Diet Quality Index Research Articles

Mediterranean Dietary Patterns Related to Sleep Duration and Sleep-Related Problems among Adolescents: The EHDLA Study.

The aim of the present study was to examine the association of adherence to the Mediterranean Diet (MD) and its specific components with both sleep duration and sleep-related disorders in a sample of adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a sample of 847 Spanish adolescents (55.3% girls) aged 12-17 years. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Teenagers. Sleep duration was reported by adolescents for weekdays and weekend days separately. The BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) screening was used to evaluate issues related to sleep, which include difficulties at bedtime, excessive drowsiness during the day, waking up frequently during the night, irregularity, length of sleep, and breathing issues while sleeping. Adolescents who presented a high adherence to the MD were more likely to meet the sleep recommendations (OR = 1.52, 95% CI 1.12-2.06, p = 0.008) and less likely to report at least one sleep-related problem (OR = 0.56, 95% CI 0.43-0.72, p < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, waist circumference, energy intake, physical activity, and sedentary behavior, indicating a significant association of adherence to the MD with sleep outcomes (meeting sleep recommendations: OR = 1.40, 95% CI 1.00-1.96, p = 0.050; sleep-related problems: OR = 0.68, 95% CI 0.50-0.92, p = 0.012). Adolescents with high adherence to the MD were more likely to report optimal sleep duration and fewer sleep-related problems. This association was more clearly observed for specific MD components, such as fruits, pulses, fish, having breakfast, dairies, sweets, and baked goods/pastries.

Evaluation of the Pragmatic Implementation of a Digital Health Intervention Promoting Healthy Nutrition, Physical Activity, and Gestational Weight Gain for Women Entering Pregnancy at a High Body Mass Index.

txt4two is a multi-modality intervention promoting healthy pregnancy nutrition, physical activity (PA), and gestational weight gain (GWG), which had been previously evaluated in a pilot randomized controlled trial (RCT). This study aimed to evaluate a pragmatic implementation of an adapted version of txt4two in a public tertiary hospital. Using a consecutive cohort design, txt4two was delivered to women with a pre-pregnancy BMI > 25 kg/m2, between 10 + 0 to 17 + 6 weeks. Control and intervention cohorts (n = 150) were planned, with surveys and weight measures at baseline and 36 weeks. The txt4two cohort received a dietetic goal-setting appointment and program (SMS, website, and videos). The navigation of disparate hospital systems and the COVID-19 pandemic saw adaptation and adoption take two years. The intervention cohort (n = 35; 43% full data) demonstrated significant differences (mean (SD)), compared to the control cohort (n = 97; 45% full data) in vegetable intake (+0.9 (1.2) versus +0.1 (0.7), p = 0.03), fiber-diet quality index (+0.6 (0.8) versus 0.1 (0.5), p = 0.012), and total diet quality index (+0.7 (1.1) versus +0.2 (±0.6), p = 0.008), but not for PA or GWG. Most (85.7%) intervention participants found txt4two extremely or moderately useful, and 92.9% would recommend it. Embedding the program in a non-RCT context raised implementation challenges. Understanding the facilitators and barriers to adaptation and adoption will strengthen the evidence for the refinement of implementation plans.

Breast cancer and dietary fat quality indices in Iranian women: A case-control study.

The association between breast cancer (BC) and different indices of dietary fats has not been well-studied. Thus, this study aimed to investigate the association between BC and dietary fat quality (DFQ) indices in Iranian women. This case-control study was conducted on 120 women with breast cancer and 240 healthy women in Tehran, Iran. Food Frequency Questionnaire and nutritionist IV software were used to assess the intake of dietary fats and to calculate the DFQ indices. The patients with BC had a higher total fat (TF) (P < 0.01) and a lower ratio of polyunsaturated fatty acids (PUFAs) omega-3 to PUFAs omega-6 (ω-3/ω-6) compared with the controls (P < 0.001). TF had a significant association with BC risk (OR: 1.16; 95% CI: 1.01-1.33, P < 0.001). No significant association was found between BC and PUFA/saturated fatty acid ratio or the ω-3/ω-6 ratio. The patients with BC had a lower ω-3/ω-6 ratio and a higher total dietary fat intake than the healthy women. Total dietary fat intake was also directly associated with the risk of BC. Thus, low-fat diets may have beneficial effects for BC prevention. Further longitudinal studies are warranted.

