Whole Grain Intake Research Articles

Unhealthy plant-based diet is associated with a higher cardiovascular disease risk in patients with prediabetes and diabetes: a large-scale population-based study

BackgroundThe role of plant-based dietary patterns in preventing cardiovascular disease (CVD) among individuals with prediabetes and diabetes remains unclear. We aimed to evaluate the associations of plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) with cardiovascular disease (CVD) risk and explore potential contributing factors among people with prediabetes and diabetes.MethodsA total of 17,926 participants with prediabetes and 7798 with diabetes were enrolled from the UK Biobank between 2006 and 2010 and followed until the end of 2020. We calculated the PDI, hPDI, and uPDI based on 18 major food groups including plant-based foods and animal-based foods and applied Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD risk related to PDI, hPDI, and uPDI. Decomposition analysis was performed to assess the role of dietary components, and mediation analysis was performed to assess the potential mediating role of serum biomarkers underlying these associations.ResultsA total of 2324 CVD events were documented among individuals with prediabetes, while 1461 events occurred among patients with diabetes. An inverse association was found between hPDI and CVD risk among individuals with prediabetes (HR T3 vs. T1 = 0.88, 95% CI = 0.79–0.98, Ptrend = 0.025) but not those with diabetes. A positive association was found between uPDI and CVD risk among individuals with prediabetes (HR T3 vs. T1 = 1.17, 95% CI = 1.05–1.30, Ptrend = 0.005) and those with diabetes (HR T3 vs. T1 = 1.14, 95% CI = 1.00–1.29, Ptrend = 0.043). High-sugar-sweetened beverages (SSB) intake accounted for 35% of the hPDI-CVD association and 15% of the uPDI-CVD association among individuals with prediabetes, whereas low intake of whole grain accounted for 36% of the association among patients with diabetes. Elevated cystatin C levels explained the largest proportion of the association between uPDI and CVD risk among individuals with prediabetes (15%, 95% CI = 7–30%) and diabetes (44%, 95% CI = 9–86%).ConclusionsAdherence to an unhealthy plant-based diet is associated with a higher CVD risk in people with prediabetes or diabetes, which may be partially attributed to low consumption of whole grains, high intake of SSB, and high blood cystatin C levels.

Is Starch Intake Associated With Periodontal Status? An 11-Year Longitudinal Analysis Among Finnish Adults.

To evaluate the association between baseline starch intake (amount and sources) and changes in periodontal status over 11 years in adults. Adults aged 30-82 years, who participated in the Finnish Health 2000 survey and were re-examined in 2004/2005 and/or 2011 were included in the study. The consumption of total starch and six relevant food groups (potatoes, fried potatoes, roots and tubers, pasta, wholegrains and legumes) over the past year was determined at baseline with a validated food frequency questionnaire. The number of teeth with periodontal pocketing ≥ 4 mm (NTPP) was recorded during clinical examinations in 2000, 2004/2005 and 2011. The association between baseline starch intake and the 11-year change in the NTPP was tested in mixed-effects negative binomial regression models, adjusting for covariates. A total of 1369 adults were included in the analysis. The mean NTPP was 4.1 ± 5.6, 6.3 ± 5.6, and 4.8 ± 5.9 in waves 1, 2 and 3, respectively. Baseline starch intake (in g/day or % energy intake) was not associated with changes in the NTPP after adjustment for covariates. In analysis by food groups, the baseline intake of wholegrains was negatively associated with the NTPP at baseline. This study found no evidence of an association between baseline starch intake and changes in periodontal status. Baseline intake of wholegrains was associated with better periodontal status at baseline.

Carbohydrate quality index and risk of non-alcoholic fatty liver disease in Iranian adults

Background/aimIn the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.MethodsThis case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20–60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components.ResultsThe participant’s mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m2 and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15–25) and 23 (18–28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11–0.39), Ptrend <0.001)]. Also, the odds of NAFLD decreased across tertiles of solid carbohydrates to total carbohydrates ratio [(OR: 0.39; 95%CI: 0.22–0.69), Ptrend <0.001)]. However, a high dietary glycemic index (GI) was associated with increased odds of NAFLD [(OR:7.47; 95%CI: 3.89–14.33, Ptrend<0.001)]. There was no significant relationship between other CQI components, including fiber intake and whole grain/total grains and the risk of NAFLD.ConclusionsOur results revealed that a diet with a high quality of carbohydrates, characterized by higher intakes of solid carbohydrates, whole grain, and low GI carbohydrates, can be related to a reduced risk of NAFLD.

