Improve Diet Quality Research Articles

Snacking Consumption among Adults in the United States: A Scoping Review.

Snacks are a staple of the American diet, contributing to approximately 20% of energy intake. Most U.S. adults consume one to three snacks/day, yet few reviews have focused on snacking among this population. This scoping review was conducted to characterize snacks and snacking occasions among U.S. adults to further inform healthy eating practices. The protocol was prepared following the PRISMA-Extension for Scoping Reviews. Three web databases were used to identify articles using snacking or eating occasions as primary or secondary outcomes among U.S. adults. A search strategy was developed using subject headings, truncation, and phrase searching in the title and abstract of articles published between 2010 and 2022. A two-stage, multi-step screening process identified 31 of 4795 publications as meeting the inclusion criteria. Findings included identification of snacking themes, e.g., cues and motivations; diet composition; and weight management. Food quality, time of consumption, and convenience emerged as characteristics of snacking; time of day was found to influence food choice. Snacks contribute to or detract from a healthy diet. Strategic selection of healthy snack options can improve diet quality. Applied to nutrition education, this information can help strengthen programs or policies, ultimately contributing to health and wellbeing.

Effect of a dietary intervention based on the Mediterranean diet on the quality of life of patients recovered from depression: Analysis of the PREDIDEP randomized trial

IntroductionThere is substantial evidence supporting that improving diet quality leads to improved health-related quality of life (HRQoL). Our major aim was to assess the effectiveness of a Mediterranean diet–based nutritional intervention to improve HRQoL in the context of a secondary prevention trial of depression. Secondarily to assess its effectiveness among adults aged 60 or more years. MethodsThe PREDIDEP study is a 2-year multicentre, randomized, single-blinded nutritional trial. At baseline and at 1-year and 2-year follow-up, SF-36 health survey questionnaire was collected to evaluate participants' HRQoL (total and specific range for each of the 8 dimensions: 0 to 100 points). Mixed effect linear models were used to assess changes in HRQoL according to adherence to the Mediterranean diet. The trial was registered at ClinicalTrials.govNCT03081065. ResultsAfter 2 years of intervention, the Mediterranean Diet intervention group compared to control group (without nutritional intervention, only usual clinical care) showed an improvement in some dimensions of HRQoL such as Mental Health (7.22; 95 % CI = 2.22–12.22) (between-group difference: 6.79; 95 % CI −0.14–13.73, p = 0.055); Vitality (9.51; 95 % CI = 4.00–15.03) (between-group difference: 9.00; 95 % CI 1.75–16.25, p = 0.020); Mental Summary Component (2.83; 95 % CI = 0.55–5.11) (between-group difference: 1.17; 95 % CI = −1.96–4.30, p = 0.462); and General Health (10.70; 95 % CI = 5.58–15.81) (between-group difference: 6.20; 95 % CI = −0.89–13.28, p = 0.086). Similar results were observed for participants aged 60 or more years. ConclusionThe intervention based on Mediterranean diet in patients with previous depression seems to be effective in improving HRQoL, especially the mental dimensions. This effect is also observed among participants aged 60 or more years.

Current and emerging medications for the management of obesity in adults.

Current and emerging medications for the management of obesity in adults.

Free sugar intake from snacks and beverages in Canadian preschool- and toddler-aged children: a cross-sectional study

BackgroundExcess consumption of free sugar (FS) increases the risk of dental caries and unhealthy weight gain. However, the contribution of snacks and beverages to young children’s FS intake is not well understood. The purpose of this study was to determine FS intake from snacks and beverages among preschool-aged Canadian children.MethodsThis cross-sectional study examined baseline data from 267 children 1.5 to 5 y enrolled in the Guelph Family Health Study. Dietary assessment was completed over a 24-h period using ASA24-Canada-2016 to, 1) estimate the proportion of children whose FS intake from snacks and beverages consumed exceeded 5% total energy intake (TE) and 10% TE, and 2) identify the top snack and beverage sources of FS.ResultsFS contributed 10.6 ± 6.9% TE (mean ± SD). 30 and 8% of children consumed ≥ 5% TE and ≥ 10% TE from snack FS, respectively. Furthermore, 17 and 7% of children consumed ≥ 5% TE and ≥ 10% TE from beverages FS, respectively. Snacks and beverages accounted for 49 ± 30.9% of FS energy. Top snack sources of FS (% children, children’s %TE from FS) were bakery products (55%, 2.4%), candy and sweet condiments (21%, 3.0%), and sugar-containing beverages (20%, 4.1%). Top sugar-containing beverage sources of FS (48%, 5.3%) were 100% fruit juice (22%, 4.6%) and flavored milk (11%, 3.1%).ConclusionsSnacks and beverages contributed nearly half of FS intake among a sample of young children in Canada. Thus, long-term monitoring of snacking behavior and consumption of FS is warranted. These findings may help inform nutritional strategies and public policies to improve diet quality and FS intake in preschool-aged children.Trial registrationThe Clinical Trial Registry number is NCT02939261 from clinicaltrials.gov. Date of Registration: October 20, 2016.

