Dietary Score Research Articles

A Mediterranean dietary pattern intervention does not improve cardiometabolic risk but does improve quality of life and body composition in an Aotearoa New Zealand population at increased cardiometabolic risk: A randomised controlled trial.

To test if a New Zealand food-based Mediterranean diet (NZMedDiet) with behavioural intervention improves cardiometabolic health and wellbeing. A randomised controlled trial comparing 12 weeks of the NZMedDiet to usual diet in participants with increased cardiometabolic risk (metabolic syndrome severity score [MetSSS] > 0.35). The intervention group was provided with food and recipes to meet 75% of their energy requirements, supported by a behavioural intervention to improve adherence. The primary outcome measure was (MetSSS) after 12 weeks. Two hundred individuals with mean (SD) age 49.9 (10.9) years of which 62% women were enrolled with their household/whānau. After 12 weeks, the mean (SD) MetSSS was 1.0 (0.7) in the control (n = 98) and 0.8 (0.5) in the intervention (n = 102) group; estimated difference (95% confidence interval [CI]) of -0.05 (-0.16 to 0.06), p = 0.35. The Mediterranean diet score (PyrMDS) was greater in the intervention group 1.6 (1.1-2.1), p < 0.001, consistent with a change to a more Mediterranean dietary pattern. Weight reduced in the NZMedDiet group compared with control (-1.9 kg [-2.0 to -0.34]), p = 0.006 and wellbeing, assessed by the SF-36 quality of life questionnaire, and improved across all domains. For example, the physical component summary score difference (95% CI) was 4.0 (2.4-5.7), p < 0.001, and the mental component summary score difference was 3.0 (0.7-5.2), p = 0.01. In participants with increased cardiometabolic risk, food provision with a Mediterranean dietary pattern and a behavioural intervention did not improve metabolic risk scores but was associated with reduced weight and improved quality of life.

Onset of cognitive impairment, diet quality and adherence to dietary guidelines over 12 years: the Personality and Total Health Cohort Study.

Around 55 million people worldwide live with dementia, and more are expected due to population ageing. We aimed to investigate associations between healthy diet and mild cognitive impairment and dementia in 1753 older adults aged 60-64 from the PATH (Personality and Total Health Through Life Cohort) study. Healthy diet was defined by the Mediterranean-DASH diet Intervention for Neurological Delay (MIND) and two dietary guideline quality scores (Dietary Guideline Index (DGI) and Index Diet Quality (IDQ)), which were calculated from baseline FFQ. Higher dietary scores indicated higher diet quality. Incidence of Alzheimer's disease/vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) was assessed after 12 years of follow-up using validated questionnaires with nominated proxies. Logistic regression explored associations between dietary scores and cognitive function, adjusting for demographics, lifestyle factors and medical preconditions. Adjusted logistic regression comparing the per unit linear increase in diet scores showed MIND (OR = 0·82, 95 % CI = 0·68, 0·99), but not DGI (0·99 (0·97, 1·00)) or IDQ (1·12 (0·95, 1·32)), was significantly associated with lower odds of developing cognitive impairment. In conclusion, a healthier neuroprotective dietary pattern is associated with better cognitive function over time, whereas dietary patterns generated from general dietary guidelines did not show a significant association. Further research and well-designed clinical studies are needed to determine the effects of the MIND diet on cognitive impairment in older adults without a family history of dementia.

Comparison of diet quality indices for predicting metabolic syndrome in Iran: cross-sectional findings from the persian cohort study

BackgroundThe metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one.MethodsThis cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year’s food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices.ResultsThis study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93–0.95), OR: 0.85, (95% CI: 0.81–0.89), OR: 0.84, (95% CI: 0.80–0.89), OR: 1.22, (95%CI: 1.11–1.34), OR: 0.95, (95%CI 0.94–0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS.ConclusionThe present study’s findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS.

