Search

BackgroundEating a high-quality diet or adhering to a given dietary strategy may influence weight loss. However, these 2 factors have not been examined concurrently for those following macronutrient-limiting diets.ObjectiveTo determine whether improvement in dietary quality, change in dietary macronutrient composition, or the combination of these factors is associated with differential weight loss when following a healthy low-carbohydrate (HLC) or healthy low-fat (HLF) diet.DesignGenerally healthy adults were randomly assigned to HLC or HLF diets for 12 mo (n = 609) as part of a randomized controlled weight loss study. Participants with complete 24-h dietary recall data at baseline and 12-mo were included in this secondary analysis (total N = 448; N = 224 HLC, N = 224 HLF). Participants were divided into 4 subgroups according to 12-mo change in HEI-2010 score [above median = high quality (HQ) and below median = low quality (LQ)] and 12-mo change in macronutrient intake [below median = high adherence (HA) and above median = low adherence (LA) for net carbohydrate (g) or fat (g) for HLC and HLF, respectively]. Baseline to 12-mo changes in mean BMI were compared for those in HQ/HA, HQ/LA, LQ/HA subgroups with the LQ/LA subgroup within HLC and HLF.ResultsFor HLC, changes (95 % confidence level [CI]) in mean BMI were -1.15 kg/m2 (-2.04, -0.26) for HQ/HA, -0.30 (-1.22, 0.61) for HQ/LA, and -0.80 (-1.74, 0.14) for LQ/HA compared with the LQ/LA subgroup. For HLF, changes (95% CI) in mean BMI were -1.11kg/m2 (-2.10, -0.11) for HQ/HA, -0.26 (-1.26, 0.75) for HQ/LA, and -0.66 (-1.74, 0.41) for LQ/HA compared with the LQ/LA subgroup.ConclusionWithin both HLC and HLF diet arms, 12-mo decrease in BMI was significantly greater in HQ/HA subgroups relative to LQ/LA subgroups. Neither HQ nor HA alone were significantly different than LQ/LA subgroups. Results of this analysis support the combination of dietary adherence and high-quality diets for weight loss.Clinical trial registryclinicaltrials.gov (Identifier: NCT01826591).

In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.

Summary Adolescence is an important period of increasing independence, when adolescents experience changing influences of family and friends on their diets as they transition into adulthood. We conducted a scoping review to map the literature on interpersonal determinants of diet quality and eating behaviors among individuals aged 13–30 years. We searched seven literature databases, and following screening, 329 papers were included. Determinants were grouped according to sub‐categories of the Determinants of Nutrition and Eating framework: family structure (n = 122), social influences (n = 121), parental behaviors (n = 90), family food culture (n = 83), social support (n = 69), parental feeding styles (n = 24), parental attitudes/beliefs (n = 8), and parental resources/risk factors (n = 6), and we added two new sub‐categories: parenting style (n = 74) and partner behaviors (n = 6). Fruit/vegetable (n = 143) and sugar‐sweetened beverage (n = 102) intake were the most commonly measured diet outcomes, and breakfast consumption (n = 41) and fast food/takeaway intake (n = 39) the most commonly examined eating behaviors. This review highlights the gaps in the literature, both across the determinant sub‐categories and also the relative paucity of longitudinal evidence and lack of evidence in emerging adults, particularly outside of university settings. Future research should focus on these areas to provide stronger evidence to support better design of interventions for this age group. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to assess the relationship between the quality of meals and its context. Methods: We conducted a cross-sectional study of 222 Japanese adults aged 30–76 years in 2021. The following information was obtained from the 4-d weighed dietary records: the recording day (working or not), meal type (breakfast, lunch, or dinner), eating companions (alone or with someone), eating location (at home or away from home), and screen-based activity (yes or no). The nutritional quality of each meal was evaluated using the Healthy Eating Index 2020 (HEI-2020). Results: The analysis included 1,295 meals for males and 1,317 for females. The mean HEI-2020 ranged from 43.0 (lunch) to 51.9 (dinner) in males and from 45.7 (breakfast) to 52.0 (dinner) in females. Multilevel linear regression showed that, in males, lunch had a significantly lower HEI-2020 score compared to breakfast (β = −1.81, 95% confidence interval [CI]: −3.42, − 0.20), while dinner had a significantly higher HEI-2020 score (β = 6.77, 95% CI: 5.34, 8.20). Eating with someone was significantly associated with a higher HEI-2020 score (β = 2.22, 95% CI: 0.76, 3.67). Among females, dinner had a higher HEI-2020 score than breakfast (β = 5.21, 95% CI: 3.72, 6.70). Eating away from home was associated with higher HEI-2020 scores (β = 2.14, 95% CI: 0.04, 4.24). Conclusion: Meal type, location, and eating companions were associated with meal quality in this population, with differences between males and females. Incorporating these factors in nutrition education and interventions can enhance diet quality. [ABSTRACT FROM AUTHOR]

Purpose: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines. Methods: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm. Results: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star). Conclusions: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices. [ABSTRACT FROM AUTHOR]

The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with limited research in this area. Therefore, the objective of this study was to examine the cross‐sectional associations between diet quality and common mental disorders (CMD) such as depression and anxiety in UK undergraduate students. A cross‐sectional survey consisting of demographic information and validated questionnaires (the Short‐Form Food Frequency Questionnaire [SFFFQ] and the Hospital Anxiety and Depression Scale [HADS]) was conducted to measure diet quality and anxiety and depression in young adults in 44 UK‐based universities. Multiple regression analysis adjusting for confounding factors was used to assess the associations between them. Undergraduate university students (n = 202, 67% female) with a mean age of 20.9 ± 3.6 years and a mean body mass index (n = 170) of 22.6 ± 3.2 kg/m2 took part in the study. Prevalence of anxiety was high, with 40% of the sample having an anxiety score in the severe range (≥12 points) while the prevalence of depression was lower, with 6% of the population having a depression score in the severe range (≥12 points). Diet quality was significantly higher for females than males (p = 0.034) and was poor for 38% of the sample, being more common in males compared to females, although not significantly so (43% and 36%, respectively). Diet quality was inversely associated with anxiety (β = −0.427; p = 0.029) and was more likely to be associated with anxiety in females than males (β = 0.743; p = 0.043). No significant relationship between diet quality and depression was found. Better self‐reported health, father's qualification and smoking status were also associated with less anxiety and depression. This research supports other research suggesting that UK universities should explore whether the implementation of dietary interventions and improving the food environment would be a cost‐effective option to reduce the high prevalence of anxiety among students. [ABSTRACT FROM AUTHOR]

Purpose: Use qualitative and quantitative methods to explore factors influencing the adoption of guideline-based physical activity (PA) and dietary recommendations among participants enrolled in a lifestyle intervention during and after chemotherapy for breast cancer. Methods: Among women with stage I-III breast cancer who participated in the intervention arm of the Lifestyle, Exercise, and Nutrition early after diagnosis (LEANer) trial, we used stratified, purposeful sampling to interview women who met both, one, or neither intervention goal after the 1-year intervention: (1) 150 min/week moderate-to-vigorous intensity exercise via a self-reported PA questionnaire and (2) improved self-reported diet quality measured by the Healthy Eating Index-2015. Semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Results: The 29 women interviewed were 52 ± 11 years old on average, with a mean body mass index of 29.6 ± 7.7 kg/m2. Three themes emerged regarding aspects of the LEANer intervention that facilitated behavior change: (1) providing a conduit of trustworthy, timely, and personalized support and education; (2) shifting mindsets and enhanced understanding of the benefits of PA and nutrition during chemotherapy; and (3) fostering a sense of control and alternative focus. Factors described as hindering adoption of goals included: (1) adverse effects of chemotherapy and (2) competing priorities. Conclusions: Women reported the external support, tailored education, and experiencing the physical and mental benefits of the LEANer intervention facilitated the adoption of the interventions’ behavioral goals. Addressing chemotherapy-related symptoms and competing priorities may facilitate adherence to lifestyle interventions during chemotherapy for breast cancer. [ABSTRACT FROM AUTHOR]

