Higher Healthy Eating Index-2005 Scores Research Articles

Nutrient Intake, Diet Quality, and Weight/Adiposity Parameters in Breakfast Patterns Compared with No Breakfast in Adults: National Health and Nutrition Examination Survey 2001-2008

BackgroundThe effect of different breakfast consumption patterns on nutrient intake, diet quality, and weight/adiposity status is unknown. ObjectiveTo compare nutrient intake, diet quality, and weight/adiposity measures of consumers assigned to different breakfast patterns with breakfast skippers. Design and participantsThese associations were assessed in adults 19+ years (N=18,988) participating in the 2001-2008 National Health and Nutrition Examination Survey. Intake was determined from 1-day 24-hour dietary recall. Diet quality was quantified using the Healthy Eating Index-2005. Body mass index (calculated as kg/m2) and waist circumferences were determined. Twelve patterns (including No Breakfast [approximately 19% of population]), explaining 58% of the variance in energy from the breakfast meal, were examined. Covariate adjusted general linear models were used to compare nutrient intakes, Healthy Eating Index-2005 scores, and body mass index/waist circumference of consumers of different patterns with breakfast skippers. The P value was Bonferroni corrected (<0.05/12 breakfast patterns <0.0042). ResultsConsumers of the Grain/100% Fruit Juice and Presweetened Ready-to-Eat Cereal (RTEC)/Lower-Fat Milk patterns had lower daily intakes of nutrients to limit (added sugars, saturated fatty acids, solid fats, cholesterol, and sodium) than breakfast skippers. Consumers of the Grain/100% Fruit Juice; Presweetened RTEC/Lower-Fat Milk; and RTEC/Lower-Fat Milk/Whole Fruit/100% Fruit Juice patterns had higher daily intakes of all shortfall nutrients examined (dietary fiber; vitamins A, D, and C; calcium, potassium, folate, iron, and magnesium) than breakfast skippers. Consumers of the Grain/100% Fruit Juice; Grain; Presweetened RTEC/Lower-Fat Milk; RTEC/Lower-Fat Milk/Whole Fruit/100% Fruit Juice; Cooked Cereal; Lower-Fat Milk/Whole Fruit; and Whole Fruit patterns had higher Healthy Eating Index-2005 scores than breakfast skippers. Consumers of the Grain/100% Fruit Juice; Presweetened RTEC/Lower-Fat Milk; RTEC/Lower-Fat Milk/Whole Fruit/100% Fruit Juice; and Cooked Cereal patterns had lower body mass indexes and waist circumferences than breakfast skippers. ConclusionsResults suggest dietary and weight advantages of consuming breakfast, especially ones that include grains, cereals, lower-fat milk, and whole fruit/100% fruit juice, in contrast to the potential adverse effects of skipping breakfast.

Intensively managed young children with type 1 diabetes consume high-fat, low-fiber diets similar to age-matched controls

Despite significant emphasis on nutrition, older children with diabetes demonstrate poor dietary quality. We tested the hypothesis that dietary quality in young children with type 1 diabetes (T1D) would be better than age-matched children in the US population. Dietary data from children with T1D (n = 67) aged 2 to 12 years attending a pediatric diabetes clinic were compared with a nationally representative, age-matched sample from the National Health and Nutrition Examination Survey (NHANES; n = 1691). Multiple 24-hour dietary recalls were used. Recommended intakes were based on national guidelines, and dietary quality was assessed using the Healthy Eating Index-2005. More children with T1D were overweight or obese compared with children participating in NHANES (42% vs 30%, P = .04). Greater proportions of children with T1D met daily recommendations for vegetables (22% vs 13%, P = .03), whole grains (12% vs 5%, P = .005), and dairy (55% vs 36%, P = .001) compared with NHANES children, whereas similar proportions met daily fruit recommendations (40% vs 33%, P = .2). Less than one-third of all children limited total fat to recommended levels; children with T1D consumed more saturated fat than did NHANES children (14% vs 12% total energy intake, P = .0009). Fiber intakes were very low in both groups. Compared with NHANES children, children with T1D had higher Healthy Eating Index-2005 scores (59.6 vs 49.7, P = .0006) primarily because of lower intakes of added sugars. The nutritional intake of young children with T1D remains suboptimal in the contemporary era of diabetes management. Despite focused nutrition management, young children with T1D consume high-fat, low-fiber diets comparable with youth in the general population.

