Healthy Diet Indicator Research Articles

Does greater adherence to a healthy dietary pattern correspond to a better body composition and cardiorespiratory fitness in adults with overweight and primary hypertension? Data from the EXERDIET-HTA study.

Cardiovascular events are positively associated with primary hypertension (HTN), obesity, and low cardiorespiratory fitness (CRF) and negatively with healthy dietary patterns, such as Healthy Diet Indicator (HDI), Mediterranean diet (MD), and the Dietary Approaches to Stop Hypertension (DASH). The aim is to analyze the association between healthy dietary patterns with body composition and CRF. Body composition (bioimpedance) and CRF [peak oxygen uptake (V̇O2peak)] were assessed in 165 participants with HTN and overweight/obesity. There were (1) a positive association (unadjusted) between fat-free mass (%) with DASH and MD (P = 0.03) and a negative association between fat mass (%) and MD (P = 0.03); (2) positive associations (adjusted) between V̇O2peak (l·min-1) with DASH (P = 0.007), HDI (P = 0.017), and MD (P = 0.010) and V̇O2peak (ml·kg-1·min-1) with DASH (P = 0.005); (3) a negative relationship (unadjusted and adjusted) between energy intake and DASH (P = 0.004). In conclusion, these findings highlight the cardiovascular health protection provided by healthy dietary patterns associated with healthier CRF and body composition in people with a profile of HTN and overweight.

Association between different diet quality scores and depression risk: the REGICOR population-based cohort study

BackgroundOur aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.MethodsProspective observational study using participants’ baseline (2003–2006), follow-up (2007–2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used.ResultsMain analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71–0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70–0.93). Adjusting for BMI did not attenuate the findings.ConclusionsA significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.

The association between healthy diet indicator and phytochemical index with prostate cancer odds ratio: a case-control study

Background and objectiveHealthy diets and diets rich in phytochemicals can have health-promoting benefits in prostate cancer. Therefore, this study aimed to explore the possible association between Healthy Diet Indicator (HDI) and Phytochemical Index (PI) with prostate cancer odds ratio.MethodsThis is a case-control study conducted in Shiraz, Iran, involving 62 newly diagnosed prostate cancer cases and 63 hospital-based controls. The study collected demographic and anthropometric data, as well as dietary intake information via a semi-quantitative food frequency questionnaire. Logistic regression models were employed to evaluate the association between HDI and PI with prostate cancer.ResultsThe study included 120 participants and found that individuals with higher HDI and PI scores had a lower odds ratio of prostate cancer (HDI: odds ratio (OR): 0.322 – confidence interval (CI) 95%: 0.14–0.700 - PI: OR: 0.426 - CI 95%: 0.204–0.888). After adjusting for potential confounders, a lower odds ratio of prostate cancer was observed specifically among those with higher HDI scores (OR: 0.376 - CI 95%: 0.163–0.868).ConclusionThe findings of the present study suggest that adopting healthier dietary habits rich in dietary phytochemicals could be effective in preventing and halting the progression of prostate cancer.

Design of a multidimensional diet quality score for a global sustainable healthy diet based on plant food variety, intake of animal products and dietary contribution of ultra-processed foods (SUSDIET)

