Healthy Eating Index Research Articles

Association between healthy eating index-2015 scores and metabolic syndrome among Iranian women: a cross-sectional study

BackgroundMetabolic syndrome (MetS) is one of the leading public health issues in the world with a reported prevalence of nearly 25% in the past decades in Iran. The present research aimed to identify the association between the Healthy Eating Index (HEI) and MetS components among female teachers.MethodsIn this cross-sectional study, 97 female teachers aged 31–57 years were enrolled from 2018 to 2019 in Qom, Iran. Usual dietary intakes were assessed using a validated 168-item Food Frequency Questionnaire (FFQ). HEI-2015 was calculated according to the consumption of whole fruits, vegetables, protein foods, beans, seafood, plant proteins, total and refined grain, dairy, fatty acid ratio, saturated fats, added sugars, and sodium. We also measured anthropometric and biochemical parameters. To evaluate the association between HEI-2015 and MetS, multivariate logistic regression was performed.ResultsMetS was found in 59.8% of participants. Total HEI-2015 scores were significantly lower in participants with MetS compared to those without MetS (59.69 ± 8.98 vs. 64.21 ± 8.71, respectively; p = 0.02). Daily energy intake, weight, body mass index, waist circumference, systolic and diastolic blood pressure, serum triglyceride, and fasting blood sugar levels were higher in women with MetS (all p < 0.05). Higher HEI-2015 total scores (OR: 0.94; 95% CI: 0.89–0.99; p = 0.02) and scores of total vegetables (OR: 0.62; 95% CI: 0.42–0.91; p = 0.02), dark green vegetables and beans (OR: 0.62; 95% CI: 0.39–0.98; p = 0.04), fatty acid ratio (OR: 0.83; 95% CI: 0.68–0.99; p = 0.04), refined grain (OR: 0.86; 95% CI: 0.75–0.99; p = 0.04), and added sugars (OR: 0.44; 95% CI: 0.26–0.75; p = 0.002) were all associated with lower odds of having MetS.ConclusionsHigher HEI-2015 scores, particularly in total vegetables, dark green vegetables, beans, and fatty acid ratio, as well as refined grain and added sugars were found to be associated with reduced odds of having MetS among Iranian female teachers. However, further prospective studies are required to confirm this finding.

Chewing Gum Is Associated with Better Diet Quality but Not Oral Health Measures in U.S. Adults

Objective Chewing gum (especially sugar-free gum) has been linked to improved oral health, however there is an absence of observational research using nationally-representative data in the United States. We sought to examine the factors associated with chewing gum and its relationship with the oral health status of U.S. adults. Methods Cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2013–2018 cycles were used in these analyses. Primary outcomes were the odds of having gum disease, treatment for gum disease, ever being told of bone loss around teeth, root caries, caries, and restoration. Unadjusted and multivariate logistic regression models were used to investigate the relationship of chewing gum use with demographic/lifestyle factors and the oral health status of participants. Results 2.40% (n = 365) of adults were users of chewing gum and the average among users was 5.20 ± 0.40 g/d. Users of chewing gum were more likely to be female, younger in age, and non-Hispanic Black or Hispanic. Self-reported chewing gum use did not affect the oral health status of U.S. adults (OR: 1.10, 95% CI: 0.42–2.88 for gum disease; OR: 1.34, 95% CI: 0.64–2.81 for treatment for gum disease; OR: 0.56, 95% CI: 0.27–1.17 for bone loss around teeth; OR: 1.01, 95% CI: 0.32–3.12 for root caries; OR: 0.96, 95% CI: 0.54–1.69 for caries), except for restoration (OR: 3.54, 95% CI: 1.78–7.06), but was associated with improved diet quality (OR: 1.86, 95% CI: 1.11–3.12 for a healthy eating index (HEI) of 51–59; OR: 1.96, 95% CI: 1.08–3.56 for HEI of 60–93); and decreased intakes of snacks (OR: 1.64, 1.01–2.69), and added sugars. Conclusion Future observational studies that more accurately capture chewing gum usage are needed, as these analyses have several limitations.

Associations of healthy eating index-2015 with osteoporosis and low bone mass density in postmenopausal women: a population-based study from NHANES 2007-2018.

