Diet Quality Index Research Articles

Are food and beverage purchases reflective of dietary intake? Validity of supermarket purchases as indicator of diet quality in the Supreme Nudge Trial.

Dietary intake assessment is often complicated by intrinsic bias. This study investigated whether food purchase data could constitute a valid indication of dietary intake, by evaluating the extent to which diet quality as measured by supermarket food purchases is correlated with diet quality as measured by reported dietary intake. We used data from the Supreme Nudge cluster-randomised controlled supermarket trial (n=227). Data were collected at baseline from supermarket purchases (loyalty cards) and a dietary questionnaire (short 40-item food frequency questionnaire (FFQ)) to compute two scores reflecting diet quality from purchasing data (purchased diet quality) and FFQs (consumed diet quality). Both scores constituted of 13 food groups and could theoretically range between 0 (low diet quality) to 130 (high diet quality). The relationship between purchased diet quality and consumed diet quality was assessed using correlation coefficients, and the Bland-Altman limits-of-agreement method. Multiple linear regression was fitted between purchased diet quality and consumed diet quality, adjusted for age, sex, waist circumference, educational level, and household size. Consumed and purchased diet qualities were modestly positively correlated (Pearson's ρ = 0·31, 95% CI: 0·18 - 0·42). A positive association from linear regression was found after confouding adjustments (βbaseline = 0·22, 95%CI: 0·10 - 0·34). Purchased diet quality was systematically lower than the consumed diet quality. This study found that diet quality as measured by supermarket purchases provided a reasonable indication of diet quality as reported by short-FFQs, albeit modest.

Associations of nutrition education with diet quality indexes and chronotype: a cross-sectional study

ABSTRACT This study examined the impact of nutrition education on chronotype, sleep quality, and dietary quality among university students. Participants included 317 students with nutrition education and 280 without. Data were collected through questionnaires assessing demographic characteristics, chronotype (using the Morning-Evening Questionnaire), sleep quality (via the Pittsburgh Sleep Quality Index), and dietary habits. Anthropometric measurements and 24-hour food recalls were also recorded. Dietary quality was evaluated using the Healthy Eating Index (HEI)-2020, while dietary fat and carbohydrate quality were assessed with the Fat Quality Index (FQI) and Carbohydrate Quality Index (CQI), respectively. Results indicated that students who received nutrition education had significantly lower body weight, height, and waist circumference compared to those without. Of the students, 8.9% had a morning, 7% had an evening and the rest had an intermediate chronotype. HEI-2020, CQI, and FQI scores were significantly higher in the nutrition education group. Although no significant relationship was found between nutrition education and chronotype, improved dietary and sleep quality were observed in the group with education. This suggested that enhancing nutritional knowledge can positively impact health by improving dietary quality and sleep.

Adaptation of the Diet Quality Questionnaire as a global public good for use in 140 countries

BackgroundFood group consumption data is useful for measuring and monitoring diet quality. To collect valid data across contexts, consistent and rigorous adaptation of survey questions is needed. ObjectivesThe objective of this research is to adapt food group consumption survey questions for 140 countries, by identifying the most common (sentinel) food items in each food group using a structured, participatory process and global standards for classification. MethodsSurvey questions were adapted for 29 food groups of the Diet Quality Questionnaire (DQQ) and for additional questions for infant and young child feeding (IYCF) indicators. For each country, adaptation comprised: (1) review of existing questionnaires, dietary intake data, and other information to draft food lists; (2) key informant (KI) interviews with 5-12 experts to identify and prioritize sentinel items including terminology; (3) comparison of items across countries within the same region to identify discrepancies, and follow-up with KIs to resolve them. Results1,016 KIs contributed to the adapted DQQs for 140 countries and IYCF DQQs for 96 countries, amounting to approximately 9,550 hours of collective effort (68 person-hours/country on average) from 2020-2024. The process revealed numerous challenges and decisions to ensure consistent classification of items and valid question formulation. ConclusionCountry-specific questions adhering to global standards, and adapted through cumulative and iterative input of local experts, enable the collection of food group consumption data that is valid and comparable across time and geographies. The adapted survey questions have been implemented in the Demographic and Health Surveys (DHS) and Gallup World Poll in 94 countries, generating the first cross-country data on minimum dietary diversity (MDD) and other diet quality indicators. The finalized country-adapted DQQs and IYCF DQQs were translated to 143 national languages and are published online as a global public good for population-level diet quality measurement.