A range of metrics have been developed and used to measure components of dietary patterns (e.g., adequacy, quality, diversity). However, no existing dietary metric simultaneously captures the three key dimensions of sustainable healthy diets recommended by the Food and Agriculture Organization of the United Nations and the World Health Organization: food processing; dietary diversity; and intake of animal products(1). This study aimed to identify indicators of a global sustainable healthy diet and translate these features into a multidimensional diet quality score (SUSDIET). Informed by our scoping review(1), a Delphi method was adopted in the form of a three-round online survey of 13 national and international experts in nutritional epidemiology, environmental health, dietary assessment and/or food and nutrition policy. Surveys were conducted between November 2022 and May 2023. Participants were asked about procedures to establish an operational definition for a global sustainable healthy diet. Based on consensus from global experts, we developed the SUSDIET, a food-based diet quality score incorporating variety of plant foods, intake of animal products, and dietary contribution of ultra-processed foods (the ‘dimensions’). Categories and amounts of foods consumed were informed by the Global Diet Quality Score(2), EAT Lancet Planetary Health(3) and a meta-analysis of the relationship between ultra-processed foods and all-cause mortality(4). The variety of plant foods is measured based on 12 food groups (citrus fruits, deep orange fruits, other fruits, dark green leafy vegetables, cruciferous vegetables, deep orange vegetables, other vegetables, legumes, deep orange tubers, nuts and seeds, whole grains, white roots and tubers), animal intake based on 5 food groups (egg, dairy, poultry, fish and seafood, red meat), and ultra-processed foods as one food group. Three categories of consumed amounts (in grams per day) are defined for variety of plant foods and animal intake, scoring as 0, 0.5 or 1. Ultra-processed food consumption is scored as 0 or 1 using ≤10% or >10% of total dietary intake as cut-offs. The components of each dimension are weighted so the three dimensions equally range from 0-5. SUSDIET overall score ranges from 0-15 (up to 5 points per dimension), with a higher score indicating a more healthy and sustainable diet. SUSDIET will be of immediate use for research aiming to assess the impact of diets on both health and environmental sustainability outcomes among the general adult population. This multidimensional diet quality score can also be used to inform and assess the effectiveness of policy actions that promote sustainable healthy diets, including the monitoring and surveillance of diets globally.

Cost and affordability of healthy diets in Vietnam.

To estimate the cost and affordability of healthy diets recommended by the 2016-2020 Vietnamese food-based dietary guidelines (FBDG). Cross-sectional analysis. The Cost of a Healthy Diet (CoHD) indicator was used to estimate the lowest cost of healthy diets and compare the cost differences by food group, region and seasonality. The affordability of healthy diets was measured by further comparing the CoHD to food expenditures and incomes. Food prices of 176 food items from January 2016 to December 2020 were derived using data from monthly Consumer Price Index databases nationally and regionally. Food expenditures and incomes of participants from three latest Vietnam Household Living Standard Surveys were used. The average CoHD between 2016 and 2020 in Vietnam was 3·08 international dollars using 2017 Purchasing Power Parity (24 070 Vietnamese Dongs). The nutrient-rich food groups, including protein-rich foods, vegetables, fruits and dairy, comprised approximately 80 % of the total CoHD in all regions, with dairy accounting for the largest proportion. Between 2016 and 2020, the cheapest form of a healthy diet was affordable for all high-income and upper-middle-income households but unaffordable for approximately 70 % of low-income households, where adherence to the Vietnamese FBDG can cost up to 70 % of their income. Interventions in local food systems must be implemented to reduce the cost of nutrient-rich foods to support the attainment of healthier diets in the Vietnamese population, especially for low-income households.

Association of five diet scores with severe NAFLD incidence: A prospective study from UK Biobank.

This study aimed to contrast the associations of five common diet scores with severe non-alcoholic fatty liver disease (NAFLD) incidence. In total, 162 999 UK Biobank participants were included in this prospective population-based study. Five international diet scores were included: the 14-Item Mediterranean Diet Adherence Screener (MEDAS-14), the Recommended Food Score (RFS), the Healthy Diet Indicator (HDI), the Mediterranean Diet Score and the Mediterranean-DASH Intervention for Neurodegenerative Delay score. As each score has different measurements and scales, all scores were standardized and categorized into quartiles. Cox proportional hazard models adjusted for confounder factors investigated associations between the standardized quartiles and severe NAFLD incidence. Over a median follow-up of 10.2 years, 1370 participants were diagnosed with severe NAFLD. When the analyses were fully adjusted, participants in quartile 4 using the MEDAS-14 and RFS scores, as well as those in quartiles 2 and 3 using the HDI score, had a significantly lower risk of severe incident NAFLD compared with those in quartile 1. The lowest risk was observed in quartile 4 for the MEDAS-14 score [hazard ratio (HR): 0.76 (95% confidence interval (CI): 0.62-0.94)] and the RFS score [HR: 0.82 (95% CI: 0.69-0.96)] and as well as in quartile 2 in the HDI score [HR: 0.80 (95% CI: 0.70-0.91)]. MEDAS-14, RFS and HDI scores were the strongest diet score predictors of severe NAFLD. A healthy diet might protect against NAFLD development irrespective of the specific approach used to assess diet. However, following these score recommendations could represent optimal dietary approaches to mitigate NAFLD risk.

