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Brown C, Hernandez R, Ford T, Aksan N, DiVincenzo C, Muir AJ. Inadequate Dietary Education and Poor Adherence to a High Protein, Low Sodium Diet in Cirrhosis: Mixed Methods Approach. Dig Dis Sci 2024:10.1007/s10620-024-08526-2. [PMID: 38940972 DOI: 10.1007/s10620-024-08526-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Malnutrition in cirrhosis is associated with poor outcomes, leading to guidelines for a high protein, low sodium diet; however, there is no guidance regarding the implementation of diet education in clinical practice. METHODS A mixed methods study enrolled 21 patients with cirrhosis and their caregivers. Semi-structured interviews on barriers and facilitators of dietary education and adherence were conducted. Demographic and clinical data were obtained, along with quantitative measures of dietary adherence, including 24-h food recall and spot urine sodium. Combined deductive and inductive coding was used to identify qualitative themes, along with a quantitative assessment of interviews. Quantitative data was reported using descriptive statistics with frequencies, mean and confidence intervals. RESULTS Participants were mostly male (16/21) with a mean age 57.8 years (SE 2.8) and MELD-Na 9 (SE 1.2). 4 themes emerged: 1. More than 50% of participants and caregivers endorsed no or inadequate diet education 2. They reported mostly negative experiences with dietary adherence with largest impact on social life 3. Facilitators of adherence included the presence of household support and fear of complications of cirrhosis 4. Overwhelmingly desired non-generic handouts and information. Dietary adherence was poor with only one participant meeting protein and sodium requirements based on food recall. Four participants who adhered to < 2000 mg sodium had inadequate daily caloric intake. CONCLUSIONS Dietary education is inadequate, and adherence to dietary recommendations is poor in patients with cirrhosis. Future studies should use these barriers and facilitators for intervention development.
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Affiliation(s)
- Cristal Brown
- Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA.
- Ascension Medical Group, 1601 Trinity St., Building B, Austin, TX, 78712, USA.
- University of Texas Health Austin, 1601 Trinity St Building A, Austin, TX, 78712, USA.
- University of Texas at Austin, Health Discovery Building 1601 Trinity St Z0900, Austin, TX, 78712, USA.
| | - Rabecca Hernandez
- Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA
| | - Ty Ford
- Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA
| | - Nazan Aksan
- Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA
| | - Clara DiVincenzo
- Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA
- Ascension Medical Group, 1601 Trinity St., Building B, Austin, TX, 78712, USA
- University of Texas Health Austin, 1601 Trinity St Building A, Austin, TX, 78712, USA
| | - Andrew J Muir
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, 300 W Morgan St., Durham, NC, 27701, USA
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Jenkins PE, Proctor K, Snuggs S. Dietary intake of adults with eating disorders: A systematic review and meta-analysis. J Psychiatr Res 2024; 175:393-404. [PMID: 38772131 DOI: 10.1016/j.jpsychires.2024.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/09/2024] [Accepted: 05/15/2024] [Indexed: 05/23/2024]
Abstract
Studies have confirmed the link between altered dietary intake and eating disorders (EDs), although no systematic assessment of this research exists. Rigorous synthesis of dietary intake in anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and similar EDs is needed to explore similarities and differences. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we conducted a systematic review and quantitative synthesis of studies of dietary intake. Searches of three electronic databases resulted in thirty-nine included studies. Meta-analyses of subsets of these studies were undertaken to summarise macronutrient intake across AN, BN, and BED. Study quality was assessed using the American Academy of Nutrition and Dietetics Quality Criteria Checklist, with ratings either Positive (k = 27) or Neutral (k = 12). Adults with AN had low energy intake and those with BED reported elevated macronutrient intake. Individuals with BN reported wide variation in energy intake, including some of the highest estimates. Individuals with AN were likely to under-consume key micronutrients, with sodium potentially over-consumed in BN and BED. Vitamin D was under-consumed across all disorders. This meta-analysis highlights important diagnostic differences and synthesises dietary intake in EDs, with particular relevance to risk assessment and treatment.
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Affiliation(s)
- Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom.
| | - Katy Proctor
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom
| | - Sarah Snuggs
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6ES, UK, United Kingdom
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3
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Wills O, Wright B, Greenwood LM, Solowij N, Schira M, Maller JJ, Gupta A, Magnussen J, Probst Y. Lifestyle management and brain MRI metrics in female Australian adults living with multiple sclerosis: a feasibility and acceptability study. Pilot Feasibility Stud 2024; 10:71. [PMID: 38698454 PMCID: PMC11064336 DOI: 10.1186/s40814-024-01495-3] [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: 06/14/2023] [Accepted: 04/14/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Limited studies of multiple sclerosis (MS) exist whereby magnetic resonance imaging (MRI) of the brain with consistent imaging protocols occurs at the same time points as collection of healthy lifestyle measures. The aim of this study was to test the feasibility, acceptability and preliminary efficacy of acquiring MRI data as an objective, diagnostic and prognostic marker of MS, at the same time point as brain-healthy lifestyle measures including diet. METHODS Participants living with relapsing remitting MS partook in one structural MRI scanning session of the brain, completed two online 24-hour dietary recalls and demographic and self-reported lifestyle questionnaires (e.g. self-reported disability, comorbidities, physical activity, smoking status, body mass index (BMI), stress). Measures of central tenancy and level of dispersion were calculated for feasibility and acceptability of the research protocols. Lesion count was determined by one radiologist and volumetric analyses by a data analysis pipeline based on FreeSurfer software suite. Correlations between white matter lesion count, whole brain volume analyses and lifestyle measures were assessed using Spearman's rank-order correlation coefficient. RESULTS Thirteen female participants were included in the study: eligibility rate 90.6% (29/32), recruitment rate 46.9% (15/32) and compliance rate 87% (13/15). The mean time to complete all required tasks, including MRI acquisition was 115.86 minutes ( ± 23.04), over 4 days. Conversion to usual dietary intake was limited by the small sample. There was one strong, negative correlation between BMI and brain volume (rs = -0.643, p = 0.018) and one strong, positive correlation between physical activity and brain volume (rs = 0.670, p = 0.012) that were both statistically significant. CONCLUSIONS Acquiring MRI brain scans at the same time point as lifestyle profiles in adults with MS is both feasible and accepted among adult females living with MS. Quantification of volumetric MRI data support further investigations using semi-automated pipelines among people living with MS, with pre-processing steps identified to increase automated feasibility. This protocol may be used to determine relationships between elements of a brain-healthy lifestyle, including dietary intake, and measures of disease burden and brain health, as assessed by T1-weighted and T2-weighted lesion count and whole brain volume, in an adequately powered sample. TRIAL REGISTRATION The study protocol was retrospectively registered in the Australia New Zealand Clinical Trials Registry (ACTRN12624000296538).
