Healthy Eating Index Scores Research Articles

Healthy eating index and bone health markers in adults with metabolically healthy and unhealthy obese phenotypes.

The Healthy Eating Index (HEI) estimates the diet quality, and low HEI scores are associated with adverse bone outcomes. However, the relationship between HEI scores and bone health in individuals who are obese but otherwise healthy or obese with comorbidities remains unclear. We aimed to evaluate the association of HEI scores with bone mineral density (BMD), bone regulating hormones and bone turnover markers in individuals with metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) phenotypes. This was a cross-sectional analysis of 122 adults who were overweight or obese. A questionnaire was completed to obtain demographic data. Body composition and BMD were assessed by a Dual Energy X-Ray Absorptiometry (DXA) exam. The HEI scores and dietary components were calculated using a 24-h dietary recall. Blood samples were collected for the analysis of serum 25-hydroxyvitamin D (s25OHD), total osteocalcin (OC), parathyroid hormone (PTH), and C-terminal telopeptide (CTx) concentrations. The MHO and MUO phenotypes were classified according to the absence or presence of metabolic abnormalities. The sample mean age was 37.91 ± 12.66 years, 50.8% were men, mean body mass index (BMI) was 30.01 ± 4.63 kg/m2, and 45.9% were classified as the MUO phenotype. The mean HEI scores were 54.42 ± 16.25 and 61.48% had low-diet quality. HEI scores were positively associated with s25OHD in the MUO phenotype group (β = 0.194, 95%CI = 0.038-0.350, p = 0.016). Certain dietary score components, such as fruits, seafood and plant protein, added sugars, whole grains, and fatty acids were also associated with bone health markers. However, HEI scores were not associated with BMD measures, neither with other bone regulating hormones and turnover markers. There was a positive association between HEI scores and s25OHD in adults who were overweight or obese with MUO phenotype. Additionally, the adequate consumption of specific food groups may benefit bone mass and metabolism. These results emphasize the importance of lifestyle interventions encouraging healthy eating habits to prevent s25OHD deficiency, poor bone health, and cardiometabolic complications.

Assessing the acceptability and feasibility of using a computerized food frequency questionnaire (FFQ) to determine dietary patterns in survivors of head and neck cancer (HNC).

e24103 Background: Malnutrition and poor dietary habits are associated with worse outcomes and decreased quality of life (QOL) in patients with HNC. Given the lack of standardized assessment of diet in survivors of HNC but the concern for long term malnutrition risk, we piloted a recently developed computerized FFQ that provides individualized dietary feedback (Vioscreen) in survivors of HNC. We sought to assess its feasibility and acceptability and explore associations between diet quality, QOL, and patient/treatment characteristics. Methods: We recruited HNC patients who had completed cancer treatment (radiation alone, chemoradiation, surgery/radiation, surgery/chemoradiation) at least 6 months prior to study enrollment who did not have a feeding tube. Dietary assessment was conducted using Vioscreen. Dietary quality was defined by Healthy Eating Index (HEI) and calculated by the participant’s response. All patients received an individualized feedback report. Patients also completed the EORTC QLQ-C30 and H&N35. At 6 weeks, we administered an acceptability questionnaire on usability of Vioscreen and perceived dietary changes. Results: 50 patients consented to participate. Of these, 34 (68%) completed all initial questionnaires. Of the 34 participants, majority were white/non-Hispanic, male, with oropharynx primaries, and median time from treatment was 68.4 months. Of the 27 who completed acceptability, 15 (56%) considered the Vioscreen tool to be useful, 9 (36%) reported they made changes to diet, and 16 (59%) would recommend to others. Mean HEI score was 63.2 (SD 11.3). There were no statistically significant differences in HEI scores between participants who were male vs female or based on time from treatment. There was a numeric difference in HEI scores for those with oral cavity/larynx cancers vs. oropharynx (58.3 vs 65.6; p = 0.06), and those with bimodality vs. trimodality treatment (66.1 vs 57.3; p = 0.07), but this did not reach statistical significance. There was a significant positive correlation with higher HEI scores and less trismus as reported on the EORTC H&N35 questionnaire (r = .49, p < .01). Additionally, the participants who found the Vioscreen useful were less likely to report swallowing difficulties on the EORTC H&N35 (p = 0.046) and less likely to have had surgery as part of treatment (p = 0.046). Conclusions: For survivors of HNC, Vioscreen was useful to > 50% of participants. Diet quality and swallowing issues were worse in patients receiving trimodality treatment; those reporting more swallowing complaints also reported the Vioscreen tool was less useful. Thus, using Vioscreen as a stand-alone intervention may be insufficient for these populations. Future studies will couple the Vioscreen FFQ with a nutrition counseling intervention.

