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Abstract Background and aims Waist circumference (WC) is a significant indicator of body adiposity and is associated with increased mortality and morbidity of cardiovascular diseases. Although, single nutrient intake and candidate genes were previously associated with WC. Little is known about WC association with overall diet quality, genetic risk score and gene-nutrient interaction. This study aims to investigate the influence of overall diet quality and multiple WC-associated single nucleotide polymorphisms on WC. In addition to investigating gene-nutrient interaction association with WC. Methods This study explored cross-sectional data from two large sample-size studies, to provide reproducible results. As a representation of the UK population, the Airwave Health Monitoring Study (n = 6,502) and the UK-Biobank Cohort Study (n = 171,129) were explored for factors associated with WC. Diet quality was evaluated based on the Mellen Index for Dietary Approaches to Stop Hypertension (Mellen-DASH). The genetic risk score for WC (GRS-Waist) was calculated by screening the population genotype for WC-associated single nucleotide polymorphisms. Multivariate linear regression models were built to explore WC association with diet quality and genetic risk score. Gene-nutrient interaction was explored by introducing the interaction term (GRS-Waist X Mellen-DASH score) to multivariate linear regression analysis. Results The prevalence of high WC (Female > 80 cm, Male > 94 cm) was 46.5% and 51.7% in both populations. Diet quality and genetic risk score of WC were significantly associated with WC. There was no evidence of interaction between GRS-Waist, DASH diet scores and nutrient intake on WC. Conclusion This study’s findings provided reproducible results on waist circumference association with diet and genetics and tested the possibility of gene-nutrient interaction. These reproducible results are successful in building the foundation for using diet and genetics for early identification of those at risk of having high WC and WC-associated diseases. In addition, evidence on gene-diet interactions on WC is limited and lacks replication, therefore our findings may guide future research in investigating this interaction and investigating its application in precision nutrition.

Background and aims: Waist circumference (WC) is a significant indicator of body adiposity and is associated with increased mortality and morbidity of cardiovascular diseases. Although, single nutrient intake and candidate genes were previously associated with WC. Little is known about WC association with overall diet quality, genetic risk score and gene-nutrient interaction. This study aims to investigate the influence of overall diet quality and multiple WC-associated single nucleotide polymorphisms on WC. In addition to investigating gene-nutrient interaction association with WC. Methods: This study explored cross-sectional data from two large sample-size studies, to provide reproducible results. As a representation of the UK population, the Airwave Health Monitoring Study (n = 6,502) and the UK-Biobank Cohort Study (n = 171,129) were explored for factors associated with WC. Diet quality was evaluated based on the Mellen Index for Dietary Approaches to Stop Hypertension (Mellen-DASH). The genetic risk score for WC (GRS-Waist) was calculated by screening the population genotype for WC-associated single nucleotide polymorphisms. Multivariate linear regression models were built to explore WC association with diet quality and genetic risk score. Gene-nutrient interaction was explored by introducing the interaction term (GRS-Waist X Mellen-DASH score) to multivariate linear regression analysis. Results: The prevalence of high WC (Female > 80 cm, Male > 94 cm) was 46.5% and 51.7% in both populations. Diet quality and genetic risk score of WC were significantly associated with WC. There was no evidence of interaction between GRS-Waist, DASH diet scores and nutrient intake on WC. Conclusion: This study's findings provided reproducible results on waist circumference association with diet and genetics and tested the possibility of gene-nutrient interaction. These reproducible results are successful in building the foundation for using diet and genetics for early identification of those at risk of having high WC and WC-associated diseases. In addition, evidence on gene-diet interactions on WC is limited and lacks replication, therefore our findings may guide future research in investigating this interaction and investigating its application in precision nutrition. [ABSTRACT FROM AUTHOR]

High adherence to the Mediterranean diet (MD) has been associated with lower incidence of cardiovascular disease, increased HDL-cholesterol levels, and decreased triglycerides (TG), and total and LDL cholesterol levels. We aimed to assess the association of MD adherence at baseline with the lipid profile both cross-sectionally and prospectively in a sample of apparently healthy community-dwelling subjects. We conducted three cross-sectional studies using data from follow-ups 1 (FU1, 2009–2012), 2 (FU2, 2014–2017), and 3 (FU3, 2018–2021) of CoLaus|PsyCoLaus, a population-based sample from Lausanne, Switzerland. Dietary intake was assessed with a food frequency questionnaire. Two MD scores (Trichopoulou and Vormund) were computed, ranging from 0 (low) to 9 (high). In total, LDL and HDL cholesterol and TG were assessed. Incident dyslipidemia was defined as hypolipidemic treatment at FU2 or FU3. Overall, 4249 participants from FU1 (53.7% women, 57.6 ± 10.5 years, Trichopoulou 4.0 ± 1.5, Vormund 4.7 ± 1.9) were included. Neither MD score correlated significantly with the lipid markers and similar results were obtained according to the hypolipidemic status. Among the 3092 untreated FU1 participants with FU2 and FU3 data, 349 (11.3%) developed dyslipidemia by FU2 or FU3. No difference in MD scores was found between participants who developed dyslipidemia and those who did not (4.1 ± 1.5 vs. 4.0 ± 1.5 and 4.8 ± 1.8 vs. 4.8 ± 1.9 for Trichopoulou and Vormund, respectively, p > 0.05). Finally, no associations were found between MD score and lipid changes at 5 or 10 years. Contrary to other studies, adherence to MD at baseline did not show any significant effects on lipid composition/incident dyslipidemia in Colaus|PsyCoLaus participants. [ABSTRACT FROM AUTHOR]

Increasing attention is being paid to the role of diet quality in the prevention and management of non-communicable diseases. We developed a scoring system for the traditional Japanese diet and its modified version considering the dietary culture in Japan, dietary guidelines for the Japanese, and updated evidence for disease prevention. The traditional Japanese diet comprises white rice, miso soup, soybean products, vegetables, mushrooms, seaweeds, fish and shellfish, high-sodium foods, and green tea. In the modified Japanese diet, unprocessed or minimally refined rice and raw vegetables, milk and dairy products, and fruits were additionally considered, while salty food was reverse-scored. The cutoff for the intake frequency of each food/food group was determined with reference to a health survey of >12,000 workers. Among the participants in the validation study, we confirmed the nutritional gradient with increasing scores in the expected direction. The scores were closely correlated with the respondents' backgrounds, including occupational factors. This simple scoring system can be used for diet quality assessments and epidemiological research. [ABSTRACT FROM AUTHOR]

