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Davies KP, Gibney ER, Leonard UM, Lindberg L, Woodside JV, Kiely ME, Nugent AP, Arranz E, Conway MC, McCarthy SN, O'Sullivan AM. Developing and testing personalised nutrition feedback for more sustainable healthy diets: the MyPlanetDiet randomised controlled trial protocol. Eur J Nutr 2024:10.1007/s00394-024-03457-0. [PMID: 38970665 DOI: 10.1007/s00394-024-03457-0] [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: 12/18/2023] [Accepted: 06/22/2024] [Indexed: 07/08/2024]
Abstract
PURPOSE Agriculture and food production contribute to climate change. There is mounting pressure to transition to diets with less environmental impact while maintaining nutritional adequacy. MyPlanetDiet aimed to reduce diet-related greenhouse gas emissions (GHGE) in a safe, nutritionally adequate, and acceptable manner. This paper describes the trial protocol, development, and testing of personalised nutrition feedback in the MyPlanetDiet randomised controlled trial (RCT). METHODS MyPlanetDiet was a 12-week RCT that provided standardised personalised nutrition feedback to participants based on new sustainable healthy eating guidelines (intervention) or existing healthy eating guidelines (control) using decision trees and corresponding feedback messages. To test the personalised nutrition feedback, we modelled a sample of 20 of the MyPlanetDiet participants baseline diets. Diets were modelled to adhere to control and intervention decision trees and feedback messages. Modelled nutrient intakes and environmental metrics were compared using repeated measure one-way analysis of covariance. RESULTS Intervention diets had significantly lower (p < 0.001) diet-related GHGE per 2500 kilocalories (kcal) (4.7 kg CO2-eq) relative to control (6.6 kg CO2-eq) and baseline (7.1 kg CO2-eq). Modelled control and intervention diets had higher mean daily intakes of macronutrients (carbohydrates, fibre, and protein) and micronutrients (calcium, iron, zinc, and iodine). Modelled control and intervention diets had lower percent energy from fat and saturated fat relative to baseline. CONCLUSIONS Adherence to the MyPlanetDiet personalised nutrition feedback would be expected to lead to better nutrient intakes and reduced diet-related GHGE. The MyPlanetDiet RCT will test the effectiveness and safety of personalised feedback for a more sustainable diet. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION Clinical trials registration number: NCT05253547, 23 February 2022.
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Affiliation(s)
- Katie P Davies
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Ursula M Leonard
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Leona Lindberg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, BT12 6BJ,, Belfast, UK
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, BT12 6BJ,, Belfast, UK
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, BT9 5DL, UK
| | - Elena Arranz
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- Department of Nutrition and Food Science, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marie C Conway
- Department of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, Ireland
| | - Sinead N McCarthy
- Department of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, Ireland
| | - Aifric M O'Sullivan
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
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Henriksen HB, Knudsen MD, Hjartåker A, Blomhoff R, Carlsen MH. Digital Food Frequency Questionnaire Assessing Adherence to the Norwegian Food-Based Dietary Guidelines and Other National Lifestyle Recommendations: Instrument Validation Study. J Med Internet Res 2024; 26:e53442. [PMID: 38687986 PMCID: PMC11094607 DOI: 10.2196/53442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/12/2024] [Accepted: 03/09/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Valid assessment tools are needed when investigating adherence to national dietary and lifestyle guidelines. OBJECTIVE The relative validity of the new digital food frequency questionnaire, the DIGIKOST-FFQ, against 7-day weighed food records and activity sensors was investigated. METHODS In total, 77 participants were included in the validation study and completed the DIGIKOST-FFQ and the weighed food record, and of these, 56 (73%) also used the activity sensors. The DIGIKOST-FFQ estimates the intake of foods according to the Norwegian food-based dietary guidelines (FBDGs) in addition to lifestyle factors. RESULTS At the group level, the DIGIKOST-FFQ showed good validity in estimating intakes according to the Norwegian FBDG. The median differences were small and well below portion sizes for all foods except "water" (median difference 230 g/day). The DIGIKOST-FFQ was able to rank individual intakes for all foods (r=0.2-0.7). However, ranking estimates of vegetable intakes should be interpreted with caution. Between 69% and 88% of the participants were classified into the same or adjacent quartile for foods and between 71% and 82% for different activity intensities. The Bland-Altman plots showed acceptable agreements between DIGIKOST-FFQ and the reference methods. The absolute amount of time in "moderate to vigorous intensity" was underestimated with the DIGIKOST-FFQ. However, estimated time in "moderate to vigorous intensity," "vigorous intensity," and "sedentary time" showed acceptable correlations and good agreement between the methods. The DIGIKOST-FFQ was able to identify adherence to the Norwegian FBDG and physical activity recommendations. CONCLUSIONS The DIGIKOST-FFQ gave valid estimates of dietary intakes and was able to identify individuals with different degrees of adherence to the Norwegian FBDG and physical activity recommendations. Moderate physical activity was underreported, water was overreported, and vegetables showed poor correlation, which are important to consider when interpreting the data. Good agreement was observed between the methods in estimating dietary intakes and time in "moderate to vigorous physical activity," "sedentary time," and "sleep."
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Affiliation(s)
- Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Markus Dines Knudsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Anette Hjartåker
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Lawson I, Wood C, Syam N, Rippin H, Dagless S, Wickramasinghe K, Amoutzopoulos B, Steer T, Key TJ, Papier K. Assessing Performance of Contemporary Plant-Based Diets against the UK Dietary Guidelines: Findings from the Feeding the Future (FEED) Study. Nutrients 2024; 16:1336. [PMID: 38732583 PMCID: PMC11085280 DOI: 10.3390/nu16091336] [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: 03/29/2024] [Revised: 04/12/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
Uncertainty remains about the composition of contemporary plant-based diets and whether they provide recommended nutrient intakes. We established Feeding the Future (FEED), an up-to-date online cohort of UK adults following different plant-based diets and diets containing meat and fish. We recruited 6342 participants aged 18-99 [omnivores (1562), flexitarians (1349), pescatarians (568), vegetarians (1292), and vegans (1571)] between February 2022 and December 2023, and measured diet using a food frequency questionnaire and free text. We compared personal characteristics and dietary intakes between diet groups and assessed compliance with dietary guidelines. Most participants met UK dietary recommendations for fruit and vegetables, sodium, and protein, although protein intakes were lowest among vegetarians and vegans. Omnivores did not meet the fibre recommendation and only vegans met the saturated fat recommendation. All diet groups exceeded the free sugars recommendation. Higher proportions of vegetarians and vegans were below the estimated average requirements (EARs) for zinc, iodine, selenium, and, in vegans, vitamins A and B12, whereas calcium intakes were similar across the diet groups. People following plant-based diets showed good compliance with most dietary targets, and their risk for inadequate intakes of certain nutrients might be mitigated by improved dietary choices and/or food fortification.
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Affiliation(s)
- Izabella Lawson
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
| | - Caroline Wood
- Public Affairs & Communications Directorate, University of Oxford, Oxford OX1 2JD, UK;
| | - Nandana Syam
- Medical Sciences Division, University of Oxford, Oxford OX3 9DU, UK;
| | - Holly Rippin
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Selina Dagless
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Kremlin Wickramasinghe
- Special Initiative on NCDs and Innovation, World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark; (H.R.); (S.D.); (K.W.)
| | - Birdem Amoutzopoulos
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SL, UK; (B.A.); (T.S.)
| | - Toni Steer
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SL, UK; (B.A.); (T.S.)
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (I.L.); (T.J.K.)
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Shi J, Han Q, Cao Z, Wang Z. DeepTrayMeal: Automatic dietary assessment for Chinese tray meals based on deep learning. Food Chem 2024; 434:137525. [PMID: 37742550 DOI: 10.1016/j.foodchem.2023.137525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 09/26/2023]
Abstract
Tray meal is a popular way of eating in China, and tray-based automatic dietary assessment is important for public health. Relevant research is lacking because public tray meal datasets and suitable methods are unavailable. In this study, we established and published the first Chinese tray meal dataset, the ChinaLunchTray-99. We collected real-world 1185 tray meal images, covering 99 dish categories with corresponding manually annotated bounding box and category-level labels. We developed a new framework for automatic dietary assessment, which consists of dish image recognition, volume estimation and nutrition mapping. First, we demonstrated a tray meal detection model considering feature extraction, anchor scales, and loss function, resulting in a high mean Average Precision of 92.13%. Second, we proposed an automatic method to estimate volume via detection results and tray's information. Finally, nutrients were mapped from the estimated volume. Our research can promote applications of automatic dietary assessment for Chinese tray meals.
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Affiliation(s)
- Jialin Shi
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China
| | - Qi Han
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China
| | - Zhongxiang Cao
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China
| | - Zongjie Wang
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China.
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Béjar LM, Mesa-Rodríguez P, García-Perea MD. Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial. JMIR Mhealth Uhealth 2024; 12:e49302. [PMID: 38190226 PMCID: PMC10804253 DOI: 10.2196/49302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients' behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits. OBJECTIVE This study focused only on the dietary aspect of the PCPs' lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs. METHODS An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy. RESULTS The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory. CONCLUSIONS The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients. TRIAL REGISTRATION ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137.
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Affiliation(s)
- Luis María Béjar
- Department of Preventive Medicine and Public Health, Institute of Anatomy, School of Medicine, University of Seville, Seville, Spain
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Lei C, Tao X, Xiao Y. Dietary Iodine Intake and Related Factors among Secondary School Students in Macao. Healthcare (Basel) 2023; 11:healthcare11101472. [PMID: 37239759 DOI: 10.3390/healthcare11101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Iodine is a crucial micronutrient that is indispensable for optimal physical growth and cognitive maturation. However, the dietary iodine intake status of Macao's population is unknown. Therefore, a cross-sectional study was conducted to assess the dietary iodine intake of Macao secondary school students. Four hundred and twenty-four students filled in a self-developed, 61-item, iodine-specific food frequency questionnaire (I-FFQ). The dietary iodine intake was calculated based on the I-FFQ and food composition database. The median daily iodine intake of the students was 74.4 µg, which is lower than the 150 µg recommended by the World Health Organization (WHO). The intake frequency of dried seaweed and kelp was also low, with 49.3% and 64.2% of students consuming these foods infrequently over a month. In conclusion, the dietary iodine intake of secondary school students in Macao was inadequate. It is recommended that individuals should take the initiative to gain iodine-related knowledge. Students are advised to eat a variety of iodine-rich foods, such as seaweed and seafood, as part of a healthy, balanced diet to ensure sufficient iodine intake. Furthermore, it will be necessary to measure urinary iodine for the iodine status assessment of the Macao population in future.
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Affiliation(s)
- Cleandy Lei
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, China
| | - Xiaoyu Tao
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, China
| | - Ying Xiao
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, China
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Béjar LM, Mesa-Rodríguez P, Quintero-Flórez A, Ramírez-Alvarado MDM, García-Perea MD. Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial. Nutrients 2023; 15:nu15071688. [PMID: 37049528 PMCID: PMC10096856 DOI: 10.3390/nu15071688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).
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Rogers B, Somé JW, Bakun P, Adams KP, Bell W, Carroll DA, Wafa S, Coates J. Validation of the INDDEX24 mobile app v. a pen-and-paper 24-hour dietary recall using the weighed food record as a benchmark in Burkina Faso. Br J Nutr 2022; 128:1817-1831. [PMID: 34823617 PMCID: PMC9592947 DOI: 10.1017/s0007114521004700] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 12/29/2022]
Abstract
Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18-49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities' divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17-45 % for macronutrients, 5-17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.
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Affiliation(s)
- Beatrice Rogers
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Jérome W. Somé
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Peter Bakun
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Katherine P. Adams
- University of California, Davis, Institute for Global Nutrition, Department of Nutrition, Davis, CA, USA
| | - Winnie Bell
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - David Alexander Carroll
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Sarah Wafa
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Jennie Coates
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, USA
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Henriksen HB, Knudsen MD, Carlsen MH, Hjartåker A, Blomhoff R. A Short Digital Food Frequency Questionnaire (DIGIKOST-FFQ) Assessing Dietary Intake and Other Lifestyle Factors Among Norwegians: Qualitative Evaluation With Focus Group Interviews and Usability Testing. JMIR Form Res 2022; 6:e35933. [DOI: 10.2196/35933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background
In-person dietary counseling and interventions have shown promising results in changing habits toward healthier lifestyles, but they are costly to implement in large populations. Developing digital tools to assess individual dietary intake and lifestyle with integrated personalized feedback systems may help overcome this challenge. We developed a short digital food frequency questionnaire, known as the DIGIKOST-FFQ, to assess diet and other lifestyle factors based on the Norwegian Food-Based Dietary Guidelines. The DIGIKOST-FFQ includes a personalized feedback system, the DIGIKOST report, that benchmarks diet and lifestyle habits. We used qualitative focus group interviews and usability tests to test the feasibility and usability of the DIGIKOST application.
