Low Sugar-sweetened Beverage Intake Research Articles

Trends in Diet Quality Among U.S. Adults From 1999 to 2020 by Race, Ethnicity, and Socioeconomic Disadvantage.

Few data have assessed trends in diet quality among U.S. adults. To evaluate trends in diet quality by race, ethnicity, and socioeconomic disadvantage. Repeated cross-sectional study. United States. Noninstitutionalized adults aged 20 years or older who responded to the 1999-2020 National Health and Nutrition Examination Survey (NHANES). The proportion of participants meeting the targets of the validated American Heart Association (AHA) 2020 continuous diet score (based on higher intake of fruits, vegetables, whole grains, fish and shellfish, and nuts, seeds, and legumes and lower intake of sugar-sweetened beverages, processed meat, saturated fat, and sodium) and the Healthy Eating Index (HEI)-2015, and energy-adjusted consumption of their components and other individual food groups and nutrients. Poor diet was defined as less than 40% adherence to the AHA score, intermediate as 40% to 79.9% adherence, and ideal as at least 80% adherence. A total of 51 703 adults were included. From 1999 to 2020, the proportion of U.S. adults with poor diet quality decreased from 48.8% to 37.4% (difference, -11.4 percentage points [95% CI, -16.8 to -5.96 percentage points]), the proportion with intermediate quality increased from 50.6% to 61.1% (difference, 10.5 percentage points [CI, 5.20 to 16.1 percentage points]), and the proportion with ideal quality increased from 0.66% to 1.58% (difference, 0.93 percentage points [CI, 0.35 to 1.51 percentage points]) (P for trend < 0.001 for each). Persistent or worsening disparities in diet quality were observed by age, sex, race and ethnicity, education, income, food security, Supplemental Nutrition Assistance Program participation, and health insurance coverage. For example, the proportion of adults with poor diet quality decreased from 47.9% to 33.0% among those with food security (P for trend < 0.001) but did not change (51.3% to 48.2%) among those experiencing food insecurity (P for trend = 0.140) (P for interaction = 0.001). Findings were similar for HEI-2015. Self-reported diet; cross-sectional study design. Diet quality among U.S. adults improved modestly between 1999 and 2020, but the proportion with poor diet quality remains high, and dietary disparities persist or are worsening. National Institutes of Health.

Place of Residence Is Associated with Dietary Intake and BMI-SDS in Children and Adolescents: Findings from the DONALD Cohort Study.

We aimed to determine whether place of residence in the German urban food environment is associated with habitual dietary intake (energy, macronutrients, and food groups) and body mass index (standard deviation score of BMI and BMI-SDS). Our hypothesis was that place of residence may explain some variation in dietary intake and nutritional outcomes. For the cross-sectional analyses of DONALD study data, we grouped participants according to their geocoded residence in the north or south of Dortmund. We applied robust multi-level mixed effects regression models using residence as a predictor and (1) BMI-SDS or (2) dietary data (daily intake of energy (kcal), macronutrients (energy percentage), or food groups (g/1000 kcal)) as the outcome. Models were adjusted for age, sex, and household socio-economic status. An analysis was carried out on 1267 anthropometric measurements collected annually from 360 participants aged 6-18 years (935 3-day weighed dietary records from 292 participants) between 2014 and 2019. In the fully adjusted models, residence in the south was associated with a lower BMI-SDS (β = -0.42, p = 0.02), lower intake of sugar-sweetened beverages (β = -47.00, p = 0.04), and higher intake of vegetables (β = 11.13, p = 0.04). Findings suggest that the place of residence, beyond individuals' socio-economic statuses, may be a contributing factor to dietary quality.

Interrogating Components of 2 Diet Quality Indices in Pregnancy using a Supervised Statistical Mixtures Approach

