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Jenkins M, Jefferds MED, Aburto NJ, Ramakrishnan U, Hartman TJ, Martorell R, Addo OY. Development of a Population-Level Dichotomous Indicator of Minimum Dietary Diversity as a Proxy for Micronutrient Adequacy in Adolescents Aged 10-19 Y in the United States. J Nutr 2024; 154:2795-2806. [PMID: 38917947 DOI: 10.1016/j.tjnut.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Diversity is a key component of diet quality and health, but no indicator exists for adolescents under the age of 15 y. OBJECTIVES To establish a dichotomous indicator for population-level assessment of adolescent dietary diversity as a proxy for micronutrient adequacy. METHODS We used the probability approach to construct mean probability of adequacy (MPA) of 11 micronutrients from 2 d of 24-h dietary recall data from NHANES, 2007-2018. For each micronutrient, probability of adequacy (PA) was calculated using the best linear unbiased predictor of usual intake. Adolescent dietary diversity score (ADDS) was derived with a maximum score of 10 food groups. Generalized linear mixed models were used to examine associations between ADDS and MPA. Receiver operating characteristic analysis was used to establish a cutoff for minimum dietary diversity for adolescents (MDD-A) using an energy-adjusted logistic model with ADDS predicting MPA > 0.6. RESULTS PA was >80% for all nutrients except vitamin C (42.1%), folate (65.7%), and calcium (23.8%). Population MPA was 79.4%, and nearly 92% of adolescents had an MPA > 0.6. ADDS was positively associated with MPA, and energy was a significant confounder. The area under the curve was >0.8 on both days with sensitivity and specificity ranging from 0.71 to 0.80. The MDD-A cutoff was calculated as 5.12 and 5.10 food groups on days 1 and 2, respectively. CONCLUSIONS In U.S. adolescents, the best cutoff for a dichotomous indicator of dietary diversity as a proxy for micronutrient adequacy is 6 food groups in a given day. Future research could validate MDD-A and its associated cutoff for use across country contexts.
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Affiliation(s)
- Mica Jenkins
- International Micronutrient Malnutrition Prevention and Control (IMMPaCt) Program, Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States; Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States.
| | - Maria Elena D Jefferds
- International Micronutrient Malnutrition Prevention and Control (IMMPaCt) Program, Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Nancy J Aburto
- Food and Nutrition Division, Food and Agriculture Organization, Rome, Italy
| | - Usha Ramakrishnan
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Terryl J Hartman
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Reynaldo Martorell
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - O Yaw Addo
- International Micronutrient Malnutrition Prevention and Control (IMMPaCt) Program, Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States; Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Kong A, Sanchez-Flack J, Fitzgibbon M, Schiffer L, Hubbard C. Race/Ethnicity Modifies the Relationship Between Diet Quality at the Home- and Individual-Levels and Weight Status Among African American and Hispanic/Latinx Households With Preschool-Age Children. Child Obes 2024; 20:378-385. [PMID: 37856653 DOI: 10.1089/chi.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background: Higher obesity prevalence and poorer diet quality disproportionately impacting groups based on income and race/ethnicity may be partially attributed to the home food environment. This study examined home- and individual-level diet quality with weight status among racially/ethnically diverse households. Methods: This cross-sectional study included African American (AA) and Hispanic/Latinx (H/L) households with preschool-age children (n = 97). Home-level diet quality was based on comprehensive home food inventories and individual-level diet quality was based on 24-hour dietary recalls; scores were estimated with the Healthy Eating Index. Child and adult appropriate weight categories based on BMI were estimated with measured heights and weights. Multiple linear regression models (independent variable: weight status, outcome: diet quality scores) with an interaction term for weight status and race/ethnicity and adjusting for potential confounding factors were used to estimate adjusted mean diet quality scores. Postestimation pairwise comparisons of these scores were used to look for within and between group differences by weight status and race/ethnicity. Results: Home-level diet quality scores were significantly higher among H/L households compared to AA counterparts regardless of weight status. AA parents with BMI <30 and AA children with BMI <85th percentile had poorer individual-level diet quality scores compared to AA parents and children of lower weight status and all H/L parents and children. Conclusions: These findings offer evidence that race/ethnicity modifies the relationship between diet quality and weight among AA and H/L households. Future research needs to examine the distinctive ways race/ethnicity shapes the relationship between weight and diet quality in these households.
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Affiliation(s)
- Angela Kong
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
| | - Jennifer Sanchez-Flack
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Marian Fitzgibbon
- University of Illinois Cancer Center, Chicago, Illinois, USA
- Institute for Health Research and Policy, Chicago, Illinois, USA
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Linda Schiffer
- Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Colin Hubbard
- Department of Medicine, Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
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Huang S, He Q, Wang X, Choi S, Gong H. Associations of the planetary health diet index (PHDI) with asthma: the mediating role of body mass index. BMC Public Health 2024; 24:2305. [PMID: 39187832 PMCID: PMC11346270 DOI: 10.1186/s12889-024-19856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 08/22/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Given the global shifts in environmental conditions and dietary habits, understanding the potential impact of dietary factors and body mass index (BMI) on respiratory diseases, including asthma, is paramount. Investigating these relationships can contribute to the formulation of more effective prevention strategies. The Planetary Health Diet Index (PHDI), a dietary scoring system that balances human health with environmental sustainability, underscores the importance of increasing the consumption of plant-based foods while reducing the intake of red meat, sugar, and highly processed foods. The objective of this study was to assess the association between PHDI and the prevalence of asthma and the mediation effect of BMI in a US general population. METHODS This study utilized data from 32,388 participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between PHDI, individual nutrients, and asthma. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between PHDI and asthma. Interaction analyses were conducted on subgroups to validate the findings. Mediation analysis was performed to examine the effect of BMI on the relationship between PHDI and asthma. RESULTS There was a significant negative association between PHDI and asthma. After adjusting for covariates, for every 10-point increase in PHDI, there was a 4% decrease in the prevalence of asthma (P = 0.025). Moreover, as PHDI increased, there was a trend towards lower asthma prevalence (P for trend < 0.05). WQS analyses showed consistent associations (OR = 0.93, 95%CI: 0.88, 0.98), with Fiber, Vitamin C, and Protein significant factors. The dose-response curve indicated a linear association between PHDI and asthma, with higher PHDI associated with lower asthma prevalence. Additionally, BMI is significantly positively associated with asthma (P < 0.001), and BMI decreases as the PHDI increases (β = -0.64, P < 0.001). Mediation analysis indicates that BMI significantly mediates the relationship between PHDI and asthma, with a mediation proportion of 33.85% (P < 0.001). CONCLUSION The results of this study show a strong negative correlation between PHDI and the prevalence of asthma. In addition, BMI mediated this negative relationship.
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Affiliation(s)
- Shaoqun Huang
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou City, Fujian Province, China
| | - Qiao He
- Graduate School of Tianjin, University of Traditional Chinese Medicine, Tianjin City, China
| | - Xiaoxuan Wang
- Graduate School of Tianjin, University of Traditional Chinese Medicine, Tianjin City, China
| | - Seok Choi
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Korea
| | - Hongyang Gong
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Korea.
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Alves IA, Jessri M, Monteiro LS, Gomes LEDS, Lopes TDS, Yokoo EM, Sichieri R, Pereira RA. Energy-Dense and Low-Fiber Dietary Pattern May Be a Key Contributor to the Rising Obesity Rates in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1038. [PMID: 39200648 PMCID: PMC11354081 DOI: 10.3390/ijerph21081038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 09/02/2024]
Abstract
Hybrid methods are a suitable option for extracting dietary patterns associated with health outcomes. This study aimed to identify the dietary patterns of Brazilian adults (20-59 years old; n = 28,153) related to dietary components associated with the risk of obesity. Data from the 2017-2018 Brazilian National Dietary Survey were analyzed. Food consumption was obtained through 24 h recall. Dietary patterns were extracted using partial least squares regression, using energy density (ED), percentage of total fat (%TF), and fiber density (FD) as response variables. In addition, 32 food groups were established as predictor variables in the model. The first dietary pattern, named as energy-dense and low-fiber (ED-LF), included with the positive factor loadings solid fats, breads, added-sugar beverages, fast foods, sauces, pasta, and cheeses, and negative factor loadings rice, beans, vegetables, water, and fruits (≥|0.15|). Higher adherence to the ED-LF dietary pattern was observed for individuals >40 years old from urban areas, in the highest income level, who were not on a diet, reported away-from-home food consumption, and having ≥1 snack/day. The dietary pattern characterized by a low intake of fruits, vegetables, and staple foods and a high intake of fast foods and sugar-sweetened beverages may contribute to the obesity scenario in Brazil.
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Affiliation(s)
- Iuna Arruda Alves
- Graduate Program in Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-590, RJ, Brazil
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Centre for Health Services and Policy Research (CHSPR), Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Luana Silva Monteiro
- Institute of Food and Nutrition, Federal University of Rio de Janeiro (UFRJ), Macaé 27930-560, RJ, Brazil;
| | - Luiz Eduardo da Silva Gomes
- Graduate Program in Statistics, Institute of Mathematics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-909, RJ, Brazil;
- Department of Quantitative Methods, Center of Exact Sciences and Technology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 22290-240, RJ, Brazil
| | - Taís de Souza Lopes
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-590, RJ, Brazil; (T.d.S.L.); (R.A.P.)
| | - Edna Massae Yokoo
- Department of Epidemiology and Biostatistics, Institute of Collective Health, Fluminense Federal University (UFF), Niterói 24030-210, RJ, Brazil;
| | - Rosely Sichieri
- Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rio de Janeiro 20550-013, RJ, Brazil;
| | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-590, RJ, Brazil; (T.d.S.L.); (R.A.P.)
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Avraham SB, Chetrit A, Agay N, Freedman LS, Saliba W, Goldbourt U, Keinan-Boker L, Kalter-Leibovici O, Shahar DR, Kimron L, Dankner R. Methodology and challenges for harmonization of nutritional data from seven historical studies. Nutr J 2024; 23:88. [PMID: 39107818 PMCID: PMC11302319 DOI: 10.1186/s12937-024-00976-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Collection of detailed dietary data is labor intensive and expensive, harmonization of existing data sets has been proposed as an effective tool for research questions in which individual studies are underpowered. METHODS In this paper, we describe the methodology used to retrospectively harmonize nutritional data from multiple sources, based on the individual participant data of all available studies, which collected nutritional data in Israel between 1963 and 2014. This collaboration was established in order to study the association of red and processed meat with colorectal cancer. Two types of nutritional questionnaires, the Food Frequency Questionnaires (FFQ) and the 24-h dietary recall (24HR recall), and different food composition tables, were used by the participating studies. The main exposure of interest included type of meat (total meat, red meat, and poultry) and level of processing. RESULTS A total of 29,560 Israeli men and women were enrolled. In studies using FFQ,the weighted mean intakes of total, red, processed meat, and poultry were 95, 27, 37 and 58 gr/day and 92, 25, 10, and 66 gr/day in studies using 24HR recall, respectively.. Despite several methodological challenges, we successfully harmonized nutritional data from the different studies. CONCLUSIONS This paper emphasizes the significance and feasibility of harmonization of previously collected nutritional data, offering an opportunity to examine associations between a range of dietary exposures and the outcome of interest, while minimizing costs and time in epidemiological studies.
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Affiliation(s)
- Sivan Ben Avraham
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Angela Chetrit
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Nirit Agay
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Laurence S Freedman
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Uri Goldbourt
- Department for Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
- School of Public Health, University of Haifa, Haifa, Israel
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- Department for Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Danit R Shahar
- Department of Epidemiology, Biostatistics and Community Health Sciences, The International Center of Health Innovation & Nutrition, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Lizie Kimron
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Rachel Dankner
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel.
- Department for Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Silva AM, Levy J, De Carli E, Cacau LT, de Alvarenga JFR, Benseñor IJM, Lotufo PA, Fiamoncini J, Brennan L, Marchioni DML. Biomarker panels for fruit intake assessment: a metabolomics analysis in the ELSA-Brasil study. Metabolomics 2024; 20:88. [PMID: 39073486 DOI: 10.1007/s11306-024-02145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 06/24/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Food intake biomarkers are used to estimate dietary exposure; however, selecting a single biomarker to evaluate a specific dietary component is difficult due to the overlap of diverse compounds from different foods. Therefore, combining two or more biomarkers can increase the sensitivity and specificity of food intake estimates. OBJECTIVE This study aimed to evaluate the ability of metabolite panels to distinguish between self-reported fruit consumers and non-consumers among participants in the Longitudinal Study of Adult Health. MATERIALS AND METHODS A total of 93 healthy adults of both sexes were selected from the Longitudinal Study of Adult Health. A 24-h dietary recall was obtained using the computer-assisted 24-h food recall GloboDiet software, and 24-h urine samples were collected from each participant. Metabolites were identified in urine using liquid chromatography coupled with high-resolution mass spectrometry by comparing their exact mass and fragmentation patterns using free-access databases. Multivariate receiver operating characteristic curve (ROC) analysis and partial least squares discriminant analysis were used to verify the ability of the metabolite combination to classify daily and non-daily fruit consumers. Fruit intake was identified using a 24 h dietary recall (24 h-DR). RESULTS Bananas, grapes, and oranges are included in the summary. The panel of biomarkers exhibited an area under the curve (AUC) > 0.6 (Orange AUC = 0.665; Grape AUC = 0.622; Bananas AUC = 0.602; All fruits AUC = 0.679; Citrus AUC = 0.693) and variable importance projection score > 1.0, and these were useful for assessing the sensitivity and predictability of food intake in our population. CONCLUSION A panel of metabolites was able to classify self-reported fruit consumers with strong predictive power and high specificity and sensitivity values except for banana and total fruit intake.