Diet quality trajectories from infancy to age 18 and their association with diet quality at age 26

Abstract Background and objectives Dietary habits during childhood and adolescence show strong stability. However, no studies have investigated dietary trajectories from infancy to adulthood. We therefore aimed to 1) identify diet quality trajectories from age 1 to 18 years and 2) explore how trajectories are associated with diet quality at age 26 years. Methods The study included 620 individuals from the Special Turku Coronary Risk Factor Intervention Project (STRIP), started in infancy (n = 1062). Food and nutrient intake was assessed annually from age one to age 18, and again at age 26 using 4-day food records. A food-based diet score (range 0-33) was calculated to indicate diet quality. Group-based modelling was used to model trajectories of diet quality between the ages of 1 and 18 years. Linear regression analyses were used to investigate associations between the diet quality trajectory groups and diet quality at age 26 years. Results By the age of 18, we found five diet quality groups: 1) low (19% of participants) with a mean diet score of 12 points, 2) decreasing (25%) with a mean diet score of 15 points, 3) increasing (15%) with a mean diet score of 16 points, 4) intermediate (31%) with a mean diet score of 18 points, and 5) high (10%) with a mean diet score of 22 points. The diet quality trajectory groups were associated with 0.4 (decreasing), 2.5 (medium), 3.8 (increasing) and 4.1 (high) points higher diet scores at age 26 compared to the low diet quality trajectory group (p &amp;lt; 0.001 for all). Discussion Five distinct dietary trajectories were found from infancy to late adolescence, with a clear difference between the groups with the lowest and highest diet quality. However, the differences in diet quality levelled out by the age of 26 years. Our results suggest that diet quality established already in childhood moderately predicts diet quality into adulthood. Key messages • Diet quality established in childhood moderately predicts diet quality in young adulthood. • Five distinct dietary trajectories were found from infancy to late adolescence, with a clear difference between the groups with the lowest and highest diet quality.

Effectiveness of Internet + E-Coach chronic disease management on blood glucose, lipid levels, liver function, and quality of life in patients with chronic diabetic retinopathy: a comparative study

ObjectiveThis study aims to explore the effect of Internet + E-Coach chronic disease system intervention on fasting blood glucose (FPG), 2-hour postprandial blood glucose(2hPG), fasting serum insulin (FINS), triglyceride (TG), alanine transaminase (ALT) and quality of life in patients with chronic diabetic retinopathy.Methods208 patients with chronic diabetic retinopathy who were treated in the hospital from March 2021 to March 2023 are chosen and separated into two groups by random number Table 104 patients in the control group received routine continuous intervention, and the research group received Internet + E-Coach chronic disease system intervention. The cognition of disease related knowledge, blood related indicators inflammatory factor levels and improvement of life quality between the two groups before intervention, 6 and 12 months after intervention were compared.ResultsBefore the intervention, the comparison between the two groups in disease related knowledge scores, blood glucose, blood lipid, liver function indicators, inflammatory factor, and low vision quality of life scale (CLVQOL) scores was with P > 0.05. After 6 and 12 months of intervention, the research group had significantly higher scores for basic blood glucose intervention, healthy diet, reasonable exercise, and correct medication use compared to the control group (P < 0.05). FPG, 2hPG, TG and ALT in the research group were lower than those in the control group. FINS were higher in the control group, with P < 0.05. Interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and hypersensitive C-reactive protein (Hs-CRP) in the research group were obviously lower than those in the control group (P < 0.05). The scores of far vision, movement and light perception, adjustment ability, reading and fine work, and daily living ability in the research group were higher than those in the control group, with P < 0.05.ConclusionThe intervention of Internet + E-Coach chronic disease system can improve the knowledge of chronic diabetic retinopathy patients about their own condition, stabilize the levels of blood sugar, blood lipid and liver function indicators, reduce the inflammatory reaction of the body, and improve the quality of life.

Correlations Between Dietary Magnesium Consumption and Magnesium Depletion Score in Relation to Parkinson's Disease: A Population-Based Study.

