Diet Quality Index Research Articles

Diet quality indices and changes in cognition during chemotherapy.

No evidence-based prevention strategies currently exist for cancer-related cognitive decline (CRCD). Although patients are often advised to engage in healthy lifestyle activities (e.g., nutritious diet), little is known about the impact of diet on preventing CRCD. This secondary analysis evaluated the association of pre-treatment diet quality indices on change in self-reported cognition during chemotherapy. Study participants (n = 96) completed the Block Brief Food Frequency Questionnaire (FFQ) before receiving their first infusion and the PROMIS cognitive function and cognitive abilities questionnaires before infusion and again 5days later (i.e., when symptoms were expected to be their worst). Diet quality indices included the Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet (aMED), and a low carbohydrate diet index and their components. Descriptive statistics were generated for demographic and clinical variables and diet indices. Residualized change models were computed to examine whether diet was associated with change in cognitive function and cognitive abilities, controlling for age, sex, cancer type, treatment type, depression, and fatigue. Study participants had a mean age of 59 ± 10.8years and 69% were female. Although total diet index scores did not predict change in cognitive function or cognitive abilities, higher pre-treatment ratio of aMED monounsaturated/saturated fat was associated with less decline in cognitive function and cognitive abilities at 5-day post-infusion (P ≤ .001). Higher pre-treatment ratio of monounsaturated/saturated fat intake was associated with less CRCD early in chemotherapy. Results suggest greater monounsaturated fat and less saturated fat intake could be protective against CRCD during chemotherapy.

Diet Quality, Nutritional Adequacy and Anthropometric Status among Indigenous Women of Reproductive Age Group (15-49 Years) in India: A Narrative Review.

In India, indigenous communities are nutritionally vulnerable, with indigenous women suffering the greater burden. Studies and surveys have reported poor nutritional outcomes among indigenous women in India, yet systematic documentation of community-specific nutrition data is lacking. We conducted a narrative review of 42 studies to summarise the nutritional profile of indigenous women of India, with details on their food and nutrient intakes, dietary diversity, traditional food consumption and anthropometric status. Percentage deficits were observed in intake of pulses, green leafy vegetables, fruits, vegetables, flesh foods and dairy products when compared with recommended dietary intakes for moderately active Indian women. Indices of diet quality in indigenous women were documented in limited studies, which revealed poor dietary diversity as well as low consumption of diverse traditional foods. A high risk of nutritional inadequacy was reported in all communities, especially for iron, calcium, and vitamin A. Prevalence of chronic energy deficiency was high in most communities, with dual burden of malnutrition in indigenous women of north-eastern region. Findings from this review can thus help guide future research and provide valuable insights for policymakers and program implementers on potential interventions for addressing specific nutritional issues among indigenous women of India.

Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020–2025 Dietary Guidelines for Americans

BackgroundAccurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. ObjectivesThe goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. MethodsWe used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. ResultsNearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. ConclusionsWe found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.

Diet quality and risk of gastric adenocarcinoma: The Multiethnic Cohort

BackgroundCertain dietary patterns (i.e., low intake of fruit/vegetables and high intake of salt and processed meats) have been associated with the risk of gastric cancer. However, it is unclear whether overall diet quality assessed by predefined indices that consider the complexity of dietary intake is associated with gastric cardia and distal adenocarcinoma. ObjectivesTo examine the association of a variety of diet indices with the risk of gastric cardia and distal adenocarcinoma and assess whether there are any subgroups that may benefit from better diets to reduce the risk of gastric adenocarcinoma. MethodsDietary indices of interest included the Alternative Healthy Index (AHEI)-2010, Healthy Eating Index (HEI)-2015, the Dietary Approach to Stop Hypertension, alternate Mediterranean diet (aMED), and the energy-adjusted Dietary Inflammatory Index. ResultsAfter an average follow-up time of 19.2 years, there were 836 incident cases of gastric distal adenocarcinoma and 207 cases of gastric cardia adenocarcinoma. We did not observe any significant associations between the dietary indices and gastric cancer for either anatomic site. Among former aspirin users, we observed an inverse association between aMED with distal cancer (HRQ5 vs. Q1: 0.64; 95% CI: 0.33, 1.23; P-trend = 0.03). Never smokers, who showed high-quality diet according to AHEI-2010, exhibited a 40% decreased risk of gastric distal cancer compared with those with the poorest-quality AHEI-2010 diet (HRQ5 vs. Q1: 0.60; 95% CI: 0.41, 0.88; P-trend = 0.08). ConclusionsIn a multiethnic population, we did not observe overall significant associations between these dietary quality indices and risk of gastric cancer. However, among former aspirin users and never smokers, there could be a reduction of gastric distal adenocarcinoma risk with a higher adherence to a Mediterranean diet.

