Health Eating Index Research Articles

Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial

IntroductionSmoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as ‘SNAP’). Australia’s first...

Dietary quality and carotid intima media thickness in type 1 and type 2 diabetes: Follow-up of a randomised controlled trial

Background and aimsThe relationship between dietary intake and carotid intima media thickness (IMT) and pulse wave velocity (PWV) in individuals with type 1 and type 2 diabetes has not been well studied. We investigated the association between dietary intake and common carotid artery intima media thickness (CCA IMT) and PWV in a cohort with type 1 and type 2 diabetes. Methods and resultsA one-year randomised controlled trial was conducted to investigate the effect of improving dietary quality on CCA IMT. These subjects were followed up again approximately 12 months after the completion of the trial (i.e. approximately 24 month since baseline). The study cohort included 87 subjects that had dietary intake and CCA IMT measured at baseline and after a mean of 2.3 years' follow-up. PWV was measured in a subsample of this cohort.Age and baseline mean CCA IMT were strongly associated with mean CCA IMT at 24 months. After adjustment for age and baseline mean CCA IMT, baseline consumption of carbohydrate (r = −0.28; p = 0.01), sugars (r = −0.27; p = 0.01), fibre (r = −0.26; p = 0.02), magnesium (r = −0.25; p = 0.02) and the Alternate Health Eating Index (AHEI) score (r = −0.23; p = 0.03) were inversely associated with mean CCA IMT at 24 months. Mixed linear modelling showed an interaction between mean CCA IMT and AHEI at baseline (p = 0.024). Those who were in the highest AHEI tertile at baseline had greater CCA IMT regression at 24 months compared to those in the lowest tertile, after adjustment for baseline age, BMI, smoking pack years, time since diabetes diagnosis, and mean arterial pressure at baseline (mean −0.043 mm; 95% CI -0.084, −0.003; p = 0.029). ConclusionsIn this prospective analysis greater diet quality at baseline, as measured by the AHEI, was associated with greater CCA IMT regression after approximately two years. This suggests that greater diet quality is associated with better longer term vascular health in individuals with type 1 and type 2 diabetes.

Bridging The Gap Between Campaigns And Programs. The Country-based Public Health Policy Issue

Cardiovascular disease and risks factors are worldwide concerning problems leading to public health policies and strategies to avoid high costs and low outcomes to populations. Physical inactivity is a major risk factor and play an important role that should lead to global public health strategy for its cost-efficiency and cost-effectiveness. The main issues are the specific country-based public health policies, wich continuously leads to campaign to avoid sedentary behavior and physical inactivity, and not population-based exercise programs policies. PURPOSE: The purpose of our study was to share data from a community-based exercise program (“Move it”) contextualized on the Brazilian public health policy (SUS) for the last 20 years. MEHODS AND RESULTS: The program “Move it” is a multidisciplinary program that runs on primary care facilities of a inner state city of São Paulo (Botucatu), Brazil, that has been implemented 25 years ago. So far, 2% of the city population has been involved (2800 participants; 55±9 years, 74% females and 68,7% under 60 years of age), participating on protocols that runs on city’s facilities (parks, public gyms and squares), involving diagnosis, fitness analysis and exercise program (80 minutes, 3 times a week). Metabolic Syndrome (ATP criteria) prevalence is 35%, with a succesfull response to the program of 20% after 10 weeks. VO2 max (Balke protocol) improvement is 30% and muscular strength (25%). Blood Pressure (BP) normalization occurs after 20 weeks, returning to basal levels (High BP) when detrain occurs (Hollydays). Health Eating Index (HEI) and sedentary behavior (IPAQ and Baecke questionnairies) improves after 8 weeks. Figure 1. “Move-it”: Flow-chart and interactions with the national public health policy (SUS): CONCLUSION: Cardiorrespiratory fitness, healthy eating index, lipid profile, insulin sensitivity and body composition were improved. Since the primary care system in Brazil is based on active search (“Estratégia Saúde da Família - agentes comunitários”), the adhesion, acceptance and effectiveness of this model should be encourage for nation wide application. Strategies leading transition from campaigns to programs should be encourage world wide.