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Affiliation(s)
- Olivia Wills
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Brooklyn Wright
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Lisa-Marie Greenwood
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
- School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Mark Schira
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Jerome J Maller
- General Electric Healthcare, Richmond, Melbourne, Australia
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Alok Gupta
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
- Wollongong Diagnostic Imaging Group, Wollongong, NSW, Australia
| | - John Magnussen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
- Illawara Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
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Porter J, Ward LC, Nguo K, Ward A, Davidson Z, Gibson S, Prentice R, Neuhouser ML, Truby H. Development and validation of age-specific predictive equations for total energy expenditure and physical activity levels for older adults. Am J Clin Nutr 2024; 119:1111-1121. [PMID: 38503654 DOI: 10.1016/j.ajcnut.2024.02.005] [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: 08/21/2023] [Revised: 12/12/2023] [Accepted: 02/06/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Predicting energy requirements for older adults is compromised by the underpinning data being extrapolated from younger adults. OBJECTIVES To generate and validate new total energy expenditure (TEE) predictive equations specifically for older adults using readily available measures (age, weight, height) and to generate and test new physical activity level (PAL) values derived from 1) reference method of indirect calorimetry and 2) predictive equations in adults aged ≥65 y. METHODS TEE derived from "gold standard" methods from n = 1657 (n = 1019 females, age range 65-90 y), was used to generate PAL values. PAL ranged 1.28-2.05 for males and 1.26-2.06 for females. Physical activity (PA) coefficients were also estimated and categorized (inactive to very active) from population means. Nonlinear regression was used to develop prediction equations for estimating TEE. Double cross-validation in a randomized, sex-stratified, age-matched 50:50 split, and leave one out cross-validation were performed. Comparisons were made with existing equations. RESULTS Equations predicting TEE using the Institute of Medicine method are as follows: For males, TEE = -5680.17 - 17.50 × age (years) + PA coefficient × (6.96 × weight [kilograms] + 44.21 × height [centimeters]) + 1.13 × resting metabolic rate (RMR) (kilojoule/day). For females, TEE = -5290.72 - 8.38 × age (years) + PA coefficient × (9.77 × weight [kilograms] + 41.51 × height [centimeters]) + 1.05 × RMR (kilojoule/day), where PA coefficient values range from 1 (inactive) to 1.51 (highly active) in males and 1 to 1.44 in females respectively. Predictive performance for TEE from anthropometric variables and population mean PA was moderate with limits of agreement approximately ±30%. This improved to ±20% if PA was adjusted for activity category (inactive, low active, active, and very active). Where RMR was included as a predictor variable, the performance improved further to ±10% with a median absolute prediction error of approximately 4%. CONCLUSIONS These new TEE prediction equations require only simple anthropometric data and are accurate and reproducible at a group level while performing better than existing equations. Substantial individual variability in PAL in older adults is the major source of variation when applied at an individual level.
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Affiliation(s)
- Judi Porter
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, the University of Queensland, Brisbane, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Zoe Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, WA, United States
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Batubo NP, Nwanze NM, Alikor CA, Auma CI, Moore JB, Zulyniak MA. Empowering healthcare professionals in West Africa-A feasibility study and qualitative assessment of a dietary screening tool to identify adults at high risk of hypertension. PLoS One 2024; 19:e0294370. [PMID: 38662712 PMCID: PMC11045096 DOI: 10.1371/journal.pone.0294370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/09/2024] [Indexed: 04/28/2024] Open
Abstract
Dietary risks significantly contribute to hypertension in West Africa. Food frequency questionnaires (FFQs) can provide valuable dietary assessment but require rigorous validation and careful design to facilitate usability. This study assessed the feasibility and interest of a dietary screening tool for identifying adults at high risk of hypertension in Nigeria. Fifty-eight (58) consenting adult patients with hypertension and their caregivers and 35 healthcare professionals from a single-centre Nigerian hospital were recruited to complete a 27-item FFQ at two-time points and three 24-hour recalls for comparison in a mixed method study employing both quantitative questionnaires and qualitative techniques to elicit free form text. Data analyses were conducted using R software version 4.3.1 and NVivo version 14. The trial was registered with ClinicalTrials.gov: NCT05973760. The mean age of patients was 42.6 ± 11.9 years, with an average SBP of 140.3 ± 29.8 mmHg and a BMI of 29.5 ± 7.1 Kg/m2. The adherence rate was 87.9%, and the mean completion time was 7:37 minutes. 96.6% of patients found the FFQ easy to complete, comprehensive, and valuable. A minority reported difficulty (3.4%), discomfort (10.3%), and proposed additional foods (6.9%). Healthcare professionals considered the dietary screening tool very important (82.9%) and expressed a willingness to adopt the tool, with some suggestions for clarification. Patients and healthcare professionals found the screening tool favourable for dietary counselling in hypertension care. The tailored dietary screening tool (FFQ) demonstrated promising feasibility for integration into clinical care as assessed by patients and healthcare professionals. Successful implementation may benefit from proactive time management and addressing training needs. This user-centred approach provided key insights to refine FFQ and set the foundation for ongoing validity testing and evaluation in clinical practice.
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Affiliation(s)
- Nimisoere P. Batubo
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Nnenna M. Nwanze
- Department of Family Medicine, Rivers State University/Rivers State University of Teaching Hospitals, Port Harcourt, Rivers State, Nigeria
| | - Chizindu A. Alikor
- Department of Internal Medicine, Rivers State University/Rivers State University of Teaching Hospitals, Port Harcourt, Rivers State, Nigeria
| | - Carolyn I. Auma
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - J. Bernadette Moore
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Michael A. Zulyniak
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
- Food, Nutrition and Health Program, University of British Columbia, Vancouver, British Columbia, Canada
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6
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Lemieux S. S'attaquer aux défis de l'adhésion aux principes de la saine alimentation. Appl Physiol Nutr Metab 2024. [PMID: 38587179 DOI: 10.1139/apnm-2023-0564] [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: 04/09/2024]
Abstract
The purpose of this article is to describe the impact of the research program entitled "Adherence to healthy eating recommendations: identification of measures, determinants and interventions". Beyond the main results described in this article, this program had a major impact on the training of graduate students. It was also a unique opportunity to develop and validate measurement tools relevant to nutrition research, and to make them available to the scientific community. Lastly, this program was a catalyst for establishing new collaborations and setting up larger-scale studies.