Major dietary patterns in the United Kingdom Women's Cohort Study showed no evidence of prospective association with pancreatic cancer risk

Diet is a modifiable risk factor for pancreatic cancer. We hypothesized that specific dietary patterns would increase/decrease pancreatic cancer risk. We evaluated the association of dietary patterns with pancreatic cancer risk in the UK Women's Cohort Study. Dietary patterns were assessed at enrollment using: (1) self-reported practice of vegan/vegetarian dietary habits, (2) diet quality indices (World Health Organization Healthy Diet Indicator and Mediterranean Diet Score), and (3) principal component analysis-derived dietary patterns. The association of dietary patterns with pancreatic cancer incidence was quantified using Cox regression survival analysis. Over a median follow-up of 19 years of 35,365 respondents, there were 136 incident cases of pancreatic cancer. No association between dietary habits/quality and pancreatic cancer incidence was evident after adjustments (hazard ratio (95% confidence interval): self-reported omnivores vs vegan/vegetarian dietary habit: 1.13 (0.73-1.76); per-unit increase in World Health Organization Healthy Diet Indicator scores: 0.99 (0.91-1.09); per-unit increase in Mediterranean Diet Score: 0.92 (0.83-1.02). Similarly, no association of principal component analysis-derived dietary patterns with pancreatic cancer risk was evident ("prudent:" 1.02 [0.94-1.10]; ``meat-based:'' 1.00 [0.92-1.09]; ``fast-food, sugar-sweetened beverages, and carbohydrate-rich snacks:'' 0.96 [0.86-1.07]; ``cereal and dairy-rich:'' 1.04 [0.94-1.16], and ``low-diversity and lowfat:'' 1.00 [0.89-1.13]). In this prospective cohort of women, several major dietary patterns were of poor quality. There was no evidence of a prospective association between any of the dietary patterns explored and pancreatic cancer incidence.

Assessment of the nutritional value and quality of diets offered in popular apps.

People commonly use new technologies to promote a healthy lifestyle and help them lose weight through nutritional programs. This study evaluated the quality of individualized meal plans offered by dietary apps. Ten apps that offer personalized meal plans were selected for the study, weekly meal plans were generated, and the nutritional values of the diets were calculated. The Healthy Diet Indicator and the Diet Quality Index were estimated. Significant differences between apps were observed in the calculated energy values (p<0.0001) and macronutrients (p<0.05), the content of vitamins (vitamin A, E, K, B1, B3, B6, folates, C: p<0.05) and minerals (potassium, calcium, phosphor, magnesium, iron, zinc, copper, manganese: p<0.05), as well as diet quality (p<0.05) and food group consumption (vegetables, fruits, grains, dairy products, vegan products, meat, nuts, fats, sweets, beverages: p<0.05). Most diets covered the demand for the required nutrients, but the percentage of energy from fats, proteins and carbohydrates differed from the recommendations. Moreover, the nutritional values of the diets provided in the apps significantly differ from the values calculated using the nutritional databases. The meal plans from apps significantly differ in nutrients and food group intake. The quality of the diets offered in the app should be improved.

Diet quality, sleep and quality of life in Parkinson’s disease: a cross-sectional study

