7-day Recall Research Articles

A Prospective Study of the Relationship Between Dietary Patterns during the Second Trimester of Pregnancy and Gestational Weight Gain

To study dietary patterns during the second trimester of pregnancy and to investigate the relationship between dietary patterns and gestational weight gain (GWG). A prospective cohort study was conducted to select healthy singleton pregnant women at 8-14 weeks of gestation in a maternal and child health care institution in Chengdu city. Food items and quantities were collected at 8-14, 24-28, 32-36 weeks of gestation by using the 3-day 24-hour dietary recall and energy intakes were calculated. Dietary patterns during the second trimester were established by factor analysis and factor scores were calculated. The weight of pregnant women was measured at 8-14, 24-28 weeks of gestation and 1 week before delivery, and the total GWG and the GWG rates in the second and third trimesters were calculated. Multiple linear regression analyses were used to analyze the association between dietary patterns and GWG. A total of 1 004 samples were included. Three dietary patterns were identified: Milk-egg-whole grain pattern, Beverage-dessert pattern and Traditional pattern. The average total GWG was (13.2±4.5) kg. The average weight gain rate was (0.4±0.2) kg/week in the second trimester. The average weight gain rate was (0.5±0.3) kg/week in the third trimester. After adjusting for confounding factors including maternal age, body mass index before pregnancy, dietary energy intake, physical activity, multiple linear regression analysis showed that the factor score of Beverage-dessert pattern was positively associated with the total GWG and the weight gain rate in the third trimester ( β=0.370, 95% confidence interval ( CI): (0.103, 0.636), P=0.007; β=0.014, 95% CI: (0.000, 0.027), P=0.049, respectively), and the factor score of Traditional pattern was negatively associated with the total GWG ( β=-0.285, 95% CI: (-0.555, -0.015), P=0.039). There was no association between the Milk-egg-whole grain pattern and GWG. Dietary patterns during the second trimester of pregnancy are associated with GWG. The Beverage-dessert pattern may increase the total GWG and weight gain rate in the third trimester. The traditional pattern may help control the total GWG.

Determinants of antiretroviral therapy adherence among older adolescents living with HIV in Kenya during the transition to adult care; An observational study.

Lower levels of adherence to antiretroviral therapy (ART) among older adolescents as compared to adults are influenced by individual, psychosocial, and treatment-related factors. Successful transition of older adolescents into HIV adult care from paediatric & adolescent focused care requires an understanding of barriers to ART adherence. This study aimed at determining individual factors affecting ART adherence among older HIV positive adolescents transitioning to adult care. Between December 2018 and January 2019, we conducted a cross-sectional study among 82 perinatally infected adolescents aged 16-19 years in an HIV care and treatment clinic in Nairobi, Kenya. We used completed structured questionnaires and abstracted data from clinical charts. We performed multivariate logistic regression to identify factors independently associated >95% self-reported ART adherence (7-day recall). The study participants had a median age of 17 (IQR 16,18) on ART for a median duration of 11 years (IQR 7,13). Sixty-four per cent (52) of the adolescents reported optimal adherence was of >95%, and 15% reported missing doses for three or more months. Self -reported adherence had a high correlation with viral loads of <1000 copies ml (Kappa= 0.087). Adolescents with high self-efficacy were eight times more likely to report adherence of >95% [OR 8.1, 95% CI (2.31- 28.18)]. Once a day, dosing was also independently associated with adherence [OR 1.58, 95 %CI [0.62-4.08]. The reduction of ART pill burden and the inclusion of assessment of ART self -efficacy may contribute to transition preparedness among adolescents.

