Nutrition Data System Research Articles

Vitamin C intake, psychological distress and health outcomes in patients with heart failure

Abstract Background Patients with heart failure (HF) have lower dietary vitamin C intake than healthy adults, which may increase oxidative stress and worsen important patient-reported health outcomes (functional status and quality of life [QOL]). Patients with HF are more likely to have higher levels of psychological distress (anxiety and depressive symptoms). However, it is not known whether psychological distress is a link in the association of dietary vitamin C with health outcomes. Objective To examine the inter-relationships among dietary vitamin C intake, psychological distress (anxiety and depressive symptoms), and health outcomes (functional status and QOL) in patients with HF. Method We performed a secondary analysis of baseline data from 206 adults with HF (female: 33%, age: 61±12, NYHA class III/IV: 44%) with complete data on dietary vitamin C intake, anxiety, depressive symptoms, functional status, and QOL. Dietary vitamin C intake was assessed using a 4-day food diary and analyzed using the Nutrition Data System for Research software program. Low dietary vitamin C intake was defined as averaged daily intake below the estimated average requirement (EAR) from the Institute of Medicine of 75 mg/day for men and 60 mg/day for women. Anxiety was assessed using the Brief Symptom Inventory Anxiety subscale. Depressive symptoms were assessed using the Beck Depression Inventory II. Functional status was measured using the Duke Activity Status Index. Quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. Linear regression was conducted using the PROCESS macro in SPSS. Results Eighty-four patients (41%) had low dietary vitamin C intake based on the EAR standard. In bivariate analyses, patients with low dietary vitamin C intake had higher levels of anxiety, depressive symptoms, poorer functional status, and worse QOL (all p <.005). In the mediation regression model, low dietary vitamin C intake was directly associated with higher levels of anxiety, but not with depressive symptoms. Depressive symptoms were directly associated with functional status and QOL. Dietary vitamin C intake was not directly associated with functional status or QOL. Low dietary vitamin C intake was indirectly associated with poor functional status through higher levels of anxiety and depressive symptoms (Figure 1). Similarly, low dietary vitamin C intake was indirectly associated with worse QOL (Figure 2). Conclusion Anxiety and depressive symptoms link the relationship between dietary vitamin C intake and functional status and between dietary vitamin C intake and QOL. Our findings highlight the importance of including interventions to enhance diet quality and psychological well-being as part of HF treatment to improve health outcomes.Vitamin C and functional statusVitamin C and quality of life

Nutritional analysis of vegan recipes: From social media to plate.

The study aimed to determine the nutritional composition of vegan recipes shared on the Instagram social media platform and to compare these ingredients with their non-vegan/omnivorous versions. Turkish and English vegan recipes of meatballs (n = 53), burgers (n = 12), pizza (n = 15), pasta (n = 38), cake (n = 58), and cookies (n = 52) were obtained from Instagram. They all met the criteria of being shared as #vegan labeled, presented detailed information about ingredients, and only included plant-based ingredients. Afterward, non-vegan/omnivorous recipes (n = 228) were determined as equivalent to the vegan recipes in each food group, and a total of 456 recipes were evaluated. The amounts of macro- and micronutrients per 100-gram serving were obtained by the Nutritional Data System (BeBiS). According to the outcomes, the most significant differences in nutritional composition were found between vegan and non-vegan meatball recipes. The levels of cholesterol and B12 were significantly lower in English vegan recipes of meatballs, pasta, cake, and cookies compared to their non-vegan versions (p < .05). Consuming different vegan foods throughout the day could provide complementary nutrient intake and sustainable optimal health. Nevertheless, recipe-based updates could be an innovative approach in future vegan studies. In addition, analysis of vegan recipes could be considered to modulate vegan supplementation programs.

Identification and Categorization of Ultra-Processed Food Intake in Clinical Trials Using Dietary Records and Nutrition Data System for Research

Identification and Categorization of Ultra-Processed Food Intake in Clinical Trials Using Dietary Records and Nutrition Data System for Research

Associated Factors of Dietary Patterns among Adolescents in the Rural Northern Region of Thailand: A Community-Based Cross-Sectional Study.

