Diet Quality In Adolescents Research Articles

Association of the Healthy Eating Index (HEI) Score of Children Enrolled in School Lunch and Breakfast Program and Frequency of Meals at School: NHANES 2015–2016

Abstract Objectives Nutritious and well-balanced school meals are critical to curbing the obesity epidemic in school-aged children while also providing adequate nutrition to sustain healthy growth and development. The school lunch program underwent a significant revamp in 2012 to align the menu with the US Dietary Guidelines. The Healthy Eating Index (HEI) is a metric that measures this alignment. The purpose of this study is to calculate usual HEI scores for children and compare HEI scores across frequency of school meals consumed using NHANES 2015–2016. Methods Children 18y and younger were included in the analyses and categorized into one of five groups for breakfast and lunch, each. Either consuming no school breakfast/lunch or consuming school breakfast/lunch 1–5 times daily. Usual HEI scores and standard errors were determined using the NCI method. Independent samples t-tests were computed for pairwise comparisons between no school breakfast/lunch consumption and increasing frequency of consumption. All analyses were performed using SAS version 9.4. Results Mean HEI scores for children consuming 0, 1, 2, 3, 4, 5 school breakfasts per week was 44.7 ± 0.8, 44 ± 1.9, 41.4 ± 2.4, 43.9 ± 1.4, 40.8 ± 2.3, 42.7 ± 1.0 and the mean HEI score for children consuming 0, 1, 2, 3, 4, 5 lunches per week was 44.7 ± 0.8, 46.7 ± 0.8, 42.3 ± 2.5, 45.0 ± 0.9, 46.1 ± 0.9, 43.3 ± 0.8, respectively. These results indicate that there are no significant differences across children who consumed these meals at various frequencies with those that do not consume school meals. Although there were no observed differences, overall diet quality was poor for those who do and do not consume school breakfast/lunch. Conclusions Although children and adolescents who consumed school breakfast/lunch did not appear to have greater diet quality than those who did not, overall diet quality was poor for all groups. Therefore, additional efforts are needed to improve diet quality in children and adolescents. Funding Sources Texas Woman's University.

Portuguese adolescents diet quality, lifestyle variables and body composition, in relation to precise measures of maturity

BACKGROUND:A healthy diet reflects other healthy behaviours and contributes to better health outcomes. OBJECTIVE:This study aimed to describe the diet quality of Portuguese adolescents and its associations with physical activity, screen-time, sleep duration, and socioeconomic status, considering bo dy composition and maturity. METHODS:A cross-sectional study included 669 participants aged 10–17 years from four state schools in the Lisbon area, Portugal. The diet quality was obtained through the Diet Quality Index-International (DQI-I), adapted for the Mediterranean diet. The lifestyle variables (physical activity, screen-time, sleep duration, and socioeconomic status) were reported in the Biosocial and Life Routine Questionnaire (RAPIL II). The fat mass (FM) was estimated from skinfolds thickness and body mass index (BMI) was calculated using the World Health Organization criteria. Maturity indicators were predicted and objectively measured. Analyses were stratified by sex. RESULTS:Participants showed a mean DQI-I of 50.0% and a high compliance with protein, iron, vitamin C, and cholesterol recommendations. More than 50% exhibit low vegetables and fruit consumption and high saturated fat, sodium and “empty calorie foods” intakes. Fruit, grain, fibre, iron, calcium, cholesterol, sodium, “empty calorie foods”, and fatty acid ratio showed significant sex differences (p < 0.05), mainly due to age and physical activity. CONCLUSIONS:Overall adolescents showed low diet quality. Most participants reported not to meet vegetable, fruit, grain, and fibre recommendations. Both, the older boys and with the lowest FM showed better adequacy for grain and fibre intakes, whereas worse compliance for cholesterol. Among girls, higher grain and calcium intake reflect higher levels of physical activity.

Chrono-Nutrition and Diet Quality in Adolescents with Delayed Sleep-Wake Phase Disorder.