Aim: To assess whether the Mediterranean diet (MD) is associated with lower levels of type 2 diabetes (T2D) in a non-Mediterranean population. Methods: Cross-sectional analysis of follow-ups 1 (FU1, 2009–2012, n = 4398, 45.7% men, 57.7 ± 10.5 years), 2 (FU2, 2014–2017, n = 3154, 45.0% men, 61.7 ± 9.9 years), and 3 (FU3, 2018–2021, n = 2394, 45.2% men, 65.0 ± 9.6 years) of the Colaus|PsyCoLaus study (Lausanne, Switzerland). Two MD scores (Trichopoulou, noted MD1, and Sofi, noted MD2) were calculated using participants' dietary data. T2D was defined as a fasting plasma glucose ≥7 mmol/L and/or the presence of an antidiabetic drug treatment. Results: Participants with the highest MD adherence had a higher educational level, a lower BMI, were less frequent smokers, presented less frequently with hypertension, and were more frequent alcohol consumers. After multivariable adjustment, no differences were found between participants with and without T2D regarding MD scores: 3.93 ± 0.07 vs. 3.97 ± 0.02; 4.08 ± 0.10 vs. 3.98 ± 0.03, and 3.83 ± 0.11 vs. 3.97 ± 0.03, respectively, for the MD1 score in FU1, FU2, and FU3. In addition, no association was found between adherence to MD and T2D: odds ratio (and 95% confidence interval) for medium and high relative to low adherence to MD1: 0.87 (0.68–1.10) and 0.89 (0.64–1.24) in FU1, 1.04 (0.76–1.42) and 1.07 (0.68–1.67) in FU2, and 0.73 (0.53–1.03) and 0.61 (0.37–1.02) in FU3, respectively. Corresponding results for MD2 were 0.90 (0.70–1.15) and 1.03 (0.69–1.53) in FU1, 1.16 (0.82–1.63) and 1.40 (0.81–2.41) in FU2, and 0.93 (0.65–1.34) and 0.55 (0.28–1.08) in FU3. Conclusion: We found no association between Mediterranean diet adherence and T2D in a non-Mediterranean population. [ABSTRACT FROM AUTHOR]

Lifestyle-related factors influence risk of endometrial and ovarian cancers, but few studies have examined their joint associations with risk of these cancers. Using multivariable Cox regression models, we assessed the association of a healthy lifestyle index (HLI-a composite score (range, 0-20) involving diet, alcohol consumption, physical activity, body mass index, and smoking; higher scores represent healthier behavior) with risk of endometrial and ovarian cancers among 108,136 postmenopausal women who were recruited in the US Women's Health Initiative study between 1993 and 1998. After a median follow-up of 17.9 years, 1,435 endometrial cancer cases and 904 ovarian cancer cases had been ascertained. Women in the highest quintile of the HLI score had a lower risk of overall, type I, well-differentiated, moderately differentiated, poorly differentiated, and localized endometrial cancer than those in the lowest quintile (for quintile 5 vs. quintile 1, hazard ratio (HR) = 0.61 (95% CI: 0.51, 0.72), HR = 0.60 (95% CI: 0.49, 0.72), HR = 0.66 (95% CI: 0.46, 0.96), HR = 0.69 (95% CI: 0.52, 0.90), HR = 0.49 (95% CI: 0.34, 0.72), and HR = 0.61 (95% CI: 0.50, 0.74), respectively). The HLI score had a weak positive association with risk of serous ovarian cancer. Our findings underscore the potential importance of a healthy lifestyle in lowering endometrial cancer risk among postmenopausal women.

Understanding the dietary characteristics of people living with multiple sclerosis (plwMS) may assist in the planning of nutrition interventions for multiple sclerosis; yet dietary assessment methods in existing studies are not well established. The aim of this study was to validate the psychometric properties (construct validity and internal consistency) of the Dietary Habits Questionnaire (DHQ) against repeated online 24-h recall dietary assessments. The DHQ is a 24-item tool that is scored using ten dietary sub-scores. Total DHQ scores can range from 20–100 and are considered indicative of the quality of dietary intake with higher scores reflecting increased quality. People living with a relapsing-remitting MS phenotype who had completed a modified DHQ were recruited from the international Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis (HOLISM) cohort. Repeated 24-h recall via the online Automated Self-administered Assessment-24 (ASA-24) tool were modelled to reflect usual dietary intakes using the Multiple Source Method. DHQ scores of eight sub-scores: three key nutrients, three food groups and two food preparation practices, were calculated and statistically compared with ASA-24 usual intake data. Principal component analysis of the ASA-24 data was undertaken to understand dietary patterns of the sample. Of the 105 participants, valid 24-h recall data were available for 96 plwMS (n = 66 1 day, n = 30 ≥ 2 day). The median total DHQ score was 84.50 (IQR: 77.04, 91.83) points. The highest absolute correlations were between the DHQ scores and ASA-24 data for cereal (r = 0.395, p < 0.001), fruit and vegetables (r = 0.436, p < 0.001), and total dietary fiber (r = 0.482, p < 0.001). Five dietary patterns emerged from the data explaining 42.12% variance and reflecting exposure of plwMS to the influence of 'MS diets'. The DHQ appears to be appropriate for screening participants with relapsing-remitting MS. Evidence-based dietary models focusing on food are required to monitor the quality of an overall dietary pattern and set priorities for the planning nutrition interventions for plwMS. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the relationship between adherence to a healthy diet, such as the Mediterranean diet (MedDiet), and C-reactive protein (CRP) in Italian heavy smokers undergoing an LDCT screening program (bioMILD trial), using scores calculated by simple questionnaires. Simple formats of food frequency questionnaires were administered to a sample of 2438 volunteers, and the adherence to a healthy diet was measured by the validated 14-point MEDAS and by two adaptations proposed by us: 17-item revised-MEDAS and 18-item revised-MEDAS. The OR of CRP ≥ 2 mg/L for 1-point increase in 14-point MEDAS score was 0.95 (95% CI 0.91–0.99), for 17-point score was 0.94 (95% CI 0.91–0.98), and for 18-point score was 0.92 (95% CI 0.88–0.97). These inverse associations remained statistically significant also after further adjustment for body mass index. These results showed the efficacy of simplified scores and their relationship with lower levels of CRP in a population of heavy smokers. This suggests that a targeted nutritional intervention might achieve a substantial reduction in CRP levels. The findings will be prospectively tested in a new randomized study on primary prevention during lung cancer screening. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is a main cause of mortality and disability worldwide. One of the key factors in the soaring prevalence of CVD globally has been nutrition transitions and changes in dietary patterns. Objective: This study investigated the association between two diet scores, namely, a high-fat dietary (HFD) pattern score and a Mediterranean diet (MedDiet) score, and CVD risk factors (obesity, hypertension, total cholesterol, and blood glucose) and serum 25 hydroxy vitamin D (25[OH]D) levels. Methods: Three hundred twenty-one participants were included in this study. Fasting blood tests were collected from all participants for biochemical measurements. Blood pressure and anthropometric measurements were also taken. A validated, semi-quantitative food frequency questionnaire was used to collect data on participants’ dietary intake. Dietary scores for the HFD pattern were calculated based on recommended food groups. MedDiet scores were calculated based on a previously validated method that contains 14 questions related to MedDiet. Both diet scores were classified into tertiles. Linear regression analyses were performed to assess the statistical significance of the tertile groups. Result: A significant association was found between HFD score and obesity when comparing the lowest tertile (27.3±4.6 kg/m2) of HFD scores with the medium tertile (29.2±5.7 kg/m2; P = 0.02). A higher HFD score was significantly associated with lower 25(OH)D levels (P = 0.02). In addition, a significant association was observed between MedDiet scores and 25(OH)D levels, with an increase in MedDiet score resulting in an increase in 25(OH)D levels (P = 0.01). Furthermore, a significant negative association between MedDiet scores and low-density lipoprotein levels was reported only in participants with CVD (P = 0.03). Conclusion: The results of this study revealed that HFD and MedDiet scores might have a role in the development of CVD and vitamin D deficiency among the Saudi Arabian population. Further studies are required using diet scores to assess the quality of dietary patterns and their association with an increased risk of diseases in Saudi Arabians.

