Higher Healthy Eating Index Research Articles

Association of healthy eating index (HEI), alternative healthy eating index (AHEI) with antioxidant capacity of maternal breast milk and infant’s urine: a cross-sectional study

Maternal dietary quality may alter the nutrient content of breast milk. In this study, we aimed to investigate the relationship between the healthy eating index (HEI) and alternative healthy eating index (AHEI) of a breastfeeding mother’s diet with the antioxidant profile of her breast milk and her infant’s urine. This study included 300 healthy mother-infant pairs. The participants’ dietary intake was estimated using a validated semi-quantitative food frequency questionnaire. The diet quality of participants was assessed using the HEI and AHEI. The total antioxidant content of the breast milk and infant’s urine was evaluated using ferric reducing antioxidant power (FRAP), 2, 2′-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Thiol quantification assays. After adjusting for confounding factors, the odds of a low malondialdehyde (MDA) content of breast milk were significantly higher in the highest quartile of HEI than in the lowest quartile. The odds of low DPPH and FRAP in infant urine decreased in the highest quartile of HEI compared to the lowest quartile. No significant relationship was found between AHEI and antioxidant levels of breast milk and the infant’s urine. Our findings demonstrate that a high quality diet of breastfeeding mothers, identified by a higher HEI, can affect the oxidant-antioxidant balance of a mother’s breast milk and her infant’s urine.

Association between Healthy Eating Index-2015 total and component food scores with reproductive lifespan among postmenopausal women: a population-based study from NHANES 2005–2016

BackgroundPrior research has demonstrated that nutrition plays a crucial role in the establishment and maturation of the reproductive lifetime. Although the specific dietary components involved in preventing or postponing the reproductive lifespan are still unknown, a healthy diet can affect the reproductive lifespan. Here, the study aimed to explore the relationship between reproductive lifespan and diet quality by utilizing the Healthy Eating Index-2015 (HEI-2015).MethodsIn this study, a total of 2761 postmenopausal women were selected from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. Diet quality was determined using HEI-2015 based on two 24-hour dietary recalls. Reproductive lifespan was defined as the number of years between self-reported age at menarche and menopause. Weighted linear regression and eXtreme Gradient Boosting (XGBoost) models were used to analyze the relationship between HEI-2015 and reproductive lifespan. Subsequently, the impact of various components of HEI-2015 on reproductive lifespan was assessed through weighted quantile sum (WQS) regression models.ResultsAmong 2761 postmenopausal women, the mean age was 63.7 years. 41.5% were obese, and 49.7% were non-Hispanic white. After adjusting for sociodemographic characteristics, lifestyle factors, and medical history, individuals in the highest tertile of HEI-2015 had a 4.81% (95% CI: 1.82–7.79%) longer reproductive time life. Higher HEI-2015 was also significantly associated with a higher likelihood of late menopause (p for trend < 0.05). Based on XGBoost models, the relative importance of HEI-2015 on reproductive lifespan was determined. Whole fruits, whole grains, total protein foods, and greens and beans significantly contributed to extending age at menopause and reproductive time life in the HEI-2015. The weights of the WQS index for age at menopause were 27.1%, 23.2%, 10.1%, and 7.5% respectively, while the weights of the WQS index for reproductive time life were 30.2%, 14.6%, 9.3%, and 14.0% respectively.ConclusionThere is a positive association between the HEI-2015 and reproductive lifespan. This underscores the significance of enhancing adherence to healthy dietary patterns in preventing a shorter reproductive lifespan.

Diet quality is associated with adipose tissue and muscle mass: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Aging is associated with changes in body composition, and preventing loss of muscle mass and accumulation of excess adipose tissue in middle-aged adults may reduce age-related conditions at older ages. Dietary intake is one lifestyle factor shown to improve or maintain body composition. However, few studies have examined the Healthy Eating Index2015 (HEI2015), a measure of diet quality, and the association with body composition in adult men and women. Participant data (n=3017) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were used to examine the associations of the HEI2015 with body composition measures at Year 25 (Y25), including (1) 25year-change in weight, body mass index (BMI), and waist circumference and (2) a computed tomography (CT) scan at Y25 measured muscle mass, muscle quality (better quality=less lipid within the muscle), and adipose tissue depots visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and adipose within skeletal muscle (intermuscular adipose tissue; IMAT). Dietary intake was assessed by a diet history three times over 20years, at years 0, 7, and 20. HEI2015, averaged over three exams, was created and categorized into quintiles. Multiple regression analysis evaluated the associations of body composition stratified across quintiles of HEI2015 adjusted for demographic characteristics, energy intake, lifestyle factors, and baseline anthropometric measures as appropriate. Race-sex interaction was tested (Pinteraction >0.30). Over 25years of follow-up, averaged HEI2015 was significantly and inversely associated with weight gain (Quintile 1 (Q1) 37.3lb vs. 32.9 in Q5; Ptrend =0.01), change in BMI (Q1 5.8kg/m2 vs. 5.0 in Q5; Ptrend =0.005), and change in waist circumference (Q1 17.5cm vs. 15.2cm in Q5; Ptrend <0.001). By Y25, HEI2015 was inversely associated with VAT Q1 136.8cm3 vs. 116.6 in Q5; Ptrend <0.001) and IMAT volumes (Q1 9.52 vs. 8.12cm3 in Q5; Ptrend <0.001). Although total muscle volume declined (Ptrend =0.03), lean muscle mass volume was similar across quintiles (Ptrend =0.55). The IMAT/total muscle mass ratio declined across HEI2015 quintiles (Ptrend <0.001). Finally, higher HEI2015 was associated with better muscle quality at Y25 (higher value=less lipid within the muscle; Q1 41.1 vs. 42.2 HU in Q5; Ptrend =0.002). HEI2015 was nonlinearly, but inversely, associated with SAT (nonlinear P=0.011). Improving diet quality in young to middle-aged adults is a recommended strategy to promote better measures of body composition. Our study findings suggest that healthier food choices may influence body composition.

