Energy-adjusted Intake Research Articles

654P - Adherence to recommended intake of calcium and colorectal cancer risk in the HEXA study

BackgroundMany studies have suggested that dietary calcium has a protective effect on colon cancer development. The mean dietary calcium intake of Koreans is 490mg/day, which is far less than the recommended intake of calcium 700-800mg/day. In this study, we explored the relationship between dietary calcium intake and colorectal cancer development in Koreans with relatively low calcium intake compared to Western countries. MethodsThe Health Examinees (HEXA) Study, large-scale genomic community-based prospective cohort study was designed to identify the general characteristics of major chronic disease in Korean. Participants in this analysis consisted with 135,230 participants aged 40-69 years recruited between 2004 and 2013. The calcium intake level was categories by Dietary Reference Intakes for Koreans (KDRIs). Cox proportional hazards regression model was used to estimate hazard ratio (HR) and corresponding 95% confidence intervals (CI) for colorectal cancer risk adjusting for potential confounders. ResultsMedian energy-adjusted calcium intake was 385.5mg/day in men and 420.2mg/day in women. In the multivariate-adjusted model, compared with the group consumed less than the recommended intake of calcium, the group consumed more than the recommended intake of calcium showed a marginally significant reduction in the risk of colorectal cancer in women. (HR=0.62, 95% CI: 0.38-1.02). But, among men, no significant association were observed between the dietary calcium intake and colorectal cancer risk (HR=0.88, 95% CI: 0.56-1.37). ConclusionsKorean women who adhere to the recommended intake of calcium showed a reduced risk of colorectal cancer. Legal entity responsible for the studyThe authors. FundingThe National Research Foundation of Korea, No. 2017R1A2B4009233. DisclosureAll authors have declared no conflicts of interest.

Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma?

Obesity has been repeatedly linked to asthma, and several potential mechanisms have been proposed in the etiologies of the obese-asthma phenotype. Considering that lungs play an important role in systemic pH and acid–base regulation, are a key organ in asthma development, and that nutritional inadequacy of several nutrients and high dietary acid load can affect airway inflammation and reactivity, we aimed to test the hypothesis that dietary acid load may be associated with asthma in children. Data on 699 children (52% females), aged 7–12 years, were analyzed. Anthropometric measurements were performed to assess body mass index. Dietary acid load was calculated using potential renal acid load (PRAL) equations from a 24 h dietary recall administrated to children. Adjusted PRAL for total energy intake was applied with the use of the residual method. Lung function and airway reversibility were assessed with spirometry. Asthma was defined by a positive bronchodilation or self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) in the past 12 months. After adjustment for energy intake, sex, age, parent’s education level, and physical activity, positive and significant associations were found between asthma and PRAL [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730) in overweight/obese children. Our findings suggest that dietary acid load might be a possible mechanism in overweight/obese-asthma phenotype development.

Micronutrient intake in children with cystic fibrosis in Sydney, Australia

BackgroundChildren with CF have been reported to consume significantly more energy-dense, nutrient-poor foods than controls where there are now concerns of inadequate micronutrient intake. There are no current or comprehensive dietary studies assessing micronutrient intake in CF children. ObjectivesTo evaluate micronutrient intake in children with CF compared to recommended dietary intakes (RDIs). MethodsDietary intake of 13 micronutrients was measured in CF children aged 2–18 years and age- and sex-matched controls using a validated food frequency questionnaire (The Australian Child and Adolescent Eating Survey). ResultsCF children (n = 82) consumed significantly more energy than controls (n = 82) [3142(2531–3822) kcal vs 2216(1660–2941) kcal; p < .001]. Absolute intake in CF children was significantly higher in all micronutrients except vitamin C and folate, however energy-adjusted intake was significantly lower for all micronutrients except vitamin A, sodium, calcium and phosphorous. Energy-adjusted intake in primary school CF children was significantly less than controls in 8/13 micronutrients. Overall, median intakes exceeded the RDIs for all micronutrients however CF children fell short of the RDIs for folate (26.8%), iron (15.9%) and calcium (9.8%). In pre-school, 50% of CF children and 91.7% of controls did not meet the iron RDI. High school CF and control children failed to meet RDIs for 7/13 and 9/13 micronutrients respectively. ConclusionIncreased intake of most micronutrients in CF children was largely attributed to higher energy consumption. However, micronutrient density of the diet declined with increasing age, where high school children failed to meet RDIs for most key micronutrients.