Dietary quality indices and recurrent chronic kidney disease in Taiwanese post-renal transplant recipients.

This study investigated the association between dietary quality indices and recurrent chronic kidney disease (rCKD) in Taiwanese post-renal transplant recipients (RTRs). This prospective study recruited RTRs aged >18 years with a functioning allograft and without any acute rejection in the past 3 months from September 2016 to June 2018. Dietary quality indices included the Alternative Healthy Eating Index (AHEI) and AHEI-2010, and the Taiwanese version of the AHEI (AHEI-Taiwan) was calculated using 3-day dietary records, and calculated scores were divided into quartiles. Laboratory data were collected from medical records. rCKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Logistic regression analysis was performed to analyze the associations. This study included 102 RTRs. The RTRs with higher AHEI, AHEI-Taiwan, and AHEI-2010 scores were older and had higher eGFRs and lower odds of rCKD. As compared with the lowest quartile, patients with the highest quartiles of the AHEI [odds ratio (OR), 0.10; 95% confidence interval (95% CI): 0.02, 0.49; p-trend = 0.004), AHEI-2010 (OR, 0.17; 95% CI: 0.04, 0.72; p-trend = 0.016], and AHEI-Taiwan (OR, 0.13; 95% CI: 0.03-0.59; p-trend = 0.008) had lower odds of rCKD, respectively. As compared with the lowest quartile, patients who consumed the highest quartiles of red and processed meat had 11.43 times higher odds of rCKD (OR, 11.43; 95% CI: 2.30-56.85; p for trend <0.01). Higher dietary quality indices are associated with lower odds of rCKD in Taiwanese RTRs. Particularly, a positive association between a higher intake of red meat and processed meat and higher odds of rCKD remained exists after transplantation in Taiwanese RTRs. Further dietary guidelines and individualized dietary education were necessary for RTRs to prevent graft function deterioration.

Tendencias en la calidad de dieta de los hogares argentinos entre 1996-2018, diferencias según región, tipo de hogar y nivel de ingreso

Introduction: Food is a health determinant, bad quality diets represent one of the main risk factors of morbidity and mortality. Objective: The objective of this work was to evaluate the tendency in food quality in the last two decades and its relationship with sociodemographic characteristics in Argentinian homes in the last period. Methods: Observational cross-sectional study; data collected for the National Survey of Home Expenditure in the periods 1996-97, 2004-05, 2012-13 and 2017-18 were analyzed. The total score and the scores for each component of Argentinian Index of Diet Quality (ICDAr, according to Spanish acronym) were estimated and a bivariate analysis was done to evaluate differences according to region, home type and income level. Results: A significant loss in food quality is observed in Argentinian homes throughout time, especially because of the greater participation of the optional consumption food group. ICDAr went from 58.8±0.1 points in 1996-97 to 52.9±0.1 (p &lt;0.001) in 2017-18, and only 1.7% and 0.8% of the homes reached a score higher than 80 points (p &lt;0.001), respectively. In general, homes in Patagonia and the Metropolitan area, single-owner homes and homes with higher incomes showed worse results. Conclusions: These findings show necessary aspects to be improved regarding eating habits in Argentinian population and contribute to the planning of policies and actions towards better food quality.

Association between diet quality and BMI with side effects of Pfizer-BioNTech COVID-19 vaccine and SARS-CoV-2 immunoglobulin G titers

PurposeThe nutritional and anthropometric status can be essential in determining their immune response to vaccines. The purpose of this paper was to investigate the association between diet quality and anthropometric indices with the side effects of the Pfizer-BioNTech COVID-19 vaccine and the SARS-CoV-2 immunoglobulin G titer among Kurdish adults.Design/methodology/approachThis cross-sectional survey-based study was conducted between December 2021 and February 2022. This paper included data on 115 adults, 20–89 years old, from the Kurdistan region. Dietary information was collected using a short food frequency questionnaire, and diet quality was assessed using a plant-based healthy diet score. A blood test was performed to measure the SARS-CoV-2 immunoglobin G (IgG) titer after the vaccination's first and second doses.FindingsOverweight and obese subjects reported more local pain, myalgia, headache, local bruising and local reactions after receiving the first dose of the vaccine (p = 0.04). People on a less healthy diet reported more local pain, myalgia and headache (p = 0.04) and more local bruising and reactions (p = 0.01) after receiving the second dose of the vaccine. On the other hand, the authors observed that those with healthy dietary habits had more IgG titer after the first and second doses of vaccination than those with less healthy dietary habits (p = 0.001).Originality/valueThe results showed that participants with a healthy diet and normal weight status had fewer side effects of the Pfizer-BioNTech COVID-19 vaccine than obese people and those with a less healthy diet.

