A Higher Healthy Eating Index Is Associated with Decreased Markers of Inflammation and Lower Odds for Being Overweight/Obese Based on a Case-Control Study

Could the Wheel of Cardiovascular Health Diet Be a Tool for Diet Quality in Nutritional Counseling? Comparison with Healthy Eating Index-2020

OBJECTIVE

The Wheel of Cardiovascular Health Diet was recently elaborated based on current nutritional recommendations for healthy eating and was made for person-centered nutritional counseling, thus it may be an interesting tool to improve food awareness. However, its validity is yet to be tested. We hypothesized that the self-perception of patients diagnosed with chronic diseases, evaluated by the Wheel of Cardiovascular Health Diet, is satisfactory in assessing the quality of their diets, compared with the Healthy Eating Index-2020.

METHODS

This is a cross-sectional analysis of adults with uncontrolled hypertension or type 2 diabetes. The patients answered the Wheel of Cardiovascular Health Diet, and then, based on the food frequency questionnaire, we analyzed the Healthy Eating Index-2020.

RESULTS

A total of 330 patients were included in the study: 91.5% had hypertension, 58.5% had type 2 diabetes, and the median age was 58 (50-65) years. The mean difference observed between the percentage of the graphic area assessed by the patients' self-perception from the Wheel of Cardiovascular Health Diet and Healthy Eating Index-2020 was -10.0% (95%CI -35.3 to 15.3), and a moderate correlation was observed. Linear Regression models showed that a 10-point increase in patients' self-perception in the Wheel of Cardiovascular Health Diet is associated with a 2.9% increase (95%CI 2.08 to 3.70) in the diet quality by the Healthy Eating Index-2020 and is associated with lower BMI values: β = -0.42 kg/m2 (95%CI -0.83 to -0.01).

CONCLUSION

The Wheel of Cardiovascular Health Diet performed satisfactorily regarding validity and reliability by BMI and was associated with higher overall dietary quality, with the Healthy Eating Index-2020 as a relative reference.

Association of healthy eating index and self-rated health in adults living in Tehran: a cross-sectional study

BACKGROUND

Self-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran.

METHODS

This cross-sectional study was carried out among 850 adult men and women aged 20-59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: "In general, how do you rate your health?". We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH.

RESULTS

The final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH.

CONCLUSION

According to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.

Association between healthy eating index-2015 and abdominal aortic calcification: A population-based cross-sectional study

Background

An association between the healthy eating index (HEI)-2015 and risk of abdominal aortic calcification (AAC) is unclear in the general population of the United States (U.S.). Therefore, we examined the relationship between HEI-2015 and AAC risk in our research.

Methods

A cross-sectional study of National Health and Nutrition Examination Surveys (NHANES) participants between 2013 and 2014 was conducted. For the analysis of the association between HEI-2015 and AAC, the restricted cubic spline (RCS) plot and multivariable logistic regression models were used. In addition, we also conducted subgroup analysis for the relationship between HEI-2015 and AAC.

Results

There was a total of 1162 individuals. As shown by the RCS plot, HEI-2015 was linked with AAC risk in a U-shaped pattern (P for nonlinearity < 0.05). Taking into account known confounding variables, compared with the lowest quartiles, the odds ratios with 95% confidence intervals for AAC across the quartiles were 0.637 (0.425,0.956), 0.763 (0.499, 1.167), and 0.842 (0.561, 1.265). Based on the results of subgroup analysis, the HEI-2015 and AAC risk were U-curve correlated among all age groups, sex, with or without hypertension or DM, and BMI of <30 kg/m2. The greens and beans, and whole fruits are independent protective factor for AAC.

Conclusions

The U-shaped relationships exist between HEI-2015 and prevalence of AAC in the general U.S. population. Consequently, prevalence of AAC may be mitigated with reasonable and balanced diet.

The micronutrient content of the diet is correlated with serum glucose biomarkers and lipid profile and is associated with the odds of being overweight/obese-a case-control study

Background

A low micronutrient intake has been reported to contribute to the double-burden of obesity, increasing the risk for chronic diseases such as cardiovascular disease, diabetes, cancer, and mental disorders. This case-control study compared micronutrient intake profiles in overweight/obese vs. normal-weight individuals. We hypothesized that a low intake of certain micronutrients would increase the odds of being overweight/obese.

Methods

The case group (n = 812 adults) consisted of individuals with a BMI of ≥25  kg/m², and the control group (n = 793) had BMIs of 17.9-24.9  kg/m². A validated 124-item food frequency questionnaire was used to determine micronutrient-related dietary-quality, using the index of nutritional quality (INQ), calculated as the fraction of a micronutrient consumed vs. its dietary requirement. In addition, body surface area (BSA) was calculated according to the Mosteller formula.