The current study aimed to explore the associations of diet quality assessed by healthy eating index-2015 (HEI-2015) with risks of osteoporosis and low bone mineral density (BMD) among American postmenopausal women aged 50 years and older. Postmenopausal women aged 50 years and older in the National Health and Nutrition Examination Survey from 2007 through 2018 were included in the final sample. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across tertiles of HEI-2015. Univariate and multivariate weighted logistic regression models were employed to explore the associations of HEI-2015 tertiles and continuous HEI-2015 with the risks of osteoporosis and low BMD. Nonlinear dose-response associations were evaluated using weighted restricted cubic spline analyses, and the contributions of various HEI-2015 components were assessed using weighted quantile sum regression models. The final sample included 3,421 postmenopausal women aged 50 years and older representative for approximately 28.38 million non-institutionalized U.S. postmenopausal women. Osteoporosis prevalence decreased with HEI-2015 tertiles while the prevalence of low BMD showed no significant decrease. Compared with postmenopausal women in the first tertile of HEI-2015, those with the second (OR: 0.57, 95%CI: 0.38-0.84) and third (OR: 0.48, 95%CI: 0.29-0.78) HEI-2015 tertiles were associated with reduced osteoporosis risk after multivariate adjustments, but no significant association of HEI-2015 with the risk of BMD was identified. Furthermore, similar effects were confirmed in the sensitivity analyses and subgroup analyses and interaction effects. Moreover, significant nonlinear associations were observed between HEI-2015 with osteoporosis risk, and total vegetables, refined grains and greens and beans demonstrated the strongest protective effect among HEI-2015 components against osteoporosis. This study strongly suggests the significant negative associations of HEI-2015 with osteoporosis risk in American postmenopausal women. These findings highlight the importance of adherence to the dietary guidelines for Americans in reducing the risk of osteoporosis.

The Relationship between Healthy Eating Index and Lipid Profile in Healthy Individuals: A Systematic Review.

The Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI) are instruments developed by competing American research teams, aiming to assess the level of adherence to a dietary pattern, claimed to prevent chronic illness conditions such as dyslipidemia. This systematic review evaluated cross-sectional studies examining the association between HEI/AHEI score and the lipid profile in healthy participants. The systematic review was Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant, and a search process was conducted through Scopus, Web of Knowledge, Google Scholar, Cochrane, PubMed, and ScienceDirect up to November 2022. Studies assessing the relationship between HEI/AHEI and lipid profile (low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG)) were eligible for inclusion. The statistical differences in outcomes, anthropometric indices, and demographic data were extracted from the selected studies. Also, the quality assessment of studies was performed using the Newcastle-Ottawa scale. The systematic search presented 17 cross-sectional studies. Most of the studies revealed a significant correlation between HEI score and lipid profile (LDL-C, HDL-C, TG, and TC) (P < 0.05), while a few of them indicated a significant relationship between AHEI score and these factors. Overall, the elevation of HEI/AHEI score was associated with the improvement in lipid profile (P < 0.05), though this association was more obvious for HEI compared with AHEI. Overall, the results of the study indicated that an improved lipid profile in healthy individuals is associated with a higher score in either HEI or AHEI. Further research in the future is required to confirm the claim.

Adherence to the healthy eating index-2010 and alternative healthy eating index-2010 in relation to metabolic syndrome among African Americans in the Jackson heart study.

The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome. This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score. Hinds, Madison and Rankin counties, Mississippi, USA. African American adults, ages 21-94 years, 60·9 % female. Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03). These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.

Association between dietary quality and accelerated aging: a cross-sectional study of two cohorts.

Background: Diet quality significantly influences aging processes and age-related health outcomes. This study aims to explore the association between dietary quality and accelerated aging in two large cohorts. Methods: This study collected data from the Kailuan and National Health and Nutrition Examination Survey (NHANES) cohorts; participants' dietary quality was evaluated using the American Heart Association (AHA) dietary score and Healthy Eating Index-2015 (HEI-2015), respectively. Accelerated aging in participants was determined by calculating the difference between phenotypic age and chronological age. Logistic regression models were used to explore the association between dietary quality scores and accelerated aging. Additionally, variations in this association across different subgroups were investigated. To minimize the influence of excessive aging, individuals aged 75 and above were excluded in sensitivity analyses. Results: In this study, we included 33 701 participants (27.3% female, mean age 57.29 ± 11.88) from the Kailuan study and 9285 participants (50.6% female, mean age 49.83 ± 17.62) from NHANES. In the Kailuan cohort, individuals with dietary scores ranging from 3 to 5 exhibited a 22% lower risk of accelerated aging compared to those scoring between 0 and 2 (OR = 0.78, 95% CI = 0.72-0.85). Similarly, in the NHANES cohort, participants in the highest quartile of HEI-2015 experienced a 34% reduction in the risk of accelerated aging compared to those in the lowest quartile (OR = 0.66, 95% CI = 0.52-0.84). Subgroup analyses underscored a more pronounced association between dietary quality and accelerated aging among males and individuals with unhealthy lifestyles. Sensitivity analyses confirmed the robustness of the association between dietary quality and accelerated aging. Conclusion: In summary, our study found a significant association between dietary quality and accelerated aging. Better dietary quality was associated with a reduced risk of accelerated aging, particularly among males, smokers, and participants with unhealthy lifestyles.

