Diet History Interview Research Articles

Higher Dietary Inflammatory Index and Systemic Immune-Inflammation Index Score are Associated With Higher Risk of Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey From 1999 to 2018

ObjectiveChronic kidney disease (CKD) is characterized by a gradual decline in kidney function over time. The influence of dietary inflammatory potential on systemic inflammation has been acknowledged, albeit limited research exists on the association between dietary inflammatory index (DII) and CKD. Although inflammation has been implicated in kidney damage, the role of systemic immune-inflammation index (SII) in individuals with CKD remains uncertain. Therefore, the objective of this study was to explore the potential correlation between DII and SII with the prevalence of CKD in adult Americans. MethodsThis cross-sectional study used data from the National Health and Nutrition Examination Study (NHANES) between 1999 and 2018. The DII was calculated based on the 24 h dietary history interview, while the SII was calculated as the product of platelet count multiplied by neutrophil count and divided by lymphocyte count. CKD was diagnosed based on impaired glomerular filtration rate (< 60 ml/min per 1.73 m2) or urinary albumin-creatinine ratio (UACR) ≥30 mg/g. Multivariable logistic regression analyses and subgroup analyses were performed to examine the association between DII/SII and CKD. ResultsIn total, this study included 40,388 participants, of whom 7443 (18.4%) had CKD for the diagnosis. The prevalence of CKD changed from 14.84 % (95% CI: 13.20 to 16.48%) in 1999-2000 to 12.76% (95% CI: 11.10 to 14.43%) in 2017-2018. According to adjusted multivariate logistic regression models, individuals with higher DII scores had a higher likelihood of having CKD (OR = 1.24; 95% CI: 1.12-1.37). Similarly, Logistic regression analysis confirmed that higher SII scores were associated with a higher risk of CKD (OR = 1.37; 95% CI: 1.25-1.50). Subgroup analyses further demonstrated relatively stronger associations between DII/SII and CKD among individuals with other factors such as sex, age, BMI, smoking status, drinking status, hypertension, and diabetes. ConclusionsThe DII and SII scores were significantly positively associated with higher risks of CKD. Anti-inflammatory diet might have the potential to prevent CKD. The SII may serve as a cost-effective and straightforward approach for detecting CKD. Further prospective longitudinal studies are needed to verify the causality.

Association of dietary flavonoid intakes with prevalence of chronic respiratory diseases in adults

Background and aimsFlavonoids are a class of secondary plant metabolites that have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. This study was to explore the association between dietary flavonoid consumption and the prevalence of chronic respiratory diseases (CRDs) in adults.Methods and resultsThe six main types of flavonoids, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols, were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 and 2017–2018 by the two 24-h recall interviews. The prevalence of CRDs, including asthma, emphysema, and chronic bronchitis, was determined through a self-administered questionnaire. The analysis included 15,753 participants aged 18 years or older who had completed a diet history interview. After adjustment for potential confounders, the inverse link was found with total flavonoids, anthocyanidins, flavanones, and flavones, with an OR (95%CI) of 0.86 (0.75–0.98), 0.84 (0.72–0.97), 0.80(0.69–0.92), and 0.85(0.73–0.98) for the highest group compared to the lowest group. WQS regression revealed that the mixture of flavonoids was negatively linked with the prevalence of CRDs (OR = 0.88 [0.82–0.95], P < 0.01), and the largest effect was mainly from flavanones (weight = 0.41). In addition, we found that flavonoid intake was negatively linked with inflammatory markers, and systemic inflammation significantly mediated the associations of flavonoids with CRDs, with a mediation rate of 12.64% for CRP (P < 0.01).ConclusionHigher flavonoid intake was related with a lower prevalence of CRDs in adults, and this relationship may be mediated through systemic inflammation.

