Healthy Diet Recommendations Research Articles

Dietary responses to a multiple sclerosis diagnosis: a qualitative study.

Multiple sclerosis (MS) is an immune-mediated disease with no known cure and insufficient evidence to support a special therapeutic diet to alter symptom management or disease progression. Several studies have reported dietary changes made by people with MS, but there has been limited investigation into experiences surrounding diet in those recently diagnosed. This study explored responses to diet after a recent diagnosis of MS in people living in Western Australia. Eleven adults with MS (mean time since diagnosis 8 months) participated in semi-structured interviews focusing on responses to diet since MS diagnosis. Interviews were transcribed, coded and analysed using grounded theory principles. Three theme responses emerged; (1) the perceived incompatibility of lack of/or generalised dietary advice with disease seriousness at the time of diagnosis; (2) extensive personal research and information seeking with difficulty judging credibility, and (3) self-experimentation with diet to either control MS symptoms or to cure MS. Given the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time.

Dietary patterns associated with overweight among Brazilian adolescents

The present study aims to identify the dietary patterns of adolescents and associate these patterns with overweight. We analyzed food-consumption data from 6784 adolescents in the age group 10–18 years old collected in the Household Budget Survey 2008–2009. Dietary patterns were assessed through exploratory factor analysis. Logistic regression models were used in order to associate dietary patterns with overweight. Four dietary patterns were recorded: Traditional Brazilian Pattern, Snacks Pattern, Fast Food Pattern, and the Milk, Fruit and Cereal Breakfast Pattern. Results were adjusted according to the sociodemographic variables and showed that the higher the adherence to Snacks (OR: 1.50 fifth quintile vs first (95% CI: 1.13, 1.99) p linear trend <0.001) and Fast Food patterns (OR: 1.55 fifth quintile vs first (95% CI = 1.12, 2.12) p linear trend <0.001), the higher the chances of becoming overweight. These data indicate that the local public health and nutrition policies focused on adolescents should be more attentive to the eating habits of this population in Brazil, since the current research related regular poor nutritional quality dietary patterns to increased overweight among adolescents. In addition, understanding adolescents' eating habits according to their dietary patterns may guide the development of healthy dietary recommendations based on the combination between food and food groups, rather than only on nutrients or nutritional adequacy.

Improving Metabolic Health Through Precision Dietetics in Mice.

The incidence of diet-induced metabolic disease has soared over the last half-century, despite national efforts to improve health through universal dietary recommendations. Studies comparing dietary patterns of populations with health outcomes have historically provided the basis for healthy diet recommendations. However, evidence that population-level diet responses are reliable indicators of responses across individuals is lacking. This study investigated how genetic differences influence health responses to several popular diets in mice, which are similar to humans in genetic composition and the propensity to develop metabolic disease, but enable precise genetic and environmental control. We designed four human-comparable mouse diets that are representative of those eaten by historical human populations. Across four genetically distinct inbred mouse strains, we compared the American diet's impact on metabolic health to three alternative diets (Mediterranean, Japanese, and Maasai/ketogenic). Furthermore, we investigated metabolomic and epigenetic alterations associated with diet response. Health effects of the diets were highly dependent on genetic background, demonstrating that individualized diet strategies improve health outcomes in mice. If similar genetic-dependent diet responses exist in humans, then a personalized, or "precision dietetics," approach to dietary recommendations may yield better health outcomes than the traditional one-size-fits-all approach.

Does nurses’ role, health or symptoms influence their personal use of ingestible complementary and alternative medicines?