Association between Fecal Microbiota, SCFA, Gut Integrity Markers and Depressive Symptoms in Patients Treated in the Past with Bariatric Surgery-The Cross-Sectional Study.

(1) Background: Depressive symptoms often appear after surgical treatment. (2) Methods: We involved 41 adults who underwent bariatric surgery a minimum of 6 months before the study and had the Beck scale ≥12. We analysed patients' mental state, gut barrier markers, faecal short chain fatty acids, and microbiota. (3) Results: Gut microbiota composition differed significantly among patients undergoing two different types of surgery (F = 1.64, p = 0.00002). Additionally, we discovered an association between short chain fatty acids and the Beck scale (F = 1.22, p = 0.058). The rearrangement of bacterial metabolites may be due to the patients' use of increased dietary protein, with insufficient intake of products containing vegetable fiber (Diet Quality Index (DQI-I )adequacy 22.55 (±3.46) points). (4) Conclusions: Bariatric surgery affects the gut microbiota, which may play an important role in the development of depressive and gastrointestinal symptoms in patients after bariatric surgery. Low fiber consumption and increased levels of faecal isobutyric acid may lead to intestinal inflammation. There is a need for further research on this topic including a larger sample size.

Interaction between caveolin-1 polymorphism and dietary fat quality indexes on visceral adiposity index (VAI) and body adiposity index (BAI) among overweight and obese women: a cross-sectional study

Background and aimsCaveolin-1 (CAV-1) in adipocyte tissue and other body parts possesses numerous biological functions. In the present study, we sought to investigate the interaction between CAV-1 polymorphism and dietary fat quality indexes on visceral adiposity index (VAI) and body adiposity index (BAI) among overweight and obese women.MethodsThis study was conducted on 386 women aged 18–48 years old. Biochemical measurements were assessed by standard protocols. We used a food frequency questionnaire (FFQ) to calculate the dietary intake and the indexes of dietary fat quality intake. Anthropometric values and body composition were measured by standard methods. Finally, the CAV-1 genotype was measured using the PCR–RFLP method.ResultsWe found marginally significant differences between AA and GG genotypes of waist-to-hip ratio (WHR) (P = 0.06) and BAI (P = 0.06) of participants after adjusting for potential confounders. For dietary intakes, after adjusting with the energy intake, mean differences in biotin (P = 0.04) and total fiber (P = 0.06) were significant and marginally significant, respectively. The interaction between two risk alleles (AA) with omega-6 to omega-3 ratio (W6/W3) on BAI, after adjustment for potential confounders (age, physical activity, energy intake, education), was marginally positive (β = 14.08, 95% CI = − 18.65, 46.81, P = 0.07). In comparison to the reference group (GG), there was a positive interaction between the two risk alleles (AA) with W6/W3 ratio on VAI (β = 2.81, 95% CI = 1.20, 8.84, P = 0.06) in the adjusted model.ConclusionsWe found that there might be an interaction between CAV-1 genotypes with dietary quality fat indexes on VAI and BAI among overweight and obese women.

Association between Dietary Diversity Score and Metabolic Syndrome in Korean Adults: A Community-Based Prospective Cohort Study.

