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Pagoto S, Lueders N, Palmer L, Idiong C, Bannor R, Xu R, Ingels S. Best Practices for Designing and Testing Behavioral and Health Communication Interventions for Delivery in Private Facebook Groups: Tutorial. JMIR Form Res 2024; 8:e58627. [PMID: 39231426 PMCID: PMC11411228 DOI: 10.2196/58627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 09/06/2024] Open
Abstract
Facebook, the most popular social media platform in the United States, is used by 239 million US adults, which represents 71% of the population. Not only do most US adults use Facebook but they also spend an average of 40 minutes per day on the platform. Due to Facebook's reach and ease of use, it is increasingly being used as a modality for delivering behavioral and health communication interventions. Typically, a Facebook-delivered intervention involves creating a private group to deliver intervention content for participants to engage with asynchronously. In many interventions, a counselor is present to facilitate discussions and provide feedback and support. Studies of Facebook-delivered interventions have been conducted on a variety of topics, and they vary widely in terms of the intervention content used in the group, use of human counselors, group size, engagement, and other characteristics. In addition, results vary widely and may depend on how well the intervention was executed and the degree to which it elicited engagement among participants. Best practices for designing and delivering behavioral intervention content for asynchronous delivery in Facebook groups are lacking, as are best practices for engaging participants via this modality. In this tutorial, we propose best practices for the use of private Facebook groups for delivery and testing the efficacy of behavioral or health communication interventions, including converting traditional intervention content into Facebook posts; creating protocols for onboarding, counseling, engagement, and data management; designing and branding intervention content; and using engagement data to optimize engagement and outcomes.
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Affiliation(s)
- Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | | | - Lindsay Palmer
- University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Christie Idiong
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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Kant AK, Graubard BI. Self-Reported Weekend Temporal Eating Patterns of American Adults Differ From Weekday: National Health and Nutrition Examination Surveys: 2015-2020 Prepandemic. J Acad Nutr Diet 2024:S2212-2672(24)00718-4. [PMID: 39032606 DOI: 10.1016/j.jand.2024.07.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Weekend-weekday differences in time of ingestive events may be implicated in adverse metabolic and health outcomes. However, little is known about the nature of weekend-weekday differences in temporal eating behaviors of the US adult population. OBJECTIVE The study aimed to examine weekend-weekday differences in temporal and energy characteristics of ingestive events self-reported by American adults. DESIGN Observational; within-person comparative. PARTICIPANTS/SETTING The data were from the National Health and Nutrition Examination Surveys (NHANES) 2015-March 2020 (pre-pandemic) for ≥20-year-old adults who provided 1 weekday (M-Th) and 1 weekend (F, S, Su) 24-h dietary recall (n = 3564 men and 3823 women). MAIN OUTCOME MEASURES Prespecified primary temporal outcomes were recalled: time of ingestive events, and the duration of ingestive and fasting windows. Secondary outcomes included frequency and energy characteristics of ingestive events. STATISTICAL ANALYSIS PERFORMED Gender-specific, survey-weighted, multiple linear regression models that accounted for complex survey design with dummy covariates for weekend/weekday, mode of recall administration (in-person on day 1 and telephone on day 2), and a respondent-specific fixed intercept. RESULTS In both men and women, the weekend recalled time of first ingestive event, breakfast, and lunch were later than weekday (P ≤ .0008); however, no statistically significant differences were observed in time of dinner and the last eating episode. The mean weekend ingestive window (interval between the time of first and last eating events of the day) was shorter by 24 minutes (95% confidence interval [CI], -32, -11) in men and 18 minutes (95% CI, -20, -15) in women, and the mean overnight fasting window was correspondingly longer (P ≤ .0001). No statistically significant differences were observed between weekend and weekday frequency of ingestive events. Energy density of weekend food selections reported by women, and of beverages by men, was found to be higher than weekday (P ≤ .002). CONCLUSIONS Weekend ingestive patterns were characterized by later time of first ingestive event, breakfast, and lunch, and selection of higher-energy-density foods and beverages.