Objective
We aimed to explore attitudes, perceptions, and challenges in completing the DIGIKOST-FFQ. We also investigated perceptions and understanding of the personalized feedback in the DIGIKOST report and the technical flow and usability of the DIGIKOST-FFQ and the DIGIKOST report.
Methods
Healthy individuals and cancer survivors were invited to participate in the focus group interviews. The transcripts were analyzed using thematic analysis. Another group of healthy individuals completed the usability testing, which was administered individually by a moderator and 2 observers. The results were analyzed based on predefined assignments and discussion with the participants about the interpretation of the DIGIKOST report and technical flow of the DIGIKOST-FFQ.
Results
A total of 20 individuals participated in the focus group interviews, divided into 3 groups of healthy individuals and 3 groups of cancer survivors. Each group consisted of 3 to 4 individuals. Five main themes were investigated: (1) completion time (on average 19.1, SD 8.3, minutes, an acceptable duration), (2) layout (participants reported the DIGIKOST-FFQ was easy to navigate and had clear questions but presented challenges in reporting dietary intake, sedentary time, and physical activity in the last year), (3) questions (the introductory questions on habitual intake worked well), (4) pictures (the pictures were very helpful, but some portion sizes were difficult to differentiate and adding weight in grams would have been helpful), and (5) motivation (users were motivated to obtain personalized feedback). Four individuals participated in the usability testing. The results showed that the users could seamlessly log in, give consent, fill in the DIGIKOST-FFQ, and receive, print, and read the DIGIKOST report. However, parts of the report were perceived as difficult to interpret.
Conclusions
The DIGIKOST-FFQ was overall well received by participants, who found it feasible to use; however, some adjustments with regard to reporting dietary intake and lifestyle habits were suggested. The DIGIKOST report with personalized feedback was the main motivation to complete the questionnaire. The results from the usability testing revealed a need for adjustments and updates to make the report easier to read.
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Evaluation of paper-based and web-based food frequency questionnaires for 7-year-old children in Singapore. Br J Nutr 2022; 128:1626-1637. [PMID: 34776027 DOI: 10.1017/s0007114521004517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Advances in technology enabled the development of a web-based, pictorial FFQ to collect parent-report dietary intakes of 7-year-old children in the Growing Up in Singapore Towards healthy Outcomes study. This study aimed to compare intakes estimated from a paper-FFQ and a web-FFQ and examine the relative validity of both FFQ against 3-d diet records (3DDR). Ninety-two mothers reported food intakes of their 7-year-old child on a paper-FFQ, a web-FFQ and a 3DDR. A usability questionnaire collected participants' feedback on the web-FFQ. Correlations and agreement in energy, nutrients and food groups intakes between the dietary assessments were evaluated using Pearson's correlation, Lin's concordance, Bland-Altman plots, Cohen's κ and tertile classification. The paper- and web-FFQ had good correlations (≥ 0·50) and acceptable-good agreement (Lin's concordance ≥ 0·30; Cohen's κ ≥ 0·41; ≥ 50 % correct and ≤ 10 % misclassification into same or extreme tertiles). Compared with 3DDR, both FFQ showed poor agreement (< 0·30) in assessing absolute intakes except micronutrients (web-FFQ had acceptable-good agreement), but showed acceptable-good ability to classify children into tertiles (κ ≥ 0·21; ≥ 40 % and ≤ 15 % correct or misclassification). Bland-Altman plots suggest good agreement between web-FFQ and 3DDR in assessing micronutrients and several food groups. The web-FFQ was well-received, and majority (81 %) preferred the web-FFQ over the paper-FFQ. The newly developed web-FFQ produced intake estimates comparable to the paper-FFQ, has acceptable-good agreement with 3DDR in assessing absolute micronutrients intakes and has acceptable-good ability to classify children according to categories of intakes. The positive acceptance of the web-FFQ makes it a feasible tool for future dietary data collection.
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Identification of Factors Necessary for Enabling Technology-Based Dietary Record Surveys: A Qualitative Focus Group Interview with Japanese Dietitians. Nutrients 2022; 14:nu14204357. [PMID: 36297041 PMCID: PMC9609297 DOI: 10.3390/nu14204357] [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: 09/14/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/20/2022] Open
Abstract
Weighed food records together with an in-person interview approach constitute the most basic methods used to estimate energy and nutrient intakes in dietary surveys. In the background of the coronavirus disease-2019 pandemic, the need for non-face-to-face dietary surveys using information and communication technology (ICT) is increasing. We aimed to evaluate ICT-based dietary record surveys and identify factors that may enable this survey method to become more widely used in the future. We conducted a non-face-to-face survey of dietary records of 44 Japanese individuals, maintained by dietitians using dietary photography and video conferencing services. We conducted a focus group interview with the six dietitians who conducted that survey. Their opinions on the factors necessary to popularize ICT-based dietary survey method were analyzed. In the focus group interview, dietitians highlighted fewer restrictions on time and place as positive aspects. Negative aspects included insufficient skills to operate computers, difficulty in hearing, and understanding facial expressions using ICT. We identified three main factors for enabling widespread use of ICT-based dietary record survey: individual skill, device and technology, and social environmental factors. This suggests that a comprehensive approach is necessary for popularizing the use of ICT in dietary surveys.
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Béjar LM, García-Perea MD, Mesa-Rodríguez P. Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study. Nutrients 2022; 14:nu14194196. [PMID: 36235848 PMCID: PMC9571971 DOI: 10.3390/nu14194196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: ‘feedback’ e-12HR (IG) and ‘non-feedback’ e-12HR (CG). Only the ‘feedback’ e-12HR had two specific automatic functions: 1. Evaluation of the user’s AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.
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Affiliation(s)
- Luis M. Béjar
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, 41004 Seville, Spain
- Correspondence: ; Tel.: +34-954-551-771
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Livingstone KM, Brayner B, Celis-Morales C, Moschonis G, Manios Y, Traczyk I, Drevon CA, Daniel H, Saris WHM, Lovegrove JA, Gibney M, Gibney ER, Brennan L, Martinez JA, Mathers JC. Associations between dietary patterns, FTO genotype and obesity in adults from seven European countries. Eur J Nutr 2022; 61:2953-2965. [PMID: 35307761 PMCID: PMC9363276 DOI: 10.1007/s00394-022-02858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/02/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE High-fat and low-fibre discretionary food intake and FTO genotype are each associated independently with higher risk of obesity. However, few studies have investigated links between obesity and dietary patterns based on discretionary food intake, and the interaction effect of FTO genotype are unknown. Thus, this study aimed to derive dietary patterns based on intake of discretionary foods, saturated fatty acids (SFA) and fibre, and examine cross-sectional associations with BMI and waist circumference (WC), and interaction effects of FTO genotype. METHODS Baseline data on 1280 adults from seven European countries were included (the Food4Me study). Dietary intake was estimated from a Food Frequency Questionnaire. Reduced rank regression was used to derive three dietary patterns using response variables of discretionary foods, SFA and fibre density. DNA was extracted from buccal swabs. Anthropometrics were self-measured. Linear regression analyses were used to examine associations between dietary patterns and BMI and WC, with an interaction for FTO genotype. RESULTS Dietary pattern 1 (positively correlated with discretionary foods and SFA, and inversely correlated with fibre) was associated with higher BMI (β:0.64; 95% CI 0.44, 0.84) and WC (β:1.58; 95% CI 1.08, 2.07). There was limited evidence dietary pattern 2 (positively correlated with discretionary foods and SFA) and dietary pattern 3 (positively correlated with SFA and fibre) were associated with anthropometrics. FTO risk genotype was associated with higher BMI and WC, with no evidence of a dietary interaction. CONCLUSIONS Consuming a dietary pattern low in discretionary foods and high-SFA and low-fibre foods is likely to be important for maintaining a healthy weight, regardless of FTO predisposition to obesity. TRIAL REGISTRATION Clinicaltrials.gov NCT01530139. Registered 9 February 2012 https://clinicaltrials.gov/ct2/show/NCT01530139.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, 3220, Australia.
| | - Barbara Brayner
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, 3220, Australia
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Pl, Glasgow, G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, 3466706, Talca, Chile
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Yannis Manios
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, München, Germany
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Mike Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - J Alfredo Martinez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Kaiser B, Stelzl T, Finglas P, Gedrich K. The Assessment of a Personalized Nutrition Tool (eNutri) in Germany: Pilot Study on Usability Metrics and Users’ Experiences. JMIR Form Res 2022; 6:e34497. [PMID: 35925664 PMCID: PMC9389388 DOI: 10.2196/34497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/10/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background
To address the epidemic burden of diet-related diseases, adequate dietary intake assessments are needed to determine the actual nutrition intake of a population. In this context, the eNutri web app has been developed, providing online automated personalized dietary advice, based on nutritional information recorded via an integrated and validated food frequency questionnaire (FFQ). Originally developed for a British population and their dietary habits, the eNutri tool has specifically been adapted to the German population, taking into account national eating habits and dietary recommendations.
Objective
The primary aim of this study is to evaluate the system usability and users’ experience and feedback on the eNutri app in a small-scale preliminary study. The secondary aim is to investigate the efficacy of personalized nutrition (PN) recommendations versus general dietary advice in altering eating habits.
Methods
The app was piloted for 4 weeks by 106 participants from across Germany divided into a PN group and a control group. The groups differed according to the degree of personalization of dietary recommendations obtained.
Results
An overall System Usability Scale (SUS) score of 78.4 (SD 12.2) was yielded, indicating an above average user experience. Mean completion time of the FFQ was 26.7 minutes (SD 10.6 minutes). Across subgroups (age, sex, device screen sizes) no differences in SUS or completion time were found, indicating an equal performance for all users independent of the assigned experimental group. Participants’ feedback highlighted the need for more personalized dietary advice for controls, while personalized nutritional recommendations improved the awareness of healthy eating behavior. Further improvements to the eNutri app were suggested by the app users.
Conclusions
In total, the eNutri app has proven to be a suitable instrument to capture the dietary habits of a German population sample. Regarding functionality, system usability, and handling, direct user feedback was quite positive. Nutritional advice given was rated ambivalent, pointing to several weaknesses in the eNutri app, minimizing the system’s full potential. A higher level of personalization within nutritional advice subjectively improved the app’s usability. The insights gained will be used as a basis to further develop and improve this digital diet assessment tool.
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Affiliation(s)
- Birgit Kaiser
- Research Group Public Health Nutrition, ZIEL - Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Tamara Stelzl
- Chair of Analytical Food Chemistry, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Paul Finglas
- Quadram Bioscience Institute, Norwich, United Kingdom
| | - Kurt Gedrich
- Research Group Public Health Nutrition, ZIEL - Institute for Food & Health, TUM School of Life Sciences, Technical University of Munich, Freising, Germany
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Béjar LM. Weekend-Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students. Nutrients 2022; 14:nu14142811. [PMID: 35889767 PMCID: PMC9317012 DOI: 10.3390/nu14142811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023] Open
Abstract
Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend−weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m2; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake.
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Affiliation(s)
- Luis M Béjar
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, 41004 Seville, Spain
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17
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González-Alzaga B, Hernández AF, Kim Pack L, Iavicoli I, Tolonen H, Santonen T, Vinceti M, Filippini T, Moshammer H, Probst-Hensch N, Kolossa-Gehring M, Lacasaña M. The questionnaire design process in the European Human Biomonitoring Initiative (HBM4EU). ENVIRONMENT INTERNATIONAL 2022; 160:107071. [PMID: 34979351 DOI: 10.1016/j.envint.2021.107071] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/17/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Designing questionnaires is a key point of epidemiological studies assessing human exposure to chemicals. The lack of validated questionnaires can lead to the use of previously developed and sub-optimally adapted questionnaires, which may result in information biases that affect the study's validity. On this ground, a multidisciplinary group of researchers developed a series of tools to support data collection within the HBM4EU initiative. The objective of this paper is to share the process of developing HBM4EU questionnaires, as well as to provide researchers with harmonized procedures that could help them to design future questionnaires to assess environmental exposures. METHODS In the frame of the work package on survey design and fieldwork of the HBM4EU, researchers carried out procedures necessary for the development of quality questionnaires and related data collection tools. These procedures consisted of a systematic search to identify questionnaires used in previous human biomonitoring (HBM) studies, as well as the development of a checklist and evaluation sheet to assess the questionnaires identified. The results of these evaluations were taken into consideration for the development of the final questionnaires. RESULTS The main points covered by each of the sections included in HBM4EU questionnaires are described and discussed in detail. Additional tools developed for data collection in the HBM4EU (e.g. non-responder questionnaire, satisfaction questionnaire, matrix-specific questionnaire) are also addressed. Special attention is paid to the limitations faced and hurdles overcome during the process of questionnaire development. CONCLUSIONS Designing questionnaires for use in HBM studies requires substantial effort by a multidisciplinary team to guarantee that the quality of the information collected meets the study's objectives. The process of questionnaire development described herein will contribute to improve the harmonization of HBM studies within the social and environmental context of the EU countries.
