Energy intake and sources of energy intake in the European Prospective Investigation into Cancer and Nutrition

Consumer Preference Segments for Plant-Based Foods: The Role of Product Category

A survey of willingness to consume (WTC) 5 types of plant-based (PB) food was conducted in USA, Australia, Singapore and India (n = 2494). In addition to WTC, emotional, conceptual and situational use characterizations were obtained. Results showed a number of distinct clusters of consumers with different patterns of WTC for PB foods within different food categories. A large group of consumers did not discriminate among PB foods across the various food categories. Six smaller, but distinct clusters of consumers had specific patterns of WTC across the examined food categories. In general, PB Milk and, to a much lesser extent, PB Cheese had highest WTC ratings. PB Fish had the lowest WTC, and two PB meat products had intermediate WTC. Emotional, conceptual and situational use characterizations exerted significant lifts/penalties on WTC. No penalty or lifts were imparted on WTC by the situational use of 'moving my diet in a sustainable direction', whereas uses related to 'when I want something I like' and 'when I want something healthy' generally imparted WTC lifts across clusters and food categories. The importance of this research for the study of PB foods is its demonstration that consumers are not monolithic in their willingness to consume these foods and that WTC is often a function of the food category of the PB food.

Differences in Dietary Intake Exist among U.S. Adults by Diabetic Status Using NHANES 2009-2016

The objective was to determine the most frequently consumed food items, food subcategories, and food categories, and those that contributed most to total energy intake for the group of U.S. adults reporting taking insulin, those with type 2 diabetes (T2D) not taking insulin, and those without diabetes. Laboratory tests and questionnaires of the National Health and Nutrition Examination Survey 2009-2016 classified 774 participants reporting taking insulin, 2758 participants reporting T2D not taking insulin, and 17,796 participants without diabetes. Raw and weighted frequency and energy contributions of each food item, food subcategory, and food category were calculated and ranked. Comparisons among groups by broad food category used the Rao-Scott modified chi-square test. Soft drinks ranked as the 8th and 6th most consumed food subcategory of participants with T2D not taking insulin and those without diabetes, and contributed 5th and 2nd most to energy, respectively. The group reporting taking insulin is likely to consume more protein foods and less soft drink compared to the other two groups. Lists of the most frequently reported foods and foods contributing most to energy may be helpful for nutrition education, prescribing diets, and digital-based dietary assessment for the group reporting taking insulin.

A systematic review on consumer acceptance of alternative proteins: Pulses, algae, insects, plant-based meat alternatives, and cultured meat

Consumers' dietary patterns have a significant impact on planetary and personal health. To address health and environmental challenges one of the many possible solutions is to substitute meat consumption with alternative protein sources. This systematic review identifies 91 articles with a focus on the drivers of consumer acceptance of five alternative proteins: pulses, algae, insects, plant-based alternative proteins, and cultured meat. This review demonstrates that acceptance of the alternative proteins included here is relatively low (compared to that of meat); acceptance of insects is lowest, followed by acceptance of cultured meat. Pulses and plant-based alternative proteins have the highest acceptance level. In general, the following drivers of acceptance consistently show to be relevant for the acceptance of various alternative proteins: motives of taste and health, familiarity, attitudes, food neophobia, disgust, and social norms. However, there are also differences in relevance between individuals and between alternative proteins. For example, for insects and other novel alternative proteins the drivers of familiarity and affective processes of food neophobia and disgust seem more relevant. As part of gaining full insight in relevant drivers of acceptance, the review also shows an overview of the intervention studies that were included in the 91 articles of the review, providing implications on how consumer acceptance can be increased. The focal areas of the intervention studies included here do not fully correspond with the current knowledge of drivers. To date, intervention studies have mainly focussed on conscious deliberations, whereas familiarity and affective factors have also been shown to be key drivers. The comprehensive overview of the most relevant factors for consumer acceptance of various categories of alternative proteins thus shows large consistencies across bodies of research. Variations can be found in the nuances showing different priorities of drivers for different proteins and different segments, showing the relevance of being context and person specific for future research.