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Affiliation(s)
- Ashima K Kant
- Department of Family, Nutrition, and Exercise Sciences, Queens College of the City University of New York, Flushing, New York.
| | - Barry I Graubard
- Senior Investigator, Division of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Montarroyos ECL, Nakano EY, Bousquet-Santos K. Analysis of nutrient intake and dietary adequacy on weekdays and weekends among undergraduate students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1120-1126. [PMID: 35549621 DOI: 10.1080/07448481.2022.2068957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 02/17/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
Objective: To comparatively analyze nutrient intake and dietary adequacy on weekdays (WKDs) and weekends (WKNs) among undergraduate students. Participants: University students (N = 210), 18-30 years old. Methods: A two-day food record was used. Intake of energy, macronutrients, micronutrients and fiber were calculated, without and with an adjustment for 2000 kcal of energy and compared to the corresponding nutritional requirements. Results: Energy and macronutrients' intake was higher on WKNs (1,776.84 ± 40.68 vs. 2,025.76 ± 52.46 kcal; p < .05). There was a high predominance of hypocaloric diet on both WKDs (72%) and WKNs (57%). A low prevalence (<50%) of favorable intake level of most micronutrients and fiber was found on WKDs, WKNs, or both. There was a lower favorable intake of vitamins A, C, iron, and magnesium on WKNs, after adjusting for 2000 kcal. Conclusion: Undergraduate students showed an unfavorable nutrient intake and poor dietary quality on WKNs. Interventions that promote healthy eating are needed.
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Affiliation(s)
- Ellen C L Montarroyos
- Graduate Program of Sciences and Technologies in Health, University of Brasilia, Brasilia, Brazil
| | - Eduardo Y Nakano
- Department of Statistics, University of Brasilia, Brasilia, Brazil
| | - Kelb Bousquet-Santos
- Department of Biological and Health Sciences, University of Brasilia, Brasilia, Brazil
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Lin L, Guo J, Gelfand SB, Bhadra A, Delp EJ, Richards EA, Hennessy E, Eicher-Miller HA. Temporal Dietary Pattern Cluster Membership Varies on Weekdays and Weekends but Both Link to Health. J Nutr 2024; 154:722-733. [PMID: 38160806 PMCID: PMC10900253 DOI: 10.1016/j.tjnut.2023.12.049] [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: 10/11/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Energy and dietary quality are known to differ between weekdays and weekends. Data-driven approaches that incorporate time, amount, and duration of dietary intake have previously been used to partition participants' daily weekday dietary intake time series into clusters representing weekday temporal dietary patterns (TDPs) linked to health indicators in United States adults. Yet, neither the relationship of weekend day TDPs to health indicators nor how the TDP membership may change from weekday to weekend is known. OBJECTIVES This study was conducted to determine the association between TDPs on weekdays and weekend days and health indicators [diet quality, waist circumference (WC), body mass index (BMI), and obesity] and their overlap among participants. METHODS A weekday and weekend day 24-hour dietary recall of 9494 nonpregnant United States adults aged 20-65 years from the cross-sectional National Health and Nutrition Examination Survey 2007-2018 was used to determine the timing and amount of energy intake. Modified dynamic time warping and kernel k-means algorithm clustered participants into 4 TDPs on weekdays and weekend days. Multivariate regression models determined the associations between TDPs and health indicators, controlling for potential confounders and adjusting for the survey design and multiple comparisons. The percentages of overlap in cluster membership between TDPs on weekdays and weekend days were also determined. RESULTS United States adults with a TDP of evenly spaced, energy-balanced eating occasions, representing the TDP of more than one-third of all adults on weekdays and weekends, had significantly higher diet quality, lower BMI, WC, and odds of obesity when compared to those with other TDPs. Membership of most United States adults to TDPs varied from weekdays to weekends. CONCLUSIONS Both weekday and weekend TDPs were significantly associated with health indicators. TDP membership of most United States adults was not consistent on weekdays and weekends.
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Affiliation(s)
- Luotao Lin
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, New Mexico, United States
| | - Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | | | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States
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Béjar LM. Weekend-Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students. Nutrients 2022; 14:nu14142811. [PMID: 35889767 PMCID: PMC9317012 DOI: 10.3390/nu14142811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023] Open
Abstract
Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend−weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.
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Affiliation(s)
- Luis M Béjar
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, 41004 Seville, Spain
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Weekday and Weekend Differences in Eating Habits, Physical Activity and Screen Time Behavior among a Sample of Primary School Children: The "Seven Days for My Health" Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074215. [PMID: 35409899 PMCID: PMC8998659 DOI: 10.3390/ijerph19074215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Healthy eating and active lifestyle habits are essential for a child's development, wellbeing, and health. School setting and family environment play a crucial role in shaping these habits and this could be reflected in different behavior patterns during weekdays and weekends. METHODS We investigated primary school children's lifestyle habits through a cross-sectional analysis of 428 Italian primary school children, with a mean age of 8.99 years (±1.43). Data were collected from May to June 2017 using a weekly diary to assess children's lifestyles. RESULTS Children who eat their morning snack and lunch at school three or more times during the weekdays were 5.47 times more likely (95% CI 3.02, 10.2) to consume adequate snacks and 7.79 times more likely (95% CI 4.43, 14.5) to have adequate meals than those who did not. CONCLUSION Consumption of vegetables, lunch, and snacks are significantly more adequate during the weekdays as compared to the weekends. Physical activity levels did not differ between weekdays and weekends. Moreover, children spent more time engaged in physical activities than in front of a screen during both the weekdays and the weekends. The present results are good indicators of the importance of the school canteen in defining correct eating habits. Family-based and school-based interventions could represent valuable integrative strategies for promoting a healthy lifestyle in children.