ObjectivesTo investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary and Alternative Medicine (CAM) use within the Australian nursing and midwifery workforce. BackgroundCAM use is widespread worldwide, but there is little research into nurses’ and midwives’ personal use of ingestible CAM in Australia. MethodsAn online survey in 2014–15 used validated instruments and items to examine use of ingestible biologically-based CAM (herbs, foods and vitamins, minerals, amino acids, enzymes and other supplements), and the health and work-related characteristics of 5041 nurses and midwives recruited through the New South Wales Nurses and Midwives Association and professional networks. ResultsA small proportion of nurses (6.8%) identified as personal CAM users. Most were female, older, worked in foundational roles (frontline Registered and Enrolled Nurses/Midwives) and used one CAM, most commonly a multivitamin, although Vitamin D, Fish Oil, Calcium and Glucosamine±Chondroitin were also common. In comparison to non-users, CAM users were less likely to take sick days or indulge in risky drinking, but more likely to be symptomatic (with stiff joints, bodily/joint pain, severe tiredness, allergies, indigestion/heartburn), diagnosed with osteoarthritis and to adhere to healthy diet recommendations. ConclusionsFindings showed a credible pattern of front line workers with physically demanding workloads that impact their physical health and are linked to frequent symptoms, using CAM treatments and achieving some success in being able to continue working and avoid sickness absence. Further investigation is warranted to protect and maintain the health of the nursing and midwifery workforce.

PRADINIŲ KLASIŲ MOKINIŲ MITYBOS YPATUMŲ POKYČIAI. PALYGINAMASIS 2010 IR 2014 METŲ TYRIMAS

Tyrimo medžiaga ir metodai. 2010 metais dviejose Vilniaus miesto pradinėse mokyklose anoniminės anketinės apklausos būdu apklausti 460 1-4 klasių mokinių tėvai. 2014 metais tose pačiose mokyklose analogiškai apklausti 346 tėvai. Duomenys analizuoti SPSS 22.0 programa. Kokybinių duomenų analizei naudotas Pearson‘o chi kvadratas (χ²). Duomenų skirtumas laikytas statistiškai reikšmingu, kai p≤0,05. Rezultatai. 2010 metais sveikos mitybos rekomendacijų laikėsi 73,3% pradinukų tėvų, 2014 metais – 84,8%, atitinkamai kasdien pusryčiaudavo 65,7% ir 73,7% vaikų, prieš miegą valgantys vaikai 2010 metais sudarė 55,2%, o 2014 metais – 45,7%. 3 ir daugiau kartų per dieną daržoves 2010 metais valgė 12,2% respondentų vaikų, 2014 metais – 11,9%, atitinkamai vaisius 22,9% ir 25,0%, duoną ir grūdinius produktus – 28,5% ir 24,3%. Maisto papildus 2010 metais vartojo 44,4% pradinių klasių mokinių, 2014 metais – 52,6%. Išvados. Padaugėjo besilaikančių sveikos mitybos rekomendacijų tėvų, kasdien pusryčiaujančių, taip pat vartojančių maisto papildus vaikų. Reikšmingai sumažėjo prieš miegą valgančių vaikų.

Microbiota and metabolic syndrome

The role of gut bacteria in the pathogenesis and treatment of various diseases has been a focus of attention in the last 10 years. Prevalence of diabetes, obesity, and cardiovascular diseases continues to increase, in spite of technological developments and treatment alternatives. Microbial dysbiosis, described as the decrease of useful bacteria and the increase of harmful bacteria, has been associated with diabetes, obesity, atherosclerosis, and metabolic syndrome. In microbial dysbiosis, increase of harmful metabolites and changes to composition of bile acids occur via carbohydrate and protein fermentation. As a result, insulin resistance pathways are activated, which initiate the processes of obesity, diabetes, and atherosclerosis. Healthy diet recommendations, including prebiotic and probiotic foods and the use of probiotic agents, look promising for future treatment of metabolic syndrome and cardiovascular diseases.

Eligibility and Success Criteria for Bariatric/Metabolic Surgery.

Obesity is a worldwide main health concern, with a high treatment failure. This chapter focuses on the definition of obesity, based on excessive fat accumulation and thus underscores the importance of body composition, and the clinical tools currently used to diagnose it, mainly body mass index that is only a proxy measure of body composition. It also highlights the importance of the personal commitment to comply to a healthy diet and physical activity recommendations since surgery is most effective when accompanied by lifestyle modifications. Additionally, it addresses the description of types of patients who could benefit most from surgical management of excessive body fat percentage and metabolic derangements, as well as on the indications for surgery that are currently valid.

