Health Eating Index Research Articles

Association between Healthy Eating Index-2015 and prostate enlargement: A cross-sectional study of the National and Nutrition Examination Survey 2001-2008.

Benign prostate hyperplasia (BPH) occurs in elder men globally with high prevalence. Human diet and lifestyle aroused great attention in the prevalence of BPH. Prostate enlargement (PE) is a major symptom of BPH. To elaborate the effect of total diet quality for adults from the United States, we investigated the association between Health Eating Index (HEI)-2015 and the risk of PE in adults from the National Health and Nutrition Examination Survey (NHANES). This cross-sectional study was conducted based on NHANES 2001-2008. Participants who reported a PE history were included. We conducted a logistic regression analysis to investigate the association between HEI-2015 and PE. A total of 4,866 male participants aged 40 and above were enrolled. Compared with Q1 of HEI-2015, no significant differences were found in adjusted models. Higher vegetables intake (Odds ratio [OR] = 1.073; 95% confidence interval [95%CI] 1.015 to 1.134, P = 0.02) and higher total dairy intake (OR = 1.034; 95%CI 1.009 to 1.061, P = 0.01) were significantly related with higher risk of PE. There was no significant difference between HEI-2015 and PE after full adjustment. Total vegetables and dairy product might be associated with higher risk of PE and needed further validation.

Adherence to the Alternative Health Eating Index and Planetary Health Diet Index in the New England Centenarian Study

Adherence to the Alternative Health Eating Index and Planetary Health Diet Index in the New England Centenarian Study

Age-specific association between meal-skipping patterns and the risk of hyperglycemia in Korean adults: a national cross-sectional study using the KNHANES data

BackgroundGlucose metabolism regulation is influenced by age and meal skipping, although research on their interplay with hyperglycemia remains limited. This study aims to explore the intricate relationship between meal-skipping patterns and hyperglycemia risk across distinct age groups in South Korean adults.MethodsUtilizing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2013 to 2020, comprising 28,530 individuals aged 19 years and older, this study employed multivariable logistic regression models to examine the associations between meal-skipping patterns and the risk of hyperglycemia.ResultsMeal-skipping patterns were categorized into three groups: no skipping (NS), skipping breakfast (SB), and skipping dinner (SD). Age groups were defined as “young” (aged 19–44), “middle-aged” (aged 45–64), and “elderly” adults (over 65 years old). Among “young” adults, SB was associated with a 1.33-fold higher risk of hyperglycemia (OR = 1.33, 95% CI = 1.14–1.54) compared to NS. Conversely, in “elderly” adults, SD was linked to a 0.49-fold reduced risk (95% CI = 0.29–0.82) when compared to NS. Additionally, we observed that the Korean Health Eating Index (KHEI) scores, representing the quality of diet on a scale of 0 to 100, were consistently lower in SB compared to NS across all age groups. Intriguingly, specifically among the “elderly” group, this score was higher in SD compared to NS (p < 0.001).ConclusionsThis study demonstrates age-specific variations in the association between meal-skipping patterns and the risk of hyperglycemia.

Temporary Employment Is Associated with Poor Dietary Quality in Middle-Aged Workers in Korea: A Nationwide Study Based on the Korean Healthy Eating Index, 2013-2021.

Temporary employment is associated with an elevated risk of cardiovascular diseases and mortality. This study explored the association between temporary employment and dietary quality in middle-aged workers. This cross-sectional study included a nationwide sample of middle-aged Korean workers (n = 6467). Employment type was categorized into regular, fixed-term, and daily employment, based on labor contract duration. Dietary quality was assessed using the Korean Health Eating Index (KHEI), which ranges from 0 to 100, with higher scores indicating superior dietary quality. Linear regression was used to estimate beta coefficients (β) and 95% confidence intervals (CI). The survey-weighted proportion of regular, fixed-term, and daily employment was 79.0%, 14.2%, and 6.8%, respectively. Fixed-term and daily employment were associated with a reduced KHEI compared with regular employment (β [95% CI]: -1.07 [-2.11, -0.04] for fixed-term and -2.46 [-3.89, -1.03] for daily employment). In sex-stratified analysis, the association between temporary employment and dietary quality was more pronounced in men (β [95% CI]: -1.69 [-3.71, 0.33] for fixed-term and -2.60 [-4.63, -0.53] for daily employment than in women. In conclusion, this study suggests that temporary employment is a social determinant of dietary quality in middle-aged workers.