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Intake Differences between Subsequent 24-h Dietary Recalls Create Significant Reporting Bias in Adults with Obesity. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In depth understanding of the dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro-, and micronutrient reported intakes in four non-consecutive 24-h dietary recalls from 388 adults with obesity using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367). Significant decreases were identified for reported energy and several, macro- and micronutrient intakes, between the first and subsequent 24-h recalls. Significant differences of reported intakes were identified in sensitivity analyses, suggesting that the first recall (also the only one performed on site, face-to-face) might be a point of bias. A comparison of the differences in intakes between weekend and weekday, after adjustment for false discovery rate were non-statistically significant either in male, females, or in total. To overcome this potential bias, studies should be carefully conducted, starting from the design phase, through to the analysis and interpretation phases of the study. Prior to averaging specific intakes across all sessions of reporting, a preliminary analysis must be conducted to identify if a certain time point had significant differences from all other time points and overview potential sources of bias: reporting bias, training bias, or behavioral changes could be responsible for such differences.
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Migliavada R, Ricci FZ, Denti F, Haghverdian D, Torri L. Is purchasing of vegetable dishes affected by organic or local labels? Empirical evidence from a university canteen. Appetite 2022; 173:105995. [DOI: 10.1016/j.appet.2022.105995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
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Kharmats AY, Wang C, Fuentes L, Hu L, Kline T, Welding K, Cheskin LJ. Monday-focused tailored rapid interactive mobile messaging for weight management 2 (MTRIMM2): results from a randomized controlled trial. Mhealth 2022; 8:1. [PMID: 35178432 PMCID: PMC8800204 DOI: 10.21037/mhealth-21-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/12/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Text-messaging interventions can reach many individuals across a range of socioeconomic groups, at a low cost. Few randomized controlled trials (RCTs) of text-messaging weight loss interventions have been conducted in United States. METHODS From September of 2016 to September of 2018, we conducted a two-parallel group, superiority, RCT of a 16-week text-messaging, weight loss intervention in Baltimore, Maryland, in overweight and obese adults younger than 71, who were able to receive text-messages. Our objective was to assess the effect of receiving the message content only (in printed documents distributed at baseline and week 8), versus receiving messages via short messaging service (SMS) on weight loss (primary outcome), body mass index, perceived exercise benefits and barriers, self-efficacy, and physical activity (PA). The random allocation sequence was equally balanced intervention groups by gender and age groups. Participants were randomized after the baseline assessment. Then, participants and most study staff were unblinded. Follow-up assessments were conducted at 8-, 16-, and 42-week post randomization. We performed intention-to-treat analysis using mixed linear regression models. RESULTS Of the 155 adults randomized (printed messages =77, SMS =78), 87.1% were women, 53.5% were African Americans, and 93.5% non-Hispanic. Participants who completed at least one follow-up assessment were included in regression analyses (n=145, printed messages =74, SMS =71). Compared to baseline, at the 42-week assessment, the average percent weight loss was 1.23 for the SMS group (P=0.006) and 0.86 for the printed messages group (P=0.047). Both groups experienced small reductions in weight (printed messages: -0.96 kg, P=0.022; SMS: -1.19 kg, P=0.006), BMI (printed messages: -0.32, P=0.035; SMS: -0.52, P=0.002), and percent energy from fat consumption (printed messages: -1.43, P=0.021; SMS: -2.14, P≤0.001). No statistically significant between groups differences were detected for any of the study outcomes. SMS response rates were not statistically significantly associated with study outcomes. No adverse events were reported. CONCLUSIONS A semi-tailored SMS weight loss intervention among overweight and obese adults was not statistically superior in efficacy to paper-based messaging. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04506996.
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Affiliation(s)
- Anna Y. Kharmats
- Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Baltimore, MD, USA
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Chan Wang
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Laura Fuentes
- Bloomberg School of Public Health, Department of Health, Behavior & Society, Baltimore, MD, USA
| | - Lu Hu
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Tina Kline
- Bloomberg School of Public Health, Department of Health, Behavior & Society, Baltimore, MD, USA
| | - Kevin Welding
- Bloomberg School of Public Health, Department of Health, Behavior & Society, Baltimore, MD, USA
| | - Lawrence J. Cheskin
- George Mason University, College of Health and Human Services, Department of Nutrition and Food Studies, Fairfax, VA, USA
- Johns Hopkins School of Medicine, Department of Medicine, Baltimore, MD, USA
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Dutch DC, Golley RK, Johnson BJ. Diet Quality of Australian Children and Adolescents on Weekdays versus Weekend Days: A Secondary Analysis of the National Nutrition and Physical Activity Survey 2011-2012. Nutrients 2021; 13:nu13114128. [PMID: 34836383 PMCID: PMC8621206 DOI: 10.3390/nu13114128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022] Open
Abstract
Daily routines may influence children and adolescents’ eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011–2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2–17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.