Dietary diversity is recognized as a key indicator of dietary quality and is known to affect the burden of non-communicable diseases. This study examined the gender-stratified association between dietary diversity score (DDS) and risk of metabolic syndrome (MetS) in 5468 adults aged 40-69 years during a 12-year follow-up of the Korean Genome and Epidemiology Study (KoGES). DDS was calculated according to the consumption of the five food groups based on the Dietary Reference Intakes (DRIs) for Koreans. The Cox proportional hazard model was used to evaluate MetS risk according to DDS. A higher DDS was negatively associated with the consumption of grains but positively associated with the consumption of fruits and non-salted vegetables. Furthermore, participants with a higher DDS showed higher consumption of fish and milk. Prospectively, a higher DDS was significantly associated with a lower risk of MetS in men (HR: 0.76, 95% CI: 0.63-0.92, p &lt; 0.01). In all participants, a higher DDS was inversely associated with the incidence of abdominal obesity (men, HR: 0.76, 95% CI: 0.62-0.93, p &lt; 0.01; women, HR: 0.79, 95% CI: 0.67-0.94, p &lt; 0.01). Furthermore, men with a higher DDS had a lower risk of hypertriglyceridemia (HR: 0.83, 95% CI: 0.71-0.97, p &lt; 0.05). These findings suggested that eating a more varied diet might have favorable effects on preventing MetS in Korean adults.

Ultra-processed food consumption and associations with biomarkers of nutrition and inflammation in pregnancy: The Norwegian Environmental Biobank.

A high consumption of ultra-processed foods (UPFs) is often associated with low nutritional quality, but data on associations with biomarkers are scarce. We aimed to explore associations between UPF intake, diet quality, and concentrations of biomarkers of nutrition and inflammation measured in mid-pregnancy. This cross-sectional study included n = 2,984 pregnant women recruited during 2002-2008 in the Norwegian Mother, Father, and Child Cohort Study (MoBa). Concentrations of C-reactive protein (CRP) and 21 nutritional biomarkers including carotenes (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamins [α-tocopherol, γ-tocopherol, 25-hydroxyvitamin D (25-OH-D), retinol], creatinine, elements (K, Na, Co, Cu, Mn, Mo, Se, Zn), and ferritin (Fe) were measured in blood and urine collected in mid-pregnancy. Habitual diet in pregnancy was assessed using a validated semi-quantitative food frequency questionnaire. We calculated the relative (%) energy contribution of UPF to overall intake according to the NOVA classification. We also applied a diet quality index (DQI) adapted to assess adherence to Norwegian dietary guidelines (DQI; min-max: 0-110, higher score meaning higher adherence). We present summary statistics for biomarker concentrations and explored associations between UPF intake or the DQI and measured biomarkers using adjusted linear, logistic, and generalized additive regression models. Ultra-processed food intake was positively associated with biomarker concentrations of vitamin E (γ-tocopherol), creatinine, K, and Na [βs: 5.6 to 17% increase in biomarker concentration per interquartile range (IQR) increase in UPF intake] and negatively associated with carotenoids (α-carotene, β-carotene, γ-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein, lycopene), vitamin A, Mo, and Se (βs: -2.1 to -18%). Inversely, high diet quality (i.e., the DQI) was positively associated with concentrations of carotenoids, vitamins [vitamin A (retinol) and D (25-OH-D)], and Se (β: 1.5 to 25%) and negatively associated with vitamin E (γ-tocopherol), creatinine, and Na (β: -4.8 to -8.3%). A weak, positive association was found between UPF and CRP (β: 5.4%, 95% CI 0.12-11%). High UPF intake was associated with reduced concentrations of nutrition biomarkers in mid-pregnancy. Associations in the opposite direction were found with high adherence to the Norwegian dietary guidelines, suggesting that the two dietary scoring systems capture diet quality in a mirrored manner in this population.

