Mean Healthy Eating Index Score Research Articles

Diet Quality and Eating Frequency Were Associated with Insulin-Taking Status among Adults.

This pilot cross-sectional study explored differences in dietary intake and eating behaviors between healthy adults and a group of adults taking insulin to manage diabetes. A characteristic questionnaire and up to four Automated Self-Administered 24-Hour dietary recalls were collected from 152 adults aged 18-65 years (96 healthy and 56 adults taking insulin) from Indiana and across the U.S. from 2022 to 2023. The macronutrient intake, diet quality via the Healthy Eating Index (HEI)-2015, eating frequency, and consistency of timing of eating were calculated and compared between the two groups using adjusted linear or logistic regression models. The total mean HEI scores were very low, at 56 out of 100 and 49 out of 100 for the healthy and insulin-taking groups, respectively. Insulin-taking adults had significantly lower HEI total (p = 0.003) and component scores compared to the healthy group for greens and beans (2.0 vs. 3.0, p = 0.02), whole fruit (2.1 vs. 2.9, p = 0.05), seafood and plant proteins (2.1 vs. 3.3, p = 0.004), and saturated fats (3.7 vs. 5.4, p = 0.05). Eating frequency was significantly lower in the insulin-taking group than in the healthy group (3.0 vs. 3.4 eating occasions/day, p = 0.05). Evidence of the low diet quality and eating frequency of insulin takers may help inform and justify nutrition education to control and manage diabetes.

Dietary intake of polyamines in a Spanish adult population: Age-dependent and correlation with the healthy dietary index and dietary inflammatory index scores

ObjectivesA healthy and balanced diet is crucial to maintaining optimal health. Understanding the benefits of different food components is essential. Polyamine spermidine is linked to age-related disease protection, but daily intakes and whether these vary with age are unknown. This study aimed to determine polyamine intake in a Mediterranean diet population and its association with participants' age, Healthy Eating Index (HEI) and Dietary Inflammatory Index (DII) scores. Research Methods & ProceduresA database was elaborated with references concerning polyamine content in foods to determine the daily intake of frequent foods consumed by 203 participants (84 males and 119 females), aged 18–90 years, using a nutritional survey (VioScreen), that includes HEI and DII scores. ResultsThe participants' characteristics are as reported in the 2020 corresponding Spanish Nutritional Survey. Two-thirds accomplished moderate to high adherence to the Mediterranean diet. The mean HEI score was 74.45 (out of 100), and the DII was −1.94 (anti-inflammatory). The median intake of polyamines was 45.59 mg/day/person (mean: 46.89 mg/day/person, 410.57 µmol/day/person), without gender differences. After normalising the intake per kcal, the Kruskal-Wallis test showed significant differences among age groups for total polyamines ingested, putrescine, and spermidine. The intake of putrescine and spermidine was significantly higher in the 60–69 age group compared to the 24–59 and 18–23 age groups, respectively. HEI scores positively correlated with polyamine intake, while DII was negative. ConclusionsPolyamine intake was higher than reported in other populations, did not decrease based on age, and was associated with healthy eating and anti-inflammatory foods.

Assessing the acceptability and feasibility of using a computerized food frequency questionnaire (FFQ) to determine dietary patterns in survivors of head and neck cancer (HNC).

e24103 Background: Malnutrition and poor dietary habits are associated with worse outcomes and decreased quality of life (QOL) in patients with HNC. Given the lack of standardized assessment of diet in survivors of HNC but the concern for long term malnutrition risk, we piloted a recently developed computerized FFQ that provides individualized dietary feedback (Vioscreen) in survivors of HNC. We sought to assess its feasibility and acceptability and explore associations between diet quality, QOL, and patient/treatment characteristics. Methods: We recruited HNC patients who had completed cancer treatment (radiation alone, chemoradiation, surgery/radiation, surgery/chemoradiation) at least 6 months prior to study enrollment who did not have a feeding tube. Dietary assessment was conducted using Vioscreen. Dietary quality was defined by Healthy Eating Index (HEI) and calculated by the participant’s response. All patients received an individualized feedback report. Patients also completed the EORTC QLQ-C30 and H&N35. At 6 weeks, we administered an acceptability questionnaire on usability of Vioscreen and perceived dietary changes. Results: 50 patients consented to participate. Of these, 34 (68%) completed all initial questionnaires. Of the 34 participants, majority were white/non-Hispanic, male, with oropharynx primaries, and median time from treatment was 68.4 months. Of the 27 who completed acceptability, 15 (56%) considered the Vioscreen tool to be useful, 9 (36%) reported they made changes to diet, and 16 (59%) would recommend to others. Mean HEI score was 63.2 (SD 11.3). There were no statistically significant differences in HEI scores between participants who were male vs female or based on time from treatment. There was a numeric difference in HEI scores for those with oral cavity/larynx cancers vs. oropharynx (58.3 vs 65.6; p = 0.06), and those with bimodality vs. trimodality treatment (66.1 vs 57.3; p = 0.07), but this did not reach statistical significance. There was a significant positive correlation with higher HEI scores and less trismus as reported on the EORTC H&N35 questionnaire (r = .49, p < .01). Additionally, the participants who found the Vioscreen useful were less likely to report swallowing difficulties on the EORTC H&N35 (p = 0.046) and less likely to have had surgery as part of treatment (p = 0.046). Conclusions: For survivors of HNC, Vioscreen was useful to > 50% of participants. Diet quality and swallowing issues were worse in patients receiving trimodality treatment; those reporting more swallowing complaints also reported the Vioscreen tool was less useful. Thus, using Vioscreen as a stand-alone intervention may be insufficient for these populations. Future studies will couple the Vioscreen FFQ with a nutrition counseling intervention.

