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Kenney E, Adebiyi VO, Seligman HK, Ehmke MD, Guthrie JF, Coleman-Jensen A, Frongillo EA. Assessing and Monitoring Nutrition Security in the United States: A Narrative Review of Current Measures and Instruments. Curr Nutr Rep 2024:10.1007/s13668-024-00547-7. [PMID: 38916806 DOI: 10.1007/s13668-024-00547-7] [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] [Accepted: 05/01/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE OF REVIEW Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring. RECENT FINDINGS Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases.
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Affiliation(s)
- Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Victoria O Adebiyi
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
| | - Hilary K Seligman
- Division of General Internal Medicine and Center for Vulnerable Populations, University of California, San Francisco, CA, USA
| | - Mariah D Ehmke
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Joanne F Guthrie
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Alisha Coleman-Jensen
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
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Hauser ME, Hartle JC, Landry MJ, Fielding-Singh P, Shih CW, Qin F, Rigdon J, Gardner CD. Exploring Biases of the Healthy Eating Index and Alternative Healthy Eating Index When Scoring Low-Carbohydrate and Low-Fat Diets. J Acad Nutr Diet 2024:S2212-2672(24)00093-5. [PMID: 38423509 DOI: 10.1016/j.jand.2024.02.014] [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: 07/19/2023] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 (AHEI-2010) are commonly used to measure dietary quality in research settings. Neither index is designed specifically to compare diet quality between low-carbohydrate (LC) and low-fat (LF) diets. It is unknown whether biases exist in making these comparisons. OBJECTIVE The aim was to determine whether HEI-2010 and AHEI-2010 contain biases when scoring LC and LF diets. DESIGN Secondary analyses of the Diet Intervention Examining the Factors Interacting With Treatment Success (DIETFITS) weight loss trial were conducted. The trial was conducted in the San Francisco Bay Area of California between January 2013 and May 2016. Three approaches were used to investigate whether biases existed for HEI-2010 and AHEI-2010 when scoring LC and LF diets. PARTICIPANTS/SETTING DIETFITS participants were assigned to follow healthy LC or healthy LF diets for 12 months (n = 609). MAIN OUTCOMES MEASURES Mean diet quality index scores for each diet were measured. STATISTICAL ANALYSIS Approach 1 examined both diet quality indices' scoring criteria. Approach 2 compared scores garnered by exemplary quality LC and LF menus created by registered dietitian nutritionists. Approach 3 used 2-sided t tests to compare the HEI-2010 and AHEI-2010 scores calculated from 24-hour dietary recalls of DIETFITS trial participants (n = 608). RESULTS Scoring criteria for both HEI-2010 (100 possible points) and AHEI-2010 (110 possible points) were estimated to favor an LF diet by 10 points. Mean scores for exemplary quality LF menus were higher than for LC menus using both HEI-2010 (91.8 vs 76.8) and AHEI-2010 (71.7 vs 64.4, adjusted to 100 possible points). DIETFITS participants assigned to a healthy LF diet scored significantly higher on HEI and AHEI than those assigned to a healthy LC diet at 3, 6, and 12 months (all, P < .001). Mean baseline scores were lower than mean scores at all follow-up time points regardless of diet assignment or diet quality index used. CONCLUSIONS Commonly used diet quality indices, HEI-2010 and AHEI-2010, showed biases toward LF vs LC diets. However, both indices detected expected changes in diet quality within each diet, with HEI-2010 yielding greater variation in scores. Findings support the use of these indices in measuring diet quality differences within, but not between, LC and LF diets.
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Affiliation(s)
- Michelle E Hauser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California; Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, California; Internal Medicine-Obesity Medicine, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
| | - Jennifer C Hartle
- Department of Public Health and Recreation, San José State University, San José, California
| | - Matthew J Landry
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, California
| | | | - Cynthia W Shih
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California
| | - FeiFei Qin
- Quantitative Sciences Unit, School of Medicine, Stanford University, Stanford, California
| | - Joseph Rigdon
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christopher D Gardner
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California.
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Lin IH, Van Duong T, Nien SW, Tseng IH, Wu YM, Chiang YJ, Wang HH, Chiang CY, Wang MH, Chiu CH, Lin YT, Wong TC. High diet quality indices associated with lower risk of lipid profile abnormalities in Taiwanese kidney transplant recipients. Sci Rep 2023; 13:19662. [PMID: 37952063 PMCID: PMC10640642 DOI: 10.1038/s41598-023-46736-2] [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: 06/21/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023] Open
Abstract
Cardiovascular disease (CVD) and its risk factors seem to be linked with deteriorated graft function and persists as the major cause of mortality in kidney transplant recipients (KTRs). Diet quality is associated with CVD prevention in the healthy population, however, less study focuses on KTRs. The study aimed to determine the association between diet quality indices and lipid profile abnormalities as risk factors for CVD in KTRs. This prospective study enrolled 106 KTRs who had functioning allografts from September 2016. Lipid profiles included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) and were based on the National Cholesterol Education Program Adult Treatment Panel III recommendations. Three-day dietary data were collected by a well-trained registered dietitian. The Alternative Healthy Eating Index-Taiwan (AHEI-Taiwan), Alternative Healthy Eating Index-2010 (AHEI-2010), and Healthy Eating Index-2015 (HEI-2015) scores were calculated and divided into quartiles and compared accordingly. KTRs' mean LDL-C, HDL-C, TC, and TG levels were 119.8 ± 36.6 mg/dL, 52.0 ± 17.9 mg/dL, 205.8 ± 43.9 mg/dL, and 160.2 ± 121.6 mg/dL, respectively. Compared with the lowest quartile, only the highest quartile of AHEI-Taiwan had lower TC and LDL-C levels. After adjustment for age, gender, energy, Charlson comorbidity index, transplant duration, and dialysis duration, logistic regression analysis revealed that the highest quartile of AHEI-Taiwan had 82% (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.04-0.72, p < 0.05) lower odds of high TC and 88% (OR 0.12; 95% CI 0.03-0.58, p < 0.05) lower odds of high LDL-C, and the highest quartile of HEI-2015 had 77% (OR 0.23; 95% CI 0.05-0.95, p < 0.05) lower odds of high LDL-C. Higher adherence to a healthy diet as per AHEI-Taiwan and HEI-2015 guidelines associated with lower risk of lipid profile abnormalities in KTRs.
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Affiliation(s)
- I-Hsin Lin
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shih-Wei Nien
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
| | - I-Hsin Tseng
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
| | - Yi-Ming Wu
- Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
| | - Yang-Jen Chiang
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
- Department of Medicine, Chang Gung University, Taoyüan, Taiwan, ROC
| | - Hsu-Han Wang
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, ROC
- Department of Medicine, Chang Gung University, Taoyüan, Taiwan, ROC
| | - Chia-Yu Chiang
- Department of Business Administration, College of Management, National Changhua University of Education, Changhua, Taiwan, ROC
| | - Ming-Hsu Wang
- Center for General Education, Taipei Medical University, Taipei, Taiwan, ROC
| | - Chia-Hui Chiu
- Center for General Education, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ying-Tsen Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Te-Chih Wong
- Department of Nutrition and Health Sciences, Chinese Culture University, Taipei, Taiwan, ROC.
