Poor Diet Quality Research Articles

Linear Programming Optimization of Local Food-Based Recommendations for Undernourished Urban Poor Malaysian Children Aged 2 to 5 Years.

Poor diet quality may contribute to undernutrition, particularly affecting young children from low-income households. Therefore, affordable and healthy local food-based recommendations (FBRs) are needed. This study aimed to (1) identify problem nutrient(s), (2) identify locally available nutrient-dense food sources that can provide adequate nutrients to meet the recommended dietary intakes of undernourished urban poor children aged 2-5 years, and (3) use linear programming to recommend a daily diet based on the current food patterns that achieves dietary adequacy and meets average food costs for these children. A cross-sectional study was conducted in Seremban, Malaysia. Three-day 24hour dietary recalls were collected from the mothers (n = 168). Food costs were estimated using market surveys. The FBRs were formulated by linear programming analysis using Optifood software. Folate was an "absolute problem nutrient" (such a nutrient does not achieve the 100% recommended nutrient intake even upon diet optimization). Full-cream milk, chocolate malted milk, fortified cornflakes, and chicken egg were the common locally available nutrient-dense foods that would provide adequate nutrients to meet the recommended dietary intakes of undernourished urban poor children. The final FBR set would ensure dietary adequacy for eight to nine of 11 nutrients at a cost of ringgit Malaysia (RM) 4.80/day (US $1.05/day) and RM6.20/day (US $1.34/day), depending on the age group. Interventions are required to ensure dietary adequacy for undernourished urban poor children under 5 years old. Dietary adequacy could be improved via realistic changes in habitual food consumption practices.

Association Between Chewing Capacity and Mortality Risk: The Role of Diet and Ageing.

Masticatory dysfunction due to tooth loss is a potentially modifiable risk for mortality, but the pathway behind that remains to be investigated. This prospective study aimed to examine the role of diet and ageing in the associations between chewing capacity and long-term mortality. Data were obtained from participants (aged ≥ 20) in the National Health Nutritional and Health Survey (NHANES 1999-2010, n = 22,900). The mortality follow-up ended on 31 December 2019. Chewing capacity was determined by the number of functional tooth units (FTUs). Diet information in NHANES was collected using a 24-h-recall questionnaire, and diet quality was measured by three index-based dietary patterns, namely the nutrition index (NI), energy-adjusted dietary inflammatory index (E-DII) and healthy eating index-2015 (HEI-2015). The biological ageing process was reflected using phenotypic age acceleration (PhenoAgeAccel) and frailty index. Mediation analyses were conducted to assess the role of diet quality in the association between FTUs and ageing, as well as the role of ageing in the association between impaired chewing capacity (ICC) and mortality. Participants with more FTUs were found to have a slower biological ageing process. Diet quality scores were estimated to mediate 9.0%-23.0% of the association between chewing capacity and biological ageing. Multivariable Cox proportional hazards regression models found a positive association between ICC and all-cause mortality (hazard ratio = 1.282 [95% confidence interval: 1.189-1.382]). Also, ICC was significantly associated with a 28.9% higher risk of mortality due to cardiovascular disease (CVD) and a 32.7% higher risk of mortality due to cancer. Mediation analyses indicated that PhenoAgeAccel mediated the effect of ICC on all-cause, CVD and cancer mortality with proportions of 18.1%, 17.3% and 12.5%, respectively. Similar mediating proportions were observed in the frailty index (range: 11.6%-23.5%). ICC was associated with poorer diet quality and accelerated ageing, resulting in higher mortality risk. Therefore, it is plausible that dietary interventions and oral rehabilitation would promote healthy longevity, although further investigations are needed.

Increased consumption of ultra-processed foods and worse diet quality in colorectal cancer patients after colostomy: A prospective study.