The Global Diet Quality Score predicts diet quality of women of reproductive age in Addis Ababa, Ethiopia.

Improving diet quality is recognised as a double-duty action that can simultaneously address multiple forms of malnutrition. This study aimed to assess diet quality among non-pregnant non-lactating women of reproductive age (WRA) in Addis Ababa, Ethiopia. A 1-d quantitative 24 h recall was conducted among 653 non-pregnant/non-lactating women. Diet quality, assessed using the women dietary diversity score (WDDS), the Global Diet Quality Score (GDQS) and the Nova 4 classification reflecting consumption of ultra-processed foods (UPF), was compared. The proportion that meets the minimum dietary diversity for women (MDD-W) was estimated. The average MDD-W score was 2·6 (sd 0·9), with only 3 % of women meeting the MDD-W (≥ 5 food groups). Consumption of wholegrain and legumes was high, but UPF were also consumed by 9 % of the women. GDQS was positively associated with WDDS, age and skipping breakfast and was negatively associated with eating out of home and UPF consumption (P < 0·05). The multivariate regression model showed that GDQS (total) was not associated with wealth but was significantly associated with both UPF and WDDS (P < 0·001). Unlike UPF and WDDS alone, GDQS was able to predict both nutrient adequacy and unhealthy dietary practices. The diet quality of WRA in Addis Ababa is low in diversity, possibly exposing them to higher risk of nutrient inadequacy and non-communicable diseases as reflected by the low GDQS. Understanding what drives food and dietary choices in urban settings is urgently needed.

Abstract MP64: Impact of a Vegan Diet Compared to Omnivorous Diet on Blood Lipids and Weight Among Identical Twins: The Twins Nutrition Study (TwiNS) Randomized Controlled Trial

Introduction: Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity. Growing evidence suggests potential cardiovascular benefits of vegan diets due to improvements in diet quality (i.e., higher consumption of vegetables, fruits whole grains, nuts, legumes, and seeds). Methods: The TwiNS randomized controlled trial examined the cardiometabolic impact of a healthy vegan diet compared to a healthy omnivorous diet (NCT05297825). These diets were examined in 22 pairs of identical twins, where one twin followed the vegan diet, and the other twin followed the omnivorous diet for 8 weeks. Diet specific meals were provided via a meal delivery service from baseline through week 4, and during weeks 5-8 participants prepared their own diet appropriate meals and snacks. The primary outcome was difference in LDL cholesterol from baseline to week 8. Secondary outcome measures included change in triglycerides, HDL-cholesterol and body weight. Adherence to study diets, ease/difficulty in following the diets, participant energy levels, and sense of wellbeing were also measured. A linear mixed model was used to investigate a difference in the change in primary and secondary outcomes from baseline and included a random effect for twin pair, to account for the correlation between identical twins. Results: Participants were generally healthy adults, average age 39.6 years, primarily non-Hispanic White, and had an average BMI of 26.2. On average, twins randomized to the healthy vegan diet had decreased their LDL-cholesterol more after 8 weeks compared to twins on the healthy omnivorous diet (-15.2 vs. -2.3mg/dL, 95% CI: 4.3-24.8). Participants on the healthy vegan diet also had decreased their body weight more after 8 weeks (-1.9 vs. -0.29 kg, 95% CI: 0.9-3.0). No significant differences were observed between the vegan and omnivorous diets for secondary outcomes of triglycerides or HDL-C. Conclusion: This study contributes to growing evidence that vegan diets may offer a protective cardiometabolic advantage compared to a healthy, omnivorous diet. Further analyses of the TwINS trial will examine changes to the gut microbiome (i.e., microbial diversity), inflammatory markers, and other health factors.

