Individual Food Groups Research Articles

Fat tax or thin subsidy? How price increases and decreases affect the energy and nutrient content of food and beverage purchases in Great Britain

Suboptimal diet is a leading risk factor for early death and disability globally. Changing food prices via tax or subsidy policies is often recommended to improve diets, particularly increasing the relative price of sugar-sweetened beverages to reduce sugar consumption. Less evidence exists on how such policies, if applied across a wide range of foods and beverages, could affect purchases and diet quality. Using home-scan data from a sample of 26,799 households in Great Britain (2012-2013) we estimate separate demand elasticities for price increases and decreases using a reference-price dependent demand model, to simulate the impact of a 20% price change on purchases of energy and nutrients from 26 healthier and less healthy food groups that make up the full basket of purchases. Where asymmetry exists between elasticity of price increase and decrease, household response to price increases is stronger. Households with low socio-economic status (SES) respond to price changes in either direction more strongly than high-SES, especially for less healthy foods. On average, energy and nutrient content of take-home purchases were near or above reference daily intake levels. The combined effect of increasing the price of all less healthy foods, and decreasing the price of all healthier foods, led to an overall improvement with a net reduction in energy (by 67.6kcal per capita/day), sugar (6.3g), salt (0.21g) and saturated fat (2.3g) content, and a net increase in protein (3.4g) and fibre (0.9g) content of purchases. From individual food groups, the greatest reduction in energy, sugar and saturated fat content was observed for price increases in sweet snacks, desserts and puddings, and fats and oils. Dietary quality of the purchases of low-SES households generally improved most. Our findings support the view that price change policies can lead to dietary improvements, if they are based on the healthiness of food and beverages.

Association of food groups with depression and anxiety disorders

PurposeAdherence to the Mediterranean diet has been associated with fewer depressive symptoms, however, it is unknown whether this is attributed to some or to all components. We examined the association between the individual food groups of the Mediterranean Diet Score (MDS), in isolation and in combination, with depression and anxiety (symptom severity and diagnosis).MethodsData from 1634 adults were available from the Netherlands Study of Depression and Anxiety. Eleven energy-adjusted food groups were created from a 238-item food frequency questionnaire. In regression analysis, these were associated in isolation and combination with (1) depressive and anxiety disorders (established with the Composite International Diagnostic Interview) (current disorder n = 414), and (2) depression and anxiety severity [measured with the Inventory of Depressive Symptomatology (IDS), the Beck Anxiety Inventory (BAI) and the Fear Questionnaire (FEAR)].ResultsOverall, the MDS score shows the strongest relationships with depression/anxiety [Diagnosis: odds ratio (OR) 0.77 per SD, 95% confidence interval (95% CI) 0.66–0.90, IDS: standardised betas (β) − 0.13, 95% CI − 0.18, − 0.08] and anxiety (BAI: β − 0.11, 95% CI − 0.16, − 0.06, FEAR: β − 0.08, 95% CI − 0.13, − 0.03). Greater consumption of non-refined grains and vegetables was associated with lower depression and anxiety severity, whilst being a non-drinker was associated with higher symptom severity. Higher fruit and vegetable intake was associated with lower fear severity. Non-refined grain consumption was associated with lower odds and being a non-drinker with greater odds of current depression/anxiety disorders compared to healthy controls, these associations persisted after adjustment for other food groups (OR 0.82 per SD, 95% CI 0.71–0.96, OR 1.26 per SD 95% CI 1.08–1.46).ConclusionWe can conclude that non-refined grains, vegetables and alcohol intake appeared to be the driving variables for the associated the total MDS score and depression/anxiety. However, the combined effect of the whole diet remains important for mental health. It should be explored whether an increase consumption of non-refined grains and vegetables may help to prevent or reduce depression and anxiety.

