Block Food Frequency Questionnaire Research Articles

8395 Exploring the Relationship of Dietary Advanced Glycation End-products (AGEs) with Glycemic Control among Adults with Type 1 Diabetes (T1D)

Abstract Disclosure: C.E. Nevarez: None. A.B. Murthy: None. G. Jung: None. B. Gray: None. E. Cagliero: None. V. Aroda: None. E.W. Yu: None. Introduction: Accumulation of advanced glycation end products (AGEs) are thought to play a crucial role in the pathophysiology of diabetic complications, yet the contributions of dietary AGE (dAGE) intake to systemic AGE levels and glycemic control have not been established. Utilizing a newly developed methodology for evaluating dAGEs, our objective was to test whether dAGE impact systemic AGEs and glycemic outcomes in adults with longstanding Type 1 Diabetes (T1D). Methods: We examined adults aged 50+ years participating in the T1D BEACON cohort (n=97 T1D, n=53 non-diabetic controls). We developed a novel algorithm to quantify dietary AGE intake by associating items from the 2014 Block Food Frequency Questionnaire with their AGE content (as determined by ELISA from a previously published dataset; Urribarri et al., 2010). Daily dAGE intake was normalized using the nutrient density method (Willett et al., 1997). Additional measurements included autofluorescent skin AGEs (AGE Reader, DiagnOptics Technologies), diabetic history, hemoglobin A1C and 14-day continuous glucose monitoring to assess percentage time in glucose target range (70-180 mg/dL). We compared dAGEs between T1D and controls and evaluated associations of dAGEs with outcomes using independent t-tests, Pearson’s correlations, and multivariate linear regression with adjustments for age, sex, and body mass index (BMI). Results: Mean age and sex distribution was similar in the T1D and control groups (63.54 ± 6.7 yrs, 50.7% female). BMI was higher in the T1D group (27.9 ± 5.0 vs. 26.0 ± 4.9 kg/m^2, p = 0.031). The mean ± SD duration of diabetes in the T1D cohort was 46.1 ± 9.8 yrs, with A1c of 7.1 ± 1.0%. Utilizing our novel algorithm, the mean daily normalized dAGE intake was higher in the T1D than control groups (8.8 ± 2.3 kU/kcal vs. 7.9 ± 2.5 kU/kcal, p = 0.046) although this did not remain significant after multivariate adjustment (adj p = 0.123). Skin AGEs were higher in the T1D group (3.0 vs 2.5 AU, adj p<0.001). Within the full cohort, dAGE intake was significantly correlated with skin AGEs (r = 0.32, adj. p = 0.003), which was driven primarily by association within the T1D group (r = 0.32, adj p = 0.002). Additionally, dAGE intake was associated with higher A1C values within the full cohort (r = 0.27, adj. p = 0.019), and there was a trend that higher dAGE correlated with decreased time in target glucose range (r = -0.22, adj p = 0.062). Conclusion: Our analyses have revealed novel associations between dAGE intake, skin AGEs, and glycemic outcomes among adults with type 1 diabetes, underscoring the contribution of dietary patterns to systemic AGEs and physiological outcomes within diabetic populations. Future investigations will be needed to validate this novel dAGE assessment in external cohorts and to evaluate the potential impact of dietary AGE intake upon diabetic complications. Presentation: 6/1/2024

Effectiveness of the CATCH (Coordinated Approach to Child’s Health) Rainbow Program in Elementary Schools for Change in Fruit and Vegetable Intake

Background: Nutrition, cooking, and gardening lessons individually and together have been shown to increase fruit and vegetable (FV) consumption in school-aged children. The CATCH Rainbow program incorporated nutrition education, cooking, and gardening lessons aimed at increasing FV consumption in elementary school-aged children and assessed changes in participants’ BMI, self-reported FV consumption, and skin carotenoid levels at baseline and post-intervention. Methods: Two-hundred and twenty-five 4th and 5th graders (mean age: 9.8 years and 52% male participants) at Genoa Elementary School participated in six cooking and six gardening sessions between September 2021 and May 2022. Each nutrition education session was 25 min long, paired with either hands-on cooking activities or gardening skills. At baseline and post-intervention, participants’ height and weight were assessed with a stadiometer/scale, and skin carotenoid measurement was taken by a Veggie Meter® (Longevity Link Corporation (Salt Lake City, UT, USA)). Students also completed the Block Food Frequency Questionnaire to self-report FV consumption at both time points. Focus groups were conducted with children at the end of the program for qualitative feedback. Results: paired samples T-test and regression analysis results indicate no significant decrease in BMI or significant increase in skin carotenoid scores from pre- to post-intervention. However, though not significant, there was an increase in self-reported FV intake by 0.4 servings. Additionally, the qualitative feedback was positive, as children mentioned benefits of healthy eating and expressed enjoyment for growing, cooking, and tasting fruits and vegetables. Conclusion: Results from this study can be used to guide future cooking and gardening programs for elementary school children. Time of the year when implementing these programs and collecting data may impact study outcomes due to seasonal variations in fruit and vegetable intake.

