Weekly patterns, diet quality and energy balance

Self-Reported Weekend Temporal Eating Patterns of American Adults Differ From Weekday: National Health and Nutrition Examination Surveys: 2015-2020 Prepandemic

BACKGROUND

Weekend-weekday differences in time of ingestive events may be implicated in adverse metabolic and health outcomes. However, little is known about the nature of weekend-weekday differences in temporal eating behaviors of the US adult population.

OBJECTIVE

The study aimed to examine weekend-weekday differences in temporal and energy characteristics of ingestive events self-reported by American adults.

DESIGN

Observational; within-person comparative.

PARTICIPANTS/SETTING

The data were from the National Health and Nutrition Examination Surveys (NHANES) 2015-March 2020 (pre-pandemic) for ≥20-year-old adults who provided 1 weekday (M-Th) and 1 weekend (F, S, Su) 24-h dietary recall (n = 3564 men and 3823 women).

MAIN OUTCOME MEASURES

Prespecified primary temporal outcomes were recalled: time of ingestive events, and the duration of ingestive and fasting windows. Secondary outcomes included frequency and energy characteristics of ingestive events.

STATISTICAL ANALYSIS PERFORMED

Gender-specific, survey-weighted, multiple linear regression models that accounted for complex survey design with dummy covariates for weekend/weekday, mode of recall administration (in-person on day 1 and telephone on day 2), and a respondent-specific fixed intercept.

RESULTS

In both men and women, the weekend recalled time of first ingestive event, breakfast, and lunch were later than weekday (P ≤ .0008); however, no statistically significant differences were observed in time of dinner and the last eating episode. The mean weekend ingestive window (interval between the time of first and last eating events of the day) was shorter by 24 minutes (95% confidence interval [CI], -32, -11) in men and 18 minutes (95% CI, -20, -15) in women, and the mean overnight fasting window was correspondingly longer (P ≤ .0001). No statistically significant differences were observed between weekend and weekday frequency of ingestive events. Energy density of weekend food selections reported by women, and of beverages by men, was found to be higher than weekday (P ≤ .002).

CONCLUSIONS

Weekend ingestive patterns were characterized by later time of first ingestive event, breakfast, and lunch, and selection of higher-energy-density foods and beverages.

Analysis of nutrient intake and dietary adequacy on weekdays and weekends among undergraduate students

Objective: To comparatively analyze nutrient intake and dietary adequacy on weekdays (WKDs) and weekends (WKNs) among undergraduate students. Participants: University students (N = 210), 18-30 years old. Methods: A two-day food record was used. Intake of energy, macronutrients, micronutrients and fiber were calculated, without and with an adjustment for 2000 kcal of energy and compared to the corresponding nutritional requirements. Results: Energy and macronutrients' intake was higher on WKNs (1,776.84 ± 40.68 vs. 2,025.76 ± 52.46 kcal; p < .05). There was a high predominance of hypocaloric diet on both WKDs (72%) and WKNs (57%). A low prevalence (<50%) of favorable intake level of most micronutrients and fiber was found on WKDs, WKNs, or both. There was a lower favorable intake of vitamins A, C, iron, and magnesium on WKNs, after adjusting for 2000 kcal. Conclusion: Undergraduate students showed an unfavorable nutrient intake and poor dietary quality on WKNs. Interventions that promote healthy eating are needed.

Temporal Patterns of Diet and Physical Activity and of Diet Alone Have More Numerous Relationships With Health and Disease Status Indicators Compared to Temporal Patterns of Physical Activity Alone

BACKGROUND

Daily temporal patterns of energy intake (temporal dietary patterns [TDPs]) and physical activity (temporal physical activity patterns [TPAPs]) have been independently and jointly (temporal dietary and physical activity patterns [TDPAPs]) associated with health and disease status indicators.

OBJECTIVE

The aim of this study was to compare the number and strength of association between clusters of daily TDPs, TPAPs, and TDPAPs and multiple health and disease status indicators.

DESIGN

This cross-sectional study used 1 reliable weekday dietary recall and 1 random weekday of accelerometer data to partition to create clusters of participants representing the 3 temporal patterns. Four clusters were created via kernel-k means clustering algorithm of the same constrained dynamic time warping distance computed over the time series for each temporal pattern.

PARTICIPANTS/SETTING

From the National Health and Nutrition Examination Survey (2003-2006), 1,836 US adults aged 20 through 65 years who were not pregnant and had valid diet, physical activity, sociodemographic, anthropometric, questionnaire, and health and disease status indicator data were included.