Influence of genetic predisposition and lifestyle on modifiable cardiovascular risk factors among survivors of childhood cancer.

10061 Background: We aimed to evaluate associations between polygenic risk score (PRS), and lifestyle with cardiovascular risk factors (CVRFs) assessed as continuous phenotypes (LDL, HDL, triglycerides, fasting glucose [FG], systolic [SBP] and diastolic blood pressure [DBP]) among childhood cancer survivors. Methods: Participants included 2,347 White survivors (mean age=35.5 (±9.3) years) enrolled in the St. Jude Lifetime Cohort. Phenotype-specific PRS (derived from general population) were divided into tertiles and survivors classified as being at low-, intermediate-, or high-genetic risk. Lifestyle, classified as good, intermediate, or poor, was assessed based on four factors (smoking [yes/no], physical activity [meeting CDC guidelines for physical activity], diet quality [Healthy Eating Index score >59], and obesity [BMI≥30kg/m2]). A general linear model was created for each CVRF in which the effect of lifestyle (good, intermediate, poor) was examined within genetic risk group (low, intermediate, high), adjusting for sex, age, cancer therapies and current medication use. Results: The table shows worsening CVRF profiles associated with declining lifestyle and with increasing genetic risk. For example, among survivors with poor lifestyle-high genetic risk, SBP and DBP were higher on average by 14 (95% CI = 9-18) and 9 (95% CI = 6-12) mmHg respectively, compared to survivors with good lifestyle-low genetic risk. In analyses restricted to survivors with high genetic risk, mean SBP (7, 95% CI=2-12) mmHg, DBP (4, 95% CI=1-7) mmHg, triglyceride (61, 95% CI=5-117) mg/dL, and FG (7, 95% CI=4-10) mg/dL values were higher among survivors with poor versus good lifestyle, while mean HDL was lower (-13, 95% CI= -8- -18) mg/dL. Conclusions: While the risk of CVRFs among cancer survivors are associated with high genetic risk and cancer therapies, healthy lifestyle choices may partially ameliorate perturbations in CVRFs even among those with high genetic risk. Our findings highlight the importance of developing interventions targeting modifiable behaviors in this high-risk population. [Table: see text]

Pre-diagnosis dietary patterns and risk of multiple myeloma in the NIH-AARP cohort.

