Dietary Trajectories Research Articles

Dietary Pattern Trajectories in Middle Age and Physical Function in Older Age.

Increasingly, lifestyle factors in midlife are reported to impact health and functional status in old age. This work examines associations between dietary trajectories in middle age and subsequent impairments in physical function. Data are from 851 participants (61% men, mean age at first dietary assessment = 47 years, range 30-59 years) from the Baltimore Longitudinal Study of Aging. We used latent class analysis to derive dietary trajectories based on adherence to the Alternative Healthy Eating Index-2010 (AHEI), and further classified them based on tertiles, as poor (score <39.3), intermediate (39.3-48.9), or good (>48.9). Physical function was assessed with the Short Physical Performance Battery (SPPB). Random effects tobit regression models were used to examine associations between dietary trajectories and later physical function. Two latent classes of AHEI scores were generated and labeled "greatly improved" or "moderately improved." In the greatly improved class, participants showed a trend in overall AHEI score from poor/intermediate to good diet categories across dietary assessments with age, over time. In the moderately improved class, the overall AHEI score shifted from poor to intermediate diet categories over time, and the prevalence of the good diet category remained low. Mean AHEI score between ages 30 and 59 years was higher in the greatly, than moderately, improved class. The moderately improved class had 1.6 points lower SPPB score (indicating poorer physical function) at older age than the greatly improved class (p = .022). Findings suggest that improving diet quality in middle age may contribute to better physical function in older age.

Current dietary advice and challenges for adolescents.

The major risk factors driving the global burden of disease are diet related. Adolescence presents a window of opportunity for establishing healthy dietary trajectories. Yet around the world, adolescents experience many barriers that prevent them from consuming diets that would give them the foundation for long, healthy and productive adult lives. A narrative literature search of most relevant original, review and meta-analyses, restricted to English was conducted in Medline, Web of Science and PubMed up to December 2019 together with published papers known to the author concerning the current dietary advice and challenges for adolescent nutrition. Adolescence is a critical period of growth and development and adequate nutrition is essential. Sufficient population data indicate adolescents are not meeting dietary recommendations and are a vulnerable population group for malnutrition in all its forms. Despite extensive studies on dietary risk factors and the global burden of disease and population data demonstrating inadequate nutritional intake in adolescent populations, few effective interventions and policies have been scaled up to support adolescent nutrition. Improving the diets of adolescents, especially vulnerable adolescents from low- and middle-income countries and socioeconomically disadvantaged backgrounds, has the potential to impact individuals, societies and economies. Future research should focus on vulnerable adolescent populations by addressing food environments, food insecurity and ensuring effective programmes and strategies are integrated within broader adolescent health strategies and implemented into government policies.

The Diet, Health, and Environment Trilemma

As populations become more affluent and urbanized, diets are shifting such that they are becoming higher in calories and include more highly processed foods and animal products. These dietary shifts are driving increases in diet-related diseases and are also causing environmental degradation. These linked impacts pose a new key issue for global society—a diet, health, and environment trilemma. Recent dietary shifts have contributed to increasing diet-related health and environmental impacts, including an 80% increase in global diabetes prevalence and an 860% increase in global nitrogen fertilizer use. Furthermore, if current dietary trajectories were to continue for the next several decades, diet-related diseases would account for three-quarters of the global burden of disease and would also lead to large increases in diet-related environmental impacts. We discuss how shifts to healthier diets—such as some Mediterranean, pescetarian, vegetarian, and vegan diets—could reduce incidence of diet-related diseases and improve environmental outcomes. In addition, we detail how other interventions to food systems that use known technologies and management techniques would improve environmental outcomes.

Childhood dietary trajectories and adolescent cardiovascular phenotypes: Australian community-based longitudinal study.

