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Santiago S, Ochoa Díaz ME, Zazpe I, Hershey MS, Bes-Rastrollo M, Martínez González MÁ. Association between overall quality of macronutrients and incidence of overweight and obesity in the SUN (Seguimiento Universidad de Navarra) cohort. NUTR HOSP 2024. [PMID: 39054857 DOI: 10.20960/nh.05181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION no previous large prospective studies have assessed the global quality of macronutrients in association with the risk of overweight/obesity. OBJECTIVE to prospectively assess the association of an overall macronutrient quality index (MQI) with weight change and the incidence of overweight/obesity in the Seguimiento Universidad de Navarra (SUN) cohort. METHODS the diet of 9,344 Spanish university graduates (mean age: 36.5 [SD, 11.1]) was assessed through a validated 136-item food frequency questionnaire. The MQI was calculated as the sum of the Carbohydrate Quality Index, the Fat Quality Index, and the Healthy Plate Protein Quality Index. Participants were classified into groups according to MQI. Incident overweight/obesity was defined if follow-up questionnaires indicated BMI was ≥ 25 kg/m2. Multiple linear regression models and Cox proportional hazard models were used to assess the average yearly weight change and the risk of overweight/obesity over follow-up time. RESULTS 2,465 cases of incident overweight/obesity were identified (median follow-up: 10.7 years). Increasing MQI was significantly associated with lower annual weight gain (g): ß coefficient: -99.0, (95 % CI: -173.6 to -24.5) in the Q4 vs Q1, p for trend = 0.007. In the fully adjusted model the incidences of overweight/obesity in Q4 and Q1 were 21.7 % (431 cases) and 29.3 % (954 cases), respectively. The adjusted HR was 0.87 (95 % CI, 0.77-0.98, p for trend = 0.036). When we used repeated analyses updating the MQI after 10 years of follow-up, results remained similar. CONCLUSIONS a significant inverse association between a multidimensional MQI and the risk of overweight/obesity was found in this Mediterranean cohort of adults.
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Affiliation(s)
- Susana Santiago
- Department of Nutrition and Food Sciences and Physiology. Universidad de Navarra. Instituto de Investigación Sanitaria de Navarra (IdiSNA)
| | | | - Itziar Zazpe
- Department of Nutrition and Food Sciences and Physiology. Universidad de Navarra. Instituto de Investigación Sanitaria de Navarra (IdiSNA). CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn). Instituto de Salud Carlos III
| | | | - Maira Bes-Rastrollo
- Instituto de Investigación Sanitaria de Navarra (IdiSNA). CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn). Instituto de Salud Carlos III. Department of Preventive Medicine and Public Health. Facultad de Medicina. Clínica Universidad de Navarra
| | - Miguel Ángel Martínez González
- Instituto de Investigación Sanitaria de Navarra (IdiSNA). CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn). Instituto de Salud Carlos III. Department of Preventive Medicine and Public Health. Facultad de Medicina. Clínica Universidad de Navarra
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Simpson EEA, Doherty J, Timlin D. Menopause as a window of opportunity: the benefits of designing more effective theory-driven behaviour change interventions to promote healthier lifestyle choices at midlife. Proc Nutr Soc 2024; 83:120-129. [PMID: 37955168 DOI: 10.1017/s0029665123004810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Menopause is a natural developmental phase that all women go through from their early forties to mid-fifties, marking the transition from the reproductive to the non-reproductive years. This is characterised as the permanent cessation of menses due to progressive ovarian failure. Each woman's experience of the menopause is unique. Biopsychosocial changes occur during this time with some symptoms affecting up to 80 % of women and lasting for 4-5 years from the peri- to post-menopause. Reduced oestrogen may predispose some women to health issues following menopause, such as heart disease, diabetes, stroke and cognitive decline. It is vital to understand how to promote health and well-being to reduce the risk of developing chronic conditions in later life. Increased symptoms and concerns about health during the menopausal transition can be cues to action for some women to actively maintain their health. Menopause represents a window of opportunity to promote health, and to support women to make healthier lifestyle choices, part of the National Institute for Clinical Excellence guidelines for menopause management. Identifying appropriate strategies to change behaviour is less clear. Theories of behaviour change can provide frameworks to gain more insight into the facilitators and barriers to behaviour and can inform the researcher on what needs to change. This information can be used to inform the design, content, implementation and evaluation of a lifestyle intervention. This review paper will explore the impact of menopause on health and well-being generally, and the benefits of designing more effective theory-driven behaviour change interventions for menopause.