BackgroundThe Healthy Eating Index (HEI)-2015 and Alternative Healthy Eating Index (AHEI)-2010 evaluate diet holistically in pregnancy. However, it remains unclear how individual index components interact to contribute to health. ObjectivesTo evaluate associations of HEI-2015 and AHEI-2010 components with gestational length using traditional and novel statistical methods in a prospective cohort. MethodsPregnant women completed a 3-mo food-frequency questionnaire (FFQ) at median 13 wk gestation to calculate the HEI-2015 or AHEI-2010. Covariate-adjusted linear regression models evaluated associations of HEI-2015 and AHEI-2010 total scores and individual components (one at a time and simultaneously adjusted) with gestational length. Covariate-adjusted weighted quantile sum regression models evaluated 1) associations of HEI-2015 or AHEI-2010 components as mixtures with gestational length and 2) contributions of components to these associations. ResultsEach 10-point increase in HEI-2015 and AHEI-2010 total score was associated with 0.11 (95% CI: −0.05, 0.27) and 0.14 (95% CI: 0.00, 0.28) wk longer gestation, respectively. In individual or simultaneously adjusted HEI-2015 models, higher intakes of seafood/plant proteins, total protein foods, greens/beans, and saturated fats but lower intakes of added sugars and refined grains were associated with longer gestational length. For the AHEI-2010, higher intake of nuts/legumes and lower intake of sugar-sweetened beverages (SSBs)/fruit juice were associated with longer gestational length. Jointly, 10% increases in HEI-2015 or AHEI-2010 mixtures were associated with 0.17 (95% CI: 0.001, 0.34) and 0.18 (95% CI: 0.05, 0.30) wk longer gestational length, respectively. Seafood/plant protein, total protein foods, dairy, greens/beans, and added sugars were the largest contributors to the HEI-2015 mixture. Nuts/legumes, SSBs/fruit juice, sodium, and DHA/EPA were the largest contributors to the AHEI-2010 mixture. Associations were less precise but consistent in women with spontaneous labors. ConclusionsCompared to traditional methods, associations of diet index mixtures with gestational length were more robust and identified unique contributors. Additional studies could consider interrogating these statistical approaches using other dietary indices and health outcomes.

The Association Between Frequent Sugar-Sweetened Beverage Intake and Sleep Duration in School Children: A Cross-Sectional Study.

BackgroundHigher consumption of sugar-sweetened beverages (SSBs) maybe association with children's sleep pattern. However, few studies have considered this association in Asia, especially in school children. This study investigated the relationship between children's consumption frequency of such beverages and their sleep duration.MethodsParticipants aged 6–12 years were analyzed from two survey data in 2012 and 2013–2016 Nutrition and Health Surveys in Taiwan. A total of 2,628 participants were included in the analysis (2012, N = 1,267; 2013–2016, N = 1,361). Beverages weekly consumption were divided into low and high intake groups by medians cut-off points. The sleep variables were the sleep duration at night (including school days and weekends) and sleep debt. After controlling the confounders, the correlation between sugar-sweetened beverage consumption and sleep duration was examined using multinomial logistic regression analysis.ResultsThe students slept for an average of 8.8 h on school days and 9.7 h on weekends. Relative to the low SSB intake group, the high intake group exhibited shorter sleep durations on school days (P < 0.001), greater sleep debt (P = 0.049). In logistic regression, high intake group were more likely to sleep for <8.5 h on school days (OR = 1.67, P = 0.002) and exhibit >2 h of sleep debt than low intake group (OR = 1.41, P = 0.022).ConclusionsChildren who had consumed sugar-sweetened beverages frequently slept for shorter durations at night on school days and exhibited greater sleep debt. The causal relationship was not clear. Nonetheless, these two factors are important in promoting children health.

Intersectionality between parenting styles, area of residence and gender on food group consumption among Costa Rican adolescents

Little is known about how parenting styles can influence the adolescent’s consumption of sugar-sweetened beverages (SSB), fruits and vegetables (FV) and beans in Latin America. This study uses hierarchical moderated regression models to examine such association by area of residence, sex of the parent and of the adolescent in Costa Rica. Results showed that fathers' authoritarian style was significantly associated with lower intake of sugar-sweetened beverages (SSB) among boys (b = -0.163, p = 0.050), but not girls (b = 0.097, p = 0.114) while mother's authoritarian style was associated with lower SSB intake among girls (b = -0.138, p = 0.031), but not boys (b = 0.159, p = 0.059). Fathers’ authoritative style was associated with higher consumption of fruits and vegetables (FV) among boys in rural areas (b=0.440, p= 0.017), but this association was not significant for girls (b=-0.033, p= 0.800) in rural areas or for either gender in urban areas. Parenting styles of the mothers' and fathers' were not significantly associated with Costa Rican adolescent bean consumption, in general or for any of the subgroups. Findings suggest an intersectionality in the effects of parentchild interactions by child and parent sex, cultural and geographic context, and the eating behaviors examined.

Diet diversity score and healthy eating index in relation to diet quality and socio-demographic factors: results from a cross-sectional national dietary survey of Swedish adolescents.

Groups with low socio-economic status have less healthy diets and higher prevalence of non-communicable diseases. Using the latest Swedish national dietary survey data, we developed a healthy eating index and a diet diversity score with the aim to explore associations between the scores and socio-demographic factors. Cross-sectional national dietary survey. A web-based retrospective registration of food and beverages during 2 d was used to assess dietary intake. This information was used to construct the Swedish Healthy Eating Index for Adolescents 2015 (SHEIA15) and the Riksmaten Adolescents Diet Diversity Score (RADDS). The scores were based on the latest Swedish dietary guidelines from 2015. Intakes of food and nutrients across the scores were examined. Mixed-effects multilevel models were used to assess associations between the scores and household education, sex, school grade, weight status and school municipality. School-based survey in Sweden. 2905 adolescents in grades 5, 8 and 11, 56 % girls. High scores on SHEIA15 and RADDS were associated with higher intake of vegetables, fish and several nutrients, and lower intake of sugar-sweetened beverages and red meat. Boys and participants in households with lower education level scored lower on both indices. Individuals with overweight/obesity scored lower on RADDS. The newly developed indices can be used to identify healthy eating patterns among Swedish adolescents. Both indices show that boys and adolescents from households with lower education level have poorer dietary habits. Lower diet diversity was related to overweight/obesity, but the overall healthy eating index was not.