Dietary patterns among pregnant women in the SELMA study

Background: Nutrition is important during pregnancy both for the health of the mother and fetal development. There are nutritional guidelines for pregnant women in order to get the nutrients that are needed for healthy pregnancy outcomes. Our objective was to identify dietary patterns among pregnant women. Methods: We used data from 1,770 pregnant women participating in the Swedish Environmental Longitudinal Mother and child Asthma and allergy (SELMA) study. Food intake was collected through a 30-day recall food-frequency questionnaire during 2nd trimester of pregnancy. Dietary intake was calculated to grams per day. We performed principal component (PC) analysis to identify different food patterns. Results: Overall, women were 31 years of age, of normal weight (BMI=25), a college degree or higher (65%), and were mainly non-smokers (95%). We found 11 principal components (PC) with eigenvalues above 1 explaining 61% of the dietary variation. PC1, representing 13% of the variance, showed a varied diet with higher positive loadings for meat, fish, vegetables, fruits, cakes, and sweets. PC2 (8% variance) had higher loadings on cakes and sweets and lower on vegetables, whereas PC3 (7% variance) had negative loadings on fish. The group in PC4 (6% variance) had a less varied diet with positive loadings on sweets and vegetables but negative loadings on dairy, cereals, meat and fish. Women in PC8 (4% variance) ate more dairy, meat and fish but no sweets, bread or cereals. These dietary patterns are currently being analyzed with a nutrition index based on nutritional guidelines and with prenatal exposure to endocrine disruptors (EDCs) in a mixture analysis. Conclusion: Results provide a depiction of women’s dietary patterns during mid-pregnancy. They will be further analyzed with prenatal nutrient intake and exposure to EDCs in order to get a better understanding of the relationship between food patterns, nutrition, and exposure to EDCs

Development and content validation of the Pediatric Oral Medicines Acceptability Questionnaires (P-OMAQ): patient-reported and caregiver-reported outcome measures

BackgroundEvolving regulatory guidelines recommend routine assessment of the acceptability of pediatric oral medicines throughout clinical development processes. However, such assessment is problematic owing to a lack of standard methods or criteria that define acceptability for children and their caregivers. This research aimed to identify the attributes of acceptability for targeted oral formulation types that are important to children, and to develop content-valid patient- and caregiver-reported outcome acceptability measures for use in the context of clinical drug development.MethodsA concept-focused literature review and two advisory panel meetings involving researchers, clinicians, and measurement scientists were conducted to identify acceptability attributes that may be relevant to children taking targeted oral medicine formulations. The Pediatric Oral Medicines Acceptability Questionnaires (P-OMAQs), including patient (P-OMAQ-P) and caregiver (P-OMAQ-C) versions, were drafted to assess these attributes. Qualitative concept elicitation (CE) and cognitive debriefing (CD) patient and caregiver interviews were conducted to confirm key acceptability attribute concepts for measurement and to evaluate patient and caregiver ability to understand and respond to the questions.ResultsA full-text review of 40 articles identified 24 acceptability attributes that were categorized into 10 overarching domains and organized into a preliminary conceptual model. Feedback from the advisory panel refined the preliminary model. In total, 14 attributes were reported during the CE phase of the interviews (n = 23 pediatric patients, n = 13 caregivers); six attributes were included in the final model. The draft P-OMAQ was refined over four waves of CD interviews (n = 31 pediatric patients, n = 48 caregivers). The final version of the P-OMAQ-P is a 12-item questionnaire designed for young people aged 8–17 years. The P-OMAQ-C is a 19-item questionnaire designed for adult caregivers of young people aged 6 months to 17 years. There are two versions of each questionnaire: one with a 24-h recall period and one with a 7-day recall period. All items are answered on a 5-point numerical rating scale.ConclusionsThis research supports the content validity of the patient and caregiver versions of the P-OMAQ. Both questionnaires appropriately assess the acceptability of oral medicine formulations from the perspective of pediatric patients and their caregivers.

Cardiorespiratory Fitness and Diet Quality Profile of the Lithuanian Team of Deaf Women's Basketball Players.