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Affiliation(s)
- Alexsandro Macedo Silva
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Jéssica Levy
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Eduardo De Carli
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Leandro Teixeira Cacau
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - José Fernando Rinaldi de Alvarenga
- Department of Food Science and Experimental Nutrition, Faculty of Pharmaceutical Sciences, Food Research Center (FoRC), University of São Paulo, São Paulo, SP, Brazil
| | | | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Jarlei Fiamoncini
- Department of Food Science and Experimental Nutrition, Faculty of Pharmaceutical Sciences, Food Research Center (FoRC), University of São Paulo, São Paulo, SP, Brazil
| | - Lorraine Brennan
- School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
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Xu X, Han Q, Lin X, Lin J, Wang S. Association between dietary niacin intake and lung function among American adults: A cross-sectional analysis from national health and nutrition examination survey, 2007-2012. Heliyon 2024; 10:e33482. [PMID: 39027602 PMCID: PMC11255858 DOI: 10.1016/j.heliyon.2024.e33482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 06/08/2024] [Accepted: 06/21/2024] [Indexed: 07/20/2024] Open
Abstract
Background The pathogenesis of pulmonary senescence involves immune system dysregulation, oxidative stress, and mitochondrial dysfunction. The effects on lung function of niacin, an essential coenzyme involved in mitochondrial energy metabolism with known antioxidant properties, are poorly understood. Methods This cross-sectional study used data from the 2007-2012 National Health and Nutrition Examination Survey, including spirometry data and niacin intake information of 9706 adults. This study investigated various spirometry measures, such as forced expiratory volume in 1 s, forced vital capacity, pulse expiratory flow, (forced expiratory volume in 1 s)/(forced vital capacity)ratio, and predicted forced expiratory volume in 1 s and forced vital capacity percentages. Additionally, a secondary analysis was conducted using Global Initiative for Chronic Obstructive Lung Disease and chronic obstructive pulmonary disease. Foundation Spirometry Grade criteria to assess the relationship between niacin intake, airflow limitation, and obstruction. Multivariate regression models were used to adjust for relevant covariates. Results The study included 9706 U S. adults (4788 men and 4918 women) with a median age of 46.2 years. After adjusting for relevant factors, a positive correlation was observed between niacin intake and lung function. Compared to the lowest quintile of niacin intake (Q1, ≤14.5 mg/day), individuals in the highest quintile (Q5, >34.5 mg/day) exhibited significant increases in lung function parameters, including forced expiratory volume in 1s (69.84 mL, p = 0.003), pulse expiratory flow (254.48 mL, p < 0.001), (forced expiratory volume in 1 s)/(forced vital capacity)(0.01, p = 0.041), percent predicted forced expiratory volume in 1 s(2.05, p = 0.002), and percent predicted forced vital capacity(1.29, p = 0.042).Subset analyses of individuals with spirometry-defined airflow obstruction showed associations of high niacin intake with significantly improved forced expiratory volume, pulse expiratory flow, and percent predicted pulse expiratory flow and an interaction among race, education, and smoking status with respect to the relationship between niacin intake and lung function parameters. Conclusions Higher niacin intake was associated with increased measures of lung function. A diet rich in niacin-containing foods may play a role in improving lung health.
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Affiliation(s)
- Xiaoli Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
- School of Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qiong Han
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
- School of Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Xiaoying Lin
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Jianping Lin
- School of Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Shizhong Wang
- School of Health, Fujian Medical University, Fuzhou, Fujian Province, China
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Tugault-Lafleur CN, Polsky JY. Temporal snacking patterns among Canadian children and adolescents. Appl Physiol Nutr Metab 2024. [PMID: 38981135 DOI: 10.1139/apnm-2024-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Snacking is nearly universal among children but there is growing concern around snacking patterns and energy contribution. This study aimed to characterize temporal snacking patterns among Canadian children and adolescents. A cross-sectional analysis drew on data from 5209 respondents aged 4-18 years from the 2015 Canadian Community Health Survey Nutrition, using one 24 h dietary recall. Descriptive statistics estimated proportions of morning, afternoon, and evening snackers, the mean caloric contribution of each snacking period to total daily energy intake, and the top food categories consumed as snacks (kcal per capita). Snacking was nearly universal and accounted for one of every four calories consumed. Morning snacks were more popular among children vs. adolescents and contributed significantly less energy than afternoon or evening snacking periods for both age groups (P < 0.001). The top food groups consumed as snacks were the same for children and adolescents, although the ranking order varied. Fruits were the leading food group in terms of per capita energy for children and second for adolescents. Aside from fruits and milks, all other top per capita energy contributors were generally more energy-dense, nutrient-poor foods such as cookies, biscuits and cereal bars, and other breads. Among children, morning snacks were higher in desirable nutrients compared with afternoon snacks. Not all snacking periods are equal in terms of energy and nutrients. A better understanding of how time of day may influence the quality of snack foods can inform meal-based guidance and help children achieve the recommended daily amounts of foods and nutrients.
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Affiliation(s)
| | - Jane Y Polsky
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
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Hillestad EMR, Steinsvik EK, Teige ES, Rasmussen SH, Brønstad I, Lundervold A, Hausken T, Hanevik K, Lied GA, Berentsen B. Nutritional safety and status following a 12-week strict low FODMAP diet in patients with irritable bowel syndrome. Neurogastroenterol Motil 2024; 36:e14814. [PMID: 38689453 DOI: 10.1111/nmo.14814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/26/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND A low FODMAP diet (LFD) is an established dietary treatment for patients with irritable bowel syndrome (IBS). However, knowledge on the extended effects of the restriction phase regarding nutrient intake, symptom severity, and quality of life (QoL) is sparse. Therefore, our objectives were to evaluate the safety of a dietitian-led 12-week strict LFD on measures of blood biochemistry, nutritional status, symptom severity, and QoL. METHODS In this open-label dietitian-led 12-week strict LFD intervention for IBS patients with predominantly diarrhea or mixed stool pattern (IBS-D/-M), we collected data on diet intake (3-day dietary record), overnight fasting routine blood samples, body weight, IBS symptoms (IBS Severity Scoring System (IBS-SSS)), and IBS-related QoL (IBS-QoL) at baseline and after 12 weeks. KEY RESULTS Thirty-six participants completed the 12-week follow-up (mean age: 37 years, 67% women, IBS-SSS: 242 (101)). All blood parameters measured were within established reference values at both time points. We found no change in intake of macro- or micronutrients, but several micronutrients were below the recommendations both before and after 12 weeks. BMI slightly decreased, primarily driven by participants with BMI >25 (p < 0.005). QoL improved among most subdomains (p ≤ 0.002), except food avoidance and social reaction. CONCLUSION An extended dietitian-guided LFD (12 weeks) is not inferior to the participants' baseline diet, since no clinically meaningful changes in nutritionally related blood samples and no changes in macro- or micronutrient intake were observed. However, the intake of several nutrients was below the recommendations at both time points indicating low diet quality.
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Affiliation(s)
- Eline Margrete Randulff Hillestad
- Department of Clinical Medicine, Faculty of Medicine, Center for Nutrition, University of Bergen, Bergen, Norway
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Elisabeth Kjelsvik Steinsvik
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Erica Sande Teige
- Department of Clinical Medicine, Faculty of Medicine, Center for Nutrition, University of Bergen, Bergen, Norway
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Stella Hellgren Rasmussen
- Department of Clinical Medicine, Faculty of Medicine, Center for Nutrition, University of Bergen, Bergen, Norway
| | - Ingeborg Brønstad
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Arvid Lundervold
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Department of Radiology, Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Trygve Hausken
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kurt Hanevik
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Gülen Arslan Lied
- Department of Clinical Medicine, Faculty of Medicine, Center for Nutrition, University of Bergen, Bergen, Norway
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Birgitte Berentsen
- Department of Medicine, Division of Gastroenterology, National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
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10
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Shen S, Salehi E, White C, Chen Y, Iyengar NM. Evaluation of a mobile behavior change program for weight loss in breast cancer survivors. NPJ Breast Cancer 2024; 10:53. [PMID: 38951532 PMCID: PMC11217495 DOI: 10.1038/s41523-024-00659-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/14/2024] [Indexed: 07/03/2024] Open
Abstract
Post-diagnosis weight gain is common in early-stage breast cancer and is associated with increased risk of recurrence and mortality. Intentional weight loss is difficult to maintain, and digital lifestyle interventions may provide a scalable approach to address this challenge. In this prospective single-arm study (ClinicalTrials.gov NCT04753268; February 15, 2021), key eligibility criteria included: stage I-III breast cancer, body mass index (BMI) ≥ 27.5 kg/m2, and completion of cancer treatment ≥6 months before study enrollment. Participants were provided with a behavioral change mobile application (Noom®). The primary endpoint was a change in self-reported weight from baseline to 26 weeks. Secondary endpoints included engagement, changes in physical activity, dietary patterns, and patient-reported outcomes (PRO). In total, 31 patients were enrolled (mean age 56.8 ± 9.9, mean baseline BMI 33.5 kg/m2 ± 6.5). The mean weight change was -4.8 kg ( ± 4.4, P < 0.001), mean percent weight change was -5.6% ( ± 5.0%); 11/31 patients (35.5%) lost ≥5% of their initial weight. Metrics of digital application engagement associated with weight loss ≥5% included articles read (P = 0.012), weights logged (P = 0.006), food records logged (P = 0.001), messages sent (P = 0.001), and application open count (P = 0.014). Significant increases were seen in mean daily step count (P = 0.004), GPAQ scores (P = 0.002), and Body Image Scale scores (P < 0.001). Mean energy intake remained consistently in a calorie-restricted range of 1300-1400 kcal/day. In this study, breast cancer survivors were highly engaged with a behavioral change smartphone application which led to clinically significant weight loss, increased physical activity, maintenance of an energy-restricted diet, and improvements in body image.
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Affiliation(s)
- Sherry Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Erica Salehi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charlie White
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuan Chen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Neil M Iyengar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Weill Cornell Medicine, New York, NY, USA.
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11
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Ooi KJ, Taylor RM, Fenton S, Hutchesson MJ, Collins CE. Evaluating Validated Diet Quality Indices Used in Pregnant Women in High-Income Countries: A Systematic Review. Nutr Rev 2024:nuae073. [PMID: 38899508 DOI: 10.1093/nutrit/nuae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Diet quality indices (DQIs) assess the level of adherence to dietary recommendations and a specified dietary pattern in populations; however, there is limited evidence regarding the construct criteria and validation methodology of DQIs used in pregnant women. OBJECTIVES The objectives of this study were to (i) identify and describe characteristics of DQIs that have been validated for use in pregnant women in high-income countries, and (ii) evaluate criteria used to develop DQIs and validation methodologies employed. DATA SOURCES CINAHL, Embase, Medline, SCOPUS, and Web of Science were systematically searched for eligible articles published between 1980 and November 2022 that focused on DQIs validated for use in pregnant women from high-income countries. DATA EXTRACTION Characteristics, development criteria, and validation methodologies used in the included articles were extracted by one reviewer and checked by a second reviewer. DATA ANALYSIS A narrative synthesis and descriptive statistics were used to summarize the review findings. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Six articles with 5 validated DQIs were identified. In total, 3777 participants were included - five articles had pregnant women aged 31-50 years and in their second trimester. Food frequency questionnaires were used as the dietary assessment method in all studies, and 3 DQIs were used to assess dietary intake at 1 time point, using 2 different dietary assessment methods. No indices fulfilled preferred features for the DQI development criteria developed by Burggraf et al (2018). Construct validity was assessed by all DQIs, followed by criterion validity (n = 4) and test-retest reliability (n = 2). CONCLUSION Limited high-quality validated DQIs for use in pregnant women in high-income countries were identified. Scoring for DQI components were not specific to nutrient requirements for pregnant women. Findings from this review may inform the development of DQIs that evaluate specific dietary requirements and specific food safety considerations applicable to pregnancy. SYSTEMATIC REVIEW REGISTRATION https://osf.io/u2hrq.
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Affiliation(s)
- Kee June Ooi
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Rachael M Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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12
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Assaad M, Ajjour S, Rahme M, Al-Shaar L, Sakr M, Ghattas H, El-Hajj Fuleihan G, Jabbour J. Development and validity of the 'Modified Mediterranean Prime Screen' to assess dietary intake among women of reproductive age in Lebanon. Br J Nutr 2024:1-9. [PMID: 38818715 DOI: 10.1017/s0007114524000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
The Mediterranean Region registers an increasing prevalence of obesity. The region lacks a diet screener to assess obesogenic nutrients. This study aimed to evaluate the reproducibility and validity of the Modified Mediterranean Prime Screen (MMPS) in estimating obesogenic nutrients' intake among women of reproductive age, as compared with a culturally validated Food Frequency Questionnaire (FFQ), in Lebanon. We developed the MMPS consisting of thirty-two food/beverage items specific to the Lebanese Mediterranean culture. The MMPS and FFQ were administered in two visits (2 weeks-6 months apart), face to face and via telephone during the coronavirus disease 2019 pandemic. The reproducibility and validity of the MMPS were assessed using intraclass correlation coefficients (ICC) and Pearson's correlations, respectively. The study included 143 women, aged 31·5 (sd 4·6) years, BMI 24·2 (sd 4·0) kg/m2, 87 % with university education and 91 % food secure. The reproducibility of the MMPS was moderate for energy and all assessed nutrients except for SFA (ICC = 0·428). The agreement of the MMPS with the reference FFQ was adequate for energy and obesogenic nutrients. Yet, the Pearson correlations for energy-adjusted nutrient intake were low for trans-fatty acids (0·294) and PUFA (0·377). The MMPS can be a time-efficient tool for dietary assessment of energy and many obesogenic nutrients. Future studies should validate the MMPS across the lifespan and re-evaluate it after updating the fatty acid profiles in the culturally specific food composition tables.