Background: Delayed sleep-wake phase disorder (DSPD), characterized by delayed sleep-onset and problems with awakening in the morning, is mostly prevalent in adolescents. Several studies have suggested chrono-nutrition could present a possible modifiable risk factor for DSPD. Objective: To describe differences in chrono-nutrition and diet quality in adolescents with DSPD compared to age-related controls. Methods: Chrono-nutrition and diet quality of 46 adolescents with DSPD, aged 13–20 years, and 43 controls were assessed via questionnaires. Diet quality included the Dutch Healthy Diet index (DHD-index) and Eating Choices Index (ECI). Results were analysed using logistic regression and Spearman’s partial correlation. Results: Compared with controls, DSPD patients consumed their first food of the day significantly later on weekdays (+32 ± 12 min, p = 0.010) and weekends (+25 ± 8 min, p = 0.005). They consumed their dinner more regularly (80.4% vs. 48.8%, p = 0.002) and consumed morning-snacks less frequently (3.0 ± 2.1 days vs. 4.2 ± 1.7 days, p = 0.006). No differences in clock times of breakfast, lunch, or dinner were found. Moreover, no significant differences in overall diet quality were observed. Conclusion: This descriptive study showed chrono-nutritional differences between adolescents with and without DPSD. Further studies are needed to explore features of chrono-nutrition as a possible treatment of DPSD.

The development of a short food frequency questionnaire to assess diet quality in UK adolescents

AbstractUK adolescents have poorer diets than other age groups. Improving adolescents’ diets has the potential to improve their health now and in later life, and the health of their future offspring. Established dietary assessment techniques can be difficult to use with adolescents due to high participant burdens. Robust and easy-to-implement techniques are required to assess adolescent diet in large-scale studies. This study aimed to identify the key indicator foods that contribute most to better quality dietary patterns in UK adolescents for use in a short food frequency questionnaire (FFQ).Dietary data, collected using 4-day diet diaries, and nutritional biomarker data from waves 1–8 of the National Diet and Nutrition Survey rolling programme were used. Principal component analysis (PCA) was applied to 139 food groups to identify the key indicator foods that contribute most to better quality dietary patterns.A 20-group diet score was calculated using coefficients for the 20 indicator foods from the 139-group PCA and multiplying by their standardised reported frequency of consumption. Scores were standardised to a mean of zero and a standard deviation (SD) of one.The association and the agreement between the 139-group diet quality score and 20-group score were calculated using Spearman's correlation coefficient and Bland-Altman limits of agreement, respectively. Spearman's correlations were used to examine the associations between the two diet quality scores and nutritional biomarkers.NDNS dietary data were available for 1282 boys and 1305 girls aged 11–18 years. The first PCA component explained 3.0% of variance in the dietary data. A high-quality diet was characterised by greater consumption of fruit, vegetables, beans and pulses, wholegrains, nuts, and tap water, plus lower consumption of sugar-sweetened beverages, chips, processed meats, white bread, crisps, whole milk, baked beans, and added sugar.A correlation of 0.86 was observed between the full 139-group score and the 20-group score with the difference between being 0 SDs. Bland-Altman 95% limits of agreement were -0.98 to 0.98 SDs. Correlations, in the expected direction, were seen between the 139-group score and all nutritional biomarkers (25-hydroxyvitamin D(rs = 0.14), vitamin C(rs = 0.30), total carotenoids(rs = 0.25), total serum folate(rs = 0.42), homocysteine(rs = -0.25) and vitamin B12(rs = 0.21)). Correlations with the 20-group score were only slightly attenuated.The 20-group diet quality score showed reasonable agreement with the full 139-item score. Both scores were correlated with nutritional biomarkers. A short 20-item FFQ can provide a meaningful and easy-to-implement tool to assess diet quality in adolescents.