Adult dietary fat intake and ovarian cancer risk

The association of dietary fat intake with ovarian cancer risk has been inconsistent across populations. We examined dietary fat intake, overall and by type and ovarian cancer risk in two prospective cohort studies. We assessed long-term dietary fat intake among Nurses' Health Study (NHS) and NHSII participants using food frequency questionnaires administered every 2-4 years beginning in 1984 and 1991, respectively. We examined cumulative energy-adjusted intake of total fat, specific types of fat (animal, vegetable, saturated, monounsaturated, polyunsaturated and trans fat) and cholesterol. We identified 700 ovarian cancer cases in NHS and 196 in NHSII with dietary information. Cox proportional hazards regression was used to estimate associations between intake and ovarian cancer risk. Dietary fat intake changed over time in both cohorts and was lower in NHS than NHSII. Higher cumulative average intakes of animal fat and cholesterol were significantly positively associated with risk of ovarian cancer in NHS (relative risk [RR] comparing extreme quartiles = 1.57, 95% CI: 1.20, 2.06 and 1.35, 95% CI: 1.08, 1.69, respectively), but not in NHSII. Other dietary fat sources were not clearly associated with risk in either population. We did not observe clear associations between dietary fat and ovarian cancer risk in two large prospective cohort studies.

Past and Recent Salted Fish and Preserved Food Intakes Are Weakly Associated with Nasopharyngeal Carcinoma Risk in Adults in Southern China

Chinese-style salted fish intake in early life is considered an established risk factor for nasopharyngeal carcinoma (NPC). However, results for adult intakes of salted fish and preserved foods are inconsistent. The aim of this study was to ascertain the relations of Chinese-style hard and soft salted fish and preserved food intakes with NPC risk. We conducted a population-based case-control study in southern China with 2554 NPC cases identified through a rapid case ascertainment system and 2648 healthy controls, frequency-matched on age, sex, and area. Subjects (aged 20-74 y) were interviewed via a food-frequency questionnaire, including information on portion size. Data were also collected on alcohol consumption and potential confounders. Food intake was grouped into 3-5 energy-adjusted intake levels during adulthood (10 y prior) and adolescence (16-18 y). For childhood (at age 10 y), intake frequency of selected food items was collected. Multivariate-adjusted ORs with 95% CIs were estimated via logistic regression. We found no association between NPC and intake of hard Chinese-style salted fish during adulthood, and an increased risk at the highest level of intake during adolescence (OR: 1.19; 95% CI: 1.03, 1.39). In contrast, we found a decreased risk for the middle intake level of soft salted fish during adulthood (OR: 0.68; 95% CI: 0.57, 0.81) and adolescence (OR: 0.71; 95% CI: 0.59, 0.85). Preserved foods showed contrasting risk profiles, e.g., the highest adult intake level of salted egg (OR: 1.51; 95% CI: 1.22, 1.87) and fermented black beans (OR: 0.67; 95% CI: 0.56, 0.80). Associations with NPC were weaker than previously reported, e.g., for weekly childhood intake of salted fish (OR: 1.56; 95% CI: 1.24, 1.97). Hard and soft salted fish have different risk profiles. Salted fish and other preserved foods were at most weak risk factors for NPC in all periods and may play a smaller role in NPC occurrence than previously thought.

Prenatal oxidative balance and risk of asthma and allergic disease in adolescence

Fetal oxidative balance (achieved when protective prenatal factors counteract sources of oxidative stress) might be critical for preventing asthma and allergic disease. We examined prenatal intakes of hypothesized protective nutrients (including antioxidants) in conjunction with potential sources of oxidative stress in models of adolescent asthma and allergic disease. We used data from 996 mother-child pairs in Project Viva. Exposures of interest were maternal prepregnancy body mass index and prenatal nutrients (energy-adjusted intakes of vitamins D, C, and E; β-carotene; folate; choline; and n-3 and n-6 polyunsaturated fatty acids [PUFAs]), air pollutant exposures (residence-specific third-trimester black carbon or particulate matter with a diameter of less than 2.5μm [PM2.5]), acetaminophen, and smoking. Outcomes were offspring's current asthma, allergic rhinitis, and allergen sensitization at a median age of 12.9years. We performed logistic regression. Continuous exposures were log-transformed and modeled as z scores. We observed protective associations for vitamin D (odds ratio [OR], 0.69 [95% CI, 0.53-0.89] for allergic rhinitis), the sum of the n-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid (OR, 0.81 [95% CI, 0.66-0.99] for current asthma), and the n-3 PUFA α-linolenic acid (OR, 0.78 [95% CI, 0.64-0.95] for allergen sensitization and OR, 0.80 [95% CI 0.65-0.99] for current asthma). Black carbon and PM2.5 were associated with an approximately 30% increased risk for allergen sensitization. No multiplicative interactions were observed for protective nutrient intakes with sources of oxidative stress. We identified potential protective prenatal nutrients (vitamin D and n-3 PUFAs), as well as adverse prenatal pro-oxidant exposures that might alter the risk of asthma and allergic disease into adolescence.

