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Ooi KJ, Taylor RM, Fenton S, Hutchesson MJ, Collins CE. Evaluating Validated Diet Quality Indices Used in Pregnant Women in High-Income Countries: A Systematic Review. Nutr Rev 2024:nuae073. [PMID: 38899508 DOI: 10.1093/nutrit/nuae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Diet quality indices (DQIs) assess the level of adherence to dietary recommendations and a specified dietary pattern in populations; however, there is limited evidence regarding the construct criteria and validation methodology of DQIs used in pregnant women. OBJECTIVES The objectives of this study were to (i) identify and describe characteristics of DQIs that have been validated for use in pregnant women in high-income countries, and (ii) evaluate criteria used to develop DQIs and validation methodologies employed. DATA SOURCES CINAHL, Embase, Medline, SCOPUS, and Web of Science were systematically searched for eligible articles published between 1980 and November 2022 that focused on DQIs validated for use in pregnant women from high-income countries. DATA EXTRACTION Characteristics, development criteria, and validation methodologies used in the included articles were extracted by one reviewer and checked by a second reviewer. DATA ANALYSIS A narrative synthesis and descriptive statistics were used to summarize the review findings. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Six articles with 5 validated DQIs were identified. In total, 3777 participants were included - five articles had pregnant women aged 31-50 years and in their second trimester. Food frequency questionnaires were used as the dietary assessment method in all studies, and 3 DQIs were used to assess dietary intake at 1 time point, using 2 different dietary assessment methods. No indices fulfilled preferred features for the DQI development criteria developed by Burggraf et al (2018). Construct validity was assessed by all DQIs, followed by criterion validity (n = 4) and test-retest reliability (n = 2). CONCLUSION Limited high-quality validated DQIs for use in pregnant women in high-income countries were identified. Scoring for DQI components were not specific to nutrient requirements for pregnant women. Findings from this review may inform the development of DQIs that evaluate specific dietary requirements and specific food safety considerations applicable to pregnancy. SYSTEMATIC REVIEW REGISTRATION https://osf.io/u2hrq.
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Affiliation(s)
- Kee June Ooi
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Rachael M Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Lefferts EC, Lee D. Greater Adherence to Life's Essential 8 for Cardiovascular Health Is Associated With Lower Arterial Stiffness in Survivors of Cancer. J Am Heart Assoc 2024; 13:e032886. [PMID: 38842278 PMCID: PMC11255755 DOI: 10.1161/jaha.123.032886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/01/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer. METHODS AND RESULTS This cross-sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100-point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (<60), moderate (60-79), or high (≥80) cardiovascular health. Pulse wave velocity (PWV) was used to assess arterial stiffness; with high arterial stiffness defined as a pulse wave velocity ≥10 m/s. The mean cardiovascular health score was 72±11 and 40 survivors (23%) had high arterial stiffness. Compared with low cardiovascular health, the odds ratio of high arterial stiffness was 0.12 (95% CI, 0.03-0.50) and 0.02 (95% CI, 0.003-0.18) for moderate and high cardiovascular health, respectively. Every 10-point increase in the cardiovascular health score was associated with a 0.43 m/s reduction in pulse wave velocity (P<0.001). CONCLUSIONS Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.
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Affiliation(s)
| | - Duck‐Chul Lee
- Department of Kinesiology, College of Human SciencesIowa State UniversityAmesIAUSA
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Wong FMF, Shie HWH, Kao E, Tsoi HM, Leung WK. Educational Programme on Knowledge, Attitudes, and Practice of Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Case-Control Study. Geriatrics (Basel) 2024; 9:16. [PMID: 38392103 PMCID: PMC10888457 DOI: 10.3390/geriatrics9010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Much attention has been paid to advocate proper oral care/hygiene provision by healthcare providers in long-term care institutions (LTCIs). This study aimed to evaluate the effects of an oral health education (OHE) programme (intervention) on knowledge, attitudes, and practice (KAP) of healthcare providers in providing oral care/hygiene to older residents in LTCIs. METHODS A case control study was conducted at two LTCIs, with one assigned as the intervention group and the other as the control group. A KAP survey was administered before and after the intervention, and oral status was assessed by standardized clinical photographs taken before and after oral hygiene provision on three older residents. RESULTS A total of 40 healthcare providers (20 in intervention and 20 in control groups) participated, with the attitudes and overall KAP significantly improved in the intervention group after the OHE programme. Interestingly, the knowledge of those in the control LTCI was significantly declined at re-evaluation (mean scores were from 17.25 to 14.30), indicating inadequate oral health and care training despite having more experience in taking care of older people. Significant differences in practice were observed between the two groups after the OHE programme (p = 0.006). The three older residents exhibited poor oral health and multiple oral problems. CONCLUSIONS This study revealed that the OHE programme effectively improved attitudes of the healthcare providers and provided a sustaining effect on attitude towards oral health and oral care. However, there were still inadequacies in oral hygiene provision by some healthcare providers, possibly due to unattended oral diseases and hygiene needs, as well as personal and environmental barriers that merit further investigation. Regular evaluation and enforcement of oral care/hygiene provision in LTCIs are necessary to maintain oral health and prevent dental and gum diseases in older residents. Immediate referral for dental treatment is recommended for older people with signs of dental/oral disease(s).