Healthy eating index and bone health markers in adults with metabolically healthy and unhealthy obese phenotypes.

The Healthy Eating Index (HEI) estimates the diet quality, and low HEI scores are associated with adverse bone outcomes. However, the relationship between HEI scores and bone health in individuals who are obese but otherwise healthy or obese with comorbidities remains unclear. We aimed to evaluate the association of HEI scores with bone mineral density (BMD), bone regulating hormones and bone turnover markers in individuals with metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) phenotypes. This was a cross-sectional analysis of 122 adults who were overweight or obese. A questionnaire was completed to obtain demographic data. Body composition and BMD were assessed by a Dual Energy X-Ray Absorptiometry (DXA) exam. The HEI scores and dietary components were calculated using a 24-h dietary recall. Blood samples were collected for the analysis of serum 25-hydroxyvitamin D (s25OHD), total osteocalcin (OC), parathyroid hormone (PTH), and C-terminal telopeptide (CTx) concentrations. The MHO and MUO phenotypes were classified according to the absence or presence of metabolic abnormalities. The sample mean age was 37.91 ± 12.66 years, 50.8% were men, mean body mass index (BMI) was 30.01 ± 4.63 kg/m2, and 45.9% were classified as the MUO phenotype. The mean HEI scores were 54.42 ± 16.25 and 61.48% had low-diet quality. HEI scores were positively associated with s25OHD in the MUO phenotype group (β = 0.194, 95%CI = 0.038-0.350, p = 0.016). Certain dietary score components, such as fruits, seafood and plant protein, added sugars, whole grains, and fatty acids were also associated with bone health markers. However, HEI scores were not associated with BMD measures, neither with other bone regulating hormones and turnover markers. There was a positive association between HEI scores and s25OHD in adults who were overweight or obese with MUO phenotype. Additionally, the adequate consumption of specific food groups may benefit bone mass and metabolism. These results emphasize the importance of lifestyle interventions encouraging healthy eating habits to prevent s25OHD deficiency, poor bone health, and cardiometabolic complications.

Nutritional status of Syrian female migrants in Turkey: a cross- sectional study

<p>It is known that individuals who are immigrants experience malnutrition due to various reasons. The present study was conducted to compare the nutritional status of immigrant women, who arrive in Turkey from Syria, before and after migration, and to determine the factors that affect their current healthy eating index scores. The individuals participating in the study were recruited from Immigrant Health Unit in Mardin-Turkey. The sampling of this cross-sectional study consisted of the women who were between the ages of 15-49, 450 Syrian migrant women participated in the study. The data were collected with face-to-face interview technique and with a questionnaire that consisted of 2 parts. According to the Healthy Eating Index (HEI)-2015 score of the individuals mean was found to be 52.90±9.40. According to the hierarchical regression model, the monthly income, life expectancy in Turkey, body mass index (BMI), and the number of individuals in the family were statistically significant components to predict the mean HEI score. It was determined that the basic eating habits of individuals changed in the country of immigration, and more foods with high carbohydrate and saturated fat contents were consumed. It is required to design comprehensive studies and policies.</p>

Popular diets as selected by adults in the United States show wide variation in carbon footprints and diet quality