Eating Habits of Children Born after Maternal Bariatric Surgery

Mothers who underwent bariatric surgery (BS) before pregnancy have worrisome eating habits, but little is known about the eating habits of their offspring. EFFECTOR is a cross-sectional, long-term follow-up study of 4-11-year-old children born from mothers that underwent bariatric surgery before pregnancy (n = 36), mothers with overweight/obesity (OW/OB) in a control group (n = 71), and mothers with a normal weight (NW) in a second control group (n = 35). Data on anthropometry and on eating habits obtained through a Food Frequency Questionnaire were collected prospectively. The children's body mass index (BMI) scores significantly correlated with maternal pre-pregnancy BMI. The prevalence of overweight and obesity was the highest in children of the BS group (38.9% vs. 15.5% for children of the OW/OB group and 5.7% for those of the NW group; p = 0.004). Meal-skipping behavior was comparable between the groups. There was no difference in fruit and vegetable consumption. The BS group consumed more low-calorie sweetened beverages compared to the NW group (p = 0.01) but less fruit juice compared to the NW and OW/OB groups (p = 0.01). Our results may indicate a sugar-avoiding behavior in children of the BS group, fitting dietary maternal habits in a strategy to prevent dumping syndrome. In conclusion, maternal pre-pregnancy bariatric surgery does not alter unhealthy eating behaviors and the risk of development of overweight during childhood in their children.

Protein intake pattern over the day and its association with low total protein intake in Dutch community-dwelling older adults

Objective:

Investigate protein intake patterns over the day and their association with total protein intake in older adults.

Design:

Cross-sectional study utilising the dietary data collected through two non-consecutive, dietary record-assisted 24-h recalls. Days with low protein intake (n 290) were defined using the RDA (<0·8 g protein/kg adjusted BW/d). For each day, the amount and proportion of protein ingested at every hour of the day and during morning, mid-day and evening hours was calculated. Amounts and proportions were compared between low and high protein intake days and related to total protein intake and risk of low protein intake.

Setting:

Community.

Participants:

739 Dutch community-dwelling adults ≥70 years.

Results:

The mean protein intake was 76·3 (sd 0·7) g/d. At each hour of the day, the amount of protein ingested was higher on days with a high protein intake than on days with a low protein intake and associated with a higher total protein intake. The proportion of protein ingested during morning hours was higher (22 v. 17 %, P < 0·0001) on days with a low protein intake, and a higher proportion of protein ingested during morning hours was associated with a lower total protein intake (P < 0·0001) and a higher odds of low protein intake (OR 1·04, 95 % CI 1·03, 1·06). For the proportion of protein intake during mid-day or evening hours, opposite but weaker associations were found.

Conclusions:

In this sample, timing of protein intake was associated with total protein intake. Additional studies need to clarify the importance of these findings to optimise protein intake.

Tendência temporal e fatores associados ao consumo de carnes gordurosas na população brasileira entre de 2007 a 2014

Resumo O objetivo deste artigo é analisar a tendência temporal do consumo de carnes gordurosas (CG) e fatores associados ao seu consumo habitual entre 2007 e 2014. Série temporal do consumo de CG (vermelha e frango/galinha) realizada a partir do inquérito telefônico “Vigilância de Fatores de Risco e Proteção para Doenças Crônicas” (Vigitel). A tendência do consumo foi analisada por regressão “joinpoint” e expressa em variação percentual anual (VPA[IC95%]), enquanto os fatores sociodemográficos e comportamentais associados em 2007 e 2014 por modelo linear generalizado (log-binomial). Entre 2007-2014, o consumo ≥ 5x/semana de carnes brancas aumentou (VPA 6,9% [5,7; 8,1]), enquanto as vermelhas permaneceu estável. O consumo CG apresentou redução significativa a partir de 2011 (VPA -4,0%[-7,5; -0,2]), provavelmente em função da redução no consumo das vermelhas gordurosas. Identificamos que o sexo masculino, as faixas etárias mais jovens, residir nas regiões CO/SE/S, escolaridade ≤ 8 anos e o uso abusivo de álcool e tabaco se associaram com o consumo de CG; assistir televisão > 3h/dia foi associada apenas em 2014. No período analisado houve redução no consumo de CG pela população brasileira, sendo seu consumo associado a fatores sociodemográficas e outros comportamentos promotores de DCNT.

