Dietary Patterns Of Population Research Articles

Rethinking Efforts to Improve Dietary Patterns Among Long-Haul Truck Drivers: Transforming Truck Stop Retail Food Environments Through Upstream Change.

A multitude of upstream occupational exposures influence poor dietary patterns that contribute to cardiometabolic health disparities among long-haul truck drivers in the United States. Herein, we delineate the unique characteristics of the truck driving profession that shape dietary patterns. Next, we discuss current health promotion efforts and why they are unlikely to be sufficient for improving population-level dietary patterns. We then advocate for prioritizing health promotion efforts that target upstream factors that influence population dietary patterns and have the potential to holistically and sustainably support drivers' nutrition. Finally, we propose novel research directions to catalyze upstream-oriented health promotion efforts.

Food composition databases in the era of Big Data: Vegetable oils as a case study.

Understanding the population's dietary patterns and their impacts on health requires many different sources of information. The development of reliable food composition databases is a key step in this pursuit. With them, nutrition and health care professionals can provide better public health advice and guide society toward achieving a better and healthier life. Unfortunately, these databases are full of caveats. Focusing on the specific case of vegetable oils, we analyzed the possible obsolescence of the information and the differences or inconsistencies among databases. We show that in many cases, the information is limited, incompletely documented, old or unreliable. More importantly, despite the many efforts carried out in the last decades, there is still much work to be done. As such, institutions should develop long-standing programs that can ensure the quality of the information on what we eat in the long term. In the face of climate change and complex societal challenges in an interconnected world, the full diversity of the food system needs to be recognized and more efforts should be put toward achieving a data-driven food system.

Obesity, public health ethics and the nanny state

Unhealthy dietary patterns are an important contributor to obesity and related non-communicable diseases (NCDs). As with any public health challenge, as well as providing care to affected individuals, whole-population interventions are required to mitigate the environmental determinants of population dietary patterns. The World Health Organisation (WHO) has established recommendations, including a set of low-cost, high-impact ‘best buys’ for governments seeking to implement these strategies. The Irish government has stated that it wishes to make ‘the healthy choice the easy choice.’ Yet, in marked contrast to its approach to tobacco- or alcohol-related harms, the Irish government has shown reluctance in implementing those WHO-endorsed strategies or other population-level measures to address unhealthy dietary patterns. Meanwhile, commercial interests work to discredit these measures as “paternalism” or more commonly as “nanny state” violations of individual liberty. We conducted a narrative review of the philosophical literature on paternalism, particularly the work of the 19th century philosopher John Stuart Mill, who originally formulated what became known as the ‘harm principle.’ Though an ardent defender of free trade and individual liberty, Mill argued that governments have a responsibility to limit the activities of commercial interests (such as taverns or gambling houses) where they encourage ‘excess’ that might harm the individual or society. The philosophical literature on paternalism gives strong arguments that government measures to limit potential public health harms arising from the consumption of unhealthy diets are not violations of individual liberty. On the contrary, governments are ethically obliged to make such interventions as are necessary to protect the liberty of individuals who are being misinformed and manipulated by industry. Rather than public health measures representing nannying by the state, we argue that they serve to counteract the ‘nefarious nannying’ by commercial actors, thus enhancing individual liberty rather than diminishing it.

Dietary Patterns Derived from UK Supermarket Transaction Data with Nutrient and Socioeconomic Profiles.

Poor diet is a leading cause of death in the United Kingdom (UK) and around the world. Methods to collect quality dietary information at scale for population research are time consuming, expensive and biased. Novel data sources offer potential to overcome these challenges and better understand population dietary patterns. In this research we will use 12 months of supermarket sales transaction data, from 2016, for primary shoppers residing in the Yorkshire and Humber region of the UK (n = 299,260), to identify dietary patterns and profile these according to their nutrient composition and the sociodemographic characteristics of the consumer purchasing with these patterns. Results identified seven dietary purchase patterns that we named: Fruity; Meat alternatives; Carnivores; Hydrators; Afternoon tea; Beer and wine lovers; and Sweet tooth. On average the daily energy intake of loyalty card holders -who may buy as an individual or for a household- is less than the adult reference intake, but this varies according to dietary purchase pattern. In general loyalty card holders meet the recommended salt intake, do not purchase enough carbohydrates, and purchase too much fat and protein, but not enough fibre. The dietary purchase pattern containing the highest amount of fibre (as an indicator of healthiness) is bought by the least deprived customers and the pattern with lowest fibre by the most deprived. In conclusion, supermarket sales data offer significant potential for understanding population dietary patterns.