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Goddard L, Begovich L, Tokic I, Clegg ME, Thondre PS. Gluten-free diet intervention reduces thiamine intake in two weeks, increases glycaemic response and decreases body weight in four weeks, with no long term nutritional deficiencies. Int J Food Sci Nutr 2021; 73:367-377. [PMID: 34583628 DOI: 10.1080/09637486.2021.1980865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This research investigated the effects of gluten free diet (GFD) on nutritional intake, glycaemic and insulin response. In a cross-sectional study, participants who consumed gluten-containing diet (GCD; n = 11) and GFD (n = 11) completed a food diary, blood glucose and insulin measurements. In a pre-post intervention study (n = 11), glycaemic and insulin responses were tested before and after four weeks of a GFD. Food intake was recorded before and after two weeks. No significant differences in nutrient intake, glycaemic or insulin responses were found in the cross-sectional study. In the intervention study, there was a significant reduction in body weight (p = .007) and body mass index (BMI) (p = .004) after four weeks and lower thiamine intake (p = .021) after two weeks of GFD. Glycaemic response was significantly higher (p < .05) following GFD with no differences in insulin response. These differences were not evident if GFD was followed for a longer period, possibly due to improved food choices.
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Affiliation(s)
- Lucy Goddard
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Lina Begovich
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Iva Tokic
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Miriam E Clegg
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, UK
| | - Pariyarath Sangeetha Thondre
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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[A joint study of the multidimensional factors associated with the overall quality of adult diets in Canada]. Rev Epidemiol Sante Publique 2020; 68:375-383. [PMID: 32981771 DOI: 10.1016/j.respe.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/07/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With 26% of Canadians suffering from obesity, significant steps are needed to reduce the social and economic costs entailed by their condition. Given its major contribution to this phenomenon, the quality of diet has been at the heart of numerous previous studies. The objective of the study is to analyze, based on recent data, the association between the quality of the diet of Canadian adults (18 years old and over), and their individual characteristics as well as those of their living environment, including several new elements (prices of fruits and vegetables, food security status). METHODS Using data from the 2015 CCHS-Nutrition Survey and information from the 2007 Canadian Food Guide, a diet quality score (also called healthy eating index) was first calculated and then associated with different factors (identified in a literature review) through multiple linear regressions. RESULTS In addition to confirming its association with age, gender, overall well-being and other socio-economic factors, this study reveals that quality of adult diets is negatively correlated with the evolution of people's food insecurity status and the increase of vegetable prices in the Canadian provinces since 2002. The positive link between diabetes and the quality of diet could reflect healthier eating behaviors due to the constraints generated by this disease. While city dwellers generally have access to a more diversified food supply, they nevertheless do not have a better diet than the rural population. Finally, non-North American immigrants appear to have a better diet than non-autochthonous Canadians. CONCLUSION Paying more attention to food insecurity and to the affordability of vegetables are avenues to explore in view of improving the quality of nourishment in Canada. In any event, longitudinal studies shall be required to confirm the role and to measure the actual influence of these variables on the quality of individual adult diets.
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Plate Waste Generated by Spanish Households and Out-of-Home Consumption: Results from the ANIBES Study. Nutrients 2020; 12:nu12061641. [PMID: 32498253 PMCID: PMC7352750 DOI: 10.3390/nu12061641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/23/2020] [Accepted: 05/28/2020] [Indexed: 12/18/2022] Open
Abstract
Food waste is a major environmental issue that must be tackled in order to achieve a sustainable food supply chain. Currently, in Spain there are no studies that examine the amounts and sources of plate waste (PW) produced by both household and out-of-home consumption. The present study aims to provide this information from a representative sample from the Spanish population. A total of 2009 individuals aged 9–75 years, from the ANIBES study (“anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain”), completed a three-day dietary record, collected by a tablet device. Photographs of all foods and beverages consumed both at home and outside were taken before and after meals. Median PW across the total population was 7.3 (0.0–37.3) g/day and was significantly higher in females than males (p < 0.05) and in children vs. adolescents, adults, and elderly (p < 0.01). Regarding meals, PW across all age groups was higher at lunch (40%), dinner (27%), and breakfast (11%). The highest PW was observed for bread (25%) main courses (16%), first and second courses (15%), vegetables and fruits (12%), ready-to-eat meals (10%), cereals and grains (10%), oils and fats (10%), pulses (10%), meat products (8%), sauces and condiments (8%), and starters (8%). Our results reinforce the need for new strategies to focus on reducing plate leftovers, which are crucial from a nutritional, economic, and environmental point of view. Additionally, this evidence is important for relying on more accurate information on actual intakes when using dietary surveys.