Socio-economic patterning of food consumption and dietary diversity among Indian children: evidence from NFHS-4

Background/ObjectivesMost interventions to foster child growth and development in India focus on improving food quality and quantity. We aimed to assess the pattern in food consumption and dietary diversity by socioeconomic status (SES) among Indian children.Subjects/MethodsThe most recent nationally representative, cross-sectional data from the National Family Health Survey (NFHS-4, 2015–16) was used for analysis of 73,852–74,038 children aged 6–23 months. Consumption of 21 food items, seven food groups, and adequately diversified dietary intake (ADDI) was collected through mother’s 24-h dietary recall. Logistic regression models were conducted to assess the association between household wealth and maternal education with food consumption and ADDI, after controlling for covariates.ResultsOverall, the mean dietary diversity score was low (2.26; 95% CI:2.24–2.27) and the prevalence of ADDI was only 23%. Both household wealth and maternal education were significantly associated with ADDI (OR:1.28; 95% CI:1.18–1.38 and OR:1.75; 95% CI:1.63–1.90, respectively), but the SES gradient was not particularly strong. Furthermore, the associations between SES and consumption of individual food items and food groups were not consistent. Maternal education was more strongly associated with consumption of essential food items and all food groups, but household wealth was found to have significant influence on intake of dairy group only.ConclusionsInterventions designed to improve food consumption and diversified dietary intake among Indian children need to be universal in their targeting given the overall high prevalence of inadequate dietary diversity and the relatively small differentials by SES.

The Diet of the Brown Bear (Ursus arctos) in the Central Forest Nature Reserve (West-European Russia), Based on Scat Analysis Data

Abstract—The diet of the brown bear (Ursus arctos) is described for the territory of the southern taiga subzone illustrated by the example of the Central Forest Nature Reserve (West-European Russia) and the protection zone surrounding it. Based on an analysis of 474 scat samples, we established the most commonly consumed food items and food groups and determined their proportions, nutritional value, and importance in the total diet of the species using basic techniques widely adopted abroad for processing the data. The investigation revealed 26 food items, including 18 plant (FO = 97.9%) and eight animal items (9.1%). Correction factors were used for each diet item. Food habits were assessed separately for the spring, summer, summer–autumn, and autumn periods. The frequency of scat occurrence per 10 km averaged 1.30. The most important in the bears’ diet were apples (EDEC = 31.1%), hazelnuts (19.1%), oats (12.5%), blueberries (6.8%), and forbs (4.3%). Mammal food had a certain value (EDEC = 11.1%), but mostly in the spring season. The width of the trophic niche decreased from spring to autumn. The diet composition varied greatly throughout the year, except for a hyperphagia period, which included summer and autumn. The territory of the moderately disturbed protection zone was more attractive to bears than the intact area of the reserve. Overall, scat analysis in the study area adequately reflects the basic preferences of the species, but underestimates the values of individual food groups, primarily insects, overestimates the value of apples, and poorly characterizes the feeding habits in the first half of the year.

Higher Mediterranean Diet scores are not cross-sectionally associated with better cognitive scores in 20- to 70-year-old Dutch adults: The NQplus study

Adherence to the Mediterranean Diet (MedDiet) has been suggested to reduce the risk of age-related cognitive decline. Therefore, we hypothesized that adults consuming a more Mediterranean-like diet were more likely to have better cognitive scores. We investigated cross-sectional associations between MedDiet adherence and cognitive performance using data of 1607 Dutch men and women aged 20–70 years. Dietary intake was assessed using a 183-item Food Frequency Questionnaire. MedDiet adherence was defined by a 0–9 point scale; which was based on intakes of vegetables, legumes, fruits/nuts, cereals, fish/seafood, meat/poultry, dairy, ethanol and the MUFA:SFA ratio. Cognitive function was assessed with a neuropsychological test battery. Linear regression analyses adjusted for relevant covariates showed a significant inverse association between MedDiet adherence and everyday memory: specifically β = −0.107 ± 0.046 points (P = .02) for the total population and β = −0.139 ± 0.055 points (P = .01) for those aged ≥50 years. Further exploration of the individual MedDiet food groups suggested that the association between MedDiet and every day memory was predominantly driven by the MUFA:SFA ratio. Moreover, associations were observed between higher ethanol intake with better semantic memory and language production (β = 0.016 ± 0.008 P = .05), higher vegetable intake with better processing speed (β = 0.005 ± 0.002, P = .02), and higher legumes intake with poorer processing speed (β = −0.014 ± 0.006, P = .03). Thus, in this Dutch cohort, higher MedDiet adherence was associated with poorer everyday memory.

Challenges of Increasing Childcare Center Compliance With Nutrition Guidelines: A Randomized Controlled Trial of an Intervention Providing Training, Written Menu Feedback, and Printed Resources.