Oatmeal consumption is associated with increased nutrient intake, better diet quality, and lower body mass index in adult participants (19+ y) from the NHANES (2001‐2010) (810.12)

The association between oatmeal consumption with nutrient intake, dietary quality, and body weight parameters was examined in adults (n=22,823) using data from NHANES (2001‐2010). Consumers (n=1,419) were defined as having any amount of oatmeal during a 24‐hour diet recall. ANOVA (covariate adjusted) were conducted using appropriate sample weights. Diet quality was calculated using the Healthy Eating Index‐2005 (HEI). Energy adjusted protein (87±1.3 v 83±0.3 g/d), dietary fiber (20.5±0.3 v 15.8±0.1 g/d), vitamin A (826±24 v 610±7 RAE µg/d), Ca (1041±20 v 927±6 mg/d), P (1488±16 v 1351±5 mg/d), Mg (361±6 v 289±1 mg/d), Fe (17.0±0.2 v 15.5±0.1 mg/d), and K (2958±34 v 2714±12 mg/d) intake were higher (p&lt;0.01) in consumers than non‐consumers. Total fat (75±0.6 v 83±0.3 g/d), SFA (24.3±0.3 v 27.2±0.1 g/d), cholesterol (239±6 v 290±2 mg/d), and vitamin B12 (4.4±0.1 v 5.5±0.1 µg/d) were lower in consumers. Consumers had higher HEI scores (58.9±0.5 v 50.6±0.2) due to more whole grains (2.7±0.06 v 0.6±0.01 cup eq/d) and less SFA, solid fat (39.0±0.6 v 46.1±0.2 g/d), and added sugars (17.2±0.5 v 19.3±0.2 tsp/d). BMI (27.5±0.3 v 28.5±0.1) and waist circumference (94.9±0.5 v 97.5±0.2 cm) were lower in consumers. Consumers were 25% less likely to be overweight or obese and had a 21% reduced risk of increased waist size. Oatmeal consumption was associated with better nutrient intake, diet quality, and weight parameters in adults.Grant Funding Source: PepsiCo

Hummus (H)/garbanzo bean (GB) consumption is associated with increased nutrient intake, better diet quality, and lower body mass index in adult participants (19+ y) from the NHANES (2003‐2010) (810.15)

The association between H/GB consumption with nutrient intake, dietary quality, and weight parameters was examined in adults using data from NHANES (2003‐2010). Consumers (n=264) were defined as having any amount of H/GB during either 24‐hour diet recall. Means and ANOVA (covariate adjusted) were determined using appropriate sample weights; significance was p&lt;0.05. Diet quality was calculated using the Healthy Eating Index‐2005 (HEI). Fiber (24.4±0.7 v 10.1±0.1 g/d), PUFA (19.5±0.4 v 17.3±0.1 g/d), vitamins A (787±42 v 640±6 RAE mcg/d), E (10.1±0.5 v 7.5±1.01 mcg/d), and C (119±8 v 86.4±4.3 mg/d), folate (627±16 v 547±4 mcg/d), magnesium (385±13 v 292±4 mg/d), potassium 3103±59 v 2697±12 mg/d), and iron (17.4±0.5 v 15.8±0.1 mg/d) intake was higher in consumers. Total fat (76.4±4.5 v 80.4±0.3 g/d), SFA (22.4±0.7 v 26.6±0.1 g/d), and cholesterol (227±8 v 288±2 mg/d) were lower in consumers. Consumers had higher HEI scores (62.2±1.3 v 51.9±0.2). BMI (26.4±0.5 v 28.6±0.1) and waist circumference (92.2±1.3 v 97.9±0.3 cm) were lower in consumers.Consumers were 43% less likely to be overweight or obese and had a 48% reduced risk of increased waist size. H/GB consumption was associated with better nutrient intake, diet quality and weight parameters in adults.Grant Funding Source: Supported by Sabra Dipping Co., LLC., and USDA.

Abstract P192: Healthy Eating Index and Metabolically Healthy Obesity in U.S. Adolescents and Adults