BackgroundParkinson’s disease (PD) is a neurodegenerative disorder characterised by motor and non-motor symptoms that impact quality of daily life, including diet and sleep. However, relatively little is known about dietary intake and quality in people with PD (PwP). Lifestyle factors, and how they relate to diet, are also insufficiently understood.The aims of this study were to investigate dietary intake and quality, sleep and quality of life in PwP, and to explore the relationships between these factors.MethodsForty-five community-dwelling participants with PD (n = 45) were recruited to this cross-sectional study through the Cork Parkinson’s Association, Ireland. Dietary intake was assessed using the EPIC food frequency questionnaire, and diet quality was assessed using the Healthy Diet Indicator. Dietary intakes were compared to Irish RDAs for adults > 65 years. Sleep duration and quality were subjectively measured using the PD Sleep Scale and Pittsburgh sleep quality index and objectively measured by actigraphy in a subset of participants (n = 27). QOL was measured using the validated PDQ-39 questionnaire.ResultsEnergy intake in PwP was significantly higher than that of the general population (2013 vs 1755 kcal/d, p = 0.01), despite their lower mean BMI (25.9 vs 27.7 kg/m2, p = 0.02). Intakes of carbohydrate, protein and fruits and vegetables were significantly higher in PwP compared to recommended and population intakes (all p < 0.01), but fibre intake was significantly lower than recommended (17.3 vs 25 g/d, ple 0.05). Seventy-eight percent of participants had poor dietary quality, and poor sleep quality was associated with poor QOL.ConclusionsCarbohydrates, protein, fruit and vegetable intakes were greater in PwP than population norms, but overall diet quality was low. Interventions to improve dietary and lifestyle factors may improve health and QOL in PwP.

Dietary Total Antioxidant Capacity-A New Indicator of Healthy Diet Quality in Cardiovascular Diseases: A Polish Cross-Sectional Study.

This study aimed to assess the relationship between the dietary total antioxidant capacity (DTAC) and the occurrence of cardiovascular diseases (CVDs), as well as healthy diet quality, in a representative sample (n = 5690) of the whole Polish adult population (WOBASZ II study). Daily food consumption was estimated by the single 24 h dietary recall method. Antioxidant vitamins (C, E, and β-carotene) and minerals (Zn, Fe, Mn, and Cu) from the diet and supplements were calculated using 5D Diet software, and dietary total polyphenol intake (DTPI) was determined using the Phenol-Explorer database and our database. Total diet quality was measured by the Healthy Diet Indicator (HDI) based on World Health Organization (WHO) recommendations for the prevention of CVD. DTAC was calculated using the data on food consumption and the antioxidant potential of foods measured by the FRAP (ferric ion reducing antioxidant potential) method. It was shown that higher DTAC was associated with a higher intake of polyphenols, antioxidant vitamins, and minerals. Moreover, a higher quartile of DTAC was associated with a reduced odds ratio for cardiovascular diseases in a Polish population, as well as with a higher HDI. Therefore, dietary recommendations for the prevention and therapy of CVDs should take into account a high DTAC. DTAC, measured by the FRAP method, can be considered an indicator of healthy diet quality.

Associations between three diet quality indices, genetic risk and body composition: A prospective cohort study

Diet and genetic predisposition to adiposity are independent predictors of body composition, yet few cohort studies have examined the association between overall diet quality indices, genetic risk and body composition. This study examined the prospective association of three diet quality indices and a polygenic risk score (PRS) with trunk fat mass, total fat mass, lean mass and bone mineral content. Adults from UK Biobank cohort were included. Dietary intake was assessed using the Oxford WebQ and three diet quality indices calculated: Recommended Food Score (RFS); Mediterranean Diet Score (MDS); Healthy Diet Indicator (HDI). Bioimpedance data were available for trunk fat, total fat and lean mass (kg). Trunk fat mass (kg), total fat mass (kg) and lean mass (kg) were assessed using bioelectrical impedance (BIA) in 17,478 adults. Bone mineral content (g) was available from dual energy x-ray absorptiometry (DXA) scans in 11,887 participants. Linear regression analyses, adjusted for demographic and lifestyle confounders, were used to estimate prospective associations between each diet quality index and body composition outcomes. A PRS created from 97 adiposity-related single nucleotide polymorphisms was used to examine interaction effects. A total of 17,478 adults (M=55.9, SD 7.5 years) were followed up for up to 10 years. RFS, HDI and MDS were inversely associated with trunk fat (RFS: B-0.29; 95% CI:-0.33,-0.25; HDI:-0.23;-0.27,-0.19; MDS:-0.22;-0.26,-0.18), total fat (RFS: B-0.49; 95% CI:-0.56,-0.42; HDI:-0.38;-0.45,-0.32; MDS:-0.38;-0.44,-0.32) and lean (RFS: B-0.10; 95% CI:-0.14,-0.06; HDI:-0.07;-0.11,-0.03; MDS:-0.07;-0.11,-0.04) mass. Diet quality was positively associated with bone mineral content (RFS: B 8.23; 95% CI: 2.14, 14.3; HDI: 6.77; 1.00, 12.5). There was evidence of non-linear associations between diet quality (RFS and HDI only) and trunk fat (p<0.01) and total fat mass (p<0.05). There was limited evidence PRS was associated with body composition, with interaction effects of PRS and HDI (p-interaction=0.039) and MDS (p-interaction=0.031) on total fat mass. Higher diet quality was associated with lower trunk fat, total fat and lean mass, regardless of the diet quality index examined (RFS, HDI or MDS), while higher diet quality (RFS and HDI only) was associated with higher bone mineral content. The benefit of higher diet quality on reducing total fat mass was most evident in individuals with higher generic risk of adiposity. These findings underscore the importance of a high-quality diet for maintaining optimal body composition, particularly in individuals with genetic pre-disposition to adiposity.

