1
|
van der Pligt PF, Ebrahimi S, Kuswara K, Abbott GR, McNaughton SA, Islam SMS, Ellery SJ. Associations of adherence to the DASH diet and Mediterranean diet with maternal c-reactive protein levels during pregnancy. Nutr Metab Cardiovasc Dis 2024; 34:672-680. [PMID: 38172005 DOI: 10.1016/j.numecd.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND AIMS Elevated C-reactive protein (CRP) during pregnancy, a marker of inflammation, is associated with adverse outcomes. Better understanding the relationship between CRP and modifiable factors, including diet, is essential to assist early pregnancy lifestyle interventions. The aim of this study was to assess the relationship between adherence to the Dietary Approaches to Stop Hypertension diet (DASH-diet) and the Mediterranean diet (MED-diet) during pregnancy with maternal plasma CRP in early and late pregnancy. METHODS AND RESULTS Secondary analysis of the Creatine and Pregnancy Outcomes (CPO) study was undertaken. Women (n = 215) attending antenatal clinics through Monash Health, Melbourne were recruited at 10-20 weeks gestation. Medical history and blood samples were collected at 5 antenatal visits. Adapted DASH-diet and MED-diet scores were calculated from Food Frequency Questionnaires completed at early ([mean ± SD]) (15 ± 3 weeks) and late (36 ± 1 week) pregnancy. CRP was measured in maternal plasma samples collected at the same time points. Adjusted linear regression models assessed associations of early-pregnancy DASH and MED-diet scores with early and late pregnancy plasma CRP. There were no statistically significant changes in DASH-diet score from early (23.5 ± 4.8) to late (23.5 ± 5.2) pregnancy (p = 0.97) or MED-diet score from early (3.99 ± 1.6) to late pregnancy (4.08 ± 1.8) (p = 0.41). At early-pregnancy, there was an inverse relationship between DASH-diet scores and MED-diet scores with plasma CRP; (β = -0.04 [95%CI = -0.07, -0.00], p = 0.044), (β = -0.12 [95%CI = -0.21, -0.02], p = 0.023). CONCLUSION Adherence to the DASH-diet and MED-diet during early pregnancy may be beneficial in reducing inflammation. Assessment of maternal dietary patterns may assist development of preventive strategies, including dietary modification, to optimise maternal cardiometabolic health in pregnancy.
Collapse
Affiliation(s)
- Paige F van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3220, Australia; Department of Nutrition, Western Health, Footscray, Australia.
| | - Sara Ebrahimi
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria 3220, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Konsita Kuswara
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria 3220, Australia
| | - Gavin R Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3220, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3220, Australia
| | - Stacey J Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
2
|
Probst Y, Guan V, Neale E. Avocado intake and cardiometabolic risk factors in a representative survey of Australians: a secondary analysis of the 2011-2012 national nutrition and physical activity survey. Nutr J 2024; 23:12. [PMID: 38273346 PMCID: PMC10809541 DOI: 10.1186/s12937-024-00915-7] [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: 12/08/2022] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre and phytochemicals. Higher dietary quality is reported in studies of consumers with higher avocado intakes. The present study aimed to examine avocado consumption and cardiometabolic risk measures in a representative sample of Australian adults. METHODS A cross-sectional analysis was performed using Australian Health Survey 2011-2013 (n = 2,736 observations). Day 1 24-hour recall data was used to examine reported avocado intake (whole avocados and avocado-containing products excluding avocado oil) and cardiometabolic risk measures (LDL, HDL, and total cholesterol, triglycerides, apolipoprotein B, HbA1c, plasma glucose, systolic and diastolic blood pressure). T-tests and chi square analyses were conducted between low (5.21 [95% CI: 4.63, 5.79] grams/day) and high (44.11 [95% CI: 35.89, 52.33] grams/day) consumers of avocado. RESULTS 14.7% of Australians were 'avocado consumers' (n = 403 observations). Mean avocado intake was 24.63 (95% CI: 20.11, 29.15) grams per day, with a median intake of 10.40 (IQR: 4.49-26.00) grams per day for those considered 'avocado consumers'. Consumers of avocados had a lower BMI and waist circumference (each, p ≤ 0.001), lower plasma glucose level (p = 0.03), and higher HDL cholesterol (p ≤ 0.001) when compared with non-consumers. A trend towards lower plasma glucose, HbA1c (each, p = 0.04) and higher dietary fibre intake (p = 0.05) was found between high and low consumers of avocado. CONCLUSIONS Our study suggests favourable outcomes for avocado intake and cardiometabolic characteristics of consumers. Future studies should explore glucose homeostasis using a clinical trial design to understand potential relationships between avocado intake and cardiometabolic risk factors.
Collapse
Affiliation(s)
- Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
| | - Vivienne Guan
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Elizabeth Neale
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| |
Collapse
|
3
|
van der Pligt PF, Kuswara K, McNaughton SA, Abbott G, Islam SMS, Huynh K, Meikle PJ, Mousa A, Ellery SJ. Maternal diet quality and associations with plasma lipid profiles and pregnancy-related cardiometabolic health. Eur J Nutr 2023; 62:3369-3381. [PMID: 37646831 PMCID: PMC10611854 DOI: 10.1007/s00394-023-03244-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To assess the relationship of early pregnancy maternal diet quality (DQ) with maternal plasma lipids and indicators of cardiometabolic health, including blood pressure (BP), gestational diabetes mellitus (GDM) and gestational weight gain (GWG). METHODS Women (n = 215) aged 18-40 years with singleton pregnancies were recruited at 10-20 weeks gestation. Diet quality was assessed by the Dietary Guideline Index, calculated at early ([mean ± SD]) (15 ± 3 weeks) and late (35 ± 2 weeks) pregnancy. Lipidomic analysis was performed, and 698 species across 37 lipid classes were measured from plasma blood samples collected at early (15 ± 3 weeks) and mid (27 ± 3 weeks)-pregnancy. Clinical measures (BP, GDM diagnosis, weight) and blood samples were collected across pregnancy. Multiple linear and logistic regression models assessed associations of early pregnancy DQ with plasma lipids at early and mid-pregnancy, BP at three antenatal visits, GDM diagnosis and total GWG. RESULTS Maternal DQ scores ([mean ± SD]) decreased significantly from early (70.7 ± 11.4) to late pregnancy (66.5 ± 12.6) (p < 0.0005). At a false discovery rate of 0.2, early pregnancy DQ was significantly associated with 13 plasma lipids at mid-pregnancy, including negative associations with six triglycerides (TGs); TG(54:0)[NL-18:0] (neutral loss), TG(50:1)[NL-14:0], TG(48:0)[NL-18:0], TG(52:1)[NL-18:0], TG(54:1)[NL-18:1], TG(50:0)[NL-18:0]. No statistically significant associations were found between early pregnancy DQ and BP, GDM or GWG. CONCLUSION Maternal diet did not adhere to Australian Dietary Guidelines. Diet quality was inversely associated with multiple plasma TGs. This study provides novel insights into the relationship between DQ, lipid biomarkers and cardiometabolic health during pregnancy.
Collapse
Affiliation(s)
- Paige F van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia.