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Affiliation(s)
- Beatriz González-Alzaga
- Andalusian School of Public Health (EASP), Spain; Instituto de Investigación Biosanitaria, ibs.GRANADA. Granada, Spain
| | - Antonio F Hernández
- Andalusian School of Public Health (EASP), Spain; Instituto de Investigación Biosanitaria, ibs.GRANADA. Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain; Department of Legal Medicine and Toxicology, University of Granada (UGR) School of Medicine, Spain
| | - L Kim Pack
- German Environment Agency (UBA), Germany
| | - Ivo Iavicoli
- Section of Occupational Medicine, Department of Public Health (DPH), University of Naples Federico II, Italy
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tiina Santonen
- Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Marco Vinceti
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Hanns Moshammer
- Department of Environmental Health, Centre for Public Health, Medical University Vienna (MUW), Vienna, Austria
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland; University of Basel, Switzerland
| | | | - Marina Lacasaña
- Andalusian School of Public Health (EASP), Spain; Instituto de Investigación Biosanitaria, ibs.GRANADA. Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain; Andalusian Health and Environment Observatory (OSMAN), Granada, Spain.
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18
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El Mesmoudi N, Al Dhaheri AS, Feehan J, Stojanovska L, Ali HI. Validation of a quantitative web-based food frequency questionnaire to assess dietary intake in the adult Emirati population. PLoS One 2022; 17:e0262150. [PMID: 35085272 PMCID: PMC8794217 DOI: 10.1371/journal.pone.0262150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background and objective A culture-specific web-based food frequency questionnaire (FFQ) to assess dietary intake in the United Arab Emirates (UAE) adult population was developed using data from the 2009–2010 national nutrition survey. The objective of this study was to assess the relative validity of the newly developed FFQ for use in the adult Emirati population (AE-FFQ), which contained a list of 139 food lines. Methods A convenient sample of 60 (36 females and 24 males) adult Emiratis completed 3 non-consecutive 24HRs over a period of one month, followed by the AE-FFQ, which assessed the intake over the previous month. Relative validity was evaluated by comparing nutrient and food group intakes from the AE-FFQ with the average three 24HRs using Wilcoxon signed-rank tests, Spearman’s correlation coefficients (CC), Bland-Altman analysis, and cross-classification. Results The AE-FFQ overestimated energy and most nutrients and food groups. Bland–Altman analysis showed significant proportional bias between the 2 methods. Deattenuated energy-adjusted Spearman correlation coefficients were poor to good ranging from 0.06 (iron) to 0.62 (fiber) for nutrients, 0.39 median value, and from –0.01 (cruciferous vegetables) to 0.64 (eggs) for food groups, 0.41 median value. A fairly acceptable agreement was obtained, with correct classification into the same or adjacent quartile ranging from 34% (vitamin B12) to 78% (pyridoxine), median 69% for nutrients and from 55% (diet soft drinks) to 87% (soft drinks), median 67% for food groups. Conclusions The AE-FFQ is an acceptable tool for ranking UAE adults (aged 18 to 50) according to their dietary intake to investigate the role of Emirati dietary patterns on health and disease. Caution is needed for assessing absolute intake, however, given the bias observed in assessing group-level agreement.
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Affiliation(s)
- Najoua El Mesmoudi
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jack Feehan
- The Department of Medicine–Western Health, The University of Melbourne, Melbourne, Australia
- The Institute for Health and Sport, Victoria University, Melbourne Australia
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- The Institute for Health and Sport, Victoria University, Melbourne Australia
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
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19
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Development of a first-generation Food Cloud for data, tools and services related to the nutrition, health and agri-food sciences–contributions from UCD to the Food Nutrition Security Cloud (FNS-Cloud) project. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Development of a mapping and merging framework to address data fragmentation in nutritional research: FNS Cloud project. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122001240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Brittain M, Consedine N, Bagot KL, Booth N, Rodda SN. Sugar Habit Hacker: Initial evidence that a planning intervention reduces sugar intake. J Behav Addict 2021; 10:471-481. [PMID: 34550904 PMCID: PMC8997217 DOI: 10.1556/2006.2021.00054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/26/2021] [Accepted: 07/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Sugar is a potentially addictive substance that is consumed in such high levels the World Health Organisation has set recommended consumption limits. To date there are no empirically tested brief interventions for reducing sugar consumption in adult populations. The current study aimed to preliminarily assess the feasibility of recruitment, retention, and intervention engagement and impact of a brief intervention. METHODS This pre-post study recruited 128 adults from New Zealand to complete a 30-day internet-delivered intervention with in-person and email coaching. The intervention components were derived from implementation intention principles whereby the gap between intention and behaviour was targeted. Participants selected sugar consumption goals aligned with WHO recommendations by gender. To meet these goals, participants developed action plans and coping plans and engaged in self-monitoring. Facilitation was provided by a coach to maintain retention and treatment adherence over the 30 days. RESULTS Intervention materials were rated as very useful and participants were mostly satisfied with the program. The total median amount of sugar consumed at baseline was 1,662.5 g (396 teaspoons per week) which was reduced to 362.5 g (86 teaspoons) at post-intervention evaluation (d = 0.83). The intervention was associated with large effects on reducing cravings (d = 0.59) and psychological distress (d = 0.68) and increasing situational self-efficacy (d = 0.92) and well-being (d = 0.68) with a reduction in BMI (d = 0.51). CONCLUSION This feasibility study indicates that a brief intervention delivering goal setting, implementation planning, and self-monitoring may assist people to reduce sugar intake to within WHO recommendations.
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Affiliation(s)
- Matthew Brittain
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Nathan Consedine
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Kathleen L. Bagot
- Department of Stroke, Public Health and Health Services Research, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia
| | - Natalia Booth
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Simone N. Rodda
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand,Corresponding author. Email
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Livingstone KM, Celis-Morales C, Navas-Carretero S, San-Cristobal R, Forster H, Woolhead C, O'Donovan CB, Moschonis G, Manios Y, Traczyk I, Gundersen TE, Drevon CA, Marsaux CFM, Fallaize R, Macready AL, Daniel H, Saris WHM, Lovegrove JA, Gibney M, Gibney ER, Walsh M, Brennan L, Martinez JA, Mathers JC. Personalised nutrition advice reduces intake of discretionary foods and beverages: findings from the Food4Me randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:70. [PMID: 34092234 PMCID: PMC8183081 DOI: 10.1186/s12966-021-01136-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of personalised nutrition advice on discretionary foods intake is unknown. To date, two national classifications for discretionary foods have been derived. This study examined changes in intake of discretionary foods and beverages following a personalised nutrition intervention using these two classifications. METHODS Participants were recruited into a 6-month RCT across seven European countries (Food4Me) and were randomised to receive generalised dietary advice (control) or one of three levels of personalised nutrition advice (based on diet [L1], phenotype [L2] and genotype [L3]). Dietary intake was derived from an FFQ. An analysis of covariance was used to determine intervention effects at month 6 between personalised nutrition (overall and by levels) and control on i) percentage energy from discretionary items and ii) percentage contribution of total fat, SFA, total sugars and salt to discretionary intake, defined by Food Standards Scotland (FSS) and Australian Dietary Guidelines (ADG) classifications. RESULTS Of the 1607 adults at baseline, n = 1270 (57% female) completed the intervention. Percentage sugars from FSS discretionary items was lower in personalised nutrition vs control (19.0 ± 0.37 vs 21.1 ± 0.65; P = 0.005). Percentage energy (31.2 ± 0.59 vs 32.7 ± 0.59; P = 0.031), percentage total fat (31.5 ± 0.37 vs 33.3 ± 0.65; P = 0.021), SFA (36.0 ± 0.43 vs 37.8 ± 0.75; P = 0.034) and sugars (31.7 ± 0.44 vs 34.7 ± 0.78; P < 0.001) from ADG discretionary items were lower in personalised nutrition vs control. There were greater reductions in ADG percentage energy and percentage total fat, SFA and salt for those randomised to L3 vs L2. CONCLUSIONS Compared with generalised dietary advice, personalised nutrition advice achieved greater reductions in discretionary foods intake when the classification included all foods high in fat, added sugars and salt. Future personalised nutrition approaches may be used to target intake of discretionary foods. TRIAL REGISTRATION Clinicaltrials.gov NCT01530139 . Registered 9 February 2012.
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Affiliation(s)
- Katherine M Livingstone
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, VIC, Australia
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Research Unit on Education, Physical Activity and Health (GEEAFyS), Universidad Católica del Maule, Talca, Chile
- Centre of Research in Exercise Physiology (CIFE), Universidad Mayor, Santiago, Chile
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - Hannah Forster
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, 3086, VIC, Australia
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | | | - Christian A Drevon
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rosalind Fallaize
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Anna L Macready
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, München, Germany
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julie A Lovegrove
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Marianne Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK.
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Huybrechts I, Miglio R, Mistura L, Grioni S, Pozzebon I, Odorifero C, Borea R, Gitto A, Terrafino M, Scipioni M, Turrini A, Krogh V, Ricci S, Martucci G, Longhi A. Relative Validity of an Italian EPIC Food Frequency Questionnaire for Dietary Factors in Children and Adolescents. A Rizzoli Orthopedic Institute Study. Nutrients 2021; 13:1245. [PMID: 33918879 PMCID: PMC8069881 DOI: 10.3390/nu13041245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Dietary factors play a major role in the development of non-communicable diseases, however little is known regarding the impact of nutrition on rare diseases like sarcomas. This Rizzoli Orthopedic Institute study aimed to evaluate the relative validity of a Food Frequency Questionnaire (FFQ) to measure the consumption of foods in comparison with a 3-days diary diet in a healthy Italian student population aged between 12 and 17 years. An extended version (including food groups for children) of the semi-quantitative FFQ used in the European Prospective Investigation into Cancer and Nutrition (EPIC) was administered. The validity of the FFQ was assessed by comparing the intakes from the FFQ against the 3-day diary method. 254 Italian subjects were included in the analyses: 128 females; 126 males; 116 from High Secondary School (14-17 years); 138 from Low Secondary School (12-13 years). Mean and median intakes are overall higher in the FFQs than in the food diaries. Spearman correlations adjusted for within-person variability were highest for legumes, vegetables and coffee/tea (>0.5), followed by potatoes, meat, fruits, breakfast cereals, biscuits and candies, and milk/yoghurts (>0.4). Moderate correlations were found for alcoholic drinks, soft drinks, juices, and grains (>0.3). For some food groups, such as fish, potatoes, and bread, correlations tend to become higher when stratifying the analyses for age group. These results demonstrate that the adapted EPIC COS FFQ validated in Italian adults is also appropriate and well understood by Italian children and adolescents.
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Affiliation(s)
- Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France;
| | - Rossella Miglio
- Dipartimento Scienze Statistiche “Paolo Fortunati”, University of Bologna, 40126 Bologna, Italy;
| | - Lorenza Mistura
- Council for Agricultural Research and Economics, Research on Food Nutrition, 00178 Roma, Italy; (L.M.); (A.T.)
| | - Sara Grioni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Epidemiology and Prevention Unit, 20133 Milano, Italy; (S.G.); (V.K.)
| | - Irene Pozzebon
- LILT, Lega Italiana Lotta Contro Tumori Association, 00178 Roma, Italy; (I.P.); (C.O.); (M.S.); (G.M.)
| | - Carmen Odorifero
- LILT, Lega Italiana Lotta Contro Tumori Association, 00178 Roma, Italy; (I.P.); (C.O.); (M.S.); (G.M.)
| | - Renato Borea
- Epidemiology and Prevention Unit (EPIC), University Federico II, 80135 Napoli, Italy;
| | - Angelo Gitto
- Istituto Ortopedico Rizzoli, IRCCS, Dietetic Service, 40136 Bologna, Italy; (A.G.); (M.T.); (S.R.)
| | - Mariela Terrafino
- Istituto Ortopedico Rizzoli, IRCCS, Dietetic Service, 40136 Bologna, Italy; (A.G.); (M.T.); (S.R.)
| | - Mattia Scipioni
- LILT, Lega Italiana Lotta Contro Tumori Association, 00178 Roma, Italy; (I.P.); (C.O.); (M.S.); (G.M.)
| | - Aida Turrini
- Council for Agricultural Research and Economics, Research on Food Nutrition, 00178 Roma, Italy; (L.M.); (A.T.)
| | - Vittorio Krogh
- Fondazione IRCCS Istituto Nazionale dei Tumori, Epidemiology and Prevention Unit, 20133 Milano, Italy; (S.G.); (V.K.)
| | - Susanna Ricci
- Istituto Ortopedico Rizzoli, IRCCS, Dietetic Service, 40136 Bologna, Italy; (A.G.); (M.T.); (S.R.)
| | - Gianfranco Martucci
- LILT, Lega Italiana Lotta Contro Tumori Association, 00178 Roma, Italy; (I.P.); (C.O.); (M.S.); (G.M.)