To assess the effectiveness of an intervention including training, provision of written menu feedback, and printed resources on increasing childcare compliance with nutrition guidelines. Parallel group randomized controlled trial. Hunter New England region, New South Wales, Australia. Forty-four childcare centers that prepare and provide food on-site to children while in care. The intervention was designed using the Theoretical Domains Framework, targeted managers, and cooks and included implementation strategies that addressed identified barriers. Outcomes included the proportion of menus providing food servings (per child) compliant with overall nutrition guideline recommendations and each individual food group assessed via menu assessments. Cook knowledge of recommendations, intervention acceptability, adverse events, and barriers were also assessed via questionnaires with cooks and managers. Logistic regression models, adjusted for baseline values of the outcome. At baseline and follow-up, zero centers in the intervention and control groups were compliant with the overall menu guidelines or for the vegetable and meat food groups. Follow-up between-group differences in compliance for discretionary (33.3 vs 5, P = .18), dairy (41.7 vs 15, P = .16), breads and cereals (8.3 vs 10 P = 1.00), and fruit (16.7 vs 10, P = .48) were all nonsignificant. Relative to the control group, intervention centers showed a significantly greater increase in percentage of cooks with correct knowledge for vegetable servings (93.3 vs 36.4, P = .008). Although the application of the theoretical framework produced a broader understanding of the determinants of menu compliance, due to the complexity of guidelines, limited follow-up support, lower training uptake, and low intervention dose, the intervention was not effective in supporting the practice change required.

Dietary determinants of obesity among Mexican women

Introduction Lifestyle and dietary habits in the Mexican population have dramatically changed in the last 20 years, reflected in an increased prevalence of overweight and obesity in both urban and rural adult populations. The prevalence of overweight and obesity in Mexican adults is 38.8% and 32.4%, respectively. In adults, abdominal obesity is more prevalent among women than men (82.8% versus 64.5%, respectively). In women over 60 years of age, overweight and obesity rates are even greater—nearly 40% are overweight and 35.5% obese. A healthy diet has been shown to prevent weight gain. It is therefore important to investigate dietary factors that are most strongly associated with obesity in this highly obese population group. Dietary patterns are used to assess the overall diet. One approach to evaluate dietary patterns is to use a priori patterns which are based on dietary recommendations. The objective of this study was to evaluate the associations between the consumption of food groups and a priori defined dietary patterns and anthropometric measures in women from the CAMA study. Methods Our study population is based on 1062 women (35 to 69-years-old) from the control group of the CAMA study, which is a multi-centre population-based case-control study on breast cancer conducted in Mexico. Each woman was interviewed via personal interview during which dietary intakes were assessed using a semi-quantitative Food Frequency Questionnaire. The indices used in the study are the Dietary Approaches to Stop Hypertension (DASH) score, the Healthy Eating Index (HEI) score, the Mediterranean Diet Score (MDS) and the Diet Quality Index (DQI) score. To estimate associations of food groups and dietary patterns with anthropometric measures, generalized linear regression models were used and adjusted for potential confounders, such as age, centre and educational level. Results Mean age, body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) among the participants were 51.1 (years), 30.5 (kg/m2), 99.4 (cm), 109.3 (cm) and 0.91, respectively. When individual food groups were examined, a higher consumption of legumes was associated with lower body mass index (BMI), waist circumference (WC) and hip circumference (HC). Regarding dietary patterns, a higher adherence to MDS was associated with lower WC. We did not observe any significant association between other food groups or a priori dietary patterns and anthropometric measurements in models adjusted for confounders. Conclusions In this population of Mexican women, most of the a priori dietary scores appeared to be of limited value in predicting the association between diet and anthropometric measures. However, higher adherence to the Mediterranean diet was associated with lower WC.