Maternal dietary patterns and placental outcomes among pregnant women in Los Angeles

IntroductionEpidemiological studies have linked prenatal maternal diet to fetal growth, but whether diet affects placental outcomes is poorly understood. MethodsWe collected past month dietary intake from 148 women in mid-pregnancy enrolled at University of California Los Angeles (UCLA) antenatal clinics from 2016 to 2019. We employed the food frequency Diet History Questionnaire II and generated the Healthy Eating Index-2015 (HEI-2015), the Alternate Healthy Eating Index for Pregnancy (AHEI-P), and the Alternate Mediterranean Diet (aMED). We conducted T2-weighted magnetic resonance imaging (MRI) in mid-pregnancy (1st during 14–17 and 2nd during 19–24 gestational weeks) to evaluate placental volume (cm3) and we measured placenta weight (g) at delivery. We estimated change and 95 % confidence interval (CI) in placental volume and associations of placenta weight with all dietary index scores and diet items using linear regression models. ResultsPlacental volume in mid-pregnancy was associated with an 18.9 cm3 (95 % CI 5.1, 32.8) increase per 100 gestational days in women with a higher HEI-2015 (≥median), with stronger results for placentas of male fetuses. We estimated positive associations between placental volume at the 1st and 2nd MRI and higher intake of vegetables, high-fat fish, dairy, and dietary intake of B vitamins. A higher aMED (≥median) score was associated with a 40.5 g (95 % CI 8.5, 72.5) increase in placenta weight at delivery, which was mainly related to protein intake. DiscussionPlacental growth represented by volume in mid-pregnancy and weight at birth is influenced by the quality and content of the maternal diet.

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.

Food Insecurity, Dietary Quality, and the Role of Social Network Support and Barriers Among Immigrant Latino Adults in New York City

ABSTRACT The goal of this study is to describe the social networks of Latino immigrants (n = 80) in New York City, and how various network features are linked with dietary quality and food insecurity. Participants had higher Healthy Eating Index (HEI) scores if their social networks were more transitive (β = 6.11, p < .001) and had a higher proportion of social supporters (β = 4.91, p < .001). Participants who were food insecure had networks with a higher proportion of social barriers (OR = 2.6, p < .05). Supportive and cohesive networks may benefit dietary quality, while networks with more social barriers may exacerbate food insecurity.

Association between healthy eating index-2015 and abdominal aortic calcification among US Adults.

To evaluate the relationship of the healthy eating index-2015 (HEI-2015) with abdominal aortic calcification (AAC) in US adults. We conducted a cross-sectional study with data extracted from the National Health and Nutrition Examination Survey (NHANES). AAC score was measured using the scoring system of Kauppila (AAC-24) and Schousboe (AAC-8). HEI-2015, which was used for evaluating compliance with Dietary Guidelines for Americans (DGA), was calculated through two rounds of 24-h recall interviews. HEI-2015 was categorized as inadequate (<50), average (50~70), and optimal (≥70) groups for analysis, while the AAC-24 score was grouped by whether the score was >0. Weighted multiple regression analyses were conducted to estimate the association of HEI-2015 with AAC score and the presence of AAC. Moreover, smooth curve fittings, based on a generalized additive model (GAM), were applied to evaluate a possible non-linear relationship. Sensitivity analysis and subgroup analysis were performed to provide more supporting information. A total of 2,704 participants were included in the study (mean age, 57.61 ± 11.40 years; 51.78% were women). The mean score of HEI-2015 was 56.09 ± 13.40 (41.33 ± 6.28, 59.44 ± 5.54, and 76.90 ± 5.37 for inadequate, average, and optimal groups, respectively). After adjusting for covariates, higher HEI-2015 was associated with decreased AAC score (AAC-24: β = -0.121, 95% CI: -0.214, -0.028, P = 0.010; AAC-8: β= -0.054, 95% CI: -0.088, -0.019, P = 0.003) and lower risk of AAC (OR = 0.921, 95% CI: 0.855, 0.993, P = 0.031). Among the components of HEI-2015, a higher intake of fruits, greens, and beans was associated with a lower AAC score. Subgroup analysis showed that an inverse association of HEI-2015 with AAC score existed among different groups. The study presented that higher HEI-2015 was related to a lower AAC score and decreased risk of having AAC, indicating that greater compliance with 2015-2020 DGA, assessed by HEI-2015, might be beneficial for preventing vascular calcification and CVD among US adults.