Colorectal cancer (CRC) is commonly treated with intestinal resections that lead to colostomy, which can influence changes in eating habits. This study aimed to analyze energy and nutrient intake, diet quality, and food consumption based on the processing level in CRC patients after colostomy. A prospective study was carried out at three time points (T0-recent colostomy, T1-3 months after colostomy, and T2-6 months after colostomy). Food intake was assessed by 24-hour dietary recall. Macro-micronutrient consumption, the Brazilian Healthy Eating Index-Revised (BHEI-R), and food consumption according to processing level by NOVA classification (raw or minimally processed, processed, and ultra-processed foods) were estimated. Generalized estimating equations were used to compare the food intake variables with time points. Of the 46 patients, 52.2% were women, and the mean age was 60.6±12.2 years old. There was a change in food consumption over time, with an increase in energy consumption (kcal and kcal/kg), lipids, and sodium, in addition to a reduction in some nutrients such as protein (g and g/kg), fiber, vitamin B1 and C and phosphorus. Regarding the key outcomes, BHEI-R and NOVA classification showed a poor diet quality with a reduction in total index (p = 0.022), raw food (p = 0.001), total fruits, and whole fruit consumption (p = 0.001), and an increase in sodium (p = 0.001) at 3 and/or 6 months after colostomy concomitant an increase in ultra-processed food (p = 0.015). Nutritional counseling is essential in care, effective eating changes habits improvement of symptoms and nutritional status, besides avoiding potential cancer recurrence.

Evaluation of dietary quality in patients with functional gastrointestinal symptoms: a Norwegian single centre study.

Poor dietary quality has been described as a contributor to symptoms in subjects with functional gastrointestinal (GI) symptoms. Hitherto, the focus in dietary evaluation and treatment in this patient group has mainly been on avoiding individual nutrient deficiencies, and less attention has been given to the dietary pattern and the overall food quality. Hence, we aim to describe and evaluate the dietary quality in patients with functional GI symptoms. Patients with GI symptoms and a diagnosis of irritable bowel syndrome or inflammatory bowel disease in remission, consecutively referred to a clinical dietitian for nutritional guidance, were included. All participants completed a 7-day weighed food record. The intake of foods, energy, macro- and micronutrients was computed. Dietary quality was evaluated by intake frequencies based on a predefined food index, combined with assessing achievement of nutrient intake recommendations. A total of 35 patients were included. Intake frequencies of red meat, cheese and sweets were high, whereas intake frequencies of green leafy vegetables, berries, nuts, whole grain and legumes were low. The total intake of vegetables, fruit, berries, fish and nuts was lower than current recommendations, and the intake corresponded to intake below recommendations for several micronutrients, including vitamins D, C and A; iodine; folate; potassium; and selenium. The group of patients with GI symptoms had overall inadequate dietary quality. Low intake of nutrient-dense food groups considered as beneficial for health corresponded with insufficient intake of several micronutrients. We recommend that dietary evaluation should focus on the intake of food groups, rather than nutrients, in the treatment of patients with functional GI symptoms, to ensure a better evaluation of dietary quality.

Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity

BackgroundHealth-related outcomes and behaviours in university students are known to be poor relative to the general population. The substantial contextual shifts related to the COVID-19 pandemic, combined with increased numbers of students from minoritised ethnicity backgrounds and presenting as trans and gender diverse (TGD), means that up-to-date information is unavailable. The primary aim of this study was therefore to characterise the current movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students and assess differences between genders and ethnic groups.MethodsAn online, self-report survey was administered across three years (2021–2023). Three independent cohorts of university students’ (n = 6,327) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders (men, women, TGD), and independent samples t-tests were used to assess differences between ethnic groups (White, Minoritised Ethnicity).Results30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥ 6 h·d− 1, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P < 0.05), with men having better mental health and engaging in healthier movement and sleeping behaviours, whereas women had more healthful dietary and drinking behaviours, and TGD students had poorer outcomes compared to cis-gender students in most domains. Differences between White and minoritised ethnicity students were present for all variables other than sedentary behaviour, diet quality, WPA and BMI (P < 0.05); students of minoritised ethnicity engaged in better movement, drinking and sleep behaviours in addition to having more positive mental health than White students.ConclusionThe findings of the current study provide an update on the landscape of UK university students’ health and health-related behaviours. Overall, health-related outcomes and behaviours are poor in this population and these data suggest that gender and ethnicity play a role in determining students’ health and health-related behaviours. Therefore, these factors should be considered when developing strategies to promote healthy living in the context of higher education.