Plant-based diets-impacts of consumption of little or no animal-source foods on human health.

The world, in 2024, faces both climate and biodiversity crises, and the food system does contribute significantly to these crises. For some, the solution is simple - intakes of animal source foods (ASFs) should be considerably reduced, and consumption of plant-source foods (PSFs) should be greatly increased. Advocates for such a dietary transformation express confidence that plant-based diets will not only benefit planetary health, but will provide nutrient adequacy for all, and will also result in considerable protection from chronic non-communicable diseases (NCDs). However, as described in this perspective, the dramatic reductions in ASFs, entailed by many plant-based diets, will worsen already prevalent micronutrient and protein deficiencies. The protections provided by plant-based diets against NCDs appear to be more strongly associated with reduced intakes of calories and salt, and increased intakes of fruit, vegetables, nuts and whole grains, rather than with reduced intakes of ASFs. Any possible absolute adverse effects of red and processed meat consumption on NCDs are very small and uncertain. Other ASFs either appear to have no impact on NCDs (poultry meat and eggs), or are associated with protections against obesity, cardiovascular events, brain disorders and some cancers (seafood and dairy). Rigorous randomized controlled trials of all newly proposed environmentally-protective plant-based diets are required, so as to provide clear-cut evidence of micronutrient and protein adequacy, with or without, supplementation, fortification and/or biofortification. In the meantime, dietary guidelines should advise moderating excessive consumption, rather than substantially limiting or excluding ASFs from the human diet.

What is the dietary intake and nutritional status of defence members: a systematic literature review.

Optimal diet and nutrition is vital for military readiness, performance and recovery. Previous research on military diets has primarily focused on the nutritional composition of field/combat rations and dietary intake during deployment. There is accumulating research exploring the usual free-living dietary intake and nutritional status of defence members in garrison (i.e. military bases on which personnel are stationed). However, no comprehensive review has been conducted to assess the overall dietary quality of defence members internationally. Therefore, this review assessed the diets of military populations against national nutritional guidelines and Military Dietary Reference Intakes (MDRI). A systematic literature review of original research was conducted. CINAHL, Medline (EBSCO), Scopus (Elsevier), PubMed and AMED databases were searched up to the 20/02/2023. A total of thirty-six studies met the inclusion criteria. The overall quality of included studies was high, with a low risk of bias. The diet quality scores indicate poor to fair diet quality among defence members. Defence members display low intakes of fruits, vegetables, wholegrains, seafood, plant protein and nuts and high intakes of added sugars, trans fat and processed meat. Results also indicated suboptimal intake of fibre, essential fatty acids, vitamin A, vitamin E, folate, Mg, Zn and iodine. This may lead to reduced performance, increased risk of chronic diseases and mental health disorders. More research is needed to assess the long-term consequences of poor diet quality in defence members. These results require the attention of policymakers to ensure that military education and food environment is supportive of healthy eating.

Adherence to a healthful plant-based diet and risk of mortality among individuals with chronic kidney disease: A prospective cohort study

BackgroundPlant-rich dietary patterns may protect against negative health outcomes among individuals with chronic kidney disease (CKD), although aspects of plant-based diet quality have not been studied. This study aimed to examine associations between healthful and unhealthful plant-based dietary patterns with risk of all-cause mortality among CKD patients for the first time. MethodsThis prospective analysis included 4,807 UK Biobank participants with CKD at baseline. We examined associations of adherence to both the healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI), calculated from repeated 24-hour dietary assessments, with risk of all-cause mortality using multivariable Cox proportional hazard regression models. ResultsOver a 10-year follow-up, 675 deaths were recorded. Participants with the highest hPDI scores showed a 34% lower risk of mortality [HRQ4vsQ1 (95% CI): 0.66 (0.52-0.83), ptrend <0.001]. Those with the highest uPDI scores had a 52% [1.52 (1.20-1.93), ptrend = 0.002] higher risk of mortality compared to participants with the lowest respective scores. In food group-specific analyses, higher wholegrain intakes were associated with a 29% lower mortality risk, while intakes of refined grains, and sugar-sweetened beverages were associated a 30% and 34% higher risk, respectively. ConclusionsIn CKD patients, a higher intake of healthy plant-based foods was associated with a lower risk of mortality, while a higher intake of less healthy plant-based foods was associated with a higher risk of mortality. These results underscore the importance of plant food quality and support the potential role of healthy plant food consumption in the treatment and management of CKD to mitigate unfavourable outcomes.

