Mixed Dishes Research Articles

Databases of Iodine Content of Foods and Dietary Supplements–Availability of New and Updated Resources

The iodine status of the U.S. population is adequate overall, but some people might have insufficient or overly high iodine intakes and would benefit from certain dietary changes. Identifying these individuals can be challenging, however, due to a lack of data on the iodine content of foods and dietary supplements. To fill this gap, a new online database--the USDA, FDA, and ODS-NIH Database for the Iodine Content of Common Foods--was released in 2020. It contains about 430 foods and beverages, such as dairy products and eggs, baby foods, vegetables, meats, mixed dishes, juices, seafood, various types of salt, restaurant foods, and baked goods, including breads made with and without iodate-containing dough conditioners. Data are presented as mean iodine content for both standard serving sizes and per 100 g of food, along with standard deviations, value ranges, and sample sizes. The new database, combined with the existing Dietary Supplement Ingredient Database, which contains chemically analyzed values for the iodine content of dietary supplements, and the newly updated Dietary Supplement Label Database, which contains label information from thousands of dietary supplements on the market, provides comprehensive data to help assess the iodine intakes of individuals and populations.

Differences in Dietary Quality by Sexual Orientation and Sex in the United States: NHANES 2011-2016

BackgroundThere are persistent disparities in weight- and diet-related diseases by sexual orientation. Lesbian and bisexual females have a higher risk of obesity and cardiovascular disease compared with heterosexual females. Gay and bisexual males have a higher risk of diabetes and cardiovascular disease compared with heterosexual males. However, it remains unknown how sexual orientation groups differ in their dietary quality. ObjectiveThis study aimed to determine whether dietary quality differs by sexual orientation and sex among US adults. DesignThis was a cross-sectional study of 24-hour dietary recall data from a nationally representative sample of adults aged 20 through 65 years participating in the 2011-2016 National Health and Nutrition Examination Survey. Participants/settingStudy participants were adults (n = 8,851) with complete information on dietary intake, sexual orientation, and sex. Main outcome measuresThe main outcome measures were daily energy intake from 20 specific food and beverage groups and Healthy Eating Index-2015 (HEI-2015) scores for sexual orientation groups (heterosexual vs gay/lesbian/bisexual). Statistical analyses performedOrdinary least squares regressions were used to calculate adjusted means for each food and beverage group and HEI-2015, stratified by sex and controlling for covariates (eg, age and race/ethnicity) and survey cycles (2011-2012, 2013-2014, and 2015-2016). ResultsAmong males, red and processed meat/poultry/seafood (P = .01) and sandwiches (P = .02) were smaller contributors to energy intake for gay/bisexual males compared with heterosexual males. Among females, cereals (P =.04) and mixed dishes (P = .02) were smaller contributors to energy intake for lesbian/bisexual females compared with heterosexual females. Gay/bisexual males had significantly higher total HEI-2015 scores than heterosexual males (mean ± standard deviation 53.40 ± 1.36 vs 49.29 ± 0.32, difference = 4.14; P = .004). Lesbian/bisexual females did not differ in total or component HEI-2015 scores from heterosexual females. ConclusionsAlthough gay/lesbian/bisexual groups were similar for a variety of dietary outcomes compared with heterosexual groups, gay and bisexual men displayed healthier dietary quality for processed meat (by consuming smaller amounts) and overall dietary quality (according to HEI-2015) compared with heterosexual males.

Fortified Balanced Energy-Protein Supplements Increase Nutrient Adequacy without Displacing Food Intake in Pregnant Women in Rural Burkina Faso

