Higher Healthy Eating Index Scores Research Articles

Characterisation of vitamin and mineral supplement users differentiated according to their motives for using supplements: results of the German National Nutrition Monitoring (NEMONIT).

To characterise German vitamin and mineral supplement users differentiated by their motives for supplement use. Data were obtained from the German National Nutrition Monitoring (2010/11) via two 24 h dietary recalls and a telephone interview. Motive-based subgroups of supplement users were identified by factor and cluster analysis. Sociodemographic, lifestyle, health and dietary characteristics and supplement use were examined. Differences were analysed using χ 2 tests, logistic and linear regression models. Germany, nationwide. Individuals (n 1589) aged 18-80 years. Three motive-based subgroups were identified: a 'Prevention' subgroup (n 324), characterised by the motive to prevent nutrient deficiencies; a 'Prevention and additional benefits' subgroup (n 166), characterised by motives to prevent health problems and improve well-being and performance; and a 'Treatment' subgroup (n 136), characterised by motives to treat nutrient deficiencies or diseases. Members of the two prevention subgroups had a higher Healthy Eating Index score and tended to be more physically active than non-users. Those in the 'Prevention and additional benefits' subgroup supplemented with a greater number of micronutrients. Members of the 'Treatment' subgroup tended to be older and have a lower self-reported health status than non-users, and supplemented with a smaller number of micronutrients. The majority of supplement users take supplements for preventive purposes and they are more health conscious than non-users of supplements due to their concerns about developing health problems. Those supplementing for treatment purposes may have underlying health indications and may be more likely to benefit from supplementation than those supplementing for preventive purposes.

Adherence to Healthy Eating Index-2010 is inversely associated with metabolic syndrome and its features among Iranian adult women

Nowadays, metabolic syndrome (MetS) is deemed as a major public health challenge in both developed and developing countries. Therefore, the aim of this study was to determine the association between Healthy Eating Index-2010 (HEI-2010) score and MetS and its features among Iranian female nurses. This cross-sectional study was performed among 1036 Iranian women. A validated, self-administered, dish-based, semiquantitative food frequency questionnaire was used to assess the habitual intake of participants. HEI-2010 score was used to assess diet quality of participants. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to assess the relation between HEI-2010 and MetS. After adjusting for potential confounders, participants in the highest quartile of HEI-2010 had the lowest risk of MetS compared with those in the first quartile (odds ratio: 0.72; 95% confidence interval: 0.50-0.96). Furthermore, the risk of MetS features including abdominal obesity, high blood pressure, high serum triacylglycerol and low serum high-density lipoprotein-cholesterol significantly decreased across HEI-2010 quartiles (P<0.05). Higher HEI-2010 scores were inversely associated with lower risk of MetS and its components among Iranian women.

Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial.

Optimal nutritional choices are linked with better health, but many current interventions to improve diet have limited effect. We tested the hypothesis that providing personalized nutrition (PN) advice based on information on individual diet and lifestyle, phenotype and/or genotype would promote larger, more appropriate, and sustained changes in dietary behaviour. : Adults from seven European countries were recruited to an internet-delivered intervention (Food4Me) and randomized to: (i) conventional dietary advice (control) or to PN advice based on: (ii) individual baseline diet; (iii) individual baseline diet plus phenotype (anthropometry and blood biomarkers); or (iv) individual baseline diet plus phenotype plus genotype (five diet-responsive genetic variants). Outcomes were dietary intake, anthropometry and blood biomarkers measured at baseline and after 3 and 6 months' intervention. At baseline, mean age of participants was 39.8 years (range 18-79), 59% of participants were female and mean body mass index (BMI) was 25.5 kg/m 2 . From the enrolled participants, 1269 completed the study. Following a 6-month intervention, participants randomized to PN consumed less red meat [-5.48 g, (95% confidence interval:-10.8,-0.09), P = 0.046], salt [-0.65 g, (-1.1,-0.25), P = 0.002] and saturated fat [-1.14 % of energy, (-1.6,-0.67), P < 0.0001], increased folate [29.6 µg, (0.21,59.0), P = 0.048] intake and had higher Healthy Eating Index scores [1.27, (0.30, 2.25), P = 0.010) than those randomized to the control arm. There was no evidence that including phenotypic and phenotypic plus genotypic information enhanced the effectiveness of the PN advice. Among European adults, PN advice via internet-delivered intervention produced larger and more appropriate changes in dietary behaviour than a conventional approach.