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Abstract
OBJECTIVE To compare dietary intake and physical activity (PA) between days of the week in a large sample of the Danish population; furthermore, to investigate the influence of gender and age as determinants for weekly variation. DESIGN Analysis was based on cross-sectional data from the Danish National Survey of Diet and Physical Activity 2011-2013. Dietary intake and PA were assessed by 7 d of pre-coded food diaries and pedometer-determined step counts. Dietary intake and PA on weekdays (Monday-Thursday), Friday, and weekend days (Saturday and Sunday) were compared using linear mixed models. SETTING Survey with national representation, conducted in Denmark between 2011 and 2013. PARTICIPANTS A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively. RESULTS Energy intake during Friday and weekend days was 7-20 % higher compared with weekdays, while step counts were 10 and 17 % lower on Saturday and Sunday, respectively (all P < 0·001). Energy density of liquids and solids, consumption of added sugar, alcohol, discretionary foods, beer, wine and sugar-sweetened beverages were substantially higher, and consumption of dietary fibre, vegetables, fruit and wholegrain products were lower, during Friday and weekend days compared with weekdays (all P < 0·001). The observed patterns were present across gender and age, although weekly variation was most pronounced among children and relatively modest among the elderly. CONCLUSIONS Weekend health behaviours of Danes display less favourable eating and PA behaviour compared with weekdays, making the weekend an important target for public health interventions aiming to improve dietary intake and PA behaviour.
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Irwin C, Desbrow B, Khalesi S, McCartney D. Challenges following a personalised diet adhering to dietary guidelines in a sample of Australian university students. Nutr Health 2019; 25:185-194. [PMID: 30971181 DOI: 10.1177/0260106019841247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Food-based dietary guidelines are designed to support populations to adopt a healthy diet. University students studying nutrition related courses are typically en-route to professional roles that involve advocating a healthy diet. AIM The present study compared the dietary intake of university students enrolled in a foundation nutrition course against the Australian Dietary Guidelines (ADGs) and Nutrient Reference Values (NRVs), and explored students' experiences of following a 3-day self-determined diet plan adhering to the ADGs/NRVs. METHODS Students (n = 115) initially collected, and subsequently analysed a 3-day prospective diet record to determine food group/nutrient intake. Individuals then modified their diet to comply with recommendations (ADGs/NRVs) and attempted to implement the diet plan. Challenges associated with meeting the ADGs/NRVs were described in an online survey form. RESULTS Baseline food group and nutrient intakes deviated from the guidelines, with 'lean meats & alternatives' the only group consumed in recommended quantities. Students demonstrated the capacity to plan a modified personal diet adhering to the ADGs food group recommendations. However, when following this, several key challenges to dietary adherence were identified. Challenges were categorised as personal/behavioural factors (e.g. the quantity/type of food) and societal factors (e.g. time, cost, social factors). CONCLUSION Overall, this study highlights challenges influencing adherence to dietary guidelines in a sample of undergraduate university students. Understanding these factors may help tailor advice to facilitate improved dietary patterns in this population group.