You say potato, I say vegetable; you say tomato, I say fruit: Cognitive validity of food group-based dietary recall questions

BackgroundThere is a need for valid, standardized approach for list-based questionnaires to measure food group consumption for indicators of diet quality including dietary diversity. ObjectiveA common method for collecting dietary diversity data consists of open-ended food group questions, e.g. Yesterday, did you eat any vegetables, such as cucumber, cabbage, or celery? We sought to examine the cognitive validity of open-ended questions that require respondents to categorize foods, and closed-ended alternatives using sentinel foods. MethodsPretesting and 83 cognitive interviews were conducted in five languages in São Paulo and New York City in 2018. In structured interviews, respondents were asked to describe their thought processes in answering each question. Their feedback and responses to closed-ended and open-ended food group questions were compared. The Gallup World Poll then piloted two versions of the questionnaire in a nationally representative sample of 1,000 in Brazil in 2018. ResultsRespondents in all settings miscategorized foods when asked open-ended food group questions (0-82%, depending on the food group), respondents varied in their ability to think of other foods that belonged to specified food groups (35-50% could think of any items), and open-ended questions presented an additional cognitive burden. There were no significant differences between the results from closed-ended and open-ended questions in the national pilot test. In the context of a multi-topic survey, the finalized questionnaire took 3-5 minutes, had no additional training requirements, and enumerators reported similar ease in administration as other survey modules. ConclusionsFor data collection on food group consumption, open-ended questions requiring respondents to categorize foods present cognitive validity problems. Closed-ended questions using sentinel foods reduce or eliminate ambiguity, presenting lower cognitive burden and greater comprehension. Based on these results, the closed-ended method has been adopted in international survey platforms for measuring dietary diversity and other aspects of diet quality.

The association between dietary quality index- international and metabolic risk factors in RaNCD cohort study

BackgroundNon-communicable diseases (NCDs) are the leading cause of death around the world. The Dietary Quality Index-International (DQI-I) is one of the indicators that shows changes in diet and its association with NCDs. The aim of this study is to measure the association between the DQI-I and major metabolic risk factors.MethodsThis study is a cross-sectional study based on data collected in the first phase of the prospective cohort study on Ravansar non-communicable diseases (RaNCD). To perform clinical and biochemical tests such as lipid profile, blood glucose and liver enzymes, blood samples were collected using standard vacutainer blood collection techniques. Information from the food frequency questionnaire containing 118 food items was used to score each person’s DQI-I. Binary logistic regression was used to determine the association between the DQI-I tertile and the metabolic risk factors. Linear regression was also used for the association between subgroups of DQI-I score and the metabolic risk factors.ResultsThe total number of subjects in this study was 7,115, with a mean age of 47.14 ± 8.29 years. Dietary quality was generally poor, with 37.03% in the lowest tertile. Men had better dietary quality than women. Anthropometric measures, blood pressure, triglycerides and blood glucose were lower in the lowest tertile of dietary quality. A one-unit increase in the total DQI-I resulted in a 0.19 decrease in total cholesterol. Higher dietary quality was associated with a 22% increased risk of high triglycerides, a 19% increased risk of low high-density density lipoprotein, a 5% decreased risk of elevated low-density lipoprotein, a 42% increased risk of high blood pressure, and a 99% increased risk of high fasting blood glucose. Higher dietary quality was also associated with a 33% increased risk of overweight/obesity.ConclusionThe study found that participants had poor dietary quality, with some favorable metabolic outcomes in the lowest tertile, but concerning associations in the highest tertile, including increased risk for high triglycerides, blood pressure, and obesity. The complex associations suggest that balanced, multifaceted interventions are needed.

Comparison of diet quality indices for predicting metabolic syndrome in Iran: cross-sectional findings from the persian cohort study

BackgroundThe metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one.MethodsThis cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year’s food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices.ResultsThis study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93–0.95), OR: 0.85, (95% CI: 0.81–0.89), OR: 0.84, (95% CI: 0.80–0.89), OR: 1.22, (95%CI: 1.11–1.34), OR: 0.95, (95%CI 0.94–0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS.ConclusionThe present study’s findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS.

The relationship between anxiety and diet quality in adolescent populations: a cross-sectional analysis.

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.

Onset of cognitive impairment, diet quality and adherence to dietary guidelines over 12 years: the Personality and Total Health Cohort Study.