There are about 466 million people with hearing impairments in the world. The scientific literature does not provide sufficient data on the actual nutrition and other variables of professional deaf athletes. The objectives of this study were to investigate and evaluate the body composition, the physical working capacity, the nutrition intake, and the blood parameters of iron and vitamin D in the Lithuanian high-performance deaf women’s basketball team players. The female athletes (n = 14) of the Lithuanian deaf basketball team aged 26.4 ± 4.5 years were recruited for an observational cross-sectional study. A 7-day food recall survey method was used to investigate their actual diet. The measurements of the body composition were performed using the BIA (bioelectrical impedance analysis) tetra-polar electrodes. In order to assess the cardiorespiratory and aerobic fitness levels of athletes, ergo-spirometry (on a cycle ergometer) was used to measure the peak oxygen uptake (VO2peak) and the physical working capacity at a heart rate of 170 beats per minute (PWC170). The athletes’ blood tests were taken to investigate the red blood cells, hemoglobin, 25-hydroxyvitamin D, ferritin, transferrin, iron concentrations, and total iron-binding capacity (TIBC). The consideration of the VO2peak (55.9 ± 6.1 mL/min/kg of body weight, 95% CI: 51.8, 58.9) and the low VO2peak (56–60 mL/min/kg of body weight) (p = 0.966) in the deaf women’s basketball team players revealed no differences. For the deaf female athletes, the PWC170 was equal to 20.3 ± 2.0 kgm/min/kg of body weight and represented only the average aerobic fitness level. The carbohydrate and protein intakes (5.0 ± 1.3 and 1.3 ± 0.3 g/kg of body weight, respectively) met only the minimum levels recommended for athletes. The fat content of the diet (38.1 ± 4.1% of energy intake) exceeded the maximum recommended content (35% of energy intake) (p = 0.012). The mean blood serum concentrations of 25(OH)D and ferritin (24.1 ± 6.6 nmol/L and 11.0 ± 4.1 µg/L, respectively) predicted vitamin D and iron deficits in athletes. Female athletes had an increased risk of vitamin D and iron deficiencies. Regardless of iron deficiency in the body, the better cardiorespiratory fitness of the deaf female athletes was essentially correlated with the higher skeletal muscle mass (in terms of size) (r = 0.61, p = 0.023), the lower percentage of body fat mass (r = −0.53, p = 0.049), and the reduced intake of fat (r = −0.57, p = 0.040).

Abstract A16: Use of a smartphone application for weight loss versus a paper-based dietary diary: A randomized trial

Abstract Objectives: The World Health Organization (WHO) announced in 2018 that one-third of deaths from cancer are due to dietary and behavioral risks including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use. Therefore, effective intervention strategies to maintain a balanced diet and healthy weight are needed to reduce the burden of cancer. There is increasing evidence that mobile health (mHealth) tools have value in dietary monitoring and assessment. This study aims to evaluate the effectiveness of the smartphone application (app) for weight loss versus a paper-based dietary diary among adults with a body mass index (BMI) of 23 kg/m2 or above. Methods: A total of 33 men and 17 women aged 18-39 years participated in a six-week randomized trial. We randomly assigned participants to one of two groups: (A) smartphone app group (n=25) or (B) paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using “Well-D”—a self-dietary monitoring app developed by our team. The paper-diary group was instructed to record foods or supplements that they consumed using the self-recorded diary. The primary outcomes were weight, BMI, and waist circumference. We also examined changes in nutrient intakes including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals using 3-day 24-hour recalls (24HR) across time at pre- and post-intervention. Differences between pre- and post-interventions within each group were compared using a paired t-test or Wilcoxon signed rank test. Differences in changes between the two groups were analyzed using an independent t-test. Results: Body weight, BMI, and waist circumference were not significantly different between the app group and paper-diary group (p&amp;gt;0.2). We observed a significant decrease in BMI in the paper-diary group (p=0.02) but not in the Well-D group (p=0.26) upon comparing pre-intervention anthropometric measures with the post-intervention measures. The waist circumferences decreased significantly in both groups (p&amp;lt;0.01). The caloric intake decreased from pre- to post-intervention in both groups (p=0.04 for the Well-D group and p=0.06 for the paper-diary group). However, the changes in nutrient intakes were not statistically significant between the two groups. Conclusions: There were no differences in body weight, BMI, waist circumference, and nutrient intakes between the app group and the paper-diary group. Body weight and BMI were reduced from pre- to post-intervention in the paper-diary group and waist circumference was reduced in both groups. Funding: This research was supported by the MSIT (Ministry of Science and ICT), Korea, under the ITRC (Information Technology Research Center) support program (IITP-2018-2014-1-00720) supervised by the IITP (Institute for Information &amp; Communications Technology Promotion). Citation Format: Jeong Sun Ahn, Heejin Lee, Jiae Kim, Haemin Park, Dong Woo Kim, Jung Eun Lee. Use of a smartphone application for weight loss versus a paper-based dietary diary: A randomized trial [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A16.