| | - Alessandra Longhi
- Istituto Ortopedico Rizzoli, IRCCS, Chemotherapy Unit, 40136 Bologna, Italy
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24
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Alawadhi B, Fallaize R, Franco RZ, Hwang F, Lovegrove J. Web-Based Dietary Intake Estimation to Assess the Reproducibility and Relative Validity of the EatWellQ8 Food Frequency Questionnaire: Validation Study. JMIR Form Res 2021; 5:e13591. [PMID: 33650974 PMCID: PMC7967232 DOI: 10.2196/13591] [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: 02/07/2019] [Revised: 06/08/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The web-based EatWellQ8 food frequency questionnaire (FFQ) was developed as a dietary assessment tool for healthy adults in Kuwait. Validation against reliable instruments and assessment of its reproducibility are required to ensure the accuracy of the EatWellQ8 FFQ in computing nutrient intake. OBJECTIVE This study aims to assess the reproducibility and relative validity of the EatWellQ8 146-item FFQ, which included images of food portion sizes based on The Composition of Foods by McCance and Widdowson and food composition tables from Kuwait and the Kingdom of Bahrain, against a paper-based FFQ (PFFQ) and a 4-day weighed food record (WFR). METHODS Reproducibility of the EatWellQ8 FFQ was assessed using a test-retest methodology. Participants were required to complete the FFQ at 2 time points, 4 weeks apart. To assess the relative validity of the EatWellQ8 FFQ, a subset of the participants were asked to complete a PFFQ or a 4-day WFR 1 week after the administration of the EatWellQ8 FFQ. The level of agreement between nutrient and food group intakes was estimated by repeated EatWellQ8 FFQ administration. The EatWellQ8 FFQ, PFFQ, and 4-day WFR were also evaluated using the Bland-Altman methodology and classified into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrients and food groups. RESULTS A total of 99 Kuwaiti participants (64/99, 65% female and 35/99, 35% male) completed the study-53 participated in the reproducibility study and the 4-day WFR validity study (mean age 37.1 years, SD 9.9) and 46 participated in the PFFQ validity study (mean age 36.2 years, SD 8.3). Crude unadjusted correlations for repeated EatWellQ8 FFQs ranged from 0.37 to 0.93 (mean r=0.67, SD 0.14; 95% CI 0.11-0.95) for nutrients and food groups (P=.01). Mean cross-classification into exact agreement plus adjacent was 88% for nutrient intakes and 86% for food groups, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. The association between the EatWellQ8 FFQ and PFFQ varied, with crude unadjusted correlations ranging from 0.42 to 0.73 (mean r=0.46, SD 0.12; 95% CI -0.02 to 0.84; P=.046). Mean cross-classification into exact agreement plus adjacent was 84% for nutrient intake and 74% for food groups. Bland-Altman plots showed moderate agreement for both energy and energy-controlled nutrient intakes. Crude unadjusted correlations for the EatWellQ8 FFQ and the 4-day WFR ranged from 0.40 to 0.88 (mean r=0.58, SD 0.13; 95% CI 0.01-0.58; P=.01). Mean cross-classification into exact agreement plus adjacent was 85% for nutrient intake and 83% for food groups. Bland-Altman plots showed moderate agreement for energy-adjusted macronutrient intakes. CONCLUSIONS The results indicate that the web-based EatWellQ8 FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement compared with a PFFQ and a 4-day WFR for measuring energy and nutrient intakes.
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Affiliation(s)
- Balqees Alawadhi
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.,School of Life and Medical Science, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Rodrigo Zenun Franco
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Faustina Hwang
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Julie Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
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Blaurock J, Kaiser B, Stelzl T, Weech M, Fallaize R, Franco RZ, Hwang F, Lovegrove J, Finglas PM, Gedrich K. Dietary Quality in Vegetarian and Omnivorous Female Students in Germany: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1888. [PMID: 33669236 PMCID: PMC7919835 DOI: 10.3390/ijerph18041888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/25/2022]
Abstract
Vegetarian diets have gained in popularity, especially among highly educated women, and are considered beneficial to health. Comparative studies assessing the diet of vegetarians against omnivores are rather limited and often provide ambivalent results. Therefore, this study examined the nutrient intake and nutritional quality of vegetarian and omnivorous diets in a group of 61 female students in Germany. Habitual dietary intake was evaluated using a validated graphical online food frequency questionnaire (FFQ). Differences in nutrient intakes were analyzed by Mann-Whitney-U-Tests. Odds Ratios (OR) were calculated for vegetarians exceeding dietary reference values (DRV) compared to omnivores. The overall nutritional quality was assessed using the Healthy-Eating-Index-2015 (HEI-2015). In omnivores, intakes of total energy from saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), long-chain omega-3 polyunsaturated fatty acids (LC-n3-PUFA), cholesterol, sucrose, lactose, retinol, and cobalamin were significantly higher than in vegetarians. Significantly lower intakes were observed for fiber, magnesium, and beta-carotene. Significant OR were detected for total fat (OR = 0.29), SFA (OR = 0.04), beta-carotene (OR = 4.55), and cobalamin (OR = 0.32). HEI-2015 scores were higher for vegetarians than for omnivores (79 points versus 74 points) and significant differences were recorded for the HEI-2015 components dairy, seafood & plant proteins, fatty acids, added sugars, and saturated fatty acids.
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Affiliation(s)
- Julia Blaurock
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
| | - Birgit Kaiser
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
| | - Tamara Stelzl
- Analytical Food Chemistry, Technical University of Munich, 85354 Freising, Germany;
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | | | - Faustina Hwang
- Biomedical Engineering, School of Biological Sciences, University of Reading, Reading RG6 6DH, UK;
| | - Julie Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | | | - Kurt Gedrich
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
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Abstract
OBJECTIVE The aim of the present study was to develop and validate a vitamin D FFQ for assessment of dietary vitamin D intake in healthy adults in England, UK. DESIGN The current study assessed the agreement between a four-day food diary (4 d-FD) and a new vitamin D FFQ to measure dietary intake of vitamin D. Dietary intake was estimated using Nutritics dietary analysis software, and Spearman's and Bland-Altman tests were utilised to assess correlation and agreement, respectively. Participants also provided a blood sample for plasma analysis of vitamin D concentrations. SETTING Home setting. PARTICIPANTS Fifty participants were recruited to the study from the University of Chester and vicinity. RESULTS Results showed a strong correlation between vitamin D intake recorded by the FFQ and the 4 d-FD (r = 0·609; P < 0·0001) within 95 % limits of agreement. Furthermore, a significant correlation between plasma 25(OH)D concentrations and vitamin D intake measured by the FFQ (r = 0·290, P = 0·041) and the 4 d-FD (r = 0·360, P = 0·01) was observed. CONCLUSION Our analysis suggests this FFQ is a useful and rapid tool for researchers and health professionals to assess vitamin D dietary intakes in healthy adults in the UK.
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Ji Y, Plourde H, Bouzo V, Kilgour RD, Cohen TR. Validity and Usability of a Smartphone Image-Based Dietary Assessment App Compared to 3-Day Food Diaries in Assessing Dietary Intake Among Canadian Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16953. [PMID: 32902389 PMCID: PMC7511869 DOI: 10.2196/16953] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/06/2020] [Accepted: 06/13/2020] [Indexed: 01/19/2023] Open
Abstract
Background Accurate dietary assessment is needed in studies that include analysis of nutritional intake. Image-based dietary assessment apps have gained in popularity for assessing diet, which may ease researcher and participant burden compared to traditional pen-to-paper methods. However, few studies report the validity of these apps for use in research. Keenoa is a smartphone image-based dietary assessment app that recognizes and identifies food items using artificial intelligence and permits real-time editing of food journals. Objective This study aimed to assess the relative validity of an image-based dietary assessment app — Keenoa — against a 3-day food diary (3DFD) and to test its usability in a sample of healthy Canadian adults. Methods We recruited 102 participants to complete two 3-day food records. For 2 weeks, on 2 non-consecutive days and 1 weekend day, in random order, participants completed a traditional pen-to-paper 3DFD and the Keenoa app. At the end of the study, participants completed the System Usability Scale. The nutrient analyses of the 3DFD and Keenoa data before (Keenoa-participant) and after they were reviewed by dietitians (Keenoa-dietitian) were analyzed using analysis of variance. Multiple tests, including the Pearson coefficient, cross-classification, kappa score, % difference, paired t test, and Bland-Altman test, were performed to analyze the validity of Keenoa (Keenoa-dietitian). Results The study was completed by 72 subjects. Most variables were significantly different between Keenoa-participant and Keenoa-dietitian (P<.05) except for energy, protein, carbohydrates, fiber, vitamin B1, vitamin B12, vitamin C, vitamin D, and potassium. Significant differences in total energy, protein, carbohydrates, % fat, saturated fatty acids, iron, and potassium were found between the 3DFD and Keenoa-dietitian data (P<.05). The Pearson correlation coefficients between the Keenoa-dietitian and 3DFD ranged from .04 to .51. Differences between the mean intakes assessed by the 3DFD and Keenoa-dietitian were within 10% except for vitamin D (misclassification rate=33.8%). The majority of nutrients were within an acceptable range of agreement in the Bland-Altman analysis; no agreements were seen for total energy, protein, carbohydrates, fat (%), saturated fatty acids, iron, potassium, and sodium (P<.05). According to the System Usability Scale, 34.2% of the participants preferred using Keenoa, while 9.6% preferred the 3DFD. Conclusions The Keenoa app provides acceptable relative validity for some nutrients compared to the 3DFD. However, the average intake of some nutrients, including energy, protein, carbohydrates, % fat, saturated fatty acids, and iron, differed from the average obtained using the 3DFD. These findings highlight the importance of verifying data entries of participants before proceeding with nutrient analysis. Overall, Keenoa showed better validity at the group level than the individual level, suggesting it can be used when focusing on the dietary intake of the general population. Further research is recommended with larger sample sizes and objective dietary assessment approaches.
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Affiliation(s)
- Yuwei Ji
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Hugues Plourde
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Valerie Bouzo
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Robert D Kilgour
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada.,PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Tamara R Cohen
- PERFORM Centre, Concordia University, Montreal, QC, Canada.,Faculty of Land and Food Systems, Food, Nutrition and Health, University of British Columbia, Vancouver, BC, Canada
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Characteristics of participants who benefit most from personalised nutrition: findings from the pan-European Food4Me randomised controlled trial. Br J Nutr 2020; 123:1396-1405. [PMID: 32234083 DOI: 10.1017/s0007114520000653] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Little is known about who would benefit from Internet-based personalised nutrition (PN) interventions. This study aimed to evaluate the characteristics of participants who achieved greatest improvements (i.e. benefit) in diet, adiposity and biomarkers following an Internet-based PN intervention. Adults (n 1607) from seven European countries were recruited into a 6-month, randomised controlled trial (Food4Me) and randomised to receive conventional dietary advice (control) or PN advice. Information on dietary intake, adiposity, physical activity (PA), blood biomarkers and participant characteristics was collected at baseline and month 6. Benefit from the intervention was defined as ≥5 % change in the primary outcome (Healthy Eating Index) and secondary outcomes (waist circumference and BMI, PA, sedentary time and plasma concentrations of cholesterol, carotenoids and omega-3 index) at month 6. For our primary outcome, benefit from the intervention was greater in older participants, women and participants with lower HEI scores at baseline. Benefit was greater for individuals reporting greater self-efficacy for 'sticking to healthful foods' and who 'felt weird if [they] didn't eat healthily'. Participants benefited more if they reported wanting to improve their health and well-being. The characteristics of individuals benefiting did not differ by other demographic, health-related, anthropometric or genotypic characteristics. Findings were similar for secondary outcomes. These findings have implications for the design of more effective future PN intervention studies and for tailored nutritional advice in public health and clinical settings.
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Wald JP, Asare E, Nakua EK, Nohr D, Lambert C, Riedel S, Gola U, Biesalski HK. Validation of a computer-based analysis tool for real-time dietary assessment within a Ghanaian region. NFS JOURNAL 2019. [DOI: 10.1016/j.nfs.2019.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Celis-Morales C, Livingstone KM, Petermann-Rocha F, Navas-Carretero S, San-Cristobal R, O'Donovan CB, Moschonis G, Manios Y, Traczyk I, Drevon CA, Daniel H, Marsaux CFM, Saris WHM, Fallaize R, Macready AL, Lovegrove JA, Gibney M, Gibney ER, Walsh M, Brennan L, Martinez JA, Mathers JC. Frequent Nutritional Feedback, Personalized Advice, and Behavioral Changes: Findings from the European Food4Me Internet-Based RCT. Am J Prev Med 2019; 57:209-219. [PMID: 31248745 DOI: 10.1016/j.amepre.2019.03.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study tested the hypothesis that providing personalized nutritional advice and feedback more frequently would promote larger, more appropriate, and sustained changes in dietary behavior as well as greater reduction in adiposity. STUDY DESIGN A 6-month RCT (Food4Me) was conducted in seven European countries between 2012 and 2013. SETTING/PARTICIPANTS A total of 1,125 participants were randomized to Lower- (n=562) or Higher- (n=563) Frequency Feedback groups. INTERVENTION Participants in the Lower-Frequency group received personalized nutritional advice at baseline and at Months 3 and 6 of the intervention, whereas the Higher-Frequency group received personalized nutritional advice at baseline and at Months 1, 2, 3 and 6. MAIN OUTCOME MEASURES The primary outcomes were change in dietary intake (at food and nutrient levels) and obesity-related traits (body weight, BMI, and waist circumference). Participants completed an online Food Frequency Questionnaire to estimate usual dietary intake at baseline and at Months 3 and 6 of the intervention. Overall diet quality was evaluated using the 2010 Healthy Eating Index. Obesity-related traits were self-measured and reported by participants via the Internet. Statistical analyses were performed during the first quarter of 2018. RESULTS At 3 months, participants in the Lower- and Higher-Frequency Feedback groups showed improvements in Healthy Eating Index score; this improvement was larger in the Higher-Frequency group than the Lower-Frequency group (Δ=1.84 points, 95% CI=0.79, 2.89, p=0.0001). Similarly, there were greater improvements for the Higher- versus Lower-Frequency group for body weight (Δ= -0.73 kg, 95% CI= -1.07, -0.38, p<0.0001), BMI (Δ= -0.24 kg/m2, 95% CI= -0.36, -0.13, p<0.0001), and waist circumference (Δ= -1.20 cm, 95% CI= -2.36, -0.04, p=0.039). However, only body weight and BMI remained significant at 6 months. CONCLUSIONS At 3 months, higher-frequency feedback produced larger improvements in overall diet quality as well as in body weight and waist circumference than lower-frequency feedback. However, only body weight and BMI remained significant at 6 months. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01530139.