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Affiliation(s)
- Ellen Elizabeth Anne Simpson
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, County Londonderry, Northern Ireland, UK
| | - Julie Doherty
- School of Nursing & Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Deirdre Timlin
- Department of Psychology, Rockhampton Hospital, Queensland Health, Rockhampton, Australia
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Basak Tukun A, Rowe S, Johnson LK, Love DC, Belury M, Conrad Z. Micronutrient intake from three popular diet patterns in the United States: modeled replacement of foods highest in added sugar and sodium using the National Health and Nutrition Examination Survey, 2005-2018. Front Nutr 2023; 10:1217774. [PMID: 37908301 PMCID: PMC10614668 DOI: 10.3389/fnut.2023.1217774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction Fifty-two percent of adults in the United States reported following a popular diet pattern in 2022, yet there is limited information on daily micronutrient intakes associated with these diet patterns. The objective of the present study was to model the impact on micronutrient intake when foods highest in added sugar and sodium were replaced with healthier alternatives to align with the Dietary Guidelines for Americans recommendations. Methods Dietary data were acquired from 34,411 adults ≥ 20 y in the National Health and Nutrition Examination Survey, 2005-2018. The National Cancer Institute methodology was used to estimate usual dietary intake at baseline of 17 micronutrients using information from up to two dietary recalls per person. A food substitution model was used to evaluate the impact on micronutrient intake when three servings of foods highest in added sugar and sodium were substituted with healthier alternatives. Results Dietary modeling to replace foods highest in added sugar with healthier alternatives increased the mean intake of fat-soluble vitamins (0.15% for vitamin A to 4.28% for vitamin K), most water-soluble vitamins (0.01% for vitamin B1 to 12.09% for vitamin C), and most minerals (0.01% for sodium to 4.44% for potassium) across all diet patterns. Replacing foods highest in sodium had mixed effects on the mean intake of micronutrients. The intake of most fatsoluble vitamins increased by 1.37-6.53% (particularly vitamin A and D), yet while the intake of some water-soluble vitamins and minerals increased by 0.18-2.64% (particularly vitamin B2, calcium, and iron) others decreased by 0.56-10.38% (notably vitamin B3 and B6, magnesium, sodium, and potassium). Discussion Modeled replacement of foods highest in added sugar led to more favorable changes in mean micronutrient intake compared to modeled replacement of foods highest in sodium. Due to the composite nature of mixed dishes that include multiple ingredients, food substitutions may result in both favorable and unfavorable changes in micronutrient intake. These findings highlight the challenges of making singleitem food substitutions to increase micronutrient intake and call for further research to evaluate optimal combinations of replacement foods to maximize the intake of all micronutrients simultaneously.
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Affiliation(s)
- Avonti Basak Tukun
- OSU Nutrition Interdisciplinary Graduate Program, The Ohio State University, Columbus, OH, United States
| | - Sarah Rowe
- College of Arts and Sciences, William & Mary, Williamsburg, VA, United States
| | | | - David C. Love
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD, United States
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Martha Belury
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, United States
| | - Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA, United States
- Global Research Institute, William & Mary, Williamsburg, VA, United States
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Nieman DC, Sakaguchi CA, Pelleigrini M, Thompson MJ, Sumner S, Zhang Q. Healthy lifestyle linked to innate immunity and lipoprotein metabolism: a cross-sectional comparison using untargeted proteomics. Sci Rep 2023; 13:16728. [PMID: 37794065 PMCID: PMC10550951 DOI: 10.1038/s41598-023-44068-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/03/2023] [Indexed: 10/06/2023] Open
Abstract
This study used untargeted proteomics to compare blood proteomic profiles in two groups of adults that differed widely in lifestyle habits. A total of 52 subjects in the lifestyle group (LIFE) (28 males, 24 females) and 52 in the control group (CON) (27 males, 25 females) participated in this cross-sectional study. Age, education level, marital status, and height did not differ significantly between LIFE and CON groups. The LIFE and CON groups differed markedly in body composition, physical activity patterns, dietary intake patterns, disease risk factor prevalence, blood measures of inflammation, triglycerides, HDL-cholesterol, glucose, and insulin, weight-adjusted leg/back and handgrip strength, and mood states. The proteomics analysis showed strong group differences for 39 of 725 proteins identified in dried blood spot samples. Of these, 18 were downregulated in the LIFE group and collectively indicated a lower innate immune activation signature. A total of 21 proteins were upregulated in the LIFE group and supported greater lipoprotein metabolism and HDL remodeling. Lifestyle-related habits and biomarkers were probed and the variance (> 50%) in proteomic profiles was best explained by group contrasts in indicators of adiposity. This cross-sectional study established that a relatively small number of proteins are associated with good lifestyle habits.