Per- and polyfluoroalkyl substances and bone mineral content in early adolescence: Modification by diet and physical activity

BackgroundPer- and polyfluoroalkyl substance (PFAS) exposures may negatively impact bone mineral accrual, but little is known about potential mitigators of this relation. We assessed whether associations of PFAS and their mixture with bone mineral content (BMC) in adolescence were modified by diet and physical activity. MethodsWe included 197 adolescents enrolled in a prospective pregnancy and birth cohort in Cincinnati, Ohio (2003–2006). At age 12 years, we collected serum for PFAS measurements and used dual-energy x-ray absorptiometry to measure BMC. We calculated dietary calcium intake and Health Eating Index (HEI) scores from repeated 24-h dietary recalls, physical activity scores using the Physical Activity Questionnaire for Older Children (PAQ-C), and average moderate to vigorous physical activity (MVPA) based on accelerometry. We estimated covariate-adjusted differences in BMC z-scores per interquartile range (IQR) increase of individual PFAS concentrations using linear regression and per simultaneous IQR increase in all four PFAS using g-computation. We evaluated effect measure modification (EMM) using interaction terms between each modifier and PFAS. ResultsHigher serum perfluorooctanoic acid, perfluorooctanesulfonic acid, and perfluorononanoic acid concentrations and the PFAS mixture were associated with lower BMC z-scores. An IQR increase in all PFAS was associated with a 0.27 (−0.54, 0.01) lower distal radius BMC z-score. Associations with lower BMC were generally stronger among adolescents classified as < median for calcium intake, HEI scores, or MVPA compared to those ≥ median. The difference in distal radius BMC z-score per IQR increase in all PFAS was −0.38 (−0.72, −0.04) for those with <median calcium intake versus −0.03 (−0.48, 0.35) for ≥ median (EMM p-value = 0.16); the corresponding differences by MVPA were −0.42 (−0.76, −0.07) for < median and −0.05 (−0.42, 0.32) for ≥ median (EMM p-value = 0.13). ConclusionHealthy, calcium-rich diets and higher intensity physical activity may mitigate the adverse impact of PFAS on adolescent bone health.

Abstract P482: Associations Between Determinates of Food Choice and Healthy Eating Index-2015 in Adults: An NHANES 2017 - 2018 Analysis

Introduction: Previous work in nationally representative US samples has focused on associations between single determinants of food choice and diet quality assessed by the Health Eating Index-2015 (HEI-2015). Limited research has examined the relationship between multiple domains of food choice and diet quality. A greater understanding of the association between individual-level determinants of food choice and diet quality may inform the development of interventions to improve diet quality. Aim: The aim was to examine the association between potentially modifiable factors known to affect individual-level food choice and HEI-2015. Methods: This cross-sectional analysis included adult participants in NHANES 2017 - 2018. Determinates of individual-level food choice were based on a previously proposed framework. Variables assessed in NHANES were mapped to the following four domains: 1) food-external factors (use of nutrition labels, hours worked weekly, typical work schedule); 2) personal-state factors (health status, consumption of food away from home); 3) cognitive factors (perceived diet quality, knowledge of MyPlate); 4) society-related features (monthly grocery expenditures, food security status, income to poverty ratio). Univariate regression assessed the relationship between food choice determinates and HEI-2015 score. Statistically significant variables were entered into multivariate regression models predicting HEI-2015 score. Significant variables from the final model were used in multivariate regression models predicting adequacy and moderation component sub scores of HEI-2015. All models were adjusted for non-modifiable determinates of food choice, including age, sex, race, BMI, education, and relationship status. All analyses were survey weighted. Results: The weighted mean HEI-2015 score for the sample (N=1467) was 51.69 points (95% CI 49.55, 53.84; weighted n=95.6 million). In the final model, perceived diet quality, food away from home, and use of nutrition labels were significant predictors of HEI-2015 (R 2 adj =0.25, p&lt;0.001). Those with excellent/very good perceived diet quality had a 4.88-pt higher HEI-2015 score than those with fair/poor perceived diet quality (p&lt;0.001). Consuming food away from home ≥5 times per week resulted in a 5.92-pt lower HEI-2015 score than 0 times per week (p=0.02). Always/most of the time using nutrition labels was associated with a 7.85-pt higher HEI-2015 score compared to rarely/never using labels (p&lt;0.001). Variables accounted for a higher proportion of variance in adequacy score (R 2 adj =0.10, p&lt;.001) than moderation score (R 2 adj =0.24, p&lt;.001). Conclusion: Food-external, personal-state, cognitive, and socio-cultural factors are associated with diet quality. Future research should consider multiple individual-level food-choice determinates when developing interventions to improve diet quality.