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Affiliation(s)
- Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Exercise Physiology Research Centre (CIFE), Universidad Mayor, Santiago, Chile; BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Fanny Petermann-Rocha
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, Munich, Germany
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rosalind Fallaize
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom; Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Marianne Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain; Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Béjar LM, García-Perea MD, Reyes ÓA, Vázquez-Limón E. Relative Validity of a Method Based on a Smartphone App (Electronic 12-Hour Dietary Recall) to Estimate Habitual Dietary Intake in Adults. JMIR Mhealth Uhealth 2019; 7:e11531. [PMID: 30973343 PMCID: PMC6489347 DOI: 10.2196/11531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/30/2018] [Accepted: 02/24/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Accurate dietary assessment is key to understanding nutrition-related outcomes and for estimating the dietary change in nutrition-based interventions. When researching the habitual consumption of selected food groups, it is essential to be aware of factors that could possibly affect reporting accuracy. OBJECTIVE This study aimed to evaluate the relative validity of the current-day dietary recall, a method based on a smartphone app called electronic 12-hour dietary recall (e-12HR), to categorize individuals according to habitual intake, in the whole sample of adults and in different strata thereof. METHODS University students and employees over 18 years recorded the consumption of 10 selected groups of food using e-12HR during 28 consecutive days. During this period, they also completed 4 dietary records. Once the period was finished, the subjects then completed a food frequency questionnaire (FFQ) and a usability-rating questionnaire for e-12HR. The food group intakes estimated by the e-12HR app, the dietary records, and the FFQ were categorized into sextiles: less than once a week, once or twice a week, 3-4 times a week, 5-6 times a week, once or twice a day, and 3 or more times a day. The 10 selected groups with e-12HR were compared with 4 dietary records and an FFQ reference method, in the whole sample and in different strata thereof: age (years): <25 and ≥25; gender: females and males; occupation: students and employees; smoking: no and yes; physical activity (minutes/week): ≥150 and <150; and body mass index (kg/m2): <25 and ≥25. The association between the different methods was assessed using Spearman correlation coefficient (SCC). Cross-classification and kappa statistic were used as a measure of agreement between the different methods. RESULTS In total, 203 participants completed the study (56.7% [115/203] women, and 43.3% [88/203] men). For all food groups and all participants, the mean SCC for e-12HR versus FFQ was 0.67 (≥0.62 for all strata). On average, 50.7% of participants were classified into the same category (≥47.0% for all strata) and 90.2% within the nearest category (≥88.6% for all strata). Mean weighted kappa was 0.49 (≥0.44 for all strata). For e-12HR versus RDs, mean SCC was 0.65 (≥0.57 for all strata). On average, 50.0% of participants were classified into the same category (≥47.0% for all strata) and 88.2% within the nearest category (≥86.1% for all strata). Mean weighted kappa was 0.50 (≥0.44 for all strata). CONCLUSIONS The results indicate that e-12HR generated categories of dietary intake highly comparable with the 2 reference methods in the whole sample and in different strata thereof. The inclusion of photographs to facilitate estimation of the servings consumed generated correlation/agreement data between e-12HR and the FFQ that were similar to a previous study using an older version of the app, which did not include photographs.
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Affiliation(s)
- Luis María Béjar
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, Seville, Spain
| | | | | | - Esther Vázquez-Limón
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, Seville, Spain
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Fallaize R, Franco RZ, Hwang F, Lovegrove JA. Evaluation of the eNutri automated personalised nutrition advice by users and nutrition professionals in the UK. PLoS One 2019; 14:e0214931. [PMID: 30943252 PMCID: PMC6447217 DOI: 10.1371/journal.pone.0214931] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/24/2019] [Indexed: 12/18/2022] Open
Abstract
Nutrition apps have great potential to support people to improve their diets, but few apps give automated validated personalised nutrition advice. A web app capable of delivering automated personalised food-based nutrition advice (eNutri) was developed. The aims of this study were to i) evaluate and optimise the personalised nutrition report provided by the app and ii) compare the personalised food-based advice with nutrition professionals’ standards to aid validation. A study with nutrition professionals (NP) compared the advice provided by the app against professional Registered Dietitians (RD) (n = 16) and Registered Nutritionists (RN) (n = 16) standards. Each NP received two pre-defined scenarios, comprising an individual’s characteristics and dietary intake based on an analysis of a food frequency questionnaire, along with the nutrition food-based advice that was automatically generated by the app for that individual. NPs were asked to use their professional judgment to consider the scenario, provide their three most relevant recommendations for that individual, then consider the app’s advice and rate their level of agreement via 5-star scales (with 5 as complete agreement). NPs were also asked to comment on the eNutri recommendations, scores generated and overall impression. The mean scores for the appropriateness, relevance and suitability of the eNutri diet messages were 3.5, 3.3 and 3.3 respectively.
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Affiliation(s)
- Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, United Kingdom
- School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - Rodrigo Zenun Franco
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Faustina Hwang
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, United Kingdom
- * E-mail:
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Hooson Jzh J, Hutchinson Jyh J, Warthon-Medina M, Hancock N, Greathead K, Knowles B, Vargas-Garcia E, Gibson LE, Bush LA, Margetts B, Robinson S, Ness A, Alwan NA, Wark PA, Roe M, Finglas P, Steer T, Page P, Johnson L, Roberts K, Amoutzopoulos B, Burley VJ, Greenwood DC, Cade JE. A systematic review of reviews identifying UK validated dietary assessment tools for inclusion on an interactive guided website for researchers: www.nutritools.org. Crit Rev Food Sci Nutr 2019; 60:1265-1289. [PMID: 30882230 PMCID: PMC7114915 DOI: 10.1080/10408398.2019.1566207] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Health researchers may struggle to choose suitable validated dietary assessment tools (DATs) for their target population. The aim of this review was to identify and collate information on validated UK DATs and validation studies for inclusion on a website to support researchers to choose appropriate DATs.Design: A systematic review of reviews of DATs was undertaken. DATs validated in UK populations were extracted from the studies identified. A searchable website was designed to display these data. Additionally, mean differences and limits of agreement between test and comparison methods were summarized by a method, weighting by sample size.Results: Over 900 validation results covering 5 life stages, 18 nutrients, 6 dietary assessment methods, and 9 validation method types were extracted from 63 validated DATs which were identified from 68 reviews. These were incorporated into www.nutritools.org. Limits of agreement were determined for about half of validations. Thirty four DATs were FFQs. Only 17 DATs were validated against biomarkers, and only 19 DATs were validated in infant/children/adolescents.Conclusions: The interactive www.nutritools.org website holds extensive validation data identified from this review and can be used to guide researchers to critically compare and choose a suitable DAT for their research question, leading to improvement of nutritional epidemiology research.
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Affiliation(s)
- Jozef Hooson Jzh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Jayne Hutchinson Jyh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Marisol Warthon-Medina
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.,Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Neil Hancock
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Katharine Greathead
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Bethany Knowles
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Elisa Vargas-Garcia
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lauren E Gibson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Linda A Bush
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Barrie Margetts
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andy Ness
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Nisreen A Alwan
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.,Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Petra A Wark
- Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, UK.,Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Mark Roe
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK.,EuroFIR AISBL, Brussels, Belgium
| | - Paul Finglas
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Toni Steer
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Polly Page
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katharine Roberts
- Public Health Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.,Public Health England, London, UK
| | | | - Victoria J Burley
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Faculty of Medicine and Health Division of Biostatistics, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Fuscà E, Bolzon A, Buratin A, Ruffolo M, Berchialla P, Gregori D, Perissinotto E, Baldi I. Measuring Caloric Intake at the Population Level (NOTION): Protocol for an Experimental Study. JMIR Res Protoc 2019; 8:e12116. [PMID: 30860491 PMCID: PMC6434395 DOI: 10.2196/12116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/16/2022] Open
Abstract
Background The monitoring of caloric intake is an important challenge for the maintenance of individual and public health. The instruments used so far for dietary monitoring (eg, food frequency questionnaires, food diaries, and telephone interviews) are inexpensive and easy to implement but show important inaccuracies. Alternative methods based on wearable devices and wrist accelerometers have been proposed, yet they have limited accuracy in predicting caloric intake because analytics are usually not well suited to manage the massive sets of data generated from these types of devices. Objective This study aims to develop an algorithm using recent advances in machine learning methodology, which provides a precise and stable estimate of caloric intake. Methods The study will capture four individual eating activities outside the home over 2 months. Twenty healthy Italian adults will be recruited from the University of Padova in Padova, Italy, with email, flyers, and website announcements. The eligibility requirements include age 18 to 66 years and no eating disorder history. Each participant will be randomized to one of two menus to be eaten on weekdays in a predefined cafeteria in Padova (northeastern Italy). Flows of raw data will be accessed and downloaded from the wearable devices given to study participants and associated with anthropometric and demographic characteristics of the user (with their written permission). These massive data flows will provide a detailed picture of real-life conditions and will be analyzed through an up-to-date machine learning approach with the aim to accurately predict the caloric contribution of individual eating activities. Gold standard evaluation of the energy content of eaten foods will be obtained using calorimetric assessments made at the Laboratory of Dietetics and Nutraceutical Research of the University of Padova. Results The study will last 14 months from July 2017 with a final report by November 2018. Data collection will occur from October to December 2017. From this study, we expect to obtain a series of relevant data that, opportunely filtered, could allow the construction of a prototype algorithm able to estimate caloric intake through the recognition of food type and the number of bites. The algorithm should work in real time, be embedded in a wearable device, and able to match bite-related movements and the corresponding caloric intake with high accuracy. Conclusions Building an automatic calculation method for caloric intake, independent on the black-box processing of the wearable devices marketed so far, has great potential both for clinical nutrition (eg, for assessing cardiovascular compliance or for the prevention of coronary heart disease through proper dietary control) and public health nutrition as a low-cost monitoring tool for eating habits of different segments of the population. International Registered Report Identifier (IRRID) DERR1-10.2196/12116
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Affiliation(s)
- Elisa Fuscà
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Anna Bolzon
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Alessia Buratin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Mariangela Ruffolo
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Egle Perissinotto
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Ileana Baldi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Eldridge AL, Piernas C, Illner AK, Gibney MJ, Gurinović MA, de Vries JHM, Cade JE. Evaluation of New Technology-Based Tools for Dietary Intake Assessment-An ILSI Europe Dietary Intake and Exposure Task Force Evaluation. Nutrients 2018; 11:E55. [PMID: 30597864 PMCID: PMC6356426 DOI: 10.3390/nu11010055] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/20/2018] [Accepted: 12/25/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND New technology-based dietary assessment tools, including Web-based programs, mobile applications, and wearable devices, may improve accuracy and reduce costs of dietary data collection and processing. The International Life Sciences Institute (ILSI) Europe Dietary Intake and Exposure Task Force launched this project to evaluate new tools in order to recommend general quality standards for future applications. METHODS A comprehensive literature search identified technology-based dietary assessment tools, including those published in English from 01/2011 to 09/2017, and providing details on tool features, functions and uses. Each of the 43 tools identified (33 for research and 10 designed for consumer use) was rated on 25 attributes. RESULTS Most of the tools identified (79%) relied on self-reported dietary intakes. Most (91%) used text entry and 33% used digital images to help identify foods. Only 65% had integrated databases for estimating energy or nutrients. Fewer than 50% contained any features of customization and about half generated automatic reports. Most tools reported on usability or reported validity compared with another assessment method (77%). A set of Best Practice Guidelines was developed for reporting dietary assessment tools using new technology. CONCLUSIONS Dietary assessment methods that utilize technology offer many advantages for research and are often preferable to consumers over more traditional methods. In order to meet general quality standards, new technology tools require detailed publications describing tool development, food identification and quantification, customization, outputs, food composition tables used, and usability/validity testing.