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Affiliation(s)
- David C Nieman
- Human Performance Laboratory, Biology Department, Appalachian State University, North Carolina Research Campus, Kannapolis, NC, USA.
| | - Camila A Sakaguchi
- Human Performance Laboratory, Biology Department, Appalachian State University, North Carolina Research Campus, Kannapolis, NC, USA
| | - Matteo Pelleigrini
- Department of Molecular, Cell, and Developmental Biology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael J Thompson
- Department of Molecular, Cell, and Developmental Biology, University of California Los Angeles, Los Angeles, CA, USA
| | - Susan Sumner
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, 28081, USA
| | - Qibin Zhang
- UNCG Center for Translational Biomedical Research, University of North Carolina at Greensboro, North Carolina Research Campus, Kannapolis, NC, USA
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Bailey RL, Stover PJ. Precision Nutrition: The Hype Is Exceeding the Science and Evidentiary Standards Needed to Inform Public Health Recommendations for Prevention of Chronic Disease. Annu Rev Nutr 2023; 43:385-407. [PMID: 37603433 PMCID: PMC11015823 DOI: 10.1146/annurev-nutr-061021-025153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
As dietary guidance for populations shifts from preventing deficiency disorders to chronic disease risk reduction, the biology supporting such guidance becomes more complex due to the multifactorial risk profile of disease and inherent population heterogeneity in the diet-disease relationship. Diet is a primary driver of chronic disease risk, and population-based guidance should account for individual responses. Cascading effects on evidentiary standards for population-based guidance are not straightforward. Precision remains a consideration for dietary guidance to prevent deficiency through the identification of population subgroups with unique nutritional needs. Reducing chronic disease through diet requires greater precision in (a) establishing essential nutrient needs throughout the life cycle in both health and disease; (b) considering effects of nutrients and other food substances on metabolic, immunological, inflammatory, and other physiological responses supporting healthy aging; and (c) considering healthy eating behaviors. Herein we provide a template for guiding population-based eating recommendations for reducing chronic diseases in heterogenous populations.
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Affiliation(s)
- Regan L Bailey
- Institute for Advancing Health through Agriculture and Department of Nutrition Science, Texas A&M University, College Station, Texas, USA;
| | - Patrick J Stover
- Institute for Advancing Health through Agriculture and Department of Nutrition Science, Texas A&M University, College Station, Texas, USA;
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Storz MA. Does Self-Perceived Diet Quality Align with Nutrient Intake? A Cross-Sectional Study Using the Food Nutrient Index and Diet Quality Score. Nutrients 2023; 15:2720. [PMID: 37375624 DOI: 10.3390/nu15122720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
A reliable diet quality (DQ) assessment is critical to empower individuals to improve their dietary choices. Controversies persist as to whether self-perceived DQ is accurate and correlated with actual DQ as assessed by validated nutrient intake indexes. We used National Health and Nutrition Examination Surveys data to examine whether a higher self-perceived DQ was positively associated with a more optimal nutrient intake as reflected by the Food Nutrient Index (FNI) and Diet Quality Score (DQS). Comparative analyses were performed for three self-perceived DQ groups: (I) "excellent or very good" DQ, (II) "good or fair" DQ, and (III) "poor" DQ. The FNI and DQS differed substantially across groups and sexes. FNI scores ranged from 65 to 69 in participants with a self-reported excellent or very good DQ, whereas participants with a self-perceived poor DQ scored significantly lower (53-59). We also observed age- and sex-specific patterns, with the lowest overall FNI scores found in males aged 18-30 years and females aged 31-50 years. DQ intergroup differences were more pronounced in females than in males. Our findings suggest that higher self-perceived DQ is associated with a more optimal nutrient intake and indicate potential helpfulness of self-perceived DQ as a quick and still underexplored indicator with intrinsic limitations.