Social jetlag and diet quality among US young adults: interactions with race/ethnicity

Abstract The objective was to examine associations between social jetlag and diet quality among young adults in the US using nationally representative data from the 2017–2018 NHANES survey, and evaluate effect modification by gender and race/ethnicity. Social jetlag was considered ≥2-hour difference in sleep midpoint (median of bedtime and wake time) between weekends and weekdays. Diet quality was assessed with the Healthy Eating Index (HEI)-2015 and its 13 dietary components. Ordinal logistic models were run with diet scores binned into tertiles as the outcome. Models accounted for potential confounders and survey weights. Effect modification by gender and race/ethnicity was examined. The study sample included 1,356 adults aged 20–39 years. 31% of young adults had social jetlag. Overall, there were no associations between social jetlag and diet quality. However, interaction analysis revealed several associations were race-specific (P, interaction&lt;0.05). Among Black adults, social jetlag was associated with lower overall diet quality (OR = 0.4, 95% CI 0.2, 0.8; i.e. less likely to be in higher diet quality tertiles) and more unfavourable scores on Total Vegetables (OR = 0.6, 95% CI 0.3, 1.0) and Added Sugar (i.e. OR = 0.6, 95% CI 0.4, 0.9). For Hispanic adults, social jetlag was associated with worse scores for Sodium (OR = 0.6, 95% CI 0.4, 0.9) However, White adults with social jetlag had better scores of Greens and Beans (OR = 1.9, 95% CI 1.1, 3.2). Within a nationally representative sample of US young adults, social jetlag was related to certain indicators of lower diet quality among Black and Hispanic Americans.

Identifying the most critical behavioral lifestyles associated with MAFLD: evidence from the NHANES 2017-2020.

Accumulating studies have demonstrated associations between single lifestyle exposures and metabolic dysfunction-associated fatty liver disease (MAFLD). However, the joint effects of lifestyle exposures remain unclear, hindering the development of targeted prevention and control strategies. We aimed to investigate the joint associations between lifestyle exposomes and MAFLD. This study included 5,002 participants from NHANES 2017-2020. Lifestyle exposomes, including sleep duration, metabolic equivalent of task (MET), Healthy Eating Index (HEI)-2015 score, alcohol consumption, and smoke exposure, were identified from questionnaire data. MAFLD was diagnosed by vibration-controlled transient elastography measurements and laboratory data. A logistic regression model and the weighted quantile sum method were used to evaluate the associations of single and joint lifestyle exposomes, respectively, with MAFLD. The population attributable fractions (PAFs) were calculated to assess the population benefits of different intervention strategies. Per-quartile range increases in sleep duration (OR=0.883, 95% CI: 0.826-0.944), MET (0.916, 0.871-0.963), and HEI-2015 score (0.827, 0.756-0.904) were significantly associated with MAFLD. The joint exposure of sleep duration, MET, and HEI-2015 score was associated with MAFLD (0.772, 0.688-0.865), with the highest weight (importance) for MET (0.526). PAFs revealed greater intervention benefits for sleep and the HEI-2015 when the majority of the population (>5%) had a low MAFLD risk (weak intervention targets), whereas MET was the most efficient intervention strategy when minority populations (≤5%) had a low MAFLD risk (strong intervention targets). This study demonstrated significant associations between MAFLD and single and joint exposures to sleep duration, MET, and HEI-2015 and identified physical activity as the most important lifestyle factor. Further population benefit analyses may provide evidence and suggestions for population-level interventions.

