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Lee YQ, Colega M, Sugianto R, Lai JS, Godfrey KM, Tan KH, Shek LPC, Loy SL, Müller-Riemenschneider F, Padmapriya N, Chong YS, Eriksson JG, Chan JKY, Chan SY, Tai BC, Chong MFF. Tracking of dietary patterns between pregnancy and 6 years post-pregnancy in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Eur J Nutr 2022; 61:985-1001. [PMID: 34686887 PMCID: PMC7612407 DOI: 10.1007/s00394-021-02703-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Few studies have described adherence to dietary patterns over time in women of childbearing age. This study aims to describe, examine the stability and changes in dietary patterns between pregnancy and 6 years post-pregnancy and the sociodemographic and lifestyle factors influencing the adherence over time. METHODS During pregnancy and at 6 years post-pregnancy, 24-h recalls and food frequency questionnaires were collected, respectively, from 709 women. Data on sociodemographic and lifestyle factors were collected via questionnaires. Dietary patterns were identified using principal component analysis and stability assessed using Pearson's correlation coefficients (r) and Cohen's weighted kappa (κ). Associations with sociodemographic characteristics were assessed by multiple logistic regression. RESULTS The 'Fruits, Vegetables and Legumes' (FVL) and 'Seafood, Noodle, Soup' (SNS) patterns were identified at both time points, with low correlation for the dietary pattern z scores (r 0.2 and 0.3, respectively) and modest agreement in tertile assignment, suggesting poor stability. An 'unhealthy' pattern was only observed at 6 years post-pregnancy. Women who showed increased adherence to FVL pattern had higher educational attainment and exhibited healthy lifestyle behaviours. Women who had gestational diabetes during pregnancy were less likely to decrease adherence to FVL pattern over time. Women who adhered more closely to the 'unhealthy' pattern at 6 years post-pregnancy tended to be younger, of Malay ethnicity, had lower socioeconomic status, were less physically active and had additional pregnancies. CONCLUSIONS Dietary habits of women became less healthy during the transition from pregnancy to 6 years post-pregnancy. However, results should be interpreted with caution due to the different dietary assessment tools used at the two time points.
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Affiliation(s)
- Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
| | - Ray Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Jun Shi Lai
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, SO16 6YD, UK
| | - Kok Hian Tan
- Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, 229899, Singapore
- Graduate Medical School, Duke-National University of Singapore, Singapore, 169857, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228, Singapore
| | - See Ling Loy
- Graduate Medical School, Duke-National University of Singapore, Singapore, 169857, Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, 229899, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Digital Health Center, Berlin Institute of Health, Charite University Medical Centre, Berlin, Germany
| | - Natarajan Padmapriya
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 117597, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 117597, Singapore
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 117597, Singapore
- Folkhälsan Research Center, 00250, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland
| | - Jerry Kok Yen Chan
- Graduate Medical School, Duke-National University of Singapore, Singapore, 169857, Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, 229899, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 117597, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A*STAR), Singapore, 117609, Singapore
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Nguyen HH, Wu F, Oddy WH, Wills K, Brennan-Olsen SL, Jones G, Winzenberg T. Longitudinal associations of dietary patterns with sociodemographic and lifestyle factors in older adults: the TASOAC study. Eur J Clin Nutr 2020; 75:759-767. [PMID: 33199850 DOI: 10.1038/s41430-020-00802-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 10/01/2020] [Accepted: 10/28/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To derive dietary patterns and examine their longitudinal associations with sociodemographic and lifestyle factors in the Tasmanian Older Adult Cohort. SUBJECTS/METHODS This is a corrected analysis of a retracted paper. We followed 1098 adults aged ≥50 years for 5 years. Dietary intake was assessed using a validated food frequency questionnaire. Baseline dietary patterns were identified using exploratory factor analysis and scores at each time point calculated using the weighted sum score method. Associations of energy-adjusted dietary pattern scores with participant characteristics were assessed using linear mixed-effects models. RESULTS The four dietary patterns identified were: fruit and vegetable (vegetables, potatoes, fruits); animal protein (poultry, red meats, fish); snack (snacks, sweets, nuts); western (meat pies, hamburgers, pizzas). Fruit and vegetable pattern scores were lower in men and current smokers at baseline. Animal protein scores were lower in older and retired people but higher in men and smokers at baseline. The sex difference in animal protein score increased over time (p = 0.012). At baseline, snack score was positively associated with age and physical activity, but lower in men and current smokers. The effect of age on snack score lessened over time (p = 0.035). Western scores were lower in older people but higher in men, current smokers and those living in disadvantaged areas at baseline. The effect of age on western score reduced over time (p = 0.001). CONCLUSIONS The higher scores for healthy and/or lower scores for unhealthy patterns in men, smokers, retirees and those experiencing social disadvantage suggest these could be target groups for interventions to improve diet quality in older adults.