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Affiliation(s)
- Mariam Assaad
- Calcium Metabolism and Osteoporosis Program, World Health Organization Collaborating Center for Metabolic Bone Disorders, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - Sara Ajjour
- Calcium Metabolism and Osteoporosis Program, World Health Organization Collaborating Center for Metabolic Bone Disorders, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - Maya Rahme
- Calcium Metabolism and Osteoporosis Program, World Health Organization Collaborating Center for Metabolic Bone Disorders, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - Laila Al-Shaar
- Department of Public Health Sciences, Penn State University, University Park, USA
| | - May Sakr
- Department of Clinical Nutrition, American University of Beirut Medical Center, Beirut, 1107 2020, Lebanon
| | - Hala Ghattas
- Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, World Health Organization Collaborating Center for Metabolic Bone Disorders, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - Jana Jabbour
- Nutrition Program, Department of Natural Sciences, Lebanese American University, Beirut, Lebanon
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13
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Lemke S, de Andrade DF, de Fragas Hinnig P, da Silva SA, Vincenzi SL, Roberto DMT, Lobo AS, Vieira FGK, Di Pietro PF, de Assis MAA. Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory. Nutr J 2024; 23:50. [PMID: 38745270 PMCID: PMC11092231 DOI: 10.1186/s12937-024-00948-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil. METHODS A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372). RESULTS Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns. CONCLUSIONS IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.
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Affiliation(s)
- Stella Lemke
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Dalton Francisco de Andrade
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patrícia de Fragas Hinnig
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Silvio Aparecido da Silva
- Knowledge Management Department, Federal Institute of Education, Science and Technology of Santa Catarina, Florianópolis, Brazil
| | - Silvana Ligia Vincenzi
- Informatics and Statistics Department, Technological Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Denise Miguel Teixeira Roberto
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Adriana Soares Lobo
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Francilene Gracieli Kunradi Vieira
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patricia Faria Di Pietro
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil.
- Federal University of Santa Catarina, Campus Trindade, Florianópolis, Santa Catarina, 88040-370, Brazil.
| | - Maria Alice Altenburg de Assis
- Nutrition Postgraduate Program, Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Karlsen MC, Staffier KL, Pollard KJ, Cara KC, Hulit SM, Campbell EK, Friedman SM. Piloting a brief assessment to capture consumption of whole plant food and water: version 1.0 of the American College of Lifestyle Medicine Diet Screener (ACLM Diet Screener). Front Nutr 2024; 11:1356676. [PMID: 38737510 PMCID: PMC11085256 DOI: 10.3389/fnut.2024.1356676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/29/2024] [Indexed: 05/14/2024] Open
Abstract
Background Despite the availability of various dietary assessment tools, there is a need for a tool aligned with the needs of lifestyle medicine (LM) physicians. Such a tool would be brief, aimed at use in a clinical setting, and focused on a "food as medicine" approach consistent with recommendations for a diet based predominately on whole plant foods. The objective of this study is to describe the development and initial pilot testing of a brief, dietary screener to assess the proportion of whole, unrefined plant foods and water relative to total food and beverage intake. Methods A multidisciplinary study team led the screener development, providing input on the design and food/beverage items included, and existing published dietary assessment tools were reviewed for relevance. Feedback was solicited from LM practitioners in the form of a cross-sectional survey that captured information on medical practice, barriers, and needs in assessing patients' diets, in addition to an opportunity to complete the screener and provide feedback on its utility. The study team assessed feedback and revised the screener accordingly, which included seeking and incorporating feedback on additional food items to be included from subject matter experts in specific cultural and ethnic groups in the United States. The final screener was submitted for professional design, and scoring was developed. Results Of 539 total participants, the majority reported assessing diet either informally (62%) or formally (26%) during patient encounters, and 73% reported discussing diet with all or most of their patients. Participants also reported facing barriers (80%) to assessing diet. Eighty-eight percent believed the screener was quick enough to use in a clinical setting, and 68% reported they would use it. Conclusion The ACLM Diet Screener was developed through iterative review and pilot testing. The screener is a brief, 27-item diet assessment tool that can be successfully used in clinical settings to track patient dietary intakes, guide clinical conversations, and support nutrition prescriptions. Pilot testing of the screener found strong alignment with clinician needs for assessing a patient's intake of whole plant food and water relative to the overall diet. Future research will involve pilot testing the screener in clinical interventions and conducting a validation study to establish construct validity.
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Affiliation(s)
- Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, United States
- Applied Nutrition and Global Public Health, University of New England, Biddeford, ME, United States
| | - Kara L. Staffier
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Kathryn J. Pollard
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Kelly C. Cara
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Sarah M. Hulit
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Erin K. Campbell
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Susan M. Friedman
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
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15
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Morales R, Martinez-Arroyo A, Aguilar E. Robust Deep Neural Network for Learning in Noisy Multi-Label Food Images. SENSORS (BASEL, SWITZERLAND) 2024; 24:2034. [PMID: 38610246 PMCID: PMC11014385 DOI: 10.3390/s24072034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/17/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024]
Abstract
Deep networks can facilitate the monitoring of a balanced diet to help prevent various health problems related to eating disorders. Large, diverse, and clean data are essential for learning these types of algorithms. Although data can be collected automatically, the data cleaning process is time-consuming. This study aims to provide the model with the ability to learn even when the data are not completely clean. For this purpose, we extend the Attentive Feature MixUp method to enable its learning on noisy multi-label food data. The extension was based on the hypothesis that during the MixUp phase, when a pair of images are mixed, the resulting soft labels should be different for each ingredient, being larger for ingredients that are mixed with the background because they are better distinguished than when they are mixed with other ingredients. Furthermore, to address data perturbation, the incorporation of the Laplace approximation as a post-hoc method was analyzed. The evaluation of the proposed method was performed on two food datasets, where a notable performance improvement was obtained in terms of Jaccard index and F1 score, which validated the hypothesis raised. With the proposed MixUp, our method reduces the memorization of noisy multi-labels, thereby improving its performance.
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Affiliation(s)
- Roberto Morales
- Departamento de Ingeniería y Sistemas de Computación, Universidad Católica del Norte, Av. Angamos 0610, Antofagasta 1270709, Chile;
| | - Angela Martinez-Arroyo
- Centro de Investigación del Comportamiento Alimentario, Escuela Nutrición y Dietética, Universidad de Valparaíso, Av. Gran Bretaña. Playa Ancha, Valparaíso 2360102, Chile;
| | - Eduardo Aguilar
- Departamento de Ingeniería y Sistemas de Computación, Universidad Católica del Norte, Av. Angamos 0610, Antofagasta 1270709, Chile;
- Departament de Matemàtiques i Informàtica, Universitat de Barcelona, Gran Via de les Corts Catalanes 585, 08007 Barcelona, Spain
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16
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Charpentier N, Dumas A, Morisset AS, Fontaine-Bisson B. Evaluation of the Olo Prenatal Nutrition Follow-up Care for Vulnerable Pregnant Women. CAN J DIET PRACT RES 2024; 85:2-11. [PMID: 37220174 DOI: 10.3148/cjdpr-2023-006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Olo nutritional follow-up care offers vulnerable pregnant women food vouchers, multivitamin supplements, tools, and nutritional counselling to support healthy pregnancy outcomes.Purpose: To evaluate the contribution of Olo follow-up care to nutritional intakes and eating practices, as well as to assess the programme-related experience of participants.Methods: Participants (n = 30) responded to questionnaires and web-based 24-hour dietary recalls and participated in a semi-structured interview (n = 10).Results: Olo follow-up care reduced the proportion of participants below the recommended intake for groups for many micronutrients, with the greatest reduction for folate (by 96.7%), vitamin D (by 93.3%), iron (by 70.0%), calcium (by 50.0%), and zinc (by 30.0%), mainly due to the prenatal multivitamin supplements. Most participants (96.7%) did not follow Olo's typical recommendations but, if they had, hypothetically they would have consumed an average of 746 additional calories per day and be above the recommendations for excessive intakes of folic acid and iron (100% and 33.3%, respectively). More than half of the participants were moderately to severely food insecure. Olo contributed to reducing the impact of isolation and increased food accessibility and budget flexibility among participants.Conclusion: Olo follow-up care helped reduce the proportion of women below the recommended intake for micronutrients, but revising the food offered and strategies to address food insecurity may be necessary.
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Affiliation(s)
- Noémie Charpentier
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON
| | - Alex Dumas
- School of Human Kinetics, University of Ottawa, Ottawa, ON
| | | | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON
- Institut du savoir Montfort, Montfort Hospital, Ottawa, ON
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17
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Fox K, Melo Herrera Y, Abreu AM, Vadiveloo MK. Variety of High and Very Low-Energy Density Foods among Preschool-Aged Children and Associations with Food Intake, Diet Quality, and Weight Status. J Nutr 2024; 154:697-705. [PMID: 38135003 DOI: 10.1016/j.tjnut.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Energy density (ED) and the variety of foods are 2 factors that may have a combined effect on preschool-aged children's ability to regulate food intake. However, little is known about the variety of foods consumed within different ED categories by children in the United States. OBJECTIVE Therefore, we explored the variety of high ED (HED, 4-9 kcal/g) and very low ED (VLED, <0.6 kcal/g) foods consumed by a nationally representative sample of children aged 2-5 y in the United States and the relationship between variety with food intake, diet quality, and weight status. METHODS ED, variety, and diet quality were assessed using two 24-h dietary recalls collected as part of the National Health And Nutrition Examination Survey 2011-2018 cycles (n = 1682). We assessed associations between HED and VLED varieties with energy intake, volume of food, diet quality, and weight status using multivariable linear and logistic regressions. RESULTS The HED variety was positively associated with energy intake (P < 0.0001). The VLED variety was positively associated with the volume of food (P < 0.0001) and diet quality (P < 0.0001). VLED was negatively associated with the odds of having obesity in minimally adjusted models [odds ratio (OR): 0.62; 95% confidence interval (CI): 0.31, 0.87]; however, the relationship was not significant in fully adjusted models. Patterns of variety intake were differently associated with energy, volume, and diet quality. Children consuming the high VLED variety and the low HED variety had lower odds of obesity [OR: 0.43; 95% CI: 0.21, 0.90]; however, this pattern was rare (10%). CONCLUSIONS These findings suggest that the variety of HED foods is associated with higher average energy intake per day, and the variety of VLED foods is associated with a higher volume of food consumed per day and diet quality in a nationally representative sample of preschool-aged children.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States
| | - Yarisbel Melo Herrera
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Alyssa M Abreu
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Maya K Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States.
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18
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Pastori G, Brouwer ID, Feskens EJM, Huong LT, Samuel FO, Xuan LTT, Shittu OF, Eyinla TE, Talsma EF. A simple fruit and vegetable score is a valid tool to assess actual fruit and vegetable intake. Br J Nutr 2023; 130:1942-1949. [PMID: 37143365 PMCID: PMC10632721 DOI: 10.1017/s0007114523001125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023]
Abstract
With the recent growing interest in improving fruit and vegetable intake for better health and limited research resources in many settings, simple-to-administer and low-priced indicators are essential tools for monitoring fruit and vegetable intake at the population level. A potential candidate indicator is the fruit and vegetable component of the Global Dietary Recommendation score (FV-GDR) based on data collected using the Diet Quality Questionnaire (DQQ). We investigated the relative validity of FV-GDR collected with the DQQ to measure fruit and vegetable intake by comparison with a 24-h recall (24hR) as a reference collected from 620 Vietnamese and 630 Nigerian adults in 2021. We found proportional differences in the prevalence of intake of vitamin A-rich vegetables, other vegetables and other fruits in Vietnam and all vegetable food groups in Nigeria. In both countries, we found a small difference in the total FV-GDR from DQQ compared with the 24hR, and the percentage of agreement between the two methods was quite high for the majority of the food groups. The FV-GDR calculated from the DQQ correlated with the actual intake, although less strongly than the FV-GDR from 24hR. The DQQ is a promising low-burden, low-cost and simple tool to calculate FV-GDR and to monitor fruit and vegetable consumption at the population level. This provides the possibility of evaluating an important aspect of diet quality in low-resource settings.
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Affiliation(s)
- Giulia Pastori
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, 6700 AAWageningen, the Netherlands
| | - Inge D. Brouwer
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, 6700 AAWageningen, the Netherlands
- International Food Policy Research Institute, Washington, DC, USA
| | - Edith J. M. Feskens
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, 6700 AAWageningen, the Netherlands
| | - Le Thi Huong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Folake O. Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Nigeria
| | - Le Thi Thanh Xuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Oluyemisi F. Shittu
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Nigeria
| | - Toluwalope E. Eyinla
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Nigeria
| | - Elise F. Talsma
- Department of Global Nutrition, Division of Human Nutrition and Health, Wageningen University and Research, 6700 AAWageningen, the Netherlands
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Larke JA, Chin EL, Bouzid YY, Nguyen T, Vainberg Y, Lee DH, Pirsiavash H, Smilowitz JT, Lemay DG. Surveying Nutrient Assessment with Photographs of Meals (SNAPMe): A Benchmark Dataset of Food Photos for Dietary Assessment. Nutrients 2023; 15:4972. [PMID: 38068830 PMCID: PMC10708545 DOI: 10.3390/nu15234972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Photo-based dietary assessment is becoming more feasible as artificial intelligence methods improve. However, advancement of these methods for dietary assessment in research settings has been hindered by the lack of an appropriate dataset against which to benchmark algorithm performance. We conducted the Surveying Nutrient Assessment with Photographs of Meals (SNAPMe) study (ClinicalTrials ID: NCT05008653) to pair meal photographs with traditional food records. Participants were recruited nationally, and 110 enrollment meetings were completed via web-based video conferencing. Participants uploaded and annotated their meal photos using a mobile phone app called Bitesnap and completed food records using the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24®) version 2020. Participants included photos before and after eating non-packaged and multi-serving packaged meals, as well as photos of the front and ingredient labels for single-serving packaged foods. The SNAPMe Database (DB) contains 3311 unique food photos linked with 275 ASA24 food records from 95 participants who photographed all foods consumed and recorded food records in parallel for up to 3 study days each. The use of the SNAPMe DB to evaluate ingredient prediction demonstrated that the publicly available algorithms FB Inverse Cooking and Im2Recipe performed poorly, especially for single-ingredient foods and beverages. Correlations between nutrient estimates common to the Bitesnap and ASA24 dietary assessment tools indicated a range in predictive capacity across nutrients (cholesterol, adjusted R2 = 0.85, p < 0.0001; food folate, adjusted R2 = 0.21, p < 0.05). SNAPMe DB is a publicly available benchmark for photo-based dietary assessment in nutrition research. Its demonstrated utility suggested areas of needed improvement, especially the prediction of single-ingredient foods and beverages.