The academic success of children contributes to their income, social status, and public health. This study was conducted with 217 elementary school students from western China. Scores on the Chinese Children Dietary Index (CCDI), Dietary Approaches to Stop Hypertension (DASH), adjusted DASH, and KIDMED index were calculated to evaluate diet quality. Eating behavior and sleep quality were assessed using the Children's Eating Behavior Questionnaire (CEBQ) and Children's Sleep Habits Questionnaire (CHSQ), respectively. Academic achievement was measured using school-provided average grades. Higher CCDI scores, longer sleep time, lower total CHSQ scores, and lower subscores on "satiety responsiveness," "slowness in eating," "emotional undereating," and "food fussiness" dimensions of the CEBQ were associated with high academic achievement. In conclusion, good diet quality, sleep quality, healthy eating behaviors, and adequate sleep duration were associated with better academic performance. Interventions are recommended to be developed in education system to improve healthy diets and lifestyles, enhancing academic achievement. [ABSTRACT FROM AUTHOR]

Both overweight/obesity and a Western lifestyle are associated with a poorer prognosis in women with breast cancer. The primary aim of this analysis was to examine the effect of a telephone-delivered lifestyle intervention program on reducing body weight and waist circumference, decreasing cardiovascular risk factors and improving lifestyle. Data is derived from an open-label, randomized, controlled phase III study that evaluated two chemotherapy regimens and the impact of a 2-year lifestyle intervention on disease-free survival and secondary outcomes in women with intermediate-risk to high-risk breast cancer. Initially, 2292 women with a body mass index (BMI) between 24 and 40 kg/m2 were randomized into one of two arms of the lifestyle intervention study. After accounting for dropout, 1785 participants remained: 776 in the intervention group (IG) who received a telephone-delivered lifestyle intervention supported by mailed materials, and 1009 in the low-level intervention group (LLIG) who received only mailed educational materials with general recommendations for a healthy lifestyle. Body weight, waist circumference, dietary intake, physical activity, and cardiovascular disease risk parameters were measured repeatedly throughout the intervention and a subsequent 2-year follow-up period. Linear mixed models for repeated measures were used to assess differences in study outcomes between the LLIG and IG at each measured time point. IG participants showed a mean weight loss of −2.7 kg (kg) (versus +0.4 kg, LLIG) at 6 months, −2.8 kg (vs. +0.8 kg, LLIG) at 12 months and −1.8 kg at 24 months (versus +0.9 kg, LLIG). Significant between-group differences for weight loss and reduced waist circumference were observed at all time points until the end of the lifestyle intervention (all p-values < 0.0001), including post-intervention. Reduced energy intake and a higher alternate healthy eating index (AHEI) score in the IG was detected during the lifestyle intervention (AHEI at 24 months: IG 49.1% versus LLIG 42.0%, p < 0.001). Modest significant improvements in several cardiovascular risk factors were observed during the intervention, including fasting plasma glucose, HbA1c, systolic and diastolic blood pressure, and lipids. A mainly telephone-delivered lifestyle intervention program can reduce body weight and waist circumference, improve diet quality, and decrease cardiometabolic risk in women with overweight/obesity and newly diagnosed, human epidermal growth factor receptor 2 (HER2)/neu-negative, intermediate-risk to high-risk breast cancer. Weight loss, reduced waist circumference and improved dietary patterns were maintained for up to two years post-intervention. The protocol was registered under the EU Clinical Trials Register, https://www.clinicaltrialsregister.eu/ , identifier: 2008-005453-38. • Lifestyle intervention leads to healthy weight loss in breast cancer survivors. • Telephone-delivered lifestyle counseling promotes a healthier eating pattern. • Lifestyle intervention in breast cancer survivors can reduce cardiometabolic risk. • Effects of a 2-year lifestyle intervention are partly retained for another 2 years. [ABSTRACT FROM AUTHOR]

Recent studies suggest that shift working may trigger health issues through disrupted circadian rhythms and altered eating habits. This study aimed to examine the possible associations of shift work with sleep quality, diet quality and obesity-related parameters. This study was conducted with 150 males (75 shift and daytime workers) aged 24–50 years. Dietary intake was determined using the 24-hour recall method, and dietary quality was evaluated using the Healthy Eating Index-2010 (HEI-2010). Anthropometrical measurements and body composition were assessed. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Fasting and postprandial glucose and insulin, and fasting lipid levels were analyzed. HOMA-IR was calculated, and blood pressure was measured. The total HEI-2010 score of shift workers (52.6 [45.4–58.8]) was lower than the daytime workers (55.9 [49.1–64.9]) (p = 0.016). Among individuals with good sleep quality, the total HEI-2010 score, seafood and plant proteins, fatty acids, and sodium scores were lower in shift workers compared to others (p < 0.05 for each). Non-obese shift workers had higher body weight, waist circumference, waist/hip ratio, VLDL-cholesterol, triglyceride, postprandial glucose, and insulin levels compared to daytime workers (p < 0.05 for each). This study demonstrates that shift working is associated with lower diet quality independent of sleep quality. [ABSTRACT FROM AUTHOR]

This study aimed to explore the relation between adherence to the Mediterranean diet, adequacy to the Italian dietary recommendations, and several domains of diet quality in a sample of Italian adults.The dietary habits of a total of 1936 participants were investigated. Adherence to the Mediterranean diet and diet quality were assessed through the Medi-Lite and the Diet Quality Index-International (DQI-I).The global DQI-I score positively correlated with the Medi-Lite score. Negative coefficients were found for protein intake and calcium in the adequacy category, total fat in the moderation category, and fatty acid ratio in the overall balance category. More than half of the participants were adherent to national recommendations for potatoes, cereals, red meat, and other fats consumption. In contrast, recommendations on legumes, fruit, vegetables, and processed meat were met by about half of the participants while those for dairy products (milk and yogurt) and cheese, eggs, and white meat were rather underrepresented. Higher scores in DQI-I and Medi-Lite well predicted adequacy to recommendations on fruit and vegetables, legumes, processed meat, cereals, and legumes.Individuals reporting higher adherence to the Mediterranean diet show better diet quality and a higher probability of meeting the dietary recommendations. [ABSTRACT FROM AUTHOR]

Background: Limited information exists linking food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels. Our aim was to examine the association between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels in the Iranian population. Methods: This cross-sectional study included 200 students randomly selected from a university in Iran. Dietary intakes, physical activity (PA), and happiness levels of study participants were assessed using validated questionnaires. The anthropometric indices examined in this study included the body shape index (ABSI), body roundness index (BRI), and abdominal volume index (AVI). Multiple logistic regression models were used to examine the association between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels. Results: The mean age and body mass index (BMI) of study participants were 23.5 years ± 4.52 and 23.8 kg/m2 ± 3.17, respectively. In the study population, no significant association was seen between ABSI, BRI, AVI and happiness with food habits, diet quality, and lifestyle scores respectively. After adjusting for potential confounders (age, energy intake, marital status, education, smoking, physical activity, gender, and BMI), the association remained not significant for ABSI and food habits, diet quality, and lifestyle scores respectively (OR: 0.56, 95% CI (0.25–1.34), P = 0.193; OR: 0.59, 95% CI (0.22–1.57), P = 0.413; OR:1.19, 95%CI (0.54–2.63), P = 0.652), BRI and food habits, diet quality, and lifestyle scores respectively (OR:1.98, 95% CI (0.41–9.49), P = 0.381; OR: 0.57, 95%CI (0.12–2.74), P = 0.512; OR: 1.19, 95% CI (0.3–4.71), P = 0.811), AVI and food habits, diet quality, and lifestyle scores (OR:1.15, 95% CI (0.53–2.48), P = 0.743, OR:1.01, 95% CI (0.47–2.18), P = 0.965; OR: 1.3, 95% CI (0.64–2.65), P = 0.465) and happiness and food habits, diet quality, and lifestyle scores respectively (OR:0.3, 95%CI (0.07–1.25), P = 0.972; OR: 0.77, 95%CI (0.18–3.19), P = 0.724, OR: 0.3, 95% CI (0.07–1.25), P = 0.083). Conclusions: No significant association was detected between food habits, diet quality, and lifestyle scores with anthropometric indices and happiness levels. However, longitudinal studies are required to confirm these findings. [ABSTRACT FROM AUTHOR]