BackgroundIn many low- and middle-income countries, the prevalence of energy and nutrient deficiencies is high among pregnant women. Balanced energy-protein (BEP) supplements are a promising strategy to cover nutritional requirements during pregnancy and improve birth outcomes. However, the displacement of nutrient-dense foods by BEP might attenuate the efficacy of supplementation. ObjectiveThis cross-sectional study of participants in a randomized controlled trial evaluated the difference in energy and macro- and micronutrient intakes, food groups, and nutrient adequacy between a control and intervention group receiving either a daily iron–folic acid (IFA) tablet or IFA and BEP supplement during pregnancy, respectively. MethodsWe collected a single multiple-pass 24-h recall from 470 pregnant women from the MIcronutriments pour la SAnté de la Mère et de l'Enfant (MISAME) III study that investigates the efficacy of BEP supplementation on birth outcomes and infant growth. Dietary intake (median and IQR) and nutrient adequacy were assessed using individual recipes and preparation methods of mixed dishes for each participant. Linear regression models were fitted to compare energy and nutrient intakes. ResultsDietary energy, and macro- and micronutrient intakes were significantly higher among women in the intervention group when including BEP [2329 kcal/d (1855, 3008 kcal/d) compared with 1942 kcal/d (1575, 2405 kcal/d) in the control group (all P < 0.001)]. The difference in median energy intake (448 kcal/d; 95% CI: 291, 605 kcal/d) was approximately equivalent to a daily dose of the BEP supplement (393 kcal). Nutrient adequacy ratios for both groups were low for all micronutrients (between 0.02 and 0.66), when excluding BEP (except iron and folic acid, due to standard supplemental doses) from analysis. However, nutrient intakes increased to the Estimated Average Requirement for pregnant women when including BEP supplements. ConclusionsBEP supplementation increases energy and macro- and micronutrient intakes among pregnant women and fills nutrient gaps without displacing food intake. This trial was registered at clinicaltrials.gov as NCT03533712 (https://clinicaltrials.gov/ct2/show/NCT03533712).

Associations Among Select State Policies and the Nutritional Quality of Household Packaged Food Purchases in the United States from 2008 Through 2017

BackgroundPolicy interventions are important public health tools because they can reach large numbers of people. State context has been associated with health outcomes, yet few studies have examined the extent to which state-level policies are associated with dietary quality. ObjectivesThe objective of this study was to evaluate whether state policies are associated with the nutritional quality of household packaged food purchases. DesignThis observational study used data from Nielsen Homescan, an open-cohort household panel where participants track purchases, and a combination of state-level food and social safety net policy variables from 2008 through 2017. Participants and settingThis study included 615,634 household-year observations in the United States from 2008 through 2017. Household-year observations were excluded in the case that a household did not make a minimum number of purchases and in the case that they had incorrect geographic information. The final analytic sample was 611,719 household-years. Main outcome measuresStudy outcomes included a set of nutrition-related measures of public health interest, including nutrients of concern (eg, sugar, saturated fat, and sodium) and calories from specific food groups (eg, fruits, nonstarchy vegetables, processed meats, mixed dishes, sugar-sweetened beverages, and desserts and snacks). Statistical analysisThis study used multilevel generalized linear models with state fixed effects on three samples: all households, only households with low income, and only households with low educational attainment. ResultsFew significant associations were found between healthy food retail policies and the nutritional quality of purchases, and mixed associations were found between social safety net policies and lower or higher quality packaged food purchases. ConclusionsLittle evidence was found that state policy context in 2008 through 2017 was associated with the quality of packaged food purchases. However, variation in state policies is increasing over time, warranting future research into the relationship between these policies, the quality of packaged food purchases, and the rest of the diet.

Utilization of Shrimp Waste as a Raw Material in Shrimp Sauce and Its Application on Shrimp Sauce Tilapia Dishes