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Affiliation(s)
- Alison L Eldridge
- Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
| | - Anne-Kathrin Illner
- College of Health Sciences, Polytechnic Institute UniLaSalle Beauvais, 60026 Beauvais, France.
| | - Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin D04 V1W8, Ireland.
| | - Mirjana A Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade 11000, Serbia.
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University, 6708WE Wageningen, The Netherlands.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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36
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Gibney MJ, O'Sullivan A, Flynn A, Walton J, Daniel H, Manios Y, Martinez A, Saris WHM, Gibney ER, Uzhova I. Analysis of the National Adult Nutrition Survey (Ireland) and the Food4Me Nutrition Survey Databases to Explore the Development of Food Labelling Portion Sizes for the European Union. Nutrients 2018; 11:nu11010006. [PMID: 30577456 PMCID: PMC6356260 DOI: 10.3390/nu11010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/21/2018] [Accepted: 12/14/2018] [Indexed: 12/15/2022] Open
Abstract
The present study set out to explore the option of developing food portion size for nutritional labelling purposes using two European Union (EU) dietary surveys. The surveys were selected as they differed in (a) methodologies (food diary versus food frequency questionnaire), (b) populations (Irish National Adult Nutrition Survey (NANS) versus a seven-country survey based on the pan EU study Food4Me), (c) food quantification (multiple options versus solely photographic album) and (d) duration (4 consecutive days versus recent month). Using data from these studies, portion size was determined for 15 test foods, where portion size was defined as the median intake of a target food when consumed. The median values of the portion sizes derived from both the NANS and Food4Me surveys were correlated (r = 0.823; p < 0.00) and the mean of the two survey data sets were compared to US values from the Recognized as Customarily Consumed (RACC) database. There was very strong agreement across all food categories between the averaged EU and the US portion size (r = 0.947; p < 0.00). It is concluded that notwithstanding the variety of approaches used for dietary survey data in the EU, the present data supports using a standardized approach to food portion size quantification for food labelling in the EU.
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Affiliation(s)
- Michael J Gibney
- Institute of Food & Health, University College Dublin, D04V1W8 Dublin, Ireland.
| | - Aifric O'Sullivan
- Institute of Food & Health, University College Dublin, D04V1W8 Dublin, Ireland.
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, T12Y337 Cork, Ireland.
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, T12Y337 Cork, Ireland.
| | - Hannelore Daniel
- Molecular Nutrition Unit, Center of Life and Food Sciences Weihenstephan, Technische Universität München, D-85354 Freising, Germany.
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31009 Pamplona, Spain.
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, 6200MD Maastricht, The Netherlands.
| | - Eileen R Gibney
- Institute of Food & Health, University College Dublin, D04V1W8 Dublin, Ireland.
| | - Irina Uzhova
- Institute of Food & Health, University College Dublin, D04V1W8 Dublin, Ireland.
- Department of Health and Nutritional Sciences, Institute of Technology Sligo, F92YW50 Sligo, Ireland.
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Strategies for online personalised nutrition advice employed in the development of the eNutri web app. Proc Nutr Soc 2018; 78:407-417. [PMID: 30560739 DOI: 10.1017/s0029665118002707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The internet has considerable potential to improve health-related food choice at low-cost. Online solutions in this field can be deployed quickly and at very low cost, especially if they are not dependent on bespoke devices or offline processes such as the provision and analysis of biological samples. One key challenge is the automated delivery of personalised dietary advice in a replicable, scalable and inexpensive way, using valid nutrition assessment methods and effective recommendations. We have developed a web-based personalised nutrition system (eNutri) which assesses dietary intake using a validated graphical FFQ and provides personalised food-based dietary advice automatically. Its effectiveness was evaluated during an online randomised controlled trial dietary intervention (EatWellUK study) in which personalised dietary advice was compared with general population recommendations (control) delivered online. The present paper presents a review of literature relevant to this work, and describes the strategies used during the development of the eNutri app. Its design and source code have been made publicly available under a permissive open source license, so that other researchers and organisations can benefit from this work. In a context where personalised diet advice has great potential for health promotion and disease prevention at-scale and yet is not currently being offered in the most popular mobile apps, the strategies and approaches described in the present paper can help to inform and advance the design and development of technologies for personalised nutrition.
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Haydar S, Paillot T, Fagot C, Cogne Y, Fountas A, Tutuncu Y, Vintila M, Tsatsoulis A, Thanh Chi P, Garandeau P, Chetea D, Badiu C, Gheorghiu M, Ylli D, Lautier C, Jarec M, Monnier L, Normand C, Šarac J, Barakat A, Missoni S, Pugeat M, Poucheret P, Hanzu F, Gomis R, Macias JM, Litvinov S, Khusnutdinova E, Poiana C, Pasquali R, Lauro D, Sesti G, Trischitta V, Abdelhak S, Zenati A, Ylli A, Satman I, Kanninen T, Rinato Y, Grigorescu F. Branched-Chain Amino Acid Database Integrated in MEDIPAD Software as a Tool for Nutritional Investigation of Mediterranean Populations. Nutrients 2018; 10:E1392. [PMID: 30275383 PMCID: PMC6213539 DOI: 10.3390/nu10101392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/24/2022] Open
Abstract
Branched-chained amino acids (BCAA) are essential dietary components for humans and can act as potential biomarkers for diabetes development. To efficiently estimate dietary intake, we developed a BCAA database for 1331 food items found in the French Centre d'Information sur la Qualité des Aliments (CIQUAL) food table by compiling BCAA content from international tables, published measurements, or by food similarity as well as by calculating 267 items from Greek, Turkish, Romanian, and Moroccan mixed dishes. The database embedded in MEDIPAD software capable of registering 24 h of dietary recalls (24HDR) with clinical and genetic data was evaluated based on archived 24HDR of the Saint Pierre Institute (France) from 2957 subjects, which indicated a BCAA content up to 4.2 g/100 g of food and differences among normal weight and obese subjects across BCAA quartiles. We also evaluated the database of 119 interviews of Romanians, Turkish and Albanians in Greece (27⁻65 years) during the MEDIGENE program, which indicated mean BCAA intake of 13.84 and 12.91 g/day in males and females, respectively, comparable to other studies. The MEDIPAD is user-friendly, multilingual, and secure software and with the BCAA database is suitable for conducting nutritional assessment in the Mediterranean area with particular facilities for food administration.
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Affiliation(s)
- Sara Haydar
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | | | | | - Yannick Cogne
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Athanasios Fountas
- Department of Endocrinology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
| | - Yildiz Tutuncu
- Department of Internal Medicine, Istanbul University, 34093 Istanbul, Turkey.
| | - Madalina Vintila
- Department of Endocrinology, Universitatea de Medicina si Farmacie Carol Davila, 011863 Bucharest, Romania.
| | - Agathocles Tsatsoulis
- Department of Endocrinology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece.
| | - Pham Thanh Chi
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Patrick Garandeau
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Dan Chetea
- Nicolae Paulescu National Institute, 020475 Bucharest, Romania.
| | - Corin Badiu
- Department of Endocrinology, Universitatea de Medicina si Farmacie Carol Davila, 011863 Bucharest, Romania.
| | - Monica Gheorghiu
- Department of Endocrinology, Universitatea de Medicina si Farmacie Carol Davila, 011863 Bucharest, Romania.
| | - Dorina Ylli
- Faculty of Medicine, Mjekesise University of Tirana, 1005 Tirana, Albania.
| | - Corinne Lautier
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Morana Jarec
- Institute for Anthropological Research, 10000 Zagreb, Croatia.
| | - Louis Monnier
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Christophe Normand
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
| | - Jelena Šarac
- Institute for Anthropological Research, 10000 Zagreb, Croatia.
| | | | - Sasa Missoni
- Institute for Anthropological Research, 10000 Zagreb, Croatia.
| | - Michel Pugeat
- Fédération d'Endocrinologie, Cardio-Neuro Hospital, University Claude Bernard de Lyon 1, 69677 Lyon-Bron, France.
| | - Patrick Poucheret
- Faculty of Pharmacy, UMR 95 Qualisud, University of Montpellier, 34398 Montpellier, France.
| | - Felicia Hanzu
- Institut d'Investigacions Biomediques August Pi i Sunyer, 08036 Barcelona, Spain.
| | - Ramon Gomis
- Institut d'Investigacions Biomediques August Pi i Sunyer, 08036 Barcelona, Spain.
| | | | | | | | - Catalina Poiana
- Department of Endocrinology, Universitatea de Medicina si Farmacie Carol Davila, 011863 Bucharest, Romania.
| | - Renato Pasquali
- Division of Endocrinology, University Alma Mater Studiorum, 40138 Bologna, Italy.
| | - Davide Lauro
- Department of Internal Medicine, Universita degli Studi di Roma Tor Vergata, 00173 Roma, Italy.
| | - Giorgio Sesti
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | | | - Sonia Abdelhak
- Institut Pasteur de Tunis, Laboratory of Biomedical Genomics and Oncogenetics, 1002 Tunis, Tunisia.
| | - Akila Zenati
- Laboratoire de Biochimie Génétique, CHU Bab-El-Oued, Université d'Alger, Alger 16000, Algeria.
| | - Agron Ylli
- Faculty of Medicine, Mjekesise University of Tirana, 1005 Tirana, Albania.
| | - Ilhan Satman
- Department of Internal Medicine, Istanbul University, 34093 Istanbul, Turkey.
| | | | - Yves Rinato
- Intactile Design SA, 34000 Montpellier, France.
| | - Florin Grigorescu
- Unité Mixte de Recherche (UMR)204 NUTRIPASS (Nutrition et Alimentation des Populations aux Suds, IRD, UM, SupAgro), Molecular Endocrinology, Institut Universitaire de Recherche Clinique (IURC), Faculty of Medicine, University of Montpellier, 34093 Montpellier, France.
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Zenun Franco R, Fallaize R, Lovegrove JA, Hwang F. Online dietary intake assessment using a graphical food frequency app (eNutri): Usability metrics from the EatWellUK study. PLoS One 2018; 13:e0202006. [PMID: 30096211 PMCID: PMC6086444 DOI: 10.1371/journal.pone.0202006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 07/25/2018] [Indexed: 12/13/2022] Open
Abstract
Background With widespread use of the internet, lifestyle and dietary data collection can now be facilitated using online questionnaires as opposed to paper versions. We have developed a graphical food frequency assessment app (eNutri), which is able to assess dietary intake using a validated food frequency questionnaire (FFQ) and provide personalised nutrition advice. FFQ user acceptance and evaluation have not been investigated extensively and only a few studies involving user acceptance of nutrition assessment and advice apps by older adults are published. Methods A formative study with 20 participants (including n = 10 ≥60 years) assessed the suitability of this app for adults and investigated improvements to its usability. The outcomes of this formative study were applied to the final version of the application, which was deployed in an online study (EatWellUK) with 324 participants (including n = 53 ≥60 years) in the UK, using different devices (smartphones, tablets and laptops/desktops). Completion times were based on browser timestamps and usability was measured using the System Usability Scale (SUS), scoring between 0 and 100. Products with a SUS score higher than 70 are considered to be good. Results In the EatWellUK study, SUS score median (n = 322) was 77.5 (IQR 15.0). Out of the 322 SUS questionnaire completions, 321 device screen sizes were detected by the app. Grouped by device screen size, small (n = 92), medium (n = 38) and large (n = 191) screens received median SUS scores of 77.5 (IQR 15.0), 75.0 (IQR 19.4) and 77.5 (IQR 16.25), respectively. The median SUS scores from younger (n = 268) and older participants (n = 53) were the same. The FFQ contained 157 food items, and the mean completion time was 13.1 minutes (95% CI 12.6–13.7 minutes). Small, medium and large screen devices resulted in completion times of 11.7 minutes (95% CI 10.9–12.6 minutes), 14.4 minutes (95% CI 12.9–15.9 minutes) and 13.6 minutes (95% CI 12.8–14.3 minutes), respectively. Conclusions The overall median SUS score of 77.5 and overall mean completion time of 13.3 minutes indicate good overall usability, and equally, comparable SUS scores and completion times across small, medium and large screen sizes indicates good usability across devices. This work is a step toward the promotion of wider uptake of online apps that can provide online dietary intake assessment at-scale, with the aim of addressing pressing epidemiological challenges.
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Affiliation(s)
- Rodrigo Zenun Franco
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
- * E-mail:
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Faustina Hwang
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
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Navas-Carretero S, San-Cristobal R, Livingstone KM, Celis-Morales C, Marsaux CF, Macready AL, Fallaize R, O'Donovan CB, Forster H, Woolhead C, Moschonis G, Lambrinou CP, Jarosz M, Manios Y, Daniel H, Gibney ER, Brennan L, Walsh MC, Drevon CA, Gibney M, Saris WHM, Lovegrove JA, Mathers JC, Martinez JA. Higher vegetable protein consumption, assessed by an isoenergetic macronutrient exchange model, is associated with a lower presence of overweight and obesity in the web-based Food4me European study. Int J Food Sci Nutr 2018; 70:240-253. [PMID: 30049236 DOI: 10.1080/09637486.2018.1492524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The objective was to evaluate differences in macronutrient intake and to investigate the possible association between consumption of vegetable protein and the risk of overweight/obesity, within the Food4Me randomised, online intervention. Differences in macronutrient consumption among the participating countries grouped by EU Regions (Western Europe, British Isles, Eastern Europe and Southern Europe) were assessed. Relation of protein intake, within isoenergetic exchange patterns, from vegetable or animal sources with risk of overweight/obesity was assessed through the multivariate nutrient density model and a multivariate-adjusted logistic regression. A total of 2413 subjects who completed the Food4Me screening were included, with self-reported data on age, weight, height, physical activity and dietary intake. As success rates on reducing overweight/obesity are very low, form a public health perspective, the elaboration of policies for increasing intakes of vegetable protein and reducing animal protein and sugars, may be a method of combating overweight/obesity at a population level.