- Department of Nutrition and Dietetics, Western Health, Footscray, Australia.
| | - Konsita Kuswara
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168, Australia
| | - Stacey J Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| |
Collapse
|
4
|
Mohamadi A, Shiraseb F, Mirzababaei A, AkbarySedigh A, Ghorbani M, Clark CCT, Aali Y, Mirzaei K. The association between adherence to diet quality index and cardiometabolic risk factors in overweight and obese women: a cross-sectional study. Front Public Health 2023; 11:1169398. [PMID: 37521997 PMCID: PMC10374417 DOI: 10.3389/fpubh.2023.1169398] [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: 02/19/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Background Obesity and overweight status increase the risk of cardiovascular disease. Diet quality can also predict the risk of cardiovascular diseases in obese and overweight patients. Therefore, in this study, we sought to examine the relationship between diet quality index (DQI) and cardiometabolic risk factors in obese and overweight women. Method A cross-sectional study was conducted on 197 Iranian women with a Body Mass Index (BMI) > 25, 18-48 years, and recruited from 20 Tehran Health Centers. Nutrition intake and DQI were assessed using a 147-item semi-quantitative food frequency questionnaire (FFQ). Additionally, anthropometric measurements, body composition, biochemical evaluations, and cardiometabolic risk factors were evaluated. Results There was an association between DQI and waist-to-hip ratio (WHR), atherogenic index of plasma (AIP), and CHOLINDEX in obese women, after adjusting for potential confounders. Whereas, there were no significant associations of the tertiles of DQI compared with the first tertile in other cardiometabolic risk factors, before and after adjustment. Conclusion This study provides evidence that dietary intake and DQI are associated with cardiometabolic risk factors and that dietary modification may be a predictor for reducing WHR, AIP, and CHOLINDEX. However, more research is needed to develop a DQI that reflects changes in cardiometabolic risk factors by considering women's eating habits and patterns.
Collapse
Affiliation(s)
- Azam Mohamadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Assa AkbarySedigh
- Department of Clinical Nutrition, School of Nutritional Science Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Ghorbani
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
5
|
Alston L, Nichols M, Allender S, Versace V, Brown LJ, Schumacher T, Howard G, Shikany JM, Bolton KA, Livingstone K, Zorbas C, Judd SE. Dietary patterns in rural and metropolitan Australia: a cross-sectional study exploring dietary patterns, inflammation and association with cardiovascular disease risk factors. BMJ Open 2023; 13:e069475. [PMID: 37270193 DOI: 10.1136/bmjopen-2022-069475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES This study sought first to empirically define dietary patterns and to apply the novel Dietary Inflammation Score (DIS) in data from rural and metropolitan populations in Australia, and second to investigate associations with cardiovascular disease (CVD) risk factors. DESIGN Cross-sectional study. SETTING Rural and metropolitan Australia. PARTICIPANTS Adults over the age of 18 years living in rural or metropolitan Australia who participated in the Australian Health survey. PRIMARY OUTCOMES A posteriori dietary patterns for participants separated into rural and metropolitan populations using principal component analysis. SECONDARY OUTCOMES association of each dietary pattern and DIS with CVD risk factors was explored using logistic regression. RESULTS The sample included 713 rural and 1185 metropolitan participants. The rural sample was significantly older (mean age 52.7 compared with 48.6 years) and had a higher prevalence of CVD risk factors. Two primary dietary patterns were derived from each population (four in total), and dietary patterns were different between the rural and metropolitan areas. None of the identified patterns were associated with CVD risk factors in metropolitan or rural areas, aside diet pattern 2 being strongly associated with from self-reported ischaemic heart disease (OR 13.90 95% CI 2.29 to 84.3) in rural areas. There were no significant differences between the DIS and CVD risk factors across the two populations, except for a higher DIS being associated with overweight/obesity in rural areas. CONCLUSION Exploration of dietary patterns between rural and metropolitan Australia shows differences between the two populations, possibly reflective of distinct cultures, socioeconomic factors, geography, food access and/or food environments in the different areas. Our study provides evidence that action targeting healthier dietary intakes needs to be tailored to rurality in the Australian context.
Collapse
Affiliation(s)
- Laura Alston
- Deakin Rural Health, Deakin University, Warnambool, Victoria, Australia
- Research Unit, Colac Area Health, Colac, Victoria, Australia
| | - Melanie Nichols
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, Deakin University, Warnambool, Victoria, Australia
| | - Leanne J Brown
- Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy Schumacher
- Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - George Howard
- Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, UK
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
| | - Kristy A Bolton
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Katherine Livingstone
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Christina Zorbas
- Global Centre for Preventative Health and Nutriton, Deakin University, Geelong, Victoria, Australia
| | - Suzanne E Judd
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, UK
| |
Collapse
|
6
|
Brayner B, Keske MA, Kaur G, Islam SMS, Perez-Cornago A, Piernas C, Livingstone KM. Longitudinal Associations Between Fat-Derived Dietary Patterns and Early Markers of Cardiovascular Disease Risk in the UK Biobank Study. J Am Heart Assoc 2022; 11:e024069. [PMID: 35621194 PMCID: PMC9238710 DOI: 10.1161/jaha.121.024069] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although the impact of dietary fats on cardiovascular disease (CVD) risk is widely researched, longitudinal associations between dietary patterns (DPs) based on fat type and early markers of CVD risk remain unclear. Methods and Results UK Biobank participants (46.9% men, mean age 55 years) with data on early markers of CVD risk (n=12 706) were followed longitudinally (2014-2020; mean 8.4 years). Two DPs (DP1, DP2) were derived using reduced rank regression (response variables: monounsaturated fat, polyunsaturated fat, and saturated fat based on two 24-hour dietary assessments. Multivariable logistic and linear regression were used to investigate associations between DPs and odds of elevated CVD risk (using the nonlaboratory Framingham Risk Score) and changes in early CVD markers, respectively. DP1 (characterized by higher nuts and seeds and lower fruit and legumes intake) was positively correlated with saturated fat, monounsaturated fat, and polyunsaturated fat; DP2 (characterized by higher butter and high-fat cheese, lower nuts and seeds intake) was positively correlated with saturated fat and negatively with polyunsaturated fat and monounsaturated fat. DP2 was associated with slightly higher odds of elevated CVD risk (odds ratio, 1.04 [95% CI, 1.00-1.07]). DP1 was associated with higher diastolic blood pressure (β, 0.20 [95% CI, 0.01-0.37]) and lower cardiac index (β, -0.02 [95% CI, -0.04 to -0.01]); DP2 was associated with higher carotid intima medial thickness (β, 1.80 [95% CI, 0.01-3.59]) and lower left ventricular ejection fraction (β, -0.15 [95% CI, -0.24 to -0.07]) and cardiac index (β, -0.01 [95% CI, -0.02 to -0.01]). Conclusions This study suggests small but statistically significant associations between DPs based on fat type and some early markers of CVD risk. Further research is needed to confirm these associations.
Collapse
Affiliation(s)
- Barbara Brayner
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Michelle A Keske
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Gunveen Kaur
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Sheikh Mohammed Shariful Islam
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Old Road Campus Headington, Oxford United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences Medical Sciences Division Radcliffe Primary Care Building Radcliffe Observatory QuarterUniversity of Oxford United Kingdom
| | - Katherine M Livingstone
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| |
Collapse
|
7
|
Teas E, Kimiecik J, Ward RM, Timmerman K. Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:412-421. [PMID: 35534099 PMCID: PMC9097336 DOI: 10.1016/j.jneb.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Examine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease. DESIGN Cross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry. SETTING Small, midwestern college town. PARTICIPANTS Community older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity). VARIABLES MEASURED Independent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days. ANALYSIS Multiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05. RESULTS Greater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = -0.45, P = 0.001) and lower triglycerides (β = -0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers. CONCLUSIONS AND IMPLICATIONS Intuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.
