Unhealthy diets are major contributors to the global burden of non-communicable diseases, particularly cardiovascular disease and metabolic syndrome, where dietary fat quality plays a critical role. Among dietary fats, linoleic acid (LA)-the predominant omega-6 polyunsaturated fatty acid-has been at the center of a long-standing and evolving controversy. Initially promoted for its cholesterol-lowering properties, LA later became the focus of debate due to hypotheses suggesting pro-inflammatory and oxidative effects, which led to conflicting interpretations of its metabolic impact and inconsistent dietary guidelines over time. This review traces the origins and progression of this controversy, examining how shifts in biochemical understanding, experimental design, and population dietary patterns have shaped current perspectives on LA and cardiometabolic health. By integrating evidence from biochemical, preclinical, and human studies, we clarify the mechanistic and clinical bases underlying LA's actions and re-evaluate its role in lipid metabolism, inflammation, and glucose regulation. Overall, most human evidence supports beneficial associations between LA exposure and cardiometabolic outcomes, though heterogeneity across studies underscores the relevance of dietary context, genetic background, and metabolic status. Understanding how the controversy emerged and evolved is essential to refine current recommendations for dietary fat and disease prevention.

Introduction and Objective: Diabetes mellitus (DM) contributes to cardiovascular disease (CVD) morbidity and mortality. Effective treatment coverage (ETC) for cardiovascular risk factors (CVRFs) represents the percentage of individuals achieving therapeutic goals for CVRFs. The 2009-2010 Chilean National Health Survey (NHS) highlighted suboptimal ETC among people with diabetes. This study aimed to update ETC data using the 2016-2017 NHS and compare the results to the 2009-2010 findings. Methods: This cross-sectional analysis included a nationally representative sample of 859 adults with DM (glycemia ≥126 mg/dL and/or self-reported DM) from the 2016-2017 NHS. Therapeutic goals were assessed based on the 2010 Chilean Ministry of Health guidelines for DM, including HbA1c <7%, blood pressure (BP) <130/80 mmHg, LDL cholesterol <70 mg/dL, triglycerides ≤150 mg/dL, HDL cholesterol ≥50 mg/dL (women) or ≥40 mg/dL (men), absence of nephropathy, normal nutritional status (BMI <25 kg/m2), smoking abstinence, and routine physical activity. Results: The proportions of people with DM meeting therapeutic goals were for HbA1c: 57.8%, BP: 39.5%, LDL cholesterol: 25.1%, triglycerides: 50.3%, HDL cholesterol: 45.6%, absence of nephropathy: 63.2%, normal nutritional status: 10.3%, smoking abstinence: 73.4%, and leisure-time physical activity: 6.4%. Only 5% achieved HbA1c, BP and LDL cholesterol goals, and none met ≥7 CVRF treatment targets. Compared to 2009-2010, ETC improved across most CVRFs, except for BP control, normal nutritional status, and physical activity, which declined. Conclusion: Despite modest progress in some areas, ETC for key CVRFs among Chilean people with DM remains suboptimal, underscoring the need for targeted interventions to enhance comprehensive DM management. These findings should inform strategies to optimize therapeutic outcomes and reduce the increasing DM-associated CVD burden in Chile. D. Dusic: None. S. Gancheva: None. A. Rigotti: Advisory Panel; Merck Sharp & Dohme Corp. Research Support; Merck Sharp & Dohme Corp. G. Echeverría: None. This research used information from the Health Surveys for epidemiological surveillance of the Undersecretariat of Public Health. The author thanks the Ministry of Health of Chile for allowing him/her to use the database. All results obtained from the study or research are the responsibility of the author and do not in any way compromise said institution.