Purpose: Studies of dietary intake between metabolically healthy obese (MHO) and metabolically abnormal obese (MAO) cardiometabolic profiles have been limited to macronutrient and micronutrient composition in postmenopausal women. Thus, the purpose of this study is to determine whether diet quality, measured by total and component Healthy Eating Index 2005 (HEI-2005), is different between MHO and MAO in a nationally representative sample. Methods: Data from two National Health and Nutrition Examination Surveys (2007-2008; 2010-2011) were used to identify 133 obese (≥85th BMI %tile) adolescents 12-18 years, and 1164 obese (≥30kg/m2) adults 19-85 years. Adolescents and adults were classified as MAO if they had ≥2 cardiometabolic risk factors (adults: blood pressure ≥130/85 mmHg; triglycerides ≥150 mg/dL, HDL-C men &lt;40, women &lt;50 mg/dL; glucose ≥100 mg/dL; or on relevant medications; adolescents: triglycerides ≥150 mg/dL; HDL-C &lt;40/50 mg/dL for boys/girls; blood pressure ≥90th %tile for age, gender, and height; glucose ≥100 mg/dL or on relevant medications), or MHO if they had &lt;2 cardiometabolic risk factors. HEI-2005 scores were calculated from in-person 24-hour recall. Age group (12-18 years n=133, 19-44 years n=491; 45-85 years n=673) general linear regression models were used to determine whether total and component HEI-2005 scores differed between MHO and MAO after controlling for age, race, gender, NHANES wave, BMI and moderate to vigorous physical activity. Results: MHO adolescents (n=45; 72%) had better quality diets as indicated by a higher total HEI-2005 score compared with MAO (MHO vs. MAO, mean ± SE; p-value for difference: 55.2 ± 1.2 vs. 47.8 ± 2.6; p=0.005), higher milk scores (5.2 ± 0.4 vs. 3.5 ± 0.7; p=0.03), and higher scores from calories from solid fats, alcohol beverages, and added sugars (SoFAAS) (15.5 ± 0.7 vs. 11.6 ± 1.0, p=0.007). The SoFAAS component score is reverse coded where a higher score indicates better adherence to diet recommendations (&lt;20%). Adults 19-44 years with MHO profiles (n=229, 46%) had higher HEI-2005 scores compared with MAO (54.0 ± 1.0 vs. 51.3 ± 0.8; p=0.008) and higher whole grain scores (0.9 ± 0.1 vs. 0.4 ± 0.07, p=0.003). No significant differences between MHO (n=127; 23%) vs. MAO in HEI-2005 scores or its component scores were observed in adults 45-85 years of age. Conclusion: MAO and MHO cardiometabolic profiles are characterized by differences in HEI-2005 total and component scores, though these differ by age group. Results suggest potential intervention targets which may improve cardiometabolic risk within obesity.

Index-based dietary patterns and risk of head and neck cancer in a large prospective study

Head and neck cancer (HNC) is the seventh most common cancer worldwide. Although diet has been proposed to play an important role in HNC, few associations with diet have been convincing other than alcohol intake. Studies of dietary patterns that examine overall diets may provide broader insight than studies of individual foods. Little is known about the association between dietary patterns and risk of HNC. We prospectively evaluated the association between 2 index-based dietary patterns [ie, the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet Score (aMED)] and risk of head and neck squamous cell carcinoma. We included 494,967 participants from the NIH-AARP Diet and Health study (1995-2006). HRs (95% CIs) were estimated by using Cox regression. Scores for the HEI-2005 and aMED were calculated on the basis of diet assessed by using a baseline food-frequency questionnaire. Higher scores reflected adherence to dietary recommendations for healthy eating. Our main outcome was the incidence of HNC, including cancer of the larynx, oral cavity, and orohypopharynx. A total of 1868 HNC cases were identified during follow-up. Higher HEI-2005 scores were associated with reduced risk of HNC in men [HR: 0.74 (95% CI: 0.61, 0.89) for highest compared with lowest quintiles; P-trend = 0.0008] and women [HR: 0.48; 95% CI: 0.33, 0.70; P-trend < 0.0001]. High aMED scores were also associated with lower HNC risk in men (HR: 0.80; 95% CI: 0.64, 1.01; P-trend = 0.002) and women (HR: 0.42; 95% CI: 0.24, 0.74; P-trend < 0.0001). Associations were similar among subsites. We did not find significant interactions between smoking and alcohol intake and each index on HNC risk. HEI-2005 and aMED scores were associated inversely with risk of HNC. Large interventional studies are required to assess the causality before conveying definite public health messages.

The association between Healthy Eating Index-2005 scores and disability among older Americans

several studies examining diet and functional status of individuals have focused on single nutrients or food groups. Studies examining the relationship between diet and health have increasingly witnessed a shift in focus from single nutrients to overall diet quality. The objective of this study was to examine the association between overall diet quality and self-reported disability. the 1999-2004 National Health and Nutrition Examination Survey (NHANES). a nationally representative sample of Americans ≥60 years. overall diet quality was assessed using the United States Department of Agriculture's (USDA) Healthy Eating Index-2005 (HEI-2005). Self-reported measures of disability included activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSAs), lower extremity mobility (LEM) and general physical activities (GPAs). older adults with higher HEI-2005 scores were less likely to experience LEM (P for trend=0.001) and GPAs (P for trend<0.001) disability. Compared with older adults whose HEI-2005 scores were in the lowest quartile, the likelihood of both IADLs and GPAs disability were significantly lower in those with HEI-2005 scores in quartiles two, three and four. Compared with those who had HEI-2005 scores in the lowest quartile, the odds of LEM disability were significantly lower for those with HEI-2005 scores in the highest quartile. older adults who do not adhere to the 2005 Dietary Guidelines for Americans report disability more frequently than those who do adhere to the guidelines.