There is growing concern among policymakers and researchers about the negative health and climate impacts of meat consumption. Consumers are encouraged to re-evaluate their dietary choices to preserve our ecosystem and reduce the burden of diet-related diseases. However, limited information is available about how price changes in animal protein sources affect plant-based protein demand and the consequences for nutrient intake and/or diet quality. The goal of the present paper is to fill this gap by explaining how consumers react to price changes in animal protein types and to present the implications for nutrition or diet quality. This paper applied the exact affine stone index implicit (EASI) Marshallian demand system to 2021 home scan panel data collated by the Kantar Worldpanel to estimate both price and expenditure elasticities. Twelve food groups of seven animal-based protein products and five plant-based protein products were considered. The results revealed that dairy and eggs are daily necessities for the people of Scotland. The demand for fish and non-dairy milk are the most sensitive to price. Estimates based on expenditure elasticities show that beef is considered a luxury and a highly substitutable product in the Scottish diet. Peas are relatively basic, essential foodstuffs. In general, increasing the price of animal protein sources will shift demand towards plant protein. On the positive side, there will be a significant reduction in cholesterol and fat purchases. However, there would also be a significant reduction in the total amount of protein, carbohydrates, and healthy fats, such as unsaturated fatty acids, purchased by the average household. This shows that increases in plant-based protein are not enough to compensate for the reductions in essential macro- and micronutrient purchases from animal protein. From the climate perspective, reductions in meat purchases could reduce emissions from production and consumption. [ABSTRACT FROM AUTHOR]

(1) Background: Although daily time-use is associated with diet quality and cardiorespiratory fitness (CRF) in children, their interdependence remains unexplored. This study first examined the associations between reallocating daily movement time and diet quality and CRF, and second the mediating role of diet quality in the relationship between daily time-use and CRF. (2) Methods: This study included 1131 Chinese children (aged 8 to 10 years; median [interquartile range]: 8.5 [8.3, 8.8]) at baseline (September 2022) and 1268 children at the 9-month follow-up (June 2023) from the OptiChild study. Daily durations of moderate-to-vigorous physical activity (MVPA), sleep, and sedentary behavior (e.g., screen time) were self-reported or proxy-reported by parents. Diet quality was assessed via the Diet Quality Questionnaire (DQQ), which uses a 24 h dietary recall and is categorized according to the Global Dietary Recommendations (GDR) score and Food Group Diversity Score (FGDS). The CRF was measured using VO2max after the 20 m shuttle run test. Longitudinal associations between daily time-use, diet quality, and CRF were calculated using isotemporal substitution models. Mediation analyses were used to determine whether diet quality mediated the associations between daily time-use and CRF. (3) Results: Reallocation of 30 min from screen time to MVPA resulted in significant improvements in the GDR score (β baseline = 0.11, p = 0.024; β follow-up = 0.26, p < 0.001), FGDS (β baseline = 0.11, p = 0.006; β follow-up = 0.19, p < 0.001), and CRF (β baseline = 0.40, p < 0.001; β follow-up = 0.26, p = 0.001). Diet quality partially mediated the associations between MVPA, screen time, and CRF. Substituting 30 min of screen time for MVPA led to diet quality mediating a proportion of the association with CRF (GDR score: 11.4%, FGDS: 6.6%). (4) Conclusions: These findings underscore the importance of optimizing daily time-use of MVPA and screen time and improving diet quality to promote physical fitness in school-aged children. [ABSTRACT FROM AUTHOR]

The main objective of this study was to examine the actor and partner effects between Perceived Workplace Support for Families (PWSFs) and family support (PFS), diet quality, and satisfaction with food-related life (SWFoL) in households with both parents working and adolescents, along with the role of the three family members' diet quality as a mediator. During the second year of the pandemic in Chile, 860 dual-earner parents of different sexes and their adolescent child (average age 13 years, with 50.7% being male) were recruited from two cities. Parents responded to a measure of PWSFs and the Perceived Family Support Scale. Mothers, fathers, and adolescents answered the Adapted Healthy Eating Index (AHEI) and the satisfaction with food-related life Scale. The examination employed the mediation Actor–Partner Interdependence Model and structural equation modeling for the analyses. Results showed that mothers' PWSFs improved their and their teenage children's SWFoL, while fathers' PWSFs only improved their SWFoL. The mothers' PFS improved their and the fathers' diet quality while enhancing their SWFoL and the adolescents' SWFoL. The fathers' PFS enhanced their and the adolescents' SWFoL. The mothers' PFS also indirectly enhanced their and the fathers' SWFoL via each parent's diet quality. Each family member's diet quality was positively related to their SWFoL, while mothers' diet quality was positively related to the fathers' SWFoL. These results imply that resources obtained by parents from PFS positively impact the SWFoL of the three family members through different mechanisms. They also highlight the importance of maternal family support for SWFoL during the pandemic. [ABSTRACT FROM AUTHOR]

In Canada, unhealthy dietary patterns comprise diets with poor nutrient density and are associated with chronic conditions. Plant-based diets have gained popularity due to their ability to provide a nutritionally adequate healthy diet. This study aims to compare sociodemographic, socioeconomic, and health characteristics, and diet quality between Canadian adults following plant-based and omnivore diets as well as assess the extent to which key nutrient intakes are of public health concern among Canadians following plant-based diets. The study used nationally representative nutritional data from the 2015 Canadian Community Health Survey and descriptive statistics were computed. The analysis determined that Canadians following strict plant-based diets (1% of total population) were significantly more likely to be an immigrant to Canada, less likely to meet national physical activity guidelines, and less likely to be overweight, compared to Canadians following omnivore diets. Compared to omnivore diets, plant-based diets were nutritionally superior according to the Nutrient-Rich Food index. Continued knowledge translation on what comprises healthy plant-based diets, public guidance on the intersection between diet and health, and the completion of prospective cohort studies are needed. To conclude, the research suggests well-planned plant-based diets, in comparison to omnivore diets, offer a nutrient-dense diet. [ABSTRACT FROM AUTHOR]

Purpose: A healthy diet reduces the risk of non-alcoholic fatty liver disease (NAFLD) in the general population, especially in individuals who are genetically predisposed to NAFLD. Little is known in patients who suffered from a myocardial infarction (MI). We examined the interaction between diet quality and genetic predisposition in relation to NAFLD in post-MI patients. Methods: We included 3437 post-MI patients from the Alpha Omega Cohort. Diet quality was assessed with adherence to the Dutch Healthy Diet index 2015 (DHD15-index). A weighted genetic risk score (GRS) for NAFLD was computed using 39 genetic variants. NAFLD prevalence was predicted using the Fatty Liver Index. Prevalence ratios (PR) with 95% confidence intervals of DHD15-index and GRS in relation to NAFLD were obtained with multivariable Cox proportional hazards models. The interaction between DHD15-index and GRS in relation to NAFLD was assessed on an additive and multiplicative scale. Results: Patients had a mean age of 69 (± 5.5) years, 77% was male and 20% had diabetes. The DHD15-index ranged from 28 to 120 with a mean of 73. Patients with higher diet quality were less likely to suffer from NAFLD, with a PR of 0.76 (0.62, 0.92) for the upper vs lower quintile of DHD15-index. No association between the GRS and NAFLD prevalence was found (PR of 0.92 [0.76, 1.11]). No statistically significant interaction between the DHD15-index and GRS was observed. Conclusion: In Dutch post-MI patients, adherence to the Dutch dietary guidelines was associated with a lower prevalence of NAFLD, as assessed by the FLI. This association was present regardless of genetic predisposition in this older aged cohort. [ABSTRACT FROM AUTHOR]