Validating the dietary inflammatory index using inflammatory biomarkers in a Japanese population: A cross-sectional study of the JPHC-FFQ validation study.

Persistent low-grade inflammation is related to the development of many chronic diseases. The dietary inflammatory index (DII®) is designed to assess the potential effects of diet on an individual's inflammation status. The aim of this study was to evaluate the construct validity of the DII using inflammation biomarkers in Japanese adults. Overall, 565 participants from the food frequency questionnaire (FFQ) validation study of the Japan Public Health Center-Based Prospective Cohort were included in the present study. This cohort consisted of two independently recruited and examined, cohorts I and II. Dietary records (DR) were collected for 28 d and two FFQs were administered. Blood samples also were obtained for the analysis of high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 concentrations. DII scores were calculated from DR and FFQ using energy-adjusted dietary intakes by the density method. Higher DII scores indicate a greater proinflammatory potential of the diet. The associations between DII and inflammatory biomarkers were assessed using regression models adjusted for age, body mass index, smoking status, and amount of physical activity. The associations between DR- and FFQ-derived DII scores were moderate. Higher DR-derived DII scores, representing a more proinflammatory diet, were significantly correlated with IL-6, but not hs-CRP, concentrations in men. The geometric means of IL-6 concentrations in the lowest and highest DII quartiles were 1.05 and 1.33 pg/mL (P = 0.02 for trend) in cohort I, and 1.00 and 1.24 pg/mL (P = 0.03 for trend) in cohort II, respectively. Furthermore, IL-6 concentration appeared to increase across DII quartiles calculated from FFQ in men. However, there was no association between DII and inflammatory biomarkers in women. Null findings in women may reflect the generally lower levels of chronic systemic inflammation among Japanese versus their Western counterparts. These findings indicate that DII may be applied to measure the potential effects of diet on chronic diseases through inflammatory pathways in Japanese men.

Dietary cadmium intake and risk of cutaneous melanoma: An Italian population-based case-control study

IntroductionExposure to the heavy metal cadmium has been associated with many adverse health effects, such as atherosclerosis, diabetes, and cancer, possibly melanoma. In non-occupationally exposed individuals, food intake is a major source of cadmium exposure, after smoking. We aimed to assess the risk of melanoma in relation to dietary cadmium intake. MethodsUsing a population-based case-control study design, we recruited 380 incident cases of newly-diagnosed cutaneous melanoma and 719 matched controls in the Emilia-Romagna Region, Northern Italy in the years 2005-2006. We evaluated dietary intake using a semi-quantitative food frequency questionnaire. We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for melanoma according to quintiles of dietary cadmium intake, adjusting for several potential confounders, and we modeled the association non-parametrically, using restricted cubic splines. ResultsMedian energy-adjusted intake of cadmium was 6.11 μg/day (interquartile range 5.38–6.91) among cases and 5.97 μg/day (5.15–6.79) among controls. For each 1 μg/day-increase in cadmium intake, the OR for melanoma was 1.11 (95% CI 1.00–1.24). Melanoma risk generally increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99–2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12–2.75), and 1.65 (95% CI 1.05–2.61) for the second through fifth quintiles, compared with the lowest quintile. Sex-stratified analysis showed ORs per 1 μg/day-increase in cadmium intake of 1.10 (95% CI 0.93-1-29) among men and 1.15 (95% CI 0.99–1.33) among women. Using spline regression analysis, we observed a generally linear increase in melanoma risk up to 6 μg/day of cadmium intake, after which the risk appeared to plateau. ConclusionsWe observed a positive non-linear association between dietary cadmium intake and risk of cutaneous melanoma in a Northern Italy population. However, further studies are needed to elucidate this association, due to concerns about exposure misclassification, unmeasured confounding, and the limited and conflicting evidence from epidemiological findings.