The Effect of a Pilot Dietary Intervention on Pain Outcomes in Patients Attending a Tertiary Pain Service

The aim of this study was to examine the effect of a six-week 2 × 2 design on pain scores, quality of life, and dietary intake in patients attending an Australian tertiary pain clinic. The two intervention components were (1) personalized dietary consultations or waitlist control, and (2) active or placebo dietary supplement (fruit juice). Sixty participants were randomized into one of four groups at baseline (68% female, mean age 49 ± 15 years) with 42 completing the study (70% retention). All groups had statistically significant improvements in three of five pain outcomes. The personalized dietary consultation groups had clinically important improvements in three of five pain outcomes compared to the waitlist control groups. All groups had a statistically significant improvement in six of eight quality-of-life categories post intervention. All groups increased percentage energy from nutrient-dense foods (+5.2 ± 1.4%, p < 0.001) with a significant group-by-time effect for percentage energy from total fat (p = 0.024), with the personalized dietary consultations plus placebo fruit juice reporting the largest reduction (−5.7 ± 2.3%). This study indicates that dietitian-delivered dietary intervention can improve pain scores, quality of life, and dietary intake of people experiencing chronic pain. Future research should evaluate efficacy in a full-powered randomized control trial.

The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Background

Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects.

Methods

Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m² (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups.

Results

Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures.

Conclusions

ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted.

Trial registration

ClinicalTrials.gov (NCT01738256), registered 17 August, 2012.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0654-8) contains supplementary material, which is available to authorized users.

Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

OBJECTIVE

To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

DESIGN

Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.

SETTING

Twenty-seven centres across ten European countries.

SUBJECTS

Women (64 %) and men (36 %) aged 35-74 years (n 36 020).

RESULTS

Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe.

CONCLUSIONS

We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

Secular changes in intakes of foods among New Zealand adults from 1997 to 2008/09

OBJECTIVE

To examine changes in the food choices of New Zealand (NZ) adults, between the 1997 National Nutrition Survey (NNS97) and the 2008/09 NZ Adult Nutrition Survey (2008/09 NZANS).

DESIGN

The 2008/09 NZANS and the NNS97 were cross-sectional surveys of NZ adults (aged 15 years and over). Dietary intake data were collected using a computer-based 24 h diet recall. Logistic regression models were used to examine changes over time in the percentage reporting each food group, with survey year, sex and age group (19-30 years, 31-50 years, 51-70 years, ≥71 years) as the variables.

SETTING

NZ households.

SUBJECTS

Adults aged 19 years and over (NNS97, n 4339; 2008/09 NZANS, n 3995).

RESULTS

In the 2008/09 NZANS compared with NNS97, males and females were less likely to report consuming bread, potatoes, beef, vegetables, breakfast cereal, milk, cheese, butter, pies, biscuits, cakes and puddings, and sugar/confectionery (all P<0.001). In contrast, there was an increase in the percentage reporting rice and rice dishes (P<0.001), and among females a reported increase in snacks and snack bars (e.g., crisps, extruded snacks, muesli bars; P=0.007) and pasta and pasta dishes (P=0.017). Although food choices were associated with sex and age group, there were few differential changes between the surveys by sex or age group.

CONCLUSIONS

For all age groups there was a shift in the percentage who reported consuming the traditional NZ foods, namely bread, beef, potatoes and vegetables, towards more rice and rice dishes. Declines in the consumption of butter, pies, biscuits, cakes and puddings are congruent with current dietary guidelines.

Seasonal variation in food intake and the interaction effects of sex and age among adults in southern Brazil

BACKGROUND/OBJECTIVES

Because studies have evidenced variations in nutrient intake, further investigation of the interaction between demographic characteristics and the seasons is necessary. We aimed to test the differences in food intake throughout the seasons and the interaction between the seasons and sex and age.

SUBJECTS/METHODS

This study included 273 individuals. Food intake was evaluated with 24-hour dietary recalls, and the reported food items were sorted into food groups. We performed the test on the differences in intake of food groups throughout the seasons with repeated measures and on the interaction effect by using the Generalized Estimate Equation.

RESULTS

Intake of fruits and natural fruit juices and sweetened beverages was lower, whereas that of grains and derivatives was higher in the winter. The intake of leafy vegetables and fish and seafood was lower in the autumn. The consumption of coffee and eggs was higher in the spring. Intake of chocolate powder and sugar, salt and lean poultry was higher in the winter. The variation in consumption of grains and derivatives, eggs, fatty poultry and processed meat over the seasons was more likely to be modified by sex. Age interacted with the seasons for leafy vegetables, beans and lentils, lean beef, lean poultry, low fat milk and light yogurt, vegetable oil and unsalted margarine, chocolate powder and sugar and processed meat.

CONCLUSIONS

This study shows that food intake may change seasonally and that seasonal variation depends on sex and age, which might aggregate a specific co-variation component.

