From Food Frequency Questionnaires Research Articles

Abstract PO1-11-05: Diet quality and cardiovascular disease risk among breast cancer survivors in the Pathways Study

Abstract Background: While studies have shown that breast cancer survivors with healthier diets have a lower risk of non-breast cancer-specific and all-cause mortality after a breast cancer diagnosis, the relationship between diet quality and cardiovascular disease (CVD) among breast cancer survivors is not well characterized. We examined the association between diet quality at the time of breast cancer diagnosis and CVD-related outcomes in the Pathways Study, a prospective cohort of 3,415 women diagnosed with invasive breast cancer. Methods: This analysis included four diet quality indices (DQIs) consistent with healthy eating: 1. Dietary Approaches to Stop Hypertension (DASH), 2. healthy plant-based dietary index (hPDI), 3. 2015 Healthy Eating Index (HEI), 4. American Cancer Society nutrition guidelines (ACS). Each DQI was calculated from food frequency questionnaires (FFQ) at or around the time of breast cancer diagnosis, between 2005 and 2013, with a higher score representing a more healthful dietary pattern. DQI scores were categorized into quartiles with the most concordant diets in the highest quartile and the least concordant diets in the lowest quartile, for each DQI. CVD outcomes were ascertained through December 31, 2021 and included ischemic heart disease, heart failure, cardiomyopathy, stroke/transient ischemic attack, arrhythmia, cardiac arrest, valvular disease, venous thromboembolic disease and CVD-related death. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated from proportional hazards regression accounting for clinical and demographic factors. Results: FFQs were completed an average 2.2 (range=0.3-7.6) months after a breast cancer diagnosis, and a total 623 (18.2%) incident CVD events and 340 (10.0%) CVD-related deaths were ascertained over 39,263 person-years of follow-up. Participants in the highest quartile of the DASH DQI had substantially reduced risks of heart failure (HR=0.50, 95% CI 0.31-0.81), arrhythmia (HR=0.76, 95% CI 0.62-0.93), cardiac arrest (HR=0.75, 95% CI 0.60-0.93), valvular disease (HR=0.77, 95% CI 0.62-0.96), venous thromboembolic disease (HR=0.74, 95% CI 0.59-0.92), and a 33% reduced risk of CVD-related death (HR=0.67, 95% CI 0.48-0.95) relative to those in the lowest quartile. Tests for trend across quartiles of the DASH DQI were also statistically significant at a p-value < 0.03. The only notable association found in the other three DQIs was between hPDI and lower risk of heart failure (HR=0.61, 95% CI 0.39-0.95) in women in the highest quartile compared to the lowest quartile (Table 1). Summary: These findings suggest that diets concordant with DASH and hPDI dietary patterns, may be beneficial for preventing CVD and CVD-related death after a breast cancer diagnosis. Table 1. Cox proportional hazard ratios and 95% confidence intervals for quartiles of diet quality indices and CVD events and CVD-related death Citation Format: Isaac Ergas, Janise Roh, Lawrence Kushi, Carlos Iribarren, Mai Nguyen-Huynh, Jamal Rana, Eileen Rillamas-Sun, Cecile Laurant, Valerie Lee, Richard Cheng, Heather Greenlee, Marilyn Kwan. Diet quality and cardiovascular disease risk among breast cancer survivors in the Pathways Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-05.

Abstract 2218: Dietary insulinemic potential and survival after breast cancer diagnosis