Abstract 31: Energy Intake and Dietary Glycemic Load in Late Morning and Risk of Type 2 Diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Meal timing may affect type 2 diabetes risk due to the circadian regulation of glucose metabolism. However, the optimal meal timing for lowering diabetes risk remains unknown. Objective and Hypothesis: We aimed to identify the optimal meal timing for diabetes prevention. Since glucose tolerance peaks in the morning, we hypothesized that eating more in the morning is associated with a lower risk of diabetes when daily diet quantity and quality are held constant. Methods: We included 7716 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) who were free of diabetes at baseline (2008-2011) and attended clinic visit 2 (2014-2017). Incident diabetes was identified during the annual phone follow-up (through self-reported diabetes) or at visit 2 (through self-reported diabetes or antihyperglycemic medication usage or laboratory tests using the ADA criteria). Dietary intakes at baseline were assessed using two 24-hour dietary recalls, and meal timing was categorized into early morning (6:00-8:59 AM), late morning (9:00-11:59 AM), afternoon (12:00-5:59 PM), evening (6:00-11:59 PM), and night (0:00-5:59 AM). We calculated energy intake (EI) in kilocalories and energy-adjusted glycemic load (GL) in each meal timing. We estimated their associations with incident diabetes using the Cox proportional hazards models, accounted for the HCHS/SOL complex survey design and adjusted for age, sex, field center, Hispanic/Latino background, income, education, smoking, alcohol intake, sleep duration, physical activity, BMI, family history of diabetes, hypertension, dyslipidemia, total energy intake, and diet quality (Health Eating Index for energy intake in each meal timing as the exposure; total GL and fiber intake for GL in each meal timing as the exposure). Results: At baseline, the analytic population had a mean (SE) age of 39.0 (0.3) years, and 50.9% were female. Over a median (range) follow-up of 5.8 (0.8-9.6) years, 1,262 incident diabetes cases were documented. EI and GL exhibited strong positive correlations throughout the day. EI and GL in late morning were inversely associated with diabetes risk, whereas those in other meal timings were not associated with diabetes risk. In fully adjusted models, the hazard ratios (HRs) of diabetes were 0.94 (95% CI: 0.91 to 0.97) for a 100-kcal increase of EI and 0.93 (0.89 to 0.97) for a 10-unit increase of GL in late morning. The associations were stronger and showed a linear dose-response relationship in males and adults with overweight/obesity. Replacing energy intake or GL, from early morning, afternoon, or evening with late morning equivalents was associated with comparable reductions in diabetes risk. Conclusions: This study identifies late morning as a favorable meal timing for lowering diabetes risk in Hispanic/Latino adults, providing a novel perspective on type 2 diabetes prevention that warrants confirmation.