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Affiliation(s)
- Maximilian Andreas Storz
- Center for Complementary Medicine, Department of Internal Medicine II, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
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Heerschop SN, Kanellopoulos A, Biesbroek S, van 't Veer P. Shifting towards optimized healthy and sustainable Dutch diets: impact on protein quality. Eur J Nutr 2023:10.1007/s00394-023-03135-7. [PMID: 36949232 DOI: 10.1007/s00394-023-03135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 03/10/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To reduce the environmental impact of Western diets, a reduction of meat consumption and a substitution by plant-based protein sources is needed. This protein transition will affect the quantity and quality of dietary protein. Therefore, the aim of this study was to evaluate the protein adequacy of diets optimized for nutritional health and diet-related greenhouse gas emission (GHGE). METHODS Data from 2150 adult participants of the Dutch National Food Consumption Survey were used, with diet assessed using two non-consecutive 24 h dietary recalls. Utilizable protein of current diets per day was based on meal composition and the Protein Digestibility-Corrected Amino Acid Score and was compared to protein requirements. Optimized diets were derived as linear combinations of current diets that minimized GHGE and maximized the Dutch Healthy Diet 2015 score, with/without constraints to keep dietary change within 33% of current consumption. Protein adequacy was evaluated in both current and optimized diets. RESULTS In all age and gender strata, the healthiest diets had higher GHGE, the most sustainable diets had the lowest dietary quality, though higher than current diets, and protein adequacy remained sufficient. When limiting dietary change to 33% of current consumption, in the most promising trade-off diet GHGE was reduced by 12-16%. The current diet provided 1.4-2.2 times the required amount of utilizable protein. CONCLUSION These results suggest that a realistic aim for the next decade might be to reduce diet-related GHGE to 12-16% of the current levels without compromising protein adequacy and diet quality. To achieve global targets, upstream food system transformations are needed with subsequent dietary changes.
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Affiliation(s)
- Samantha N Heerschop
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands.
| | - Argyris Kanellopoulos
- Operations Research and Logistics Group, Wageningen University and Research, Wageningen, Gelderland, The Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands
| | - Pieter van 't Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands
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Boaz M, Kaufman-Shriqui V, Moore LW, Kalantar-Zadeh K. Diet Quality Index in Kidney Health and Kidney Disease. J Ren Nutr 2023; 33:1-3. [PMID: 36526157 DOI: 10.1053/j.jrn.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Mona Boaz
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel.
| | - Vered Kaufman-Shriqui
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel
| | - Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Transplantation, Department of Medicine, University of California-Irvine, Irvine, California
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Wabo TMC, Wang Y, Nyamao RM, Wang W, Zhu S. Protein-to-carbohydrate ratio is informative of diet quality and associates with all-cause mortality: Findings from the National Health and Nutrition Examination Survey (2007-2014). Front Public Health 2022; 10:1043035. [PMID: 36620249 PMCID: PMC9814161 DOI: 10.3389/fpubh.2022.1043035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background Dietary protein and carbohydrate intake and health outcomes have received extensive attention in recent years. However, the nutritional context in which these associations occur is less studied. Objectives We aimed to examine the dietary context associating protein-to-carbohydrate ratio and all-cause mortality in US adults. Methods Data from 17,814 adults enrolled in the 2007-2014 NHANES was analyzed. Information on mortality was obtained from the US mortality registry updated in December 2015. Diet quality was assessed using the Healthy Eating Index (HEI) and Total Nutrients Index (TNI). ANCOVA was used to test the mean differences in HEI and TNI scores across %E P:C quintiles. Linear regression examined the association of HEI and TNI with %E P:C. Cox proportional hazards regression evaluated the association between %E P:C and all-cause mortality. A restricted cubic spline examined the non-linear relationship between %E P:C and death. Results Low %E P:C was associated with lower HEI and TNI scores while higher %E P:C was associated with healthier HEI and TNI scores. HEI and TNI were positively associated with %E P:C (β = 0.22, 95% CI: 0.19-0.25, and β = 0.16, 95% CI: 0.14-0.18), respectively. Low %E P:C was associated with an increased risk of death from all-cause. The higher HRs (95% CIs) of all-cause mortality were 1.97(1.46-2.65), and 7.35 (2.57-21.03) in the second quintile for the age-sex-ethnicity model, and the fully adjusted model, respectively. There was a significant reverse U-shape relationship between %E P:C and all-cause mortality with P, non-linearity < 0.001. Conclusion This study indicates that a low %E P:C that gives emphasis to unhealthy foods increases the risk of death. Hence, it would be useful to consider the complete diet associated with protein intake when making dietary recommendations for populations.