Estimation of the Quality of the Diet of Mexican University Students Using DQI-I

The quality of diet can be measured using diet quality indices, based on knowledge of associations between diet and health. The objective of this work was to evaluate whether the International Diet Quality Index is suitable for use as a diet quality index in populations of Mexican university girls. A cross-sectional nutritional survey was conducted at the University of Chihuahua (Mexico), collecting semi-quantitative nutritional information and socio-economic and lifestyle data from a representative sample of 400 women. Mean (Standard Deviation (SD)) age was 21.43 years (SD: 3.72); 59.1% were normal weight, 26.6% overweight, 15.3% obesity. The Diet Quality Index-International (DQI-I) was developed according to the method of Kim et al. (2003) and focused on major aspects of a high-quality diet (variety, adequacy, moderation and overall balance). The total score of Diet Quality Index-International reached 53.86% (SD: 11.43), indicating that the general diet of Mexican women a poor-quality diet. Adequacy scored highest, followed by moderation and variety. Overall balance scored the lowest. Variety: 26.3 % consumed less than 4 food groups daily, only 12.8% take more than 1 serving from each food group, and 50.6% consumed only one source of protein daily. Regarding adequacy, a large proportion of the population reported an intake of proteins, vitamin C, calcium, iron, and fruit greater than 50% of recommendation; the vegetables, fiber and grain groups were less 50%. Poor scores were obtained for total fat and SFA consumption (moderation). No statistically significant differences are observed for any of the variables under study and score of the Diet Quality Index-International: body mass index, weight, physical activity level, education level of father and mother, location of lunch, breakfast considered important, knowledge of nutrition, which allows us to consider a relatively uniform population in its eating habits. These people are close to a Westernized diet, and an intervention in nutritional education would be advisable to improve the intake of unprocessed foods, consume a greater variety of protein sources and significantly reduce consumption of sugary foods and soft drinks. Due to different methodological and cultural factors, the proposed Diet Quality Index-International dietary assessment method does not seem to be useful in the assessment of diet quality in the Mexican university population, so further research is needed to develop a diet quality index adapted to the Mexican population.

Changing Landscape from Nutrients to Dietary Patterns: Implications for Child Health.

Dietary patterns (DPs) have shifted the focus in nutrition epidemiology away from being nutrient centered. Foods are consumed not as single nutrients but as a combination of dietary components interacting with each other. DPs are indicators of diet quality. Two approaches are used to derive them: the index-based and data-driven approaches, each with its own advantages and disadvantages. Studies on diet-disease relationships are now concentrated on DPs. Most available studies are in adults, which emphasize the role of DPs as contributors to certain chronic diseases like cardiovascular diseases, diabetes, and certain cancers. Only few studies were conducted among children, mostly using a data-driven approach and population specific. The available studies identify associations with some diseases like obesity, neurobehavioral disorders, asthma, and cardiometabolic markers. Tracking of DP consumption from early childhood to later life stages including adulthood has been shown from longitudinal studies to predict certain cardiometabolic risk factors and adiposity that may predispose to certain diseases later in life. The influences of sociodemographic factors, most especially maternal education, have predictive effects on adherence to certain DPs, whether the "healthy" or "unhealthy" type. More studies are needed to strongly elucidate this DP-disease outcome relationship in children.

Adults allostatic load is less with greater dietary quality: National Health and Nutrition Examination Survey (NHANES) 2015-2018.