Abstract P301: Diet Quality and Frailty in Israeli Adults 65 Years or Older

Background: Frailty represents a transition state between successful aging and disability. Nutrition may promote successful aging. However, only a few studies explicitly examined the association between overall diet quality and frailty in the oldest old age group. Methods: We studied an older adult (65+) cohort that participated in the Israeli National Health and Nutrition Survey of Older Adults in 2005-2006 (T1, N=1,799). Survivors of T1 were contacted, and from 2017-2019, an extensive interview and a functional assessment were conducted (T2) among 604 past participants. A 24-hour dietary recall, assessed at T1, was used to calculate the healthy eating index (HEI-2015), a measure of diet quality used to assess how well a set of foods aligns with key recommendations. A frailty index (FI) based on accumulation of deficits was developed and comprised 33 variables, including clinical, functional, and cognitive measures. A threshold of ≥ 0.26 was used to define frailty. Frail participants at T1 were excluded from the analysis (n=125). Logistic regression models were constructed to assess the association of HEI-2015 with frailty incidence. Inverse probability weighting was used to minimize attrition bias. Results: Among the 479 T2 participants analyzed (mean [SD], age 84 [5] years, 50% women), 225 (46%) were classified as frail. Frail participants were older, less educated, with a lower household income and a higher comorbidity burden at baseline than non-frail subjects. After adjustment for sociodemographic and lifestyle factors, a higher HEI-2015 score was associated with decreased odds of incident frailty [odds ratio, 0.56 (95% CI: (0.35-0.90), for the upper tertile; 0.68, (95% CI: 0.42-1.09), for the middle tertile, compared with the lower tertile ( P for trend = .005). A spline analysis supported a linear decline in frailty with increasing HEI-2015 scores (Figure). Conclusion: In this cohort study of oldest-old participants, improved diet quality was inversely associated with frailty incidence in a dose-dependent manner.

Abstract P616: Implementing a Dietary Energy Density Intervention in Preschool Children

Introduction: The preschool years have been identified as a critical time to intervene on energy balance behaviors to halt the progression of obesity. In children, strategies for achieving physical activity recommendations are well established. Less clear are strategies for implementing an optimal dietary approach—one that maintains a healthy body weight and improves diet quality. Energy density (ED), the amount of energy per unit weight of food (kcal/g), may be a promising dietary approach. Hypothesis: We tested the hypothesis that a lower ED dietary approach will lower ED and energy intake and demonstrate better maintenance of body mass index (BMI z-score) than standard dietary recommendations in young children at risk for obesity. Methods: Thirty-six preschool children (3.5±1.1 years; 52.8% female; 52.8% White; 16.7% Hispanic or Latino; BMI percentile 56.8±22.2) and their parent (35.4±6.2 years; 86.1% female; 55.6% White; 13.9% Hispanic or Latino; BMI 38.2±5.4 kg/m 2 ) participated in a 6-month, 14-session, family-based behavioral intervention. Participants were randomized to a low-ED dietary approach (consume ≥10 foods/day with an ED ≤1.0 kcal/g and ≤2 foods/day with an ED ≥ 3.0 kcal/g; LOW-ED), or standard dietary recommendations (meet recommended daily servings of fruits, vegetables, and whole grains; STANDARD). Both interventions had physical activity goals of 60 minutes/day for children and 150 minutes/week for adults. Dietary and anthropometric assessments occurred at baseline and 6-months. Completer and intent-to-treat (ITT) analyses, with outliers removed, used repeated measures general linear mixed models to examine child change in ED (calculated as both all foods and beverages and food only), kcals, and BMI z-score from baseline to 6 months. Results: ITT analyses showed that the change in ED did not differ between the LOW-ED condition and STANDARD condition when calculated as for foods and beverages (LOW-ED: &amp;#916;-0.1 kcal/g vs. STANDARD: &amp;#916;+0.1 kcal/g, p = 0.12) or food only (LOW-ED: &amp;#916;-0.2 kcal/g vs. STANDARD: &amp;#916;+0.1 kcal/g, p = 0.06). There was a significant time by condition interaction with kcals/d decreasing in LOW-ED and increasing in STANDARD over time for completers (LOW-ED: &amp;#916;-98 kcals vs. STANDARD: &amp;#916;+212 kcals, p = 0.04), but not when using ITT (LOW-ED: &amp;#916;+5 kcals vs. STANDARD: &amp;#916;+211 kcals, p = 0.09). Under ITT BMI z-score had a main effect of time, with both LOW-ED and STANDARD conditions significantly increasing over time (p=0.03). Conclusion: In conclusion, these data suggest a LOW-ED dietary approach is an alternative way to lower ED and energy intake in young children at risk for obesity.