Change in Energy Intake and Health Eating Index in Response to Exercise During Weight Maintenance

Change in Energy Intake and Health Eating Index in Response to Exercise During Weight Maintenance

Association between Socioeconomic Status and the Mexican Diet Quality Index score in Adults. Results from the Mexican National Health and Nutrition Survey 2012

BackgroundUnderstanding diet quality is relevant to identify those who would benefit from nutrition interventions and policies. An understanding of overview quality of the Mexican diet is missing so the objective is to create a Mexican Diet Quality Index (Mx‐DQI) and examine it by socioeconomic status (SES) among Mexican adults.Data/methodsDietary data was collected by 24‐hour recall in 3,173 adults aged 20 years or older who participated in the nationally representative Mexican National Health and Nutrition Survey 2012. The Mx‐DQI was constructed based on the 2015–2020 Dietary Guidelines for Americans, which aligns well with Dietary Guidelines in Mexico. An adequacy category encompassed total fruit, whole fruit, total vegetables, greens and beans, whole grains, dairy, total protein foods, and seafood and plant proteins, whereas a moderation category included refined grains, fatty acids, sodium, and added sugars. Weights for each category followed the Health Eating Index model with updates for the new guidelines. The maximum total Mx‐DQI score was 100 points. Household assets were used to create three tertiles of socioeconomic status. Unadjusted means with standard errors were computed for both the total Mx‐DQI score and the individual Mx‐DQI component scores by SES. The continuous measure of the total Mx‐DQI score was then categorized into tertiles for evaluating variations in the diet quality score. Survey weights were applied to make results nationally representative.ResultsThe difference in total Mx‐DQI score was small but significant among SES groups (high SES=42.1 pts; medium SES=39.2 pts; low SES=40.1 pts, p<0.01). Adults with high compared with medium and low SES had higher scores for total fruit (2.1 pts; 1.5 pts; 1.3 pts, respectively, p<0.01), whole fruit (2.5 pts; 1.9 pts; 1.7 pts, respectively, p<0.01), greens and beans (1.2 pts; 0.9 pts; 0.6 pts, respectively, p<0.01), dairy (3.9 pts; 3.0 pts; 2.1 pts, respectively, p<0.01), and refined grains (5.5 pts; 4.2 pts; 3.2 pts, respectively, p<0.01). Conversely, adults with low versus medium and high SES had higher scores for fatty acids (9.1 pts; 7.3 pts; 6.2 pts, respectively, p<0.01), and added sugars (5.6 pts; 4.1 pts; 4.0 pts, respectively, p<0.01). To examine problem areas of diet more closely in each SES group, we looked at the group of individuals in the lowest Mx‐DQI score tertile. Medium SES compared with low and SES had the highest proportion of individuals with a poor score (37.7%; 34.3%; and 31.5%; respectively). The proportion of adults with poorer Mx‐DQI scores for total fruit, whole fruit, dairy, and refined grains was consistently lower in high versus medium and low SES, while the proportion of individuals with poorer Mx‐DQI scores for fatty acids and added sugars was consistently lower in low versus medium and high SES groups.ConclusionThere is a small but significant difference in total Mx‐DQI score by SES. However, differences in Mx‐DQI score distribution by SES are higher. The findings of this study provide an insight for targeting nutrition interventions and policies that can impact diet quality according to SES.Support or Funding InformationThis support comes primarily from the Bloomberg Philanthropies (grants to UNC and CINyS INSP), with support from the NIH R01DK108148, Robert Wood Johnson Foundation (Grant 71698), and the Carolina Population Center and its NIH Center grant (P2C HD0550924).

Socio‐Demographic and Disease Related Factors Associated with Diet Quality Among Adult Cancer Patients