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Affiliation(s)
- Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- École de nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
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Pomey MP, Le Roux E, Nadon N, Perron J, Barry A, Bémeur C, Poder TG, Duford F, Laviolette L, Tétrault-Lassonde J, Vialaron C, Escalona MJ, Normandin L, Huard G, Girardin C, Rose C, Malas K, Ouellet D, Vincent C. Telehealth-Delivered Program and Accompanying Patients to Enhance the Clinical Condition of Patients Throughout a Liver Transplant: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e54440. [PMID: 38517464 PMCID: PMC10998179 DOI: 10.2196/54440] [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: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Liver transplantation (LT) is indicated in patients with severe acute or chronic liver failure for which no other therapy is available. With the increasing number of LTs in recent years, liver centers worldwide must manage their patients according to their clinical situation and the expected waiting time for transplantation. The LT clinic at the Centre hospitalier de l'Université de Montréal (CHUM) is developing a new health care model across the entire continuum of pre-, peri-, and posttransplant care that features patient monitoring by an interdisciplinary team, including an accompanying patient; a digital platform to host a clinical plan; a learning program; and data collection from connected objects. OBJECTIVE This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention's cost-effectiveness. METHODS Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study. RESULTS In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited. CONCLUSIONS The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54440.
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Affiliation(s)
- Marie-Pascale Pomey
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
| | - Enora Le Roux
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France
- AP-HP.Nord-Université Paris Cité, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nathalie Nadon
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Jessie Perron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Regroupement cardio-vasculaire, hépatologie et transplantation, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Angèle Barry
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Réseau transplantation et cliniques externes de transplantation et d'hépatologie, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Chantal Bémeur
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thomas G Poder
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada
| | - Fernand Duford
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Louise Laviolette
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Johanne Tétrault-Lassonde
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Cécile Vialaron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Manuel J Escalona
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Normandin
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Geneviève Huard
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Catherine Girardin
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Christopher Rose
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Denis Ouellet
- Direction de la biovigilance et de la biologie médicale, Ministère de la Santé et des Services sociaux du Québec, Montreal, QC, Canada
| | - Catherine Vincent
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
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8
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Devarakonda SLS, Superdock DK, Ren J, Johnson LM, Loinard-González A(AP, Poole AC. Gut microbial features and dietary fiber intake predict gut microbiota response to resistant starch supplementation. Gut Microbes 2024; 16:2367301. [PMID: 38913541 PMCID: PMC11197919 DOI: 10.1080/19490976.2024.2367301] [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: 12/04/2023] [Accepted: 06/07/2024] [Indexed: 06/26/2024] Open
Abstract
Resistant starch (RS) consumption can have beneficial effects on metabolic health, but the response, in terms of effects on the gut microbiota and host physiology, varies between individuals. Factors predicting the response to RS are not yet established and would be useful for developing precision nutrition approaches that maximize the benefits of dietary fiber intake. We sought to identify predictors of gut microbiota response to RS supplementation. We enrolled 76 healthy adults into a 7-week crossover study with 59 individuals completing the study. Participants consumed RS type 2 (RS2), RS type 4 (RS4), and digestible starch, for 10 d each with 5-d washout periods in between. We collected fecal and saliva samples and food records during each treatment period. We performed 16S rRNA gene sequencing and measured fecal short-chain fatty acids (SCFAs), salivary amylase (AMY1) gene copy number, and salivary amylase activity (SAA). Dietary fiber intake was predictive of the relative abundance of several amplicon sequence variants (ASVs) at the end of both RS treatments. AMY1-related metrics were not predictive of response to RS. SAA was only predictive of the relative abundance of one ASV after digestible starch supplementation. Interestingly, SCFA concentrations increased the most during digestible starch supplementation. Treatment order (the order of consumption of RS2 and RS4), alpha diversity, and a subset of ASVs were predictive of SCFA changes after RS supplementation. Based on our findings, dietary fiber intake and gut microbiome composition would be informative if assessed prior to recommending RS supplementation because these data can be used to predict changes in specific ASVs and fecal SCFA concentrations. These findings lay a foundation to support the premise that using a precision nutrition approach to optimize the benefits of dietary fibers such as RS could be an effective strategy to compensate for the low consumption of dietary fiber nationwide.
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Affiliation(s)
| | | | - Jennifer Ren
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Lynn M. Johnson
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | | | - Angela C. Poole
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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9
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Dhaliwal KK, Avedzi HM, Richard C, Zwaigenbaum L, Haqq AM. Brief Report: Plasma Leptin and Mealtime Feeding Behaviors Among Children with Autism Spectrum Disorder: A Pilot Study. J Autism Dev Disord 2023; 53:4929-4936. [PMID: 35583626 DOI: 10.1007/s10803-022-05581-4] [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] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
We examined the relationship between weight status, appetite regulating hormones, and mealtime behaviors among children, (5-12 years old), diagnosed with Autism Spectrum Disorder (ASD) in a cross-sectional study. All (N = 21) completed anthropometry measurements and (n = 18) provided blood samples for hormone analysis. Mealtime behavior, dietary, physical activity, puberty stage, and social impairment data were collected. Under fasting conditions, overweight/obese (OWOB) participants, (n = 6), had higher leptin concentrations (p < 0.02) and more feeding challenges (p < 0.05) than normal weight (n = 15). Higher leptin levels and disruptions in mealtime behaviors may exist among OWOB children in this study. Future longitudinal studies that examine appetite regulating hormones and mealtime behaviors may inform our understanding of the role of these markers in the development of obesity in ASD.
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Affiliation(s)
- Khushmol K Dhaliwal
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Hayford M Avedzi
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Caroline Richard
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Andrea M Haqq
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada.
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada.
