Correlating the Guide Against Age-Related Disease (GARD) Score with Clinical Biomarkers and Patient Outcomes: A Matched Cohort Study in the Context of Sustainable Diets and Sports Health

Introduction:
The Guide Against Age-Related Disease (GARD) Screener quantifies dietary complexity and food behaviors, offering a bias-mitigating approach to nutritional assessment. The original Diet to Data study validated GARD’s accuracy, yet its relationship with health-related biomarkers and functional recovery in active populations remains unexplored. Sustainable sports performance requires not only acute fueling strategies but also long-term dietary patterns that support metabolic resilience and overall health. We hypothesize that the GARD score correlates with key metabolic and health indicators relevant to sustainable performance, including glycemic control, kidney function, and chronic disease burden.

Methods:
A digital version of the GARD screener will be administered to a population of adult patients at a family medicine clinic, including recreationally active individuals. Participants will be matched for age and gender to form comparable high- versus low-GARD cohorts. Electronic health record (EHR) data will be extracted for hemoglobin A1c, body mass index (BMI), estimated glomerular filtration rate (eGFR), and number of chronic conditions (hypertension, diabetes, obesity, cancer, chronic kidney disease, depression, and anxiety). Statistical analyses will assess associations between GARD score and these outcomes.

Results:
We anticipate higher GARD scores to correlate with lower BMI, improved biomarker profiles, and fewer chronic conditions, suggesting enhanced capacity for sustained activity and reduced long-term health risk. Conversely, lower GARD scores are expected to be associated with metabolic risk factors that may hinder recovery and performance sustainability.

Conclusions:
This study will be the first to link GARD scores with real-world clinical biomarkers in a matched population, offering insights into how dietary complexity may contribute to both long-term health and sustained sports participation. If validated, GARD could serve as a practical, scalable tool to guide dietary strategies that balance performance and health in athletic and active populations.