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Xu Y, Li Y, Hu J, Gibson R, Rodriguez-Mateos A. Development of a novel (poly)phenol-rich diet score and its association with urinary (poly)phenol metabolites. Food Funct 2023; 14:9635-9649. [PMID: 37840467 DOI: 10.1039/d3fo01982a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background: Estimating (poly)phenol intake is challenging due to inadequate dietary assessment tools and limited food content data. Currently, a priori diet scores to characterise (poly)phenol-rich diets are lacking. This study aimed to develop a novel (poly)phenol-rich diet score (PPS) and explore its relationship with circulating (poly)phenol metabolites. Methods: A total of 543 healthy free-living participants aged 18-80 years completed a food frequency questionnaire (FFQ) (EPIC-Norfolk) and provided 24 h urine samples. The PPS was developed based on the relative intake (quintiles) of 20 selected (poly)phenol-rich food items abundant in the UK diet, including tea, coffee, red wine, whole grains, chocolate and cocoa products, berries, apples and juice, pears, grapes, plums, citrus fruits and juice, potatoes and carrots, onions, peppers, garlic, green vegetables, pulses, soy and soy products, nuts, and olive oil. Foods included in the PPS were chosen based on their (poly)phenol content, main sources of (poly)phenols, and consumption frequencies in the UK population. Associations between the PPS and urinary phenolic metabolites were investigated using linear models adjusting energy intake and multiple testing (FDR adjusted p < 0.05). Result: The total PPS ranged from 25 to 88, with a mean score of 54. A total of 51 individual urinary metabolites were significantly associated with the PPS, including 39 phenolic acids, 5 flavonoids, 3 lignans, 2 resveratrol and 2 other (poly)phenol metabolites. The total (poly)phenol intake derived from FFQs also showed a positive association with PPS (stdBeta 0.32, 95% CI (0.24, 0.40), p < 0.01). Significant positive associations were observed in 24 of 27 classes and subclasses of estimated (poly)phenol intake and PPS, with stdBeta values ranging from 0.12 (0.04, 0.20) for theaflavins/thearubigins to 0.43 (0.34, 0.51) for flavonols (p < 0.01). Conclusion: High adherence to the PPS diet is associated with (poly)phenol intake and urinary biomarkers, indicating the utility of the PPS to characterise diets rich in (poly)phenols at a population level.
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Affiliation(s)
- Yifan Xu
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Yong Li
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Jiaying Hu
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Rachel Gibson
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
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Patel PR, Armistead-Jehle P, Eltman NR, Heath KM, Cifu DX, Swanson RL. Brain Injury: How Dietary Patterns Impact Long-Term Outcomes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023; 11:367-376. [PMID: 37732170 PMCID: PMC10506931 DOI: 10.1007/s40141-023-00413-7] [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] [Accepted: 06/23/2023] [Indexed: 09/22/2023]
Abstract
Purpose of Review Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided. Recent Findings We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability. Summary While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.
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Affiliation(s)
- Palak R. Patel
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | | | - Nicholas R. Eltman
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ USA
| | - Kelly M. Heath
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
| | - David X. Cifu
- Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, USA
- Physical Medicine and Rehabilitation, Central Virginia Veterans Health Care System, Richmond, USA
| | - Randel L. Swanson
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
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Gao V, Long MT, Singh SR, Kim Y, Zhang X, Rogers G, Jacques PF, Levy D, Ma J. A Healthy Diet is Associated with a Lower Risk of Hepatic Fibrosis. J Nutr 2023; 153:1587-1596. [PMID: 37023964 PMCID: PMC10273161 DOI: 10.1016/j.tjnut.2023.03.038] [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: 12/23/2022] [Revised: 03/13/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Higher diet quality is associated with a lower risk of NAFLD. OBJECTIVES We examined the relationship between diet quality and hepatic fibrosis. METHODS We analyzed cross-sectional associations between 3 a priori diet quality scores-the Dietary Approaches to Stop Hypertension (DASH) score, the Alternative Healthy Eating Index (AHEI), and a modified Mediterranean-style Diet Score (MDS)-and hepatic fat [controlled attenuation parameter (CAP)] and fibrosis [liver stiffness measurement (LSM)] measured by vibration-controlled transient elastography (VCTE) in 2532 Framingham Heart Study (FHS) participants and 3295 participants of the National Health and Nutrition Examination Survey (NHANES). RESULTS Higher diet quality scores were associated with lower LSM in both FHS and NHANES after adjustment for demographic and lifestyle factors. Additional adjustment for CAP or BMI attenuated the observed associations. Association strength was similar across all 3 diet quality scores. Fixed-effect meta-analysis demonstrated that, under CAP-adjusted models, the LSM decreases associated with 1-SD increase of the DASH, AHEI, and MDS scores were 2% (95% CI: 0.7%, 3.3%; P = 0.002), 2% (95% CI: 0.7%, 3.3%; P = 0.003), and 1.7% (95% CI: 0.7%, 2.6%; P = 0.001), respectively, whereas in the meta-analysis of BMI-adjusted models, LSM reductions associated with 1-SD increase of the DASH, AHEI, and MDS scores were 2.2% (95% CI: -0.1%, 2.2%; P = 0.07), 1.5% (95% CI: 0.3%, 2.7%; P = 0.02), and 0.9 (95% CI: -0.1%, 1.9%; P = 0.07), respectively. CONCLUSIONS We demonstrated associations of higher diet quality with favorable hepatic fat and fibrosis measures. Our data suggest that a healthy diet may reduce the likelihood of obesity and hepatic steatosis as well as the progression of steatosis to fibrosis.
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Affiliation(s)
- Vincent Gao
- Emory College of Arts and Sciences, Emory University, Atlanta, GA, United States
| | - Michelle T Long
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Shridhar R Singh
- Department of Ophthalmology and Visual Sciences, UMass Chan Medical School, Worcester, MA, United States
| | - Youjin Kim
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Gail Rogers
- Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, United States
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, United States
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, and the Framingham Heart Study, Framingham, MA, United States
| | - Jiantao Ma
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
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Lopes T, Zemlin AE, Sekgala MD, Mchiza ZJR, Erasmus RT, Kengne AP. The Association between Plant-Based Diets and Dietary Patterns with Cardiometabolic Risk in a Sample of Commercial Taxi Drivers in South Africa. Nutrients 2023; 15:nu15071789. [PMID: 37049628 PMCID: PMC10096944 DOI: 10.3390/nu15071789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
The consumption of unhealthy foods and a sedentary lifestyle predispose individuals to non-communicable diseases. This study investigated the distribution and the association of plant-based diets (PBDs) and dietary patterns in relation to the cardiometabolic risks in commercial taxi drivers. A cross-sectional analysis was conducted among males (≥19 years) who consumed street foods sold by vendors in the Cape Metropole. A validated questionnaire was administered, including a quantified 24 h dietary recall, and fasting blood samples were collected for biochemical analyses. Statistical analyses were performed to investigate the association between dietary habits and cardiometabolic risks, while adjusting for confounding variables. The analytic sample consisted of 189 males with a median age of 38 years. The taxi drivers who ranked in the top-third of the healthy plant-based diet index (hPDI) had a 1–4% lower likelihood of having raised triglycerides (TG). Furthermore, consumption patterns including refined grains and meat conferred a 33% lower likelihood of dysglycaemia (p = 0.049), while fish/seafood, potatoes, and vegetables conferred a 43% greater likelihood of low high-density lipoprotein cholesterol (HDL-C) (p = 0.026) and 44% greater probability of raised low-density lipoprotein cholesterol (LDL-C) (p = 0.027). Consumption patterns, including sugar-sweetened beverages and eggs, conferred a 37% greater probability of hypertension (p = 0.047) and 53% greater likelihood of subclinical inflammation (p = 0.017). These preliminary findings require larger and more elaborate studies to explore the associations between PBDs and dietary patterns in at-risk African populations, with or without sedentary lifestyles, and exposure to unhealthy food environments.