Food and nutrition literacy: a predictor for diet quality and nutrient density among late adolescents.

Evidence regarding an individual`s food and nutrition literacy (FNL), and its impact on dietary behaviours, could guide the development of more effective interventions. This study sought to examine the association between FNL and its components with diet quality and nutrient density among Iranian senior highschool students. In this cross-sectional study, 755 senior high school students were recruited from high schools in Tehran, Iran. FNL was assessed using the Food and Nutrition Literacy Assessment Tool (FNLAT), a selfadministered questionnaire which has been locally designed and validated. Dietary assessment was performed by obtaining two 24-hour dietary recalls. Healthy Eating Index-2010 (HEI-2010) and nutrient-rich food index 9.3 (NRF9.3) were calculated to evaluate diet quality. Socioeconomic status, anthropometric measures, and the health status of participants were also assessed. Higher FNL score was significantly correlated with higher HEI-2010 (β = 0.167, p < 0.001) and NRF9.3 (β = 0.145, p < 0.001) scores. Subgroup analysis indicated that these associations were significant only among males, but not females. Regarding components of FNL, skill dimension of FNL was a stronger predictor for HEI- 2010 (β = 0.174, p < 0.001) and NRF9.3 (β = 0.153, p < 0.001) than knowledge (β = 0.083, p = 0.054 for HEI-2010 and β = 0.107, p = 0.01 for NRF9.3). FNL may be a significant predictor of diet quality and nutrient density among late adolescents. To improve the effectiveness of food and nutrition education, emphasis must be placed on skill development.

A Higher Healthy Eating Index Is Associated with Decreased Markers of Inflammation and Lower Odds for Being Overweight/Obese Based on a Case-Control Study

Obesity is a health risk characterized by chronic inflammation, and food choices are strongly associated with its etiology. Our objective was to investigate the association between dietary patterns and the healthy eating index (HEI) with the odds of overweight/obesity and related inflammatory markers. Within a population-based case-control study, we collected data and samples from 793 normal-weight and 812 overweight/obese Iranian people (based on either body mass index (BMI) or body surface area (BSA)). Dietary intake and HEI scores were obtained via a validated 124-item food frequency questionnaire. Anthropometric and socioeconomic parameters, as well as blood inflammatory markers, were measured. Participants with higher HEI scores had higher serum high-density lipoprotein-cholesterol (HDL-C) and significantly lower energy intake. Water consumption in the overweight/obese group was significantly lower than in the control group. In the final models using partial correlation and controlling for multiple confounders, there was a significant inverse correlation between HEI and interleukin-4 (IL-4, R = -0.063), IL-1β (R = -0.054), and high-sensitivity C-reactive protein (hs-CRP, R = -0.069). Based on multivariable logistic regression models adjusted for multiple confounders, there was a significant association between HEI as a continuous variable (OR = 0.993, 95% CI: 0.988-0.999) and categorical variable (OR = 0.801, 95% CI: 0.658-0.977) and odds of overweight/obesity across BMI groups. The dietary patterns in the case and control groups however were similar, and we failed to find a significant association between HEI and odds of overweight/obesity based on BSA. Adherence to healthy eating recommendations may be a prudent recommendation to prevent overweight/obesity and keeping inflammatory indicators low.