10635 Background: Despite patient interest in knowing whether diet is linked to multiple myeloma (MM), there is limited research on dietary patterns and MM risk (Malik et al. BCJ 2022). Two studies have assessed this risk, albeit with a small number of MM cases. The EPIC-Oxford cohort and Oxford Vegetarian study (65 MM cases) showed that fish eaters, vegetarians and vegans had significantly reduced MM risk compared to meat eaters (Key et al. AJCN 2014). The Nurses’ Health Study and Health Professionals Follow-up Study (478 MM cases) showed a significantly increased MM risk in men with Empirical Dietary Inflammatory Pattern (Lee et al. JNCI Can Spectr 2019). To our knowledge, this is the largest epidemiologic study to date assessing pre-diagnosis dietary patterns and MM risk. Methods: The NIH-AARP Diet and Health study is a prospective cohort of 567,169 persons who completed a food frequency questionnaire in 1995-1996 and were followed until December 2011. Healthy Eating Index-2015 (HEI-2015), Healthy Diet Score (HDS), alternate Mediterranean Diet (aMED) and healthful Plant-based Diet Index (hPDI) scores were calculated using a priori defined methods and grouped into quartiles, with higher scores reflecting healthier eating patterns. We prospectively evaluated the association between pre-diagnosis dietary patterns and MM incidence in this cohort. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using multivariate Cox proportional hazards models adjusted for age at study entry, sex, race, body mass index, education, and total energy intake (by residual method). Sensitivity analysis was conducted to assess reverse causality by excluding MM cases diagnosed within one year of follow-up. Results: Among 392,589 participants (after exclusions), a total of 1,366 MM cases (59% males; 92% non-Hispanic whites) were identified during the follow-up period. Analysis revealed a significant association between hPDI scores and reduced MM risk (highest vs lowest quartile, HR 0.85; 95%CI 0.73-1.0; p=0.043) (Table). In sensitivity analysis (1,302 MM cases), the association was no longer significant (HR 0.87; 95%CI 0.74-1.03; p 0.09) but trended in the same direction. This may be due to small sample size, given MM is a rare disease. HEI-2015, HDS and aMED scores were not associated with MM risk. Conclusions: A healthful plant-based diet was associated with reduced MM risk in the NIH-AARP cohort. These results will help oncologists and patients make informed choices about their diet. [Table: see text]

Nutritional status of Syrian female migrants in Turkey: a cross- sectional study

<p>It is known that individuals who are immigrants experience malnutrition due to various reasons. The present study was conducted to compare the nutritional status of immigrant women, who arrive in Turkey from Syria, before and after migration, and to determine the factors that affect their current healthy eating index scores. The individuals participating in the study were recruited from Immigrant Health Unit in Mardin-Turkey. The sampling of this cross-sectional study consisted of the women who were between the ages of 15-49, 450 Syrian migrant women participated in the study. The data were collected with face-to-face interview technique and with a questionnaire that consisted of 2 parts. According to the Healthy Eating Index (HEI)-2015 score of the individuals mean was found to be 52.90±9.40. According to the hierarchical regression model, the monthly income, life expectancy in Turkey, body mass index (BMI), and the number of individuals in the family were statistically significant components to predict the mean HEI score. It was determined that the basic eating habits of individuals changed in the country of immigration, and more foods with high carbohydrate and saturated fat contents were consumed. It is required to design comprehensive studies and policies.</p>

Potential Renal Acid Load, Salivary Buffer Capacity and Healthy Eating Index as Predictors of Children's Dental Caries: A Cross-Sectional Study.

Dental caries is one of the most common childhood diseases. This study purposed to investigate the prediction capability of potential renal acid load(PRAL), salivary buffer capacity (SBC), and Healthy Eating Index (HEI) on children's dental caries. The decay, missing, filing, and teeth for primary teeth (dmft)/Decay, Missing, Filling, and Teethfor permanent teeth (DMFT) indexes of the children aged 7-12 years who applied to our faculty were recorded. Approximately 1 mL of unstimulated saliva samples were collected, and SBC was evaluated. PRAL and HEI scores were calculated by entering the data in the form of a daily nutrition record of the children into the BeBiS software (Ebispro for Windows, Stuttgart, Germany). The association of dental caries indices with PRAL, SBC, and HEI was analyzed using an independent samplet-test. A binomial logistic regression analysis was performed to predict the dental caries burden. The statistical significance level was adjusted to a=0.05. A total of 150 children, 88 (58.6%) females and 62 (41.4%) males, were included in the study. Significant differences were found between the low and high dental caries groups for dmft regarding PRAL and SBC (p<0.001). A significant difference was found between the low and high dental caries groups for DMFT in terms of SBC (p<0.05). In our study, established regression models significantly predicted dental caries in primary teeth. SBC was the most influential factor in predicting dental caries compared to PRAL and HEI. There was a significant relationship between SBC, PRAL, and caries in primary teeth. In the model we created, the strongest predictor was SBC.