Dietary Intake of Selenium in Relation to Pubertal Development in Mexican Children.

Alterations in pubertal timing have been associated with long-term health outcomes. While a few reports have shown that dietary intake of selenium is associated with fertility and testosterone levels in men, no human studies have considered the association between selenium and pubertal development in children. We examined the cross-sectional association of childhood dietary intake of selenium with pubertal development among 274 girls and 245 boys aged 10–18 years in Mexico City. Multiple logistic and ordinal regression models were used to capture the association between energy-adjusted selenium intake (below Recommended Dietary Allowance (RDA) vs. above RDA) and stages of sexual maturity in children, adjusted for covariates. We found that boys with consumption of selenium below the RDA had lower odds of a higher stage for pubic hair growth (odds ratio (OR) = 0.51, 95% confidence interval (95% CI): 0.27–0.97) and genital development (OR = 0.53, 95% CI: 0.28–0.99) as well as a lower probability of having matured testicular volume (OR = 0.37, 95% CI: 0.15–0.88) compared with boys who had adequate daily dietary intake of selenium (above RDA). No associations were found in girls. According to our results, it is possible that inadequate consumption of selenium may be associated with later pubertal development in boys, suggesting a sex-specific pattern. Future work with a larger sample size and measures of selenium biomarkers is needed to confirm our findings and improve understanding of the role of this mineral in children’s sexual development.

Combined effect of physical activity and sedentary behavior on body composition in university students

This study aimed to evaluate the domain-specific physical activity (PA) levels and sitting time of a sample of university students and examine the association of PA with percent body fat. Two hundred and twenty-one students were included in the analysis. We administered the long form of the International Physical Activity Questionnaire (IPAQ) twice within one-month interval. Total PA as well as occupational, transportation-, housework-, and leisure-related PA were assessed, in addition to sitting time. Dietary intake was derived from six non-consecutive 24-hour dietary recalls. Percent body fat (dependent variable) was analyzed using a bioelectrical impedance analyzer (BIA). Multivariate logistic regression, adjusted for potential confounders, examined the associations of domain-specific PA and sitting time with percent body fat. Men had higher levels of total and leisure PA than women. All participants had prolonged sitting time, with 48% having a sitting time of more than 10.15 hours/day. In multivariate analysis, moderate leisure PA, compared to vigorous PA was associated with a lower percent body fat. This association remained statistically significant even after adjustment for energy intake and sitting time. Housework-related PA was associated with a higher percent body fat. Moderate leisure PA was highly associated with percent body fat even after adjustment for confounding variables. Adequate interventions targeting this kind of leisure should be promoted among universities students.

Variation in dietary intake and body fatness by socioeconomic status among women in the context of Costa Rican nutrition transitions.

The Nutrition Transition model posits that vegetable oils, animal source foods (ASFs) and caloric sweeteners contribute to increases in adiposity and hence body mass index. Body mass index (BMI) is increasing more rapidly among Latin American populations of low versus high socioeconomic status (SES). The objectives of this study among Costa Rican women were to: (1) compare indicators of adiposity and dietary intake by SES and (2) evaluate the relationship between intake of foods high in vegetable oils, ASFs or caloric sweeteners and body fatness. This cross-sectional study, conducted in 2014-2015, included 128 low-, middle- and high-SES non-pregnant, non-lactating women aged between 25 and 45 years with 1-4 live births. Anthropometry was used to assess BMI, body composition and body fat distribution. Dietary recalls (n = 379) were used to assess dietary intake. Percentage body fat was greater in low- versus high-SES women (31.5 ± 3.9 vs 28.2 ± 4.7%). Skinfold measurements at four sites on the upper and lower body were greater in low- versus high-SES women. Body mass index did not vary in low- versus high-SES women. Intake frequency of foods high in vegetable oils was greater in low- and middle- (1.8 and 1.8 times/day, respectively) versus high- (1.1 times/day) SES women. For individual foods, intake frequency varied significantly by SES for high-fat condiments, fried vegetables, dairy, sweetened coffee/tea and pastries and desserts. Intake frequency of Nutrition Transition food categories was not associated with percentage body fat after adjustment for energy intake. Indicators of body composition provide additional information beyond BMI that are useful in understanding SES-adiposity associations in Latin America. Approaches to understanding diet and adiposity in Latin America that focus on vegetable oils, ASFs and caloric sweeteners should consider within-country variation in the pace of the Nutrition Transition, especially when explaining variation in adiposity by SES.