Previously, the attempt to compile German dietary guidelines into a diet score was predominantly not successful with regards to preventing chronic diseases in the EPIC-Potsdam study. Current guidelines were supplemented by the latest evidence from systematic reviews and expert papers published between 2010 and 2020 on the prevention potential of food groups on chronic diseases such as type 2 diabetes, cardiovascular diseases and cancer. A diet score was developed by scoring the food groups according to a recommended low, moderate or high intake. The relative validity and reliability of the diet score, assessed by a food frequency questionnaire, was investigated. The consideration of current evidence resulted in 10 key food groups being preventive of the chronic diseases of interest. They served as components in the diet score and were scored from 0 to 1 point, depending on their recommended intake, resulting in a maximum of 10 points. Both the reliability (r = 0.53) and relative validity (r = 0.43) were deemed sufficient to consider the diet score as a stable construct in future investigations. This new diet score can be a promising tool to investigate dietary intake in etiological research by concentrating on 10 key dietary determinants with evidence-based prevention potential for chronic diseases. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is to examine the relationship between dietary patterns and sarcopenia using a protocol developed for use by the 2020 Dietary Guidelines Advisory Committee, and to conduct a meta-analysis to summarize the evidence. Multiple electronic databases were searched for studies investigating sarcopenia risk factors or risk of sarcopenia and dietary patterns. Eligible studies were 1) peer-reviewed controlled trials or observational trials, 2) involving adult or older-adult human subjects who were healthy and/or at risk for chronic disease, 3) comparing the effect of consumption or adherence to dietary patterns (measured as an index/score, factor or cluster analysis; reduced rank regression; or a macronutrient distribution), and 4) reported on measures of skeletal muscle mass, muscle strength, muscle performance, and/or risk of sarcopenia. Thirty-eight publications met all inclusion criteria for qualitative synthesis. Thirteen observational studies met inclusion criteria for meta-analysis. Higher adherence to a healthy dietary pattern was associated with a decreased risk of gait speed reduction (OR = 0.58; 95% CI: 0.18, 0.97). The association between healthy dietary pattern adherence and other intermediate markers or risk of sarcopenia was not statistically significant. The majority of individual studies were judged as "serious" risk of bias and analysis of the collective evidence base was suggestive of publication bias. Studies suggest a significant association between healthy dietary patterns and maintenance of gait speed with age, an intermediate marker of sarcopenia risk, but the evidence base is limited by serious risk of bias, within and between studies. Further research is needed to understand the association between healthy dietary patterns and risk of sarcopenia. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson’s correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson’s correlations were studied between baseline and 1 year score, within the control group only. Results The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p

Objective: To ascertain which of the Alternative Healthy Eating Index (AHEI) 2010, Dietary Inflammatory Index (DII®) and Mediterranean Diet Score (MDS) best predicted BMI and waist-to-hip circumference ratio (WHR). Design: Body size was measured at baseline (1990–1994) and in 2003–2007. Diet was assessed at baseline using a FFQ, along with age, sex, socio-economic status, smoking, alcohol drinking, physical activity and country of birth. Regression coefficients and 95 % CI for the association of baseline dietary scores with follow-up BMI and WHR were generated using multivariable linear regression, adjusting for baseline body size, confounders and energy intake. Setting: Population-based cohort in Melbourne, Australia. Participants: Included were data from 11 030 men and 16 774 women aged 40–69 years at baseline. Results: Median (IQR) follow-up was 11·6 (10·7–12·8) years. BMI and WHR at follow-up were associated with baseline DII® (Q5 v. Q1 (BMI 0·41, 95 % CI 0·21, 0·61) and WHR 0·009, 95 % CI 0·006, 0·013)) and AHEI (Q5 v. Q1 (BMI −0·51, 95 % CI −0·68, −0·35) and WHR −0·011, 95 % CI −0·013, −0·008)). WHR, but not BMI, at follow-up was associated with baseline MDS (Group 3 most Mediterranean v. G1 (BMI −0·05, 95 % CI −0·23, 0·13) and WHR −0·004, 95 % CI −0·007, −0·001)). Based on Akaike's Information Criterion and Bayesian Information Criterion statistics, AHEI was a stronger predictor of body size than the other diet scores. Conclusions: Poor quality or pro-inflammatory diets predicted overall and central obesity. The AHEI may provide the best way to assess the obesogenic potential of diet. [ABSTRACT FROM AUTHOR]