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Affiliation(s)
- Tatum Lopes
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town 7505, South Africa
| | - Annalise Edith Zemlin
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town 7505, South Africa
- National Health Laboratory Service (NHLS), Tygerberg Hospital, Cape Town 7505, South Africa
| | - Machoene Derrick Sekgala
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
- Human and Social Capabilities, Human Sciences Research Council, Cape Town 8000, South Africa
| | - Zandile June-Rose Mchiza
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Rajiv Timothy Erasmus
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town 7505, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
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Association of diet quality indices with serum and metabolic biomarkers in participants of the ORISCAV-LUX-2 study. Eur J Nutr 2023:10.1007/s00394-023-03095-y. [PMID: 36917281 DOI: 10.1007/s00394-023-03095-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/12/2023] [Indexed: 03/15/2023]
Abstract
PURPOSE Diet quality is a critical modifiable factor related to health, including the risk of cardiometabolic complications. Rather than assessing the intake of individual food items, it is more meaningful to examine overall dietary patterns. This study investigated the adherence to common dietary indices and their association with serum/metabolic parameters of disease risk. METHODS Dietary intakes of the general adult population (n = 1404, 25-79 years) were assessed by a validated food-frequency questionnaire (174 items). The French ANSES-Ciqual food composition database was used to compute nutrient intakes. Seven indicators were calculated to investigate participants' diet quality: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension Score (DASH-S), Mediterranean Diet Score (MDS), Diet Quality Index-International (DQI-I), Dietary Inflammatory Index (DII), Dietary Antioxidant Index (DAI), and Naturally Nutrient-Rich Score (NNRS). Various serum/metabolic parameters were used in the validity and association analyses, including markers of inflammation, blood glucose, and blood lipid status. RESULTS Following linear regression models adjusted for confounders, the DASH-S was significantly associated with most metabolic parameters (14, e.g., inversely with blood pressure, triglycerides, urinary sodium, uric acid, and positively with serum vitamin D), followed by the DQI-I (13, e.g., total cholesterol, apo-A/B, uric acid, and blood pressure) and the AHEI (11, e.g., apo-A, uric acid, serum vitamin D, diastolic blood pressure and vascular age). CONCLUSION Food-group-based indices, including DASH-S, DQI-I, and AHEI, were good predictors for serum/metabolic parameters, while nutrient-based indices, such as the DAI or NNRS, were less related to biological markers and, thus, less suitable to reflect diet quality in a general population.
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Frankenfeld CL. Population-Specific Diet Quality Scores in Nutritional Epidemiology. J Nutr 2023; 153:608-609. [PMID: 36931743 DOI: 10.1016/j.tjnut.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 02/27/2023] Open
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Phelan JM, Rosenkranz RR, Phelan CJ, Rosenkranz SK. Holistic Framework to Contextualize Dietary Quality Assessment: A Critical Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3986. [PMID: 36900992 PMCID: PMC10002241 DOI: 10.3390/ijerph20053986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Numerous dietary quality indices exist to help quantify overall dietary intake and behaviors associated with positive health outcomes. Most indices focus solely on biomedical factors and nutrient or food intake, and exclude the influence of important social and environmental factors associated with dietary intake. Using the Diet Quality Index- International as one sample index to illustrate our proposed holistic conceptual framework, this critical review seeks to elucidate potential adaptations to dietary quality assessment by considering-in parallel-biomedical, environmental, and social factors. Considering these factors would add context to dietary quality assessment, influencing post-assessment recommendations for use across various populations and circumstances. Additionally, individual and population-level evidence-based practices could be informed by contextual social and environmental factors that influence dietary quality to provide more relevant, reasonable, and beneficial nutritional recommendations.
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Affiliation(s)
- Jessica M. Phelan
- Department of Food Nutrition Dietetics and Health, Kansas State University, Manhattan, KS 66506, USA
- Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Manhattan, KS 66506, USA
- Department of Health and Human Performance, Fort Hays State University, Hays, KS 67601, USA
| | - Richard R. Rosenkranz
- Department of Food Nutrition Dietetics and Health, Kansas State University, Manhattan, KS 66506, USA
- Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Manhattan, KS 66506, USA
- Department of Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Connor J. Phelan
- Department Geosciences, Fort Hays State University, Hays, KS 67601, USA
| | - Sara K. Rosenkranz
- Department of Food Nutrition Dietetics and Health, Kansas State University, Manhattan, KS 66506, USA
- Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Manhattan, KS 66506, USA
- Department of Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, NV 89154, USA
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New Validated Short Questionnaire for the Evaluation of the Adherence of Mediterranean Diet and Nutritional Sustainability in All Adult Population Groups. Nutrients 2022; 14:nu14235177. [PMID: 36501206 PMCID: PMC9736956 DOI: 10.3390/nu14235177] [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: 11/10/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
High adherence to a Mediterranean diet (MD) is favourable for its sustainability and beneficial effects on health. The available questionnaires, according to the MD dietary pattern, include the assessment of moderate alcohol consumption; but some groups, such as young adults and pre-conceptional and pregnant women, are not allowed to consume it. The aim of this study was to validate a new short questionnaire (MedQ-Sus) excluding alcohol consumption, to measure the adherence to the MD and to evaluate the nutritional adherence to a sustainable diet. The Harvard validated questionnaire was used for the validation study. A total of 316 subjects (20 to 70 YOA) completed both questionnaires. A high Spearman correlation coefficient (rho = 0.69; p < 0.01) was found between the MedQ-Sus and Harvard scores; a statistically significant positive correlation was found for all eight food groups. The MedQ-Sus had a significant discriminative capacity between adherence and non-adherence to the MD (optimal cut-off point = 9.5, sensitivity 0.86, specificity = 0.65). A very high nutritional adherence to a sustainable diet was found in the subjects for olive oil (97%), dairy food (90%), fresh vegetables (89%), fish and fish products (73), fresh fruit (56%), and cereals and cereals products (42%). A very low adherence was found for legumes (22%) and meat and meat products (9%). The results showed MedQ-Sus is a valid and quick assessment instrument for the evaluation of the adherence to the MD in all population groups, and could also be useful to evaluate the nutritional sustainability of the diet.