Highlights from European Society of Cardiology Congress: a focus on nutrition

The relationship between nutrition and cardiovascular health has emerged over the past two decades. European Society of Cardiology has become a leading platform for discussion. This article encompasses the main findings of a multitude of studies presented at ESC. The assessment of population dietary patterns should include the data on the profile of food and nutrients as well as their lifestyle, socio-economic status, the quality of products, and macronutrients replacement. The study design aimed at assessing dietary patterns nutrition should be a prospective long-term study focusing on collecting the data on ethnic and socio-economic components as well as the data suggesting the adherence to a particular dietary pattern.

Trends in the dietary patterns of Mexican adults by sociodemographic characteristics

BackgroundSociodemographic characteristics are associated with the dietary patterns of populations. However, the direction of the association is not consistent among countries: it is contingent on the nutritional transition phase, level of economic development, cultural contexts and both the social and health policies prevailing in each country. The objective of this study was to identify the trends in dietary patterns observed in 2006, 2012 and 2016 among Mexican adults by sociodemographic characteristic.MethodsTo determine and compare dietary patterns, we performed a secondary analysis of dietary and sociodemographic data for adults 20–59 years old. Data were drawn from the 2006 and 2012 National Health and Nutrition Surveys (ENSANUTs) together with the 2016 Half-Way National Health and Nutrition Survey (ENSANUTMC). To estimate the dietary patterns, we used an adapted version of the Healthy Eating Index-2015 (HEI-2015) and a quantile-based regression model to compare the HEI medians by sociodemographic characteristic.ResultsFrom 2006 to 2016, the quality of the diet of Mexican adults scored under 50 points on a scale of 0 to 100, markedly below the maximum scores for the majority of HEI-2015 components. Diet quality varied according to age, sex, socioeconomic status (SES), area (urban/rural) and region of residence, with the highest quality observed among older individuals (within the 40–59 age group), women, people of lower SES and residents of rural areas, particularly in southern Mexico. Although this trend remained constant overall throughout 2006, 2012 and 2016, specific HEI-2015 components showed an opposite trend by sociodemographic strata.ConclusionThe diet quality of Mexican adults was suboptimal from 2006 to 2016, with notorious disparities persisting over time among sociodemographic strata. Our results can serve as a basis for formulating recommendations on ways to improve the population diet, where those components diverging the most from adequate scores could be highlighted in public-health messages.

Empirical dietary patterns and their influence on health in epidemiological studies

The last two or three decades in the epidemiology of nutrition empirical approaches to assessing the diet of the population are increasingly being used. However, in Russian studies, these approaches are used extremely rarely, which may be due to insufficient knowledge of the essence, methodological aspects and the field of application of posterior dietary patterns. In this regard, the aim of this review was to highlight the essence, methods and main results of using empirical approaches to assessing the diet of the population. Results. This review discusses the main methodological features of multivariate analysis methods - factor analysis (principal component analysis) and cluster analysis. The main trends of dietary patterns characteristic of the epidemiology of nutrition, and various in different countries and regions are shown. The results of studies of the impact of dietary patterns on some indicators of health status (cardiovascular and oncological diseases, diseases of the musculoskeletal system, diabetes mellitus, metabolic syndrome and its components, mortality) are considered. A brief description of the few Russian studies that used the principal component method in identifying empirical dietary patterns of population is given. In general, this review indicates that the use of multidimensional statistics to highlight population dietary patterns as part of an empirical assessment is nowadays one of the most important components of nutrition epidemiology in different countries. An empirical assessment allows us to consider the diets of the population from a factual point of view and significantly supplements the scientific knowledge obtained using other epidemiological approaches. Currently, considerable experience in the development of methodological approaches to dietary patterns, as well as in the analysis of their associations with various indicators of health status has been accumulated. Conclusion. All this testifies to the high relevance of the considered epidemiological approaches and the need for their testing in Russian conditions, which, perhaps, will give new knowledge about the dietary patterns formation and its impact on the health status of Russians.