One of the innovations to increase the economic value of shrimp waste is the implementation of shrimp waste into shrimp sauce and its use in shrimp sauce tilapia dishes. The purpose of this study was to determine the protein and lead (Pb) content of shrimp waste and shrimp sauce, the degree to which shrimp sauce differed in aroma, taste, and color from commercial oyster sauce, and the degree to which panelists preferred shrimp sauce tilapia dishes via organoleptic tests. This was a two-repetition experimental study with a completely randomized design (CRD). The protein content was determined using the Kjeldahl semi-micro method, whereas the lead content was determined using the spectrophotometric method. The Duo-Trio Test was used to determine the difference in organoleptic properties between shrimp sauce and commercial oyster sauce, whereas ANOVA followed by DMRT was used to analyze the hedonic properties of shrimp sauce tilapia dishes. The results of this study indicate that shrimp waste contains 18.281 percent protein and shrimp sauce contains 6.107 percent protein. The content of lead (Pb) in shrimp waste was 0.750 mg/kg, while the content of lead (Pb) in shrimp sauce was 0.052 mg/kg. The organoleptic tests revealed that shrimp sauce had a distinct aroma, taste, and color from commercial oyster sauce, whereas the hedonic tests revealed no difference in the hedonic properties of the three dishes' aromas, but there were differences in the hedonic properties of their taste and properties. The three dishes exhibit hedonic color. Panelists preferred commercial oyster sauce tilapia dishes over shrimp sauce tilapia dishes and commercial oyster sauce mixed tilapia dishes in terms of aroma, taste, and color (1:1). The shrimp sauce formula should be refined further so that it more closely resembles commercial oyster sauce in terms of aroma, flavor, and color.

Many Foods Contribute Sodium in Toddlers’ and Preschoolers’ Diets: Data from the 2016 Feeding Infants and Toddlers Study (FITS)

List the top sources of sodium in the diets of toddler and preschool-aged children in the United States. The 2020-2025 Dietary Guidelines for Americans recommend limiting foods/beverages high in sodium for children under age 2 years, citing salty snacks, commercial toddler foods and processed meats as sodium sources. The guidelines recommend children ages 2-3 years reduce sodium intake if above 1200mg/day. FITS 2016 reported mean sodium intakes are 1448mg/day (age 1 year), 1978mg/day (age 2 years) and 2091mg/day (age 3 years). FITS is the largest national cross-sectional dietary survey of children under age four years. Food/beverage intake is assessed via 24-hr dietary recall. Sodium sources were ranked according to percent contribution to total sodium intake using 24-hour recalls of children ages 1- 3 years (n= 1733). Nineteen or more foods contribute 2% or more of sodium intake. As food groups mixed dishes (23-25% of sodium intake), meats (21-22%), grains (17-22%) and dairy (14-19%) are top sources for all ages. Individual foods contributing the most sodium at age 1 are milk (11%), chicken/turkey (7%) and processed meats (7%). By age 3, processed meats (8%), cheese (8%), and breads (8%) are top sources. Commercial toddler foods were not significant sources. Sodium intake among young children comes from many foods including those that provide nutrients like protein, iron, calcium and vitamin D. Examining sodium sources identifies how parents and caregivers may reduce their child’s sodium intake while providing a variety of nutritious foods. Strategies to reduce sodium include replacing processed meats with other meats, choosing lower sodium cheeses and aiming to lower sodium in mixed dishes.

P80 Exposure to Healthy Food Increases Food Preferences Among Children and Youth in Low-Income School Settings

<h3>Objective</h3> To increase healthy food preference through taste tests among children and youth <h3>Use of Theory or Research</h3> This study utilized the short-term outcome indicator of the SNAP-Ed evaluation framework to examine food preference intention at the individual level, from tasting a variety of foods from the 5 food groups, consistent with Dietary Guidelines recommendations. <h3>Target Audience</h3> K-8th graders in SNAP-Ed eligible schools across 2 counties of Central California. <h3>Program Description</h3> In 2019-20, Calfresh Healthy Living, UC (CFHL, UC) nutrition education program was implemented with tasting activities among K-8th graders. Youth taste tests occurred as part of the direct and indirect nutrition education, and policy, systems, and environment initiatives in collaboration with community partners. <h3>Evaluation Methods</h3> Nutrition educators administered the Youth Taste Testing Tool to capture student intention in food preferences immediately following food tastings. Descriptive analysis was performed. In Tulare county, 363 tastings were conducted and in Kings county, 106 tastings were conducted. <h3>Results</h3> In Tulare county, of the 7,614 students tasting variety of food, 14% of students tasted the target food before, 97% tried it today, 81% were willing to eat it again, and 79% were willing to ask for it at home. In Kings county, of the 1,920 students tasting variety of food, 31% of students tasted the target food before, 98% tried it today, 84% were willing to eat it again, and 82% were willing to ask for it at home. Foods tasted were from all food groups- fruits, vegetables, grains, proteins, and dairy and served raw, paired with a familiar food, cooked or included in a mixed dish. <h3>Conclusion</h3> Taste tests provide opportunity to try a variety of foods from 5 food groups that compose MyPlate which is a promising strategy for promoting healthy food preferences among children and youth. Healthy food preferences, in turn, are associated with healthy food consumption patterns.