Low carbohydrate high fat-diet in real life assessed by diet history interviews

BackgroundLow carbohydrate high fat (LCHF) diet has been a popular low carbohydrate diet in Sweden for 15 years. Many people choose LCHF to lose weight or control diabetes, but there are concerns about the effect on long-term cardiovascular risks. There is little data on how a LCHF diet is composed in real-life. The aim of this study was to evaluate the dietary intake in a population with self-reported adherence to a LCHF diet.MethodsA cross-sectional study of 100 volunteers that considered themselves eating LCHF was conducted. Diet history interviews (DHIs) and physical activity monitoring for validation of the DHIs were performed.ResultsThe validation shows acceptable agreement of measured energy expenditure and reported energy intake. Median carbohydrate intake was 8.7 E% and 63% reported carbohydrate intake at potentially ketogenic levels. Median protein intake was 16.9 E%. The main source of energy was dietary fats (72.0 E%). Intake of saturated fat was 32 E% and cholesterol was 700 mg per day, both of which exceeded the recommended upper limits according to nutritional guidelines. Intake of dietary fiber was very low in our population. The use of dietary supplements was high, and it was more common to exceed the recommended upper limits of micronutrients than to have an intake below the lower limits.ConclusionsOur study indicates that in a well-motivated population, a diet with very low carbohydrate intake can be sustained over time and without apparent risk of deficiencies. High intake of saturated fats and cholesterol as well as low intake of dietary fiber remains a concern.

Dietary Inflammatory Index and All-Cause Mortality in Older Adults with Hypertension: Results from NHANES.

Both diet and inflammation are strongly associated with hypertension. However, the relationship between the dietary inflammatory index (DII) and the prognosis of hypertensive patients over 65 years of age is unclear. The objective of this study is to investigate the correlation between DII and all-cause mortality in older adults with hypertension. Data were obtained from the 2011−2018 National Health and Nutrition Examination Survey (NHANES) and followed for survival through December 31, 2019. DII was calculated by the 24 h dietary history interview. Cox proportional hazards models were used to investigate the associations. A total of 2531 participants were finally included. During a median follow-up of 4.33 years, 471 participants were determined as all-cause mortality. After adjusting for confounding factors, DII was positively correlated with the risk of all-cause mortality (HR = 1.08, 95% CI = 1.01−1.16). Compared with the anti-inflammatory diet group (DII < 0), the pro-inflammatory diet group (DII > 0) had a 54% increased risk of all-cause death (HR = 1.54, 95% CI = 1.13−2.10). The results were robust in subgroup and sensitivity analyses. DII was positively correlated with the all-cause mortality of elderly hypertensive patients. The results provided an aid to dietary evaluation in the nonpharmacologic management of hypertension.

Food frequency questionnaire for dietary assessment among adults at a risk of coronary heart disease: A mixed-methods study.

To develop and psychometrically test a food frequency questionnaire for adults at risk of coronary heart disease (Cardio-FFQ). Comprehensive dietary assessment is critical for the prevention of cardiovascular disease, but appropriate instruments to perform this work are lacking. A sequential mixed-methods study followed the COREQ and STROBE guidelines. This study was conducted between April 2016 and November 2017. It started with dietary history interviews (Phase 1) to identify candidate food items of the Cardio-FFQ, which validity and reliability were assessed (Phase 2) through expert consultation and four seasonal measurements, including test and retest with a 2-week gap every season. Physical activity and blood glucose and lipids were assessed seasonally, while another FFQ was administered during the fourth measurement. Content analysis was used to analyse verbatim interview transcripts, while descriptive and inferential analyses were used to simplify the Cardio-FFQ and examine its psychometric properties. Phase I involved 34 participants during their first onset of acute coronary syndrome and generated 176 candidate food items (consumed by at least three participants) under 12 food categories. These food items were simplified to form the 133-item Cardio-FFQ after discarding items with trivial contributions to food commonalities or between-person variance. Further analysis showed that the simplified questionnaire had satisfactory content validity, concurrent validity, convergent validity, predictive validity, known-group validity and test-retest reliability. The 133-item Cardio-FFQ is a valid and reliable tool for a comprehensive dietary assessment appropriate for adults at risk of coronary heart disease. Nurses may use the Cardio-FFQ to conduct a dietary assessment to better support people to commit to healthy diets, aiming to reduce the risk of coronary heart disease.