Background: Asian Indians are culturally different and have diverse dietary and culinary habits. Further, there are potential biological differences in metabolism due to genetic or cultural factors. This warrants the development of a unique population-specific food-based diet score for prevention of noncommunicable disorders. Materials and Methods: Dietary intake was assessed using a validated food frequency questionnaire in 1033 adults who participated in the 10-year follow-up study of Chennai Urban Rural Epidemiological Study (CURES). The diet score was developed considering eight food groups and one major cooking oil that were either significantly associated with a higher or lower risk of incident type 2 diabetes (T2D). The foods that showed a protective effect was assigned higher scores and vice versa for foods that increased the risk of diabetes assigned the lower. We further assessed the effect of Indian Diet Quality score (IDQS) and three popular diet quality indices: the Healthy Eating Index-2015 (HEI), the Dietary Approach to Stop Hypertension (DASH), and Diabetes Diet Score (DDS) in relation to the risk of incidence of diabetes among Indian population. Results: Higher IDQS is associated with a significant lower risk of diabetes incidence; however, no such significant association was observed with diet quality indices (DASH, HEI-2015, and DDS) and diabetes incidence. This warrants the need for population-specific diet score for Indians. Conclusion: Higher IDQS was associated with a lower risk of T2D among South Indian adults. Thus, IDQS can be a suitable tool to identify the diet–disease relationship especially in a population with diverse dietary intakes.

Background: Randomized controlled trials targeting maternal dietary and physical activity behaviors during pregnancy have generally failed to accomplish reductions in the prevalence of adverse maternal and neonatal outcomes. Interventions carried out during pregnancy could thus be missing the mark in maximizing intervention health benefit. Objective: To investigate whether pre-pregnancy and early pregnancy dietary behavior as reported at inclusion into the Norwegian Fit for Delivery (NFFD) trial was associated with maternal and neonatal outcomes irrespective of subsequent randomization assignment. Design: The study is a post-hoc observational analysis of data from a randomized controlled lifestyle intervention. We constructed two diet scores from participant responses to a 43-item questionnaire that addressed dietary behavior in retrospect (pre-pregnancy diet score) and dietary behavior at inclusion (early pregnancy diet score), respectively. The diet scores ranged from 0 to 10, with higher score reflecting healthier dietary behavior. Associations between diet scores and maternal and neonatal health outcomes were estimated in multivariate logistic regression models. Results: A total of 591 women were eligible for analysis. A one-point increase in pre-pregnancy diet score was associated with lower odds of excessive gestational weight gain (GWG) (odds ratio [OR]adj: 0.92; 95% confidence interval [CI]: 0.84–1.00, p = 0.050), preterm delivery (ORadj: 0.81; 95% CI: 0.68–0.97, p = 0.019), and birthweight ≥ 4,000 g (ORadj: 0.88; 95% CI: 0.78–0.99, p = 0.038). A one-point increase in early pregnancy diet score was associated with lower odds of excessive GWG (ORadj: 0.88; 95% CI: 0.79–0.97, p = 0.009), preterm delivery (ORadj: 0.82; 95% CI: 0.67–0.99, p = 0.038), and preeclampsia (ORadj: 0.78; 95% CI: 0.62–0.99, p = 0.038). Discussion: Higher diet score either pre-pregnancy or in early pregnancy was protectively associated with excessive GWG and preterm delivery, whereas the protective association with high birthweight was confined to pre-pregnancy diet and with preeclampsia to early pregnancy diet. Conclusions: Both pre-pregnancy and early pregnancy dietary behavior was associated with important maternal and neonatal health outcomes in the NFFD dataset.

Background: Cardiovascular disease (CVD) is a main cause of mortality and disability worldwide. One of the key factors in the soaring prevalence of CVD globally has been nutrition transitions and changes in dietary patterns. Objective: This study investigated the association between two diet scores, namely, a high-fat dietary (HFD) pattern score and a Mediterranean diet (MedDiet) score, and CVD risk factors (obesity, hypertension, total cholesterol, and blood glucose) and serum 25 hydroxy vitamin D (25[OH]D) levels. Methods: Three hundred twenty-one participants were included in this study. Fasting blood tests were collected from all participants for biochemical measurements. Blood pressure and anthropometric measurements were also taken. A validated, semi-quantitative food frequency questionnaire was used to collect data on participants' dietary intake. Dietary scores for the HFD pattern were calculated based on recommended food groups. MedDiet scores were calculated based on a previously validated method that contains 14 questions related to MedDiet. Both diet scores were classified into tertiles. Linear regression analyses were performed to assess the statistical significance of the tertile groups. Result: A significant association was found between HFD score and obesity when comparing the lowest tertile (27.3±4.6 kg/m²) of HFD scores with the medium tertile (29.2±5.7 kg/m2; P = 0.02). A higher HFD score was significantly associated with lower 25(OH)D levels (P = 0.02). In addition, a significant association was observed between MedDiet scores and 25(OH)D levels, with an increase in MedDiet score resulting in an increase in 25(OH)D levels (P = 0.01). Furthermore, a significant negative association between MedDiet scores and low-density lipoprotein levels was reported only in participants with CVD (P = 0.03). Conclusion: The results of this study revealed that HFD and MedDiet scores might have a role in the development of CVD and vitamin D deficiency among the Saudi Arabian population. Further studies are required using diet scores to assess the quality of dietary patterns and their association with an increased risk of diseases in Saudi Arabians. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson's correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson's correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner. Trial registration: Clinicaltrials.gov NCT02393872. Registered March 20, 2015. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported a positive association between scoring on healthy Nordic diet scales and the intake of healthy foods and nutrients, and also with higher intake of meat, sweets, cakes, and energy in general. These studies have used the same food frequency questionnaire (FFQ) responses for constructing the diet score as for calculating intakes of foods and nutrients. Thus, it is not clear whether the coexistence of healthy and less healthy dietary aspects among adherers to Nordic diets would occur even though separate methods were applied for exploring these relations. Objective: To assess the association between adherence to the New Nordic Diet (NND), derived from an FFQ, and diet quality, determined from two 24-h dietary recall interviews. Design: In total, 65 parents of toddlers in Southern Norway answered the NND FFQ and two 24-h dietary recall interviews. NND adherence was determined from the FFQ and categorized into low, medium, and high adherence. The two 24-h recalls provided data for the intake of specific foods and nutrients, selected on the basis of the Norwegian food-based guidelines as an indicator of a healthy diet. The Kruskal–Wallis test was used for assessing differences in food and nutrient intake across NND groups. Results: High NND adherence derived from FFQ was associated with a high intake of fruits (p=0.004) and fiber (p=0.02), and a low intake of meat (p=0.004) and margarines (p=0.05), derived from recalls. A larger proportion of high NND adherers (68%) complied with the national dietary recommendation targeting meat intake compared with low NND adherers (29%) (p=0.04). Conclusion: The present study showed that higher NND adherence measured with FFQ was associated with a higher intake of selected healthy foods and nutrients, measured with recalls. However, a higher intake of meat, sweets, and energy, as earlier reported, was not observed.