Few studies have explored the relationship between overall diet quality and stress load. Therefore, we have evaluated the association between dietary quality and allostatic load (AL) in adults. The data were derived from the 2015-2018 National Health and Nutri-tion Examination Survey (NHANES). Dietary intake information was obtained by 24-hour dietary recall. The Healthy Eating Index (HEI) 2015 version was estimated as an indicator of dietary quality. The AL was in-dicative of the accumulated chronic stress load. The weighted logistic regression model was used to explore the relationship between dietary quality and the risk of high AL in adults. A total of 7557 eligible adults older than 18 years were enrolled in this study. After being fully adjusted, we found a significant asso-ciation between HEI score and the risk of high AL (ORQ2 =0.73, 95% CI: 0.62,0.86; ORQ3 =0.66, 95% CI: 0.55,0.79; ORQ4 =0.56, 95% CI: 0.47,0.67) in logistic regression model. Increased intake of total fruits and whole fruits or decreased intake of sodium, refined grains, saturated fats and added sugars were associated with the risk of high AL (ORtotal fruits =0.93, 95%CI: 0.89,0.96; ORwhole fruits =0.95, 95%CI: 0.91,0.98; ORwhole grains =0.97, 95%CI: 0.94,0.997; ORfatty acid =0.97, 95%CI: 0.95,0.99; ORsodium =0.95, 95%CI: 0.92,0.98; ORre-fined grains =0.97, 95%CI: 0.94,0.99; ORsaturated fats =0.96, 95%CI: 0.93,0.98; ORadded sugars =0.98, 95%CI: 0.96,0.99). We found that dietary quality was inversely associated with allostatic load. High di-etary quality presumptively less cumulative stress.

Salt-Taste Polymorphism TRPV1-rs8065080 Is Associated with Increased Likelihood of Depression in an Elderly Cohort

Introduction: Despite the prevalence of depression and anxiety worldwide, their aetiologies remain unclear, and they can be difficult to diagnose and treat. Changes in salt-taste perception have been found in both conditions. Single-nucleotide polymorphisms (SNPs) in the salt-taste-related gene, TRPV1, have been associated with alterations to salt-taste perception, preference, and sodium consumption. Diet quality is a known modifier of depression and anxiety and recently, sodium intake has been studied in mental health. However, the relationships between salt-taste genetics, depression, anxiety, and these dietary factors are yet to be elucidated. Methods: Data from the well-characterized cross-sectional Retirement Health and Lifestyle Study (n = 536, ≥65 y) were used to explore the relationships between the salt-taste SNP TRPV1-rs8065080, levels of depression and anxiety (Hospital Anxiety and Depression Scale, HADS), estimated sodium intake, and diet quality in this secondary analysis. Standard least-squares regression and nominal logistic regression modelling were used to compare continuous and categorical variables, respectively, with analyses stratified by sex. Results: Presence of the TRPV1-rs8065080 variant allele (C) was found to increase the likelihood of having depression (HADS) in the total population and in males. The associations remained significant after adjusting for sodium intake, three diet quality indices, and demographic variables, suggesting that TRPV1-rs8065080 genotype is driving the association with depression. Discussion/Conclusion: Future studies should explore extra-oral functions of the SNP and salt-taste receptors in the brain and the roles of neurotransmitters common to both depression and salt taste to improve the management of this increasingly prevalent and difficult-to-treat condition.

Abstract C102: Interactions of a polygenic risk score and modifiable lifestyle factors for breast cancer in the Multiethnic Cohort