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Affiliation(s)
- Therese M. C. Wabo
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China,Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yifeng Wang
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China,Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, China
| | - Rose M. Nyamao
- Department of Medical Microbiology and Parasitology, School of Medicine, Kenyatta University, Nairobi, Kenya,Department of Microbiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Wenjie Wang
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China,Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, China
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China,Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, China,*Correspondence: Shankuan Zhu
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Cowan AE, Bailey RL, Jun S, Dodd KW, Gahche JJ, Eicher-Miller HA, Guenther PM, Dwyer JT, Potischman N, Bhadra A, Carroll RJ, Tooze JA. The Total Nutrient Index is a Useful Measure for Assessing Total Micronutrient Exposures Among US Adults. J Nutr 2021; 152:863-871. [PMID: 34928350 PMCID: PMC8891182 DOI: 10.1093/jn/nxab428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most dietary indices reflect foods and beverages and do not include exposures from dietary supplements (DS) that provide substantial amounts of micronutrients. A nutrient-based approach that captures total intake inclusive of DS can strengthen exposure assessment. OBJECTIVES We examined the construct and criterion validity of the Total Nutrient Index (TNI) among US adults (≥19 years; nonpregnant or lactating). METHODS The TNI includes 8 underconsumed micronutrients identified by the Dietary Guidelines for Americans: calcium; magnesium; potassium; choline; and vitamins A, C, D, and E. The TNI is expressed as a percentage of the RDA or Adequate Intake to compute micronutrient component scores; the mean of the component scores yields the TNI score, ranging from 0-100. Data from exemplary menus and the 2003-2006 (≥19 years; n = 8861) and 2011-2014 NHANES (≥19 years; n = 9954) were employed. Exemplary menus were used to determine whether the TNI yielded high scores from dietary sources (women, 31-50 years; men ≥ 70 years). TNI scores were correlated with Healthy Eating Index (HEI) 2015 overall and component scores for dairy, fruits, and vegetables; TNI component scores for vitamins A, C, D, and E were correlated with respective biomarker data. TNI scores were compared between groups with known differences in nutrient intake based on the literature. RESULTS The TNI yielded high scores on exemplary menus (84.8-93.3/100) and was moderately correlated (r = 0.48) with the HEI-2015. Mean TNI scores were significantly different for DS users (83.5) compared with nonusers (67.1); nonsmokers (76.8) compared with smokers (70.3); and those living with food security (76.6) compared with food insecurity (69.1). Correlations of TNI vitamin component scores with available biomarkers ranged from 0.12 (α-tocopherol) to 0.36 (serum 25-hydroxyvitamin D), and were significantly higher than correlations obtained from the diet alone. CONCLUSIONS The evaluation of validity supports that the TNI is a useful construct to assess total micronutrient exposures of underconsumed micronutrients among US adults.
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Affiliation(s)
- Alexandra E Cowan
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Kevin W Dodd
- NIH National Cancer Institute, Bethesda, MD, USA
| | | | | | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Johanna T Dwyer
- NIH Office of Dietary Supplements, Bethesda, MD, USA,Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | | | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, College Station, TX, USA
| | - Janet A Tooze
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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