Dietary diversity and its associated factors among adolescent girls in Ethiopia: a systematic review and meta-analysis

BackgroundEven though fragmented and inconsistent findings have been reported in Ethiopia, adolescence is a period of rapid growth following infancy and is severely affected by micronutrient deficiencies, food insecurity, and poor-quality diets. Therefore, the aim of this meta-analysis was to estimate the pooled prevalence of dietary diversity and its associated factors among adolescent girls in Ethiopia.MethodsInternational databases such as EMBASE, Hinari, Scopus, PubMed, Google Scholar, and direct Google searches were systematically used to search for articles and reports. The Newcastle-Ottawa Scale, modified as appropriate, was used for cross-sectional studies to assess the quality of the included articles and reports. A Microsoft Excel sheet was used for data extraction and then exported into STATA version 17 for further analysis. The pooled prevalence of dietary diversity was estimated using a random effects meta-analysis approach. Egger’s and Begg’s tests were employed to evaluate publication bias.ResultsThe pooled prevalence of minimum dietary diversity among adolescent girls in Ethiopia was 43% (95% CI: 30, 56) with significant heterogeneity (I2 = 99.2%, p = 0.00). Urban residence (OR: 2.46), mother being a government employee (OR: 2.31), attending a private school (OR: 6.24), adolescent having formal maternal education (OR: 4.49), adolescent having formal paternal education (OR: 3.26), father being a government employee (OR: 3.50), father being a merchant employee (OR: 2.51), middle family wealth index (OR: 1.76), household food security (OR: 3.96), receiving nutrition counseling (OR: 2.46), and higher meal frequency (OR: 7.35) were significantly associated with minimum dietary diversity.ConclusionThe pooled prevalence of dietary diversity among adolescent girls was low. Factors significantly associated with achieving minimum dietary diversity included urban residence, higher parental education and employment in government, private school attendance, household wealth, food security, receiving nutrition counseling, and higher meal frequency. These findings emphasize the need to improve dietary diversity among rural adolescent girls and food insecure households. Establishing nutrition counseling services could enhance understanding and skills related to a varied diet.

Dietary Patterns and Fibre Intake Are Associated with Disease Activity in Australian Adults with Inflammatory Bowel Disease: An Exploratory Dietary Pattern Analysis.

Few studies have explored the relationship between habitual dietary patterns and disease activity in people with Inflammatory Bowel Disease (IBD). This cross-sectional study explored the association between dietary patterns and clinical and objective markers of inflammation in adults from the Australian IBD Microbiome Study. Dietary patterns were derived using principal component analysis (PCA) of baseline food frequency questionnaire data. Food intake was quantified using 3-day food record data. Associations between dietary intake and both clinical disease activity index (CDAI) and faecal calprotectin (FCP) were analysed. Participants included 412 adults (IBD = 223, Healthy controls (HC) = 189). Both cohorts consumed poor-quality diets with inadequate servings of most food groups compared to Australian reference standards. IBD participants without FCP inflammation had significantly higher fibre intake than those with moderate FCP. In the Crohn's Disease group, high adherence to 'High plant diversity' and 'Meat eaters' dietary patterns were associated with increased CDAI and FCP, respectively. In the combined IBD cohort, high adherence to a 'Vegan-style' dietary pattern was associated with increased FCP. There is a need for dietary modifications among Australian adults, both with and without IBD, to improve dietary fibre intake and adherence to dietary guidelines. Dietary patterns characterised by a high intake of plant foods or meat products were both positively associated with indicators of active IBD. It is possible that some participants with active IBD were modifying their diet to try to manage their disease and reduce symptoms, contributing to the association between healthier dietary patterns and active disease. Further clinical and longitudinal studies are needed to expand upon the findings. This study offers a unique contribution by utilising FCP as an objective marker of intestinal inflammation and applying dietary pattern analysis to investigate the relationship between diet and inflammatory markers.