Around 55 million people worldwide live with dementia, and more are expected due to population ageing. We aimed to investigate associations between healthy diet and mild cognitive impairment and dementia in 1753 older adults aged 60-64 from the PATH (Personality and Total Health Through Life Cohort) study. Healthy diet was defined by the Mediterranean-DASH diet Intervention for Neurological Delay (MIND) and two dietary guideline quality scores (Dietary Guideline Index (DGI) and Index Diet Quality (IDQ)), which were calculated from baseline FFQ. Higher dietary scores indicated higher diet quality. Incidence of Alzheimer's disease/vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) was assessed after 12 years of follow-up using validated questionnaires with nominated proxies. Logistic regression explored associations between dietary scores and cognitive function, adjusting for demographics, lifestyle factors and medical preconditions. Adjusted logistic regression comparing the per unit linear increase in diet scores showed MIND (OR = 0·82, 95 % CI = 0·68, 0·99), but not DGI (0·99 (0·97, 1·00)) or IDQ (1·12 (0·95, 1·32)), was significantly associated with lower odds of developing cognitive impairment. In conclusion, a healthier neuroprotective dietary pattern is associated with better cognitive function over time, whereas dietary patterns generated from general dietary guidelines did not show a significant association. Further research and well-designed clinical studies are needed to determine the effects of the MIND diet on cognitive impairment in older adults without a family history of dementia.

International dietary quality index and its association with diabetes in RaNCD cohort study

Diabetes and its complications pose a significant threat to global health. Various factors contribute to the development of diabetes, with diet being an important trigger. The Dietary Quality Index-International (DQI-I) serves as an indicator of changes in diet and its association with chronic diseases, including diabetes. The aim of this study is to examine the association between DQI-I and diabetes in adults. Data from the first phase of the Ravansar Non-Communicable Disease Cohort Study (RaNCD) were used for this cross-sectional study. The study included individuals from western Iran aged between 35 and 65 years. The DQI-I was used to assess diet quality and the essential aspects of a healthy diet. Multiple logistic regression analyses were performed to compare DQI-I total score and diabetes. A total of 7,079 individuals were included, including 608 diabetic and 6,471 healthy individuals. The mean DQI-I score was 60.51 ± 8.47 in healthy individuals and 63.12 ± 8.64 in diabetics. The odds of developing diabetes were higher in individuals with a higher DQI-I (adjusted odds ratio: 1.49, 95% CI: 1.30–1.73). The variety was 13.43 ± 4.47 in diabetics and 12.59 ± 4.79 in healthy individuals. Adequacy was 33.23 ± 3.71 in diabetics and 33.79 ± 3.37 in healthy individuals. Moderation was 13.27 ± 6.05 in diabetics and 11.79 ± 5.47 in healthy individuals. The overall balance was 2.88 ± 2.21 in the healthy group and 2.61 ± 2.13 in the diabetics. The macronutrient ratio was 2.15 ± 1.88 in the healthy group and 2.04 ± 1.84 in the diabetics. The fatty acid ratio was 0.72 ± 1.29 in the healthy group and 0.56 ± 1.17 in the diabetic group. The overall balance score was higher in the healthy subjects. The DQI-I total score was higher in diabetics, indicating a positive association between diabetes and the DQI-I. Therefore, the importance of continuous dietary management and education of diabetic patients should be emphasized.

Infant diet quality index predicts nutrients of concern and ultra-processed food intake in low-income children in the United States