Urban-Rural Disparities in Knowledge, Use and Perceived Benefits of Nutrition Labels in China: Evidence from 10 Provinces.

There exist significant gaps in nutritional status between urban and rural populations in China. The previous literature has shown that more knowledge and usage of nutrition labels are instrumental in improving diet quality and health. The aim of the study is to analyze: (1) Are there urban-rural disparities in consumer knowledge, use and perceived benefits of nutrition labels in China; (2) If so, what are the magnitudes of the disparities; (3) What can explain the disparities, and how can the disparities be reduced? The Oaxaca-Blinder (O-B) decomposition is utilized to analyze the predictors of urban-rural disparities in nutrition labels based on a self-conducted study of Chinese individuals. The information from a total of 1635 individuals (aged 11-81 years) across China in 2016 was collected in the survey. We find that rural respondents have less knowledge, lower usage and perceived benefits of nutrition labels than their urban counterparts. Demographics, focus on food safety, frequent shopping locations and income jointly explain 98.9% of the disparity in the knowledge of nutrition labels. Nutrition label knowledge is the predictor which contributes most to urban-rural disparity in label use-accounting for 29.6% of the disparity. Nutrition label knowledge and use are the two biggest predictors of disparities in perceived benefits-accounting for 29.7% and 22.8% of the disparity in perceived benefits, respectively. Our study suggests that policies aiming to improve income and education, as well as raising awareness of food safety in rural areas, are promising in closing the urban-rural disparities in nutrition labels knowledge, use, diet quality and health in China.

Does mindful eating affect the diet quality of adults?

ObjectivesThis study aimed to examine the relationship between mindful eating and diet quality among adults in Turkey. MethodsA total of 207 adults, 138 women (66.7% of 207) and 69 men (33.3%), participated. This cross-sectional survey was carried out among adults aged 20–50 y. The following data were collected from face-to-face interviews: sociodemographic variables, health information, nutritional habits, anthropometric measurements, 24-h dietary records, and scores from the Mindful Eating Questionnaire (MEQ), Mediterranean Diet Adherence Screener (MEDAS), and Healthy Eating Index-2015 (HEI-2015). ResultsThe mean MEDAS scores of females were higher than those of males (P = 0.012). The mean HEI-2015 scores did not significantly differ between females and males (P > 0.05). The mean scores of the MEQ (P = 0.024) and its disinhibition (P = 0.005) and emotional eating (P = 0.000) subfactors were higher in males than in females. The MEQ mean score was negatively associated with daily energy (P = 0.038), carbohydrate (P = 0.046), and fat intake (P = 0.036). As the MEQ mean score increased, the greens and beans score (P = 0.009) and dairy intake score (P = 0.031) increased. A positive correlation was present between the eating discipline subfactor of the MEQ score and both the HEI-2015 (P = 0.002) and MEDAS mean scores (P = 0.001). However, no significant correlation was found between the mean MEQ and HEI-2015 scores and the MEDAS mean scores (P > 0.05). ConclusionsDeveloping mindful eating might be helpful for individual health promotion and quality of life by providing improvements in diet quality of adults.

Adaptation and Validation of the Well-Being Related to Food Questionnaire (Well-BFQ©) for the French-Speaking General Adult Population of Québec, Canada.

Efforts to develop effective strategies that improve dietary intake are needed; however, this improvement in diet quality must not be at the expense of well-being. The Well-Being related to Food Questionnaire (Well-BFQ©) is a tool that has been developed in France to comprehensively measure food well-being. Even though the same language is spoken in France and in Québec, cultural and linguistic differences are present, which supports the importance of adapting and validating this tool before its use in the Québec population. This study aimed to adapt and validate the Well-BFQ© for the French-speaking general adult population of Québec, Canada. The Well-BFQ© underwent a full linguistic adaptation process, including an expert panel adaptation step, a pretest among 30 French-speaking adult (18-65 years) Quebecers, and a final proofreading. The questionnaire was thereafter administered to 203 French-speaking adult Quebecers (49.3% females, MAGE = 34.9, SD = 13.5; 88.2% Caucasians; 54.2% with a university degree). The exploratory factor analysis showed a two-factor structure: (1) food well-being related to physical and psychological health (27 items) and (2) food well-being related to symbolic/pleasure of food (32 items). Internal consistency was adequate, with a Cronbach's α of 0.92 and 0.93, respectively, for the subscales, and 0.94 for the total scale. The total food well-being score, as well as the two subscale scores, were associated with psychological and eating-related variables in expected directions. Overall, the adapted version of the Well-BFQ© was found to be a valid instrument to measure food well-being in the French-speaking general adult population of Québec, Canada.