Nutrition Practices of Family Child Care Home Providers and Children's Diet Quality

ObjectiveTo examine the relationship between the diet quality of children aged 2–5 years cared for in family child care homes (FCCHs) with provider adherence to nutrition best practices. DesignCross-sectional analysis. ParticipantsFamily child care home providers (n = 120, 100% female, 67.5% Latinx) and children (n = 370, 51% female, 58% Latinx) enrolled in a cluster-randomized trial. Main Outcome MeasuresData were collected over 2 days at each FCCH. The Environment and Policy Assessment and Observation tool was used to document whether providers exhibited nutrition practices on the basis of the Nutrition and Physical Activity Self-Assessment for Child Care. Each practice was scored as either present or absent. Children's food intake was observed using Diet Observation at Child Care and analyzed with the Healthy Eating Index–2015. AnalysisMultilevel linear regression models assessed the association between providers exhibiting best practices regarding nutrition and children's diet quality. The model accounted for clustering by FCCH and controlled for provider ethnicity, income level, and multiple comparisons. ResultsChildren in FCCHs in which more of the best practices were implemented had higher diet quality (B = 1.05; 95% confidence interval [CI], 0.12–1.99; P = 0.03). Specifically, children whose providers promoted autonomous feeding (B = 27.52; 95% CI, 21.02–34.02; P < 0.001) and provided nutrition education (B = 7.76; 95% CI, 3.29–12.23; P = 0.001) had higher total Healthy Eating Index scores. Conclusions and ImplicationsFuture interventions and policies could support FCCH providers in implementing important practices such as autonomy feeding practices, talking informally to children about nutrition, and providing healthful foods and beverages.

Healthy eating index (HEI) as the predictor of asthma: Findings from NHANES

Previous studies have shown that the formation and development of asthma are closely related to diet. A proper diet can control asthma onsetalthough the precise dietary components involved in preventing or delaying the onset of asthma remain unclear. The healthy eating index (HEI-2015) is a dietary score that measures the overall diet quality as well as the quality of several dietary components. We aimed to explore the relationship between HEI and asthma. This is a cross-sectional study that used data from the 2005 to 2018 National Health and Nutritional Examination Survey (NHANES) in adults (n=26,567). Our inclusion criteria were adults ≥18 years, completion of asthma-related questionnaires and availability of HEI data. Weighted logistic regression was performed to assess the association between asthma and HEI after adjusting for several covariates. Patients with asthma were more likely to be female, come from a poorer background, have a raised body mass index (BMI) and a lower HEI total score. Higher HEI total scores were associated with a lower risk of asthma in adults. In addition, eating more whole fruits, more greens and beans, more total protein foods, more seafood and plant proteins, and having a reduced dietary intake of added sugars reduces the risk of asthma. In asthmatic populations, higher HEI scores are associated with older age at onset of asthma. There is an inverse association between the HEI and asthma. This underlines the importance of improving adherence to healthy dietary patterns in the prevention of asthma.

Dietary Macronutrient Composition and Quality, Diet Quality, and Eating Behaviors at Different Times Since Laparoscopic Sleeve Gastrectomy.

This study aimed to compare energy, macronutrients (quantity and quality), the overall dietary quality, and eating behaviors of patients undergoing laparoscopic sleeve gastrectomy (LSG) at different times since surgery. This cross-sectional study included 184 adults at least 1 year post-LSG. Dietary intakes were assessed by a 147-item food frequency questionnaire. Macronutrient quality was assessed by computing the macronutrient quality index (MQI), carbohydrate quality index, fat quality index, and healthy plate protein quality index (HPPQI). The Healthy Eating Index (HEI)-2015 was used to assess diet quality. The Dutch Eating Behavior Questionnaire was used to assess eating behaviors. Based on the time since LSG, the time at which eating data were also collected, participants were categorized into three groups: 1-2 years (group 1), 2-3 years (group 2), and 3-5 years (group 3). Group 3 consumed significantly more energy and absolute carbohydrates than group 1. The MQI and HPPQI scores of group 3 were significantly lower than those of group 1. The HEI score was significantly lower in group 3 compared to group 1, with a mean difference of 8.1 points. Compared to patients with 1-2 years following LSG, those with 2-3 and 3-5 years consumed more refined grains. Eating behavior scores did not differ between groups. Patients at 3-5 years post-LSG consumed more energy and carbohydrates than those at 1-2 years after the surgery. Protein quality, overall macronutrient quality, and overall diet quality decreased as time passed following surgery.