Collapse
Affiliation(s)
- Elizabeth Teas
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN; Center for Aging and the Life Course, Purdue University, West Lafayette, IN.
| | - Jay Kimiecik
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Kyle Timmerman
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| |
Collapse
|
8
|
Stannard S, Berrington A, Alwan NA. The mediating pathways between parental separation in childhood and offspring hypertension at midlife. Sci Rep 2022; 12:7062. [PMID: 35488035 PMCID: PMC9054745 DOI: 10.1038/s41598-022-11007-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
Social life course determinants of adult hypertension are relatively unknown. This paper examines how parental separation before age 10 relates to hypertension at age 46. Adjusting for parental confounders and considering the role of adult mediators, we aim to quantify unexplored mediating pathways in childhood using prospectively collected data. Data from the 1970 British Birth Cohort Study are utilised. Hypertension is measured by health care professionals at age 46. Potential mediating pathways in childhood include body mass index (BMI), systolic and diastolic blood pressure, illness, disability, family socioeconomic status (SES) and cognitive and developmental indicators at age 10. Additionally, we explore to what extent childhood mediators operate through adult mediators, including health behaviours, family SES, BMI and mental wellbeing. We also test for effect modification of the relationship between parental separation and hypertension by gender. Nested logistic regression models test the significance of potential mediating variables. Formal mediation analysis utilising Karlson Holm and Breen (KHB) method quantify the direct and indirect effect of parental separation on offspring hypertension at midlife. There was an association between parental separation and hypertension in mid-life in women but not men. For women, family SES and cognitive and behavioural development indicators at age 10 partly mediate the relationship between parental separation and hypertension at age 46. When adult mediators including, health behaviours, family SES, BMI and mental wellbeing are included, the associations between the childhood predictors and adult hypertension are attenuated, suggesting that these childhood mediators in turn may work through adult mediators to affect the risk of hypertension in midlife. We found family SES in childhood, cognitive and behaviour development indicators at age 10, including disruptive behaviour, coordination and locus of control in childhood, to be important mediators of the relationship between parental separation and midlife hypertension suggesting that intervening in childhood may modify adult hypertension risk.
Collapse
Affiliation(s)
- Sebastian Stannard
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK. .,ESRC Centre for Population Change, University of Southampton, Southampton, UK.
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK.,ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Applied Research Collaboration Wessex, Southampton, UK
| |
Collapse
|
9
|
Ridoutt B, Baird D, Hendrie GA. Diets with Higher Vegetable Intake and Lower Environmental Impact: Evidence from a Large Australian Population Health Survey. Nutrients 2022; 14:nu14071517. [PMID: 35406130 PMCID: PMC9002518 DOI: 10.3390/nu14071517] [Citation(s) in RCA: 1] [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: 02/27/2022] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 12/21/2022] Open
Abstract
Increasing the consumption of vegetables is a public health nutrition priority in Australia. This must be achieved in the context of lowering dietary environmental impacts. In this study, a subgroup of 1700 Australian adult daily diets having a higher diet-quality score and a lower environmental impact score was isolated from Australian Health Survey data. These diets were primarily distinguished by their lower content of energy-dense/nutrient-poor discretionary foods. Among these diets, those with higher levels of vegetable intake were characterized by greater variety of vegetables eaten, lower intake of bread and cereal foods, and higher intake of red meat. These diets also had a greater likelihood of achieving recommended intakes for a range of vitamins and minerals. These findings highlighted the importance of considering the total diet in developing strategies to promote healthy and sustainable food consumption, as well as the need to understand the interrelationships between foods that exist in a local cultural context. As vegetables are usually eaten with other foods, higher vegetable consumption in Australia could be supported by encouraging more regular consumption of the types of meals that include larger quantities of vegetables. Our results showed that this was possible while also substantially lowering total dietary environmental impacts.
Collapse
Affiliation(s)
- Bradley Ridoutt
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Clayton, VIC 3169, Australia
- Department of Agricultural Economics, University of the Free State, Bloemfontein 9300, South Africa
- Correspondence: ; Tel.: +61-3-9545-2159
| | - Danielle Baird
- CSIRO Health and Biosecurity, Adelaide, SA 5000, Australia; (D.B.); (G.A.H.)
| | - Gilly A. Hendrie
- CSIRO Health and Biosecurity, Adelaide, SA 5000, Australia; (D.B.); (G.A.H.)
| |
Collapse
|
10
|
Livingstone KM, Milte CM, Torres SJ, Hart MJ, Dingle SE, Shaw JE, Magliano DJ, McNaughton SA. Nineteen-Year Associations between Three Diet Quality Indices and All-Cause and Cardiovascular Disease Mortality: The Australian Diabetes, Obesity, and Lifestyle Study. J Nutr 2022; 152:805-815. [PMID: 34791367 DOI: 10.1093/jn/nxab386] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/15/2021] [Accepted: 11/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and cardiovascular disease (CVD) mortality. OBJECTIVES To examine the association between 3 diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality, and nonfatal CVD events ≤19 y later. METHODS Data on 10,009 adults (mean age 51.8 y; 52% female) from the Australian Diabetes, Obesity, and Lifestyle study were used. An FFQ was used to calculate DGI, DII, and MIND at baseline. Cox proportional hazard models were used to estimate HRs and 95% CI of all-cause mortality, CVD mortality, and nonfatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status. RESULTS Deaths due to all-cause (n = 1955) and CVD (n = 520), and nonfatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4, and 9.6 y, respectively. For all-cause mortality, HRs associated with higher DGI, DII, and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15), and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII, and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24), and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and nonfatal CVD events. CONCLUSIONS A better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, whereas a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean-style diet, and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.
Collapse
Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Michael J Hart
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sara E Dingle
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
11
|
Energy-dense dietary patterns high in free sugars and saturated fat and associations with obesity in young adults. Eur J Nutr 2021; 61:1595-1607. [PMID: 34870745 PMCID: PMC8921009 DOI: 10.1007/s00394-021-02758-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022]
Abstract
Purpose To derive dietary patterns based on dietary energy density (DED), free sugars, SFA, and fiber and investigate association with odds of overweight/obesity in young adults. Methods Cross-sectional data from 625 young Australian adults (18–30 years) were used. Dietary patterns were derived using reduced rank regression based on dietary data from a smartphone food diary using DED, free sugars, SFA, and fiber density as response variables. Multivariable logistic regression was used to investigate associations between dietary patterns and odds of self-reported overweight/obesity (BMI ≥ 25 kg/m2). Results Two dietary patterns were identified (DP1 and DP2). DP-1 was positively correlated with DED, free sugars, and SFA, and inversely correlated with fiber density. It was characterized by higher sugar-sweetened beverages intake and lower vegetable intake, and associated with higher odds of overweight/obesity (OR: 1.22; 95% CI 1.05, 1.42). DP-2 was positively correlated with fiber density and free sugars, and inversely correlated with DED and SFA. It was characterized by higher sugar-sweetened beverages intake and lower non-lean red meat intake, and was not significantly associated with overweight/obesity. Conclusion An energy-dense dietary pattern high in free sugars and SFA and low in fiber was associated with higher odds of obesity in young adults. These findings support dietary interventions that target reductions in energy-dense foods and sugar-sweetened beverages. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02758-y.