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Affiliation(s)
- Jules A. Larke
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA 95616, USA
| | - Elizabeth L. Chin
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA 95616, USA
| | - Yasmine Y. Bouzid
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Tu Nguyen
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA 95616, USA
| | - Yael Vainberg
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Dong Hee Lee
- Department of Computer Science, University of California Davis, Davis, CA 95616, USA (H.P.)
| | - Hamed Pirsiavash
- Department of Computer Science, University of California Davis, Davis, CA 95616, USA (H.P.)
| | | | - Danielle G. Lemay
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA 95616, USA
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
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20
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Viroli G, Kalmpourtzidou A, Cena H. Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability. Nutrients 2023; 15:4723. [PMID: 38004117 PMCID: PMC10675717 DOI: 10.3390/nu15224723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Unhealthy dietary patterns are directly linked to the current Global Syndemic consisting of non-communicable diseases, undernutrition and climate change. The dietary shift towards healthier and more sustainable plant-based diets is essential. However, plant-based diets have wide intra differences; varying from vegan diets that totally exclude meat and animal products to traditional ones such as the Mediterranean diet and the new Nordic diet. It is acknowledged that plant-based diets may contribute simultaneously to improving population health as well as to decreasing the environmental impact of food systems. Evidence from cohort and randomized-controlled trials suggests that plant-based dietary patterns have beneficial effects on bodyweight control, cardiovascular health and diabetes prevention and treatment. On the other hand, micronutrient requirements may not be met, if some plant-based diets are not well-planned. Additionally, studies showed that lower consumption of meat and animal products results in lower environmental impacts. Consequently, plant-based diets could be a key factor to increase diet sustainability. This narrative review addresses the advantages of adherence to plant-based diets on human and planetary health considering strains and barriers to achieve this dietary transition, including cultural acceptability and affordability factors. Finally, potential intervention and policy recommendations are proposed, focusing on the update of current national food-based dietary guidelines.
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Affiliation(s)
- Giulia Viroli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
| | - Aliki Kalmpourtzidou
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
- Clinical Nutrition Unit, General Medicine, ICS Maugeri IRCCS, 27100 Pavia, Italy
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21
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Dubois L, Bédard B, Goulet D, Prud'homme D, Tremblay RE, Boivin M. Experiencing food insecurity in childhood: influences on eating habits and body weight in young adulthood. Public Health Nutr 2023; 26:2396-2406. [PMID: 37665116 DOI: 10.1017/s1368980023001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood. DESIGN A longitudinal study design was used to derive trajectories of household food insecurity from age 4·5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4·5 to 13 years and both dietary and weight outcomes at age 22 years. SETTING A birth cohort study conducted in the Province of Quebec, Canada. PARTICIPANTS In total, 698 young adults participating in the Québec Longitudinal Study of Child Development. RESULTS After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared with low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0·64; 95 % CI (0·27, 1·00)), non-whole-grain cereal products (ßadj: 0·32; 95 % CI (0·07, 0·56)) and processed meat (ßadj: 0·14; 95 % CI (0·02, 0·25)), with skipping breakfast (ORadj: 1·97; 95 % CI (1·08, 3·53)), with eating meals prepared out of home (ORadj: 3·38; 95 % CI (1·52, 9·02)), with experiencing food insecurity (ORadj: 3·03; 95 % CI (1·91, 4·76)) and with being obese (ORadj: 2·01; 95 % CI (1·12, 3·64)), once reaching young adulthood. CONCLUSION Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public health policies and programmes tackling poverty and food insecurity, particularly for families with young children.
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Affiliation(s)
- Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Brigitte Bédard
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Danick Goulet
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | | | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montréal, Montréal, QC, Canada
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- École de Psychologie, Université Laval, Québec, QC, Canada
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22
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Sauder KA, Cohen CC, Mueller NT, Hockett CW, Switkowski KM, Maldonado LE, Lyall K, Kerver JM, Dabelea D, O'Connor TG, Glueck DH, Melough MM, Couzens GL, Catellier DJ, Smith PB, Newby KL, Benjamin DK. Identifying Foods That Optimize Intake of Key Micronutrients During Pregnancy. J Nutr 2023; 153:3012-3022. [PMID: 37604382 PMCID: PMC10613721 DOI: 10.1016/j.tjnut.2023.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/21/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Most pregnant women in the United States are at risk of inadequate intake of vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids from foods alone. Very few United States dietary supplements provide sufficient doses of all 6 nutrients without inducing excess intake. OBJECTIVE We aimed to identify energy-efficient foods that provide sufficient doses of these nutrients and could be consumed in lieu of dietary supplements to achieve the recommended intake in pregnancy. METHODS In a previous analysis of 2,450 pregnant women, we calculated the range of additional intake needed to shift 90% of participants to intake above the estimated average requirement and keep 90% below the tolerable upper level for these 6 nutrients. Here, we identified foods and beverages from the 2019 to 2020 Food and Nutrient Database for Dietary Studies that provide target levels of these nutrients without exceeding the additional energy intake recommended for pregnancy beginning in the second trimester (340 kilocalories). RESULTS We identified 2358 candidate foods meeting the target intake range for at least one nutrient. No candidate foods provided target amounts of all 6 nutrients. Seaweed (raw or cooked without fat) provided sufficient vitamin A, folate, calcium, iron, and omega-3s (5 of 6 nutrients) but would require an intake of >5 cups/d. Twenty-one other foods/beverages (mainly fish, vegetables, and beverages) provided target amounts of 4 of the 6 nutrients. Few foods met targets for vitamin D (n = 54) or iron (n = 93). CONCLUSIONS Results highlight the difficulty in meeting nutritional requirements from diet alone and imply that dietary supplements are likely necessary to meet vitamin D and iron targets in pregnancy, as well as omega-3 fatty acid targets for individuals who do not consume fish products. Other foods could be added in limited amounts to help meet intake targets without exceeding caloric recommendations or nutrient safety limits.
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Affiliation(s)
- Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
| | - Catherine C Cohen
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Christine W Hockett
- Avera Research Institute and Department of Pediatrics, University of South Dakota, Sioux Falls, SD, United States
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Jean M Kerver
- Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Thomas G O'Connor
- Obstetrics & Gynecology, University of Rochester Medical Center, Rochester, NY, United States
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Melissa M Melough
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | - G Lance Couzens
- RTI International, Research Triangle Park, NC, United States
| | | | - P B Smith
- Duke Clinical Research Institute, Durham, North Carolina
| | - K L Newby
- Duke Clinical Research Institute, Durham, North Carolina
| | - D K Benjamin
- Duke Clinical Research Institute, Durham, North Carolina
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23
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Chang DC, Stinson EJ, Dodd KW, Bowles HR, Herrick KA, Schoeller DA, Barrett B, Votruba SB, Krakoff J, Kavouras SA. Validation of Total Water Intake from the Automated Self-Administered 24-h Recall, 4-d Food Records, and a Food Frequency Questionnaire Using Doubly Labeled Water. J Nutr 2023; 153:3049-3057. [PMID: 37660952 PMCID: PMC10613756 DOI: 10.1016/j.tjnut.2023.08.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Although prior evidence indicates that water intake is important for health, the ability to accurately measure community-dwelling intake is limited. Only a few studies have evaluated self-reported water intake against an objective recovery biomarker. OBJECTIVES The aim was to compare preformed water intakes (all sources including food) by multiple Automated Self-Administered 24-h recalls (ASA24s), food frequency questionnaires (FFQs), and 4-d food records (4DFRs) against a recovery biomarker, doubly labeled water (DLW), to assess measurement error. METHODS Over 1 y, 1082 women and men (50%), aged 50 to 74 y, were asked to complete 6 ASA24s, 2 FFQs, 2 unweighted 4DFRs, and an administration of DLW (n = 686). Geometric means of water intake by self-report tools were compared with DLW. Attenuation factors and correlation coefficients between self-reported and the recovery biomarker (DLW) were estimated. RESULTS Mean water intakes by DLW were 2777 mL/d (interquartile range, 2350 to 3331) in women and 3243 mL/d (interquartile range, 2720 to 3838) in men. Compared with DLW, water intake was underestimated by 18% to 31% on ASA24s and 43% to 44% on 4DFRs. Estimated geometric means from FFQs differed from DLW by -1% to +13%. For a single ASA24, FFQ, and 4DFR, attenuation factors were 0.28, 0.27, and 0.32 and correlation coefficients were 0.46, 0.48, and 0.49, respectively. Repeated use of 6 ASA24s, 2 FFQs, and 2 4DFRs improved attenuation factors to 0.43, 0.32, and 0.39 and correlation coefficients to 0.58, 0.53, and 0.54, respectively. CONCLUSIONS FFQs may better estimate population means for usual water intake compared with ASA24 and 4DFR. Similar attenuation factors and correlation coefficients across all self-report tools indicate that researchers have 3 feasible options if the goal is understanding intake-disease relationships. The findings are useful for planning future nutrition studies that set policy priorities for populations and to understand the health impact of water. This trial was registered at clinicaltrials.gov as NCT03268577.
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Affiliation(s)
- Douglas C Chang
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States.
| | - Emma J Stinson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Kevin W Dodd
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Heather R Bowles
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Kirsten A Herrick
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
| | - Dale A Schoeller
- Department of Nutritional Sciences, College of Agricultural and Life Sciences, University of Wisconsin, Madison, WI, United States
| | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, United States
| | - Susanne B Votruba
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Stavros A Kavouras
- Arizona State University, Hydration Science Lab, Phoenix, AZ, United States
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24
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Downs SM, Gueye D, Sall M, Ndoye B, Sarr NN, Sarr M, Mboup S, Alam NA, Diouf A, Merchant EV, Sackey J. The impact and implementation of an mHealth intervention to improve infant and young child feeding in Senegal: IIMAANJE protocol for a cluster randomized control trial. Front Public Health 2023; 11:1258963. [PMID: 37818304 PMCID: PMC10561905 DOI: 10.3389/fpubh.2023.1258963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/31/2023] [Indexed: 10/12/2023] Open
Abstract
Behavior change communication (BCC) strategies have the potential to improve infant feeding and nutrition outcomes among infants and young children in low- and middle-income countries. More recently, there has been a shift toward the adoption of mHealth interventions-the use of mobile phones to transmit health-related information or direct care-to promote recommended BCC strategies among the caregivers of infants and young children. In Senegal, most infants and young children are not fed according to recommended practices leading to a high prevalence of undernutrition and micronutrient deficiencies. The aims of this cluster randomized control trial, using an effectiveness-implementation (type 1) hybrid design, were to: (1) determine the impact of an mHealth IYCF intervention on IYCF practices and nutrition outcomes; and (2) examine the implementation, costs, and opportunities for scaling up the mHealth messaging intervention. The trial was conducted in three regions in Senegal (Thies, Fatick, Diourbel) with 488 mother, father and children (6-23 months) triads. The intervention included 8 scripted messages, that underwent cognitive testing prior to the intervention implementation, and 8 unscripted messages from positive deviants. One voice message and one text message were sent each week to members of our experimental group for a 16-week period. The impact of the intervention was assessed through a household survey, 24-h dietary recall, and hemoglobin measurements before and after the intervention implementation. The primary outcomes were minimal acceptable diet (MAD) and anemia. We also included a total of 54 participants in nine focus groups held with mothers and fathers and semi-structured interviews with Badienou Gox (i.e., community health workers) (n = 6) and national partners and program implementers (n = 6) to examine the intervention implementation process. The study was registered prior to data collection on Clinicaltrials.gov (Identifier: NCT05374837).
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Affiliation(s)
- Shauna M. Downs
- Department of Health Behavior, Society and Policy, School of Public Health, Rutgers University, New Brunswick, NJ, United States
| | - Daouda Gueye
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF), Pole Urbain de Diamniadio, Dakar, Senegal
| | | | - Bamba Ndoye
- Consulting and Training Group, Dakar, Senegal
| | - Ndèye Ndambao Sarr
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Faculté des Sciences et Techniques, Université Cheikh Anta Diop, Dakar, Senegal
| | - Moussa Sarr
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF), Pole Urbain de Diamniadio, Dakar, Senegal
| | - Souleymane Mboup
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF), Pole Urbain de Diamniadio, Dakar, Senegal
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Faculté des Sciences et Techniques, Université Cheikh Anta Diop, Dakar, Senegal
| | - Emily V. Merchant
- Department of Health Behavior, Society and Policy, School of Public Health, Rutgers University, New Brunswick, NJ, United States
| | - Joachim Sackey
- School of Health Professions, Rutgers University, Newark, NJ, United States
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Franck K, Puglisi M, Roe AJ, Baker S, Henson T, Earnesty D, Sankavaram K. Conducting 24-Hour Dietary Recalls in Group Settings with Adults Having Low-Income: Perspectives of EFNEP Peer Educators. Nutrients 2023; 15:4020. [PMID: 37764803 PMCID: PMC10534895 DOI: 10.3390/nu15184020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
The Expanded Food and Nutrition Education Program (EFNEP) is a federally funded program that teaches nutrition education to adults and youth with low-income. EFNEP is funded throughout the United States including federal territories. The purpose of EFNEP is to provide nutrition education. Evaluation for adult programs includes pre/post surveys and pre/post 24-h diet recalls (24HDR). A validated standard of dietary measures, 24HDR are useful when collected as designed: one-on-one by a trained professional. In EFNEP, 24HDR are collected in group settings by EFNEP peer educators who often have not received a college degree or any formal education in nutrition. The purpose of this study was to explore attitudes and behaviors of EFNEP peer educators regarding how they collect diet recalls in a group setting, their perceptions of how adult participants feel about the recalls, and the benefits and challenges of using recalls. Online interviews were conducted with EFNEP peer educators across the U.S. Peer educators recognized the importance of collecting the recall data but identified several challenges such as time, resources, and participant reluctance to complete the recall. Program evaluation through methods like the 24HDR is important to measure outcomes and inform program improvements but also needs to include how evaluation can benefit participants and minimize data collection burden. Future research needs to examine the validity of collecting recalls in a group setting compared to other measures of diet quality.