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Affiliation(s)
- Hoa H Nguyen
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia.,Ho Chi Minh City University of Medicine and Pharmacy, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne-Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia.,School of Health and Social Development, Deakin University, Geelong Waterfront Campus, Gheringhap Street, Geelong, VIC, Australia.,Institute for Health Transformation, Deakin University, Geelong Waterfront Campus, Gheringhap Street, Geelong, VIC, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, TAS, Australia.
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Thorpe MG, Milte CM, Crawford D, McNaughton SA. Education and lifestyle predict change in dietary patterns and diet quality of adults 55 years and over. Nutr J 2019; 18:67. [PMID: 31699092 PMCID: PMC6839215 DOI: 10.1186/s12937-019-0495-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022] Open
Abstract
Background Diet is a key risk factor for chronic disease, and an increasing concern among older adults. We aim to examine the changes in dietary patterns using principal component analysis and a diet quality index among older adults and examine the predictors of dietary change over a 4 year period. Methods Data was obtained via a postal survey in a prospective cohort, the Wellbeing Eating and Exercise for a Long Life (WELL) study. Australian adults aged 55 years and over (n = 1005 men and n = 1106 women) completed a food frequency at three time points and provided self-reported personal characteristics. Principal component analysis was used to assess dietary patterns and diet quality was assessed using the 2013 Revised Dietary Guideline Index. The relationships between predictors and change in dietary patterns were assessed by multiple linear regression. Results Two dietary patterns were consistently identified in men and women at three time points over 4 years. One was characterised by vegetables, fruit and white meat, and the other was characterised by red and processed meat and processed foods. Reduced consumption of key food groups within the principal component analysis-determined dietary patterns was observed. An increase in diet quality over 4 years was observed in men only. Reported higher education levels and favourable lifestyle characteristics, including not smoking and physical activity, at baseline predicted an increase in healthier dietary patterns over 4 years. Conclusions There was stability in the main dietary patterns identified over time, however participants reported an overall decrease in the frequency of consumption of key food groups. Compliance with the Australian Dietary Guidelines remained poor and therefore targeting this population in nutritional initiatives is important. Design of nutrition promotion for older adults need to consider those with lower socioeconomic status, as having a lower level of education was a predictor of poorer dietary patterns. It is important to consider how nutrition behaviours can be targeted alongside other lifestyle behaviours, such as smoking and inadequate physical activity to improve health.
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Affiliation(s)
- Maree G Thorpe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Yang Y, Wu F, Antony B, Pan F, Winzenberg T, Jones G. The Association between First Fractures Sustained during Childhood and Adulthood and Bone Measures in Young Adulthood. J Pediatr 2019; 212:188-194.e2. [PMID: 31262529 DOI: 10.1016/j.jpeds.2019.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/16/2019] [Accepted: 05/13/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe the association between fractures sustained at different stages of growth and bone measures in early adulthood. STUDY DESIGN Participants (n = 201) in southern Tasmania were at birth at a higher risk of sudden infant death syndrome; they were followed to age 25. Outcomes were areal bone mineral density at the spine, hip, and total body (by dual-energy x-ray absorptiometry) and trabecular and cortical bone measures at the radius and tibia (by high-resolution peripheral quantitative computed tomography). Fractures were self-reported and confirmed by radiographs at 8, 16, and 25 years of age. Multivariable linear regression was used to analyze the association of the occurrence of prepubertal (<9 years of age), pubertal (9-16 years of age), and postpubertal (17-25 years of age) fractures with all bone measures. RESULTS Over 25 years, 99 participants had at least 1 fracture. For high-resolution peripheral quantitative computed tomography measures at age 25, prepubertal fractures were negatively associated with cortical and trabecular volumetric bone mineral density and most microarchitecture measures at both the tibia and radius. Prepubertal fractures had a significant association with smaller increase of areal bone mineral density from age 8 to 16 years and at 25 years of age compared with participants with no fractures. Pubertal fractures had no association with any bone measures and postpubertal fractures were only associated with a lower trabecular number at the tibia. CONCLUSIONS Prepubertal fractures are negatively associated with areal bone mineral density increases during growth and high-resolution peripheral quantitative computed tomography bone measures in young adulthood. There is little evidence that fractures occurring from age 8 years onward with bone measures in young adulthood, implying that prepubertal fractures may be associated with bone deficits later in life.
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Affiliation(s)
- Yi Yang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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