Search

Objectives: We investigated whether a Mediterranean-style diet (MedDiet) supplemented with fish oil can improve mental health in adults suffering depression. Methods: Adults with self-reported depression were randomized to receive fortnightly food hampers and MedDiet cooking workshops for 3 months and fish oil supplements for 6 months, or attend social groups fortnightly for 3 months. Assessments at baseline, 3 and 6 months included mental health, quality of life (QoL) and dietary questionnaires, and blood samples for erythrocyte fatty acid analysis. Results: n = 152 eligible adults aged 18–65 were recruited (n = 95 completed 3-month and n = 85 completed 6-month assessments). At 3 months, the MedDiet group had a higher MedDiet score (t = 3.95, P < 0.01), consumed more vegetables (t = 3.95, P < 0.01), fruit (t = 2.10, P = 0.04), nuts (t = 2.29, P = 0.02), legumes (t = 2.41, P = 0.02) wholegrains (t = 2.63, P = 0.01), and vegetable diversity (t = 3.27, P < 0.01); less unhealthy snacks (t = −2.10, P = 0.04) and red meat/chicken (t = −2.13, P = 0.04). The MedDiet group had greater reduction in depression (t = −2.24, P = 0.03) and improved mental health QoL scores (t = 2.10, P = 0.04) at 3 months. Improved diet and mental health were sustained at 6 months. Reduced depression was correlated with an increased MedDiet score (r = −0.298, P = 0.01), nuts (r = −0.264, P = 0.01), and vegetable diversity (r = −0.303, P = 0.01). Other mental health improvements had similar correlations, most notably for increased vegetable diversity and legumes. There were some correlations between increased omega-3, decreased omega-6 and improved mental health. Discussion: This is one of the first randomized controlled trials to show that healthy dietary changes are achievable and, supplemented with fish oil, can improve mental health in people with depression. Refereed/Peer-reviewed

Added sugar intake has been associated with several health issues, but few studies have examined its association with overall diet quality. We aimed at examining the association between added sugar intake and overall diet quality in Finnish adults. Associations between added sugar intake and sociodemographic factors, lifestyle factors, and BMI were also explored. Our data comprised 5094 adults residing in Finland who participated in the National FinHealth 2017 Study. Dietary intake was assessed by a validated FFQ. Food consumption and nutrient intakes were calculated using the Finnish national food composition database. Added sugar intake was estimated based on food categorisation and identifying naturally occurring sugar sources. Overall diet quality was assessed by the modified Baltic Sea Diet Score. The average added sugar intake was 7·6 E % in women and 8·3 E % in men in this study population. Added sugar intake was inversely associated with education (P = 0·03 women; P = 0·001 men), physical activity (P < 0·0001), and BMI in men (P = 0·003), and directly with smoking (P = 0·002 women; P < 0·0001 men). Added sugar intake was inversely associated with overall diet quality in both sexes (P < 0·0001). No interactions were found except for men’s physical activity subgroups, the inverse association being stronger among active men than moderately active or inactive men (Pfor interaction = 0·005). Our findings suggest that high added sugar intake is associated with several unhealthy dietary and lifestyle habits, including poor-quality diets, smoking and leisure-time inactivity in Finnish adults. Efforts to improve diet quality should consider added sugar intake equally in the whole population.

BACKGROUND Although higher diet quality at mid-life has been associated with better cognitive function in late adulthood, it is unclear whether dietary improvement after mid-life may reduce the risk of cognitive impairment. OBJECTIVES We examined associations between changes in diet quality and risk of cognitive impairment in the Singapore Chinese Health Study cohort. METHODS We used data from 14,683 Chinese men and women who were recruited at ages 45 to 74 y from 1993 to 1998 and re-interviewed after 20 y at ages 61 to 96 y during follow-up 3 (2014-2016). Diet quality was measured using the Dietary Approaches to Stop Hypertension (DASH) scores at baseline and follow-up 3 interviews. Cognitive impairment was defined using scores from the Singapore-modified Mini-Mental State Examination at the follow-up 3 interview. Multivariable logistic regression models were used to estimate ORs and 95% CIs for the associations between change in DASH scores and cognitive impairment. RESULTS Higher quintiles in DASH scores at baseline and follow-up 3 interviews were associated with lower odds of cognitive impairment in a dose-dependent manner (both: P-trend

OBJECTIVE Knowledge remains scarce regarding diet and systemic lupus erythematosus (SLE) risk. Our objective was to investigate 4 dietary quality scores and SLE risk overall and by anti-double-stranded DNA (anti-dsDNA) positive versus negative subtypes. METHODS We studied 79,568 women in the Nurses' Health Study (1984-2014) and 93,554 in the Nurses' Health Study II (1991-2013). Using validated food frequency questionnaires, we calculated 4 dietary scores: the 2010 Alternative Healthy Eating Index (AHEI-2010), the Alternative Mediterranean Diet Score (aMed), the Dietary Approach to Stop Hypertension (DASH), and the Empirical Dietary Inflammatory Pattern (EDIP). Incident SLE was confirmed by medical record review. Time-varying Cox regression models estimated pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) of SLE risk, overall and by anti-dsDNA, for cumulative average dietary quality score tertiles and individual AHEI-2010 components. RESULTS We identified 194 incident SLE cases. SLE risk was similar in women with the highest (versus lowest) dietary scores (AHEI-2010 HR 0.78 [95% CI 0.54-1.14], aMed HR 0.82 [95% CI 0.56-1.18], DASH HR 1.16 [95% CI 0.81-1.66], EDIP HR 0.83 [95% CI 0.57-1.21]). No association was demonstrated for anti-dsDNA+ or anti-dsDNA- SLE risk. Women in the highest (versus lowest) AHEI-2010 tertile of nut/legume intake had a decreased SLE risk (HR 0.59 [95% CI 0.40-0.87]). No association was demonstrated for other AHEI-2010 components and SLE risk. CONCLUSION We observed no association between long-term adherence to the AHEI-2010, aMed, DASH, or EDIP scores with SLE risk, suggesting a large effect of dietary quality on SLE risk is unlikely. However, potential reduction in overall SLE risk with high nut/legume intake warrants further investigation.

Background Plant-based substitutes are designed to have the same use as animal-based foods in the diet and could therefore assist the transition toward more plant-based diets. However, their nutritional impact has not been characterized. Objectives We assessed and compared the effects of plant-based substitutes on the nutritional quality of the diet. Methods We simulated separately the substitution of meat, milk, and dairy desserts with 96 plant-based substitutes in the diets of 2121 adults (18-79 y old) from the cross-sectional French Third Individual and National Study on Food Consumption Survey (INCA3; 2014-2015). The quality of initial individual diets and the 203,616 substituted diets was evaluated using the Probability of Adequate Nutrient Intake (PANDiet) scoring system, which assesses the probability of adequate (sufficient and not excessive) nutrient intake; also, nutrient security was evaluated using the SecDiet scoring system, which assesses the risk of overt deficiency. Results Impacts on PANDiet depended on both the food substituted and the types of substitutes. Soy-based substitutes provided a slight improvement in diet quality (0.8% increase of the PANDiet score when substituting meat), whereas cereal-based substitutes resulted in a 1.1% decrease. Globally, substitutions led to better adequacies for fiber, linoleic acid, α-linolenic acid, vitamin E, folate, and SFAs, but lower adequacies regarding vitamin B-12 and riboflavin, as well as bioavailable zinc and iron when substituting meat, and calcium and iodine when substituting milk/dairy desserts. When they substituted dairy products, calcium-fortified substitutes allowed maintenance of calcium adequacy but there was a higher risk of iodine deficiency when substituting dairy, which may warrant iodine fortification. Substitutions modified the energy share of ultra-processed foods from 29% to 27%-40%, depending on the food substituted and the substitute used. Conclusions Plant-based substitutes had a small effect on overall diet quality and heterogeneous impacts on nutrient adequacy and security. Plant-based substitutes that include legumes appear more nutritionally adequate to substitute animal products than do other substitutes.