The Association of Specific Dietary Patterns with Cardiometabolic Outcomes in Women with a History of Gestational Diabetes Mellitus: A Scoping Review

Gestational diabetes mellitus is associated with a significantly increased risk of later type 2 diabetes (T2DM) and cardiovascular disease (CVD). Post-natal interventions aim to reduce this risk by addressing diet and lifestyle factors and frequently focus on restricting energy or macronutrient intake. With increased interest in the role of complete dietary patterns in the prevention of cardiometabolic disease, we sought to evaluate what is known about the role of dietary patterns in reducing cardiometabolic risk in women with previous GDM. A systematic search was conducted to identify studies relating to dietary pattern and cardiometabolic parameters in women with a history of GDM. The search criteria returned 6014 individual studies. In total, 71 full texts were reviewed, with 24 studies included in the final review. Eleven individual dietary patterns were identified, with the Alternative Health Eating Index (AHEI), Mediterranean diet (MD), and low glycaemic index (GI) as the most commonly featured dietary patterns. Relevant reported outcomes included incident T2DM and glucose tolerance parameters, as well as several cardiovascular risk factors. Dietary patterns which have previously been extensively demonstrated to reduce the risk of cardiovascular and metabolic disorders in the general population, including AHEI, MD, and DASH, were found to be associated with a reduction in the incidence of T2DM, hypertension, and additional risk factors for cardiometabolic disease in women with a history of GDM. Notable gaps in the literature were identified, including the relationship between dietary patterns and incident CVD, as well as the relationship between a low GI diet and the development of T2DM in this population.

Disparities in Perceived Availability of Healthful Foods, Dietary Behaviors, Diet Quality, and Obesity Among Mothers from Low-Income Households: Additional Evidence in the Call for Broader Approaches to Obesity Prevention.

To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers from low-income California households. Cross-sectional telephone surveys of mothers from randomly sampled households with incomes ≤185% federal poverty level in 2018 and 2019 using a validated 24-h dietary recall assessment. Dietary outcomes were cups of fruits and vegetables, ounces of sugar-sweetened beverages, teaspoons of added sugars, and kilocalories consumed the previous day. Diet quality was assessed by calculating Health Eating Index-2015 scores. Supplemental survey items assessed mothers' weight and height. Body mass index (BMI) was calculated with a BMI of 30 or higher considered obese. Perceived availability of fresh fruits and vegetables and healthy foods in general within one's neighborhood was recorded. The analytic sample of 9200 mothers was 66.3% Latina, 17.3% white, 12.6% African American, and 3.8% Asian American, Native Hawaiian, or Pacific Islander (AANHPI). African American mothers consumed the fewest cups of fruits and vegetables and the most teaspoons of added sugars, reported poor diet quality, and had the highest obesity rate, 54.7% versus 46.9% for Latinas, 39.9% for whites, and 23.5% for AANHPIs. Accordingly, a greater proportion of African Americans reported limited availability of fresh fruits and vegetables and healthy foods in general in their neighborhood. Findings are interpreted in light of recent calls for broader approaches to address health disparities, including strategies that focus on inequalities in racial/ethnic socioeconomic status and systemic racism.

The Mediating Effect of Central Obesity on the Association between Dietary Quality, Dietary Inflammation Level and Low-Grade Inflammation-Related Serum Inflammatory Markers in Adults

To date, few studies have explored the role of central obesity on the association between diet quality, measured by the health eating index (HEI), inflammatory eating index (DII), and low-grade inflammation-related serum inflammatory markers. In this paper, we use the data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES) to explore this. Dietary intakes were measured during two 24-h dietary recall interviews and using USDA Food Pattern Equivalence Database (FPED) dietary data. Serum inflammatory markers were obtained from NHANES Laboratory Data. Generalized structural equation models (GSEMs) were used to explore the mediating relationship. Central obesity plays a significant mediating role in the association between HEI-2015 and high-sensitivity C-reactive protein (hs-CRP), mediating 26.87% of the associations between the two; it also mediates 15.24% of the associations between DII and hs-CRP. Central obesity plays a mediating role in 13.98% of the associations between HEI-2015 and white blood cells (WBC); it also mediates 10.83% of the associations between DII and WBC. Our study suggests that central obesity plays a mediating role in the association of dietary quality with low-grade inflammation-related serum inflammatory markers (hs-CRP and WBC).