Associations between dietary intake of total protein and sources of protein (plant vs. animal) and risk of all-cause and cause-specific mortality in older Australian men: The Concord Health and Ageing in Men Project.

The association between dietary protein intake and the risk of mortality is still controversial. The present study aimed to examine the associations between dietary total, animal and plant protein intake and all-cause and cause-specific mortality. Community-dwelling men aged ≥70 years were recruited from local government areas surrounding Concord Hospital in Sydney, New South Wales for the Concord Health and Ageing in Men Project (CHAMP). The research dietitian administered a standardised validated diet history questionnaire to capture baseline dietary intake. In total, 794 men participated in a detailed diet history interview at the third wave. Adequacy of protein intake was assessed by comparing participant intake with the Nutrient Reference Values. Total protein intake was categorised into quintiles. Sources of protein were also captured. Mortality was ascertained through the New South Wales death registry. Cox proportional hazard models were used to assess the association between dietary total, animal and plant protein intake and risk of mortality. The mean age of the CHAMP men was 81 years. In total, 162 men died during a median follow-up of 3.7years. Of these, 54 (33.3%) and 49 (30.2%) men died due to cancer and cardiovascular disease, respectively. There were U-shaped associations between protein intake and all-cause and cancer mortality. In multiple adjusted analysis, the second (hazard ratio [HR]=0.38; 95% confidence interval [CI]=0.18-0.82) and third (HR=0.36; 95% CI=0.16-0.82) quintiles of protein intakes were significantly associated with reduced risk of all-cause and only second quintile (HR=0.47; 95% CI=0.10-0.93) of protein intake was significantly associated with cancer mortality. Each serve increase in animal protein was significantly associated with 12% (HR=1.12; 95% CI=1.00-1.26) and 23% (HR=1.23; 95% CI=1.02-1.49) increased risk of all-cause mortality and cancer mortality respectively. Conversely, each serve increase in plant protein intake was significantly associated with 25% (HR=0.75; 95% CI 0.61-0.92) and 28% (HR=0.72; 95% CI=0.53-0.97) reduced risk of all-cause and cancer mortality, respectively. No such associations were observed for cardiovascular disease mortality. Both second and third quintiles of total protein intake were associated with reduced all-cause and cancer mortality. Plant protein was inversely associated with all-cause and cancer mortality, whereas animal protein intake was positively associated with mortality.

Changes in micronutrient intake and factors associated with this change among older Australian men: the Concord Health and Ageing in Men Project.

To examine changes in micronutrient intake over 3 years and identify any associations between socio-economic, health, lifestyle and meal-related factors and these changes in micronutrient intakes among older men. Prospective study. Dietary adequacy of individual micronutrient was compared to the estimated average requirement of the nutrient reference values (NRV). Attainment of the NRV for twelve micronutrients was incorporated into a dichotomised variable 'not meeting' (meeting ≤ 6) or 'meeting' (meeting ≥ 7) and categorised into four categories to assess change in micronutrient intake over 3 years. The multinomial logistic regression analyses were conducted to model predictors of changes in micronutrient intake. Seven hundred and ninety-four men participated in a detailed diet history interview at the third wave (baseline nutrition) and 718 men participated at the fourth wave (3-year follow-up). The mean age was 81 years (range 75-99 years). Median intakes of the majority of micronutrients decreased significantly over a 3-year follow-up. Inadequacy of the NRV for thiamine, dietary folate, Zn, Mg, Ca and I were significantly increased at a 3-year follow-up than baseline nutrition. The incidence of inadequate micronutrient intake was 21 % and remained inadequate micronutrient intake was 16·4 % at 3-year follow-up. Changes in micronutrient intakes were significantly associated with participants born in the UK and Italy, low levels of physical activity, having ≥2 medical conditions and used meal services. Micronutrient intake decreases with age in older men. Our results suggest that strategies to improve some of the suboptimal micronutrient intakes might need to be developed and implemented for older men.