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12
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Zhao C, Wang Y, Shi B, Li M, Yan W, Yang H. Domination of H-Bond Interactions in the Solvent-Triggering Gelation Process. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2022; 38:7965-7975. [PMID: 35731623 DOI: 10.1021/acs.langmuir.2c00677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Gels prepared with the solvent-triggering method are attractive for their easy and fast preparation; however, the role of solvents in this process remains unclear, which hinders the efficient and accurate control of desired gel properties. In this study, the role of solvents in the solvent-triggering gelation process is studied using 9-fluorenylmethoxycarbonyl (Fmoc)-protected diphenylalanine (Fmoc-FF) as the gelator. Density functional theory (DFT)-based calculations and corresponding wavefunction analyses are conducted to identify the H-bonding interaction sites between the molecules. The calculation results clearly annotate the activating role of DMF and the triggering role of H2O in the gelation process. The solvation of Fmoc-FF by DMF can activate the H-bonding sites on the peptide chain, showing a conformation reversal and higher electrostatic potentials. Then, the H-bonding between Fmoc-FF and H2O is facilitated to trigger gelation. The physical Fmoc-FF/DMF/H2O gels show easily tuned mechanical strengths (G' of 102-105 Pa), injectable potentials (general yield strain < 100%), and stable recoverability (80-98% within 100 s). The regulation of these properties depends on not only the gelator concentration but also the H-bonding interactions with solvent molecules, which have seldom been studied in detail before. By understanding the effect of solvents, low-molecular-weight gelator-based gels can be designed, prepared, and tuned efficiently for potential applications.
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Affiliation(s)
- Chengcheng Zhao
- State Key Laboratory of Multiphase Flow in Power Engineering, Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yanyao Wang
- State Key Laboratory of Multiphase Flow in Power Engineering, Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Bofang Shi
- State Key Laboratory of Multiphase Flow in Power Engineering, Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Mingtao Li
- State Key Laboratory of Multiphase Flow in Power Engineering, Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Wei Yan
- State Key Laboratory of Multiphase Flow in Power Engineering, Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Honghui Yang
- Xi'an Key Laboratory of Sustainable Energy Materials Chemistry, Department of Applied Chemistry, Xi'an Jiaotong University, Xi'an 710049, China
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Wingrove K, Lawrence MA, McNaughton SA. A Systematic Review of the Methods Used to Assess and Report Dietary Patterns. Front Nutr 2022; 9:892351. [PMID: 35694166 PMCID: PMC9175067 DOI: 10.3389/fnut.2022.892351] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/25/2022] [Indexed: 01/02/2023] Open
Abstract
The use of dietary pattern assessment methods has increased over time. However, data from individual studies can be difficult to compare and synthesize when the dietary pattern assessment methods, and the dietary patterns that are identified are not described sufficiently. The aims of this systematic review were to analyze the application and reporting of dietary pattern assessment methods, and the reporting of the dietary patterns that were analyzed with health outcomes. Three electronic databases were searched (Medline, Embase, and Global Health). Cohort and nested case control studies published in English between January 1980 and March 2019 that examined associations between dietary patterns and health outcomes (including cardiovascular disease, cancer, diabetes and metabolic syndrome, and body weight) in apparently healthy, community dwelling adults (aged over 18 years) or children (aged 2–18 years) were eligible for inclusion. A narrative synthesis was conducted and descriptive statistics were used to summarize the application and reporting of each dietary pattern assessment method, and the reporting of the identified dietary patterns. Analysis of associations between dietary patterns and health outcomes was beyond the scope of this review. Of the included studies (n = 410), 62.7% used index-based methods, 30.5% used factor analysis or principal component analysis, 6.3% used reduced rank regression, and 5.6% used cluster analysis. Some studies (4.6%) used more than one method. There was considerable variation in the application and reporting of dietary pattern assessment methods. For example, the application of Mediterranean diet indices varied in terms of the nature of dietary components (foods only or foods and nutrients) and the rationale behind the cut-off points (absolute and/or data driven). In some cases, important methodological details were omitted. The level of detail used to describe the dietary patterns also varied, and food and nutrient profiles were often not reported. To ensure dietary patterns evidence can be synthesized and translated into dietary guidelines, standardized approaches for the application and reporting of dietary pattern assessment methods and the reporting of the identified dietary patterns would be beneficial.
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Aljahdali AA, Peterson KE, Cantoral A, Ruiz-Narvaez E, Tellez-Rojo MM, Kim HM, Hébert JR, Wirth MD, Torres-Olascoaga LA, Shivappa N, Baylin A. Diet Quality Scores and Cardiometabolic Risk Factors in Mexican Children and Adolescents: A Longitudinal Analysis. Nutrients 2022; 14:nu14040896. [PMID: 35215546 PMCID: PMC8878155 DOI: 10.3390/nu14040896] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 01/27/2023] Open
Abstract
There is limited evidence for the effects of diet on cardiometabolic profiles during the pubertal transition. We collected repeated measures of diet quality and cardiometabolic risk factors among Mexican youth. This analysis included 574 offspring of the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort followed up to three time points. Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet (aMedDiet), and Children’s Dietary Inflammatory Index (C-DIITM) scores were computed from food frequency questionnaires. Higher DASH and aMedDiet scores reflect a higher diet quality, and lower C-DII scores reflect an anti-inflammatory diet. Cardiometabolic risk factors were lipid profile, glucose homeostasis, blood pressure, and waist circumference. Linear mixed models were used between quartiles of each diet score and outcomes. Compared to the first quartile, the fourth DASH quartile was inversely associated with log serum insulin (μIU/mL) [β = −0.19, p = 0.0034] and log-Homeostatic Model Assessment of Insulin Resistance [β = −0.25, p = 0.0008]. Additionally, log serum triglycerides (mg/dL) was linearly associated with aMedDiet score [β = −0.03, p = 0.0022]. Boys in the highest aMedDiet quartile had higher serum high-density lipoprotein cholesterol (mg/dL) [β = 4.13, p = 0.0034] compared to the reference quartile. Higher diet quality was associated with a better cardiometabolic profile among Mexican youth.
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Affiliation(s)
- Abeer Ali Aljahdali
- Department of Clinical Nutrition, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA; (E.R.-N.); (A.B.)
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA; (E.R.-N.); (A.B.)
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-(734) 647-1923
| | - Alejandra Cantoral
- Department of Health, Iberoamericana University, Mexico City 01219, Mexico;
| | - Edward Ruiz-Narvaez
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA; (E.R.-N.); (A.B.)
| | - Martha M. Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico; (M.M.T.-R.); (L.A.T.-O.)
| | - Hyungjin Myra Kim
- Center for Computing, Analytics and Research, University of Michigan, Ann Arbor, MI 48109, USA;
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.R.H.); (M.D.W.); (N.S.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Michael D. Wirth
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.R.H.); (M.D.W.); (N.S.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA
| | - Libni A. Torres-Olascoaga
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico; (M.M.T.-R.); (L.A.T.-O.)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.R.H.); (M.D.W.); (N.S.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA; (E.R.-N.); (A.B.)