Mood disturbance, but not overall diet quality, is associated with fecal microbiome diversity in free-living adults

ABSTRACT Objectives To investigate the gut-brain axis, we explored the relationships among mood disturbance (MD), diet quality (DQ), and fecal microbiota in free-living adults. Methods A cross-sectional analysis was conducted with data from 75 healthy adults enrolled in two studies. Anthropometrics, 16s rRNA gene sequencing of fecal microbes, DQ as assessed by Healthy Eating Index-2015 (HEI), and MD determined by Profile of Mood States (POMS) were included. Alpha-diversity and DQ differences were explored between low (n = 37) and high MD (n = 38) groups. Spearman correlations were used to investigate relationships between alpha-diversity, DQ, and POMS subscales. Moderation analysis explored the effect of HEI score on the relationship between MD and alpha-diversity. Results Participants were mostly white (67%), 54.5 years old (±11.8), and overweight (28.5 ± 6.5 kg/m2). Shannon and Simpson indices indicate higher alpha-diversity in participants with low MD compared to high MD (p = 0.004 and p = 0.008, respectively). Simpson and Shannon indices were correlated with subscale of anger (rho = −0.303, p = 0.011; rho = −0.265, p = 0.027, respectively)and total MD (rho = −0.404, p = 0.001; rho = −0.357, p = 0.002, respectively). Refined grains were associated with fatigue and tension subscales (rho = 0.428, p < 0.001; rho = 0.302, p = 0.014, respectively). DQ did not significantly moderate the relationship between alpha-diversity and mood disturbance (F(7, 53) = 2.00, p = 0.072, R 2 = 0.209). Shannon index was a significant predictor of MD (b = −4.39, t(53) = −2.55, p = 0.014), but total HEI score and the interaction (Shannon index*HEI score) were not significant. Discussion Greater bacterial diversity was associated with lower MD, and DQ was associated with various mood state subscales in this sample of adults.

Diet quality and anthropometric indices of patients undergone bariatric surgery: the prospective Tehran obesity treatment study

BackgroundPatients undergone bariatric surgery (BS) has long-term risks including decrease in diet quality, nutritional deficiencies and weight regain. This study focus on assessing dietary quality and food group components in patients one year after BS, the relationship between dietary quality score and anthropometric indices, and also evaluating the trend of body mass index (BMI) of these patients three years after BS.MethodsA total of 160 obese patients (BMI ≥ 35 kg/m2) were undergone sleeve gastrectomy (SG) (n = 108) or gastric bypass (GB) (n = 52), participated in this study. They were assessed for dietary intakes using three 24-hour dietary recalls one year after surgery. Dietary quality was assessed using food pyramid for post BS patients and healthy eating index (HEI). Anthropometric measurements were taken pre-surgery and 1, 2 and 3 years after operation.ResultsThe mean age of patients was 39.9 ± 11 years (79% female). The mean ± SD percentage of excess weight loss was 76.6 ± 21.0 one year after surgery. Intake patterns are generally (up to 60%) not consistent with the food pyramid. The mean total HEI score was 64 ± 12 out of 100. More than %60 of participants is exceeding the recommendations for saturated fat and sodium. The HEI score did not show significant relationship with anthropometric indices. The mean of BMI in SG group increased over three years of follow up, while in GB group, there were no significant differences in BMI during three years of follow up.ConclusionsThese findings showed that patients had not healthy pattern intake one year after BS. Diet quality did not show significant relationship with anthropometric indices. The trend of BMI three years after surgery was different based on surgery types.

Improving school lunch menus with multi-objective optimisation: nutrition, cost, consumption and environmental impacts.