Purpose: This study examined maternal diet quality trajectories from pregnancy to 3.5 years postpartum and associated maternal factors. Methods: Data of 473 Australian women from the Healthy Beginnings Trial were used. A food frequency questionnaire collected dietary intake in pregnancy and 1, 2 and 3.5 years postpartum. Diet quality scores were calculated using the 2013 Dietary Guideline Index (DGI-2013) and RESIDential Environments Guideline Index (RDGI). Group-based trajectory modelling identified diet quality trajectories from pregnancy to 3.5 years postpartum. Multivariable logistic regression investigated factors associated with maternal diet quality trajectories. Results: Two stable trajectories of low or high diet quality were identified for the DGI-2013 and RDGI. Women who smoked had higher odds of following the low versus the high DGI-2013 (OR 1.77; 95%CI 1.15, 2.75) and RDGI (OR 1.80; 95%CI 1.17, 2.78) trajectories, respectively. Women who attended university had lower odds of following the low versus the high DGI-2013 (OR 0.41; 95%CI 0.22, 0.76) and RDGI (OR 0.38; 95%CI 0.21, 0.70) trajectories, respectively. Women who were married had lower odds of following the low versus the high DGI-2013 trajectory (OR 0.39; 95%CI 0.17, 0.89), and women who were unemployed had higher odds of following the low versus the high RDGI trajectory (OR 1.78; 95%CI 1.13, 2.78). Maternal age, country of birth, household composition and pre-pregnancy body mass index were not associated with diet quality trajectories. Conclusion: Maternal diet quality trajectories remained stable from pregnancy to 3.5 years postpartum. Women who smoked, completed high school or less, were not married or were unemployed tended to follow low, stable diet quality trajectories. [ABSTRACT FROM AUTHOR]

Introduction: The Healthy Eating Index (HEI) is a comprehensive measure to assess diet quality. Because of the various factors that influence the nutritional status of older adults, there is a need to adapt an index that assesses the quality of the diet considering the dietary requirements of aging and health promotion. This study aimed to adapt the HEI for older adults, considering their needs for healthy eating. Methods: Food consumption data was collected by means of three non-consecutive 24-hour food recalls (R24h). For the adaptation of the Healthy Eating Index for Older Adults (HEI-OA), the components and scoring methodology of HEI-2015 were maintained and Brazilian food intake recommendations for the older population were used, which are in line with international recommendations. The validity of the HEI-OA was assessed by four ideal diets, Mann-Whitney's test, Spearman's correlation analysis and Cronbach's coefficient. Results: Content validity of the HEI-OA was confirmed by the maximum score for diets recommended to older adults and by the score between groups with known differences in diet quality. The HEI-OA total score did not correlate with total energy intake (TEI - total energy value: r = -0.141, p > 0.05). The total HEI-OA score showed a statistically significant correlation with several nutrients. These correlations allowed identifying that these nutrients are closely related to the components of the HEI-OA. The internal consistency value for the HEI-OA total score was 0.327, similar to the 2005 and 2010 versions of the HEI. Conclusion: The HEI was successfully adapted for use with older adults, presenting validity and reliability. The HEI-OA can be used to assess diet quality in line with international dietary guidelines for healthy aging. [ABSTRACT FROM AUTHOR]

Background: Given the growing popularity of plant‐based diets, this study investigated the dietary habits and self‐reported health outcomes of health‐conscious adults consuming plant‐based diets. Methods: A cross‐sectional online survey (n = 315) was distributed to members of Plant‐Based Health Professionals UK, a community interest company. Dietary intake was assessed through a food frequency questionnaire. Data were summarised descriptively. Dietary habits among respondents following a whole food plant‐based (WFPB) and vegan diet were compared using hypothesis tests. Results: Respondents reported following a WFPB (61%), vegan (28%) and semi plant‐based (11%) diet. Median time on current dietary pattern was 5 years. Daily or more frequent consumption was reported for the following foods: fruits 77%, berries 51%, green vegetables 48%, cruciferous vegetables 45%, other vegetables 64%, beans/legumes 41%, whole grains 62%, nuts and all seeds 63%. Consumption of ultra‐processed foods and plant‐based meat alternatives was low. About 93% of those on a WFPB or vegan diet supplemented with vitamin B12 and 61% with vitamin D. The median body mass index was 22.4 kg/m2. Fifty per cent of participants reported weight loss after adopting a plant‐based diet, with a median loss of 6.4 kg. Thirty‐five per cent reported reversing or improving an underlying health condition, and 15% were able to stop or reduce prescribed medication use as a result of dietary changes. Conclusions: This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. How to best encourage such sustainable diets among the broad population requires further research. Key points: Dietary intakes were consistent with a high‐quality diet, with a variety of whole plant foods consumed and minimal ultraprocessed foods, refined grains, sugar‐sweetened beverages and meat alternatives.Whole food plant‐based (WFPB) participants followed, on average, healthier diets than vegan participants and engaged in more physical activity.In this plant‐based population, there were indicators of favourable health outcomes such as low body mass index (BMI) and low levels of common chronic conditions.Participants reported improvements in a range of health conditions and a reduction in medication as a result of adopting plant‐based diets, with some requiring further research.This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. [ABSTRACT FROM AUTHOR]

Background: Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI. Methods: Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18–35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two‐sample t‐test, chi‐squared and one‐way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders. Results: The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males. Conclusion: Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings. Key points: Young male and female adults (18–35 years) demonstrate significantly different diet quality, with females scoring higher.Diet quality and body mass index (BMI) were inversely associated in both males and females, but the impact of diet quality on BMI varies by gender.Dietary interventions in young adults are needed to improve diet quality and the contribution to BMI status. [ABSTRACT FROM AUTHOR]

Diet plays an essential role in health and disease. Therefore, its determination is an important component of many investigations. The aim of the study was to evaluate the effect of a nutritional intervention on the urinary metabolome in children aged 6–12 years. Also, it was intended to identify biomarkers of diet quality and dietary intake. A 2‐month, randomized, controlled, parallel trial was conducted in Spanish children. The analyses focused on the ALINFA group, which followed a full‐fixed meal plan including healthy products, ready‐to‐eat meals, and healthy recipes. Diet quality was assessed by the KIDMED index and dietary intake by a food frequency questionnaire. Untargeted metabolomic analysis on urine samples was carried out, and multivariate analyses were performed for pattern recognition and characteristic metabolite identification. PLS‐DA and Volcano plot analyses were performed to identify the discriminating metabolites of this group. 12 putative metabolites were found to be the most relevant to this intervention. Most of them were products derived from protein and amino acid metabolism (N‐Ribosylhistidine, indolacrylic acid, and peptides) and lipid metabolism (3‐oxo‐2‐pentylcyclopentane‐1‐hexanoic acid methyl, Suberoyl‐L‐carnitine, and 7‐Dehydrodichapetalin E). All these metabolites decreased after the intervention, which was mainly associated with a decrease in the consumption of fatty meat and total fat, especially saturated fat. In turn, N‐Ribosylhistidine and Suberoyl‐L‐carnitine were negatively associated with diet quality, as well as able to predict the change in KIDMED index. In conclusion, the changes observed in urinary metabolome demonstrate the effectiveness of the ALINFA nutritional intervention. [ABSTRACT FROM AUTHOR]