Effect of consuming novel foods consisting high oleic canola oil, barley β-glucan, and DHA on cardiovascular disease risk in humans: the CONFIDENCE (Canola Oil and Fibre with DHA Enhanced) study – protocol for a randomized controlled trial

BackgroundMetabolic syndrome (MetS) has been identified as a major contributor to the development of cardiovascular disease (CVD). Current recommendations for dietary management of people with MetS involve quantitative and qualitative modifications of food intake, such as high consumption of vegetables, fruits, and whole grain foods. The results from our previous human trials revealed the potential of the dietary components high-oleic acid canola oil (HOCO)-docosahexaenoic acid (DHA) and high molecular weight barley β-glucan individually in managing CVD risk factors. Foods with a combination of HOCO-DHA and barley β-glucan have never been tested for their effects on CVD risk. The objective is to determine the effects of consuming novel foods HOCO-DHA, and barley β-glucan on managing CVD risk factors in people with MetS.Methods/DesignWe are conducting a randomized, single-blind crossover trial with four treatment phases of 28 days each separated by a 4-week washout interval. Participants (n=35) will be provided with weight-maintaining, healthy balanced diet recommendations according to their energy requirements during the intervention periods. Participants will receive muffins and cookies as treatment foods in a random order and will consume at least one meal per day at the research center under supervision. The four treatments include muffins and cookies consisting of (1) all-purpose flour and HOCO-DHA (50 g/day); (2) barley flour (4.36 g/day of β-glucan) and a blend of sunflower oil, safflower oil, and butter as control oil (50 g/day); (3) barley flour (4.36 g/day of β-glucan) and HOCO-DHA (50 g/day; dosage of DHA would be 3 g/day); and (4) all-purpose flour and control oil (50 g/day). At the beginning and end of each phase, we will evaluate anthropometrics; systolic and diastolic blood pressure; blood lipid profile; low-density lipoprotein subfractions and particle size; 10-year Framingham CVD risk score; inflammatory status; and plasma and red blood cell fatty acid profiles, fecal microbiome, and body composition by dual-energy X-ray absorptiometry.ConclusionCholesterol synthesis will also be studied, using a stable isotope approach. The proposed study will lead to innovation of novel food products, which may result in improvement in the overall cardiovascular health of humans.Trial registrationClinical trials.gov identifier: NCT02091583. Date of registration: 12 March 2014.

Social Support in Context and its Association with Three Healthy Diet Indicators

Few studies have examined the association between social support and dietary intake in ethnic minority populations. The notion of social support involves a complexity that is often ignored in research. We quantified emotional and functional support, and contact frequency from various social sources, and created four factors of social integration, to investigate their combined effect on three diet indicators, the USDA Healthy Eating Index (HEI), the American Heart Association's healthy diet recommendations (AHA-DQ), and the AHA Life's Simple-7 (LSS) healthy diet score. In multivariate linear regression for HEI and AHA and multivariate logistic regression for LSS, no significant associations were found between a general measure of social support and dietary quality. However, when examining social support in context, greater functional support from immediate family was associated with healthier HEI, greater contact with extended family with healthier AHA, greater contact with neighbors with healthier HEI and LSS, greater engagement in recreational activities with healthier HEI and AHA, and greater church activities with healthier HEI. Greater contact with friends was associated with less healthy HEI scores, and greater emotional support from neighbors with less healthy HEI and LSS scores. Compared to men, women were more likely to have a healthier LSS with greater contact with neighbors, but were less likely of a healthier LSS with greater emotional support from neighbors. Findings point to the importance of investigating the influence of distinct individual social environments on the adoption of healthy diets as a relevant factor for interventions aimed at improving individual's diet quality

Effects of the "PreveDi" lifestyle modification trial on metabolic syndrome.