Dietary Patterns among Asian Indians Living in the United States Have Distinct Metabolomic Profiles That Are Associated with Cardiometabolic Risk

BackgroundRecent studies, primarily in non-Hispanic whites, suggest that dietary patterns have distinct metabolomic signatures that may influence disease risk. However, evidence in South Asians, a group with unique dietary patterns and a high prevalence of cardiometabolic risk, is lacking. ObjectiveWe investigated the metabolomic profiles associated with 2 distinct dietary patterns among a sample of Asian Indians living in the United States. We also examined the cross-sectional associations between metabolomic profiles and cardiometabolic risk markers. MethodsWe used cross-sectional data from 145 Asian Indians, aged 45–79 y, in the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) pilot study. Metabolomic profiles were measured from fasting serum samples. Usual diet was assessed by using a validated food-frequency questionnaire. We used principal components analysis to derive dietary and metabolomic patterns. We used adjusted general linear regression models to examine associations between dietary patterns, individual food groups, metabolite patterns, and cardiometabolic risk markers. ResultsWe observed 2 major principal components or metabolite clusters, the first comprised primarily of medium- to long-chain acylcarnitines (metabolite pattern 1) and the second characterized by branched-chain amino acids, aromatic amino acids, and short-chain acylcarnitines (metabolite pattern 2). A “Western/nonvegetarian” pattern was significantly and positively associated with metabolite pattern 2 (all participants: β ± SE = 0.180 ± 0.090, P = 0.05; participants without type 2 diabetes: β ± SE = 0.323 ± 0.090, P = 0.0005). In all participants, higher scores on metabolite pattern 2 were adversely associated with measures of glycemia (fasting insulin: β ± SE = 2.91 ± 1.29, P = 0.03; 2-h insulin: β ± SE = 22.1 ± 10.3, P = 0.03; homeostasis model assessment of insulin resistance: β ± SE = 0.94 ± 0.42, P = 0.03), total adiponectin (β ± SE = −1.46 ± 0.47, P = 0.002), lipids (total cholesterol: β ± SE = 7.51 ± 3.45, P = 0.03; triglycerides: β ± SE = 14.4 ± 6.67, P = 0.03), and a radiographic measure of hepatic fat (liver-to-spleen attenuation ratio: β ± SE = −0.83 ± 0.42, P = 0.05). ConclusionsOur findings suggest that a “Western/nonvegetarian” dietary pattern is associated with a metabolomic profile that is related to an adverse cardiometabolic profile in Asian Indians. Public health efforts to reduce cardiometabolic disease burden in this high-risk group should focus on consuming a healthy plant-based diet.

P120 - Draw Your Dinner: Examining Perceptions of Meal Size Using Incrementally Reduced Plate Sizes in College Students

Background (Background, Rationale, Prior Research, and/or Theory): The ways in which food is presented can influence the amount of food selected and consumed as well as how accurately those meals are perceived and recalled. Hence, if the method of food recall is modified through the use of incrementally changing plate sizes for participants to draw their meals on, they may align their food sizes to fit the plate rather than accurately reporting portion sizes. Objective: The purpose of this study was to examine the association between plate size and meal recall through drawn food representations over a 10-week period. Study Design, Setting, Participants, Intervention: Using a longitudinal design, we had 293 undergraduate students enrolled in an introductory Nutrition lecture course draw their last night's meal for 10 weeks on either a 10.5” diameter plate, an 8.5” diameter plate, or a 10.5” diameter plate that was reduced in size by .2 inches every week. One hundred ninety-five students who completed >60% of their meal recalls, including the first and final weeks, were included for analysis. Outcome Measures and Analysis: One-way and two-way ANOVA as well as independent samples t-tests were used to compare total area, % of plate coverage, individual food group food portion size across Large, Small, and Incrementally-changing plates. Results: Participants provided with 10.5” diameter plates generally drew significantly more food on them than participants with 8.5” diameter plates (P = < .001). Participants provided with incrementally shrinking plates drew meal sizes similar to the large plates at week 1 and drew meal sizes similar to small plates by week 10. Conclusions and Implications: These findings suggest that people's conceptualization of previous meal consumption may be influenced by the size of the plate on which they draw upon, suggesting that the external environment can modify participant drawn recall of their meal sizes. Funding: None.