To support school foods programmes by evaluating the relationship between nutritional quality, cost, student consumption and the environmental impacts of menus. Using linear programming and data from previously served menu items, the relationships between the nutritional quality, cost, student consumption and the environmental impacts of lunch menus were investigated. Optimised lunch menus with the maximum potential student consumption and nutritional quality and lowest costs and environmental impacts were developed and compared with previously served menus (baseline). Boston Public Schools (BPS), Boston Massachusetts, USA. Menu items served on the 2018-2019 BPS lunch menu (n 142). Using single-objective models, trade-offs were observed between most interests, but the use of multi-objective models minimised these trade-offs. Compared with the current weekly menus offered, multi-objective models increased potential caloric intake by up to 27 % and Healthy Eating Index scores by up to 19 % and reduced costs and environmental impacts by up to 13 % and 71 %, respectively. Improvements were made by reducing the frequency of beef and cheese entrées and increasing the frequency of fish and legume entrées on weekly menus. This work can be extrapolated to monthly menus to provide further direction for school districts, and the methods can be employed with different recipes and constraints. Future research should test the implementation of optimised menus in schools and consider the broader implications of implementation.

Impact of Dietary Quality on Genital Oncogenic Human Papillomavirus Infection in Women.

Most cervical cancers are directly linked to oncogenic or high-risk human papillomavirus (HR-HPV) infection. This study evaluates associations between diet quality and genital HPV infection in women. This study included 10 543 women from the 2003-2016 National Health and Nutrition Examination Survey. The outcome was the genital HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV). Dietary quality was evaluated using the Healthy Eating Index (HEI), in which a higher score indicates a better diet quality. Women who did not consume total fruits (15.8%), whole fruits (27.5%), or green vegetables and beans (43%) had a significantly higher risk of HR-HPV infection than women who complied with the Dietary Guidelines for Americans (HR-HPV odds ratio = 1.76, 1.63, and 1.48 for a HEI score of 0 vs 5, respectively) after adjusting confounding factors. Similar results of these food components on LR-HPV infection were found. In addition, intake of whole grains and dairy was inversely associated with LR-HPV infection. This study showed that women who did not eat fruits, dark-green vegetables, and beans had a higher risk of genital HR-HPV infection. Intake of these food components is suggested for women to prevent HPV carcinogenesis.

Dietary per- and polyfluoroalkyl substance (PFAS) exposure in adolescents: The HOME study

BackgroundDiet is the primary exposure pathway for per- and polyfluoroalkyl substances (PFAS) in non-occupationally exposed populations. Few studies have examined associations of dietary quality and macronutrient intake with PFAS exposure among US adolescents. ObjectiveTo assess relationships of self-reported dietary quality and macronutrient intake with serum PFAS concentrations in adolescents. MethodsWe used cross-sectional data from 193 Cincinnati, Ohio area adolescents (median age 12.3 years) collected from 2016 to 2019. Using 24-h food recalls completed by adolescents on three separate days, we derived Healthy Eating Index (HEI) scores, HEI components, and macronutrient intake. We measured perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) concentrations in fasting serum samples. Using linear regression, we estimated covariate-adjusted associations between dietary variables and serum PFAS concentrations. ResultsThe median HEI score was 44 and median serum PFOA, PFOS, PFHxS, and PFNA concentrations were 1.3, 2.4, 0.7, and 0.3 ng/mL respectively. In adjusted models, higher total HEI scores, whole fruit and total fruit HEI component scores, and total dietary fiber intake were associated with lower concentrations of all four PFAS. For example, serum PFOA concentrations were 7% lower (95% CI: −15, 2) per standard deviation increase in total HEI score and 9% lower (95% CI: −18, 1) per standard deviation increase in dietary fiber. SignificanceGiven adverse health effects associated with PFAS exposure, it is crucial to understand modifiable exposure pathways. Findings from this study may inform future policy decisions aiming to limit human exposure to PFAS.

Association Between County-Level Food Retail and Socioeconomic Environment and Nutritional Quality of Household Food Purchases, 2015.