Dietaryindex: a user-friendly and versatile R package for standardizing dietary pattern analysis in epidemiological and clinical studies

BackgroundFew standardized and open-source tools exist for calculating multiple dietary pattern indexes from dietary intake data in epidemiological and clinical studies. ObjectivesThe primary aim is to develop and validate dietaryindex, a user-friendly and versatile R package that standardizes the calculation of dietary indexes. MethodsDietaryindex can calculate multiple dietary indexes of high interest in research, including the Healthy Eating Index (HEI)-2020, the Alternative HEI 2010, the Dietary Approaches to Stop Hypertension Index, the Alternate Mediterranean Diet Score, the Dietary Inflammatory Index, the American Cancer Society 2020 dietary index, and the Planetary Health Diet Index from the EAT-Lancet Commission. The package includes generic dietary index calculation functions that accept any dietary assessment with preprocessed serving sizes of food groups and nutrients as defined by the research group that developed each index. For ease of use and to eliminate any need for data preprocessing, dietaryindex also offers 1-step functions that directly reference common datasets and tools, including the National Health and Nutrition Examination Survey (NHANES), the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24), the Diet History Questionnaire III (DHQ3), and the Block Food Frequency Questionnaire. At least 2 independent researchers validated the serving size definitions and scoring algorithms of dietaryindex. ResultsIn our validation process, dietaryindex demonstrated full accuracy (100%) in all generic functions with 2-decimal rounding precision when compared with hand-calculated results. Similarly, using NHANES 2017–2018 data and ASA24 and DHQ3 example data, the HEI-2015 outputs from dietaryindex aligned (99.95%–100%) with results using the Statistical Analysis System codes from the National Cancer Institute. ConclusionsDietaryindex is a user-friendly, versatile, and validated informatics tool for standardized dietary index calculations. We have open-sourced all validation files and codes with detailed tutorials on GitHub (https://github.com/jamesjiadazhan/dietaryindex).

Dietary choline and betaine intake minimally impacts rate of annualized cognitive performance throughout the menopause transition: data from the Study of Women's Health Across the Nation.

Dietary choline is associated with lower risk of dementia in older adults, yet this association during mid-life remains unknown. Given that menopause reflects a nutrition-sensitive time point where prevention strategies may mitigate cognitive deficits, we examined the relationship of choline, betaine, and egg intakes (ie, dietary exposures) with cognitive performance in the Study of Women's Health Across the Nation (SWAN) cohort ( N = 1,006). SWAN is a longitudinal study of women across the menopause transition. Diet was assessed via modified Block food frequency questionnaire, and cognitive function was examined using the Symbol Digit Modalities Test, Digits Backward Test, and East Boston Memory Test (EBMT). Annualized rate of cognitive scores and quartiles of diet were computed using linear mixed models overall (all diet exposures) and by baseline menopausal status (choline, betaine only). Among all women, higher choline ( P -for-trend = 0.006) and betaine ( P -for-trend = 0.005) intakes, independently and combined (ie, choline + betaine; P -for-trend = 0.001), were significantly associated with reduced rate of change on the EBMT-Delayed Recall (DR), but egg intake did not consistently impact cognitive function. By menopausal status, higher betaine, but not choline, was associated with a lower annualized rate of change in cognitive performance on the EBMT-DR (mean difference [95% confidence interval]; Q1: referent vs Q4: -0.071 [-0.17, 0.03]; P -for-trend = 0.006) for early perimenopausal women; nevertheless, choline and betaine were not associated with cognitive function among premenopausal women. Higher dietary betaine intake among early perimenopausal women and higher dietary intakes of betaine and choline, independently and combined, among all women, were minimally associated with the trajectory of verbal episodic memory, yet no associations between diet and cognition were observed among premenopausal women. Future research should address the relationship between dietary intake and cognition during menopause in other research settings and cohorts.

Reliability of a short diet and vitamin supplement questionnaire for retrospective collection of maternal nutrient intake

BackgroundGestational nutrition can protect against adverse neurodevelopmental outcomes. ObjectivesWe developed a short tool for collecting maternal nutritional intake during pregnancy to facilitate research in this area and compared its retrospective use to prospectively-collected food frequency questionnaires (FFQ). MethodsMaternal nutritional intake was retrospectively assessed using three versions (full interview, full self-administered online, and shortened interview) of the Early Life Exposure Assessment Tool (ELEAT) among participants of the MARBLES pregnancy cohort study of younger siblings of autistic children. Retrospective responses were compared with responses to supplement questions and the validated 2005 Block FFQ prospectively collected in MARBLES during pregnancies 2–7 years prior. ELEAT nutrient values were calculated using reported food intake frequencies and nutrient values from the USDA nutrient database. Correlations between retrospectively- and prospectively-reported intake were evaluated using Kappa coefficients, Youden's J, and Spearman Rank Correlation Coefficients (rs). ResultsMARBLES FFQ dietary intakes were compared among 54 women who completed the ELEAT full form including 12 online, and among 23 who completed the ELEAT short form. Correlations across most foods were fair to moderate. Most ELEAT quantified nutrient values were moderately correlated (rs = 0.3–0.6) with those on the Block FFQ. Supplement questions in both MARBLES and the ELEAT were completed by 114 women. Kappas were moderate for whether or not supplements were taken, but modest for timing. Correlations varied by version and child diagnosis or concerns, and were higher when mothers completed the ELEAT when their child was 4 years old or younger. ConclusionsWith recall up to several years, ELEAT dietary and supplement module responses were modestly to moderately reliable and produced nutrient values moderately correlated with prospectively-collected measures. The ELEAT dietary and vitamin supplements modules can be used to rank participants in terms of intake of several nutrients relevant for neurodevelopment.