Introduction and Objective: Understanding diabetes heterogeneity across diverse populations is critical for advancing precision medicine. However, data on diabetes subphenotypes in South America remains limited. Here we analyze the distribution of Ahlqvist clusters among a nationally representative cohort of Chilean individuals with diabetes and their relation to chronic kidney disease (CKD). Methods: This cross-sectional analysis included 627 adults with diabetes mellitus from the Chilean National Health Survey (NHS) 2009-2010 and 2016-2017 with BMI 31 ± 6 kg/m2, HbA1c of 7.8 ± 2.2% and diabetes duration of 10 ± 10 years. They were assigned to the Mild Age-Related Diabetes (MARD), Mild Obesity-Related Diabetes (MOD), Severe Insulin-Resistant Diabetes (SIRD), and Severe Insulin-Deficient Diabetes (SIDD) clusters using the approach proposed by Bello-Chavolla et al., that relies on BMI, HDL, triglycerides, waist circumference, age at diagnosis and NHS, sex, glucose, and HbA1c. CKD markers (GFR and albumin-to-creatinine ratio, ACR) and self-reported complications (retinopathy, diabetic foot ulcers) were assessed. Results: Clusters were distributed as follows: MARD 24.2 %, MOD 31.6 %, SIRD 11.5 %, and SIDD 32.7 %. Both MARD and SIRD had lower GFR and higher rates of stage 3 CKD compared to MOD. SIDD exhibited the highest HbA1c and 2-5 times higher ACR (p < 0.01 vs. all other clusters). Rates of retinopathy and diabetic foot ulcers did not differ among clusters. In a subgroup with recent diagnosis (<3 years, n=193), SIDD represented a smaller proportion (15.5 %), but CKD marker disparities across clusters were consistent. Conclusion: SIDD accounts for a substantial segment of Chilean diabetes cases, characterized by poor glycemic control and markedly elevated proteinuria. This contrasts with findings from Caucasian cohorts where SIRD is tightly linked to CKD, underscoring the importance of population-specific data for developing equitable precision medicine strategies. S. Gancheva: None. V. Serrano: None. G. Echeverría: None. A. Rigotti: Advisory Panel; Merck Sharp & Dohme Corp. Research Support; Merck Sharp & Dohme Corp. This research used information from the Health Surveys for epidemiological surveillance of the Undersecretariat of Public Health. The author thanks the Ministry of Health of Chile for allowing him/her to use the database. All results obtained from the study or research are the responsibility of the author and do not in any way compromise said institution.

The overweight/obesity high prevalence and the effects of climate change in Latin America underscores the possible positive outcomes of adopting a healthy and sustainable diet to respond to the region’s burden of nutrition‐related noncommunicable diseases (NCDs). However, research on adherence to the EAT‐Lancet diet in Latin America and its association with overweight/obesity is limited. This study explores the relationship between the EAT‐Lancet diet adherence and overweight/obesity in a cross‐sectional and urban multicentric study involving 6683 participants aged 15–65. Adherence to the EAT‐Lancet diet was evaluated using the Planetary Health Diet Index (PHDI). The findings indicate that high adherence to the EAT‐Lancet diet (fifth quintile) was not significantly associated with overweight/obesity (reference: first PHDI quintile, PR: 1.057, CI: 0.993–1.125, p ‐trend = 0.140) after adjusting for key covariates. Equivalent outcomes were found when assessing adherence to the EAT‐Lancet diet using the EAT‐Lancet Index, the World Index for Sustainability and Health (WISH), and the Healthy and Sustainable Diet Index (HSDI), after adjusting for the same variables. The persistently high prevalence of overweight/obesity among different adherence levels to the dietary pattern and the study’s design, do not appear to be the key factors contributing to the lack of association between these variables. Instead, the considerably low adherence to the EAT‐Lancet diet in the sample as well as the low variability in adherence across participants with and without excess weight might help explain the lack of observed association. However, further research is needed to verify this conclusion.

Red wine grape pomace (RWGP), a winemaking by-product rich in phenolics, flavonoids, and dietary fiber, has shown promise in mitigating cardiovascular disease (CVD), however, its mechanisms of action remain incompletely understood. This study comprehensively profiled the phenolic composition of RWGP—including free, esterified, etherified, and insoluble-bound fractions—and evaluated the effects of RWGP dietary supplementation on gut barrier integrity, inflammation, oxidative stress, and survival in SR-B1−/−ApoE-R61h/h mice, a model of diet-induced lethal ischemic heart disease. RWGP supplementation significantly improved survival rates and restored gut barrier function, as evidenced by lower plasma FITC-dextran and LPS levels, increased circulating ZO-1 levels, and reduced histopathological colon damage. In addition, RWGP reduced pro-inflammatory cytokines (IL-1β) and showed a trend toward attenuating systemic oxidative stress (TBARS). Analysis of phenolic compounds indicated a significant presence of insoluble-bound phenolics. Nevertheless, the beneficial effects observed are likely attributable to the synergistic actions of RWGP’s complex phytochemical and fiber composition. These results highlight RWGP’s potential as a sustainable, gut-targeted functional food ingredient for CVD prevention and management.