Background Maternal nutrition interventions are inadequately integrated into antenatal care (ANC). Alive & Thrive aimed to strengthen delivery of micronutrient supplements and intensify interpersonal counseling and community mobilization through government ANC services. Objectives We compared nutrition-intensified ANC (I-ANC) with standard ANC (S-ANC) on coverage of nutrition interventions and maternal nutrition practices. Methods We used a cluster-randomized design with cross-sectional baseline (2017) and endline (2019) surveys (n ∼660 pregnant and 1800 recently delivered women per survey) and a repeated-measures longitudinal study in 2018–2019 (n = 400). We derived difference-in-difference effect estimates (DIDs) for diet diversity, consumption of micronutrient supplements, weight monitoring, and early breastfeeding practices. Results Despite substantial secular improvements in service coverage from India's national nutrition program, women in the I-ANC arm received more home visits [DID: 7–14 percentage points (pp)] and counseling on core nutrition messages (DID: 10–23 pp) than in the S-ANC arm. One-third of women got ≥3 home visits and one-fourth received ≥4 ANC check-ups in the I-ANC arm. Improvements were greater in the I-ANC arm than in the S-ANC arm for any receipt and consumption of iron–folic acid (DID: 7.5 pp and 9.5 pp, respectively) and calcium supplements (DID: 14.1 pp and 11.5 pp, respectively). Exclusive breastfeeding improved (DID: 7.5 pp) but early initiation of breastfeeding did not. Maternal food group consumption (∼4 food groups) and probability of adequacy of micronutrients (∼20%) remained low in both arms. Repeated-measures longitudinal analyses showed similar results, with additional impact on consumption of vitamin A–rich foods (10 pp, 11 g/d), other vegetables and fruits (22–29 g/d), and gestational weight gain (0.4 kg). Conclusions Intensifying nutrition in government ANC services improved maternal nutrition practices even with strong secular trends in service coverage. Dietary diversity, supplement consumption, and breastfeeding practices remained suboptimal. Achieving greater behavior changes will require strengthening the delivery and use of maternal nutrition services integrated into ANC services in the health system. This trial was registered at clinicaltrials.gov as NCT03378141.

Objective To examine how changes in feeling bored and eating because of boredom during the coronavirus disease 2019 (COVID-19) pandemic relate to intuitive eating, diet quality, and snacking. Methods A representative sample of 360 US adults completed an online survey including changes in feeling bored and eating because of boredom since the COVID-19 pandemic. An ANCOVA and multivariate analysis of covariance were used to examine relationships between intuitive eating, diet quality, and snacking in individuals who experienced: (1) increases in feeling bored and eating because of boredom, (2) eating because of boredom only, (3) increases in feeling bored only, and (4) no change/decreases in feeling bored and eating because of boredom. Results Individuals who increased feeling bored and eating because of boredom and increased eating because of boredom only snacked more and scored lower in intuitive eating. Diet quality did not differ across groups. Conclusions and Implications Although diet quality did not differ, eating because of boredom is potentially a negative impact on diet quality. Programs enhancing intuitive eating may be helpful.

Background There is little information about how diet quality evolves in early childhood, whether children exhibit varying diet quality trajectories, or which components of diet quality should be targeted for intervention. Objective The goal of this study was to identify and evaluate trajectories of dietary quality in young children. Design This was a secondary analysis of an observational, longitudinal cohort study of non-Hispanic African American or White children and their parents from racially concordant households with 4 years of follow-up (up to 13 study visits). Data on mother, infant feeding, and body mass index were assessed at baseline. Diet was evaluated using 3-day diaries at each visit. Participants/setting Of 372 children enrolled, 349 children had at least 3 study visits with dietary data for this analysis. Participants were enrolled at age 3 years between March 2001 and August 2002 in Cincinnati, OH. Final study visits were conducted between February 2005 and June 2006. Main outcome measure The main outcome measure was the total Healthy Eating Index 2005 (HEI-2005) score and HEI-2005 component scores. Statistical analyses Diet quality trajectories were modeled using group-based modeling techniques. Results The total HEI-2005 score was low at age 3 years (mean ± standard error = 55.1 ± 0.4 of maximum 100 points) and remained stable to age 7 years (mean ± standard error = 54.0 ± 0.6; P = 0.08 for trend). Five HEI-2005 trajectory groups were identified, of which 1 declined and 1 improved over time. HEI-2005 component scores, except milk intake and meat/beans scores, differed significantly (all, P ≤ 0.02) among trajectory groups at age 3 years, and most differences were maintained at age 7 years. Total vegetables, dark green and orange vegetables and legumes, and whole grains component scores were low for all trajectory groups. Whole fruit; total fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugars (SoFAAS) were highly variable among trajectory groups. Children in the lowest diet quality trajectory group were less likely to be breastfed and more likely to have been regular consumers of soft drinks (e.g., powdered drink mixes, sport drinks, or soda pop) before age 3 years. Conclusions Young childhood diet quality was low at age 3 years and remained stable to age 7 years. Improving intake of vegetables and whole grains is needed for all children. Focused attention regarding increasing fruit intake and reducing SoFAAS may be needed for families at increased risk for low overall diet quality.

There is limited information regarding the nutrition profile and diet quality of meal plans from currently popular weight loss diets in Australia. This includes the energy content (kilojoules), the macronutrient distribution, and the micronutrient composition. Further, these diets have not been compared with current government guidelines and healthy eating principles for nutritional adequacy. Popular diets were identified through grey literature, trending searches and relative popularity in Australia. Meal plans for each diet were analysed using Foodworks Dietary Software to determine food group intake, micronutrient, and macronutrient distribution. Results indicated that all popular diets assessed deviated from government recommended healthy eating principles such as the Australian Guide to Healthy Eating and the Mediterranean Diet. In most cases both popular diets, and the healthy eating principles had low intakes of multiple food groups, low intakes of essential micronutrients, and a distorted macronutrient distribution. Popular diets may not provide adequate nutrition to meet needs, particularly in the long-term and potentially resulting in micronutrient deficiency. When energy restricting for weight loss, meal plans should be highly individualized in conjunction with a qualified nutrition professional to ensure adequate dietary intake. Refereed/Peer-reviewed

Mycoprotein is a fungal-based ingredient rich in fibre and protein used in meat substitutes called Quorn. Fibre and protein positively regulate glycaemia, lipidaemia and energy intake which are non-communicable diseases’ (NCD) markers. We performed a cross-sectional study to investigate the association of mycoprotein intake with diet quality, nutrient, energy intake and NCD risk within 5507 UK free-living adults from the National Diet and Nutrition Survey from years 2008/2009 to 2016/2017. Dietary approaches to stop hypertension (DASH) and healthy diet index (HDI) were calculated to estimate diet quality. Comparison between mycoprotein consumers (>1 % kcal) and non-consumers, and associations between consumers and nutrient intakes, NCD’s risk markers and diet quality were investigated using a survey-adjusted general linear model adjusted for sex, age, BMI, ethnicity, socio-economic, smoking status, region of residency, total energy, energy density, HDI and non-mycoprotein fibre intake. Mycoprotein consumers (3·44 % of the cohort) had a higher intake of dietary fibre (+22·18 %, P < 0·001), DASH score (+23·33 %) and HDI (+8·89 %) (P < 0·001, both) and lower BMI (−4·77 %, P = 0·00) v. non-consumers. There was an association (P = 0·00) between mycoprotein consumers and diet quality scores (+0·19 and +0·26), high fibre (+3·17 g), total and food energy (+3·09 and +0·22 kcal), but low energy density intakes (−0·08 kcal/g, P = 0·04). Consumers were negatively associated with fasting blood glucose (−0·31 mmol/l, P = 0·00) and glycated HbA1c (−0·15 %, P = 0·01). In conclusion, mycoprotein intake is associated with lower glycaemic markers and energy density intake, and high fibre, energy intake and diet quality scores.