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Affiliation(s)
- Santiago Navas-Carretero
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain.,b CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III , Madrid , Spain
| | - Rodrigo San-Cristobal
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain
| | - Katherine M Livingstone
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - Carlos Celis-Morales
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - Cyril F Marsaux
- d Department of Human Biology , NUTRIM School for Nutrition and Translational Research in Metabolism. Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Anna L Macready
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - Rosalind Fallaize
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - Clare B O'Donovan
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Hannah Forster
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Clara Woolhead
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - George Moschonis
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | - Christina P Lambrinou
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | | | - Yannis Manios
- g Department of Nutrition and Dietetics , Harokopio University of Athens , Athens , Greece
| | - Hannelore Daniel
- i ZIEL Research Center of Nutrition and Food Sciences , Biochemistry Unit, Technische Universität München , Munich , Germany
| | - Eileen R Gibney
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Lorraine Brennan
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Marianne C Walsh
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Christian A Drevon
- j Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Mike Gibney
- f UCD Institute of Food and Health, UCD School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Wim H M Saris
- d Department of Human Biology , NUTRIM School for Nutrition and Translational Research in Metabolism. Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Julie A Lovegrove
- e Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading , Reading , UK
| | - John C Mathers
- c Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University , Newcastle Upon Tyne , UK
| | - J Alfredo Martinez
- a Department of Nutrition Food Science and Physiology , Centre for Nutrition Research, University of Navarra , Pamplona , Spain.,b CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III , Madrid , Spain.,k Instituto de Investigaciones Sanitarias de Navarra (IDisNa) , Pamplona , Spain.,l Institute IMDEA Food , Madrid , Spain
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Affret A, El Fatouhi D, Dow C, Correia E, Boutron-Ruault MC, Fagherazzi G. Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment. J Med Internet Res 2018; 20:e227. [PMID: 29980502 PMCID: PMC6053608 DOI: 10.2196/jmir.9113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/01/2018] [Accepted: 02/18/2018] [Indexed: 12/29/2022] Open
Abstract
Background Dietary questionnaires currently available which can assess the habitual diet are timely, costly, or not adapted well to the modern diet; thus, there is a need for a shorter food frequency e-Questionnaire (FFeQ) adapted to Western diets, in order to properly estimate energy and macronutrient intakes or rank individuals according to food and nutrient intakes. Objective The aim of this study was to evaluate the relative validity and reproducibility of a 30-minute and 44-item FFeQ in a sample of adults obtained from the general population. Methods A sample of French adults was recruited through social media and an advertising campaign. A total of 223 volunteers completed the FFeQ twice at one-year intervals and were included in the reproducibility study. During that interval, 92 participants completed three-to-six 24-hour recalls and were included in the validity study. Nutrient and dietary intakes were computed for all validity and reproducibility participants. The level of agreement between the two methods was evaluated for nutrient and food group intakes using classification into quintiles of daily intake, correlation coefficients and Bland-Altman plots. Results For relative validity, correlation coefficients ranged from 0.09 to 0.88 (unadjusted correlation coefficients, median: 0.48) and 0.02 to 0.68 (deattenuated and energy adjusted correlation coefficients, median: 0.50) for food group and nutrient intakes, respectively. The median proportion of subjects classified into the same or adjacent quintile was 73% and 66% for food and nutrient intakes, respectively. Bland-Altman plots showed good agreement across the range of intakes. Regarding reproducibility, intraclass correlation coefficients ranged from 0.33 to 0.72 (median: 0.60) and 0.55 to 0.73 (median: 0.64), for food and nutrient intakes, respectively. Conclusions The FFeQ showed acceptable validity and reproducibility in a sample of adults based on their food and nutrient intakes. The FFeQ is a promising and low-cost tool that can be used in large-scale online epidemiological studies or clinical routines and could be integrated into evidence-based smartphone apps for assessing diet components.
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Affiliation(s)
- Aurélie Affret
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Douae El Fatouhi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Courtney Dow
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Emmanuelle Correia
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Guy Fagherazzi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Béjar LM, Reyes ÓA, García-Perea MD. Electronic 12-Hour Dietary Recall (e-12HR): Comparison of a Mobile Phone App for Dietary Intake Assessment With a Food Frequency Questionnaire and Four Dietary Records. JMIR Mhealth Uhealth 2018; 6:e10409. [PMID: 29907555 PMCID: PMC6026301 DOI: 10.2196/10409] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/01/2018] [Accepted: 05/05/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND One of the greatest challenges in nutritional epidemiology is improving upon traditional self-reporting methods for the assessment of habitual dietary intake. OBJECTIVE The aim of this study was to evaluate the relative validity of a new method known as the current-day dietary recall (or current-day recall), based on a smartphone app called 12-hour dietary recall, for determining the habitual intake of a series of key food and drink groups using a food frequency questionnaire (FFQ) and four dietary records as reference methods. METHODS University students over the age of 18 years recorded their consumption of certain groups of food and drink using 12-hour dietary recall for 28 consecutive days. During this 28-day period, they also completed four dietary records on randomly selected days. Once the monitoring period was over, subjects then completed an FFQ. The two methods were compared using the Spearman correlation coefficient (SCC), a cross-classification analysis, and weighted kappa. RESULTS A total of 87 participants completed the study (64% women, 56/87; 36% men, 31/87). For e-12HR versus FFQ, for all food and drink groups, the average SCC was 0.70. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 51.5%; exact agreement + adjacent was 91.8%, and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.51. For e-12HR versus the four dietary records, for all food and drink groups, the average SCC was 0.63. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 47.1%; exact agreement + adjacent was 89.2%; and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.47. CONCLUSIONS Current-day recall, based on the 12-hour dietary recall app, was found to be in good agreement with the two reference methods (FFQ & four dietary records), demonstrating its potential usefulness for categorizing individuals according to their habitual dietary intake of certain food and drink groups.
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Affiliation(s)
- Luis María Béjar
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, Seville, Spain
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Manios Y, Moschonis G, Lambrinou CP, Mavrogianni C, Tsirigoti L, Hoeller U, Roos FF, Bendik I, Eggersdorfer M, Celis-Morales C, Livingstone KM, Marsaux CFM, Macready AL, Fallaize R, O'Donovan CB, Woolhead C, Forster H, Walsh MC, Navas-Carretero S, San-Cristobal R, Kolossa S, Hallmann J, Jarosz M, Surwiłło A, Traczyk I, Drevon CA, van Ommen B, Grimaldi K, Matthews JNS, Daniel H, Martinez JA, Lovegrove JA, Gibney ER, Brennan L, Saris WHM, Gibney M, Mathers JC. Associations of vitamin D status with dietary intakes and physical activity levels among adults from seven European countries: the Food4Me study. Eur J Nutr 2018; 57:1357-1368. [PMID: 28289868 DOI: 10.1007/s00394-017-1415-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 02/19/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To report the vitamin D status in adults from seven European countries and to identify behavioural correlates. METHODS In total, 1075 eligible adult men and women from Ireland, Netherlands, Spain, Greece, UK, Poland and Germany, were included in the study. RESULTS Vitamin D deficiency and insufficiency, defined as 25-hydroxy vitamin D3 (25-OHD3) concentration of <30 and 30-49.9 nmol/L, respectively, were observed in 3.3 and 30.6% of the participants. The highest prevalence of vitamin D deficiency was found in the UK and the lowest in the Netherlands (8.2 vs. 1.1%, P < 0.05). In addition, the prevalence of vitamin D insufficiency was higher in females compared with males (36.6 vs. 22.6%, P < 0.001), in winter compared with summer months (39.3 vs. 25.0%, P < 0.05) and in younger compared with older participants (36.0 vs. 24.4%, P < 0.05). Positive dose-response associations were also observed between 25-OHD3 concentrations and dietary vitamin D intake from foods and supplements, as well as with physical activity (PA) levels. Vitamin D intakes of ≥5 μg/day from foods and ≥5 μg/day from supplements, as well as engagement in ≥30 min/day of moderate- and vigorous-intensity PA were associated with higher odds (P < 0.05) for maintaining sufficient (≥50 nmol/L) 25-OHD3 concentrations. CONCLUSIONS The prevalence of vitamin D deficiency varied considerably among European adults. Dietary intakes of ≥10 μg/day of vitamin D from foods and/or supplements and at least 30 min/day of moderate- and vigorous-intensity PA were the minimum thresholds associated with vitamin D sufficiency.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Heath Science and Education, Harokopio University, Athens, Greece.
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70, El Venizelou Ave, Kallithea, 176 71, Athens, Greece.
| | - George Moschonis
- Department of Nutrition and Dietetics, School of Heath Science and Education, Harokopio University, Athens, Greece
| | - Christina P Lambrinou
- Department of Nutrition and Dietetics, School of Heath Science and Education, Harokopio University, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Heath Science and Education, Harokopio University, Athens, Greece
| | - Lydia Tsirigoti
- Department of Nutrition and Dietetics, School of Heath Science and Education, Harokopio University, Athens, Greece
| | - Ulrich Hoeller
- Analytical Research Centre and Human Nutrition & Health, DSM Nutritional Products, 4002, Basel, Switzerland
| | - Franz F Roos
- Analytical Research Centre and Human Nutrition & Health, DSM Nutritional Products, 4002, Basel, Switzerland
| | - Igor Bendik
- Analytical Research Centre and Human Nutrition & Health, DSM Nutritional Products, 4002, Basel, Switzerland
| | - Manfred Eggersdorfer
- Analytical Research Centre and Human Nutrition & Health, DSM Nutritional Products, 4002, Basel, Switzerland
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Hannah Forster
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Marianne C Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Santiago Navas-Carretero
- Department of Nutrition and Physiology, University of Navarra; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition and Physiology, University of Navarra; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Spain
| | - Silvia Kolossa
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munich, Germany
| | - Jacqueline Hallmann
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munich, Germany
| | | | | | - Iwona Traczyk
- National Food & Nutrition Institute (IZZ), Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ben van Ommen
- Microbiology and Systems Biology Group, TNO, Zeist, the Netherlands
| | | | - John N S Matthews
- School of Mathematics and Statistics, Newcastle University, Newcastle upon Tyne, UK
| | - Hannelore Daniel
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munich, Germany
| | - J Alfredo Martinez
- Department of Nutrition and Physiology, University of Navarra; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Spain
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Kang M, Park SY, Boushey CJ, Wilkens LR, Monroe KR, Le Marchand L, Kolonel LN, Murphy SP, Paik HY. Portion Sizes from 24-Hour Dietary Recalls Differed by Sex among Those Who Selected the Same Portion Size Category on a Food Frequency Questionnaire. J Acad Nutr Diet 2018; 118:1711-1718. [PMID: 29752189 DOI: 10.1016/j.jand.2018.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Accounting for sex differences in food portions may improve dietary measurement; however, this factor has not been well examined. OBJECTIVE The aim of this study was to examine sex differences in reported food portions from 24-hour dietary recalls (24HDRs) among those who selected the same portion size category on a quantitative food frequency questionnaire (QFFQ). DESIGN This study was conducted with a cross-sectional design. PARTICIPANTS/SETTING Participants (n=319) were members of the Hawaii-Los Angeles Multiethnic Cohort who completed three 24HDRs and a QFFQ in a calibration study conducted in 2010 and 2011. MAIN OUTCOME MEASURES Portions of individual foods reported from 24HDRs served as the outcome measures. STATISTICAL ANALYSES PERFORMED Mean food portions from 24HDRs were compared between men and women who reported the same portion size on the QFFQ, after adjustment for race/ethnicity using a linear regression model. Actual amount and the assigned amount of the selected portion size in the QFFQ were compared using one-sample t test for men and women separately. RESULTS Of 163 food items with portion size options listed in the QFFQ, 32 were reported in 24HDRs by ≥20 men and ≥20 women who selected the same portion size in the QFFQ. Although they chose the same portion size on the QFFQ, mean intake amounts from 24HDRs were significantly higher for men than for women for "beef/lamb/veal," "white rice," "brown/wild rice," "lettuce/tossed salad," "eggs cooked/raw," "whole wheat/rye bread," "buns/rolls," and "mayonnaise in sandwiches." For men, mean portions of 14 items from the 24HDRs were significantly different from the assigned amounts for QFFQ items (seven higher and seven lower), whereas for women, mean portions of 14 items were significantly lower from the assigned amounts (with five significantly higher). CONCLUSIONS These sex differences in reported 24HDR food portions-even among participants who selected the same portion size on the QFFQ-suggest that the use of methods that account for differences in the portions consumed by men and women when QFFQs are quantified may provide more accurate absolute dietary intakes.