Associations Between Added Sugars Intake from Various Food and Beverage Sources and Diet Quality Among the U.S. Population.

Background: A diet high in added sugars has been linked to poor diet quality; however, little is known about specific sources of added sugars and their association with diet quality. Objective: This study examined associations between added sugars intake from specific food and beverage sources and diet quality, as indicated by the Healthy Eating Index (HEI) 2020 score, among the U.S. population. Methods: Data from eight consecutive 2-year cycles of the National Health and Nutrition Examination Survey (2003-2004 through 2017-2018) were pooled, and regression analysis was conducted to examine associations between total HEI-2020 score or HEI-2020 component scores and added sugars intake (% kcal) from key contributors: soft drinks, fruit drinks and coffee and tea; ready-to-eat cereals; flavored milk; sweet bakery products; and snack/meal bars. Results: A higher added sugars intake from soft drinks, fruit drinks and coffee and tea was associated with lower diet quality (lower total HEI score and lower scores on most of the HEI components) among both children and adults (p < 0.0001). In contrast, higher added sugars intakes from flavored milk (p < 0.0001) and snack/meals bars (p < 0.001) among children, and from sweet bakery products (p < 0.0001) among adults, were associated with higher diet quality. For all these associations, changes in the total HEI score across quintiles of added sugars intake were very small, ranging from 50.2 to 52.8 for children and 55.4 to 57.5 for adults, depending on the added sugars source. Conclusions: The nature of the relationship between added sugars intake and diet quality depends on the source of added sugars. While the small differences in diet quality may be of limited practical significance, our results suggest that the consideration of the different roles of various added sugars sources in the diet is warranted when developing dietary guidance.

ABC Grow Healthy Practices and Obesity-Related Health Behaviours in Family Child Care Homes in South Carolina.

Many states throughout the United States have introduced Quality Rating and Improvement Systems (QRIS) to address childhood obesity in preschool-age children, but few have examined the impact of these standards in Family Child Care Homes (FCCHs). In South Carolina, the ABC Grow Healthy Practices are specific QRIS items that include diet, physical activity and sleep practices. The purposes of this cross-sectional study are to (1) describe physical activity levels, sleep duration and diet quality of children attending FCCHs in South Carolina and (2) compare physical activity levels, sleep duration and diet quality between children attending FCCHs that were enrolled versus not enrolled in the ABC programme. Means and percentages were used to summarize child- and parent-level descriptive characteristics, physical activity levels, diet quality and sleep behaviours overall and by sex, race/ethnicity and ABC participation. t tests and chi-square analyses were used to compare child- and parent-level demographic characteristics as well as child-level behaviours by ABC status. Results revealed low physical activity levels (11.2 ± 4.1 min/h of total physical activity and 5.5 ± 2.6 min/h of moderate and vigorous physical activity) and poor diet quality (Healthy Eating Index 56.0 ± 10.3) in all children. There were statistically significant differences in fat and protein consumption between ABC and non-ABC FCCHs, as well as differences in demographic characteristics. Future research is recommended to assess whether strengthening guidelines and improving implementation of obesity prevention standards will improve physical activity levels and diets of children attending FCCHs.

Ultra‐processed food consumption and overweight in children, adolescents and young adults: Long‐term data from the Kiel Obesity Prevention Study (KOPS)