The association between antioxidant intake, dietary pattern and depressive symptoms in older Australian men: the Concord Health and Ageing in Men Project.

The objectives of the study were to evaluate the associations between antioxidant intake, dietary patterns and depressive symptoms among older men. 794 men participated in a detailed diet history interview at the Concord Health and Ageing in Men Project 3rd wave (considered baseline nutrition) and 781 men participated at the 4th wave (considered 3-year follow-up). Depressive symptoms were measured using the Geriatric Depression Scale (GDS ≥ 5). Dietary adequacy of antioxidant intake was assessed by comparing participants' median intake of vitamin A, E, C and zinc to the Nutrient Reference Values for Australia. Attainment of NRVs of antioxidant was categorised into a dichotomised variable 'poor' (meeting ≤ 2) or 'good' (meeting ≥ 3). Individual antioxidant nutrient was categorised into quartiles. The Australian and Mediterranean diet scores were assessed as predictor variables. The prevalence of GDS ≥ 5 was 12.8% at baseline nutrition and 13.2% of men developed GDS ≥ 5 at a 3-year follow-up. There was a significant cross-sectional association between poor antioxidant intake and GDS ≥ 5 in adjusted analyses [OR: 1.95 (95% CI 1.03, 3.70)]. Poor antioxidant intake at baseline nutrition remained prospectively associated with incident GDS ≥ 5 [OR: 2.46 (95% CI 1.24, 4.88)] in adjusted analyses. This association was also found for the lowest quartile of zinc [OR 2.72 (95% CI 1.37, 5.42)] and vitamin E intake [OR 2.18 (95% CI 1.05, 4.51)]. None of the other antioxidants and dietary patterns had a significant association with incident depressive symptoms. Inadequacy of antioxidant intake, particularly zinc and vitamin E, is associated with increased risk of clinically significant depressive symptoms in older men.

Energy drink consumption among 12- to 17-year-olds in Germany - Results of EsKiMo II.

Energy drinks are soft drinks that usually contain a large content of caffeine and sugar. Excessive caffeine intake can lead to side effects such as nausea and anxiety. Up to three milligrams of caffeine per kilogram of body weight per day is considered safe for children and young people. The second Eating study as a KiGGS Module (EsKiMo II, 2015–2017) collected nationwide representative data about children’s and adolescents’ dietary behaviour. To collect food intake data from 12- to 17-year-olds (n=1,353), a dietary history interview was used. 8.9% of the girls and boys stated that they had consumed energy drinks during the four-week reference period, with nearly a quarter of these individuals (n=99) exceeding the limit of safe caffeine intake solely through their consumption of energy drinks. This corresponds to 2.2% of the 12- to 17-year-olds in Germany. In addition to a general warning about the high levels of sugar present in sugary drinks, awareness also needs to be raised among young people about the dangers of excessive caffeine intake resulting from the consumption of energy drinks. Regulations governing sales and advertising should also be considered.

Fruit and vegetable consumption assessed by three dietary assessment methods in regard to sex, age, BMI and socio economic status

AbstractIntroductionA comparison of means of food consumption assessed by three different dietary assessment methods (diet history interviews [DHI], 24h-recalls [24HR] and weighing food records [WR]) used in the German National Nutrition Survey (NVS) II showed higher consumption means in 7 out of 18 food groups for DHI compared to 24HR and WR. Especially for food groups perceived as socially desirable such as fruit and vegetable means were highest for DHI. In the following, it is examined whether differences in fruit and vegetable consumption assessed by three different dietary assessment methods are related to sex, age, body mass index (BMI) or socio economic status (SES).MethodsA subgroup of 677 participants of the NVS II (2005–2007, 14–80 years of age) completed all three dietary assessment methods. DHI covered the food consumption of the past month, 24HR of the previous day and WR two times four days. Body height and weight were measured. SES was defined as an index based on the household income, employment status of the household's principle earner, and education level of the participant. The Multiple Source Method was applied to estimate population distributions of usual intakes based on two 24HR. Confidence intervals were calculated on basis of bootstrapping samples. Differences are considered to be significant if confidence intervals do not overlap.ResultsFor vegetable consumption, all subgroups regarding sex (male, female), age (14–18 years, 19–24 years, 25–34 years, 51–64 years, 65 years and older), body mass index (&lt; 25 kg/m2, 25–30 kg/m2, &gt; 30 kg/m2) and SES (5 groups from 1 = lower to 5 = upper SES) showed higher means for DHI compared to 24HR and WR. For fruit consumption, in almost all subgroups higher means for DHI compared to 24HR and WR could be found, except for the age group 19–24 years and the lowest SES group.DiscussionThe results show that higher means in fruit and vegetable consumption assessed by DHI compared to 24HR and WR are independent of sex, age, BMI and SES. A reason why socially desirable foods like fruit or vegetables are stated in higher amounts by DHI may be the enormous cognitive task of participants necessary to estimate quantities and frequencies over the long period of time covered by DHI.