Higher dietary quality and muscle mass decrease the odds of low phase angle in bioelectrical impedance analysis in Brazilian individuals

AbstractAimPhase angle is a bioimpedance parameter that is suggested as an indicator of cellular death and membrane integrity. Studies have shown an association between phase angle and nutritional status in many diseases, but little is known about its association with body composition and diet in free‐living individuals. The present study investigated potential associations of dietary and anthropometric parameters with phase angle.MethodsThis cross‐sectional study included 493 individuals (97 men and 396 women), older than 18 years, clinically screened for a lifestyle modification program from 2005 to 2011. All participants were assessed for body composition, anthropometric and dietary data, and were divided in two groups according to the cut‐off point of phase angle determined by the median value (6.35°). Statistical comparisons were undertaken between groups and logistic regression was performed to evaluate the odds ratio (OR) and 95% CI for the potential predictors of phase angle.ResultsParticipants with phase angle of 6.35° or below were older, had lower body mass index, waist circumference, muscle mass index, energy intake and Healthy Eating Index (HEI) score. After adjustments for confounding factors, higher muscle mass index (OR: 0.425; 95% CI: 0.204–0.887) and higher HEI score (OR: 0.357; 95% CI: 0.190–0.672) showed lower odds for low phase angle.ConclusionsHigher dietary quality and muscle mass decreased the odds for low phase angle.

Abstract 11926: An Intensive Heart Health Intervention Can Improve Diet Quality and Reduce Cardiovascular Risk Factors in Individuals Residing in Rural Environments

Introduction: Kentucky consistently ranks in the top ten for worst health outcomes in the U.S. Fifty four Kentucky counties are in Appalachia, the region with the nation’s worst social, environmental and health conditions. U.S. Preventive Services Task Force recommends that adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors be offered intensive behavioral counseling that includes a healthy diet to promote CVD prevention. Purpose: To investigate whether an intensive self-management intervention for CVD risk reduction (HeartHealth) improved diet quality and risk factors in persons living in rural Appalachian Kentucky. Methods: A sample of 719 adults (age 53±14 years, 74% female, 43±19 years living in Kentucky, 87% overweight or obese) with two or more CVD risk were enrolled in the 12-week HeartHealth intervention that included strategies to improve diet to promote CVD risk reduction. Diet quality was measured by healthy eating index (HEI) calculated from food frequency questionnaires with higher HEI score indicating more healthy diets. The intervention was delivered in small groups using culturally appropriate approaches. Paired t-tests were used to compare HEI scores and CVD risk factors pre- and post-intervention. Results: HEI total score increased 8% from 63.3±11.6 to 68.5±11.4 (p&lt;0.005). HEI scores for total fruit; whole fruit; total vegetable; legumes, orange and dark green vegetables; whole grain; and milk increased by 31%, 28%, 7%, 20%, 15%, and 3% ,respectively, post intervention when compared to the baseline (p&lt;0.05). Diet quality for saturated fat; and calories from solid fats, alcoholic beverages and added sugar also improved by 28% and 12%, respectively (p&lt;0.005). Total cholesterol, systolic blood pressure, and hemoglobin A1C levels decreased from 191.8±37.8 to 187.5±36.9 mg/dL, 128.7±16.4 to 125.2±15.6 mmHg, and 5.77±0.96 to 5.70±0.90 %, respectively (p&lt;0.005). Conclusion: An intensive behavioral counseling intervention promoted a healthy diet and reduced CVD risk in overweight or obese adults living in a rural socioeconomically distressed environment.