Prenatal Iodine Intake and Maternal Pregnancy and Postpartum Depressive and Anhedonia Symptoms: Findings from a Multiethnic US Cohort.

Objective: Emerging evidence suggests that essential trace elements, including iodine, play a vital role in depressive disorders. This study investigated whether prenatal dietary iodine intake alone and in combination with supplemental iodine intake during pregnancy were associated with antepartum and postpartum depressive and anhedonia symptoms. Methods: The study population included 837 mothers in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study. The modified BLOCK food frequency questionnaire was used to estimate prenatal dietary and supplemental iodine intake, while the 10-item Edinburg Postpartum Depression Scale (EPDS) ascertained depressive symptoms. Analyses considered the global EPDS score and the anhedonia and depressive symptom subscale scores using dichotomized cutoffs. Logistic regression estimating odds ratios and 95% confidence intervals (CIs) assessed associations of iodine intake in the second trimester of pregnancy and 6-month postpartum depressive and anhedonia symptoms considering dietary intake alone and combined dietary and supplementary intake in separate models. Results: Most women were Black/Hispanic Black (43%) and non-Black Hispanics (35%), with 39% reporting a high school education or less. The median (interquartile range, IQR) dietary and supplemental iodine intake among Black/Hispanic Black (198 (115, 337) µg/day) and non-Black Hispanic women (195 (126, 323) µg/day) was higher than the overall median intake level of 187 (116, 315) µg/day. Relative to the Institute of Medicine recommended iodine intake level of 160-220 µg/day, women with intake levels < 100 µg/day, 100-<160 µg/day, >220-<400 µg/day and ≥400 µg/day had increased adjusted odds of 6-month postpartum anhedonia symptoms (aOR = 1.74 (95% CI: 1.08, 2.79), 1.25 (95% CI: 0.80, 1.99), 1.31 (95% CI: 0.82, 2.10), and 1.47 (95% CI: 0.86, 2.51), respectively). The corresponding estimates for postpartum global depressive symptoms were similar but of smaller magnitude. Conclusions: Prenatal iodine intake, whether below or above the recommended levels for pregnant women, was most strongly associated with greater anhedonia symptoms, particularly in the 6-month postpartum period. Further studies are warranted to corroborate these findings, as dietary and supplemental iodine intake are amenable to intervention.

Serum zinc concentration and dietary zinc intake in relation to cognitive function: an analysis of the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort.

There are several pathways by which zinc may be a modifiable factor to slow age-related cognitive decline. We investigated the associations between serum and dietary zinc and cognitive impairment in a longitudinal cohort. We used data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort (n = 30,239) and the REGARDS Trace Element Study (n = 2666). Baseline serum zinc concentrations (2003-2007) were measured using inductively coupled plasma mass spectrometry. Baseline dietary zinc intake was measured via the Block food frequency questionnaire. Serum zinc concentrations and dietary zinc intake were categorized into quartiles. The outcome of interest was impairment on the Six-Item Screener (SIS), a measure of global cognitive functioning administered annually. The Enhanced Cognitive Battery (ECB), a more comprehensive series of tests assessing memory and fluency, was administered every two years and considered a secondary outcome. Associations between zinc and incident impairment were assessed using multivariable logistic regression. Among 2065 participants with serum zinc data, 184 individuals developed impairment over 10years of follow-up. In adjusted models, there was no significant association between serum zinc and impairment as assessed by the SIS or the ECB. Among 18,103 participants who had dietary data, 1424 experienced incident impairment on the SIS. Dietary zinc intake was not significantly associated with impairment as assessed by the SIS or the ECB in adjusted models. Findings from this U.S. cohort did not support the hypothesis that serum zinc concentration or dietary zinc intake is associated with the risk of cognitive impairment.