A high carbohydrate-to-fiber ratio is associated with a low diet quality and high fat mass in young women

Regular intake of dietary fiber is critical for adequate metabolic health and the prevention of obesity. The relevancy of fiber intake is well illustrated by accounting for the ratio of carbohydrates-to-fiber (CFR). However, it is not well known if the CFR is associated with body composition and the quality of diet in young women who are known to have a higher incidence of eating disorders related to restrictive carbohydrate diets. The purpose of this study was to explore the difference in body composition and the quality of diet in women with a low and high CFR. A total of 22 participants were clustered into two groups (group 1 – below the median CFR and group 2 – above the median CFR). Body composition was analyzed via dual-energy X-ray absorptiometry. Dietary analysis via a 3-day food log was conducted to examine the overall energy intake, macronutrient breakdown, and diet quality. One-way ANOVA and Point-biserial analyses were performed to explore group differences and correlations. The mean CFR for Group 1 was 9.23 ± 2.85 and for Group 2 was 20.75 ± 8.71, which was significantly different between the groups F (1,21) = 17.368, p < 0.001. Group 1 (fat mass: 13.07 ± 3.67 kg; body fat percentage: 21.93 ± 5.78%) had a significantly lower fat mass [ F (1,21) = 4.521, p = 0.046] and body fat percentage [ F (1,21) = 7.574, p = 0.012] than Group 2 (fat mass: 16.06 ± 2.89 kg; body fat percentage: 27.59 ± 3.62%). A higher CFR was associated with a higher percentage of carbohydrate intake ( r pb (20) = 0.466, p = 0.029) and a higher percentage of added sugar intake ( r pb (20) = 0.504, p = 0.017). This study confirms the applicability of the CFR as an indicator of diet quality in young women. In addition, the presented differences in body composition suggest that a diet consisting of a low CFR may play a positive role in body composition by maintaining a lower fat mass. • Age had no effect on the carbohydrate-to-fiber ratio. • The carbohydrate-to-fiber ratio is a good measure of diet quality. • A low carbohydrate-to-fiber ratio is associated with reduced fat mass. • A high carbohydrate-to-fiber ratio is associated with a high intake of added sugars.

MIND Dietary Pattern Adherence Is Selectively Associated with Cognitive Processing Speed in Middle-Aged Adults

Most previous work has focused on a single-nutrient, bottom-up approach when examining the influence of diet on neurocognition. Thus, the impact of dietary patterns on cognitive health is underinvestigated. We aimed to investigate the relation between different diet indices [i.e., Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index-2015 (HEI-2015), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)] and attentional inhibition and neuroelectric function. We undertook a cross-sectional analysis of adults aged 34.1 ± 6.0 y (n = 207, 116 females) with a BMI of 18.5 to >40 kg/m2 who completed the Dietary History Questionnaire II (DHQII) FFQ (Past Month and Year with Serving Sizes) to assess adherence to different diet quality indices. Attentional inhibition was assessed using a modified Eriksen flanker task during which event-related potentials (ERPs) were recorded. The amplitude and latency of the P3/P300 ERP were used to index attentional resource allocation and information processing speed, respectively. P3 peak latency was inversely associated with greater adherence to the MIND dietary pattern during incongruent flanker trials (∆R2 = 0.02, β = -0.14, P = 0.043) but not during congruent trials. Adherence to the Mediterranean, DASH, and HEI-2015 patterns was not associated with P3 latency (P > 0.05). No associations were observed between the diet indices and attentional inhibition at the behavioral level (i.e., accuracy or reaction time) or P3 amplitude (all P values >0.05). Greater adherence to the MIND diet was selectively associated with faster information processing speed in middle-aged adults with healthy to obese BMI. Further, the influence of the MIND diet for faster information processing speed might be particularly beneficial when cognitive control demands are increased. Future intervention trials testing the effects of consuming a MIND diet on cognitive function are warranted to help inform dietary recommendations for healthy cognitive aging.

Assessment of the nutritional value and quality of diets offered in popular apps.

People commonly use new technologies to promote a healthy lifestyle and help them lose weight through nutritional programs. This study evaluated the quality of individualized meal plans offered by dietary apps. Ten apps that offer personalized meal plans were selected for the study, weekly meal plans were generated, and the nutritional values of the diets were calculated. The Healthy Diet Indicator and the Diet Quality Index were estimated. Significant differences between apps were observed in the calculated energy values (p<0.0001) and macronutrients (p<0.05), the content of vitamins (vitamin A, E, K, B1, B3, B6, folates, C: p<0.05) and minerals (potassium, calcium, phosphor, magnesium, iron, zinc, copper, manganese: p<0.05), as well as diet quality (p<0.05) and food group consumption (vegetables, fruits, grains, dairy products, vegan products, meat, nuts, fats, sweets, beverages: p<0.05). Most diets covered the demand for the required nutrients, but the percentage of energy from fats, proteins and carbohydrates differed from the recommendations. Moreover, the nutritional values of the diets provided in the apps significantly differ from the values calculated using the nutritional databases. The meal plans from apps significantly differ in nutrients and food group intake. The quality of the diets offered in the app should be improved.