Different versions of the German nutrient database affect energy and nutrient intake among adolescents

Updates of food composition data complicate comparisons of energy and nutrient intake between consecutive dietary surveys. The effect of an update of the German Nutrient Database (BLS) from version BLS2.3 to BLS3.02 on calculated energy and nutrient intake was evaluated among 1272 adolescents aged 12 to 17 years from the first German children and adolescents nutrition survey EsKiMo. Food consumption during the past four weeks was assessed by computer assisted dietary history interviews. Energy and nutrient intake was calculated using BLS2.3 and recalculated using BLS3.02. Pair-wise differences in intakes derived from BLS2.3 and BLS3.02 were statistically significant for all nutrients except for cholecalciferol. Differences were less than 5% for energy and macronutrients but exceeded 10% for ß-carotene (+12.3%), biotin (+12.9%), calcium (-18.7%), magnesium (-19.6%), iron (-17.6%), copper (-19.1%), and manganese (-11.8%). In total, 72.6 to 95.0% of participants were assigned to the same intake tertile based on both BLS-versions. Kappa-coefficients varied between 0.68 and 0.94. Median intakes were consistently above or below 100% of the reference values using both BLS versions, except for iron and calcium. In order to make more cautious interpretations of differences over time, recalculation of intakes according to the actual food composition database should be considered.

Micronutrient intake and biochemistry in adolescents adherent or nonadherent to supplements 5 years after Roux-en-Y gastric bypass surgery

BackgroundRoux-en-Y gastric bypass (RYGB) is an effective obesity treatment in adults and has become established in adolescents. Lower adherence to supplementation in adolescents confers a risk for long-term nutritional deficiencies. ObjectivesTo assess adherence to supplementation, micronutrient intake, and biochemistry in adolescents through 5 years after RYGB. SettingUniversity hospitals, multicenter study, Sweden. MethodsMicronutrient intake and adherence to supplementation were assessed by diet history interviews and biochemistry preoperatively, 1, 2, and 5 years after RYGB in 85 adolescents (67% females), aged 16.5 years (± 1.2) with a body mass index of 45.5 kg/m2 (± 6.0). Adherence was defined as taking prescribed supplements ≥3 times a week. Micronutrient intake and biochemistry were compared with matched controls at 5 years. ResultsOver 75% completed the dietary assessments across 5 years after RYGB. Adherence ranged between 44–61% through 5 years. At 5 years, ferritin and hemoglobin decreased (P < .04) and 61% had iron deficiency (P ≤ .001). Among females with iron deficiency, most did not adhere to supplementation (P = .005), and 59% of these had anemia (P < .001). Vitamin D insufficiency continued after surgery and 80% of participants who did not adhere to supplementation had insufficiency (P = .002). Adolescents not adhering had lower levels of vitamin D, B12, and ferritin (females) compared with both adhering adolescents and the control group (all P < .04). ConclusionsHalf of adolescents after RYGB reported sufficient long-term adherence to supplementation. Adhering to supplements and reporting a higher micronutrient intake were associated with more favorable biochemistry. Results support the recommendations for monitoring micronutrient intake and biochemistry in all patients who have undergone RYGB surgery, and the recommendation of higher preventive supplementation of vitamin D and iron in both sexes. As hypothesized, adolescents not adhering had a higher prevalence of long-term micronutrient deficiencies.