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Affiliation(s)
- Karen Franck
- Department of Family and Consumer Sciences, The University of Tennessee, Knoxville, TN 37996-4501, USA
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Annie J. Roe
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844-3183, USA;
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA;
| | - Teresa Henson
- Family and Consumer Sciences Department, University of Arkansas at Pine Bluff, Pine Bluff, AR 71601, USA;
| | - Dawn Earnesty
- Health and Nutrition Institute, Michigan State University Extension, Saginaw, MI 48607, USA;
| | - Kavitha Sankavaram
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA;
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26
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Papathanail I, Abdur Rahman L, Brigato L, Bez NS, Vasiloglou MF, van der Horst K, Mougiakakou S. The Nutritional Content of Meal Images in Free-Living Conditions-Automatic Assessment with goFOOD TM. Nutrients 2023; 15:3835. [PMID: 37686866 PMCID: PMC10490087 DOI: 10.3390/nu15173835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
A healthy diet can help to prevent or manage many important conditions and diseases, particularly obesity, malnutrition, and diabetes. Recent advancements in artificial intelligence and smartphone technologies have enabled applications to conduct automatic nutritional assessment from meal images, providing a convenient, efficient, and accurate method for continuous diet evaluation. We now extend the goFOODTM automatic system to perform food segmentation, recognition, volume, as well as calorie and macro-nutrient estimation from single images that are captured by a smartphone. In order to assess our system's performance, we conducted a feasibility study with 50 participants from Switzerland. We recorded their meals for one day and then dietitians carried out a 24 h recall. We retrospectively analysed the collected images to assess the nutritional content of the meals. By comparing our results with the dietitians' estimations, we demonstrated that the newly introduced system has comparable energy and macronutrient estimation performance with the previous method; however, it only requires a single image instead of two. The system can be applied in a real-life scenarios, and it can be easily used to assess dietary intake. This system could help individuals gain a better understanding of their dietary consumption. Additionally, it could serve as a valuable resource for dietitians, and could contribute to nutritional research.
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Affiliation(s)
- Ioannis Papathanail
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (I.P.); (L.A.R.); (L.B.); (M.F.V.)
| | - Lubnaa Abdur Rahman
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (I.P.); (L.A.R.); (L.B.); (M.F.V.)
| | - Lorenzo Brigato
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (I.P.); (L.A.R.); (L.B.); (M.F.V.)
| | - Natalie S. Bez
- School of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (N.S.B.); (K.v.d.H.)
| | - Maria F. Vasiloglou
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (I.P.); (L.A.R.); (L.B.); (M.F.V.)
| | - Klazine van der Horst
- School of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (N.S.B.); (K.v.d.H.)
| | - Stavroula Mougiakakou
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (I.P.); (L.A.R.); (L.B.); (M.F.V.)
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27
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Brassard D, Chevalier S. Relationship between Adherence to the 2019 Canada's Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults. J Nutr 2023; 153:2699-2708. [PMID: 37460086 DOI: 10.1016/j.tjnut.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Following Canada's food guide (CFG) recommendations should ensure adequate nutrient intakes. Older adults have increased needs for certain nutrients and nutrient density; the extent to which adherence to CFG recommendations can help reduce inadequate nutrient intakes is unknown. OBJECTIVES We aimed to assess the relationship between adherence to CFG recommendations on healthy food choices and intake of key nutrients in adults 65 y and older from the Canadian Community Health Survey 2015 - Nutrition. METHODS Secondary analysis of data from 4093 older adults of the Canadian Community Health Survey 2015 - Nutrition (mean age, 73.6 y, 54% females). Dietary intakes were measured using an interviewer-administered 24-h dietary recall, including 1 repeat in a subsample (42%). The National Cancer Institute multivariate method was used to estimate usual (i.e., long-term) dietary intakes. Adherence to CFG recommendations was measured using the Healthy Eating Food Index (HEFI)-2019 score. Simple linear and logistic regression models estimated the effect of increased HEFI-2019 score on usual nutrient intakes and the prevalence of inadequate nutrient intakes (i.e., below the estimated average requirements), respectively. RESULTS Compared with the prevalence of inadequate intakes at median HEFI-2019 score (46.4/80 points), a higher HEFI-2019 (+11 points) was associated with reductions in the prevalence of inadequate intakes of magnesium, vitamin B6 and protein [-19.8% (95% confidence interval (CI): -30.8, -8.9), -12.7% (95% CI: -22.5, -3.0), and -4.7% (95% CI: -9.4, -0.1), respectively]. In contrast, data for higher HEFI-2019 scores were compatible with increased prevalence of inadequate intakes of folate, vitamin D, and calcium [4.0% (95% CI: -8.4, 16.3), 2.6% (95% CI: 1.1, 4.0), and 2.3% (95% CI: -3.0, 7.5), respectively]. CONCLUSIONS Based on dietary intakes of Canadian older adults in 2015, increasing the degree of adherence to CFG recommendations on healthy food choices may reduce nutrient intake inadequacy for most key nutrients except folate, vitamin D, and calcium.
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Affiliation(s)
- Didier Brassard
- School of Human Nutrition, McGill University, Montréal, QC, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Montréal, QC, Canada; Research Institute of the McGill University Health Centre, Montréal, QC, Canada.
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28
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Bailey RL, Jun S, Cowan AE, Eicher-Miller HA, Gahche JJ, Dwyer JT, Hartman TJ, Mitchell DC, Seguin-Fowler RA, Carroll RJ, Tooze JA. Major Gaps in Understanding Dietary Supplement Use in Health and Disease. Annu Rev Nutr 2023; 43:179-197. [PMID: 37196365 PMCID: PMC11078263 DOI: 10.1146/annurev-nutr-011923-020327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Precise dietary assessment is critical for accurate exposure classification in nutritional research, typically aimed at understanding how diet relates to health. Dietary supplement (DS) use is widespread and represents a considerable source of nutrients. However, few studies have compared the best methods to measure DSs. Our literature review on the relative validity and reproducibility of DS instruments in the United States [e.g., product inventories, questionnaires, and 24-h dietary recalls (24HR)] identified five studies that examined validity (n = 5) and/or reproducibility (n = 4). No gold standard reference method exists for validating DS use; thus, each study's investigators chose the reference instrument used to measure validity. Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs. The inventory method captured nutrient amounts more accurately than the other methods. Reproducibility (over 3 months to 2.4 years) of prevalence of use estimates on the questionnaires was acceptable for common DSs. Given the limited body of research on measurement error in DS assessment, only tentative conclusions on these DS instruments can be drawn at present. Further research is critical to advancing knowledge in DS assessment for research and monitoring purposes.
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Affiliation(s)
- Regan L Bailey
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Shinyoung Jun
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Alexandra E Cowan
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | | | - Jaime J Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, USA
| | - Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, USA
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Diane C Mitchell
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Rebecca A Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, College Station, Texas, USA
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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29
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Sharpe I, Kirkpatrick SI, Smith BT, Keown-Stoneman CDG, Omand JA, Vanderhout S, Warren C, Maguire JL, Birken CS, Anderson LN. Validation of a parent proxy-reported beverage screener compared to a 24-hour dietary recall for the measurement of sugar-containing beverage intake among young children. PLoS One 2023; 18:e0288768. [PMID: 37471316 PMCID: PMC10358879 DOI: 10.1371/journal.pone.0288768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Measures that can provide reasonably accurate estimates of sugar-containing beverage (SCB) intake among children are needed. The primary objective of this study was to evaluate the relative validity of a short beverage screener (Nutrition and Health Questionnaire, NHQ) compared to a 24-hour recall (Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool-Canada) for assessing parent proxy-reported daily SCB intake among children aged 4-14 years from the TARGet Kids! research network in Toronto, Canada. Children for whom a NHQ completed between March 2018 and June 2019 and an ASA24 completed within one year were included. A total of 471 parents who completed the NHQ beverage screener were also asked to complete the ASA24. One-hundred sixty-three completed the ASA24 and of this group, 109 were analyzed. Estimates of daily intake of 100% juices, sweetened drinks and soda, and total SCBs from the two measures were compared. The mean difference in beverage intake, Spearman correlations, and Bland-Altman plots were estimated for continuous measures. The kappa coefficient, sensitivity, and specificity were calculated for dichotomous measures of any daily intake versus none. The mean difference in total SCB intake between the NHQ and ASA24 was 0.14 cups/day (95% CI 0.01, 0.29) and the correlation was 0.43 (95% CI 0.26, 0.57). Sensitivity and specificity for any daily SCB intake were 0.63 and 0.76, respectively. Overall, parent proxy-reporting of children's total SCB intake from a beverage screener can provide reasonable estimates of SCB intake when detailed dietary assessment is not feasible.
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Affiliation(s)
- Isobel Sharpe
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sharon I Kirkpatrick
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Brendan T Smith
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jessica A Omand
- Division of Child Health Evaluative Sciences (CHES), Sick Kids Research Institute, Toronto, Ontario, Canada
| | - Shelley Vanderhout
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Christine Warren
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Catherine S Birken
- Division of Child Health Evaluative Sciences (CHES), Sick Kids Research Institute, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Child Health Evaluative Sciences (CHES), Sick Kids Research Institute, Toronto, Ontario, Canada
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30
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Petrone BL, Aqeel A, Jiang S, Durand HK, Dallow EP, McCann JR, Dressman HK, Hu Z, Tenekjian CB, Yancy WS, Lin PH, Scialla JJ, Seed PC, Rawls JF, Armstrong SC, Stevens J, David LA. Diversity of plant DNA in stool is linked to dietary quality, age, and household income. Proc Natl Acad Sci U S A 2023; 120:e2304441120. [PMID: 37368926 PMCID: PMC10319039 DOI: 10.1073/pnas.2304441120] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/10/2023] [Indexed: 06/29/2023] Open
Abstract
Eating a varied diet is a central tenet of good nutrition. Here, we develop a molecular tool to quantify human dietary plant diversity by applying DNA metabarcoding with the chloroplast trnL-P6 marker to 1,029 fecal samples from 324 participants across two interventional feeding studies and three observational cohorts. The number of plant taxa per sample (plant metabarcoding richness or pMR) correlated with recorded intakes in interventional diets and with indices calculated from a food frequency questionnaire in typical diets (ρ = 0.40 to 0.63). In adolescents unable to collect validated dietary survey data, trnL metabarcoding detected 111 plant taxa, with 86 consumed by more than one individual and four (wheat, chocolate, corn, and potato family) consumed by >70% of individuals. Adolescent pMR was associated with age and household income, replicating prior epidemiologic findings. Overall, trnL metabarcoding promises an objective and accurate measure of the number and types of plants consumed that is applicable to diverse human populations.
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Affiliation(s)
- Brianna L. Petrone
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Medical Scientist Training Program, Duke University School of Medicine, Durham, NC27710
| | - Ammara Aqeel
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Sharon Jiang
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Heather K. Durand
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Eric P. Dallow
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Jessica R. McCann
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Holly K. Dressman
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | - Zhengzheng Hu
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | | | - William S. Yancy
- Duke Lifestyle and Weight Management Center, Durham, NC27710
- Department of Medicine, Duke University School of Medicine, Durham, NC27710
| | - Pao-Hwa Lin
- Department of Medicine, Nephrology Division, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC27705
| | - Julia J. Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA22903
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA22903
| | - Patrick C. Seed
- Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL60611
| | - John F. Rawls
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
| | - Sarah C. Armstrong
- Department of Pediatrics, Duke University School of Medicine, Durham, NC27710
| | - June Stevens
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Lawrence A. David
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
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31
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Reyneke GL, Beck EJ, Lambert K, Neale EP. The Effect of Non-Oil Seed Legume Intake on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:637-651. [PMID: 37031751 PMCID: PMC10334154 DOI: 10.1016/j.advnut.2023.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023] Open
Abstract
Hypertension is a primary modifiable risk factor for CVD, whereby even small reductions in blood pressure (BP) can decrease risk for CVD events. Modification of dietary patterns is an established, nonpharmacologic approach for the prevention and management of hypertension. Legumes are a prevailing component of dietary patterns associated with lower BP in observational research, but there is a need to understand the effects of legume consumption on BP. This study aimed to synthesize evidence from randomized controlled trials (RCTs) for the effects of non-oil seed legume consumption on systolic blood pressure (SBP) and diastolic blood pressure (DBP) (PROSPERO registration: CRD42021237732). We searched CINAHL, Cochrane, Medline, and PubMed scientific databases from inception through November 2022. A random-effects meta-analysis was conducted to assess the mean differences (MDs) for each outcome variable between legume-based and comparator diets. This review included 16 RCTs and 1092 participants. Studies ranged in duration (4-52 wk), participant age (17-75 y), and weekly legume dose (450-3150 g) in whole or powdered form. No significant overall effect between legume consumption and BP amelioration was observed in the meta-analysis (SBP-MD: -1.06 mm Hg; 95% CI: -2.57, 0.4410 mm Hg; I2 = 45%; DBP-MD: -0.48 mm Hg; 95% CI: -1.06, 0.10 mm Hg; I2 = 0%). The certainty of evidence was determined as low for SBP and DBP. Significant subgroup differences in SBP were found when studies were grouped according to participant BMI, with SBP reduction found for participants with overweight/obese BMI (MD -2.79 mm Hg, 95% CI: -4.68, -0.90 mm Hg). There is a need for large, high-quality trials to clearly define the benefits and mechanisms of legume consumption in BP management. Consideration of the relevance in individuals with obesity, overweight, and hypertension may also be warranted. This trial was registered at PROSPERO as CRD42021237732.