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Affiliation(s)
| | | | - Enoch Kao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hoi Mei Tsoi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Jackey B, Song HJ, Patel D, Habibi M. Examining Predictors of Nutritional Risk among Older Adults: A Needs Assessment. J Nutr Gerontol Geriatr 2023; 42:127-143. [PMID: 37733608 DOI: 10.1080/21551197.2023.2259341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Older adults are the fastest growing population in the United States. This group is at risk for developing chronic diseases resulting from high nutritional risk. The objective of this study was to assess nutritional risks and their key predictors among older adults. In this cross-sectional study, the Dietary Screening Tool, the Nutrition Self-efficacy Scale, food security, perceived health, and sociodemographics were measured. A total of 475, English-speaking adults, 50 years of age or older, residing in Maryland and attending senior congregate sites, participated in the study (urban n = 215, rural n = 260). Results showed 88.8% of participants were classified as being nutritionally 'at risk' or 'possible' risk. Higher education level, higher nutrition self-efficacy, and food security were significant predictors associated with lower nutritional risk among older adults. Implementing suitable and effective nutrition interventions requires assessing diet and identifying the needs specific to older adult populations. Utilizing appropriate screening tools is an important step in improving overall diets and may reduce barriers to adopting healthy eating behaviors in this population.
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Affiliation(s)
- Beverly Jackey
- Extension, University of Maryland, College Park, Maryland, USA
| | - Hee-Jung Song
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
| | - Dhruti Patel
- Extension, University of Maryland, College Park, Maryland, USA
| | - Mona Habibi
- Extension, University of Maryland, College Park, Maryland, USA
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Flores AC, Jensen GL, Mitchell DC, Na M, Wood GC, Still CD, Gao X. Prospective Study of Diet Quality and the Risk of Dementia in the Oldest Old. Nutrients 2023; 15:nu15051282. [PMID: 36904280 PMCID: PMC10005581 DOI: 10.3390/nu15051282] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
This study examined the associations between overall diet quality and the risk of dementia in a rural cohort among the oldest old. Included in this prospective cohort study were 2232 participants aged ≥ 80 years and dementia-free at the baseline according to the Geisinger Rural Aging Study (GRAS), a longitudinal cohort in rural Pennsylvania. In 2009, diet quality was assessed by a validated dietary screening tool (DST). Incident cases of dementia during 2009-2021 were identified using diagnosis codes. This approach was validated by a review of electronic health records. Associations between diet quality scores and the incidence of dementia were estimated using the Cox proportional hazards models, adjusted for potential confounders. Across a mean of 6.90 years of follow-up, we identified 408 incident cases of all-cause dementia. Having a higher diet quality was not significantly associated with a lower risk for incidents of all-cause dementia (adjusted HR for the highest compared with the lowest tertile: 1.01, 95% CI: 0.79, 1.29, P-trend = 0.95). Similarly, we did not observe a significant association between diet quality and altered risks of Alzheimer's disease and other forms of dementia. Overall, having a higher diet quality was not significantly associated with a lower risk of dementia among the oldest old during the full follow-up.