Ultra-processed and fast food consumption, exposure to phthalates during pregnancy, and socioeconomic disparities in phthalate exposures

BackgroundConsuming ultra-processed foods may increase exposure to phthalates, a group of endocrine disruptors prevalent in food contact materials. ObjectivesInvestigate associations between ultra-processed food intake and urinary phthalates during pregnancy, and evaluate whether ultra-processed foods mediate socioeconomic disparities in phthalate exposures. MethodsIn a socioeconomically diverse sample of 1031 pregnant women from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study in the urban South, the Block Food Frequency Questionnaire was administered and urinary phthalate metabolites were measured in the second trimester. Linear regressions modeled associations between phthalates and overall ultra-processed food consumption, individual ultra-processed foods, and exploratory factor analysis dietary patterns. Causal mediation analyses examined whether ultra-processed food intake mediates relationships between socioeconomic disparities and phthalate exposures. ResultsUltra-processed foods constituted 9.8–59.0 % (mean = 38.6 %) of participants’ diets. 10 % higher dietary proportion of ultra-processed foods was associated with 13.1 % (95 %CI: 3.4 %–22.9 %) higher molar sum concentrations of di(2-ethylhexyl) phthalate metabolites (ΣDEHP). 10 % higher consumption of minimally-processed foods was associated with lower ΣDEHP (10.8 %: 3.4 %–22.9 %). Ultra- and minimally-processed food consumption were not associated with non-DEHP metabolites. Standard deviation higher consumptions of hamburger/cheeseburger, French fries, soda, and cake were associated with 10.5 % (4.2 %-17.1 %), 9.2 % (2.6 %-16.2 %), 7.4 % (1.4 %-13.6 %), and 6.0 % (0.0 %-12.4 %), respectively, higher ΣDEHP. Exploratory factor analysis corroborated positive associations of processed food with ΣDEHP, and uncovered a healthy dietary pattern associated with lower urinary ΣDEHP, mono(2-ethyl-5-hydroxyhexyl) (MEHHP), mono(2-ethyl-5-carboxypentyl) (MECPP), mono(2-carboxymethylhexyl) (MCMHP), and mono-isononyl (MINP) phthalates. Significant indirect effects indicated that lower income and education levels were associated with 1.9 % (0.2 %-4.2 %) and 1.4 % (0.1 %-3.3 %) higher ΣDEHP, respectively, mediated via increased ultra-processed food consumption. ConclusionsConsumption of ultra-processed foods may increase exposure to phthalates. Policies to reduce dietary phthalate exposures from food packaging and processing are needed, as socioeconomic barriers can preclude dietary recommendations as a sole means to reduce phthalate exposures.

Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months.

To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time. Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives. Central Illinois, USA. Participants were 468 children at 24, 36 and 48 months of age. Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets. These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.

Plasma lipidomic markers of diet quality are associated with incident coronary heart disease in American Indian adults: the Strong Heart Family Study

BackgroundIdentifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet- coronary heart disease (CHD) association. ObjectivesThis study aimed to identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. MethodsUsing liquid chromatography–mass spectrometry, we measured 1542 lipid species from 1694 American Indian adults (aged 18–75 years, 62% female) in the Strong Heart Family Study. Participants were followed up for development of CHD through 2020. Information on the past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed-effects linear regression was used to identify individual lipids cross-sectionally associated with AHEI. In prospective analysis, Cox frailty model was used to estimate the hazard ratio (HR) of each AHEI-related lipid for incident CHD. All models were adjusted for age, sex, center, education, body mass index, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Multiple testing was controlled at a false discovery rate of <0.05. ResultsAmong 1542 lipid species measured, 71 lipid species (23 known), including acylcarnitine, cholesterol esters, glycerophospholipids, sphingomyelins and triacylglycerols, were associated with AHEI. Most of the identified lipids were associated with consumption of ω-3 (n–3) fatty acids. In total, 147 participants developed CHD during a mean follow-up of 17.8 years. Among the diet-related lipids, 10 lipids [5 known: cholesterol ester (CE)(22:5)B, phosphatidylcholine (PC)(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4)B, phosphatidylethanolamine (PE)(p-18:0/20:4)/PE(o-18:0/20:4), and sphingomyelin (d36:2)A] were associated with incident CHD. On average, each standard deviation increase in the baseline level of these 5 lipids was associated with 17%–23% increased risk of CHD (from HR: 1.17; 95% CI: 1, 1.36; to HR: 1.23; 95% CI: 1.05, 1.43). ConclusionsIn this study, lipidomic markers of diet quality in American Indian adults are found. Some diet-related lipids are associated with risk of CHD beyond established risk factors.

Dietary Composition, Angiographic Coronary Disease, and Cardiovascular Outcomes in the WISE Study (Women's Ischemia Syndrome Evaluation).

Studies relating diet to angiographic coronary artery disease (CAD) and subsequent major adverse cardiac events (MACE) in women are limited. Information on diet was collected in the Women's Ischemia Syndrome Evaluation (WISE), a prospective cohort study of symptomatic women referred for coronary angiography to evaluate suspected ischemic heart disease. A consecutive subgroup (n = 201 of 936) of enrolled women completed the modified Block food frequency questionnaire (FFQ). Data on outcomes were collected and adjudicated after 8-year follow-up. A set of logistic regression models were fitted for non-obstructive versus obstructive coronary stenosis (<50% versus ≥50%). Cox proportional hazard regression models were fitted for outcomes, with each dietary composition variable adjusted for the degree of coronary stenosis. At baseline, the subgroup cohort was 58 ± 12 years old with a body mass index (BMI) of 30 ± 7 kg/m2. An increased proportion of calories consumed from protein was associated with higher levels of baseline obstructive coronary stenosis. Those individuals who ate a higher amount of protein, carotene, and servings of vegetables and meat, however, were each associated with lower subsequent adverse outcomes, respectively. Among women undergoing coronary angiography for suspected CAD, a higher percentage of protein intake was associated with higher baseline stenosis severity; however, the amount of protein intake, vegetable, meat, and carotene intake, was conversely associated with subsequent lower adverse cardiovascular outcome risk.