Milk fat content and DGAT1 genotype determine lipid composition of the milk fat globule membrane

During secretion of milk fat globules, triacylglycerol (TAG) droplets are enveloped by a phospholipid (PL) trilayer. Globule size has been found to be related to polar lipid composition and fat content, and milk fat content and fatty acid composition have been associated with the diacylglycerol acyltransferase 1 (DGAT1) K232A polymorphism; however, the association between the DGAT1 polymorphism and fat globule size and polar lipid composition has not been studied. The ratio between polar and neutral lipids as well as the composition of the polar lipids in milk has industrial as well as nutritional and health implications. Understanding phenotypic and genotypic factors influencing these parameters could contribute to improving milk lipid composition for dairy products. The focus of the present study was to determine the effect of both fat content and DGAT1 polymorphism on PL/TAG ratio, as a marker for milk fat globule size, and detailed PL composition. Milk samples were selected from 200 cows such that there were equal numbers of samples for the different fat contents as well as per DGAT1 genotype. Samples were analyzed for neutral and polar lipid concentration and composition. PL/TAG ratio was significantly associated with both fat content and DGAT1 genotype. Phosphatidylinositol and phosphatidylserine concentrations were associated with fat content*DGAT1 genotype with a stronger association for the AA than the KK genotype. Sphingomyelin concentration tended to interact with fat content*DGAT1 genotype. Phosphatidylethanolamine (PE) concentration showed a biphasic response to fat content, suggesting that multiple biological processes influence its concentration. These results provide a new direction for controlling polar lipid concentration and composition in milk through selective breeding of cows.

Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus

BACKGROUND

Dietary fiber, carbohydrate quality and quantity are associated with mortality risk in the general population. Whether this is also the case among diabetes patients is unknown.

OBJECTIVE

To assess the associations of dietary fiber, glycemic load, glycemic index, carbohydrate, sugar, and starch intake with mortality risk in individuals with diabetes.

METHODS

This study was a prospective cohort study among 6,192 individuals with confirmed diabetes mellitus (mean age of 57.4 years, and median diabetes duration of 4.4 years at baseline) from the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline (1992-2000) with validated dietary questionnaires. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for all-cause and cardiovascular mortality, while adjusting for CVD-related, diabetes-related, and nutritional factors.

RESULTS

During a median follow-up of 9.2 y, 791 deaths were recorded, 306 due to CVD. Dietary fiber was inversely associated with all-cause mortality risk (adjusted HR per SD increase, 0.83 [95% CI, 0.75-0.91]) and CVD mortality risk (0.76[0.64-0.89]). No significant associations were observed for glycemic load, glycemic index, carbohydrate, sugar, or starch. Glycemic load (1.42[1.07-1.88]), carbohydrate (1.67[1.18-2.37]) and sugar intake (1.53[1.12-2.09]) were associated with an increased total mortality risk among normal weight individuals (BMI≤25 kg/m(2); 22% of study population) but not among overweight individuals (P interaction≤0.04). These associations became stronger after exclusion of energy misreporters.

CONCLUSIONS

High fiber intake was associated with a decreased mortality risk. High glycemic load, carbohydrate and sugar intake were associated with an increased mortality risk in normal weight individuals with diabetes.

An urgent need to include risk-benefit analysis in clinical trials investigating conjugated linoleic acid supplements in cancer patients

Malnutrition and weight loss are common in patients with cancer, both factors could potentially affect the response and tolerance to treatment, decreased quality of life, and thus associate them with poor survival. Conjugated linoleic acid (CLA) is shown to have beneficial health effects in healthy and disease situations including chemoprotective properties in various experimental cancer models. However, the anticarcinogenic property of CLA in animal and tissue culture models could not be confirmed in the Netherlands Cohort Study on Diet and Cancer and a prospective cohort of Swedish women. Cancer patients are already at increased risk of anorexia and there are evidences that CLA suppresses appetite even in healthy individuals. Risk/benefit analysis of CLA supplementation has never been reported before and it is not clear whether any beneficial anti-tumor effect of CLA prevails over its anti-appetite and/or weight lowering side effect in these patients. I suggest that clinical trials investigating CLA supplements in cancer patients, measure appropriate variables such as food intake, weight, and appetite change to yield preliminary data for future trials. I also suggest that data from previous trials that have administered CLA supplements to cancer patients be re-analyzed retrospectively to attempt to find out any effect from routine nutritional measures such as weight, serum albumin and such as those.