Abstract Background: Hyperinsulinemia may promote the growth and metastasis of breast cancers by activating the insulin/insulin-like growth factor 1 signaling pathways. Whether the insulinemic potential of the diet contributes to breast cancer prognosis has not been examined previously. Here, we focused on a food-based empirical dietary index for hyperinsulinemia (EDIH), an index previously designed as most predictive of fasting plasma C-peptide. We aimed to investigate whether EDIH (at different time settings) is associated with overall and breast cancer-specific mortality. Methods: For 9,640 women with stage I-III breast cancer from the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII), we calculated the cumulative average EDIH, using repeated measures of post-diagnostic diet from food frequency questionnaires (FFQ). We also considered the pre-diagnostic EDIH score (using the last FFQ reported before diagnosis), the first postdiagnostic EDIH score, as well as a simple updated EDIH score. Information on diet and other factors was repeatedly measured in validated questionnaires every two to four years. Deaths were ascertained by report from family members or by searching the National Death Index. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. Results: Participants were followed up for a median of 12 years after breast cancer diagnosis. We documented 1,120 deaths due to breast cancer and 2,762 all-cause deaths. Women with higher post-diagnostic EDIH had a 40% higher risk of all-cause mortality (HR for quintile 5 vs. quintile 1 [HRQ5vs.Q1], 1.40; 95% CI, 1.22, 1.61; P-trend<0.0001). EDIH was also associated with a 19% increased risk of breast cancer mortality, although the confidence interval included the null (HRQ5vs.Q1, 1.19; 95% CI, 0.95, 1.48; P-trend=0.17). Findings for overall mortality were similar for EDIH measured at other timings/settings: last pre-diagnosis dietary assessment (HRQ5vs.Q1,1.21; 95% CI, 1.06, 1.39; P-trend<0.0001) and first post-diagnosis dietary assessment (HRQ5vs.Q1,1.23; 95% CI, 1.08, 1.40; P-trend<0.0001). Conclusions: In this large prospective study of breast cancer survivors, higher hyperinsulinemic dietary scores (reflecting higher dietary insulinemic potential) were associated with worse survival outcomes following diagnosis. Thus, dietary recommendations emphasizing the importance of avoiding high insulinemic dietary patterns (i.e., processed meat and red meat) and prioritizing low insulinemic dietary patterns (i.e., coffee, whole fruit and green-leafy vegetables) as components of a healthy diet may improve overall survival. Citation Format: Andrea Romanos-Nanclares, Tengteng Wang, Bernard A. Rosner, Michelle D. Holmes, Wendy Y. Chen, Walter C. Willett, Rulla M. Tamimi, A. Heather Eliassen. Dietary insulinemic potential and survival after breast cancer diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2218.

Associations of Dietary Patterns with Colorectal Adenomas in the Prostate, Lung, Colorectal, and Ovarian Cancer Cohort.

Most colorectal cancers arise from adenomas, and although insulinemic and inflammatory dietary patterns have been associated with colorectal cancer risk, these dietary patterns have not been studied in relation to adenoma risk. Using data from 21,192 participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer screening cohort, we calculated the Empirical Dietary Index for Hyperinsulinemia (EDIH), Empirical Dietary Inflammatory Pattern (EDIP), and overall dietary quality measured via the Healthy Eating Index (HEI-2015), from food frequency questionnaires (FFQ). In multivariable-adjusted logistic regression, we investigated associations of these dietary indices with adenoma (any adenoma, advanced adenoma, n = 19,493) and recurrent adenoma (n = 1,699). EDIH was not associated with adenoma or advanced adenoma but was marginally associated with recurrent adenoma. The OR (95% CI) comparing highest (lowest insulinemic) versus lowest (most hyperinsulinemic) quintiles was 0.76 (0.55-1.05) after multivariable adjustment including BMI. EDIP and HEI-2015 were not associated with any of the three outcomes. In the PLCO cohort, we did not observe substantial associations between dietary patterns and risk of colorectal adenomas. Pending confirmation in larger prospective studies, our findings suggest that these dietary patterns may not substantially affect colorectal cancer risk via the adenoma-carcinoma sequence.

Quality Specific Associations of Carbohydrate Consumption and Frailty Index

Background: The quality of carbohydrate consumed may influence the risk of frailty. In this study, we tested the hypothesis that indices of carbohydrate intake are associated with trajectories of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Methods: Cross sectional and longitudinal analyses were conducted in 1024 BLSA participants to examine the association between usual intake of carbohydrate and frailty index. Seven measures of carbohydrate consumption were estimated using data derived from Food Frequency Questionnaires (FFQs) and examined in association with a 43-item Frailty Index (FI). Results: In cross-sectional analyses, there was a significant, positive association between higher tertiles of total carbohydrate, glycemic load, and non-whole grains and FI. Conversely, higher tertiles of fiber-to-carbohydrate ratio was associated with lower FI. These differences persisted over the follow-up period of up to 13.8 years. Women in the highest tertile of the fiber-to-carbohydrate ratio showed a less steep increase in FI over time. Conclusions: Carbohydrate intake was positively associated with increased frailty risk in the BLSA participants, whereas a higher fiber-to-carbohydrate ratio was related to reduced risk for frailty.

Lutein and Zeaxanthin Intake during Pregnancy and Visual Function in Offspring at 11-12 Years of Age.