Abstract Purpose: A polygenic risk score (PRS) has demonstrated great potential in stratifying breast cancer risk in non-African ancestry populations. Several modifiable lifestyle risk factors have been identified for breast cancer, although little is known regarding their effects among women with varying genetic risk. Methods: In the Multiethnic Cohort (MEC), we conducted a nested case-control study of 3,229 breast cancer cases and 3,921 controls from five major racial/ethnic groups (White, African American, Latino, Japanese American, and Native Hawaiian). We examined a PRS of 313 variants in association with breast cancer risk and evaluated the interaction with selected modifiable lifestyle factors on the risk of breast cancer. The modifiable lifestyle factors examined included body mass index (BMI), physical activity, smoking, alcohol consumption, and five diet quality indexes, such as the Healthy Eating Index (HEI)-2010, the Alternative Healthy Eating Index (AHEI)-2010, the alternate Mediterranean Diet score (aMED), the Dietary Approaches to Stop Hypertension score (DASH), and the Dietary Inflammatory Index (DII). Results: The 313-variant PRS was strongly associated with breast cancer risk across the five racial/ethnic groups, with per standard deviation (SD) odds ratios (OR) of 2.07 (95% CI=1.63-2.63) in Native Hawaiian, 1.72 (95% CI=1.54-1.92) in White, 1.56 (95% CI=1.36-1.77) in Latina, 1.45 (95% CI=1.31-1.60) in Japanese American, and 1.32 (95% CI=1.20-1.44) in African American women. For the lifestyle factors, BMI (OR=0.84, 95% CI=0.75-0.93, for &amp;lt;25 vs. ≥ 25 kg/m2) and alcohol consumption (OR=1.14, 95% CI=1.02-1.26 for drinkers vs. non-drinkers) were significantly associated with breast cancer risk. We also observed a suggestive positive association for smoking (OR=1.14, 95% CI=0.98-1.32 for current vs. never/past smokers) and a suggestive inverse association for AHEI-2010 (OR=0.96, 95%CI=0.91-1.01 per SD increment). No association was observed for physical activity or other dietary indexes. We found that the association of BMI and AHEI-2010 with breast cancer risk depended on PRS. Specifically, among women with above-average genetic risk (50-100% of PRS), the OR of breast cancer was 0.77 (95% CI=0.66-0.88) for women with a BMI &amp;lt;25 kg/m2 (vs. BMI³25 kg/m2), while among women with below-average genetic risk (0-50% of PRS) the OR was 0.96 (95%CI=0.81-1.14, P-heterogeneity=0.04). In contrast, a significant inverse association of AHEI-2010 (per SD) with breast cancer risk was only observed in women with below-average genetic risk (OR=0.90, 95%=0.83-0.97) but not among women with above-average genetic risk (OR=1.00, 95%CI=0.94-1.08, P-heterogeneity=0.04). Conclusions: In line with previous reports, the 313-variant PRS was effective in stratifying breast cancer risk, with diminished transferability for women of African ancestry. Our findings also suggest that maintaining a healthy BMI may offset the genetic risk of breast cancer, while adhering to a healthy dietary pattern may further reduce risk for women with lower genetic risk. Citation Format: Alisha Chou, Fei Chen, Peggy Wan, Xin Sheng, Song-Yi Park, Daniel O. Stram, Lynne R. Wilkens, Loic Le Marchand, Christopher A. Haiman. Interactions of a polygenic risk score and modifiable lifestyle factors for breast cancer in the Multiethnic Cohort [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C102.

Survey-derived activity space-based exposures to fast food outlets and their cross-sectional associations with use of fast food outlets, diet quality and BMI.

There is a need for conceptual and methodological innovation in food environment-health research. We compared different operationalizations of survey-derived activity space exposures to fast food outlets (FFOs) in associations with use of FFO, diet quality and body mass index (BMI). FFO exposure was determined for home, work and a maximum of sixteen other locations reported by 1728 Dutch adults. Considerable differences in count of FFO between locations were found. Adjusted linear regression analyses resulted in small, unexpected associations with use of FFO, diet quality and BMI, whereby the strength of associations differed between exposure measures. Using home and work areas may be a cost-efficient compromise to capture large parts of the exposure to FFOs.

COVID-19 Pandemi Öncesi ve Sırasında Besin Destekleri Kullanım Durumu ve Akdeniz Diyet Kalite İndeksi Skorları: Üniversite Öğrencileri Örneği, Türkiye: Kesitsel Çalışma

COVID-19 Pandemi Öncesi ve Sırasında Besin Destekleri Kullanım Durumu ve Akdeniz Diyet Kalite İndeksi Skorları: Üniversite Öğrencileri Örneği, Türkiye: Kesitsel Çalışma

A scoping review of approaches used to develop plant-based diet quality indices

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ANÁLISIS DE BRECHAS EN LA CALIDAD DE DIETA DE LA POBLACIÓN ARGENTINA DE 1 A 69 AÑOS. ESTUDIO ABCDIETA