Effects of a cardioprotective nutritional program (BALANCE program) on diet quality, anthropometric features and cardiovascular risk factors in primary cardiovascular prevention: A workplace feasibility study

The Cardioprotective Nutritional Program (BALANCE Program) was created for the secondary cardiovascular prevention setting, shown to be effective in improving the diet quality, body weight and cardiovascular risk factor in individuals with previous cardiovascular disease. However, it has been not tested among employees at primary cardiovascular prevention conditions. The aim of this study was to evaluate the feasibility of the BALANCE Program in a workplace, and its possible effects on diet quality, body composition and cardiovascular risk factors. This was a before-after feasibility study conducted in an Occupational Medicine Service at a tertiary hospital. The nutritional-education program intervention comprised a ludic nutritional counselling about healthy and affordable foods, and individual/group counselling sessions as well. One hundred twenty-one workers with cardiovascular risk factors were enrolled to follow the BALANCE Program for 6 months. In addition to the dietary intake, glycemic and blood lipids profile, blood pressure and body composition features were evaluated. Feasibility was measured by participant's adherence to a specific diet quality index (the BALANCE index) and to the protocol sessions. Mean data differences from baseline to 3 and 6 months were compared using a paired Student's t -test or Wilcoxon test. The BALANCE Program improved diet quality by increasing BALANCE Index ( P = 0.001). 80% of participants attended the individual visits with dietitian. There was a significant reduction at 6 months in anthropometric indexes [body mass index ( P = 0.034), waist and neck circumferences ( P = 0.003 and P < 0.001, respectively)], body fat percentage ( P = 0.014) and metabolic parameters [total cholesterol ( P = 0.02), high density lipoprotein-cholesterol ( P = 0.011), fasting glucose (P = 0.021), glycated hemoglobin ( P = 0.039) and diastolic blood pressure ( P < 0.001)] after intervention. The BALANCE Program might be implemented in Occupational Medicine Services aiming to improve employee's diet and cardiovascular risk factors. • BALANCE Program was created aiming at secondary cardiovascular prevention. • It comprises ludic nutritional counselling about healthy and affordable food. • BALANCE Program seems to be applied to primary cardiovascular prevention in hospital workers. • The Program improved diet quality in primary prevention and reduced both anthropometric indexes and metabolic parameters.

Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: Findings from a prospective cohort study.

This study aimed to examine the associations between dietary protein score and carbohydrate quality index (CQI) and the risk of chronic kidney disease (CKD) in Iranian adults. This population-based cohort study was performed within the Tehran Lipid and Glucose Study framework on 6,044 subjects aged ≥18 years old, who were followed up for a mean of 7.7 years. Dietary protein score and CQI were determined using a food frequency questionnaire. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2. A multivariate Cox proportional hazard regression model was used to estimate the risk of CKD across tertiles of protein score and CQI. The mean (standard deviation) of age and body mass index of participants were 37.9 (12.8) years and 26.8 (4.7) kg/m2, respectively. During the 7.7 ± 2.7 years of follow-up, 1,216 cases (20.1%) of CKD were ascertained. In the final adjusted model, individuals in the highest tertile of protein score had decreased risk of CKD (HR: 0.85, 95% CI: 0.74-0.98, P trend = 0.033). Also, there is a significant association between total carbohydrate score (HR: 0.85, 95% CI: 0.73-0.99, P trend = 0.016), the ratio of whole grain/total grains (HR: 0.81, 95% CI: 0.70-0.94, P trend = 0.004), and glycemic index (HR: 1.30, 95% CI: 1.12-1.51, P trend < 0.001) and risk of CKD. However, no significant association was found between total protein intakes, plant-to-animal ratio, and solid carbohydrate/total carbohydrate with the risk of CKD. Our results revealed a diet with a high protein score and high quality of carbohydrates, characterized by higher intakes of plant proteins, low glycaemic index (GI) carbohydrates, whole grain, fibers, and lower intakes of animal proteins, can be related to reduced CKD risk.