With the intention to inform future public health initiatives, we aimed to determine the extent to which typical childhood dietary trajectories predict adolescent cardiovascular phenotypes. Longitudinal study. Exposure was determined by a 4 d food diary repeated over eight waves (ages 4-15 years), coded by Australian Dietary Guidelines and summed into a continuous diet score (0-14). Outcomes were adolescent (Wave 8, age 15 years) blood pressure, resting heart rate, pulse wave velocity, carotid intima-media thickness, retinal arteriole-to-venule ratio. Latent class analysis identified 'typical' dietary trajectories from childhood to adolescence. Adjusted linear regression models assessed relationships between trajectories and cardiovascular outcomes, adjusted for a priori potential confounders. Community sample, Melbourne, Australia. Children (n 188) followed from age 4 to 15 years. Four dietary trajectories were identified: unhealthy (8 %); moderately unhealthy (25 %); moderately healthy (46 %); healthy (21 %). There was little evidence that vascular phenotypes associated with the trajectories. However, resting heart rate (beats/min) increased (β; 95 % CI) across the healthy (reference), moderately healthy (4·1; -0·6, 8·9; P=0·08), moderately unhealthy (4·5; -0·7, 9·7; P=0·09) and unhealthy (10·5; 2·9, 18·0; P=0·01) trajectories. Decade-long dietary trajectories did not appear to influence macro- or microvascular structure or stiffness by mid-adolescence, but were associated with resting heart rate, suggesting an early-life window for prevention. Larger studies are needed to confirm these findings, the threshold of diet quality associated with these physiological changes and whether functional changes in heart rate are followed by phenotypic change.

Parental health behaviour predictors of childhood and adolescent dietary trajectories.

To determine which parental health behaviours early in childhood most strongly predict whole-of-childhood dietary trajectories. Population-based Longitudinal Study of Australian Children (LSAC, waves 1-6; 2004-2014). Exposures were parents' fruit/vegetable consumption, alcohol, smoking and physical activity at child age 0-1 years (B Cohort) or 4-5 years (K Cohort). Outcomes, from repeated biennial short diet diaries, were group-based trajectories of (i) dietary scores and empirically derived patterns of (ii) healthful and (iii) unhealthful foods consumed, spanning ages 2-3 to 10-11 years (B Cohort) and 4-5 to 14-15 years (K Cohort). We investigated associations of baseline parental health behaviours with child dietary trajectories using multinomial logistic regression. Australian homes. Of children, 4443 (87·0 %) from the B Cohort and 4620 (92·7 %) from the K Cohort were included in all trajectories. Multivariable analyses included 2719 to 2905 children and both parents. Children whose primary caregiver reported the lowest fruit/vegetable consumption had markedly higher odds of belonging to the least healthy score and pattern trajectories (K Cohort: OR=8·7, 95 % CI 5·0, 15·1 and OR=8·4, 95 % CI 4·8, 14·7, respectively); associations were weaker (K Cohort: OR=2·3, 95 % CI 1·0, 5·2) for the unhealthiest pattern trajectory. Secondary caregiver fruit/vegetable associations were smaller and inconsistent. Parental alcohol, smoking and physical activity were not predictive in multivariable analyses. Results were largely replicated for the B Cohort. Low primary caregiver fruit/vegetable consumption increased nearly ninefold the odds of children being in the lowest intake of healthy, but only weakly predicted unhealthy, food trajectories. Healthy and unhealthy food intake may have different determinants.

Stability and change in dietary scores and patterns across six waves of the Longitudinal Study of Australian Children.