Abstract P210: Associations Of Early Parental Feeding Concerns And Behaviors With Child’s Dietary Intakes Throughout Childhood

Introduction: Parental feeding behaviors have been found to be associated with dietary intakes and weight status in children, although the longitudinal associations of parental feeding behaviors in early life with diet later in childhood have been scarcely studied. Hypothesis: We hypothesized that parental feeding restriction, pressure to eat, and concerns about child’s weight would be associated with poorer diet quality throughout childhood. Methods: Among 1172 mother-child pairs from Project Viva, we examined associations of parental feeding behaviors at 2 years assessed via questions from the Child Feeding Questionnaire (behaviors dichotomized as yes vs. no) with diet quality in early (mean: 3.2, SD 0.2 years; n=1076) and mid-childhood (mean: 7.8, SD 0.7 years; n=993) assessed via food frequency questionnaires. We used linear regression models adjusted for socio-demographic characteristics, maternal and paternal body mass index, and maternal diet quality in pregnancy. Results: At 2 years postpartum, 47% of parents pressured/encouraged their child to eat more, 8% restricted their intakes, 15% were concerned about their child being overweight and 7% about their child being underweight. Parental pressure to eat at 2 years was associated with higher child intake of fruit juice (β 0.17 serving/day; 95% CI 0.01, 0.34) and snack foods (0.12 serving/day; 0.01, 0.22) in early childhood and with lower youth healthy eating index score (-1.32 points; -2.54, -0.10; score from 0 to 85 points) in mid-childhood. Parental feeding restriction at 2 years was associated with lower intake of sugar-sweetened beverages (-0.17 serving/day; -0.27, -0.06) in early childhood and with lower intake of dairy (-0.29 serving/day; -0.56, -0.02) in mid-childhood. Parental concerns about their child being underweight was associated with lower youth healthy eating index score (-2.18 points; -4.30, -0.05; score from 0 to 95 points) in early childhood while concerns about their child being overweight was associated with higher intakes of red and processed meat (0.14 serving/day; 0.04, 0.23) in early childhood and higher intake of baked products in mid-childhood (0.07 serving/day; 0.01, 0.13). Conclusions: We found that early parental feeding behaviors may have a modest contribution to dietary intakes throughout childhood. However, only a few associations persisted after adjusting for socio-economic and parental characteristics and effect sizes were modest. Strategies to improve diet quality in children might need to focus on the broader family and socio-economic context.

A Comprehensive Assessment of Food Parenting Practices: Psychometric Properties of the Portuguese Version of the HomeSTEAD Family Food Practices Survey and Associations with Children's Weight and Food Intake.

The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) survey evaluates a broad spectrum of food parenting practices related to parental use of control, autonomy support, and structure. This study aims to test the psychometric properties of the Portuguese version of the HomeSTEAD family food practices survey in parents of 3–12 year old children. Data were collected from 184 parents/caregivers. We performed an exploratory factor analysis (EFA), calculated the internal consistency coefficients of each subscale, and tested for associations with children’s food intake and weight. Based on the EFA, 61 items were included in the Portuguese version of the HomeSTEAD family food practices survey, and were distributed among four Coercive Control Practices (16 items); five Autonomy Support Practices (17 items); and nine Structure Practices (28 items). All scales demonstrated an acceptable level of internal consistency. A higher body mass index (BMI) SD score in children was associated with higher levels of restriction and weight talk by parents and distractions during meals. Higher levels of distractions during meals were also associated with higher sweets intake in children. Additionally, higher levels of parental modeling and the establishment of rules and limits were associated with lower intake of sugar-sweetened beverages. These associations provide preliminary evidence of the HomeSTEAD family food practices survey’s construct validity and attest to its potential to assess parental strategies and provide useful information to improve children’s eating.