Introduction: Diet Quality Index represents one way to study food patterns. Some of them are based on the nutritional density of foods. The concept summarizes the relationship between energy and nutrients to promote and limit, making visible nutrient adequacy in line with energy balance. The objective is to study the quality of the diet and its gaps in a sample of the urban population of Argentina and to describe the food pattern according to levels of nutritional quality using the nutritional density approach. Methods: Data from a self-registration dietary survey on 1030 subjects from 11 cities in Argentina were analyzed. It was determined the nutritional density of the reported consumptions through an index (IDN) based on energy, 9 nutrients to promote and 4 to limit. The IDN of the total diet, 5 moments of intake and food groups was analyzed. Results: The average diet quality was half the standard of a healthy pattern (10.6 out of 20 points). The best results were concentrated in children under 3 years of age (17% presented a good quality diet). Compared to the standard, the quality of lunches and dinners exceeded breakfasts and snacks. Legumes, vegetables, fruits and dairy products were the groups with the largest quality gaps. Occasional and starchy foods in general –also meats– reflected excesses. Preparations and fast meals reached up to 21% of the total nutritional density. Conclusions: The nutritional density approach complements the understanding of food gaps in the Argentine population, providing arguments in favor of interventions aimed at a better balance, particularly in protective foods, which are deficient in the conformation of the food pattern. Keywords: diet quality; nutrient density; consumes; consumption; food gaps.

Inequalities in the association between adherence to the Mediterranean diet and physical fitness in the young population during the COVID-19 lockdown.

Objective: this study analyzed the association between adherence to the Mediterranean diet and proxy-reported physical fitness among Spanish and Brazilian youths during the COVID-19 lockdown according to several inequality indicators. Methods: we conducted a cross-sectional study with parents and guardians of children and adolescents from Spain and Brazil. The evaluation process was through the use of online questionnaires. Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Quality Index in Children and Adolescents. Proxy-reported physical fitness was determined using the International Fitness Scale. Inequality indicators (gender, nationality, socioeconomic status, and parents/guardians' education level) were evaluated with a survey completed by the participants' parents/guardians. Binary logistic regression models estimated the association between adherence to the Mediterranean diet and proxy-reported physical fitness, with stratification according to inequality variables. A total sample of 1,099 Spanish and Brazilian individuals (47.6% girls, aged 3 to 17 years) were included in the analysis. Results: compared to the "improvement needed to Mediterranean diet" category, the "optimal Mediterranean diet" group was significantly associated with "very good" physical fitness in boys (OR = 1.5; 95 % CI: 1.0-2.1) and in participants with parents/legal guardians' education level without university studies (OR = 1.5; 95 % CI: 1.0-2.4). Conclusions: gender and parents/guardians' education level plays a significant role in the association between the "optimal Mediterranean Diet" and "very good" physical fitness level in Spanish and Brazilian children and adolescents. Future prospective studies are needed to investigate the role of inequality indicators in this relationship.

Covid-19 Pandemisinde Sosyal İzolasyonun Çocuklarda Beslenme Alışkanlıkları, Diyet Kalitesi, Yaşam Tarzı Değişiklikleri ve Obezite Üzerine Etkisi

Aim: This cross-sectional study aimed to evaluate the effects of social isolation on children's nutritional habits, diet quality, lifestyle changes, and obesity during the Covid-19 pandemic. Material and methods: This study was conducted on 222 (110 boys and 112 girls) children and adolescents aged 6-18 years who were forced to quarantine themselves at home. A web-based survey was used to obtain study data. Children and adolescents were asked about their demographic characteristics, eating habits, the Mediterranean Diet Quality Index (KIDMED), sleep duration, screen time, physical activity status and anthropometric measurements (body weight and height). Results: It was found that children's screen time and sleep duration increased in both gender and percentage of doing physical activity decreased during the pandemic. Body weight and body mass index of children increased mean 1.5±2.21 kg and 0.6±0.91 kg/m2 respectively. The mean KIDMED score of children was 6.4±2.37 and more than half of children complianced with Mediterranean diet moderately during the pandemi period. It was determined that children consumed more snacks (sweet and salty), dessert and pastry products than before the pandemic period, but some healthy eating habits such as vegetables, fruits, nuts, and oilseed consumption increased during the pandemic. Conclusion: Children’s increased weight gain, changed eating habits and physical activity may be associated with increased the time spent at home due to social isolation during the pandemic period. For this reason, frequent monitoring and evaluation of the nutritional status of children during the Covid-19 lockdown is very important for public health authorities to make future policies on children’s nutritional recommendations when new pandemics arrive and lockdown policies are implemented.

Differences in Cost-Effectiveness of Adherence to Nutritional Recommendations: Why, Where, and What?