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Porter J, Ward LC, Nguo K, Davidson Z, Gibson S, Prentice R, Neuhouser ML, Truby H. Development and validation of new predictive equations for the resting metabolic rate of older adults aged ≥65 y. Am J Clin Nutr 2023; 117:1164-1173. [PMID: 37054885 PMCID: PMC10447471 DOI: 10.1016/j.ajcnut.2023.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The aging process alters the resting metabolic rate (RMR), but it still accounts for 50%-70% of the total energy needs. The rising proportion of older adults, especially those over 80 y of age, underpins the need for a simple, rapid method to estimate the energy needs of older adults. OBJECTIVES This research aimed to generate and validate new RMR equations specifically for older adults and to report their performance and accuracy. METHODS Data were sourced to form an international dataset of adults aged ≥65 y (n = 1686, 38.5% male) where RMR was measured using the reference method of indirect calorimetry. Multiple regression was used to predict RMR from age (y), sex, weight (kg), and height (cm). Double cross-validation in a randomized, sex-stratified, age-matched 50:50 split and leave one out cross-validation were performed. The newly generated prediction equations were compared with the existing commonly used equations. RESULTS The new prediction equation for males and females aged ≥65 y had an overall improved performance, albeit marginally, when compared with the existing equations. It is described as follows: RMR (kJ/d) = 31.524 × W (kg) + 25.851 × H (cm) - 24.432 × Age (y) + 486.268 × Sex (M = 1, F = 0) + 530.557. Equations stratified by age (65-79.9 y and >80 y) and sex are also provided. The newly created equation estimates RMR within a population mean prediction bias of ∼50 kJ/d (∼1%) for those aged ≥65 y. Accuracy was reduced in adults aged ≥80 y (∼100 kJ/d, ∼2%) but was still within the clinically acceptable range for both males and females. Limits of agreement indicated a poorer performance at an individual level with 1.96-SD limits of approximately ±25%. CONCLUSIONS The new equations, using simple measures of weight, height, and age, improved the accuracy in the prediction of RMR in populations in clinical practice. However, no equation performs optimally at the individual level.
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Affiliation(s)
- Judi Porter
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Burwood, Melbourne, Victoria, Australia.
| | - Leigh C Ward
- Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Zoe Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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11
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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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12
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Peterson L, Lee H, Huybrechts I, Biessy C, Neuhouser ML, Haaland B, Krick B, Gunter M, Schulze MB, Jannasch F, Coletta AM, Hardikar S, Chaix A, Bauer CX, Xiao Q, Playdon MC. Reliability estimates for assessing meal timing derived from longitudinal repeated 24-hour dietary recalls. Am J Clin Nutr 2023; 117:964-975. [PMID: 36921904 PMCID: PMC10206325 DOI: 10.1016/j.ajcnut.2023.02.026] [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: 07/29/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. OBJECTIVES To evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs). METHODS Intraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo). RESULTS Measurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies. CONCLUSIONS Our results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.
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Affiliation(s)
- Lacie Peterson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hyejung Lee
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Inge Huybrechts
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Benjamin Krick
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Marc Gunter
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Adriana M Coletta
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Sheetal Hardikar
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Cici X Bauer
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
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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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Devarakonda SLS, Superdock DK, Ren J, Johnson LM, Loinard-Gonz Lez AAP, Poole AC. Gut microbial features and dietary fiber intake predict gut microbiota response to resistant starch supplementation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.24.23287665. [PMID: 37034622 PMCID: PMC10081390 DOI: 10.1101/2023.03.24.23287665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Resistant starch (RS) consumption can have beneficial effects on human health, but the response, in terms of effects on the gut microbiota and host physiology, varies between individuals. Factors predicting the response to RS are not yet established and would be useful for developing precision nutrition approaches that maximize the benefits of dietary fiber intake. We sought to identify predictors of gut microbiota response to RS supplementation. We enrolled 76 healthy adults into a seven-week crossover study. Participants consumed RS type 2 (RS2), RS type 4 (RS4), and a digestible starch, for ten days each with five-day washout periods in between. We collected fecal and saliva samples and food records before and during each treatment period. We performed 16S rRNA gene sequencing and measured fecal short-chain fatty acids (SCFAs), salivary amylase gene copy number, and salivary amylase activity (SAA). Dietary fiber intake was predictive of relative abundance of several amplicon sequence variants (ASVs) at the end of both RS treatments. Treatment order (the order of consumption of RS2 and RS4), alpha diversity, and a subset of ASVs were predictive of SCFA changes after RS supplementation. SAA was only predictive of the relative abundance of ASVs after digestible starch supplementation. Based on our findings, dietary fiber intake and gut microbiome composition would be informative if assessed prior to recommending RS supplementation. Using a precision nutrition approach to optimize the benefits of dietary fibers such as RS could be an effective strategy to compensate for the low consumption of dietary fiber nationwide.
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15
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Feasibility of a Food Delivery Intervention during Pregnancy in a Rural US Population: The PEAPOD Pilot Study. Nutrients 2023; 15:nu15040816. [PMID: 36839174 PMCID: PMC9958944 DOI: 10.3390/nu15040816] [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: 12/07/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Pregnancy nutrition is important for maternal and child health and may affect the development of the infant gut microbiome. Our objective was to assess the feasibility of implementing a food-based intervention designed to increase fiber intake among pregnant women in a rural setting. Participants were enrolled (N = 27) mid-pregnancy from a prenatal care clinic in rural Michigan, randomized to intervention (N = 13) or usual care (N = 14), and followed to 6 weeks postpartum. The intervention was designed to be easily replicable and scalable by partnering with hospital foodservices and included non-perishable high fiber foods and recipes, as well as weekly delivery of salads, soup, and fresh fruit. Surveys, maternal blood, urine, and stool were collected at 24- and 36-weeks gestation and at 6 weeks postpartum. Infant stool was collected at 6 weeks. Participants were 100% White (7% Hispanic White, 7% Native American and White); 55% with education < 4-year college degree. Data on dietary intake and urinary trace elements are presented as evidence of feasibility of outcome measurement. Retention was high at 93%; 85% reported high satisfaction. The intervention described here can be replicated and used in larger, longer studies designed to assess the effects of pregnancy diet on the establishment of the infant gut microbiome and related health outcomes.
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Mossavar-Rahmani Y, Shaw PA, Hakun JG, Katz MJ, Wylie-Rosett J, Sliwinski MJ. Multicultural Healthy Diet to Reduce Cognitive Decline & Alzheimer's Disease Risk: Study protocol for a pilot randomized controlled trial. Contemp Clin Trials 2023; 124:107006. [PMID: 36396064 PMCID: PMC9839583 DOI: 10.1016/j.cct.2022.107006] [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: 07/22/2022] [Revised: 10/13/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Emerging evidence indicates that healthy dietary patterns are associated with higher cognitive status; however, few clinical trials have explored this association in diverse middle-aged adults before the onset of cognitive decline. We use novel ambulatory methods to assess cognition in natural settings in tandem with diet recording. AIMS We investigate whether the Multicultural Healthy Diet Study to Reduce Cognitive Decline & Alzheimer's Disease Risk, a pilot randomized controlled trial of an anti-inflammatory dietary pattern compared to usual diet, can mitigate cognitive decline and Alzheimer's Disease risk in a diverse population of 40-65 year old adults in Bronx, New York. METHODS Primary cognitive outcomes assessed at nine months are collected in an ecological momentary assessment "measurement burst" design, over the course of participants' daily lives. These ultra-brief, ambulatory cognitive assessments examine processing speed, visuospatial working memory, short-term associative memory binding, long-term associative memory, and working memory capacity. Key secondary outcomes relate to comparing dietary intake between study arms with respect to cognitive outcomes. We assess diet with food records using the National Cancer Institute's Automated Self-Administered 24-h record and serum biomarkers. We further investigate the association of self-reported diet and dietary biomarkers with inflammatory-based biomarkers. CONCLUSION This randomized controlled trial of diet and cognition for the first time combines novel measures of ambulatory cognitive assessment with web-based assessment of dietary intake recording. This new approach enabled the study to continue in the midst of the COVID-19 pandemic in remote format.