Association of Breastfeeding and Sugar-Sweetened Beverage Consumption with Obesity Prevalence in Offspring Born to Mothers with and Without Gestational Diabetes Mellitus (P11-098-19)

ObjectivesPrenatal and early life factors such as Gestational Diabetes Mellitus (GDM), exclusive breastfeeding (EBF), and early exposure to sugar-sweetened beverages (SSBs) may contribute to obesity in children. The relationship of EBF and SSBs with obesity prevalence in children exposed to GDM has rarely been evaluated. This study examined the association of EBF and early SSBs consumption with obesity prevalence in children (1-5y) born to mothers with and without GDM. MethodsThis study used data from the 2014 Los Angeles County Women, Infants, and Children(WIC) Survey, which included 3,707 mothers and their children (1-5y). Infants (1-2y) with weight-for-height ≥ 97.7thpercentile were classified as subjects with high weight-for-length and children (2-5y) were classified as subjects with obesity if their BMI-for-age was ≥ 95thpercentile. ResultsThe individual and combination interaction effects of GDM, SSBs intake, and EBF on obesity prevalence were all significant (P < 0.05). Compared to GDM offspring, with low SSBs intake, and who were EBF (referent), those who were GDM, with high SSBs intake and who were EBF had approximately a five-fold increase in odds of obesity (OR = 4.77, 95%CI 1.55-8.60, P = 0.03). Compared to the GDM referent group, GDM offspring who were not EBF with low and high SSBs intake had 4.3- and 4.4-times higher odds of obesity, respectively (OR = 4.33, 95%CI 1.42- 8.07, P = 0.01; OR = 4.38, 95%CI 1.39- 8.16, P = 0.01). Using non-GDM, EBF and low SSBs as referent, those who were not EBF, with either high or low SSBs had approximately a 4-fold increase in odds of obesity (OR = 3.62, 95%CI: 2.16-6.05, P < 0.0001; OR = 3.83, 95%CI: 2.26-6.48, P < 0.0001). Compared to the non-GDM referent group, those who were EBF and had high SSBs intake had 77% higher odds of obesity (OR = 1.77, 95%CI 0.93-3.37, P = 0.001). ConclusionsIn non-GDM offspring, EBF was protective against odds of obesity in both high and low SSBs consumers. In GDM offspring, EBF was only protective against obesity when SSBs intake was low. Surprisingly, GDM offspring who were EBF and had high SSBs consumption had a 4- to 5-fold increase in odds of obesity compared to those not EBF with either low or high SSBs intake. These results suggest that interventions should focus on the combined protective effects of EBF and low SSBs intake, particularly in GDM offspring. Funding SourcesFirst 5 LA.

Exploring the Role of Family Functioning in the Association Between Frequency of Family Dinners and Dietary Intake Among Adolescents and Young Adults

ImportanceEating meals, particularly dinner, with family members has been associated with improved dietary intake among youths. However, existing studies have not examined how family functioning may moderate or confound this association.ObjectiveTo examine whether level of family functioning is associated cross-sectionally with frequency of family dinners and dietary intake among a US national sample of adolescents and young adults.Design, Setting, and ParticipantsData from the 2011 questionnaire in the Growing Up Today Study 2 were used for this cross-sectional study. Linear regression models examined the extent to which family dinner frequency was associated with self-reported intake of fruits and vegetables, sugar-sweetened beverages, fast food, and takeout food among 2728 adolescents and young adults (age, 14-24 years). To explore effect modification by family functioning, an interaction term for family functioning and family dinner frequency was included for each dietary outcome. To explore confounding, models adjusted for family functioning were run. All models were stratified by sex and included participant age, educational attainment of mother’s spouse or partner, and family structure as covariates. Statistical analysis was conducted between January 1, 2017, and August 31, 2018.Main Outcomes and MeasuresDietary intake measured by consumption of fruits and vegetables, sugar-sweetened beverages, takeout food, and fast food; family dinner frequency per week; and family functioning.ResultsAmong the 2728 participants, there were 1559 female and 1169 male participants who were 14 to 24 years of age (mean [SD] age, 19.4 [1.9] years) and were living with their parents in 2011. Most participants (2453 of 2649 [92.6%]) identified as white. More frequent family dinners were associated with higher-quality dietary intake regardless of level of family functioning; interactions between family functioning and family dinner frequency were not significant. Associations between family meal frequency and dietary intake outcomes did not change substantively when adjusting for family functioning. In adjusted models, more frequent family dinners were associated with higher intakes of fruits (female participants: β, 0.09 servings/d; 95% CI, 0.04-0.15 servings/d; male participants: β, 0.07 servings/d; 95% CI, 0.01-0.12 servings/d) and vegetables (female participants: β, 0.21 servings/d; 95% CI, 0.12-0.30 servings/d; male participants: β, 0.19 servings/d; 95% CI, 0.09-0.30 servings/d), and lower intakes of fast food (female participants: β, –0.04 times/wk; 95% CI, –0.07 to 0.00 times/wk; male participants: β, –0.10 times/wk; 95% CI, –0.15 to –0.04 times/wk) and takeout foods (female participants: β, –0.04 times/wk; 95% CI, –0.07 to –0.01 times/wk; male participants: β, –0.06 times/wk; 95% CI, –0.10 to –0.02 times/wk). More frequent family dinners were associated with lower intake of sugar-sweetened beverages for male participants only (β, –0.07 servings/d; 95% CI, –0.13 to –0.02 servings/d).Conclusions and RelevanceMore frequent family dinners are associated with healthful dietary intakes among youths, regardless of level of family functioning. Family dinners may be an appropriate intervention target for improving dietary intake among youths.