The purpose of the study was to examine whether magnesium (Mg) depletion score (MDS) and dietary Mg intake are associated in adults with the risk of developing Parkinson's disease (PD). In this study, we analyzed data from the National Health and Nutrition Examination Survey (NHANES), which included 20,010 adults aged over 40 years old. To evaluate the linear association between PD and dietary intake of Mg or MDS, we conducted weighted logistic regression for univariate analysis and multivariate linear regression models. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models. A restricted cubic spline (RCS) was drawn to visualize the nonlinear relationship between MDS/dietary Mg intake and PD. In addition, we examined the variations in the relationship between MDS and PD across different confounding factors of the association using subgroup analysis. There were 240 PD cases (1.2%), and 19770 non-PD were included in the study. We found that a higher MDS was associated with an increased risk of PD after adjusting for covariates (OR per 1-unit increase, 1.47; 95% CI, 1.16-1.86). There is insufficient evidence to support a significant statistical association between Mg intake and the risk of PD. According to nonlinear regression, high MDS was associated with higher odds of PD and lower odds of PD above 250 mg/day intake of Mg. It has been shown that Mg bioavailability may be negatively associated with PD as measured by MDS. MDS is a potential method for screening the population with PD. Maintaining adequate Mg status may be important for PD prevention.

The relationship between anxiety and diet quality in adolescent populations: a cross-sectional analysis.

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.

Characterising users of community-based interventions designed to improve the food practices

Abstract Promoting affordable ways to help low-income families improve dietary behaviours and achieve a healthy weight represents a priority for UK public health policy. For such interventions to be appropriately tailored and targeted, it is important to better understand the intended recipients. The present study aimed to assess the dietary practices and psychosocial characteristics of users of Aberdeen City community-based interventions (e.g., food banks, pantries, social cafés) designed to support low-income communities in accessing food and engaging in healthier food practices. From January to June 2023, a cross-sectional survey was conducted employing convenience sampling among users of community-based interventions (N = 105; 73 females). The questionnaire assessed diet quality (SFFQ), household food insecurity (HFIAS), mental health (PHQ-4), well-being (Cantril Ladder), intention and self-efficacy toward healthy eating, and sociodemographic variables. Data were analysed using descriptive statistics, group comparisons, correlations, and regression analyses. Results indicated that community-based food provision users are highly vulnerable to food insecurity. Among participants, 53.3% reported severe food insecurity, and 18.1% reported moderate levels. Service users’ diets were high in discretionary foods and drinks (26% consume daily &amp;gt;1 portion of fizzy juice, 18.2% sweets, 16.7% crisps vs. 11.5% fruits and 10.6% vegetables). The mean dietary quality score was 9.48 (SD = 1.90) from a possible 15. Higher food insecurity and lower diet quality were significantly associated with greater mental distress (r=.41, p&amp;lt;.001; r=-.287, p=.005;) and poorer well-being (r=-.460, p&amp;lt;.001; r=.19, p=.049;). This study is part of a larger project aiming to optimise community-based dietary interventions for low-income populations. The results provide a clearer picture of the intended beneficiaries of such interventions and highlight user needs that can be prioritised in optimisation efforts. Key messages • Community-based food provision users are highly vulnerable to food insecurity and related negative health experiences. • The burden of poor diet and its associated health consequences disproportionately affect those living in the most deprived communities.

Mediterranean diet score linked to cognitive functioning in women: evidence from the Czech Republic

Abstract Background Evidence suggests that adherence to the Mediterranean diet (MED) may be beneficial in preventing cognitive decline, although findings are inconsistent. We aimed to explore this association in the Czech population of older adults. Methods A total of 6,028 males and females from the Czech arm of the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study were included in the analysis. Dietary data were collected using a food frequency questionnaire, and MED was calculated based on nine food groups. The MED score ranged from 0 to 16 points and was categorized into three groups: 0-7, 8-10, and 11-16 points. Cognitive function was measured using four tests assessing verbal memory and learning, verbal fluency, and attention, mental speed and concentration, from which single z-scores were computed. The composite score of cognitive function was computed as the mean of z-scores. The cross-sectional associations between MED and composite score of cognitive function were analyzed using multivariate linear regression. Results Females with a dietary score of 8-10 points (Beta=0.05, 95% CI: -0.002; 0.097), and those with a score of 11-16 points (Beta=0.08, 95% CI: 0.016; 0.140) had a higher composite cognitive score than women in lowest adherence group. Looking at specific domains, women in the highest adherence group had significantly better immediate verbal memory (Beta=0.12, 95% CI: 0.031; 0.205) and delayed recall (Beta=0.12, 95% CI: 0.027; 0.212), respectively, than those in the lowest adherence group. There were no associations in males. Conclusions Higher adherence to the MED was associated with better cognitive functioning in verbal memory and composite cognitive score in Czech females. The results suggest that the Mediterranean diet may help to improve cognitive functioning in older women. #NGEU Key messages • Findings suggest that Mediterranean diet may be beneficial in cognitive functioning in older women. • Higher adherence to the Mediterranean diet is connected to better cognitive function particularly in verbal memory domain.