Collapse
|
12
|
Diet quality in an ethnically diverse population of older men in Australia. Eur J Clin Nutr 2021; 75:1792-1800. [PMID: 33712723 DOI: 10.1038/s41430-021-00893-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND/OBJECTIVES To compare the Australian Dietary Guideline Index (DGI-2013) and the Pyramid-based Mediterranean Diet Score (pyrMDS) as measures of diet quality in an ethnically diverse group of older men. SUBJECTS/METHODS Seven hundred and ninety-four older men aged ≥75 participated in wave 3 (2012-2013) of the Concord Health and Ageing in Men Project. Dietary intake was assessed using a validated diet history questionnaire. Ethnicity was based on self-reported country of birth and categorised as Australian-born (418 men), Italian or Greek migrants (188), and other migrants (188). Incident cardiovascular outcomes until March 2018 were measured using the composite of major adverse cardiovascular events (MACE), which comprises all-cause mortality, acute myocardial infarction, congestive cardiac failure, coronary revascularisation and/or ischaemic stroke. Ability to predict incident cardiovascular outcomes and all-cause mortality were compared between standardised DGI-2013 pyrMDS scores by comparison of hazard ratios, discrimination (Harrell's C-statistic) and calibration (calibration plots). RESULTS Italian and Greek migrant men had significantly lower DGI-2013 scores (91.7 vs. 93.9; p = 0.01) but significantly higher pyrMDS scores (8.8 vs. 8.2; p < 0.0001) than Australian-born men. In the whole sample (794 men), the pyrMDS was a better predictor of both MACE (age-adjusted HR = 0.84; 95% CI = 0.75-0.94 vs. HR = 0.92; 95% CI = 0.82-1.03 for DGI-2013) and all-cause mortality (age-adjusted HR = 0.69; 95% CI = 0.60-0.80 vs. HR = 0.86; 95% CI = 0.74-0.99). The pyrMDS also demonstrated superior discrimination for predicting all-cause mortality and superior calibration for MACE and all-cause mortality. CONCLUSIONS The DGI-2013 appears to underestimate diet quality in older Italian and Greek migrant men. The pyrMDS appears superior to the DGI-2013 for prediction of incident cardiovascular disease and mortality regardless of ethnic background.
Collapse
|
13
|
Association of adherence to the Australian Dietary Guidelines with cognitive performance and cognitive decline in the Sydney Memory and Ageing Study: a longitudinal analysis. J Nutr Sci 2021; 10:e86. [PMID: 34733498 PMCID: PMC8532065 DOI: 10.1017/jns.2021.44] [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: 03/25/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/08/2022] Open
Abstract
This study investigated associations of adherence to the Australian Dietary Guidelines (ADG) with cognitive performance and cognitive decline over 6 years. We used longitudinal data from the Sydney Memory and Aging Study comprising 1037 community-dwelling non-demented participants aged 70–90 years. Dietary intake was assessed at baseline using the Dietary Questionnaire for Epidemiological Studies Version 2. Adherence to the ADG was scored using the Dietary Guideline Index 2013 (DGI-2013). Cognition was assessed using neuropsychological tests in six cognitive domains and global cognition at baseline and 2, 4 and 6 years later. Linear mixed models analysed the association between adherence to the ADG and cognitive function and cognitive decline over 6 years. Results indicated that overall adherence to the ADG was suboptimal (DGI-2013 mean score 43⋅8 with a standard deviation of 10⋅1; median score 44, range 12–73 with an interquartile range of 7). The percent of participants attaining recommended serves for the five food groups were 30⋅2 % for fruits, 11⋅2 % for vegetables, 54⋅6 % for cereals, 28⋅9 % for meat and alternatives and 2⋅1 % for dairy consumption. Adherence to the ADG was not associated with overall global cognition over 6 years (β = 0⋅000; 95 % CI: −0⋅007, 0⋅007; P = 0⋅95). Neither were DGI-2013 scores associated with change in global cognitive performance over 6 years (β = 0⋅002; 95 % CI: −0⋅002, 0⋅005; P = 0⋅41) nor in any individual cognitive domains. In conclusion, adherence to the ADG was not associated with cognitive health over time in this longitudinal analysis of older Australians. Future research is needed to provide evidence to support specific dietary guidelines for neurocognitive health among Australian older adults.
Collapse
Key Words
- ADG, Australian Dietary Guidelines
- APOE, apolipoprotein E
- Cognitive health
- DASH, Dietary Approaches to Stop Hypertension
- DGI-2013, Dietary Guideline Index
- DQES v2, Dietary Questionnaire for Epidemiological Studies Version 2
- Diet quality
- Dietary Guide Index
- Food consumption
- HEI, Healthy Eating Index
- MAS, Memory and Ageing Study
- MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay
- NESB, non-English-speaking background
- Nutrition epidemiology
- WHO, World Health Organization
Collapse
|
14
|
Corona G, Dubowitz T, Troxel WM, Ghosh-Dastidar M, Rockette-Wagner B, Gary-Webb TL. Neighborhood Food Environment Associated with Cardiometabolic Health among Predominately Low-income, Urban, Black Women. Ethn Dis 2021; 31:537-546. [PMID: 34720557 DOI: 10.18865/ed.31.4.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives This study sought to: 1) understand how the perceived food environment (availability, accessibility, and affordability) is associated with cardiometabolic health outcomes in predominately low-income Black residents in urban neighborhoods with limited healthy food access; and 2) examine the association of shopping at specific store types with cardiometabolic health outcomes. Methods We report on cross-sectional data from 459 individuals participating in the Pittsburgh, PA Hill/Homewood Research on Neighborhoods and Health (PHRESH) study. Mean participant age was 60.7 (SD=13.9); 81.7% were female. We used logistic regression to examine associations between three factors (perceived fruit and vegetable availability, quality, and price; primary food shopping store characteristics; and frequency of shopping at stores with low or high access to healthy foods) and cardiometabolic and self-rated health. Results Adjusting for sociodemographic characteristics, participants with higher perceived fruit and vegetable accessibility (AOR:.47, 95%CI: .28-.79, P=.004) and affordability (AOR:.59, 95%CI: .36-.96, P=.034) had lower odds of high blood pressure. Shopping often (vs rarely) at stores with low access to healthy foods was associated with higher odds of high total cholesterol (AOR:3.52, 95%CI: 1.09-11.40, P=.035). Finally, primary food shopping at a discount grocery (vs full-service supermarket) was associated with lower odds of overweight/obesity (AOR:.51, 95%CI: .26-.99, P=.049). Conclusions These results suggest that both perceived accessibility and affordability of healthy foods are associated with reduced cardiometabolic risk factors in this urban, low-income predominantly Black population. Additionally, discount grocery stores may be particularly valuable by providing access and affordability of healthy foods in this population.
Collapse
Affiliation(s)
- Gabrielle Corona
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA
| | - Tamara Dubowitz
- RAND Corporation, Behavior and Policy Sciences, Pittsburgh, PA
| | - Wendy M Troxel
- RAND Corporation, Behavior and Policy Sciences, Pittsburgh, PA
| | | | - Bonny Rockette-Wagner
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA
| | - Tiffany L Gary-Webb
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA
| |
Collapse
|
15
|
Brayner B, Kaur G, Keske MA, Perez-Cornago A, Piernas C, Livingstone KM. Dietary Patterns Characterized by Fat Type in Association with Obesity and Type 2 Diabetes: A Longitudinal Study of UK Biobank Participants. J Nutr 2021; 151:3570-3578. [PMID: 34522964 DOI: 10.1093/jn/nxab275] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/30/2021] [Accepted: 07/27/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The fat type consumed is considered a risk factor for developing obesity and type 2 diabetes (T2D). However, these associations have not been investigated using a dietary patterns approach, which can capture combinations of foods and fat type consumed. OBJECTIVES This study aimed to investigate associations between dietary patterns with varying proportions of SFAs, MUFAs, or PUFAs and obesity, abdominal obesity, and self-reported T2D incidence. METHODS This study included UK Biobank participants with 2 or more 24-h dietary assessments, free from the outcome of interest at recruitment, and with outcome data at follow-up (n = 16,523; mean follow-up: 6.3 y). Reduced rank regression was used to derive dietary patterns with SFAs, MUFAs, and PUFAs (% of energy intake) as response variables. Logistic regression, adjusted for sociodemographic and health characteristics, was used to investigate the associations between dietary patterns and obesity [BMI (kg/m2) ≥30], abdominal obesity (waist circumference; men: ≥102 cm; women: ≥88 cm) and T2D incidence. RESULTS Two dietary patterns, DP1 and DP2, were identified: DP1 positively correlated with SFAs (r = 0.48), MUFAs (r = 0.67), and PUFAs (r = 0.56), characterized by higher intake of nuts, seeds, and butter and lower intake of fruit and low-fat yogurt; DP2 positively correlated with SFAs (r = 0.76) and negatively with PUFAs (r = -0.64) and MUFAs (r = -0.01), characterized by higher intake of butter and high-fat cheese and lower intake of nuts and seeds. Only DP2 was associated with higher obesity and abdominal obesity incidence (OR: 1.24; 95% CI: 1.02, 1.45; and OR: 1.19; 95% CI: 1.02, 1.38, respectively). Neither of the dietary patterns was associated with T2D incidence. CONCLUSIONS These findings provide evidence that a dietary pattern characterized by higher SFA and lower PUFA foods is associated with obesity and abdominal obesity incidence, but not T2D.