This cross-sectional study aims to explore the dietary patterns and associated factors of adolescents, which are often overlooked in nutrition data systems. Face-to-face interviews were conducted with 304 participants aged 10 to 19 in rural northern Thailand, utilizing both open recall and list-based 24 h recall techniques, with the data recorded online. Dietary diversity (DD) was assessed using ten food groups as per the Food and Agricultural Organization guidelines. We employed binary logistic regression and multivariable logistic regression analyses. Most participants consumed items from the grains, white roots, and tubers food group, while the nuts, seeds, and pulses food group was the least consumed. The mean number of food groups consumed was 5.23 ± 0.12, with no significant differences across gender and age groups, and participants reporting no influence of mass media on food choices were more likely to have inadequate DD (AOR = 2.94; 95% CI 1.38-6.28). Conversely, those not influenced by social media when choosing food (AOR = 0.45; 95% CI 0.21-0.96), who felt relaxed during meals (AOR = 0.33; 95% CI 0.19-0.59), and with no role in family meal decisions (AOR = 0.55; 95% CI 0.31-0.95) were less likely to have inadequate dietary diversity. We suggest that assisting adolescents with mealtime management and involving them in selecting healthy menus could improve their dietary variety. Moreover, future research should further investigate these mechanisms to inform strategies for improving DD in this age group.

Augmenting the National Nutrition Data System to Promote Diet Sustainability Analyses

Research on sustainable diets has become an important and growing area of the nutrition field, but recent studies have pointed to a lack of sustainability metrics and methods that are hindering research and policy progress. To fill this gap, the White House National Strategy on Hunger, Nutrition, and Health calls for increased funding to improve metrics, data collection, and research to address all domains of sustainability, which include nutrition/health, economic, environmental, and social domains. Commodity recipe databases, such as the Food Commodity Intake Database (FCID), are important tools for conducting diet sustainability analyses because they translate mixed dishes from dietary surveys, such as the National Health and Nutrition Examination Survey (NHANES), into commodity ingredients. These ingredients have been linked to data on environmental impacts and economic costs from other databases, thus facilitating collaboration between nutrition researchers, environmental scientists, economists, and others. These linkages cannot be made with other components of the national nutrition data system, such as the Food Patterns Equivalents Database (FPED), because the disaggregated food groups from them are not relevant for examining environmental impacts. Although the NHANES is conducted on an ongoing basis, and FPED is continually updated, the FCID has not been officially updated since 2010. This severely limits advancements in sustainability research and related policy analyses. In this commentary, we argue that the federal government should promote this diet sustainability work by integrating a commodity recipe database into the national nutrition data system, and updating it on a regular basis, as it does with other component databases.