Sodium-to-Potassium Ratio as an Indicator of Diet Quality in Healthy Pregnant Women

This study aimed to investigate diet quality in healthy pregnant women based on the Na-to-K ratio from 24 h urine sample and food frequency questionnaire (FFQ), to compare dietary micro- and macronutrient intake with current nutritional recommendations (RDA), and to investigate whether gestational weight gain (GWG) is associated with Na-to-K ratio and diet quality during pregnancy in general. Sixty-four healthy pregnant women between 37 and 40 weeks of gestation participated in the study. Participants' GWG, body composition, molar 24 h urine Na-to-K ratio, and FFQ data on average daily total energy, food groups, and micro-/macronutrient intake were obtained. A Na-to-K ratio of 2.68 (1.11-5.24) does not meet nutrition quality and is higher than the WHO recommendations due to excessive sodium and insufficient potassium intake. FFQ Na-to-K ratio was associated with a higher daily intake of soups, sauces, cereals, fats, and oils and a low intake of fruit and non-alcoholic beverages. A total of 49% of pregnant women exhibited excessive GWG, which was attributed to the increase in adipose tissue mass. GWG was not associated with total energy but may be the result of insufficient physical activity during pregnancy. Daily intake of vitamin D, vitamin E, folate, niacin, riboflavin, calcium, iron, and zinc was suboptimal compared to RDA.

Diet quality indices and their associations with all-cause mortality, CVD and type 2 diabetes mellitus: an umbrella review.

Numerous observational studies have investigated associations between diet indices and health outcomes. Our aim was to systematically synthesise data that was previously summarised separately for each diet index in one umbrella review of all diet indices with sufficient evidence gained in systematic reviews and to assess the quality and strength of evidence for selected health outcomes. The MEDLINE, EMBASE and Scopus databases were systematically searched following the PRISMA guidelines through October 2021 for systematic reviews of observational studies investigating associations between adherence to diet indices and selected health outcomes (all-cause mortality, CVD incidence or mortality, type 2 diabetes mellitus incidence or mortality). Methodological quality and quality of evidence were assessed using the AMSTAR 2 and NutriGrade tools. The inclusion criteria were met by seven systematic reviews, entirely based on prospective cohort studies and reviewing five different diet indices - alternate healthy eating index (AHEI), dietary approaches to stop hypertension (DASH), dietary inflammatory index (DII), healthy eating index (HEI) and Mediterranean diet (MedDiet). All seven included systematic reviews showed that greater adherence to these diet indices reduces the risks of all-cause mortality, CVD incidence and mortality and type 2 diabetes mellitus incidence. Moderate meta-evidence was presented for AHEI and DASH for all outcomes, also for DII for all-cause mortality, CVD mortality and incidence, MedDiet for all-cause mortality and for HEI for CVD incidence and mortality. Our umbrella review provides further evidence for AHEI, DASH, DII and HEI diet indices to be used as predictors of selected health outcomes.

Relationship between the Dietary Inflammatory Index and Cardiovascular Health among Children.

The aim of this study was to evaluate the relationship between the Dietary Inflammatory Index (DII®) and cardiovascular health indicators in children. The sample consisted of 365 schoolchildren aged 8 to 12 from the Region of Madrid. Anthropometric and hemodynamic measurements were collected. Variables relating to habits and lifestyles, parental level of education, and data on their diet, through three 24 h food recall surveys, were also collected. The diet quality indicators considered are the DII based on 25 nutrients and the KIDMED index. Children with a more pro-inflammatory diet came from families with lower levels of parental education (p < 0.05). Predictive models show that in the group with a more pro-inflammatory diet (>P50), the likelihood of developing hypertension in childhood is 2.1 times higher (OR = 2.085 (1.107-3.927)) and they have more than twice the risk of developing obesity (OR = 2.3) or developing obesity and hypertension simultaneously (OR = 1.290 (1.316-3.985)). Furthermore, predictive models showed that the children with a pro-inflammatory diet (>P50) had higher values for BFM% (β = 1.957; p = 0.026) and BMI (β = 0.015; p = 0.012) than children with a lower inflammatory diet (<P50). Higher values on the DII are related to poorer nutritional status and cardiovascular health in childhood. Thus, a pro-inflammatory diet is also associated with a lower socio-economic level and poorer diet quality.