Abstract 2261: Impact of healthy eating patterns on HPV infection in women

Abstract Background: Most cervical cancers are directly linked to infection with Human Papillomavirus (HPV), especially oncogenic or high-risk HPVs (HR-HPVs). Studies showed that high levels of several nutritional antioxidants (such as vitamin A, B2, E, and folate) are inversely associated with HR-HPV genital infection among women. These antioxidants are associated with dietary patterns, but associations between dietary patterns and genital HPV infection in women are understudied. To address this gap, this study aims to evaluate associations between healthy eating quality and patterns and genital HPV infection in women. Method: The study included 10,543 women aged 18-59 years from the 14-year (2003-2016) National Health and Nutrition Examination Survey, a US population-based survey. The outcome variable is the HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV), measured based on vaginal swabs. The dietary patterns were evaluated using the Healthy Eating Index (HEI), which measures diet quality based on 13 food components based on key recommendations of the Dietary Guidelines for Americans. A higher HEI score (overall score: range 0-100 or component score: 0-5 or 10) indicates a better diet quality. Associations between the HEI scores and HPV infections were evaluated using the survey weighting multinomial logistic regression adjusting for potential confounding factors. Results: The mean HEI score for US women is 54.5 (standard error=0.4). Women with vaginal HPV infection tended to have a low HEI score (p&amp;lt;0.001). The mean HEI scores for women with HPV-negative, LR-HPV, and HR-HPV are 55.6, 53.1, and 42.2, respectively. However, the association with the overall HEI score became non-statistically significant after adjusting the confounding factors (such as age, smoking, and sexual behavior). The women with the highest intake (score=5 out of 5) of greens and beans and total fruit had a lower risk of HR-HPV (OR=0.70 vs. score=0, p&amp;lt;0.001, and OR=0.57, p&amp;lt;0.01, respectively) adjusted for confounding factors. A high intake of whole grains and dairy can lower the risk of LR-HPV but not HR-HPV. In addition, women with a high score of total protein had a higher risk of HR-HPV (OR=2.1 for score=5 vs. 0-2, p&amp;lt;0.05). Conclusion: This study showed that healthy eating patterns are inversely associated with vaginal HPV infection for US women. These findings can provide valuable insight into developing an intervention to prevent HPV infection from getting established or HPV persistence among the population at higher risk for cervical cancer. Citation Format: Huiyi Lin, Qiufan Fu, Tung-sung Tseng, Krzysztof Reiss, Joseph Su, Martin J. Ronis, Jennifer E. Cameron, Michael E. Hagensee. Impact of healthy eating patterns on HPV infection in women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2261.

Exposure to O3 and NO2 in physically active adults: an evaluation of physiological parameters and health risk assessment.

The gaseous air pollutants ozone (O3) and nitrogen dioxide (NO2) have a large public health relevance and trigger environmental health risk. On the other hand, despite the health benefits, exercise practices might increase the susceptibility to air pollutants exposure. However, there are innumerous lifestyle factors besides physical activity habits that must be considered in the daily air pollution exposure and are still not fully comprehended. This study aimed to evaluate the effects of O3 and NO2 exposure on cardiorespiratory fitness, lipid accumulation product (LAP), and environmental health risk during the entire daily routine of physically active adults that exercise in outdoor and indoor environments. One hundred and twenty healthy young men were assigned to untrained (n = 52), indoor exercise (n = 36), and outdoor exercise (n = 32) groups, following their lifestyle exercise habits, and O3 and NO2 were assessed by personal monitoring. Exercised groups demonstrated higher healthy eating index (HEI) (p < 0.001), physical activity (PA) (p < 0.001), metabolic equivalent of task (MET) (p < 0.001), and peak oxygen uptake VO2peak (p < 0.001), while outdoor group had lower LAP index (p < 0.001) and higher O3 concentration (p = 0.0442). Environmental health risk demonstrated no difference (p > 0.05). The higher O3 concentration was positively correlated with the risk quotient (p = 0.003) and MET (p = 0.020), and a negative correlation between LAP and VO2peak was observed (p < 0.001). In conclusion, physically active individuals might have a lower risk of developing cardiovascular and metabolic diseases despite the higher O3 concentration exposure, and the exposure during exercise did not represent an additional health risk.

Compliance with dietary guidelines and its relationship with symptoms and clinical outcomes in patients with advanced cancer in early-phase oncology clinical trials.