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
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15
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Effect of a Multicomponent mHealth Intervention on the Composition of Diet in a Population with Overweight and Obesity-Randomized Clinical Trial EVIDENT 3. Nutrients 2022; 14:nu14020270. [PMID: 35057451 PMCID: PMC8778755 DOI: 10.3390/nu14020270] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 11/17/2022] Open
Abstract
A balanced diet can help in the prevention of chronic diseases. The aim of this study was to evaluate the effect of an mHealth intervention on the distribution of macronutrients and the intake of food groups. A total of 650 participants were included in this multi-center, clinical, randomized, controlled trial (Evident 3 study). All participants were given brief advice about diet and exercise. The intervention group received, in addition, an app (Evident 3) for the self-recording of their diet and an activity tracker wristband for 3 months. Follow-up visits were performed at 3 and 12 months to collect the diet composition using the Food Frequency Questionnaire. There were decreases in the intake of total calories, fat, protein and carbohydrates in both groups throughout the study, without significant differences between them. The intervention group reduced the intake of cholesterol (−30.8; 95% CI −59.9, −1.7) and full-fat dairies (−23.3; 95% CI −42.8, −3.8) and increased the intake of wholemeal bread (3.3; 95% CI −6.7, 13.3) and whole-grain cereals (3.4; 95% CI −6.8, 13.7) with respect to the control group. No differences were found in the rest of the nutritional parameters. The brief advice is useful to promote a healthier diet, and the app can be a support tool to obtain changes in relevant foods, such as integral foods, and the intake of cholesterol. Trial registration: ClinicalTrials.gov with identifier NCT03175614.
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16
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Dietary score associations with markers of chronic low-grade inflammation: a cross-sectional comparative analysis of a middle- to older-aged population. Eur J Nutr 2022; 61:3377-3390. [PMID: 35511284 PMCID: PMC9464136 DOI: 10.1007/s00394-022-02892-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/12/2022] [Indexed: 12/18/2022]
Abstract
PURPOSE To assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet (MD), Dietary Inflammatory Index (DII®) and Energy-adjusted DII (E-DII™) scores and pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cells. METHODS This was a cross-sectional study of 1862 men and women aged 46-73 years, randomly selected from a large primary care centre in Ireland. DASH, MD, DII and E-DII scores were derived from validated food frequency questionnaires. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with biomarker concentrations. RESULTS In fully adjusted models, higher diet quality or a less pro-inflammatory diet was associated with lower concentrations of c-reactive protein, neutrophils (all dietary scores), complement component 3 [C3], interleukin 6 [IL-6], tumour necrosis factor-alpha [TNF-α], white blood cell count [WBC], the neutrophil-to-lymphocyte ratio [NLR] (DASH, DII and E-DII), monocytes (DASH and DII) and resistin (DII and E-DII). After accounting for multiple testing, relationships with C3 (DASH: β = - 2.079, p = .011 and DII: β = 2.521, p = .036), IL-6 (DASH: β = - 0.063, p = .011), TNF-α (DASH: β = - 0.027, p = .034), WBC (DASH: β = - 0.028, p = .001 and DII: β = 0.029, p = .02), neutrophils (DASH: β = - 0.041, p = .001; DII: β = 0.043, p = .007; E-DII: β = 0.029, p = .009) and the NLR (DASH: β = - 0.035, p = .011) persisted. CONCLUSIONS Better diet quality, determined by the DASH score, may be more closely associated with inflammatory biomarkers related to health in middle- to older-aged adults than the MD, DII and E-DII scores.
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17
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Petersen KS, Kris-Etherton PM. Diet Quality Assessment and the Relationship between Diet Quality and Cardiovascular Disease Risk. Nutrients 2021; 13:nu13124305. [PMID: 34959857 PMCID: PMC8706326 DOI: 10.3390/nu13124305] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 01/08/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the U.S. and globally. Dietary risk factors contribute to over half of all CVD deaths and CVD-related disability. The aim of this narrative review is to describe methods used to assess diet quality and the current state of evidence on the relationship between diet quality and risk of CVD. The findings of the review will be discussed in the context of current population intake patterns and dietary recommendations. Several methods are used to calculate diet quality: (1) a priori indices based on dietary recommendations; (2) a priori indices based on foods or dietary patterns associated with risk of chronic disease; (3) exploratory data-driven methods. Substantial evidence from prospective cohort studies shows that higher diet quality, regardless of the a priori index used, is associated with a 14-29% lower risk of CVD and 0.5-2.2 years greater CVD-free survival time. Limited evidence is available from randomized controlled trials, although evidence shows healthy dietary patterns improve risk factors for CVD and lower CVD risk. Current dietary guidance for general health and CVD prevention and management focuses on following a healthy dietary pattern throughout the lifespan. High diet quality is a unifying component of all dietary recommendations and should be the focus of national food policies and health promotion.
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Affiliation(s)
- Kristina S. Petersen
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Correspondence:
| | - Penny M. Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, State College, PA 16802, USA;
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18
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Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation. Nutrients 2021; 13:nu13093130. [PMID: 34579008 PMCID: PMC8468062 DOI: 10.3390/nu13093130] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 12/14/2022] Open
Abstract
The ‘Developmental Origins of Health and Diseases’ hypothesis posits that prenatal maternal diet influences offspring growth and later life health outcomes. Dietary assessment has focused on selected nutrients. However, this approach does not consider the complex interactions between foods and nutrients. To provide a more comprehensive approach to public health, dietary indices have been developed to assess dietary quality, dietary inflammation and risk factors for non-communicable diseases. Thus far, their use in the context of placental development is limited and associations with offspring outcomes have been inconsistent. Although epidemiological studies have focused on the role of maternal diet on foetal programming, the underlying mechanisms are still poorly understood. Some evidence suggests these associations may be driven by placental and epigenetic changes. In this narrative review, we examine the current literature regarding relationships between key validated diet quality scores (Dietary Inflammatory Index [DII], Mediterranean diet [MD], Healthy Eating Index [HEI], Alternative Healthy Eating Index [AHEI], Dietary Approaches to Stop Hypertension [DASH], Glycaemic Index [GI] and Glycaemic Load [GL]) in pregnancy and birth and long-term offspring outcomes. We summarise findings, discuss potential underlying placental and epigenetic mechanisms, in particular DNA methylation, and highlight the need for further research and public health strategies that incorporate diet quality and epigenetics.
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Monge-Rojas R, O'Neill J, Lee-Bravatti M, Mattei J. A Traditional Costa Rican Adolescents' Diet Score Is a Valid Tool to Capture Diet Quality and Identify Sociodemographic Groups With Suboptimal Diet. Front Public Health 2021; 9:708956. [PMID: 34458228 PMCID: PMC8397381 DOI: 10.3389/fpubh.2021.708956] [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: 05/13/2021] [Accepted: 07/06/2021] [Indexed: 01/10/2023] Open
Abstract
Traditional diet indices may capture diet quality according to local food culture. Higher adherence to traditional diet scores may help prevent disease, yet evidence in adolescents is limited. This cross-sectional study aimed to develop and validate a Traditional Costa Rica Adolescents Diet Score (TCRAD) and determine its association with sociodemographic characteristics, under the hypothesis that girls, adolescents from rural areas, and with low socioeconomic status, have a more traditional healthy diet. A total of 804 urban and rural adolescents (13-18 years old) participated in the study. The TCRAD showed adequate internal validity as shown by significant associations with intake of 14 traditional foods and nutrients (legumes, vegetables, fruits, oils, dairy, and corn tortilla scored as healthy; and white rice, red/processed meat, solid fats, desserts/pastries, sugar-sweetened beverages, snacks, fast food, and bread and cookies scored as unhealthy). A high TCRAD score, indicative of a healthier and more traditional diet, was observed among adolescents in the low socioeconomic group vs. medium or high socioeconomic categories (42.9, 41.2, and 38.2%, respectively, p < 0.05), adolescents living in rural areas vs. urban (47.6 vs. 34.2%, p < 0.05), and among boys vs. girls (46.9 vs. 37.5%, p < 0.05). The TCRAD score is a valid tool to capture diet quality of adolescents in Costa Rica and could be used to measure association of diet with disease outcomes in this and similar populations. Public health nutrition programs in Costa Rica should focus on improving intake of foods and nutrients, and prioritize girls, adolescents in urban areas, and adolescents with high socioeconomic status.