Dietary risk factors for hypertensive disorders of pregnancy

Poor diet quality, as assessed by the US Department of Agriculture’s Health Eating Index (HEI), has previously been linked with hypertensive disorders of pregnancy (HDP). We assessed specific dietary components contributing to this increased risk of HDP. This is a nested case control study in a cohort of 450 study participants with singleton pregnancies who completed the NIH Dietary Health Questionnaire II (DHQ-II) in the third trimester or within 3 months of delivery from 2017-2020. Patients with fetal anomalies, pregnancies conceived by in-vitro fertilization, and deliveries at an outside hospital were excluded. Cases were patients diagnosed with HDP and controls were patients without HDP. Cases were matched to controls by BMI class in a 1:2 ratio. The primary exposures of interest were HEI score components and other DHQ-II dietary components including minerals, caffeine, and water. These dietary components were compared between cases and controls using univariate analyses. 150 patients with HDP were matched to 300 controls without HDP. Baseline demographics were similar between groups, including BMI. Patients with HDP were less likely to have high quality diets (HEI≥70) than controls (7.3% v 15.7%, P=0.02). HDP was associated with significantly higher dairy, saturated fat, and sodium intake compared to controls. Other HEI components such as protein, vegetable, added sugar, and fatty acid uptake were similar between groups (Figure). Caffeine, water, and mineral consumption was similar between groups (Table). Patients with HDP are more likely to have consumed a diet higher in sodium, dairy, and saturated fats. Antenatal diet modification in patients at high risk of HDP should be further studied.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Diet, Physical Activity, and Stress Among Wheelchair Users with Multiple Sclerosis: Examining Behavioral Risk Factors

<h3>Research Objectives</h3> To examine the distribution, prevalence, and correlates of health behaviors in a sample of wheelchair users with MS across the United States. <h3>Design</h3> Cross-sectional. <h3>Setting</h3> General Community. <h3>Participants</h3> One hundred twenty-five wheelchair users with MS were recruited through advertisements via the National MS Society, iConquerMS, and North American Research Committee on MS (NARCOMS) Registry. Participant inclusion criteria: (a) age 18 years or older, (b) diagnosis of MS, (c) use of a wheelchair for mobility ≥50% of the day, (d) Internet access, and (e) willingness to complete the study protocol. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Participants were mailed a packet that included an accelerometer for measuring moderate-vigorous physical activity (MVPA) and instructions for accessing online questionnaires that included: demographic and clinical characteristics, the Perceived Stress Scale, and three dietary recalls using the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool for calculating Health Eating Index scores. Standard cut-points were utilized to identify the extent and distribution of negative health behaviors both individually and co-occurring. We then analyzed the associations between health behaviors and wellness outcomes, including comorbid conditions, symptoms (fatigue, depression, anxiety, pain, and sleep quality), and health-related quality of life (HRQOL). <h3>Results</h3> The mean age among participants was 60.5±9.9, 76% identified as female, 82% progressive clinical course and mean MS duration 23.0±9.7. Twenty-seven participants were classified as 0 negative health behaviors (22%), 38 participants with 1 negative health behavior (31%), 46 participants with 2 negative health behaviors (38%), and 10 participants with all 3 negative health behaviors (8%). Number of negative health behaviors was significantly related to HRQOL (p=.43 physical; p=.48 psychological), sleep (p=.27), depression (p=.33), and anxiety (p=.38). <h3>Conclusions</h3> Seventy-eight percent of wheelchair users with MS report at least 1 negative health behavior and the number of negative health behaviors was related to poor HRQOL and worse symptoms (sleep, depression, and anxiety). Further research is needed examining the impact of behavioral interventions targeting diet, physical activity, and stress management for improving health and wellbeing among wheelchair users with MS. <h3>Author(s) Disclosures</h3> The authors declare no conflicts.

Association between dietary patterns and body composition in normal-weight subjects with metabolic syndrome.