MAIN OUTCOME MEASURES

Health status indicators used as outcome measures were body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, triglycerides, high-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure; disease status indicators included obesity, type 2 diabetes mellitus, and metabolic syndrome.

STATISTICAL ANALYSES PERFORMED

Multivariate regression models determined associations between the clusters representing each pattern and health and disease status indicators, controlling for confounders and adjusting for multiple comparisons. The number of significant differences among clusters and adjusted R2 and Akaike information criterion compared the strength of associations between clusters of patterns and continuous and categorical health and disease status indicators.

RESULTS

TDPAPs showed 21 significant associations with health and disease status indicators, including body mass index, waist circumference, obesity, and type 2 diabetes; TDPs showed 19 significant associations; and TPAPs showed 8 significant associations.

CONCLUSIONS

TDPAPs and TDPs had stronger and more numerous associations with health and disease status indicators compared with TPAPs. Patterns representing the integration of daily dietary habits hold promise for early detection of obesity.

In Which Situations Do We Eat? A Diary Study on Eating Situations and Situational Stability

Eating situations are crucial for understanding and changing eating behavior. While research on individual situational dimensions exists, little is known about eating situations as a whole. This study aimed to fill this gap by identifying eating situations as combinations of multiple situational dimensions and describing how stable individuals eat in those situations. In a five-day online diary study, 230 participants reported a total of 2461 meals and described the corresponding eating situation using predefined situational dimensions. Divisive hierarchical cluster analyses were conducted separately for breakfast, lunch, and dinner, resulting in unique cluster solutions that characterized the most common eating situations. The most common breakfast situations were characterized by a combination of the dimensions social, affect, and hunger. The most common lunch and dinner situations were characterized by varying combinations of the dimensions social, affect, and activity. Based on the identified situations, a situational stability index was developed to describe how stable individuals eat in the same situations. The findings suggest high interindividual differences in situational stability, which were associated with socio-demographic characteristics like age or employment. This study enhances our understanding of the situational aspects of eating behavior while offering tools to describe eating situations and situational stability.

Obesogenic Diet Cycling Produces Graded Effects on Cognition and Microbiota Composition in Rats

SCOPE

The effects of diet cycling on cognition and fecal microbiota are not well understood.

METHOD AND RESULTS

Adult male Sprague-Dawley rats were cycled between a high-fat, high-sugar "cafeteria" diet (Caf) and regular chow. The impairment in place recognition memory produced by 16 days of Caf diet was reduced by switching to chow for 11 but not 4 days. Next, rats received 16 days of Caf diet in 2, 4, 8, or 16-day cycles, each separated by 4-day chow cycles. Place recognition memory declined from baseline in all groups and was impaired in the 16- versus 2-day group. Finally, rats received 24 days of Caf diet continuously or in 3-day cycles separated by 2- or 4-day chow cycles. Any Caf diet access impaired cognition and increased adiposity relative to controls, without altering hippocampal gene expression. Place recognition and adiposity were the strongest predictors of global microbiota composition. Overall, diets with higher Caf > chow ratios produced greater spatial memory impairments and larger shifts in gut microbiota species richness and beta diversity.

CONCLUSION

Results suggest that diet-induced cognitive deficits worsen in proportion to unhealthy diet exposure, and that shifting to a healthy chow for at least a week is required for recovery under the conditions tested here.

Weekend-Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students

Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend−weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.

HYPO-CHEAT's aggregated weekly visualisations of risk reduce real world hypoglycaemia

Background

Children with congenital hyperinsulinism (CHI) are at constant risk of hypoglycaemia with the attendant risk of brain injury. Current hypoglycaemia prevention methods centre on the prediction of a continuous glucose variable using machine learning (ML) processing of continuous glucose monitoring (CGM). This approach ignores repetitive and predictable behavioural factors and is dependent upon ongoing CGM. Thus, there has been very limited success in reducing real-world hypoglycaemia with a ML approach in any condition.

Objectives

We describe the development of HYPO-CHEAT (HYpoglycaemia-Prevention-thrOugh-CGM-HEatmap-Technology), which is designed to overcome these limitations by describing weekly hypoglycaemia risk. We tested HYPO-CHEAT in a real-world setting to evaluate change in hypoglycaemia.