Westernized and Diverse Dietary Patterns Are Associated With Overweight-Obesity and Abdominal Obesity in Mexican Adult Men.

IntroductionThe prevalence of overweight and obesity in Mexican adults is very high. To identify the dietary characteristics related with this disorder is necessary to design intervention. The objective was to analyze the association between dietary patterns and obesity in Mexican adults.Materials and MethodsThis is a cross-sectional study carried out in Mexican adults (20–59 years old) participating in the Halfway National Health and Nutrition Survey 2016. Participants (n = 5,735) were classified as having normal weight, overweight-obesity and by their abdominal circumference as having abdominal obesity or not. With information from a 7-day food frequency questionnaire, we used a K-means cluster analysis to derive dietary patterns and calculated a healthy diet indicator to evaluate quality. The association between dietary patterns and overweight-obesity and abdominal obesity was assessed with Poisson regression models adjusted by some characteristics.ResultsWe identified a Rural pattern characterized by tortilla, legumes and egg consumption; a Diverse pattern, characterized by fruits, meat and poultry, vegetables, and dairy beverages, and desserts; and a Westernized pattern, characterized by sweetened non-dairy beverages, fast food, bakery and cookies, candies and salty snacks. In men, Westernized pattern was associated with overweight-obesity (PR = 1.11, 95% CI 0.97–1.27), and abdominal obesity (PR = 1.15, 95% CI 1.00–1.33), the Diverse pattern was associated with overweight-obesity (PR = 1.18, 95% CI 1.00–1.38), and abdominal obesity (PR = 1.27, 95% CI 1.07–1.50), compared with the Rural pattern. In women, these dietary patterns were not associated with obesity.DiscussionWesternized and Diverse patterns are associated with overweight and obesity and abdominal obesity in men. Gender-specific recommendations and surveillance are necessary in the Mexican adult population.

Abstract 2003: Poor diet quality is associated with immune aging in survivors of pediatric acute lymphoblastic leukemia

Abstract Rationale and objectives: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer. Despite a 90% five-year survival rate, survivors of childhood ALL often suffer from late effects, including cardiometabolic disorders. Contributing factors such as inflammation and oxidative stress, combined with drug treatments, can induce premature aging and cellular senescence with a significant impact on cardiometabolic disorders. Premature aging can lead to decreased thymic T-cell production, resulting in decreased circulation of T-cell receptor excision circles (TRECs). Because diet has been associated with cardiometabolic disorders, we hypothesized that the quality of diet in children who had survived ALL was related to the immune aging biomarker TREC, in concert with inflammatory status. Methods: Adolescent and young adult survivors of pediatric ALL of the PETALE cohort (n=241, 22.1 ± 6.3 years at diagnosis, 49.4% male) were examined in their profile for TREC levels (by qPCR) and for adherence to 6 diet quality indices. Results: Adjusted linear regressions revealed that the Healthy Diet Indicator (HDI) was associated with TREC levels (β=50.0, p=0.005, adjusted p=0.03). After performing a conceptual relational analysis (CAR) for data mining of various biomarkers of inflammation, oxidative stress, endotoxemia, and endothelial or adipose dysfunction; interleukin-6 (IL-6) and C-reactive protein (CRP) were found to be negatively associated with TREC levels (β= -80 and -80.1, p=0.017 and 0.026, respectively) but not with HDI. Further analysis revealed that IL-6 and CRP levels were moderators, but not mediators, of the association between HDI and TREC. Conclusion: This study supports the positive impact of a healthy diet on premature immune aging and the moderating role of inflammation in this association. Citation Format: Abderrahim Benmoussa, Tibila Kientega, Sophia Morel, Guillaume Cardin, Sophie Bérard, Mickael wajnberg, Petko Valtchev, Alexandre Blondin-Masse, Daniel Curnier, Maja Krajinovic, Caroline Laverdière, Daniel Sinnett, Emile Levy, Sophie Marcoux, Francis Rodier, Valérie Marcil. Poor diet quality is associated with immune aging in survivors of pediatric acute lymphoblastic leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2003.