BackgroundCarbon footprints of vegetarian, pescatarian, and other popular diets have been studied previously, but mostly as idealized versions modeled to meet dietary recommendations. Less is known about the footprints of popular diets as they are consumed by US adults, and thus the potential trade-offs with diet quality for free-living individuals. ObjectivesThis study estimated the carbon footprint and diet quality of popular diets as selected by a nationally representative sample of US consumers, including the recently trending keto- and paleo-style diets. MethodsThe 2005–2010 NHANES 24-h recall data were used to categorize individual adult diets (n = 16,412) into 6 types: vegan, vegetarian, pescatarian, paleo, keto, and all other diets, referred to here as omnivore diets. Average daily greenhouse gas emissions in kilograms of carbon dioxide equivalents per 1000 kcal (kg CO2-eq/1000 kcal) were calculated for each diet by matching our previously developed database to NHANES individual diet data. Diet quality was determined using the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index. Survey-weighted ordinary least-squares regression was used to assess mean differences in diets. ResultsThe average carbon footprints of vegan (0.69 ± 0.05 kg CO2-eq/1000 kcal) and vegetarian (1.16 ± 0.02) diets were lower (P < 0.05) than those of the pescatarian (1.66 ± 0.04), omnivore (2.23 ± 0.01), paleo (2.62 ± 0.33), or keto (2.91 ± 0.27) diets. Mean HEI scores were highest for pescatarian diets (58.76 ± 0.79) and higher (P < 0.05) for vegetarian (51.89 ± 0.74) than for omnivore (48.92 ± 0.33) or keto (43.69 ± 1.61) diets. ConclusionsOur results highlight the nuances when evaluating the nutritional quality of diets and their carbon footprints. On average, pescatarian diets may be the healthiest, but plant-based diets have lower carbon footprints than other popular diets, including keto- and paleo-style diets.

Evaluation of Food Consumption, Dietary and Lifestyle Habits in a Sample of Jordanian Adults in Al-Zarqa City

Healthy eating habits should include the right amount of food consumed daily to meet the needs for different nutrients. The aim of this study is to determine the indexes of healthy nutrition in a sample of Jordanian university students aged 18–25 years and to compare them with the Healthy Eating Index (HEI). This descriptive cross-sectional design study was conducted among Zarqa University students over a period of six months. The study included 332 participants (150 males and 182 females). Energy and nutrients were calculated from dietary data by using a single 24- hour dietary recall. The mean daily intake was compared with the Dietary Recommended Intake (DRI). Energy intake was less than 1500 kcal in both genders, and dietary fiber intake was less than the recommendations. The mean score of the HEI in the whole sample is 57.4. The majority of students (65.1% of the whole sample) have diets rated in the "Needs Improvement" category. The mean HEI values for each BMI category among the underweight, normal, overweight, and obese males and females were 53.7, 58.3, 57.3, and 56.5, respectively. The mean HEI score of grains was 7.72, vegetables 3.07, fruits 4.44, milk 1.49, meat 6.39, total fat 6.04, saturated fat 7.00, cholesterol 7.72, sodium 7.83, and variety 6.59 in the whole sample. The results show that students need to increase their intake of fruits, vegetables, and dairy products. The results could provide a basis for developing suitable intervention programs to encourage healthy eating in this age group.

No Effect of Calorie Restriction or Dietary Patterns on Spatial Working Memory During a 2-Year Intervention: A Secondary Analysis of the CALERIE Trial

BackgroundThe effect of calorie restriction (CR) on cognitive function is not well understood, and the impact of the dietary patterns consumed during CR has not been investigated. ObjectivesWe analyzed the combined association of CR and dietary quality with spatial working memory (SWM) in healthy adults without obesity. MethodsThe Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial was a 2-y, multisite clinical trial. This trial was registered at clinicaltrials.gov as NCT00427193. Participants were randomized to a 25% reduction in EI (n = 143) or an ad libitum Control (n = 76). The Dietary Inflammatory Index (DII) and the Healthy Eating Index (HEI) captured dietary quality, with a lower DII and higher HEI score indicating a healthier diet. The Cambridge Neuropsychological Test Automated Battery battery was used to assess SWM. Longitudinal associations between each dietary pattern index and SWM for CR and Control were assessed by multivariable negative binomial models that included baseline, 12-mo, and 24-mo visits. ResultsParticipants were aged 38.1 ± 7.2 y with a BMI of 25.1 ± 1.7 kg/m2. A total of 70% of the participants were female. Baseline mean DII and HEI scores were −0.15 (range: −3.77, 4.21) and 59.1 (24.1, 91.0) and did not differ between groups. Improvements in DII and HEI were significantly different between CR and Control over 2 y (both P-interaction = 0.001). In longitudinal analyses, there was no association of either index with SWM. Furthermore, though within-group improvements in SWM were observed at 12 mo, there was no statistically significant difference between CR (SWM errors: 9.0; 95% CI: 1.9, 41.6) and Control (11.7; 95% CI: 2.6, 53.5; P > 0.99), holding DII constant. Comparable results were observed at 24 mo and for the HEI. ConclusionsDietary quality during CR was not associated with measures of SWM over 2 y in healthy adults without obesity. These results suggest that, in healthy populations, dietary patterns and CR may have a limited impact on working memory. Further research is required to understand the concurrent effect of these nutritional strategies.