Adherence to WHO’s nutrition recommendations in the UK: Dietary patterns and policy implications from a national survey

Analysis of dietary patterns has largely focused on their association with diseases or risk factors, but limited research has been conducted on the heterogeneity of population dietary patterns and their adherence to international or national nutritional guidelines. As a result, the aim of this study is to identify latent dietary patterns of UK residents and to assess how well different segments comply with WHO dietary norms.To achieve this objective, the UK’s National Diet and Nutrition Surveys for 2011–12 dataset was analysed performing a latent class analysis on energy (kcals) derived from selected food groups. To assess adherence to different dietary patterns of the British population to nutritional guidelines, a traffic light system and a composite conformity index were developed to establish how well the identified segments comply with current dietary WHO norms regarding salt, free sugars, total fat, saturated fat, fruit and vegetables and dietary fibre.Results show four different segments which on the basis of heterogeneity of dietary patterns were named ‘high sugar/high fat consumers’, ‘prudent eaters’, ‘high fat consumers’ and ‘junk food eaters’. These segments show significant differences within and between groups in terms of dietary calories intakes and their adherence to WHO norms. Although ‘prudent eaters’ are closer to WHO dietary guidelines than other segments, none of the identified segments fully comply with dietary WHO norms. Policy implications of these findings are fully discussed in the conclusions arguing how current, future and potential dietary demand and supply measures affect consumers’ compliance with WHO norms.

PP57 Effectiveness of policy actions to improve population dietary patterns and prevent diet related non-communicable diseases: scoping review

Background Non-communicable diseases (NCDs) cause over two thirds of all global deaths. Poor diet generates more NCD and disability than tobacco, alcohol and physical inactivity combined. Worldwide, many different policy options have been proposed to promote healthier eating and prevent diet related NCDs. However, these options are diverse and potentially confusing. A key policy question is thus: how can diets best be improved to prevent NCDs nationally and globally? We reviewed the potential effectiveness of policy actions to improve healthy eating and thereby prevent NCDs. Methods We searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy. We focussed on systematic and non-systematic reviews dating from January 2004 onwards, containing quantitative outcomes. Retrieved studies were screened independently by two researchers. A PICOS approach (Participants, Interventions, Comparators, Outcomes and Study design) was used to assess the retrieved studies that fulfilled the criteria. Extracted data were categorised using an updated version of the ‘4Ps’ marketing framework: Price; Promotion; Provision; Product (adding Supply Chain, Trade and Investment; and Multi-component interventions). Results After screening 1800 candidate publications, 57 systematic and non-systematic reviews were identified for inclusion in the review. Eight reviews provided information on more than one category. Thus, 19 papers provided data on food price interventions; 10 food promotion, 10 food provision, 2 food composition, 6 food labelling, 6 food supply chain, trade and investment, and 4 for multi-component interventions. Price interventions appeared to be consistently very effective in improving healthy eating, both taxing unhealthy foods and subsidising healthy options such as fruit and vegetables. Product interventions, especially elimination of trans-fat and salt reduction, and comprehensive strategies involving multi-component interventions also proved powerfully effective in improving healthy eating and preventing NCDs. Food Supply Chain and Trade and Investment studies reporting potential negative health effects of market liberalisation and globalisation appear potentially powerful and merit further research. Other interventions, particularly reformulation, labelling, restrictions on the provision or marketing of unhealthy food also tended to improve healthy eating and prevent NCDs. However, their effectiveness was often limited and their sustainability was rarely studied. Conclusion Increasingly strong evidence is now highlighting potentially powerful policies to improve diet and prevent NCDs, especially taxes, subsidies, reformulation, multi-component interventions and possibly also trade agreements affecting food supply chain. The other interventions appear to be, at best, modestly effective in the short term.

Vitamin and mineral supplements: regulation, consumption, and health implications

Micronutrient supplementation to reduce nutritional deficiencies has grown in recent years due to changes in the population's dietary patterns. Widespread preoccupation with health, ease in marketing vitamin and mineral supplements, and strong advertising appeal have encouraged increasing consumption of these products, thereby posing health risks. The current study addresses legislation, consumption, and health risks related to vitamin and mineral supplements in Brazil. The Brazilian legislation on dietary supplements is complex. Studies on their consumption by the Brazilian population are limited, and inappropriate use due to gaps in knowledge poses a potential health risk to the population. The study concludes that public policies are needed to raise awareness on this topic among the general public, health professionals, and sales personnel.

Shifts in population dietary patterns and physical inactivity as determinants of global trends in the prevalence of diabetes: An ecological analysis