Fruit, Vegetable, and Sugar-Sweetened Beverage Intake Among Young Children, by State — United States, 2021

Good nutrition in early childhood supports optimal growth, development, and health (1). Federal guidelines support a dietary pattern with daily fruit and vegetable consumption and limited added sugars, including limited consumption of sugar-sweetened beverages (1). Government-published dietary intake estimates for young children are outdated at the national level and unavailable at the state level. CDC analyzed data from the 2021 National Survey of Children's Health (NSCH)* to describe how frequently, according to parent report, children aged 1-5 years (18,386) consumed fruits, vegetables, and sugar-sweetened beverages, nationally and by state. During the preceding week, approximately one in three (32.1%) children did not eat a daily fruit, nearly one half (49.1%) did not eat a daily vegetable, and more than one half (57.1%) drank a sugar-sweetened beverage at least once. Estimates of consumption varied by state. In 20 states, more than one half of children did not eat a vegetable daily during the preceding week. In Vermont, 30.4% of children did not eat a daily vegetable during the preceding week, compared with 64.3% in Louisiana. In 40 states and the District of Columbia, more than one half of children drank a sugar-sweetened beverage at least once during the preceding week. The percentage of children drinking sugar-sweetened beverages at least once during the preceding week ranged from 38.6% in Maine to 79.3% in Mississippi. Many young children are not consuming fruits and vegetables daily and are regularly consuming sugar-sweetened beverages. Federal nutrition programs and state policies and programs can support improvements in diet quality by increasing access to and availability of fruits and vegetables and healthy beverages in places where young children live, learn, and play.

Perceived and calculated diet quality improvements in a randomized mHealth weight loss trial

The diet quality of US adults is poor and cross-sectional analyses suggest self-perception of healthful dietary intake may be overestimated. This analysis assessed the concordance between calculated and perceived diet quality and changes in diet quality among adults seeking weight loss and enrolled in a 12-month randomized behavioral trial. Healthy Eating Index-2015 diet quality (HEI) was calculated from self-administered 24-hour recalls. Perceived diet quality (PDQ) was measured on a 100-point scale. Higher scores indicate better diet quality. Concordance was assessed using the concordance correlation coefficient and Bland-Altman plots. The one hundred and five participants with complete dietary data were mostly female and white. There was good agreement between HEI and PDQ scores at 12 months for less than a third of participants. Most of the disagreement arose from PDQ scores being higher than HEI scores. Even fewer participants had good agreement between HEI changes and PDQ changes. Participants perceived greater improvement in diet quality than indicated by HEI score changes. Concordance was low at 12 months and for change in diet quality. Despite the diet quality of adults seeking weight loss being suboptimal and not improving, many perceived their diet quality and diet quality improvements as better than calculated. Future studies might explore the effect of misperceptions on weight loss outcomes.

Shorter sleep among adolescents is associated with lower fruit and vegetable consumption the following day