BackgroundRecent studies have shown the consumption of higher quality diets to be significantly associated with lower risk of cancer mortality (Onvani et al., 2016; George et al., 2014). However, characteristics predictive of higher diet quality have not been well elucidated among the cancer population. The study therefore aims to determine socio‐demographic as well as disease related predictors of diet quality among cancer patients.MethodsThis was a cross‐sectional study that recruited 100 cancer patients from two large cancer clinics in central Ohio. After providing consent, individuals 18 years and older completed questionnaires that assessed sociodemographic variables, disease characteristics, and diet quality. Food and beverages consumed in the previous 6 months were assessed using the Block food frequency questionnaire and used in computing diet quality scores; measured as Health Eating Index 2010 (HEI 2010). Independent sample t‐test and one‐way ANOVA were used to compare mean HEI scores across characteristics. Multiple linear regression was used to identify factors associated with HEI scores.ResultsAbout 84% of study participants were females and over half (51%) had a breast cancer diagnosis. The average HEI score was 65.24 (SD = 10.66). Females (M = 66.19, SD = 10.50) had significantly higher mean HEI scores than males (M = 60.23, SD = 10.34, p < 0.05). Individuals who paid bills late due to medical expenses reported significantly lower diet quality (M = 60.42, SD = 10.63) than those who did not (M = 66.76, SD = 10.27, p = 0.01). Education status significantly affected HEI scores (F (3, 95) = 3.937, p = 0.01). Individuals with less than high school education (M = 60.81, SD = 10.71) had significantly lower diet quality scores than did those with a college degree (M = 69.24, SD = 7.36). Gender, education status, monthly income, marital status, smoking status, and timeliness of bill payment were included in the linear regression model. This model explained 26.2% of the variance in HEI scores (R2 = 0.26, F (8, 86) = 3.816, p < 0.01). Smoking status (current smokers) significantly predicted HEI scores (β = −8.411, p = 0.05) as did having to pay bills late due to medical expenses for cancer treatment (β = −4.637, p = 0.05).ConclusionDiet quality is significantly lower in individuals who are current smokers or who have to pay bills late due to medical expenses from cancer treatment. These findings allow healthcare providers to identify patients at risk for consuming low diet quality and therefore in need of targeted interventions that helps improve diet quality. Improvements in diet quality have implications for mortality in this population.Support or Funding InformationFood Innovation Center New Faculty Initiative Award. The Ohio State University.

The Impact of Macronutrients on Retinal Microvasculature among Singapore Pregnant Women during the Mid-Late Gestation.

BackgroundImbalanced macronutrient intakes can induce impairment of endothelial and vascular function, and further lead to metabolic and cardiovascular disease. However, little is known about the influence of such diets on endothelial and vascular dysfunction in pregnant women, even though high-fat diet is a known risk for pregnancy complications such as gestational diabetes and pre-eclampsia.ObjectiveWe aimed to assess the association between maternal macronutrient intakes (protein, fat and carbohydrates), dietary quality and retinal microvascular changes in a multi-ethnic Asian mother-offspring cohort.MethodsPregnant women (n = 614) with singleton pregnancies were recruited during their first trimester from June 2009 to Sep 2010. Maternal diet quality and macronutrient intakes, expressed as a percentage of total energy during pregnancy, were ascertained using 24 hr recalls and 3 d food diaries at 26–28 weeks gestation. Retinal examination was completed at the same clinic visit. Dietary quality was assessed and scored using the Health Eating Index in Asian Pregnant women (HEI-AP), while macronutrients intakes ware expressed as percentages of total energy and further log transformed for analysis. Associations were examined cross-sectionally by substitution models with the use of multiple linear regression.ResultsIn adjusted model, each 20 points decrease in HEI-AP score was associated with a significant increase of 1.70 μm (p<0.05) in retinal venular calibre. Each 0.1 log increase in percentage of total fat intake was associated with a significant increment of 1.84 μm (p<0.05) in retinal venular caliber. Additionally, each 0.1 log increase in percentage of mono-unsaturated fat intake was associated with an increment of 1.84 μm (p<0.01) in retinal venular caliber.ConclusionsIn this cross-sectional study, we found that women with higher fat and lower protein intakes, and lower diet quality tended to have wider retinal venular caliber, which is suggestive of suboptimal microvasculature.

Dietary Intake of Isoflavone and All‐Cause Mortality in Women with Breast Cancer: the Breast Cancer Family Registry

Dietary Intake of Isoflavone and All‐Cause Mortality in Women with Breast Cancer: the Breast Cancer Family Registry

Dietary energy density was associated with diet quality in Brazilian adults and older adults