199 Background: We examined compliance with the Dietary Guidelines for Americans and its association with symptom burden and clinical outcomes in patients with advanced cancer in early-phase clinical trials testing novel immunotherapeutic and targeted agents. Methods: Patients starting an early-phase clinical trial (ECOG-PS = 0-1) were recruited into a prospective, longitudinal design with assessments at baseline and at the end of Cycle 1. Diet and symptom burden were assessed using the validated National Cancer Institute Diet History Questionnaire (NCI-DHQ) and the MD Anderson Symptom Inventory, respectively. Compliance with the Dietary Guidelines for Americans recommendations was measured via the Healthy Eating Index (HEI) (a measure of dietary intake per total energy), computed from NCI-DHQ food group and nutrient scores; higher HEI scores indicate greater compliance with dietary guidance recommendations (possible range = 0–100). Statistical tests included Spearman rank correlations (rho), and Cox proportional hazards models. Results: Among early-phase clinical trial patients [N = 40; 50% female; 80% Non-Hispanic White; 80% ECOG = 1; 36% on trials including an immunotherapeutic agent and 64% on targeted therapy trials; mean age = 55y; mean BMI = 28], mean HEI was 69, compared to 59 for the US general population. The proportion of phase I clinical trial patients who met adequacy guidelines were 80% for whole fruit, 73% for total protein foods, 55% for seafood and plant proteins, 55% for total fruit, 50% for greens and beans, 28% for total vegetables, 15% for fatty acids [(PUFAs + MUFAs)/SFAs ≥2.5], 13% for dairy, and 0% for whole grains. The proportion of patients who met moderation guidelines were 28% for refined grains, 28% for added sugar, 13% for saturated fat, and 0% for sodium. Female patients had higher HEI scores than male patients (73 vs. 65, P = 0.004). Patients who were normal weight (BMI &lt; 25) had higher scores for meeting the moderation in sugar intake guideline than overweight patients (BMI≥25) (7.7 vs. 5.5, P = 0.031). Higher intakes of cooked lean meat from beef, pork, veal, lamb, and game were linked to prolonged overall survival (HR = 0.5, 95%CI = 0.26, 0.96, P = 0.039). In immunotherapy patients, greater compliance with seafood and plant protein recommendations was associated with less fatigue at end of Cycle 1 (rho = -0.7, P = 0.008); in targeted therapy patients, higher glycemic load was associated with worse pain (rho = 0.7, P = 0.004). Conclusions: Diets of these early-phase clinical trial patients overall were congruent with recommendations in the Dietary Guidelines for Americans. However, increasing intakes of whole grains and reducing sodium intakes may be useful dietary goals for this population. Also, dietary factors may influence symptoms, such as fatigue and pain, in early-phase clinical trial patients with advanced cancer.

Diet quality among Indigenous and non-Indigenous children and youth in Canada in 2004 and 2015: a repeated cross-sectional design.

The objectives were to describe changes in diet quality between off-reserve Indigenous and non-Indigenous children and youth from 2004 to 2015 and examine the association between food security and diet quality. We utilised a repeated cross-sectional design using both the 2004 and 2015 nutrition-focused Canadian Community Health Surveys, including 24-h dietary recall. Diet quality was estimated according to the Healthy Eating Index (HEI). The surveys were conducted off-reserve in Canada's ten provinces. Our analysis included children and youth 2-17 years old (n 18189). Indigenous and non-Indigenous participants were matched, and using a general linear model, we tested time period and (non-)Indigenous identifiers, including their interaction effect, as predictors of HEI. Both Indigenous and non-Indigenous children and youth had significantly higher HEI scores in 2015 as compared to 2004. There was not a significant (non-)Indigenous and time period interaction effect, indicating the improvements in diet quality in 2015 were similar between both Indigenous and non-Indigenous populations. Improvements in diet quality are largely attributed to reductions in percentage energy from 'other' foods, though a disparity between Indigenous and non-Indigenous children and youth persisted in 2015. Overall, food security was lower among the Indigenous population and positively, and independently, associated with diet quality overall, though this relationship differed between boys and girls. School policies may have contributed to similar improvements in diet quality among Indigenous and non-Indigenous populations. However, an in-depth sex and gender-based analysis of the relationship between food security and diet quality is required.

Diet Quality, Gut Microbiome and Metabolism

ObjectivesDietary pattern is associated with circulatory and gut metabolome variation. However, it is unclear if this association is mediated by gut microbiome composition. We investigated whether the interaction between diet quality and gut microbiome influenced circulatory and gut metabolites. MethodsWe conducted a cross-sectional study among 75 healthy adults in the ABO Study. Diet quality was assessed using the Healthy Eating Index (HEI). Metabolome profiling (800 circulatory and 767 gut metabolites) was performed at Metabolon Inc. Two gut microbiome Enterotypes (1 and 2) were identified using the Partitioning Around Medoids method. Metabolite set enrichment analysis was performed using Metaboanalyst 4.0. Multivariable linear regression was conducted to test for an interaction between the gut microbiome-HEI and metabolite levels. ResultsDiet quality was significantly higher in participants with Enterotype 2, compared to those with Enterotype 1 (P = 0.01). The gut microbiome-HEI interaction (Enterotype 2 and higher HEI) was directly related to omega-3/omega-6 poly-unsaturated fatty acids (PUFAs) and acetyl/acyl derivatives of amino acids. It was inversely linked to polar lipids including 1-palmitoyl-2-linoleoyl-GPC (16:0/18:2), which demonstrated the most significant association (β = 0.008, P = 0.0009) among circulatory metabolites. Considering gut metabolome, however, the interaction directly associated with metabolites involved in DNA synthesis including thymidine 5′-monophosphate, which showed the strongest association (β = 0.041, P = 0.0007), and bile acids derivatives. It inversely associated with fatty acids and branch chain amino acids. ‘Glycine and serine metabolism’ was the only pathway that was significantly enriched by the interaction (P = 0.044). ConclusionsFuture research is warranted; however, these findings suggest that the efficacy of dietary interventions targeted at altering metabolism (the metabolism of lipids (PUFAs and polar lipids), amino acids and nucleotides) may be dependent on gut microbiome composition. Funding SourcesThe National Institutes of Health.