O38 How Seafood Says “Sustainable”: A Content Analysis of Retail Package Labels

<h3>Background</h3> When harvested or raised within sustainable systems, products of domestic fisheries and aquaculture offer healthy, affordable seafood choices with minimal environmental impact that can help Americans meet dietary guidelines for seafood intake. However, some consumers hesitate to purchase seafood products, associating them with negative environmental impact, and adherence to intake recommendations remains low. Consistent sustainability labeling on seafood products could better signal environmental responsibility and encourage consumers toward increased intake. <h3>Objective</h3> To characterize label attributes indicative of sustainability on seafood packages. <h3>Study Design, Setting, Participants</h3> A content analysis of seafood package labels was conducted using the Label Insight product database. Characterized attributes included 320 terms and certifications documented on packages. From over 400,000 food products, 2,200 seafood packages were selected for inclusion based on type: salmon (n = 730), shrimp (n = 1,387), and oysters (n = 83). Mixed dishes were excluded. <h3>Measurable Outcome/Analysis</h3> Four trained coders characterized label attributes according to a priori themes, including sustainability. Total usage frequencies of sustainability-related labels, and frequencies of specific terms and certifications, were determined for each seafood type. Pearson chi-square analyses were conducted to evaluate statistical associations between seafood type and sustainability labeling practices. <h3>Results</h3> Thirty-eight attributes (11.9%) were coded as sustainability labels. Overall, more salmon (47.9%) and shrimp (47.6%) packages displayed sustainability labels than did oysters (26.5%), (χ² (2, N = 2,200) = 14.443, <i>P</i> = 0.001). Specific terms used varied by seafood type. Salmon (41.6%) and oyster (26.5%) packages displaying sustainability labels most frequently utilized unstandardized "environmental" terms, whereas shrimp packages (36%) most often displayed a third-party sustainability certification label. Lesser-used terms included planet friendly, responsibly produced, and responsibly caught. <h3>Conclusion</h3> While encouraging that nearly half the evaluated salmon and shrimp packages reference sustainability, use of terminology and certifications across and within seafood types is inconsistent. Future studies might investigate whether more frequent use of standardized sustainability labels measurably increases seafood purchase and consumption.

Impact of intra-category food substitutions on the risk of type 2 diabetes: a modelling study on the pizza category.

Advice on replacing unhealthy foods with healthier alternatives within the same food category may be more acceptable and might ease the transition towards a healthy diet. Here, we studied the potential impact of substitutions within the pizza category on the risk of type 2 diabetes (T2D). The study sample consisted of 2510 adults from the INCA2 French national survey. Based on their nutritional characteristics, the 353 pizzas marketed in France were grouped into 100 clusters that were used to run various scenarios of pizza substitutions, which were either isoenergetic (IE) or non-isoenergetic (NIE). We then used a model structurally similar to the Preventable Risk Integrated ModEl to assess the expected rate of change in risk of T2D. Pizzas characterised by a low energy, high vegetable content and whole grain dough were associated with a greater reduction in the risk of T2D. The rates of change in risk of T2D were markedly stronger in men and for NIE substitutions. When the rates of change were estimated in the subsample of pizza consumers, replacing the observed pizzas with the best pizza resulted in a T2D risk reduction of -6·7 % (-8·4 %; -4·9 %, IE) and -8·9 % (-11·2 %; -6·3 %, NIE), assuming that this is their usual diets. The greatest risk reduction induced by an IE substitution of the observed pizza with a mixed dish was similar to that observed with the best pizzas. Overall, this modelling study suggests that healthy swaps within a category can effectively supplement broader dietary changes towards a healthier diet.

