The association between Diet Quality Index-International score and risk of diminished ovarian reserve: a case-control study

Introduction

Although limited evidence exists on the beneficial reproductive effects of diet quality indices, the association is still largely unknown. We aimed to investigate the association between Diet Quality Index-International (DQI-I) and antral follicle count (AFC) and serum antimullerian hormone (AMH) as precise and sensitive markers of ovarian reserve and to assess the risk of diminished ovarian reserve (DOR) in women seeking fertility treatments.

Methods

In a case-control study, 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and body mass index (BMI), were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The quality of diets was assessed using DQI-I, which included four major dietary components: variety (0-20 points), adequacy (0-40 points), moderation (0-30 points), and overall balance (0-10 points). DQI-I score was categorized by quartiles based on the distribution of controls. AFC, serum AMH and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of DQI-I score.

Results

Increased adherence to DQI-I was associated with higher AFC in women with DOR. After adjusting for potential confounders, the odds of DOR decreased with increasing DQI-I score (0.39; 95% CI: 0.18-0.86).

Conclusion

Greater adherence to DQI-I, as a food and nutrient-based quality index, may decrease the risk of DOR and improve the ovarian reserve in women already diagnosed with DOR. Our findings, though, need to be verified through prospective studies and clinical trials.

Diet Quality and Measures of Sarcopenia in Developing Economies: A Systematic Review

Sarcopenia refers to common age-related changes characterised by loss of muscle mass, strength, and physical performance that results in physical disability, poorer health status, and higher mortality in older adults. Diet quality is indicated as a potentially modifiable risk factor for sarcopenia. However, the association between diet quality and sarcopenia in developing economies appears to be conflicting. Hence, we conducted a systematic review of the literature from developing economies examining the relationship between diet quality and at least one of the three components of sarcopenia, including muscle mass, muscle strength, and physical performance, and the overall risk of sarcopenia. No restrictions on age and study design were employed. We identified 15 studies that met review inclusion criteria. There was heterogeneity among the studies in the diet quality metric used and sarcopenia-related outcomes evaluated. Longitudinal evidence and studies relating diet quality to a holistic definition of sarcopenia were lacking. Although limited and predominantly cross-sectional, the evidence consistently showed that diet quality defined by diversity and nutrient adequacy was positively associated with sarcopenia components, such as muscle mass, muscle strength, and physical performance.

Interaction between the dietary indices and PPAR-γ Pro12Ala gene variants on cardiovascular risk factors in patients with type 2 diabetes mellitus

AIMS

We investigated the interaction between peroxisome proliferator-activated receptor gamma (PPAR-γ) Pro12Ala polymorphism and healthy eating index (HEI), Dietary Quality Index-International (DQI-I), and dietary phytochemical index (DPI) on cardiovascular disease (CVD) risk factors in patients with type 2 diabetes mellitus (T2DM).

METHODS

This cross-sectional study was conducted on 393 diabetic patients. PPAR-γ Pro12Ala was genotyped by the PCR-RFLP method. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α). Interleukin 18 (IL18), leptin, and ghrelin were measured by standard protocol. Food-frequency questionnaires (FFQ) were used for dietary indices (DQI-I, DPI, HEI) calculation.

RESULTS

Homozygous carriers of the rs1801282 C allele showed higher leptin compared G allele carriers (P = .015). The rs1801282-DQI-I interactions were significant on waist circumference (WC) (P = .019). Thus, C-allele carriers in the higher tertile of DQI-I had higher WC compared with GG homozygous. Further, an interaction was observed between PPAR rs1801282 polymorphism and DQI-I on serum IL-18 level (P = .032). Besides, a significant rs1801282-DPI interaction was shown on HDL concentration (P = .041), G allele carriers who were in the highest tertile of DPI, had lower HDL. Moreover, there were significant rs1801282-HEI interactions on serum leptin (P = .021). Individuals with (CC, CG) genotypes in the higher tertile of HEI, had lower leptin concentration.

CONCLUSION

Higher dietary indices (DQI-I, DPI, HEI) may affect the relationship between PPAR-γ Pro12Ala polymorphism and WC, ghrelin, leptin, HDL, and IL-18 concentration in patients with T2DM.

Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index

BACKGROUND/OBJECTIVES

As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index.

SUBJECTS/METHODS

A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed.

RESULTS

The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01).

CONCLUSIONS

The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.

Dietary Patterns and Their Associations with the Diet Quality Index-International (DQI-I) in Korean Women with Gestational Diabetes Mellitus

The aim of this study was to examine dietary pattern, nutritional intake, and diet quality of Korean pregnant women with gestational diabetes mellitus (GDM). Between October 2008 and May 2012, 166 pregnant women diagnosed with GDM completed a questionnaire and dietary intake was assessed using a 3-day food record. Blood pressure, fasting plasma glucose, and glycated hemoglobin (HbA1c) concentrations were measured and oral glucose tolerance test (OGTT) was performed. Two major dietary patterns ("carbohydrate and vegetable" and "western" patterns) were identified through factor analysis. Dietary pattern scores for each dietary pattern were categorized into tertiles. The dietary quality index-international (DQI-I) was used to measure overall diet quality. Subjects with higher carbohydrate and vegetable pattern scores reported less physical activity (p < 0.05) and have higher diastolic blood pressure levels (p = 0.05). After adjusting for age and energy intake, higher carbohydrate and vegetable pattern scores were associated with higher sodium intakes (p = 0.02), but lower intakes of fat (p = 0.002) and other micronutrients. On the other hand, higher western pattern scores were associated with higher fat intake (p = 0.0001), but lower intakes of sodium (p = 0.01) and other micronutrients. Higher scores for both dietary patterns were associated with lower scores in the moderation category of the DQI-I (p < 0.0001). HbA1c and fasting plasma glucose levels were significantly lower among participants with high DQI-I than those with low DQI-I (p < 0.05). The study findings suggest that many Korean women with GDM do not consume nutritionally adequate or balanced diets, regardless of dietary pattern.

Development and formative evaluation of a web-based self-management exercise and diet intervention program with tailored motivation and action planning for cancer survivors

Background

Most dietary and exercise interventions developed to date for cancer survivors have employed intensive clinic-based face-to-face counseling sessions. However, when the clinic-based face-to-face intervention ends, the participants cannot receive feedback from the experts, and the motivation for regular exercise and diet practices decreases. One way to overcome the shortcomings of clinic-based face-to-face intervention is to employ the Internet to this end. To maximize effectiveness when providing Web-based interventions, action planning should be able to start at the right time, education should be tailored to motivational readiness, and self-efficacy should be enhanced at appropriate intervals.

Objective

The aim of this study was to develop a Web-based self-management diet and exercise intervention program with the aid of the transtheoretical model (TTM) and to conduct formative evaluations.

Methods

The Web-based self-management exercise and diet intervention program was developed employing a 5-phase system development life-cycle (SDLC) method. The 5 phases were 1) identification of user requirements, 2) system design, 3) system development, 4) system evaluation, and 5) system application. An expert group composed of 3 content experts, a Web developer, and 2 Web designers, evaluated the usability and accuracy of the content. The program was evaluated by 30 breast cancer survivors for perceived ease of use.

Results

The Web-based self-managed exercise and diet intervention program contained 5 components differing in screen layout. These components are introduction, assessment, education (tailored information provision), action planning (goal setting, scheduling, keeping a diary), and automatic feedback. Education, action planning, and automatic feedback were tailored to each participant through the assessment. The processes of change, self-efficacy, and decisional balance, which are the principal strategies encouraging behavioral change according to the TTM theory, were reflected in the education, and self-efficacy was also reflected in the automatic feedback. After iterative testing by experts on problems that arose in terms of usability and content accuracy during system operation, the perceived ease of use of the program was evaluated by 29 breast cancer survivors. The end users rated the program as being easy to understand and use (a total usability score of 81.3 points). In addition, program feasibility was evaluated using the percentage of patients (27/30, 90%) who consistently used the program.

Conclusions

The use of Internet technology allowed immediate and easy access to interventions, real-time monitoring of progress, online education, tailored action planning, and tailored short message services using mobile phones.