Cross-sectional and longitudinal studies present association of low dietary energy density with higher intake of vitamins, minerals and dietary fiber, lower intake of fat, and better balance of macronutrients. The objective of this study was to verify the relationship between dietary energy density and diet quality measured by an index of diet quality. This study used data from 496 adults and 445 older adults of cross-sectional population-based survey from São Paulo conducted in 2008–2009, Brazil. Dietary intake data was assessed by two 24-h dietary recalls. Dietary energy density values were calculated based on foods only method. Dietary energy density and revised Brazilian Health Eating Index and its components, were estimated by usual intake using Multiple Source Method. The relationship between dietary energy density and the total revised Brazilian Health Eating Index and its components were assessed by Gaussian family log-link model for each age group. The analyses showed an inverse association between dietary energy density and total revised Brazilian Health Eating Index in adults (T2:β = 0.96, p < 0.001; T2:β = 0.86, p < 0.001) and older adults (T2:β = 0.96, p < 0.001; T2:β = 0.90, p < 0.001), and an inverse association between dietary energy density and nine of twelve revised Brazilian Health Eating Index components in adult and/or older adults groups. Dietary energy density was associated with diet quality in Brazilian adults and older adults regardless of sex, per capita household income, body mass index, physical activity level, current smoking habits status, alcohol beverage drinking status and usual energy intake (kilocalories) from beverages.

Socioeconomic inequalities in children's diet: the role of the home food environment.

BackgroundIt is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns.MethodsUsing data on 4th grade children from the 2009–2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences.ResultsSmall but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home food environment and neighborhood environment measures in this model eliminates these differences (-0.7, p=0.145). Home food environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (food availability) of the home food environment are strongly associated with consumption of healthy and unhealthy foods.ConclusionsOur findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy food.

Abstract P163: Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes

Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertension, compared with parous women without GDM. The role of diet in the progression to hypertension among this highly susceptible population is unknown. Methods: We conducted a prospective cohort study among 3,818 women with a history of GDM in the Nurses’ Health Study II, as a part of the ongoing Diabetes &amp; Women’s Health Study. These women were followed from 1991 until 2011. Incident hypertension was identified by self-report with a previously validated questionnaire. Adherence scores for the 2010 Alternative Health Eating Index (AHEI-2010), the Alternate Mediterranean Diet (aMed) and the Dietary Approaches to Stop Hypertension (DASH) were computed for each participant; higher scores indicate better diet quality. Cox proportional hazard models were used adjusting for major risk factors for hypertension, including dietary and lifestyle factors, medical history, reproductive factors and medications. Results: We documented 1,069 incident hypertension cases during a median of 18.5 years follow-up. After multivariate adjustment, the AHEI-2010, and DASH scores were significantly and inversely associated with risk of hypertension. Hazard ratio (HR) and 95% confidence interval (CI) comparing the extreme quartiles (highest vs. lowest) was 0.78 (0.63-0.96, P for linear trend=0.02) for AHEI-2010, 0.77 (0.62-0.96, P for trend=0.02) for DASH score and 0.80 (0.65-0.99, P for trend=0.06) for aMed score. Conclusion: After GDM, adherence to a healthful dietary pattern was related to a lower risk of developing hypertension.

The link between dietary sugar intake and cardiovascular disease mortality: an unresolved question.

1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index.

Added sugar intake and cardiovascular diseases mortality among US adults.

IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality. OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality. DESIGN, SETTING, AND PARTICIPANTS National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31,147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study. MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality. RESULTS Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P < .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163,039 person-years. Age-, sex-, and race/ethnicity-adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index. CONCLUSIONS AND RELEVANCE Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.

Abstract 39: Added Sugar Intake and Lipids Profile Among US Adolescents: NHANES 2005-2010