Estimated Protein Intake From Animal and Plant Foods by U.S. Adults, What We Eat in America, NHANES, 2015–2016

Abstract Objectives The 2020–2025 Dietary Guidelines for Americans encourage varying protein intake to include both animal foods and plant foods for the range of nutrients provided. The objective of this study is to estimate proportions of adults’ protein intake from animal and plant sources and the contribution of foods to each. Methods One day dietary intake data of adults 20+ years (N = 5017) in What We Eat in America (WWEIA), NHANES 2015–2016 were used. Proportions of protein intake from animal and plant sources were estimated from the ingredients for the foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2015–2016. Single ingredient foods such as chicken or beans were classified as 100% animal or plant, respectively. Proportions from multi-ingredient foods were determined from the amounts of animal and plant food ingredients in each item. If ingredients were not specified, the proportions from a similar food were applied. The proportions were applied to the dietary intakes to determine the population intake of protein from animal and plant sources. The WWEIA food categories were used to describe contribution of foods to animal and plant protein intake. Results Animal and plant foods accounted for 67% and 33% of total protein intake, respectively. Excluding mixed dishes, animal protein intake was contributed by dairy products (14%); meats (12%); poultry (16%); seafood (6%); cured meats (8%); and eggs (6%). Mixed dishes contributed 31% of animal protein intake. Protein from plant foods, excluding mixed dishes, was contributed by grains (24%); plant-based protein foods including legumes (4%), nuts and seeds (7%) soy products (1%); vegetables (9%); and fruit (2%). Mixed dishes accounted for 30% of plant protein intake; snacks and sweets contributed 14%. Conclusions Although protein intake from animal sources is relatively diverse, encouraging greater variety of protein intake from plant-based protein foods appears warranted. Funding Sources ARS-USDA.

Omissions, Intrusions, and Use of Standard Recipes in Computer Assisted and Pen and Paper 24-hour Dietary Recalls Compared With Weighed Food Record: Results From Burkina Faso

ObjectivesA validation study in Burkina Faso compared accuracy of two modes of administration of a 24-hour individual dietary recall (24HR), pen-and-paper (PAPI) and tablet (computer-assisted, CAPI), using weighed food record (WFR) as a benchmark. Sources of divergence between the WFR and each 24HR mode were explored, including number of times items in the WFR were omitted from the 24HR (omissions), and number of times items appeared in the 24HR but not the WFR (intrusions). MethodsSubjects were 231 rural women aged 18–49 years. For the WFR an enumerator visited the household and recorded all food consumed from early morning until after the evening meal, at home and away. Food prepared at home was weighed before and after cooking; amount taken by the respondent was weighed; leftovers subtracted. For mixed dishes, the enumerator weighed all ingredients prior to cooking, the finished dish, and the amount consumed by the respondent, assuming equal distribution of ingredients. The following day a different enumerator administered a multiple pass 24HR of the previous day. Mixed dishes were recorded in two ways: if the dish was similar to a standard recipe (SR) obtained from previous surveys, the quantity was recorded assuming the ingredients and proportions matched the SR. If the dish was not similar, it was considered a non-standard recipe (NSR), and the enumerator recorded the quantity of each ingredient, the final dish, and amount consumed. ResultsIn both modes, omissions outnumbered intrusions. About 1/4 of foods in the WFR were omitted from the 24HR: 26.5% (PAPI); 25.1% (CAPI); about 10% of foods in both 24HR did not match the WFR. For NSRs, omissions and intrusions were less frequent: 15.1% (PAPI) and 16.5% (CAPI) omissions; 2.5% (PAPI) and 5.1% (CAPI) intrusions. SRs were recorded less frequently than individual foods or NSRs. PAPI, 400 foods, 404 NSRs, 91 SRs; CAPI, 386 foods, 411 NSRs, 100 SRs. SRs were more frequently omitted in CAPI (30%) than PAPI (18.7%); and added: CAPI (15.0%); PAPI (7.7%). ConclusionsRespondents to both 24HR modes were more likely to forget items than recall them erroneously. SRs are intended to reduce respondent burden but were infrequently used. The time saved using SRs should be balanced against possible loss of accuracy. Sources of divergence between 24HR and the WFR need investigation. Funding SourcesBill and Melinda Gates Foundation.