Index-based dietary patterns and colorectal cancer risk: a systematic review.

Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.

Oatmeal consumption is associated with better diet quality and lower body mass index in adults: the National Health and Nutrition Examination Survey (NHANES), 2001-2010

Data from the 2001-2010 National Health and Nutrition Examination Survey were analyzed to assess the relationship between oatmeal consumption and nutrient intake, diet quality, and physiological measures in adults 19 years and older (n = 22,823). We hypothesized that oatmeal consumption is associated with a more favorable nutrient intake profile, better diet quality, and healthier physiological end points. Oatmeal consumers (n = 1429) were defined as those who had consumed any amount of cooked oatmeal cereal during a 24-hour recall period. Multiple regression analysis, after transforming variables to normality and using appropriate sample weights to ensure national representation, was used to assess differences between oatmeal consumers and nonconsumers in terms of demographics, and covariate-adjusted analysis of variance was used to assess differences between consumers and nonconsumers in nutrient intakes, diet quality (calculated using the Healthy Eating Index-2010), and physiological measures. Our results show that oatmeal consumers were older than nonconsumers and more likely to be female; they also were less likely to smoke and consumed less alcohol. Consumers had higher intakes of protein, dietary fiber, vitamin A, thiamin, calcium, phosphorus, magnesium, iron, copper, selenium, and potassium and lower intakes of total, monounsaturated, and saturated fats; cholesterol; and vitamin B12. Oatmeal consumers had higher Healthy Eating Index-2010 scores and lower body weights, waist circumferences, and body mass indices. To conclude, our results suggest that consuming oatmeal is consistent with better nutrient intakes and a higher diet quality.

Local Food Consumption Is Associated With Higher Healthy Eating Index Score

The primary objective of this study was to determine the influence of local food consumption over diet quality. Purposeful sampling was employed to recruit 186 participants in Austin, Texas. Participants were asked to complete and return a survey, as well as several online 24-hour recalls using the Automated Self-administered 24-hour Recall system. MyPyramid Equivalents were then calculated and converted into a Healthy Eating Index (HEI) 2005 score. These scored were then included in regression models with the self-reported amount of local food in the diet. A higher proportion of local food in the diet was associated with a higher overall HEI score, as well as higher score in important subgroups.

Consumption of apples is associated with a better diet quality and reduced risk of obesity in children: National Health and Nutrition Examination Survey (NHANES) 2003-2010.

BackgroundMost children do not meet the recommendation for fruit consumption. Apples are the second most commonly consumed fruit in the US; however, no studies have examined the association of total apple products, apples, apple sauce, and 100 % apple juice consumption on diet quality and weight/adiposity in children.MethodsThe purpose of this study was to examine the association between various apple consumption forms with diet quality and weight/adiposity in a nationally representative sample of children. Participants were children 2–18 years of age (N = 13,339) from the National Health and Nutrition Examination Survey 2003–2010. Intake was determined using a single interview administered 24-h diet recall. Apple product consumption was determined using the cycle-appropriate USDA Food and Nutrient Database for Dietary Studies food codes. Total diet quality and component scores were determined using the Healthy Eating Index-2010 (HEI). Anthropometrics were determined using standard methods. Covariate adjusted linear and logistic regressions were used to compare apple product consumers with non-consumers; sample weights were used. Probability was set at <0.01.ResultsApproximately 26 % of the population (n = 3,482) consumed some form of apple products. Consumers of apple products, whole apples, apple sauce, and 100 % apple juice had higher HEI scores than non-consumers: 50.4 ± 0.4 v 41.9 ± 0.3, 52.5 ± 0.5 v 42.7 ± 0.3, 52.1 ± 0.8 v 47.2 ± 0.4, and 51.4 ± 0.6 v 46.5 ± 0.4, respectively. Apple products and whole apple consumers had lower BMI z-scores than non-consumers: 0.4 ± 0.04 v 0.5 ± 0.03 and 0.3 ± 0.1 v 0.5 ± 0.02, respectively. Apple products and whole apple consumers were 25 % (0.59–0.95 99th CI) and 30 % (0.52–0.95 99th CI), respectively, were less likely to be obese than non-consumers.ConclusionsConsumption of any form of apples contributed to the fruit recommendation of children and improved diet quality. Apples should be included in the diets of children as a component of an overall healthy diet.