A diet high in sugar-sweetened beverage and low in fruits and vegetables is associated with adiposity and a pro-inflammatory adipokine profile.

Diet, obesity and adipokines play important roles in diabetes and CVD; yet, limited studies have assessed the relationship between diet and multiple adipokines. This cross-sectional study assessed associations between diet, adiposity and adipokines in Mexican Americans. The cohort included 1128 participants (age 34·7±8·2 years, BMI 29·5±5·9 kg/m2, 73·2 % female). Dietary intake was assessed by 12-month food frequency questionnaire. Adiposity was measured by BMI, total percentage body fat and percentage trunk fat using dual-energy X-ray absorptiometry. Adiponectin, apelin, C-reactive protein (CRP), dipeptidyl peptidase-4 (DPP-IV), IL-1β, IL-1ra, IL-6, IL-18, leptin, lipocalin, monocyte chemo-attractant protein-1 (MCP-1), resistin, secreted frizzled protein 4 (SFRP-4), SFRP-5, TNF-α and visfatin were assayed with multiplex kits or ELISA. Joint multivariate associations between diet, adiposity and adipokines were analysed using canonical correlations adjusted for age, sex, energy intake and kinship. The median (interquartile range) energy intake was 9514 (7314, 11912) kJ/d. Overall, 55 % of total intake was accounted for by carbohydrates (24 % from sugar). A total of 66 % of the shared variation between diet and adiposity, and 34 % of diet and adipokines were explained by the top canonical correlation. The diet component was most represented by sugar-sweetened beverages (SSB), fruit and vegetables. Participants consuming a diet high in SSB and low in fruits and vegetables had higher adiposity, CRP, leptin, and MCP-1, but lower SFRP-5 than participants with high fruit and vegetable and low SSB intake. In Mexican Americans, diets high in SSB but low in fruits and vegetables contribute to adiposity and a pro-inflammatory adipokine profile.

Clustering of Obesity-Related Risk Behaviors Among Families With Preschool Children Using a Socioecological Approach: Cross-Sectional Study.

BackgroundLimited attention has been given to assessing home environments of parents with preschool-aged children using a socioecological approach to better understand potential influencers of obesity risk.ObjectiveThe purpose of this cross-sectional study was to examine the clustering of obesity-related risk behaviors among mothers with preschool children.MethodsMothers with preschool-aged children (ages 2 to 5 years) who participated in the online Home Obesogenic Measure of Environments (HOMES) survey were examined in clustering of four healthy recommended behaviors (ie, mother’s fruit and vegetable intake ≥5 per day, sedentary screen time <4 hours per day, sugar-sweetened beverage intake <1 time/day, and increased physical activity level). Frequencies and percents of the clustering variables were conducted along with Spearman rank order correlations to determine significant associations. Ward’s method with squared Euclidean distances were performed for the cluster analysis using the four standardized continuous variables. Identification of total cluster number was determined by visually inspecting the dendogram. Sociodemographic, intrapersonal, social environment, and home physical environment characteristic differences between cluster groups were further examined by independent t tests and chi-square analysis to validate findings.ResultsOf the 496 participants (72.6%, 360/496 white; age mean 32.36, SD 5.68 years), only a third (37.1%, 184/496) consumed five or more servings of fruits/vegetables daily, had low sedentary screen time of <4 hours/day, and reported moderate to high levels of physical activity (34.1%, 169/496). More than half (57.7%, 286/496) consumed <1 sugar-sweetened beverage serving daily. A positive correlation (r=.34, P<.001) between physical activity level and fruit/vegetable intake (≥5 servings/day), and a positive correlation (r=.15, P=.001) between low sedentary screen time (<4 hours/day) and low sugar-sweetened beverage intake (<1 serving/day) were found. Ward’s hierarchical analysis revealed a two-cluster solution: less healthy/inactive moms (n=280) and health conscious/active moms (n=216). Health conscious/active moms were significantly (P<.010) likely to be more physically active, have lower sedentary screen time, lower daily intake of sugar-sweetened beverages, and greater daily intake of fruits and vegetables compared to less healthy/inactive moms. Less healthy/inactive moms were significantly more likely to have a higher body mass index and waist circumference compared to the other cluster; however, there were no significant sociodemographic differences. There were many intrapersonal (eg, importance of physical activity for child and self) and home physical environment (eg, home availability of fruits/vegetables and salty/fatty snacks) characteristic differences between clusters, but few significant differences emerged for social environment characteristics (eg, family meals, family cohesion).ConclusionsFindings may have implications in tailoring future obesity prevention interventions among families with young children.