BackgroundDiet quality during infancy can influence nutrient intake and ultra-processed foods (UPFs) consumption throughout later childhood. ObjectivesThis study investigated the predictive validity of Infant Diet Quality Index (IDQI) scores from 0 to 1 y of age and consumption of select nutrients and UPFs at different time points in low-income children aged 2–5 y. MethodsDietary surveys and 24-h dietary recalls collected between ages 0 and 12 months from 2613 Special Supplemental Women, Infants, and Children Infant Toddler Feeding Practices Study-2 participants were used to assess infant diet quality by final IDQI score ranging from 0 (nonadherence to dietary guidelines) to 1 (complete adherence to guidelines). Single 24-h recalls collected across multiple time points per child aged between 2 and 5 y were used to determine nutrient intakes: vitamin B12 (μg), vitamin D (μg), calcium (mg), iron (mg), zinc (mg), potassium (mg), saturated fat (g), dietary fiber (g), and added sugars (g). Likewise, Nova was used to classify foods (to estimate the percentage of energy from foods) by level of industrial processing at each point in time across ages 2–5 y. Survey-weighted regression analyses estimated associations between total IDQI score and nutrient intake and percentage of energy consumption from each Nova food group at each age between 2–5 y. ResultsIDQI scores based on diet quality from 0–1 y of age were positively associated with children’s dietary fiber and potassium intake at ages 2–5 y. Additionally, IDQI was negatively associated with added sugar intake. No associations were observed between IDQI and saturated fat consumption. IDQI scores at age 1 were positively associated with the percentage of energy attributed to unprocessed/minimally processed foods (20%–23%) and negatively associated with UPF consumption at ages 2–5 y (−24% to −29%). ConclusionsIDQI predicts intake of select nutrients and UPF consumption among low-income US children aged 2–5 y.This trial was registered at https://clinicaltrials.gov/study/NCT02031978 as “Feeding My Baby – A National WIC Study,” NCT02031978.

Dietary Pattern Trajectories in French Adults of the NutriNet-Santé Cohort Over Time (2014-2022): Role of Socioeconomic Factors.

While dietary transitions towards more plant-based diets are urgently needed, few studies have investigated current diet trajectories, based on observed longitudinal data. This study investigated current dietary transitions of French adults over an 8 years period (2014-2022), while assessing the diet quality and the role of diverse socio-economic factors.Consumption data from 17,187 NutriNet-Santé cohort participants weighted for the French Census were collected using a food frequency questionnaire in 2014, 2018, and 2022. Adopting a gender-specific approach, consumption changes in 23 food groups were assessed over time. The diet quality was evaluated using the Comprehensive Diet Quality Index (cDQI) score, categorizing foods into "healthy" and "unhealthy". The socioeconomic analysis targeted four food groups (red meat (including fresh beef, pork, offal, and lamb), processed meat (e.g. sausages, ham, and bacon), legumes, and wholegrain products), strongly linked to mortality risk and recognized as significant markers of the sustainable diet transition. All analyses were conducted using multi-adjusted mixed-effects models.Consumption of some healthy plant-based foods (nuts +59 %, legumes +22%, wholegrain products +7%) significantly increased over time; while consumption of some unhealthy foods (red meat -19%, refined cereals -18%, sweetened drinks -15%) decreased. Conversely, consumption of prepared and mixed dishes (+16%), and processed meat (+35%) increased. These changes differed in magnitude between genders and translated into an improved diet quality score (cDQI). Occupational status was linked to longitudinal changes in food consumption, showing increased consumption of plant-based foods among students and higher socio-professional categories.Our findings provide accurate data on trends and factors for targeted initiatives, guiding strategic interventions for a sustainable dietary transition.

Associations of mediterranean diet score and age-related macular degeneration in Korean elderly

BackgroundPrevious studies have reported associations between individual nutrients or specific foods and the risk of age-related macular degeneration (AMD). However, the relationship between overall dietary quality, specifically the alternative Mediterranean diet (aMED) score, and AMD remains unclear. Therefore, this study aimed to investigate the association between the aMED score, as an indicator of overall diet quality, and AMD in the Korean population.MethodsWe conducted a cross-sectional analysis using nationally representative samples of older adults aged ≥ 65 years (895 men and 1,191 women) from the Korea National Health and Nutrition Examination Survey (2017–2018). Food intake and the aMED score were estimated using 24-h recall. AMD was diagnosed by an ophthalmologist based on fundus photography. The associations of aMED score tertiles with AMD were determined using odds ratios (ORs) from multivariate logistic regressions.ResultsMultiple logistic regression analysis revealed a significantly negative association between the aMED score and AMD (adjusted ORs = 0.58; 95% confidence interval = 0.39–0.88; p-trend = 0.021) in older men after adjusting for confounding factors such as age, body mass index, family monthly income, current smoking, alcohol consumption, physical activity, chronic disease status, and energy intake. Notably, this association was exclusively observed in men, and no significant association was observed between the aMED score and AMD in women (adjusted OR = 0.88; 95% CI = 0.61–1.29; p-trend = 0.691).ConclusionsThis study’s findings suggest that a high aMED score may be associated with a reduced risk of AMD in older men. Future studies with larger sample sizes and a prospective or interventional design are required to enhance current understanding regarding the association between diet quality and AMD.