Prevalence of adherence to cardiovascular drugs in outpatients with coronary artery disease

Objectives: To describe the prevalence of adherence to drug treatment and the association with sociodemographic, clinical and pharmacotherapeutic factors, in patients diagnosed with coronary artery disease, seen at a multiprofessional cardiology clinic in a public hospital in Belo Horizonte, Minas Gerais. Methods: This is a cross-sectional study conducted between April 2018 and February 2019 in a multiprofessional outpatient cardiology clinic at a teaching hospital. The dependent variable is adherence to treatment with cardiovascular drugs measured by self-report using the 7-day recall and the independent variables evaluated were the sociodemographic, clinical and pharmacotherapeutic variables. Descriptive analysis was performed using frequency distributions for categorical variables and measures of central tendency and dispersion for continuous variables. The association between treatment adherence and independent variables was performed using bivariate analysis using Pearson's chi-square test and the magnitude of the association was expressed by the odds ratio with a 95% confidence interval. Results: 148 patients with a median age of 62 years (IQR = 17.0), mostly male (104; 70.3%) and a median of four years of education (IQR = 4.0). The most prevalent cardiovascular diagnosis was ST-segment elevation acute myocardial infarction (58.8%), followed by non-ST-segment elevation acute myocardial infarction (26.4%) and arrhythmia (23.7%). The most frequent comorbidities were hypertension (72.3%) and diabetes (33.1%). Beta-blockers 98.1% (n = 130) and renin-angiotensin system agents 68.3% (n = 101) were the most commonly used cardiovascular drug classes. No statistically significant association was identified between adherence and sociodemographic, clinical and pharmacotherapeutic factors. Conclusion: The frequency of adherence to treatment measured by 7-days recall was high.

Human Milk Intake of Thai Breastfed Infants During the First 6 Months Using the Dose-to-Mother Deuterium Dilution Method.

Data on infant human milk intakes in low- and middle-income countries are limited, although the deuterium oxide dose-to-mother method (DTM) is an accurate tool for its estimation. We assessed human milk intakes of Thai infants during the first 6 months comparing exclusive breastfeeding (EBF), predominant breastfeeding (PBF), and partial breastfeeding (PartBF). One hundred and ten healthy Thai lactating mother-infant pairs were followed from birth. Human milk intakes were determined at 6 weeks, 3 months, and 6 months using the DTM method. Daily energy and protein intakes were assessed using 3-day nonconsecutive 24-hour recalls. Sociodemographic characteristics were collected using a questionnaire. To compare breastfeeding practices, one-way analysis of variance with Tukey post hoc test assessed normally distributed data, while the Kruskal-Wallis test with Mann-Whitney U test was used for not normally distributed data. No difference existed in human milk intakes during the first 6 months between EBF (743-776 g/d) and PBF (748-862 g/d). Human milk intakes of PartBF infants were significantly lower compared to other infants. Human milk intake was sufficient to meet infant energy and protein requirements during the first 3 months for EBF and PBF groups. Infant formula largely replaced human milk during the first 3 months; other solid foods were also introduced among the PartBF infants. Human milk intakes were comparable between EBF and PBF infants during the first 6 months and provided adequate energy and protein to meet requirements. Infant formula largely replaced breast milk among PartBF infants, although other foods were also given early. This study was registered at clinicaltrials.gov as NCT04020640.

Association between dietary glycemic load during first trimester and the risk of gestational diabetes mellitus: a prospective study

Objective: To explore the effects of dietary glycemic load (GL) during first trimester on the risk of gestational diabetes mellitus (GDM). Methods: A prospective study was conducted among healthy women with singleton pregnancy at 8-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu, Sichuan province. Information on dietary intake during the first trimester was collected through a 3-day 24-hour dietary recall. Glycemic index (GI) values were obtained from China Food Composition Tables (Standard Edition) and International Tables of Glycemic Index and Glycemic Load Values (2008). Dietary GL and GLs of staple foods were calculated based on GI values and the amount of carbohydrate consumed per day. Diagnostic criteria of GDM was followed the Guidelines for Diagnosis and Treatment of Pregnancy Diabetes in China (2014), and used on participants who underwent an oral glucose tolerant test during 24-28 weeks of gestation. Log-binomial regression models were used to explore the associations between both quartiles of dietary GL, GLs of staple foods and the risks of GDM,respectively. Results: The medians of dietary GL and GL of staple foods were 145.70 (113.23-180.85) and 121.05 (89.08-155.70), respectively. The median GL of both rice and tubers were 73.14 (43.89-107.50) and 3.43 (0.00-9.84), respectively. After adjusting for the age at pregnancy, pre-pregnancy body mass index and other confounding factors, results of log-binomial regressions analysis showed that when compared with the lowest quartile of dietary GL group, the third and highest quartiles of dietary GL groups increased the risk of GDM (RR=1.47, 95%CI: 1.20-1.80; RR=1.31, 95%CI: 1.04-1.64), respectively. Compared with the lowest quartile of GL of staple foods, the third and highest quartiles of GL of staple foods groups also increased the risk of GDM (RR=1.28, 95%CI: 1.04-1.58; RR=1.27, 95%CI: 1.02-1.60), respectively. The third and highest quartiles of GL of rice groups increased the risk of GDM (RR=1.30, 95%CI: 1.06-1.59; RR=1.28, 95%CI: 1.03-1.59), respectively, than the lowest quartile of GL of rice group. When compared with the lowest quartile of GL of tubers group, the highest quartile of GL of tubers group increased the risk of GDM (RR=1.30, 95%CI: 1.09-1.54). However, we did not notice the effects of wheat GL and coarse grain GL on the risk of GDM. Conclusions: A positive association was found between dietary glycemic load and the risk of GDM. Higher dietary glycemic load, especially in rice and tubers during first trimester, seemed to have increased the risk of GDM.