The association between carbohydrate quality index and conventional risk factors of cardiovascular diseases in an Iranian adult population

ObjectiveCardiovascular diseases (CVDs) are the most common cause of death worldwide. Diet plays an important role among many risk factors for CVDs. The present study aimed to investigate the relationship between carbohydrate quality index (CQI) and conventional risk factors of CVDs in Iranian adults.ResultsA higher CQI was related to a higher intake of energy, fiber, whole grains, fruits, vegetables, nuts, legumes, and dairy products. Additionally, a significant negative association was observed between CQI and triglycerides (TG) (odds ratio (OR) = 0.85; 95% confidence interval (CI): 0.73–0.98, highest versus the lowest tertile, p for trend = 0.026) and non-high density lipoprotein cholesterol (non-HDL-C) (OR = 0.85; 95% CI: 0.75–0.96, highest versus the lowest tertile, p for trend = 0.012). No significant correlation was shown between CQI and other cardiovascular risk factors. The findings indicate that the CQI is inversely associated with TG and non-HDL-C. Further studies are proposed to confirm these findings.

Maternal dietary patterns associated with bone density in Chinese lactating women and infants at 6 months postpartum: a prospective study using data from 2018–2019

This cohort study was designed to explore the relationship between maternal dietary patterns (DPs) and bone health in Chinese lactating mothers and infants. We recruited 150 lactating women at 1-month postpartum. The estimated bone mineral density (eBMD) of subjects’ calcanei and the information on dietary intake were collected. After 5-month follow-up, the eBMD of mothers and their infants were measured again. Factor analysis was applied to determine maternal DPs. General linear models were used to evaluate the association between maternal DPs and maternal eBMD loss or infants’ eBMD. With all potential covariates adjusted, Factor 2 (high intake of whole grains, tubers, mixed beans, soybeans and soybean products, seaweeds, and nuts) showed a positive association with the changes of maternal eBMD (β = 0.16, 95 % CI: 0.005, 0.310). Factor 3 (high intake of soft drinks, fried foods, and puffed foods) was inversely correlated with the changes of maternal eBMD (β = –0. 22, 95 % CI: -0.44, 0.00). The changes of maternal eBMD were positively associated with 6-month infants’ eBMD (β = 0.34, 95 % CI: 0.017, 0.652). In conclusion, Factor 2 might contribute to the maintenance of eBMD in lactating women, while Factor 3 could exacerbate maternal eBMD loss. Additionally, the changes of maternal eBMD presented a positive correlation with 6-month infants’ eBMD.

Investigating the impact of dietary guidelines transition on cardiometabolic risk profile: a forensic analysis using diet quality metrics

Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population’s diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were ‘poor’ for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently ‘eating out’ as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21–0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21–0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31–0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (− 14%), WC (− 9%), LDL-C (− 32%), TG (− 15%), HOMA2-IR (− 9%) and hsCRP (− 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally ‘poor’ DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refinedgrain, added sugar and saturated fat.

Reproducibility and comparison of a digital food frequency questionnaire (DIGIKOST-FFQ) assessing adherence to national diet and lifestyle recommendations.

We have developed a digital semi-quantitative food frequency and lifestyle questionnaire, the DIGIKOST-FFQ, based on the validated paper-based NORDIET-FFQ. The study aims to investigate the reproducibility of the DIGIKOST-FFQ and to compare the DIGIKOST-FFQ against the NORDIET-FFQ for the adjusted questions for intakes of fruits, vegetables, whole grains, fish, meat, and dairy products. Participants were recruited from May to September 2021 through a random sample from the National Population Register and advertisements on Facebook in Norway. In the reproducibility study, the DIGIKOST-FFQ was completed twice by the participants, 1-2 months apart. In the comparison study, the DIGIKOST-FFQ was completed 1-2 months prior to the NORDIET-FFQ. In the reproducibility study, 317 individuals were included. For 12 out of 16 food groups there were no significant differences in intake estimations between the first and second DIGIKOST-FFQ administrations. A small but significant median difference was observed for fruits (6 g/day) and vegetables (24 g/day). Correlations were satisfactory for all items (r = 0.60-1.00), and in the cross-classification 85% of the participants were classified into the same or adjacent quartile for all items. The comparison study included 81 individuals. Compared to the NORDIET-FFQ a significant median difference was observed for fruits 29 g/day, vegetables 36 g/day, whole grains -10 g/day, and red meat -11 g/day, but not for fish, processed meat, or dairy products. The DIGIKOST-FFQ was able to reproduce diet and lifestyle at the group level. An intended difference for the food groups where questions had been adjusted, was observed between DIGIKOST-FFQ and NORDIET-FFQ in the comparison study.