Index-based dietary patterns and risk of incident hepatocellular carcinoma and mortality from chronic liver disease in a prospective study.

The role of diet in hepatocellular carcinoma (HCC) and its typical precursor, chronic liver disease (CLD), is poorly understood. Following dietary recommendations has been shown to reduce risk of many cancers, but whether such diets are associated with HCC and CLD is unknown. We prospectively evaluated the association of two dietary indices, the Healthy Eating Index-2010 (HEI-2010) and the alternate Mediterranean Diet Score (aMED), with HCC incidence and CLD mortality in a large U.S. prospective cohort. We calculated the HEI-2010 and aMED scores for 494,942 participants in the National Institutes of Health-AARP Diet and Health study, based on typical diet assessed using a food frequency questionnaire FFQ between 1995 and 1996. Hazard ratios (HRs) and 95% confidence intervals (CIs) for quintiles of each index were estimated using Cox's proportional hazards regression, after adjusting for alcohol intake, smoking, body mass index, diabetes, and other covariates. A total of 509 HCC cases (1995-2006) and 1,053 CLD deaths (1995-2011) were documented during follow-up. Higher HEI-2010 scores, reflecting favorable adherence to dietary guidelines, were associated with lower risk of HCC (HR, 0.72, 95% CI: 0.53-0.97 for the highest quintile, compared to lowest; P trend = 0.03) and lower mortality resulting from CLD (HR, 0.57; 95% CI: 0.46-0.71; P trend < 0.0001). High aMED scores were also associated with lower risk of HCC (HR, 0.62; 95% CI: 0.47-0.84; P trend = 0.0002) and lower risk of CLD mortality (HR, 0.52; 95% CI: 0.42-0.65; P trend < 0.0001). Adhering to dietary recommendations may reduce the risk of developing HCC and dying of CLD.

Vegetable Variety Is a Key to Improved Diet Quality in Low-Income Women in California

Primary prevention education interventions, including those sponsored by the US Department of Agriculture for low-income families, encourage and support increases in vegetable intake. Promoting vegetable variety as a focal point for behavior change may be a useful strategy to increase vegetable consumption. A simple vegetable variety evaluation tool might be useful to replace the time-intensive 24-hour dietary recall. The purpose of our study was to determine whether vegetable variety is associated with vegetable consumption and diet quality among US Department of Agriculture program participants. Variety of vegetable intake and measures of total vegetable intake, diet quality, and diet cost were evaluated. Low-income, female participants (N=112) aged 20 to 55 years with body mass index 17.7 to 68.5 who were the primary food purchasers/preparers for their households were recruited from four California counties representing rural, urban, and suburban areas. Energy density and Healthy Eating Index-2005 were used to assess diet quality. Vegetable variety was based on number of different vegetables consumed per week using a food frequency questionnaire, and three groups were identified as: low variety, ≤5 different vegetables per week; moderate variety, 6 to 9 vegetables per week; and high variety, ≥10 vegetables per week. Compared with the low-variety group, participants in the high-variety group ate a greater quantity of vegetables per day (P<0.001); their diets had a higher Healthy Eating Index score (P<0.001) and lower energy density (P<0.001); and costs of their daily diet and vegetable use were higher (P<0.001). Thus, greater vegetable variety was related to better overall diet quality, a larger quantity of vegetables consumed, and increased diet cost.