(1) Background: Lutein and zeaxanthin (L&Z) are essential dietary nutrients that are a crucial component of the human macula, contributing to visual functioning. They easily cross the placental barrier, so that retinal deposition commences during foetal development. This study aims to assess associations between maternal L&Z intake during pregnancy and offspring visual function at 11–12 years. (2) Methods: Using the Spanish INfancia y Medio Ambiente project (INMA) Sabadell birth cohort, 431 mother–child pairs were analysed. L&Z data were obtained from food frequency questionnaires (FFQ) at week 12 and 32 of pregnancy, alongside other nutritional and sociodemographic covariates. Contrast vision (CS) and visual acuity (VA) were assessed using the automated Freiburg Acuity and Contrast Testing (FRACT) battery. Low CS and VA were defined as being below the 20th cohort centile. Associations were explored using multiple logistic regression. (3) Results: After controlling for potential confounders, L&Z intake during the 1st and 3rd trimester did not reveal any statistically significant association with either CS or VA in offspring at age 11/12 years. (4) Conclusions: No evidence of a long-term association between L&Z intake during pregnancy and visual function in offspring was found. Further larger long-term studies including blood L&Z levels are required to confirm this result.

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF)

BackgroundRecent lifestyle changes include increased consumption of highly processed foods (HPF), which has been associated with an increased risk of non-communicable diseases (NCDs). However, nutritional information relies on the estimation of HPF consumption from food-frequency questionnaires (FFQ) that are not explicitly developed for this purpose. We aimed to develop a short screening questionnaire of HPF consumption (sQ-HPF) that integrates criteria from the existing food classification systems.MethodsData from 4400 participants (48.1% female and 51.9% male, 64.9 ± 4.9 years) of the Spanish PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial were used for this analysis. Items from the FFQ were classified according to four main food processing-based classification systems (NOVA, IARC, IFIC and UNC). Participants were classified into tertiles of HPF consumption according to each system. Using binomial logistic regression, food groups associated with agreement in the highest tertile for at least two classification systems were chosen as items for the questionnaire. ROC analysis was used to determine cut-off points for the frequency of consumption of each item, from which a score was calculated. Internal consistency of the questionnaire was assessed through exploratory factor analysis (EFA) and Cronbach’s analysis, and agreement with the four classifications was assessed with weighted kappa coefficients.ResultsRegression analysis identified 14 food groups (items) associated with high HPF consumption for at least two classification systems. EFA showed that items were representative contributors of a single underlying factor, the “HPF dietary pattern” (factor loadings around 0.2). We constructed a questionnaire asking about the frequency of consumption of those items. The threshold frequency of consumption was selected using ROC analysis. Comparison of the four classification systems and the sQ-HPF showed a fair to high agreement. Significant changes in lifestyle characteristics were detected across tertiles of the sQ-HPF score. Longitudinal changes in HPF consumption were also detected by the sQ-HPF, concordantly with existing classification systems.ConclusionsWe developed a practical tool to measure HPF consumption, the sQ-HPF. This may be a valuable instrument to study its relationship with NCDs.Trial registrationRetrospectively registered at the International Standard Randomized Controlled Trial Registry (ISRCTN89898870) on July 24, 2014.

Anti-inflammatory diet consumption reduced fatty liver indices

The aim of this study was to assess the association between dietary inflammatory index (DII) and non-invasive markers of liver status in adults. This cross-sectional study was performed on 8520 adults, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort study, western Iran. The DII score was calculated based on participants’ dietary intakes obtained from Food Frequency Questionnaire (FFQ). Fatty Liver Index (FLI) score was calculated by anthropometric measurements and some non-invasive markers of liver status. Linear regression models were applied to estimate the associations and adjust the possible confounding factors. A greater DII score was significantly associated with higher energy intake, body mass index (BMI), body fat mass (BFM), blood pressure, and FLI (P < 0.001). Participants with the highest DII score had a significantly higher consumption saturated fat, trans fat and red meat than those in the lowest quartile (P < 0.001). After adjustments of age and sex, participants in the highest quartile of the DII score had a greater risk of FLI (β: 0.742, 95% CI: 0.254, 0.601). More pro-inflammatory diet in participants was associated with a higher FLI. The DII score was positively associated with non-invasive liver markers. Thus, having an anti-inflammatory diet can help balance liver enzymes, reduce obesity, and decrease fatty liver.

Associations between dietary acid load and obesity among Iranian women.