Empirical dietary inflammatory pattern could increase the odds of breast cancer: a case-control study

BackgroundIt has been shown that chronic inflammation is a significant factor in cancer development and progression. The current study aimed to investigate whether a higher score on the empirical dietary inflammatory pattern (EDIP), which indicates a more pro-inflammatory diet, is related to higher odds of breast cancer in Iranian women.MethodsIn the present case-control study, subjects in the case (n = 133) and control (n = 265) groups were chosen from the hospitals in Tehran, Iran. The cases consisted of women with newly diagnosed breast cancer, while the controls were selected from other parts of the same hospital and had no history of cancer or hormone therapy. Individuals whose reported energy intake deviated by three standard deviations above or below the mean energy intake of the population were excluded from the study. A reliable and valid semi-quantitative food frequency questionnaire was used to determine the participants’ dietary intake. Additionally, the association between breast cancer and EDIP was evaluated by logistic regression analysis in both crude and adjusted models.ResultsThe median scores of EDIP in the case and control groups were 0.65 and 0.61, respectively. The findings also indicated that, in the adjusted model, the odds of developing breast cancer significantly increased in the last tertile of EDIP compared to the first tertile (odds ratio (OR) = 1.859; 95% confidence interval (CI): 1.059–3.265; P = 0.031). Additionally, after adjusting for potential confounders, higher odds of breast cancer were observed in the last tertile of EDIP compared to the first tertile in postmenopausal women (OR = 2.516; 95% CI: 1.081–5.856; P = 0.033).ConclusionsThe current study indicated that individuals with a higher pro-inflammatory diet score were more likely to develop breast cancer.

Mediterranean Diet, ultra-processed food consumption and semen quality in healthy young men

Abstract Background Diet quality can have beneficial effects on male reproductive health, although studies are still limited, and little is known on the potential impact of ultra-processed foods (UPFs) on semen quality parameters. Methods A cross-sectional analysis was run on 126 participants (mean age 20.0 ± 1.2 y) from the FAST randomized controlled trial in 2018-2019. Food intake was assessed through a FFQ. UPF was defined following the Nova classification and calculated as the ratio (weight ratio) between UPF (g/d) and total food (g/d). Adherence to the Mediterranean Diet (MD) was ascertained by the Mediterranean Diet Score (MDS). The semen analyses were performed using a microscope for optical evaluation with a Makler counting chamber and two automated semen analysers. The primary outcomes were sperm volume, concentration, motility and morphology. A hierarchical mixed model approach was utilized to accommodate the within-subject correlation arising from the triple temporal repetition of measurements. Results Highest UPF consumption (Q4), compared to lowest (Q1), was associated with lower sperm concentration (β=-54.1×106 spz./ml; 95%CI: -92.9 to -15.4; p-trend=0.002 across quarters), and progressive motility (β=-14.2%; 95%CI: -28.2 to -0.09; p-trend=0.036). The percentage of cells with normal morphology tended to be reduced in young men consuming more UPF compared to lowest intake (β=-2.93%; 95%CI: -6.22 to 0.37; p-trend=0.071). The MDS was not associated with any of the parameters under study. Conclusions A larger dietary share of UPF was inversely associated with sperm concentration and progressive motility in young men of reproductive age. MD adherence was not associated with semen quality parameters, and this is possibly due to the low variability of MD adherence in this sample. Dietary recommendations for improving sperm health should prioritize limiting UPF in the diet. Key messages • Ultra-processed food (UPF) intake was unfavourably associated with semen quality parameters amongst young men. • Dietary recommendations for improving sperm health should recommend limiting UPF.