A comprehensive analysis of physical activity, nutrition, body composition and functional fitness of women over 60 years old

BACKGROUND: A healthy lifestyle provides a number of benefits, few comprehensive studies have assessed functional fitness and its association with physical activity, nutrition and body composition in older people. OBJECTIVE: The aim of the study was to evaluate the association between functional fitness, physical activity, nutrition and body composition of women aged above 60 years. METHODS: A group of 168 women was divided into two subgroups (‘active’ and ‘inactive’) based on their participation in organized exercise. Physical activity was measured with ActiGraph GT3-BT, nutrition was evaluated with the 4-day record intake, body composition was assessed with a bioelectrical impedance analyzer, functional fitness was measured using the Senior Fitness Test. RESULTS: A significant relationship was found between the functional fitness index, age and body fat in the ‘active’ group. In the ‘inactive’ group, a relationship was found between the length of moderate-to-vigorous physical activity (MVPA) per day, Healthy Diet Indicator, body fat and functional fitness index. CONCLUSION: Fat mass is of significant importance in maintaining functional fitness in women over 60 years of age, regardless of undertaking organized physical activity

Dietary Patterns and Nonmotor Symptoms in Parkinson’s Disease: A Cross-Sectional Analysis

Objective Evidence-based treatment for nonmotor symptoms in Parkinson’s disease (PD) is limited. Lifestyle-based improvements including dietary changes may be a potential management strategy. The intent of this research was to investigate the extent to which 3 dietary indices (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay [MIND], Dietary Inflammation Index [DII], and Healthy Diet Indicator [HDI-2020]) are associated with overall and individual nonmotor symptom severity among individuals with PD. Method An exploratory cross-sectional analysis of dietary (food frequency questionnaire) and clinical data was undertaken, including measures of overall nonmotor symptom severity, such as fatigue, depression, anxiety, apathy, sleep problems, daytime sleepiness, and cognitive impairment. The relationship between each dietary score and symptom outcome was assessed by linear regression for continuous variables and through general linear model analysis for tertiles of dietary adherence. Results None of the dietary indices significantly predicted the total nonmotor symptom severity score. The HDI predicted a significant decrease in fatigue scores as measured by the NeuroQoL fatigue item (standardized β = −.19, p = 0.022), after adjusting for age, sex, energy intake, years since diagnosis, physical activity level, education, and smoking. Self-reported depression symptoms reduced by .17 (standardized β) for each unit increase in HDI score (p = 0.035), after controlling for age, gender, energy intake, and years since diagnosis. No other significant associations were evident between dietary scores and any other nonmotor symptoms. Conclusions Our results indicate that fatigue and depression in PD may be modified by diet; however, more research is needed using a larger sample to replicate these findings. Supplemental data for this article is available online at https://doi.org/10.1080/07315724.2022.2056544 .

Diet Quality Indices in Relation to Cardiovascular Risk Factors in T2DM Patients: A Systematic Review.