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Affiliation(s)
- Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Belfer Building 1312C, Bronx, NY 10461 USA.
| | - Pamela A Shaw
- Biostatistics Unit, Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA.
| | - Jonathan G Hakun
- Department of Neurology, The Pennsylvania State University, College of Medicine, 700 HMC Crescent Road, Hershey, PA 17033, USA; Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA 16802, USA; Center for Healthy Aging, Fourth Floor Biobehavioral Health Building, The Pennsylvania State University, University Park, PA 16802, USA; Translational Brain Research Center, The Pennsylvania State University, College of Medicine, 700 MHC Crescent Road, Hershey, PA 17033, USA.
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Van Etten Building, Rm 3C5, 1225 Morris Park Avenue, Bronx, NY 10461, USA.
| | - Judith Wylie-Rosett
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Belfer Building 1307, Bronx, NY 10461, USA.
| | - Martin J Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, College of Medicine, University Park, PA, 16802, USA; Department of Human Development & Family Studies, The Pennsylvania State University, College of Medicine, University Park, PA, 16802. USA.
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Spangler HB, Driesse T, Fowler M, Lynch DH, Liang X, Gross D, Petersen C, Batsis JA. Feasibility of using the Automated Self-Administered 24-hour (ASA-24) dietary assessment tool in older adults. Digit Health 2023; 9:20552076231212802. [PMID: 37954690 PMCID: PMC10637164 DOI: 10.1177/20552076231212802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Background Dietary patterns can impact the trajectories of healthy aging. However, dietary assessment tools can be challenging to use. With the increased use of technology in older adults, we aimed to evaluate the feasibility of older adults completing the online, Automated Self-Administered 24-h (ASA-24) dietary assessment tool. Methods We conducted a randomized, two-period, two-sequence, crossover design of twenty community-dwelling older adults (≥65 years) comparing their preference for completing the ASA-24 alone versus with a research assistant (RA). Participants were recruited via ResearchMatch.com and randomly allocated 1:1 to a sequence of completing both an ASA-24 alone or with an RA, separated by one week. After each session, participants completed an online 11-item feasibility survey (Likert-scale range of 1-5, strongly disagree to strongly agree). Mean and standard deviations were reported for each question. Results Mean age was 69 ± 3.5 years (90% females), with no differences were observed for sex, age, race, ethnicity, education, or income. Neither group felt a need for RA assistance (p = 0.34). However, both groups felt the system was easier to follow with the help of an RA (RA: 4.4 ± 1.3, vs. SA 4.6 ± 0.5, p = 0.65), particularly when they completed the ASA-24 alone, first (p = 0.04). When conducting the ASA-24 alone, there was less confidence the system could be learned quickly (SA 4.5 ± 0.5→3.4 ± 1.0 vs RA 3.4 ± 1.0→3.4 ± 0.7, p = 0.001). The ASA-24 was thought to be less cumbersome after repeated exposure in those concluding with the RA. Conclusion While older adults were able to complete the ASA-24 independently, the use of an RA led to improved confidence. Enhancing the sample diversity in a larger number of participants could provide helpful data to improve the science of dietary assessment.
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Affiliation(s)
- Hillary B Spangler
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Tiffany Driesse
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Michael Fowler
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David H Lynch
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Xiaohui Liang
- Department of Computer Science, University of Massachusetts Boston, Boston, MS, USA
| | - Danae Gross
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Curtis Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - John A Batsis
- Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Moyen A, Rappaport AI, Fleurent-Grégoire C, Tessier AJ, Brazeau AS, Chevalier S. Relative Validation of an Artificial Intelligence–Enhanced, Image-Assisted Mobile App for Dietary Assessment in Adults: Randomized Crossover Study. J Med Internet Res 2022; 24:e40449. [DOI: 10.2196/40449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 10/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background
Thorough dietary assessment is essential to obtain accurate food and nutrient intake data yet challenging because of the limitations of current methods. Image-based methods may decrease energy underreporting and increase the validity of self-reported dietary intake. Keenoa is an image-assisted food diary that integrates artificial intelligence food recognition. We hypothesized that Keenoa is as valid for dietary assessment as the automated self-administered 24-hour recall (ASA24)–Canada and better appreciated by users.
Objective
We aimed to evaluate the relative validity of Keenoa against a 24-hour validated web-based food recall platform (ASA24) in both healthy individuals and those living with diabetes. Secondary objectives were to compare the proportion of under- and overreporters between tools and to assess the user’s appreciation of the tools.
Methods
We used a randomized crossover design, and participants completed 4 days of Keenoa food tracking and 4 days of ASA24 food recalls. The System Usability Scale was used to assess perceived ease of use. Differences in reported intakes were analyzed using 2-tailed paired t tests or Wilcoxon signed-rank test and deattenuated correlations by Spearman coefficient. Agreement and bias were determined using the Bland-Altman test. Weighted Cohen κ was used for cross-classification analysis. Energy underreporting was defined as a ratio of reported energy intake to estimated resting energy expenditure <0.9.
Results
A total of 136 participants were included (mean 46.1, SD 14.6 years; 49/136, 36% men; 31/136, 22.8% with diabetes). The average reported energy intakes (kcal/d) were 2171 (SD 553) in men with Keenoa and 2118 (SD 566) in men with ASA24 (P=.38) and, in women, 1804 (SD 404) with Keenoa and 1784 (SD 389) with ASA24 (P=.61). The overall mean difference (kcal/d) was −32 (95% CI −97 to 33), with limits of agreement of −789 to 725, indicating acceptable agreement between tools without bias. Mean reported macronutrient, calcium, potassium, and folate intakes did not significantly differ between tools. Reported fiber and iron intakes were higher, and sodium intake lower, with Keenoa than ASA24. Intakes in all macronutrients (r=0.48-0.73) and micronutrients analyzed (r=0.40-0.74) were correlated (all P<.05) between tools. Weighted Cohen κ scores ranged from 0.30 to 0.52 (all P<.001). The underreporting rate was 8.8% (12/136) with both tools. Mean System Usability Scale scores were higher for Keenoa than ASA24 (77/100, 77% vs 53/100, 53%; P<.001); 74.8% (101/135) of participants preferred Keenoa.