Insect herbivore diet mediates interactions with entomopathogens, yet this is relatively unexplored for microsporidia. Here, we examine a diet‐mediated tri‐trophic interaction between an outbreaking forest defoliator, forest tent caterpillar (FTC) Malacosoma disstria Hübner and Nosema sp. microsporidia.We conducted two experiments where diet quality was manipulated by incorporating lyophilized aspen (Populus tremuloides Michaux) foliage into an artificial diet, which was compared to a standard artificial diet. Diet quantity varied between fully fed and partially starved conditions, simulating an outbreak scenario. Microsporidia infection occurred naturally or was induced via experimental inoculation. We assessed FTC survival, microsporidia infection and load, and sublethal effects of treatments on FTC traits.Plant secondary metabolite concentrations in aspen‐augmented diets varied between experiments. In Experiment 1, the aspen‐augmented diet contained lyophilized aspen foliage with low concentrations of secondary metabolites, which increased FTC survival and reduced microsporidia infection. Diet quality and infection load also interactively influenced adult wing traits in Experiment 1. In Experiment 2, the aspen‐augmented diet contained lyophilized aspen foliage with higher concentrations of secondary metabolites, which negatively affected FTC. No diet‐mediated interactions with microsporidia were observed in Experiment 2.Diet quality (Experiments 1 and 2), diet quantity (Experiment 2) and microsporidia infection (Experiments 1 and 2) directly influenced FTC survival and/or had sublethal effects on FTC that may have cascading effects on population dynamics and dispersal.We demonstrated that diet quality can mediate interactions between FTC and microsporidia, but these interactions depend on the defensive chemistry of the FTC diet. To our knowledge, this is the first study to report diet‐mediated interactions between an outbreaking forest pest and microsporidia and one of only a few studies to examine this tri‐trophic interaction among Lepidoptera. [ABSTRACT FROM AUTHOR]

Obesity as assessed by body mass index (BMI) is associated with increased risk of chronic disease. Health fatalism, defined as the belief that health outcomes are outside of one's control, is also associated with chronic disease risk. The purpose of this cross-sectional study was to understand the relationship between health fatalism and BMI in healthy adults. Secondary outcomes assessed the relationships between health fatalism and diet quality and health fatalism and physical activity. Healthy individuals aged 18 to 65 years were recruited via ResearchMatch, electronic mailing lists, and social media. Participants completed online questionnaires on demographic characteristics, diet quality, physical activity, and degree of health fatalism. Regression models were used to assess the primary and secondary outcomes. For the primary outcome, the model of health fatalism (predictor) and BMI (outcome) was also adjusted for diet quality, physical activity, and demographic characteristics. Participants (n = 496) were 38.7 ± 14.3 years old and primarily female (76%) and White (81%), with a BMI of 25.1 ± 5.2 kg/m2. Most participants had a college or post-college education (74%), stated that they always had sufficient income to live comfortably (90%), and were moderately to highly active (91%). There was no relationship between health fatalism and BMI (p > 0.05) or health fatalism and physical activity (p > 0.05); however, there was a significant relationship between health fatalism and diet quality (beta coefficient: −0.046; 95% confidence interval, −0.086 to −0.0058; p = 0.025), such that a higher degree of fatalism predicted a slight decrease in diet quality. Although health fatalism did not predict BMI in this population, fatalistic beliefs were associated with poorer diet quality. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare workers. This observational follow-up study involved 450 healthcare workers working night shifts (327 females, 123 males). A survey form requesting sociodemographic information (gender, age, marital status), job title, sleeping duration during the night shift, 24 h dietary records for pre-night-shift, during night shift, and post-night-shift, and anthropometric measurements (body weight and height) was applied. The scores of the Planetary Health Diet Index (PHDI) and the Healthy Eating Index 2020 (HEI-2020) were calculated according to the dietary records. The total HEI-2020 and PHDI scores decreased significantly (p < 0.05) during the night shift (44.0 ± 8.8 and 48.3 ± 13.2, respectively) compared to pre-night-shift (46.1 ± 9.2 and 51.9 ± 13.4, respectively) and increased post-night-shift (44.7 ± 9.9 and 50.6 ± 14.9, respectively), with no statistically significant difference between pre- and post-night-shift. There was a significant main effect of night shift working on total PHDI (F(896, 2) = 8.208, p < 0.001, ηp2 = 0.018) and HEI-2020 scores (F(894, 2) = 6.277, p = 0.002, ηp2 = 0.014). Despite healthcare workers' knowledge of health factors, night shifts lead to poor dietary choices. To improve diet quality and sustainability, it is crucial to enhance access to healthy food options in their work environment. [ABSTRACT FROM AUTHOR]

Nutritional epidemiological studies have evolved from a focus of single nutrients to diet patterns to capture the protective role of healthy diets on chronic disease development. Similarly, in inflammatory bowel disease (IBD), a healthy diet may be protective against its development in individuals with genetic susceptibility, but the definitions of the optimal diet pattern deserve further exploration. Hence, this review article presents evidence, mainly from prospective cohort studies, for the role of diet quality based on adherence to dietary guidelines, traditional and modern diet patterns in the prevention of IBD. Findings from a limited number of studies on diet quality suggest that high diet quality scores are associated with lower risk of developing Crohn's disease, but the data are inconsistent for ulcerative colitis (UC). There are signals that a Mediterranean diet pattern reduces the risk of Crohn's disease but, again, the data are inconsistent and further studies are much needed. Finally, the evidence is conflicting regarding the role of food additives, with difficulties in the assessment of their intake, namely non‐nutritive sweeteners and emulsifiers, precluding accurate assessment of a relationship with IBD risk. In contrast, emerging evidence for a role of ultra‐processed food in the development of Crohn's disease but not UC is identified. Given the potential influence of diet quality, a Mediterranean diet and ultra‐processed food intake on the risk of Crohn's disease, assessment and implementation of dietary advice for these patients need to be tailored. The search for an optimal diet for UC remains elusive and further research for increasing the evidence in the area is greatly needed. [ABSTRACT FROM AUTHOR]

Background: Increasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India. Methods: This study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (< 12 weeks gestation). Dietary data (24-h dietary recall) were collected in mid-pregnancy (23 ± 2 weeks). Nutrient intakes were compared with the Estimated Average Requirements (EAR) for pregnant Indian women. Dietary diversity score (DDS, range 0–10) and unhealthy food (sweet snacks, sweet beverages, fried and salty food) group score (range 0–3) were calculated as per FAO guidelines. Multivariate logistic regression was conducted to examine determinants of adequate dietary diversity (DDS ≥ 5). Results: The average age of women was 25 (4.5) years. The median (Q1, Q3) total energy and protein intakes were 1771 (1456, 2185) kcal/d and 44.7 (34.7, 55.0) g/d, respectively. Total energy and protein were consumed as per EAR by 37% and 54% of women, respectively. Forty percent of women exceeded the recommended energy intake from carbohydrates. Diets of slum-dwelling women were lacking in multiple micronutrients (especially iron, zinc, riboflavin, thiamine, folate). The mean DDS was 4.2 ± 1.2 and 36.5% of the women had DDS ≥ 5. All women consumed mainly cereal-based starchy staples; 80% consumed pulses and legumes, and 60% consumed other vegetables. Fifty-nine percent of women consumed ≥ 2 unhealthy food groups. Higher educational and occupational status of the primary earning members of the family and lower parity were determinants of adequate dietary diversity. Conclusion: The diets of pregnant slum-dwelling women were lacking in numerous micronutrients. Dietary counselling programs need to be tailored to the socioeconomic backgrounds of pregnant slum-dwelling women and involve their family members to improve reach and effectiveness. [ABSTRACT FROM AUTHOR]