Background: There is a growing interest in the New Nordic Diet (NND) as a potentially health promoting, environmentally friendly, and palatable regional diet. Also, dietary scores are gaining ground as a complementary approach for examining relations between dietary patterns and various health outcomes. A score assessing adherence to the NND has earlier been published, yet not tested for reliability. Objective: To assess the test–retest reliability of the NND score in a sample of parents of toddlers, residing in Southern Norway. Design: A questionnaire survey was completed on two occasions, approximately 14 days apart, by 67 parents of toddlers [85% females, mean age 34 years (SD=5.3 years)]. The NND score was constructed from 24 items and comprised 10 subscales that summarize meal pattern and intake of typical Nordic foods. Each subscale was dichotomized by the median and assigned values of ‘0’ or ‘1’. Adding the subscales yielded a score ranging from 0 to 10, which was further trichotomized. Test–retest reliability of the final NND score and individual subscales was assessed by Pearson's correlation coefficient and Spearman's rank correlation coefficient, respectively. Additionally, cross tabulation and kappa measure of agreement (k) were used to assess the test–retest agreement of classification into the NND score, and the subscales. Results: Test–retest correlations of the NND score and subscales were r=0.80 (Pearson) and r=0.54–0.84 (Spearman), respectively, all p

Background: Randomized controlled trials targeting maternal dietary and physical activity behaviors during pregnancy have generally failed to accomplish reductions in the prevalence of adverse maternal and neonatal outcomes. Interventions carried out during pregnancy could thus be missing the mark in maximizing intervention health benefit. Objective: To investigate whether pre-pregnancy and early pregnancy dietary behavior as reported at inclusion into the Norwegian Fit for Delivery (NFFD) trial was associated with maternal and neonatal outcomes irrespective of subsequent randomization assignment. Design: The study is a post-hoc observational analysis of data from a randomized controlled lifestyle intervention. We constructed two diet scores from participant responses to a 43-item questionnaire that addressed dietary behavior in retrospect (pre-pregnancy diet score) and dietary behavior at inclusion (early pregnancy diet score), respectively. The diet scores ranged from 0 to 10, with higher score reflecting healthier dietary behavior. Associations between diet scores and maternal and neonatal health outcomes were estimated in multivariate logistic regression models. Results: A total of 591 women were eligible for analysis. A one-point increase in pre-pregnancy diet score was associated with lower odds of excessive gestational weight gain (GWG) (odds ratio [OR]adj: 0.92; 95% confidence interval [CI]: 0.84-1.00, p = 0.050), preterm delivery (ORadj: 0.81; 95% CI: 0.68-0.97, p = 0.019), and birthweight ≥ 4,000 g (ORadj: 0.88; 95% CI: 0.78-0.99, p = 0.038). A one-point increase in early pregnancy diet score was associated with lower odds of excessive GWG (ORadj: 0.88; 95% CI: 0.79-0.97, p = 0.009), preterm delivery (ORadj: 0.82; 95% CI: 0.67-0.99, p = 0.038), and preeclampsia (ORadj: 0.78; 95% CI: 0.62-0.99, p = 0.038). Discussion: Higher diet score either pre-pregnancy or in early pregnancy was protectively associated with excessive GWG and preterm delivery, whereas the protective association with high birthweight was confined to pre-pregnancy diet and with preeclampsia to early pregnancy diet. Conclusions: Both pre-pregnancy and early pregnancy dietary behavior was associated with important maternal and neonatal health outcomes in the NFFD dataset. [ABSTRACT FROM AUTHOR]

Abstract Objective : To evaluate the relationship between diet quality score, as measured by the Australian Recommended Food Score (ARFS) and six‐year weight gain in middle‐aged Australian women. Methods : Participants were a sub‐sample of women from the Australian Longitudinal Study on Women's Health (ALSWH) who were followed up from 2001 to 2007 (n= 7,155, aged 48 to 56 years). The ARFS was derived from responses to a sub‐set of questions from a food frequency questionnaire, with possible scores ranging from 0 to 74 (maximum). Absolute weight gain was calculated from the difference in self‐reported weight between 2001 and 2007. Linear regression was used to test the relationship between diet score and weight change. Results : On average, women gained weight during follow‐up (1.6 ± 6.2 kg) and had a mean baseline ARFS of 32.6 (SD 8.7) which was not optimal. There was no association between ARFS and weight change during follow‐up (β= 0.016; p=0.08) in the fully adjusted model that included total energy intake, education, area of residence, baseline weight, physical activity, smoking and menopause status. Conclusions : Weight gain and low ARFS were common. However, diet quality as measured by the ARFS did not predict six‐year weight gain. Implications : This lack of association may be due to limitations related to AFRS, or may be a false negative finding. Further research is warranted to evaluate the impact of promoting optimal diet quality on weight gain prospectively.

We have assessed serum lipids, systolic (SBP) and diastolic (DBP) blood pressure in a healthy, free living population over 70 years old residing for more than 20 years in a rural area located in the southern Spain, the Sierra de Huelva. 401 elderly, 229 women (F) and 179 men (M) mean age 79.36 ± 6.9 were included in this cross-sectional observational study. Dietary habits were assessed by means of a Modification of the Mediterranean Diet Score (MDDS), which comprised 11 components. A total score ranging from 0-44 was calculated. Mean concentration for lipids were: Total cholesterol (TC) 193.8 ± 23.1, M 195.2 ± 25.7 and F 192.7 ± 20.8 (p = 0.29); HDLc 60.3 ± 7.6 mg/dl, M 60.0 ± 8.0 and F 60.5 ± 7.2 (p = 0.49); TC/HDLc 3.3 ± 1.1 mg/dl, M 3.4 ± 1.2 and F 3.3 ± 1.1 mg/dl (p < 0.35); LDLc 127.3  30.1 mg/dl, M 129.0 ± 32.9 F 126.0 ± 27.8 mg/dl (p = 0.33); TG 137.7 ± 18.3, M 138.8 ± 19.4 and F 136 ± 17.4 (p = 0.30). Global prevalence of hypercholesterolemia (TC ≥200 mg/dl) was 8.7%, F 7.9% and M 9.9%; 10.7% had LDLc≥160 mg/dl. In this study, age was negatively correlated (p < 0.05) with TC, LDLc, TG and SBP and positively with HDLc. Pig meat consumption was negatively correlated with CT and LDLc, and positively with HDLc. According to MMDS data, 60.6 ± 6.9% of adherence to the Mediterranean diet was obtained. The MMDS was positively associated with age and negatively with TG (p < 0.05). Further studies are needed to establish the influence of local Iberian pig meat products consumption and life style on the lower incidence of risk factors for CVD and the higher life expectancy of the studied population.