Intake of α-linolenic acid is not consistently associated with a lower risk of peripheral artery disease: results from a Danish cohort study.

Intake of the plant-derived n-3 fatty acid α-linolenic acid (ALA) has been associated with anti-atherosclerotic properties. However, information on the association between ALA intake and development of peripheral artery disease (PAD) is lacking. In this follow-up study, we investigated the association between dietary intake of ALA and the rate of PAD among middle-aged Danish men and women enrolled into the Danish Diet, Cancer and Health cohort between 1993 and 1997. Incident PAD cases were identified through the Danish National Patient Register. Intake of ALA was assessed using a validated FFQ. Statistical analyses were performed using Cox proportional hazard regression allowing for separate baseline hazards among sexes and adjusted for established risk factors for PAD. During a median of 13·6 years of follow-up, we identified 950 valid cases of PAD with complete information on covariates. The median energy-adjusted ALA intake within the cohort was 1·76 g/d (95 % central range: 0·94-3·28). In multivariable analyses, we found no statistically significant association between intake of ALA and the rate of PAD (P = 0·339). Also, no statistically significant associations were observed in analyses including additional adjustment for co-morbidities and in sex-specific analyses. In supplemental analyses with additional adjustment for potential dietary risk factors, we found a weak inverse association of PAD with ALA intake above the median, but the association was not statistically significant (P = 0·314). In conclusion, dietary intake of ALA was not consistently associated with decreased risk of PAD.

Association of Dietary Intake of Polyunsaturated Fatty Acids with Depression in Korean Adults (P14-009-19)

Abstract Objectives Several epidemiological studies have suggested that polyunsaturated fatty acids (PUFAs) have a preventive effect on depression, but these findings are inconsistent. This study was aimed to investigate the association of PUFA intake with depression among Korean adults based on the national survey data. Methods Using data from the 2014–2016 Korea National Health and Nutrition Examination Survey, a total of 9201 adults (3719 men and 8482 women) aged ≥19 years were involved in this study. Dietary intakes of PUFAs including n-3 PUFA, n-6 PUFA, n-6/n-3 ratio, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were estimated by a 24-h dietary recall. The presence of depression was diagnosed with a validated Patient Health Questionnaire (PHQ-9) scale. The odds ratios (OR) for the presence of depression according to the quartile of PUFAs intakes were calculated using a multiple logistic regression model. Results The prevalence of depression among the participants was 6.35%.The mean intake of n-3 PUFA was 1.64 g/day for the study participants, which was higher in participants without depression (1.65 g/day) than those with depression (1.43 g/day). A higher intake of n-3 PUFA (both % energy and energy-adjusted intake) was associated with a decreased prevalence of depression (OR of the highest quartile vs lowest quartile of the % E from n-3 PUFA, 0.61; 95% CI, 0.44–0.87; P for trend = 0.0241 and OR of the highest quartile vs lowest quartile of energy-adjusted n-3 PUFA, 0.63; 95% CI, 0.46–0.86; P for trend = 0.0124). There was no significant sex difference between dietary n-3 PUFA and depression. However, the associations between the intakes of n-6 PUFA, n-6/n-3 ratio, EPA, and DHA and the prevalence of depression were not significant. Conclusions Our findings suggest that a higher intake of dietary n-3 PUFA might be associated with a lower risk of depression in adults of Korean population. Thus, further studies are necessary to elucidate underlying mechanism of n-3 PUFA to prevent depression. Funding Sources This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (No. 21B20151213037). Supporting Tables, Images and/or Graphs

Higher-protein Intakes Are Associated with an Improved Dietary Micronutrient Profile (FS03-06-19)