Objective:The objectives were to describe changes in diet quality between off-reserve Indigenous and non-Indigenous children and youth from 2004 to 2015 and examine the association between food security and diet quality.Design:We utilised a repeated cross-sectional design using both the 2004 and 2015 nutrition-focused Canadian Community Health Surveys, including 24-h dietary recall. Diet quality was estimated according to the Healthy Eating Index (HEI).Setting:The surveys were conducted off-reserve in Canada’s ten provinces.Participants:Our analysis included children and youth 2–17 years old (n 18 189). Indigenous and non-Indigenous participants were matched, and using a general linear model, we tested time period and (non-)Indigenous identifiers, including their interaction effect, as predictors of HEI.Results:Both Indigenous and non-Indigenous children and youth had significantly higher HEI scores in 2015 as compared to 2004. There was not a significant (non-)Indigenous and time period interaction effect, indicating the improvements in diet quality in 2015 were similar between both Indigenous and non-Indigenous populations. Improvements in diet quality are largely attributed to reductions in percentage energy from ‘other’ foods, though a disparity between Indigenous and non-Indigenous children and youth persisted in 2015. Overall, food security was lower among the Indigenous population and positively, and independently, associated with diet quality overall, though this relationship differed between boys and girls.Conclusions:School policies may have contributed to similar improvements in diet quality among Indigenous and non-Indigenous populations. However, an in-depth sex and gender-based analysis of the relationship between food security and diet quality is required.

The importance of diet and nutrition to military readiness and performance has been recognized for centuries as dietary nutrients sustain health, protect against illness, and promote resilience, performance and recovery. Contemporary military nutrition research is increasingly inter-disciplinary with emphasis often placed on the broad topics of (1) determining operational nutrition requirements in all environments, (2) characterizing nutritional practices of military personnel relative to the required (role/environment) standards, and (3) developing strategies for improving nutrient delivery and individual choices. This review discusses contemporary issues shared internationally by military nutrition research programmes, and highlights emerging topics likely to influence future military nutrition research and policy. Contemporary issues include improving the diet quality of military personnel, optimizing operational rations, and increasing understanding of biological factors influencing nutrient requirements. Emerging areas include the burgeoning field of precision nutrition and its technological enablers.

Objective Using 24-hour dietary recalls, compare Healthy Eating Index (HEI)-2005 scores of Expanded Food and Nutrition Education Program participants before and after 8–12 weekly lessons. Design Analysis of preexisting 24-hour dietary recalls information collected from October, 2012 through September, 2014. Participants Participants with complete pre-post dietary data (n = 122,961); subset of those with complete demographic data (n = 97,522). Main Outcome Measures Change in HEI-2005 scores (total and components). Statistical Analysis Linear regression model fit separately for total HEI and 12 components. The response variable was changed in the HEI-2005 score; predictor variables included age, education, sex, and race/ethnicity. Results The mean total HEI scores were 51.1 (SD, 13.7) at entry and 56.5 (SD, 13.7) at exit, with a change of 5.4 (SD, 16.2). Nine of 12 component scores increased. Changes were greater as age increased, with increasing education, and in women. Hispanics had the greatest improvement (mean ± SE) in total HEI score (8.3 ± 0.1). Conclusions and Implications Although diet quality remained poor, participation in the Expanded Food and Nutrition Education Program resulted in improvement in dietary quality. The degree of improvements varied among demographic groups, but all groups improved.

Profound understanding of healthy eating beliefs in populations with a low socioeconomic position (SEP) can benefit attempts to improve diet quality in this population, but literature on this subject is fragmented. The purpose of this scoping review was to systematically map healthy eating beliefs and the meaning of food and eating in populations with a low SEP. Systematic search of electronic databases yielded 35 relevant publications that were included in a qualitative synthesis. Populations with a low SEP perceived healthy eating as important, although they expressed various meanings of ‘healthy’ and ‘good’ eating. Lack of time and money posed perceived barriers to healthy eating, as well as social influences, and desired identities that can be expressed by specific foods. Traditions were important influences on food and eating practices. Eating behavior was perceived as one's own responsibility and desirably within one's own control. Parents expressed the role of food to regulate children's (eating) behavior. In conclusion, perceived limited control over what is eaten due to various barriers as described by populations with a low SEP, may also be viewed as competing values. Deeper understanding of reasons and thoughts underlying healthy eating beliefs and what it means to eat ‘well’ is largely lacking in this domain. The findings call for an in-depth exploration of the origin and construction of beliefs regarding ‘healthy’ and ‘good’ eating in populations with a low SEP.

Objectives To identify food sources of nutrients in First Nations adults in Canada and to establish whether these populations are meeting their nutrient requirements and whether traditional foods (TF) contribute to better nutrient intake. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults living south of the 60th parallel. Twenty-four-hour recalls were conducted in 92 First Nations communities from 2008 to 2016. Repeat recalls were attempted with 20% of participants to adjust for within-person variation and estimate the proportion of individuals below recommendations according to Institute of Medicine guidelines. Nutrients from days with and without TF were compared. The main food sources of select nutrients were identified, including TF. Results Mean energy intakes among women and men ranged from 1664 to 1864 and from 1761 to 2298 kcal/day respectively. Most macronutrients were within the acceptable macronutrient diet range except for fat in most age groups and carbohydrates in men 71 years of age and older. Saturated fat was above recommendations for all ages. Only niacin was identified as above recommendations in all age and sex categories. Days where TF were eaten showed greater intakes of key nutrients. Conclusion It is imperative that we find culturally appropriate ways to improve the quality and nutritional value of First Nations Peoples food intake by improving TF access and use on the one hand and conversely providing better quality store-bought foods. For success in this, we must empower First Nations communities and health practitioners to collaboratively overcome these challenges.

A plant-based eating pattern is associated with a reduced risk of developing type 2 diabetes and is highly effective in its treatment. Diets that emphasize whole grains, vegetables, fruits, and legumes and exclude animal products improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure and play an important role in reducing the risk of cardiovascular and microvascular complications. This article reviews scientific evidence on the effects of plant-based diets for the prevention and treatment of type 2 diabetes. The mechanisms by which plant-based diets improve body weight, insulin sensitivity, and β-cell function are described. Practical considerations including education, nutrition adequacy, and adjusting medications will enhance the success of patients who have diabetes., This article examines the evidence on plant-based nutrition for the prevention and treatment of type 2 diabetes, mechanisms, and considerations when recommending such diets.