IntroductionEnergy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin America countries.MethodsA total of 680 adolescents aged 15 to 18 were included in this study. The estimation of EI was based on two non-consecutive 24-h dietary recalls. EE was predicted from Schofield equations using physical activity level obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables.ResultsThe mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina had the highest EI and EIG, whereas Chile had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p < 0.05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p < 0.05). Subjects with low socioeconomic status (SES) had a lower EE (2047.0 kcal) than those with a high SES (2164.2 kcal) (p < 0.05).ConclusionSex and BMI were associated with EIG in adolescents from Latin America.

The EAT-Lancet Commission proposed a dietary framework aimed at reducing the ecological footprint of diets worldwide, but research on adherence to this diet in Latin America is limited. This study aimed to describe the adherence of urban diets in 8 Latin American countries to the EAT-Lancet diet and its association with micronutrient intake inadequacy. This cross-sectional study analyzed baseline data from the Latin American Study of Nutrition and Health, involving 6835 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Data collection included two 24-hour recalls, alongside socio-demographic variables. Usual dietary intake was estimated via the Multiple Source Method and micronutrient inadequacy was evaluated with the Nutrient Adequacy Ratio. The Planetary Health Diet Index (PHDI; ranged between 0 and 150) assessed adherence to the EAT-Lancet diet. Adherence was low (29.7%) across the region, with an average PHDI score of 44.6 ± 9.2 points. Costa Rica had the highest adherence (32.9%), while Argentina had the lowest (25.8%). Older participants, those with overweight/obesity, and with higher socioeconomic status, education, and physical activity had higher adherence. Higher adherence was associated with increased inadequacy risks for cobalamin, vitamin D, and calcium, but decreased risks for pyridoxine, folate, vitamin C, magnesium, and zinc. The study suggests that low adherence may stem from a disconnect between culturally ingrained dietary habits and the EAT-Lancet recommendations, which are primarily informed by nutritional epidemiology and environmental considerations. Recognizing and honoring diverse food cultures is crucial for promoting dietary practices that support human health and environmental sustainability.

Japanese adults typically have healthier lipid profiles than American and European adults and a lower prevalence and later onset of atherosclerotic cardiovascular disease (ASCVD). Many Japanese also have uniquely elevated levels of high-density lipoprotein cholesterol (HDL-C). The following analysis examined the relationship between HDL-C level and HDL-C peroxide content, a bioindicator of unhealthy lipid metabolism in Japanese adults. Blood samples were collected from 463 participants, 31-84 years of age, who lived in Tokyo. A second blood sample was collected 5 years later from 241 of the participants, allowing us to evaluate the temporal stability of the inverse correlation between HDL-C level and HDL-C peroxide content. Glucoregulation and inflammatory activity were assessed because both can be associated with dyslipidemia and HDL-C dysfunction. Obesity and central adiposity were also considered. Overall, women had healthier HDL-C profiles than men. Elevated HDL-C (>90 mg/dL) was common (16.6%) and found more often in women. Higher HDL-C peroxide content was associated with older age and central adiposity and incremented further when HA1c and CRP were higher. When assessed 5 years later, lower HDL-C peroxide content continued to be evident in adults with higher HDL-C. While similar associations have been described for other populations, most Japanese adults typically had healthier levels of HDL-C with lower HDL-C peroxide content than previously reported for American adults.