Relationships between excessive gestational weight gain and energy and macronutrient intake in pregnant women.

ObjectiveThis study aimed to compare energy and macronutrient intake, birth weight, and anthropometric parameters (mid-upper arm circumference or tricipital skin-fold thickness) between women who had adequate and excessive gestational weight gain (GWG) during pregnancy.MethodsWe studied 115 pregnant women and divided them according to GWG into two groups: adequate GWG (n = 49) and excessive GWG (n = 66). We assessed the medical history, clinical examinations, and dietary habits through a detailed 7-day dietary recall using myfitnesspal software.ResultsWeight, body mass index, mid-upper arm circumference, and tricipital skin-fold thickness were significantly higher at the time of delivery in women with excessive GWG compared with those with adequate GWG. A lipid-based diet was a risk factor for excessive GWG (relative risk: 1.488, 95% confidence interval: 1.112–1.991), whereas a protein-based diet was a protective factor (relative risk: 0.6723, 95% confidence interval: 0.4431–1.020). We found no significant relationship between a carbohydrate-based diet and GWG. The total energy intake was significantly higher in the excessive GWG group than in the adequate GWG group.ConclusionsMainly a lipid-based diet in pregnant women might represent a risk factor for excessive GWG. However, a protein-based diet is a protective factor for excessive GWG.

Use of a Smartphone App for Weight Loss Versus a Paper-Based Dietary Diary in Overweight Adults: Randomized Controlled Trial

BackgroundMobile health (mHealth) tools may be useful platforms for dietary monitoring and assessment.ObjectiveThis study aims to evaluate the effectiveness of a mobile dietary self-monitoring app for weight loss versus a paper-based diary among adults with a BMI of 23 kg/m2 or above.MethodsA total of 33 men and 17 women aged 18-39 years participated in a 6-week randomized controlled trial. We randomly assigned participants to one of two groups: (1) a smartphone app group (n=25) or (2) a paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using Well-D, a dietary self-monitoring app developed by our team. The paper-based diary group was instructed to record foods or supplements that they consumed using a self-recorded diary. The primary outcomes were weight, BMI, waist circumference, body fat mass, and skeletal muscle mass. We also examined changes in nutrient intake, including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals, using 3-day 24-hour recalls. Differences in changes between the two groups were analyzed using independent t tests or Wilcoxon Mann-Whitney tests. All of the data were analyzed using intent-to-treat analysis.ResultsThe mean number of days recorded was 18.5 (SD 14.1) for the app group and 15.5 (SD 10.1) for the paper-based diary group. The differences in changes in weight, BMI, and waist circumference were not significantly different between the app group and paper-based diary group (P=.33, .34, and .70, respectively). Similarly, changes in body fat mass or skeletal muscle mass did not differ between the two groups (P=.71 and .054, respectively). Although energy intake was reduced in both groups, there was no significant difference in changes in energy intake between the two groups (P=.98).ConclusionsThere were no differences in changes in anthropometric measures and nutrient intake between the app group and the paper-based diary group. Both mobile dietary self-monitoring app and paper-based diary may be useful for improving anthropometric measures.Trial RegistrationClinical Research Information Service KCT0003170; https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=11642<ype=&rtype=