Metabolic syndrome (MetS) is a cluster of metabolic disorders that includes central obesity, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia and high blood pressure (BP). Statistical reports suggest that the prevalence of MetS has dramatically increased during the recent years and is considered a worldwide epidemic. MetS has been found to be associated with increased risk of all-cause mortality, cardiovascular diseases (CVD), type 2 diabetes mellitus, chronic kidney disease and some types of cancer. MetS has a high socioeconomic cost and it is therefore extremely important that MetS is prevented and treated by simple and feasible methods. The PreveDi study is a pilot before/after preventive trial aimed at the evaluation of the impact of a brief lifestyle intervention on changes in metabolic syndrome (MetS) risk factors. Recruitment was carried out in two community (council-run) pharmacies in the province of Perugia, Italy and the sample population consisted of 186 adults aged 45 or more who volunteered to participate. At enrolment the participants received a booklet illustrating general recommendations for MetS. During the 6-months follow-up period, participants were invited (by brochures and text messaging on cellular phones) to attend five conferences, five cooking classes, and twelve physical activity sessions. The conferences and the kitchen course were aimed to disseminate a healthy diet strategy focused primarily on reducing glycemic and insulinemic response. At baseline and follow-up MetS parameters were evaluated using medical equipments available in community pharmacies. At baseline, MetS was observed approximately in 52.2% of the PreveDi population, the MetS prevalence decreased with a higher education level in women, but not in men. Attendance to intervention programs was low and there was no significant difference between physical activity recorded at baseline and at follow-up. A slightly increased adherence to the healthy diet recommendations was observed for males. Waist circumference, systolic and diastolic blood pressure, fasting glucose and triglycerides did not change significantly, whereas weight, BMI and total cholesterol did. At follow-up the prevalence of MetS decreased, though not significantly, only in women (from 54,1 to 45.2%). Moreover, in women the negative correlation with education level was lost. This pilot study, even if with some limitations, suggests that MetS can be prevented and/or treated by simple and sustainable methods.

Abstract 17960: Influence of a Weight Management Intervention for Overweight and Obese Cardiac Rehabilitation Patients on Macronutrient Dietary Intake and Use of Weight Loss Strategies

Introduction: The majority of cardiac patients who enter cardiac rehabilitation (CR) are overweight. However, few patients lose enough weight to reduce their risk for heart disease. Purpose: To examine the influence of a weight management (WM) intervention for overweight and obese CR patients on the outcomes of dietary macronutrient (protein, carbohydrate, and fat) intake and use of WM strategies. Methods: Overweight or obese CR patients were randomized to a 12-week WM intervention (n=22) or usual care (UC) (n=21) group. Baseline, 4- and 6-month data were obtained after cardiac revascularization [coronary artery bypass surgery (CABS) or percutaneous coronary intervention (PCI)]. The 3-day diet diary, analyzed with the Minnesota Nutrition Data System V5.0, measured dietary macronutrient intake. The Diet and Exercise Self-Management survey measured subjects’ use of WM strategies. Results: Using RM ANCOVA, there were no significant group * time interactions controlling for % of calories from dietary fat, carbohydrate or protein intake at baseline. There were significant main effects by group, with the WM group having a significantly [F(1, 38)=4.2, p=.04] lower % intake of calories from dietary fat (29.9% compared to 34.1% for the UC group); and a significantly [F(1,38)=8.5, p=.006] higher % intake of calories from protein intake (23.7% compared to 19.9% for the usual care group). At 4-months after CABS or PCI, the WM group reported significantly higher use of WM diet behavior strategies for self-monitoring diet intake [F(1,38)=11.3, p=.002], planning [F(1,38)=9.7, p=.003], preparing and buying [F(1,38)=12.2, p=.001], and portion control [F(1,38)=7.8, p=.008]. Conclusions: The WM intervention influenced percentages of macronutrient dietary intake consistent with heart healthy diet recommendations. The WM intervention had an impact on improving reported use of weight loss strategies. Findings support the importance of a WM intervention for overweight and obese cardiac patients to improve weight outcomes not achieved in CR participation alone. Further research in a larger, controlled study is needed to examine how WM strategies can be integrated as an augmented intervention into standard CR.

Long-term Adherence to Healthy Dietary Guidelines and Chronic Inflammation in the Prospective Whitehall II Study