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Affiliation(s)
- Ashley C. Flores
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - Gordon L. Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Diane C. Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
| | - G. Craig Wood
- Obesity Institute, Geisinger Health System, Danville, PA 17822, USA
| | | | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA 16801, USA
- School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200437, China
- Correspondence:
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Davis B, Liu YH, Stampley J, Wood GC, Mitchell DC, Jensen GL, Gao X, Glynn NW, Still CD, Irving BA. The Association between Poor Diet Quality, Physical Fatigability and Physical Function in the Oldest-Old from the Geisinger Rural Aging Study. Geriatrics (Basel) 2021; 6:geriatrics6020041. [PMID: 33920900 PMCID: PMC8167721 DOI: 10.3390/geriatrics6020041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 01/09/2023] Open
Abstract
More perceived physical fatigability and poor diet quality are associated with impairments in physical function in older adults. However, the degree to which more perceived fatigability explains the association between poor diet quality and low physical function is unknown. We examined this relationship in 122 (66F, 56M) of the oldest-old participants from the Geisinger Rural Aging Study (GRAS). We used 24-h dietary recalls to assess the Healthy Eating Index (HEI), the Pittsburgh Fatigability Scale (PFS, 0–50) to assess perceived physical fatigability, and the PROMIS Physical Function 20a* to assess physical function. We grouped participants into three age categories: 80–84 (n = 51), 85–89 (n = 51), and 90+ (n = 20) years. Multiple linear regression revealed that a lower HEI was associated with higher PFS Physical score after adjusting for age group, sex, body mass index, and the number of medical conditions (p = 0.001). Several macro- and micro-nutrient intakes were also lower in those reporting more (≥15) compared to less (<15) perceived physical fatigability. Mediation analysis revealed that PFS Physical scores explained ~65% (p = 0.001) of the association between HEI total score and PROMIS19 Physical Function score. Poor diet quality may contribute to more perceived physical fatigability, which could exacerbate impairments in the oldest-old’s physical function.
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Affiliation(s)
- Brett Davis
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
| | - Yi-Hsuan Liu
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - James Stampley
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
| | - G. Craig Wood
- Geisinger Obesity Institute, Geisinger Health System, Danville, PA 17822, USA; (G.C.W.); (C.D.S.)
| | - Diane C. Mitchell
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - Gordon L. Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05401, USA;
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - Nancy W. Glynn
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Christopher D. Still
- Geisinger Obesity Institute, Geisinger Health System, Danville, PA 17822, USA; (G.C.W.); (C.D.S.)
| | - Brian A. Irving
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
- Correspondence: ; Tel.: +1-225-578-7179
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Liu YH, Jensen GL, Na M, Mitchell DC, Wood GC, Still CD, Gao X. Diet Quality and Risk of Parkinson's Disease: A Prospective Study and Meta-Analysis. JOURNAL OF PARKINSONS DISEASE 2020; 11:337-347. [PMID: 33104042 DOI: 10.3233/jpd-202290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several dietary components have been shown to be neuroprotective against risk of neurodegeneration. However, limited observational studies have examined the role of overall diet quality on risk of Parkinson's disease. OBJECTIVES We examined the associations between diet quality and risk of Parkinson's disease in a prospective cohort study and meta-analysis. METHODS Included in the cohort study were 3,653 participants (1,519 men and 2,134 women; mean age: 81.5 years) in the Geisinger Rural Aging Study longitudinal cohort in Pennsylvania. Diet quality was assessed using a validated dietary screening tool containing 25 food- and behavior-specific questions in 2009. Potential Parkinson's cases were identified using electronic health records based on ICD9 (332.*), ICD10 (G20), and Parkinson-related treatments. Hazard ratios (HRs) and 95% confidence intervals (CIs) across diet quality tertiles were calculated using Cox proportional hazards models after adjusting for potential confounders. We further performed a meta-analysis by pooling our study with four published papers on this topic. Random-effects model was utilized to calculate the pooled risk ratios and 95% CIs. RESULTS During a mean of 6.94 years of follow-up, 47 incident Parkinson's cases were documented. Having high diet quality at baseline was associated with lower Parkinson's disease risk (adjusted HR for the highest vs the lowest diet quality tertile = 0.39; 95% CI: 0.17, 0.89; p-trend = 0.02). The meta-analysis including 140,617 individuals also showed that adherence to high diet quality or a healthy dietary pattern was associated with lower risk of Parkinson's disease (pooled risk ratio = 0.64; 95% CI: 0.49, 0.83). CONCLUSION Having high diet quality or a healthy dietary pattern was associated with lower future risk of Parkinson's disease.
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Affiliation(s)
- Yi-Hsuan Liu
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Gordon L Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Diane C Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - G Craig Wood
- Obesity Institute, Geisinger Health System, Danville, PA, USA
| | | | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
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