Sex differences in diet quality and health measures in US Soldiers entering initial military training

The Dietary Guidelines for Americans (DGA) aim to provide nutrition recommendations that promote health and the Healthy Eating Index (HEI) provides a measure of adherence to the DGA. The HEI may be a useful tool for assessing Soldiers’ diets and identifying nutrition education topics of benefit. This study assessed diet quality and health biomarkers of female (n= 71) and male (n= 117) Soldiers (20 ± 3 yr [mean ± SD]). A quantitative food frequency questionnaire (FFQ) and fasting blood were collected at the beginning of basic combat training. FFQ data were then converted to a HEI score, which ranges from 0–100. The average HEI score was 58.8 ± 10.6. Females had a higher HEI score than males (62.9 ± 11.7 v. 56.4 ± 9.2, P &lt; 0.05) indicating females had better adherence to the DGA. Male HEI scores negatively correlated with their total cholesterol (−0.228; P &lt; 0.05). However, there were no significant correlations between HEI scores and weight, BMI, percent body fat, HDL, LDL, triglycerides, or glucose for either sex. Females had higher HEI scores than males for intake of calories from solid fats, alcoholic beverages and added sugars, percent of energy from saturated fat, whole and total fruit servings, and total vegetable servings (P &lt; 0.05, all such). These data indicate sex differences in diet quality and may provide insight into which topics should be the focus of nutrition education for Soldiers.Research supported by MRMC.

Healthy Eating Index and Cardiovascular Risk Factors among Iranians

Objective: To determine the associations between Healthy Eating Index (HEI) and cardiometabolic risk factors among Iranian population.Methods: This cross-sectional study was conducted on 9568 Iranians who participated in Isfahan Healthy Heart program (IHHP). Dietary intakes were assessed using a 48-item food frequency questionnaire (FFQ). HEI scores were calculated based on the number of food groups, different kinds of fat intakes, sodium intake, and dietary diversity score in 10 separate components. The assessment of anthropometric and biochemical variables was done using standard protocols.Results: Mean ± SD of the HEI score was 39.1 ± 5.2. Those in the highest quintile of HEI consumed more fruits, vegetables, and dairy products and had lower total fat, saturated fatty acid, cholesterol, and sodium intakes. HEI scores were inversely associated with serum C-reactive protein (CRP) levels in both women and men (β = −0.07 for both men and women; p < 0.001). Women in the highest quintile of HEI had the lowest mean values of systolic blood pressure and apolipoprotein B (mean ± SD = 112.7 ± 20.2, 112.6 ± 20.5, 110.6 ± 19.5 mmHg; p = 0.001 and mean ± SD = 99.3 ± 26.0, 100.1 ± 26.6, 97.7 ± 23.1 (mg/dL); p = 0.04, respectively). HEI weakly correlated with various cardiovascular risk factors.Conclusions: The low mean of HEI scores in this sample indicates the need to improve diet quality. Higher HEI scores were associated with healthier dietary habits and a weak inverse association was found between HEI scores and serum levels of CRP, apolipoprotein B, and systolic blood pressure.

Obesogenic neighbourhoods: the impact of neighbourhood restaurants and convenience stores on adolescents' food consumption behaviours.

To examine the relationship between the neighbourhood food environment and dietary intake among adolescents. Cross-sectional design using: (i) a geographic information system to assess characteristics of the neighbourhood food environment and neighbourhood socio-economic status; (ii) the modified Healthy Eating Index (HEI) to assess participants' overall diet quality; and (iii) generalized linear models to examine associations between HEI and home and school food environmental correlates. Mid-sized Canadian city in Ontario, Canada. Participants Grade 7 and 8 students (n 810) at twenty-one elementary schools. Students living in neighbourhoods with a lower diversity of land-use types, compared with their higher diversity counterparts, had higher HEI scores (P < 0.05). Students with more than 1 km between their home and the nearest convenience store had higher HEI scores than those living within 1 km (P < 0.01). Students attending schools with a distance further than 1 km from the nearest convenience store (P < 0.01) and fast-food outlet (P < 0.05) had higher HEI scores than those within 1 km. Those attending schools with three or more fast-food outlets within 1 km had lower HEI scores than those attending schools with no fast-food outlet in the school surroundings (P < 0.05). Close proximity to convenience stores in adolescents' home environments is associated with low HEI scores. Within adolescents' school environments, close proximity to convenience and fast-food outlets and a high density of fast-food outlets are associated with low HEI scores.