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Affiliation(s)
- Rafael Monge-Rojas
- Nutrition and Health Unit, Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Ministry of Health, Tres Ríos, Costa Rica
| | - June O'Neill
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Michelle Lee-Bravatti
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
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20
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Aldaya MM, Ibañez FC, Domínguez-Lacueva P, Murillo-Arbizu MT, Rubio-Varas M, Soret B, Beriain MJ. Indicators and Recommendations for Assessing Sustainable Healthy Diets. Foods 2021; 10:999. [PMID: 34063236 PMCID: PMC8147455 DOI: 10.3390/foods10050999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/12/2022] Open
Abstract
Research coupling human nutrition and sustainability concerns is a rapidly developing field, which is essential to guide governments' policies. This critical and comprehensive review analyzes indicators and approaches to "sustainable healthy diets" published in the literature since this discipline's emergence a few years ago, identifying robust gauges and highlighting the flaws of the most commonly used models. The reviewed studies largely focus on one or two domains such as greenhouse gas emissions or water use, while overlooking potential impact shifts to other sectors or resources. The present study covers a comprehensive set of indicators from the health, environmental and socio-economic viewpoints. This assessment concludes that in order to identify the best food option in sustainability assessments and nutrition analysis of diets, some aspects such as the classification and disaggregation of food groups, the impacts of the rates of local food consumption and seasonality, preservation methods, agrobiodiversity and organic food and different production systems, together with consequences for low-income countries, require further analysis and consideration.
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Affiliation(s)
- Maite M. Aldaya
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - Francisco C. Ibañez
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | | | - María Teresa Murillo-Arbizu
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - Mar Rubio-Varas
- Institute for Advanced Research in Business and Economics (INARBE), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain;
| | - Beatriz Soret
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - María José Beriain
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
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21
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Livingstone KM, Abbott G, Bowe SJ, Ward J, Milte C, McNaughton SA. Diet quality indices, genetic risk and risk of cardiovascular disease and mortality: a longitudinal analysis of 77 004 UK Biobank participants. BMJ Open 2021; 11:e045362. [PMID: 33795309 PMCID: PMC8023730 DOI: 10.1136/bmjopen-2020-045362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/17/2020] [Accepted: 03/17/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To examine associations of three diet quality indices and a polygenic risk score with incidence of all-cause mortality, cardiovascular disease (CVD) mortality, myocardial infarction (MI) and stroke. DESIGN Prospective cohort study. SETTING UK Biobank, UK. PARTICIPANTS 77 004 men and women (40-70 years) recruited between 2006 and 2010. MAIN OUTCOME MEASURES A polygenic risk score was created from 300 single nucleotide polymorphisms associated with CVD. Cox proportional HRs were used to estimate independent effects of diet quality and genetic risk on all-cause mortality, CVD mortality, MI and stroke risk. Dietary intake (Oxford WebQ) was used to calculate Recommended Food Score (RFS), Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS). RESULTS New all-cause (n=2409) and CVD (n=364) deaths and MI (n=1141) and stroke (n=748) events were identified during mean follow-ups of 7.9 and 7.8 years, respectively. The adjusted HR associated with one-point higher RFS for all-cause mortality was 0.96 (95% CI: 0.94 to 0.98), CVD mortality was 0.94 (95% CI: 0.90 to 0.98), MI was 0.97 (95% CI: 0.95 to 1.00) and stroke was 0.94 (95% CI: 0.91 to 0.98). The adjusted HR for all-cause mortality associated with one-point higher HDI and MDS was 0.97 (95% CI: 0.93 to 0.99) and 0.95 (95% CI: 0.91 to 0.98), respectively. The adjusted HR associated with one-point higher MDS for stroke was 0.93 (95% CI: 0.87 to 1.00). There was little evidence of associations between HDI and risk of CVD mortality, MI or stroke. There was evidence of an interaction between diet quality and genetic risk score for MI. CONCLUSION Higher diet quality predicted lower risk of all-cause mortality, independent of genetic risk. Higher RFS was also associated with lower risk of CVD mortality and MI. These findings demonstrate the benefit of following a healthy diet, regardless of genetic risk.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Steven J Bowe
- Deakin Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Joey Ward
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine Milte
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
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Wong MMH, Louie JCY. A priori dietary patterns and cardiovascular disease incidence in adult population-based studies: a review of recent evidence. Crit Rev Food Sci Nutr 2021; 62:6153-6168. [PMID: 33715546 DOI: 10.1080/10408398.2021.1897517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. Studies using the a priori dietary pattern approach have been criticized for the heterogeneity of their scoring methods. This review aimed to evaluate the evidence on the association between a priori dietary patterns and CVD incidence in recent adult population-based studies. Similar to the conclusions of previous systematic reviews and meta-analyses, our review found that the majority of recent studies suggested that Mediterranean diet (6 out of 10 studies), Dietary Approaches to Stop Hypertension diet (4 out of 6 studies), Dietary Guidelines-based (11 out of 13 studies) patterns, and other emerging dietary patterns, including carbohydrate quality, Dietary Inflammatory Index, Plant-based Diet Index and Healthy Nordic Food Index, were cardioprotective in the general population; however, there was substantial heterogeneity among the studies, possibly due to differences in scoring methods and analytical approaches used and inclusion of different confounders, as well as other methodological drawbacks, such as low numbers of cases and short follow-up periods. Future studies should simultaneously examine and compare multiple a priori dietary patterns in a specific population using a uniform statistical approach. A consensus on the scoring methods for each a priori dietary pattern is also necessary.