SummaryObjectiveThe aim was to assess ultra‐processed food (UPF) consumption, its impact on overweight and its association with weight trends from childhood and adolescence to young adulthood.MethodsLong‐term UPF consumption (13.3 years) by NOVA was analysed (children/adolescents and adults, n = 182) in the Kiel Obesity Prevention Study (KOPS, n = 10 750).ResultsIn children/adolescents (13.1 ± 1.9 years), a UPF‐based dietary pattern showed an inverse association with BMI‐SDS and fat mass index (males: r = −0.301, p = 0.01; r = −0.376, p = 0.001; females: r = −0.315, p &lt; 0.001; r = −0.282, p = 0.003). Longitudinal analysis indicated that UPF consumption in childhood and adolescence was correlated with UPF consumption in adulthood among females (r = 0.272; p = 0.004) but not among males. In young adults (26.7 ± 2.2 years), UPF consumption accounted for nearly 50% of daily energy intake and was higher with overweight compared to normal weight and in incident overweight compared to persistent normal weight (both p &lt; 0.05). High UPF consumption was associated with markers of poor diet quality (lower intake of fibre, higher intake of salt and energy‐dense food, all p &lt; 0.05).ConclusionsHigh UPF consumption in young adults was associated with both prevalence and incidence of overweight from childhood and adolescence to adulthood.

Prevalence of cardiovascular risk factors according to Life's Essential 8 in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis including 1 526 173 participants from 42 countries.

Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains. PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure. Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%-85.64%), inadequate physical activity 70.81% (95% CI 64.41%-76.83%), nicotine exposure 9.24% (95% CI 5.53%-13.77%) and sleep disorders 33.49% (95% CI 25.24%-42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%-20.04%), dyslipidaemia 1.87% (95% CI 1.73%-2.01%), diabetes 1.17% (95% CI 0.83%-1.58%) and elevated blood pressure 11.87% (95% CI 0.26%-36.50%). These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.

“We go hunting …”: Understanding experiences of people living with obesity and food insecurity when shopping for food in the supermarket to meet their weight related goals

The high prevalence of food insecurity in the United Kingdom has been exacerbated by the cost-of-living crisis. In high-income countries, those experiencing food insecurity struggle to buy and consume foods that meet Government healthy eating recommendations, and are at increased risk of obesity, linked to poor diet quality. Individuals in high-income countries purchase most of their food to consume at home from supermarkets, making this an important context within which healthier and environmentally sustainable food purchasing should be supported. However, the lived experience of supermarket food purchasing in people living with obesity and food insecurity has not been explored in depth. Adults, living in England and Scotland, who self-identified as living with obesity and food insecurity and looking to reduce their weight, were recruited to take part in semi-structured interviews (n = 25) or focus groups (n = 8) to explore their experience of shopping for food in the supermarket. Using thematic analysis, four main themes were generated: 1) the Restricted Consumer; restrictions around the type of food purchased, where food can be purchased and the resulting emotional toll, 2) the Conscious Consumer; decision making and effortful practices both in preparation of and during the shopping trip, 3) Mitigating the Rising Cost of Food; agency and actions taken to mitigate high food prices, 4) Stigma; instances of perceived and/or experienced weight and poverty-related stigma and the physical actions and cognitive social comparisons used to minimise stigma. Findings provide insights for evidence-based policy on the need for upstream changes within the wider food system to address the social determinants of health and support people living with obesity and food insecurity to eat healthier and more sustainable diets.

Association of Social Jetlag with the Dietary Quality Among Korean Workers: Findings from a Nationwide Survey.

Background/Objectives: Social jetlag, which refers to the misalignment between biological rhythms and social schedule, is linked to an increased risk of metabolic diseases. This cross-sectional study investigated the relationship between social jetlag and workers' dietary quality. Methods: This secondary data analysis included a sample of workers from the Korea National Health and Nutrition Examination Survey (n = 11,430). Social jetlag was determined by calculating the difference in the sleep midpoint between free days and workdays, based on sleep onset and offset times. The Korean Health Eating Index (KHEI) was calculated based on 24-h recalls, with higher scores indicating superior dietary qualities (range: 0-100). Poor dietary quality was defined as a KHEI below the lowest quartile (<51.6). Linear or logistic regressions were utilized to estimate β or odds ratio (OR), respectively. Results: Among study participants, 12.1% of workers experienced ≥120 min of social jetlag. ≥120 min of social jetlag was associated with a reduced KHEI score compared with 0-59 min (β: -1.23, 95% confidence interval [CI]: -2.16, -0.30). Those with ≥120 min of social jetlag were more likely to have poor dietary quality than those with 0-59 min (OR: 1.27, 95% CI: 1.08, 1.50). Conclusions: Workers experiencing ≥120 min of social jetlag had poorer dietary quality compared with workers with 0-59 min of social jetlag. Therefore, this study suggests that policy efforts are needed to reduce social jetlag among workers in Korea.