Lifestyle of Italian University Students Attending Different Degree Courses: A Survey on Physical Activity, Sleep and Eating Behaviors during the COVID-19 Pandemic

The current study aimed to evaluate the Italian university students’ lifestyle during the COVID-19 pandemic, considering the degree courses, chronotype, and sex. Five-hundred thirty-three participants (21.46 ± 0.18 yrs, 335 females) filled out: Godin-Shephard Leisure Time Physical Activity Questionnaire (GSL-TPAQ), Pittsburgh Sleep Quality Index (PSQI), Mediterranean Diet Quality Index (KIDMED), Reduced Morningness-Eveningness Questionnaire (rMEQ) to assess physical activity, sleep, nutrition and chronotype. Use of electronic devices, smoking, and drinking habits were also evaluated. Sports science students were more active (60.92 ± 2.96), slept better (4.40 ± 0.15), showed greater Mediterranean diet adherence (5.98 ± 0.31), and smoked less (smokers: 14.5%) than nursing students (GSL-TPAQ: 38.62 ± 2.92, PSQI: 5.29 ± 0.18, KIDMED: 4.23 ± 0.33, smokers: 27.9%). They displayed a higher percentage of beer drinkers (40% vs. 28.7%) and lower use of electronic devices (5.92 ± 0.17 vs. 9.07 ± 1.17). Evening-type students showed worse sleep (5.96 ± 0.30) and lower Mediterranean diet adherence (4.32 ± 0.52) than Neither- (PSQI: 4.58 ± 0.13, KIDMED: 5.13 ± 0.28) and Morning-types (PSQI: 4.33 ± 0.33, KIDMED: 6.71 ± 0.64). Evening-types also showed a higher percentage of smokers (29.9%) and drinkers (beer: 53.3%, wine: 45.8%, alcohol: 40.2%) than Neither- (smokers: 20.3%, beer: 31.4%, wine: 31.4%, alcohol: 23.5%) and Morning-types (smokers: 8.9%, beer: 19.6%, wine: 19.6%, alcohol: 8.9%). Evening-type males used electronic devices longer (9.10 ± 3.05) than females (6.71 ± 0.41). Females showed fewer drinkers (beer: 26.6%, wine: 29.6%) than males (beer: 49.0%, wine: 38.9%). Maintaining a correct lifestyle even in this unusual condition is essential, in particular among the Evening-type students.

Validation of a new scoring approach of a child dietary questionnaire for use in early childhood among low-income, Latino populations

BackgroundMeasuring diet quality in early childhood requires time-intensive and costly measurements (e.g., 24-hour diet recall) that are especially burdensome for low-income, minority populations. This study aimed to validate a new method for calculating overall diet quality among low-income, Latino preschoolers.MethodsThis study was an observational study using data from a randomized controlled trial. Participants included parents of Latino preschoolers who reported child diet quality at baseline, 4-month, 7-month, 12-month, and 13-month follow-up. At each timepoint parents responded to a 28-item child dietary questionnaire (CDQ), based on the National Health and Nutrition Examination Survey (NHANES) dietary module, which generated the number of times/day that a child ate each of 28 foods in the past month. These 28 items were then used to create a total standardized child diet quality index (possible range 0-100), using a percent of maximum method. Parents were asked to complete three 24-hour diet recalls at the 13-month follow-up, from which the 2015 Healthy Eating Index (HEI) was derived. Construct validity was evaluated by Spearman’s rank correlations between the new child diet quality index and the 2015 HEI at the 13-month follow-up. Test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sequential pairs of time points.ResultsAmong 71 eligible parent-child pairs, mean child age was 4.2 (SD = 0.8) years, 50.7% of children were female, and mean child body mass index (BMI) was 17.8 (SD = 2.0) kg/m2. Mean Child Diet Quality Index was 45.2 (SD = 3.2) and mean HEI was 68.4 (SD = 10.5). Child Diet Quality Index and HEI total scores were significantly correlated (r = 0.37; p = 0.001). Test-retest ICCs were statistically significant between all sequential pairs of time points.ConclusionThe new approach for calculating a measure of overall diet quality from the previously-validated 28-item dietary questionnaire demonstrated modest construct validity. When time and resources are limited, this new measure of overall diet quality may be an appropriate choice among low-income, Latino preschoolers.Trial RegistrationThis reports presents observational data collected as a part of a clinical trial, which was registered on clinicaltrials.gov prior to participant enrollment (NCT03141151).