Posteriori Diet Patterns of Formula-Fed Infants During First 1.5 Years

Abstract Objectives For the first time in American history, the 2020–2025 Dietary Guidelines for Americans (DGA) focus on the diet patterns of children under age two. Given the importance of nutrition in early life, the present study reports on the longitudinal data-derived diet patterns of a racially diverse group of infants from the age of 0.5 months, when they were exclusively formula fed, until 1.5 years. Methods Weighed/measured diet records were obtained monthly from enrollment (0.5 months) to 1 year, and at 1.5 years during a trial on healthy infants who were randomized to one of two isocaloric commercial infant formulas. Diet records were analyzed using Nutrient Data System for Research from which foods and beverages were assigned to mutually exclusive ‘What We Eat in America’ food categories; each infant's intake was standardized (g/kg body weight) at each age. Principal component analysis and scree plot inspection were used to derive diet patterns; an absolute loading of at least 0.2 indicated food categories highly correlated within a diet pattern. Results Over the first 1.5 years, regardless of randomization, four diet patterns were identified. The diet pattern for the vast majority of infants at 4.5–5.5 months consisted of iron-fortified infant formula. At 6.5–7.5 months, two-thirds of infants began to transition to a first foods diet pattern comprised primarily of infant cereals, fruits, vegetables, grain mixed dishes, and potatoes (not fried). Shortly thereafter, two unique diet patterns containing table foods emerged, such that by 1–1.5 years, the diet patterns for the majority included but were not limited to pizza, high sugar cereal, milk, fried foods, bakery products and vegetables. Conclusions Infant diet patterns emerge and transition rapidly. While the pattern for the majority of infants was infant formula at or before 5.5 months, as recommended, the diet patterns that emerged during the next 6–12 months contained foods that the DGA recommends should be limited (e.g., fried foods) or eliminated (e.g., added sugars) for young children, underscoring the urgent need to focus on diet patterns before 2 years. Funding Sources NIH Grants R01HD072307 and R03HD09408.

A Validation Study of NOVA Classification for Ultra-Processed Food on the USDA Food and Nutrient Database

Abstract Objectives In the last years, a group of Brazilian researchers has proposed a new food classification system, named NOVA, based on the extent of food processing. However, the feasibility of such classification has been debated, together with its cross-cultural validity. The present work assessed the NOVA classification feasibility, conducting a validation study on the USDA Food Composition Database. Methods Two independent reviewers rated each food reported in the 2015–2016 USDA Food and Nutrient Database to be or not ultra-processed food (UPF) according to the criteria presented in the manuscripts published by Monteiro CA et al. in 2016 and 2019 presenting the NOVA classification. A third independent reviewer solved disagreements. The Cohen's Kappa was calculated to evaluate the agreement between the two independent reviewers. Results The agreement between the reviewers was only moderate, with a Cohen's Kappa of 0.58. The disagreement pertained mainly the mixed dishes since it was difficult for the two independent reviewers to rate (UPF or not) the single food components of the mixed dishes. Conclusions Such work provides insights on the difficulties encountered in applying the NOVA classification to a real-word food database outside the cultural context in which the NOVA classification was developed. Funding Sources N/A.