To understand the perspectives of individuals living within food swamps and how they may perceive their access to healthy vs. unhealthy foods before and during the COVID-19 pandemic. Additionally, we examine how they may navigate their food environment to feed themselves and their families. We recruited women of color living within a food swamp neighborhood to share their perspectives on healthy and unhealthy food access, healthy eating, neighborhood resources, and community support. We employed the Photovoice model to engage participants to take photographs and document their experiences through two surveys. A focus group was completed to identify solutions and priorities to improve healthy food access. Nine themes related to food access including marketing, food quality, and affordability were identified. Participants conveyed the “saddening” or “frustrating” experience of taking images, which allowed them to document what they feel is the unfair experience of purchasing food in their own neighborhood. Participants highlighted goals they believed would improve outcomes for their neighborhood while discussing potential stakeholders who may assist the community. Participants identified several existing community assets such as local markets and schools that should be leveraged and expanded to enhance the overall health-promoting aspects of their neighborhood. Community members are able to identify the prevalence of unhealthy foods in their neighborhoods and work diligently to combat issues of food access. After completion of the Photovoice study, participants felt more confident about their ability to influence community. [ABSTRACT FROM AUTHOR]

Background: The diet quality of the US population is significantly unhealthy, with critical long-term implications for the nation's health. A few studies have explored diet quality in the future primary care workforce. This cross-sectional study quantifies the diet quality of medical students and primary care residents at a Midwestern college of medicine in the United States. Methods: 250 medical students and 148 primary care residents were surveyed electronically utilizing the Rapid Eating Assessment for Participants—Shortened Version (REAP-S). The survey consists of 13 questions that can be scored on a scale from 1 to 3, along with 3 questions that are not scored. The average REAP-S score for a US omnivorous diet is 32 (range 13 to 39) with higher scores indicating a higher quality diet. We obtained average REAP-S scores for all respondents and descriptive summary statistics for individual REAP-S items. Students' REAP-S total scores were compared to those of residents and the interaction between student/resident status and BMI category on REAP-S total scores were analyzed using analyses of variance. Differences between students and residents on BMI categories and other outcomes (individual REAP-S items, pandemic dietary and weight changes) were analyzed using Chi-Square Tests of Independence or Fisher's Exact Tests. Results: Medical students (n = 99; 39.6% response rate) had a significantly higher mean REAP-S score (30.5, SD = 3.9) than primary care residents (n = 72; 49% response rate) (mean = 28.6, SD = 3.9; p = 0.006). Total mean REAP-S scores were significantly higher for those with BMI < 25 (mean = 30.8, SD = 3.7) than for those with BMI > = 25 (mean = 28.3, SD = 4.0; p < 0.001). There was not a statistically significant interaction between role (student vs. resident) and BMI category on total REAP-S scores (p = 0.39). Most respondents (89.3%) indicated that they were willing to improve their diet. Conclusion: Our data suggest that the diet quality of surveyed medical students and primary care residents, as quantified by the REAP-S, is suboptimal. Early detection and improvement of diet quality may be necessary for our medical profession trainees to avert potential long-term adverse cardiometabolic health outcomes, and to optimize the health of our future primary care workforce. [ABSTRACT FROM AUTHOR]

Simple Summary: Quality of life significantly affects health outcomes in cancer patients. However, evidence of an association between diet quality and quality of life in cancer survivors is sparse in Mediterranean countries. The aim of this study was to evaluate the associations between an a priori diet quality index, the Healthy Eating Index-2015 (HEI-2015), and quality of life, assessed through a validated questionnaire targeted at women with a breast cancer diagnosis. A higher HEI-2015 score was positively associated with summary quality of life score and inversely associated with symptom scores. Health-related quality of life (HRQoL) represents one of the most concerning aspects for cancer patients. The Healthy Eating Index (HEI) is an a priori diet quality index directly associated with health outcomes and HRQoL in cancer survivors in North American populations. We evaluated, in a Mediterranean population, the baseline associations between HEI-2015 and HRQoL in 492 women with breast cancer recruited in a DEDiCa lifestyle trial. Dietary data were obtained from 7-day food records; HRQoL was assessed through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) and the C30 Summary Score (SumSc). Analysis of variance and multivariable linear and log-gamma regression models were performed. Mean and standard deviation for HEI-2015 score was 68.8 ± 11.2; SumSc was 81.5 ± 12.9. Women with lower HEI-2015 score had higher BMI, were more frequently exposed to tobacco smoke and had fewer years of education. Patients with a HEI-2015 score greater than 68.7 (median value) showed a significant increase in SumSc of 4% (p = 0.02). HEI-2015 components also associated with SumSc were beans and greens (β = 1.04; p = 0.02). Weak associations were found for total vegetables and saturated fats. Higher diet quality in breast cancer survivors was associated with higher overall HRQoL in this cross-sectional analysis. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was the association between the relationship between Dietary Quality Index-International (DQI-I) and Healthy Eating Index (HEI) and the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) was investigated as indicators of oxidative stress. Results: Based on HEI (low, moderate, and good), the diet quality of both groups was classified as moderate. In all participants, HEI (β=-0.29; P = 0.04) and DQI-I (β=-0.46; P = 0.005) were inversely associated with 8-OHdG. Furthermore, a negative correlation was found between HEI (mean β=-3.53; P = 0.04) and DQI-I (mean β=-5.53; P = 0.004) with F2a-IP. The quality of the footballers' diet was higher than that of the control group. Following a high-quality diet, which is rich in antioxidants, is likely to effectively reduce oxidative stress. [ABSTRACT FROM AUTHOR]

Peru is one of the most diverse countries in the world in terms of food production, but also suffers a wide range of food security challenges, including malnutrition, the impact of natural hazards, and rising food prices. People living in poverty conditions are the main victims of these problems, which trigger undernutrition, obesity, and diet‐related non‐transmittable diseases. Despite these challenges, Peru lacks historical food intake data. Therefore, in the current study, we assess the diet quality evolution in the period 2008–2021 based on apparent household purchases extracted from the National Household Survey. The results reveal significant variations in the consumption of certain food items and groups, and the consequences of these changes are discussed in environmental and human health terms. The consumption of lower environmental impact animal protein, such as chicken, eggs, and marine fish, has increased by 37%, 69%, and 29%, respectively; whereas the consumption of high environmental impact foods, such as beef and other red meat, has decreased. Moreover, consumption of less processed carbohydrate sources (e.g., legumes, fruits, and vegetables) has risen, while refined sugar and sugar‐sweetened beverages have decreased significantly (almost 45%). Regional differences were also visible; hence, cities on the Northern coast and the Amazon basin had similar consumption habits, whereas Central/Southern coastal and Andean cities had closer consumption patterns. On average, this improvement was reflected in the increase in calories (9.9%) and macronutrient intake (up to 15%), but at the socioeconomic level, food inequality persists, with consumption of many food groups below minimum thresholds in lower socioeconomic strata. This article met the requirements for a gold/gold JIE data openness badge described at http://jie.click/badges. [ABSTRACT FROM AUTHOR]

Women, particularly those in college, have the highest prevalence of any mental illness (MI), which negatively impacts social connection, academic performance, and health. Research into alternative treatment methods suggests that lifestyle behaviors are safer and more effective than medication at reducing MI symptoms. This study explores the relationship between lifestyle behaviors and MI in college women through an online survey. The survey included a food frequency questionnaire (Diet History Questionnaire II) and questions about lifestyle behaviors, symptoms of MI, and sociodemographic information. Diet quality was calculated using the Healthy Eating Index (HEI), and MI was assessed using the Depression, Anxiety, and Stress Scale-21. Independent sample t-tests, ANOVA, and chi-square analyses were conducted. A total of 222 women completed the survey. Overall, diet quality was poor, with a mean HEI of 62.6 ± 10.4. No significant differences or associations were found between MI groups for total HEI score, sleep, or tobacco use. However, alcohol use was significantly associated with MI (p = 0.049). Individuals with fewer concurrent unhealthy lifestyle behaviors had less severe symptoms of depression (p = 0.009) and anxiety (p < 0.001) compared to those with more unhealthy lifestyle behaviors. In this study, alcohol use was the only independent lifestyle behavior associated with symptoms of MI. We also found an association between the number of concurrent unhealthy lifestyle behaviors and depression and anxiety symptoms. Future research should explore the benefits of a healthy lifestyle on MI in a more diverse sample of women. [ABSTRACT FROM AUTHOR]