Diet quality, diet motives, and nutrition literacy of vegans, vegetarians, and semi-vegetarians.

Limited research is available on how motivations to adopt plant-based diets and nutrition literacy influence diet quality. This study assessed diet quality, diet motives and nutrition literacy in vegans, vegetarians, and semi-vegetarians, and investigated predictors of dietary quality. Cross-sectional study, participants completed an online survey about diet-related motives and nutrition literacy. Dietary intake was assessed with the Diet History Questionnaire III and diet quality was calculated with the Healthy Eating Index (HEI)-2015. A one-way ANCOVA was used to compare diet quality, nutrition literacy, and diet motives among diets. Hierarchical regression analysis was performed to identify significant predictors of diet quality. Online survey, participants were recruited through paid targeted social media (Facebook/Instagram) advertising. Adults following a plant-based diet, including 117 (52.5%) vegans, 51 (22.9%) vegetarians, and 55 (24.6%) semi-vegetarians. Vegans had higher HEI-2015 scores (80.8±6.5, p<0.001) compared to vegetarians (75.1±9.1), and semi-vegetarians (76.8±7.5). Most participants (74%) had good nutrition literacy scores. Total nutrition literacy did not differ between groups, but vegans had higher vegetarian nutrition literacy than vegetarians and semi-vegetarians (p<0.001). Ecological welfare, health, and sensory appeal were highly important to all participants. Motives accounted for 12.8% of the variance in diet quality scores. HEI-2015 scores were positively associated with motives of health and natural content, but negatively associated with weight control motivation (all p<0.05). Individuals following plant-based dietary patterns have high diet quality and nutrition literacy. Messages valuing intrinsic over extrinsic factors may facilitate healthier dietary adherence in this population.

Associations of dietary patterns with risk of gastrointestinal disorders: a prospective cohort study.

Gastrointestinal (GI) disorders are highly prevalent and severely diminish life quality. It is yet unknown which dietary pattern is optimal for the prevention of GI disorders. Among 141 450 participants from UK Biobank with a median follow-up of 15 years, we comprehensively assessed 13 dietary patterns in relation to 6 GI disorders. Multivariable Cox proportional hazards models demonstrated that adherence to healthy diets was associated with lower risk of GI disorders, with the strongest associations observed for the Dietary Approaches to Stop Hypertension (DASH) diet (HRQ4 vs. Q1 = 0.85, 95% CI: 0.81, 0.88), the Alternate Mediterranean Diet (AMED) (HRQ4 vs. Q1 = 0.85, 95% CI: 0.81, 0.88), and the Alternate Healthy Eating Index-2010 (AHEI-2010) (HRQ4 vs. Q1 = 0.86, 95% CI: 0.82, 0.89). AHEI-2010 (HRs ranging from 0.76 to 0.90) and DASH (HRs ranging from 0.75 to 0.88) showed inverse associations with every individual GI disorder. Furthermore, comorbidities decreased significantly in number with higher AMED and DASH diet scores (P for trend <0.001). Finally, the associations of AHEI-2010, AMED and DASH with GI disorders diminished most intensely after removing the component of fruits or whole grains. The combined intake of fruits and whole grains was inversely associated with the risk of overall GI disorders (HRT3 vs. T1 = 0.89, 95% CI: 0.86, 0.93). In conclusion, AHEI-2010 and DASH were the most recommended dietary patterns for the prevention of GI disorders. Fruits and whole grains are the most significant contributors to the protective effect.

Body mass index mediates the association between four dietary indices and phenotypic age acceleration in adults: a cross-sectional study.