The development of metabolic syndrome (MetS) has been proposed to be related to dietary pattern and body compostion indexes. Diet is one of the most important lifestyle-related factors which may regulate the inflammatory process. Numerous individual foods and dietary patterns can have a valuable health effect that is associated with their anti-inflammatory properties. Here we aimed to investigate the association between body composition indexes and dietary patterns in individuals with metabolic syndrome who were nnormal for weight. Normal weight subjects with MetS were recruited as part of Survey of Ultraviolet Intake by Nutritional Approach (SUVINA). A validated food frequency questionnaire (FFQ) was used to determine dietary patterns that were: low-, or high in antioxidant; dietary inflammation index (DII) and health eating index (HEI) were also determined. Body composition indexes including basal metabolic rate (BMR), body free fat mass (BFFM), body fat mass (BFM), body fat percentage (BFP), trunk fat and total body water (TBW) were measured using a InBody body composition analyser. A P value <0.05 was considered significant. A total 77 individuals including 29 males and 48 females were recruited into the study. A high-antioxidant dietary pattern was significantly correlated with BMR (p = 0.002), BFFM (p = 0.007) and TBW (p = 0.002). There was no significant relationship between body compostion with a low-antioxidant dietary pattern, DII and HEI. After adjusting for age and sex, our findings showed that a high-antioxidant dietary pattern were independently associated with BMR, BFFM and TBW. A high-antioxidant dietary pattern was independently associated with decreased BMR, BFFM and TBW, while no association was found between body composition indexes and DII and HEI in normal weight paticipants with MetS.

Assessment of diet quality and nutrition status of Turkish elite adolescent male soccer players

This study aimed to assess the anthropometric characteristics, nutrient intake levels, nutritional status of elite adolescent soccer players, and the dietary quality of athletes. Elite male adolescent soccer players of the youth soccer team of a soccer club in the Turkish Super League were included in this study by categorizing them into three separate groups as U14/U15 (n=32), U16/U17 (n=44), and U19 (n=17). Anthropometric measurements of the athletes and food consumption records for three consecutive days were recorded during the competition season. Although the available energy value of the U14/U15 group was higher than the other groups, the available energy was determined to be at a suboptimal level in all groups. The U14/U15 group had the highest Health Eating Index-2015 score (43.7±5.57), while the score was 42.9±4.79 in the U19 group and 42.1±3.69 in the U16/U17 group (p&amp;gt;0.05), and 93.5% of the players were determined to be in the group with poor diet quality. The carbohydrate intake of adolescent soccer players was 5.3±1.16 g/kg body mass/day in the U14/U15 group, while it was 4.4 ± 0.87 g/kg body mass/day in the U16/U17 group, and 4.4±0.94 g/kg body mass/day in the U19 group. In this study, it was found out that adolescent football players had a poor diet quality, their carbohydrate consumption was inadequate, their fat intake level was high, and the protein intake was high in the U14/15 group whereas it was at the recommended levels in other groups. Providing recurrent nutritional training to adolescent football players and their families would assist athletes in gaining healthy eating habits as well as increasing their performance.

Duration of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participation is Associated With Children's Diet Quality at Age 3 Years

Adequate childhood nutrition contributes to prevention of chronic diseases. The supplemental foods and nutrition education provided by the Special Supplemental Nutrition Program for Women, Infants, and Children, a federal program serving women, infants, and children up to age 5 years in low-income families and at nutritional risk, intend to optimize dietary intakes. This study assesses associations between duration of the Special Supplemental Nutrition Program for Women, Infants, and Children participation, early feeding practices, and children's diet quality at age 3 years. Using data collected between 2013 and 2017 from the Special Supplemental Nutrition Program for Women, Infants, and Children Infant and Toddler Feeding Practices Study-2, investigators derived 4 mutually exclusive patterns of the Special Supplemental Nutrition Program for Women, Infants, and Children participation: participation in the child's first year only, participation into the second year, participation into the third year, and intermittent participation across 3 years. In 2021, multivariable regression assessed associations between these patterns, early feeding practices, and 2015 Health Eating Index total score at age 3 years. When compared with children who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children into their third year, children who participated in their first year only (p<0.01) had 2015 Healthy Eating Index total scores that were 3.6 points lower on a given day. Children introduced to sugar-sweetened beverages in their first year had scores that were 2.4 points lower than children not introduced to them in their first 2 years (p=0.03), whereas those breastfed longer exhibited a small increase in scores (p<0.01). Longer participation in the Special Supplemental Nutrition Program for Women, Infants, and Children improves children's diets, potentially mitigating chronic disease risk. Clinician efforts to refer at-risk families to the Special Supplemental Nutrition Program for Women, Infants, and Children during the early childhood years are supported.