ObjectivesThe Dietary Guidelines for Americans 2015–2020 indicate that potassium, choline, magnesium, calcium, vitamins A, D, E, and C are underconsumed (i.e., shortfall) micronutrients. Intakes of specific performance-related micronutrients (i.e., calcium, magnesium, folate, choline, iron, zinc, and vitamins A, D, E, B1, B2, B3, and B12), may also be a concern, as suboptimal intakes may limit adaptations to unaccustomed physical training, such as initial military training (IMT). Protein-containing foods are nutrient-dense; therefore, dietary protein intake may alter the amount of shortfall and performance-related micronutrients habitually consumed. This study explored associations between dietary protein (PRO) intake and shortfall or performance-related micronutrient intakes at IMT accession. MethodsA 3-month food frequency questionnaire was used to estimate habitual dietary intake in male (n = 276, age: Mean (SD), 21.1 (3.8)) and female (n = 254, age: 21.2 (3.7)) recruits. Multivariate-adjusted MANCOVA and ANCOVA models were used to identify associations between quartiles of PRO intake and shortfall micronutrients or performance-related micronutrients. Models were adjusted for age, sex, ethnicity, race, physical activity, energy density, and total energy intake. ResultsMean (SE) energy-adjusted PRO intakes were 29.3 (3.2), 36.0 (1.4), 40.8 (1.3), and 47.7 (3.9) g/1000 kcal for quartiles 1–4, respectively. Composite shortfall micronutrient intake differed (P < 0.001) by PRO quartile, as intake of each micronutrient, except vitamin C, progressively increased (all, P < 0.05) with increasing PRO quartiles. Similarly, composite (P < 0.001), and most individual (all, P < 0.05) performance-related micronutrient intakes, except calcium, were different across PRO quartiles. Calcium intake only differed for PRO quartile 1 and was lower than all other quartiles (P < 0.00). ConclusionsThese cross-sectional data suggest that habitually consuming more protein is associated with greater intakes of shortfall and performance-related micronutrients in young healthy adults entering the military. Funding SourcesSupported by US Army Medical Research and Materiel Command; authors’ views not official US Army or DoD policy.

Intrinsic Mitochondrial Nutrient Utilization May Underlie the Association of Metabolite Levels with BMIz and Insulin Resistance (FS03-02-19)

ObjectivesTo identify metabolites associated with BMIz and insulin resistance (IR) among 108 girls and 98 boys aged 8–14 years. We sought evidence of whether altered mitochondrial nutrient utilization, as indicated by mitochondrial-derived metabolites, mediates the relationship between diet, IR and obesity. MethodsAnthropometry, fasting untargeted-liquid chromatography/mass spectrometry-derived metabolites and C-Peptide, and semi-quantitative food frequency questionnaires were collected from adolescents in the Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) birth cohort. Sex-stratified generalized linear models were used to identify metabolites that are marginally associated BMIz and HOMA C-peptide (HOMA-CP), accounting for puberty, age and muscle and fat area (FDR < 0.1). Assessed the relationship between energy-adjusted macronutrient intake with HOMA-CP and BMIz. Structural equation models coupled with hierarchical clustering identified clusters of metabolites that may mediate the relationship between macronutrient intake with BMIz and HOMA-CP. ResultsStratification by sex demonstrated sex-specific associations with BMIz. Most notable were girl’s positive association with diacylglycerols and boy’s positive association with branched chain and aromatic amino acids, independent of HOMA-CP. Intermediates in fatty acid metabolism, including medium chain acylcarnitines (acylCN), were inversely associated with HOMA-CP. No direct relationship was observed between macronutrient intake with BMIz and IR. Using mediation analyses, fat intake is positively associated with BMIz and HOMA-CP through increases in levels of dicarboxylic fatty acids (DiC-FA), products of omega-oxidation. Carbohydrate intake is positively associated with HOMA-CP through decreases in levels of medium chain acylCN, products of β-oxidation. ConclusionsInsulin resistance in children appears to be associated with reduced fatty acid oxidation capacity. When consuming more grams of fat, there is evidence for increased extra-mitochondrial fatty acid metabolism (DiC-FA), while higher carbohydrate intake appears to lead to accumulation of intermediates of β-oxidation. Thus, biomarkers of IR and mitochondrial oxidative capacity may depend on macronutrient intake. Funding SourcesThis work was supported by the NIEHS, EPA and NIDDK.

Dietary Saturated Fat Is Associated with Larger LDL Particle Size and Reduced CVD Risk in Framingham Offspring Study (P08-128-19)