Introduction: Diet-induced acid load may be associated with overweight and obesity as well as with diet quality. We aimed to study how dietary acid load is associated with overweight, obesity and diet quality indices in healthy women. Methods: We randomly selected 306 healthy 20 to 55 year-old women from health centers affiliated with Tehran University of Medical Science. They were enrolled in a cross-sectional study between June2016 and March 2017. Potential renal acid load (PRAL), net endogenous acid production (NEAP) and dietary acid load (DAL) were calculated for each person. Dietary quality index international (DQI-I),mean adequacy ratio (MAR), and energy density (ED) were estimated. Anthropometry was measured using standard protocols. Nutritional data were obtained from food frequency questionnaires (FFQ). We used multivariable logistic regression models to assess dietary acid load indices in relation to overweight, obesity and abdominal adiposity. Results: Participants had a mean age of 32.4 years. The number and percentage of women who were overweight, obese and who had abdominal obesity were 94(30.7), 38(12.4) and 126(41.2), respectively.The odds of obesity (adjusted odds ratio; Adj. OR = 2.41, 95% confidence interval; CI:1.01-5.74,P = 0.045) and abdominal adiposity (Adj. OR = 2.4, 95% CI:1.34-4.60, P = 0.004) increased significantly with tertile of DAL. Other dietary acid load indices (PRAL and NEAP) showed no significant association with obesity, overweight or abdominal obesity. As dietary acid load scores (PRAL, NEAP and DAL)increased, DQI-I and MAR significantly decreased whereas ED significantly increased across tertilesof dietary acid load indices (P < 0.001). Conclusion: Dietary acid load is associated with obesity and abdominal obesity and is also considered an indicator of diet quality.

Adults With Clinically Meaningful Depressive Symptoms Are More Vulnerable to the Effects of a Pro-inflammatory Diet on Frailty Onset

Abstract Objectives The dietary inflammatory index (DII®) reflects the inflammatory potential from dietary intakes. A pro-inflammatory diet (higher DII score) has been linked with frailty and increased risk of depression. It is unclear if depressive symptoms exacerbate the association between a pro-inflammatory diet and frailty. We determined if the association between DII score and frailty differed by depressive symptoms in adults from the Framingham Heart Study (FHS). Methods This prospective study included non-frail individuals (n = 1712) with baseline (1998–2001) diet assessment from food frequency questionnaire (FFQ), depressive symptoms from Center for Epidemiologic Studies Depression (CES-D) scale and follow-up frailty measurement (2011–2014). Energy-adjusted DII (E-DIITM) scores were calculated from foods and nutrients reported on the FFQ. Frailty was defined as fulfilling ≥3 Fried frailty criteria: unintentional weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength. We stratified by baseline CES-D scores &amp;lt;16 or ≥ 16, which denotes the absence or presence of clinically meaningful depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) for frailty development, adjusting for baseline age, sex, energy intake, current smoking, treatment for diabetes and/or cardiovascular disease, and non-skin cancers. Results Of the 1712 non-frail individuals at baseline (mean age: 58 ± 8 years, range: 33–81; 45% male), 227 individuals became frail over 16 years. Mean E-DII for all participants was −1.95 ± 2.20 (range: −6.71–5.44). Mean E-DII in frail individuals was −1.73 ± 2.13, while in non-frail individuals it was −1.98 ± 2.21. In those with CES-D &amp;lt; 16, one-unit increase in E-DII (more pro-inflammatory diet) was associated with 16% higher odds (95%CI:1.08–1.26) of frailty. In the cohort who had CES-D ≥16(∼6%), one-unit increase in E-DII was associated with 51% higher odds of frailty (95%CI:1.12–2.03). Conclusions In this cohort of older adults, those with depressive symptoms had higher odds of frailty with a more inflammatory diet compared to those without. Thus, especially among those with depressive symptoms, addressing the pro-inflammatory diet components may be a useful strategy for reducing or preventing frailty in older adults. Funding Sources NIA(T32-AG023480)

806 Diet quality is associated with vaginal alpha diversity in the first trimester of pregnancy

Understanding environmental influences on the vaginal microbiome may help to translate to improved pregnancy outcomes. While some dietary patterns have been associated with improved vaginal microbial health, few studies have investigated the impact of comprehensive diet quality on this outcome. Our study aimed to associate Diet Quality as defined by the Healthy Eating Index (HEI) with alpha diversity metrics longitudinally across pregnancy in healthy, low risk pregnancy women. Forty women were recruited, 10 from the 4 largest ethnic groups in Hawaii. Diet Quality indices were assigned from Food Frequency Questionnaires (FFQs) during each trimester (12 weeks, 20 weeks and 34-36 weeks). Vaginal swabs were collected from the mid-vagina concomitantly at each time point, from which DNA extraction and 16s rRNA sequencing were performed. Alpha and beta diversity profiles were assigned, and correlated in a linear fashion with HEI Score. Linear regression models were also used to account for confounding demographic factors. Longitudinal data was available for 35 participants. HEI score was stable across pregnancy, and correlated with alpha diversity metrics during the first trimester. Diet quality did not impact richness or evenness during the second or third trimester. There were no detectable differences between ethnicities, weight class, or pregnancy outcomes. 4 Community State Types predominated: Lactobacillus iners, Lactobacillus crispatus, Lactobacillus gasseri, and lactobacillus deficient/mixed anaerobes predominant), and were evenly distributed among four quartiles of HEI scores. Overall a paucity of the Lactobacillus jensenii species was noted. Alpha diversity decreased throughout pregnancy in this cohort, commensurate with other studies. Diet quality was most associated with microbial composition in the first trimester, but likely has lesser impact on microbial transition than hormonal factors as pregnancy progresses.