Poor dietary patterns at 1–5 years of age are related to food neophobia and breastfeeding duration but not age of introduction to solids in a relatively advantaged sample

Previous studies have investigated associations between individual foods or food group intake, and breastfeeding duration, age of solid introduction and food neophobia. This study aimed to investigate associations between whole dietary patterns in young children, and breastfeeding duration, age of solid introduction and food neophobia. Parents of children (N = 234) aged 1–5 years completed an online questionnaire. Dietary risk scores were calculated using the Toddler (1–3 years) or Preschool (>3–<5 years) Dietary Questionnaires which evaluates the previous week's food-group intake (scored 0–100; higher score = higher risk of poor dietary quality). Neophobia was measured using the Child Food Neophobia scale (1.0–4.0; higher score = more neophobic). Associations were investigated using multivariable linear regression, adjusting for covariates. Children (54% female, 3.0 ± 1.4 years) were from advantaged families and were breastfed until 11.8 (5.0–16.0) months, started solids at 5.6 ± 1.4 months of age, moderately neophobic (2.1 ± 0.7) and at moderate dietary risk (29.2 ± 9.2). Shorter breastfeeding duration (β = −0.21; p = 0.001) and poorer child food neophobia scores (β = 0.36; p < 0.001) were associated with higher dietary risk scores. Age of introduction to solids showed no association with dietary risk (p = 0.744). These findings suggest that in addition to breastfeeding promotion, supporting parents to manage neophobic behaviour may be important in promoting healthy eating patterns in early childhood.

Using the Theory of Planned Behavior to Explore Pediatric Heart Transplant Recipients’ Dietary Behavior

Abstract. Heart transplantation is the treatment of choice for children with end-stage heart disease. Coronary artery vasculopathy is, however, a significant morbidity and leading cause of late graft loss, and hyperlipidemia a risk factor for its development. Improving diet in this population could have important benefits for patients. We wanted to understand what influences decisions about food intake in this patient group. Dietary intentions and behavior were examined using a questionnaire based on the Theory of Planned Behavior (TPB) with 67 children who had undergone heart transplantation at least 12 months previously. The TPB model was significant for both healthy and unhealthy dietary behaviors, explaining 55% and 38% of the variance, respectively. Ten percent of children reported not eating any fruit and/or vegetables in the previous week and only 29% reported eating fruit and/or vegetables every day. The Theory of Planned Behavior provides a framework for explaining some specific dietary behaviors related to individual food groups in children who have undergone heart transplantation. These preliminary data support using this approach to inform the development of interventions to improve fruit and vegetable consumption but the approach may be less useful for explaining and developing interventions to reduce the consumption of unhealthy foods.

Abstract MP39: Trends in Diet Quality Among US Adults by Supplemental Nutrition Assistance Program Participation Status: 1999-2014

Introduction: Unhealthful diet is one of the top contributors to the chronic disease burden in the U.S. There are growing concerns that socioeconomic disparities exist in Americans’ diets and this disparity may have widened over time. Aim: To characterize trends in dietary intake of key food groups and nutrients among low-income Americans who participated in the Supplemental Nutrition Assistance Program (SNAP), and assess whether disparities in U.S. diets have persisted, improved, or worsened over time. Methods: Nationally representative sample of 6,162 adults aged 20 years or older who participated in SNAP, 6,692 income-eligible nonparticipants, and 25,842 higher-income nonparticipants from 8 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2014). Exposures are calendar year and SNAP participation status. Survey-weighted, energy-adjusted mean scores and proportion meeting the American Heart Association (AHA) 2020 Strategic Impact Diet Goals (5 primary components: fruits/vegetables, whole grains, fish/shellfish, sugar-sweetened beverages (SSBs), sodium; 3 secondary components: nuts/seeds/legumes, processed meats, saturated fat). Intakes of individual food groups and nutrients were also assessed. Results: From 2003-2004 to 2013-2014 among SNAP participants with data on two-day dietary recall, primary diet score (maximum of 50) modestly increased (15.6 to 16.6; P-trend =0.03) while the secondary diet score (maximum of 80 points) did not change (31.5 to 32.1; P-trend =0.11). The proportion of SNAP participants having a poor diet decreased from 74.3% to 68.6%, the proportion having an intermediate-quality diet increased from 25.5% to 31.2%, and the proportion of having an ideal diet remained unchanged (0.2%.). Among primary components, changes were strongest for SSBs (-0.43 servings/d, P-trend=0.001) and whole grains (+0.25 servings/d, P-trend&lt;0.001). Compared to higher-income nonparticipants and income-eligible nonparticipants, SNAP participants had weaker improvements in both primary and secondary diet scores. From 1999-2000 to 2013-2014, disparities persisted for most dietary components, worsened for nuts/seeds and added sugars, and weakened for sodium. Conclusion: Despite some improvements in diet quality, SNAP participants still fall far short of meeting the AHA Goals for a healthful diet, and dietary disparities persisted or worsened for most dietary components.