Dietary biodiversity, defined as the variety of consumed plants, animals and other organisms, can be measured by dietary species richness (DSR). This study investigated associations between DSR and diet quality in Dutch adults. Dietary intake data of 2078 Dutch participants, aged 19 to 79 years, were collected by the Dutch National Food Consumption Survey between 2012 and 2016 via two non-consecutive 24-h dietary recalls. DSR scores were calculated based on the total count of unique species consumed per individual over the two measurement days. An overall DSR score and separate scores for fruit and vegetable species consumption were calculated. The Dutch Healthy Diet index 2015 (DHD15-index) was used to measure diet quality. Linear regression analyses were performed to investigate associations between DSR scores and DHD15-index. Analyses were stratified by age and adjusted for relevant confounders. In total, 157 unique species were identified within the investigated food groups. On average, individuals consumed 13 unique species over two days (SD 4.55). For every additional species consumed, the DHD15-index increased by 1.40 points (95%CI 1.25–1.55). Associations between DSR and DHD15-index were higher in younger adults. DSR fruit showed the strongest associations with DHD15-index (β 4.01 [95%CI 3.65–4.38]). Higher DSR scores are associated with higher diet quality in Dutch adults. These newly developed DSR scores create opportunities for further research to explore the implications of dietary biodiversity in Western diets on health and related outcomes. [ABSTRACT FROM AUTHOR]

Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18–65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Progress in the field of ecological stoichiometry has demonstrated that the outcome of ecological interactions can often be predicted a priori based on the nutrient ratios (e.g., carbon: nitrogen: phosphorus, C:N:P) of interacting organisms. However, the challenges of accurately measuring the nutrient content of active parasites within hosts has limited our ability to rigorously apply ecological stoichiometry to host–parasite systems. Traditional nutrient analyses require high parasite biomasses, often preventing individual‐level analyses. This prevents researchers from estimating variation in the nutrient content of individual parasites within a single host infrapopulation, a critical factor that could define how the ecology of the parasite affects the host–parasite interaction. Here, we explain how energy dispersive technology, a technique currently used to measure the elemental content of free‐living microbes, can be adapted for parasitic microbial infrapopulations. We demonstrate the power of accurately quantifying the biomass stoichiometry of individual microbial parasites sampled directly from individual hosts. Using this approach, we show that the stoichiometric composition of two microbial parasites capable of infecting the same host are stoichiometrically distinct and respond to host diet quality differently. We also demonstrate that characteristics of the stoichiometric trait distributions of these infrapopulations were important predictors of host fecundity, a proxy for virulence in this system, and better predictors of parasite load than the mean parasite stoichiometry or our parasite and diet treatments alone. EDS provides a rigorous tool for applying ecological stoichiometry to host–parasite systems and enables researchers to explore the nutritional physiology of host–parasite interactions at a scale that is more relevant to the ecology and evolution of the system than traditional nutrient analyses. Here we demonstrate that this level of resolution provides useful insights into the diet‐dependent physiology of microbial parasites and their hosts. We anticipate that this improved level of resolution has the potential to elucidate a range of eco–evo interactions in host–parasite systems that were previously unobservable. [ABSTRACT FROM AUTHOR]

The quality of complementary feeding can have both short‐ and long‐term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non‐quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra‐processed food (UPFs). Up to one‐in‐five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient‐dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes. Key messages: Complementary diets in rural Ethiopia are extremely low in diversity.Consumption of unhealthy foods is more prevalent than the proportion that meets the minimum dietary diversity.Consumption of ultra‐processed foods was not associated with household wealth score.Indicators of unhealthy feeding practices should be integrated into nutrition programme monitoring. [ABSTRACT FROM AUTHOR]

Ensuring diet quality in the first 2 years of life is critical to preventing malnutrition and instilling healthy food preferences. Children's diet quality has changed little over time and inequalities by socioeconomic status, rural–urban residence, but also by food group may exist. Using data from the 2011, 2016 and 2019 demographic and health surveys (DHS), we estimated the prevalence and inequalities in the minimum diet diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). We further assessed food group‐level inequities. In 2019, only 13.5% of children 6–23 months of age met the MDD, 55% met the MMF and only 11% met the MAD indicator. Absolute and relative measures of inequality were calculated. Modest increases in MDD, MMF and MAD were observed over the past decade (2011–2019). These modest improvements were concentrated in limited geographical areas, among children in wealthier households, and urban residents. Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing; whereas, inequities in the consumption of nutrient‐dense foods have widened. Nevertheless, children from the wealthiest quintile also failed to meet the MDD. Multisectoral efforts that span from diversifying the food supply, regulating the marketing of unhealthy foods, and promoting minimal processing of perishables (i.e., to extend shelf‐life) are needed. Context‐adapted behavioural change communication along with nutrition‐sensitive social protection schemes are also needed to equitably improve the diet quality of children in Ethiopia. Key messages: Improvements in child diet quality are concentrated in limited geographical areas, primarily among wealthier households, and urban residents.Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing over the past decade.Inequalities in the consumption of nutrient‐dense foods have been widening in the last decade. [ABSTRACT FROM AUTHOR]

Women empowerment is an underlying factor of child feeding and nutrition. However, the lack of standardized measurements has made it difficult to design interventions that embed women empowerment and measure their impacts. This study aimed to assess temporal trends in women empowerment in Ethiopia and evaluate their contribution towards improving dietary diversity in infants and young children. We used women and child data from the Ethiopian Demographic and Health Survey 2005, 2011, and 2016, yielding a total sample of 6113 mother–child pairs. The survey‐based women's empowerment index (SWPER) developed and validated for use in Africa was used to assess three dimensions of women empowerment: (i) social autonomy, (ii) decision making; and (iii) attitude to violence. We used multiple‐linear and multivariable logistic regression to assess the associations between SWPER and the number of food groups consumed/and the minimum dietary diversity (MDD). To determine drivers of changes over time, a regression decomposition analysis was run. Women empowerment indices have improved over the 2005–2016 period, but a significant proportion of women had low standardized SWPER scores for autonomy/social independence (47%) and attitude to violence (49%) domains in 2016. SWPER autonomy and SWPER decision‐making scores were strongly associated with the odds of meeting MDD. Changes in women empowerment accounted for 17% of the improvements in MDD between 2005 and 2016. SWPER was a stronger predictor of the change in MDD, than known predictors like wealth, child age, and urban residence. As a critical underlying driver of child nutrition, women empowerment should be boldly addressed and integrated in nutrition interventions. [ABSTRACT FROM AUTHOR]

Despite sustained nutrition education, consumption of animal source foods (ASFs) has been hindered by their low availability, accessibility and affordability. Drying eggs into powder can reduce transport/storage costs, increase shelf‐life and allow easier dosage for use of smaller portions. This study aimed to evaluate the contribution of integrating egg powder to the nutrient adequacy and affordability of diets. Using the 'cost of the diet' analysis, we simulated the incorporation of egg powder into households' and children's diet and evaluated its contribution to the nutrient adequacy and affordability of diets. Analysis of the household consumption and expenditure survey (HCES 2016) revealed that only 0.2% of the total consumption expenditure was allocated for eggs, far below the 2.2% and 4.3% required to allow the consumption of one egg a day by the average and the poorest households, respectively. However, the minimum‐cost nutritious diet required only 2.5 g of egg powder/person/day to reduce the cost of the optimized diet by 14% (0–24%), allowing an additional 1.2 million households (~4–6 million individuals) afford the optimized diet. The optimized diet for a child 6–23 months of age could be afforded by all households, except by those in the poorest wealth quintile. But, free distribution of egg powder to households in the poorest wealth quintile, if supplemented by effective nutrition education, can allow them to afford the minimum‐cost nutritious diet for their 6‐ to 23‐month child. The simple dehydration of egg into egg powder can have a substantial contribution towards increased egg consumption by increasing the affordability of the minimum‐cost nutritious diet. [ABSTRACT FROM AUTHOR]