Collapse
Affiliation(s)
- Barbara Brayner
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Gunveen Kaur
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
16
|
Osei TB, van Dijk AM, Dingerink S, Chilunga FP, Beune E, Meeks KAC, Bahendeka S, Schulze MB, Agyemang C, Nicolaou M, Holleboom AG, Danquah I. Reduced Rank Regression-Derived Dietary Patterns Related to the Fatty Liver Index and Associations with Type 2 Diabetes Mellitus among Ghanaian Populations under Transition: The RODAM Study. Nutrients 2021; 13:nu13113679. [PMID: 34835937 PMCID: PMC8620643 DOI: 10.3390/nu13113679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/08/2021] [Accepted: 10/16/2021] [Indexed: 12/05/2022] Open
Abstract
The Fatty Liver Index (FLI) is a proxy for the steatotic component of non-alcoholic fatty liver disease (NAFLD). For sub-Saharan African populations, the contribution of dietary factors to the development of NAFLD in the etiology of type 2 diabetes mellitus (T2DM) remains to be clarified. We identified sex-specific dietary patterns (DPs) related to the FLI using reduced ranked regression (RRR) and evaluated the associations of these DPs with T2DM. This analysis used data from the RODAM, a multi-center cross-sectional study of Ghanaian populations living in Ghana and Europe. The daily intake frequencies of 30 food groups served as the predictor variables, while the FLI was the response variable. The odds ratios and 95% confidence intervals for T2DM were calculated per one standard deviation increase in the DP score using logistic regression. In males, the DP score explained 9.9% of the variation in their food intake and 16.0% of the variation in the FLI. This DP was characterized by high intakes of poultry, whole-grain cereals, coffee and tea, condiments, and potatoes, and the chance of T2DM was 45% higher per 1 DP score-SD (Model 2). Our results indicate that the intake of modernized foods was associated with proxies of NAFLD, possibly underlying the metabolic pathways to developing T2DM.
Collapse
Affiliation(s)
- Tracy Bonsu Osei
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany;
| | - Anne-Marieke van Dijk
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (A.-M.v.D.); (S.D.); (A.G.H.)
| | - Sjoerd Dingerink
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (A.-M.v.D.); (S.D.); (A.G.H.)
| | - Felix Patience Chilunga
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.B.); (K.A.C.M.); (C.A.); (M.N.)
| | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.B.); (K.A.C.M.); (C.A.); (M.N.)
| | - Karlijn Anna Catharina Meeks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.B.); (K.A.C.M.); (C.A.); (M.N.)
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, MD 20892-2152, USA
| | - Silver Bahendeka
- Department of Internal Medicine, St. Francis Hospital Nsambya, MKPGMS-Uganda Martyrs University, Kampala 5498, Uganda;
| | - Matthias Bernd Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany;
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.B.); (K.A.C.M.); (C.A.); (M.N.)
| | - Mary Nicolaou
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.B.); (K.A.C.M.); (C.A.); (M.N.)
| | - Adriaan Georgius Holleboom
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (A.-M.v.D.); (S.D.); (A.G.H.)
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany;
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany;
- Correspondence: ; Tel.: +49-622156-5086
| |
Collapse
|
17
|
Abstract
OBJECTIVE To examine how socio-demographic characteristics and diet quality vary with consumption of ultra-processed foods (UPF) in a cross-sectional nationally representative survey of Australian adults. DESIGN Using a 24-h recall, this cross-sectional analysis of dietary and socio-demographic data classified food items using the NOVA system, estimated the percentage of total energy contributed by UPFs and assessed diet quality using the Dietary Guideline Index (DGI-2013 total and components). Linear regression models examined associations between socio-demographic characteristics and diet quality with percentage of energy from UPF. SETTING Australian Health Survey 2011-2013. PARTICIPANTS Australian adults aged ≥ 19 years (n 8209). RESULTS Consumption of UPF was higher among younger adults (aged 19-30 years), adults born in Australia, those experiencing greatest area-level disadvantage, lower levels of education and the second lowest household income quintile. No significant association was found for sex or rurality. A higher percentage of energy from UPF was inversely associated with diet quality and with lower DGI scores related to the variety of nutritious foods, fruits, vegetables, total cereals, meat and poultry, fish, eggs, nuts and seeds, legumes/beans, water and limits on discretionary foods, saturated fat and added sugar. CONCLUSIONS This research adds to the evidence on dietary inequalities across Australia and how UPF are detrimental to diet quality. The findings can be used to inform interventions to reduce UPF consumption and improve diet quality.
Collapse
|
18
|
Koutras Y, Chrysostomou S, Poulimeneas D, Yannakoulia M. Examining the associations between a posteriori dietary patterns and obesity indexes: Systematic review of observational studies. Nutr Health 2021; 28:149-162. [PMID: 34100659 DOI: 10.1177/02601060211020975] [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: 12/18/2022]
Abstract
BACKGROUND Few reports on the association of population-derived dietary patterns with excess body weight, using the approach of a systematic review currently exist. AIM The aim of the present systematic review was to identify dietary patterns associated with body mass index (BMI), body weight (BW)/BMI change, weight status and weight loss maintenance status. METHODS Using MEDLINE (via PubMed) and EBSCO Host databases, we systematically reviewed studies from 1980 to 2020, which included men and women, aged ≥18 years. Primary outcome was BMI or the longitudinal change of individuals' BW or BMI, or weight status (normal weight/overweight/obesity) or weight loss maintenance status. We included observational studies, with or without a prospective design. Studies which met the inclusion criteria were evaluated based on the Newcastle-Ottawa Scale; only a posteriori dietary patterns were evaluated. RESULTS Twenty-six studies were eligible for inclusion in the current analysis. The results indicate a relationship between adherence to a lacto-vegetarian dietary pattern, characterized by high intake of fruits, vegetables, whole grains, unprocessed cereals, dairy and low intake of high-fat foods and sweets, and longitudinal change of individuals' BW or BMI, or the risk of overweight/obesity. CONCLUSIONS Promotion of this healthy dietary pattern, as an alternative to focusing on specific nutrients or foods, may be a promising approach to be included in future long-term weight maintenance interventions.