Unsupervised Diet Partitions Better Explain Variations of the Gut Microbiome Compared to Individual Dietary Markers in U.S. Adults of the American Gut Project Cohort

Abstract Objectives Eating habits have been shown to impact the gut microbiome. Here we aimed to define several types of dietary patterns in a U.S. adult cohort and test their associations with the gut microbiome. Methods Using supervised and unsupervised approaches, we built dietary patterns based on a food frequency questionnaire of the American Gut Project database. Focusing on 1800 adult participants living in the United States, we defined patterns as partitions (groups of participants) or factors (combinations of food variables) driven by specific dietary criteria: fibers, proteins, Healthy Eating Index (HEI 2010), food items, food groups and micronutrients. We then associated these patterns with 16S gut microbiome data for 744 participants, excluding those reporting antibiotic intake in the last year or specific diseases. Analyses were adjusted for age, sex and BMI. Results Compared to individual features like fibers and proteins, or to factors representing reduced numbers of features, five unsupervised partitions based on food groups were best associated with gut microbiome beta-diversity. Two partitions presented a lower consumption of animal products, with one being almost completely exclusive and the other, close to a flexitarian diet, presenting the best diet quality as measured by HEI. A third one consisted mostly of participants under low carbohydrate diets with nearly no consumption of starchy foods or sweet products. Finally, the last two partitions presented Western-like diets with increased consumption of mixed dishes, sweet products and refined cereals, one of them being more diverse with increased nuts and whole cereals. Gut microbiome alpha-diversity was slightly increased in the flexitarian partition compared to the most westernized one. Strikingly, the low carbohydrate partition was associated with low levels of the Bifidobacterium genus. Conclusions We showed in a U.S. adult cohort that a global diet may be more associated with gut microbiome variations than individual features like fibers or proteins. Five diet partitions were identified and their specific associations with gut microbiome were studied. These results confirm the importance to consider diet as a whole when studying gut microbiota diversity. Funding Sources Danone Research.

Dietary patterns are associated with central adiposity and carotid intima-media thickness in children and adolescents with congenital heart disease.

Unhealthy dietary patterns (DP) in childhood are associated with cardiovascular disease in adulthood. DP in children and adolescents with congenital heart disease (CHD) are unknown. The aims of this study were to describe DPs of children and adolescents with CHD and to evaluate their associations with central adiposity, high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (cIMT). A cross-sectional study including 232 children and adolescents with CHD. Dietary data were based on three 24-h dietary recalls. Central adiposity was evaluated by waist circumference. hs-CRPs were determined by nephelometry. The cIMT was measured using ultrasound. DPs were identified using principal component analysis. Data were examined using logistic and linear regressions. Six DPs were identified. In multivariable-adjusted analysis, unhealthy DP (high intake of poultry, red meat, cold cuts and processed meats, soft drinks and sweetened beverages) and healthy DP (high intake of fish, eggs, bread, beans, tubers and roots, fruit and fruit juice) were associated with increased and decreased odds of central adiposity, respectively (Odds ratio (OR):2.10; 95% confidence interval (95% CI) 1.09; 4.02; OR: 0.48 95% CI 0.24; 0.93). Besides, low-fat dairy DP (high intake of low-fat milk and dairy, mixed dishes, ultra-processed breads, candy and chocolate) was inversely associated with cIMT (β: -0.024; 95% CI -0.04; -0.01). Unhealthy DP seems to increase the risk of central adiposity, while the healthy DP seems to decrease the risk of central adiposity. Still, low-fat dairy DP was inversely associated with cIMT. These findings may be helpful to develop nutrition recommendations for early cardiovascular disease prevention in children and adolescents with CHD.

Mixed Dish Recognition With Contextual Relation and Domain Alignment

Mixed dish is a food category that contains different dishes mixed in one plate, and is popular in Eastern and Southeast Asia. Recognizing the individual dishes in a mixed dish image is important for health related applications, e.g. to calculate the nutrition values of the dish. However, most existing methods that focus on single dish classification are not applicable to the recognition of mixed dish images. The main challenge of mixed dish recognition comes from three aspects: a wide range of dish types, the complex dish combination with severe overlap between different dishes and the large visual variances of same dish type caused by different cooking/cutting methods applied in different canteens. In order to tackle these problems, we propose the contextual relation network that encodes the implicit and explicit contextual relations among multiple dishes from region-level features and label-level co-occurrence respectively. Besides, to address the visual variances of dish instances from different canteens, we introduce the domain adaption networks to align both local and global features, and eliminating domain gaps of dish features across different canteens. In addition, we collect a mixed dish image dataset containing 9254 mixed dish images from 6 canteens in Singapore. Extensive experiments on both our dataset and public one validate that our methods can achieve top performance for localizing and recognizing multiple dishes and solve the domain shift problem to a certain extent in mixed dish images.