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Affiliation(s)
- Christopher Irwin
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Ben Desbrow
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Saman Khalesi
- Physical Activity Research Group, Appleton Institute & School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, Australia
| | - Danielle McCartney
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
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Low-Income Population Sugar (Sucrose) Intake: A Cross-Sectional Study among Adults Assisted by a Brazilian Food Assistance Program. Nutrients 2019; 11:nu11040798. [PMID: 30965573 PMCID: PMC6520722 DOI: 10.3390/nu11040798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 12/16/2022] Open
Abstract
Non-communicable diseases are increasing worldwide, and it has been known that sugar intake is associated with health implications. Studies show that sugar consumption is high among the low-income population. In Brazil, there is a Food Assistance Program to offer inexpensive and healthy meals to the low-income population, aiming to improve their health. However, no study has evaluated either the amount of sugar consumption by the Brazilian low-income population or its distribution among the consumed products. This work aimed to analyze the sugar (sucrose) consumption by the Brazilian low-income population. We carried out a cross-sectional and descriptive study to evaluate the typical customers of a popular restaurant (PR) in Brazil (a Brazilian Food Assistance Program for low-income people). In the final sample, 1232 adult PR customers were surveyed. The exclusion criteria were pregnant women, diabetics, or people following any special diet with sucrose restrictions. Individuals were selected at lunchtime while they were in line waiting to collect their meal. Invitations to participate occurred to the first person in line, then the 15th person, and this pattern was used until the sample was completed. Three-day 24 h recall was used to evaluate sugar consumption. Sociodemographic and anthropometric data were collected to allow profiling of the customers. A statistical analysis of the data with descriptive nature (frequency, mean, median, percentage, and standard deviation) was performed to characterize the sample. For all the analyses, statistical normality tests were performed (Kolmogorov⁻Smirnov) to verify the statistical test assumptions. The mean total energy value (TEV) over the evaluated three-day period was 1980.23 ± 726.75 kcal. A statistically significant difference was found between income groups (p < 0.01). The North and Northeast region presented the lowest mean income in Brazil, statistically different from the South (p < 0.01) and the Southeast (p < 0.01). The North region presented the lowest sugar intake from industrialized products-different from the Northeast (p = 0.007), the Southeast (p = 0.010), and the South (p = 0.043). Also, the North presented the lowest consumption for food prepared at home among other regions (p < 0.001). Total sugar (sucrose) intake did not differ according to body mass index (p = 0.321). There was no significant difference in sugar (sucrose) consumption among the three days (p = 0.078). The addition of sugar (sucrose) contributed to 36.7% of all sugar (sucrose), and sweetened beverages with 22.53%. Food prepared at home contributed 20.06% and industrialized products 22.53% of the sugar (sucrose) intake. Therefore, free sugar (sucrose) consumption is still the largest contributor to the total consumption of sugar (sucrose), followed by sweetened drinks, especially during the weekend. The average percentage of sugar (sucrose) intake is above the World Health Organization recommendation to consume less than 5% of the total energy that comes from sugars. Since this population presents a high percentage of overweight and obese, the sugar (sucrose) consumption could increase health implications, increasing the costs for public health.
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Schwedhelm C, Iqbal K, Schwingshackl L, Agogo GO, Boeing H, Knüppel S. Meal analysis for understanding eating behavior: meal- and participant-specific predictors for the variance in energy and macronutrient intake. Nutr J 2019; 18:15. [PMID: 30845933 PMCID: PMC6407220 DOI: 10.1186/s12937-019-0440-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/26/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Meals differ in their nutritional content. This variation has not been fully addressed despite its potential contribution in understanding eating behavior. The aim of this study was to investigate the between-meal and between-individual variance in energy and macronutrient intake as a measure of variation in intake and the meal type-specific relative importance of predictors of these intake variations. METHODS Energy and macronutrient intake were derived from three 24 h dietary recalls in an EPIC-Potsdam sub-cohort of 814 German adults. Intra-class correlation was calculated for participants and meal type. Predictors of intake were assessed using meal type-specific multilevel regression models in a structural equation modeling framework at intake and participant levels using the Pratt Index. The importance of the predictor energy misreporting was assessed in sensitivity analyses on 682 participants. 95% confidence intervals were calculated based on 1000 bootstrap samples. RESULTS Differences between meal types explain a large proportion of the variation in intake (intra-class correlation: 39% for energy, 25% for carbohydrates, 47% for protein, and 33% for fat). Between-participant variation in intake was much lower, with a maximum of 3% for carbohydrate and fat. Place of meal was the most important intake-level predictor of energy and macronutrient intake (Pratt Index of up to 65%). Week/weekend day was important in the breakfast meal, and prior interval (hours passed since last meal) was important for the afternoon snack and dinner. On the participant level, sex was the most important predictor, with Pratt Index of up to 95 and 59% in the main and in the sensitivity analysis, respectively. Energy misreporting was especially important at the afternoon snack, accounting for up to 69% of the explained variance. CONCLUSIONS The meal type explains the highest variation in energy and macronutrient intakes. We identified key predictors of variation in the intake and in the participant levels. These findings suggest that successful dietary modification efforts should focus on improving specific meals.