Collapse
Affiliation(s)
- Yiannis Koutras
- Department of Life Sciences, Nutrition and Dietetics Program, European University, Cyprus.,Department of Health Sciences, Public Health Program, European University, Cyprus
| | - Stavri Chrysostomou
- Department of Life Sciences, Nutrition and Dietetics Program, European University, Cyprus
| | - Dimitrios Poulimeneas
- Department of Nutrition and Dietetics, Harokopio University, School of Health Sciences and Education, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, School of Health Sciences and Education, Greece
| |
Collapse
|
19
|
Ritter JDA, Cureau FV, Ronca DB, Blume CA, Teló GH, Camey SA, de Carvalho KMB, Schaan BD. Association between diet quality index and cardiometabolic risk factors in adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). Nutrition 2021; 90:111216. [PMID: 33934056 DOI: 10.1016/j.nut.2021.111216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study evaluated the association between diet quality, assessed by the Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR), and cardiometabolic markers in adolescents. METHODS The DQIA-BR and cardiometabolic markers were assessed in 36 956 Brazilian adolescents (12-17 y old) enrolled in the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional multicenter study in Brazil. For analyses, the sample was stratified by sex and nutritional status. Multiple linear regressions were used to investigate the association between DQIA-BR and cardiometabolic markers (total cholesterol, HDL-c, LDL-c, triglycerides, fasting glucose and HOMA-IR). Adjusted models were constructed with two input levels of covariates. The first model was adjusted for sex, age, and socioeconomic status; in the second model, total energy intake, physical activity, and sedentary behavior were included. RESULTS A higher DQIA-BR score was associated with a better cardiometabolic profile in girls with normal weight; however, no association was observed in those with overweight/obesity. In boys with overweight/obesity, a better quality of diet was associated with lower concentrations of total cholesterol (β = -0.338, 95% confidence interval [CI]: -0.611 to -0.066) and LDL-c (β = -0.227, 95% CI: -0.448 to -0.005), but only LDL-c remained significant in those with normal weight (β = -0.115, 95% CI: -0.224 to 0.005). CONCLUSION The effects of diet quality on cardiometabolic risk factors differ according to sex and the presence of overweight/obesity. Overall, DQIA-BR is a suitable tool to evaluate the association between diet quality and cardiometabolic markers in normal-weight adolescents, but not for adolescents, especially girls, with overweight/obesity.
Collapse
Affiliation(s)
- Julianna do Amaral Ritter
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Felipe Vogt Cureau
- Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Carina Andriatta Blume
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Heiden Teló
- School of Medicine and Postgraduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Suzi Alves Camey
- Postgraduate Program in Epidemiology, Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Beatriz D Schaan
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
20
|
Tan EJ, Hayen A, Clarke P, Jackson R, Knight J, Hayes AJ. Trends in Ischaemic Heart Disease in Australia, 2001-2015: A Comparison of Urban and Rural Populations. Heart Lung Circ 2021; 30:971-977. [PMID: 33454212 DOI: 10.1016/j.hlc.2020.11.009] [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: 08/12/2020] [Revised: 10/24/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Ischaemic heart disease (IHD) is a major source of disease burden worldwide. Recent trends show incidence is declining but it is unclear whether the trends are similar in urban and rural populations. This study examines the trends of IHD events (i.e. hospitalisations and deaths) in New South Wales, Australia by rurality. METHODS This was a retrospective analysis of linked administrative data for hospitalisation and death records across NSW between 2001 and 2015. Participants were NSW residents aged 15-105 years who died or were hospitalised with a principal diagnosis of IHD. The main outcome measures were annual age-standardised mortality and hospitalisations for IHD by calendar year and rurality. RESULTS Between 2001 and 2015, age-standardised annual IHD hospitalisations declined in urban areas from 587 to 260 and in rural areas from 766 to 395 per 100,000 people. The annual decline in hospitalisations was greater in urban than rural areas, with Annual Percentage Change (APC) of -5.6% (95% CI, -6.1%, -5.0%) and -4.5% (95% CI, -5.0%, -4.0%), respectively (p=0.012). Ischaemic heart disease mortality declined at a similar rate in urban and rural regions (APC -7.6% and -6.7% per annum, p=0.28). Absolute inequalities in IHD deaths persisted until 2015 when there were 49 (urban) and 70 (rural) IHD deaths per 100,000 people. CONCLUSIONS Ischaemic heart disease hospitalisations and mortality have declined considerably between 2001 and 2015 in both rural and urban areas, yet inequalities persist, suggesting more intensive preventive efforts are required to further reduce the burden of IHD in rural populations.
Collapse
Affiliation(s)
- Eng Joo Tan
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, Australia
| | - Andrew Hayen
- Discipline of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Philip Clarke
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rod Jackson
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Josh Knight
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic, Australia
| | - Alison J Hayes
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, Australia.
| |
Collapse
|
21
|
Diet Quality Indices Used in Australian and New Zealand Adults: A Systematic Review and Critical Appraisal. Nutrients 2020; 12:nu12123777. [PMID: 33317123 PMCID: PMC7763901 DOI: 10.3390/nu12123777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critically appraise all DQI used within Australian and New Zealand adult populations. Twenty-five existing DQI were identified by electronic searching in Medline and hand searching of reference lists. DQI were constructed based on the respective national dietary guidelines and condition-specific recommendations. For preferable features of DQI, six captured the dimensions of adequacy, moderation and balance; five had a nested structure; 12 consisted of foods, food groups and nutrients; 11 used metric scoring systems and most of those with metric scales used normative cutoff points. Food frequency questionnaires, either alone or with other methods, were the most common dietary assessment method used in 20 DQI. For evaluation of DQI, construct validity and relative validity are reported. Based on our critical appraisal, Dietary Guideline Index (DGI), Dietary Guideline Index-2013 (DGI-2013), Total Diet Score (TDS), Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), and Aussie-Diet Quality Index (Aussie-DQI) were the preferred DQI used in Australian adults according to dimension, indicator selection, scoring criteria and evaluation. Further work is needed to enhance the construction of all Australian and New Zealand DQI, especially in terms of dimension and structure, for alignment with recommended construction criteria.
Collapse
|
22
|
Borges LPSL, de Santana NL, da Costa THM. Adherence to National Food Guide Recommendations: Can It Slow the Obesity Epidemic? A Systematic Review. Curr Nutr Rep 2020; 9:316-328. [PMID: 33145722 DOI: 10.1007/s13668-020-00339-9] [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] [Accepted: 10/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Dietary guidelines (DG) have the objective to promote healthy diet and prevent chronic diseases. In order to evaluate if this purpose is being achieved, we systematically reviewed studies that associated adherence to DG with obesity. RECENT FINDINGS We identified 2012 articles published in the last 5 years, and 38 remained in the final sample. The majority of studies demonstrated a negative association between adherence to DG and obesity. Studies with positive or no association presented mutual characteristics, such as populations composed only by children or adolescents, and dietary intake or dietary adherence assessed through non-validated or weak methods. Adherence to DG seems to be a protective factor for obesity in adults, but this relationship is not so clear for children and adolescents. To improve the quality of dietary intake results, studies must utilize appropriate methods to answer their questions with less biased estimate of dietary intake.
Collapse
Affiliation(s)
| | | | - Teresa Helena Macedo da Costa
- Department of Nutrition, School of Health Science, University of Brasilia, Brasilia, 70919-970, Brazil.
- University of Oxford, Oxford, England.
- Human Nutrition Research, Medical Research Council, Cambridge, England.