Association of a healthy plant-based heart-protective diet with reduced cardiovascular disease incidence and mortality: findings from the UK Biobank Study

Abstract Importance Previous research examining the effects of omnivorous and plant-based diets on CVD outcomes has produced inconsistent findings, and the importance of diet quality is overlooked. Objective To assess the relation between adherence to a healthy plant-based, heart-protective diet and the risk of cardiovascular disease (CVD) events. Design: Prospective cohort study. Methods and Results 192,274 (mean age: 56.3±7.9 years, 43.3% males) participants in UK Biobank without CVD at baseline who completed a 24-hour recall questionnaire. Using data generated by Oxford WebQ, we developed a novel heart-protective diet score (HPDS) based on 22 food groups. Cox proportional hazard models were used to study associations. During a median follow-up of 12.3 years, there were 20,692 CVD events and 1,131 CVD deaths. After adjusting for demographics, Townsend deprivation index, lifestyle factors, and history of chronic diseases, participants in the top quartile of the HPDS were at the lower risk of overall CVD (HR: 0.92, 95% CI: 0.88 to 0.95), ischemic heart disease (HR: 0.88 [95% CI: 0.83 to 0.93]), myocardial infarction (HR: 0.82, 95% CI: 0.74 to 0.90), and heart failure (HR: 0.86, 95% CI: 0.78 to 0.95) than those in the bottom quartile. Participants who adhered closely to a healthy plant-based heart-protective diet had the lowest risk of overall CVD (HR: 0.72, 95% CI: 0.61 to 0.86), ischemic heart disease (HR: 0.68, 95% CI: 0.52 to 0.89), myocardial infarction (HR: 0.65, 95% CI: 0.46 to 0.91), and heart failure (HR: 0.51, 95% CI: 0.30 to 0.85) mortality. Conclusions and relevance: Adherence to a healthy plant-based heart-protective diet rich in non-starchy vegetables, fruits, whole grains, legumes, and fish, is associated with a reduced cardiovascular disease incidence and mortality. Further research in diverse ethnic populations is necessary to validate our findings and enhance their generalizability.

Combined association between dietary antioxidant quality score and leisure-time physical activity on sleep pattern in cancer survivors: a cross-sectional study of NHANES database.

This study aimed to explore the combined association between the dietary antioxidant quality score (DAQS) and leisure-time physical activity on sleep patterns in cancer survivors. Data of cancer survivors were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2014 in this cross-sectional study. Weighted multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of DAQS and leisure-time physical activity on sleep patterns. The combined association was also assessed in subgroups of participants based on age, and use of painkillers and antidepressants. Among the eligible participants, 1,133 had unhealthy sleep patterns. After adjusting for covariates, compared to low DAQS level combined with leisure-time physical activity level <600 MET·min/week, high DAQS level combined with leisure-time physical activity ≥600 MET·min/week was associated with lower odds of unhealthy sleep patterns (OR=0.41, 95%CI: 0.23-0.72). Additionally, the association of high DAQS level combined with high leisure-time physical activity with low odds of unhealthy sleep patterns was also significant in <65 years old (OR=0.30, 95%CI: 0.13-0.70), non-painkiller (OR=0.39, 95%CI: 0.22-0.71), non-antidepressant (OR=0.49, 95%CI: 0.26-0.91) and antidepressant (OR=0.11, 95%CI: 0.02-0.50) subgroups. DAQS and leisure-time physical activity had a combined association on sleep patterns in cancer survivors. However, the causal associations of dietary nutrient intake and physical activity with sleep patterns in cancer survivors needs further clarification.