Adherence to a Mediterranean diet and its association with age-related macular degeneration. The Coimbra Eye Study-Report 4.

This study aimed to characterize the association of lifestyle and nutritional risk profiles with age-related macular degeneration (AMD) in two subpopulations with differing AMD prevalence. This case-control study (n = 1992) included 768 patients with AMD and 1224 age- and sex-matched participants without AMD with a single visit at a primary health care unit. Enrolled participants completed a validated lifestyle and food frequency questionnaire. A score to measure adherence to the Mediterranean diet (mediSCORE; Range, 0-9) was constructed from individual food intakes, which were further analyzed by conversion to nutrient consumption. Higher adherence to the Mediterranean diet (mediSCORE ≥6) was significantly associated with no AMD (odds ratio [OR] = 0.73; P = 0.009). The subpopulation with lower AMD prevalence presented significantly higher adherence to the Mediterranean diet in relation to all individual food groups that comprised the mediSCORE (P < 0.014) with the exception of cereals. Food group analysis showed significant associations between the increased consumption of vegetables (OR = 0.63; P < 0.001) and fruit and nuts (OR = 0.78; P = 0.010) with no AMD. Nutrient analysis revealed that an increased ingestion of water, fibers, total fat, monounsaturated and polyunsaturated fatty acids, linoleic acid, vitamins A and C, carotene, alpha-tocopherol, folate, magnesium, iron, and zinc were significantly associated with no AMD (P < 0.0013). Finally, regular physical activity was associated with no AMD (P = 0.003). High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts.

High dietary diversity is associated with child obesity in Iranian school children: An evaluation of dietary diversity score.

Objective: The prevalence of overweight and obesity in Iranian children has increased considerably in the last decades. Obesity in children is a major concern. Higher variety score of diet may cause obesity and overweight among urban schoolchildren. The objective of this study was to measure dietary diversity score and obesity in child from Iran. Methods: The present study examined Dietary Diversity Score(DDS) and weight status by calculating Body Mass Index (BMI) and the World Health Organization's (WHO) anthropometric indices of weight-for-age (WA) and weight-for-height. A cross sectional study was performed on 2500 Iranian school children 1176 girls and 1324 boys aged 6-9 years, attending primary schools residing in urban area from low and middle-income categories. Dietary diversity scores were assessed based on frequency of consumption of individual food items categorized into 11 individual food groups. Results: Overweight children showed the highest mean score for cereals (F=2.209, P=0.005), vegetables (F=5.234, P=0.001), non-vegetarian foods (F=12.3920, P=0.000), mixed dishes (F=9.899, P=0.000), beverages (F=9.654, P=0.000), sweets and sugar (F=5.122, P=0.002) and fats (F=10.263, P=0.000). Mean scores for vegetables, sweets, beverages and fat consumption increased with increasing weight. High scores for pulses and legumes consumption was observed in obese children. Scores for vegetable consumption were higher among overweight children. Conclusion: Overweight and obese school children had high diversity scores in their diet.

Exploring the Relationship between Varieties of Variety and Weight Loss: When more Variety can Help People Lose Weight

Prior research has indicated that greater dietary variety in a single eating episode increases caloric intake, contributing to weight gain and obesity. This study presents a novel conceptual framework for investigating dietary variety across the entire diet according to time frame (cumulative vs. daily), aggregation level (overall vs. episode-specific), and categorization level (individual foods vs. food groups). This framework is used to assess how naturally occurring dietary variety relates to weight loss among overweight/obese women enrolled in a 16-week trial to achieve weight loss. Acknowledging this is a first exploratory attempt to test such relationships using correlational analyses, the authors uncover several key findings. First, whereas cumulative overall variety was not associated with weight loss, daily overall variety was positively associated with weight loss. Second, this relationship was strongest for variety during breakfast and afternoon snacks and was particularly driven by consuming greater vegetable variety. Overall, the authors develop a novel conceptual framework for investigating variety, and through application to a unique data set, uncover novel findings countering some existing theories about how dietary variety relates to weight loss success.