Segmented assimilation as a mechanism to explain the dietary acculturation paradox

Latinos have disproportionately high rates of diet-related diseases which are associated with acculturation to the U.S. This negative shift in dietary quality is paradoxical in light of gains in income and education that would be expected to lead to better diet. We examined the extent to which the dietary acculturation paradox among Mexican Americans can be explained by segmented assimilation, a theory that considers how immigrants' and their descendants’ trajectories of integration are influenced by a complex interplay of individual, social, and structural factors. First, we performed confirmatory cluster analysis to identify three assimilation segments (classic, underclass, and selective) based on education, income, and an acculturation proxy derived from language, nativity, and time in the U.S. among Mexican-origin participants (N = 4475) of the 2007–2016 National Health and Nutrition Examination Survey (NHANES). These segments were then used as independent variables in linear regression models to estimate the relationship between cluster and dietary quality (assessed by the Health Eating Index (HEI)) and the interaction between cluster and gender, controlling for marital status. There were strong effects of cluster on dietary quality, consistent with hypotheses per segmented assimilation theory. The classic assimilation segment had the poorest diet, despite having higher income and education than the underclass segment. The selective segment had higher or similar dietary quality to the underclass segment. Consistent with expectations, this difference was driven by the relatively higher consumption of greens and beans and whole grains of those in the selective and underclass segments. Overall, women had better diets than men; however, the strongest gender contrast was in the underclass segment. This study advances understanding of dietary acculturation and potential disparities in diet-related health outcomes.

Impact of Recent Job Loss on Sleep, Energy Consumption and Diet.

Adequate sleep and self reported dietary recall data from the Assessing Daily Activity Patterns through Occupational Transitions (ADAPT) study was analysed. Primary sleep indices used were total sleep time, time spent in bed after final awakening, and sleep quality as measured by the Daily Sleep Diary (DSD). Mean Energy consumption (MEC) was the primary nutritional index. Secondary indices included diet quality using the Health Eating Index 2015 (HEI), and self-reported intake of protein, carbohydrates and fats. The study participants were comprised mainly of women (61%) and non-Hispanic white. The participants had at least 2 years of college education and mean body mass index of 30.2±8.08 (kg/m 2). The average time in bed was 541.8 (9.0 hrs) ±77.55 minutes and total sleep time was 461.1 (7.6 hrs) ±56.49 minutes. Mean sleep efficiency was 91±6%, self-reported sleep quality was 2.40±0.57 (0-4 scale, 4 = very good), and minutes earlier than planned morning awakening were 14.36±24.15. Mean HEI score was 47.41±10.92. Although the MEC was below national average for both men and women, male sex was associated with higher MEC. In a fully adjusted model sleep quality was positively associated with MEC. Daily overall assessments of sleep quality among recently unemployed persons were positively associated with mean energy consumption. Additionally, the diet quality of unemployed persons was found to be unhealthier than the average American and consistent with the relationship between poor socioeconomic status and lower diet quality.

Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults.