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Affiliation(s)
- Gynette L Reyneke
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
| | - Eleanor J Beck
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia; School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
| | - Elizabeth P Neale
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, Australia.
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32
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Mahal SS, Kucha C, Kwofie EM, Ngadi M. Design and Development of 'Diet DQ Tracker': A Smartphone Application for Augmenting Dietary Assessment. Nutrients 2023; 15:2901. [PMID: 37447227 DOI: 10.3390/nu15132901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The purpose of the current study was to describe the design, development, and validation of the 'Diet DQ Tracker'. The 'Diet DQ Tracker' is the first self-administered smartphone app designed to collect dietary data for diet diversity indicators. The main objective of the app was to replace the traditional methods of dietary data collection, such as in-person or telephone 24 h recall via pen and paper questionnaire or tablets. The real-time meal recording, extensive food database, and automatic score calculations and visualizations for MDD-W, IYCF-MDD, and HDDS have the potential to overcome the drawbacks of 24 h recalls. Recall depends on respondent memory, food expertise, and time consumption and demands skilled interviewers. Further, SAIN, LIM recommendations in the app prompt users to diversify diets with healthy foods. The pilot study determined the acceptability, feasibility, and relative validity of the 'Diet DQ Tracker' with a 24 h dietary recall. The results demonstrated minimal differences in dietary scores by both methodologies. The app, being convenient, easy to use, less time-consuming, and enjoyable, was preferred by the entire study sample over 24 h recall. The app will be continually updated with foods from different cultures for validating in large-scale studies. The future studies will help to improve the subsequent versions of the app.
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Affiliation(s)
- Subeg Singh Mahal
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Christopher Kucha
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
- Department of Food Science and Technology, University of Georgia, 100 Cedar St., Athens, GA 30602, USA
| | - Ebenezer M Kwofie
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Michael Ngadi
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
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33
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Peltonen H, Erkkola M, Abdollahi AM, Leppänen MH, Roos E, Sajaniemi N, Pajari AM, Vepsäläinen H. Associations of dietary patterns with common infections and antibiotic use among Finnish preschoolers. Food Nutr Res 2023; 67:8997. [PMID: 37351020 PMCID: PMC10284098 DOI: 10.29219/fnr.v67.8997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/20/2023] [Accepted: 05/08/2023] [Indexed: 06/24/2023] Open
Abstract
Background Preschoolers suffer frequently from infections. Although nutrition plays a key role in immune function, very little is known about the impact of overall diet on preschoolers' infections. Objective To assess the associations between dietary patterns, common infections and antibiotic use among Finnish preschoolers. Design The study included 721 3-6-year-old preschoolers participating in the cross-sectional DAGIS survey. Parents retrospectively reported the number of common colds, gastroenteritis episodes and antibiotic courses their children had acquired during the past year. Food consumption outside preschool hours was recorded using a food frequency questionnaire. Dietary patterns were derived from the consumption frequencies using principal component analysis. Associations between the thirds of the dietary pattern scores and the outcomes were analysed using logistic and negative binomial regression models. Results Prevalence of common colds was lower in moderate and high adherence to the sweets-and-treats pattern than in low adherence (prevalence ratio [PR]: 0.89, 95% confidence interval [CI]: 0.80-1.00, and PR: 0.88, 95% CI: 0.79-0.99, respectively) and higher in high adherence to the health-conscious pattern than in low adherence (PR: 1.13, 95% CI: 1.01-1.27) after adjusting for age, sex, number of children living in the same household, frequency of preschool attendance, family's highest education and probiotic use. The risk of ≥1 gastroenteritis episode and the prevalence of antibiotic courses were lower in moderate adherence to the sweets-and-treats pattern than in low adherence (odds ratio [OR]: 0.63, 95% CI: 0.44-0.92 and PR: 0.77, 95% CI: 0.59-1.00, respectively). Conclusions The results were unexpected. Parents who were most health-conscious of their children's diet might also have been more aware of their children's illness.
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Affiliation(s)
- Henna Peltonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anna M. Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Marja H. Leppänen
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Nina Sajaniemi
- Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Anne-Maria Pajari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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34
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Evans ME, Herrick KA, Regan KS, Shams-White MM, Vargas AJ, Reedy J. A Decade of Dietary Assessment Methodology Research at the National Institutes of Health, 2012-2021. J Nutr 2023; 153:1627-1635. [PMID: 36921805 PMCID: PMC10196585 DOI: 10.1016/j.tjnut.2023.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Assessment of individual and population-level dietary intake is critical for public health surveillance, epidemiology, and dietary intervention research. In recognition of that need, the National Insitutes of Health (NIH) has a history of funding research projects designed to support the development, implementation, and refinement of tools to assess dietary intake in humans. OBJECTIVES This report provides data and information on NIH-funded dietary intake assessment methodological research over the period of 2012-2021. METHODS Data were extracted from an internal NIH data system using the Research, Condition, and Disease Categorization (RCDC) spending category for Nutrition. Data were then examined to identify research focused on dietary assessment tools or methods to capture or analyze dietary intake. RESULTS Over the decade of 2012-2021, NIH supported 46 grants and 2 large contracts specific to dietary assessment methods development. The top 6 Institutes and Offices funding dietary assessment methods research were identified. Most projects were limited to adults. Projects ranged from novel methods to capture dietary intake, and refinement of analytical methods, to biomarkers of dietary intake. One key contract supported the automated self-administered 24-h dietary assessment tool (ASA24), a widely used, free tool available to the research community for assessing dietary intake. CONCLUSIONS NIH's support for dietary assessment methods development over this 10-y period was small but grew over time with an expanding number and variety of methods, data sources, and technological advancements in the assessment of dietary intake. NIH remains committed to supporting research seeking to advance the field of dietary assessment methods research.
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Affiliation(s)
- Mary E Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.
| | - Kirsten A Herrick
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Karen S Regan
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States
| | - Marissa M Shams-White
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Jill Reedy
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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Monteiro CDM, Ferreira SMR, Almeida CCB, Duarte LM, Crispim SP. Dietary exposure to food azo-colours in a sample of pre-school children from Southern Brazil. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2023; 40:613-624. [PMID: 37099730 DOI: 10.1080/19440049.2023.2203778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The dietary exposure of six food azo-colours was assessed in a sample of pre-schoolers from Guaratuba-Paraná, Brazil. Consumption data of 323 children aged 2 to 5 years was collected through 3-day food records. Dietary exposure, is expressed by milligrams of food colour by kilogram of body weight per day, as compared to the Acceptable Daily Intake (ADI). Three exposure scenarios were developed to account for uncertainties around consumption estimates. Intakes of Amaranth (INS 123) described in means, 50th and 95th percentiles exceeded ADI levels in the two most conservative scenarios, with the highest percentiles exceeding about four times the ADI. High intakes of Sunset Yellow FCF (INS 110) were also observed, of up to 85% of the ADI in the worst-case scenario. Findings suggest high exposure levels to azo-dyes in the survey population, with children likely exceeding the ADI for Amaranth (INS 123) and concerns for Sunset Yellow FCF (INS 110). Major food contributors were beverages (juice powders and soft drinks), dairy and sweets. Further studies on dietary exposure assessment are needed at the national level. The authors highlight the need of controlling the use of such additives through national policies that are aligned with the consumption patterns observed in the country.
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Affiliation(s)
| | | | | | - Larissa Marinho Duarte
- Postgraduate Program in Food and Nutrition, Federal University of Paraná - UFPR, Curitiba, Brazil
| | - Sandra Patricia Crispim
- Postgraduate Program in Food and Nutrition, Federal University of Paraná - UFPR, Curitiba, Brazil
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36
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Murai U, Tajima R, Matsumoto M, Sato Y, Horie S, Fujiwara A, Koshida E, Okada E, Sumikura T, Yokoyama T, Ishikawa M, Kurotani K, Takimoto H. Validation of Dietary Intake Estimated by Web-Based Dietary Assessment Methods and Usability Using Dietary Records or 24-h Dietary Recalls: A Scoping Review. Nutrients 2023; 15:nu15081816. [PMID: 37111035 PMCID: PMC10141001 DOI: 10.3390/nu15081816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
The goal was to summarize studies comparing the accuracy of web-based dietary assessments with those of conventional face-to-face or paper-based assessments using 24-h dietary recall or dietary record methods in the general population. Using two databases, mean differences and correlation coefficients (CCs) for intakes of energy, macronutrients, sodium, vegetables, and fruits were extracted from each study independently by the authors. We also collected information regarding usability from articles reporting this. From 17 articles included in this review, the mean dietary intake differences in the web-based dietary assessment compared to conventional methods, were -11.5-16.1% for energy, -12.1-14.9% for protein, -16.7-17.6% for fat, -10.8-8.0% for carbohydrates, -11.2-9.6% for sodium, -27.4-3.9% for vegetables, and -5.1-47.6% for fruits. The CC was 0.17-0.88 for energy, protein, fat, carbohydrates, and sodium, and 0.23-0.85 for vegetables and fruits. In three out of four studies reporting usability, more than half of the participants preferred the web-based dietary assessment. In conclusion, % difference and CC of dietary intake were acceptable in both web-based dietary records and 24-h dietary recalls. The findings from this review highlight the possibility of wide-spread application of the web-based dietary assessment in the future.
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Affiliation(s)
- Utako Murai
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Yoko Sato
- Department of the Science of Living, Kyoritsu Women's Junior College, Tokyo 101-8437, Japan
| | - Saki Horie
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Emiko Koshida
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tomoko Sumikura
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Midori Ishikawa
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Kayo Kurotani
- Faculty of Food and Health Sciences, Showa Women's University, Tokyo 154-8533, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
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Sauder KA, Couzens GL, Bailey RL, Hockett CW, Switkowski KM, Lyall K, Kerver JM, Dabelea D, Maldonado LE, O'Connor TG, Deoni SC, Glueck DH, Catellier DJ. Selecting a dietary supplement with appropriate dosing for 6 key nutrients in pregnancy. Am J Clin Nutr 2023; 117:823-829. [PMID: 37019542 PMCID: PMC10273074 DOI: 10.1016/j.ajcnut.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Most pregnant women in the United States (US) are at risk of inadequate intake of key nutrients during pregnancy from foods alone. Current dietary supplement practices reduce risk of inadequacy for only some nutrients and induce excessive intake of other nutrients. OBJECTIVES Our study aimed to estimate the doses of supplementation needed to help most pregnant women achieve the recommended intake without exceeding upper limits for key prenatal nutrients and to identify US dietary supplements providing these doses. METHODS We conducted 24-h dietary recalls in 2450 pregnant participants aged 14-50 y from 2007 to 2019. We estimated the usual intake of vitamins A and D, folate, calcium, iron, and ω-3 FAs from foods alone. We calculated the target doses of supplementation needed to shift 90% of participants to consume above the estimated average requirement and keep 90% below the tolerable upper limit. We identified products in the Dietary Supplement Label Database providing these target doses of supplementation. RESULTS The target dose for supplementation was ≥198 mcg retinol activity equivalents of total vitamin A (with ≤2063 mcg preformed retinol); 7-91 mcg vitamin D; 169-720 mcg dietary folate equivalents of folic acid; 383-943 mg calcium; 13-22 mg iron; and ≥59 mg ω-3 FAs. Out of 20,547 dietary supplements (including 421 prenatal products), 69 products (33 prenatal) contained all 6 nutrients; 7 products (2 prenatal) contained target doses for 5 nutrients. Only 1 product (not a prenatal) contained target doses for all 6 nutrients, but it currently costs ∼USD200/mo and requires 7 tablets per daily serving. CONCLUSIONS Almost no US dietary supplements provide key nutrients in the doses needed for pregnant women. Affordable and convenient products that fill the gap between food-based intake and estimated requirements of pregnancy without inducing excess intake are needed to support pregnant women and their offspring. Am J Clin Nutr 20XX;xx:xx-xx.