Comprehensive Nutrition Assessment in Adults with Sickle Cell Disease Using the Dietary Inflammatory Index and Healthy Eating Index

Increasing evidence shows that nutrition plays a role in the pathogenesis and progression of many diseases. Certain diets are shown to play a role in driving systemic inflammation and consequently contribute to exacerbation of disease processes. Systematic nutrition assessment in individuals with sickle cell disease (SCD) is largely unexplored and thus it is not well understood how diet impacts SCD complications and health outcomes. Therefore, the objective of this study was to assess both the inflammatory nature and quality of diet in adults with SCD. Individuals with SCD age ≥18 years were eligible for enrollment. Consented participants completed the validated diet assessment, the Block 2014 Food Frequency Questionnaire. This questionnaire has a recall period of one year and includes questions on the intake of 127 food and beverage items. Data collected from this questionnaire are sent to the developer for secondary and tertiary analyses for quantification of nutrients and food groups and the returned quantifications were used to calculate the Dietary Inflammatory Index (DII) and the Healthy Eating Index (HEI). The DII is a validated measure that quantifies the inflammatory nature of individuals' diet based on the potential of nutrients to trigger inflammation, whereas the HEI is a metric that assesses overall diet quality and several individual dietary components. DII is calculated based on the global mean intake and standard deviation (SD), and overall inflammatory effect score for specific food parameters. A total of 30 food parameters (Figure 1) were used for DII calculation in this study. Global mean intake and SD are used to calculate a Z-score for each nutrient which is then converted to the centered percentile. It is then multiplied with the overall food parameter-specific inflammatory effect score from the DII database to get a DII for each nutrient. These individual nutrient scores are summed to create the 'overall DII score' for an individual. Possible overall DII scores range from -8.87 to +7.98, with negative scores indicating an anti-inflammatory diet and positive scores indicating a pro-inflammatory diet. The HEI reflects adherence to Dietary Guidelines for Americans (DGA) and considers density-based (amounts per 1,000 kcal) intake of the following 13 components: total fruits, whole fruits, total vegetables, greens and beans, whole grains, dairy, total protein foods, seafood and plant proteins, fatty acids, refined grains, sodium, added sugars, saturated fats. Fruits, vegetables, and proteins are assigned a maximum of 5 points each because they are represented by two components (i.e., total fruits and whole fruits) while other food groups receive a maximum of 10 points because they are represented by one component. Maximum points are assigned if the a priori set thresholds for the specific components are met (detailed in Figure 2 legend). Final HEI is a sum of scores for each component. The HEI has a range of 0 (reflecting no adherence to DGA) to 100 (reflecting complete adherence to DGA). The mean HEI for Americans aged 19-59 years old is 57. We report the range and mean for both the DII and HEI indices. A total of 28 adults with SCD completed the Block Food Frequency questionnaire. Mean age of participants was 33.7 (SD 10.5) years with range of 19-58 years and 46.4% (n=13) were female. Figure 1 represents the DII scores for our study cohort. We found 25% (n=7) of individuals had a negative DII indicating consumption of an anti-inflammatory diet, and 75% (n=21) of individuals had a positive DII indicating consumption of a pro-inflammatory diet. The DII ranged from -5.25 to 6.55, with a median DII of 2.62 (IQR -0.49, 4.45). The mean HEI score for the study cohort was 60. Individual components of the mean HEI for SCD individuals and for average adult Americans are shown in Figure 2. Numbers in the radar graph represent the percentage of maximum possible score for each component. The majority of adults with SCD in our cohort have evidence of a pro-inflammatory diet. Our cohort had a similar HEI to average Americans, but its components vary between the food groups and require further assessment. These data are the first step to systematically assessing nutrition in individuals with SCD. Further research is necessary to investigate if nutrition impacts disease expression and health outcomes in SCD and determine whether diet is a modifiable target for interventions. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Racial and ethnic differences in diet quality and food insecurity among adults with fatty liver and significant fibrosis: a U.S. population-based study.