Methods

HYPO-CHEAT aggregates individual CGM data to identify weekly hypoglycaemia patterns. These are visualised via a hypoglycaemia heatmap along with actionable interpretations and targets. The algorithm is iterative and reacts to anticipated changing patterns of hypoglycaemia. HYPO-CHEAT was compared with Dexcom Clarity's pattern identification and Facebook Prophet's forecasting algorithm using data from 10 children with CHI using CGM for 12 weeks. HYPO-CHEAT's efficacy was assessed via change in time below range (TBR).

Results

HYPO-CHEAT identified hypoglycaemia patterns in all patients. Dexcom Clarity identified no patterns. Predictions from Facebook Prophet were inconsistent and difficult to interpret. Importantly, the patterns identified by HYPO-CHEAT matched the lived experience of all patients, generating new and actionable understanding of the cause of hypos. This facilitated patients to significantly reduce their time in hypoglycaemia from 7.1% to 5.4% even when real-time CGM data was removed.

Conclusions

HYPO-CHEAT's personalised hypoglycaemia heatmaps reduced total and targeted TBR even when CGM was reblinded. HYPO-CHEAT offers a highly effective and immediately available personalised approach to prevent hypoglycaemia and empower patients to self-care.

Diet Quality of Australian Children and Adolescents on Weekdays versus Weekend Days: A Secondary Analysis of the National Nutrition and Physical Activity Survey 2011-2012

Daily routines may influence children and adolescents’ eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011–2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2–17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.

Obesogenic Clusters Associated with Weight Status in Brazilian Adolescents of the Movimente School-Base Intervention

Background: the relationship between behavior clusters and weight status, mainly in low- and middle-income countries, remains unclear. This study aimed to examine the association between profiles of physical activity (PA), diet and sedentary behavior (SB) with weight status in adolescents from a southern Brazilian city, according to sex. Methods: data from the Movimente Intervention study were analyzed (n = 812 / mean age 13.0 years (sd 1.04). Data on SB hours per day, PA minutes per week and weekly consumption frequencies of fruits, vegetables, salty snacks, candies and soda were self-reported on the validated Movimente questionnaire. Classes of healthy and unhealthy behaviors were derived by latent class analysis. Logistic regression analysis was used to estimate the associations between adolescents’ weight status and classes. Results: two classes were identified for the whole sample and for boys and girls. All classes had high probabilities of engaging high time in SB. Male adolescents in the unhealthy class had low probabilities of being active and high probability of consuming a low-quality diet. In contrast, girls’ healthiest profile presented lower probabilities of being active compared to boys’ healthiest profiles. No association was found between weight status and classes. Conclusion: All classes had at least one unhealthy behavior, for both the whole sample, and for girls and boys. Girls’ profiles were unhealthier compared to boys’ profiles. Hence, it is recommended that intervention strategies to change behaviors need to be distinct according to sex, targeting more than one obesogenic behavior at the same time.

Irregular daily energy intake and diet quality in Iranian adults

The present cross-sectional study aimed to assess the association of daily irregularity in energy intake and diet quality among apparently healthy adults in Iran. The research was conducted on 850 adult men and women (age range: 20-59 years) who attended health care centres in Tehran. Dietary intake was assessed by three, 24-h dietary recalls. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) diet score and Healthy Eating Index-2015 (HEI-2015). An irregularity score of daily energy intake was calculated based on the deviation from the 3-d mean energy intake, with a higher score indicating more fluctuations in daily energy intake. Multiple linear regression analysis was used to assess the association of irregularity score of daily energy intake with food group intakes and DASH diet score and HEI-2015, controlling for age, sex, BMI, physical activity, education level and occupation status. The range of irregularity score was 0·55-133·3 (22·4 (sd 19·0)). Higher irregularity score of daily energy intake was significantly associated with a lower consumption of fruit, vegetables, legumes, low-fat dairy products and poultry, higher consumption of soft drinks, processed meat and nuts, and lower overall DASH diet score and HEI-2015. Overall, our findings showed that more day-to-day variations in energy intake may be correlated with a lower diet quality. More research is needed to confirm the associations observed in the present study and to clarify potential mechanisms explaining these associations.