Associations of socio-demographic, environmental and parental factors, and nutritional status with fast food consumption among children aged 7-11 years old in Selangor

Introduction: This cross-sectional study examined fast food consumption and its associated factors among primary school children in Selangor. Methods: A total of 221 children aged 7-11 years from six randomly selected primary schools in Petaling Perdana, Gombak, and Hulu Langat participated in this study. Parents completed a self-administered questionnaire on socio-demographic characteristics, exposure to fast food advertising, home food availability, parental stress, attitude towards fast food, intake of fast food, and two-day dietary record of children. Height and weight of children were obtained from their school SEGAK records. Results: Mean age of children was 9±1 years. Mean days per week of fast food consumption among children was 3.2±1.6 days, with 45.7% consuming fast food for &gt;3 days/ week. Factors associated with frequent fast food consumption were children whose fathers had non-tertiary education levels (aOR 2.53, 95% CI 1.18–5.40), children with higher total screen viewing time (aOR 1.21, 95% CI 1.00–1.46), lower home food availability score (aOR 0.87, 95% CI 0.76–0.98), overweight and obese (aOR 2.38, 95% CI 1.23–4.60), requiring dietary improvements (aOR 4.03, 95% CI 1.36–11.98), and with poor diet quality (aOR 5.08, 95% CI 1.57–16.44). Conclusion: More than one third of the children consumed fast food for &gt;3 days/week. Screen viewing time and home food availability should be considered when promoting healthy diets among children. Future research should consider other potential factors associated with children’s consumption of fast food

Dietary Intake and Quality in Irritable Bowel Syndrome: A Comparative Study With Controls and the Association With Symptom Severity.

Patients with irritable bowel syndrome (IBS) often attribute the onset or worsening of gastrointestinal symptoms to intake of food. Hence, to alleviate symptoms, patients with IBS may avoid triggering foods, potentially impacting their dietary intake and diet quality. This study aimed to compare the habitual diet intake and quality of patients with IBS with controls and to explore the association between dietary habits and symptoms in patients with IBS. Patients with IBS were included in 4 clinical studies reporting habitual dietary intakes at baseline. Age- and sex-matched controls representing the general population were derived from the Swedish population-based Riksmaten study. Dietary intakes were assessed using 4-day food diaries. Diet quality was measured using the diet quality index-Swedish national dietary guidelines (DQI-SNR), and diet diversity was scored based on the variety of food groups consumed. The study included 646 patients with IBS and 646 controls (38 ± 14 years, 77% female). Both groups adhered to Nordic nutrition recommendations for macronutrients, except patients consumed fewer carbohydrates. Patients reported eating less carbohydrates, coffee, and dairy products and more fats, lactose-free dairy products, and nuts and seeds compared with controls. Fewer patients had a good diet quality according to the DQI-SNR. In patients, symptom severity and gastrointestinal-specific anxiety were associated with reduced energy and carbohydrate intake, lower diet diversity, and worse diet quality. Poor diet quality was associated with younger age, more severe IBS symptoms, anxiety, and depression. Patients with IBS exhibit different dietary patterns compared with controls, with poorer dietary habits linked to more severe symptoms. Understanding food-symptom associations may enhance the optimization and personalization of dietary management for patients with IBS.

Dietary Habits of Individuals With Primary Sclerosing Cholangitis-Poor Fat-Soluble Vitamin Intake and Dietary Quality.