About 40 million Americans do not have easy access to affordable nutritious foods. Healthier foods are less likely to be available to those living in rural and/or lower-income communities. The objective of this study was to analyze the association between nutritional quality of household food purchases and county-level food retail environment; county-level demographic, health, and socioeconomic indicators; and household composition, demographic characteristics, and socioeconomic characteristics. This study is a secondary analysis of the 2015 Information Resources Inc Consumer Network panel; Purchase-to-Plate Crosswalk, which links US Department of Agriculture nutrition databases to Information Resources Inc scanner data; County Health Rankings; and the Food Environment Atlas data. A total of 63,285 households, representative of the contiguous US population, consistently provided food purchase scanner data from retail stores throughout2015. Nutritional quality of retail food purchases was assessed using the Healthy Eating Index 2015 (HEI-2015). Multivariate linear regression analysis was used to simultaneously test the relationship between the main outcome and household-level demographic and socioeconomic characteristics as well as the county-level demographic, health, socioeconomic, and retail food environment. Household heads who had higher education and households with higher incomes purchased food of better nutritional quality (ie, higher HEI-2015 scores). Also, the association between retail food purchase HEI-2015 scores and the food environment was weak. Higher density of convenience stores was associated with lower retail food purchase nutritional quality for higher-income households and households living in urban counties, whereas low-income households in counties with higher specialty (including ethnic) store density purchased higher nutritional quality food. Both in the full sample and when stratified by household income or county rural vs urban status, no association was found between grocery store, supercenters, fast-food outlets, and full-service restaurant densities and retail food purchase HEI-2015 scores. HEI-2015 scores were negatively correlated with the county average number of mental health days for higher income and urban households. The study findings suggest that availability of healthier food alone may not improve healthfulness of retail food purchases. Future studies examining the influence of demand-side factors/interventions, such as habits, cultural preferences, nutrition education, and cost/affordability, on household purchasing patterns could provide complementary evidence to inform effective intervention strategies.

Association of Above-Average Healthy Eating Index and Pregnancy Outcomes [ID: 1375493

INTRODUCTION: Nutritional health plays an important role in the intrauterine environment's effect on the developmental origins of disease. The Healthy Eating Index (HEI), a measure of dietary quality scaled 0–100 with 100 being ideal, has been shown to be poor on average in Americans. In a prospective cohort study of healthy pregnant individuals with a singleton gestation, we assessed dietary quality and its association with pregnancy outcomes. METHODS: Individuals completed their first study visit at a mean gestational age of 15 weeks, and three, 24-hour dietary recalls were obtained. Participants were dichotomized by HEI scores as above and at or below the U.S. average (&gt;58 and ≤58). We assessed outcomes including gestational diabetes (GDM), hypertensive disorders of pregnancy (HDP), and large for gestational age (LGA &gt;90th percentile). Statistical analysis was completed using two-sample t tests and Fisher's exact tests (P=.05). The study was IRB approved. RESULTS: Of the 67 participants included in the analysis, 45 (67%) had above average and 22 (33%) had below average HEI scores. The incidence of HDP was significantly lower among individuals with higher dietary quality (22.8% versus 4.4%, P=.03). Although the rates of GDM were not different between the two groups (15.6% versus 9.1%, P=.71), the proportion of LGA infants trended lower in those with higher HEI (4% versus 22%, P=.19). CONCLUSION: Our data suggest that higher dietary quality may lead to improved pregnancy outcomes and support the potential role of the HEI for further exploring these relationships in future research.

Do Locus of Control Affect Anthropometric Measurements, Food Intake and Diet Quality in Adolescent Soccer Players?