Self-reported food intake decreases over recording period in the National Diet and Nutrition Survey

From 2008, the UK's National Diet and Nutrition Survey (NDNS) changed the method of dietary data collection from a 7-d weighed diary to a 4-d unweighed diary, partly to reduce participant burden. This study aimed to test whether self-reported energy intake changed significantly over the 4-d recording period of the NDNS rolling programme. Analyses used data from the NDNS years 1 (2008/2009) to 8 (2015/2016) inclusive, from participants aged 13 years and older. Dietary records from participants who reported unusual amounts of food and drink consumed on one or more days were excluded, leaving 6932 participants. Mean daily energy intake was 7107 kJ (1698 kcal), and there was a significant decrease of 164 kJ (39 kcal) between days 1 and 4 (P < 0·001). There was no significant interaction of sex or low-energy reporter status (estimated from the ratio of reported energy intake:BMR) with the change in reported energy intake. The decrease in reported energy intake on day 4 compared with day 1 was greater (P < 0·019) for adults with higher BMI (>30 kg/m2) than it was for leaner adults. Reported energy intake decreased over the 4-d recording period of the NDNS rolling programme suggesting that participants change their diet more, or report less completely, with successive days of recording their diet. The size of the effect was relatively minor, however.

The relationship between lifestyle components and dietary patterns

We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socio-economic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'.

Weekly variation in diet and physical activity among 4-75-year-old Danes

OBJECTIVE

To compare dietary intake and physical activity (PA) between days of the week in a large sample of the Danish population; furthermore, to investigate the influence of gender and age as determinants for weekly variation.

DESIGN

Analysis was based on cross-sectional data from the Danish National Survey of Diet and Physical Activity 2011-2013. Dietary intake and PA were assessed by 7 d of pre-coded food diaries and pedometer-determined step counts. Dietary intake and PA on weekdays (Monday-Thursday), Friday, and weekend days (Saturday and Sunday) were compared using linear mixed models.

SETTING

Survey with national representation, conducted in Denmark between 2011 and 2013.

PARTICIPANTS

A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively.

RESULTS

Energy intake during Friday and weekend days was 7-20 % higher compared with weekdays, while step counts were 10 and 17 % lower on Saturday and Sunday, respectively (all P < 0·001). Energy density of liquids and solids, consumption of added sugar, alcohol, discretionary foods, beer, wine and sugar-sweetened beverages were substantially higher, and consumption of dietary fibre, vegetables, fruit and wholegrain products were lower, during Friday and weekend days compared with weekdays (all P < 0·001). The observed patterns were present across gender and age, although weekly variation was most pronounced among children and relatively modest among the elderly.

CONCLUSIONS

Weekend health behaviours of Danes display less favourable eating and PA behaviour compared with weekdays, making the weekend an important target for public health interventions aiming to improve dietary intake and PA behaviour.

Do socio-demographic and anthropometric characteristics predict food choice motives in an Irish working population?

Dietary behaviour is influenced by a complex web of biological, psychological, physiological, social, economic and cultural factors. Understanding socio-demographic and anthropometric characteristics that influence food choice may be important in guiding dietary interventions. The present study aimed to identify whether socio-demographic and anthropometric characteristics influence food choice in an Irish working population. A cross-sectional survey was conducted in 2014 as part of the Food Choice at Work Study, a large clustered non-randomised, controlled trial based in county Cork, Ireland. Information regarding food motives was collected at the 3-4 months follow-up. The 'Food Choice Questionnaire' was used to measure food motives. Multiple linear regression was conducted to test the association between socio-demographic and anthropometric characteristics (age, sex, BMI, education, type of accommodation, living situation, marital status, parental status) and worksite and food motives. A total of 678 employees were included in the analysis. Overall, only a small percentage of food choice was influenced by the characteristics included in this analysis (1·6 to 8·8 %). Sensory appeal and satisfaction were scored most important by all sub-populations. Sex was most often associated with differences in food motives (i.e. all food motives except for familiarity and ethical concern were significantly more important to females compared with males; P = 0·001/P < 0·001). Worksite, age, BMI and marital status also seemed to play a small role in influencing food choice. The results show that food choice is complex and not easily explained by differences in socio-demographic or anthropometric population characteristics.