Background: Studies suggest that higher consumption of added sugar is associated with cardiovascular risk factors in adolescents. However, these studies were subject to measurement error due to the lack of adjustment for day-to-day variability. Hypothesis: We hypothesized that higher usual percent of calories from added sugar is associated with dyslipidemia. Methods: We analyzed data on 3322 adolescents aged 12-19 years who were not on low fat/low cholesterol diet or on sugar free/low sugar diet from the 2005-2010 National Health and Nutrition Examination Surveys. We estimated the usual percent of calories from added sugar from the diet accounting for measurement error. Multivariable linear regression was used to examine the associations between the percent of calories from added sugar with lipids profile. Results: The average usual percent of calories from added sugar was 17.5%. Ninety-one percent and 11% adolescents had usual percent ≥10% and ≥25%, respectively. After adjustment for potential confounders (age, sex, race/ethnicity, body mass index, parental educational attainment, smoking status, physical activity, 2010 Health Eating Index score except sugar component, and total calorie intake), usual percent of calories from added sugar was inversely associated with high-density lipoprotein and positively associated with triglycerides and the ratio of total cholesterol to high-density lipoprotein. Among the lowest and the highest quintiles of intake, high-density lipoprotein were 52.4 mg/dL (95% CI: 50.9 to 53.9) and 49.0 (95% CI: 47.9 to 50.2) (P trend = 0.003), triglycerides were 80.2 mg/dL (95% CI: 70.5 to 90.0) and 100.4 mg/dL (95% CI: 86.7 to 114.2) (P trend = 0.028), and the ratio of total cholesterol to high-density lipoprotein were 3.16 (95% CI: 2.8 to 3.6) and 3.49 (95% CI: 3.0 to 4.0) (P trend =0.006), respectively. The patterns of association were largely consistent across gender, race/ethnicity, and body mass index (normal vs. overweight/obese) subgroups, except in non-Hispanic black and Mexican American, in which the magnitude of the association tended to be smaller. Sensitivity analysis showed that, when intake data from the 1 st 24-hour dietary recall was used, the association remained significant but attenuated substantially. No association was found for total cholesterol and low-density lipoprotein. Conclusions: Overwhelming majority of US adolescents consumed more added sugar than recommended for heart health. Increased intake of added sugar is associated with several measures of dyslipidemia, and reduction of added sugar consumption among adolescents might reduce the risk of developing cardiovascular disease in adults.

Energy density and diet quality among Brazilian workers

Purpose – The purpose of this paper is to evaluate the energy density (ED) of workers' diets and examine their relationship with nutrient intake, diet quality, socio‐demographic and anthropometric factors.Design/methodology/approach – Dietary data were collected by a 24‐hour recall. ED, defined as energy per unit weight of diet, included all food and excluded all beverages. Diet quality was evaluated using the Brazilian version of the health eating index. The associations between ED and socio‐demographic variables and body mass index were examined using regression models.Findings – The study evaluated 201 individuals: 51 percent male; mean age 33.4 years (SD=9.5); 43 percent overweight. Women and men presented similar mean ED: 1.99 (95 percent CI: 1.90‐2.09) and 1.95 (95 percent CI: 1.89‐201). ED was inversely associated with age (β: −0.009; 95 percent CI: −0.015; −0.002) and with leisure physical activity (β: −0.049; 95 percent CI: −0.096; −0.002) and directly associated with liquid intake during meals (...

NP005 Measuring dietary pattern change after cardiac events

There has been a strong link made between dietary content and cardiac disease risk. Diets high in fruits, vegetables, whole grains, fish and poultry and lower in red meat have been shown to lower cardiac disease risk in both women and men. National diet guidelines, such as the Canada Food Guide (CFG), provide information on basic healthful eating. However, the CFG lacks the details that are recommended in several cardiac disease specific diets. The Alternate Health Eating Index (AHEI) is a scoring index that accounts for specific dietary factors such as types of fat, forms of carbohydrates and specific protein sources. High levels of adherence to the AHEI are associated with significantly lower cardiovascular disease risk in both men and women. Current methods of measuring adherence to dietary recommendations do not capture subtle shifts in diet for patient with cardiac disease. The purpose of this ongoing study is to describe trends in dietary patterns, using both the CFG and AHEI, of patients with coronary heart disease, after admission to the hospital with a cardiac event. If trends do exist in dietary adherence, educational and other interventions can be focused on critical times when patterns are likely to change.

Effects Of A 10-wk Physical Exercise Low-energy Density Diet Protocol On Metabolic Syndrome Reduction In Overweight Adults

Lifestyle modification focusing on improving diet and exercise behavior is the preferred first-line treatment for the management of metabolic syndrome (MetS). Dietary fiber adequacy is the key objective as limiting energy consumption when fat loss is the goal. PURPOSE: This study aimed to reduce MetS after a short-time (10 wk) of lifestyle modification program (LMP) with physical exercises and low-energy density diet (30g fiber/day). METHODS: In a controlled parallel group design participants (n=50; 50.5 ± 11.8 yrs) were allocated either to intervention of high-fiber through recommendations for adequate intakes of fruits and vegetables (G1, n=28, 6M, 22F, BMI=33.6 ± 5.3kg/m2, MetS=46%) or control (G2, n=22, 5M, 17F, BMI=32.1 ± 5.3kg/m2, MetS=40%). Both groups were in a weekly LMP with daily 60 min sessions of aerobic exercises alternating brisk walking (3d/wk) and muscle strength (2d/wk). Clinical, anthropometric, dietary, fitness and plasma biochemical assessments were undertaken at baseline (M0) and after 10 weeks (M1). Groups and moments were statistically compared by either Student's t test or Wilcoxon Mann Whitney test for p=0.05. RESULTS: At M0 both groups were similar in all variables and after 10 weeks of LMP they both improved health-eating index (HEI), fiber intake and kept their muscle mass. However only G1 increased the intake of fiber (211%) along with plasma b-carotene (150%), additionally to greater reductions in body fat (4%), abdominal fat (7%) and obesity (16%) leading to reduced MetS (24%) by normalizing blood pressure, triglycerides and glucose. CONCLUSIONS: Thus short-time (10 weeks) LMP reduced MetS by improving HEI, body composition and mostly blood markers. Supported by CNPq and FAPESP.