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Affiliation(s)
- Martin M H Wong
- School of Professional and Continuing Education, University of Hong Kong, Hong Kong SAR, China
| | - Jimmy Chun Yu Louie
- School of Biological Sciences, Faculty of Science, University of Hong Kong, Hong Kong SAR, China
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23
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Sullivan VK, Petersen KS, Fulgoni VL, Eren F, Cassens ME, Bunczek MT, Kris-Etherton PM. Greater Scores for Dietary Fat and Grain Quality Components Underlie Higher Total Healthy Eating Index-2015 Scores, While Whole Fruits, Seafood, and Plant Proteins Are Most Favorably Associated with Cardiometabolic Health in US Adults. Curr Dev Nutr 2021; 5:nzab015. [PMID: 33834158 PMCID: PMC8015867 DOI: 10.1093/cdn/nzab015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/05/2021] [Accepted: 02/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND High-quality diets reduce the risk of cardiometabolic and other chronic diseases. The dietary components that distinguish higher from lower quality diets, and their associations with health, have not been fully investigated. OBJECTIVES This study aimed to assess the component scores that underlie differences in total Healthy Eating Index (HEI)-2015 scores, quantify fatty acid (saturated, monounsaturated, polyunsaturated) intakes that comprise Fatty Acids component scores, and assess associations between component scores and cardiometabolic risk factors. METHODS A cross-sectional analysis of data from the NHANES (2001-2016) was conducted. Total and component HEI-2015 scores were assessed in adult (≥19 y) participants who provided one 24-h dietary recall (n = 39,799). Survey-weighted mean component scores by quartile of total HEI-2015 score were determined. Regression analyses were conducted to assess fatty acid intakes across quartiles of Fatty Acids component scores. Separate regression analyses were conducted to assess associations between component scores and cardiometabolic risk factors, after adjusting for demographic characteristics and health behaviors. RESULTS Scores for components related to dietary fat (Fatty Acids, Saturated Fats) and grain quality (Whole Grains, Refined Grains) accounted for the greatest differences in HEI-2015 scores. Higher Fatty Acids scores were primarily composed of lower saturated and greater polyunsaturated fat intakes. Whole Fruits, and Seafood and Plant Proteins, were most favorably associated with cardiometabolic risk factors including anthropometric measures (P < 0.001), systolic blood pressure (P < 0.01), glycemic markers (Whole Fruits only, P < 0.01), and HDL cholesterol and triglycerides (Seafood and Plant Proteins only, P < 0.001). CONCLUSIONS Average diet quality in US adults is suboptimal. Higher quality diets are primarily distinguished by the types of fats and grain-based foods that are consumed. Interventions targeting dietary components that are most favorably associated with cardiometabolic risk factors-whole fruits, seafood, and plant proteins-may have the greatest impact on disease risk.
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Affiliation(s)
- Valerie K Sullivan
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Kristina S Petersen
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | | | - Fulya Eren
- ACH Food Companies, Inc., Oakbrook Terrace, IL, USA
| | | | | | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
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24
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Lindström J, Aittola K, Pölönen A, Hemiö K, Ahonen K, Karhunen L, Männikkö R, Siljamäki-Ojansuu U, Tilles-Tirkkonen T, Virtanen E, Pihlajamäki J, Schwab U. Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2362. [PMID: 33670967 PMCID: PMC7967771 DOI: 10.3390/ijerph18052362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022]
Abstract
Lack of tools to evaluate the quality of diet impedes dietary counselling in healthcare. We constructed a scoring for a validated food intake questionnaire, to measure the adherence to a healthy diet that prevents type 2 diabetes (T2D). The Healthy Diet Index (HDI) consists of seven weighted domains (meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy, snacks and treats). We studied the correlations of the HDI with nutrient intakes calculated from 7-day food records among 52 men and 25 women, and associations of HDI with biomarkers and anthropometrics among 645 men and 2455 women. The HDI correlated inversely with total fat (Pearson's r = -0.37), saturated fat (r = -0.37), monounsaturated fat (r = -0.37), and the glycaemic index of diet (r = -0.32) and positively with carbohydrates (r = 0.23), protein (r = 0.25), fibre (r = 0.66), magnesium (r = 0.26), iron (r = 0.25), and vitamin D (r = 0.27), (p < 0.05 for all). In the linear regression model adjusted for BMI and age, HDI is associated inversely with waist circumference, concentrations of fasting and 2-h glucose and triglycerides in men and women, total and LDL cholesterol in women, and fasting insulin in men (p < 0.05 for all). The HDI proved to be a valid tool to measure adherence to a health-promoting diet and to support individualised dietary counselling.
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Affiliation(s)
- Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Kirsikka Aittola
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
| | - Auli Pölönen
- Division 1, Tampere University Hospital, 33520 Tampere, Finland
| | - Katri Hemiö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Kirsti Ahonen
- Clinical Nutrition Unit, Tampere University Hospital, 33520 Tampere, Finland
| | - Leila Karhunen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
| | - Reija Männikkö
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 Kuopio, Finland
| | | | - Tanja Tilles-Tirkkonen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
| | - Eeva Virtanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Jussi Pihlajamäki
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 Kuopio, Finland
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25
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Johnston EA, Petersen KS, Beasley JM, Krussig T, Mitchell DC, Van Horn LV, Weiss R, Kris-Etherton PM. Relative validity and reliability of a diet risk score (DRS) for clinical practice. BMJ Nutr Prev Health 2020; 3:263-269. [PMID: 33521537 PMCID: PMC7841834 DOI: 10.1136/bmjnph-2020-000134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction Adherence to cardioprotective dietary patterns can reduce risk for developing cardiometabolic disease. Rates of diet assessment and counselling by physicians are low. Use of a diet screener that rapidly identifies individuals at higher risk due to suboptimal dietary choices could increase diet assessment and brief counselling in clinical care. Methods We evaluated the relative validity and reliability of a 9-item diet risk score (DRS) based on the Healthy Eating Index (HEI)-2015, a comprehensive measure of diet quality calculated from a 160-item, validated food frequency questionnaire (FFQ). We hypothesised that DRS (0 (low risk) to 27 (high risk)) would inversely correlate with HEI-2015 score. Adults aged 35 to 75 years were recruited from a national research volunteer registry (ResearchMatch.org) and completed the DRS and FFQ in random order on one occasion. To measure reliability, participants repeated the DRS within 3 months. Results In total, 126 adults (87% female) completed the study. Mean HEI-2015 score was 63.3 (95% CI: 61.1 to 65.4); mean DRS was 11.8 (95% CI: 10.8 to 12.8). DRS and HEI-2015 scores were inversely correlated (r=-0.6, p<0.001; R2=0.36). The DRS ranked 37% (n=47) of subjects in the same quintile, 41% (n=52) within ±1 quintile of the HEI-2015 (weighted κ: 0.28). The DRS had high reliability (n=102, ICC: 0.83). DRS mean completion time was 2 min. Conclusions The DRS is a brief diet assessment tool, validated against a FFQ, that can reliably identify patients with reported suboptimal intake. Future studies should evaluate the effectiveness of DRS-guided diet assessment in clinical care. Trial registration details ClinicalTrials.gov (NCT03805373).
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Affiliation(s)
- Emily A Johnston
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kristina S Petersen
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jeannette M Beasley
- Department of Medicine, NYU Langone Medical Center, New York City, New York, USA
| | - Tobias Krussig
- Penn State College of Medicine, University Park, Pennsylvania, USA
| | - Diane C Mitchell
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Linda V Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Penny M Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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26
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Lee YQ, Loh J, Ang RSE, Chong MFF. Tracking of Maternal Diet from Pregnancy to Postpregnancy: A Systematic Review of Observational Studies. Curr Dev Nutr 2020; 4:nzaa118. [PMID: 32793849 PMCID: PMC7408223 DOI: 10.1093/cdn/nzaa118] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
We systematically reviewed studies to examine changes in women's diets from pregnancy to the postpregnancy period and sought to understand the characteristics of women making these changes. From a search of 4 databases and up to November 2019, 17 studies met our inclusion criteria. They reported changes in various dietary aspects. Mixed findings were reported for changes in energy and micronutrient intakes. Most studies reported significant decreases in fruit and vegetable consumption, diet quality, and adherence to a healthier dietary pattern during the transition from pregnancy to postpregnancy, whereas increases in discretionary food and fat intakes were observed. Women with lower education level, lower income, and/or who worked full-time tended to have poorer dietary behaviors postpregnancy. Further research, with better aligned dietary measurement time points during pregnancy and postpartum and standardization of dietary assessment tools, is needed for future studies to be comparable. The systematic review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews as CRD42020158033.
