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Diet Quality Index for older adults (DQI-65): development and use in predicting adherence to dietary recommendations and health markers in the UK National Diet and Nutrition Survey. Br J Nutr 2022; 128:2193-2207. [PMID: 34933704 DOI: 10.1017/s0007114521005043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Diet quality indexes (DQI) are useful tools for assessing diet quality in relation to health and guiding delivery of personalised nutritional advice; however, existing DQI are limited in their applicability to older adults (aged ≥ 65 years). Therefore, this research aimed to develop a novel evidence-based DQI specific to older adults (DQI-65). Three DQI-65 variations were developed to assess the impacts of different component quantitation methods and inclusion of physical activity. These were Nutrient and Food-based DQI-65 (NFDQI-65), NFDQI-65 with Physical Activity (NFDQI-65+PA) and Food-based DQI-65 with Physical Activity (FDQI-65+PA). To assess their individual efficacy, the NFDQI-65, NFDQI-65+PA and FDQI-65+PA were explored alongside the validated Healthy Eating Index-2015 (HEI-2015) and Alternative Healthy Eating Index-2010 (AHEI-2010) using data from the cross-sectional UK National Diet and Nutrition Survey (NDNS) rolling programme. Scores for DQI-65 variations, the HEI-2015 and AHEI-2010 were calculated for adults ≥ 65 years from years 2-6 of the NDNS (n 871). Associations with nutrient intake, nutrient status and health markers were analysed using linear and logistic regression. Higher DQI-65 and HEI-2015 scores were associated with increased odds of meeting almost all our previously proposed age-specific nutritional recommendations, and with important health markers of importance for older adults, including lower BMI, lower medication use and lower C-reactive protein (P < 0·01). Few associations were observed for the AHEI-2010. This analysis suggests value of all three DQI-65 as measures of dietary quality in UK older adults. However, methodological limitations mean further investigations are required to assess validity and reliability of the DQI-65.
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Godny L, Reshef L, Sharar Fischler T, Elial-Fatal S, Pfeffer-Gik T, Raykhel B, Rabinowitz K, Levi-Barda A, Perets TT, Barkan R, Goren I, Ollech JE, Yanai H, Gophna U, Dotan I. Increasing adherence to the Mediterranean diet and lifestyle is associated with reduced fecal calprotectin and intra-individual changes in microbial composition of healthy subjects. Gut Microbes 2022; 14:2120749. [PMID: 36226673 PMCID: PMC9578447 DOI: 10.1080/19490976.2022.2120749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The Mediterranean diet (MED) is associated with the modification of gut microbial composition. In this pilot study, we investigate the feasibility of a microbiota-targeted MED-based lifestyle intervention in healthy subjects. MED intervention integrating dietary counseling, a supporting mobile application, and daily physical activity measurement using step trackers was prospectively applied for 4 weeks. Blood and fecal samples were collected at baseline, after the 4-week intervention, and at 6 and 12 months. Blood counts, inflammatory markers, microbial and eukaryotic composition were analyzed. Dietary adherence was assessed using daily questionnaires. All 20 healthy participants (females 65%, median age 37), completed the 4-week intervention. Adherence to MED increased from 15.6 ± 4.1 (baseline) to 23.2 ± 3.6 points (4 weeks), p < .01, reflected by increased dietary fiber and decreased saturated fat intake (both p < .05). MED intervention modestly reduced fecal calprotectin, white blood cell, neutrophil, and lymphocyte counts, within the normal ranges (P < .05). Levels of butyrate producers including Faecalibacterium and Lachnospira were positively correlated with adherence to MED and the number of daily steps. Bacterial composition was associated with plant-based food intake, while fungal composition with animal-based food as well as olive oil and sweets. Increasing adherence to MED correlated with increased absolute abundances of multiple beneficial gut symbionts. Therefore, increasing adherence to MED is associated with reduction of fecal calprotectin and beneficial microbial alterations in healthy subjects. Microbiota targeted lifestyle interventions may be used to modify the intestinal ecosystem with potential implications for microbiome-mediated diseases.
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Affiliation(s)
- L. Godny
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L. Reshef
- The Shmunis School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - T. Sharar Fischler
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S. Elial-Fatal
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T. Pfeffer-Gik
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - B. Raykhel
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K. Rabinowitz
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A. Levi-Barda
- Biobank, Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - TT. Perets
- Gastroenterology Laboratory, Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel,Adelson School of Medicine, Ariel University, Ariel, Israel
| | - R. Barkan
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I. Goren
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Department of inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Ohio, USA
| | - JE. Ollech
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H. Yanai
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - U. Gophna
- The Shmunis School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - I. Dotan
- Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,CONTACT I. Dotan Division of Gastroenterology, Rabin Medical Center, Petah-Tikva, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kaiser B, Stelzl T, Finglas P, Gedrich K. The Assessment of a Personalized Nutrition Tool (eNutri) in Germany: Pilot Study on Usability Metrics and Users’ Experiences. JMIR Form Res 2022; 6:e34497. [PMID: 35925664 PMCID: PMC9389388 DOI: 10.2196/34497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/10/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background
To address the epidemic burden of diet-related diseases, adequate dietary intake assessments are needed to determine the actual nutrition intake of a population. In this context, the eNutri web app has been developed, providing online automated personalized dietary advice, based on nutritional information recorded via an integrated and validated food frequency questionnaire (FFQ). Originally developed for a British population and their dietary habits, the eNutri tool has specifically been adapted to the German population, taking into account national eating habits and dietary recommendations.
Objective
The primary aim of this study is to evaluate the system usability and users’ experience and feedback on the eNutri app in a small-scale preliminary study. The secondary aim is to investigate the efficacy of personalized nutrition (PN) recommendations versus general dietary advice in altering eating habits.
Methods
The app was piloted for 4 weeks by 106 participants from across Germany divided into a PN group and a control group. The groups differed according to the degree of personalization of dietary recommendations obtained.
Results
An overall System Usability Scale (SUS) score of 78.4 (SD 12.2) was yielded, indicating an above average user experience. Mean completion time of the FFQ was 26.7 minutes (SD 10.6 minutes). Across subgroups (age, sex, device screen sizes) no differences in SUS or completion time were found, indicating an equal performance for all users independent of the assigned experimental group. Participants’ feedback highlighted the need for more personalized dietary advice for controls, while personalized nutritional recommendations improved the awareness of healthy eating behavior. Further improvements to the eNutri app were suggested by the app users.
Conclusions
In total, the eNutri app has proven to be a suitable instrument to capture the dietary habits of a German population sample. Regarding functionality, system usability, and handling, direct user feedback was quite positive. Nutritional advice given was rated ambivalent, pointing to several weaknesses in the eNutri app, minimizing the system’s full potential. A higher level of personalization within nutritional advice subjectively improved the app’s usability. The insights gained will be used as a basis to further develop and improve this digital diet assessment tool.
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Affiliation(s)
- Birgit Kaiser
- Research Group Public Health Nutrition, ZIEL - Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Tamara Stelzl
- Chair of Analytical Food Chemistry, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Paul Finglas
- Quadram Bioscience Institute, Norwich, United Kingdom
| | - Kurt Gedrich
- Research Group Public Health Nutrition, ZIEL - Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
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