The Bidirectional Effects of Periodontal Disease and Oral Dysbiosis on Gut Inflammation in Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) flares can lead to excessive morbidity and mortality. This study aimed to determine whether oral dysbiosis/periodontal disease (PD) is common in IBD and is associated with disease activity in IBD. This single-center, prospective, cross-sectional, proof-of-concept, observational study assessed the frequency of periodontal inflammatory disease and interrogated oral and stool microbiota using 16S rRNA gene amplicon sequencing of active-IBD (aIBD), inactive-IBD (iIBD), and healthy controls (HC). Questionnaires assessed diet, alcohol usage, oral hygiene behavior, and disease activity. A subset of participants underwent comprehensive dental examinations to evaluate PD. PD was severer in aIBD subjects than in HC, as aIBD had poorer quality diets (lower Mediterranean diet scores) than iIBD and HC. Significant differences in microbial community structure were observed in unstimulated saliva, stimulated saliva, gingiva, and stool samples, primarily between aIBD and HC. Saliva from aIBD had higher relative abundances of putative oral pathobionts from the genera Streptococcus, Granulicatella, Rothia, and Actinomyces relative to HC, despite similar oral hygiene behaviors between groups. Our study suggests that patients with aIBD have severer periodontal disorders and higher relative abundances of putative "pro-inflammatory" microbiota in their oral cavity, despite normal oral hygiene behaviors. Our data are consistent with the potential presence of an oral-gut inflammatory-axis that could trigger IBD flare-ups in at-risk patients. Routine dental health assessments in all IBD patients should be encouraged as part of the health maintenance of IBD and as a potential strategy to decrease the risk of IBD flares.

Adherence to lifelines diet is associated with lower lung cancer risk in 98,459 participants aged 55 years and above: a large prospective cohort study

BackgroundLifelines Diet Score (LLDS) was developed based on the 2015 Dutch Dietary Guidelines and current international scientific evidence. As a dietary quality assessment tool, the LLDS aims to evaluate the association between the Lifeline diet and the risk of chronic diseases. However, the evidence linking LLDS to lung cancer risk is currently limited.ObjectiveOur objective was to explore whether adherence to the LLDS is associated with reduced incidence and mortality of lung cancer, including its major histological subtypes: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).MethodsData for this research were sourced from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Trial. The LLDS for each participant was calculated based on responses to the dietary history questionnaire (DHQ), and subsequently analyzed after being categorized into quintiles. The Cox proportional hazards regression model was utilized to compute the hazard ratios (HRs) and 95% confidence intervals (CIs) for both the incidence and mortality of lung cancer, SCLC and NSCLC. Additionally, stratified analyses were conducted to ascertain possible effect modifiers, and several sensitivity analyses were performed to evaluate the robustness of the findings.ResultsDuring the mean follow-up periods of 8.8 years for incidence and 15.1 years for mortality, we identified 1,642 new cases and 1,172 related deaths from lung cancer. Participants in the highest quartiles of LLDS compared to those in the lowest exhibited a reduced incidence (HRQ4:Q1 = 0.80, 95% CI = 0.68–0.94, P for trend = 0.003) and mortality (HRQ4:Q1 = 0.81, 95%CI = 0.67–0.98, P for trend = 0.009) of lung cancer. Furthermore, this negative association remained for SCLC incidence (HRQ4:Q1 = 0.55, 95% CI = 0.35–0.87, P for trend = 0.002) and mortality (HRQ4:Q1 = 0.42, 95% CI = 0.25–0.70, P for trend &amp;lt;0.001). The association between LLDS and the incidence and mortality of lung cancer is not influenced by pre-defined potential effect modifiers (all Pinteraction &amp;gt; 0.05). The sensitivity analyses substantiated the robustness of the results.ConclusionIn conclusion, our research indicates that among 98,459 U.S. adults aged 55 and older, adherence to the LLDS is linked to a diminished incidence and mortality of lung cancer.