Aim: This study was conducted to examine the effect of locus of control on anthropometric measurements, nutritional status, and diet quality in adolescent soccer players. Subjects and Method: The study involved 72 male soccer players between the ages of 14 and 18. The researcher utilized the Rotter Locus of Control Scale face-to-face to the athletes to ascertain their locus of control. The 3-day food consumption records of athletes were gathered in order to assess their nutritional state. The Healthy Eating Index-2015 was used to assess the athletes’ dietary quality. Results: The average score of the athletes on Rotter’s Locus of Control Scale was determined as 10.28 ± 3.15. The athletes’ ages, total weights, skeletal muscle weights, and body mass index values were found to have a positive and statistically significant weak connection with the players’ scores on the “Locus of Control”(r: 0.268; p = 0.023; p &lt;0.05). The Total Healthy Eating Index (HEI) score was 37.16±10.14 on average, 90.3% (n=65) of the athletes had a “poor” diet, and 9.7% (n=7) had a diet quality that needed improvement. There was no statistically significant relationship between the athletes’ total HEI score and Rotter’s Locus of Control Scale score (p&gt; 0.05). Regression analysis reveals that it is connected to skeletal muscle weight as a factor in determining the degree of the locus of control (F = 5.756; p = 0.019; p &lt;0.05). Conclusion: Findings related to locus of control of athletes are interesting, however, there is a need for more comprehensive studies that can determine the relationship of locus of control with anthropometric measurements and food intake.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

Trends in dietary patterns over the last decade and their association with long-term mortality in general US populations with undiagnosed and diagnosed diabetes

BackgroundDietary management plays an important role in diabetes care, while the trends in dietary patterns over the last decade in US adults with diagnosed and undiagnosed diabetes remain unknown. This study aims to estimate the dietary patterns over the last decade by baseline diabetes diagnoses and explore their association with long-term prognosis.MethodsParticipants’ data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2007–2018, which were divided into three groups according to the diabetes diagnosis: without diabetes, undiagnosed diabetes, and diagnosed diabetes. Healthy eating index (HEI) and dietary inflammatory index (DII) were used to evaluate dietary patterns. Survival analyses were adopted to estimate the association between HEI/DII scores and long-term all-cause mortality and cause-specific mortality.ResultsThe prevalence of diabetes was increasing among US adults over the last decade. HEI scores of all three groups presented a downward trend in recent years. Participants with undiagnosed diabetes (weighted mean: 50.58, 95% CI: 49.79, 51.36) got significantly lower HEI score in comparison to participants with diagnosed diabetes (weighted mean: 51.59, 95% CI: 50.93, 52.25). Compared with participants without diabetes, participants in the undiagnosed or diagnosed diabetes group had higher DII scores, indicating a higher dietary inflammatory potential. Survival analysis found a significant association between HEI scores and all-cause mortality and death of heart diseases. Similar correlation was observed in DII scores.ConclusionsAlong with the growth in diabetes prevalence in the US, dietary management of people with diabetes is decreasing. The management of US adults’ diets needs special attention, and dietary inflammatory potential may be considered in the dietary intervention.

Interactions of BDNF Val66met and dietary indices in relation to metabolic markers among patient with type 2 diabetes mellitus: a cross-sectional study

BackgroundGene–diet interaction is related to the progression of diabetes and cardiovascular diseases biomarkers. We aimed to evaluate the interaction between diet quality indices and BDNF Val66Mat (rs6265) on cardiometabolic markers among diabetic patients.MethodsThis cross-sectional study was conducted on 634 patients with type 2 diabetes mellitus, which were randomly recruited from diabetic centers in Tehran. Dietary intakes were estimated by a previously validated semi-quantitative food frequency questionnaire comprising 147 items. All participants were categorized into three categories, based on healthy eating index (HEI), diet quality index (DQI), and phytochemical index (PI) scores. Polymerase chain reaction was used for genotyping the BDNF Val66Met. Interactions were tested using analysis of covariance in adjusted and crude models.ResultsOur result showed that higher DQI, HEI, and PI scores significantly decrease body mass index and waist circumference among individuals with Met/Met, Val/Met, and Val/Val genotypes (P interactions < 0.05). Moreover, the highest quartile of the DQI and PI, compared to the lowest, showed lower TG level among Met allele carriers compared to Val/Val homozygotes (P interaction = 0.004 and 0.01, respectively) and a faster reduction in IL-18 and TC level was seen among Met/Met, Val/Met who had higher HEI intake than those with Val/Val genotype.ConclusionsBDNF Val66Met polymorphism may interact with HEI, DQI, and PI. We have revealed that Met allele acts as a protective allele for diabetic patients and may have a beneficial influence on cardio-metabolic factors through regulating dietary intake.