Changes in Dietary Inflammatory Index Patterns with Weight Loss in Women: A Randomized Controlled Trial.

Dietary composition can influence systemic inflammation; higher levels of circulating inflammatory biomarkers are associated with increased risk of breast and other cancers. A total of 438 overweight/obese, healthy, postmenopausal women were randomized to a caloric-restriction diet (goal: 10% weight-loss), aerobic-exercise (225 min/week moderate-to-vigorous activity), combined diet+exercise, or control. Dietary inflammatory index (DII) and energy-adjusted (E-DII) scores were derived from food frequency questionnaires (FFQ) and could be calculated for 365 participants with complete FFQs at baseline and 12 months. Changes from baseline to 12 months in E-DII scores in the intervention arms versus controls were analyzed using generalized estimating equations, adjusted for confounders. We examined associations between changes in previously measured biomarkers and E-DII at 12 months. Participants randomized to diet and diet+exercise arms had greater reductions in E-DII (-104.4% and -84.4%), versus controls (-34.8%, both P < 0.001). Weight change had a more marked effect than E-DII change on biomarkers at 12-months; associations between E-DII and biomarker changes were reduced after adjustment by weight change. Changes in E-DII at 12 months, adjusted for weight change, were negatively associated with changes in ghrelin [r = -0.19; P = 0.05 (diet), r = -0.29; P = 0.02 (diet+exercise)], and positively with VEGF [r = 0.22; P = 0.03 (diet+exercise)], and red blood cell counts [r = 0.30; P = 0.004 (exercise)]. C-reactive protein (CRP) and IL6 levels were not associated with E-DII changes at 12 months. In conclusion, a behavior change of low-calorie, low-fat diet significantly reduces dietary inflammatory potential, modulating biomarkers that are associated with tumorigenesis, such as VEGF, but not CRP or IL6. PREVENTION RELEVANCE: Diets high in saturated fats and low in fruit and vegetable intake are associated with increased inflammation, which increases cancer risk. This study showed that changes in diet quality had effects on factors associated with cancer; however, the majority of beneficial effects were associated with weight loss rather than diet quality.

Prenatal Nutrition measured by My Nutrition Index is associated with Birth Weight and Cognitive Function in Children at 7 years

Nutrition is a multi-faceted, complex construct, where good nutrition should be associated with improved health outcomes. This is particularly true during pregnancy when prenatal maternal nutrition may impact the child’s development. Most research papers on nutrition focus on individual nutrients and health outcomes. In contrast, our focus is on a holistic measure of nutrition. My Nutrition Index (MNI) is an index that measures the nutrient quality (i.e., “nutritiousness”) of a specified daily diet and is calculated based on quantification of dozens of macro- and micronutrients that are specific to an individual’s nutritional needs (as defined by published recommended guidelines for individual nutrient target ranges) by incorporating dietary restrictions, subject characteristics, activity level, and health behaviors. Other nutrition indices are based on scored food groups consumed and may not adequately adjust for micronutrient inadequacies during pregnancy. The Swedish Environmental, Longitudinal, Mother and child, Asthma and allergy (SELMA) study is a pregnancy cohort in Värmland, Sweden, with prenatal endocrine disrupting chemicals (EDC) exposure and dietary data available, making it possible to test for the potential mitigating effect of good nutrition on health effects from EDCs. Using prenatal nutrients from food frequency questionnaire (FFQ) data to construct an individual’s MNI, the index is significantly and positively associated with important metabolic (as measured by birth weight) and cognitive function at age 7 years (as measured by IQ-WISC) in children when adjusted for co-variates. Regression models included both prenatal concentrations of an EDC (bisphenol F and PFOA) and MNI demonstrating the adverse association with EDCs and the positive association of a nutritious diet during pregnancy. Thus, MNI is evidently a metric of the general nutritiousness of daily diets and is useful in environmental health studies in representing the impact of good nutrition. (We gratefully acknowledge support from NIEHS: #R01ES028811)

Lifestyle and glycemic health 5\xa0years postpartum in obese and non-obese high diabetes risk women

AimWomen with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI.MethodsThe RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI ≥ 30 kg/m2 and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m2.ResultsAltogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c.ConclusionLifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women.Clinical trial registrationClinicalTrials.gov, http://www.clinicaltrials.com, NCT01698385.