This study aimed to derive and compare longitudinal trajectories of dietary scores and patterns from 2-3 to 10-11 years and from 4-5 to 14-15 years of age. In waves two to six of the Baby (B) Cohort and one to six of the Kindergarten (K) Cohort of the population-based Longitudinal Study of Australian Children, parents or children reported biennially on the study child's consumption of twelve to sixteen healthy and less healthy food or drink items for the previous 24 h. For each wave, we derived a dietary score from 0 to 14, based on the 2013 Australian Dietary Guidelines (higher scores indicating healthier diet). We then used factor analyses to empirically derive dietary patterns for separate waves. Using group-based trajectory modelling, we generated trajectories of dietary scores and empirical patterns in 4504 B and 4640 K Cohort children. Four similar trajectories of dietary scores emerged for the B and K Cohorts, containing comparable proportions of children in each cohort: 'never healthy' (8·8 and 11·9 %, respectively), 'moderately healthy' (24·0 and 20·7 %), 'becoming less healthy' (16·6 and 27·3 %) and 'always healthy' (50·7 and 40·2 %). Deriving trajectories based on dietary patterns, rather than dietary scores, produced similar findings. For 'becoming less healthy' trajectories, dietary quality appeared to worsen from 7 years of age in both cohorts. In conclusion, a brief dietary measure administered repeatedly across childhood generated robust, nuanced dietary trajectories that were replicable across two cohorts and two methodologies. These trajectories appear ideal for future research into dietary determinants and health outcomes.

Dietary Patterns Track from Infancy to Preschool Age: Cross-Sectional and Longitudinal Perspectives1–3

Although it has been suggested that dietary patterns emerge early in life, less is known about the extent to which they track through the toddler and preschool ages. The objectives of this study were to derive cross-sectional dietary patterns at 2, 3, and 5 y of age and assess their correlations and to derive multi-time point dietary patterns from ages 2-5 y and assess their associations with sociodemographic factors and infant feeding patterns. Depending on the age considered, analyses included 989-1422 children from the EDEN (Étude des Déterminants pré- et postnatals précoces du développement et de la santé de l'ENfant) mother-child cohort. Dietary intake was collected with the use of food-frequency questionnaires at 2, 3, and 5 y of age. Principal component analyses were applied to these data, first cross-sectionally at each age, then longitudinally accounting for the data collected at all 3 ages. Tracking between patterns was estimated by Spearman correlation coefficients and associations with either the infant feeding patterns or the demographic and socioeconomic factors were assessed with the use of multivariable linear regression analyses. Overall, we derived 2 main cross-sectional patterns labeled "Processed and fast foods" and "Guidelines," the latter being characterized by intakes approximating age-specific dietary guidelines; and 2 multi-time point dietary patterns that corresponded to consistent exposures to similar foods across the 3 ages. The first, labeled "Processed and fast foods at 2, 3, and 5 y," was inversely associated with maternal education and age, and positively associated with the presence of older siblings. The second, called "Guidelines at 2, 3, and 5 y," was predicted by maternal education. Moderate tracking was observed between similar patterns assessed at different ages. Our findings confirmed the emergence of dietary profiles socially differentiated early in life as well as a moderate tracking of the diet. The promotion of healthy dietary trajectories should be encouraged as early as infancy, in particular in the presence of older siblings and among the most socially disadvantaged population groups.

Do dietary trajectories between infancy and toddlerhood influence IQ in childhood and adolescence? Results from a prospective birth cohort study.

ObjectiveWe examined whether trajectories of dietary patterns from 6 to 24 months of age are associated with intelligence quotient (IQ) in childhood and adolescence.MethodsParticipants were children enrolled in a prospective UK birth cohort (n = 7652) who had IQ measured at age 8 and/or 15 years. Dietary patterns were previously extracted from questionnaires when children were aged 6, 15 and 24 months using principal component analysis. Dietary trajectories were generated by combining scores on similar dietary patterns across each age, using multilevel mixed models. Associations between dietary trajectories and IQ were examined in generalized linear models with adjustment for potential confounders.ResultsFour dietary pattern trajectories were constructed from 6 to 24 months of age and were named according to foods that made the strongest contribution to trajectory scores; Healthy (characterised by breastfeeding at 6 months, raw fruit and vegetables, cheese and herbs at 15 and 24 months); Discretionary (biscuits, chocolate, crisps at all ages), Traditional (meat, cooked vegetables and puddings at all ages) and, Ready-to-eat (use of ready-prepared baby foods at 6 and 15 months, biscuits, bread and breakfast cereals at 24 months). In fully-adjusted models, a 1 SD change in the Healthy trajectory was weakly associated with higher IQ at age 8 (1.07 (95%CI 0.17, 1.97)) but not 15 years (0.49 (−0.28, 1.26)). Associations between the Discretionary and Traditional trajectories with IQ at 8 and 15 years were as follows; Discretionary; 8 years −0.35(−1.03, 0.33), 15 years −0.73(−1.33, −0.14) Traditional; 8 years −0.19(−0.71, 0.33)15 years −0.41(−0.77, −0.04)). The Ready-to-eat trajectory had no association with IQ at either age (8 years 0.32(−4.31, 4.95), 15 years 1.11(−3.10, 5.33).ConclusionsThe Discretionary and Traditional dietary pattern trajectories from 6 to 24 months of age, over the period when food patterns begin to emerge, are weakly associated with IQ in adolescence.