Dietary Quality Index and Associated Factors among Adolescents of the State of Sao Paulo, Brazil

To assess dietary quality and associated factors in adolescents. We conducted a population-based cross-sectional study in a sample of 1584 adolescents living in areas of the state of São Paulo, Brazil. Dietary intake was measured with the 24-hour recall method, and dietary quality was assessed by means of the Health Eating Index (HEI), adapted to fit to the local requirements. Linear regression analyses were performed to assess the association between the HEI and demographic, socioeconomic, and lifestyle variables. A total of 97.1% of the adolescents studied had an inadequate diet or a diet that needed improvement. The mean overall HEI score was 59.7. Lower mean HEI scores were found for fruits, dairy products, and vegetables. Male adolescents who were physically active and lived in a house or apartment had higher HEI scores. The multiple regression analyses showed that the quality of the diet improved as age decreased. Adolescents who lived in houses or apartments had higher HEI scores than adolescents living in shacks or slums, regardless of age and energy intake. Dietary quality is associated with income and age. A better understanding of the factors associated can provide input to the formulation of policies and development of nutritional actions.

Healthy Eating Index and abdominal obesity

Although diet is a modifiable lifestyle factor to reduce abdominal obesity risk, the relationship between the Health Eating Index (HEI) and waist circumference (WC) has not been studied. The present study aimed to describe relationships between the HEI and abdominal obesity among adults. Secondary data analysis of a cross-sectional national survey, the Third National Health and Nutrition Examination Survey (NHANES III). The HEI data, including the total HEI score and HEI component scores, were collected with a 24 h recall. WC measures were taken during a physical examination. Abdominal obesity was defined as WC > or = 102 cm for men and WC > or = 88 cm for women. Other covariates were collected during an interview. In total 15 658 US adults, men (n 7470) and non-pregnant women (n 8188). The odds of abdominal obesity was 8.3 % (95 % CI 1.8, 14.9 %, P = 0.014) lower for women and 14.5 % (95 % CI 6.8, 21.9 %, P < or = 0.001) lower for men with each 10-unit increase in total HEI score (HEI scale, 0-100). For each point increase for the fruit score, abdominal obesity risk decreased by 2.6 % (95 % CI 0.8, 4.4 %, P = 0.007) for women. Abdominal obesity risk decreased for men with each point increase in saturated fat and variety scores, by 3.1 % (95 % CI 0.1, 6.0 %, P = 0.042) and 4.0 % (95 % CI 0.1, 7.7 %, P = 0.043) respectively. Dietary consumption that follows the HEI is associated with a lower risk for abdominal obesity.

Poor Intake of Milk, Vegetables, and Fruit with Limited Dietary Variety by Botswana's Elderly

The aim of this research was to determine dietary intake of elderly Batswana, evaluate the diet quality using the Health Eating Index (HEI), identify factors associated with poor quality, and determine the impact of age on dietary scores. Villages and towns were selected in three strata: urban, semiurban, and rural. A total of 99 elderly (67% female, 33% males), age range 60–95 years, were recruited through purposive sampling. A 24-hour multiplepass food recall was combined with demographic, health, and cooking responsibilities questions. The elderly diet met requirements for only the Grains group (9 serving/day). Most elderly obtained good HEI component scores on fat, saturated fat, cholesterol, sodium, and Grains group intake. The HEI scores were poor for variety, milk, fruits, and vegetables. Most elderly had poor diet (38%) or a diet that needed improvement (59%), and only 3% had a good diet.