Healthy lifestyle challenges among older female cancer survivors.

156 Background: Healthy lifestyles including consuming a healthy diet, being physically active, and maintaining a normal weight can improve prognosis and health-related quality of life (HRQoL) among cancer survivors. The largest proportion of cancer survivors are older adults (≥65 years), yet their lifestyle behaviors are understudied. This study examined the lifestyle behaviors (diet quality, physical activity, maintaining healthy weight) of older female cancer survivors and associations with HRQoL. Methods: Women aged 65 years or older, with all cancer subtypes and stages, who had completed primary cancer treatment (i.e., chemotherapy, surgery, radiation) within the past five years, were eligible to participate. Older female cancer survivors (n = 171) completed one-time surveys to assess HRQoL (RAND-36), unintentional weight loss, body mass index (BMI), diet quality (Diet History Questionnaire II), and physical activity. Demographic information and medical record data were also collected. Diet History Questionnaire II results were converted to Healthy Eating Index (HEI)-2015 scores. Descriptive analyses, correlations, and stepwise linear regressions were utilized. Results: The majority of the sample (median age = 74.50±8.43 years) were white (90%), married (54.7%), breast cancer survivors (67.7%), and completed at least a bachelor’s degree (54.7%). Physical and mental HRQoL of the sample were low; 41.94±10.50 and 48.47±7.18, respectively, out of 100. Physical activity was low; 75.3%, 54.2%, and 68.1% reported no strenuous, moderate, and mild physical activity, respectively. Mean BMI was 27.71±6.24 (overweight), with 64% of the participants being overweight or obese. Mean HEI-2015 scores were 66.54+10.0 out of 100 and below the cutoff score of 80, which represents a “good diet”. Participating in moderate physical activity was associated with higher physical HRQoL (β = 0.42, p = 0.004). Being older (β = 0.27, p = 0.025), white (β = 0.53, p &lt; 0.001), and having higher HEI scores (β = 0.30, p = 0.011) was associated with higher mental HRQoL. Conclusions: Older female cancer survivors reported lifestyle challenges including poor diet quality, low levels of physical activity, and high rates of being overweight or obese, which were associated with HRQoL. Results indicate the need for tailored health interventions for older female cancer survivors regarding their lifestyle behaviors to improve prognosis and HRQoL.

Longitudinal Changes in Diet Quality over Adulthood and Physical Function in Older Life: Findings from a British Birth Cohort

Abstract Objectives A healthy diet has been linked to better physical function in older adults but evidence on the role of cumulative dietary exposure is scarce. Sex differences in the relationship are also underexplored. The objective was to explore the longitudinal association of diet quality in adulthood (from 36–64 y), in line with dietary guidelines, and walking speed as an objective measure of later life physical function. Methods Study sample was derived from the Insight 46 (n = 502), a neuroscience sub-study of the longitudinal National Survey of Health and Development, UK. Diet was assessed four times, at age 36 y, 43 y, 53 y and 60–64 y using five-day food diaries, from which the Healthy Eating Index-2015 (HEI) was calculated (0 - low quality, 100 - high quality). Walking speed was estimated in a 10-meter walk test at self-selected pace, using an inertial measurement unit at age 69–71 y. Linear mixed models with random effects and group-based trajectory modeling were used to assess individual and group changes in HEI in adulthood. Multivariable linear regression models with sex as modifier, controlling for multiple characteristics assessed the association between adulthood HEI trajectories and walking speed at 71 y. The final sample was 226 women and 230 men. Results Men and women improved diet quality linearly in adulthood (β: 0.6 HEI/y, 95% CI: 0.5, 0.7). Three linear HEI trajectories were identified (21% “Low” βo: 33, β: 3.6; 59% “Medium” βο: 38, β: 6.1; 20% “High” βο: 52, β: 5.5, P &amp;lt; 0.001). Women had faster increase rates, higher HEI at each age (β: 4 HEI points, 95% CI: 3, 6) and were more likely to belong to the “High” HEI trajectory than men (β: 1.97, P &amp;lt; 0.001). There was no overall association but in women a 10 point increase in predicted HEI trajectory and membership in the “High” vs “Medium”-“Low” HEI trajectories were associated with faster walking speed (β: 0.04 m/s, 95% CI: 0.01, 0.08, β: 0.06 m/s, 95% CI: 0.01, 0.11, respectively). Association was attenuated in multivariable models. No association was observed in men. Conclusions In women, higher diet quality in adulthood was associated with faster walking speed in later life. Achieving and maintaining high diet quality in adulthood is likely of importance to yield benefits in physical function. Funding Sources Medical Research Council UK Alzheimer's Research UK Dementias Platform UK Wolfson Foundation UK CLOSER UK.