Development of a Diabetes Dietary Quality Index: Reproducibility and Associations with Measures of Insulin Resistance, Beta Cell Function, and Hyperglycemia.

Various dietary risk factors for type 2 diabetes have been identified. A short assessment of dietary patterns related to the risk for type 2 diabetes mellitus may be relevant in clinical practice given the largely preventable nature of the disease. The aim of this study was to investigate the reproducibility of a short food frequency questionnaire based on available knowledge of diabetes-related healthy diets. In addition, we aimed to investigate whether a Diabetes Dietary Quality Index based on this questionnaire was related to metabolic risk factors, including measures of beta cell function and insulin sensitivity. A short food frequency questionnaire was composed by selecting fourteen questions (representing eight dietary factors) from existing food frequency questionnaires on the basis of their reported relationship with diabetes risk. Healthy participants (N = 176) from a Dutch family study completed the questionnaire and a subgroup (N = 123) completed the questionnaire twice. Reproducible items from the short questionnaire were combined into an index. The association between the Diabetes Dietary Quality index and metabolic risk factors was investigated using multiple linear regression analysis. Measures of beta cell function and insulin sensitivity were derived from a mixed meal test and an euglycemic-hyperinsulinemic and modified hyperglycemic clamp test. Our results show that this new short food frequency questionnaire is reliable (Intraclass Correlations ranged between 0.5 and 0.9). A higher Diabetes Dietary Quality index score was associated with lower 2 h post-meal glucose (β -0.02, SE 0.006, p < 0.05), HbA1c (β -0.07, SE 0.02, p < 0.05), total cholesterol, (β -0.02, SE 0.07, p < 0.05), LDL cholesterol, (β -0.19, SE 0.07, p < 0.05), fasting (β -0.4, SE 0.16, p < 0.05) and post-load insulin, (β -3.9, SE 1.40, p < 0.05) concentrations and the incremental AUC of glucose during MMT (β -1.9, SE 0.97, p < 0.05). The scores obtained for the oral glucose insulin sensitivity-derived mixed meal test were higher in subjects who scored higher on the Diabetes Dietary Quality index (β 0.89, 0.39, p < 0.05). In contrast, we found no significant associations between the Diabetes Dietary Quality index and clamp measures of beta cell function. We identified a questionnaire-derived Diabetes Dietary Quality index that was reproducible and inversely associated with a number of type 2 diabetes mellitus and metabolic risk factors, like 2 h post-meal glucose, Hba1c and LDL, and total cholesterol. Once relative validity has been established, the Diabetes Dietary Quality index could be used by health care professionals to identify individuals with diets adversely related to development of type 2 diabetes.

The effect of diet quality and body mass index on depression in older adults: a growth curve analysis

BackgroundNutrition not only plays an important role in one’s physical health, but also mental health. The causal association between nutrition and mental health remains unclear. While a healthy dietary pattern may protect one against mental illness, it is also possible that poor mental health could lead to unhealthy eating habits or choices. Furthermore, emerging studies suggest that a higher body mass index (BMI) is associated with a lower risk of depressive symptoms in older adults, contrasting the effect observed in other populations. With an ageing population, this study aimed to investigate the long-term impact of a healthy dietary pattern, BMI, and other covariates on depressive symptoms in older adults.MethodsWe conducted a cohort study between 2014 and 2017, with each follow-up assessment being one year apart. A total of 2081 participants above 65 years old (M = 79.65, SD = 7.94) completed the baseline assessment in 2014, which included basic demographics, self-reported eating habits, depressive symptoms, and the measurement of height and weight. Distance to supermarkets and fast food was calculated based on participants’ residential addresses. Two growth models were performed to assess the trajectory of change in depressive symptoms over time.ResultsOlder adults experienced a significant decrease in depressive symptoms over time (intercept = 2.68, p < .001; slope = -0.25, p < .001). At baseline, a higher diet quality (B = -0.95, p < .001), higher BMI (B = -0.09, p < .001), younger age (B = 0.40, p = .001), being a male (B = 0.76, p < .001), and having fewer chronic diseases (B = 0.39, p < .001) were associated with lower levels of depressive symptoms. Over time, a higher diet quality (B = 0.14, p = .05), higher BMI (B = 0.02, p = .04), and fewer chronic diseases (B = -0.08, p < .001) predicted lower levels of depressive symptoms over time.ConclusionsA higher diet quality and higher BMI may serve as protective factors for depressive symptoms in older adults. Potential implications are being discussed.