Effects of Different Physical Activity Levels during a Single Day on Energy Intake, Appetite, and Energy Balance: A Preliminary Study

We aimed to investigate the effects of a wide range of daily physical activity (PA) levels on energy balance (EB), energy intake (EI), and appetite. Nine young men completed three different PA levels in a metabolic chamber in a random order: (1) no exercise (Low-PA); (2) 25 min walking seven times (Mid-PA); and (3) 25 min running seven times (High-PA) within a 24 h period. Interval exercise (25 min exercise and 35 min rest) was performed three times in the morning and four times in the afternoon. The exercise intensities were 21.6% and 53.7% V˙O₂ peak for the Mid-PA and High-PA days, respectively. Participants were served three standardized meals and a buffet for dinner. The 24 h EB was calculated as 24 h energy expenditure (EE) minus 24 h EI. The 24 h EEs for the Low-PA, Mid-PA, and High-PA days were 1907 ± 200, 2232 ± 240, and 3224 ± 426 kcal, respectively, with significant differences observed among the three conditions (p < 0.01 for Low-PA vs. Mid-PA, Low-PA vs. High-PA, and Mid-PA vs. High-PA, respectively). The 24 h EIs for the Low-PA, Mid-PA, and High-PA days were 3232 ± 528, 2991 ± 617, and 3337 ± 684 kcal, and were unaffected by PA levels (p = 0.115). The 24 h EBs were 1324 ± 441 kcal (Low-PA), 759 ± 543 kcal (Mid-PA), and 113 ± 430 kcal (High-PA), with significant differences observed between Low-PA vs. Mid-PA (p = 0.0496), Low-PA vs. High-PA (p ≤ 0.01), and Mid-PA vs. High-PA (p = 0.017) conditions. The EB in the Low-PA group was the highest of the three conditions. Appetite perception did not differ among the study days, however there was an interaction trend (p = 0.078, time × condition). Thus, significantly different daily PA did not affect 24 h EI, however markedly affected 24 h EB, implying that EB is not automatically matched during a single day.

Timing of eating across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

OBJECTIVE

To examine timing of eating across ten European countries.

DESIGN

Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995-2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as well as the later:earlier energy intake ratio, with earlier and later intakes defined as 06.00-14.00 and 15.00-24.00 hours, respectively. Type III tests were used to examine associations of sociodemographic, lifestyle and health variables with timing of energy intake.

SETTING

Ten Western European countries.

SUBJECTS

In total, 22 985 women and 13 035 men aged 35-74 years (n 36 020).

RESULTS

A south-north gradient was observed for timing of eating, with later consumption of meals and snacks in Mediterranean countries compared with Central and Northern European countries. However, the energy load was reversed, with the later:earlier energy intake ratio ranging from 0·68 (France) to 1·39 (Norway) among women, and from 0·71 (Greece) to 1·35 (the Netherlands) among men. Among women, country, age, education, marital status, smoking, day of recall and season were all independently associated with timing of energy intake (all P<0·05). Among men, the corresponding variables were country, age, education, smoking, physical activity, BMI and day of recall (all P<0·05).

CONCLUSIONS

We found pronounced differences in timing of eating across Europe, with later meal timetables but greater energy load earlier during the day in Mediterranean countries compared with Central and Northern European countries.

Empirically derived dietary patterns through latent profile analysis among Brazilian children and adolescents from Southern Brazil, 2013-2015

The aims of this study were to identify dietary patterns (DPs) of children and adolescents participating in three cross-sectional surveys (2013-2015) and to test their associations with sociodemographic variables, physical activity (PAS), screen-based sedentary activity (SA), and weight status. One-day data were obtained from 5,364 schoolchildren (7-12 years) from public schools of Florianopolis (South of Brazil), using the validated questionnaire Web-CAAFE (Food Intake and Physical Activity of Schoolchildren). DPs were derived from the frequency of daily consumption of 32 foods/beverages by latent profile analysis. Multinomial logistic regression analysis was used to estimate the association of the DPs with sociodemographic variables, physical activity, screen activity and weight status. 'Traditional', 'Monotonous', and 'Mixed' DPs were identified. The percentages of children and adolescents within these profiles were 41.3, 36.3, and 22.4%, respectively. Children and adolescents in the highest tertiles of both PAS and daily frequency of SA had a higher probability to present a 'Mixed' DP compared to peers with less PAS and SA. Children and adolescents who reported having a school meal were significantly more likely to present the 'Traditional'DP, while boys who did not report having a school meal had a higher probability to present the 'Monotonous' DP. The DPs were not associated with the year of survey, age, family income, or weight status.