Assess the diet quality of First Nations adults in Canada using percentage energy from traditional foods (TF) and ultra-processed products (UPP), food portions from the 2007 Eating Well with Canada's Food Guide - First Nations, Inuit and Métis (EWCFG-FNIM) and a Healthy Eating Index (HEI).Data collection for this participatory research occurred in 92 First Nations reserves across Canada from 2008 to 2016. Percent daily energy intakes were estimated from 24-hour recalls for TF and NOVA food categories. Portions of food groups from the 2007 EWCFG-FNIM were compared to recommendations. A Canadian-adapted HEI was calculated for each participant.The percent energy from TF was 3% for all participants and 18% for consumers. Meat and alternatives were above the EWCFG-FNIM recommendations and all other food groups were below these. HEI was "low" with only older individuals attaining "average" scores. HEI was above "average" in 4 regions. UPP represented 55% of energy, the largest proportion from a NOVA category.The diet quality of First Nations adults in Canada is nutritionally poor. The nutrition, food security and health of First Nations would be improved by better access to TF and healthy store-bought food. However, poor diet is only one aspect of the difficulties facing First Nations in Canada. Researchers and policy makers must strive to better understand the multiple challenges facing First Nations Peoples in order to foster empowerment and self-determination to develop First Nations living conditions and lifestyles that are more culturally sound and more conducive to health.RéSUMé: OBJECTIFS: Évaluer la qualité de l’alimentation des adultes des Premières Nations du Canada en calculant l’énergie provenant des aliments traditionnels (AT) et des produits ultra-transformés, en comparant les portions consommées avec celles recommandées dans Bien manger avec le Guide alimentaire canadien Premières Nations, Inuit et Métis (BMGAC-PNIM) de 2007 et en mesurant l’indice d’alimentation saine. MéTHODE: La collecte de données pour cette recherche participative a eu lieu dans 92 réserves des Premières Nations au Canada entre les années 2008 et 2016. À partir des rappels de 24 heures, la proportion d’énergie provenant des AT pour les individus les ayant consommés ou non a été comparée, les portions des catégories d’aliments proposées par le BMGAC-PNIM ont été comparées aux recommandations, l’indice d’alimentation saine adapté pour le Canada a été calculé pour chaque participant et la proportion d’énergie des produits ultra-transformés a été établie. RéSULTATS: La proportion d’énergie provenant des AT chez les consommateurs et non-consommateurs était de 3 % et celle pour les consommateurs d’AT était de 18 %. Seuls les viandes et substituts dépassaient les recommandations du BMGAC-PNIM tandis que la consommation de toutes les autres catégories était inférieure aux recommandations. L’indice d’alimentation saine était “bas” avec seulement les individus plus âgés atteignant un score “moyen”. L’indice d’alimentation saine était supérieur à “moyen” dans 4 régions. Les aliments ultra-transformés représentaient 55 % de l’énergie, la plus grande proportion de toutes les catégories NOVA. CONCLUSION: La qualité de l’alimentation des Premières Nations n’est pas optimale. Leur alimentation pourrait être améliorée avec un meilleur accès aux AT et aux aliments sains provenant du marché. Une mauvaise alimentation n’est toutefois pas la seule difficulté à laquelle font face les Premières Nations du Canada. Les Peuples des Premières Nations doivent être impliquées avec les chercheurs et les responsables politiques pour mieux comprendre les défis multiples auxquels ils font face et instaurer des conditions de vie qui soient culturellement sécuritaires et plus propices à la santé.

Renewed debate over what benefits females might gain from producing extra‐pair offspring emphasizes the possibility that apparent differences in quality between within‐pair and extra‐pair offspring are confounded by greater maternal investment in extra‐pair offspring. Moreover, the attractiveness of a female's social mate can also influence contributions of both partners to a reproductive attempt. Here, we explore the complexities involved in parental investment decisions in response to extra‐pair offspring and mate attractiveness with a focus on the female point of view. Adult zebra finches paired and reproduced in a colony setting. A male's early‐life diet quality and his extra‐pair reproductive success were used as metrics of his mating attractiveness. Females paired with males that achieved extra‐pair success laid heavier eggs than other females and spent less time attending their nests than their mates or other females. Extra‐pair nestlings were fed more protein‐rich hen's egg than within‐pair nestlings. Females producing extra‐pair offspring had more surviving sons than females producing only within‐pair offspring. Collectively, results show that females differentially allocate resources in response to offspring extra‐pair status and their social mate's attractiveness. Females may also obtain fitness benefits through the production of extra‐pair offspring., To understand how female birds benefit from mating with males other than their social partners (extra‐pair mating), we assessed how the production of extra‐pair offspring and the relative attractiveness of their social partners influence maternal caregiving and reproduction. Collectively, results show that females differentially allocate resources in response to offspring extra‐pair status and their social mate's attractiveness. Females may also obtain direct fitness benefits through the production of extra‐pair offspring. ​

Objective: To explore differences between mothers’ and fathers’ complementary feeding practices. Methods: An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index. Results: In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02). Conclusions and Implications: Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.

Our objectives were to understand the links between intake of traditional foods, food security and diet quality in low-income Alaska Native women living in an urban center. Seventy-three Alaska Native women completed two 24-hour dietary recalls, a food frequency questionnaire, and the USDA Adult Food Security Survey Module. An increase in 10% calories from traditional foods (equivalent to approximately 195 kcals) was associated with a 7.3 point increase on the Healthy Eating Index , a measure of diet quality (scale is 0-100). Findings highlight the importance of policies and programs that ensure consistent access to traditional foods in urban areas.

Objective:To evaluate diets in terms of nutritional characteristics and quality from the perspectives of health, greenhouse gas emissions (GHGE) and possible associations with each other in a representative sample of students at a public university.Design:Cross-sectional. Dietary intake was evaluated with a validated FFQ, and diet quality was assessed through the Healthy Eating Index (HEI-2010) and MedDietScore (MDS). GHGE data were obtained from the literature. In addition, sex, socio-economic status (SES) and body fat (BF) status were analysed as covariates.Setting:Basque Autonomous Community, Spain.Participants:Totally, 26 165 healthy adults aged 18–28 years.Results:Student diets were characterised by low consumption of carbohydrates (38·72 % of total energy intake (TEI)) and a high intake of lipids (39·08 % of TEI). Over half of the participants had low dietary quality. The low-emitting diets were more likely to be consumed by subjects with low HEI-2010 scores (β: 0·039 kg eCO2/1000 kcal/d) and high MDS scores (β: −0·023 kg eCO2/1000 kcal/d), after controlling for sex, SES and BF status. Both the low-emitting and healthy diets were more likely to be consumed by women and by those with normal BF percentage.Conclusions:UPV/EHU university students’ diets were characterised by moderate quality from a nutritional perspective and moderate variation in the size of carbon footprints. In this population, diets of the highest quality were not always those with the lowest diet-related GHGE; this relationship depended in part on the constructs and scoring criteria of diet quality indices used.

Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period.