Individuals with primary sclerosing cholangitis (PSC) have expressed a need for more dietary information. The aim of this study was to evaluate the dietary intake of individuals with PSC and compare it with Nordic nutrition recommendations 2023 (NNR2023). A cross-sectional assessment of dietary intake was performed using a food-frequency questionnaire among 120 individuals with PSC from five regions across Sweden. Macro- and micronutrient intake was compared to NNR2023. Dietary quality was evaluated using an index developed by the National Food Agency in Sweden. The median age was 47 years (IQR 18), and median body mass index (BMI) was 25.2 kg/m2 (IQR 5.9). Eight percent had a BMI < 20, and 13% had a BMI > 30. The average fibre intake was 18 g (IQR 18). Median energy distribution included 36% from fat (15% saturated, 4.6% polyunsaturated), 17% from protein and 43% from carbohydrates, highlighting an imbalanced diet with low carbohydrate, fibre and polyunsaturated fat intake and high saturated fat consumption. More than half reported suboptimal intake of zinc, selenium and vitamins C, D and K and > 30% suboptimal intake of vitamins A, B6, E, niacin, folate, potassium, magnesium and iron. Forty percent had poor dietary quality. Longer PSC duration and previous colectomy were associated with a lower dietary quality. Many individuals with PSC do not reach the recommended levels of various micronutrients, especially fat-soluble vitamins and report a poor dietary quality. The results highlight the need for a comprehensive approach to nutritional management in this population. ClinicalTrials.gov identifier: NCT04133792.

The Role of Fermented Vegetables as a Sustainable and Health-Promoting Nutritional Resource

The increasing global burden of morbidity and mortality from chronic diseases related to poor diet quality, coupled with the unsustainable depletion of vital planetary resources by current food production systems, threatens future food security and highlights the urgent need to transition to high-quality plant-based diets as a viable solution to mitigate economic, health, and environmental challenges. Taking into consideration the significant role that fermented vegetables may play as a sustainable, healthy, long-lasting, and plant-based nutritional resource, this narrative review analyzes their production and benefits. For this purpose, the mechanisms of the fermentation process are explored, along with the importance of probiotic cultures in plant-based fermented foods, and with the implications of fermentation on food safety within the broader framework of low-impact, organic, plant-derived nutrition. Additionally, the health benefits of fermented vegetables and probiotics are examined, including their effects on mental health. Vegetable fermentation is a versatile method for enhancing food preservation, nutritional quality, and safety. This ancient practice prolongs the shelf life of perishable items, reduces the toxicity of raw ingredients, and improves digestibility. Specific starter cultures, particularly lactic acid bacteria, are essential for controlling fermentation, ensuring safety, and maximizing health benefits. Fermented vegetables, rich in probiotics, support gut health and immune function. Emerging research indicates their potential to alleviate adverse mental health symptoms such as stress and anxiety, highlighting their significance in modern dietary guidelines and chronic health management.

Lipidomic Signature of Healthy Diet Adherence and Its Association with Cardiometabolic Risk in American Adults.

The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR). Self-reported information about diet and blood samples were obtained from 2114 adult participants in the Midlife in the United States study (MIDUS). Food intake data were used to design a Healthy Diet Index (MIDUS-HEI) and to evaluate the predictive value by examining its association with health variables. The associated lipid signature (HEI-LS) was constructed using Lasso regression, from lipidomic data (LC/MS). Associations between HEI-LS, cardiometabolic biomarkers, and estimated CVR were assessed using multiple linear regression. MIDUS-HEI score was a robust indicator of dietary quality and inversely associated with body mass index (p < 0.001) and metabolic syndrome (p = 0.012). A lipidomic signature comprising 57 distinct lipid species was highly correlated with the MIDUS-HEI score (r = 0.39, p < 10⁻16). It was characterized by lower levels of saturated fatty acid and adrenic acid (n-6) and higher levels of docosahexaenoic acid (n-3). Healthier HEI-LS scores were strongly associated with better cardiometabolic indicators and lower estimated CVR (OR 0.89 CI 95% 0.87-0.91). The MIDUS-HEI effectively assessed dietary quality, confirming the link between poor diet quality and metabolic disorders in American population. Lipidomic profiling offered an objective assessment of dietary patterns and provided insights into the relationship between diet quality, metabolic responses, and CVR. This approach supports precision nutrition strategies for at-risk populations.