The development of a Chinese Healthy Eating Index for School-age Children and its Application in children from China Health and Nutrition Survey

This study aimed to develop a Chinese Healthy Eating Index for School-age Children (CHEI-SC), apply it in the 2011 China Health and Nutrition Survey (CHNS) to assess dietary quality, and compared it with our former developed index named CHEI. Data of 3-day 24-hour diet recalls and household food inventory survey from 1600 school-age children in CHNS-2011 were used to develop the CHEI-SC, using the methods of standard portion size, energy-density-based approach, and least restrictive approach. The CHEI-SC included 19 components with a total score (T-score) ranging from 0 to 100. The investigated children had a median score of 49.6. Children with a higher T-score were more likely to have higher social economic status (SES), higher level of urbanisation, fewer family size, and regularly attending school. The CHEI-SC was able to assess dietary quality of Chinese school-age children, was sensitive to demographics, and more comprehensive and accurate than the CHEI.

Patient demographic and psychosocial characteristics associated with 30-day recall of self-reported lower urinary tract symptoms.

Measurement of self-reported lower urinary tract symptoms (LUTS) typically uses a recall period, for example, "In the past 30 days…." Compared to averaged daily reports, 30-day recall is generally unbiased, but recall bias varies by item. We examined the associations between personal characteristics (eg, age, symptom bother) and 30-day recall of LUTS using items from the Symptoms of Lower Urinary Tract Dysfunction Research Network Comprehensive Assessment of Self-reported Urinary Symptoms questionnaire. Participants (127 women and 127 men) were recruited from 6 US tertiary care sites. They completed daily assessments for 30 days and a 30-day recall assessment at the end of the study month. For each of the 18 tested items, representing 10 LUTS, the average of the participant's daily responses was modeled as a function of their 30-day recall, the personal characteristic, and the interaction between the 30-day recall and the characteristic in separate general linear regression models, adjusted for sex. Nine items representing 7 LUTS exhibited under- or overreporting (recall bias) for at least 25% of participants. Bias was associated with personal characteristics for six LUTS. Underreporting of incontinence was associated with older age, lower anxiety, and negative affect; overreporting of other LUTS was associated with, symptom bother, symptom variability, anxiety, and depression. We identified under- or overreporting that was associated with personal characteristics for six common LUTS. Some cues (eg, less bother and lower anxiety) were related to recall bias in an unexpected direction. Thus, providers should exercise caution when making judgments about the accuracy of a patient's symptom recall based on patient demographic and psychosocial characteristics.

Association of dietary patterns with serum phosphorus in maintenance haemodialysis patients: a cross-sectional study

Sources of dietary phosphate differentially contribute to hyperphosphatemia in maintenance haemodialysis (MHD) patients. This cross-sectional study in Malaysia investigated association between dietary patterns and serum phosphorus in MHD patients. Dietary patterns were derived by principal component analysis, based on 27 food groups shortlisted from 3-day dietary recalls of 435 MHD patients. Associations of serum phosphorus were examined with identified dietary patterns. Three dietary patterns emerged: Home foods (HFdp), Sugar-sweetened beverages (SSBdp), and Eating out noodles (EO-Ndp). The highest tertile of patients in HF (T3-HFdp) pattern significantly associated with higher intakes of total protein (p = 0.002), animal protein (p = 0.001), and animal-based organic phosphate (p < 0.001), whilst T3-SSBdp patients had significantly higher intakes of total energy (p < 0.001), inorganic phosphate (p < 0.001), and phosphate:protein ratio (p = 0.001). T3-EO-Ndp patients had significantly higher intakes of total energy (p = 0.033), total protein (p = 0.003), plant protein (p < 0.001), but lower phosphate:protein ratio (p = 0.009). T3-SSBdp patients had significantly higher serum phosphorus (p = 0.006). The odds ratio of serum phosphorous > 2.00 mmol/l was significantly 2.35 times higher (p = 0.005) with the T3-SSBdp. The SSBdp was associated with greater consumption of inorganic phosphate and higher serum phosphorus levels.

Methodological considerations when measuring oral health-related quality of life.

Dental patient-reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence-based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results. In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed. Oral disease-generic and dimension-generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5-item version being the one with the lowest burden for the patient. Responses are given on a 5-point ordinal rating scale, the recommended response scale for dPROMs. A 7-day recall period allows for assessment of short-term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument. OHIP-5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions.