Higher Healthy Eating Index-2005 Scores Are Associated With Better Physical Performance

Little is known regarding the relationship between overall diet quality and physical performance among older adults. We examined the association between overall diet quality, as measured by the US Department of Agriculture's Healthy Eating Index-2005 (HEI-2005), and physical performance, as measured by gait speed (n = 2,132) and knee extensor power (n = 1,392), among adults aged 60 years or older. Using data from the 1999-2002 National Health and Nutrition Examination Survey, multiple linear regression models controlling for age, gender, race/ethnicity, education, smoking status, comorbidities, medication use, cognitive function, body mass index, and physical activity were used in the analyses. After adjusting for age, gender, race/ethnicity, education, and smoking status, total HEI-2005 scores were positively associated with both gait speed (p for trend = .02) and knee extensor power (p for trend = .05). Older adults with higher HEI-2005 scores had a faster gait speed (p = .03 for both Quartile 3 and Quartile 4 vs quartile 1) compared with those with HEI-2005 scores in the lowest quartile. Those with HEI-2005 scores in Quartile 4 had a greater knee extensor power compared with those with HEI-2005 scores in the lowest quartile (p = .04). The associations between HEI-2005 scores and physical performance remained after further adjustment for comorbidities, medication use, cognitive function, and body mass index. However, the associations were no longer statistically significant after further adjustment for physical activity. Adherence to overall dietary recommendations is associated with better physical performance among older adults.

Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer

To investigate, among women with breast cancer, how postdiagnosis diet quality and the combination of diet quality and recreational physical activity are associated with prognosis. This multiethnic, prospective observational cohort included 670 women diagnosed with local or regional breast cancer. Thirty months after diagnosis, women completed self-report assessments on diet and physical activity and were followed for 6 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals for death from any cause and breast cancer death. Women consuming better-quality diets, as defined by higher Healthy Eating Index-2005 scores, had a 60% reduced risk of death from any cause (HR(Q4:Q1): 0.40, 95% CI: 0.17, 0.94) and an 88% reduced risk of death from breast cancer (HR(Q4:Q1): 0.12, 95% CI: 0.02, 0.99). Compared with inactive survivors consuming poor-quality diets, survivors engaging in any recreational physical activity and consuming better-quality diets had an 89% reduced risk of death from any cause (HR: 0.11, 95% CI: 0.04, 0.36) and a 91% reduced risk of death from breast cancer (HR: 0.09, 95% CI: 0.01, 0.89). Associations observed were independent of obesity status. Women diagnosed with localized or regional breast cancer may improve prognosis by adopting better-quality dietary patterns and regular recreational physical activity. Lifestyle interventions emphasizing postdiagnosis behavior changes are advisable in breast cancer survivors.

Higher Healthy Eating Index-2005 Scores Associated with Reduced Symptoms of Depression in an Urban Population: Findings from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study

Background Depression affects more than 15 million Americans in a given year. Compared to physical health, less is known about the affect of diet quality on symptoms of depression. Objective This study investigated the relationship between diet quality and reported symptoms of depression in a low-income urban population. Subjects/setting Subjects included 1,118 African-American and white adults, aged 30 to 64 years, living in Baltimore, MD, and represented a subsample of the initial examination and recruitment phase of the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Methods Nutrition data were based on two 24-hour dietary recalls collected by trained interviewers using the US Department of Agriculture Automated Multiple Pass Method. Diet quality was calculated using the US Department of Agriculture Healthy Eating Index (HEI)-2005. Depressive symptoms were assessed by a trained interviewer using the Center for Epidemiologic Studies Depression scale. Statistical analysis Both linear and logistic regression analyses were used to examine whether or not diet quality was associated with depressive symptoms. The dependent variable was depressive symptoms and independent variables included HEI-2005, race, sex, age, education, income, and food-assistance program participation. Results Mean HEI-2005 score was 52.17±0.40 (out of 100). Mean Center for Epidemiologic Studies Depression scale score was 11.64±0.25 (out of 40). Diet quality was significantly associated with reported symptoms of depression. However, income was a significantly stronger predictor of depression compared to diet quality, education, and sex. Conclusions Registered dietitians should be aware of relationships between psychological status and nutritional health when assisting clients to better manage their food choices to improve their overall health and quality of life.