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Affiliation(s)
- Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jason Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Rebekah Su Ern Ang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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27
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Xu R, Blanchard BE, McCaffrey JM, Woolley S, Corso LML, Duffy VB. Food Liking-Based Diet Quality Indexes (DQI) Generated by Conceptual and Machine Learning Explained Variability in Cardiometabolic Risk Factors in Young Adults. Nutrients 2020; 12:E882. [PMID: 32218114 PMCID: PMC7231006 DOI: 10.3390/nu12040882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023] Open
Abstract
The overall pattern of a diet (diet quality) is recognized as more important to health and chronic disease risk than single foods or food groups. Indexes of diet quality can be derived theoretically from evidence-based recommendations, empirically from existing datasets, or a combination of the two. We used these methods to derive diet quality indexes (DQI), generated from a novel dietary assessment, and to evaluate relationships with cardiometabolic risk factors in young adults with (n = 106) or without (n = 106) diagnosed depression (62% female, mean age = 21). Participants completed a liking survey (proxy for usual dietary consumption). Principle component analysis of plasma (insulin, glucose, lipids) and adiposity (BMI, Waist-to-Hip ratio) measures formed a continuous cardiometabolic risk factor score (CRFS). DQIs were created: theoretically (food/beverages grouped, weighted conceptually), empirically (grouping by factor analysis, weights empirically-derived by ridge regression analysis of CRFS), and hybrid (food/beverages conceptually-grouped, weights empirically-derived). The out-of-sample CRFS predictability for the DQI was assessed by two-fold and five-fold cross validations. While moderate consistencies between theoretically- and empirically-generated weights existed, the hybrid outperformed theoretical and empirical DQIs in cross validations (five-fold showed DQI explained 2.6% theoretical, 2.7% empirical, and 6.5% hybrid of CRFS variance). These pilot data support a liking survey that can generate reliable/valid DQIs that are significantly associated with cardiometabolic risk factors, especially theoretically- plus empirically-derived DQI.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Bruce E. Blanchard
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Jeanne M. McCaffrey
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Stephen Woolley
- Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA;
| | - Lauren M. L. Corso
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269, USA; (R.X.); (B.E.B.); (J.M.M.); (L.M.L.C.)
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28
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Bernal-Orozco MF, Salmeron-Curiel PB, Prado-Arriaga RJ, Orozco-Gutiérrez JF, Badillo-Camacho N, Márquez-Sandoval F, Altamirano-Martínez MB, González-Gómez M, Gutiérrez-González P, Vizmanos B, Macedo-Ojeda G. Second Version of a Mini-Survey to Evaluate Food Intake Quality (Mini-ECCA v.2): Reproducibility and Ability to Identify Dietary Patterns in University Students. Nutrients 2020; 12:nu12030809. [PMID: 32204379 PMCID: PMC7146109 DOI: 10.3390/nu12030809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/19/2022] Open
Abstract
Evaluation of food intake quality using validated tools makes it possible to give individuals or populations recommendations for improving their diet. This study’s objective was to evaluate the reproducibility and ability to identify dietary patterns of the second version of the Mini Food Intake Quality Survey (Mini-ECCA v.2). The survey was administered using a remote voting system on two occasions with four-week intervals between administrations to 276 health science students (average age = 20.1 ± 3.1 years; 68% women). We then performed a per-question weighted kappa calculation, a cluster analysis, an ANOVA test by questionnaire item and between identified clusters, and a discriminant analysis. Moderate to excellent agreement was observed (weighted κ = 0.422–0.662). The cluster analysis identified three groups, and the discriminant analysis obtained three classification functions (85.9% of cases were correctly classified): group 1 (19.9%) was characterized by higher intake of water, vegetables, fruit, fats, oilseeds/avocado, meat and legumes (healthy food intake); group 2 (47.1%) frequently consumed both fish and unhealthy fats (habits in need of improvement); group 3 (33%) frequently consumed sweetened beverages, foods not prepared at home, processed foods, refined cereals and alcohol (unhealthy food intake). In conclusion, the Mini-ECCA v.2 has moderate to excellent agreement, and it is able to identify dietary patterns in university students.
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Affiliation(s)
- María Fernanda Bernal-Orozco
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Department of Human Reproduction, Growth and Child Development, CUCS, UdeG, Hospital 320, Colonia El Retiro, Guadalajara, Jalisco, ZC 44100, Mexico
- Translational Nutrigenetics and Nutrigenomics Institute, CUCS, UdeG, Sierra Mojada 950, Building Q, first floor, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
| | - Patricia Belen Salmeron-Curiel
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
| | - Ruth Jackelyne Prado-Arriaga
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
| | - Jaime Fernando Orozco-Gutiérrez
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
| | - Nayeli Badillo-Camacho
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
| | - Fabiola Márquez-Sandoval
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Department of Human Reproduction, Growth and Child Development, CUCS, UdeG, Hospital 320, Colonia El Retiro, Guadalajara, Jalisco, ZC 44100, Mexico
- Translational Nutrigenetics and Nutrigenomics Institute, CUCS, UdeG, Sierra Mojada 950, Building Q, first floor, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
| | - Martha Betzaida Altamirano-Martínez
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Department of Human Reproduction, Growth and Child Development, CUCS, UdeG, Hospital 320, Colonia El Retiro, Guadalajara, Jalisco, ZC 44100, Mexico
| | - Montserrat González-Gómez
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
| | - Porfirio Gutiérrez-González
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Mathematics Department, Centro Universitario de Ciencias Exactas e Ingenierías, UdeG, Blvd. Marcelino García Barragán 1421, Guadalajara, Jalisco, ZC 44430, Mexico
| | - Barbara Vizmanos
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Department of Human Reproduction, Growth and Child Development, CUCS, UdeG, Hospital 320, Colonia El Retiro, Guadalajara, Jalisco, ZC 44100, Mexico
- Translational Nutrigenetics and Nutrigenomics Institute, CUCS, UdeG, Sierra Mojada 950, Building Q, first floor, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
| | - Gabriela Macedo-Ojeda
- Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico; (M.F.B.-O.); (P.B.S.-C.); (R.J.P.-A.); (J.F.O.-G.); (N.B.-C.); (F.M.-S.); (M.B.A.-M.); (M.G.-G.); (B.V.)
- Doctorate in Traslational Nutritional Sciences, CUCS, UdeG, Juan Díaz Covarrubias and Salvador Quevedo y Zubieta, Building “C”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Translational Nutrigenetics and Nutrigenomics Institute, CUCS, UdeG, Sierra Mojada 950, Building Q, first floor, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Department of Public Health, CUCS, UdeG, Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara, Jalisco, ZC 44340, Mexico
- Correspondence: ; Tel.: +52-331-058-5200 (ext. 33900)
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