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Affiliation(s)
- Carolina Schwedhelm
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research, Berlin-Potsdam, Germany
| | - Khalid Iqbal
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research, Berlin-Potsdam, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany
| | - George O. Agogo
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT USA
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
- NutriAct – Competence Cluster Nutrition Research, Berlin-Potsdam, Germany
| | - Sven Knüppel
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
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18
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Noorwali EA, Hardie LJ, Cade JE. Recommended sleep duration is associated with higher consumption of fruits and vegetables; cross-sectional and prospective analyses from the UK Women’s Cohort Study. SLEEP SCIENCE AND PRACTICE 2018. [DOI: 10.1186/s41606-018-0032-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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19
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Do Aspects of Protein Intake Vary Across the Week in Healthy Community-Dwelling Older Adults?-An enable Study. Nutrients 2018; 10:nu10091217. [PMID: 30177590 PMCID: PMC6164059 DOI: 10.3390/nu10091217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 12/15/2022] Open
Abstract
Various aspects of protein intake are thought to be crucial for the prevention of sarcopenia in older adults. Information about the day-to-day variation in these aspects is lacking. Our objective was to examine whether daily protein intake, protein distribution across meals, number of meals providing adequate protein, and protein sources vary across the week in healthy community-dwelling older adults. In 140 persons (51% women) that were aged 75–85 years, protein intake was assessed by seven-day food records. On average across the week, protein intake (median [IQR]) was 0.93 [0.79–1.10] g/kg body weight (BW) and the coefficient of variation across the three main meals was 0.50 [0.40–0.61]. The number of meals per day providing ≥0.4 g protein/kg BW was 0.57 [0.43–1.00] and 60.0 [52.4–65.2]% of protein intake was animal-based. According to Friedman’s test, differences throughout the week were observed in women for daily protein intake (p = 0.038; Sunday: 0.99 [0.78–1.31] vs. Tuesday: 0.79 [0.68–1.12] g/kg BW) and number of meals with adequate protein (p = 0.019; ≥1 daily meal: Sunday: 69.4% vs. Tuesday: 41.7%). On Sunday, protein intake was most in agreement with suggestions to prevent sarcopenia. In men, protein intake did not differ throughout the week.
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Hill C, Weir BW, Fuentes LW, Garcia-Alvarez A, Anouti DP, Cheskin LJ. Relationship Between Weekly Patterns of Caloric Intake and Reported Weight Loss Outcomes: Retrospective Cohort Study. JMIR Mhealth Uhealth 2018; 6:e83. [PMID: 29661750 PMCID: PMC5928328 DOI: 10.2196/mhealth.8320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/15/2018] [Accepted: 01/31/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although millions of overweight and obese adults use mobile phone apps for weight loss, little is known about the predictors of success. OBJECTIVE The objective of this study was to understand the relationship between weight loss outcomes and weekly patterns of caloric intake among overweight and obese adults using a mobile phone app for weight loss. METHODS We examined the relationship between weekly patterns of caloric intake and weight loss outcomes among adults who began using a weight loss app in January 2016 and continued consistent use for at least 5 months (N=7007). Unadjusted and adjusted linear regression analyses were used to evaluate the predictors of percentage of bodyweight lost for women and men separately, including age, body mass index category, weight loss plan, and difference in daily calories consumed on weekend days (Saturday and Sunday) versus Monday. RESULTS In adjusted linear regression, percentage of bodyweight lost was significantly associated with age (for women), body mass index (for men), weight loss plan, and differences in daily caloric intake on Mondays versus weekend days. Compared with women consuming at least 500 calories more on weekend days than on Mondays, those who consumed 50 to 250 calories more on weekend days or those with balanced consumption (±50 calories) lost 1.64% more and 1.82% more bodyweight, respectively. Women consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 1.35% more and 3.58% more bodyweight, respectively. Compared with men consuming at least 500 calories more on weekend days than on Mondays, those consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 2.27% and 3.42% less bodyweight, respectively. CONCLUSIONS Consistent caloric intake on weekend days and Mondays or consuming slightly fewer calories per day on Mondays versus weekend days was associated with more successful weight loss. TRIAL REGISTRATION ClinicalTrials.gov NCT03136692; https://clinicaltrials.gov/ct2/show/NCT03136692 (Archived by WebCite at http://www.webcitation.org/6y9JvHya4).