Toxoplasmosis gondii exposure has been linked to increased impulsivity and risky behaviors, which has implications for eating behavior. Impulsivity and risk tolerance is known to be related with worse diets and a higher chance of obesity. There is little known, however, about the independent link between Toxoplasma gondii (T. gondii) exposure and diet-related outcomes. Using linear and quantile regression, we estimated the relationship between T. gondii exposure and BMI, total energy intake (kcal), and diet quality as measured by the Health Eating Index-2015 (HEI) among 9,853 adults from the 2009-2014 National Health and Nutrition Examination Survey. Previous studies have shown different behavioral responses to T. gondii infection among males and females, and socioeconomic factors are also likely to be important as both T. gondii and poor diet are more prevalent among U.S. populations in poverty. We therefore measured the associations between T. gondii and diet-related outcomes separately for men and women and for respondents in poverty. Among females <200% of the federal poverty level Toxoplasmosis gondii exposure was associated with a higher BMI by 2.0 units (95% CI [0.22, 3.83]) at median BMI and a lower HEI by 5.05 units (95% CI [-7.87, -2.24]) at the 25th percentile of HEI. Stronger associations were found at higher levels of BMI and worse diet quality among females. No associations were found among males. Through a detailed investigation of mechanisms, we were able to rule out T. gondii exposure from cat ownership, differing amounts of meat, and drinking water source as potential confounding factors; environmental exposure to T. gondii as well as changes in human behavior due to parasitic infection remain primary mechanisms.

Comparing dietary score associations with lipoprotein particle subclass profiles: A cross-sectional analysis of a middle-to older-aged population

Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile. This was a cross-sectional study of 1862 men and women aged 46-73 years, randomly selected from a large primary care centre in Ireland. DASH, HEI-2015, MD and E-DII scores were derived from food frequency questionnaires. Lipoprotein subclass particle concentrations and size were determined using nuclear magnetic resonance spectroscopy. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with lipoprotein particle subclasses. In fully adjusted models, higher diet quality or a more anti-inflammatory diet was associated with less large and medium very low-density lipoprotein (VLDL) (DASH and HEI-2015), intermediate-density lipoprotein (IDL) (DASH, MD and E-DII) and small high-density lipoprotein (HDL) (DASH, HEI-2015 and E-DII) particles. After accounting for multiple testing, relationships with large VLDL (DASH: β=-0.102, p=.037), IDL (DASH: β=-0.089, p=.037) and small HDL (DASH: β=-0.551, p=.014 and E-DII: β=0.483, p=.019) concentrations persisted. These findings provide evidence that better diet quality, determined by the DASH score, may be more closely associated with a more favourable lipoprotein particle subclass profile in middle-to older-aged adults than the HEI-2015, MD and E-DII scores. A less pro-atherogenic lipoprotein status may be a potential mechanism underlying the cardioprotective effects of higher dietary quality.

The WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2) Through Age 5: What We’ve Learned, What Questions Remain, and How You Can Use This Longitudinal Dataset

Abstract Objectives By the end of the session, attendees will be able to: (1) Articulate the methodology of and notable findings from the USDA WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2); and (2) Summarize the major domains of data available through age 5 in the WIC ITFPS-2 public use dataset. Methods The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the premier public health nutrition program for low-income, nutritionally at-risk pregnant and post-partum women, infants, and children up to age five. To better understand how WIC participation is associated with the health and nutrition outcomes of young children, USDA funded the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2) in 2011. WIC ITFPS-2 is a national, longitudinal study of 3775 mother-child dyads who enrolled in WIC either during the mother's pregnancy or shortly after the child was born. The study interviews participants every 2 to 6 months through the child's fifth birthday, with two additional follow-ups at ages 6 and 9 years. The study captures information on children's health and nutrition status, including 24 hour dietary recall data; mothers’ feeding practices and beliefs; household food security; and WIC participation patterns. Data are weighted to produce national estimates. As of June 2021, data through children's fifth birthday (i.e., all years during which children were categorically eligible for WIC) are publicly available. Results Using descriptive, univariate, and multivariate techniques, analyses across the first 6 study reports have demonstrated positive associations between WIC and diet outcomes among young children. After controlling for other factors, longer WIC participation was associated with higher Health Eating Index-2015 scores at various time points, with lower daily energy intake, and with meeting the Dietary Guidelines recommendation to limit added sugar. Conclusions Across children's first five years of life, WIC participation has been associated with improved dietary intake and better diet quality, among other positive outcomes. The WIC ITFPS-2 dataset is publicly available and should be leveraged by researchers to further explore the health and nutrition status of low-income children during the early years of life. Funding Sources WIC ITFPS-2 is funded by USDA contract number AG-3198-B-11–0020 with Westat.