Background:Dietary quality indices are practical as an instrument to investigate the extent of adhering to a special diet to prevent cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Considering the lack of any systematic review with regards to this issue, our aim was to examine observational studies to test the relationship between dietary quality indices and CVD risk factors in T2DM.Methods:Systematic search was performed in Web of knowledge, PubMed, Cochrane, Science direct, Google Scholar and Scopus databases from January 1990 to July 2020. The studies exploring the relationship between dietary quality indices (diet quality score (DQS), dietary diversity score (DDS), healthy diet indicator (HDI), healthy eating index (HEI), diet quality index (DQI), Mediterranean diet score (MDS)) and lipid profile, anthropometric indices, glucose profile as well as blood pressure were eligible to be included in this review. Overall, mean changes, odd ratio (RR), correlation coefficients, and beta coefficient of outcomes were extracted, with the quality assessment of studies performed applying The Newcastle-Ottawa scale.Results:From among 1627 papers, 10 articles were included: Eight cross-sectional and two prospective (cohort) studies. The association between HEI as well as MDS and CVD risk factors was more evident in the included studies. Fasting blood sugar, hemoglobin A1c, body mass index, and waist circumference revealed the greatest inverse significant relationship with dietary quality indices in adults with T2DM.Conclusion:Overall, the findings of this study suggest that the level of CVD risk factors in T2DM decreases significantly with increase in the score of dietary quality indices. Further studies in future are required to confirm these findings.

Predicting the 10-year risk of cardiovascular diseases and its relation to healthy diet indicator in Iranian military personnel

BackgroundEpidemiological studies indicate increased prevalence of cardiovascular disease (CVD) among military personnel. Accordingly, identification of at-risk individuals and lifestyle modification such as improving diet quality can potentially inhibits the increasing trend of CVD mortality. The aim of this study was predicting the 10-year risk of CVD and its association with healthy diet indicator (HDI) among military personnel.MethodsIn this cross-sectional study, 400 male military personnel within the age range of 30–75 years were included. HDI score was calculated based on food frequency questionnaire, and the 10-year risk of CVD was evaluated using Framingham risk score (FRS). The FRS items include age, gender, total cholesterol, high density lipoprotein cholesterol (HDL-C), systolic blood pressure, status of diabetes and smoking. Partial correlation test was employed to investigate the relationship between Framingham risk score and HDI score.ResultsThe mean age and body mass index (BMI) of participants were 38.67 ± 5.3 year and 25.28 ± 3.22 kg/m2, respectively. Prediction of FRS was as follows: 96.5% were low risk, 2% were moderate risk, and 1.5% were high risk. The mean HDI score of participants in this study was 5.98 ± 1.36. While HDI score did not show a significant correlation with FRS (r: − 0.009, p:0.860), increased dietary sodium intake had a significant positive correlation with FRS (r: 0.114, p:0.026).ConclusionThe most of participants (96.5%) had in low risk of CVD development in the next 10 years. Meanwhile, the FRS showed no significant relationship with HDI score. Further researches are required to confirm the results of the present study.

Adherence to dietary guidelines and cognitive decline from middle age: the Doetinchem Cohort Study

ABSTRACTBackgroundDiet, in particular the Mediterranean diet, has been associated with better cognitive function and less cognitive decline in older populations.ObjectivesTo quantify associations of a healthy diet, defined by adherence to either the Mediterranean diet, the WHO guidelines, or Dutch Health Council dietary guidelines, with cognitive function and cognitive decline from middle age into old age.MethodsFrom the Doetinchem Cohort Study, a large population-based longitudinal study, 3644 participants (51% females) aged 45–75 y at baseline, were included. Global cognitive function, memory, processing speed, and cognitive flexibility were assessed at 5-y time intervals up to 20-y follow-up. Adherence to the Mediterranean diet was measured with the modified Mediterranean Diet Score (mMDS), adherence to the WHO dietary guidelines with the Healthy Diet Indicator (HDI), and adherence to the Dutch Health Council dietary guidelines 2015 with the modified Dutch Healthy Diet 2015 index (mDHD15-index). The scores on the dietary indices were classified in tertiles (low, medium, high adherence). Linear mixed models were used to model level and change in cognitive function by adherence to healthy diets.ResultsThe highest tertiles of the mMDS, HDI, and mDHD15-index were associated with better cognitive function compared with the lowest tertiles (P values <0.01), for instance at age 65 y equal to being 2 y cognitively younger in global cognition. In addition, compared with the lowest tertiles, the highest tertiles of the mMDS, HDI, and mDHD15-index were statistically significantly associated with 6–7% slower global cognitive decline from age 55 to 75 y, but also slower decline in processing speed (for mMDS: 10%; 95% CI: 2, 18%; for mDHD15: 12%; 95% CI: 6, 21%) and cognitive flexibility (for mDHD15: 10%; 95% CI: 4, 18%).ConclusionsHealthier dietary habits, determined by higher adherence to dietary guidelines, are associated with better cognitive function and slower cognitive decline with aging from middle age onwards.