Tracking of dietary intakes in early childhood: the Melbourne InFANT Program

The objectives of the present study were to describe food and nutrient intakes in children aged 9 and 18 months, and to assess tracking of intakes between these two ages. Participants were 177 children of first-time mothers from the control arm of the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intake was collected at 9 and 18 months using three 24 h diet recalls. Tracking was assessed for food and nutrient intakes using logistic regression analysis and estimating partial correlation coefficients, respectively. Although overall nutrient intakes estimated in this study did not indicate a particular risk of nutrient deficiency, our findings suggest that consumption of energy-dense, nutrient-poor foods occurred as early as 9 months of age, with some of these foods tracking highly over the weaning period. Intakes of healthier foods such as fruits, vegetables, dairy products, eggs, fish and water were also relatively stable over this transition from infancy to toddlerhood, along with moderate tracking for riboflavin, iodine, fibre, calcium and iron. Tracking was low but close to ρ=0.3 for zinc, magnesium and potassium intakes. The tracking of energy-dense, nutrient-poor foods has important implications for public health, given the development of early eating behaviours is likely to be modifiable. At this stage of life, dietary intakes are largely influenced by the foods parents provide, parental feeding practices and modelling. This study supports the importance of promoting healthy dietary trajectories from infancy.

Isotopic dietary reconstructions of Pliocene herbivores at Laetoli: Implications for early hominin paleoecology

Major morphological and behavioral innovations in early human evolution have traditionally been viewed as responses to conditions associated with increasing aridity and the development of extensive grassland-savanna biomes in Africa during the Plio-Pleistocene. Interpretations of paleoenvironments at the Pliocene locality of Laetoli in northern Tanzania have figured prominently in these discussions, primarily because early hominins recovered from Laetoli are generally inferred to be associated with grassland, savanna or open woodland habitats. As these reconstructions effectively extend the range of habitat preferences inferred for Pliocene hominins, and contrast with interpretations of predominantly woodland and forested ecosystems at other early hominin sites, it is worth reevaluating the paleoecology at Laetoli utilizing a new approach. Isotopic analyses were conducted on the teeth of twenty-one extinct mammalian herbivore species from the Laetolil Beds (∼ 4.3–3.5 Ma) and Upper Ndolanya Beds (∼ 2.7–2.6 Ma) to determine their diet, as well as to investigate aspects of plant physiognomy and climate. Enamel samples were obtained from multiple localities at different stratigraphic levels in order to develop a high-resolution spatio-temporal framework for identifying and characterizing dietary and ecological change and variability within the succession. In general, dietary signals at Laetoli suggest heterogeneous ecosystems with both C 3 and C 4 dietary plants available that could support grassland, woodland, and forested communities. All large-bodied herbivores analyzed yielded dietary signatures indicating mixed grazing/browsing strategies or exclusive reliance on C 3 browse, more consistent with wooded than grassland-savanna biomes. There are no clear isotopic patterns documenting shifting ecology within the Laetolil Beds or between the Laetolil and overlying Upper Ndolanya Beds, although limited data from the U. Ndolanya Beds constrains interpretations. Comparison of the results from Laetoli with isotopic enamel profiles of other African fossil and modern communities reveals significant differences in dietary patterns. Relative to extant taxa in related lineages, carbon isotopic ranges of a number of Laetoli fossil herbivores are anomalous, indicating significantly more generalized intermediate C 3/C 4 feeding behaviors, perhaps indicative of dietary niches and habitat types with no close modern analogs. Enamel oxygen isotope ranges of fossil taxa from Laetoli are consistently more 18O depleted than modern E. African herbivores, possibly indicating more humid conditions during that interval in the past. These data have important implications for reconstructing dietary trajectories of mammalian herbivore lineages, as well as the evolution of ecosystems in East Africa. Isotopic analyses of similar or related taxa at other hominin fossil sites yield signatures generally consistent with Laetoli, suggesting that mammalian communities in East Africa were sampling ecosystems with similar proportions of browse and grass. Collectively, the isotopic dietary signatures indicate heterogeneous habitats with significant wooded or forested components in the Laetoli area during deposition of the Laetolil and Upper Ndolanya Beds. Early hominin foraging activity in this interval may have included access to forest or woodland biomes within this ecosystem, complicating traditional interpretations linking early human evolutionary innovations with a shift to savanna habitats.