Design and rationale for a randomized trial of a theory- and technology- enhanced physical activity intervention for Latinas: The Seamos Activas II study

IntroductionLatina women report disproportionately high rates of physical inactivity and related chronic health conditions. Physical activity (PA) efforts to date have shown modest success in this at-risk population; thus, more effective interventions are necessary to help Latinas reach national PA guidelines and reduce related health disparities. This paper describes the design, rationale, and baseline findings from the Seamos Activas II intervention. Methods/DesignThe ongoing RCT will test the efficacy of the Seamos Saludables PA print intervention vs. a theory-and technology-enhanced version (Seamos Activas II). The purpose of the study is to increase the percentage of Latinas meeting the national PA guidelines compared to the prior trial, improve biomarkers related to disease, and extend generalizability to a broader and more representative population of Latinas (i.e. Mexican/Mexican-Americans). Intervention refinements included further targeting key constructs of Social Cognitive Theory, and incorporating interactive text message-based self-monitoring strategies. The primary outcome is change in minutes per week of MVPA measured by ActiGraph GT3X+ accelerometers at 6- and 12-months. Secondary PA outcomes assessed by the 7-Day PA Recall will be used to corroborate findings. ResultsParticipants (N = 199) are Latinas 18–65 years (mean = 43.8) of predominantly Mexican origin (89%). At baseline, objectively measured MVPA was 39.51 min/week (SD = 71.20, median = 10) and self-reported MVPA was 12.47 min/week (SD = 22.54, median = 0).Participants reported generally low self-efficacy and higher cognitive vs. behavioral processes of change. ConclusionAddressing interactivity and accountability through text messaging, and more rigorously targeting theoretical constructs may be key to helping Latinas achieve nationally recommended PA levels and thereby reducing health disparities.

Associations of dietary diversity with anaemia and iron status among 5- to 12-year-old schoolchildren in South Africa.

To examine the associations of dietary diversity with anaemia and iron status among primary school-aged children in South Africa. An analysis was conducted with pooled individual data from the baseline surveys from three previously conducted independent intervention studies. Two different dietary diversity scores (DDS) were calculated based on data from 1-day (1-d) and 3-day (3-d) dietary recall periods, respectively. Logistic regression analysis was performed to examine the associations of dietary diversity with anaemia and iron status. KwaZulu-Natal and North West provinces, South Africa. Children (n 578) 5- to 12-year-old. A DDS ≤ 4 was associated with higher odds of being anaemic (1-d P = 0·001; 3-d P = 0·006) and being iron deficient (ID) (3-d P < 0·001). For both recall periods, consumption of 'vegetables and fruits other than vitamin A-rich' and 'animal-source foods (ASF)' was associated with lower odds of being anaemic (both P = 0·002), and 'organ meats' with lower odds of being ID (1-d P = 0·045; 3-d P < 0·001). Consumption of 'meat, chicken and fish' was associated with lower odds of being anaemic (P = 0·045), and 'vegetables and fruits other than vitamin A-rich', 'legumes, nuts and seeds' and 'ASF' with lower odds of being ID for the 3-d recall period only (P = 0·038, P = 0·020 and P = 0·003, respectively). In order to improve anaemia and iron status among primary school-aged children, dietary diversification, with emphasis on consumption of vegetables, fruits and ASF (including organ meats), should be promoted.

Physical Activity, Screen Time, and Emotional Well-Being during the 2019 Novel Coronavirus Outbreak in China.

We aimed to evaluate the effects of the COVID-19 lock down on lifestyle in China during the initial stage of the pandemic. A questionnaire was distributed to Chinese adults living in 31 provinces of China via the internet using a snowball sampling strategy. Information on 7-day physical activity recall, screen time, and emotional state were collected between January 24 and February 2, 2020. ANOVA, χ² test, and Spearman’s correlation coefficients were used for statistical analysis. 12,107 participants aged 18–80 years were included. During the initial phase of the COVID-19 outbreak, nearly 60% of Chinese adults had inadequate physical activity (95% CI 56.6%–58.3%), which was more than twice the global prevalence (27.5%, 25.0%–32.2%). Their mean screen time was more than 4 hours per day while staying at home (261.3 ± 189.8 min per day), and the longest screen time was found in young adults (305.6 ± 217.5 min per day). We found a positive and significant correlation between provincial proportions of confirmed COVID-19 cases and negative affect scores (r = 0.501, p = 0.004). Individuals with vigorous physical activity appeared to have a better emotional state and less screen time than those with light physical activity. During this nationwide lockdown, more than half of Chinese adults temporarily adopted a sedentary lifestyle with insufficient physical activity, more screen time, and poor emotional state, which may carry considerable health risks. Promotion of home-based self-exercise can potentially help improve health and wellness.

