Improve Diet Quality Research Articles

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.

Towards Sustainable Food Systems: Exploring Household Food Waste by Photographic Diary in Relation to Unprocessed, Processed and Ultra-Processed Food

Global society is wasting food at unsustainable levels, and unconsumed food is contributing markedly to carbon emissions. Simultaneously, food insecurity and obesity are increasingly prevalent concerns in high-income countries. This study aimed to evaluate food waste at the household level to understand relationships between discarded food, food processing and household characteristics. A sociodemographic and food security survey of householders in Hampshire (UK) was conducted alongside a seven-day photographic food waste diary. Of the total food waste from 94 participants, 87% was unprocessed, 51% was avoidable or potentially avoidable and 36% was unavoidable. Of the total food waste, 61% occurred during food preparation. Greater amounts of avoidable food waste occurred in one, three and four+ person households than in two-person households. Potentially avoidable food waste was greater in households educated to postgraduate and university degree level than others. The outcomes of this study indicate that the focus on interventions should vary demographically. Interventions that support food security, improving diet quality and saving money, while reducing avoidable and unprocessed food waste, in one, three and four+ person households during food preparation are one option. Reducing potentially avoidable unprocessed food waste is a priority in households educated to university degree level and above.

Nutritional Assessment and Support in Children with Chronic Kidney Disease: The Benefits of Working with a Registered Dietitian.

An unbalanced dietary pattern, characterized by high animal protein content: may worsen metabolic control, accelerate renal deterioration and consequently aggravate the stage of the chronic kidney disease (CKD) in pediatric patients with this condition. to assess the effect of a registered dietitian (RD) intervention on the CKD children's eating habits. Anthropometric and dietetic parameters, obtained at baseline and 12 months after implementing healthy eating and nutrition education sessions, were compared in 16 patients (50% girls) of 8.1 (1-15) years. On each occasion, anthropometry, 3-day food records and a food consumption frequency questionnaire were carried out. The corresponding relative intake of macro- and micronutrients was contrasted with the current advice by the European Food Safety Authority (EFSA) and with consumption data obtained using the Spanish dietary guidelines. Student's paired t-test, Wilcoxon test and Mc Nemar test were used. At Baseline 6% were overweight, 69% were of normal weight and 25% were underweight. Their diets were imbalanced in macronutrient composition. Following nutritional education and dietary intervention 63%, 75% and 56% met the Dietary Reference Values requirements for fats, carbohydrates and fiber, respectively, but not significantly. CKD children decreased protein intake (p < 0.001), increased dietary fiber intake at the expense of plant-based foods consumption (p < 0.001) and a corresponding reduction in meat, dairy and processed food intake was noticed. There were no changes in the medical treatment followed or in the progression of the stages. RD-led nutrition intervention focused on good dieting is a compelling helpful therapeutic tool to improve diet quality in pediatric CKD patients.

Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic.

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural-urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults.

Feasibility, Acceptability, and Initial Efficacy of a Digital Intervention to Improve Consumption of Foods Received within a National Nutrition Assistance Program.

Many mothers are vulnerable to poor diet quality, particularly those living in low-income households. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrient-rich foods through its benefits packages, but many WIC participants are not redeeming them. We assessed the feasibility and acceptability of a digital intervention to support redemption and consumption of WIC-approved foods to ultimately improve diet quality. We enrolled 54 maternal-child dyads receiving WIC benefits to receive three to four weekly text messages for 12 weeks focused on behavioral goals to improve consumption of WIC-approved foods. We assessed engagement with weekly tracking messages and satisfaction and collected 24 h dietary recalls to assess preliminary efficacy on dietary intake. Participants were mostly non-Hispanic white (63%) and working (63%), and responded to 7.4 (standard deviation: 4.6) of the 12 weekly messages. Half (n = 27) were high engagers (responded to 80% or more of weekly messages), with 28% (n = 15) responding to all messages. Most felt the feedback (94%) and tips (87%) were helpful and would recommend the program (91%). More were consuming leafy green vegetables compared to baseline (p = 0.01). Mothers of children enrolled in WIC found a text messaging intervention focused on consumption of WIC-approved foods enjoyable and helpful.

Nutrition Literacy Is Not Sufficient to Induce Needed Dietary Changes in Nonalcoholic Fatty Liver Disease.

Dietary and lifestyle changes are the first line of therapy for nonalcoholic fatty liver disease (NAFLD), the most prevalent liver disease in the western world. Nutrition literacy is the ability to understand nutrition information and implement that knowledge. We aimed to compare indicators of nutrition literacy in subjects with and without NAFLD in a representative US cohort. In a cross-sectional study using data from the National Health and Nutrition Examination Survey 2017-2018 cycle, we included 2,938 adult subjects with complete dietary and vibration-controlled transient elastography data and no alternative reason for hepatic steatosis. Nutrition literacy was assessed using questionnaires. Diet perception accuracy was assessed by comparing self-reported diet quality with objective diet quality scores-the Healthy Eating Index and alternative Mediterranean diet score-to assess real-world application of nutrition knowledge. Nutrition literacy was not different between subjects with or without NAFLD ( P = 0.17): more than 90% of subjects reported using nutrition labels, and most of them correctly identified the meaning of daily value. Subjects with NAFLD had a lower-quality diet (Healthy Eating Index, P = 0.018; alternative Mediterranean diet, P = 0.013) and rated their diet as poorer ( P < 0.001). On self-assessment, only 27.8% of subjects overestimated their diet quality, while 37.5% consumed more calories than their self-assessed needs. Both accuracy measures were similar between subjects with NAFLD and those without ( P = 0.71 and 0.63, respectively). Subjects with NAFLD were more likely to report being advised to lose weight (42.1% vs 16.5%, P < 0.001) or to attempt losing weight (71.9% vs 60.9%, P < 0.001). Diet quality was not better in subjects with NAFLD who received dietary recommendations. Subjects with NAFLD have poor diet quality despite receiving medical recommendations to lose weight and having nutrition literacy and perception that are comparable with subjects without NAFLD. Educational approaches may not be sufficient to promote weight loss and improve diet quality in NAFLD.