BackgroundInsufficient sleep has been associated with weight gain and metabolic dysregulation, with one suggested mechanism being through reduction in diet quality. Experimental evidence supports a causal effect of sleep timings on diet but this may not be applicable to a free-living adolescent population. In this analysis we use daily measures of sleep timings and diet quality, to examine the effect of sleep duration and timing on diet quality the following day among free-living adolescents.MethodsThe ROOTS study is a prospective cohort recruited from secondary schools in Cambridgeshire and Suffolk (UK). Participants (n = 815) at mean age 15.0y (SD 0.3y) completed a diet diary and wore a combined heart rate and accelerometer device over 4 consecutive days. Sleep duration and timing (midpoint) were derived from acceleration and heart rate traces, while daily energy density and fruit and vegetable intake were calculated from dietary data. Analyses were performed at day-level (1815 person-days). Multilevel random effects models were used to test associations between sleep each night and subsequent day diet, with daily sleep and diet measures nested within individuals and schools, and adjusted for day-level and individual-level confounding variables.ResultsAdolescents slept a mean of 7.88 hrs (SD 1.10) per night, reporting a mean energy density of 2.12 kcal/g (SD 0.48) and median energy-adjusted daily fruit and vegetable intake of 137.3 g (IQR 130.4). One hour shorter sleep duration was associated with lower intake of fruit and vegetables (-6.42 g, 95%CI -1.84, -10.99) the following day. An association with higher dietary energy density (0.016 kcal/g, 95%CI 0.034, -0.002) the following day was observed but did not reach statistical significance. Sleep timing was not associated with either fruit and vegetable intake (-2.52 g/d, 95%CI -7.66, 2.62) or dietary energy density (-0.001 kcal/g, 95%CI -0.022, 0.020).ConclusionsOur observational findings from a free-living adolescent population support the experimental evidence for a causal role of sleep on diet, with shorter sleep duration at night leading to a small decrease in diet quality the following day. These findings support experimental evidence to suggest inclusion of sleep duration as one component of interventions designed to improve diet quality and weight status in adolescents.

Media use, dietary intake, and diet quality of adolescents in Saudi Arabia.

Excessive media use can affect diet of adolescents, but relevant data in Saudi Arabia are lacking. The present study aimed to explore the association between media use, dietary intake, and diet quality among adolescents. This cross-sectional study included data of 631 adolescents (ages 11-18 years) who were randomly recruited from 16 schools located in two main cities in the Western region of Saudi Arabia (Madinah and Jeddah). Envelopes including a questionnaire were sent home to collect sociodemographic data. Students then completed the short-form food frequency questionnaire to assess diet quality. Data on media use, anthropometrics, and 24-h dietary recalls were also collected. A high proportion of adolescents (86.2%) exceeded media use recommendations of ≤2 h per day. Significantly higher proportions of younger adolescents, males, and non-Saudis reported media use within the recommendation compared to their peers. Media use predicted lower diet quality score (B = -0.67 [95% CI: -1.09 to -0.28]) and lower intake of calcium, zinc, vitamin D, and vitamin C (B = -104 [95% CI: -203 to -5.24], B = -2.13 [95% CI: -4.15 to -0.11], B = -23.5 [95% CI: -41.3 to -5.65], B = -24.0 [95% CI: -45.1 to -2.96], respectively). Interventions to limit media use are urgently needed for adolescents in Saudi Arabia to improve diet quality and overall nutritional health. Excessive media use can affect diet of adolescents, but relevant data are lacking in Saudi Arabia. The majority of adolescents exceed the recommendations for media use. Media use was negatively associated with diet quality and intake of calcium, zinc, vitamin D, and vitamin C. This study will inform public health entities and policy makers to draw evidence-based, culturally tailored recommendations and develop nutrition interventions to enhance diet quality and nutritional status of adolescents. Findings of this study highlight the urgency to develop intervention programs and policies that aim to limit media use among adolescents.

Prospective Study of the Impact of Outpatient Intensive Cardiac Rehabilitation on Diet Quality, Health-related Quality of Life, and Cardiovascular Health Indices

Intensive cardiac rehabilitation (ICR) programs are approved by the Centers for Medicare & Medicaid Services on the basis of their expected benefits for cardiovascular disease (CVD) risk factors and health outcomes. However, the impact of outpatient ICR on diet quality, quality of life (QOL), and CVD risk factors has not been prospectively assessed. The aim of this cohort study was to test the hypothesis that patients enrolled in a Pritikin outpatient ICR program would show improved diet quality, QOL, and CVD health indexes, and that the improvements would be greater than those of patients in traditional cardiac rehabilitation (CR). Patients enrolled in ICR (n=230) or CR (n=62) were assessed at baseline and at visit 24. Diet quality was assessed using the Rate Your Plate questionnaire, and QOL was assessed through the Dartmouth COOP Functional Health Assessment questionnaire. Secondary end points included anthropometrics, CVD biomarkers, hemodynamics, and fitness. Patients in ICR programs displayed significant improvements at visit 24 versus baseline in Rate Your Plate and Dartmouth COOP Functional Health Assessment scores, weight, body mass index (BMI), waist circumference, fat mass, total and low-density lipoprotein cholesterol, 6-minute walk distance, and grip strength. Patients in ICR had greater improvements in diet quality (p=0.001), weight (p=0.001), and BMI (p <0.001) than did those in CR. In summary, this prospective study of Pritikin outpatient ICR revealed significant improvements in diet quality, QOL, adiposity, and other CVD risk factors. The improvements in diet quality, body weight, and BMI were greater than those observed with traditional CR.