Conclusions
The Keenoa app showed moderate to strong relative validity against ASA24 for energy, macronutrient, and most micronutrient intakes analyzed in healthy adults and those with diabetes. Keenoa is a new, alternative tool that may facilitate the work of dietitians and nutrition researchers. The perceived ease of use may improve food-tracking adherence over longer periods.
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19
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Knol LL, Crowe-White KM, Appel SJ, Daquin JC. Direct Yet Opposite Effects of Stress-related and Mindful Eating on Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:872-877. [PMID: 35835692 DOI: 10.1016/j.jneb.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Examine the relationships among dietary quality, mindful eating, and constructs of the Transactional Model of Stress and Coping. METHODS In this cross-sectional study, women (n = 67) aged 25-50 years, with a body mass index of 25-40 kg/m2 completed 3 days of 24-hour recalls and a survey that included the Perceived Stress Scale, Eating and Appraisal Due to Emotions and Stress Questionnaire, and the Mindful Eating Questionnaire. Structural equation modeling assessed relationships among all constructs with the dependent variable, the Healthy Eating Index-2015. RESULTS Mindful Eating Questionnaire (β = 0.60, P = 0.001) and Emotion and Stress-related Eating scores from Eating and Appraisal Due to Emotions and Stress Questionnaire (β = -0.69, P < 0.001) (r2 = 0.50) were directly associated with Healthy Eating Index-2015, but no indirect effects were identified. CONCLUSIONS AND IMPLICATIONS Overall dietary quality is associated with greater mindful eating but more emotion and stress-related eating scores among women who were overweight or obese. Future studies could assess model constructs using other diet quality scores and including additional coping mechanisms such as substance use, physical activity, and meditation.
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Affiliation(s)
- Linda L Knol
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, AL.
| | - Kristi M Crowe-White
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, AL
| | - Susan J Appel
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL
| | - Jane C Daquin
- Department of Criminology and Criminal Justice, Institute for Social Science Research, The University of Alabama, Tuscaloosa, AL
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20
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Herman PM, Chen AYA, Sturm R. Improving Diet Quality in U.S. Adults: A 30-Year Health and Economic Impact Microsimulation. Am J Prev Med 2022; 63:178-185. [PMID: 35321795 PMCID: PMC9308633 DOI: 10.1016/j.amepre.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Epidemiologic studies relating health outcomes to dietary patterns captured by diet quality indices have shown better quality scores associated with lower mortality and chronic disease incidence. However, changing chronic disease risk factors only alters population health over time, and initial diet quality systematically varies across the population by sociodemographic status. This study uses microsimulation to examine 30-year impacts of improved diet quality by sociodemographic group. METHODS Diet quality across 12 sex-, race/ethnicity-, and education-defined subgroups was estimated from the 2011-2012 National Health and Nutrition Examination Survey. In 2021, the Future Adults (dynamic microsimulation) Model was used to simulate population health and economic outcomes over 30 years for these subgroups and all adults. The modeled pathway was through lowering risk for heart disease by following U.S. Dietary Guidelines. RESULTS Diet quality varied across the sociodemographic subgroups, and half of U.S. adults had diet quality that would be classified as poor. Improving U.S. diet quality to that reported for the top 20% in 2 large health professionals' samples could reduce incidence of heart disease by 9.9% (7.6%-13.8% across the 12 sociodemographic groups) after 30 years. Year 30 would also have 37,000 fewer deaths, 694,000 more quality-adjusted life years, and healthcare cost savings of $59.6 billion (2019 U.S. dollars). CONCLUSIONS Dynamic microsimulation enables predictions of socially important outcomes of prevention efforts, most of which are many years in the future and beyond the scope of trials. This paper estimates the 30-year population health and economic impact of poor diet quality by sociodemographic group.
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Affiliation(s)
| | - Annie Yu-An Chen
- RAND Corporation, Santa Monica, California; Pardee RAND Graduate School, Santa Monica, California
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21
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Kirkpatrick SI, Troiano RP, Barrett B, Cunningham C, Subar AF, Park Y, Bowles HR, Freedman LS, Kipnis V, Rimm EB, Willett WC, Potischman N, Spielgelman D, Baer DJ, Schoeller DA, Dodd KW. Measurement Error Affecting Web- and Paper-Based Dietary Assessment Instruments: Insights From the Multi-Cohort Eating and Activity Study for Understanding Reporting Error. Am J Epidemiol 2022; 191:1125-1139. [PMID: 35136928 DOI: 10.1093/aje/kwac026] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/14/2022] Open
Abstract
Few biomarker-based validation studies have examined error in online self-report dietary assessment instruments, and food records (FRs) have been considered less than food frequency questionnaires (FFQs) and 24-hour recalls (24HRs). We investigated measurement error in online and paper-based FFQs, online 24HRs, and paper-based FRs in 3 samples drawn primarily from 3 cohorts, comprising 1,393 women and 1,455 men aged 45-86 years. Data collection occurred from January 2011 to October 2013. Attenuation factors and correlation coefficients between reported and true usual intake for energy, protein, sodium, potassium, and respective densities were estimated using recovery biomarkers. Across studies, average attenuation factors for energy were 0.07, 0.07, and 0.19 for a single FFQ, 24HR, and FR, respectively. Correlation coefficients for energy were 0.24, 0.23, and 0.40, respectively. Excluding energy, the average attenuation factors across nutrients and studies were 0.22 for a single FFQ, 0.22 for a single 24HR, and 0.51 for a single FR. Corresponding correlation coefficients were 0.31, 0.34, and 0.53, respectively. For densities (nutrient expressed relative to energy), the average attenuation factors across studies were 0.37, 0.17, and 0.50, respectively. The findings support prior research suggesting different instruments have unique strengths that should be leveraged in epidemiologic research.