Dietary Patterns Among Individuals with Plasma Cell Disorders Compared to the General US Population

Background Increasingly, there is evidence supporting the benefit of healthy dietary habits during prevention, treatment, and survivorship. The median survival for patients with multiple myeloma (MM) has increased from approximately 3 to 10 years in the last decade necessitating discussions about the integration of lifestyle medicine. MM patients with healthier pre diagnosis dietary patterns have longer survival than those with less healthy diets ( Lee et al. IJC 2020). Similarly, higher adherence to the Healthy Eating Index (HEI)-2015 has been associated with reduced all-cause and cancer-specific mortality ( Shan et al. JAMA 2023). A higher HEI score has been linked to reduced risk of chronic diseases as well. However, there is a paucity of demographic data for dietary patterns in individuals with plasma cell disorders (PCDs). Therefore, we examined the dietary patterns of individuals with PCDs in comparison to the US population. Method This study used the validated Block Food Frequency Questionnaire (FFQ) to survey individuals with a known history of a PCD in HealthTree Cure Hub, a patient data portal hosted by HealthTree Foundation. The questionnaire was used to calculate HEI-2015 scores which include 13 components that reflect the recommendations in the Dietary Guidelines for Americans, 2020-2025, with higher scores indicating greater adherence to the guidelines. Fruit (cup equivalents/day), vegetable (cup equivalents/day), fiber (grams/day), and sugar (grams/day) were also calculated. Mean values were compared using the Kruskal-Wallis test across subgroups: age, sex, race, body mass index (BMI), type of PCD, and level of education. In addition, with Z-test, HEI scores from participants in this study were compared to HEI scores of the general US population from National Health and Nutrition Examination Survey (NHANES) across age, sex, and race. Results We received 152 survey responses. Older age groups, and individuals with lower BMI had higher HEI scores (p=0.003 and p=0.016, respectively). There was no difference in HEI scores based on sex, race, or type of PCD. There was a trend for higher HEI scores with higher levels of education (p=0.093). There was no significant difference when comparing fruits, vegetables, fiber, and sugar intake between different subgroups, with the following exceptions: individuals aged ≥71 years (1.85; 95% CI 1.47-2.23) had higher total fruit consumption compared to those aged 60-70 (1.41; 95% CI 1.19-1.64) and 30-59 (1.31; 95% CI 0.84-1.78) (p=0.026), and individuals with graduate or professional degrees (1.79; 95% CI 1.46-2.12) had higher total fruit consumption compared to those with bachelor's degrees (1.27; 95% CI 0.83-1.7) or below (1.36, 95% CI [1.01-1.71] ) (p=0.008). Compared to the general US population, participants with PCDs had higher HEI scores across age, sex, and race (p&amp;lt;0.0001). Discussion In this study, the differences in HEI scores between subgroups categorized by age and BMI are consistent with trends seen in the US population. We found that younger individuals and individuals with elevated BMIs have worse HEI scores, suggesting these subgroups may derive greater benefit from dietary interventions. Given the association between a higher education level and higher fruit consumption (and the trend towards higher HEI scores), dietary interventions should discuss affordable alternatives. The higher HEI scores in our survey compared to the US population may suggest individuals with PCDs are more aligned with the Dietary Guidelines for Americans, although there is still considerable room for improvement. This difference may be due to improvements in diet post PCD diagnosis ( Malik et al. BCJ 2022), or due to a selection bias with individuals interested in the role of nutrition or greater awareness of nutrition being more likely to participate. Additionally, many participants heard of this survey through talks on nutrition organized through their local support groups and the HealthTree Nutrition and Wellness Chapter. This difference may also be explained by the difference in the assessment method used by NHANES (24-hour dietary recall) compared to the FFQ used in this study. Conclusions Individuals with PCDs (especially younger individuals and those with an elevated BMI) may benefit from interventions to improve dietary patterns. Subsequent studies to correlate healthier diets with long-term outcomes in patients with MM need to be performed.