ObjectivesSmall dense LDL particles have been shown to promote atherogenic cardiovascular disease (CVD). Dietary fat type may impact LDL particle size, but few studies have examined the association between fatty acid intake and LDL particle size and CVD risk. Our goal was to examine the association of saturated fatty acid (SFA) intake with LDL particle size and CVD risk in subjects in the Framingham Offspring Study (FOS). MethodsLDL particle profiles were measured by NMR spectroscopic assay during exam visit 4 in the prospective FOS. Dietary fat, carbohydrate and food groups were assessed using 3-day diet records at exams 3 and 5; intakes were adjusted for body weight using the residuals from linear regression models. Multivariable Cox proportional hazards models and generalized linear modeling (GLM) were used to adjust for sex, age, height, pack-years of smoking, fruit and non-starchy vegetable intakes, dairy, LDL particle size, and prevalent hypertension. ResultsSubjects were classified into 6 categories using the combined intakes of carbohydrates (<48% vs. ≥48% of calories) and weight-adjusted SFA (<20, 20-<30, ≥30 g/day). Among those with higher carbohydrate intake, increasing levels of dietary SFA were associated with reduced risk of CVD. Specifically, those with the highest SFA intake and higher energy-adjusted carbohydrate intakes had a 56% (CI: 0.24–0.82) lower risk of CVD compared with those who had both low SFA and lower carbohydrate intakes. Moreover, increasing SFA intake among those with higher carbohydrate intakes was also associated with larger LDL particle sizes (P = 0.04, highest SFA intake vs. lowest SFA intake). Among low-carbohydrate consumers, SFA intake was not associated with risk of CVD, but was still positively associated with larger LDL particle size (P = 0.0003, highest SFA intake vs. lowest SFA intake). ConclusionsSFA intake was associated with larger LDL particle sizes regardless of carbohydrate intakes. However, a higher SFA intake was only associated with reduced CVD risk among those with higher carbohydrate intakes. Funding SourcesNational Dairy Council.

Adolescent Beverage Intake in Relation to Actigraphy-assessed Sleep Duration, Timing, and Fragmentation (P18-100-19)

ObjectivesTo examine whether usual beverage intake was associated with sleep timing, duration, and fragmentation among adolescents. MethodsThe study population included 528 Mexico City adolescents enrolled in a longitudinal study. Beverage intake over the last week was assessed with a food frequency questionnaire. The following beverage groups were analyzed: milk, sweetened milk, regular soda, coffee/tea, 100% fruit juice, commercial fruit juice with sugar, fruit drink/flavored water with sugar, and plain water. Sleep timing, duration, and fragmentation were assessed with 7-day actigraphy. Overall and sex-stratified linear regression was conducted with sleep characteristics as separate outcomes and quantiles of energy-adjusted beverage intake as exposures, accounting for sex, age, maternal education, physical activity, and smoking. ResultsThe mean age (SD) was 14.4 (2.1) years; 48% were male. The most commonly consumed drinks were water, milk, soda, and fruit juice with added sugar (energy-adjusted mean = 666 (557) mL per day, 360 (278) mL per day, 225 (251) mL per day and 203 (263) mL per day, respectively). In overall regression analysis, soda was associated with later sleep timing; those in the 4th (highest) quartile of soda consumption had a 19 minute later weekday sleep timing than those in the lowest quartile [95% CI 1, 37]. Among boys, milk and water consumption were each associated with longer weekday sleep duration (25 [1, 48] and 26 [4, 47] more minutes, respectively in the 4th compared to the 1st quartile); and higher 100% fruit juice consumption was related to earlier weekday sleep timing (−22 [−28, 1] minutes in the 1st compared to the last quantile; P trend = 0.03). Among girls, soda was associated with higher sleep fragmentation (1.6 [0.4, 2.8] % in the 4th compared to the 1st), and coffee/tea consumption was related to shorter weekend sleep duration (−23 [−44, −2] minutes in the 4th compared to the 1st). ConclusionsHigher soda intake was associated with later sleep midpoint in boys and girls, while other beverages were associated with sleep in a sex-specific manner. Among girls, adverse associations with sleep were observed for caffeinated drinks only, while boys with higher consumption of water, milk, and natural juice had evidence of healthier sleep. Funding SourcesNIH/NIEHS, EPA.

Adolescent caffeine consumption and mammographic breast density in premenopausal women.