Sodium and Potassium Intakes and Cardiovascular Risk Profiles in Childhood Cancer Survivors: The SCCSS-Nutrition Study.

Risk of cardiovascular disease (CVD), common in childhood cancer survivors (CCSs), may be affected by diet. We assessed sodium (Na) and potassium (K) intake, estimated from food frequency questionnaires (FFQs) and morning urine spots, and its associations with cardiovascular risk in CCSs. We stratified CCSs into three risk profiles based on (A) personal history (CVD, CVD risk factors, or CVD risk-free), (B) body mass index (obese, overweight, or normal/underweight), and (C) cardiotoxic treatment (anthracyclines and/or chest irradiation, or neither). We obtained an FFQ from 802 and sent a spot urine sample collection kit to 212, of which 111 (52%) returned. We estimated Na intake 2.9 g/day based on spot urine and 2.8 g/day based on FFQ; the estimated K intake was 1.6 g/day (spot urine) and 2.7 g/day (FFQ). CCSs with CVD risk factors had a slightly higher Na intake (3.3 g/day), than CCSs risk free (2.9 g/day) or with CVD (2.7 g/day, p = 0.017), and obese participants had higher Na intake (4.2 g/day) than normal/underweight CCSs (2.7 g/day, p < 0.001). Daily Na intake was above, and daily K intake below, the national recommended levels. Adult survivors of childhood cancer need dietary assistance to reduce Na and increase K intake.

Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex.

Overweight and obesity are important risk factors for type 2 diabetes (T2D). Moving towards healthier diets, namely, diets rich in bioactive compounds, could decrease the odds of suffering T2D. However, those individuals with high body mass index (BMI) may have altered absorption or metabolism of some nutrients and dietary components, including polyphenols. Therefore, we aimed to assess whether high intakes of some classes of polyphenols are associated with T2D in a population with metabolic syndrome and how these associations depend on BMI and sex. This baseline cross-sectional analysis includes 6633 participants from the PREDIMED-Plus trial. Polyphenol intakes were calculated from food frequency questionnaires (FFQ). Cox regression models with constant time at risk and robust variance estimators were used to estimate the prevalence ratios (PRs) for polyphenol intake and T2D prevalence using the lowest quartile as the reference group. Analyses were stratified by sex and BMI groups (overweight and obese) to evaluate potential effect modification. Catechins, proanthocyanidins, hydroxybenzoic acids, and lignans were inversely associated with T2D. Hydroxycinnamic acids were directly related in men. These associations were different depending on sex and BMI, that is, women and overweight obtained stronger inverse associations.

Association of dietary folate and vitamin B-12 intake with genome-wide DNA methylation in blood: a large-scale epigenome-wide association analysis in 5841 individuals

Folate and vitamin B-12 are essential micronutrients involved in the donation of methyl groups in cellular metabolism. However, associations between intake of these nutrients and genome-wide DNA methylation levels have not been studied comprehensively in humans. The aim of this study was to assess whether folate and/or vitamin B-12 intake are asssociated with genome-wide changes in DNA methylation in leukocytes. A large-scale epigenome-wide association study of folate and vitamin B-12 intake was performed on DNA from 5841 participants from 10 cohorts using Illumina 450k arrays. Folate and vitamin B-12 intakes were calculated from food-frequency questionnaires (FFQs). Continuous and categorical (low compared with high intake) linear regression mixed models were applied per cohort, controlling for confounders. A meta-analysis was performed to identify significant differentially methylated positions (DMPs) and regions (DMRs), and a pathway analysis was performed on the DMR annotated genes. The categorical model resulted in 6 DMPs, which are all negatively associated with folate intake, annotated to FAM64A, WRAP73, FRMD8, CUX1, and LCN8 genes, which have a role in cellular processes including centrosome localization, cell proliferation, and tumorigenesis. Regional analysis showed 74 folate-associated DMRs, of which 73 were negatively associated with folate intake. The most significant folate-associated DMR was a 400-base pair (bp) spanning region annotated to the LGALS3BP gene. In the categorical model, vitamin B-12 intake was associated with 29 DMRs annotated to 48 genes, of which the most significant was a 1100-bp spanning region annotated to the calcium-binding tyrosine phosphorylation-regulated gene (CABYR). Vitamin B-12 intake was not associated with DMPs. We identified novel epigenetic loci that are associated with folate and vitamin B-12 intake. Interestingly, we found a negative association between folate and DNA methylation. Replication of these methylation loci is necessary in future studies.