Food insecurity affects diet quality (DQ) and is associated with non-alcoholic fatty liver disease (NAFLD). While racial and ethnic disparities in NAFLD exist, the relationship between food insecurity and DQ by race and ethnicity is unknown. To examine the relationship between food insecurity and DQ in adults with NAFLD and significant fibrosis by race and ethnicity in a nationally representative cohort METHODS: We performed a cross-sectional analysis of U.S. adults (≥20 years) in the National Health and Nutrition Examination Survey 2017-2018 with vibration-controlled transient elastography (VCTE), DQ, and food security (FS) measurements. NAFLD and significant fibrosis were defined using validated VCTE cut-offs. We assessed total and component DQ by the healthy eating index (HEI)-2015, with poor scores defined as <25th percentile. We used multivariable linear and logistic regression to examine associations of FS and race/ethnicity with DQ. Of 1351 adults with NAFLD (17% food insecure; 248 with fibrosis), mean (standard error [SE]) DQ score was 49 (1) and 47(1.2) for food secure and insecure groups, respectively. Mean (SE) DQ was lowest for White (47[1.1]), followed by Black (49[0.9]), Hispanic (50[1.2]) and Asian persons (56[2.1]). In multivariable models, there was an inverse relationship between FS and DQ, although this did not reach statistical significance (estimated difference [coef]:-1.8 mean HEI score, 95% CI: -4.3-0.7; p= 0.14). Adjusted mean DQ scores were higher for Black (coef:+3.0, 95% CI:0.5-5.5; p= 0.02), Asian (coef:+7.4, 95% CI:3.4-11.5; p= 0.001) and Hispanic (coef: +4.3, 95% CI: 0.6-7.9; p= 0.03) compared to White persons. Greatest differences in DQ components by food security status were seen in White persons. Among adults with NAFLD, White persons had poorer DQ than other races/ethnicities. The influence of food insecurity on DQ may be potentiated in this group. Exploration of the sociocultural factors influencing DQ is needed to mitigate NAFLD disparities.

Abstract 2261: Impact of healthy eating patterns on HPV infection in women

Abstract Background: Most cervical cancers are directly linked to infection with Human Papillomavirus (HPV), especially oncogenic or high-risk HPVs (HR-HPVs). Studies showed that high levels of several nutritional antioxidants (such as vitamin A, B2, E, and folate) are inversely associated with HR-HPV genital infection among women. These antioxidants are associated with dietary patterns, but associations between dietary patterns and genital HPV infection in women are understudied. To address this gap, this study aims to evaluate associations between healthy eating quality and patterns and genital HPV infection in women. Method: The study included 10,543 women aged 18-59 years from the 14-year (2003-2016) National Health and Nutrition Examination Survey, a US population-based survey. The outcome variable is the HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV), measured based on vaginal swabs. The dietary patterns were evaluated using the Healthy Eating Index (HEI), which measures diet quality based on 13 food components based on key recommendations of the Dietary Guidelines for Americans. A higher HEI score (overall score: range 0-100 or component score: 0-5 or 10) indicates a better diet quality. Associations between the HEI scores and HPV infections were evaluated using the survey weighting multinomial logistic regression adjusting for potential confounding factors. Results: The mean HEI score for US women is 54.5 (standard error=0.4). Women with vaginal HPV infection tended to have a low HEI score (p&amp;lt;0.001). The mean HEI scores for women with HPV-negative, LR-HPV, and HR-HPV are 55.6, 53.1, and 42.2, respectively. However, the association with the overall HEI score became non-statistically significant after adjusting the confounding factors (such as age, smoking, and sexual behavior). The women with the highest intake (score=5 out of 5) of greens and beans and total fruit had a lower risk of HR-HPV (OR=0.70 vs. score=0, p&amp;lt;0.001, and OR=0.57, p&amp;lt;0.01, respectively) adjusted for confounding factors. A high intake of whole grains and dairy can lower the risk of LR-HPV but not HR-HPV. In addition, women with a high score of total protein had a higher risk of HR-HPV (OR=2.1 for score=5 vs. 0-2, p&amp;lt;0.05). Conclusion: This study showed that healthy eating patterns are inversely associated with vaginal HPV infection for US women. These findings can provide valuable insight into developing an intervention to prevent HPV infection from getting established or HPV persistence among the population at higher risk for cervical cancer. Citation Format: Huiyi Lin, Qiufan Fu, Tung-sung Tseng, Krzysztof Reiss, Joseph Su, Martin J. Ronis, Jennifer E. Cameron, Michael E. Hagensee. Impact of healthy eating patterns on HPV infection in women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2261.