Associations among sugar sweetened beverage intake, visceral fat, and cortisol awakening response in minority youth

ContextAbdominal adiposity has long been associated with excess caloric intake possibly resulting from increased psychosocial stress and associated cortisol dysfunction. However, the relationship of sugar-sweetened beverage (SSB) intake specifically with cortisol variability and visceral adipose tissue (VAT) is unknown. ObjectiveTo examine the relationships between SSB intake, VAT, and cortisol response in minority youth. DesignA cross-sectional analysis. SettingThe University of Southern California. Participants60 overweight/obese Non-Hispanic Black and Hispanic adolescents ages 14–18years. Main outcome measuresVAT via Magnet Resonance Imaging (MRI), cortisol awakening response (CAR) via multiple salivary samples, and SSB intake via multiple 24-hour diet recalls. SSB intake was divided into the following: low SSB consumers (<1 servings per day), medium SSB consumers (≥1–<2 servings per day), high SSB consumers (≥2 servings per day). Analysis of covariance were run with VAT and CAR as dependent variables and SSB intake categories (independent variable) with the following a priori covariates: sex, Tanner stage, ethnicity, caloric intake, and body mass index. ResultsThe high SSB intake group exhibited a 7% higher VAT compared to the low SSB intake group (β=0.25, CI:(0.03, 0.33), p=0.02). CAR was associated with VAT (β=0.31, CI:(0.01,0.23), p=0.02). The high SSB intake group exhibited 22% higher CAR compared to the low SSB intake group (β=0.30, CI:(0.02,0.48), p=0.04). ConclusionThis is the first study exploring the relationship between SSB, VAT, and CAR. SSB consumption appears to be independently associated greater abdominal adiposity and higher morning cortisol variability in overweight and obese minority youth. This study highlights potential targets for interventions specifically to reduce SSB intake in a minority youth population.

Greater Adherence to the Alternative Healthy Eating Index Is Associated with Lower Incidence of Physical Function Impairment in the Nurses’ Health Study

Background: Physical function is integral to healthy aging, in particular as a core component of mobility and independent living in older adults, and is a strong predictor of mortality. Limited research has examined the role of diet, which may be an important strategy to prevent or delay a decline in physical function with aging.Objective: We prospectively examined the association between the Alternative Healthy Eating Index-2010 (AHEI-2010), a measure of diet quality, with incident impairment in physical function among 54,762 women from the Nurses’ Health Study.Methods: Physical function was measured by the Medical Outcomes Short Form-36 (SF-36) physical function scale and was administered every 4 y from 1992 to 2008. Cumulative average diet was assessed using food frequency questionnaires, administered approximately every 4 y. We used multivariable Cox proportional hazards models to estimate the HRs of incident impairment of physical function.Results: Participants in higher quintiles of the AHEI-2010, indicating a healthier diet, were less likely to have incident physical impairment than were participants in lower quintiles (P-trend < 0.001). The multivariable-adjusted HR of physical impairment for those in the top compared with those in the bottom quintile of the AHEI-2010 was 0.87 (95% CI: 0.84, 0.90). For individual AHEI-2010 components, higher intake of vegetables (P-trend = 0.003) and fruits (P-trend = 0.02); lower intake of sugar-sweetened beverages (P-trend < 0.001), trans fats (P-trend = 0.03), and sodium (P-trend < 0.001); and moderate alcohol intake (P-trend < 0.001) were each significantly associated with reduced rates of incident physical impairment. Among top contributors to the food components of the AHEI-2010, the strongest relations were found for increased intake of oranges, orange juice, apples and pears, romaine or leaf lettuce, and walnuts. However, associations with each component and with specific foods were generally weaker than the overall score, indicating that overall diet pattern is more important than individual parts.Conclusions: In this large cohort of older women, a healthier diet was associated with a lower risk of developing impairments in physical function.