Healthy eating index in a nationally representative sample of children and adolescents by socio-demographic characteristics: the Weight disorders survey of the CASPIAN-IV Study

To date, the diet quality of Iranian students in relation to socio-demographic characteristics was not studied. The present study aimed to explore the association between the healthy eating index and sociodemographic characteristics among a nationally representative sample of Iranian children and adolescents. This nationwide study was conducted in 5187 children and adolescents, aged 6-18 years. Data regarding socio-demographic variables, lifestyle factors, family and student dietary habits, and quality of life were gathered via validated questionnaires. The Alternate Healthy Eating Index-2010 (AHEI-2010) was used to calculate diet quality scores. The odds of high diet quality was 24% lower in adolescents (13-18years) compared to children aged 6-12 years (OR 0.76, CI 0.64-0.89, p= 0.001). Students in families with moderate (OR 1.30, CI 1.13-1.49, p < 0.001) and high socioeconomic status (OR 1.36, CI 1.18-1.57, p < 0.001) were 30% and 36% more likely to have a higher diet quality score, respectively. Lower mean AHEI-2010 scores (CI) were found for low socio-economic status (46.18-47.10), adolescents 47.40 (46.94-47.82), boys 47.51 (47.14-47.88) and South-East area 47.19 (46.54-49.15) (p < 0.05) due to lower intake of fruits and vegetables and high intake of sodium and sugar-sweetened beverages. The overall diet quality of Iranian children and adolescents was low with disparities across sociodemographic variables notably age and familial socio-economic status.

Tip 1 Diyabetli Çocuk ve Adölesanların Diyet Kalitesi, Diyet Asit Yükü ve Glisemik Kontrol ile İlişkisi

Amaç: Artmış diyet kalitesi, Tip 1 Diabetes Mellitus’ta (T1DM) iyi bir metabolik kontrol ve azalmış komplikasyon riski ile ilişkili olabilirken, günümüzde sıkça tüketilen Batı tarzı diyetlerin düşük diyet kalitesi ve yüksek diyet asit yüküne sahip olduğu gösterilmiştir. Bu araştırmada, T1DM’li çocuk ve adölesanların diyet kalitesi ve asit yükünün saptanması ve bu parametrelerin metabolik kontrol ile ilişkisinin değerlendirilmesi amaçlanmıştır.&#x0D; Bireyler ve Yöntem: Araştırmaya, 8-18 yaş arasında 75 T1DM’li ve 88 sağlıklı birey dahil edilmiş ve tüm katılımcıların antropometrik ölçümleri yapılmıştır. Diyet kalitesinin ve asit yükünün saptanabilmesi için 24 saatlik geriye dönük besin tüketim kaydı alınmıştır. Diyet kalitesi, Sağlıklı Yeme İndeksi (SYİ)-2015 ve Türkiye Beslenme Rehberi’ne (TÜBER) göre revize edilen SYİ-2015 ile değerlendirilmiştir. Diyet asit yükünün tahmini ise potansiyel renal asit yükü (PRAL) değeri ve net endojen asit üretimi (NEAP) skoru hesaplanarak yapılmıştır. Metabolik kontrolün göstergesi olarak, son ölçülen HbA1c değerleri kaydedilmiştir.&#x0D; Bulgular: Araştırma sonucunda, T1DM’li grubun diyet kalitesi (SYİ-2015: 50.5±10.2, TÜBER’e göre SYİ-2015: 45.5±9.6) sağlıklı gruptan (SYİ-2015: 43.9±10.7, TÜBER’e göre SYİ-2015: 37.8±10.9) daha yüksek ve diyet asit yükleri daha düşük (diyabetlilerde PRAL: -3.5±20.4, NEAP: 39.3±16.4; sağlıklı PRAL: 9.8±15.0, NEAP: 55.9±21.6 mEq/gün) bulunmuştur (p&lt;0.001). Ayrıca, diyabetik grupta PRAL ve NEAP skorları ile HbA1c düzeyleri arasında pozitif yönde bir ilişki saptanırken, TÜBER’e göre SYİ-2015 toplam puanları ile HbA1c arasında negatif yönde bir ilişki olduğu görülmüştür (p&lt;0.05).&#x0D; Sonuç: T1DM’li çocukların ve ergenlerin diyet kalitesi sağlıklı yaşıtlarından daha iyi olsa da, T1DM’li kişilerin diyet kalitesi önerilen sınıflandırmaya göre hala orta-düşük düzeydeydi. Ayrıca, diyet kalitesinin iyileştirilmesi ve diyet asit yükünün azaltılması, iyi bir metabolik kontrol için faydalı olabilir.