Purpose This paper aims to evaluate the association between carbohydrate quality index (CQI) and nutrient adequacy in Iranian adults. Design/methodology/approach A total of 268 men and women with ages ranged from 18 to 70 years were evaluated in a cross-sectional study. The CQI was calculated by adding together the three components, namely, the ratio of solid to total carbohydrate, dietary fiber and glycemic index. The scores of three components were summed to calculate the CQI, with a higher score indicating a higher dietary carbohydrate quality. The odds ratios (ORs) of nutrient adequacy ratio (NAR), defined as the ratio of intake of a nutrient to the age- and gender-specific recommended dietary allowance, for the intake of energy and 10 nutrients across quartiles of the CQI were calculated by logistic regression analysis and expressed with 95% confidence intervals (CIs). Findings CQI ranged between 3 to 15 (mean ± SD: 9 ± 1.9). Being in top versus bottom quartile of the CQI was associated with a higher NAR of folic acid (OR: 3.20, 95% CI: 1.06–9.62; P-trend: P-trend: P-trend: P-trend: Originality/value A higher CQI was associated with greater micronutrient consumption adequacy in Iranian adults. The results suggest that increasing the consumption of total fiber and solid carbohydrates and decreasing the glycemic index of the diet and liquid carbohydrates can improve micronutrient intake adequacy.

Background Evidence suggests chemosensory dysfunction (CSD) patients have altered diet, but population-level evidence assessing diet quality in CSD patients is lacking. Objective We examined the association between CSD and diet quality in a representative sample of United States adults. Methods This cross-sectional study included 2831 adults aged greater than 40 years from the 2013-2014 National Health and Nutrition Examination Survey who completed the taste/smell questionnaire and examination. Mean nutrient intake in subjects with self-reported olfactory/gustatory dysfunction (sOD/sGD) and measured olfactory/gustatory dysfunction (mOD/mGD) were compared to those without CSD using univariate Wilcoxon rank-sum tests. The Healthy Eating Index (HEI), a validated measure of diet quality, was calculated. The proportion of subjects with CSD with bottom-quartile HEI was compared to those without CSD using multivariate logistic regression, adjusting for demographic and socioeconomic covariates. Results The population-weighted prevalence of sOD, sGD, mOD, and mGD was 20.1%, 14.4%, 15.9% and 25.6%, respectively. Subjects with mOD had lower mean intake of total calories, total fat, protein, sodium, and potassium compared to normal subjects (1873.4 ± 49.6 vs 2010.2 ± 24.2 kcal, 72.3 ± 2.7 vs 78.6 ± 1.0 gm, 74.0 ± 2.5 vs 80.4 ± 0.6 gm, 3122 ± 97.2 vs 3353.2 ± 37.0 mg, 2509.8 ± 69.8 vs 2684.7 ± 26.1 mg, P Conclusions This population-level study suggests an association between poor diet quality and variation in dietary intake in patients with CSD, which warrants further investigation and suggests the possible need for nutritional counseling for CSD patients.

Purpose of Review To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic. Recent Findings A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. Summary One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children’s dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children’s changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.

Diet is a modifiable risk factor for chronic disease and a potential modulator of telomere length (TL). The study aim was to investigate associations between diet quality and TL in Australian adults after a 12-week dietary intervention with an almond-enriched diet (AED). Participants (overweight/obese, 50–80 years) were randomised to an AED (n62) or isoenergetic nut-free diet (NFD,n62) for 12 weeks. Diet quality was assessed using a Dietary Guideline Index (DGI), applied to weighed food records, that consists of ten components reflecting adequacy, variety and quality of core food components and discretionary choices within the diet. TL was measured by quantitative PCR in samples of lymphocytes, neutrophils, and whole blood. There were no significant associations between DGI scores and TL at baseline. Diet quality improved with AED and decreased with NFD after 12 weeks (change from baseline AED + 9·8 %, NFD − 14·3 %;P< 0·001). TL increased in neutrophils (+9·6 bp,P= 0·009) and decreased in whole blood, to a trivial extent (–12·1 bp,P= 0·001), and was unchanged in lymphocytes. Changes did not differ between intervention groups. There were no significant relationships between changes in diet quality scores and changes in lymphocyte, neutrophil or whole blood TL. The inclusion of almonds in the diet improved diet quality scores but had no impact on TL mid-age to older Australian adults. Future studies should investigate the impact of more substantial dietary changes over longer periods of time.

Background Over the past decade, the financial crisis has affected harshly the household income of Greek people. This study aimed to investigate whether the effect of the financial crisis on food spending has affected the dietary habits in the family environment. Methods Under a cross-sectional study conducted during 2014–2016, 1145 children and their parents completed questionnaires examining socio-economic and dietary characteristics. The MedDietScore and the KIDMED Score were used to assess parental and childhood adherence to the Mediterranean diet, respectively. Results The parents who reported that the financial crisis has affected food spending used to consume weekly fewer fruits (3.26 ± 0.94 vs. 3.41 ± 0.90, P = 0.016), carbohydrate foods (3.16 ± 0.57 vs. 2.99 ± 0.55, P Conclusions The constrained food spending due to financial crisis has an independent and inverse impact on parent’s diet quality while keeping unaffected preadolescent’s diet quality. This finding highlights the role of parents as a protective ‘wall’ against the deterioration of their children’s diet quality. The modification on the prices of healthy food and the provision of food aid particularly in economically disadvantaged households is underlined.

Indigenous food systems of Pacific Small Island Developing Countries contain vast biological and cultural diversity. However, a nutrition transition is underway, characterized by shifts away from traditional diets in favour of imported and modern foods, contributing to some of the highest rates of obesity and Diabetes Type 2 Mellitus in the world. Using a mixed method approach, this study aimed to assess dietary agrobiodiversity’s relationship with nutrition indicators related to diet quality and anthropometrics within the context of the rural and Indigenous food system of Baniata village, located in the Western Province of Solomon Islands (Melanesia). A secondary aim was to evaluate the contribution of agrobiodiversity from the local food system to diet quality. A comprehensive nutrition survey was administered to the women primarily responsible for cooking of randomly selected households (n = 30). Additionally, 14 participatory focus group discussions captured the historical narrative of food system transitions, were hosted over a period of seven days, and included men, women and youth. Dietary intakes of the participants were reported below the estimated average requirement (EAR) for several essential nutrients, including protein (53%), calcium (96.6%), vitamin B1 (86.6%), vitamin B2 (80%), vitamin A (80%), zinc (40%) and fibre (77%). Focus group participants built a timeline of key historical and climatic transitions perceived to be drivers of dietary shifts away from traditional foods and towards imported and processed foods. Participants identified 221 species and varieties of agrobiodiverse foods available for cultivation or wild collection. Based on 24 h diet recalls, 87 were found to be utilised. Participants who consumed foods of a wider diversity of species richness had a higher probability of achieving recommended nutrition intakes and a lower body fat percentage (r2 = 0.205; p = 0.012). Our results suggest a nutrition transition is underway, and strategies harnessing traditional knowledge of nutrient-dense, agrobiodiverse foods can help improve food and nutrition security.

Background Nuts are nutrient-rich and reported to provide some cognitive and cardiometabolic health benefits, but limited studies have focused on older adults. This study investigated the cross-sectional relationship between habitual nut intake, dietary pattern and quality, cognition and non-alcoholic fatty liver disease (NAFLD) in older adults. Methods Older adults (≥ 60 years) from the NHANES 2011-12 and 2013-14 cohorts, who had complete data on cognitive function (as CERAD total, delayed recall, animal fluency and digit-symbol substitution test) and variables to calculate the Fatty Liver Index (FLI), an indicator of NAFLD, were included (n = 1848). Nut intake and diet quality (Healthy Eating Index 2015) were determined using two 24-hour diet recalls. Participants were categorised into one of four groups based on their habitual nut intake: non-consumers (0 g/d), low intake (0.1–15.0 g/d), moderate intake (15.1–30.0 g/d) or met recommendation (> 30 g/d), with all outcomes compared between these nut intake groups. Results Cognitive scores of older adults were the lowest in non-consumers and significantly highest in the moderate intake group, with no further increase in those who consumed nuts more than 30 g/d (p p = 0.329). Moderate nut intake was also associated with better immediate and delayed memory in older adults with high risk of NAFLD (FLI ≥ 60) (B = 1.84 and 1.11, p p Conclusions Moderate nut intake (15.1–30.0 g/d) may be sufficient for better cognitive performance, but not NAFLD risk of older adults in the US.