Abstract 13367: Plasma Lipidomic Markers of Diet Quality Are Associated With Risk of Coronary Heart Disease in American Indians

Background: Diet quality can affect lipid profiles and subsequent risk of coronary heart disease (CHD). Identifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet-CHD relation. Objective: To identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. Methods: We studied 1,694 American Indians (aged 18-75, 62% women) who were free of CHD and had lipidomic and dietary data at baseline (2001-2003). Participants were followed for development of CHD through 2020 (mean follow-up: 17.8 years; total incident cases of CHD: 147). Information on past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed effects linear regression was used to identify individual lipid species associated with AHEI at baseline. Cox frailty model was used to estimate the hazard ratio of each AHEI-related lipid for CHD risk. All models adjusted for age, sex, center, education, BMI, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Results: Among 1,542 lipid species measured, 71 lipid species (23 known) were associated with AHEI at FDR&lt;0.05. Of these, 10 lipids (5 known) were associated with incident CHD (Figure 1 ). The 5 known lipids associated with incident CHD were CE(22:5) B, PC(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4) B, PE(p-18:0/20:4)/PE(o-18:0/20:4), and SM(d36:2) A. On average, per standard deviation increase in the baseline level of these lipids was associated with 17%-23% increased risk of CHD. These AHEI-related lipids are enriched in glycerophospholipid metabolism. Conclusion: We identified lipidomic markers of diet quality in American Indians. Some diet-related lipids are associated with risk of CHD beyond established risk factors.

THU336 Correlation Between Dietary Advanced Glycation End-products (Ages) And Skin Ages In Adults With Longstanding T1D

Abstract Disclosure: A.B. Murthy: None. B.E. Gray: None. M. Cote: None. B. Zahedi: None. E.W. Yu: Grant Recipient; Self; Amgen Inc. Background: Advanced glycation end products (AGEs) are involved in the pathophysiology of diabetic complications, and are thought to accrue with aging, hyperglycemia, and through diet. Despite the postulated impact of dietary intake on circulating AGE levels, there is currently no validated methodology for dietary AGE (dAGE) assessment. Thus, we sought to develop a crosswalk algorithm to calculate AGE intake from the commonly utilized Block Food Frequency Questionnaire (FFQ), and to validate our algorithm by correlating dAGE to skin AGE values within a cohort of adults with Type 1 Diabetes (T1D). Methods: We performed preliminary analysis of 50 study participants from the ongoing Type 1 Diabetes Bone Health Connection (T1D BEACON) study evaluating postmenopausal women and men older than 50 years with T1D. Dietary AGE intake was quantified using a novel algorithm we developed to associate items from the 2014 Block FFQ with their AGE content as determined by ELISA in a published data set (Urribarri, et al. 2014). Mean daily dAGE intake (kU/day) was correlated with autoflourescent skin AGE values (AGE Reader, DiagnOptics Technologies) using multivariate linear regression, after adjusting for age and gender. Diabetic characteristics and complications were assessed through questionnaires, physical exams (mTCNS, DPNCheck), chart review, and urine/serum tests. Results: The average age of the T1D cohort was 62.7 ± 6.8 years, 50% were female, the average duration of diabetes was 45 ± 9.4 years, with average A1c of 7.2 ± 1.1. Regarding diabetic complications, 70% had retinopathy, 30% had microalbuminuria (urine albumin-creatinine ratio &amp;gt; 30 mcg/mg), and 33% had neuropathy (mTCNS score &amp;gt; 5). Using our novel algorithm, the mean daily dAGE intake was calculated as 13178 ± 4455 kU/day. Mean daily dAGE intake was significantly higher for men (15279 ± 6337 kU/day) compared to women (11628 ± 3699 kU/day) (p = 0.016). Importantly, dAGEs were significantly correlated with skin AGEs (r = 0.409, p = 0.004), an association that persisted after adjusting for age and gender (p = 0.005). Additionally, dAGEs were correlated with current A1c values (r=0.37, p = 0.009, adj. p = 0.042) and with BMI (r = 0.32, p = 0.024, adj. p = 0.020), even after adjusting for age and gender. No associations were found between dAGEs and retinopathy, microalbuminuria, or neuropathy. Additional analysis of the full planned cohort is ongoing, along with assessments of serum AGE levels. Conclusion: We have developed and validated a novel dietary AGE algorithm that quantifies dAGE intake using the Block FFQ and is correlated with skin AGEs and glycemic control among adults with T1D. If further validated in larger cohorts, we hope this dAGE tool will facilitate future investigation of the impact of dietary AGEs on diabetic complications. Presentation: Thursday, June 15, 2023

A Diet Pattern Characterized by Sugar-Sweetened Beverages Is Associated with Lower Decision-Making Performance in the Iowa Gambling Task, Elevated Stress Exposure, and Altered Autonomic Nervous System Reactivity in Men and Women.