Background: Diet and body mass index (BMI) are widely recognized as being closely associated with aging. However, it remains unclear which dietary indices are associated with aging, and the extent to which BMI mediates the relationship between diet and aging. Therefore, this study investigates the mediating role of BMI in the association between various dietary indices and phenotypic age acceleration (PhenoAgeAccel). Methods: Data were sourced from the National Health and Nutrition Examination Survey (NHANES), using two 24 hour recall interviews to compute four dietary indices: the Dietary Inflammatory Index (DII), Healthy Eating Index-2020 (HEI-2020), Alternative Healthy Eating Index-2010 (AHEI-2010), and Composite Dietary Antioxidant Index (CDAI). Linear regression analyses and mediation analyses assessed the associations between dietary indices and PhenoAgeAccel and the mediating effects of BMI. Z-score transformations (zDII, zHEI-2020, zAHEI-2010, and zCDAI) were used to ensure comparability between different dietary indices. Results: After adjusting for covariates, the zHEI-2020, zAHEI-2010, and zCDAI were negatively associated with PhenoAgeAccel (P < 0.05), with β values being -0.36, -0.40, and -0.41, respectively. The zDII was positively associated with PhenoAgeAccel (P < 0.001) with a β value of 0.70. Mediation analyses suggested that BMI significantly mediated the relationships between these dietary indices and PhenoAgeAccel. The mediation proportions were 23.7% for zDII, 43.3% for zHEI-2020, 24.5% for zAHEI-2010, and 23.6% for zCDAI. Conclusions: This study indicates that all dietary indices and BMI were significantly associated with PhenoAgeAccel. In addition, BMI exhibited the highest mediation proportion in the relationship between HEI-2020 and PhenoAgeAccel.

Comparison of nutrient intake and Korean Healthy Eating Index among the elderly in rural areas pre- and post- COVID-19 pandemic: the 2018–2021 Korea National Health and Nutrition Examination Survey data

Comparison of nutrient intake and Korean Healthy Eating Index among the elderly in rural areas pre- and post- COVID-19 pandemic: the 2018–2021 Korea National Health and Nutrition Examination Survey data

Patrones de dieta y caries dental en la dentición permanente: Una revisión exploratoria

Introduction: Dental caries is influenced by diet com-ponents. Dietary patterns are the way people combine foods and drinks. They can be derived through adherence to a standard diet (a priori), obtaining patterns from existing diet data (a posteriori), or Reduced Rank Regression. Dental caries research has focused on sugar instead of food combinations. The aim of this study was to synthesize the evidence about the relationship between caries in permanent dentition and dietary patterns. Materials and Methods: A scoping review was conducted by searching in Web of Science and PubMed. We included articles from 2001 to 2021, that studied dietary patterns or a combination of foods using one of the three methods described. Articles that dealt exclusively with breastfeeding, temporary dentition in children, or specific chronic diseases or disabilities were excluded. We assessed the quality of the articles with the Newcastle Ottawa Scale. Results: 1094 articles were identified and nine were included in qualitative synthesis. Three articles obtained dietary patterns through a priori methods and six with an a posteriori approach. Most of the studies (8) were cross-sectional. Some dietary patterns related to caries were “High in sugar-sweetened beverages and sandwiches”, “obesogenic” and “sweet”. Adherence to dietary recommendations like Alternative Healthy Eating Index-2010 and Dietary Approaches to Stop Hypertension (DASH) were associated with lower DMFS index and root caries index, respectively. Conclusions: An association between dietary patterns and caries was found, but causality cannot be affirmed. To a better understanding of this problem, new investigations are needed that should be focused on dietary styles instead of only some ingredients. Keywords: Dietary patterns; Dental caries; diet quality scores; Principal component analysis; Food combinations; Health behavior.

Plasma lipidomic markers of diet quality are associated with incident coronary heart disease in American Indian adults: the Strong Heart Family Study

BackgroundIdentifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet- coronary heart disease (CHD) association. ObjectivesThis study aimed to identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. MethodsUsing liquid chromatography–mass spectrometry, we measured 1542 lipid species from 1694 American Indian adults (aged 18–75 years, 62% female) in the Strong Heart Family Study. Participants were followed up for development of CHD through 2020. Information on the past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed-effects linear regression was used to identify individual lipids cross-sectionally associated with AHEI. In prospective analysis, Cox frailty model was used to estimate the hazard ratio (HR) of each AHEI-related lipid for incident CHD. All models were adjusted for age, sex, center, education, body mass index, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Multiple testing was controlled at a false discovery rate of <0.05. ResultsAmong 1542 lipid species measured, 71 lipid species (23 known), including acylcarnitine, cholesterol esters, glycerophospholipids, sphingomyelins and triacylglycerols, were associated with AHEI. Most of the identified lipids were associated with consumption of ω-3 (n–3) fatty acids. In total, 147 participants developed CHD during a mean follow-up of 17.8 years. Among the diet-related lipids, 10 lipids [5 known: cholesterol ester (CE)(22:5)B, phosphatidylcholine (PC)(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4)B, phosphatidylethanolamine (PE)(p-18:0/20:4)/PE(o-18:0/20:4), and sphingomyelin (d36:2)A] were associated with incident CHD. On average, each standard deviation increase in the baseline level of these 5 lipids was associated with 17%–23% increased risk of CHD (from HR: 1.17; 95% CI: 1, 1.36; to HR: 1.23; 95% CI: 1.05, 1.43). ConclusionsIn this study, lipidomic markers of diet quality in American Indian adults are found. Some diet-related lipids are associated with risk of CHD beyond established risk factors.