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

Race, Gender, Family Structure, Socioeconomic Status, Dietary Patterns, and Cardiovascular Health in Adolescents

ABSTRACTBackgroundDietary patterns represent a broad picture of food and nutrient consumption and may be more predictive of health outcomes than individual foods and nutrients.ObjectiveWe investigated the relations among race, gender, family structure, parental socioeconomic status (SES), dietary patterns, and cardiovascular disease (CVD) profiles among adolescents in the southeastern region of the United States.MethodsA total of 743 adolescents from a cross-sectional study were divided into 4 dietary pattern groups by K-means cluster analysis. Multinomial logistic regression was performed to determine the relations among the parental SES, family structures, and dietary patterns of the adolescents. Associations between dietary patterns and CVD profiles were analyzed by multiple linear regression.ResultsFour dietary patterns were derived: “healthy” (17%), “snacks and sweets” (26%), “processed meat” (20%), and “sugar-sweetened beverage (SSB) and fried food” (37%). Whites and females were more likely to have a “healthy” dietary pattern (Ps < 0.001). There were significant race/ethnicity differences in family structures, SES, and dietary patterns (Ps < 0.05). In whites, higher mother's education and father's education and occupation were associated with greater likelihood of a “healthy” dietary pattern (Ps < 0.05). Stay-at-home mother was associated with less likelihood of an “SSB and fried food” pattern (P = 0.023). In blacks, higher mother's occupation, father's education, and living with both parents were associated with more likelihood of a “healthy” dietary pattern (Ps < 0.05). Stay-at-home father was associated with less likelihood of the “snacks and sweets” (P = 0.025) and “SSB and fried food” dietary patterns (P = 0.044). Overall, adolescents with poor dietary patterns exhibited higher percentage body fat, waist circumference, systolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance, C-reactive protein, and total triglyceride (Ps < 0.05).ConclusionsOur data suggest that family structure, parental working status, and SES are associated with the diet quality in adolescents. Moreover, “snacks and sweets,” “processed meat,” and “SSB and fried food” dietary patterns are all associated with worse CVD risk profiles.

Mother’s dietary quality during pregnancy and offspring’s dietary quality in adolescence: Follow-up from a national birth cohort study of 19,582 mother–offspring pairs

BackgroundThe Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that exposures during early life, such as maternal dietary intake during pregnancy, may have a lifelong impact on the individual’s susceptibility to diseases. The individual’s own lifestyle habits are obviously an additional factor, but we have only limited knowledge regarding how it may interact with prenatal exposures in determining later disease. To gain further insight into these potentially complex relationships, we examined the longitudinal association between maternal diet quality during pregnancy and diet quality in early adolescence in a contemporary cohort.Methods and findingsFrom 1996 to 2003, the Danish National Birth Cohort (DNBC) was established. Women from across the country were enrolled, and dietary intake in midpregnancy was assessed concurrently with a 360-item food frequency questionnaire (FFQ) (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/dnbc-food-frequency-questionnaire/dnbc-food-frequency-questionnaire-pdf.pdf?la=en). During 2013–2018, dietary intake was assessed at age 14 years with a 150-item FFQ (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/ffq-14/dnbc-ffq-14-english-translation.pdf?la=en) in the DNBC children. Among the 19,582 mother–offspring pairs included in the analyses, the mean age (±standard deviation [SD]) was 30.7 (±4.1) years and 14.0 (±0.0) years for mothers and offspring, respectively. The majority of both mothers (67%) and offspring (76%) were classified as normal weight. For both questionnaires, a Healthy Eating Index (HEI) was developed as an indicator for diet quality based on current Danish Food-Based Dietary Guidelines (FBDG) including eight components: fruits and vegetables, fish, dietary fibres, red meat, saturated fatty acids (SFAs), sodium, sugar-sweetened beverages (SSBs), and added sugar. The HEI score was divided into quartiles; individuals in the highest quartile represented those with the most optimal diet. The maternal HEI score was correlated positively with offspring HEI score (Pearson r = 0.22, p < 0.001). A log-linear binomial model was used to estimate the relative risk of the offspring being in the highest quartile of HEI at age 14 years if the mother was ranked in quartile 4 during pregnancy. Results showed that offspring born to mothers who were in the highest HEI quartile during pregnancy were more likely themselves to be located in the highest HEI quartile at age 14 years (risk ratio [RR]: 2.1, 95% confidence interval [CI]: 2.0, 2.3, p < 0.001). Adjusting for maternal prepregnancy body mass index (BMI), parity, education, alcohol intake, physical activity, smoking, and breastfeeding, as well as offspring total energy intake and sex, did not influence the effect estimates. The limitations of our study include that some attrition bias towards more healthy participants was observed when comparing participants with nonparticipants. Bias in the FFQ method may also have resulted in underrepresentation of adolescents with poorer diet quality.ConclusionsIn this study using data from a large national birth cohort, we observed that maternal diet quality during pregnancy was associated with diet quality of the offspring at age 14 years. These findings indicate the importance of separating early dietary exposures from later dietary exposures when studying dietary aetiologies of diseases postulated to have developmental origins such as, for instance, obesity or asthma in observational settings.