The executive brain mediates and facilitates a set of cognitive functions, such as decision making, planning, self-regulation, emotional regulation, and attention. Executive dysfunction and related diseases are a rising public health concern. Evidence supports a link between nutritional factors and executive function (EF), but relatively little information exists about the relationship between diet patterns and this higher order cognitive ability. We and others have reported on the relationships between body weight regulation and affective decision making, as measured by performance in the Iowa Gambling Task (IGT). However, little is known about the relationships between performance in this decision-making task and whole diet patterns. In this study, we tested whether data-derived diet patterns based on energy-adjusted food intake data from the Block Food Frequency Questionnaire were associated with decision-making performance in the IGT. Secondarily, we examined the influence of these diet patterns on self-reported chronic stress exposure and heart rate variability, which is a marker of autonomic nervous system (ANS) activity. In prior studies, stress and ANS activity were shown to influence decision-making performance in the IGT. In this study, five distinct diet patterns were identified by cluster and factor analyses. A diet pattern best characterized by elevated sugar-sweetened beverage and added sugar consumption was associated with the lowest decision-making performance (p = 0.0049) and higher stress exposure (p = 0.0097). This same diet pattern was associated (p = 0.0374) with an IGT-affiliated decline in high-frequency HRV and an increase in low-frequency HRV, suggesting diet-induced ANS regulatory shifts in response to performing the EF task. Compared to the sugar-sweetened beverage diet pattern, diet patterns defined by more fruits/vegetables and low red meat (p = 0.0048) or higher omega-3 fatty acids and seafood (p = 0.0029) consumption were associated with lower chronic stress exposure. All outcomes were statistically adjusted for differences in BMI, age, sex, education level, and sensorimotor ability. Our findings provide new information that further supports the potential importance of whole diet patterns on cognitive disease prevention.

Diet Quality and Kidney Outcomes in Adolescent and Adult American Indians: the Strong Heart Family Study.

The burden of kidney disease is exceedingly high among American Indians (AIs). We sought to examine the relationship of diet quality, a modifiable risk factor, and kidney outcomes in AI adolescents and adults, hypothesizing that healthier diets are associated with lower odds of incident albuminuria and eGFR decline. This is an analysis from the Strong Heart Family Study, a longitudinal study of cardiovascular disease and its risk factors among AIs from Arizona, North and South Dakota, and Oklahoma (n = 1720, mean age 39 + / - 16years, 16% adolescents at baseline). Participants completed two exams (baseline: 2001-2003; follow-up: 2007-2009). The primary exposure was diet quality, expressed as the Alternative Healthy Eating Index 2010 (AHEI), on a 110-point scale (assessed using a 119-item Block food frequency questionnaire). The primary outcomes were as follows: 1) incident albuminuria (albumin to creatinine ratio 30mg/g or greater); and 2) eGFR decline of 30% or greater. Generalized estimating equations were used to examine the association of AHEI (in quartiles) with outcomes. Ten percent of participants (6% of adolescents) had incident albuminuria and 2% of participants (2% of adolescents) had eGFR decline. For those with normal fasting glucose levels, the odds ratio (OR) for incident albuminuria comparing extreme quartiles of diet quality (least healthy [reference] versus healthiest quartiles) was 0.48 (95% CI 0.28, 0.81) after adjustment for demographics and comorbidities. For American Indians with normal fasting glucose, higher diet quality decreases the odds of developing albuminuria. These findings inform future efforts to prevent CKD in American Indian adolescents and young adults.

Macular Pigment Optical Density and Skin Carotenoids in a Childhood Sample

BackgroundCarotenoids are plant pigments with light filtering and antioxidant properties that deposit in human tissues, including retina and skin. Descriptive characteristics and covariates of carotenoid status in macula and skin have been examined in adults; however, similar studies in children are limited. Thus, this study aimed to delineate how factors of age, sex, race, weight status, and dietary carotenoid intake relate to macular and skin carotenoids in children. MethodsChildren (7–13 y, N = 375) completed heterochromatic flicker photometry to assess macular pigment optical density (MPOD). Participants underwent anthropometrics to measure weight status (BMI percentile [BMI%]), and parent/guardian provided demographic information. Subsample data were available for skin carotenoids (N = 181), assessed using reflection spectroscopy, and dietary carotenoids (N = 101) using the Block Food Frequency Questionnaire. Relationships between skin and macular carotenoids were assessed using partial Pearson’s correlations controlling for age, sex, race, and BMI%. Relationships between dietary carotenoids and macular and skin carotenoids were assessed using stepwise linear regression including age, sex, race, and BMI% in the model. ResultsMean MPOD was 0.56 ± 0.22 and skin carotenoid score was 282 ± 94.6. There was no significant correlation between MPOD and skin carotenoids (r = 0.02, P = 0.76). BMI% was negatively associated with skin (stdβ = −0.42, P < 0.001), but not macular carotenoids (stdβ = −0.04, P = 0.70). Neither MPOD nor skin carotenoids were associated with age, sex, or race (all P > 0.10). MPOD was positively associated with energy-adjusted reported lutein + zeaxanthin intake (stdβ = 0.27, P = 0.01). Skin carotenoids were positively associated with energy-adjusted reported carotenoid intake (stdβ = 0.26, P = 0.01). ConclusionsThe mean MPOD values in children were higher than what has been reported in adult populations. Previous studies in adult samples report an average MPOD of 0.21. Although macular and skin carotenoids were not related, they were associated with dietary carotenoids relevant to the respective tissues; however, skin carotenoids may be more susceptible negative influence from higher weight status.