Diet Quality and Multimorbidity in Older Adults: A Prospective Cohort Study.

The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. We used data from 2784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015-17) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions (β [95% CI] quartile 4 vs 1: -0.57 [-0.86 to 0.27], p trend < .001] and cardiometabolic conditions (-0.30 [-0.44 to -0.17], p trend < .001) at baseline, while higher adherence to the MEDAS was associated with a lower number of total chronic conditions (-0.30 [-0.58 to -0.02], p trend = .01) and neuropsychiatric and neurodegenerative conditions (-0.09 [-0.17 to -0.01], p trend = .01). After a median follow-up of 5.2 years (range: 0.1-6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions (β [95% confidence interval] quartile 4 vs 1: -0.16 [-0.30 to -0.01], p trend = .04) and with lower rate of chronic disease accumulation. Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time.

ETHNIC DIFFERENCES IN DIET QUALITY AND COGNITION AMONG OLDER ADULTS

Abstract Research indicates an association between diet quality and cognitive outcomes. However, the association across ethnicities is not well understood. This study identifies differences in diet quality using the Healthy Eating Index (HEI-2015) score by ethnicity and its relationship to cognitive outcomes within ethnic groups. The sample includes 6,845 older adults from the 2014 wave of the Health and Retirement Study and nutrition data from the 2013 supplemental Health Care and Nutrition Survey. Cognitive functioning was measured based on a scale ranging from 0-27. Overall, 11% of respondents had a good quality diet, indicated by a HEI-2015 score of 81-100. Diet quality was significantly better among Hispanics than either non-Hispanic Blacks or Whites (p&amp;lt; 0.001 in both comparisons). Diet quality was not significantly different between Whites and Blacks (p=0.82). In a regression model controlling for age, gender, and marital status, the association between diet quality and better cognition was significant among Whites (p&amp;lt; 0.001) and Blacks (p&amp;lt; 0.05), but not significant among Hispanics (p=0.11). A one unit increase in the Healthy Eating Index is associated with a 0.05 increase in cognitive score among Whites and a 0.03 increase among Blacks. These findings suggest significant differences in diet quality across ethnicities that may impact cognition among older adults; however, the impact may differ by ethnicity.

SOCIAL ISOLATION AND DIET QUALITY AMONG US ADULTS WITH A DISABILITY IN NHANES, 2013–2018

Abstract Social isolation and disability are established risk factors for poor nutrition. There is limited understanding of how social isolation affects diet quality specifically among adults with disability. This cross-sectional analysis used NHANES 2013-2018 data to assess whether social isolation is associated with diet quality among adults with disabilities. Adults with a disability, not pregnant/breastfeeding, and not missing dietary intake data were included (n=5,167). Disability was defined based on reporting difficulty with any activities of daily living, instrumental activities of daily living, lower extremity mobility activities, or general physical activities. Diet quality was assessed using the Healthy Eating Index (HEI); higher scores corresponded to higher diet quality. We computed a social isolation index by summing single status, living alone, and two social engagement difficulty measures (1 point for each component met; 4 points maximum). Multivariable linear regression, controlling for demographic and health covariates, estimated differences in HEI scores for dietary intake, by social isolation score. The highest social isolation score category was associated with lower total HEI score (β = -1.71 points, 95% CI -3.08, -0.34), and lower intake of vegetables (β = -0.39 points, 95% CI -0.59, -0.20) and seafood/plant proteins (β = -0.37 points, 95% CI -0.60, -0.13). Single status and both social engagement measures were associated with lower scores on certain adequacy components. There was little evidence of effect modification by age or gender (p-interaction &amp;gt;0.05). Among socially isolated adults with disabilities, increasing access to fresh foods, particularly vegetables and seafood/plant proteins, should be a priority.