Healthy Eating Index (HEI) Scores Are Higher Among Older Adults Who Do Not Consume Frozen Meals Than Frequent Consumers: A Cross-Sectional Analysis of NHANES 2015–2018

ObjectivesThis study utilized the Healthy Eating Index (HEI) to assess dietary quality by the frequency of frozen meal consumption among community-dwelling older adults. MethodsA sample of 2,730 participants, ≥60 years and not participating in meal programs through the Older Americans Act, was selected from the National Health and Nutrition Examination Survey (NHANES) 2015–2018. Frequency of frozen meal consumption was recoded into non-consumers, occasional consumers, and frequent consumers (0, 1–2, and 3+ times per month, respectively). The HEI 2015 was calculated using two days of dietary recalls. Linear regression analysis was used to assess the relationships between HEI and frozen meal consumption while adjusting for gender, race/ethnicity, marital status, education, and body mass index. ResultsThe percentage of participants classified as non-consumers, occasional consumers, and regular consumers was 58.0%, 24.7%, and 17.3%, respectively. Mean HEI scores for non-consumers, occasional consumers, and regular consumers of frozen meals were 57.1 ± 0.7, 54.2 ± 0.9, and 53.5 ± 1.0, respectively. Compared to non-consumers, frequent consumers had significantly lower HEI scores (ẞ = –2.76, p < 0.03). There were no significant differences in HEI scores when comparing occasional consumers to non-consumers (ẞ = 2.22, p = 0.06) and frequent consumers (ẞ = –0.52, p = 0.66). ConclusionsFrequent consumption of frozen meals is associated with reduced diet quality among community-dwelling older adults. Older adults may benefit from nutrition education from Registered Dietitians on selecting healthy options when eating frozen meals. Additionally, participation in nutrition assistance programs for older adults may promote improved diet quality. Funding SourcesThe authors have no funding sources to disclose for this research.

Diet Quality and Growth Status of Children Aged Two to Six Years at Tuba Island, Langkawi, Malaysia

This study aimed to determine the prevalence of undernutrition, diet quality and its associated factors among children aged two to six years at Tuba Island. A total of 67 children paired with their mother or caregiver were participated in this study. A questionnaire containing socio-demographic characteristics, anthropometric measurements and two days of 24-hours dietary recall was administered. The Malaysian Healthy Eating Index (HEI) was used to assess the children’s diet quality. The prevalence of underweight, stunting and wasting were 22.4%, 20.8% and 17.9%, respectively. Mean total HEI score was 37.1±6.3, which indicate poor diet. The children had low mean scores for vegetables, fruits, milk and dairy products as well as legumes. For socio-demographic factors, number of children per household was associated with diet quality. This study points out that overall low dietary score among these children and their diet quality had no association with their growth status. The low diet quality was prevalent; thus it did not contribute to differences in growth status among these children. Therefore, it is suggested further intervention should be taken to improve the nutrition quality of these children.

The impact of slum dwelling on healthy eating index in the border of Tehran

PurposeLife conditions for most slum dwellers are deplorable, with poor socio-economic status and high rates of malnutrition and communicable diseases. Studies have shown lower intake of many nutrients in such people, but no study yet has checked the quality of diet using Healthy Eating Index (HEI) in them. This study aims to assess the quality of diet among slum dwellers of Tehran using the HEI-2015.Design/methodology/approachThis cross-sectional study was conducted among 300 slum dwellers from two slums located on the border of Tehran city which is the capital of Iran. Stratified random sampling technique was used to select subjects for this study. Data on socioeconomic characteristics and 24-hours dietary recalls were obtained through face-to-face interviews with the respondents by trained personnel.FindingsThe overall diet quality of the respondents was poor, with a mean HEI score of 40.9 ± 23.7. About 84% of the participants had low overall HEI scores. A significant relation was seen in the following: the HEI and educational level (p = 0.044); the HEI and employment status (p = 0.001); and the HEI and chronic diseases (p = 0.049). There was no significant difference between the mean HEI score and marital status, welfare status and addiction status. From the findings, the diet of most of these slum dwellers needs modification. Therefore, taking measures to reduce slum dwelling and to improve the nutritional intake of this study population is needed.Originality/valueThe study was approved by the Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran, and written informed consent was obtained from all participants.

Association between the Nutritional Quality of Household At-Home Food Purchases and Chronic Diseases and Risk Factors in the United States, 2015.

Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the respective condition. Households with a member with T2D score better on the added sugar component than those with no member reporting T2D. We found that the average food purchase quality is lower than the recommended levels, especially for households with at least one member reporting a chronic condition(s).

Dietary Quality of Pregnant Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.