Differences in presence and distribution of various food groups in persons with spinal cord injury

The aim of this study was to analyse the dietary habits of subjects with spinal cord injury (SCI), especially to evaluate differences in the presence and distribution of various food groups among a group of males and females. Subjects (n = 50, n1 = 36 males, n2 = 14 females) completed a frequency questionnaire, which included questions focused on the detection of size of consumed foods and frequency of consumption of various food groups (cereals, potatoes, vegetables, fruits, dairy products, meat, meat products, fats, sweets). We noted significant differences in the composition of breakfast (meat intake), lunch (vegetable intake, dairy intake), dinner (dairy intake, sweet intake), snacks (fats intake) in males and females. Differences in dietary habits of males and females with SCI especially concerned sizes of consumed servings of food, but also the representation of individual food groups in the diet throughout the day. In this context, the adapted food pyramid can be used as a visual tool to facilitate understanding and the maintenance of a healthy diet.

Dietary emissions patterns and their effect on the overall climatic impact of food consumption

SummaryFood consumption is responsible for a considerable proportion of greenhouse gas emissions (GHGE). This study aimed to determine whether different dietary emission patterns (EPs) are evident in the Irish population. Respondents of the national nutritional survey were segmented using cluster analysis based on GHGE generated from food groups; thereby profiling similarities in how emissions were attained. Three distinct EPs were observed: Unsustainable, Culturally Sustainable, and Nutritionally Sustainable. The Unsustainable pattern had a significantly greater climatic impact; generating significantly higher emissions from processed meat, alcohol, carbonated beverages and savoury snacks, but significantly lower emissions from dairy.Total GHGE did not differ significantly between the Culturally Sustainable and the Nutritionally Sustainable despite the latter deriving significantly lower emissions from red meat. Nevertheless, the Nutritionally Sustainable pattern adhered to more dietary guidelines than other EPs. The results imply that policy instruments should be holistic in naturerather than concentrating on individual food groups.

Maternal Dietary Diversity Decreases with Household Food Insecurity in Rural Bangladesh: A Longitudinal Analysis

Household food insecurity (HFI) can lead to a poor diet and malnutrition. Yet, little is known about the extent to which maternal diet covaries with food insecurity during pregnancy and lactation. Longitudinal associations between HFI and maternal dietary diversity from early pregnancy to 3 mo postpartum were examined in rural Bangladesh. We repeatedly assessed dietary intake by using a 7-d food-frequency questionnaire in the first and third trimesters of pregnancy and at 3 mo postpartum among 14,600 women enrolled into an antenatal micronutrient supplementation trial. Maternal dietary diversity score (DDS) was constructed as the sum of 10 food groups reportedly consumed at each assessment. Households were classified at 6 mo postpartum as being food secure or having mild, moderate, or severe HFI on the basis of a 9-item standard scale. Generalized estimating equations were used to estimate the longitudinal relation between HFI status and DDS and the likelihood of individual food-group consumption, adjusting for confounders at the maternal and household levels. The DDS decreased with progressively worse HFI, an association best explained by a derived household wealth index. Compared with women from food-secure households, women of mild, moderate, and severe HFI were less likely, in a dose-response fashion, to have consumed dairy products [adjusted ORs (95% CIs): 0.73 (0.69, 0.78), 0.62 (0.58, 0.66), and 0.52 (0.48, 0.55), respectively], eggs [0.81 (0.76, 0.85), 0.73 (0.68, 0.77), and 0.61 (0.57, 0.65)], meat [0.83 (0.79, 0.88), 0.73 (0.69, 0.78), and 0.60 (0.56, 0.64)], fish [0.87 (0.80, 0.94), 0.76 (0.70, 0.83), and 0.59 (0.54, 0.65)], legumes and nuts [0.88 (0.83, 0.93), 0.81 (0.76, 0.87), and 0.79 (0.74, 0.85)], and yellow and orange fruit and vegetables [0.85 (0.80, 0.91), 0.78 (0.73, 0.84), and 0.72 (0.67, 0.78)]. Neither intakes of dark-green leafy vegetables nor of vegetable oil were associated with HFI status. Antenatal and postnatal maternal dietary diversity, especially intakes of animal-source foods, fruit, and vegetables, declined with worsening food insecurity in rural Bangladesh.

Dietary Intake Among US Adults, 1999-2012.