Dietary Trajectories in the Menopause Transition Among Québec Women

This qualitative study explored perimenopausal women's perceptions and experiences of continuity and change in dietary behavior. This study used a naturalistic paradigm and three in-depth qualitative interviews over a 13-month period. A purposive sample of 23 perimenopausal women was recruited from community health centers and social organizations in rural and urban areas of Québec.The semistructured interview guide focused on dietary and lifestyle changes, health and body changes, social roles, and the menopause experience. Grounded theory analysis was performed on the transcribed interviews. Women's narratives described three types of dietary trajectories: unsuccessful dieting, small change, and progressive change. Women with similar trajectories shared experiences with food, dieting practices, self-efficacy, and transition in the maternal role. Although most women reported continuing on the same dietary trajectory for most of their adult lives, a few described changes in their diets. Some women associated their small changes in diet with being informed of the potential development of chronic diseases, whereas others radically changed their diets following life events such as the development of an illness. Menopause per se was not perceived by women as a time for dietary change. Health and nutrition professionals could improve the impact of their efforts by recognizing the contribution of past dietary behavior to current dietary practices. Dietary advice would also benefit from being tailored to women's existing dietary trajectories.

Life-Course Influences on Fruit and Vegetable Trajectories: Qualitative Analysis of Food Choices

Food consumption plays an important role in health, and understanding the process of food choice is central to health promotion. A person's life-course transitions and trajectories (persistent thoughts, feelings, strategies, and actions over the lifespan) are fundamental influences on the development of his or her personal system for making food choices. This analysis used a life-course perspective to examine influences on the fruit and vegetable choices of adults. A purposive, multi-ethnic sample of 86 adults in one U.S. city participated in semi-structured in-depth interviews about their life course, food choices, and influences on fruit and vegetable consumption. Qualitative analysis of interview transcripts, using a grounded theory approach based on the constant comparative method, revealed that past life-course events and experiences were strong influences on present systems for fruit and vegetable choices. Life-course transitions, especially role changes and health events, placed people on relatively stable dietary trajectories that shaped current food choices. Most people experienced a few major transitions that influenced their fruit and vegetable choices, some being abrupt and some more gradual changes in their trajectories. A life-course model of a food choice trajectory was developed from the data to reflect how past events and experiences were operationalized in present contexts to shape food choices. Key influences on the trajectory included food upbringing, roles, health, ethnic traditions, resources, location, and the food system. A life-course perspective on food choice provides unique insights that reveal how past events interact with current environments to both enable and limit current health behaviors such as food choices.