Summary A growing body of evidence suggests that diet quality may predict muscle health. This study found that a “Traditional” dietary pattern predicted greater muscle mass, and an anti-inflammatory diet predicted greater muscle mass and better muscle function over 15 years. These findings reinforce the importance of optimising dietary behaviours for healthy ageing. Introduction Research investigating the roles of individual nutrients in muscle health fails to account for the synergistic relationships between foods and nutrients. This study aimed to investigate the predictive value of diet quality and dietary patterns for muscle mass and function in men over a 15-year period. Methods This longitudinal study was conducted in 522 men from the Geelong Osteoporosis Study with complete dietary and muscle mass or muscle function data at both baseline and 15-year follow-up assessments. Dietary exposures were extracted from food frequency questionnaires and included the Australian Recommended Food Score, the Dietary Inflammatory Index (DII®), and three a posteriori dietary patterns: Plant-focused, Western, and Traditional (Anglo-Australian). Outcome variables included dual-energy X-ray absorptiometry–derived skeletal muscle index (SMI) and muscle function measured with the timed up-and-go (TUG) test. Results An anti-inflammatory diet and higher scores on a Traditional dietary pattern both predicted greater SMI ((B: −0.04 (95%CI −0.08, −0.00) kg/m2) and (B: 0.12 (95%CI 0.04, 0.20) kg/m2), respectively), while a pro-inflammatory diet predicted slower TUG (B: 0.11 (95%CI 0.001, 0.21) sec) over the 15-year follow-up period. These associations remained significant following adjustment for confounding variables. There were no associations observed for other dietary exposures. Conclusion A Traditional dietary pattern higher in vegetables, wholegrain cereals, and animal protein was associated with greater skeletal muscle mass, and an anti-inflammatory diet, also rich in vegetables, fruit, and wholegrain cereals, was associated with greater skeletal muscle mass and better muscle function over 15 years. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-021-06012-3.

To examine the mediating effects of food resource management skills (FRM) on the relationship between participation in a Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education program and diet quality.Secondary analysis of data from a propensity score-matched sample of participants (n = 396) and nonparticipants (n = 111) in a SNAP-Ed nutrition education program.Independent-samples t tests were used to compare entry, exit, and gain scores in FRM and diet quality between participants and nonparticipants. Structural equation modeling was used to examine direct and mediated relationships among participation, FRM, and diet quality.Food resource management was measured as a summated rating scale, and diet quality measured as Healthy Eating Index and program participation.Mediated effect of FRM on the relationship between participation in a SNAP-Ed program and diet quality was statistically significant (P0.01). The effect size for the mediation effect indicated that about 70% of program participation on diet quality was transferred by FRM skills. The hypothesized model had acceptable fit indices as model χParticipation in a SNAP-Ed program enhanced participants' FRM, which in turn enhanced their diet quality.

BACKGROUND: An innate preference for later timing of sleep and activity, termed evening chronotype, is linked to poorer cardiovascular health (CVH). However, associations of chronotype with specific health behaviors in US women are not well characterized. Of particular interest is habitual diet, because

Little is known about how behaviors to control weight are associated with diet quality among youth from low- and middle-income countries. The aim of this study was to examine associations between efforts to control weight (ECW) and diet quality among Brazilian adolescents and young adults. Data from 731 participants (17.89 ± 4.92 years, 51.1% female) of the 2015 Health Survey of Sao Paulo were used for this cross-sectional study. Dietary intake was assessed using a 24 h dietary recall and diet quality was calculated using the Brazilian Healthy Eating Index—Revised (BHEI-R). Participants reported their ECW, weight satisfaction, and socio-demographics. Descriptive statistics and linear regressions were calculated to investigate associations between ECW and diet quality. Approximately 47.7% of participants were dissatisfied with their current weight, and 41.0% reported ECW. Reported strategies to control weight included increased physical activity, taking care of what they eat, and dieting (8.2, 3.1, and 2.5%, respectively). After adjusting for age, sex, race/ethnicity, and body mass index, reporting at least one ECW (s = 0.08; 95% CI 0.02, 0.13), taking care of what to eat (s = 0.15; 0.08, 0.22) and being satisfied with their weight (0.08; 0.02, 0.13) were all associated with a higher overall BHEI-R score. Overall diet quality score showed a small increase in participants reporting ECW. Further studies should be conducted to provide strategies used by adolescents from low- and middle-income countries to control their weight. Thus, developing public health policies, and behavioral-change strategies. Level V: Cross-sectional descriptive study.

The aim of this study is to determine the relationship between diet quality and overall sleep quality, sleep duration, and presence of insomnia in the university-term female. This cross-sectional study was conducted on 412 female university students aged between 19 and 24 years in Turkey. The participants’ socio-demographic characteristics, anthropometric measurements, the Pittsburg Sleep Quality Index (PSQI), sleep duration and Insomnia Severity Index (ISI) and three days food intake records were taken. Healthy Eating Index (HEI)-2015 was used to assess diet quality. 64.1% of the participants had poor sleep quality and 28.4% of them were found to have insomnia. Higher PSQI scores were significantly associated with lower intakes of protein (β = − 0.53 ± 0.08% kcal, p

Background: Diet quality assessment in community health settings is critical to reduce the incidence and improve management of diet-related chronic disease. Unfortunately, understandable and action...

ObjectiveTo examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort.DesignCross-sectional.SettingOccupational cohort.Participants53 163 British police force employees enrolled (2004–2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study.Main outcome measuresA CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake.ResultsIn this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=−0.32, pConclusionsUltraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.

Objective To assess the effectiveness of food-based science, technology, engineering, arts, and mathematics (STEAM) learning activities on preschoolers’ liking of 9 target vegetables and objectively-assessed fruit and vegetable (FV) intake. Methods Seven hands-on, food-based STEAM learning activities were implemented to expose children to 9 target vegetables in 3 Head Start preschools (11 classrooms) across North Carolina. Child-reported vegetable liking scores and skin carotenoid status (SCS) were dependent variables collected at baseline, midpoint, and posttest. Adjusted repeated-measures ANOVA was used to examine intervention impact. Results A total of 113 children (intervention = 49; comparison = 64) participated. Children were an average age of 3.7 ± 0.57 years at baseline. Mean target vegetable liking scores for the intervention and comparison groups, respectively, were 3.2 ± 0.19 and 3.2 ± 0.17 at baseline, 2.9 ± 0.17 and 3.1 ± 0.15 at midpoint, and 2.8 ± 0.15 and 3.1 ± 0.13 at posttest. A time × group interaction was not significant for target vegetable liking scores. Mean SCS were 268.6 ± 13.24 and 270.9 ± 12.13 at baseline, 271.3 ± 12.50 and 275.6 ± 11.46 at midpoint, and 267.8 ± 11.26 and 229.6 ± 10.32 at posttest for the intervention and comparison groups, respectively. A time × group interaction was significant for SCS (F1,77 = 3.98; P = 0.02; r = 0.10). Both groups declined from baseline to posttest (intervention = 0.06%; comparison = 15.09%), which occurred after winter break, with a smaller decline observed in the intervention group (P = 0.02). Conclusions and Implications Food-based STEAM learning activities may present a unique opportunity to affect FV intake while meeting academic standards. More research is needed to understand how liking for familiar FV changes over time and its relationship with consumption. In addition, more implementation research featuring larger sample sizes, teachers as the interventionist, and a longer study duration is needed to confirm the outcomes of food-based STEAM learning observed in the current study and the long-term impact this approach may have on children's’ dietary quality.