Several previous studies have shown that a diet score based on the Japanese food guide Spinning Top (the original score) is associated with both favourable and unfavourable dietary intake patterns. We developed a food-based diet quality score (the modified score) and examined associations with nutrient intakes. Subjects were 3963 young (all aged 18 years), 3800 middle-aged (mean age 47·7 (sd 3·9) years) and 2211 older (mean age 74·4 (sd 5·2) years) Japanese women. Dietary intakes were assessed using comprehensive (for the young and middle-aged) and brief-type (for the older) diet history questionnaires. The original score was calculated based on intakes of grains, vegetables, fish/meat, milk, fruits, and snacks/alcoholic beverages. The modified score was similarly calculated, but included Na from seasonings and without applying the upper cut-off values for dietary components where increased consumption is advocated for Japanese women (grains, vegetables, fish/meat, milk, and fruits). The original score was positively associated with intakes of carbohydrate, dietary fibre, and all the vitamins and minerals examined including Na and inversely with intakes of fats and alcohol in young and middle-aged women. In older women, the original score was inversely associated with intakes of all nutrients except for carbohydrate and vitamin C. However, the modified score was associated positively with intakes of protein, carbohydrate, dietary fibre, K, Ca, Mg, Fe, vitamins A, C and E, and folate and inversely with intakes of fats, alcohol and Na in all generations. In conclusion, the modified diet score was positively associated with favourable nutrient intake patterns in Japanese women.

A mother’s diet during pregnancy has the potential to influence both her own and her child’s short- and long-term health. This paper reports the effects of a randomized controlled diet intervention during pregnancy on dietary behavior post-intervention as reported in late pregnancy. The diet intervention was part of a lifestyle intervention targeting both diet and physical activity behaviors among nulliparous women participating in the randomized controlled Norwegian Fit for Delivery study (NFFD). Eligible women were enrolled in early pregnancy from eight healthcare clinics in southern Norway between 2009 and 2013. The diet intervention was based on 10 dietary recommendations that were conveyed during two counseling sessions by phone and in a pamphlet describing the recommendations and their simplified rationale. A diet score was constructed from a 43-item food frequency questionnaire (FFQ) and used to assess intervention effect on dietary behavior (score range 0–10). Between-group dietary differences post-intervention were estimated with analysis of covariance, with adjustment for baseline diet. A total of 508 women completed the FFQ both at baseline and post-intervention. There were no between-group differences in diet score and subscales at baseline. Post-intervention, the intervention group had higher overall diet score (control: 4.61, intervention: 5.04, P=0.013) and favorable dietary behavior in seven of the 10 dietary domains: ‘consumption of water relative to total beverage consumption’ (P=0.002), ‘having vegetables with dinner’ (P=0.027), ‘choosing fruits and vegetables for between-meal snacks’ (P=0.023), ‘buying small portion sizes of unhealthy foods’ (P=0.010), ‘limiting sugar intake’ (P=0.005), ‘avoiding eating beyond satiety’ (P=0.009) and ‘reading food labels’ (P=0.011). The NFFD diet intervention improved dietary behavior. Potential long-term clinical influence in mother and child will be investigated in further studies. [ABSTRACT FROM PUBLISHER]

Background: Previous studies have reported a positive association between scoring on healthy Nordic diet scales and the intake of healthy foods and nutrients, and also with higher intake of meat, sweets, cakes, and energy in general. These studies have used the same food frequency questionnaire (FFQ) responses for constructing the diet score as for calculating intakes of foods and nutrients. Thus, it is not clear whether the coexistence of healthy and less healthy dietary aspects among adherers to Nordic diets would occur even though separate methods were applied for exploring these relations. Objective: To assess the association between adherence to the New Nordic Diet (NND), derived from an FFQ, and diet quality, determined from two 24-h dietary recall interviews. Design: In total, 65 parents of toddlers in Southern Norway answered the NND FFQ and two 24-h dietary recall interviews. NND adherence was determined from the FFQ and categorized into low, medium, and high adherence. The two 24-h recalls provided data for the intake of specific foods and nutrients, selected on the basis of the Norwegian food-based guidelines as an indicator of a healthy diet. The Kruskal-Wallis test was used for assessing differences in food and nutrient intake across NND groups. Results: High NND adherence derived from FFQ was associated with a high intake of fruits (p =0.004) and fiber (p = 0.02), and a low intake of meat (p = 0.004) and margarines (p = 0.05), derived from recalls. A larger proportion of high NND adherers (68%) complied with the national dietary recommendation targeting meat intake compared with low NND adherers (29%) (p = 0.04). Conclusion: The present study showed that higher NND adherence measured with FFQ was associated with a higher intake of selected healthy foods and nutrients, measured with recalls. However, a higher intake of meat, sweets, and energy, as earlier reported, was not observed. [ABSTRACT FROM AUTHOR]

Background: The use of dietary quality scores/indices to describe diet quality in children has increased in the past decade. However, to date, few studies have focused on the use of these scores on disease outcomes such as childhood obesity and most are developed from detailed dietary assessments. Therefore, the aims of this study were: firstly to construct a diet quality score (DQS) from a brief dietary assessment tool; secondly to examine the association between diet quality and childhood overweight or obesity; thirdly we also aim to examine the associations between individual DQS components and childhood overweight or obesity. Methods: A secondary analysis of cross sectional data of a sample of 8,568 9-year-old children and their families as part of the Growing Up in Ireland (GUI) study. Subjects were drawn from a probability proportionate to size sampling of primary schools throughout Ireland over the school year 2007-2008. Height and weight were measured by trained researchers using standardised methods and BMI was classified using the International Obesity Taskforce cut-points. The DQS (un-weighted) was developed using a 20-item, parent reported, food frequency questionnaire of foods consumed over the past 24 h. Adjusted odds ratios for overweight and obesity were examined by DQS quintile, using the first quintile (highest diet quality) as the reference category. Results: The prevalence of normal weight, overweight and obese was 75, 19 and 6 % respectively. DQS ranged from -5 to 25, higher scores indicated higher diet quality in the continuous score. In analyses adjusted for gender, parent's education, physical activity and T.V. viewing, child obesity but not overweight was significantly associated with poor diet quality: OR of 1.56 (95 % CI 1.02 2.38) in the 5th compared to the 1st DQS quintile. Findings from individual food items were inconsistent. Conclusions: The findings suggest that diet quality may be an important factor in childhood obesity. A simple DQS developed from a short dietary assessment tool is significantly associated with childhood obesity. [ABSTRACT FROM AUTHOR]