- Sabbatical at Iowa State University, Ames, IA, USA.
| |
Collapse
|
23
|
Yan H, Dang S, Zhang Y, Luo S. Dietary patterns of Chinese women of childbearing age during pregnancy and their relationship to the neonatal birth weight. Nutr J 2020; 19:89. [PMID: 32847595 PMCID: PMC7449039 DOI: 10.1186/s12937-020-00607-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To examine the type of maternal dietary patterns during pregnancy and the distribution characteristics of children's birth weight and the association between dietary patterns and neonatal birth weight in China. METHODS Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" in July to November in 2013. A stratified multistage random sampling method was used to select women and their children. The mother's diet during pregnancy was investigated using semi-quantitative food frequency questionnaire (FFQ) to collect the frequency and amount of food consumption, and the newborn birth weight as well as related social demographic information was collected at the same time. In our study, 0-1 year old children and their mothers with complete dietary survey data were selected as research objects. The main dietary patterns were identified according to factor analysis, and latent class analysis (LCA) was used to investigate the social demographic factors affecting dietary patterns. The logistic regression model was used to assess the association between birth weight and maternal dietary patterns during pregnancy by establishing three adjusting models and the data were stratified for further analysis by urban-rural and regions. RESULTS A total of 15,980 participants were involved in this study. Four dietary patterns were identified: "vegetarian pattern", "balance pattern", "traditional pattern" and "processing pattern". Compared with moderate tertile, women in the highest tertile of adherence to vegetarian pattern increased the risk of low birth weight in offspring in rural areas (OR = 1.61, 95%CI:1.06-2.93) and middle region (OR = 1.75, 95%CI:1.18-2.62), and the traditional pattern had greater odds of lower birth weight in the middle region (OR = 1.55, 95%CI:1.05-3.75). The processing pattern was found a protective factor for the occurrence of low birth weight in rural areas (OR = 0.98, 95%CI:0.43-0.99) but was a risk factor for low birth weight in the southern region (OR = 8.83, 95%CI:1.22-15.16). The balance pattern was a protective factor for the occurrence of low birth weight in the northern region(OR = 0.35, 95%CI:0.14-0.83). CONCLUSION The vegetarian and traditional pattern may be positively related to a higher risk of low birth weight while the balanced pattern may keep birth weight of offspring within the appropriate range. Health education of balanced diet and individual nutrition guidance during pregnancy should be strengthened, to make the dietary structure during pregnancy are more reasonable, reduce the occurrence of adverse birth weight of newborns.
Collapse
Affiliation(s)
- Hui Yan
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shaonong Dang
- School of Public Health, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yaodong Zhang
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shuying Luo
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| |
Collapse
|
24
|
Opie RS, Ball K, Abbott G, Crawford D, Teychenne M, McNaughton SA. Adherence to the Australian dietary guidelines and development of depressive symptoms at 5 years follow-up amongst women in the READI cohort study. Nutr J 2020; 19:30. [PMID: 32276594 PMCID: PMC7149932 DOI: 10.1186/s12937-020-00540-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms. METHODS Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013; score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up. RESULTS An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI - 0.08 to - 0.01, p = 0.024). CONCLUSIONS Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.
Collapse
Affiliation(s)
- Rachelle S. Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| |
Collapse
|
25
|
Karageorgou D, Magriplis E, Bakogianni I, Mitsopoulou AV, Dimakopoulos I, Micha R, Michas G, Ntouroupi T, Tsaniklidou SM, Argyri K, Chourdakis M, Panagiotakos DB, Zampelas A. Dietary patterns and cardiovascular disease in Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS). Nutr Metab Cardiovasc Dis 2020; 30:201-213. [PMID: 31761547 DOI: 10.1016/j.numecd.2019.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Empirically-derived dietary patterns have been shown to have both positive and adverse associations with cardiovascular disease (CVD). Yet, such associations remain unclear in the Greek population. The aim of this study was to investigate the association between empirically-derived dietary patterns and the presence of CVD and CVD-related medical conditions in a nationally representative sample of Greek adults. METHODS AND RESULTS Adult participants (≥20 years old) of the Hellenic National Nutrition and Health Survey (HNNHS) were included (N = 3552; 41.2% men; 43.7 years, SD: 18.1). Dietary patterns were derived by principal component analysis using 24-h recall data. The presence of dyslipidemia (elevated cholesterol and/or triglycerides), hypertension, coronary heart disease, and total CVD, was defined according to the International Clinical Diagnosis (ICD)-10 codes. Odds ratios of CVD outcomes were estimated across dietary patterns using multivariable logistic regression analysis. Three dietary patterns -Traditional (proxy Mediterranean), Western, and Prudent-were identified explaining 16.5% of the total variance in consumption. Logistic regression analysis, adjusted for age, sex, total caloric intake, sociodemographic characteristics, and other CVD risk factors, showed an inverse association between the Traditional dietary pattern and CVD presence (OR: 0.53; 95% CI: 0.30-0.95), and a positive association between the Western pattern and dyslipidemia (1.52; 1.02-2.26). No association was found between the Prudent pattern and CVD outcomes. CONCLUSION The variability of food intake combinations in the Greek population seem to be associated with the presence of CVD and CVD related conditions. Such findings are imperative for national monitoring and informed priority setting.
Collapse
Affiliation(s)
- Dimitra Karageorgou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Emmanouella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Ioanna Bakogianni
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Anastasia V Mitsopoulou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Ioannis Dimakopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Renata Micha
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Triantafyllia Ntouroupi
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Sophia M Tsaniklidou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Konstantina Argyri
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Michail Chourdakis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124 Thessaloniki, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, 176 76 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece.
| |
Collapse
|
26
|
Aljuraiban GS, Gibson R, Oude Griep LM, Okuda N, Steffen LM, Van Horn L, Chan Q. Perspective: The Application of A Priori Diet Quality Scores to Cardiovascular Disease Risk-A Critical Evaluation of Current Scoring Systems. Adv Nutr 2020; 11:10-24. [PMID: 31209464 PMCID: PMC7442364 DOI: 10.1093/advances/nmz059] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/21/2019] [Accepted: 05/19/2019] [Indexed: 12/17/2022] Open
Abstract
Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori-defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori-defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk. The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level.
Collapse
Affiliation(s)
- Ghadeer S Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Rachel Gibson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutritional Sciences, King's College London, London, United Kingdom
| | - Linda M Oude Griep
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Biomedical Research Centre, Diet, Anthropometry, and Physical Activity (DAPA) Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| |
Collapse
|
27
|
Milte CM, Ball K, Crawford D, McNaughton SA. Diet quality and cognitive function in mid-aged and older men and women. BMC Geriatr 2019; 19:361. [PMID: 31864295 PMCID: PMC6925482 DOI: 10.1186/s12877-019-1326-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/23/2019] [Indexed: 01/24/2023] Open
Abstract
Background To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. Methods Adults aged 55–65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. Results After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported “sometimes” adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported “usually” adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, − 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. Conclusion An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.
Collapse
Affiliation(s)
- Catherine M Milte
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia.
| | - Kylie Ball
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - David Crawford
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - Sarah A McNaughton
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Vic 3125, Australia
| |
Collapse
|
28
|
Chen L, Zhu H, Gutin B, Dong Y. Race, Gender, Family Structure, Socioeconomic Status, Dietary Patterns, and Cardiovascular Health in Adolescents. Curr Dev Nutr 2019; 3:nzz117. [PMID: 31750413 PMCID: PMC6856469 DOI: 10.1093/cdn/nzz117] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/04/2019] [Accepted: 10/17/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Dietary patterns represent a broad picture of food and nutrient consumption and may be more predictive of health outcomes than individual foods and nutrients. OBJECTIVE We investigated the relations among race, gender, family structure, parental socioeconomic status (SES), dietary patterns, and cardiovascular disease (CVD) profiles among adolescents in the southeastern region of the United States. METHODS A total of 743 adolescents from a cross-sectional study were divided into 4 dietary pattern groups by K-means cluster analysis. Multinomial logistic regression was performed to determine the relations among the parental SES, family structures, and dietary patterns of the adolescents. Associations between dietary patterns and CVD profiles were analyzed by multiple linear regression. RESULTS Four dietary patterns were derived: "healthy" (17%), "snacks and sweets" (26%), "processed meat" (20%), and "sugar-sweetened beverage (SSB) and fried food" (37%). Whites and females were more likely to have a "healthy" dietary pattern (Ps < 0.001). There were significant race/ethnicity differences in family structures, SES, and dietary patterns (Ps < 0.05). In whites, higher mother's education and father's education and occupation were associated with greater likelihood of a "healthy" dietary pattern (Ps < 0.05). Stay-at-home mother was associated with less likelihood of an "SSB and fried food" pattern (P = 0.023). In blacks, higher mother's occupation, father's education, and living with both parents were associated with more likelihood of a "healthy" dietary pattern (Ps < 0.05). Stay-at-home father was associated with less likelihood of the "snacks and sweets" (P = 0.025) and "SSB and fried food" dietary patterns (P = 0.044). Overall, adolescents with poor dietary patterns exhibited higher percentage body fat, waist circumference, systolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance, C-reactive protein, and total triglyceride (Ps < 0.05). CONCLUSIONS Our data suggest that family structure, parental working status, and SES are associated with the diet quality in adolescents. Moreover, "snacks and sweets," "processed meat," and "SSB and fried food" dietary patterns are all associated with worse CVD risk profiles.