Association of Intake of Whole Grains with Health Outcomes in the Chronic Renal Insufficiency Cohort Study.

Patients with chronic kidney disease (CKD) are encouraged to choose refined grains instead of whole grains as part of the low-phosphorus diet for managing chronic kidney disease-mineral and bone disorders (CKD-MBD). However, there is no direct evidence indicating that limiting whole grains has a beneficial impact on CKD outcomes. This study analyzed Chronic Renal Insufficiency Cohort data in two ways, namely cross-sectional examination of CKD-MBD biomarkers and prospective examination of health outcomes. A total of 4,067 (cross-sectional) and 4,331 (prospective) participants were included. The primary exposure was reported intake of whole grains (analyzed as servings/day, servings/1,000kcal, and refined grain servings/whole grain servings). CKD-MBD biomarkers included serum phosphorus, fibroblast growth factor-23, parathyroid hormone, calcitriol, and calcium. Outcomes included cardiovascular events, kidney failure, and all-cause mortality. In adjusted models, reported intake of whole grains was associated with higher phosphorus intake and serum phosphorus when assessed crudely (serving/day), but not when analyzed in relation to energy. Higher intake of refined grain relative to whole grains was associated (all models) with higher risk of kidney failure (Model 4: 1.01, 95% CI 1.00 to 1.02; P=0.01, all-cause mortality (Model 4: 1.01, 95% CI 1.00 to 1.01; P=0.01), and cardiovasulcar disease except for the fully adjusted model. Higher dietary density was associated with lower mortality in models adjusted for demographic and clinical factors including kidney function, but not in the fully adjusted model that futher adjusted for dietary factors. Intake of whole grains was not associated with CKD-MBD biomarkers. Intake of whole grains in relation to refined grains was associated with lower risk of cardiovascular disease, kidney failure, and mortality. The results of this study put into question the long-standing practice of restricting whole grains in patients with chronic kidney disease.

Evaluation of daily eating patterns on overall diet quality using decision tree analyses

BackgroundPreliminary evidence suggests that meal timing is associated with higher quality diets. Less is known about whether types of food consumed during specific eating episodes (i.e., day-level eating patterns) predict diet quality. ObjectivesWe investigated the association between day-level eating patterns and diet quality. MethodsDecision tree models were built using 24-h dietary recall data from the National Health and Nutrition Examination Survey 2015 and 2017 cycles in a cross-sectional study. Sixteen food groups and 12 eating episodes (e.g., breakfast, lunch) were included as input parameters. Diet quality was scored using the Healthy Eating Index-2020 and categorized as higher or lower quality diets based on the median score. Mean decrease in impurity (MDI) ± standard deviation determined the relative contribution that day-level eating patterns had on diet quality; higher values represented greater contributions. ResultsWe analyzed 12,597 dietary recalls from 9347 United States adults who were aged 18 y and older with ≥1 complete recall. Meals (breakfast, lunch, dinner) and respective snacking episodes had the greatest variety of dietary groups that contributed to the Healthy Eating Index-2020 score. Any whole-grain intake at breakfast predicted a higher quality diet (MDI = 0.08 ± 0.00), followed by lower solid fat intake (<8.94 g; MDI = 0.07 ± 0.00) and any plant protein intake at dinner (MDI = 0.05 ± 0.00). ConclusionsDay-level eating patterns were associated with diet quality, emphasizing the relevance of both food type and timing in relation to a high-quality diet. Future interventions should investigate the potential impact of targeting food type and timing to improve diet quality.

Association between Whole-Grain Intake and Obesity Defined by Different Anthropometric Indicators and Dose-Response Relationship Analysis among U.S. Adults: A Population-Based Study.