Diet Quality Measures and Cardiovascular Risk Factors in France: Applying the Healthy Eating Index to the SU.VI.MAX Study

Objective: To examine associations between diet quality measures, lifestyle variables, and cardiovascular risk factors in a large cohort of French adults.Methods: Participants were 5,081 French men and women aged 35-61 y, voluntarily enrolled in a long-term clinical trial of cancer and CVD prevention (SU.VI.MAX study). Participants provided 12 days of dietary recalls. Data on heights, weights, blood pressure, and lipid profiles were obtained from clinic visits.Statistical Analysis: Healthy Eating Index (HEI) scores were calculated for each participant. The association between dietary and lifestyle variables and health was tested using analyses of variance and regression models in a cross sectional design.Results: Mean age was 51.7 y for men and 47.0 y for women. Mean body mass index (BMI) values were 24.9 for men and 22.6 for women. Obesity rate was 4% and cardiovascular risk factors were low. Mean percent energy from fat was 37% (saturated fat 16%) and very few respondents met US dietary guidelines for fat, saturated fat, and cholesterol. Higher diet quality, as indexed by HEI scores, was associated with being older, married, better educated, physically active, and having never smoked. For men only, higher HEI scores were weakly associated with lower BMI and lower blood pressure. HEI was not associated with plasma lipid measures.Conclusions: In this sample of adult men and women in France, higher HEI scores were associated with healthier lifestyles and higher socioeconomic status. However, HEI scores were only weakly linked to health parameters or to body weight. Linking diet quality to health outcomes is a continuing challenge.

The Healthy Eating Index and Youth Healthy Eating Index Are Unique, Nonredundant Measures of Diet Quality among Low-Income, African American Adolescents

Chronic disease is related to poor diet quality. The Healthy Eating Index (HEI) was developed to assess diet quality. The Youth HEI (YHEI) is an adaptation of the HEI for use with children and adolescents. The objectives were to compare HEI and YHEI scores among adolescents at risk for chronic disease and to compare associations between the scores and health indicators. This cross-sectional study included 2 low-income, urban African American adolescent samples (Challenge, n = 196; Three Generation, n = 121). HEI and YHEI scores were calculated from a FFQ and compared with BMI, body composition, and micronutrient, energy, and dietary intakes. YHEI scores were lower than HEI scores across both adolescent samples (Challenge, 48.94 +/- 9.31 vs. 62.83 +/- 11.75; Three Generation, 47.08 +/- 9.65 vs. 59.93 +/- 11.27; P < 0.001). Females (64.47 +/- 11.70) had higher HEI scores than males (61.15 +/- 11.61) (P < 0.05), but there was no gender difference in YHEI scores. HEI and YHEI scores were associated with higher micronutrient and total energy intakes (r = 0.19-0.76; P < 0.05). Higher percent body/abdominal fat was associated with lower HEI scores (r = -0.17 to -0.19; P < 0.05) but not with YHEI scores. BMI was not associated with either HEI or YHEI scores. In conclusion, many adolescents were consuming diets that placed them at risk for developing chronic disease. Although both the HEI and YHEI are useful in assessing diet quality, the HEI is inversely associated with body composition, a predictor of chronic disease, and accounts for gender differences in the Dietary Guidelines, whereas the YHEI discounts nutrient-poor, energy-dense foods.