Associations Among Physical Activity, Protein Intake, And Clinical Indicators Of Sarcopenia

Sarcopenia is characterized by age-related loss of skeletal muscle mass and function, and is associated with increased risk of falls, fractures, and mortality. Physical inactivity and inadequate protein intake are lifestyle factors that may contribute to the development and progression of sarcopenia. Weight-adjusted skeletal muscle index (wSMI), grip-strength (GRIP) and gait-speed (GAIT) are utilized clinically to diagnose sarcopenia. Phase-angle (PhA), obtained via bioelectrical impedance, is predictive of muscular strength and may also be predictive of sarcopenia. The PURPOSE of the study was to evaluate the relationships among indicators of sarcopenia, habitual physical activity, protein intake, and PhA in older adults. METHODS: In 96 subjects (68W/28 M, 68±6years) gait speed, grip strength (dynamometer), body composition (bioelectrical impedance), and habitual physical activity (7-day accelerometry) were measured. wSMI [skeletal muscle mass (SMM)÷body mass (BM)] was also calculated. In a subset of 34 subjects, habitual dietary intake was determined (3-day diet recall). Partial correlations (controlling for age and sex) were utlized to examine the relationships among variables of interest. Significance was set to ɑ< 0.05. RESULTS: Mean values were SMM: 28±6 kg; wSMI: 0.4±0.1; GRIP: 28±9 kg; GAIT: 1.5±0.4 m/s; PhA: 4.9±0.7°; moderate-intensity PA (MOD PA): 58±31 min/day; sedentary time (SED): 707±82 min/day; relative protein intake (RPI): 0.8±0.2 g protein/kg body mass. MOD PA was significantly (p< 0.05) correlated with wSMI (r= 0.28), PBF (r= -0.25), and RPI (r= 0.42). RPI was additionally correlated with PhA (r= 0.37) and body mass (r= -0.44). There was a trend towards a significant correlation between RPI and wSMI (r= 0.29, p= 0.11). GAIT was significantly correlated with activity counts per minute (r= 0.23), PBF (r= -0.47), wSMI (r= 0.45). GRIP was significantly correlated with SMM (r= 0.40). CONCLUSIONS: These data show that greater PA and RPI are associated with better scores for some of the clinical indicators of sarcopenia. Thus, increased PA and RPI intake may represent effective strategies for decreasing the risk of sarcopenia.

539 Validation of the PROMIS Itch Questionnaire – itch severity assessments in adults with atopic dermatitis

Little is known about the validity of numeric and verbal rating scales (NRS and VRS) for itch and itch frequency for assessing itch severity in atopic dermatitis (AD). We evaluated the Patient-Reported Outcomes Information System (PROMIS®) Itch Questionnaire (PIQ) – itch severity assessment, including multiple NRS, VRS and frequency of itch assessments assessing a 7-day recall period, in adults with AD and compared their performance. Self-administered questionnaires and skin-examination were performed in 410 AD patients (age 18-90 years) in a dermatology practice setting. PIQ NRS, VRS and frequency of itch had good content validity; strong correlations with each other (Spearman correlations, P<0.0001) and weak-moderate correlations with POEM, EASI, objective-SCORAD, and DLQI (P<0.0001); and very good discriminant validity. Changes from baseline in NRS, VRS and frequency of itch were moderately to strongly correlated with each other, weakly to moderately correlated with other patient-reported (POEM, SCORAD-itch, DLQI) and clinical-reported outcomes (EASI, objective-SCORAD).There were no floor or ceiling effects for NRS or VRS itch, but there were ceiling effects for itch frequency. Each assessments was completed in <1 minute by all patients. In conclusion, NRS, VRS and frequency of itch from PIQ – itch severity showed good content and construct validity, and/or responsiveness in adults with AD, and were feasible for use in clinical trials and practice.