1075Patterns, determinants and socioeconomic inequalities in eating healthy in Kenya

Abstract Background Kenya is undergoing an epidemiological transition marked by an increase in the burden of non-communicable diseases (NCDs) with unhealthy diet being a key risk factor. This study sought to identify patterns, determinants and socioeconomic inequalities in healthy food consumption in Kenya. Methods A secondary analysis of the Kenya Integrated Household Budget Survey 2015/2016 (KIHBS) data was conducted. A healthy diet indicator (HDI) was computed from food consumption information using principal component analysis (PCA) based on WHO and FAO recommendations. Multivariable probit regression was used to identify determinants of eating healthy. The concentration index (CI) method was used to identify socioeconomic inequalities in eating healthy overall, by gender and residence using household aggregate consumption per adult equivalent. Results The final sample consisted of 21, 512 households. Two thirds of them were rural and majority were male-headed (66%). 49% of households were eating healthy countrywide. HDI scores increased with increasing socioeconomic status overall, by gender and residence. Households with higher socioeconomic status (0.30, p &amp;lt; 0.01), rural (0.20, p &amp;lt; 0.01), in union (0.07, p &amp;lt; 0.01) and Christian (0.16, p &amp;lt; 0.01) were more likely to eat healthy while male-headed (-0.04, p &amp;lt; 0.01), Muslim (-0.07, p &amp;lt; 0.05) and households whose household-heads had lower education status (-0.09, p &amp;lt; 0.01) were less likely to eat healthy. Eating healthy was concentrated among the rich overall, by gender and residence. Conclusions A large proportion of Kenyans are consuming unhealthy foods with the rich eating healthier than the poor. Key messages Interventions are required to promote healthy dietary patterns and reduce socioeconomic inequality in eating healthy.

Public health potential of guidelines-based dietary scores for non-communicable diseases mortality prevention: simulation study using the Preventable Risk Integrated ModEl (PRIME) model.

Dietary indexes measure the adherence of individuals to a set of nutritional recommendations. However, the health gains associated with adherence to various dietary indexes may vary. Our objective was to compare the magnitude of estimated avoided deaths by chronic diseases obtained by improving diet quality in the French population, measured by a variety of dietary indexes. Simulation study based on observational data. Weighted data from a French population-based cohort study. In participants from the NutriNet-Santé cohort, we computed dietary scores reflecting the adherence to various recommendations (Medi-Lite, Healthy Diet Indicator (HDI), Programme National Nutrition Santé/National Nutrition and Health Program - Guidelines Score, Diet Quality Index (DQI), Alternative Healthy Eating Index (AHEI) and the modified Food Standards Agency nutrient profiling system dietary index (FSAm-NPS DI)). Quintiles of the food groups' consumption and dietary intakes were used as input in a simulation model (Preventable Risk Integrated ModEl (PRIME)), yielding the number of delayed or avoided deaths in nutrition-related non-communicable diseases, comparing between very high or very low nutritional quality of the diet and medium nutritional quality. A modification of dietary intakes from medium quality to very low quality (i.e. from the middle quintile to the quintile with the lowest nutritional quality) was associated with an increased number of deaths ranging from 3485 (95 % uncertainty interval (CI) 4002, 2987) for HDI and 3379 (95 % CI 3881, 2894) for FSAm-NPS DI to 838 (95 % CI 1163, 523) for Medi-Lite. Conversely, a modification of dietary intakes from medium quality to very high quality was associated with a decrease in the number of deaths ranging from 1995 (95 % CI 1676, 2299) for Probability of Adequate Nutrient intake diet, 1986 (95 % CI 1565, 2361) for DQI-International, 1931 (95 % CI 1499, 2316) for FSAm-NPS DI and 858 (95 % CI 499, 1205) for HDI. Our results provide some insights as the potential impact of following various dietary guidelines to reduce mortality from nutrition-related diseases.