Existing research shows an inconsistent correlation between whole-grain intake and obesity risk, with limited study on the dose-response relationship. Here, we aimed to examine this association and dose-response relationship among U.S. adults who participated in a NHANES (2003-2018). The intake of whole grain was collected and calculated from two rounds of 24 h dietary recall. Obesity was categorized based on body mass index (BMI) and waist circumference (WC). Weighted multivariable logistic regression models were used to calculate the odds of obesity according to whole-grain intake, and the dose-response relationship was modeled by restricted cubic spline regression. Among the 27,862 participants, 38.3% had general obesity, while 58.3% had abdominal obesity. After multivariate adjustment of potential confounders, the participants in the highest quintile of whole-grain intake had a lower prevalence of general obesity (OR 0.79; 95% CI 0.72-0.88) and abdominal obesity (OR 0.80; 95% CI 0.73-0.89) compared with those in the lowest category. Spline regression showed an inversely linear dose-response association between whole-grain intake and the prevalence of general obesity and abdominal obesity. In conclusion, a higher whole-grain intake was associated with lower odds of obesity, both general and abdominal. Our findings highlight the importance of increasing the whole-grain intake to prevent and manage obesity.

Difference in Gastrointestinal Cancer Risk and Mortality by Dietary Pattern Analysis: A Systematic Review and Meta-Analysis.

Several studies have demonstrated that dietary patterns identified by a posteriori and hybrid methods are associated with gastrointestinal (GI) cancer risk and mortality. These studies applied different methods for analyzing dietary data and reported inconsistent findings. This systematic review and meta-analysis were aimed to determine the association between dietary patterns, derived using principal component analysis (PCA) and reduced rank regression (RRR), and GI cancer risk and GI cancer-caused mortality. Articles published up to June 2023 in English were eligible for inclusion. The Medline, SCOPUS, Cochrane Library, CINHAL, PsycINFO, ProQuest, and Web of Sciences databases were used to identify prospective studies. The Preferred Reporting Item for Systematic Review and Meta-analysis Protocol 2020 was used to report results. A total of 28 studies were eligible for inclusion. Varied approaches to deriving dietary patterns were used, including PCA (n = 22), RRR (n = 2), combined PCA and RRR (n = 1), cluster analysis (CA; n = 2) and combined PCA and CA (n = 1). Two dietary patterns, "healthy" and "unhealthy," were derived using PCA and RRR. The healthy dietary pattern was characterized by a higher intake of fruits, whole grains, legumes, vegetables, milk, and other dairy products, whereas the unhealthy dietary pattern was characterized by a higher intake of red and processed meat, alcohol, and both refined and sugar-sweetened beverages. The findings indicated that the PCA-derived healthy dietary pattern was associated with an 8% reduced risk (relative risk [RR], 0.92; 95% CI, 0.87-0.98), and the unhealthy dietary pattern was associated with a 14% increased risk (RR, 1.14; 95% CI, 1.07-1.22) of GI cancers. Similarly, the RRR-derived healthy dietary pattern (RR, 0.83; 95% CI, 0.61-1.12) may be associated with reduced risk of GI cancers. In contrast, the RRR-derived unhealthy dietary pattern (RR, 0.93; 95% CI, 0.57-1.52) had no association with a reduced risk of GI cancers. Similarly, evidence suggested that PCA-derived healthy dietary patterns may reduce the risk of death from GI cancers, whereas PCA-derived unhealthy dietary patterns may increase the risk. Findings from prospective studies on the association of PCA-derived dietary patterns and the risk of GI cancers support the evidence of healthy and unhealthy dietary patterns as either protective or risk-increasing factors for GI cancers and for survivorship, respectively. The findings also suggest that the RRR-derived healthy dietary pattern reduces the risk of GI cancers (albeit with low precision), but no association was found for the RRR-derived unhealthy dietary pattern. Prospective studies are required to further clarify disparities in the association between PCA- and RRR-derived dietary patterns and the risk of GI cancers. Systematic review registration: PROSPERO registration no. CRD42022321644.

The Healthy Eating Index 2020 components contributed unequally to systemic inflammatory biomarkers: A large national cross-sectional study.