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Affiliation(s)
- Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | | | - Regan L Bailey
- Institute for Advancing Health through Agriculture, College Station, TX, USA
| | - Christine W Hockett
- Avera Research Institute and Department of Pediatrics, University of South Dakota, Sioux Falls, SD, USA
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Jean M Kerver
- Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Thomas G O'Connor
- Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Sean Cl Deoni
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Karagöz MA, Sarıca K. Patient compliance to dietary recommendations: tips and tricks to improve compliance rates. World J Urol 2023; 41:1261-1268. [PMID: 36786816 DOI: 10.1007/s00345-023-04318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/28/2023] [Indexed: 02/15/2023] Open
Abstract
Urinary stone disease continues to be a public health problem with growing incidence and recurrences. Recurrence is nearly detected in 50% of the patients within 5 years after the first episode. However, stone recurrence rates can be reduced to a certain extent. The American Urological Association (AUA) and the European Urological Association (EAU) guidelines advice dietary, fluid intake, and medical treatment to prevent or minimize stone recurrence. However, studies have shown that compliance to dietary and fluid intake recommendations is low. Beside this, nutritional evaluation of the patients is sufficient. Using food frequency questionnaires (FFQs), 24 h recall methods (short, individual-oriented, and easily applicable) or mobile apps can be used. In addition, cooperation with registered dietitians (RD) and planning tailored dietary programmes may have positive effect on compliance. Providers who give dietary advices should improve their knowledge about the topic and communication skills to create a patient-provider trust relationship. Simplifying the advices (shorter lists, applicable advices), spending more time, and giving education until being sure for patients' understanding with regular remindings may improve adherence. Moreover, patients increased awareness and knowledge about dietary advices are beneficial. Smart devices for fluid uptake or urine pH monitoring, mobile apps or web-based portals, and telemedicine applications can be used to maintain the compliance on dietary advices. Compliance with dietary modifications and fluid intake recommendations can be well achieved by individualized evaluation/close follow-up and the elimination of the problems limiting the patient compliance.
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Affiliation(s)
- Mehmet Ali Karagöz
- Department of Urology, Health Sciences University, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Kemal Sarıca
- Department of Urology, Faculty of Medicine, Biruni University, Istanbul, Turkey.
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Avelino DC, Duffy VB, Puglisi M, Ray S, Lituma-Solis B, Nosal BM, Madore M, Chun OK. Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments? Nutrients 2023; 15:862. [PMID: 36839221 PMCID: PMC9964317 DOI: 10.3390/nu15040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.
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Affiliation(s)
- Daniela C. Avelino
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Snehaa Ray
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Brenda Lituma-Solis
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Briana M. Nosal
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Matthew Madore
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
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Qin Y, Rivera RL, Zhang Y, Wang Q, Tooze JA, Abbott AR, Maulding MK, Craig BA, Bailey RL, Eicher-Miller HA. A Randomized Intervention of Supplemental Nutrition Assistance Program-Education Did Not Improve Dietary Outcomes Except for Vitamin D Among Lower-Income Women in Indiana. J Acad Nutr Diet 2023; 123:284-298.e2. [PMID: 35781080 DOI: 10.1016/j.jand.2022.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The goal of US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to improve the likelihood that those eligible for SNAP will make healthy choices aligned with the Dietary Guidelines for Americans, 2020-2025. OBJECTIVE The objective of the study was to evaluate the long-term effects of a direct SNAP-Ed intervention in which participants actively engage in learning with educator instruction about dietary quality and usual intake of key nutrient and food groups among Indiana SNAP-Ed-eligible women participants as an example sample in the context of no similar existing evaluation. DESIGN The study design was a parallel-arm, randomized controlled, nutrition education intervention, with follow-up at 1 year. PARTICIPANTS/SETTING Participants (18 years and older; n = 97 women) eligible for SNAP-Ed and interested in receiving nutrition education lessons were recruited from 31 Indiana counties from August 2015 to May 2016 and randomized to an intervention (n = 53) or control (n = 44) group. INTERVENTION The intervention comprised core lessons of Indiana SNAP-Ed delivered between 4 and 10 weeks after baseline assessment. Each participant completed a baseline and 1-year follow-up assessment. Dietary intake was assessed using repeated 24-hour dietary recalls (up to 2). MAIN OUTCOME MEASURES Mean usual nutrient, food group intake, diet quality (ie, Healthy Eating Index-2010 scores), and proportion of intervention and control groups meeting Dietary Guidelines for Americans, 2020-2025 recommendations and Dietary Reference Intake indicators of requirement or adequacy, were determined using the National Cancer Institute method and the simple Healthy Eating Index-2010 scoring algorithm method. Dietary changes between intervention and control groups were examined over time using mixed linear models. STATISTICAL ANALYSES PERFORMED Bonferroni-corrected significance levels were applied to the results of the mixed linear models for comparisons of usual intake of nutrients and foods. RESULTS No differences in diet quality, intake of food group components, food group intake, or nutrients were observed at 1-year follow-up, except that vitamin D intake was higher among those who received SNAP-Ed compared with the control group. CONCLUSIONS A direct SNAP-Ed intervention did not improve diet quality, food group intake, or key nutrient intake, except for vitamin D, among Indiana SNAP-Ed-eligible women up to 1 year after the nutrition education.
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Affiliation(s)
- Yue Qin
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Rebecca L Rivera
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Yumin Zhang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Qi Wang
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Janet A Tooze
- School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Angela R Abbott
- Health and Human Sciences Extension, Purdue University, West Lafayette, IN
| | - Melissa K Maulding
- Department of Nutrition and Dietetics, Eastern Illinois University, Charleston
| | - Bruce A Craig
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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The DQQ is a Valid Tool to Collect Population-Level Food Group Consumption Data: A Study Among Women in Ethiopia, Vietnam, and Solomon Islands. J Nutr 2023; 153:340-351. [PMID: 36913471 DOI: 10.1016/j.tjnut.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The Diet Quality Questionnaire (DQQ) is a rapid dietary assessment tool designed to enable feasible measuring and monitoring of diet quality at population level in the general public. OBJECTIVES To evaluate validity of the DQQ for collecting population-level food group consumption data required for calculating diet quality indicators by comparing them with a multipass 24-h dietary recall (24hR) as the reference. METHODS Cross-sectional data were collected among female participants aged 15-49 y in Ethiopia (n = 488), 18-49 y in Vietnam (n = 200), and 19-69 y in Solomon Islands (n = 65) to compare DQQ and 24hR data in proportional differences in food group consumption prevalence, percentage of participants achieving Minimum Dietary Diversity for Women (MDD-W), percent agreement, percentage misreporting food group consumption, and diet quality scores of Food Group Diversity Score (FGDS), noncommunicable disease (NCD)-Protect, NCD-Risk, and the Global Dietary Recommendation (GDR) score using a nonparametric analysis. RESULTS The mean (standard deviation) percentage point difference between DQQ and 24hR in population prevalence of food group consumption was 0.6 (0.7), 2.4 (2.0), and 2.5 (2.7) in Ethiopia, Vietnam, and Solomon Islands, respectively. Percent agreement of food group consumption data ranged from 88.6% (10.1) in Solomon Islands to 96.3% (4.9) in Ethiopia. There was no significant difference between DQQ and 24hR in population prevalence of achieving MDD-W except for Ethiopia (DQQ 6.1 percentage points higher, P < 0.01). Median (25th-75th percentiles) scores of FGDS, NCD-Protect, NCD-Risk, and GDR score were comparable between the tools. CONCLUSIONS The DQQ is a suitable tool for collecting population-level food group consumption data for estimating diet quality with food group-based indicators such as the MDD-W, FGDS, NCD-Protect, NCD-Risk, and GDR score.
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Brassard D, Manikpurage HD, Thériault S, Arsenault BJ, Lamarche B. Greater adherence to the 2019 Canada's Food Guide recommendations on healthy food choices reduces the risk of cardiovascular disease in adults: a prospective analysis of UK Biobank data. Am J Clin Nutr 2022; 116:1748-1758. [PMID: 36124644 PMCID: PMC9761735 DOI: 10.1093/ajcn/nqac256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/10/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Canada's Food Guide (CFG) was profoundly revised in 2019, but the extent to which adherence to recommendations on healthy food choices reduces the risk of cardiovascular disease (CVD) is unknown. OBJECTIVES The aim of this study was to examine how greater adherence to the 2019 CFG's recommendations on healthy food choices influences the risk of incident CVD. METHODS Participants were a sample of adults without history of CVD, diabetes, or cancer from the UK Biobank prospective cohort study. Usual dietary intakes were estimated by modeling data from repeated Web-based 24-h dietary recalls using the National Cancer Institute multivariate method. Adherence to key CFG recommendations on healthy food choices was assessed using the Healthy Eating Food Index (HEFI)-2019, which has a maximum of 80 points. The CVD outcome was a composite of fatal and nonfatal myocardial infarction and ischemic stroke. Cox regression models adjusted via inverse probability weighting were used to estimate CVD risks. Counterfactual models were used to interpret risks of hypothetical changes in the HEFI-2019 score. RESULTS A total of 136,698 participants met the eligibility criteria (55% females; mean age: 57.2 y; range: 40-75 y). During the 11-y follow-up, there were 2843 cases of incident CVD. Compared with no change in the HEFI-2019 score, increasing the HEFI-2019 score of all participants to the 90th percentile of the score distribution (58.1 points) hypothetically reduced the risk of CVD by 24% (RR: 0.76; 95% CI: 0.58, 0.94; absolute risk difference: -0.58%). CONCLUSIONS These results suggest that greater adherence to the 2019 CFG recommendations on healthy food choices reduces the 11-y risk of CVD in middle-aged and older adults.
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Affiliation(s)
- Didier Brassard
- Center of Nutrition, Health, and Society (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Quebec, Canada
| | - Hasanga D Manikpurage
- Research Center, University Institute of Cardiology and Pneumology of Quebec, Laval University, Québec, Quebec, Canada
| | - Sébastien Thériault
- Research Center, University Institute of Cardiology and Pneumology of Quebec, Laval University, Québec, Quebec, Canada
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Faculty of Medicine, Laval University, Québec, Quebec, Canada
| | - Benoît J Arsenault
- Research Center, University Institute of Cardiology and Pneumology of Quebec, Laval University, Québec, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Laval University, Québec, Quebec, Canada
| | - Benoît Lamarche
- Center of Nutrition, Health, and Society (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Quebec, Canada
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Paloma T, Claudia CR, Naise R, Patricia B, Clevio F, Marcel Q, Pedro B, Abelardo A, Adriana B. Evaluation of nutritional status and adherence to dietary monitoring among patients with human T-cell leukemia virus type 1 infection. Clin Nutr ESPEN 2022; 52:198-207. [PMID: 36513454 DOI: 10.1016/j.clnesp.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 08/26/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS The nutritional status of people infected with Human T-Cell Leukemia Virus type 1 (HTLV-1) is rarely studied. Malnutrition affects the immune system, but the consequences of this remain unknown in HTLV-1 infection. This study aimed to analyze the nutritional status, food intake, and ability to adhere to dietary counseling in people with symptomatic HTLV-1 infection. METHODS This was a longitudinal, prospective, observational study in which the nutritional status of people with symptomatic HTLV-1 was monitored between June 2016 and August 2019 at a referral center. At the baseline (day 0) and last stage (day 90) anthropometric, bioimpedance, and dietary assessments were performed. RESULTS In total, 71 participants with symptomatic HTLV-1 infection were enrolled, the majority (43, 60.6%) of whom were female. The mean age was 59.2 (±11.1) years. Participants were often overweight or obese (40, 56.3%) had a BMI above 25 kg/m2. The average consumption of recommended fibers and liquids was positively associated with percent lean body mass (%LM). Most participants who were overweight (36.6%) or obese (19.70%) and their nutritional status and eating behavior did not change during the follow-up period. Dietary counseling was unable to promote a change in the monotony of the existing eating habits. Participants with good adherence to nutritional guidelines had higher dietary diversity scores. CONCLUSION A high proportion of participants were overweight or obese. Adherence to dietary counseling was low, and its success was limited in improving dietary diversity/nutritional status. Loss to follow-up was a limitation of this study.
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Affiliation(s)
- Torres Paloma
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil.
| | - Cople-Rodrigues Claudia
- Nutrition Institute, State University of Rio de Janeiro, Rua São Francisco Xavier 524, 12th Floor, Rio de Janeiro, RJ 20550-900, Brazil
| | - Rocha Naise
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brito Patricia
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Fonseca Clevio
- COVID-19 Hospital Center to Combat Pandemic, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Quintana Marcel
- Clinical Research Platform, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brasil Pedro
- Research Laboratory on Immunization and Health Surveillance, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Araújo Abelardo
- Clinical Research Laboratory in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Bacelo Adriana
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
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Application of the Updated WCRF/AICR Cancer Prevention Score as an Outcome for Cancer Survivors Participating in a Tailored and Intensive Dietary and Physical Activity Intervention. Nutrients 2022; 14:nu14224751. [PMID: 36432442 PMCID: PMC9699073 DOI: 10.3390/nu14224751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has defined evidence-based guidelines for cancer prevention. These recommendations have been operationalized into a quantitative index for individual assessment. Survivors of cancer are increasingly desiring guidance for diet and lifestyle, and in the absence of research in survivors, are often instructed to follow cancer prevention and public health guidelines. In this study, we examine the utility of the quantitative updated WCRF/AICR scoring criteria to assess change among cancer survivors with overweight/obesity (OW/OB) following an intensive behavioral intervention. We applied the WCRF/AICR scoring criteria (range 0−7) to examine changes over the duration of the study by paired t-tests. Two cancer survivor cohorts with OW/OB (n = 91) completed a six-month phase II clinical trial designed to improve dietary and physical activity patterns. At enrollment and post-intervention, participants completed assessments including anthropometrics, food frequency questionnaires, and objective evaluation of physical activity. Participants improved adherence to all scored recommendations, with a significant increase in mean score from enrollment (3.22 ± 1.06) to post-intervention (4.28 ± 1.04) (p < 0.001). Mean BMI and waist circumference improved (both p < 0.001). The greatest improvements were noted for fruit and non-starchy vegetable intakes (+39%, p < 0.001); the greatest decreases were observed for processed meat consumption (−70%, p < 0.001). The updated WCRF/AICR Score can be applied to cancer survivor intervention studies and provides a tool to compare trials in regard to the baseline status of populations enrolled and the success of the intervention. Future interventions incorporating standardized assessments will help guide effective strategies to improve the health and quality of life for cancer survivors.