Socio-economic gradients in diet quality are well established. However, the influence of material socio-economic conditions particularly in childhood, and the use of multiple disaggregated socio-economic measures on diet quality have been little studied in the elderly. In the present study, we examined childhood and adult socio-economic measures, and social relationships, as determinants of diet quality cross-sectionally in 4252 older British men (aged 60–79 years). A FFQ provided data on daily fruit and vegetable consumption and the Elderly Dietary Index (EDI), with higher scores indicating better diet quality. Adult and childhood socio-economic measures included occupation/father's occupation, education and household amenities, which combined to create composite scores. Social relationships included social contact, living arrangements and marital status. Both childhood and adult socio-economic factors were independently associated with diet quality. Compared with non-manual social class, men of childhood manual social class were less likely to consume fruit and vegetables daily (OR 0·80, 95 % CI 0·66, 0·97), as were men of adult manual social class (OR 0·65, 95 % CI 0·54, 0·79), and less likely to be in the top EDI quartile (OR 0·73, 95 % CI 0·61, 0·88), similar to men of adult manual social class (OR 0·66, 95 % CI 0·55, 0·79). Diet quality decreased with increasing adverse adult socio-economic scores; however, the association with adverse childhood socio-economic scores diminished with adult social class adjustment. A combined adverse childhood and adulthood socio-economic score was associated with poor diet quality. Diet quality was most favourable in married men and those not living alone, but was not associated with social contact. Diet quality in older men is influenced by childhood and adulthood socio-economic factors, marital status and living arrangements. [ABSTRACT FROM PUBLISHER]

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Background: There is a growing interest in the New Nordic Diet (NND) as a potentially health promoting, environmentally friendly, and palatable regional diet. Also, dietary scores are gaining ground as a complementary approach for examining relations between dietary patterns and various health outcomes. A score assessing adherence to the NND has earlier been published, yet not tested for reliability. Objective: To assess the test–retest reliability of the NND score in a sample of parents of toddlers, residing in Southern Norway. Design: A questionnaire survey was completed on two occasions, approximately 14 days apart, by 67 parents of toddlers [85% females, mean age 34 years (SD=5.3 years)]. The NND score was constructed from 24 items and comprised 10 subscales that summarize meal pattern and intake of typical Nordic foods. Each subscale was dichotomized by the median and assigned values of ‘0’ or ‘1’. Adding the subscales yielded a score ranging from 0 to 10, which was further trichotomized. Test–retest reliability of the final NND score and individual subscales was assessed by Pearson’s correlation coefficient and Spearman’s rank correlation coefficient, respectively. Additionally, cross tabulation and kappa measure of agreement (k) were used to assess the test–retest agreement of classification into the NND score, and the subscales. Results: Test–retest correlations of the NND score and subscales were r=0.80 (Pearson) and r=0.54–0.84 (Spearman), respectively, all p<0.001. There were 69% (k=0.52) and 67–88% (k=0.32–0.76) test–retest correct classification of the trichotomized score and the dichotomized subscales, respectively. Conclusion: The NND score and the 10 subscales appear to have acceptable test–retest reliability when tested in a sample of parents of toddlers. [ABSTRACT FROM AUTHOR]

ObjectiveThe health-related effects of the Nordic diet remain mostly unidentified. We created a Baltic Sea Diet Score (BSDS) for epidemiological research to indicate adherence to a healthy Nordic diet. We examined associations between the score and nutrient intakes that are considered important in promoting public health. We also examined the performance of the BSDS under two different cut-off strategies.DesignThe cross-sectional study included two phases of the National FINRISK 2007 Study. Diet was assessed using a validated FFQ. Food and nutrient intakes were calculated using in-house software. Nine components were selected for the score. Each component was scored according to both sex-specific consumption quartiles (BSDS-Q) and medians (BSDS-M), and summed to give the final score values.SettingA large representative sample of the Finnish population.SubjectsMen (n 2217) and women (n 2493) aged 25 to 74 years.ResultsIn the age- and energy-adjusted model, adherence to the diet was associated with a higher intake of carbohydrates (E%), and lower intakes of SFA (E%) and alcohol (E%, where E% is percentage of total energy intake; P < 0·01). Furthermore, the intakes of fibre, Fe, vitamins A, C and D, and folate were higher among participants who adhered to the diet (P < 0·05). After further adjustments, the results remained significant (P < 0·05) and did not differ remarkably between BSDS-Q and BSDS-M.ConclusionsThe BSDS can be used as a measure of a healthy Nordic diet to assess diet–health relationships in public health surveys in Nordic countries. [ABSTRACT FROM AUTHOR]

The population is aging worldwide. Delayed mortality is associated with an increased burden of chronic health conditions, many of which have a dietary component. A literature search was conducted to retrieve and review relevant articles considering quality of diets in association with mortality in older adults aged 60 years and older. In the studies we reviewed, diet quality defined using either a priori methods, which characterize dietary patterns based on existing dietary guidelines, or a posteriori methods, which define dietary patterns through statistical methods met review criteria. Sixteen articles met criteria for review. Generally, dietary patterns that demonstrated greater adherence to diets that emphasized whole fruits and vegetables, whole grains, low-fat dairy, lean meats, and legumes and nuts were inversely associated with mortality. However, a priori methods have not yet demonstrated associations between diet and mortality in older adults in the United States. Development of new methods based on regional variations in dietary intake may offer the best approach to assess associations with mortality. [ABSTRACT FROM PUBLISHER]

Diet is essential to health and can modulate inflammatory markers, the microbiota, and epigenetic outcomes. Proper nutrition is also key to good postsurgical outcomes. Diet is challenging to study, resulting in a relative dearth of influential studies. There is substantial evidence regarding the benefits of a whole food plant-predominant diet on health and longevity, in general, but limited evidence regarding otolaryngologic disorders. Diet may be associated with the risk of head and neck cancer, hearing loss, laryngopharyngeal reflux, and sinonasal symptoms. Evidence, however, is heterogenous and often insufficient for treatment recommendations. Many opportunities exist for future research and expansion.., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Abstract: Objective: To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population. Methods: Data about 20 717 subjects aged 45–59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein. Results: Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09–3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35–2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level. Conclusion: High fat-low carbohydrate diets, far different from traditional Chinese diets, are associated with the high incidence of type 2 diabetes in Chinese population. [Copyright &y& Elsevier]