The Association of Breakfast Frequency and Cardiovascular Disease (CVD) Risk Factors among Adolescents in Malaysia.

Breakfast frequency is associated with cardiovascular disease (CVD) risk in Western populations, possibly via the types of food eaten or the timing of food consumption, but associations in Malaysian adolescents are unknown. While the timing of breakfast is similar, the type of food consumed at breakfast in Malaysia differs from Western diets, which allows novel insight into the mechanisms underlying breakfast–CVD risk associations. We investigated foods eaten for breakfast and associations between breakfast frequency and CVD risk factors in the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs). Breakfast (frequency of any food/drink reported as breakfast in 7-day diet history interviews) and CVD risk factors (body mass index (BMI), waist circumference, fasting blood glucose, triacylglycerol, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and systolic and diastolic blood pressure) were cross-sectionally associated using linear regression adjusting for potential confounders (n = 795, age 13 years). Twelve percent of adolescents never ate breakfast and 50% ate breakfast daily, containing mean (SD) 400 (±127) kilocalories. Commonly consumed breakfast foods were cereal-based dishes (primarily rice), confectionery (primarily sugar), hot/powdered drinks (primarily Milo), and high-fat milk (primarily sweetened condensed milk). After adjustment, each extra day of breakfast consumption per week was associated with a lower BMI (−0.34 kg/m2, 95% confidence interval (CI) −0.02, −0.66), and serum total (−0.07 mmol/L 95% CI −0.02, −0.13) and LDL (−0.07 mmol/L 95% CI −0.02, −0.12) cholesterol concentrations. Eating daily breakfast in Malaysia was associated with slightly lower BMI and total and LDL cholesterol concentrations among adolescents. Longitudinal studies and randomized trials could further establish causality.

Prospective Associations Between Dietary Antioxidant Intake and Frailty in Older Australian Men: The Concord Health and Ageing in Men Project.

The objective of the study is to evaluate the prospective associations between antioxidant intake and incident frailty among older Australian men aged ≥75 years. Seven hundred and ninety-four men participated in a detailed diet history interview at the Concord Health and Ageing in Men Project (CHAMP) study third wave (considered baseline nutrition here) and 781 men participated at the fourth wave (considered 3-year follow-up here). The main outcome measurement was incident frailty at 3-year follow-up, using the Cardiovascular Health Study definition. Dietary adequacy of antioxidant intake was assessed by comparing participants' median intakes of four dietary antioxidants (vitamin A, E, C, and zinc) to the nutrient reference values (NRVs). Attainment of the NRVs was incorporated into a dichotomized variable "poor" (meeting ≤2 antioxidants) or "good" (meeting ≥3 antioxidants) as the independent variable using the cut-point method. Also, intakes of each individual dietary antioxidant at baseline nutrition were categorized into quartiles. Analyses were performed using multinomial logistic regression. Incidence of pre-frailty was 53.0% and frailty was 6.4% at 3-year follow-up. Poor dietary antioxidant intake (meeting ≤2) at baseline nutrition was associated with incident frailty at 3-year follow-up in unadjusted (OR: 2.59 [95% CI: 1.47, 4.59, p = .001]) and adjusted (OR: 2.46 [95% CI: 1.10, 5.51, p = .03]) analyses. The lowest quartile of vitamin E intake (<7.08 mg/d) was significantly associated with incident frailty (OR: 2.46 [95% CI: 1.01, 6.00, p = .05]). Poor antioxidant intake, particularly vitamin E, is a plausible factor associated with incident frailty among older men. This supports the need for clinical trials of diets rich in antioxidants or possibly low-dose antioxidant supplements, for prevention of frailty.

Evaluation of Reliability of the Recomputed Nutrient Intake Data in the National Heart, Lung, and Blood Institute Twin Study.