Diet quality in young adulthood and sleep at midlife: a prospective analysis in the Bogalusa Heart Study

BackgroundDiet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though longitudinal evidence for how diet associates with sleep is scarce. This study aimed to determine the prospective association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS).MethodsThis prospective study included 593 BHS subjects with dietary assessment at the 2001–2002 visit and sleep questionnaire responses from the 2013–2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested.ResultsHigher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower probability of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower probability of insomnia symptoms at follow-up (RR [95% confidence interval CI]: 0.85 [0.77, 0.93]), those in Q5 of AHEI had 0.54 times the probability as those in Q1 (95% CI: 0.39, 0.75), and there was a significant trend across quintiles (trend p = 0.001). There were no significant associations between young adult diet quality and having a high sleep apnea risk or a healthy sleep pattern at follow-up.ConclusionsA healthy diet was associated with a lower probability of future insomnia symptoms. If replicated, these findings could have implications for chronic disease prevention strategies incorporating the lifestyle behaviors of sleep and diet.

Analysing the behaviour change techniques in an effective food literacy program to inform future program design.

Food literacy programs aim to improve food related skills and knowledge and are selected Governments as a strategy to address dietary intakes at a community level. The purpose of this research is to identify behaviour change techniques in a food literacy program, which were assessed by the achievement of participant goals related to food literacy and dietary behaviour changes. Consensus methods were applied to map behaviour change techniques to an adult food literacy program. A second phase investigation applied content analysis of participant process evaluation data (collected between 2016 and June 2021) to align target behaviours and behaviour change techniques. Chi-square and ANCOVA were used to assess the statistically significant demographic characteristics, food literacy, and dietary behaviour scores for participants who set goals and recorded changes. A total of 4697 program participants provided evaluation data from the 4-week food literacy program. Participants who set goals and made changes were statistically more likely to have higher food literacy factor scores (p < 0.001) and fruit serves (p = 0.004). Statistical analysis showed that participants were more likely to have set goals and recorded changes if they were female (p < 0.001), older (p < 0.001), higher education level (p < 0.001), had a higher socioeconomic status (p = 0.049), lived with children (p = 0.014), were born in Australia (p = 0.019), or did not identify as Indigenous (p < 0.001). The behaviour change technique mapping process identified nine techniques used weekly and a total of 22 techniques used over the entire 4 week program curriculum. This is the first Australian study to link the contribution of behaviour change techniques to food literacy and dietary behaviour change in an established effective food literacy program. Knowing the behaviour change techniques associated with effective programs will facilitate replication of effective interventions.

Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort.

Diet may influence the development of cognitive impairment and affect cognitive decline, but whether this relationship varies between Black American and White American people is unclear. This study examined the association of Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) and incident cognitive impairment and cognitive trajectories in a biracial prospective cohort study. Using data derived from the Food Frequency Questionnaire in the REasons for Geographic and Racial Differences in Stroke study, we compared MIND diet adherence with incident cognitive impairment and cognitive trajectory in Black participants and White participants. Logistic regression was used to model MIND diet score (continuous variable and using tertiles) and incident cognitive impairment after adjusting for age, sex, race, region, education, income, total energy, hypertension history, dyslipidemia, diabetes, estimated glomerular filtration rate, ischemic heart conditions, atrial fibrillation, and lifestyle factors including sedentary, obesity, and smoking. Mixed-effects models were used to examine the association between cognitive trajectory and MIND diet adherence. Dietary data to calculate the MIND diet score and cognitive data were available on 14,145 participants with a mean age of 64 years (SD 9.0 years) that was 56.7% female. Greater MIND diet adherence was associated with a decreased incidence of cognitive impairment (odds ratio [OR] 0.96, 95% CI 0.93-0.99, p = 0.02) after adjusting for all covariates. In the fully adjusted model, greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants (OR 0.92, 95% CI 0.89-0.96, p < 0.001) but not in male participants (OR 1.01, 95% CI 0.97-1.06, p = 0.64). In all models, greater MIND diet adherence was associated with decreased risk of cognitive decline. MIND diet adherence was a better predictor of cognitive decline in Black participants (β = 0.04, SE = 0.007, p < 0.001) than in White participants (β = 0.03, SE = 0.004, p < 0.001). Greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants but not male participants, with no difference between Black participants and White participants. However, MIND diet adherence was a better predictor of cognitive trajectory in Black participants than in White participants.