Racial Disparities in Fluid Intake and Plasma Copeptin in Young Adults

INTRO: Underhydration, or habitual low water intake, is associated with increased plasma copeptin, a surrogate marker of arginine vasopressin. Importantly, plasma copeptin is associated with development of cardiovascular disease (CVD) and chronic kidney disease (CKD). Compared with White individuals, Black individuals are more likely to be underhydrated, to develop CVD and end-stage CKD, and exhibit higher plasma copeptin in middle-age and older adulthood. However, there is limited information on potential racial differences in plasma copeptin in young apparently healthy adults, which may have implications for incident CVD and CKD. Therefore, we sought to determine whether young Black adults reported lower fluid intake and exhibited higher plasma copeptin concentration when compared with young White adults. Methods: We analyzed pre-existing data from two registered clinical trials (NCTs 04576338 and 05132556). Participants (n=86, sex; 40F/46M, race; White n=48, Black n=38, age; 21±2 years, BMI; 25±4 kg/m2) completed a three-day food and fluid log and underwent a venous blood draw to measure plasma copeptin concentration (BRAHMS Copeptin proAVP KRYPTOR). Food and fluid records were analyzed using the Nutrition Data System for Research for % fluid from food or water. Separately, records were used to operationalize beverage intake into 8 categories (water, sugar-sweetened beverages (SSB), milk/non-dairy alternatives, 100% juice, non-caloric beverages, plain coffee or tea, milk/sugar added coffee or tea, and alcohol). Statistical analyses included Mann-Whitney U tests for fluid intake data and ANCOVA for plasma copeptin concentration (controlled for site). Plasma copeptin was log transformed. Additionally, we assessed relations between fluid intakes and plasma copeptin concentration using Spearman’s (ρ) correlations. We set α at ≤ 0.05. Results: Compared with White adults, Black adults consumed less total fluid (Black; 1981 ±1035 vs. White; 2780±1242mL), water, alcohol, and coffee/tea (plain and milk/sugar-added), but more juice (all p’s&lt;0.05). There were no differences in % fluid from food or water, milk/non-dairy alternatives, non-caloric beverages, or SSBs. Black individuals exhibited ~22% higher plasma copeptin concentration (Black; 5.5±2.8 vs. White; 4.5±2.8pmol/L, ANCOVA p=0.022). Irrespective of race, copeptin was negatively correlated with water intake (ρ=-0.230, p=0.034). CONCLUSION: Black young adults reported a significantly lower fluid intake and exhibited higher plasma copeptin concentration when compared with White young adults. Future studies should attempt to address racial disparities in hydration practices, which may attenuate racial differences in copeptin and corresponding health disparities. NIH-K01HL147998 (ATR), Auburn University Offce of Vice President for Research Support Program (ATR). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Abstract P194: Consumption of Added Sugar and Added Sugar-Rich Foods and Beverages is Associated With Accelerated Epigenetic Aging in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: Added sugar (AS) and AS-rich foods and beverages have shown unfavorable associations with overall and cardiovascular health; however, their associations with epigenetic age has not been studied. Aim: To examine the associations of AS intake and AS-rich carbohydrate (CHO) food score with the pace of epigenetic aging in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods: There were 850 adults included in this cross-sectional study using data from Year 20 (2005-06). Trained interviewers administered a diet history, and foods were coded using Nutrition Data System for Research (NDSR), which outputs nutrients, including AS, and food groups. An AS-rich CHO food score was created including refined grain breads and rolls, quick breads, sweet bakery products, ready-to-eat cereals, candy, sugar products, and sugar-sweetened beverages. Year 20 epigenetic age measures were calculated from DNA methylation data, generating acceleration measures GrimAge acceleration (GrimAA) and PhenoAge acceleration (PhenoAA). Multivariable linear regression evaluated the associations of GrimAA and PhenoAA across quartiles of AS and AS-rich CHO food score, adjusted for demographic characteristics and lifestyle factors (see footnotes in table). Results: Participants who consumed more AS completed fewer years of education, were less likely to be current drinkers or smokers, and more likely to be ever smokers. They had lower intakes of total CHO, protein, total fat, and saturated fat, and fewer servings of vegetables, red and processed meat, eggs, and diet beverages. Consuming more AS was positively associated with PhenoAA (p trend =0.029), but not GrimAA (p trend =0.85). The AS-rich CHO food score was also positively associated with PhenoAA (p trend &lt;0.001), but not GrimAA (p trend =0.14). Conclusions: Consuming greater amounts of AS and AS-rich CHO foods and beverages were associated with an increased risk for accelerated epigenetic aging.

Altered Nutrient Composition of Lactose-Reduced Infant Formula.

This research comprehensively examines 88 infant formulas available in the US market, with an emphasis on their diverging nutritional attributes based on lactose content. We stratified formulas into three categories: lactose-free, lactose-reduced, and entirely lactose-based. The formulas' nutritional content for 58 nutrients was obtained from the Nutrition Data System for Research (NDSR). Nutritional analysis revealed significant differences in nutrient composition across formula categories. For example, the results showed significant associations between the lactose content and glycemic index (GI) of the formula as well as 25 other nutrients. Specifically, we showed that for every gram of lactose per 100 g of formula that is removed, there was a 10.1% increase in GI (β = -10.12, p ≤ 0.000), a 19%,5%, and a 2% increase in added sugar (β = -0.19, p < 0.01), protein (β = -0.05, p < 0.001), and polyunsaturated fatty acids (β = -0.01, p < 0.01). The substitution of lactose in infant formulas significantly alters their nutritional profile, inducing changes in GI, added sugar, protein, and polyunsaturated fatty acids. These modifications have potential consequences for infant growth and metabolic responses and could influence long-term health trajectories. The clinical relevance of the composition differences between formulas should be further explored.