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Affiliation(s)
- Christine Hill
- Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Brian W Weir
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Laura W Fuentes
- Lerner Center for Public Health Promotion, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Alicia Garcia-Alvarez
- Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Danya P Anouti
- Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Lawrence J Cheskin
- Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Solbak NM, Xu JY, Vena JE, Csizmadi I, Whelan HK, Robson PJ. Diet quality is associated with reduced incidence of cancer and self-reported chronic disease: Observations from Alberta's Tomorrow Project. Prev Med 2017; 101:178-187. [PMID: 28601618 DOI: 10.1016/j.ypmed.2017.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 05/24/2017] [Accepted: 06/05/2017] [Indexed: 12/27/2022]
Abstract
The objective of this study was to assess diet quality using the Healthy Eating Index-2005 Canada (HEI-2005-Canada) and its association with risk of cancer and chronic disease in a sample of Alberta's Tomorrow Project (ATP) participants. Food frequency questionnaires completed by 25,169 participants (38% men; mean age 50.3 (9.2)) enrolled between 2000 and 2008 were used to calculate HEI-2005-Canada scores. Data from a subset of participants (n=10,735) who reported no chronic disease at enrollment were used to investigate the association between HEI-2005-Canada score and development of self-reported chronic disease at follow-up (2008). Participants were divided into HEI-2005-Canada score quartiles. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for cancer and chronic disease incidence. In this cohort, mean HEI-2005-Canada scores for men and women were 50.9 and 55.5 (maximum range 0-100), respectively. In men, higher HEI-2005-Canada score (Q4 vs. Q1) was associated with lower cancer risk (HR (95% CI) 0.63 (0.49-0.83)) over the course of follow-up (mean (SD)=10.4 (2.3) years); the same was not observed in women. In contrast, higher overall HEI-2005-Canada score (Q4 vs. Q1) was associated with lower risk of self-reported chronic disease (0.85 (0.75-0.97)) in both men and women over follow-up (4.2 (2.3) years). In conclusion, in this cohort better diet quality was associated with a lower risk of cancer in men and lower risk of chronic disease in both sexes. Future studies with longer follow-up and repeated measures of diet may be helpful to elucidate sex-specific associations between dietary quality and disease outcomes.
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Affiliation(s)
- Nathan M Solbak
- Cancer Measurement, Outcomes, Research and Evaluation, CancerControl Alberta, Alberta Health Services, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada.
| | - Jian-Yi Xu
- Cancer Measurement, Outcomes, Research and Evaluation, CancerControl Alberta, Alberta Health Services, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada
| | - Jennifer E Vena
- Cancer Measurement, Outcomes, Research and Evaluation, CancerControl Alberta, Alberta Health Services, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada
| | - Ilona Csizmadi
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Health Sciences Centre, Foothills Campus, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada
| | - Heather K Whelan
- Cancer Measurement, Outcomes, Research and Evaluation, CancerControl Alberta, Alberta Health Services, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada
| | - Paula J Robson
- Cancer Measurement, Outcomes, Research and Evaluation, CancerControl Alberta, Alberta Health Services, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada; Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, 410 Agriculture/Forestry Centre, Edmonton, AB T6G 2P5, Canada
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Chapple LS, Deane AM, Lange K, Kranz AJ, Williams LT, Chapman MJ. Weekend days are not required to accurately measure oral intake in hospitalised patients. J Hum Nutr Diet 2016; 30:378-384. [PMID: 27709690 DOI: 10.1111/jhn.12432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Nutrition studies in patients admitted to hospital frequently disregard oral intake because measurement is time-intensive and logistically challenging. In free-living populations, weighed food records (WFR) are the gold-standard and are conducted on weekend and weekdays to capture variations in intake, although this may not translate during hospitalisation. The present study aimed to determine whether oral intake differs between weekends and weekdays in hospitalised patients. METHODS For adult patients initially admitted to the intensive therapy unit with a moderate-severe head injury over a 12-month period, WFR were conducted each week on Tuesday, Thursday and Saturday throughout hospitalisation. Meal components were weighed before and after consumption, and energy and protein intakes were calculated using specialised software. Data are reported as the mean (SD). Differences were assessed using paired t-tests and agreement using Bland-Altman plots. RESULTS Thirty-two patients had WFR collected on 220 days, 68% (n = 149) on weekdays and 32% (n = 71) on weekends. Overall, daily intakes were 5.72 (3.67) MJ [1367 (877) kcal] and 62 (40) g protein. There were no differences in intake across all days (P = 0.937 energy, P = 0.797 protein), nor between weekdays and weekends, in weeks 1-3 of oral intake (all P > 0.1). Limits of agreement between mean intakes across days were wide for energy [range -11.20 to 9.55 MJ (-2680 to 2283 kcal)] and protein (range -125 to 110 g). CONCLUSIONS Grouped energy and protein intakes from WFR in hospitalised patients are similar on weekdays and weekends, although large intra-patient variations occur. Future quantification of oral intake during hospitalisation should include as many days as feasible, although not necessarily weekend days, to reflect true intake.
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Affiliation(s)
- L S Chapple
- Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia.,National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, SA, Australia
| | - A M Deane
- Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia.,National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, SA, Australia.,Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - K Lange
- National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, SA, Australia
| | - A J Kranz
- Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia
| | - L T Williams
- Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
| | - M J Chapman
- Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia.,National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, SA, Australia.,Intensive Care Unit, Level 4, Emergency Services Building, Royal Adelaide Hospital, Adelaide, SA, Australia
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Weekend-weekday differences in diet among U.S. adults, 2003–2012. Ann Epidemiol 2016; 26:57-65. [DOI: 10.1016/j.annepidem.2015.10.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 11/21/2022]
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