Previous studies suggest that coffee and caffeine intake may be associated with reduced breast cancer risk. To date, there is limited and inconsistent epidemiologic evidence for associations of adolescent diet with mammographic breast density, a strong and consistent predictor of breast cancer. We investigated the association of adolescent caffeine intake with mammographic density in premenopausal women. This study included 751 cancer-free women within the Nurses' Health Study II cohort. Percent breast density (PD), absolute dense (DA) and non-dense areas (NDA) were measured from digitized film mammograms using a computer-assisted thresholding technique; all measures were square root-transformed. Energy-adjusted adolescent caffeine intake was estimated using the data from a food frequency questionnaire. Information regarding breast cancer risk factors was obtained from questionnaires closest to the mammogram date. We used generalized linear regression to quantify associations of caffeine intake with breast density measures. In multivariable analyses, adolescent caffeine intake was not associated with any of the density phenotypes (caffeine 4th vs. 1st quartile: β = - 1.27, 95% CI - 4.62; 2.09, p-trend = 0.55 for percent density; β = - 0.21, 95% CI - 0.76, 0.34, p-trend = 0.65 for absolute dense area, and β = 0.23, 95% CI - 0.28, 0.74, p-trend = 0.50 for non-dense area). Additional adjustment of the models for body mass index at age 18 resulted in attenuation of the risk estimates. Our findings do not support the hypothesis that adolescent caffeine intake is associated with premenopausal mammographic breast density.

An Exploration of Milk Product Health Beliefs and Dietary Calcium Intake in Young Adults.

Purpose: Milk products (fluid milk, cheese, yogurt) typically provide a rich source of calcium and other nutrients, yet consumption is declining in Canada. This study examined milk product health beliefs among young adults and the association between these beliefs and dietary calcium intake. Methods: Seventy-nine participants (25 ± 4y; 40 males) completed a milk product health belief questionnaire to determine a milk product health belief score (MPHBS) and a 3-day food record to assess dietary intake. Results: Despite generally positive views, young adults were uncertain about milk products in relation to health, weight management, and ethical concerns. Females would be more likely than males to increase milk product intake if they were confident that milk products are ethically produced. There was no significant association between MPHBS and dietary calcium intake. Energy-adjusted dietary calcium intake was positively associated with intakes of vitamin A (r = 0.3, P < 0.05), riboflavin (r = 0.5, P < 0.01), vitamin B12 (r = 0.5, P = < 0.01), vitamin D (r = 0.4, P < 0.01), phosphorus (r = 0.4, P < 0.01), zinc (r = 0.3, P < 0.01), and with milk and alternatives servings (r = 0.8, P < 0.01). Conclusion: Nutrition education efforts focused on increasing calcium-rich food consumption will help consumers to be better informed when making dietary choices.

Higher Protein Density Diets Are Associated With Greater Diet Quality and Micronutrient Intake in Healthy Young Adults.

Objective: This study characterized habitual dietary protein intake in healthy young adults entering military service and explored whether diet protein density is associated with diet quality and micronutrient intake.Methods: An FFQ was used to estimate habitual dietary intake and calculate HEI scores in 276 males [mean(SD), age:21.1y(3.8)] and 254 females [age:21.2y(3.7)]. Multivariate-adjusted MANCOVA and ANCOVA models were used to identify associations between protein density quartiles and HEI scores and micronutrient intake. Higher HEI components scores for sodium, refined grains, and empty calories indicate lower intake; higher scores for all other components indicate higher intakes.Results: Mean(SD) energy-adjusted protein intakes were 29.3(3.2), 36.0(1.4), 40.8(1.3), and 47.9(3.9) g/1,000 kcal for protein density quartiles 1–4, respectively. For males, empty calorie scores as well as dark green and orange vegetable scores were higher in quartiles 3 and 4 than 1 and 2 (all, p < 0.05). Scores for total vegetable, dairy, and total protein foods were lower in quartile 1 vs. quartiles 2, 3, and 4 (all, p < 0.05). Sodium scores decreased as quartiles increased (p < 0.001). Total HEI, fruit, whole grains, seafood and plant protein, fatty acids, and refined grain scores did not differ. For females, total HEI, vegetable, and total protein foods scores were higher in quartiles 3 and 4 than 1 and 2 (all, p < 0.05). Empty calorie scores increased as quartile increased (p < 0.05). Dairy scores were higher in quartiles 2, 3, and 4 than 1 (p < 0.05). Whole fruit scores were lowest in quartile 1 (p < 0.05). Whole grain as well as seafood and plant protein scores were higher in quartile 4 vs. 1 (both, p < 0.05). Sodium scores decreased as quartile increased (p < 0.001). Fatty acids scores did not differ. For males and females, micronutrient intakes progressively increased across quartiles with the exception of calcium and vitamin C, (all, p < 0.05). Intakes remained nearly the same when controlled for fruit and vegetable intake.Conclusion: These cross-sectional data suggest that habitually consuming a higher protein density diet is associated with better scores for some, but not all, diet quality components in males, better overall diet quality scores in females, and greater intakes of micronutrients in both male and female healthy, young adults entering military service.