Experiences of Racial Discrimination and Periconceptional Diet Quality

BackgroundRacism is a key determinant of perinatal health disparities. Poor diet may contribute to this effect, but research on racism and dietary patterns is limited. ObjectiveWe aimed to describe the relation between experiences of racial discrimination and adherence to the 2015‒2020 Dietary Guidelines for Americans. MethodsWe used data from a prospective pregnancy cohort study conducted at 8 United States medical centers (2010‒2013). At 6‒13 weeks of gestation, 10,038 nulliparous people with singleton pregnancies were enrolled. Participants completed a Block food frequency questionnaire, assessing usual diet in the 3 mo around conception, and the Krieger Experiences of Discrimination Scale, assessing the number of situational domains (e.g., at school and on the street) in which participants ever experienced racial discrimination. Alignment of dietary intake with the 2015–2020 Dietary Guidelines for Americans was assessed using the Healthy Eating Index (HEI)-2015. ResultsThe study showed that 49%, 44%, 35%, and 17% of the Asian, Black, Hispanic, and White participants reported experiences of racial discrimination in any domain. Most participants experienced discrimination in 1 or 2 situational domains. There were no meaningful differences in HEI-2015 total or component scores in any racial or ethnic group according to count of self-reported domains in which individuals experienced discrimination. For example, mean total scores were 57‒59 among Black, 61‒66 among White, 61‒63 among Hispanic, and 66‒69 among Asian participants across the count of racial discrimination domains. ConclusionsThis null association stresses the importance of going beyond interpersonal racial discrimination to consider the institutions, systems, and practices affecting racialized people to eliminate persistent inequalities in diet and perinatal health.

Associations of Dietary Intake With Self-Reported Hearing Loss: Findings From the Survey of the Health of Wisconsin.

The purpose of this study was to evaluate associations of dietary intake components with hearing loss. Participants were from the population-based Survey of the Health of Wisconsin. The Block food frequency questionnaire measured dietary intake of carbohydrates, fiber, protein, free (added) sugars, fruits, vegetables, saturated and trans fats, and glycemic index. Intake was categorized into quintiles (Q). Hearing loss was self-reported. Logistic regression models were used to evaluate associations of dietary determinants with hearing loss. Results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs). Final models were adjusted for age, sex, total energy intake, race/ethnicity, education, smoking, and regular physical activity. There were 2,839 participants (56% women; Mage = 48.2 [SD = 14.5] years) included. Higher consumption of trans fat (Q5: OR = 1.83, 95% CI [1.27, 2.64]) and higher glycemic index (Q5: OR = 1.34, 95% CI [1.00, 1.80]) were associated with increased odds of hearing loss. Hearing loss was associated with fruit, saturated- and trans-fat intake in women, and trans-fat intake and glycemic index in men. Dietary intake was associated with self-reported hearing loss. Research on mechanistic pathways of associations and public health interventions to prevent hearing loss is needed.

Dietary Outcomes of a Multilevel, Multicomponent, Cluster Randomized Obesity Intervention in 6 Native American Communities in the Upper Midwest and Southwest United States

BackgroundImpacts of colonization on dietary intake have led to high rates of obesity and noncommunicable diseases among Native American adults. Multilevel, multicomponent (MLMC) interventions may improve dietary intake. ObjectivesTo assess the impact of a MLMC obesity intervention, OPREVENT2 (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans 2; clinicaltrials.gov NCT02803853), on dietary intake in Native American adults in Intervention versus Comparison communities. MethodsA cluster-randomized controlled trial was performed among participants in 6 communities randomized to Intervention (n = 3 and Comparison (n = 3). Adults aged 18 to 75 were recruited from tribal communities in the Southwest and upper Midwest United States from September 2016 to May 2017 (n = 601). This analysis included participants who completed baseline and follow-up surveys (82% retention), reported dietary intake between 500 and 7000 kcal/d, and had no missing data for outcomes of interest (n = 446). The intervention was implemented from May 2017, to November 2018. OPREVENT2 integrated individual, environmental, social, and structural factors and was implemented in food stores, worksites, schools, and community media outlets in Intervention communities. Activities included taste tests, cooking demonstrations, and stocking healthier items in food stores and were reinforced by a social m)edia campaign, posters, brochures, and booklets focused on nutrition. Individual-level dietary intake among participating Native American adults was assessed via modified Block food-frequency questionnaire at preintervention and postintervention. Multilevel mixed-effects linear regression, with clustering at the community level, was performed. ResultsBetween-group effects were significant (P < 0.05) for intake of carbohydrates (-23 g/d), total fat (-9 g/d), saturated fats (-3 g/d), and monounsaturated fats (-4 g/d), with greater decreases in Intervention communities. Between-group effect for total sugar (-12 g/d in Intervention communities) was not statistically significant. ConclusionsThis MLMC intervention was associated with significantly improved carbohydrate, total fat, and saturated fat intake among Native American adults. These changes are important for improving health within this population.