1323-P: Offspring Diet Quality Modifies the Effect of Gestational Diabetes Exposure on Adiposity Outcomes: The EPOCH Study

Intrauterine exposure to gestational diabetes (GDM) is associated with increased adiposity; however, not all exposed offspring exhibit excess adiposity, indicating that additional factors are involved. We examined whether higher diet quality in childhood and adolescence modifies the association between GDM exposure and adiposity outcomes. In 499 offspring (n=88 GDM-exposed), we assessed dietary intake (via food frequency questionnaire) and adiposity (BMI, waist-to-height ratio, visceral and subcutaneous adipose tissue [VAT, SAT], and subscapular-to-triceps skinfold ratio) at 6-12 and 12-19 years of age. Diet quality was estimated with the Healthy Eating Index (HEI). Linear mixed models were used to examine the association between GDM exposure and adiposity among those with higher (HEI≥60) versus lower (HEI&amp;lt;60) diet quality, adjusting for sex, race/ethnicity, age, and pubertal status. Among those with lower diet quality, exposure to GDM was associated with increased adiposity for all outcomes (all p&amp;lt;0.05; Table). Among those with higher diet quality, there was no association between GDM exposure and adiposity outcomes (all p&amp;gt;0.05). Our results suggest that higher diet quality in childhood and adolescence may be a potential postnatal strategy for reducing adiposity among offspring exposed to GDM. Disclosure K.A. Sauder: None. T.A. Bekelman: None. K.K. Harrall: None. D.H. Glueck: None. D. Dabelea: None. Funding National Institutes of Health

Diet quality index for Brazilian adolescents: the ERICA study.

This study aimed to assess the dietary patterns of adolescents using a food-based diet quality index and their compliance with a healthy dietary guideline METHODS: Participants included 71,553 Brazilian adolescents (12-17years old) from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional school-based multicenter study.. Dietary intake was measured by one 24-h recall. A second recall was collected in a random subsample (~ 10%) to correct within-person variability. The Diet Quality Index for Adolescents adapted for Brazilians (DQIA-BR) was used to measure the overall quality of the dietary intake. The National Cancer Institute method was applied to estimate usual dietary intake. The DQIA-BR and the distribution of its components (quality, diversity, and equilibrium) were analyzed according to sex, geographical area, and type of school RESULTS: The mean (SD) DQIA-BR scores were 14.8% (6.1%) for females and 19.0% (6.3%) for males. All analyzed strata revealed low scores of DQIA-BR and its components. The median usual intake was five to sevenfold below the recommendations for vegetables and fruits and approximately twofold below the recommendations for dairy. The highest DQIA-BR mean scores were found in the northern region [17.0% (6.4%), females; 20.7% (6.3%), males]. Adolescents in both types of schools had relatively similar median intakes of snacks (~ 85g) and sugared drinks (~ 600ml) CONCLUSIONS: The overall diet quality of Brazilian adolescents is inadequate based on evaluated parameters in all regions and socioeconomic backgrounds.