BackgroundInflammation plays an important role in the cause of cardiovascular diseases and may contribute to the association linking an unhealthy diet to chronic age-related diseases. However, to date the long-term associations between diet and inflammation have been poorly described. Our aim was to assess the extent to which adherence to a healthy diet and dietary improvements over a 6-year exposure period prevented subsequent chronic inflammation over a 5-year follow-up in a large British population of men and women. MethodsData were drawn from 4600 adults (mean ± standard deviation, age 49.6 ± 6.1 years, 28% were women) from the prospective Whitehall cohort II study. Adherence to a healthy diet was measured using Alternative Healthy Eating Index (AHEI) scores in 1991-1993 (50.7 ± 11.9 points) and 1997-1999 (51.6 ± 12.4 points). Chronic inflammation, defined as average levels of serum interleukin-6 from 2 measures 5 years apart, was assessed in 1997-1999 and 2002-2004. ResultsAfter adjustment for sociodemographic factors, health behaviors, and health status, participants who maintained a high AHEI score (ie, a healthy diet, n = 1736, 37.7%) and those who improved this score over time (n = 681, 14.8%) showed significantly lower mean levels of interleukin-6 (1.84 pg/mL, 95% confidence interval [CI], 1.71-1.98 and 1.84 pg/mL, 95% CI, 1.70-1.99, respectively) than those who had a low AHEI score (n = 1594, 34.6%) over the 6-year exposure period (2.01 pg/mL, 95% CI, 1.87-2.17). ConclusionsThese data suggest that maintaining and improving adherence to healthy dietary recommendations may reduce the risk of long-term inflammation.

Attachment anxiety predicts poor adherence to dietary recommendations: an indirect effect on weight change 1year after gastric bypass surgery.

Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whether attachment representations are associated with dietary adherence, (2) whether dietary adherence and weight loss are correlated and (3) whether dietary adherence mediates the relation of attachment representations with weight reduction after gastric bypass surgery. Besides attachment representations, psychological problems are examined. This longitudinal study included 105 patients who had a laparoscopic Roux-en-Y gastric bypass operation. Current and past psychological problems and attachment representations were assessed before surgery. Dietary adherence was assessed 6 and 12 months postsurgery. Patients' weight and height were collected from medical records. Multiple linear and logistic regression analyses and mediation analyses using bootstrapping resampling procedures were conducted. Of all examined predictor variables, attachment anxiety, i.e., fear of social rejection and abandonment, was most strongly associated with low dietary adherence at both 6 months (p = 0.009) and 12 months (p = 0.006) postsurgery. Dietary adherence 6 months postsurgery was associated with weight loss 1 year after the operation (p = 0.003). Dietary adherence at 6 months (β = 0.51; 95% confidence interval (CI) = 0.19-1.04) mediated the association between preoperative attachment anxiety and postoperative weight loss. The results suggest that more anxiously attached patients are less adherent to dietary recommendations 6 months after gastric bypass surgery, influencing weight loss in a negative way during the first year after surgery.

A Survey on - Healthy Diet Recommendation System using Web Data Mining

In this busy scheduled life, People usually don't care about their health. It makes the person follow unhealthy food habits in the name of saving time. So it has become very essential for the people to have a good balanced healthy diet. People set a bigger possibility of countering free radicals and warding off illness by consumption of healthy foods and by increasing their resistant system. We know the dictum Health is Wealth. Very often the desperate search for wealth takes its toll on one's health. It brings along with its stress, high cholesterol, high blood pressure, ulcers and diabetes. It deprives a man of the necessary physical exercise. Due to the poor eating habits people suffer from many diseases. In the current scenario fast food become important food in daily routine because it is effortlessly available but taking fast food in routine may cause for disease like heart attack, diabetics etc. Healthier diets help us to maintain our health and keep us away from many diseases. For better recovery from diseases or surgery etc individual have special needs according to their medical profile, cultural backgrounds and nutrient requirements. Design and implementation of healthy diet recommendation system is based on web data mining which is the application of data mining technique help us to determine pattern from web. This paper focuses on accuracy and time performance analysis of recommendation system using two decision tree learning algorithm ID3 and C4.5 and apply it on healthy diet application.

Adoption of American Heart Association 2020 Ideal Healthy Diet Recommendations Prevents Weight Gain in Young Adults