Most studies of US dietary trends have evaluated major macronutrients or only a few dietary factors. Understanding trends in summary measures of diet quality for multiple individual foods and nutrients, and the corresponding disparities among population subgroups, is crucial to identify challenges and opportunities to improve dietary intake for all US adults. To characterize trends in overall diet quality and multiple dietary components related to major diseases among US adults, including by age, sex, race/ethnicity, education, and income. Repeated cross-sectional investigation using 24-hour dietary recalls in nationally representative samples including 33,932 noninstitutionalized US adults aged 20 years or older from 7 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2012). The sample size per cycle ranged from 4237 to 5762. Calendar year and population sociodemographic subgroups. Survey-weighted, energy-adjusted mean consumption and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet scores, AHA score components (primary: total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium; secondary: nuts, seeds, and legumes, processed meat, and saturated fat), and other individual food groups and nutrients. Several overall dietary improvements were identified (P < .01 for trend for each). The AHA primary diet score (maximum of 50 points) improved from 19.0 to 21.2 (an improvement of 11.6%). The AHA secondary diet score (maximum of 80 points) improved from 35.1 to 38.5 (an improvement of 9.7%). Changes were attributable to increased consumption between 1999-2000 and 2011-2012 of whole grains (0.43 servings/d; 95% CI, 0.34-0.53 servings/d) and nuts or seeds (0.25 servings/d; 95% CI, 0.18-0.34 servings/d) (fish and shellfish intake also increased slightly) and to decreased consumption of sugar-sweetened beverages (0.49 servings/d; 95% CI, 0.28-0.70 servings/d). No significant trend was observed for other score components, including total fruits and vegetables, processed meat, saturated fat, or sodium. The estimated percentage of US adults with poor diets (defined as <40% adherence to the primary AHA diet score components) declined from 55.9% to 45.6%, whereas the percentage with intermediate diets (defined as 40% to 79.9% adherence to the primary AHA diet score components) increased from 43.5% to 52.9%. Other dietary trends included increased consumption of whole fruit (0.15 servings/d; 95% CI, 0.05-0.26 servings/d) and decreased consumption of 100% fruit juice (0.11 servings/d; 95% CI, 0.04-0.18 servings/d). Disparities in diet quality were observed by race/ethnicity, education, and income level; for example, the estimated percentage of non-Hispanic white adults with a poor diet significantly declined (53.9% to 42.8%), whereas similar improvements were not observed for non-Hispanic black or Mexican American adults. There was little evidence of reductions in these disparities and some evidence of worsening by income level. In nationally representative US surveys conducted between 1999 and 2012, several improvements in self-reported dietary habits were identified, with additional findings suggesting persistent or worsening disparities based on race/ethnicity, education level, and income level. These findings may inform discussions on emerging successes, areas for greater attention, and corresponding opportunities to improve the diets of individuals living in the United States.

Mediterranean diet and brain structure in a multiethnic elderly cohort.

To determine whether higher adherence to a Mediterranean-type diet (MeDi) is related with larger MRI-measured brain volume or cortical thickness. In this cross-sectional study, high-resolution structural MRI was collected on 674 elderly (mean age 80.1 years) adults without dementia who participated in a community-based, multiethnic cohort. Dietary information was collected via a food frequency questionnaire. Total brain volume (TBV), total gray matter volume (TGMV), total white matter volume (TWMV), mean cortical thickness (mCT), and regional volume or CT were derived from MRI scans using FreeSurfer program. We examined the association of MeDi (scored as 0-9) and individual food groups with brain volume and thickness using regression models adjusted for age, sex, ethnicity, education, body mass index, diabetes, and cognition. Compared to lower MeDi adherence (0-4), higher adherence (5-9) was associated with 13.11 (p = 0.007), 5.00 (p = 0.05), and 6.41 (p = 0.05) milliliter larger TBV, TGMV, and TWMV, respectively. Higher fish (b = 7.06, p = 0.006) and lower meat (b = 8.42, p = 0.002) intakes were associated with larger TGMV. Lower meat intake was also associated with larger TBV (b = 12.20, p = 0.02). Higher fish intake was associated with 0.019 mm (p = 0.03) larger mCT. Volumes of cingulate cortex, parietal lobe, temporal lobe, and hippocampus and CT of the superior-frontal region were associated with the dietary factors. Among older adults, MeDi adherence was associated with less brain atrophy, with an effect similar to 5 years of aging. Higher fish and lower meat intake might be the 2 key food elements that contribute to the benefits of MeDi on brain structure.