Improving diet quality among adolescents, using health belief model in a collaborative learning context: a randomized field trial study.

This study aimed to assess the impact of educational intervention, based on health belief model (HBM) and collaborative learning techniques on diet quality in adolescents. In this field trial study, 311 students aged 13-15 years old were included, of which 163 and 148 allocated in the experimental and comparison groups, respectively. They were selected through a stratified random sampling from 16 urban, secondary schools in 4 educational districts of Shiraz, the largest city in southern Iran. The revised children diet quality index was used to assess their diet quality. Using HBM as a framework for targeting determinants of dietary behavior, the intervention was performed in a collaborative learning context during the educational year (2015-16). Constructs of HBM and diet quality were measured before and after the intervention. All HBM's constructs and knowledge had significantly improved in the experimental group and mean differences were increased after the intervention. Diet quality improved in the experimental group (P < 0.001), which was significantly different from the comparison group (P = 0.001). The findings support the integration of appropriate models/theories into the context of collaborative learning methods to target large number of behavioral determinants, and ultimately increase the effectiveness of the educational interventions amongst adolescents.

Diet quality in adolescents with premenstrual syndrome: A cross-sectional study.

Premenstrual syndrome (PMS) is a complex of symptoms that can seriously affect the quality of life in women. It has been suggested that the nutritional status of adult women may influence the presence and/or severity of PMS symptoms. However, little is known about this association in adolescents. The present study aimed to examine the relationship between diet quality and the presence/severity of PMS symptoms in adolescents. A case-control study of 272 female students, aged 13-18 years, was conducted in a high school. PMS was diagnosed and the symptoms were recorded using Premenstrual Syndrome Scale (PMSS)-2006 in 2 consecutive months. Dietary intake was assessed with 24-hour-dietary intake recall method and Healthy Eating Index-2010 (HEI-2010) score was calculated as an indicator of diet quality. Anthropometric measurements, including body weight, height, waist circumference and hip circumference were taken. PMS was diagnosed in 56.9% of the study sample. The mean HEI-2010 score was significantly lower in the PMS group (47.5 ± 23.95) when compared to the control group (53.5 ± 20.98), P = 0.034. The PMS symptoms, anxiety (P = 0.009), depressive feelings (P = 0.016) and changes in sleeping pattern (P = 0.000) were associated with lower diet quality scores in the PMS group. No significant difference in anthropometric measurements was observed between the groups. The present study suggested that adolescents with a high-quality diet might experience depressive feelings, anxiety or changes in sleeping less when compared to those with a low quality diet. Therefore, the causal relationship between diet quality and presence/severity of PMS should be investigated in further studies.

Diet quality on days without breakfast or lunch – Identifying targets to improve adolescents’ diet

Dietary intake in adolescents does often not align with the recommended dietary guidelines. Excess intakes of added sugar and saturated fat, and insufficient vegetable intake are among the identified challenges, which can affect future health negatively. Identifying targets to improve dietary practices is therefore essential. The current study aimed to examine the prevalence of meal skipping and if meal skipping days had a different diet quality than other days, using data from a recent Norwegian dietary survey in adolescents (n = 689, age 12–14 years). Their dietary intake was recorded for four days, using a web-based record system. Differences between days with, and without, breakfast or lunch were explored using mixed effect models, adjusting for correlated data and covariates, including weekday-weekend effect. In total, 8% and 11% were days without breakfast and lunch, respectively. Days with breakfast or lunch were associated with higher intake of fibre, and higher odds of consuming fruits and berries, juice and smoothie, than days without breakfast or lunch. Weekdays with lunch were also associated with lower intakes of added sugar and total fat (in % of energy), and discretionary foods, compared to weekdays without lunch. Skipping breakfast and lunch was associated with reduced diet quality in adolescents. Targeting these meals, and in particular school lunch, is a potential way forward to improve adolescents’ dietary intake.