The association of Healthy Eating Index 2020 (HEI-2020), especially its components with systemic inflammatory biomarkers, has not been examined. The aim of this study was to investigate the relationship between HEI-2020 and its components with systemic inflammatory biomarkers, and to provide a dietary pattern suggestion to combat systemic inflammation. Participants aged 20 years and older with complete information on two reliable dietary recalls, blood cell counts and demographic characteristics, were recruited from six NHANES cycles from 2007 to 2018. Weighted general linear methods showed that HEI-2020 was negatively associated with systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI). Weighted quantile regression (WQS) models and quantile g-computation (QGC) models supported the negative association between the mixed components and systemic inflammation. High intakes of whole fruits, whole grains, greens and beans, and seafood and plant proteins, along with a low intake of added sugars, were associated with reduced systemic inflammation. In contrast, the scores of sodium, dairy, total protein, and refined grains showed no significant effect. Briefly, our study provides an anti-inflammatory dietary pattern suggestion based on the 13 components of HEI-2020 and Dietary Guidelines for Americans.

The Role of Food and Nutrition education in improving Dietary Habits

To find out whether teens' involvement in a non-profit organization's Food and Nutrition education program resulted in a change in the quantity of food they ate. Fifty-five low-income teenagers participating in an NGO received a six-month nutritional intervention that included six visits with dietitians and strategic communication and relationship initiatives. At baseline and after the intervention, body weight, height, BMI, nutrition and eating behaviors questionnaire, one day recall and diet quality evaluation of the Digital Food Guide's Diet Quality Index were collected. Dietary pattern improvement required a 5-point rise in the Digital Food Guide's Diet Quality Index. Food labels were better understood and daily and weekend eating habits. Fruits, vegetables, dairy goods, legumes, and milk consumption increased (adequate components). However the intake of whole grains and nuts was low while that of items that should be eaten in moderation was high. The effort altered the eating habits of teenagers, making it a practical and affordable way to promote health, avoid illness. The diet quality index in the digital meal guide has also proven useful for analyzing dietary changes and directing future counseling and nutritional intervention efforts.

Grains in a Modern Time: A Comprehensive Review of Compositions and Understanding Their Role in Type 2 Diabetes and Cancer.

Globally, type 2 diabetes (T2D) and Cancer are the major causes of morbidity and mortality worldwide and are considered to be two of the most significant public health concerns of the 21st century. Over the next two decades, the global burden is expected to increase by approximately 60%. Several observational studies as well as clinical trials have demonstrated the health benefits of consuming whole grains to lower the risk of several chronic non-communicable diseases including T2D and cancer. Cereals grains are the primary source of energy in the human diet. The most widely consumed pseudo cereals include (quinoa, amaranth, and buckwheat) and cereals (wheat, rice, and corn). From a nutritional perspective, both pseudo cereals and cereals are recognized for their complete protein, essential amino acids, dietary fibers, and phenolic acids. The bran layer of the seed contains the majority of these components. Greater intake of whole grains rather than refined grains has been consistently linked to a lower risk of T2D and cancer. Due to their superior nutritional compositions, whole grains make them a preferred choice over refined grains. The modulatory effects of whole grains on T2D and cancer are also likely to be influenced by several mechanisms; some of these effects may be direct while others involve altering the composition of gut microbiota, increasing the abundance of beneficial bacteria, and lowering harmful bacteria, increasing insulin sensitivity, lowering solubility of free bile acids, breaking protein down into peptides and amino acids, producing short-chain fatty acids (SCFAs), and other beneficial metabolites that promote the proliferation in the colon which modulate the antidiabetic and anticancer pathway. Thus, the present review had two aims. First, it summarized the recent knowledge about the nutritional composition and bioactive acids in pseudo cereals (quinoa, amaranth, and buckwheat) and cereals (wheat, rice, and corn); the second section summarized and discussed the progress in recent human studies, such as observational (cross-sectional studies, case-control studies, and cohort studies) and intervention studies to understand their role in T2D and cancer including the potential mechanism. Overall, according to the scientific data, whole grain consumption may reduce the incidence of T2D and cancer. Future studies should carry out randomized controlled trials to validate observational results and establish causality. In addition, the current manuscript encourages researchers to investigate the specific mechanisms by which whole grains exert their beneficial effects on health by examining the effects of different types of specific protein, dietary fibers, and phenolic acids that might help to prevent or treat T2D and cancer.

Gastric and colorectal cancer incidence attributable to dietary factors in Korea.