Diet quality in late midlife is associated with faster walking speed in later life in women, but not men: findings from a prospective British birth cohort.

Healthy diet has been linked to better age-related functioning, but evidence on the relationship of diet quality in late midlife and measures of physical capability in later life is limited. Research on potential sex differences in this relationship is scarce. The aim was to investigate the prospective association between overall diet quality, as assessed by the Healthy Eating Index-2015 (HEI-2015) at 60-64 years and measures of walking speed 7 years later, among men and women from the Insight 46, a neuroscience sub-study of the Medical Research Council National Survey of Health and Development. Diet was assessed at 60-64 years using 5-d food diaries, from which total HEI-2015 was calculated. At 69-71 years, walking speed was estimated during four 10-m walks at self-selected pace, using inertial measurement units. Multivariable linear regression models with sex as a modifier, controlling for age, follow-up, lifestyle, health/social variables and physical performance, were used. The final sample consists of 164 women and 167 men (n 331). Women had higher HEI-2015 and slower walking speed than men. A 10-point increase in HEI-2015 was associated with faster walking speed among women (B 0·024, 95 % CI 0·006, 0·043), but not men. The association remained significant in the multivariable model (B 0·021, 95 % CI 0·003, 0·040). In women, higher diet quality in late midlife is associated with faster walking speed. A healthy diet in late midlife is likely to contribute towards better age-related physical capability, and sex differences are likely to affect this relationship.

Association of Probiotic Consumption and Body Mass Index in the US Population: Insights from NHANES (P21-022-19)

ObjectivesTo determine the association between probiotic consumption through food or supplements and Body Mass Index (BMI) in National Health And Nutrition Examination Survey (NHANES) data. MethodsThis large US population based cross-sectional study includes 2005–2014 NHANES data. We utilized 24-hour Dietary Recall (DR) interviews and Dietary Supplement Use 30-Day recall (DSQ) to extract the Probiotic Food (PF) and Probiotic Supplements (PS) consumption, respectively, using text search terms. Adults (≥18 years), who responded to DR interviews and DSQ, were included, while pregnant women were excluded from the study. Differences in probiotic consumers and non-consumers were assessed with χ2/Wilcoxon tests.To assess the relationship among probiotic consumption and BMI, we performed multiple linear regression while adjusting for confounders such as gender, race, age, Healthy Eating Index (HEI), Kcal consumption, physical activity and antibiotic use. Results of associations were analyzed separately for PF and PS, and weighted to reflect national estimates. ResultsStudy included 15,104,111 (13.8%) PF consumers and 94,421,839 (86.2%) non-consumers. PF consumers were generally female (63.2% vs. 51.6%), white (77.6% vs. 67.1%), older [mean (±SD) 48.54 ± 0.99 vs. 46.29 ± 0.55 years], had higher HEI [57.52 ± 0.86 vs. 52.33 ± 0.37] and Kcal consumption [3861.77 ± 63.70 vs. 3737.49 ± 31.62], but similar physical activity (46.9% vs. 46.9%) and antibiotic use (4.9% vs. 4.6%) compared to non-consumers.We also identified 1108,619 (1.1%) PS users and 101,698,442 (98.9%) non-users. Compared to non-users, PS users were commonly female (67.8% vs. 51.8%), white (84.5% vs. 66.4%), older [52.60 ± 3.11 vs. 46.36 ± 1.06 years], had higher HEI [60.92 ± 2.41 vs. 52.70 ± 0.37], similar physical activity (45.3% vs. 45.0%) and Kcal Consumption [3599.08 ± 182.06 vs. 3737.43 ± 31.83], but more antibiotic users (9.4% vs. 4.5%).After adjusting for confounders, the weighted mean BMI was 0.48 kg/m2 [95% Confidence Interval (CI) = (−0.68) – (−0.28)] lower for PF consumers than non-consumers. PS users had even lower weighted mean BMI [−1.10 kg/m2, 95% CI = (−1.71) – (−0.48)] compared to non-users. ConclusionsIn this large nationally representative population-based study, probiotic consumption via food or supplement was associated with lower body mass index. Funding SourcesNone.