Metabolic syndrome in adolescents and its association with diet quality

ABSTRACT Objective Analyzing the prevalence of metabolic syndrome and its association with adolescent diet quality. Methods Cross-sectional research with 327 adolescents from public and private high schools of Teresina, Piauí. Socioeconomic, anthropometric, and food consumption data were analyzed to obtain the Brazilian Healthy Eating Index-Revised. Moreover, data related to metabolic syndrome (blood glucose, blood pressure, waist circumference, triglycerides, and high-density lipoprotein cholesterol) were also analyzed. Continuous variables were described by means, standard deviations, and 95% confi dence intervals. To verify the association between dependent and explanatory variables, we calculated the adjusted odds ratio. The level of signifi cance was set at p&lt;0.05. Results The prevalence of metabolic syndrome was 3.3%, with low high-density lipoprotein cholesterol concentration being the most frequent alteration (50.5%). The mean score on the Brazilian Healthy Eating Index-Revised was 55.4 points. The worst scores were obtained in whole cereals, dark-green and orange vegetables, oils, milk and dairy products, and whole fruits. In contrast, total cereals, meat, eggs, and legumes had scores close to the maximum stipulated. The lowest tertile of dark-green, orange, and leguminous vegetables showed risk for low high-density lipoprotein cholesterol, and the second tertile was protective against high blood glucose levels. As for the milk group, its lower intake increased the chances for high triglyceride and blood pressure levels. Conclusion Despite the low prevalence of metabolic syndrome, there were significant alterations in its components,associated with less consumption of important Brazilian Healthy Eating Index-Revised items.

Analysis of the diet quality and dietary habits of children and adolescents with type 1 diabetes.

IntroductionThe dietary habits of patients with type 1 diabetes are key elements of treatment as they facilitate the normalization of glycemia and maintenance of normal body weight (BW), lipid concentration, and the level of blood pressure. Therefore, the aim of this study was to analyze dietary habits and to verify the influence of the quality of diet on insulin dosage and selected clinical variables.Materials and methods:The study included 194 subjects (8–18 years old) suffering from type 1 diabetes and treated with the use of insulin pump. A modified KomPAN questionnaire was used to assess dietary habits and the frequency of the consumption of selected products. Two groups of patients were distinguished: G1 (poorer quality of diet) and G2 (better quality of diet). Clinical data were also collected.ResultsVery low scores were noted in the whole study group as regards the index of healthy diet (27.6±11.1, 3.8–61.0). After dividing the participants into groups, it was observed that G1 included more boys (63.8%), and more girls were found in G2 (66.9%). G2 patients chose sweet and salty snacks and fried meals less frequently, and they consumed boiled dishes and avoided sweetening with sugar or honey more frequently. The following characteristics were observed in G1 patients: longer duration of the disease (6.5 vs 5.2 years), higher doses of insulin (0.86 vs 0.76 U/kg of BW/day), and being overweight (31.0% vs 17.6%) and underweight (19.0% vs 8.8%) noted twice more frequently. We did not observe differences concerning the concentration of glycated hemoglobin and lipids in the serum and the values of blood pressure.ConclusionThe findings revealed unsatisfactory dietary habits in children and adolescents with type 1 diabetes and indicated the necessity to analyze additional factors that might influence the quality of diet of the patients.

The cross-sectional relationships between consumption of takeaway food, eating meals outside the home and diet quality in British adolescents.