Background: The disparity of overall diet quality by personal educational attainment has been a public issue. However, it remains unknown which food groups contribute to the disparity. This cross-sectional study assesses which food groups explain associations between education and overall diet quality in Japanese women. Methods: A total of 3,788 middle-aged (mean age, 47.7 years) and 2,188 older women (mean age, 74.4 years), who lived in 47 prefectures in Japan, provided data on their education (low, middle, and high) and dietary intakes from a diet history questionnaire. A diet quality score (possible score 0–70) was calculated based on seven food components. Mean diet quality scores, with adjustment for lifestyle and neighborhood variables, were estimated by education using a general linear model, and Dunnett’s multiple comparison was conducted. Additionally, mean scores of each food component were estimated by education and compared using the same manner. Results: After adjustment for lifestyle and neighborhood variables, mean diet quality score of high or middle education was higher than low education for both generations. Middle-aged women with high and middle education had higher scores of ‘milk’, ‘snacks, confection, and beverages’, ‘fruits’, and ‘vegetable dishes’ than those with low education. Older women with high and middle education had higher scores of ‘sodium from seasonings’ and ‘fruits’ than those with low education. Conclusions: This study suggests that positive associations between education and diet quality are explained by different food groups in middle-aged and older Japanese women, which are independent of lifestyle and neighborhood variables.

To examine associations of stress and sleep with diet quality of family child care home (FCCH) providers, and whether self-efficacy for healthy eating influences these associations.A cross-sectional analysis was performed using baseline data (2013-2015) from a randomized control trial with FCCH providers.The study included 166 licensed FCCH providers, aged18 years, from central North Carolina.Diet quality was assessed with a food frequency questionnaire, used to calculate a modified 2010-Healthy Eating Index score. Stress, sleep quality, and diet self-efficacy were measured via self-administered questionnaires.Using observations from 158 participants with complete data, multiple linear regression models were created to assess whether stress, sleep quality, and diet self-efficacy were associated with diet quality and whether diet self-efficacy moderated these associations (significance set at P0.05).In the initial model, only diet self-efficacy was significantly associated with diet quality (β = 0.32; P0.001). Moderation analyses showed that higher stress was associated with lower diet quality, but only when diet self-efficacy was low.Building FCCH providers' self-efficacy for healthy eating is an important component of health promotion and can buffer the impact of stress on their diet quality.

Background The relationship between diet quality and health care costs is unclear. Objective The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. Design Data from a longitudinal cohort study were analyzed. Participants/setting Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women’s Health were analyzed. Main outcome measures Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia’s universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change (“diet quality worsened” [ARFS change ≤ –4 points], “remained stable” [–3 ≤ change in ARFS ≤3 points], or “improved” [ARFS change ≥4 points]). Statistical analyses Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status. Results Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]). Conclusions Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.

Low-income households may acquire foods from purchases, federal food assistance, and alternative food sources (AFS) to meet their food needs. The objectives of this study were to quantify and compa...

One area within geriatric oncology that is understudied and undertreated is the dietary quality of older cancer survivors. Most older adults with cancer experience nutritional deficits due to their age and cancer treatment. Research has shown the impact of competing comorbidities, polypharmacy, and decline in functional and cognitive status on older adults' nutritional needs. This study sought to examine the diet quality of older female cancer survivors, and its association with inflammatory markers and physical functioning. Participants completed surveys online, by mail, or phone. Additional participant information was obtained through medical records. Descriptive statistics, Pearson's correlations, forward linear regressions were used to analyze these data. Older female cancer survivors (≥65) that had completed their initial cancer treatment in the past 5 years were recruited through cancer clinic visits and medical records. The study was conducted from November 2018 through January 2020. Self-reported physical functioning (RAND-36), diet quality (DHQ-II, HEI-2015), and BMI were obtained from surveys. Participant diagnosis, comorbidities, and inflammatory marker (c-reactive protein (CRP)) were obtained through electronic medical records; albumin was collected as a marker correlated with inflammation. The average age of participants (

Objective:To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March–3 May 2020).Design:Retrospective observational study.Setting:Italy.Participants:We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005–2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, −1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.Results:Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = −1·94; 95 % CI −2·72, −1·17 for individuals aged >75 years as compared with 18–39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = −1·32; 95 % CI −1·80, −0·84), while UPF lowering associated with increased exercise (β = −0·90; 95 % CI −1·46, −0·35) and weight loss (β = −1·05; 95 % CI −1·51, −0·59) during confinement.Conclusions:During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

BACKGROUND: Scant research has examined whether laboratory assessments of eating in the absence of hunger (EAH) relates to long-term diet quality. OBJECTIVE: This study investigates the association of EAH with diet quality during pregnancy. DESIGN: Pregnancy diet quality was assessed using 24-hour diet recalls collected in each pregnancy trimester. EAH was assessed in a counterbalanced, crossover laboratory feeding substudy in which participants completed two free access eating occasions following a standardized meal during their 2(nd) pregnancy trimester. PARTICIPANTS/SETTING: Data were collected from March 2015 to December 2016 from a subsample of participants (n=46) enrolled at ≤ 12 weeks gestation in an observational, prospective cohort study (the Pregnancy Eating Attributes Study) in North Carolina. INTERVENTION: Participants were presented with highly processed (HP) and minimally processed (MP) foods in two separate assessments. MAIN OUTCOME MEASURES: Scores for total Healthy Eating Index-2015 (HEI2015) and adherence to adequacy (HEI2015-adq) and moderation components (HEI2015-mod) were calculated from the diet recalls. Higher scores reflect better diet quality. STATISTICAL ANALYSES PERFORMED: Linear regressions estimated associations of pregnancy diet quality with EAH (energy, EAH-kcal; and percent offered, EAH-%) in each condition for all foods, and separately for sweet and savory foods. RESULTS: Lower pregnancy diet quality (all indicators) was associated with greater EAH-kcal and EAH-% of all foods and sweet foods in the HP condition. Each 100-kcal increase in EAH of HP foods was associated with a 2–3-point decrease (SE=0.7 – 0.8) in HEI2015 (P

Summary Background and aims The US News and World Report (USNWR) conducts an annual review of popular diets: Moderate (reducing energy intake from all food groups, particularly those high in fat and added sugars); Plant-based (excluding food groups, such as animal products); Low-carbohydrate (excluding/limiting carbohydrate-containing foods); and Meal-replacement diets (replacing foods with pre-made, calorie-controlled portions). The goal of this paper was to examine how these diets differ in nutrients, food groups, and diet quality. Methods This study examined the 40 diets rated by physicians and nutritionists for the 2018 USNWR and assessed differences among diets that were categorized by two independent reviewers: Moderate (n = 15), Plant-based (n = 12), Low-carbohydrate (n = 8), and Meal replacement (n = 5). Nutrient, food groups, and diet quality (Dietary Inflammatory Index (DII®), Healthy Eating Index (HEI)) were assessed from the 2018 USNWR. Results There were significant differences among the four diet types for energy; % energy from saturated fat, carbohydrates, and protein; trans fat; sugars; fiber; magnesium; cholesterol; HEI; fruit; total fruit and vegetables; whole grains; total grains; total meat; nuts and seeds; legumes; and total protein foods. Plant-based and Moderate diets, especially the Macrobiotic, Big Loser and Ornish diets, had strongly anti-inflammatory DII scores (−4.82, −4.85 and −4.06, respectively). Moderate (86.9 ± 7.7) and Plant-based (86.1 ± 10.7) diets had significantly higher HEI scores than Low-carbohydrate diets (70.6 ± 15.0; P = 0.01). Conclusions These findings provide useful information on nutrient adequacy of popular diets. Results indicate that Plant-based and Moderate diets have better dietary quality (HEI, DII) and better nutrient and food group profiles than Low carbohydrate diets.