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Riordan F, McGann R, Kingston C, Perry IJ, Schulze MB, Frost Andersen L, Geelen A, van’t Veer P, Eussen SJPM, Van Dongen MCJM, Wijckmans-Duysens NEG, Harrington JM. A systematic review of methods to assess intake of saturated fat (SF) among healthy European adults and children: a DEDIPAC (Determinants of Diet and Physical Activity) study. BMC Nutr 2018; 4:21. [PMID: 32153884 PMCID: PMC7050932 DOI: 10.1186/s40795-018-0231-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 05/02/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Dietary fat is an essential macronutrient. However, saturated fact has been associated with negative health outcomes including cardiovascular disease. Shifting consumption from saturated fat to unsaturated fats and limiting the level of saturated fat in the diet has been recommended. Currently, there is no standard method to measure saturated fat intake in etiologic studies. Therefore, it is difficult to obtain a reliable picture of saturated fat intake in Europe. To inform the development of the DEDIPAC (DEterminants of DIet and Physical Activity) toolbox of methods, we aimed to identify the assessment methods and specific instruments which have been used to assess saturated fat intake among children or adults in pan-European studies. METHODS Three electronic databases were searched for English language studies of any design which assessed intake of saturated fat. Reference lists were hand-searched. Studies were included if they were conducted in two or more European countries, and involved healthy, free-living children and adults. RESULTS The review identified 20 pan-European studies which assessed saturated fat intake. Food Frequency Questionnaires (n = 8) and diet records (n = 7) were most common, followed by 24-h recalls (n = 5). Methods differed in portion size estimation and the composition data which was used to calculate nutrient intake. Of the instruments used in more than two European countries, five Food Frequency Questionnaires had been specifically tested for validity to assess saturated fat intake; four among adults (Food4me, PURE, IMMIDIET, Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE)) and one among children (used by Piqueras et al.). CONCLUSIONS A standardised approach to portion size estimation and a common source of food composition data are required to measure saturated fat intake across Europe effectively. Only five instruments had been used in more than two European countries and specifically tested for validity to assess saturated fat intake. These instruments may be most appropriate to evaluate intake of saturated fat in future pan-European studies. However, only two instruments had been tested for validity in more than one European country. Future work is needed to assess the validity of the identified instruments across European countries.
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Affiliation(s)
- Fiona Riordan
- School of Public Health, University College Cork, Western Road, Cork, Ireland
| | - Roisin McGann
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Ciara Kingston
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Ivan J. Perry
- School of Public Health, University College Cork, Western Road, Cork, Ireland
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands
| | - Pieter van’t Veer
- Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands
| | - Simone J. P. M. Eussen
- Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martien C. J. M. Van Dongen
- Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Nicole E. G. Wijckmans-Duysens
- Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Janas M. Harrington
- School of Public Health, University College Cork, Western Road, Cork, Ireland
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46
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Accuracy of Automatic Carbohydrate, Protein, Fat and Calorie Counting Based on Voice Descriptions of Meals in People with Type 1 Diabetes. Nutrients 2018; 10:nu10040518. [PMID: 29690520 PMCID: PMC5946303 DOI: 10.3390/nu10040518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/11/2018] [Accepted: 04/19/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this work was to assess the accuracy of automatic macronutrient and calorie counting based on voice descriptions of meals provided by people with unstable type 1 diabetes using the developed expert system (VoiceDiab) in comparison with reference counting made by a dietitian, and to evaluate the impact of insulin doses recommended by a physician on glycemic control in the study’s participants. We also compared insulin doses calculated using the algorithm implemented in the VoiceDiab system. Meal descriptions were provided by 30 hospitalized patients (mean hemoglobin A1c of 8.4%, i.e., 68 mmol/mol). In 16 subjects, the physician determined insulin boluses based on the data provided by the system, and in 14 subjects, by data provided by the dietitian. On one hand, differences introduced by patients who subjectively described their meals compared to those introduced by the system that used the average characteristics of food products, although statistically significant, were low enough not to have a significant impact on insulin doses automatically calculated by the system. On the other hand, the glycemic control of patients was comparable regardless of whether the physician was using the system-estimated or the reference content of meals to determine insulin doses.
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Celis-Morales C, Livingstone KM, Marsaux CF, Macready AL, Fallaize R, O'Donovan CB, Woolhead C, Forster H, Walsh MC, Navas-Carretero S, San-Cristobal R, Tsirigoti L, Lambrinou CP, Mavrogianni C, Moschonis G, Kolossa S, Hallmann J, Godlewska M, Surwillo A, Traczyk I, Drevon CA, Bouwman J, van Ommen B, Grimaldi K, Parnell LD, Matthews JN, Manios Y, Daniel H, Martinez JA, Lovegrove JA, Gibney ER, Brennan L, Saris WH, Gibney M, Mathers JC. Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial. Int J Epidemiol 2018; 46:578-588. [PMID: 27524815 DOI: 10.1093/ije/dyw186] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/14/2022] Open
Abstract
Background Optimal nutritional choices are linked with better health, but many current interventions to improve diet have limited effect. We tested the hypothesis that providing personalized nutrition (PN) advice based on information on individual diet and lifestyle, phenotype and/or genotype would promote larger, more appropriate, and sustained changes in dietary behaviour. Methods : Adults from seven European countries were recruited to an internet-delivered intervention (Food4Me) and randomized to: (i) conventional dietary advice (control) or to PN advice based on: (ii) individual baseline diet; (iii) individual baseline diet plus phenotype (anthropometry and blood biomarkers); or (iv) individual baseline diet plus phenotype plus genotype (five diet-responsive genetic variants). Outcomes were dietary intake, anthropometry and blood biomarkers measured at baseline and after 3 and 6 months' intervention. Results At baseline, mean age of participants was 39.8 years (range 18-79), 59% of participants were female and mean body mass index (BMI) was 25.5 kg/m 2 . From the enrolled participants, 1269 completed the study. Following a 6-month intervention, participants randomized to PN consumed less red meat [-5.48 g, (95% confidence interval:-10.8,-0.09), P = 0.046], salt [-0.65 g, (-1.1,-0.25), P = 0.002] and saturated fat [-1.14 % of energy, (-1.6,-0.67), P < 0.0001], increased folate [29.6 µg, (0.21,59.0), P = 0.048] intake and had higher Healthy Eating Index scores [1.27, (0.30, 2.25), P = 0.010) than those randomized to the control arm. There was no evidence that including phenotypic and phenotypic plus genotypic information enhanced the effectiveness of the PN advice. Conclusions Among European adults, PN advice via internet-delivered intervention produced larger and more appropriate changes in dietary behaviour than a conventional approach.
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Affiliation(s)
| | | | - Cyril Fm Marsaux
- Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Hannah Forster
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Marianne C Walsh
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Santiago Navas-Carretero
- Department of Nutrition and Physiology, University of Navarra, Navarra, and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition and Physiology, University of Navarra, Navarra, and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Lydia Tsirigoti
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Silvia Kolossa
- ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany
| | - Jacqueline Hallmann
- ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany
| | | | | | - Iwona Traczyk
- National Food & Nutrition Institute (IZZ), Warsaw, Poland
| | - Christian A Drevon
- Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jildau Bouwman
- TNO, Microbiology and Systems Biology Group, Zeist, The Netherlands
| | - Ben van Ommen
- TNO, Microbiology and Systems Biology Group, Zeist, The Netherlands
| | | | - Laurence D Parnell
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.,Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - John Ns Matthews
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.,Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Hannelore Daniel
- ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany
| | - J Alfredo Martinez
- Department of Nutrition and Physiology, University of Navarra, Navarra, and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Wim Hm Saris
- Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - John C Mathers
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Traditional methods v. new technologies - dilemmas for dietary assessment in large-scale nutrition surveys and studies: a report following an international panel discussion at the 9th International Conference on Diet and Activity Methods (ICDAM9), Brisbane, 3 September 2015. J Nutr Sci 2018; 7:e11. [PMID: 29686860 PMCID: PMC5906559 DOI: 10.1017/jns.2018.4] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/08/2018] [Indexed: 11/07/2022] Open
Abstract
The aim of the present paper is to summarise current and future applications of dietary assessment technologies in nutrition surveys in developed countries. It includes the discussion of key points and highlights of subsequent developments from a panel discussion to address strengths and weaknesses of traditional dietary assessment methods (food records, FFQ, 24 h recalls, diet history with interviewer-assisted data collection) v. new technology-based dietary assessment methods (web-based and mobile device applications). The panel discussion 'Traditional methods v. new technologies: dilemmas for dietary assessment in population surveys', was held at the 9th International Conference on Diet and Activity Methods (ICDAM9), Brisbane, September 2015. Despite respondent and researcher burden, traditional methods have been most commonly used in nutrition surveys. However, dietary assessment technologies offer potential advantages including faster data processing and better data quality. This is a fast-moving field and there is evidence of increasing demand for the use of new technologies amongst the general public and researchers. There is a need for research and investment to support efforts being made to facilitate the inclusion of new technologies for rapid, accurate and representative data.
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Key Words
- AES, Australian Eating Survey
- AHS, Australian Health Survey
- AMPM, Automated Multiple-Pass Method
- ASA24, Automated Self-Administered 24-hour Recall
- DNFCS, Dutch National Food Consumption Survey
- Dietary assessment technologies
- ICDAM9, 9th International Conference on Diet and Activity Methods
- MRC, Medical Research Council
- Mobile applications
- NDNS, National Diet and Nutrition Survey
- NHANES, National Health and Nutrition Examination Survey
- Nutrition surveys
- RP, Rolling Programme
- Web-based tools
- WebDASC, Web-based Dietary Assessment Software for Children
- mFR, mobile food record
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Comparison of Environmental Impact and Nutritional Quality among a European Sample Population - findings from the Food4Me study. Sci Rep 2018; 8:2330. [PMID: 29402899 PMCID: PMC5799208 DOI: 10.1038/s41598-018-20391-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/16/2018] [Indexed: 02/08/2023] Open
Abstract
This study evaluates the relationship between environmental impacts and diet quality through several environmental and nutritional indicators, using data from over 1400 participants across seven European countries in the Food4Me study. Comparisons of environmental impacts and dietary quality were evaluated across country, gender groups, and dietary patterns. While there was clear variability within the different subsets, there were large differences observed in both dietary quality and environmental impacts between cultures, genders, and dietary patterns. Individuals abstaining from red meat consistently had lower impacts in combination with lower consumption of harmful nutrients (saturated fats, sodium, and sugars) while maintaining average intake of beneficial nutrients. A ‘best practice’ diet with low impacts, adequate nutrient intake, and low saturated fats, sodium, and sugars, was constructed from the sample and used as a benchmark. Recorded eating patterns were compared to this recommended diet. On average, intakes of sweets, meats, and drinks should be decreased and intakes of vegetables and cereals increased, at varying rates depending on country and gender. However, the study shows a large spread of eating patterns and recommendations for lowering environmental impacts and increasing nutritional quality vary greatly among individuals.
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50
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Eating Patterns in Patients with Compensated Cirrhosis: A Case-Control Study. Nutrients 2018; 10:nu10010060. [PMID: 29320416 PMCID: PMC5793288 DOI: 10.3390/nu10010060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/22/2017] [Accepted: 01/09/2018] [Indexed: 12/30/2022] Open
Abstract
Background: There is growing evidence suggesting that maintaining an adequate nutritional status for patients with liver cirrhosis (LC) is relevant to prevent complications. The present study aimed to describe dietary behaviours of patients with compensated and non-complicated LC and comparing them with those of subjects from the general population. Methods: In this case-control study, patients were volunteers enrolled in the ALICIR (ALImentation et CIRrhose) study, an observational survey nested in two French prospective cohorts of patients with biopsy-proven compensated cirrhosis related either to excessive alcohol consumption (CIRRAL) or to hepatitis B or C virus infection (CirVir). Controls were selected from the NutriNet-Santé cohort. Dietary data were collected through a semi quantitative food frequency questionnaire. Dietary and nutritional data were compared using multi-adjusted paired Student’s tests. Results: Between June 2014 and February 2016, 174 patients of CirVir (N = 97) or CIRRAL (N = 77) were matched with 348 controls from the NutriNet-Santé cohort, according to gender, age, BMI and educational level. Compared to controls, patients (mean ± SD) consumed more sodas (236.0 ± 29.8 mL vs. 83.0 ± 33.0 mL) and water (1787.6 ± 80.6 mL vs. 933.6 ± 85.3 mL), and lower amounts of salty snacks (4.2 ± 1.42 g vs. 9.0 ± 1.6 g) and alcoholic beverages (71.8 ± 23.4 g vs. 151.2 ± 25.9 g), with all p values < 0.0001. Dietary behaviours differed according to LC aetiology. Conclusions: Dietary behaviour of patients significantly differed from subjects from the general population.
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