The influence of a fruit smoothie or cereal and milk breakfast on subsequent dietary intake: a pilot study

Smoothies are popular breakfast foods. This study examined the effect of consuming Cereal & Milk (CM) or a nutritionally-comparable Fruit Smoothie (FS) for breakfast on daily energy intake (EI) in free-living adults and the extent to which individuals compensated for calories ingested in a High Energy Fruit Smoothie (HE). Ten participants (28.4 ± 2.2y; 23.3 ± 1.0 kg·m ^-2, Mean ± SEM) attended the laboratory on 3 consecutive days per week for 3 weeks. Each week, they received a CM, FS or HE breakfast, then recorded all food/beverages consumed across the remainder of the day. The CM and FS were energy-matched to participants' usual breakfast (1675 ± 283 kJ), while the HE contained an additional 100 kJ·kg^-1 of maltodextrin (3019 ± 335 kJ). Mean 3-day EI was similar on CM and FS (7894 ± 547 vs. 7570 ± 463 kJ, p > .05), but elevated on HE (8861 ± 726 kJ, p =  .012). Thus, individuals who substitute CM for a FS breakfast should be mindful that energy-dense beverages may result in increased daily EI.

Do Aspects of Protein Intake Vary Across the Week in Healthy Community-Dwelling Older Adults?-An enable Study

Various aspects of protein intake are thought to be crucial for the prevention of sarcopenia in older adults. Information about the day-to-day variation in these aspects is lacking. Our objective was to examine whether daily protein intake, protein distribution across meals, number of meals providing adequate protein, and protein sources vary across the week in healthy community-dwelling older adults. In 140 persons (51% women) that were aged 75–85 years, protein intake was assessed by seven-day food records. On average across the week, protein intake (median [IQR]) was 0.93 [0.79–1.10] g/kg body weight (BW) and the coefficient of variation across the three main meals was 0.50 [0.40–0.61]. The number of meals per day providing ≥0.4 g protein/kg BW was 0.57 [0.43–1.00] and 60.0 [52.4–65.2]% of protein intake was animal-based. According to Friedman’s test, differences throughout the week were observed in women for daily protein intake (p = 0.038; Sunday: 0.99 [0.78–1.31] vs. Tuesday: 0.79 [0.68–1.12] g/kg BW) and number of meals with adequate protein (p = 0.019; ≥1 daily meal: Sunday: 69.4% vs. Tuesday: 41.7%). On Sunday, protein intake was most in agreement with suggestions to prevent sarcopenia. In men, protein intake did not differ throughout the week.

An Evaluation of Factors Predicting Diet Quality among Cancer Patients

A high diet quality is associated with a lower risk of cancer mortality. However, the predictive factors of diet quality among cancer patients are not well understood. This study determines the socio-demographic and disease-related factors that affect diet quality among cancer patients. Two hundred and forty-two cancer patients completed questionnaires assessing sociodemographic and disease-related characteristics. Diet quality was measured using the Healthy Eating Index 2010 (HEI). Independent sample t-tests and one-way ANOVA with post-hoc analysis using the Tukey HSD test were used to compare mean HEI scores across these characteristics. A regression model was used to determine factors that predicted diet quality. The overall HEI score among cancer patients was 61.59 (SD = 11.67). Patients with a high school degree or General Education Diploma (GED) or less had lower HEI scores (β = -4.03, p = 0.04; β = -7.77, p = 0.001, respectively) compared to those with college degrees. Additionally, homemakers had significantly higher HEI scores (β = 7.95, p = 0.008) compared to those who worked at least 40 hours per week. Also, individuals with some types of cancers (e.g., endometrial or uterine) had significantly higher HEI scores (β = 12.56, p = 0.002) than those with other cancers (e.g., head and neck). Our findings will help oncology healthcare providers identify and target cancer patients with specific demographic characteristics who are at increased risk for consuming poor-quality diets with much needed food resource interventions.

Salt intake and dietary sources of salt on weekdays and weekend days in Australian adults

OBJECTIVE

To assess if there is a difference in salt intake (24 h urine collection and dietary recall) and dietary sources of salt (Na) on weekdays and weekend days.

DESIGN

A cross-sectional study of adults who provided one 24 h urine collection and one telephone-administered 24 h dietary recall.

SETTING

Community-dwelling adults living in the State of Victoria, Australia.

SUBJECTS

Adults (n 598) who participated in a health survey (53·5 % women; mean age 57·1 (95 % CI 56·2, 58·1) years).