In 2010, the American Heart Association established the concept of ideal cardiovascular health. Nationally representative data estimated that <1% of Americans meet the seven health metrics required for achieving ideal cardiovascular health, with the main challenge residing in meeting the criteria for an ideal Healthy Diet Score. In a cohort of young adults (N=196), we aimed to investigate the prevalence of ideal cardiovascular health and ideal Healthy Diet Score and its association to weight gain over a 4-year follow-up period. Anthropometric measures, blood pressure, and blood samples were taken according to standardized procedures. Dietary intake was measured by a 3-day food diary and verified by a registered dietitian. We observed that only 0.5% of our sample met the criteria for ideal cardiovascular health and only 4.1% met the criteria for an ideal Healthy Diet Score. The components of the Healthy Diet Score with the lowest observance were consumption of fruits and vegetables (9.7%) and whole grains (14.8%). Meeting zero or one out of five of the Healthy Diet Score components was associated with increased risk of weight gain over 4 years compared with meeting at least two components (P=0.03). With the exception of dietary criteria, prevalence was high for achieving ideal levels of the remaining six cardiovascular health metrics. In conclusion, in this sample of young adults, a very low prevalence of ideal overall cardiovascular health was observed, mainly driven by poor dietary habits, and a poor Healthy Diet Score was associated with increased weight gain.

Reflexão sobre a imigração japonesa no Brasil sob o ângulo da adiposidade corporal

Migrant populations represent a good opportunity to investigate the role of environmental factors for the genesis of obesity and its comorbidities. The Japanese-Brazilian Diabetes Study Group studied the prevalence of diabetes and related disorders in Japanese-Brazilians from Bauru, SP, in 1993. Using specific criteria for Asian, 22.4% of the Japanese-Brazilians were found as having overweight in this first phase of the study. In the second phase, in 2000, this prevalence increased to 44.2% and 50.3% had central obesity. This population also had high prevalence of type 2 diabetes, hypertension and dyslipidemia, components of the metabolic syndrome. The JBDS Group also showed the association between Occidentalized habits, mainly a rich saturated-fat-diet, and the occurrence of the metabolic syndrome. In 2005, motivated by these findings, the JBDS Group started the third phase of the study which was an intervention program based on healthy diet and physical activity recommendations, using resources that could be feasible in terms of public health in Brazil. After one year-intervention program, the JBDS Group observed a decrease in anthropometric parameters, blood pressure and plasma glucose and cholesterol levels. It will be necessary a longer follow-up to evaluate the maintainance of these benefits and their impact in the risk development of diabetes and cardiovascular events.

Serum Lipids and Postprandial Glucose and Insulin Levels in Hyperlipidemic Subjects after Consumption of an Oat β-Glucan-Containing Ready Meal

Background/Aims: To investigate whether a daily intake of a nutrient-balanced ready meal containing 4 g of oat β-glucans lowers total cholesterol (T-C) and low-density-lipoprotein cholesterol (LDL-C) in hyperlipidemic subjects and to evaluate its effect on postprandial glucose and insulin concentrations. Methods: A parallel, placebo-controlled trial was carried out in 43 healthy men and women with elevated serum cholesterol levels. During the 3-week run-in period, all subjects consumed daily a ready-meal soup, low in energy and fat and high in fiber but without oat β-glucans. Subjects were then randomly assigned for the following 5-week intervention period to either continue consumption of the control soup or an equal soup supplemented with β-glucan. Results: Consumption of the β-glucan-enriched ready meal decreased T-C (0.22 ± 0.41 mmol/l) and LDL-C (0.16 ± 0.36 mmol/l), but the reductions were not significantly lower compared with control. After a meal with β-glucan soup, neither postprandial glucose nor insulin concentrations were significantly different from those after a control soup. Conclusion: A daily dose of 4 g of oat β-glucans incorporated into a healthy ready meal did not significantly lower T-C and LDL-C compared with an equal ready meal without β-glucans. Thus, if a food product fulfils general healthy dietary recommendations it may not necessarily be a candidate for supplementation with β-glucans.

US consumers' perceptions of the importance of following the US dietary guidelines

This study examines the factors affecting perceptions by US consumers about the importance of following each type of healthy diet recommendation based on the Dietary Guidelines for Americans. Results generally suggest that individuals from the Northeast and non-metropolitan areas, males, less educated, not on a special diet, and those who have a lower perception of the overall importance of nutrition when food shopping are generally less likely than their counterparts to perceive individual diet recommendations as important. Income, age, and body mass index also are significant factors for some individual healthy diet recommendations. Understanding consumers' perceptions about the importance of choosing healthy diets is an important preliminary step in changing dietary behavior and nutrition policies. Given worldwide trends toward Westernized diets and resulting increases in related health problems, the findings of this study may have relevance not only in the US but also globally.