Impact of a farmers’ market healthy food subsidy on the diet quality of adults with low incomes in British Columbia, Canada: a pragmatic randomized controlled trial

BackgroundAdults with low incomes have lower diet quality than their higher income counterparts. In Canada, the British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides coupons to low-income households to purchase healthy foods in farmers’ markets. ObjectiveThe objective of this study was to examine the impact of the FMNCP on the diet quality of adults with low incomes. MethodIn a pragmatic randomized controlled trial conducted in 2019, adults with low incomes (≥18 y) were randomly assigned either to an FMNCP intervention (n = 143) or a no-intervention control group (n = 142). The FMNCP group received 16 coupon sheets valued at $21 per sheet over 10–15 wk to purchase healthy foods from farmers’ markets. Participants completed a questionnaire and 2 24-h dietary recalls at baseline (0 wk), immediately post-intervention (10–15 wk), and 16-wk post-intervention (26–31 wk). Diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015). Linear mixed-effects regression assessed differences in HEI-2015 total (primary outcome) and component scores (secondary outcomes) between the FMNCP and control groups at post-intervention and 16-wk post-intervention. Subgroup analyses examined program impacts by sex and age group (18–59 y, ≥60 y). ResultsThere were no significant differences in HEI-2015 total scores between the FMNCP and control groups at post-intervention (−0.07; 95% CI: −4.07, 3.93) or 16-wk post-intervention (1.22; 95% CI: −3.00, 5.44) overall or between subgroups. There were no significant between-group differences in HEI-2015 component scores at post-intervention, although there were significant differences in component scores for dairy and fatty acids at 16-wk post-intervention. ConclusionThe FMNCP did not significantly improve diet quality among adults with low incomes over the study period. Further research is needed to explore whether higher subsidy amounts or a longer intervention period is needed to meaningfully improve diet quality among adults with low incomes.This trial was registered at [clinicaltrials.gov] as [NCT03952338].

P622 Change in Dietary Inflammatory Index Score in patients with Crohn’s disease and healthy volunteers following the Groningen Anti Inflammatory Diet (GrAID)

Abstract Background Dietary patterns play an important role in Inflammatory Bowel Disease (IBD). The Dietary Inflammatory Index (DII) is a diet quality score that estimates the inflammatory potential of a dietary pattern on inflammatory markers. Recently, the Groningen Anti-Inflammatory Diet (GrAID) was developed to improve disease course in patients with IBD. The aim of this study is to investigate whether following the GrAID improves diet quality based on the DII compared to baseline intake in patients with Crohn’s disease (CD) and healthy volunteers (HV). Methods Between October 2021 and October 2022, patients with CD and HV completed a 12-week GrAID intervention as part of an ongoing trial: VITA-GrAID (NCT04913467). In this sub analysis, nutrient intake from a 3-day food diary was calculated at baseline (T0; habitual diet) and after 12 weeks (T3; following the GrAID), using Evry software (version 2.3.7.0). From both intakes the DII score according to the Shivappa method was calculated, based on 28 food parameters. Next, both scores were compared to the DII score of the GrAID, calculated assuming complete adherence to the GrAID. A lower DII score is regarded to having a higher anti-inflammatory potential. Paired nonparametric tests (Wilcoxon signed-rank) were performed to calculate differences between T0 and T3. Data were analysed using R (2021.09.0) and IBM SPSS Statistics 28. Results Eighteen individuals completed the 12-week GrAID intervention (12 patients with CD; and 6 HV) (table 1). Between T0 and T3, significant increases were found in fibre (16.5g), total protein (21g), total plant protein (14g), vitamin B2 (0.29ug) and beta carotene (1837ug) intake. Significant decreases were found in mono- and disaccharides (-18g), alcohol (- 5.3g), and sodium (-875mg) intake (Table 2). The median DII score at T0 was -0.112, IQR: [-1.269; 1.362] and was significantly lower at T3 (median: -2.040; IQR [-2.588; -1.417], p&amp;lt;0.05) (figure 1). Median DII score in patients with CD differed significant between T0 and T3 (0.323, IQR [-1.3897; 1.523] and -2.040, IQR [-2.665; -1.549] respectively, p&amp;lt;0.05), but not in HV (-0.692, IQR [-1.127; 0.566] and -1.998, IQR [-2.441; -1.336] respectively, p=0.09) (Figure 2). Conclusion These preliminary results show that diet quality improved in patients with CD after following the GrAID for 12 weeks. For HV, probably more participants are needed. Further research is necessary to determine whether a lower DII score will actually improve the disease course of patients with CD and the diversity of the microbiome in HV.