RESULTS

Mean (95 % CI) salt intake (dietary recall) was 6·8 (6·6, 7·1) g/d and 24 h urinary salt excretion was 8·1 (7·8, 8·3) g/d. Mean dietary and 24 h urinary salt (age-adjusted) were 0·9 (0·1, 1·6) g/d (P=0·024) and 0·8 (0·3, 1·6) g/d (P=0·0017), respectively, higher at weekends compared with weekdays. There was an indication of a greater energy intake at weekends (+0·6 (0·02, 1·2) MJ/d, P=0·06), but no difference in Na density (weekday: 291 (279, 304) mg/MJ; weekend: 304 (281, 327) mg/MJ; P=0·360). Cereals/cereal products and dishes, meat, poultry, milk products and gravy/sauces accounted for 71 % of dietary Na.

CONCLUSIONS

Mean salt intake (24 h urine collection) was more than 60 % above the recommended level of 5 g salt/d and 8-14 % more salt was consumed at weekends than on weekdays. Substantial reductions in the Na content of staple foods, processed meat, sauces, mixed dishes (e.g. pasta), convenience and takeaway foods are required to achieve a significant consistent reduction in population salt intake throughout the week.

The validity of a web-based FFQ assessed by doubly labelled water and multiple 24-h recalls

The aim of this study was to validate the estimated habitual dietary intake from a newly developed web-based FFQ (WebFFQ), for use in an adult population in Norway. In total, ninety-two individuals were recruited. Total energy expenditure (TEE) measured by doubly labelled water was used as the reference method for energy intake (EI) in a subsample of twenty-nine women, and multiple 24-h recalls (24HR) were used as the reference method for the relative validation of macronutrients and food groups in the entire sample. Absolute differences, ratios, crude and deattenuated correlations, cross-classifications, Bland-Altman plot and plots between misreporting of EI (EI-TEE) and the relative misreporting of food groups (WebFFQ-24HR) were used to assess the validity. Results showed that EI on group level was not significantly different from TEE measured by doubly labelled water (0·7 MJ/d), but ranking abilities were poor (r -0·18). The relative validation showed an overestimation for the majority of the variables using absolute intakes, especially for the food groups 'vegetables' and 'fish and shellfish', but an improved agreement between the test and reference tool was observed for energy adjusted intakes. Deattenuated correlation coefficients were between 0·22 and 0·89, and low levels of grossly misclassified individuals (0-3 %) were observed for the majority of the energy adjusted variables for macronutrients and food groups. In conclusion, energy estimates from the WebFFQ should be used with caution, but the estimated absolute intakes on group level and ranking abilities seem acceptable for macronutrients and most food groups.

The Role of Food Antioxidants, Benefits of Functional Foods, and Influence of Feeding Habits on the Health of the Older Person: An Overview

This overview was directed towards understanding the relationship of brain functions with dietary choices mainly by older humans. This included food color, flavor, and aroma, as they relate to dietary sufficiency or the association of antioxidants with neurodegenerative diseases such as dementia and Alzheimer’s disease. Impairment of olfactory and gustatory function in relation to these diseases was also explored. The role of functional foods was considered as a potential treatment of dementia and Alzheimer’s disease through inhibition of acetylcholinesterase as well as similar treatments based on herbs, spices and antioxidants therein. The importance of antioxidants for maintaining the physiological functions of liver, kidney, digestive system, and prevention of cardiovascular diseases and cancer has also been highlighted. Detailed discussion was focused on health promotion of the older person through the frequency and patterns of dietary intake, and a human ecology framework to estimate adverse risk factors for health. Finally, the role of the food industry, mass media, and apps were explored for today’s new older person generation.

Changes in Dietary Patterns from Childhood to Adolescence and Associated Body Adiposity Status

The aims of this study were to identify cross-sectional dietary patterns (DPs) in a representative sample of 7–10-year-old schoolchildren, to examine how scores for these DPs tracked over a time period of five years (from age 7–10 years to 12–15 years), and to investigate longitudinal associations between changes in DPs scores and changes in BMI (Body Mass Index) z-scores. Children aged 7–10-years were examined in 2007 (n = 1158) and a subset of the sample participated in a follow-up in 2012 (n = 458). Factor analysis (FA) was applied to derive DPs at baseline. The change in DP from childhood to adolescence was analyzed by comparing factor scores using the complete cases, in which factor loadings were the ones evaluated at baseline. Associations of BMI change with DP change were assessed by multivariate linear regression. At baseline, four DP were identified that explained 47.9% of the food intake variance. On average, the factor scores of “DP II” (salty snacks, French fries, fast-food, sugary beverages) decreased in follow-up, while no changes were observed for “DP I” (rice, cooked beans, beef/poultry, leafy vegetables), “DP III” (fruits, cooked and leafy vegetables, fruit juices, pasta, milk, cheese), and “DP IV” (milk, coffee with milk, cheese, breads/biscuits). No significant linear association was shown between changes in BMI z-scores and changes in DP scores from childhood to adolescence. In conclusion, three out of four DP scores identified at baseline tracked slightly in adolescence.