The different trends in the burden of neurological and mental disorders following dietary transition in China, the USA, and the world: An extension analysis for the Global Burden of Disease Study 2019.

The highly processed western diet is substituting the low-processed traditional diet in the last decades globally. Increasing research found that a diet with poor quality such as western diet disrupts gut microbiota and increases the susceptibility to various neurological and mental disorders, while a balanced diet regulates gut microbiota and prevents and alleviates the neurological and mental disorders. Yet, there is limited research on the association between the disease burden expanding of neurological and mental disorders with a dietary transition. We compared the disability-adjusted life-years (DALYs) trend by age for neurological and mental disorders in China, in the United States of America (USA), and across the world from 1990 to 2019, evaluated the dietary transition in the past 60 years, and analyzed the association between the burden trend of the two disorders with the changes in diet composition and food production. We identified an age-related upward pattern in disease burden in China. Compared with the USA and the world, the Chinese neurological and mental disorders DALY percent was least in the generation over 75 but rapidly increased in younger generations and surpassed the USA and/or the world in the last decades. The age-related upward pattern in Chinese disease burdens had not only shown in the presence of cardiovascular diseases, neoplasms, and diabetes mellitus but also appeared in the presence of depressive disorders, Parkinson's disease, Alzheimer's disease and other dementias, schizophrenia, headache disorders, anxiety disorders, conduct disorders, autism spectrum disorders, and eating disorders, successively. Additionally, the upward trend was associated with the dramatic dietary transition including a reduction in dietary quality and food production sustainability, during which the younger generation is more affected than the older. Following the increase in total calorie intake, alcohol intake, ratios of animal to vegetal foods, and poultry meat to pulses, the burdens of the above diseases continuously rose. Then, following the rise of the ratios of meat to pulses, eggs to pulses, and pork to pulses, the usage of fertilizers, the farming density of pigs, and the burdens of the above disease except diabetes mellitus were also ever-increasing. Even the usage of pesticides was positively correlated with the burdens of Parkinson's disease, schizophrenia, cardiovascular diseases, and neoplasms. Contrary to China, the corresponding burdens of the USA trended to reduce with the improvements in diet quality and food production sustainability. Our results suggest that improving diet quality and food production sustainability might be a promising way to stop the expanding burdens of neurological and mental disorders.

Adding Walnuts to the Usual Diet Can Improve Diet Quality in the United States: Diet Modeling Study Based on NHANES 2015-2018.

The under-consumption of calcium, potassium, fiber, and vitamin D is considered a U.S. public health concern. Shifts in eating patterns that increase the consumption of vegetables, fruits, whole grains, nuts/seeds, and dairy products can help achieve the recommended intakes of these nutrients, leading to healthier diets. We assessed the impact of adding 1 ounce (28.35 g) of walnuts to usual diets on diet quality and nutrients of concern, including magnesium, fiber, and potassium. We utilized 24 h dietary recalls obtained from the What We Eat in America, National Health and Nutrition Examination Survey (NHANES) and modeled the addition of 1 ounce (28.35 g) of walnuts to the usual diets of no-nut consumers. No-nut consumers aged ≥4 years (n = 7757) from the 2015-2018 NHANES study were included. Population percentages with intakes below the estimated average requirement (EAR) values for calcium, magnesium, folate, and vitamin E and above the adequate intake (AI) values for potassium and fiber were examined. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). The National Cancer Institute method was used to estimate the usual and modeled intakes. Significant differences between usual (current) and modeled intakes were determined using non-overlapping 95% confidence intervals. All analyses included sample weights to account for the NHANES survey design. Adding 1 ounce (28.35 g) of walnuts to the usual diet resulted in significant reductions in the percentages of adults with intakes below the EAR for magnesium and folate (69.6% vs. 52.0%; 49.2% vs. 40.6%, respectively), and increased the percentage of adults above the AI for potassium (22.8% vs. 26.5%). A similar trend was observed among children (4-18 years). HEI scores improved significantly from 49.1 (95% CI: 48.0-50.4) to 58.5 (95% CI: 57.5-59.6) in children and from 52.4 (95% CI: 51.0-53.8) to 59.2 (95% CI: 58.0-60.5) in adults. Adding 1 ounce (28.35 g) of walnuts to the usual diet of no-nut consumers improved the diet quality and adequacy of some under-consumed nutrients.

Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors.

To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the AiM, Plan, and act on LIFestYles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations. The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations. A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks. Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.