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22
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Choi Y, Hoops SL, Thoma CJ, Johnson AJ. A Guide to Dietary Pattern-Microbiome Data Integration. J Nutr 2022; 152:1187-1199. [PMID: 35348723 PMCID: PMC9071309 DOI: 10.1093/jn/nxac033] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
The human gut microbiome is linked to metabolic and cardiovascular disease risk. Dietary modulation of the human gut microbiome offers an attractive pathway to manipulate the microbiome to prevent microbiome-related disease. However, this promise has not been realized. The complex system of diet and microbiome interactions is poorly understood. Integrating observational human diet and microbiome data can help researchers and clinicians untangle the complex systems of interactions that predict how the microbiome will change in response to foods. The use of dietary patterns to assess diet-microbiome relations holds promise to identify interesting associations and result in findings that can directly translate into actionable dietary intake recommendations and eating plans. In this article, we first highlight the complexity inherent in both dietary and microbiome data and introduce the approaches generally used to explore diet and microbiome simultaneously in observational studies. Second, we review the food group and dietary pattern-microbiome literature focusing on dietary complexity-moving beyond nutrients. Our review identified a substantial and growing body of literature that explores links between the microbiome and dietary patterns. However, there was very little standardization of dietary collection and assessment methods across studies. The 54 studies identified in this review used ≥7 different methods to assess diet. Coupled with the variation in final dietary parameters calculated from dietary data (e.g., dietary indices, dietary patterns, food groups, etc.), few studies with shared methods and assessment techniques were available for comparison. Third, we highlight the similarities between dietary and microbiome data structures and present the possibility that multivariate and compositional methods, developed initially for microbiome data, could have utility when applied to dietary data. Finally, we summarize the current state of the art for diet-microbiome data integration and highlight ways dietary data could be paired with microbiome data in future studies to improve the detection of diet-microbiome signals.
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Affiliation(s)
- Yuni Choi
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
| | - Susan L Hoops
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota, MN
| | - Calvin J Thoma
- BioTechnology Institute, University of Minnesota, Saint Paul, MN
| | - Abigail J Johnson
- Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN
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23
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Lim TJ, Okine RN, Kershaw JC. Health- or Environment-Focused Text Messages as a Potential Strategy to Increase Plant-Based Eating among Young Adults: An Exploratory Study. Foods 2021; 10:foods10123147. [PMID: 34945698 PMCID: PMC8701197 DOI: 10.3390/foods10123147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Previous plant-based diet (PBD) adoption strategies have primarily focused on health rather than environmental rationale and meat reduction rather than plant-based protein promotion. In this study, we explored the effect of a theory-informed text-message intervention on dietary intentions and behaviors in young adult omnivores and the potential explanatory role of PBD beliefs, subjective norm, self-efficacy, moral norm, and health and environmental values. Participants completed baseline questionnaires and reported dietary intake before being randomly assigned to receive 2–3 health- or environment-focused text messages per week for eight weeks and then repeated baseline assessments. Although we did not see significant changes in meat or plant protein intake, we did observe a marked decrease in intentions to consume animal protein and a marginal increase in fruit and vegetable consumption intention. We identified subjective norms, self-efficacy, and moral satisfaction as the strongest predictors of changes in intention to consume animal or plant protein. Although few group differences were observed, those receiving environment-focused text messages experienced a greater change in values and were more likely to increase vegetable intake. Messages that improve sustainability awareness and provide practical adoption strategies may be part of an effective strategy to influence PBD intake among young adults.
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Affiliation(s)
- Tze Joo Lim
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Richard Nii Okine
- Department of Mathematics and Statistics, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Jonathan C. Kershaw
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
- Correspondence: ; Tel.: +1-419-372-4579
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24
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Kimmel M, Jin W, Xia K, Lun K, Azcarate-Peril A, Plantinga A, Wu M, Ataei S, Rackers H, Carroll I, Meltzer-Brody S, Fransson E, Knickmeyer R. Metabolite trajectories across the perinatal period and mental health: A preliminary study of tryptophan-related metabolites, bile acids and microbial composition. Behav Brain Res 2021; 418:113635. [PMID: 34755640 DOI: 10.1016/j.bbr.2021.113635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/26/2021] [Accepted: 10/18/2021] [Indexed: 01/06/2023]
Abstract
Depression and anxiety during pregnancy and postpartum are common, but affected women differ in timing, trajectories, and extent of symptoms. The objective of this pilot, feasibility study is to analyze trajectories of serotonin and tryptophan-related metabolites, bile acid metabolites, and microbial composition, in relation to psychiatric history and current symptoms across the perinatal period. Serum and fecal samples were collected from 30 women at three times points in the perinatal period and assayed with LC-MS/MS and 16S sequencing respectively. We defined mean trajectories for each metabolite, clustered individuals by metabolite trajectories, tested associations between metabolites, and examined metabolite levels in relation to microbial composition. Findings of note include: (1) changes in kynurenine and the ratio of kynurenic acid to kynurenine from second trimester to third trimester were strongly associated with baseline primary and secondary bile acids. (2) Secondary bile acid UDCA and its conjugated forms were associated with lower bacterial diversity and levels of Lachnospiraceae, a taxa known to produce Short Chain Fatty Acids. (3) History of anxiety was associated with UDCA levels, but history of major depression was not associated with any of the bile acids. (4) There was a trend towards lower dietary fiber for those with history of anxiety or depression. Overall, our results reveal substantial temporal variation in tryptophan-related metabolites and in bile acid metabolites over the perinatal period, with marked inter-individual variability. Trajectories of TRP -related metabolites, primary and secondary bile acids, and the absence or presence of microbes that produce Short Chain Fatty Acids (SCFAs) considered in concert have the potential to differentiate individuals based on perinatal adaptations that may impact mental and overall health.
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Affiliation(s)
- Mary Kimmel
- University of North Carolina-Chapel Hill Department of Psychiatry, United States; Uppsala University, Department of Women and Children's Health, Sweden.