To determine carotenoid intake (Beta and alpha carotene, lycopene and beta cryptoxanthin) from fruit and vegetable sources in ELANS participating countries. Data were obtained from the Latin American Health and Nutrition Study (ELANS), a multicenter study developed in urban areas of 8 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Dietary intake among 9218 participants (15- 65 y) was assessed using two 24-hour recall and processed by Nutritional Data System for Research (NDS-R). Fruits and vegetables were classified according to the 2002–2007 FAO Supply Utilization Accounts Data. Major food sources of carotenoids were assessed using weighed-proportions. Median intake, expressed as micrograms per day (mcg/d), and sources of carotenoids were performed by country. *All data is presented as mcg/d The highest intake for beta-carotene was reported in Ecuador (2659.6 ± 82.8) and the lowest in Brazil (1368.9 ± 42.2). The same trend was observed for alpha-carotene (290.6 ± 15.2 in Brazil vs 975.6 ± 33.5 in Ecuador). The main sources of these carotenoids are root vegetables such as carrots and beets. In the case of lycopene, Ecuador showed the highest average intake (3038.5 ± 174.3) whereas Peru showed the lowest (1111.7 ± 75.2). The most important source of this carotenoid is fruity vegetables, such as tomatoes. For beta cryptoxanthin, the highest intake was observed in Venezuela (246.3 ± 10.7) and the lowest was reported in Brazil (99.5 ± 5.3) Fruits and vegetables are important sources of carotenoids in the human diet. Of all countries included in this study, Brazil had the lowest intake of beta and alpha carotene and beta cryptoxanthin, and Ecuador had the highest intake of beta and alpha carotene and lycopene. Further studies are needed to assess bioavailability and serum concentrations in order to establish dietary recommendations regarding both pro vitamin and non pro-vitamin A carotenoids. The ELANS is supported by a scientific grant from the Coca Cola Company and support from participating academic institutions. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this abstract.

Background: Women’s Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups. Objective: To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries. Methods: We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA ≥ 0.70). Results: We found a mean DDS of 4.78 ± 1.33 and an MPA of 0.64 ± 0.16, with 59% of participants showing a diverse diet (DDS ≥ 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA ≥0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well. Conclusion: The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA ≥0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population.

Background/Objectives: Fats, although essential for the proper functioning of the body, have been linked to an increased risk of developing chronic diseases, especially cardiovascular disease. The aim of this study was to evaluate the intake of total fat and its components (saturated, monounsaturated, polyunsaturated, and trans fats) in men and women aged 15 to 65 years of the urban population in eight Latin American countries. Methods: Survey data were collected from the Latin American Study of Nutrition and Health (ELANS, by its acronym in Spanish), an epidemiological study, including 9218 subjects from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Results: In general, 76.2% of the subjects consumed fat within normal ranges (20-35% of the total caloric value (TCV)). When analyzing its components, a majority of the subjects consumed saturated and polyunsaturated fats within the recommended ranges. However, 94.5% of the population does not comply with the recommended maximum intake of monounsaturated fatty acids (MUFA) (10-20%), and only 57.5% comply with the intake recommendation for trans fatty acids (TRANS) (0-2%). Likewise, on average, women had a significantly higher intake of all types of fat compared to men. Finally, the average fat intake by age indicates that regardless of the age range, the consumption of all fats except MUFA and TRANS are within the recommended ranges, with MUFA being slightly below and TRANS above. Conclusions: Even though the fat intake of the population falls within the recommended range, it is necessary to improve the quality by favoring the consumption of MUFA-rich foods regionally accepted, such as avocados, and reducing the consumption of TRANS.

Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.

Background: The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR). Methodology: Self-reported information about diet and blood samples were obtained from 2114 adult participants in the Midlife in the United States study (MIDUS). Food intake data were used to design a Healthy Diet Index (MIDUS-HEI) and to evaluate the predictive value by examining its association with health variables. The associated lipid signature (HEI-LS) was constructed using Lasso regression, from lipidomic data (LC/MS). Associations between HEI-LS, cardiometabolic biomarkers, and estimated CVR were assessed using multiple linear regression. Results: MIDUS-HEI score was a robust indicator of dietary quality and inversely associated with body mass index (p < 0.001) and metabolic syndrome (p = 0.012). A lipidomic signature comprising 57 distinct lipid species was highly correlated with the MIDUS-HEI score (r = 0.39, p < 10⁻16). It was characterized by lower levels of saturated fatty acid and adrenic acid (n-6) and higher levels of docosahexaenoic acid (n-3). Healthier HEI-LS scores were strongly associated with better cardiometabolic indicators and lower estimated CVR (OR 0.89 CI 95% 0.87–0.91). Conclusions: The MIDUS-HEI effectively assessed dietary quality, confirming the link between poor diet quality and metabolic disorders in American population. Lipidomic profiling offered an objective assessment of dietary patterns and provided insights into the relationship between diet quality, metabolic responses, and CVR. This approach supports precision nutrition strategies for at-risk populations.