Dietary Quality and Relationships with Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) among United States Adults, Results from NHANES 2017-2018.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new definition for the evidence of hepatic steatosis and metabolic dysfunctions. The specific role of the dietary factors in the development and progress of the disease are not well illuminated. Thus, we conducted this study on the associations between dietary quality assessed by five dietary quality indexes (Dietary Inflammatory Index, DII; Mediterranean diet, MED; Dietary Approach to Stop Hypertension, DASH; Alternate Healthy Eating Index diet, AHEI; Healthy Eating Indices, HEI) and MAFLD phenotypes. This study was extracted from the latest NHANES 2017-2018 wave. Demographic information, health status, lifestyles, and dietary habits were reported in the questionnaire. Multivariate logistic regression and multivariate ordinal logistic regression methods were applied to explore the associations between dietary quality indexes and MAFLD or MAFLD with liver fibrosis. The weighted prevalence of Non-MAFLD, MAFLD without fibrosis, and MAFLD with fibrosis were 47.05%, 36.67%, and 16.28%, respectively, at the cutoff value of a median Controlled Attenuation Parameter (CAP) 248 dB/m and a median Liver Stiffness Measurement (LSM) 6.3 kPa. When the diagnostic cutoff values of CAP changed to 285 dB/m, the weighted prevalence of Non-MAFLD, MAFLD without liver fibrosis, and MAFLD with fibrosis turned to 64.62%, 22.08%, and 13.30%, respectively. All five dietary quality indexes, including DII, HEI-2015, AHEI, DASH, and MED, were all significantly associated with MAFLD phenotypes. DII was positively associated with MAFLD phenotypes, while other four dietary quality indexes, including HEI-2015, AHEI, DASH, and MED, were significantly associated with lower risk of MAFLD phenotypes. MAFLD is becoming a threatening public health concern among adult Americans and dietary quality is markedly associated with MAFLD phenotypes.

Mortality and Life Expectancy Lost in Canada Attributable to Dietary Patterns: Evidence From Canadian National Nutrition Survey Linked to Routinely Collected Health Administrative Databases.

Using 5 diet quality indexes, we estimated the mortality and life expectancy lost, at the national level, attributable to poor dietary patterns, which had previously been largely unknown. We used the Canadian Community Health Survey 2004, linked to vital statistics (n= 16,212 adults; representing n= 22,898,880). After a median follow-up of 7.5 years, 1,722 deaths were recorded. Population attributable fractions were calculated to estimate the mortality burden of poor dietary patterns (Dietary Guidelines for Americans Adherence Index 2015, Dietary Approaches to Stop Hypertension, Healthy Eating Index, Alternative Healthy Eating Index, and Mediterranean Style Dietary Pattern Score). Better diet quality was associated with a 32%-51% and 21%-43% reduction in all-cause mortality among adults aged 45-80 years and≥20 years, respectively. Projected life expectancy at 45 years was longer for Canadians adhering to a healthy dietary pattern (average of 5.2-8.0 years (men) and 1.6-4.1 (women)). At the population level, 26.5%-38.9% (men) and 8.9%-22.9% (women) of deaths were attributable to poor dietary patterns. Survival benefit was greater for individuals with higher scores on all diet indexes, even with relatively small intake differences. The large attributable burden was likely from assessing overall dietary patterns instead of a limited range of foods and nutrients.