Association of Four Dietary Patterns and Stair Climbing with Major Adverse Cardiovascular Events: A Large Population-Based Prospective Cohort Study

Background: The protective effect of a healthy diet combined with stair climbing on cardiovascular health is unclear. We aimed to assess the independent and joint associations of dietary patterns and stair climbing with major adverse cardiovascular events (MACEs). Methods: We included 117,384 participants with information on dietary intake and stair climbing from the UK Biobank (UKBB). We excluded participants with MACEs at baseline and death within two years of follow-up. We used restricted cubic spline (RCS) plots describing the linear or nonlinear associations between dietary patterns (the alternate Mediterranean diet score (AMED), dietary approaches to stop hypertension (DASH), the healthful planted-based diet index (HPDI) and the alternate healthy eating index-2010 (AHEI-2010)) and stair climbing and MACEs. COX regressions estimated the hazard ratios (HRs) for incident MACEs associated with dietary patterns combined with stair climbing, and adjusted for sociodemographic, lifestyle and medical factors. Results: The UKBB documented 9408 MACEs over a median follow-up of 13.3 years. Four dietary patterns were negatively and linearly associated with MACEs (P-nonlinear &gt; 0.05), whereas daily stair climbing was negatively and nonlinearly associated with MACEs (P-nonlinear = 0.011). All of the dietary patterns had significant multiplicative interactions with stair climbing (all p-values &lt; 0.05). The three dietary patterns had the lowest risk ratios for MACEs in the highest tertile (T3) combined with daily stair climbing of 60–100 steps (AMED: 0.78 (0.68, 0.89), DASH: 0.80 (0.70, 0.91) and HPDI: 0.86 (0.75, 0.98)), whereas the AHEI-2010 had the lowest HRs for MACEs in the T1 combined with stair climbing of 110–150 steps (AHEI-2010: 0.81 (0.71, 0.93)). Conclusions: Maintaining healthy dietary patterns and adhering to an average of 60–100 steps of stair climbing per day at home can be effective in preventing cardiovascular health-related events.

Association of novel dietary and lifestyle inflammation scores with incidence and progression of coronary artery calcification in middle-late adulthood: a longitudinal cohort study

BackgroundDietary patterns and lifestyle factors can influence the intensity of systemic inflammation and, consequently, the development and progression of coronary artery calcification (CAC). This study aimed to explore the relationship between the inflammatory potentials of diet and lifestyle, as captured by novel dietary and lifestyle inflammation scores (DIS and LIS), with CAC incidence and progression.MethodsWe analyzed data on 5949 Black and White men and women ≥ 45 years old participating in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Baseline data on diet and lifestyle factors were collected from 2000 to 2002 and used to construct the DIS and LIS, which reflect the overall inflammatory potential of diet and lifestyle. Cox proportional hazard regression was used to calculate the hazard ratios (HR) and 95% confidence intervals (95% CI) for CAC incidence and progression across quartiles of DIS and LIS, adjusting for potential confounders.ResultsOver a median follow-up of 8.0 years, among 2638 participants with zero CAC score at baseline, 977 individuals developed positive scores, and 1681 out of 2561 participants showed CAC progression. For individuals in the highest (more pro-inflammatory) compared to the lowest (more anti-inflammatory) quartiles of the LIS, the multivariable-adjusted HR for CAC incidence was 1.35 (95% CI, 1.10–1.65; P trend < 0.002). This association was stronger among younger adults aged < 60 years compared to those aged ≥ 60 years, with respective values of 1.76 (1.34–2.30) and 1.02 (0.78–1.35) (P interaction < 0.001). However, the LIS was not significantly associated with the progression of existing CAC. Among the components of the LIS, a body mas index (BMI) ≥ 25 kg/m2 and current smoking were significant predictors for the incidence and progression of CAC, respectively. No significant association was found between DIS and CAC incidence and progression.ConclusionsLifestyle factors, through their impact on systemic inflammation, may be associated with a higher risk of CAC incidence in middle and late adulthood.