Analysis of Nutritional Composition and Glycemic Control in Patients with Gestational Diabetes Mellitus

Background:The association between meal content and glycemic control is not well-understood in pregnancy, limits our ability to counsel patients regarding the optimal diet. We therefore sought to evaluate the relationship between maternal dietary content and glycemic control.&#x0D; Methods:This is a secondary analysis of the GDM-MOMS study, which was a randomized controlled pilot trial that compared glycemic targets in 60 pregnant individuals with GDM and either overweight or obesity. During the pilot trial, participants wore a blinded continuous glucose monitor (CGM) for two five-day periods, with the first data collection between 12-32 weeks and the second data collection between 32-36 weeks. During the time that participants wore their CGM, they also collected 3-day food diaries with detailed information regarding intake and cooking technique. These food diaries are being entered into the Nutrition Data System for Research (NDSR) software, which analyzes nutritional composition for each meal. Glycemic control as assessed by CGM will then be assessed based on maternal nutritional intake.&#x0D; Results:The American Diabetes Association recommends a 2,000-calorie daily diet with a minimum of 175g of carbohydrates (with 35% of the total calories coming from carbohydrates), 71g of protein, and 28g of fat. Preliminary data extracted from NDSR includes nutritional analysis of 38 daily food diaries from 14 patients. 12/38 (31.6%) food logs show consumption of less than 35% of their total calories from carbohydrates, with the other 26 consuming 36-62%. Glycemic load can be used to assess how a patient’s diet affects their glycemic levels. 25/38 (65.8%) of food logs demonstrate a daily glycemic load (GL) of 100, with the other 13 showing daily GLs rangingfrom 108-252.&#x0D; Conclusions and Further Directions:Further analyses will assess post-meal glycemic response using both patient-monitored glucose values and reports from their CGM to determine which types of diets allow for optimal glycemic control.

Basal Metabolic Rate Versus Dietary Vitamin D and Calcium Intakes and the Association With Body Composition and Bone Health After Chronic Spinal Cord Injury.

We examined the association among basal metabolic rate (BMR) as well as dietary intakes of vitamin D (Vit D) and calcium on body composition and bone mineral density (BMD) after spinal cord injury (SCI). Cross-sectional design. Veterans Affairs Medical Center, Richmond, VA. About 33 individuals with chronic SCI who recorded their food consumption 3 days per week for 2 weeks. BMR was measured after 10 to 12 h of overnight fast. Average daily vit D and calcium intakes, and total caloric intake were recorded and analyzed using the Nutrition Data System for Research (NDSR) software. Fasting blood analysis for 25-hydroxyvitamin D (25[OH]D) status and Triiodothyronine (T3) status was performed (n = 10). Total and regional BMD, % fat mass (FM), and % lean mass (LM) were measured by dual X-ray absorptiometry scans. Participants consumed less than the Institute of Medicine (IOM) recommended daily allowances (RDA) for vit D (600-800 IU) and calcium (1000-1200 mg) for adults. BMR was positively related to total-lean mass (r = .62, P = .0001; n = 32) and leg-lean mass (r = .51, P = .003; n = 32). Adjusted BMR was negatively related to BMD of the left (r = -.38, P = .047; n = 28) and the right (r = -.41, P = .032; n = 28) proximal tibia. Vit D intake was negatively related to percentage total-FM (r = -.33, P = .07; n = 29) and legs-%FM (r = -.37, P = .047; n = 29). Multivariate regression models indicated that adjusted BMR explained the variance in leg fat mass (34%; P = .002) and percentage fat mass (44%; P < .0001). Persons with SCI are likely to consume less than the RDAs for vit D and calcium. BMR may explain the changes in body composition and bone metabolism. Dietary vit D should be considered as a prophylactic intervention in maintenance of bone health after SCI.

Dietary advanced glycation end-products and their associations with body weight on a Mediterranean diet and low-fat vegan diet: a randomized, cross-over trial.