Adult Survivors of Childhood Cancer Have Poor Adherence to Dietary Guidelines

Background: Poor nutritional intake can exacerbate the chronic disease burden in childhood cancer survivors, whereas a healthful diet serves a protective function. Few studies have provided detailed evaluations of the diet of childhood cancer survivors.Objectives: This study aimed to evaluate diet quality and dietary intakes of key food groups and nutrients in a large cohort of childhood cancer survivors and whether cancer and treatment characteristics have an impact on survivors’ long-term intake.Methods: Diet was assessed in 2570 adult survivors of childhood cancer enrolled in the St. Jude Lifetime cohort (mean age = 32.3 y) by using the Block food-frequency questionnaire. The Healthy Eating Index–2010 (HEI-2010) was calculated to quantify diet quality. Cancer diagnosis and treatment exposure were abstracted from medical records. Differences in HEI-2010 by patient characteristics and treatment exposure were examined by using ANCOVA.Results: The mean ± SD HEI-2010 in childhood cancer survivors was 57.9 ± 12.4 of a maximum score of 100. Referenced to Dietary Reference Intakes, survivors consumed inadequate amounts of vitamin D, vitamin E, potassium, fiber, magnesium, and calcium (27%, 54%, 58%, 59%, 84%, and 90% of the recommended intakes) but excessive amounts of sodium and saturated fat (155% and 115% of the recommended intakes) from foods. Survivors diagnosed when <5 y of age had a lower diet quality than did those diagnosed when ≥5 y of age (mean HEI-2010 score: 56.9 compared with 58.2; P = 0.046). Survivors who received higher radiation doses to the abdomen had a lower diet quality than those who received lower doses (mean HEI-2010 scores = 58.9, 57.2, 56.7, and 56.1 for doses of 0, 1–19.9, 20–29.9, and ≥30 Gy, respectively; P = 0.02).Conclusions: Long-term childhood cancer survivors have poor adherence to the 2010 Dietary Guidelines for Americans. Findings reinforce the need to incorporate nutrition into cancer care to improve diet quality and to reduce morbidities.

A remote Whole Food Dietary Intervention to Reduce Fatigue and Improve Diet Quality in Lymphoma Survivors: Results of a Feasibility Pilot Study

Long-term, persistent cancer-related fatigue (CRF) is the most common side effect reported by lymphoma survivors. CRF reduces quality of life, and treatments are limited. This pilot study aimed to determine feasibility of recruiting and retaining diffuse large B-cell lymphoma (DLBCL) survivors in a 12-week remote Fatigue Reduction Diet (FRD) intervention and evaluate preliminary efficacy of the intervention. Participants met remotely with a registered dietitian nutritionist for eight individual sessions. FRD goals included consuming specific fruits, vegetables, whole grains, and omega-3 fatty acid rich foods. Acceptability was assessed by session attendance, FRD goal attainment, and exit surveys. Self-reported dietary intake and fatigue were measured using the Healthy Eating Index-2015 and PROMIS Fatigue Short Form, respectively, at baseline and post-intervention. Ten DLBCL survivors enrolled; nine attended all sessions and completed the intervention. Weekly adherence to targeted food intake goals improved significantly throughout the study (all p < 0.05), with participants meeting goals over 4 day per week by week 11. Mean[SD] diet quality improved significantly from baseline (65.9[6.3]) to post-intervention (82.2[5.0], p < 0.001). Mean[SD] fatigue reduced significantly from baseline (50.41[9.18]) to post-intervention (45.79[6.97], p < 0.05). The 12-week remote FRD intervention was feasible, acceptable, and holds promise to improve diet quality and fatigue in DLBCL survivors.