Few studies have examined the dietary intake of low-income pregnant women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The aim of this study was to assess the dietary quality of WIC-enrolled pregnant women and examine associations with maternal characteristics, nutrition knowledge, and key health indicators. Fifty-one WIC-enrolled pregnant women completed two sets of 3-day food records. Food records were analyzed for nutrient content, and diet quality was assessed using the Healthy Eating Index (HEI)-2015. Since an HEI score of less than 60 is indicative of the need to improve dietary quality, participants’ HEI scores were divided into two categories: <60 and ≥60. The total mean HEI score of the cohort based on analysis of the first set of food records was 59.1 ± 12.5 (range 37.1–89.2), while the mean score for the second 3 days of food records was 56.8 ± 12.7 (range 30.0–89.0). The majority of participants did not consume the minimum recommended servings of whole vegetables. Those in the <60 HEI category consumed on average less than 50% of the recommended servings of whole fruits and whole grains. The diets of the majority of participants were high in saturated fat and sodium. More than one-third did not meet the recommendations for folate and iron intake, while less than half met the RDA for vitamin D. Choline intake was insufficient based on analysis of the first 3 days of food records. Our results indicate that the dietary quality of WIC-enrolled pregnant women requires improvement.

Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes.

Tribal communities in the United States face disparities to accessing healthy foods including high-quality produce. A six-week fresh fruit and vegetable (FV) dietary intervention, Eat Fresh, was co-designed with a Community Advisory Board of local food and nutrition stakeholders on the Flathead Reservation of the Confederated Salish and Kootenai Tribes in Montana. Eat Fresh was implemented as a pilot study with low-income participants (n = 19) enrolled in the Food Distribution Program on Indian Reservations toward improving dietary quality and perceptions of well-being. We evaluated Eat Fresh at pre- and post-intervention on the basis on food procurement practices, dietary quality using the Healthy Eating Index (HEI), Body Mass Index (BMI), blood pressure, and participant perceptions of health. Participants reported consuming a greater number of types of FVs daily during the intervention (p < 0.005 for fruits and p > 0.19 for vegetables). Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes (39.51% of responses), time constraints to cook (35.80%), and lack of financial resources (33.33%). Dietary quality improved during the intervention from a mean HEI score of 48.82 (± 11.88) out of 100–56.92 (± 11.88; (p > 0.12). HEI scores for fruit consumption significantly increased (p < 0.05) from 1.69 (out of 5 points) during the pre-intervention to 2.96 during the post-intervention. BMI and blood pressure increased for several participants, highlighting an unintended consequence. Most participants responded that FV consumption made them feel either very good (51.16%) or good about their health (43.02%) with the majority (83%) perceiving an improvement in energy. Findings of this pilot study highlight both intended and unintended consequences of a dietary intervention that provide lessons in co-designing community-based programs.

P124 Use of HEI-2015 to Evaluate Dietary Quality of Pregnant Women Participating in the WIC Program

<h3>Background</h3> Healthy Eating Index (HEI) is a useful tool that can be used to assess dietary quality via adherence to the Dietary Guidelines for Americans. <h3>Objective</h3> The aim of this study was to evaluate diet quality of pregnant women participating in the WIC program and to examine possible associations with demographic variables, nutrition knowledge, and key health indicators. <h3>Study Design, Setting, Participants</h3> A cross-sectional study using survey methodology was conducted. Sixty pregnant women between 12 and 24 weeks of gestation and carrying a single fetus were recruited from the WIC program at a community health center. <h3>Measurable Outcome/Analysis</h3> Dietary intake was evaluated using two 3-day food records, the first set completed at baseline and the second at follow-up, around 28 weeks of gestation. Food records were analyzed and scored based on HEI-2015. An HEI score above 80 was considered adequate, between 60 and 79.99 average, and below 60 low. Participants' demographic data and key health indicators, including height and pre-pregnancy weight, were recorded. Nutrition knowledge was assessed. Descriptive and inferential statistics were used to analyze data. <h3>Results</h3> The mean HEI score of the sample was 59.1 at baseline, and 56.8 at follow-up. There was a significant difference in the distribution of participants' HEI scores among the 3 HEI categories at both baseline and follow-up (<i>P</i> < .05). Half of the participants had a HEI score below 60 at baseline, while 66.6% were in the low HEI category at follow-up. HEI was negatively correlated with pre-pregnancy BMI (r = −.314, <i>P</i> < .05). The only variable that was predictive of HEI score at both baseline and follow-up was knowledge of anemia (F (3, 47) = 3.84, <i>P</i> < .05). <h3>Conclusions</h3> The suboptimal status of the diet of study participants warrants the need for additional dietary counseling for WIC-enrolled pregnant women.