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Kazemi M, Kim JY, Wan C, Xiong JD, Michalak J, Xavier IB, Ganga K, Tay CT, Grieger JA, Parry SA, Moran LJ, Lujan ME. Comparison of dietary and physical activity behaviors in women with and without polycystic ovary syndrome: a systematic review and meta-analysis of 39 471 women. Hum Reprod Update 2022; 28:910-955. [PMID: 35639552 PMCID: PMC9629501 DOI: 10.1093/humupd/dmac023] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/08/2022] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Lifestyle (dietary and/or physical activity [PA]) modification is recommended as first-line therapy to manage polycystic ovary syndrome (PCOS). Current recommendations are based on healthy lifestyle practices for the general public since evidence for unique lifestyle approaches in PCOS is limited and low quality. OBJECTIVE AND RATIONALE We aimed to synthesize evidence on dietary and PA behaviors between women with PCOS and those without PCOS. Primary outcomes were overall diet quality, total energy intake and total PA, and secondary outcomes included macronutrients, micronutrients, food groups, foods, glycemic indices, sedentary time and sitting levels. We conducted this work to identify any unique lifestyle behaviors in women with PCOS that could underlie the propensity of weight gain and obesity in PCOS and be targeted for precision nutrition and PA interventions. These findings could be used to inform future practice recommendations and research that more effectively address complications (weight gain, obesity, diabetes, infertility, cardiovascular disease and mental health) in this high-risk population. SEARCH METHODS Databases of MEDLINE, Web of Science, Scopus and CINAHL were searched until 15 February 2022 to identify observational studies documenting dietary and PA behaviors between women with PCOS and without PCOS (Controls). Studies on children, adolescents (<18 years), pregnant or menopausal-aged women (>50 years) were excluded. Data were pooled by random-effects models and expressed as (standardized) mean differences (MD) and 95% CIs. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). OUTCOMES Fifty-four studies (N = 39 471 participants; [n = 8736 PCOS; 30 735 Controls]) were eligible (96%; [52/54] NOS scores ≥ 7). Women with PCOS had higher cholesterol (MD: 12.78, 95% CI: 1.48 to 24.08 mg/day; P = 0.03; I2 = 19%), lower magnesium (MD: -21.46, 95% CI: -41.03 to -1.91 mg/day; P = 0.03; I2 = 76%), and a tendency for lower zinc (MD: -1.08, 95% CI: -2.19 to -0.03 mg/day; P = 0.05; I2 = 96%) intake, despite lower alcohol consumption (MD: -0.95, 95% CI: -1.67 to 0.22 g/day; P = 0.02; I2 = 0%) versus Controls. Also, women with PCOS had lower total PA (standardized mean difference: -0.38, 95% CI: -0.72 to 0.03; P = 0.03; I2 = 98%). Conversely, energy, macronutrients (carbohydrate, fat, protein, fiber), micronutrients (folic acid, iron, calcium, sodium), glycemic index and glycemic load were similar (all: P ≥ 0.06). Most eligible studies reported lower total adherence to healthy eating patterns or poorer consumption of major food groups (grains, fruits, vegetables, proteins, seeds, nuts, dairy) in women with PCOS, as described narratively since variable study methodology did not permit meta-analyses. WIDER IMPLICATIONS Collective evidence supports that women with PCOS have a lower overall diet quality, poorer dietary intakes (higher cholesterol, lower magnesium and zinc) and lower total PA, despite lower alcohol consumption versus those without PCOS. Considerable heterogeneity among studies reinforces the need for research to address any relative contributions of other factors (e.g. genetic, metabolic or sociodemographic) to the observed differences. These clarifications may contribute to future evidence-based guideline recommendations on monitoring and managing PCOS in the era of precision lifestyle medicine.
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Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
- Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joy Y Kim
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Cynthia Wan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Julia D Xiong
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Julia Michalak
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Isabella B Xavier
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Kiran Ganga
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, Australia
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
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Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and-after study. Int J Behav Nutr Phys Act 2022; 19:136. [PMID: 36307849 PMCID: PMC9617427 DOI: 10.1186/s12966-022-01370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In April 2018, South Africa implemented the Health Promotion Levy (HPL), one of the first sugar-sweetened beverage (SSB) taxes to be based on each gram of sugar (beyond 4 g/100mL). The objectives of this study were to examine whether the psychological constructs tax awareness, SSB knowledge, SSB risk perception, and intentions to reduce SSB intake were associated with taxed beverage intake, whether they changed from pre- to post-tax, and whether they modified the effect of the HPL. METHODS We collected single day 24-hour dietary recalls surveyed from repeat cross-sectional surveys of adults aged 18-39 years in Langa, South Africa. Participants were recruited in February-March 2018 (pre-tax, N = 2,481) and February-March 2019 (post-tax, N = 2,507) using door-to-door sampling. Surveys measured tax awareness, SSB knowledge, SSB risk perception, and intention to reduce SSB intake. SSB intake was estimated using a two-part model. To examine changes over time, logistic regression models were used for binary outcomes (tax awareness and intention to reduce SSB consumption) and linear regression models for continuous outcomes (SSB knowledge SSB risk perceptions). Effect modification was tested using interaction terms for each psychological construct with time. RESULTS No constructs were associated with SSB intake at baseline. At post-tax, the predicted probability to consume taxed beverages was 33.5% (95% CI 28.5-38.5%) for those who expressed an intention to reduce SSB intake compared to 45.9% (95% CI 43.7-48.1%) for those who did not. Among consumers, intending to reduce SSB intake was associated with 55 (95% CI 28 to 82) kcal/capita/day less SSBs consumed. Tax awareness, SSB knowledge, and SSB risk perception increased by a small amount from pre- to post-tax. Intentions to reduce SSB intake was lower in the post-tax period. The tax effect on SSB intake was modified by SSB knowledge and intention to reduce SSB intake, with higher levels of each associated with lower SSB intake. CONCLUSION After the South African SSB tax was implemented, SSB knowledge and risk perception increased slightly, tax awareness remained low, and only SSB knowledge and behavioral intention to change were significantly associated with taxed beverage intake among participants recruited from a low-income South African township.
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Abstract
Although a decrease in carbohydrate intake and an increase in fat intake among Koreans have been reported, investigations of changes in protein intake have been limited. Thus, this study aimed to explore trends in the dietary intake of total, plant and animal proteins overall and by socio-demographic subgroups in Korea over the past two decades. A total of 78 716 Korean adults aged ≥ 19 years who participated in the seven survey cycles of the Korea National Health and Nutrition Examination Survey 1998-2018 were included. Dietary protein intake, overall and by source, was calculated using a single 24-h dietary recall data. Changes in dietary protein over 20 years were estimated using multiple linear regression analysis after adjusting for potential covariates. For total protein intake, a significant decrease was reported from 1998 to 2016-2018 (P for trendlinearity < 0·001), whereas an increasing trend was observed from 2007-2009 to 2016-2018 (P for trendlinearity < 0·001). In terms of protein intake by source, plant protein intake decreased while animal protein intake increased over the past two decades, indicating steeper trends during the recent decade (P for trendlinearity < 0·001). These trends were more pronounced among younger adults and those with higher household income and education levels. These findings suggest that continuous monitoring of dietary protein intake overall and by source (plant v. animal) across socio-demographic group is needed.
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Mackenzie KM, Kerr DA, Whitton C, Talati Z, McCaffrey TA, Mullan BA. Predicting Perceived Problems in Self-Administered 24-Hour Dietary Recalls: A Quantitative Think-Aloud Study Comparing Automated Self-Assisted 24-Hour Dietary Assessment Tool (ASA24 ®) and INTAKE24© in University Students. Nutrients 2022; 14:nu14204281. [PMID: 36296964 PMCID: PMC9607278 DOI: 10.3390/nu14204281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/26/2022] Open
Abstract
Demographic and psychosocial factors concerning dietary assessment error have been explored, but few studies have investigated the perceived problems experienced when completing dietary recalls. The aim of this research was to (i) compare the perceived problems encountered in two commonly used self-administered 24-hour dietary recall (24HR) programs (INTAKE24© and ASA24®) and (ii) explore whether mindful and habitual eating are associated with perceived problems during dietary recall. A randomised quantitative crossover design and think-aloud methodology were employed. Undergraduate university students (N = 55, Mage = 25.5, SD = 8.2, 75% female) completed a food habits and mindfulness questions pre-program, one 24HR (whilst thinking aloud), and a systems usability scale post-program. A week later, they completed the other 24HR (whilst thinking aloud). During a pilot, a coding frame of perceived problems was devised to quantify participants’ perceived problems. INTAKE24© generated significantly fewer perceived problems across all categories compared to ASA24® (17.2 vs. 33.1, p < 0.001). Of the participants, 68% reported a preference for INTAKE24© over ASA24®. Hierarchical multiple regression showed that habits and systems usability were significant predictors of perceived problems for INTAKE24© only. No significant predictors were found for ASA24®. The results provide insight into perceived problems people may encounter when using 24HR tools.
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Affiliation(s)
- Katlyn M. Mackenzie
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6845, Australia
- Enable Institute, Curtin University, Kent Street, Perth 6845, Australia
| | - Deborah A. Kerr
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6845, Australia
- Curtin Health Innovation Research Institute, Curtin University, Kent Street, Perth 6845, Australia
| | - Clare Whitton
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6845, Australia
- Curtin Health Innovation Research Institute, Curtin University, Kent Street, Perth 6845, Australia
| | - Zenobia Talati
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6845, Australia
| | - Tracy A. McCaffrey
- Department of Nutrition and Dietetics, Monash University, 264 Ferntree Gully Road, Notting Hill 3168, Australia
| | - Barbara A. Mullan
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6845, Australia
- Enable Institute, Curtin University, Kent Street, Perth 6845, Australia
- Correspondence:
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Rochefort G, Brassard D, Paquette MC, Robitaille J, Lemieux S, Provencher V, Lamarche B. Adhering to Canada's Food Guide Recommendations on Healthy Food Choices Increases the Daily Diet Cost: Insights from the PREDISE Study. Nutrients 2022; 14:nu14183818. [PMID: 36145193 PMCID: PMC9502682 DOI: 10.3390/nu14183818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the association between daily diet costs and the Healthy Eating Food Index (HEFI)-2019, an index that reflects the alignment of dietary patterns to recommendations on healthy food choices in the 2019 Canada’s Food Guide (CFG). Dietary intake data from 24 h recalls, completed between 2015 and 2017, of 1147 French-speaking participants of the web-based multicenter cross-sectional PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study in Quebec were used. Diet costs were calculated from dietary recall data using a Quebec-specific 2015–2016 Nielsen food price database. Usual dietary intakes and diet costs were estimated using the National Cancer Institute’s multivariate method. Linear regression models were used to evaluate associations between diet costs and HEFI-2019 scores. When standardized for energy intake, a higher HEFI-2019 score (75th vs. 25th percentiles) was associated with a 1.09 $CAD higher daily diet cost (95% CI, 0.73 to 1.45). This positive association was consistent among different sociodemographic subgroups based on sex, age, education, household income, and administrative region of residence. A higher daily diet cost was associated with a higher HEFI-2019 score for the Vegetables and fruits, Beverage, Grain foods ratio, Fatty acids ratio, Saturated fats, and Free sugars components, but with a lower score for the Sodium component. These results suggest that for a given amount of calories, a greater adherence to the 2019 CFG recommendations on healthy food choices is associated with an increased daily diet cost. This highlights the challenge of conciliating affordability and healthfulness when developing national dietary guidelines in the context of diet sustainability.
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Affiliation(s)
- Gabrielle Rochefort
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Didier Brassard
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
| | | | - Julie Robitaille
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Véronique Provencher
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benoît Lamarche
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
- École de Nutrition, Faculté des Sciences de l’Agriculture et de l’Alimentation, Université Laval, Québec, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-418-656-2131 (ext. 404355)
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Passarelli S, Free CM, Allen LH, Batis C, Beal T, Biltoft-Jensen AP, Bromage S, Cao L, Castellanos-Gutiérrez A, Christensen T, Crispim SP, Dekkers A, De Ridder K, Kronsteiner-Gicevic S, Lee C, Li Y, Moursi M, Moyersoen I, Schmidhuber J, Shepon A, Viana DF, Golden CD. Estimating national and subnational nutrient intake distributions of global diets. Am J Clin Nutr 2022; 116:551-560. [PMID: 35687422 PMCID: PMC9348991 DOI: 10.1093/ajcn/nqac108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Access to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available. OBJECTIVES We sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available. METHODS We compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package-nutriR-to make these distributions freely available for users to apply in their own analyses. RESULTS Usual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes. CONCLUSIONS The shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.
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Affiliation(s)
- Simone Passarelli
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Christopher M Free
- Bren School of Environmental Science and Management, University of California, Santa Barbara, Santa Barbara, CA, USA
- Marine Science Institute, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Lindsay H Allen
- ARS Western Human Nutrition Research Center, USDA, Davis, CA, USA
| | - Carolina Batis
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ty Beal
- Department of Environmental Science and Policy, University of California, Davis, Davis, CA, USA
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | - Anja Pia Biltoft-Jensen
- Division of Food Technology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Sabri Bromage
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ling Cao
- School of Oceanography, Shanghai Jiao Tong University, Shanghai, China
| | | | - Tue Christensen
- Division of Food Technology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Sandra P Crispim
- Department of Nutrition, Federal University of Paraná, Curitiba, Brazil
| | - Arnold Dekkers
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Karin De Ridder
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Selma Kronsteiner-Gicevic
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Institute for Statistics of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | | | - Yanping Li
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mourad Moursi
- Intake, Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | - Isabelle Moyersoen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Josef Schmidhuber
- Trade and Markets Division, UN's Food and Agricultural Organization, Rome, Italy
| | - Alon Shepon
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Studies, The Porter School of the Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel F Viana
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Betty and Gordon Moore Center for Science, Conservation International, Arlington, VA, USA
| | - Christopher D Golden
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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