The association between sedentary behaviors during weekdays and weekend with change in body composition in young adults

BACKGROUND

High sedentary time has been considered an important chronic disease risk factor but there is only limited information on the association of specific sedentary behaviors on weekdays and weekend-days with body composition. The present study examines the prospective association of total sedentary time and specific sedentary behaviors during weekdays and the weekend with body composition in young adults.

METHODS

A total of 332 adults (50% male; 27.7 ± 3.7 years) were followed over a period of 1 year. Time spent sedentary, excluding sleep (SED), and in physical activity (PA) during weekdays and weekend-days was objectively assessed every 3 months with a multi-sensor device over a period of at least 8 days. In addition, participants reported sitting time, TV time and non-work related time spent at the computer separately for weekdays and the weekend. Fat mass and fat free mass were assessed via dual x-ray absorptiometry and used to calculate percent body fat (%BF). Energy intake was estimated based on TDEE and change in body composition.

RESULTS

Cross-sectional analyses showed a significant correlation between SED and body composition (0.18 ≤ r ≤ 0.34). Associations between body weight and specific sedentary behaviors were less pronounced and significant during weekdays only (r ≤ 0.16). Nevertheless, decrease in SED during weekends, rather than during weekdays, was significantly associated with subsequent decrease in %BF (β = 0.06, p <0.01). After adjusting for PA and energy intake, results for SED were no longer significant. Only the association between change in sitting time during weekends and subsequent %BF was independent from change in PA or energy intake (β%BF = 0.04, p = 0.01), while there was no significant association between TV or computer time and subsequent body composition.

CONCLUSIONS

The stronger prospective association between sedentary behavior during weekends with subsequent body composition emphasizes the importance of leisure time behavior in weight management.

The Association of Physical Activity during Weekdays and Weekend with Body Composition in Young Adults

Physical activity (PA) is a key contributor in long-term weight management but there remains limited research on the association between weekly PA patterns and weight change. The purpose of the present study was to examine the prospective association between weekly PA patterns and weight change in generally healthy young adults. Anthropometric measurements, including dual X-ray absorptiometry, were obtained every 3 months over a period of one year in 338 adults (53% male). At each measurement time, participants wore a multisensor device for a minimum of 10 days to determine total daily energy expenditure and time spent sleeping, sedentary, in light PA (LPA), in moderate PA (MPA), and in vigorous PA (VPA). PA did not differ between weekdays and the weekend at baseline. Twenty-four-hour sleep time, however, was significantly longer during weekends compared to weekdays, which was associated with less time spent sedentary. Weight loss was associated with a significant increase in LPA at the expense of sedentary time during the weekend but not during weekdays. Regression analyses further revealed an inverse association between change in VPA during the weekend and body composition at 12-month follow-up. Taken together, these results suggest that weekend PA plays an important role in long-term weight management.

Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study

BACKGROUND

Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations.

OBJECTIVE

The aim of the study was to assess the factors related to sustained use of a free mobile app ("The Eatery") that promotes healthy eating through photographic dietary self-monitoring and peer feedback.

METHODS

A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as "Users" and people with one or no pictures as "Dropouts". Users who had taken at least 10 pictures and used the app for at least one week were classified as "Actives", Users with 2-9 pictures as "Semi-actives", and Dropouts with one picture as "Non-actives". The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives.

RESULTS

Overall adherence was low-only 2.58% (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28% (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34% (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31%, 900/6291) than those who had not defined any diet (3.99%, 742/18,590), said they ate everything (9.47%, 3040/32,090), or reported some other diet (11.85%, 213/1798) (χ(2) 3=826.6, P<.001). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49) (F2,58167=225.9, P<.001). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives (χ(2) 2=3515.1, P<.001). Feedback beyond ratings was relatively infrequent: 3.83% (15,247/398,228) of pictures received comments and 15.39% (61,299/398,228) received "likes" from other users. Actives were more likely to have at least one comment or one "like" for their pictures than Semi-actives or Non-actives (χ(2) 2=343.6, P<.001, and χ(2) 2=909.6, P<.001, respectively). Only 9.89% (481/4863) of Active users had a positive trend in their average healthiness ratings.

CONCLUSIONS

Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.