A cluster of factors affects nutritional status among adolescent girls in low- and middle-income countries (LMICs). We investigated the association between school attendance and diet quality among 498 rural adolescent girls (352 attending and 146 not attending school) in Tecpan, Guatemala. In a cross-sectional study, we collected sociodemographic and anthropometric data and characterized the dietary intake using a Food Frequency Questionnaire. We then calculated diet quality using the Healthy Eating Score (HES). Multiple linear regression models were conducted to evaluate the effects of school attendance on diet quality. We found that the overall diet quality among the study participants was poor, according to the HES. However, those who attended school had significantly higher intakes of vitamin A-rich fruits and vegetables (P = 0.04), other fruits (P = 0.01), and milk and milk products (P = 0.004), but a higher intake of fast foods, chips, and saturated fatty acids (P < 0.001). Furthermore, the effects of school attendance on diet quality were significant after adjusting for sociodemographic and lifestyle factors (β coefficient = -1.70, 95% CI: -3.30 to -0.11) but was attenuated when further adjusted for weight status (β coefficient = -1.58, 95% CI: -3.17 to 0.02). Our findings suggest that diet quality among girls in rural Guatemala is poor, particularly among those who do not attend school. To advance our understanding of adolescent diet in LMICs, future studies should include adolescents who are out of school.

The objective of this study was to cross-sectionally analyze the diet quality of active workers and retirees to identify possible differences by gender and subgroups of working and nonworking retirees using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of employees of six higher education centers in Brazil. In the first phase of the study, which occurred between 2008 and 2010, the diets of 7,667 participants between 50 and 69 years of age (3,393 [44%] men and 4,274 [56%] women) were analyzed using a Food Frequency Questionnaire. Diets were evaluated using the Brazilian Healthy Eating Index-Revised. We used logistic regression models stratified by sex and adjusted for demographic, social, and health conditions to calculate the odds ratio (OR) and 95% confidence interval (95% CI) for the association of diet quality with working and nonworking retirees. Using active workers as the reference group, the results showed better diet quality among male retirees who were no longer working (OR: 1.58; 95% CI: 1.03–2.41), whereas no difference was detected in male retirees who returned to work (OR: 1.17; 95% CI: 0.80–1.72) in the adjusted models. Among women, the association did not remain significant after multivariate adjustment for confounders. Our results showed gender differences in diet quality between workers and working and nonworking retirees possibly because of worse diet quality among men than among women. Work cessation after retirement is mandatory to improve diet quality among male retirees.

PurposeSnacks at work are often of poor dietary quality. The main objective of the current study is to examine the effect of making vegetable snacks available at workplace meetings on consumption.Design/methodology/approachIn three between-subjects field experiments conducted at a hospital and three ministries in the Netherlands, with meeting as the unit of condition assignment, attendees were exposed to an assortment of vegetables, varying in vegetable variety and presence of promotional leaflet in study 1 (N = 136 meetings), serving container in study 2 (N = 88 meetings) and additional presence of cookies in study 3 (N = 88 meetings). Consumption of vegetables and cookies was measured at meeting level to assess grams consumed per person.FindingsAcross the three studies, average consumption per meeting attendee was 74 g (SD = 43) for study 1; 78 g (SD = 43) for study 2 and 87 g (SD = 35) for study 3. In the first study, manipulation of perceived variety and information leaflets did not affect intake. In the second study, significantly more vegetables were eaten when they were offered in single sized portions (M = 97 g, SD = 45) versus in a shared multiple portions bowl (63 g, SD = 38) (p Practical implicationsThe present studies show how availability of vegetables at unconventional occasions makes meeting attendants consume considerable portions of vegetables on average. As such, offering healthy snacks at the workplace may be a valuable part of workplace health promotion programs and positively change the “office cake culture”.Originality/valueVegetable intake is less than recommended in many countries worldwide. Many snacking occasions are at work, which makes office meetings a potential consumption occasion to encourage vegetable intake. Hence, the aim of this study is to examine whether free availability of vegetable snacks during meetings contributes to their consumption among meeting attendees and under what conditions consumption is optimal.

The COVID-19 pandemic has heightened the importance of affordable nutrition. Fruits and vegetables are among the most commonly wasted food items, representing waste of key nutrients that are needed to maintain health and support the immune system. Food waste also represents substantial environmental burden and more than one-quarter of consumer food spending. Practical strategies are urgently needed to help nutritionists support their clients in reducing food waste, which can help improve diet quality, reduce environmental impacts, and increase financial flexibility during this critical time. Fortunately, recent research has demonstrated that efforts to reduce waste of fruits and vegetables at home, as well as meat and seafood away from home, will be particularly impactful. A number of strategies exist to help consumers reduce their food waste while making affordable food choices, and nutritionists are well poised to communicate these strategies to their clients and communities of practice.

BACKGROUND: High diet quality is associated with a lower risk of chronic diseases. Metabolomics can be used to identify objective biomarkers of diet quality. OBJECTIVES: We used metabolomics to identify serum metabolites associated with 4 diet indices and the components within these indices in 2 samples from African Americans and European Americans. METHODS: We studied cross-sectional associations between known metabolites and Healthy Eating Index (HEI)-2015, Alternative Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension Trial (DASH) diet, alternate Mediterranean diet (aMED), and their components using untargeted metabolomics in 2 samples (n(1) = 1,806, n(2) = 2,056) of the Atherosclerosis Risk in Communities study (aged 45–64 y at baseline). Dietary intakes were assessed using an FFQ. We used multivariable linear regression models to examine associations between diet indices and serum metabolites in each sample, adjusting for participant characteristics. Metabolites significantly associated with diet indices were meta-analyzed across 2 samples. C-statistics were calculated to examine if these candidate biomarkers improved prediction of individuals in the highest compared with lowest quintile of diet scores beyond participant characteristics. RESULTS: Seventeen unique metabolites (HEI: n = 6; AHEI: n = 5; DASH: n = 14; aMED: n = 2) were significantly associated with higher diet scores after Bonferroni correction in sample 1 and sample 2. Six of 17 significant metabolites [glycerate, N-methylproline, stachydrine, threonate, pyridoxate, 3-(4-hydroxyphenyl)lactate)] were associated with ≥1 dietary pattern. Candidate biomarkers of HEI, AHEI, and DASH distinguished individuals with highest compared with lowest quintile of diet scores beyond participant characteristics in samples 1 and 2 (P value for difference in C-statistics