Contribution of food groups to energy, grams and nutrients-to-limit: the Latin American Study of Nutrition and Health/Estudio Latino Americano de Nutrición y Salud (ELANS).

To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. Data from the Latin American Study of Nutrition and Health (ELANS). ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.

Food Choice and Waste in University Dining Commons—A Menus of Change University Research Collaborative Study

The purpose of this multi-campus research was to investigate the relationships of food type and personal factors with food choice, consumption, and waste behaviors of college students at all-you-care-to-eat dining facilities. The amount of food taken and wasted was indirectly measured in units relative to the plate size using before and after photos taken by the diners themselves. Animal protein and mixed dishes (e.g., stir fry, sandwich) took up more of diners’ plate space and these items were correlated to both greater hedonic appeal as well as a higher likelihood of the item being pre-plated. Greater confidence in liking an item before choosing it was correlated to a larger portion being taken. Finally, increased satisfaction with the meal and frequency of visiting the dining commons was correlated to less food waste. Understanding these potential food choice drivers can help dining facilities better target healthier meals to diners while reducing food waste.

Eating behaviors of American adults during the COVID-19 pandemic

The objective was to assess the impact of the COVID-19 pandemic on eating behaviors of a cross section of the US adult population. Participants (N=844) completed a survey via Amazon Mechanical Turk which evaluated frequency of consumption of five food categories - mixed dishes, salty, sweet, creamy foods and beverages during perceived stress. Physical, emotional and psychological self-care and demographics were also collected. Males eating behaviors especially mixed dishes, sweet foods, and creamy foods decreased when stressed. However, in females there was an increase in the consumption of sweet and creamy foods. When compared to their counterpart, there was a reduction in food choices among minorities and Hispanics. Participants with higher BMI had increased eating behaviors of mixed dishes, salty, and sweet foods. The physical self-care scale revealed there was limited consumption of sweet foods but the psychological self-care demonstrated that there was an increase in creamy food intake

Development of the Thai semiquantitative food frequency questionnaire (semi-FFQ) for people at risk for metabolic syndrome

This study aimed to describe the development of a Thai semiquantitative food frequency questionnaire (Thai semi-FFQ) for people at risk people for metabolic syndrome. Data from the Thailand National Food Consumption Survey was used to analyze food lists and portion sizes of single food items. Data for Thai mixed dishes were lacking. Hence, data on mixed dishes were collected from five cafeterias at Siriraj Hospital in Thailand. Three samples of each food item were used to weigh the major ingredients. The nutritive values were calculated using Thai food composition software. Nutrient profiling criteria (NP) were used to classify the selected food items. Ninety-one food items of eight food groups and five serving sizes were included in the Thai semi-FFQ. The food groups were fruits (n = 18), beverages (n = 10), snacks and desserts (n = 29), a la carte (n = 7), noodles (n = 11), rice with toppings (n = 8), eggs (n = 3), and salads (n = 5). The Thai mixed dishes were classified into three groups: a la carte, noodles, and rice with toppings. All mixed dishes were scored by NP criteria, with 13% receiving a ‘grade A’ (score > 16). Thirty four percent were classified as ‘grade B’ (score 12–16), and 53% were given a ‘grade C’ (score < 12). The content validity of mixed dish-based Thai semi-FFQ was evaluated by three nutrition specialists, with a score of 0.97. Our Thai semi-FFQ included single food items and, unlike other Thai FFQs, Thai mixed dish items. This Thai semi-FFQ was useful in assessing dietary food patterns of Thai populations who are at risk for non-communicable diseases.