Maternal Employment and Children’s Dietary Diversity Scores in Southwestern Guatemala (P10-039-19)

ObjectivesTo assess the relationship between maternal employment and children’s dietary diversity in rural Guatemala. MethodsA mixed-method design was used to compare quantitative findings on children’s dietary diversity collected from Food Frequency Questionnaires (FFQs) (n = 802), with qualitative data from in-depth interviews (IDIs) with a sub-sample of participants (n = 20). Mothers reported the number of times per week their child consumed select food items from seven food groups (grains, legumes, vitamin A-rich fruits & vegetables, other fruits & vegetables, eggs, dairy and meat). The total for each food item was then divided by seven to find the number of times the child consumed each food per day. Then, the daily consumption of all food items within a category was totaled for each food group. If the total for the food group was at least one, the child was given one point for daily consumption, with a maximum dietary diversity score (DDS) of seven. Using multivariate linear regression, we compared the DDS of children of employed mothers to the DDS of children of unemployed mothers. We used separate multivariate logistic regression models to estimate the association between maternal employment and consumption of each food group. Models were adjusted for maternal (age, education, marital status, parity), child (age, sex), and household (size) characteristics. IDIs explored the mechanisms by which food purchasing and preparation, as well as child-feeding behavior differed for employed and unemployed women. ResultsMaternal employment (versus unemployment) was associated with higher dietary diversity scores for children (β = 0.3; 95% CI: 0.06,0.54). The odds of consuming each food group did not differ significantly between children of employed and unemployed women, except for dairy (OR: 1.9, 95% CI: 1.0, 2.6), but the general trend suggested children of employed women were more likely to consume six of the seven food groups. Qualitative data indicates that employed women purchase higher quality and greater quantities of food. ConclusionsMaternal employment is associated with higher children’s dietary diversity scores in rural Guatemala. Quantitative and qualitative data suggests that maternal employment is related to food purchasing behavior. Funding SourcesMathile Institute & Global Obesity Prevention Center at Johns Hopkins Bloomberg School of Public Health.

Plasma Vitamin C Concentrations and Cognitive Function: A Cross-Sectional Study.

Vitamin-C is a water soluble molecule that humans have lost the ability to produce. Vitamin-C plays a role in CNS functions such as neuronal differentiation, maturation, myelin formation and modulation of the catecholaminergic systems. A recent systematic review by our team indicated the need for further research into the relationship between plasma vitamin C and cognition in cognitively intact participants using plasma vitamin C concentrations instead of estimates derived from food-frequency-questionnaires (FFQ), and more sensitive cognitive assessments suitable for cognitive abilities vulnerable to aging. It was hypothesized that higher plasma vitamin C concentrations would be linked with higher cognitive performance. This cross-sectional trial was conducted on healthy adults (n = 80, Female = 52, Male = 28, 24–96 years) with a range of plasma Vitamin C concentrations. Cognitive assessments included The Swinburne-University-Computerized-Cognitive-Assessment-Battery (SUCCAB) and two pen and paper tests, the Symbol-Digits-Modalities-Test (SDMT) and Hopkins-Verbal-Learning-Test-Revised (HVLT-R). The pen and paper assessments were conducted to establish whether their scores would correlate with the computerized tasks. Plasma-Vitamin C concentrations were measured using two biochemical analyses. Participants were grouped into those with plasma vitamin-C concentrations of adequate level (≥28 μmol/L) and deficient level (<28 μmol/L). The SUCCAB identified a significantly higher performance ratio (accuracy/reaction-time) in the group with adequate vitamin-C levels vs. deficient vitamin-C on the choice reaction time (M = 188 ± 4 vs. 167 ± 9, p = 0.039), immediate recognition memory (M = 81 ± 3 vs. 68 ± 6, p = 0.03), congruent Stroop (M = 134 ± 3 vs. 116 ± 7, p = 0.024), and delayed recognition tasks (M = 72 ± 2 vs. 62 ± 4, p = 0.049), after adjusting for age (p < 0.05). Significantly higher scores in immediate recall on the HVLT-R (M = 10.64 ± 0.16 vs. 9.17 ± 0.37, p = 0.001), delayed recall (M = 9.74 ± 0.22 vs. 7.64 ± 0.51, p < 0.001), total recall (M = 27.93 ± 0.48 vs. 24.19 ± 1.11, p = 0.003) were shown in participants with adequate plasma Vitamin-C concentrations, after adjusting for vitamin-C supplementation dose (p < 0.05). Similarly, higher SDMT scores were observed in participants with adequate plasma Vitamin-C concentrations (M = 49.73 ± 10.34 vs. 41.38 ± 5.06, p = 0.039), after adjusting for age (p < 0.05). In conclusion there was a significant association between vitamin-C plasma concentrations and performance on tasks involving attention, focus, working memory, decision speed, delayed and total recall, and recognition. Plasma vitamin C concentrations obtained through vitamin C supplementation did not affect cognitive performance differently to adequate concentrations obtained through dietary intake.Clinicaltrials.gov Unique Identifier: ACTRN 12615001140549, URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369440.