Comparative Strategies for Using Cluster Analysis to Assess Dietary Patterns

Objectives To characterize dietary patterns using two different cluster analysis strategies. Design In this cross-sectional study, diet information was assessed by five 24-hour recalls collected over 10 months. All foods were classified into 24 food subgroups. Demographic, health, and anthropometric data were collected via home visit. Subjects One hundred seventy-nine community-dwelling adults, aged 66 to 87 years, in rural Pennsylvania. Statistical Analysis Cluster analysis was performed. Results The methods differed in the food subgroups that clustered together. Both methods produced clusters that had significant differences in overall diet quality as assessed by Healthy Eating Index (HEI) scores. The clusters with higher HEI scores contained significantly higher amounts of most micronutrients. Both methods consistently clustered subgroups with high energy contribution (eg, fats and oils and dairy desserts) with a lower HEI score. Clusters resulting from the percent energy method were less likely to differentiate fruit and vegetable subgroups. The higher diet quality dietary pattern derived from the number of servings method resulted in more favorable weight status. Conclusions Cluster analysis of food subgroups using two different methods on the same data yielded similarities and dissimilarities in dietary patterns. Dietary patterns characterized by the number of servings method of analysis provided stronger association with weight status and was more sensitive to fruit and vegetable intake with regard to a more healthful dietary pattern within this sample. Public health recommendations should evaluate the methodology used to derive dietary patterns.

Dietary patterns of rural older adults are associated with weight and nutritional status.

To characterize dietary patterns of rural older adults and relate patterns to weight and nutritional status. Cross-sectional. Rural Pennsylvania. One hundred seventy-nine community-dwelling adults aged 66 to 87 years. A home visit was conducted to collect demographic, health behavior, and anthropometric data and a blood sample. Five 24-hour dietary recall were administered. Cluster analysis classified participants into dietary patterns using food subgroup servings. Chi-square, analysis of covariance, and logistic regression were used to assess differences across clusters. A low-nutrient-dense cluster (n=107), with higher intake of breads, sweet breads/desserts, dairy desserts, processed meats, eggs, and fats/oils, and a high-nutrient-dense cluster (n=72) with higher intake of cereals, dark green/yellow vegetables, other vegetables, citrus/melons/berries, fruit juices, other fruits, milks, poultry, fish, and beans, were identified. Those in the high-nutrient-dense cluster had lower energy intake; higher energy-adjusted intake of fiber, iron, zinc, folate, and vitamins B(6), B(12), and D; higher Healthy Eating Index scores; higher plasma vitamin B(12) levels; and a lower waist circumference. Those with a low-nutrient-dense dietary pattern were twice as likely to be obese, twice as likely to have low plasma vitamin B(12) levels, and three to 17 times more likely to have low nutrient intake. This study provides support for recommending a high-nutrient-dense dietary pattern for older adults. Behavioral interventions encouraging diets characterized by high-nutrient-dense foods may improve weight and nutritional status of older adults.

Validation of the Healthy Eating Index with use of plasma biomarkers in a clinical sample of women

The Healthy Eating Index (HEI) is a 100-point analytic scoring tool used to measure compliance with dietary recommendations and guidelines. The objective was to calculate HEI scores for a sample of women and to link the HEI scores to plasma biomarkers of dietary exposure. Respondents were 340 women aged 21-80 y who were enrolled in a case-control study of diet and breast cancer. The sample included 172 patients with newly diagnosed cancer (case subjects), 149 cancer-free control subjects, and 19 women at high risk of breast cancer. Dietary intake assessment was based on 3-d food records. HEI scores were calculated for all respondents. Venous blood was collected for measurements of plasma carotenoids, vitamin C, and folate. Higher HEI scores were associated most strongly with greater dietary variety (r = 0.71), higher intakes of fruit (r = 0.57), and lower intakes of fat and saturated fat. HEI scores were also associated with higher intakes of energy, carbohydrates, fiber, folate, and vitamin C. Higher HEI scores were associated with higher plasma concentrations of alpha-carotene (r = 0.40), beta-carotene (r = 0.28), beta-cryptoxanthin (r = 0.41), lutein (r = 0.23), and vitamin C (r = 0.26) after age and vitamin supplement use were controlled for in a regression model. There was a further association between HEI scores and socioeconomic variables. Women with higher HEI scores were more likely to be older, married, and better educated and to have higher household incomes.