Sodium Intake in Inner-City Patients with Diabetes and Chronic Kidney Disease (CKD): Relationship to Age, Depression/Anxiety, and Diet Quality (P04-112-19)

ObjectivesWe examined factors associated with adherence to 2.3 g/d sodium intake in a population of inner-City patients from specialty clinics where sodium restriction is advised. MethodsA random sample of 109 patients from an inner-city CKD (37), dialysis (23), medicine/diabetes (18) and transplant clinic (31) were studied. Dietary intake was assessed by 24-hour food recall, analyzed using ASA24 software and used to calculate Healthy Eating Index (HEI). Nutritional literacy was assessed via the Newest Vital Signs toolkit. Depression and anxiety were assessed using PHQ-9 and PSS scales. ResultsThere were 41 (38%) men and 67 (62%) women with 89 black, 5 white, 3 Hispanic and 14 other. 71 (65%) pts were foreign born (time in the US 35.9 ± 15.3 yrs). 43/81 (53%) pts made <$20 K/yr. Mean BMI was 29.2 ± 6.4. Mean sodium intake was 2.53 ± 0.99 g/d (range 0.95 to 6.67 g). 14 pts (14%) restricted sodium to <1.5 g/d. 45 (41%) pts ate 2.3 g or less sodium/day (LoNa). LoNa pts were older than pts who ate > 2.3 g/d (HiNa) (69.1 ± 11.4 vs 58.4 ± 15.9, P < 0.001), but did not differ for BMI, gender, education, nutritional literacy, exposure to nutrition counseling, income or marital status. LoNa had lower scores for depression (2.33 ± 4.3 vs 4.22 ± 4.3, P = 0.016) and anxiety (7.83 ± 7.4 vs 11.7 ± 6.6, P = 0.019). LoNa pts ate fewer calories overall (1093 ± 258.9 vs 1594 ± 401.5, P < 0.0001), less B1, B2, Niacin, B6 and folate but did not differ for vitamins C, E, D or K. They ate less cured meat and total grains, but similar total fat and vegetable intake, eggs, dairy, or added sugars. They ate a higher % of calories from carbohydrates (50.4 ± 13.4 vs 44.4 ± 10.9, P = 0.012), but did not differ for fat or protein. LoNa pts scored lower for food insecurity than HiNa (3.67 ± 0.69 vs 3.17 ± 1.1, P = 0.012, 4 = food secure, < 4 = food insecure) and had higher HEI (61.0 ± 12.9 vs 54.3 ± 11.5, P = 0.009). ConclusionsIn our population of inner-City pts: 1. Most patients ate >2.3 g sodium/day. 2. Pts who ate low sodium were older, ate fewer calories overall, and scored lower for depression, anxiety, and food insecurity. 3. Pts who ate low sodium ate a higher percentage of calories from carbohydrates and less B vitamins, cured meat and grains but did not differ for fat, fat soluble vitamins, vit C, vegetables, eggs, dairy or added sugar. 3. The contribution of depression/anxiety, stress and food insecurity to higher sodium intake is unclear, but warrants further study. Funding Sourcesnone.

Abstract P215: Adherence to the Healthy Eating Index-2015 May Reduce the Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality

Background: The Healthy Eating Index-2015 (HEI-2015) score measures adherence to recommendations from the most recent Dietary Guidelines for Americans . The HEI-2015 was altered from the HEI-2010 by replacing the empty calories component with saturated fat and added sugar. Few studies have examined the association between the HEI-2015 score and incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. Hypothesis: We hypothesized that a higher HEI-2015 score, indicating better diet quality, would be associated with a lower risk of incident CVD, CVD mortality, and all-cause mortality. Methods: We conducted a prospective analysis of 12,135 participants aged 45-64 years from the Atherosclerosis Risk in Communities (ARIC) study. The HEI-2015 score (0-100) was computed using the average dietary intake assessed using food frequency questionnaires at visits 1 (1987-89) and 3 (1993-95) and divided into quintiles. Incident CVD, CVD mortality, and all-cause mortality were ascertained from baseline through December 31, 2016. We conducted Cox proportional hazards models adjusted for covariates to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 4,163 cases of incident CVD, 1,429 cases of CVD mortality, and 5,173 cases of all-cause mortality over a median of 25 years of follow-up. Compared to participants in the lowest quintile of HEI-2015 score, participants in the highest quintile had a 12% lower risk of incident CVD (HR: 0.88, 95% CI: 0.79-0.98), 41% lower risk of CVD mortality (HR: 0.59, 95% CI: 0.49-0.71), and 25% lower risk of all-cause mortality (HR: 0.75, 95% CI: 0.69-0.83) after adjusting for covariates ( Table ). There were significant trends across quintiles of HEI-2015 score for all three outcomes. Results were consistent by subgroups (sex, smoking, diabetes, hypertension). Conclusions: Higher adherence to the Dietary Guidelines for Americans 2015-2020 may reduce the risk of incident CVD, CVD mortality, and all-cause mortality among middle-aged adults in the U.S.