The nutrient intake dataset is crucial in epidemiological studies. The latest version of the food composition database includes more types of nutrients than previous ones and can be used to obtain data on nutrient intake that could not be estimated before. Usual food consumption data were collected among 910 twins between 1969 and 1973 through dietary history interviews, and then used to calculate intake of eight types of nutrients (energy intake, carbohydrate, protein, cholesterol, total fat, and saturated, monounsaturated, and polyunsaturated fatty acids) in the National Heart, Lung, and Blood Institute Twin Study. We recalculated intakes using the food composition database updated in 2008. Several different statistical methods were used to evaluate the validity and the reliability of the recalculated intake data. Intra-class correlation coefficients between recalculated and original intake values were above 0.99 for all nutrients. R2 values for regression models were above 0.90 for all nutrients except polyunsaturated fatty acids (R2 = 0.63). In Bland–Altman plots, the percentage of scattering points that outlay the mean plus or minus two standard deviations lines was less than 5% for all nutrients. The arithmetic mean percentage of quintile agreement was 78.5% and that of the extreme quintile disagreement was 0.1% for all nutrients between the two datasets. Recalculated nutrient intake data is in strong agreement with the original one, supporting the reliability of the recalculated data. It is also implied that recalculation is a cost-efficient approach to obtain the intake of nutrients unavailable at baseline.

Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery

BackgroundInformation is scarce on long-term changes in energy intake (EI), dietary energy density (DED), and body composition in adolescents undergoing laparoscopic Roux-en-Y gastric bypass (RYGB). ObjectivesTo investigate long-term changes in EI, DED, and body composition in adolescents after LRYGB. SettingUniversity hospitals, multicenter study, Sweden. MethodsEighty-five adolescents (67% girls; mean ± standard deviation, age 16.0 ± 1.2 yr, body mass index 45.5 ± 6.1 kg/m2) were assessed preoperatively (baseline) and 1, 2, and 5 years after LRYGB with diet history interviews and dual-energy x-ray absorptiometry. Matched obese adolescent controls receiving nonsurgical treatment were assessed only at 5 years. ResultsWeight decreased 31%, 33%, and 28% at 1, 2, and 5 years after LRYGB (P < .001) while controls gained 13% over 5 years (P < .001). Dietary assessments were completed in 98%, 93%, 87%, and 75% at baseline and 1, 2, and 5 years, respectively, and in 65% of controls. Baseline EI (2558 kcal/d), decreased by 34%, 22%, and 10% after 1, 2, and 5 years (P < .05). DED decreased at 1 year (P = .03). Macronutrient distribution was not different from controls at 5 years, but EI and DED were 31% and 14% lower (P < .015). Fat, fat-free, and muscle mass decreased through 5 years after LRYGB (P < .001). Boys preserved muscle mass more than girls (P < .01). Adequate protein intake was associated with preservation of muscle mass (P = .003). ConclusionsIn adolescents undergoing LRYGB EI remained 10% lower 5 years after surgery. Decreased EI and DED, rather than macronutrient distribution, are important factors in weight loss after surgery. Higher protein intake may facilitate preservation of muscle mass.

Misreporting of Energy Intake in Older People: Comparison of Two Dietary Assessment Methods

Accurate assessment of dietary intake is essential in clinical practice and research. While energy intake (EI) misreporting has been extensively studied in the general population, relatively little is known about misreporting among older people. This cross-sectional study used clinical data routinely collected in 127 participants, aged 70–96 years, from the Toulouse Frailty Clinic. EI was assessed by diet history interview and three-day food record. Misreporters were identified with the Goldberg cut-off method, using the Harris–Benedict equation to estimate total energy expenditure. The response rate was 66% for three-day food record and 93% for diet history interviews. EI from diet history interviews (1799 ± 416 kcal/day) was significantly higher than from food records (1400 ± 381 kcal/day; p < 0.001) and closest to total energy expenditure (1758 ± 437 kcal/day; (p > 0.05). Thirty percent of participants were identified as underreporters with three-day food records vs. 9% with diet history interviews. Overreporters were found with diet history interviews only (11% of participants). In older people, the diet history interview has the advantage of obtaining a higher response rate and a lower underreporting rate, compared to three-day food record. Nevertheless, with this method, overreporting was observed and interpreting results should be done with caution.