The present study aimed to evaluate the association of frequency of consuming takeaway meals and meals out with diet quality of UK adolescents. The Diet Quality Index for Adolescents (DQI-A) tool was used to assess diet quality, where adolescents' food intake was based on 4d diary records obtained from the UK cross-sectional National Diet and Nutrition Survey (NDNS) rolling programme Years 1-6. Models included confounders. The DQI-A relies on three components, specifically diet quality, diversity and equilibrium, which reflect the degree of adherence of an adolescent's diet with food-based dietary guidelines.ParticipantsBritish (n 2045) adolescents aged 11-18 years. Mean diet quality score for all adolescents was 20·4 % (overall DQI-A score range: -33 to 100 %). After adjusting for age, gender and equivalised household income, DQI-A% score was higher for low and moderate takeaway consumers by 7·4 % (95 % CI 5·5, 9·2; P&lt;0·01) and 3·5 % (95 % CI 1·9, 5·1; P&lt;0·01), respectively, v. frequent consumers. Significant differences were also observed between low, moderate and frequent takeaway consumers among all DQI-A components and sub-components (P&lt;0·05), except for the diet adequacy sub-component (DAx). Results for frequent consumption of meals out were similar but attenuated and not statistically significant for individual components before or after adjusting for confounders. Frequent consumption of takeaway meals may have a negative impact on adolescents' diet quality and therefore policies to reduce the intake of takeaways should be considered in this age group.

Diet quality and well-being in children and adolescents: the UP&DOWN longitudinal study.

The present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&amp;DOWN study (follow-up in schoolchildren and adolescents with and without Down's syndrome). The present study excluded participants with Down's syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β=0·41, se 0·10, P&lt;0·001; β=0·46, se 0·10, P&lt;0·001, respectively) and to positive affect in secondary school girls and boys (β=0·16, se 0·05, P=0·006; β=0·20, se 0·05, P&lt;0·001, respectively) and in primary school boys (β=0·20, se 0·08, P=0·019). At 2-year follow-up, MD adherence was negatively related to negative affect in secondary school adolescent girls and boys (β=-0·15, se 0·07, P=0·047; β=-0·16, se 0·06, P=0·019, respectively), and MD adherence was associated with higher positive affect scores in secondary school girls (β=0·30, se 0·06, P&lt;0·001) and in primary school boys (β=0·20, se 0·09, P=0·023). However, MD adherence at baseline did not predict well-being indicators at 2-year follow-up. In conclusion, higher MD adherence was found to behave as a protective factor for positive well-being in cross-sectional analysis.

Friends and Family: How African-American Adolescents’ Perceptions of Dietary Beliefs and Behaviors of Others Relate to Diet Quality

BackgroundAdolescents’ dietary intake often fails to meet national dietary guidelines, especially among low-income African-American youth. The dietary habits established in adolescence are likely to continue into adulthood, and a poor-quality diet increases the risk of developing obesity and chronic disease. Based on principles from ecological and social-cognitive behavior change health theories, perceptions of parental beliefs about healthy eating, perceptions of peer eating behaviors, and parental monitoring of what adolescents eat may positively influence adolescent diet quality. ObjectiveThe purposes of this study were to determine whether perceived parental beliefs about nutrition, perceived peer eating behaviors, and reported parental monitoring of the adolescent diet were related to African-American adolescent diet quality and whether these relationships were moderated by adolescent age or sex. DesignThis secondary cross-sectional study used baseline data (2002 to 2004) from an urban community sample of low-income adolescents participating in a health promotion trial. Participants/settingParticipants were 216 African-American adolescent-caregiver dyads in Baltimore, MD. Main outcome measuresThe 2010 Healthy Eating Index was used to estimate adolescent diet quality. Statistical analyses performedAnalyses included correlations, t tests, age- and sex-by-perception regression interactions, and multivariate regressions adjusted for body mass index–for-age percentile, caregiver weight status, and caregiver depressive symptoms. ResultsHigher diet quality scores were related to higher levels of perceived parental and peer support for healthy eating behaviors among adolescents (β=.21; P<0.05; β=.15; P<0.05, respectively) and to caregiver reports of parental monitoring of adolescent dietary behavior (β=1.38, P<0.01). Findings were not moderated by age or sex. ConclusionsConsistent with ecological and social-cognitive theories, adolescents look to their friends and family in making healthy food choices. The relationships uncovered by this study describe some of the contextual, interpersonal influences associated with diet quality among low-income, urban African-American adolescents and warrant further exploration in future intervention studies.

Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention.

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.