Cost-effectiveness analysis of diets may comprise an important tool to promote food security; however, studies show divergent evidence regarding the relationship between diet quality and cost in diverse populations. Thus, this study assesses differences in cost-effectiveness ratios regarding adherence to nutritional recommendations using data representative of the population level in Sao Paulo municipality, Brazil. Information from adolescents and adult individuals (n = 1742) was used to estimate diet quality and cost in 2015. Differences in cost-effectiveness ratios were investigated through application of two diet quality indexes and exploration of individuals' personal and contextual characteristics. Results indicated that higher diet cost was associated with higher adherence to nutritional recommendations at the national level and inversely associated with adherence to international recommendations. Purchasing foods in street markets was linked to healthier diets at lower costs, and protein consumption was associated with higher diet cost regardless of diet quality; however, diet quality was linked to type of protein consumed by individuals. Differences in cost-effectiveness ratios were attributable to methodological choices in measuring dietary quality (why); individuals' personal and contextual characteristics, in particular, access to retail equipment (where); and certain food choices (what). Therefore, cost-effectiveness analyses should be tailored to policy goals and local environments to ensure proper assessment of nutrition programs and to foster improvements in nutritional diet quality at lower cost.

The DQQ is a Valid Tool to Collect Population-Level Food Group Consumption Data: A Study Among Women in Ethiopia, Vietnam, and Solomon Islands

BackgroundThe Diet Quality Questionnaire (DQQ) is a rapid dietary assessment tool designed to enable feasible measuring and monitoring of diet quality at population level in the general public. ObjectivesTo evaluate validity of the DQQ for collecting population-level food group consumption data required for calculating diet quality indicators by comparing them with a multipass 24-h dietary recall (24hR) as the reference. MethodsCross-sectional data were collected among female participants aged 15–49 y in Ethiopia (n = 488), 18–49 y in Vietnam (n = 200), and 19–69 y in Solomon Islands (n = 65) to compare DQQ and 24hR data in proportional differences in food group consumption prevalence, percentage of participants achieving Minimum Dietary Diversity for Women (MDD-W), percent agreement, percentage misreporting food group consumption, and diet quality scores of Food Group Diversity Score (FGDS), noncommunicable disease (NCD)-Protect, NCD-Risk, and the Global Dietary Recommendation (GDR) score using a nonparametric analysis. ResultsThe mean (standard deviation) percentage point difference between DQQ and 24hR in population prevalence of food group consumption was 0.6 (0.7), 2.4 (2.0), and 2.5 (2.7) in Ethiopia, Vietnam, and Solomon Islands, respectively. Percent agreement of food group consumption data ranged from 88.6% (10.1) in Solomon Islands to 96.3% (4.9) in Ethiopia. There was no significant difference between DQQ and 24hR in population prevalence of achieving MDD-W except for Ethiopia (DQQ 6.1 percentage points higher, P < 0.01). Median (25th–75th percentiles) scores of FGDS, NCD-Protect, NCD-Risk, and GDR score were comparable between the tools. ConclusionsThe DQQ is a suitable tool for collecting population-level food group consumption data for estimating diet quality with food group-based indicators such as the MDD-W, FGDS, NCD-Protect, NCD-Risk, and GDR score.

Dietary intakes differ between LGBTQ + and non-LGBTQ + college students

Objective: To compare dietary intakes between LGBTQ + and non-LGBTQ + college students. Participants: Participants were LGBTQ+ (n = 92) and non-LGBTQ+ (n = 491) college students. Methods: The 26-item Dietary Screener Questionnaire assessed intakes of added sugars, fiber, whole grains, fruits and vegetables, dairy, and calcium. Percentage of participants meeting Dietary Guidelines for Americans were also computed. Multivariate ANCOVA assessed differences in dietary intake. Chi-square analyses assessed differences in proportions of LGBTQ + and non-LGBTQ + students meeting recommendations. Results: LGBTQ + students reported lower intakes of fiber, whole grains, fruit, and fruits and vegetables both including and excluding French fries (all p < 0.05). Fewer LGBTQ + students met recommendations for fruit (5.7%) compared to their non-LGBTQ + counterparts (14.2%; p = .03). Conclusions: LGBTQ + students report poorer indices of diet quality compared to non-LGBTQ + students. Health promotion programming efforts to improve these outcomes may need to be tailored differently for students who identify as LGBTQ+.