Results

The control group had significantly higher INQ-scores of vitamin A, vitamin C, calcium, magnesium, and selenium compared to the case group. Furthermore, individuals with normal BSA (≤1.91 m² for men; ≤1.71  m² for women) had significantly higher INQ scores of vitamin C, calcium, magnesium, and zinc compared to participants with high BSA. In multivariable adjustment regression models, INQs of vitamin C (OR_BMI = 0.79, 95%CI: 0.64-0.97; OR_BSA = 0.81, 95%CI, 0.68-0.97) and magnesium (OR_BMI = 0.69, 95%CI: 0.47-0.99; OR_BSA = 0.71, 95%CI: 0.52-0.97) were significantly associated with the odds of obesity/overweight (in both BMI and BSA categories).

Conclusion

The significant association between micronutrient levels of the diet, especially of vitamin C and magnesium, with both obesity criteria, emphasized the importance of certain micronutrients in the obesity/overweight causal network.

The Influence of Relative Reinforcing Value of Food, Sensitization, Energy Intake and Diet Quality on zBMI Change over Two Years in Adolescents: A Longitudinal Cohort Study

The relative reinforcing value (RRV) of food and sensitization are associated with zBMI and zBMI change over time, but the mechanisms underlying these relationships is unknown. The purpose of this study was to test the hypothesis that greater RRV and sensitization to HED food is associated with lower diet quality and greater energy intake at baseline and again at 24 months and that these relationships result in greater zBMI gain. The RRV of HED and LED food and dietary intake were measured at baseline and again after 24 months in a cohort of 202 boys and girls of 12-14 years old. The baseline RRV of HED food was associated with lower diet quality and lower energy intake at 24 months. zBMI gain was positively associated with the baseline energy intake but not baseline RRV of HED food or diet quality. However, diet quality moderated the relationship between baseline energy intake and zBMI change, with no difference in zBMI change as a function of energy intake when diet quality was high but significant and opposite relationships with energy intake when diet quality was low. This study suggests that high diet quality can reduce the negative impact of greater energy intake on zBMI change in adolescents.

Sex-Specific Dietary Patterns and Social Behaviour in Low-Risk Individuals

Dietary and social behaviour are non-medical factors that influence health outcomes. Non-communicable diseases are related to dietary patterns. To date, little is known about how social behaviour is associated with health-related dietary patterns, and, in particular, we lack information about the role of sex within this possible relation. Our cross-sectional study investigated associations between dietary patterns and social behaviour including personality traits (self-control, risk taking), political preferences (conservative, liberal, ecological, social) and altruism (willingness to donate, club membership, time discounting) in men and women. We performed sex-specific correlation analyses to investigate relationships between dietary patterns based on self-reported protocols from the Mediterranean Diet Adherence Screener (MEDAS) and the validated Healthy Eating Index (HEI) from the EPIC Study and a self-reported social behaviour questionnaire. In linear regression models, we analysed associations between dietary and social behaviour patterns. Sex differences were measured by interaction analysis for each social behaviour item. The study sample consisted of N = 102 low-risk individuals. The median age of the study participants was 62.4 (25th/75th percentile 53.6, 69.1) years, and 26.5% were women. Analyses showed that a lower HEI score was correlated with a higher BMI in both women and men. MEDAS and HEI showed a positive correlation with each other in men. In men, a higher MEDAS showed a positive correlation when they estimated their ability as high, with the same for self-control and preference for ecological politics and MEDAS. A weak negative correlation has been shown between men with a preference for conservative politics and MEDAS. HEI showed a positive significant correlation with age in men. Male participants without club membership scored significantly higher in the HEI compared to non-members. A negative correlation was shown for time discounting in men. Linear regression models showed positive associations between preferences for ecological-oriented politics and nutrition for both HEI and MEDAS. No sex interactions were observed. We faced a few limitations, such as a small sample size, particularly for women, and a limited age spectrum in a European cohort. However, assuming that individuals with a preference for ecological-oriented politics act ecologically responsibly, our findings indicate that ecological behaviour in low-risk individuals might determine, at least in part, a healthy diet. Furthermore, we observed dietary patterns such as higher alcohol consumption in men or higher intake of butter, margarine and cream in women that indicate that women and men may have different needs for nutritional improvement. Thus, further investigations are needed to better understand how social behaviour affects nutrition, which could help to improve health. Our findings have the potential to inform researchers and practitioners who investigate the nature of the relationship between social behaviour and dietary patterns to implement strategies to create first-stage changes in health behaviour for individuals with a low cardiovascular risk profile.

Relevance of the Extraction Stage on the Anti-Inflammatory Action of Fucoidans

The anti-inflammatory action of fucoidans is well known, based on both in vitro and some in vivo studies. The other biological properties of these compounds, their lack of toxicity, and the possibility of obtaining them from a widely distributed and renewable source, makes them attractive novel bioactives. However, fucoidans’ heterogeneity and variability in composition, structure, and properties depending on seaweed species, biotic and abiotic factors and processing conditions, especially during extraction and purification stages, make it difficult for standardization. A review of the available technologies, including those based on intensification strategies, and their influence on fucoidan composition, structure, and anti-inflammatory potential of crude extracts and fractions is presented.