Child undernutrition disproportionally affects children in low‐ and middle‐income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6–23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight‐for‐length Z‐score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently. [ABSTRACT FROM AUTHOR]

We evaluated associations between diet quality and migraine outcomes. The current work represented a cross-sectional study on 262 patients with migraine (20–50 y). Diet quality was assessed using the standard healthy eating index 2015 (HEI-2015) and alternative healthy eating index 2010 (AHEI-2010). A validated 168-item food frequency questionnaire was used to assess dietary intake. Migraine outcomes included clinical factors (severity, duration, frequency, and disability related to migraine) and serum nitric oxide (NO). Associations between diet quality indices and migraine outcomes were evaluated using linear regressions, and β and 95% corresponding confidence interval (CI) were reported. HEI-2015 was inversely associated with migraine frequency (β = −4.75, 95% CI: −6.73, −2.76) in patients with the highest HEI scores (third tertile) vs. those with the lowest scores (first tertile) after adjusting for relevant confounders. AHEI-2010 was inversely associated with migraine frequency (β = −3.67, 95% CI: −5.65, −1.69) and migraine-related disability (β = −2.74, 95% CI: −4.79, −0.68) in adjusted models. Also, AHEI-2010 was inversely associated with migraine severity in patients in the second vs. first tertile (β = −0.56; 95% CI: −1.08, −0.05). We detected no associations between diet quality and NO levels (All P > 0.14). Improved diet quality may be associated with favorable migraine outcomes (lower headache frequency, severity, and migraine-related disability). Future studies are required to confirm and delineate the causal mechanisms of our observations. [ABSTRACT FROM AUTHOR]

Objective To assess the nutritional status and dietary quality of medical students and its influencing factors. Methods Students from Shanghai Medicial College of Fudan University were recruited to complete the 7-day and 24-hour dietary records, with food consumption measured by weight. A comprehensive evaluation of the students’ dietary quality was carried out by comparing their actual nutrient intake against recommended levels and calculating the component score of the Chinese Healthy Eating Index (CHEI). Factor analysis was used to extract dietary patterns. All subjects were further divided into high score group and low score group based on total CHEI. Binary Logistic regression was used to determine the factors influencing dietary quality. Results The study participants had an average daily energy intake of (2 057.02±501.87) kcal/d, 80% from on-campus canteen meals. Carbohydrates, proteins and fats contributed to 48.90%, 16.55% and 36.07% of the total energy intake, respectively. The CHEI median score was 67.55. Component scores for tubers, vegetables, fruits, dairy, fish and seafood, and nuts were below 60%, indicating an unbalanced diet. Being in the graduate stage (OR=0.53, 95%CI: 0.28-0.98) and having unreasonable body weight expectations (OR=0.37, 95%CI：0.17-0.81) were associated with lower CHEI scores. Conversely, higher CHEI scores were associated with the fruit-dairy dietary pattern (OR=8.20, 95%CI：3.39-19.84), the tuber-vegetable dietary pattern (OR=3.41, 95%CI: 1.58-7.32), and lower rates of on-campus dining (OR=1.92, 95%CI：1.02-3.59). Conclusion The energy intake of students at Shanghai Medical College of Fudan University appears to be adequate. However, a relatively high proportion of energy supply from fat intake indicates a need for improvement in their dietary structure. The dietary quality of students is mainly influenced by their educational level, weight expectations and dietary patterns. [ABSTRACT FROM AUTHOR]

Acrobatics and Tumbling (A&T), an emerging National Collegiate Athletics Association (NCAA) sport, involves athletes with rigorous training backgrounds, usually extending from youth through early adulthood. This study examines the sleep health, diet quality, and lipid profile of A&T athletes clustered by their performance position. Forty-two A&T athletes, clustered as tops (n = 19; age = 19.6 ± 1.0 years; body mass index [BMI] = 22.3 ± 1.7 kg/m2) and bases (n = 23; age = 19.6 ± 1.3 years; BMI = 25.7 ± 2.5 kg/m2), completed preseason sleep and diet quality (Rapid Eating Assessment for Participants–Shortened [REAP-S]) surveys. Fasting blood samples were collected for lipid analysis. Body composition was assessed via dual-energy X-ray absorptiometry. Most athletes (71.4%; base n = 14, top n = 16) reported insufficient sleep (≤7 hours) and "good" sleep quality (90.4%, n = 38; base n = 18, top n = 20). Average REAP-S score was 29.24 ± 3.74. Approximately 31% (n = 13) displayed at least one undesirable lipid concentration according to medical guidelines for normal levels (total cholesterol [TC] < 200 mg/dL, triglycerides [TG] < 150 mg/dL, high-density lipoprotein cholesterol [HDL-C] > 40 mg/dL, low-density lipoprotein cholesterol [LDL-C] < 130 mg/dL). Approximately 20% exhibited elevated TC (top n = 4, base n = 4), 12.5% had elevated TG (base n = 5), 2.5% showed low HDL-C (base n = 1), and 10% presented elevated LDL-C (top n = 2, base n = 2). Most athletes experienced suboptimal sleep (≤7 hours/night) and 31% displayed at least one undesirable lipid concentration (elevated TC, TG, or LDL-C or reduced HDL-C). Tailoring interventions with sports dietitians is recommended, focused on increasing monounsaturated and polyunsaturated fat intake while reducing saturated fat consumption. These interventions could mitigate cardiovascular risks, improve recovery, and possibly enhance athletic performance. [ABSTRACT FROM AUTHOR]

Women of reproductive age are a critical part of the population because their dietary habits and nutritional status impact the nutritional trajectory of future generations. Various studies have assessed the diet quality among women of reproductive age, but few studies have compared the diet quality of these women across the different life stages. To compare the diet quality among pregnant women, women living with children and women living without children in the United States of America (USA) using the Healthy Eating Index (HEI). This cross-sectional study was a secondary data analysis of the National Health and Nutrition Survey (NHANES), 2011–2016. Study participants comprised a total of 7120 women, ages 20–44 years in one of three life stage categories, pregnant women, women living in households with and without children less than 18 years. The HEI 2015 was used to assess the overall diet quality score as well as 13 dietary component scores-whole fruit, total fruit, greens and beans, whole grains, total vegetables, total protein foods, fatty acids, seafood and plant proteins, dairy, saturated fat, sodium, refined grains, and added sugars. The differences in HEI scores by life stage was assessed using linear regression models, adjusting for marital status, age, race and ethnicity, poverty index ratio, and educational status. The mean overall HEI score of participants was 52.0 out of 100 points. The overall HEI scores of pregnant women was significantly higher than women living with and without children respectively (β = 4.6 ± 1.42, p = 0.002; β = 3.7 ± 1.34, p = 0.009). Also, pregnant women had significantly higher scores for whole fruit (β = 0.99 ± 0.18, p < 0.001; β = 0.98 ± 0.17, p < 0.001), dairy (β = 0.63 ± 0.27, p = 0.02; β = 0.68 ± 0.29, p = 0.02) and whole grains (β = 1.05 ± 0.40, p = 0.01; β = 0.97 ± 0.39, p = 0.02) than women living with and without children respectively. On the other hand, women living without children had significantly higher scores for total vegetables (β = 0.18 ± 2.04, p = 0.002), refined grains (β = 0.22 ± 0.10, p = 0.03) and added sugars (β = 0.35 ± 0.16, p = 0.04) than women living with children. Pregnant women had the highest diet quality while women living in households with children had the lowest diet quality among the studied population. [ABSTRACT FROM AUTHOR]