Abstract PR05: Dietary quality and ovarian cancer risk in African American women

Abstract Background: Ovarian cancer is the fifth leading cause of cancer death among women in the US. Considering the poor survival rates, identifying modifiable lifestyle factors including dietary interventions for ovarian cancer is needed. Compared to single foods or nutrients, examining dietary exposures as dietary patterns may allow us to accommodate the multidimensional aspects of diet and to better capture the role of diet in ovarian cancer carcinogenesis. Healthy Eating Index (HEI) is a measure of dietary quality to assess adherence to the Dietary Guidelines for Americans. Compared to HEI-2005 edition, HEI-2010 has an increased emphasis on dietary quality and reflects the most recent dietary guidelines. Alternate Healthy Eating Index-2010 (AHEI-2010), grounded in a different eating guide, the Healthy Eating Pyramid, was based on dietary predictors of chronic diseases. To our knowledge, this is the first study to evaluate the impact of dietary quality on ovarian cancer risk in African-American women. Objective: We aimed to evaluate three index-based dietary patterns–HEI-2005, HEI-2010, AHEI-2010–in relation to ovarian cancer risk in African-American women. Methods: Analyses were conducted among 415 cases of ovarian cancer and 629 controls using data from the African American Cancer Epidemiology Study (AACES). AACES is an ongoing population-based case-control study of ovarian cancer in African-American women in 11 sites in the US. Cases were identified through rapid case ascertainment and age- and site-matched controls were identified by random-digit-dialing. Information on risk factors related to ovarian cancer was collected by computer-assisted telephone interview. Dietary information 1 year before diagnosis (cases) or interview (controls) was obtained using a Block food frequency questionnaire (FFQ). AACES FFQ data were linked to the MyPyramid Equivalents Database 2.0 or based on published descriptions to generate equivalent intake for food groups under HEIs and AHEI-2010. Both HEIs includes 12 components, with total scores ranging from 0 to 100. AHEI-2010 includes 10 components with overall scores from 0 to 110. Higher scores indicate better adherence to a healthy diet. We used multivariate unconditional logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potential socio-demographic and lifestyle risk factors. Results: Only higher AHEI-2010 scores were associated with lower risk of ovarian cancer among all African-American women [OR comparing the highest quartile (Q4) vs. lowest (Q1) =0.66, 95% CI 0.45-0.98, p-trend =0.05]. The relationships between HEIs or AHEI and ovarian cancer risk were modified by menopausal status. Among post-menopausal women, we found lower risk of ovarian cancer with higher adherence of HEI-2010 (OR Q4 vs. Q1 =0.57, 95% CI 0.36-0.92, p-trend =0.03) and AHEI-2010 (OR Q4 vs. Q1 =0.49, 95% CI 0.31-0.78, p-trend =0.01). We observed no associations among pre-menopausal women. HEI-2005 was not associated with ovarian cancer risk among all or by menopausal status. Analyses evaluating individual score components with ovarian cancer risk suggested that in our sample of African-American women the benefits of HEI-2010 mainly come from higher intake of total vegetables, greens and beans, seafood and plant proteins and lower intake of empty calories (i.e., calories from solid fats, alcohol and added sugars). Consistently, the associations with AHEI-2010 were mainly driven by higher vegetable intake and lower intake of sugar-sweetened beverages and fruit juice. Conclusion: Our findings suggest, for the first time, that a healthy diet is associated with lower risk of ovarian cancer in African Americans. Adherence to the current Dietary Guidelines for Americans may reduce ovarian cancer risk among post-menopausal African-American women. This abstract is also presented as Poster A67. Citation Format: Bo Qin, Patricia G. Moorman, Anthony J. Alberg, Jill S. Barnholtz-Sloan, Melissa Bondy, Michele L. Cote, Ellen Funkhouser, Edward S. Peters, Ann G. Schwartz, Paul Terry, Joellen M. Schildkraut, Elisa V. Bandera. Dietary quality and ovarian cancer risk in African American women. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr PR05.

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009–2010. Nearly all home/family environment variables (n=7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score (p=0.03) and positively associated with fruit/vegetable consumption (p<0.001). Most observed associations were applicable across ethnic/racial groups; however; eight relationships were found to differ by ethnicity/race. For example, parental encouragement for healthy eating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance.

Improved dietary intake among overweight and obese children followed from 8 to 12 years of age in a randomised controlled trial.

More knowledge about improving dietary intake in secondary preventive actions against childhood overweight and obesity is needed. The objective was to evaluate the impact of a 2-year intervention on energy, macronutrient and food intake of overweight and obese children participating in a randomised controlled trial. Children (8-12 years old) living in Sweden were recruited to participate for 2 years between 2006 and 2009. The children were randomised into either an intervention group (n 58), participating in an intervention concerning food habits, physical activity and behavioural change, or a control group (n 47). Dietary intake at baseline and the 2-year measurement were assessed with a diet history interview covering 14d. Energy intake (EI) of the intervention and control groups was underestimated by 28 and 21%, respectively, after 2 years, but with no difference between the groups (P=0·51). After 2 years of intervention, the intervention group, compared with the control group, had a lower intake of sugar-sweetened beverages (P=0·015) as well as a higher intake of foods high in fibre, low in saturated fat, sugar and salt (P=0·031). Further, a lower EI in relation to BMR, lower total fat, MUFA and cholesterol was seen in the intervention group compared with the control group. In conclusion, the food and nutrient intake of overweight and obese children was improved after participating in a 2-year intervention programme. Dietary counselling should be included in secondary preventive actions against childhood overweight and obesity to promote healthy food habits.