Late Evening Food Patterns of U.S. Adults Are Differentially Associated with Total Energy Intake and Diet Quality: Results from What We Eat in America, NHANES 2013–2016

Abstract Objectives Eating later versus earlier in the day has been associated with higher energy intake and lower diet quality. However, since food and beverage choices vary, these relationships may not be true of all late evening (LE) eating patterns. The goal of this study was to identify LE patterns of U.S. adults and determine their associations with energy intake and diet quality. Methods One day of dietary intake collected from 9861 adults 20 + years of age (4829 males and 5032 females) in What We Eat in America, NHANES 2013–2016 was analyzed. LE consumption was any food/beverage intake that began between 8:00 pm and 11:59 pm. Hierarchical cluster analysis was used to develop LE food/beverage patterns based on percentage of LE energy provided by each of 23 food groups with adjustment for gram weight. Adjusted estimates of energy intake and Healthy Eating Index (HEI) score were compared between reporters in each LE pattern and non-reporters. Results Nearly two-thirds (64.4%) of adults were LE reporters. The 11 LE patterns identified accounted for 65.9% of the variance in LE energy intake. The 6 most prevalent LE patterns were characterized by intake of sweets, sandwiches, and beverages (23.0% of adults); mixed dishes, meat, and vegetables (12.3%); savory snacks and alcohol (9.5%); candy, nuts, and seeds (5.2%); fruit and 100% juice (4.1%); and milk and dairy drinks (3.4%). Fewer than 3% of adults fell into each of the 5 remaining patterns (white potatoes, pizza, cereal, cooked grains, and legumes). Compared to non-reporters, LE reporters in 7 of the 11 patterns had higher mean total daily energy intake (P &amp;lt; 0.001), ranging from 12.6% higher for sweets, sandwiches, and beverages to 26.7% higher for pizza. Mean HEI scores were higher in 2 patterns (fruit and 100% juice, 56.5; legumes, 59.4) and lower in 1 pattern (pizza, 44.5) than for non-reporters (50.6). Conclusions LE food/beverage consumption is common among U.S. adults. Although most current LE patterns are associated with higher energy intake and few with better diet quality, exceptions were seen, notably for patterns characterized by fruit and legumes. For the majority of LE reporters, modifying LE food/beverage choices to better align with dietary guidance could considerably improve the nutrient density of the overall diet. Funding Sources ARS, USDA.

Diet Quality, Swallow Function, and Health-Related Quality of Life Among People with Parkinson’s Disease

Abstract Objectives To describe the diet quality, swallow function, and disease burden of people with Parkinson's disease (PwPD) and explore the relationship between diet quality, swallow function, and health related quality of life (HRQOL). Methods A convenience sample of twenty PwPD participated in this study. They completed various measures including: height and weight, two 24-h recalls, a time swallow test and a self-reported HRQOL questionnaire. Body mass index (BMI, kg/m2) were calculated from height and weight. Healthy Eating Index (HEI)-2015, a mean to assess dietary quality, was calculated from two 24-h dietary recalls. Total and component HEI-2015 scores were examined and interpreted using the graded approach (grades A-F). Radar graphs were constructed to provide visual representation of overall HEI-sores and component scores. A time swallow test assessed swallow function. The 39-item Parkinson's Disease Questionnaire (PDQ-39) assessed PD-specific HRQOL across 8 dimensions; the higher the score the lower the HRQOL. Descriptives were reported as mean ± standard deviation, frequencies, and percentages. Correlations were used to examine associations between outcome variables. Results The majority of PwPD were male (65%). The mean age was 69.7 ± 9.2 years and average time since diagnosis was 7.6 ± 5.4 years. The average BMI score was 27.1 ± 5.4 kg/m2. Mean HEI scores were 58.3 ± 12.4, translating to an F, consistent with average HEI scores for Americans. The majority (75%) had a letter grade of F or D. Mean timed swallow speed was 14.4 ± 8.4 total mL/second. However, 8 (40%) had time swallow speeds of &amp;lt;10 mL/seconds indicating a swallowing problem may be present. The mean of PDQ-39 scores were 22.0 ± 15.9 (range of 3.1–50.0). The PDQ-39 dimensions with the highest mean score were related to body discomfort (30.4 ± 28.0) and cognition (30.9 ± 21.9). There was no association between HEI scores, swallow speed, and PDQ-39 scores. Conclusions Findings indicate that although PwPD have poor diet quality, experience swallowing issues early in disease progression, they had a high HQROL overall. There was no association between these outcome variables. The results of this study can be used by nutrition experts to ensure PwPD's health longevity, which can help avoid eventual nursing home placement or extensive healthcare needs. Funding Sources There was no external funding for this study.