Over the past four decades, the prevalence of asthma has markedly increased in Westernized countries and countries transitioning to this lifestyle. It has been hypothesized that these increases are a consequence of changing environmental and/or behavioral factors. The modification of dietary habits (ie, decreased intake of fruits/vegetables and increased intake of 'Westernized' processed foods) and a decrease in sun exposure have led to decreased intake of antioxidant vitamins and fatty acids and to decreased circulating levels of vitamin D, and have been proposed to explain the rise in asthma prevalence. This article summarizes the main findings on foods and nutrients connected to asthma based on several exhaustive recent reviews on the topic, and examines the evidence for an effect of dietary patterns on asthma. Overall, findings underscore the importance of conducting prospective studies and clinical trials to better understand the role of diet in the etiology of asthma. [ABSTRACT FROM AUTHOR]

We have assessed serum lipids, systolic (SBP) and diastolic (DBP) blood pressure in a healthy, free living population over 70 years old residing for more than 20 years in a rural area Iocated in the southern Spain, the Sierra de Huelva. 401 elderly, 229 women (F) and 179 men (M) mean age 79.36 ± 6.9 were included in this cross-sectional observational study. Dietary habits were assessed by means of a Modification of the Mediterranean Diet Score (MDDS), which comprised 11 components. A total score ranging from 0-44 was calculated. Mean concentration for lipids were: Total cholesterol (TC) 193.8 ± 23.1, M 195.2 ± 25.7 and F 192.7 ± 20.8 (p = 0.29); HDLc 60.3 ± 7.6 mg/dl, M 60.0 ± 8.0 and F 60.5 ± 7.2 (p = 0.49); TC/HDLc 3.3 ± 1.1 mg/dl, M 3.4 ± 1.2 and F 3.3 _ 1.1 mg/dl (p = 0.35); LDLc 127.3 ± 30.1 mg/dl, M 129.0 ± 32.9 F 126.0 ± 27.8 mg/dl (p = 0.33); TG 137.7 ±18.3, M 138.8 ± 19.4 and F 136 ± 17.4 (p = 0.30). Global prevalence of hypercholesterolemia (TC≥ 200 mg/dl) was 8.7%, F 7.9% and M 9.9%; 10.7% had LDL≥160 mg/dl. In this study, age was negatively correlated (p < 0.05) with TC, LDLc, TG and SBP and positively with HDLc. Pig meat consumption was negatively correlated with CT and LDLc, and positively with HDLc. According to MMDS data, 60.6 ± 6.9% of adherence to the Mediterranean diet was obtained. The MMDS was positively associated with age and negatively with TG (p < 0.05). Further studies are needed to establish the influence of local Iberian pig meat products consumption and life style on the Iower incidence of risk factors for CVD and the higher life expectancy of the studied population. [ABSTRACT FROM AUTHOR]

Background/Objectives:To study quality of diet in relation to all-cause mortality, cardiovascular disease (CVD) and cancer mortality.Subjects/Methods:The population-based prospective Cohort of Swedish Men (COSM) included 40 837 men, 45–79 years of age, who filled in a FFQ (96 food items) and were CVD- and cancer-free at baseline. Quality of diet was assessed by Recommended Food Score (RFS) based on 36 items and Non-Recommended Food Score (Non-RFS) based on 16 items. Cox's proportional hazards regression models were used to estimate the hazard ratios (HRs) of mortality and 95% confidence intervals (CIs). Multivariate HRs for RFS and Non-RFS were adjusted for age, education, physical activity, martial status, self-perceived health status, smoking status, dietary supplements use, WHR, alcohol use, intake of energy and mutually adjusted.Results:Between 1998 and 2005, 4501 deaths from all-causes were registered. Between 1998 and 2003, there were 1394 CVD and 759 cancer deaths. High RFS (28) compared with low (20) was associated with lower risk of all-cause mortality (HR: 0.81; 95% CI: 0.71–0.91; P-value for trend<0.0001) and CVD mortality (HR: 0.71; 95% CI: 0.54–0.93; P-value for trend=0.003). In contrast, men with high Non-RFS (5) had higher risk of all-cause (HR: 1.21; 95% CI: 1.09–1.34; P-value for trend=0.001) and CVD mortality (HR: 1.27; 95% CI: 1.05–1.54; P-value for trend=0.07) compared to those with low Non-RFS (2 items). No significant associations with cancer mortality were observed.Conclusions:Both measures of diet quality, RFS and Non-RFS, showed statistically significant associations with all-cause and CVD mortality (recommended foods inversely while nonrecommended foods positively), but not with cancer mortality.European Journal of Clinical Nutrition (2009) 63, 451–457; doi:10.1038/sj.ejcn.1602968; published online 5 December 2007 [ABSTRACT FROM AUTHOR]

Abstract: Indices are composite tools aiming to measure and quantify a variety of clinical conditions, behaviors, attitudes and beliefs that are difficult to be measured quantitatively and accurately. In this review, the methodology used to develop dietary indices and their relationship with health determinants and outcomes is discussed. In brief, the already proposed indices are adequate tools concerning the evaluation of diet quality, but they have shown moderate predictive ability in relation to chronic diseases and health determinants. The aforementioned weaknesses could be attributed to: inappropriate selection of the components (i.e., number or content of dietary information), selection of small number of cut-off points for each component and/or equal contribution of all index items to the calculation of the total score. Nevertheless, dietary indices are important tools to evaluate not only the diet quality, but also the relationship between dietary habits and several health outcomes. [Copyright &y& Elsevier]

The literature on predefined indexes of overall diet quality is reviewed. Their association with nutrient adequacy and health outcome is considered, but our primary interest is in the make-up of the scores. In total, twenty different indexes have been reviewed, four of which have gained most attention, and many others were based on those four. The various scores differ in many respects, such as the items included, the cut-off values used, and the exact method of scoring, indicating that many arbitrary choices have been made. Correlations in intake between dietary components may not be adequately addressed. In general, diet quality scores show an association with mortality or disease risk, but these relations are generally modest. Existing indexes do not predict morbidity or mortality significantly better than individual dietary factors. Although conclusions from the review may provide guidance in the construction of a diet quality score, it is questionable whether a dietary score can be obtained that is a much better predictor of health outcome. [ABSTRACT FROM PUBLISHER]