| | - Wanting Jin
- University of North Carolina-Chapel Hill Department of Psychiatry, United States
| | - Kai Xia
- University of North Carolina-Chapel Hill Department of Psychiatry, United States
| | - Kun Lun
- University of North Carolina-Chapel Hill Gillings School of Public Health, United States
| | - Andrea Azcarate-Peril
- University of North Carolina-Chapel Hill Department of Medicine and UNC Microbiome Core, United States
| | - Anna Plantinga
- Williams College Department of Mathematics and Statistics, United States
| | - Michael Wu
- University of North Carolina-Chapel Hill Department of Psychiatry, United States
| | - Shirin Ataei
- University of North Carolina-Chapel Hill Department of Psychiatry, United States
| | - Hannah Rackers
- University of North Carolina-Chapel Hill Department of Psychiatry, United States
| | - Ian Carroll
- University of North Carolina-Chapel Hill School of Public Health Department of Nutrition, United States
| | | | - Emma Fransson
- Uppsala University, Department of Women and Children's Health, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Insitutet Centre for Translational Microbiome Research, Sweden
| | - Rebecca Knickmeyer
- University of North Carolina-Chapel Hill Department of Psychiatry, United States; Michigan State University Department of Pediatrics and Human Development, United States
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25
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Greathouse KL, Padgett RN, Petrosino J, Hastings-Tolsma M, Faucher MA. Exploration of Diet Quality by Obesity Severity in Association with Gestational Weight Gain and Distal Gut Microbiota in Pregnant African American Women: Opportunities for Intervention. Matern Child Health J 2021; 26:882-894. [PMID: 34462812 DOI: 10.1007/s10995-021-03198-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To conduct an exploratory examination of dietary patterns and quality during pregnancy in African-American women who were class I, II, or III obese, and those women with normal pre-pregnancy body mass index (pBMI), as well to identify dietary factors associated with GWG, and changes in the distal gut microbiome. African American women represent the largest group affected by pre-pregnancy obesity, a risk factor for several adverse birth outcomes. METHODS This prospective study investigated the association between diet, distal gut microbiome, and GWG among African-American women (n = 21) with obesity (n = 15) compared to women with a normal pre-pregnancy body mass index (pBMI) (n = 6) at two time points, 27-29 and 37-39 weeks gestation. Dietary patterns associated with obesity severity and GWG gain were assessed using Welch's T-test and Mann-Whitney U. The association between the gut microbiome and dietary patterns was assessed using a regression-based kernel association test and the adaptive microbiome-based sum of powered score test. RESULTS In early pregnancy, dietary intake of Total Fruits and Greens and Beans was significantly different between pBMI and GWG groups; significance was 0.022 and 0.028 respectively. Women with Class II/III obesity and those with GWG above guidelines had Healthy Eating Index (HEI) scores below 50, meeting less than 75% of dietary guidelines, and did not meet recommendations for fruit and vegetable or fiber intake. We found no significant associations between the microbiome composition and diet (HEI Scores). CONCLUSIONS FOR PRACTICE Overall, the results indicate that women with pBMI obesity are not meeting minimum dietary guidelines for nutrient intakes during pregnancy, specifically fruits, vegetables, and fiber, regardless of GWG. Interventions for African-American women with pre-pregnancy obesity, with a focus on increasing consumption of fruits and vegetables, would be beneficial to control GWG and improve birth outcomes.
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Affiliation(s)
- K Leigh Greathouse
- Nutrition Science, Baylor University, One Bear Place 97346, Waco, TX, 76798-7346, USA. .,Department of Biology, Baylor University, One Bear Place 97346, Waco, TX, 76798-7346, USA.
| | - R Noah Padgett
- Educational Psychology, Baylor University, One Bear Place 97346, Waco, TX, 76798-7346, USA
| | - Joseph Petrosino
- The Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - M Hastings-Tolsma
- Louise Herrington School of Nursing, Dallas, TX; Midwifery Specialty, Baylor University, 333 N. Washington Ave., Dallas, TX, USA
| | - M A Faucher
- Advanced Practice Nursing Women's Centers, Parkland Health and Hospital System, 5200 Harry Hines Boulevard, Dallas, TX, 75235, USA
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26
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Potential of existing online 24-h dietary recall tools for national dietary surveys. Public Health Nutr 2021; 24:5361-5386. [PMID: 34392853 DOI: 10.1017/s1368980021003517] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe existing online, 24-h dietary recall (24-h DR) tools in terms of functionalities and ability to tackle challenges encountered during national dietary surveys, such as maximising response rates and collecting high-quality data from a representative sample of the population, while minimising the cost and response burden. DESIGN A search (from 2000 to 2019) was conducted in peer-reviewed and grey literature. For each tool, information on functionalities, validation and user usability studies, and potential adaptability for integration into a new context was collected. SETTING Not country-specific. PARTICIPANTS General population. RESULTS Eighteen online 24-h DR tools were identified. Most were developed in Europe, for children ≥10 years old and/or for adults. Eight followed the five multiple-pass steps but used various methodologies and features. Almost all tools (except three) validated their nutrient intake estimates, but with high heterogeneity in methodologies. User usability was not always assessed, and rarely by applying real-time methods. For researchers, eight tools developed a web platform to manage the survey and five appeared to be easily adaptable to a new context. CONCLUSIONS Among the eighteen online 24-h DR tools identified, the best candidates to be used in national dietary surveys should be those that were validated for their intake estimates, had confirmed user and researcher usability, and seemed sufficiently flexible to be adapted to new contexts. Regardless of the tool, adaptation to another context will still require time and funding, and this is probably the most challenging step.
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27
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Novotny R, Earle ME, Jung YO, Julian GJ, Hill E, Leon Guerrero RT, Coleman P, Deenik J, Boushey C, Wilkens LR. University of Hawai'i Cancer Center Connection: Pacific Tracker (PacTrac) Version 3.1 Diet and Physical Activity Assessment Tool for the Pacific Region. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:165-168. [PMID: 34278324 PMCID: PMC8280357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Pacific Tracker (PacTrac) is a web-based diet and physical activity assessment program created to analyze dietary recall or dietary record data from the Pacific region. Version 3.1 modifications make the tool available for public use (under check it out) to enter, analyze, view and print out data; and for research use, for saving and downloading of multiple entries in a research mode. PacTrac 3.1 (https://nappactrac31.ctahr.hawaii.edu/default.htm) is managed through the Children's Healthy Living Center of Excellence (CHL Center) at the College of Tropical Agriculture and Human Resources at the University of Hawai'i, in collaboration with the University of Hawai'i Cancer Center.
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Affiliation(s)
- Rachel Novotny
- Department Human Nutrition Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI (RN, EH)
| | - Maj E Earle
- University of Hawai'i Cancer Center, Honolulu, HI (MEE, YOJ, GJJ, CB, LRW)
| | - Yun Oh Jung
- University of Hawai'i Cancer Center, Honolulu, HI (MEE, YOJ, GJJ, CB, LRW)
| | - Greg Joel Julian
- University of Hawai'i Cancer Center, Honolulu, HI (MEE, YOJ, GJJ, CB, LRW)
| | - Erik Hill
- Department Human Nutrition Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI (RN, EH)
| | | | | | - Jonathan Deenik
- Department of Tropical Plant and Soil Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, HI (JD)
| | - Carol Boushey
- University of Hawai'i Cancer Center, Honolulu, HI (MEE, YOJ, GJJ, CB, LRW)
| | - Lynne R Wilkens
- University of Hawai'i Cancer Center, Honolulu, HI (MEE, YOJ, GJJ, CB, LRW)
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