Similarities and differences of dietary and other determinants of iodine status in pregnant women from three European birth cohorts.

As a component of thyroid hormones, adequate iodine intake is essential during pregnancy for fetal neurodevelopment. Across Europe, iodine deficiency is common in pregnancy, but data are lacking on the predictors of iodine status at this life stage. We, therefore, aimed to explore determinants of iodine status during pregnancy in three European populations of differing iodine status. Data were from 6566 pregnant women from three prospective population-based birth cohorts from the United Kingdom (ALSPAC, n = 2852), Spain (INMA, n = 1460), and The Netherlands (Generation R, n = 2254). Urinary iodine-to-creatinine ratio (UI/Creat, µg/g) was measured in spot-urine samples in pregnancy (≤ 18-weeks gestation). Maternal dietary intake, categorised by food groups (g/day), was estimated from food-frequency questionnaires (FFQs). Multivariable regression models used dietary variables (energy-adjusted) and maternal characteristics as predictors of iodine status. Median UI/Creat in pregnant women of ALSPAC, INMA, and Generation R was 121, 151, and 210µg/g, respectively. Maternal age was positively associated with UI/Creat in all cohorts (P < 0.001), while UI/Creat varied by ethnicity only in Generation R (P < 0.05). Of the dietary predictors, intake of milk and dairy products (per 100g/day) was positively associated with UI/Creat in all cohorts [ALSPAC (B = 3.73, P < 0.0001); INMA (B = 6.92, P = 0.002); Generation R (B = 2.34, P = 0.001)]. Cohort-specific dietary determinants positively associated with UI/Creat included fish and shellfish in ALSPAC and INMA, and eggs and cereal/cereal products in Generation R. The cohort-specific dietary determinants probably reflect not only dietary habits but iodine-fortification policies; hence, public-health interventions to improve iodine intake in pregnancy need to be country-specific.

High sodium intake and sodium to potassium ratio may be linked to subsequent increase in vascular damage in adults aged 40 years and older: the Korean multi-rural communities cohort (MRCohort)

Subclinical vascular damage is a chronic intermediate process in cardiovascular disease (CVD) and high sodium (Na) has been regarded as an adverse factor in subclinical vascular health; however, the longitudinal relationship between Na intake and subclinical vascular damage has not been studied. We aimed to evaluate the longitudinal relationship of dietary Na intake and sodium to potassium ratio (Na:K) with brachial-ankle pulse wave velocity (baPWV) and carotid intima media thickness (cIMT) in healthy adults aged 40years and older in Korea. The present study was based on participants (n = 2145 for baPWV analysis and n = 2494 for cIMT analysis) who visited three times during 2005-2013 (median 5.3years of follow-up). We used both dietary Na intake and Na:K at baseline and its average (baseline, 2nd, 3rd), which was obtained from food frequency questionnaire (FFQ) as exposure at every visit. baPWV and cIMT levels at the third visit and change from baseline to the third visit were used to represent the level of subclinical vascular damage. After adjustment for potential confounders, significant positive relationships between dietary Na intake and both baPWV3rd and cIMT3rd were observed (baPWV: p for trend ≤ 0.0001 for Naaverage; cIMT: p for trend = 0.013 for Naaverage). Compared with Na:Ks less than 1.0, the levels of both baPWV and cIMT were higher for participants with Na:Ks over 1.0 (baPWV: p for trend = 0.0002 for Na:Kaverage; cIMT: p for trend = 0.005 for Na:Kaverage). Similar significant trends were shown in relationships between dietary Na intake and Na:K and changes in baPWV and cIMT levels. In conclusion, dietary Na intake and Na:K may be positively linked to subsequent baPWV and cIMT levels in adults aged 40years and older in Korea. Our findings may provide informative evidence on subclinical vascular damage, particularly for populations with relatively high dietary Na intake and low dietary K intake.