Collapse
Affiliation(s)
- Li Chen
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Haidong Zhu
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Bernard Gutin
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| |
Collapse
|
29
|
Ward SJ, Coates AM, Hill AM. Application of an Australian Dietary Guideline Index to Weighed Food Records. Nutrients 2019; 11:nu11061286. [PMID: 31174347 PMCID: PMC6627425 DOI: 10.3390/nu11061286] [Citation(s) in RCA: 5] [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: 05/02/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022] Open
Abstract
The Dietary Guideline Index (DGI) is a validated diet quality index that reflects adherence to the Australian Dietary Guidelines. The aim of the current study was to establish a novel methodology that applied the DGI to dietary data collected via gold standard, weighed food records (WFR). Consisting of 10 components with a maximal score of 120, the DGI reflected the food-based recommendations of the current Australian Dietary Guidelines and included indicators to score adequacy and quality of core food components and discretionary choices within the diet. The DGI was applied to WFR collected from a sample of 141 adults (84 women, 57 men). Differences between gender for each indicator, as well as subscores for core and noncore components of the DGI were examined. Construct validity was assessed by evaluating the relationship between total DGI score and intake of key nutrients of interest. Overall, the median DGI score was low, 50.87 (range 20.6-104.1). Higher DGI scores were associated with lower intakes of saturated fat, added sugars and sodium (P < 0.05). This methodological approach of applying the DGI to WFR may improve our ability to quantify diet quality, thereby providing a tool to assess changes in dietary intake over time and allow the quantification of diet quality as a variable in relation to health outcomes.
Collapse
Affiliation(s)
- Susan J Ward
- School of Health Sciences, City East Campus, University of South Australia, GPO Box 2471, ADELAIDE, SA 5001, Australia.
| | - Alison M Coates
- School of Health Sciences, City East Campus, University of South Australia, GPO Box 2471, ADELAIDE, SA 5001, Australia.
| | - Alison M Hill
- School of Pharmacy and Medical Sciences, City East Campus, University of South Australia, GPO Box 2471, ADELAIDE, SA 5001, Australia.
| |
Collapse
|
30
|
Nilsson A, Halvardsson P, Kadi F. Adherence to DASH-Style Dietary Pattern Impacts on Adiponectin and Clustered Metabolic Risk in Older Women. Nutrients 2019; 11:E805. [PMID: 30970648 PMCID: PMC6520850 DOI: 10.3390/nu11040805] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 02/07/2023] Open
Abstract
While dietary patterns are related to the age-related progression of chronic diseases, to what extent different dietary patterns influence inflammatory and metabolic risk factors in older adults remains to be elucidated. Additionally, potential moderating effects by physical activity (PA) become important to clarify. Here, we hypothesize that dietary patterns are linked to inflammatory and metabolic biomarkers and that these links are independent of PA. The present study aims to explore links between two dietary constructs and biomarkers of systemic inflammation and metabolic health in older women, while considering time spent in moderate-to-vigorous PA (MVPA). A cross-sectional analysis of a sample of 112 community-dwelling older women (65–70 years old) was performed. Dietary constructs based on the Dietary Approach to Stop Hypertension (DASH) and the dietary inflammatory index (DII) were determined from food records. MVPA was objectively assessed using accelerometry. Metabolic outcomes (waist circumference, systolic/diastolic blood pressures and levels of glucose, triglycerides and high-density lipoprotein (HDL)-cholesterol) and inflammatory biomarkers (C-reactive protein (CRP), fibrinogen and adiponectin) were determined using standardized procedures and a clustered metabolic risk score was derived. Adherence to DASH-style diet was significantly (p < 0.05) associated with a lower clustered metabolic risk, where women in the highest adherence group had a significantly (p < 0.05) lower waist circumference and blood glucose level compared to those in the lowest group. Further, a significantly higher (p < 0.05) adiponectin level was observed in the high DASH adherence group compared to those with low adherence. Notably, adjustment by waist circumference did not alter links with either adiponectin or blood glucose level. Importantly, all observed links remained significant after further adjustment for time in MVPA. Finally, no significant associations were observed when the dietary pattern was defined by the DII. The findings of this study demonstrate that DASH-style diets promote a systemic anti-inflammatory environment, while also mitigating clustered metabolic risk in older women. A key finding is that favourable impacts of the DASH-style diet are independent of time spent in moderate-to-vigorous PA, which further strengthens healthy eating behaviours as a key target for clinical and public health interventions designed to prevent age-related metabolic abnormalities.
Collapse
Affiliation(s)
- Andreas Nilsson
- School of Health Sciences, Örebro University, 70182 Örebro, Sweden.
| | | | - Fawzi Kadi
- School of Health Sciences, Örebro University, 70182 Örebro, Sweden.
| |
Collapse
|
31
|
Relationship between dietary quality, determined by DASH score, and cardiometabolic health biomarkers: A cross-sectional analysis in adults. Clin Nutr 2018; 38:1620-1628. [PMID: 30219609 DOI: 10.1016/j.clnu.2018.08.028] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/12/2018] [Accepted: 08/25/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The relationship between dietary patterns and cardiometabolic disease is of increasing interest. However, limited data regarding the association between dietary quality and biomarkers of cardiometabolic health exist. Therefore the aim of this work was to examine potential associations between dietary quality, assessed using the Dietary Approaches to Stop Hypertension (DASH) dietary quality score, adiposity and biomarkers of glucose homeostasis, lipoprotein metabolism and inflammation in a cross-sectional sample of 1493 men and women. METHODS Anthropometric measurements included BMI, hip and waist circumference (WC). Serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cell (WBC) counts were determined. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). RESULTS Higher dietary quality was associated with lower BMI (P < 0.05), WC (P < 0.001), tumour necrosis factor α (TNF-α), interleukin 6 (IL-6), WBC and plasminogen activator inhibitor-1 (PAI-1) concentrations (P < 0.01) and reduced insulin resistance (P < 0.05). In addition less small low density lipoprotein (LDL) and small high density lipoprotein (HDL) particles and less large very low density lipoprotein (VLDL) particles were observed among those with better dietary quality (P < 0.001). Individuals in the top DASH quartile had a 54% and 48% lower likelihood of central obesity and metabolic syndrome (MetS), respectively, than those in the lowest DASH quartile (P < 0.05). CONCLUSIONS Our data suggest that higher quality diet is associated with improved adiposity measures and a less insulin resistant, pro-inflammatory, pro-thrombotic and pro-atherogenic cardiometabolic profile which may impact on central obesity and MetS risk. These findings, which may be of clinical and public health significance in terms of dietary approaches to promote cardiometabolic health, warrant further examination.
Collapse
|