Dietary factors play a role in the etiology of gastrointestinal cancer. We aimed to estimate the burden of gastric and colorectal cancer that can be attributable to dietary factors in adults aged 20 years and older in Korea in 2018. Dietary intakes in 2000 were estimated using data from the 2001, 2005, and 2007-2018 Korea National Health and Nutrition Examination Survey (KNHANES). For counterfactual scenarios, the optimal level of intake suggested by the Global Burden of Disease (GBD) study was used if it was available. Otherwise, the average intake values of reference groups among published studies globally were used. Relative risks (RRs) were pooled through dose-response meta-analyses of Korean studies. In Korea in 2018, an estimated 18.6% of gastric cancer cases and 34.9% of colorectal cancer cases were attributed to the combined effect of evaluated dietary factors. High intake of salted vegetables accounted for 16.0% of gastric cancer cases, followed by salted fish at 2.4%. Low intakes of whole grains (16.6%) and milk (13.7%) were leading contributors to colorectal cancer cases, followed by high intakes of processed meat (3.1%) and red meat (5.9%), and a low intake of dietary fiber (0.5%). These results suggest that a considerable proportion of gastric and colorectal cancer incidence might be preventable by healthy dietary habits in Korea. However, further research is needed to confirm the associations between dietary factors and gastric and colorectal cancers in Korea and to formulate and apply effective cancer prevention strategies to Koreans.

Impact of the Mediterranean Diet (Med-Diet) on Cancer and Cardiovascular Disease (CVD) Prevention and Management: A Narrative Review

Cancer and cardiovascular diseases (CVD) are the leading causes of mortality and morbidity worldwide. Dietary patterns play a crucial role in the prevention and management of these life-threatening diseases. Moreover, the Mediterranean diet (Med-Diet) is consistently associated with health benefits. Therefore, the current study attempted to synthesize the contemporary scientific evidence, outlining the impact of Med-Diet on CVD. The key components of this dietary pattern include a high intake of fruits, vegetables, whole grains, seafood, olive oil, and moderate consumption of poultry and dairy products which interact to provide protective effects against these diseases. The Med-Diet emphasizes the use of monounsaturated fats from olive oil and polyunsaturated fats from seafood, which significantly contribute to cardiovascular health. This diet is also rich in antioxidants and phytochemicals, offering potential protective qualities against cancer through combating inflammation and oxidative stress. High fiber content contributes to a healthy digestive system and potentially reduces the incidence of colorectal cancers. While, the Med-Diet alone cannot guarantee complete immunity against these diseases, it is an essential element of a holistic approach to disease prevention and management. Moreover, it also reinforces the importance of incorporating dietary patterns into public health strategies. To strengthen the evidence base, future research should focus on long-term randomized controlled trials in diverse populations.

Dietary Quality and Diet-Related Factors Among Emerging Adults (18–23 y) in the United States Are a Cause for Concern: National Health and Nutrition Examination Survey 2015–2018

BackgroundPoor dietary quality is a risk factor for diet-related chronic disease and suboptimal nutritional patterns often begin early in the life course. Although the dietary intakes of young children, adolescents, and middle-aged and older adults are well established, much less is known about emerging adults, who represent a unique time point in life, as they are undergoing significant changes in food environments, autonomy, finances, and caregiver and parental involvement. ObjectivesThis study aimed to examine dietary quality, as assessed via the Healthy Eating Index (HEI), by demographic, socioeconomic, and health-related characteristics among emerging adults (18–23 y) in the United States who participated in the 2015–2018 National Health and Nutrition Examination Survey (NHANES). MethodsNHANES data were collected via a household interview and 2 24-h dietary recalls (24HR). Usual dietary intakes from the 24HRs were approximated using the multivariate National Cancer Institute Method to compute mean HEI-2015 overall and component scores (range: 0–100; higher scores indicating higher dietary quality). ResultsOverall dietary quality among emerging adults (HEI-2015: 50.3 ± 1.3) was significantly lower than other adults (≥24 y) (HEI-2015: 56.3 ± 0.5; P < 0.0001) in the United States, with differences primarily driven by lower intakes of whole fruit, vegetables, and whole grains and higher intakes of sodium, refined grains, and saturated fat. Few differences in HEI-2015 scores were noted across population subgroups by sex, food security, family income, and food assistance program participation, except for added sugar; intakes of added sugar were significantly higher among women, food insecure, and food assistance program participants than those in their counterparts, respectively. ConclusionsDietary quality is poor among emerging adults in the United States and persists across all population subgroups, suggesting a significant need for tailored public health interventions to improve dietary quality among this population. Future research investigating to what extent emerging adults prioritize healthful behaviors and exploring other indicators for identifying nutritionally vulnerable subgroups may be impactful for identifying disparities among this life stage.