Evidence suggests that changes in dietary advanced glycation end-products (AGEs) may influence body weight, but the effects of different dietary patterns remain to be explored.The aim of this study was to compare the effects of a Mediterranean and a low-fat vegan diet on dietary AGEs and test their association with body weight. In this randomized cross-over trial, 62 overweight adults were assigned to a Mediterranean or a low-fat vegan diet for 16-week periods in random order, separated by a 4-week washout. Body weight was the primary outcome. Three-day diet records were analyzed using the Nutrition Data System for Research software and dietary AGEs were estimated, using an established database. Statistical approaches appropriate for crossover trials were implemented. Dietary AGEs decreased by 73%, that is, by 9,413 kilounits AGE/day (95% -10,869 to -7,957); p < 0.001, compared with no change on the Mediterranean diet (treatment effect -10,303 kilounits AGE/day [95% CI -13,090 to -7,516]; p < 0.001). The participants lost 6.0 kg on average on the vegan diet, compared with no change on the Mediterranean diet (treatment effect -6.0 kg [95% CI -7.5 to -4.5]; p < 0.001). Changes in dietary AGEs correlated with changes in body weight (r = +0.47; p < 0.001) and remained significant after adjustment for total energy intake (r = +0.39; p = 0.003). Dietary AGEs did not change on the Mediterranean diet but decreased on a low-fat vegan diet, and this decrease was associated with changes in body weight, independent of energy intake. https://clinicaltrials.gov/, identifier NCT03698955.

Nutrition assessment and MASH severity in children using the Healthy Eating Index.

Pediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD. Diet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components. In all, 119 children were included (13.3 ± 2.7y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04). In children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.

Comparing Self-Reported Dietary Intake to Provided Diet during a Randomized Controlled Feeding Intervention: A Pilot Study.

Systematic and random errors based on self-reported diet may bias estimates of dietary intake. The objective of this pilot study was to describe errors in self-reported dietary intake by comparing 24 h dietary recalls to provided menu items in a controlled feeding study. This feeding study was a parallel randomized block design consisting of a standard diet (STD; 15% protein, 50% carbohydrate, 35% fat) followed by either a high-fat (HF; 15% protein, 25% carbohydrate, 60% fat) or a high-carbohydrate (HC; 15% protein, 75% carbohydrate, 10% fat) diet. During the intervention, participants reported dietary intake in 24 h recalls. Participants included 12 males (seven HC, five HF) and 12 females (six HC, six HF). The Nutrition Data System for Research was utilized to quantify energy, macronutrients, and serving size of food groups. Statistical analyses assessed differences in 24 h dietary recalls vs. provided menu items, considering intervention type (STD vs. HF vs. HC) (Student's t-test). Caloric intake was consistent between self-reported intake and provided meals. Participants in the HF diet underreported energy-adjusted dietary fat and participants in the HC diet underreported energy-adjusted dietary carbohydrates. Energy-adjusted protein intake was overreported in each dietary intervention, specifically overreporting beef and poultry. Classifying misreported dietary components can lead to strategies to mitigate self-report errors for accurate dietary assessment.

Abstract 16940: Nutrient Intake of Patients With Heart Failure: Different Profiles Reveal Different Intervention Targets

Introduction: Diet quality is an important, but often underappreciated part of heart failure (HF) care. Tailoring of dietary interventions must take into consideration how patients with HF eat. Purpose: To identify distinct dietary profiles representing eating patterns in patients with HF. Methods: This was a secondary analysis of data from a randomized controlled double-blind clinical trial of a nutrition intervention with patients with HF. Baseline dietary data were collected using 24-hour dietary recall that included a weekend and two weekdays. Nutritional data were generated from the Nutrition Data Systems for Research. Nine unique diet components were quantified (along with a total Healthy Eating Index) and included in modeling based on theoretical and empirical knowledge: sodium, added sugars, trans-fat, vitamin C, vitamin D, vitamin E, folate, beta-cryptoxanthin, and lutein + zeaxanthin. Latent class mixture modeling was used to identify distinct dietary profiles among these 9 components representing different eating patterns that could serve as the bases of future interventions. Results: There were 112 participants with an average age 63 ± 12, 59.8% male, and 62.5% with class III or IV HF. Two dietary profiles were identified and were labeled by the prominent dimensional characteristic. The “higher intake” profile (n=79 (69.9% of the sample)) had significantly higher intake levels of sodium, vitamin D, vitamin E, vitamin C, beta-cryptoxanthin, lutein + zeaxanthin, and folate, and a “lower intake” profile (n=34 (30.1% of the sample) had significantly lower intake of these same nutrients. Patients with HF in the lower intake profile also had significant higher quality diets (Healthy Eating Index = 63.7± 13.2) compared with those in the higher intake profile (Healthy Eating Index = 53.9 ± 14.2, p&lt;0.001). Conclusion: Two different nutrient patterns were identified that would be amenable to different interventions; one focused on total calorie reduction and the other focused on optimizing nutrient intake.

The diet quality of well adolescents: Do they really eat poorly?

BackgroundA common assumption is that adolescents have poor eating habits. However, there is minimal data regarding adolescents’ intake of macronutrients (i.e. protein, carbohydrate, and fats) and micronutrients (i.e. vitamins and minerals). In addition, few studies have used the Healthy Eating Index-2010 (HEI-2010) to assess diet quality of well adolescents. ObjectiveTo determine diet quality among patients presenting for well care by using NDSR (Nutrition Data Systems for Research) nutrition analysis software and by calculating HEI-2010 scores. MethodsA convenience sample of adolescents presenting to clinic for well care was recruited. Participants completed a 24 hour dietary recall using the multiple pass method, a validated interviewing technique. Results for each participant were entered into NDSR version 2014, which provides a detailed nutrition analysis, and these results were also used to calculate a HEI-2010 score, which measures how well dietary intake conforms to the Dietary Guidelines for Americans in terms of amounts consumed from each food group. ResultsData from 48 adolescents (30 female, 18 male; mean age 16.5, range 12–20 years; 18 Hispanic, 11 Black, 5 White, 14 other) were analyzed. Body-mass-index (BMI) ranged from 16.0 to 38.1. Average total calories were 2054 (but there was a wide range of 683 to 4801 calories). Average calories for females and males were 1723 and 2604, respectively. Average percentages of calories from macronutrients were 33.2% from fat, 50.5% from carbohydrate, and 16.3% from protein. Micronutrient content was very low (< 53% of recommended Daily Values) for vitamins E and D; moderately low (61–76%) for zinc, magnesium, potassium and copper; minimally low (86–97%) for calcium, iron and vitamin B12; and normal (≥100%) for thiamin, riboflavin, niacin, folic acid, phosphorus, manganese, selenium and vitamins C, K, and B6. HEI scores were <50 (“poor”) for 20 subjects and 51–79 (“needs improvement”) for 13 subjects. Calorie consumption was insufficient to calculate an HEI score for 15 subjects and no subjects had an HEI score >80 (“good”). ConclusionOn some measures (distribution of macronutrients, intake of most vitamins and minerals), the adolescents in this study had sufficient diets by NDSR calculations. However, no subject had an HEI score indicative of good diet quality. It is possible that adolescents are consuming adequate macro- and micronutrients in the setting of processed, fortified foods, but that optimal consumption from each food group is lacking, resulting in lower diet quality scores on the HEI.

Association of free-living diet composition with plasma lipoprotein(a) levels in healthy adults

BackgroundLipoprotein (a) [Lp(a)] is an apoB100-containing lipoprotein with high levels being positively associated with atherosclerotic cardiovascular disease. Lp(a) levels are genetically determined. However, previous studies report a negative association between Lp(a) and saturated fatty acid intake. Currently, apoB100 lowering therapies are used to lower Lp(a) levels, and apheresis therapy is FDA approved for patients with extreme elevations of Lp(a). The current study analyzed the association of free-living diet components with plasma Lp(a) levels.MethodsDietary composition data was collected during screening visits for enrollment in previously completed lipid and lipoprotein metabolism studies at Columbia University Irving Medical Center via a standardized protocol by registered dietitians using 24 hour recalls. Data were analyzed with the Nutrition Data System for Research (Version 2018). Diet quality was calculated using the Healthy Eating Index (HEI) score. Fasting plasma Lp(a) levels were measured via an isoform-independent ELISA and apo(a) isoforms were measured using gel electrophoresis.ResultsWe enrolled 28 subjects [Black (n = 18); Hispanic (n = 7); White (n = 3)]. The mean age was 48.3 ± 12.5 years with 17 males. Median level of Lp(a) was 79.9 nmol/L (34.4–146.0) and it was negatively associated with absolute (grams/day) and relative (percent of total calories) intake of dietary saturated fatty acids (SFA) (R = -0.43, P = 0.02, SFA …(% CAL): R = -0.38, P = 0.04), palmitic acid intake (R = -0.38, P = 0.05), and stearic acid intake (R = -0.40, P = 0.03). Analyses of associations with HEI score when stratified based on Lp(a) levels > or ≤ 100 nmol/L revealed no significant associations with any of the constituent factors.ConclusionsUsing 24 hour recall, we confirm previous findings that Lp(a) levels are negatively associated with dietary saturated fatty acid intake. Additionally, Lp(a) levels are not related to diet quality, as assessed by the HEI score. The mechanisms underlying the relationship of SFA with Lp(a) require further investigation.

Adapting a US dietary analysis software and nutrient database for use in Brazil.

In many countries, assessing food and nutrient intake for research and surveillance purposes is difficult due to the lack of comprehensive, country-specific food and nutrient databases and/or a dietary analysis software program. In this case study, we describe the approach used to adapt a United States (US) dietary analysis software and nutrient database (Nutrition Data System for Research [NDSR]) for use in analyzing 24-hour dietary recalls collected for the Brazil Kids Nutrition and Health Study (KNHS). A team of experts that included individuals knowledgeable about Brazil and US eating traditions was assembled to devise solutions for between-country differences in eating habits, food supply, food nomenclature, and language. Solutions devised relied on several key resources, including the Brazilian Food Composition Table (TBCA) and a list of 200 foods commonly consumed in Brazil. These solutions included creating data entry rules that specified how each reported food should be entered into NDSR, creation of User Recipes for foods lacking a close nutritionally matching food in the NDSR database, and adjustment for food fortification differences as part of the analysis of study data. This case study illustrates that NDSR can be adapted for use outside of the United States through a structured process.

Evaluating a Campus Food Pantry’s Potential Impact on Nutrition Security using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework

BackgroundCampus food pantries are uniquely positioned to promote health equity with the foods they make accessible to food-insecure students. ObjectivesThis study assessed the implementation and effectiveness of a client-choice campus food pantry to understand its potential impact on nutrition security and to inform future implementation. MethodsThis observational study was designed using the reach, effectiveness, adoption, implementation, and maintenance framework, leveraging administrative data collected from a client-choice campus food pantry at a large Midwest university from August 2020 to May 2022. Pantry staff tracked student usage and item inventory. Items were analyzed for specific nutrients using the Nutrition Data System for Research. The mean nutrients and servings per food group distributed per visit were calculated and compared with dietary recommendations (effectiveness). Characteristics of pantry operation and setup were detailed (adoption). The percentage of openings with adequate stock to meet distribution guidelines was determined (implementation). Descriptive statistics were calculated, and multiple linear regressions determined whether significant changes in nutrients and food were distributed based on distribution guidelines and stock available. ResultsEffectiveness: Vitamin D, fruits, vegetables, and whole grains were below 3 d of the recommended intake for all students, and energy, fiber, potassium, vitamin A, and grains were low for male students. Adoption: The pantry was established through a collaboration with a pre-existing community food pantry and operates as a 501(c) and is managed by campus recreation staff. Implementation: The pantry supplied enough produce for 72% of openings to meet distribution guidelines and enough dairy for 63% of openings. ConclusionsThe food and nutrients distributed in limited amounts are consistent with those underconsumed according to the Dietary Guidelines for Americans. More research is needed to understand how pantry implementation can best support nutrition security through the adequate distribution of key nutrients and food groups.

Mobile Apps for Dietary and Food Timing Assessment: Evaluation for Use in Clinical Research.

Over the last decade, health mobile apps have become an increasingly popular tool used by clinicians and researchers to track food consumption and exercise. However, many consumer apps lack the technological features for facilitating the capture of critical food timing details. This study aimed to introduce users to 11 apps from US app stores that recorded both dietary intake and food timing to establish which one would be the most appropriate for clinical research. To determine a viable app that recorded both dietary intake and food timing for use in a food timing-related clinical study, we evaluated the time stamp data, usability, privacy policies, the accuracy of nutrient estimates, and general features of 11 mobile apps for dietary assessment that were available on US app stores. The following apps were selected using a keyword search of related terms and reviewed: text entry apps-Cronometer, DiaryNutrition, DietDiary, FoodDiary, Macros, and MyPlate; image entry apps-FoodView and MealLogger; and text plus image entry apps-Bitesnap, myCircadianClock, and MyFitnessPal. Our primary goal was to identify apps that recorded food time stamps, which 8 (73%) of the 11 reviewed apps did. Of the 11 apps, only 4 (36%) allowed users to edit the time stamps. Next, we sought to evaluate the usability of the apps using the System Usability Scale across 2 days, and 82% (9/11) of the apps received favorable scores for usability. To enable use in research and clinical settings, the privacy policies of each app were systematically reviewed using common criteria, with 1 (9%) Health Insurance Portability and Accountability Act-compliant app (Cronometer). Furthermore, protected health information was collected by 9 (82%) of the 11 apps. Finally, to assess the accuracy of the nutrient estimates generated by these apps, we selected 4 sample food items and a 3-day dietary record to input into each app. The caloric and macronutrient estimates of the apps were compared with the nutrient estimates provided by a registered dietitian using the Nutrition Data System for Research database. In terms of the 3-day food record, the apps were found to consistently underestimate daily calories and macronutrients compared with the Nutrition Data System for Research output. Overall, we found that the Bitesnap app provided flexible dietary and food timing functionality capable of being used in research and clinical settings, whereas most other apps lacked in the necessary food timing functionality or user privacy.

Comparison of skin carotenoid content scores and dietary intake between cognitively normal older adults and older adults with Alzheimer’s Disease: A matched‐pair analysis

AbstractBackgroundAlzheimer’s Disease (AD) is a systemic metabolic disease with a variable number and type of clinical symptoms mostly impacting the brain. Skin carotenoid content (SCC) is an objective measure of carotenoid‐containing fruit and vegetable intake that has been validated in diverse populations. Our previous findings suggest SCC scores are impacted by various metabolic disease states. Therefore, our objective was to analyze SCC scores and dietary intake across matched pairs including unimpaired adults and those with AD.MethodBaseline data from two dietary interventions (NCT03860792, NCT03841539) were analyzed. Pairs are exact matches for sex, race/ethnicity, and education and are matched within two years of age and 4 kg/m2 body mass index. Each pair (n = 12 pairs) includes one cognitively normal (MMSE &gt; 25), community dwelling older adult (‘CN’) and one community dwelling older adult with AD (‘AD’). Baseline self‐reported dietary intake data (3‐day food records) were collected, reviewed, and entered into the Nutrition Data System for Research (NDSR 2019) database by a Registered Dietitian. SCC scores were collected through pressure‐mediated reflection spectroscopy via VeggieMeter® (Longevity Link Corporation, Holladay, UT). Two‐sample independent t‐tests assuming unequal variances were used to compare differences in SCC scores and dietary intake. Significance was set at p = 0.05.ResultThere was a significant difference in SCC scores between matched pairs (SCC scores: CN 284.25, AD 207.67, p = 0.008). There was no difference between pairs for total daily energy (kcal/day; p = 0.60), fat (g/day; p = 0.91), carbohydrate (g/day; p = 0.85), or protein (g/day; p = 0.26) intake. Both groups had similar food group intake (p‐value range 0.09‐0.79), including all fruit and vegetable groups except CN had higher intake of non‐citrus fruit (p = 0.046). Total fruit (p = 0.09) and fruit plus vegetable (p = 0.24) were not different between pairs. Dietary intake by individual carotenoid was not significantly different (total vitamin A, p = 0.48; beta‐carotene, p = 0.49; alpha‐carotene, p = 0.57; beta‐cryptoxanthin, p = 0.60; lutein plus zeaxanthin, p = 0.07; lycopene, p = 0.37).ConclusionIndividuals with AD have lower carotenoid skin content compared to matched cognitively unimpaired individuals. These differences are not explained by differences in diet suggesting that AD may be associated with disease‐associated biochemical features that are metabolism‐related and not limited to the brain.