Sugary beverage intakes and obesity prevalence among junior high school students in Beijing - a cross-sectional research on SSBs intake.

Excessive consumption of sugar-sweetened beverages (SSBs) may increase the risk of obesity. Data in regards to the consumption of SSBs is insufficient in the Chinese population, especially in middle school students experiencing rapid nutritional transition. We aimed to describe the consumption of SSBs among junior high school students and explore the relationship between SSB intake and adolescents' overweight/obesity in Beijing. This was a cross-sectional study under which 322 (46%) male and 380 (54%) female (age 11-15 y, median 13 y) were recruited from two middle schools of Xicheng District in Beijing. All subjects completed a questionnaire and 24-hour dietary recall for 3 consecutive days. Prevalence of overweight was 21.1% in males and 11.6% in females. Prevalence of obesity was 22.7% in males and 10.3% in females. Of the students, 7.7% consumed SSBs at least once per day. Students whose storage of SSBs at home is more than 1 type are more likely to consume higher quantities of SSBs everyday (p<0.001). After adjusting for confounding factors, OR of high SSBs intake group versus low SSBs intake group was 2.6. Students whose parents had a higher BMI had a higher risk of overweight/obesity (OR=1.13, p=0.007). Among middle school students in Beijing, prevalence of obesity is more severe than that of overweight. Sugar-sweetened beverages have been the most popular drinks, and consumption of SSBs has a positive association with levels of overweight/obesity among male students.

Effects of breastfeeding and low sugar-sweetened beverage intake on obesity prevalence in Hispanic toddlers

Few studies have examined the independent and additive effects of breastfeeding (BF) and sugar-sweetened beverage (SSB) intake in early life on overweight and obesity prevalence. The objective was to assess the effects of BF and SSB intake on the prevalence of overweight and obesity in Hispanic toddlers. Nutrition data were collected via phone surveys with caregivers of 1483 Hispanic children (2-4 y of age) from the Los Angeles County Women, Infants, and Children (WIC) program. BF history at 2-4 y of age was categorized as follows: no BF, >1 wk to <6 mo BF, 6 to <12 mo BF, and ≥12 mo BF. SSB intake at 2-4 y of age was categorized as follows: high SSB (≥2 SSBs/d), mid SSB (1 SSB/d), and no SSB. The height and weight of the children were measured by WIC staff and stored in the Integrated Statewide Information System. Binary logistic regressions assessed the effects of BF and SSB categories on overweight and obesity prevalence. In comparison with the no-BF participants, the odds of obesity were lower in the ≥12-mo-BF participants (OR: 0.55; 95% CI: 0.37, 0.83; P = 0.004). In comparison with high-SSB participants, the odds of obesity were lower in the no-SSB participants (OR: 0.69; 95% CI: 0.47, 1.00; P = 0.047). In comparison with the combined no-BF/high-SSB participants, the odds of obesity were lower in the ≥12-mo BF/no-SSB participants (OR: 0.39; 95% CI: 0.19, 0.80; P = 0.01). The results suggest that BF for ≥1 y and low SSB intake during the toddler years can have profound effects on reducing the prevalence of obesity in Hispanic toddlers.

Relationship Between Insulin Resistance–Associated Metabolic Parameters and Anthropometric Measurements With Sugar-Sweetened Beverage Intake and Physical Activity Levels in US Adolescents

To evaluate the relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels. A cross-sectional analysis of the National Health and Nutrition Examination Survey data collected by the National Center for Health Statistics. Nationally representative samples of US adolescents participating in the National Health and Nutrition Examination Survey during the years 1999-2004. A total of 6967 adolescents aged 12 to 19 years. Sugar-sweetened beverage consumption and physical activity levels. Glucose and insulin concentrations, a homeostasis model assessment of insulin resistance (HOMA-IR), total, high-density lipoprotein, and low-density lipoprotein cholesterol concentrations, triglyceride concentrations, systolic and diastolic blood pressure, waist circumference, and body mass index (calculated as weight in kilograms divided by height in meters squared) percentile for age and sex. Multivariate linear regression analyses showed that increased sugar-sweetened beverage intake was independently associated with increased HOMA-IR, systolic blood pressure, waist circumference, and body mass index percentile for age and sex and decreased HDL cholesterol concentrations; alternatively, increased physical activity levels were independently associated with decreased HOMA-IR, low-density lipoprotein cholesterol concentrations, and triglyceride concentrations and increased high-density lipoprotein cholesterol concentrations. Furthermore, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects of decreasing HOMA-IR and triglyceride concentrations and increasing high-density lipoprotein cholesterol concentrations. Sugar-sweetened beverage intake and physical activity levels are each independently associated with insulin resistance-associated metabolic parameters and anthropometric measurements in adolescents. Moreover, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects on several health-related outcome variables.