Combined associations of physical activity, diet quality and their changes over time with mortality: findings from the EPIC-Norfolk study, United Kingdom

BackgroundPhysical activity (PA) and diet quality have each been shown to be inversely associated with mortality but their combined impact on longevity has been less explored, particularly when considering their changes over time. This study aimed to examine the separate and combined associations of PA, diet quality and their changes over time with mortality outcomes.MethodsA prospective cohort study was performed on 9349 adults aged 40 to 79 years from the population-based European Prospective Investigation into Cancer in Norfolk Study, with repeated measurements of PA and diet (from 1993 till 2004) and subsequent follow-up till 2022 (median follow-up 18.8 years). Validated questionnaires were used to derive physical activity energy expenditure (PAEE) as a proxy of total PA and adherence to the Mediterranean diet score (MDS, range 0–15 points) as an indicator of overall diet quality, and their changes over time (∆PAEE and ∆MDS). Cox regression models adjusted for potential confounders and mediators were used to estimate hazard ratios (HRs) and 95% CIs.ResultsOver 149,681 person-years of follow-up, there were 3534 deaths. In adjusted models, for each 1-SD difference in baseline PAEE (4.64 kJ/kg/day), ∆PAEE (0.65 kJ/kg/day per year), baseline MDS (1.30 points) and ∆MDS (0.32 points per year), HRs (95% CI) for all-cause mortality were 0.90 (0.86 to 0.94), 0.89 (0.85 to 0.93), 0.95 (0.91 to 0.99) and 0.93 (0.90 to 0.97), respectively. Compared with participants with sustained low PAEE (< 5 kJ/kg/day) and low MDS (< 8.5 points), those with sustained high PAEE and high MDS had lower all-cause mortality (HR 0.78; 95% CI: 0.68–0.91), as did those who improved both PAEE and MDS (0.60; 0.44–0.82). There was no evidence of interaction between PA and diet quality exposures on mortality risk. Population impact estimates suggested that if all participants had maintained high levels of PA and diet quality consistently, cumulative adjusted mortality rate would have been 8.8% (95% CI: 2.4 to 15.3%) lower.ConclusionsThese findings suggest that adopting and maintaining higher levels of PA and diet quality are associated with lower mortality. Significant public health benefits could be realised by enabling active living and healthy eating through adulthood.

Effect of dietary carbohydrate quality index on the severity of premenstrual symptoms

The objective of the researchers of this study is to evaluate the effect of the Carbohydrate Quality Index (CQI) in the diet of university students living in dormitories on the severity of premenstrual symptoms. The researchers applied a survey to the students, including questions about their sociodemographic characteristics and eating habits, Food Frequency Questionnaire (FFQ), and Premenstrual Symptom Scale (PMSS). A total of 606 female students were included as participants in the study. CQI value of students with PMS was found to be lower (p < 0.05). It was observed that increasing the CQI could reduce the PMSS score [β (−0.228 (0.18–0.007) 95%CI] (p < 0.05).

Development of a Concise Healthy Diet Score for Cardiovascular Disease among Japanese; The Japan Collaborative Cohort Study.

Several diet quality indicators have been developed primarily for cardiovascular disease (CVD) prevention in Western countries. However, those previous indicators are complicated and less feasible in clinical and health-promoting settings. Therefore, we aimed to develop a concise dietary risk score for CVD prevention in Japanese. Using the self-administered food frequency questionnaire with 35 food items, we developed a concise healthy diet score (cHDS) ranging from 0 to 5 points. We examined the association of cHDS with risks of all-cause and cause-specific mortality among 23,115 men and 35,557 women who were free of CVD and cancer. During 19.2 years of median follow-up, 6,291 men and 5,365 women died. In men, the multivariable hazard ratios (95% confidence intervals) for the highest cHDS (5 points) compared to the lowest (0-1 points) were 0.74 (0.60-0.91, P-trend=0.008) for CVD and 0.86 (0.77-0.95, P-trend=0.05) for all causes. No significant associations were found for stroke, coronary heart disease, and other causes in men. The corresponding hazard ratio in women was 0.65 (0.52-0.81, P-trend＜0.001) for CVD, 0.63 (0.45-0.88, P-trend＜0.001) for stroke, 0.48 (0.30-0.78, P-trend=0.008) for coronary heart disease, 0.67 (0.54-0.84, P-trend＜0.001) for other causes, and 0.75 (0.66-0.85, P-trend＜0.001) for all causes. We developed a concise diet quality score named cHDS in the Japanese population and found the inverse association of cHDS with mortality from CVD and all causes for both men and women.