Translating advice to eat more vegetables into practice: observations from a 12-month weight loss trial.

This study aimed to identify the main vegetable sources of overweight participants during a 12-month randomised controlled trial for weight loss. Secondary analysis using data from diet history interviews to determine changes to daily vegetable intake amounts and types throughout the trial at 0, 3 and 12 months. Pre-trial 77% participants consumed frozen vegetables. At baseline (n = 113, 85 F), participants reported 345 ± 170 (56-920) g/day vegetables increasing to 498 ± 180 (146-930) g/day at 3 months and remaining stable at 475 ± 169(170-1053) g/day by 12 months (p = 0.001). At baseline, 32 of 34 different vegetable categories were reported, mainly tomato (69.9 g/day) and, potato (58.2 g/day). After 3 months (n = 109), seven vegetables remained in the top 10 reported (contributing 72%). Tomato remained top ranked to 12 months. Following advice to consume more vegetables, consumption increased above the Australian Dietary recommendation of ~375 g/day. Tomatoes remained a mainstay regardless of the time of year, but choices changed with time. Frozen vegetables may be a feasible option.

Comparison of food consumption and nutrient intake assessed with three dietary assessment methods: results of the German National Nutrition Survey II

PurposeComparison of food consumption, nutrient intake and underreporting of diet history interviews, 24-h recalls and weighed food records to gain further insight into specific strength and limitations of each method and to support the choice of the adequate dietary assessment method.MethodsFor 677 participants (14–80 years) of the German National Nutrition Survey II confidence intervals for food consumption and nutrient intake were calculated on basis of bootstrapping samples, Cohen’s d for the relevance of differences, and intraclass correlation coefficients for the degree of agreement of dietary assessment methods. Low energy reporters were identified with Goldberg cut-offs.ResultsIn 7 of 18 food groups diet history interviews showed higher consumption means than 24-h recalls and weighed food records. Especially mean values of food groups perceived as socially desirable, such as fruit and vegetables, were highest for diet history interviews. For “raw” and “cooked vegetables”, the diet history interviews showed a mean consumption of 144 and 109 g/day in comparison with 68 and 70 g/day in 24-h recalls and 76 and 75 g/day in weighed food records, respectively. For “fruit”, diet history interviews showed a mean consumption of 256 g/day in comparison with 164 g/day in 24-h recalls and 147 g/day in weighed food records. No major differences regarding underreporting of energy intake were found between dietary assessment methods.ConclusionsWith regard to estimating food consumption and nutrient intake, 24-h recalls and weighed food records showed smaller differences and better agreement than pairwise comparisons with diet history interviews.

Comprehensive assessment of food and nutrient intake of children and adolescents in Germany: EsKiMo II \u2013 the eating study as a KiGGS module

BackgroundAs part of the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2), food and nutrient intake of children and adolescents aged 6–17 years living in Germany is assessed in EsKiMo II – the Eating Study as a KiGGS Module.MethodsEsKiMo II is a cross-sectional study, conducted from June 2015 until September 2017. The study population comprises 6 to 17-year-old study participants from the cross-sectional sample of KiGGS Wave 2 in 167 KiGGS sample points, which are revisited by trained nutritionists. Dietary intake is assessed by weighted food records during three consecutive days plus one randomly selected day within the following 3 months for children aged 6–11 years. Dietary intake for adolescents aged 12–17 years is assessed by computer-assisted dietary history interviews, reflecting the past four weeks, using the software DISHES. Further information, for example, about specific diets and dietary supplement intake, is reported during a standardised computer assisted interview for all participants. Food items are coded by the German Food Code and Nutrient Database (BLS 3.02).DiscussionEsKiMo II provides actual data on the dietary behaviour of children and adolescents living in Germany and their determinants. Results of EsKiMo II will be relevant for decision-making, measures, and evaluations within nutrition, consumer and health policy.