Diet Quality, Sedentary Time, and Blood Pressure in the POUCHmoms Study

BackgroundElevated blood pressure (BP) is a major contributor to cardiovascular disease in womens; diet and sedentary time (ST) are modifiable lifestyle factors thought to influence BP. ObjectivesThe aim of this study was to examine 2 diet-quality measures and ST in relation to BP among parous womens. MethodsThis cross-sectional analysis uses data from 677 womens (age 25–55 y) enrolled in the Pregnancy Outcomes and Community Health (POUCH) Study and followed up in the POUCHmoms study 7–15 y after delivery (2011 and 2014). Follow-up measures included a food-frequency questionnaire (FFQ), self-report of ST (occupational and leisure), and systolic and diastolic blood pressure (SBP and DBP, respectively). The FFQ was used to calculate 2 diet-quality measures, Alternative Healthy Eating Index-2010 (AHEI) and Dietary Approaches to Stop Hypertension (DASH). Total ST h/wk was dichotomized at the median and labeled “low” or “high.” In weighted unadjusted and adjusted regression models, BP was assessed in relation to diet scores (linear and threshold associations) and combinations of dichotomized diet-quality scores (“poor” = lowest quartile compared with “not poor” = upper 3 quartiles) and ST. ResultsHigher mean SBP and DBP occurred mainly in women with a ‘“poor” diet-quality score (AHEI and DASH). Among womens with a “poor”-quality diet (on the basis of the AHEI score) and “high” ST, (N = 93) adjusted mean SBP and DBP were 4.5 mmHg and 4.4 mmHg higher, respectively, than that of the counterparts who did not have a poor-quality diet and had “low” ST (N = 275). Results were similar in analyses using the DASH diet score. ConclusionsWomen with poor-quality diets and more ST may need closer BP monitoring. Even modest improvements in womens’ diet quality and reductions in ST might help lower their BP, but this observation needs testing in prospective studies..

Associations of diet quality and food consumption with serum biomarkers for lipid and amino acid metabolism in Finnish children: the PANIC study.

To investigate the associations of overall diet quality and dietary factors with serum biomarkers for lipid and amino acid metabolism in a general population of children. We studied 194 girls and 209 boys aged 6-8years participating in the Physical Activity and Nutrition in Children study. Food consumption was assessed by 4-day food records and diet quality was quantified by the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins, as well as lipoprotein particle sizes were analyzed with high-throughput nuclear magnetic resonance spectroscopy. Data were analyzed using linear regression adjusted for age, sex, and body fat percentage. FCHEI was directly associated with the ratio of polyunsaturated (PUFA) to saturated fatty acids (SFA) (PUFA/SFA), the ratio of PUFA to monounsaturated fatty acids (MUFA) (PUFA/MUFA), the ratio of PUFA to total fatty acids (FA) (PUFA%), the ratio of omega-3-fatty acids to total FA (omega-3 FA%), and inversely associated with the ratio of MUFA to total FA (MUFA%), alanine, glycine, histidine and very-low density lipoprotein (VLDL) particle size. Consumption of vegetable oils and vegetable-oil-based margarine (≥ 60% fat) was directly associated with PUFA/SFA, PUFA/MUFA, PUFA%, the ratio of omega-6 FA to total FA (omega-6 FA%), and inversely associated with SFA, MUFA, SFA to total FA (SFA%), MUFA%, alanine and VLDL particle size. Consumption of high-fiber grain products directly associated with PUFA/SFA, PUFA/MUFA, omega-3 FA%, omega-6 FA%, PUFA% and inversely associated with SFA and SFA%. Fish consumption directly related to omega-3 FA and omega-3 FA%. Consumption of sugary products was directly associated with histidine and VLDL particle size. Vegetable, fruit, and berry consumption had direct associations with VLDL particle size and the ratio of apolipoprotein B to apolipoprotein A1. Consumption of low fat (< 1%) milk was directly associated with phenylalanine. A higher consumption of high-fat (≥ 1%) milk was associated with lower serum MUFA/SFA and higher SFA%. Sausage consumption was directly related to SFA% and histidine. Red meat consumption was inversely associated with glycine. Better diet quality, higher in intake of dietary sources of unsaturated fat and fiber, and lower in sugary product intake were associated with more favorable levels of serum biomarkers for lipid and amino acid metabolism independent of adiposity. ClinicalTrials.gov: NCT01803776, registered March 3, 2013.

Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey

Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey