Nutrition Data System Research Articles

Insufficient choline intake during pregnancy: cohort study

ABSTRACT Objective To investigate the intake of choline during pregnancy and associated factors. Methods Cohort study with 353 pregnant women recruited from the primary health care network in an inland city of the State of São Paulo. In-house interviews were conducted in each of the gestational trimesters. In each of these points in time, a 24-hour dietary recall was collected. Subsequently, a new dietary recall collection was performed by telephone in the same trimester on a non-consecutive day, differentiating weekday versus weekend/holiday. Dietary intake data were included in the Nutrition Data System for Research software, and the habitual food intake throughout pregnancy was determined, with intra-individual variation correction in the MSM software. The influence of socioeconomic, obstetric and lifestyle factors, and of the actual diet, on choline intake during pregnancy was assessed using linear regression models, that were developed with the Stata software version 14.2, at a significance level of 95%. Results Choline intake (281.1±68.6 milligrams) was below the recommended adequate intake, and only energy was positively associated with this micronutrient intake. Conclusion Choline intake in the population studied fell far short of current recommendations, and only higher energy intake was found as a factor associated with a higher intake.

Higher percent of energy intake as carbohydrates has a negative relationship with cognitive performance in APOE4 carriers

AbstractBackgroundExpression of the APOE4 allele is a known genetic risk factor of Alzheimer’s Disease. There is speculation that dietary carbohydrate intake may also influence AD risk. The purpose of this study was to evaluate the cross‐sectional relationship between dietary carbohydrate intake and cognitive performance stratified by APOE status in a population of cognitively normal, older adults.MethodBaseline data from 62 cognitively normal older adults participating in a nutrition intervention study (Nutrition Interventions for Cognitive Enhancement study; NICE study) were analyzed. Dietary intake was obtained by 3‐day diet records and entered into the Nutrition Data System for Research. Fasting blood draws were attained and APOE status was determined by Quest Diagnostics®. A cognitive battery was conducted by a trained psychometrician. Individual test z‐scores were calculated to form domains of memory (Logical Memory Tests I and II and the Free and Cued Selective Recall Test), attention (Digit Span Forward and Backward and Stroop Number Letter), visuospatial processing (Stroop Color, Block Design, Trailmaking A, and Digit Symbol Substitution Test), and executive function (Trailmaking B and Category Fluency Animals/Vegetables). We constructed ordinary least squares regression models to assess the relation between proportion of carbohydrate as energy and cognition controlled for age and gender in an APOE‐dependent manner. Statistical analyses were performed using R (v. 3.6.2; R Foundation, Vienna, Austria). Statistical significance was set at p < 0.05.ResultParticipants were 85% female and had a mean age of 72.1±4.9 years. APOE status was 32% APOE4 carriers (n=20) and 68% non‐carriers. There was no difference in age, sex or dietary macronutrient intake between carriers and non‐carriers. Within APOE4 carriers, higher percent of energy as carbohydrate was related to poorer memory (β̞=‐0.64, p=0.002) and executive function (β̞=‐0.51, p=0.02). Within the non‐carriers, there was no relationship between percent carbohydrate and cognitive performance.ConclusionAPOE4 carriers with higher percent dietary carbohydrate intake had worse performance on cognitive functions tests. These results support the concept that dietary carbohydrate may be an important modifiable risk factor for AD. These findings will be further investigated utilizing the final sample size of the NICE Study (n=200).

Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes: Differences between Latino and Non-Latino Providers

While there are several factors that contribute to the diet quality of children in childcare, one contributing factor in Family Childcare Homes (FCCHs) is the provider’s ethnicity. However, research examining the food items provided in this setting is limited; in particular, with regards to differences between FCCHs of Latino and non-Latino providers. The aim of this study was to identify and describe the food items that contribute to food group intake in preschool-aged children attending FCCHs, and to examine differences by provider ethnicity. This secondary data analysis used baseline data from Healthy Start/Comienzos Sanos: a cluster-randomized trial. Children’s dietary intake was collected using the Dietary Observation in Child Care method and entered into Nutrition Data System for Research software. Food groups were based on the Nutrition Coordinating Center classification. Contribution of food items to their respective food group was calculated as a proportion, using ratio of means and presented as a percentage. Ethnic differences were tested with ANCOVA (p < 0.05) with Bonferroni adjustments for multiple comparisons. All providers (n = 120) were female and 67.5% were Latino. Most fruit consumed by children was in the form of juice (85%), three-fourths of the grains consumed were refined (75%), and half of the sweets consumed were syrup/honey/jelly (50%). Most of the vegetables consumed were non-starchy (61%), nearly three-fourths of dairy consumed was low-fat (71%), and vegetable oils contributed the most to the fats group (89%). Food items differed by provider’s ethnicity, with children cared for by non-Latino providers consuming a higher proportion of fruit juice, animal fats and a lower proportion of legumes (p < 0.001 for all). Children with Latino providers consumed a lower proportion of non-starchy vegetables, low-fat dairy, and nuts/seeds (p < 0.001 for all). FCCH providers could offer more whole fruits and grains and a greater variety of vegetables. Differences by ethnicity suggest providers could benefit from culturally tailored recommendations.

The Carbon Isotope Ratios of Serum Amino Acids in Combination with Participant Characteristics can be Used to Estimate Added Sugar Intake in a Controlled Feeding Study of US Postmenopausal Women

Background:The carbon isotope ratio (CIR) is a proposed biomarker for added sugar (AS) intake in the United States; however, because the CIR is also associated with meat intake in most populations the need for specificity remains. The CIR of amino acids (AAs) has the potential to differentiate sugars from meat intakes, because essential AAs must derive from dietary protein whereas certain nonessential AAs can be synthesized from sugars. Objectives:We tested whether serum CIR-AAs in combination with participant characteristics could meet a prespecified biomarker criterion for AS intake in the Nutrition and Physical Activity Assessment Study Feeding Study (NPAAS-FS) of the Women’s Health Initiative, a population in which the whole-serum CIR was not associated with AS intake. Methods:Postmenopausal women (n = 145) from Seattle, WA, were provided with individualized diets that approximated their habitual food intakes for 2 wk. Dietary intakes from consumed foods were characterized over the feeding period using the Nutrition Data System for Research. The CIR of 7 AAs–Ala, Gly, Val, Leu, Ile, Pro, and Phe–were measured in fasting serum collected at the end of the 2-wk feeding period, using gas chromatography–combustion isotope ratio mass spectrometry. Biomarker models were evaluated using regressionR2 = 0.36 as a major biomarker criterion, based on the benchmarkR2values of well-established recovery biomarkers in the NPAAS-FS. Results:AS intake was associated with CIR-Ala (ρ = 0.32;P< 0.0001). A model of AS intake based on CIR-Ala, CIR-Gly, CIR-Ile, smoking, leisure physical activity, and body weight met the biomarker criterion (R2 = 0.37). Biomarker-estimated AS intake was not associated with meat or animal protein intake. Conclusions:Results support serum CIR-AAs in combination with participant characteristics as potential biomarkers of AS intake in US populations, including those with low AS intake.

Dietary Supplementation of Extra Virgin Olive Oil in Patients with Heart Failure with Preserved Ejection Fraction is Associated with Increases in Cardiorespiratory Fitness

Introduction Prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) is increasing worldwide, without effective therapies to reduce morbidity and mortality. Supplementation of extra virgin olive oil (EVOO) is a powerful primary prevention strategy against major cardiovascular events, but its effect on secondary prevention in HFpEF is unknown. Cardiorespiratory fitness (CRF), measured by peak oxygen consumption (VO2) on cardiopulmonary exercise testing (CPET), is a strong prognostic marker in HFpEF and increases in peak VO2 are linked to reductions in mortality. Our aim was to assess the effect of EVOO supplementation on measures of CRF in patients with HFpEF. Methods Nine consecutive patients were enrolled in the UFA-Preserved trial (NCT03310099), a dietitian-led 12-week pilot trial supplementing unsaturated fatty acid (UFA) rich foods, such as EVOO, in patients with HFpEF. Five-pass 24-hour dietary recalls were performed at baseline, 4, 8 and 12 week visits and analyzed with Nutrition Data Systems for Research (NDSR) software. Intake of EVOO in grams (g) was averaged across the 4, 8 and 12 week visits and average change from baseline was calculated. Peak VO2(mL.kg.min−1) and percent predicted value (% peak VO2) were measured with maximal CPET at baseline and 12 weeks along with oxygen uptake efficiency slope (OUES). Relationships between variables were analyzed with Spearman's rank test. Results are presented as median and interquartile range (IQR). Results Five subjects were female (56%) with a median age of 56 (50- 59) years. Baseline peak VO2 was 14.7 mL.kg.min−1 (11.3-22.1), % peak VO2 was 51.4 (43.8-59.4) and OUES was 1.87 (1.46-2.39). There was no EVOO intake on baseline dietary recalls, an increase in daily EVOO +23.6 g (12.0-47.6) (p=0.012) was observed between baseline and 12 weeks. EVOO consumption was significantly associated with positive improvements in peak VO2 (r=+0.850, p=0.004), % peak VO2 (r=+0.850, p=0.004), and OUES (r=+0.733,p=0.025) (Figure 1, panels A-C). Conclusion Dietary EVOO supplementation results in increased CRF in patients with HFpEF with no EVOO baseline intake. Further studies are warranted to confirm this finding and establish a basis for testing the effect of EVOO on CRF as well as major cardiovascular outcomes and to explore these effects across differing baseline intakes of EVOO.

P120 Children with Autism Spectrum Disorder Who Are Picky Eaters May Consume More Ultra-Processed Foods than Non-Picky Eaters

<h3>Background</h3> Ultra-processed foods may induce high energy intake that leads to excess weight gain, which can be problematic for children with autism spectrum disorder (ASD), as the prevalence of obesity is higher in this population than typically-developing children. Picky eating is also more common in children with ASD compared to typically-developing children, yet how picky eating is associated with types of food that children with ASD consume is unknown. <h3>Objective</h3> To examine associations between picky eating and food categories by NOVA classifications (unprocessed foods vs ultra-processed foods) among youth with ASD. <h3>Study Design, Setting, Participants</h3> A cross-sectional study conducted with 42 parents of children with ASD ages 2-17 years in Florida. <h3>Measurable Outcome/Analysis</h3> A food record and mealtime behavior survey were completed by a parent of each child. Foods were coded based on NOVA classifications, and percent energy from each food category was assessed using the Nutrition Data System for Research (NDSR) software. Parent-reported picky eating was assessed with a mealtime behavior survey. Descriptive statistics and Mann-Whitney U tests were performed. <h3>Results</h3> Ultra-processed foods accounted for the majority of the children's energy intake (mean 62.6%). Picky eaters had greater percent energy intake from ultra-processed foods (<i>P</i> = .004, mean 68.7% vs 48.0%) and lower percent energy intake from unprocessed foods (<i>P</i> = .001, mean 23.4% vs 44.7%) compared to non-picky eaters. Among the picky eaters, 5 were also considered as binge eaters, which was associated with greater percent energy intake from ultra-processed foods (<i>P</i> = .032, 79.4% vs 60.0%) and lower percent energy intake from unprocessed foods (<i>P</i> = .041, 14.8% vs 32.1%) compared to those who were picky eaters but not binge eaters and non-picky eaters combined. <h3>Conclusions</h3> Among youth with ASD, picky eaters may selectively eat more ultra-processed foods. Nutrition education for children with ASD and their parents should address both picky eating behaviors and types of foods. If children have disordered eating behaviors such as binge eating, further intervention may be necessary.

Eating Pattern and Nutritional Risks among People with Multiple Sclerosis Following a Modified Paleolithic Diet.

Preliminary studies suggest that a modified Paleolithic diet may benefit symptoms of fatigue in progressive multiple sclerosis (MS). However, this diet restricts the consumption of eggs, dairy, and gluten-containing grains, which may increase the risk of micronutrient deficiencies. Therefore, we evaluated the nutritional safety of this diet among people with progressive MS. Three nonconsecutive 24-h dietary recalls were collected from (n = 19) progressive MS participants in the final months of a diet intervention study and analyzed using Nutrition Data System for Research (NDSR) software. Food group intake was calculated, and intake of micronutrients was evaluated and compared to individual recommendations using Nutrient Adequacy Ratios (NARs). Blood was drawn at baseline and the end of the study to evaluate biomarker changes. Mean intake of fruits and vegetables exceeded nine servings/day and most participants excluded food groups. The intake of all micronutrients from food were above 100% NAR except for vitamin D (29.6 ± 34.6%), choline (73.2 ± 27.2%), and calcium (60.3 ± 22.8%), and one participant (1/19) exceeded the Tolerable Upper Limit (UL) for zinc, one (1/19) for vitamin A, and 37% (7/19) exceeded the chronic disease risk reduction (CDRR) for sodium. When intake from supplements was included in the analysis, several individuals exceeded ULs for magnesium (5/19), zinc (2/19), sodium (7/19), and vitamins A (2/19), D (9/19), C (1/19), B6 (3/19), and niacin (10/19). Serum values of vitamins D, B12, K1, K2, and folate significantly increased compared to respective baseline values, while homocysteine and magnesium values were significantly lower at 12 months. Calcium and vitamin A serum levels did not change. This modified Paleolithic diet is associated with minimal nutritional risks. However, excessive intake from supplements may be of concern.

Influence of breakfast and meal frequency in calcium intake among pregnant adolescents.

Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation.

4013 Does dietary fat composition predict short-term elevations in lipid levels in adults on a modified Atkins diet?

OBJECTIVES/GOALS: The modified Atkins diet (MAD) is used in the management of drug-resistant epilepsy in adults. Some patients on MAD show an increase in serum levels of total cholesterol and low-density lipoprotein (LDL) cholesterol. We explored whether dietary fat composition predicts short-term elevations in serum lipid levels in diet-naïve adults who begin MAD. METHODS/STUDY POPULATION: Participants self-reported their diet intake with 3-day food records at baseline, 1 month and 2 months. Food records were analyzed using Nutrition Data System for Research software. Fasting serum levels of total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides were also collected and LDL level calculated at baseline, 1 month, and 2 months. RESULTS/ANTICIPATED RESULTS: 38 patients submitted complete food records at each study visit (baseline, 1 month, and 2 month). Compared to baseline diet intake, there was a significant reduction in daily carbohydrate intake at 1 and 2 months months (p&lt;0.001). There was also a significant increase in daily saturated fatty acid (SFA) intake at 1 and 2 months (p&lt;0.001), daily mono-unsaturated fatty acid (MUFA) intake at 1 and 2 months (p&lt;0.001), and daily cholesterol intake at 1 month (p&lt;0.05) and 2 months (p&lt;0.001), but no change in daily poly-unsaturated fatty acid (PUFA) intake over time. Compared to baseline, there was a significant increase in serum LDL at 1 month (p&lt;0.001) and 2 months (p&lt;0.01) and an increase in serum TC at 1 month (p&lt;0.01) but not 2 months. DISCUSSION/SIGNIFICANCE OF IMPACT : Despite a significant increase in total fat, saturated fat and mono-unsaturated fat intake as well as an increase in total cholesterol and LDL levels following MAD initiation, dietary fat composition appears to minimally predict serum lipid values in the short term. CONFLICT OF INTEREST DESCRIPTION: Tanya McDonald has received speaking honoraria from Nutricia North America. Bobbie Henry-Barron receives grants from Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research, Nutricia and Vitaflo. Diane Vizthum receives grants from the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Mackenzie C. Cervenka has received grant support from Nutricia North America, Vitaflo, Army Research Laboratory, The William and Ella Owens Medical Research Foundation and BrightFocus Foundation. She receives speaking honoraria from LivaNova, Epigenix, Nutricia North America and the Glut1 Deficiency Foundation and performs consulting with Nutricia North America and Sage Therapeutics and receives Royalties from Demos Health.

1311-P: Number of Daily Meals and Snacks Impacts Glycemic Outcomes in Youth with T1D

Aim: Most youth with T1D meet neither nutrition guidelines nor glycemic goals. We assessed macronutrient content of meals/snacks and impact of daily number of meals/snacks on glycemic outcomes in youth with T1D over 1 year. Methods: Youth completed 3-day food records (2 week days/1 weekend day) and wore 3-day masked CGM (iPro™) every 3 months for 1 year. Diet data were reviewed by 2 RDs and analyzed using Nutrition Data System for Research (NDSR). Glycemic outcomes were A1c and CGM metrics (glucose % time in range [TIR] 70-180 mg/dL, % time [T] &amp;lt;70, %T&amp;gt;180, and glucose CV [SD/mean]). Longitudinal mixed models assessed effect of number of daily meals/snacks on glycemic outcomes. Results: Youth (N=136, ages 8-17, 48% male) were ages 12.8±2.5 years with T1D duration 5.9±3.1 years and daily insulin dose 0.9±0.3 U/kg; 73% used insulin pumps. Number of meals/snacks ranged from 1-9 with most youth (69%) reporting 3-4 meals/snacks daily. Macronutrient intake varied by meal/snack (Figure). An increase of 1 meal/snack per day led to a 0.1% decrease in A1c (p=.001), 2.4% (35 minutes/day) more TIR (p=.0006), and 3.1% (45 minutes/day) less T&amp;gt;180 (p=.0001); T&amp;lt;70 and CV were unchanged. Conclusions: In youth with T1D, eating frequent meals/snacks may lead to lower A1c, more TIR, and less hyperglycemia. These findings may be due to dividing energy intake across the day with more frequent bolus dosing, given predominance of carbohydrates in meals/snacks. Disclosure R.O. La Banca: None. L.K. Volkening: None. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. S.N. Mehta: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US. Funding National Institutes of Health (P30DK036836, K12DK094721)

224-OR: Effect of Macronutrient Intake on Glycemic Outcomes over 1 Year in Youth with T1D

Aim: Insulin bolus doses are mainly based on ambient glucose level and planned carbohydrate (CHO) intake, although fat and protein content of food also impact glycemic excursions. We examined the impact of macronutrient intake on glycemic outcomes in youth with T1D. Methods: Youth (N=136, ages 8-17) with T1D provided diet (3-day food records) and glucose (3-day masked CGM [iPro™]) data every 3 months for 1 year (5 time points). Diet data were analyzed using Nutrition Data System for Research (NDSR). Macronutrient % intake was derived as the mean for each 3-day period. Glycemic outcomes were A1c and CGM metrics: glucose % time in range (TIR) 70-180 mg/dL, % time (T) &amp;lt;70, %T&amp;gt;180, and glucose CV. Longitudinal mixed models assessed the effect of macronutrient intake on glycemic outcomes. Results: Youth (48% male) had a mean age of 12.8±2.5 years and T1D duration of 5.9±3.1 years; youth checked BGs 5.6±2.4 X/day and 73% used insulin pumps. At baseline, A1c=8.1±1.0%, %TIR=49±17% (11.8 hrs), %T&amp;lt;70=6±8% (1.4 hrs), %T&amp;gt;180=44±20% (10.6 hrs), and CV=41±8%; macronutrient % intake was 48±5% CHO, 36±5% fat, and 16±2% protein. Over 1 year, differences in macronutrient intake affected glycemic outcomes (Table). Conclusions: Our data confirm the significant impact of fat and protein intake on glycemic outcomes. These findings offer an opportunity to tailor algorithms to assist with meal-time bolus dosing and automated insulin delivery systems. Disclosure R.O. La Banca: None. L.K. Volkening: None. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. S.N. Mehta: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US. Funding National Institutes of Health (P30DK036836, K12DK094721)

Comparison of Food Composition Databases from Two Popular Commercial Nutrition Apps with a Research Food and Nutrient Database

Abstract Objectives Increasing interest in using commercial nutrition apps to evaluate energy intake and diet quality warrants further investigation of how diet data are being analyzed by clinicians. Few studies have compared food composition databases from commercial apps with a validated nutrient database used by the scientific community. We investigated the reliability of MyFitnessPal (v19.4.0) and 2017 CalorieKing databases with the 2017 Nutrition Coordinating Center Nutrition Data System for Research (NDSR) database. Methods The 50 most consumed foods were identified from an urban weight loss study. A single investigator searched each database to document data on calories and nutrients (i.e., total carbohydrates, sugars, fiber, protein, and total and saturated fat). Intraclass correlation coefficient (ICC) analyses evaluated the reliability between each commercial database with the NDSR; an ICC ≥ 0.90 was considered excellent; 0.75 to &amp;lt; 0.90 as good; 0.50 to &amp;lt; 0.75 as moderate; and &amp;lt; 0.50 as poor. Sensitivity analyses determined whether reliability differed by most frequently consumed food groups. Results The 3 most frequently consumed food groups were Fruits (15 items), Vegetables (13 items) and Protein (9 items). There was excellent reliability between CalorieKing and NDSR for all diet data (ICC range = 0.90–1.00). Between MyFitnessPal and NDSR, calories and nutrients had excellent reliability (ICC range = 0.90–1.00), except for total fat (ICC = 0.89) and fiber (ICC = 0.67). Sensitivity analyses showed good to excellent reliability between both commercial databases with NDSR for Vegetables and Protein groups (ICC range = 0.86–1.00). However, MyFitnessPal and NCC had poor reliability in calories, total carbohydrate, and fiber within the Fruit group (ICC range = 0.33–0.43). Conclusions CalorieKing had stronger agreement with NDSR. The wide range of ICCs between MyFitnessPal and NDSR is attributed to poor reliability among foods within the Fruit group. Our findings illustrate variability in nutrient data across commercial databases that can impact use in clinical nutrition analysis and translation of evidence-based interventions into practice. Future studies are needed to compare other popular commercial mobile nutrition apps with NDSR and/or other validated nutrient databases. Funding Sources The first author is supported by the National Cancer Institute.

M-Health Intervention Has the Potential to Alleviate Constraints in Using Administrative Data Systems for Improving Service Delivery in India

Abstract Objectives Administrative Data (AD) are a key component of nutrition data systems, but little is known about how AD are used or can be reshaped for accountability and action. We studied factors influencing AD use in India's Integrated Child Development Services (ICDS), in two Indian states; and assessed how an m-Health intervention (Common Application Software (CAS)) changes it. ICDS-AD system consolidates data from 11-recording registers updated every month by ∼1.3 million frontline workers (FLW). CAS digitizes these records and creates dashboards for real-time monitoring. Methods We conducted semi-structured interviews (n = 82) with supervisory staff at sub-district [Lady Supervisors (LS); Child Development Project Officer (CDPO)] and district level [District Program Officer (DPO)] to understand AD use patterns, facilitators and barriers. Data were coded, summarized and analysed across levels of supervisory staff. Results LS supervise FLWs, visit villages monthly to monitor data, and collate it to the sub-district level. Due to limited time and pressures to update AD on time, LS focus on data completeness and not on quality or data use. At the next level, CDPOs review and discuss program targets for indicators with LS, and check data completeness. They create monthly reports on targets for the districts, based on LS reports. At the district, DPOs use compiled reports to review subdistrict performance and discuss any gaps with CDPOs. CAS makes the data entry, compilation and report generation easier for all users. LS can monitor data entry daily in CAS and data collation is automated. CDPOs can review the CAS dashboard and use it to discuss issues with LS and DPOs. However, program target indicators dominate use of data. In CAS areas, these include growth monitoring completion, home visits, identification of malnourished children, and their referral. Overall, data use is target-driven, with indicators for monitoring prioritized by program management. Conclusions Focus of data use has been on reporting up on target indicators rather than on local program improvement, due to staff and time constraints. CAS can address some AD use constraints by easing data entry and data compilation but a data culture that focuses on predetermined target indicators can limit use for local program improvement. Funding Sources Bill &amp; Melinda Gates Foundation via grants to IFPRI and UCSF.

Fruit and Vegetables Carotenoids Intake in Eight Latin American Countries, Results from the ELANS Study

Abstract Objectives To determine carotenoid intake (Beta and alpha carotene, lycopene and beta cryptoxanthin) from fruit and vegetable sources in ELANS participating countries. Methods Data were obtained from the Latin American Health and Nutrition Study (ELANS), a multicenter study developed in urban areas of 8 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Dietary intake among 9218 participants (15- 65 y) was assessed using two 24-hour recall and processed by Nutritional Data System for Research (NDS-R). Fruits and vegetables were classified according to the 2002–2007 FAO Supply Utilization Accounts Data. Major food sources of carotenoids were assessed using weighed-proportions. Median intake, expressed as micrograms per day (mcg/d), and sources of carotenoids were performed by country. Results *All data is presented as mcg/d The highest intake for beta-carotene was reported in Ecuador (2659.6 ± 82.8) and the lowest in Brazil (1368.9 ± 42.2). The same trend was observed for alpha-carotene (290.6 ± 15.2 in Brazil vs 975.6 ± 33.5 in Ecuador). The main sources of these carotenoids are root vegetables such as carrots and beets. In the case of lycopene, Ecuador showed the highest average intake (3038.5 ± 174.3) whereas Peru showed the lowest (1111.7 ± 75.2). The most important source of this carotenoid is fruity vegetables, such as tomatoes. For beta cryptoxanthin, the highest intake was observed in Venezuela (246.3 ± 10.7) and the lowest was reported in Brazil (99.5 ± 5.3) Conclusions Fruits and vegetables are important sources of carotenoids in the human diet. Of all countries included in this study, Brazil had the lowest intake of beta and alpha carotene and beta cryptoxanthin, and Ecuador had the highest intake of beta and alpha carotene and lycopene. Further studies are needed to assess bioavailability and serum concentrations in order to establish dietary recommendations regarding both pro vitamin and non pro-vitamin A carotenoids. Funding Sources The ELANS is supported by a scientific grant from the Coca Cola Company and support from participating academic institutions. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this abstract.

Characterizing Dietary and Physical Activity Patterns in Relation to Hydration Among Pre-Adolescent Children

Abstract Objectives The aim of this study was to characterize food and fluid consumption as well as and physical activity patterns in children in relation to ad libitum hydration. Methods Child participants aged 9–11 years (N = 55, 28 females) reported beverage consumption with a 7-day fluid diary. Overall diet was reported using a 7-day diet record and analyses were run using the Nutritional Data System for Research (NDSR). Physical activity was assessed with hip worn accelerometers (Actigraph wGT3x+, Pensacola, FL) over 7 days and aerobic fitness was measured with a VO2 max test. Body composition was assessed with dual energy x-ray absorptiometry (DXA). Urine was collected over a 24hr period and was analyzed separately with a refractometer and freezing point depression for specific gravity (USG) and osmolality (UOsm), respectively. Results Children reported ad libitum consumption of 1645 ± 856 mL of total fluid per day, which was comprised of 37% plain water and 12% milk. The remaining 51% was composed of juice, carbonated, sports, fruit, and caffeinated beverages. Mean 24 h UOsm was 780 ± 250 mOsm/kg and USG was 1.019 ± 0.007. Activity data showed participants spent 52 minutes of MVPA/day. Partial correlations, adjusting for VO2 max, % body fat, sex, energy intake, and accelerometer wear time per day, revealed relationships between plain water consumption and USG (r = −0.32, P = 0.05). USG was related to sedentary activity/day (r = −0.37, P = 0.03); however, there were no other relationships between physical activity and urine hydration markers or plain water intake (all p's &amp;gt; 0.05). Total healthy eating index score (HEI) was not related to plain water intake (r = 0.16, P = 0.34) but trended with UOsm (r = −0.30, P = 0.07). Further, UOsm was inversely correlated with the specific HEI subcomponents of higher vegetable (Rho = −0.32, P = 0.02) and lower saturated fat (Rho = −0.28, P = 0.04) consumption. Conclusions Water consumption in children was below recommendations, and fruit drinks, carbonated drinks, and juice comprised a significant proportion of beverages consumed. Higher water consumption was correlated with lower urine concentration, providing additional support for the importance of water for hydration in children. Finally, hydration was not related to weight status, % body fat, or habitual physical activity. Funding Sources Danone Research, Palaiseau, France.

Intake of Free Sugars Among Young Children in Rural Malawi

Abstract Objectives The World Health Organization (WHO) recommends intake of free sugars to not exceed 10% of energy in children. The objectives of this study are to (1) estimate the proportion of infants in rural Malawi who exceed the recommended intake of free sugars and (2) describe the sources of free sugars in infant diets. Methods Among children enrolled in a randomized controlled trial of an egg feeding intervention, a secondary analysis was conducted using endline dietary data from a single 24-hour recall among 12- to 15-month-old children (n = 590). Free sugars in home-prepared foods were estimated using the gram weight of table sugar and honey in standardized local recipes. Free sugars from commercial foods were estimated using food composition data from the Nutrition Data System for Research. Foods and beverages containing free sugars were classified into seven food categories: maize porridge, sweetened tea, sweetened dairy, candy or table sugar, juice or soda, pastries, and cookies. The total grams of free sugars and grams of free sugars by food category and by commercial or home preparation were summed for each child. Breastmilk intake was not directly assessed, so total energy intake was assumed equal to the estimated energy requirement when assessing proportion of energy intake from free sugars. Results The mean intake of free sugars was 10.7 ± 13.1 g (6% of estimated energy requirement), and 22% of children exceeded recommended energy intake from free sugars. The majority of free sugars were consumed in maize porridge (5.1 g, 48% of total free sugars) followed by sweetened tea (2.0 g, 18%), sweetened dairy (1.7 g, 16%), candy or table sugar (1.0 g, 9%), juice or soda (0.3 g, 3%), pastries (0.3 g, 3%), and cookies (0.3 g, 3%). The average intake of free sugars from commercial foods or beverages was 3.5 ± 8.5 g (33% of total free sugar intake), whereas the average intake from home-prepared foods or beverages was 7.1 ± 9.4 g (67%). Conclusions Free sugar consumption exceeded WHO recommendations in approximately one-fifth of this sample of rural Malawian children. This data suggests the greatest opportunity for reducing free sugar consumption among young children in rural villages is by targeting sugars added to home-prepared foods and beverages. Funding Sources Bill and Melinda Gates Foundation.

The Presence of Lunasin, a Soy-Derived Bioactive Peptide in Plasma: A Randomized Clinical Trial

Abstract Objectives Lunasin is a bioactive peptide originally derived from soy protein which is being marketed as a nutraceutical product for its potential beneficial effects. Functionality of lunasin depends on its presence in circulation after digestion and metabolism. We studied safety, tolerability, and presence of lunasin in blood for the first time in humans in a well-controlled randomized clinical trial. Methods In a triple-blinded, placebo-controlled crossover study, 31 subjects (female: 19, male: 12, age = 61 ± 9.9 years) were randomized into an 8-week intervention period with capsules containing either 335 mg/d lunasin-enriched soy extract (LES) or corn fiber (placebo). This was followed by a 3-week wash-out period after which participants switched treatment groups for the next 8 weeks. In this crossover randomized study, plasma samples of subjects were collected after ingestion of a daily dose of lunasin-enriched capsules for 8 weeks, which provided 50 mg/d of lunasin. Enzyme-Linked Immunosorbent Assay was used to detect plasma lunasin level after an overnight fast. In order to assess the dietary intake of lunasin, two 24-hour dietary recalls (one in each intervention period) were obtained from each participant. Dietary intake data were collected and analyzed using Nutrition Data System for Research software version 2015, developed by the Nutrition Coordinating Center (NCC), University of Minnesota, Minneapolis, MN. Results During the intervention, no major safety concerns related to lunasin consumption were noticed. Ingestion of 335 mg/d LES for 8 weeks resulted in higher lunasin level in plasma compared to placebo. Fasting plasma lunasin levels ranged 0–10 ng/mL. The mean lunasin concentration in plasma increased by 44% after 8 weeks of daily supplementation with LES. Conclusions Lunasin was detectable in plasma after overnight fast in higher levels among LES takers. The difference in lunasin concentration was due to LES capsules and not dietary intake of lunasin-containing foods. Funding Sources The study was funded by Soy Labs Inc.

Comparison of Skin Carotenoid Content and Dietary Carotenoid Intake

Abstract Objectives Skin Carotenoid Content (SCC) is a validated biomarker of vegetable intake. The objective of this study is to compare SCC to self-reported diet and supplement intake. Methods This cross-sectional study used baseline data from 61 participants in an ongoing intervention trial (Nutrition Interventions for Cognitive Enhancement). Participants were cognitively normal older adults (≥65 years, MMSE score &amp;gt;25). SCC was determined non-invasively by Resonance Raman spectroscopy (VEGGIE METER®; Longevity Link Corporation). Three measurements were taken on the fingertip and averaged. Dietary intake was obtained by 3-day diet records. A dietitian reviewed the diet records and entered the records into the Nutrition Data System for Research (version 2019). Linear regression was used to assess relationships between self-reported carotenoid intake and SCC measurement. Results The mean SCC was 279 ± 72.1. Correlations for self-reported individual carotenoid intake and SCC scores were beta-carotene (r2 = 0.15, β̞ = 0.38, P = 0.002), alpha-carotene (r2 = 0.10, β̞ = 0.32, P = 0.01), and lutein + zeaxanthin (r2 = 0.16, β̞ = 0.41, P = 0.001). Correlations for self-reported combined diet and supplement intake and SCC scores were beta-carotene (r2 = 0.15, β̞ = 0.38, P = 0.002), alpha carotene (r2 = 0.10, β̞ = 0.32, P = 0.01), and lutein + zeaxanthin (r2 = 0.07, β̞ = 0.26, P = 0.04). Neither reported diet nor diet and supplement intakes of beta-cryptoxanthin, lycopene, and retinol were related to SCC scores. Correlations for food group and SCC scores were dark vegetables (r2 = 0.15, β̞ = 0.39, P = 0.002), deep yellow vegetables (r2 = 0.09, β̞ = 0.30, P = 0.02), and total vegetable intake (r2 = 0.16, β̞ = 0.40, P = 0.001). Conclusions Within older adults, the SCC is a good indicator of dietary lutein + zeaxanthin, beta-carotene, and alpha-carotene intake. The finding that lutein + zeaxanthin relationship decreases when accounting for combined diet and supplement intake suggests need to investigate bioavailability of supplemental lutein + zeaxanthin. Funding Sources National Institutes of Health.

Antioxidants Consumption and Depression: A Cross-Sectional Analysis of the ELSA-Brasil Study

Abstract Objectives To evaluate the association between depression and consumption of retinol, vitamins C and E, selenium and zinc in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. Methods This study is part of the ELSA-Brasil, a population-based cohort study with 15,105 civil servants aged 35–74 years. In this analysis, we included cross-sectional data from the baseline examination conducted from August 2008 to December 2010. Antioxidants consumption was measure by The Food Frequency Questionnaire (FFQ) using the Nutrition Data System for Research (NDSR) software. Depression disorder was accessed by a Clinical Interview Schedule Revised (CIS-R). The use of antidepressant drugs was recorded during a face-to-face systematic interview about use of continuous medication in the prior two weeks. Logistic regression models were built comparing two groups: DEP1 - no depression by CIS-R and no current antidepressants use, and DEP2 - depression by CIS-R or current use of antidepressant. Model 1 yield crude values and model 2 adjusted by age, sex and total energy. These analyses were carried out using the software Stata and P &amp;lt; 0.05 was considered significant. Results A total of 11.7% (n = 1761) of the sample was identified with depression by CIS-R or current use of antidepressants. Median antioxidant intake for DEP1 and DEP2 were respectively 434.76 mg and 419.73 mg for retinol; 196.84 mg and 193.87 mg for vitamin C; 9.30 mg and 9.03 mg for vitamin E; 192.24 μg and 189.24 μg for selenium, and 14.62 mg and 14.39 mg for zinc. In model 1, retinol (OR = 0.99, 95% CI = 0.99–0.99, P = 0.008) and vitamin E (OR = 0.99, 95% CI = 0.98–0.99, P = 0.036) intake levels were inversely associated with depression. In model 2 only retinol (OR = 0.99, 95% CI = 0.99–0.99, P = 0.011) intake was inversely associated with depression disorder. Conclusions A lower intake of retinol was significantly associated with more occurrence of depression or antidepressant use. Although the magnitude of ORs is small, these results suggest a possible protective effect on retinol intake against depression disorder. Funding Sources The ELSA-Brazil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Studies and projects financier and CNPq National Research Council).

Assessing Diet Quality of People with Parkinson’s Disease: Dietary Screening Tool Versus HEI-2015

Abstract Objectives To assess the diet quality of people with Parkinson's Disease (PwPD) using two assessment tools: Healthy Eating Index (HEI)-2015 and the Dietary Screening Tool (DST). HEI-2015 and DST scores were compared for alignment to explore associations between HEI-2015 and DST total scores and sub-scores. Methods This secondary data analysis utilized a total of 28 participants from two studies examining PwPD and their informal caregivers. Dietary data was collected with two 24-hour recalls using the multiple pass method and entered into the Nutrition Data System for Research (NDSR). SAS Version 9.4 was used to compute HEI-2015 scores to assess diet quality. The HEI-2015 score is a total of 100 points and is based on the Dietary Guidelines for Americans for 2015–2020. Total HEI-2015 scores and 13 component scores were interpreted using the graded approach (grades A-F). Radar graphs provide a visual representation. Participants also completed the DST. The DST is a 25-item questionnaire used to identify dietary patterns and assess nutritional risk. Total scores were categorized into at risk &amp;lt;60, possibly risk 60–75, and not at risk &amp;gt;75. Sub-scores were calculated with point classifications for specific food categories. These sub-scores were divided into tertials of recommended intakes less than 50%, 50–80% and 80–100%, and compared for alignment between DST sub-scores and HEI-2015 sub-scores by assessing total number of pairs per category. Results The mean total score was 59.4 ± 28.6 for DST and 58.7 ± 22.2 for HEI-2015. HEI-2015 scores fell into grades of A (n = 0) B (n = 3) C (n = 3) D (n = 7) F (n = 14). PwPD who were categorized at risk from the DST scores (n = 18) received an HEI grade of D/F. PwPD who were at possible risk (n = 7) received a grade of B/C/D. PwPD who were not at risk (n = 3) received a grade of B/C/D for sub-scores, vegetable intake had a 50% alignment in scores, fat/sugar 43% alignment, whole grains and dairy 46% alignment and fruit 39% alignment. Conclusions There appeared to be partial alignment between the total HEI-2015 scores and DST nutritional risk scores. Sub-scores differ 50% of the time. Due to differences between the assessment tools, more research is needed to validate the DST in PwPD as this can be a less taxing assessment compared with 24-hour recalls. Funding Sources There was no external funding for this study.