A paired-match study: Equine athletes’ nutritional habits, anthropometric measurements, and postures

Background and Purpose: The Mediterranean diet-MeD provides beneficial nutrients that improve athletes’ health. Posture is important for the performance of equine athletes-EA. This study aimed to determine adherence to the MeD, anthropometric measurements, and postures of EA. Methods: There were two study groups, EA(n:121) and non-athletes(n:121). The Mediterranean Diet Quality Index, the Mediterranean Diet Adherence Screener, the Food Frequency Questionnaire, the New York Posture Analyses-NYPA, an electronic scale, and a non-stretch tape were used. Results: EA’s MeD-characterized food consumption (vegetables, fruits, fish) frequencies were more compatible with recommendations(p

Assessment of energy and nutrient intake adequacy and dietary diversity of pregnant women in Abidjan

Background: Dietary diversity is a potential indicator of adequate nutrient intake. Aims: The study assessed dietary diversity and adequacy of nutrient intake among pregnant women in Abidjan (Côte d’Ivoire). Subjects and Methods: A cross-sectional study was conducted on 389 healthy pregnant adult women aged 20 to 43. Participants completed a three-day, 24-hour dietary recall questionnaire and dietary data were converted into nutrient amounts using Nutrisurvey software. Dietary Diversity Score (DDS) was based on nine food groups aggregated from a 15-item questionnaire. Nutrient intake was assessed using the Nutrient Adequacy Ratio (NAR) with the mean adequacy ratio (MAR) serving as an overall indicator of diet quality. Data were analyzed using SPSS version 25. Results: The mean DDS among pregnant women was low at 4.30 ± 1.04, with diet primarily consisting of cereals, white tubers, roots, vegetables and fish. The average energy intake of pregnant women was 2429 kcal/day for over 60 % of participants. While the majority met the Recommended Daily Allowance (RDA) for carbohydrates, fats, proteins, and vitamin B12. However, intakes of calcium, iron, magnesium, zinc, folates and vitamin C were below the RDAs for most pregnant women. The average MAR for pregnant women was 70.86% and exhibited a positive correlation with DDS (r = 0.37; p &lt; 0.001). NAR for energy and other nutrients was positively correlated with DDS, except for vitamins B12 and C. Conclusions: Pregnant women with adequate nutrient intakes consumed a diverse range of foods. Dietary diversity can therefore provide be a reliable indicator of nutrient adequacy in the diets of pregnant women in Abidjan’s hospital. Keywords: Dietary diversity, nutrient intake, nutrient adequacy ratio, pregnant women, Côte d'Ivoire.

Diet quality indices are associated with breast cancer by molecular subtypes in Mexican women.

Inconclusive epidemiological evidence suggests that diet quality indices may influence breast cancer (BC) risk; however, the evidence does not consider the molecular expression of this cancer. We aimed to evaluate if diet quality is related to molecular subtypes of BC, in women residing in Northern Mexico. This is a secondary analysis of 1,045 incident cases and 1,030 population controls from a previous case-control study, conducted between 2007 and 2011 in Northern Mexico. Information about the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was obtained from medical records to classify BC as luminal (ER + and/or PR+/HER2-), HER2+ (ER+/-and/or PR+/-/HER2+), or triple-negative (TN) (ER- and PR-/HER2-) cases. Food consumption was assessed with a semi-quantitative food frequency questionnaire. Diet quality was evaluated using the Mexican Diet Quality Index (MxDQI) and the Mexican Alternative Healthy Eating Index (MxAHEI). We used unconditional logistic regression models to estimate the association between Mexican diet quality indices and BC molecular subtypes. The MxDQI was related to lower odds of BC (ORT3vsT1=0.24; 95%CI: 0.18, 0.31). Similarly, MxAHEI was negatively associated with BC (ORT3vsT1=0.43; 95%CI: 0.34, 0.54). The associations of both indices remained significant in the ER + and ER- tumors, and in the BC luminal and HER2 + molecular subtypes, except in the TN molecular subtype for MxAHEI, which was not statistically significant. Our findings showed that MxDQI and MxAHEI were negatively associated with BC risk regardless of its molecular subtype.