Convergence of Alcohol Consumption and Dietary Quality in US Adults Who Currently Drink Alcohol: An Analysis of Two Core Risk Factors of Liver Disease.

Alcohol consumption and poor dietary habits are on the rise in the United States, posing significant challenges to public health due to their contribution to chronic diseases such as liver failure. While associations between alcohol consumption patterns and diet quality have been explored, the relationship between specific alcoholic beverage types and diet quality remains underexamined. This study aims to compare diet quality among consumers of different alcoholic beverage types. We conducted a cross-sectional analysis of 1917 current alcohol drinkers from the National Health and Nutrition Examination Survey (NHANES) who completed a 24 h dietary recall survey. Diet quality was assessed using the Healthy Eating Index (HEI), with higher scores indicating superior diet quality. Multivariable logistic regression models were employed to assess differences in HEI between consumers of various alcoholic beverage types, using wine-only drinkers as the reference group and controlling for demographic, socioeconomic, lifestyle, and metabolic syndrome variables. Beer-only drinkers were more likely to have lower income, higher rates of cigarette smoking, and insufficient physical activity compared to other alcohol consumers. In the fully adjusted multivariable model, beer-only drinkers had an HEI score that was 3.12 points lower than wine-only drinkers. In contrast, liquor/cocktail-only and multiple-type drinkers had similar HEI scores to wine-only drinkers. Beer-only consumption is associated with poorer diet quality among alcohol drinkers. Targeted patient education and public health campaigns may be effective in addressing the combined impact of alcohol consumption and poor diet quality on chronic disease risk.

Abstract 4136796: The effect of replacing typical snacks with pecans on vascular health and diet quality: a randomized controlled trial

Background: Poor diet quality accounts for approximately half of all deaths from cardiometabolic diseases. Food pattern modelling using nationally representative U.S. data suggests that replacing typical snacks consumed with tree nuts will improve diet quality. However, few clinical trials have assessed the potential for tree nuts to improve diet quality. Pecans are rich in polyphenols, which may improve endothelial and vascular function. This study aimed to examine how substitution of usual snack foods with 2 oz/day of pecans affects flow mediated dilation (FMD), carotid-femoral pulse wave velocity (cf-PWV), blood pressure and diet quality after 12 weeks in individuals at increased risk for cardiometabolic disease. Hypothesis: Intake of 2 oz/day of pecans in place of habitually consumed snacks will improve vascular health and diet quality compared to habitual intake. Methods: In this single-blind RCT, adults (46 ± 13 years, 29.8 ± 3.7 kg/m 2 ) with ≥1 criterion for metabolic syndrome who were free from cardiovascular disease, type 2 diabetes and other chronic diseases were included. The experimental group was provided with 2 oz/day of pre-portioned raw, unsalted pecans (~392 kcal) and instructed to replace the snacks they currently consume with the provided pecans. The control group was instructed to continue their usual diet. FMD (primary outcome), cf-PWV, brachial and central blood pressure were measured at baseline and following the intervention period (~12 weeks). At three timepoints (baseline, week 6, and week 12) during the study, participants completed three 24-hour recalls (total 9 recalls). The Healthy Eating Index-2020 (HEI-2020) was calculated to assess diet quality. Results: A total of 138 (69 per group) participants were randomized. No between-group difference in FMD, cf-PWV, or blood pressure was observed. The HEI-2020 was 11.1 points higher (95% CI 5.1, 17.2) in the pecan group compared to the usual diet group at week 12. The following HEI-2020 components were improved in the pecan group vs. the usual diet group: total protein foods (0.5 points [95% CI 0.1, 1.0]), seafood and plant proteins (2.5 points [95% CI 1.6, 3.4]), fatty acids (4.1 points [ 95% CI 2.6, 5.5]), and sodium (1.8 points [95% CI 0.3, 3.2]). Conclusion: Replacement of usual snacks with 2 oz of pecans improved adherence to the Dietary Guidelines for Americans but did not improve endothelial function, blood pressure, or arterial stiffening.