Background and aimsThe worldwide epidemiology of diabetes is rapidly changing as a result of the spreading of westernised nutritional and lifestyle habits. We conducted an ecological analysis to identify dietary, lifestyle and socio-economic factors associated with global diabetes prevalence. Methods and resultsCountry-specific estimates of diabetes prevalence were obtained. Data were then matched to year- and country-specific food and energy availability for consumption, and to year-specific information on obesity, physical inactivity, urbanisation, gross domestic product (GDP), and smoking. Data were obtained from publicly available databases compiled by the Food Agricultural Organisation (FAO), World Health Organisation (WHO) and World Bank. Cluster analysis was used to derive dietary patterns of global food consumption. The association with diabetes prevalence was evaluated. Stepwise multiple regression analysis was conducted to identify predictors associated with worldwide diabetes prevalence.96 countries were eligible for inclusion in the analysis. The average diabetes prevalence was 7.0% and the highest rate was observed in the Middle-Eastern region (13.1%). The worldwide prevalence of obesity and physical inactivity was 15.1% and 36.1%, respectively. Diabetes prevalence was associated with age and physical inactivity prevalence in a fully adjusted multiple regression model. Three dietary patterns (agricultural, transitional and westernised) were identified by the cluster analysis. Diabetes prevalence showed a direct dose–response association with the degree of exposure to a westernised dietary pattern. ConclusionsThe adoption of sedentary lifestyle and westernised dietary patterns appears to be closely linked to the global rise in diabetes prevalence.

Confirmatory factor analysis in nutrition and obesity research: Beyond dietary patterns

Confirmatory factor analysis (CFA) is primarily used for determining population's dietary patterns in nutritional epidemiological studies. However, CFA also allows substitution of easily attained variables (BMI, girth circumferences) to represent a variable otherwise measured with expensive equipment by certified staff (e.g. DXA). Our objectives were to: 1. Provide example of a model for adiposity determination in 189 postmenopausal, overweight women utilizing CFA; 2. Determine the strength of association between latent construct “adiposity” and total body fat percent (%fat) measured by iDXA as reference. Mplus Editor (v5) was used for the analysis with following: waist/hip circumference, BMI, %IBW. The construct was compared with %fat (iDXA). Model fit indices include chi‐square test (χ2), root mean square error or approximation (RMSEA), comparative fit index (CFI), and Tucker‐Lewis index (TLI). RMSEA/SRMR≥0.8 and CFI/TLI ≤0.90 or 0.95 indicates poor fit. Model fit indices (χ2=13.48, df=7, RMSEA=.10, SRMR=.03, CFI=.99, TLI=.98) were optimal and the latent construct “adiposity” significantly correlated with %fat (r=.20, p=.05). Each of the body adiposity indicators alone has certain limitations but based on this analysis, they may be more informative when used in combination as a defined latent construct and therefore substitute for less easily obtained variables.USDA/CSREES/NRI#2004‐05287Grant Funding Source: USDA

FOOD PRODUCTION, POPULATION DIETARY PATTERNS AND CLIMATE CHANGE

Background and Aims: Substantial evidence exists linking food production and environmental degradation. Often overlooked is the interconnection between food consumption patterns at the population level and climate change. The aim of this study was to compare the greenhouse gas (GHG) emissions (CO2, CH4, and N2O) from current agricultural operations to produce the foods actually consumed by a health-oriented population of vegetarians and nonvegetarians. Methods: Food consumption patterns of vegetarians were compared with nonvegetarians by using data from the Adventist Health Study, a cohort of 34,000 California Adventists, of which 45% were vegetarians. Consumption of 10 foods of a 50 food-item questionnaire were significantly different between the two dietary groups. Using primary agricultural data from California and published emission factors, we estimated CO2 emissions associated with three production inputs: primary energy, pesticides, and fertilizers, utilized to produce each of the ten foods, including the production of the feed given to animals. We also quantified emissions for CH4 from ruminant digestion and manure handling and storage, and N2O from crop N fertilization and animal waste management. Results: Production of the plant foods consumed by the average vegetarian results in greater emissions compared to nonvegetarians: 35 versus 27 Kg of CO2-eq/yr. Conversely, the per capita consumption of animal foods by vegetarians results in much less emissions compared to nonvegetarians: 19 versus 475 Kg of CO2-eq/yr. Overall, the per capita difference in annual emissions is 449 Kg of CO2-eq greater for the nonvegetarian diet. Conclusions: These findings support the hypothesis that plant-based diets have markedly lower GHG emissions and thus less global warming potential than meat-based diets, although exceptions may occur in relation to some agricultural practices, transportation and processing. Daily food choices of large segments of the population may ultimately result in major impacts on the environment and have public health consequences.

Performance of a Method for Identifying the Unique Dietary Patterns of Adult Women and Men: The Framingham Nutrition Studies

Background Identification of population dietary patterns has been recommended by experts as a key to developing innovative and targeted nutrition interventions and achieving long-term dietary behavior changes for health promotion and chronic disease risk reduction. Essential in this task is the evaluation of methods to accurately identify these unique dietary patterns. Objective To evaluate the validity and test the performance of a method for classifying adult men and women into one of five a priori dietary patterns. Design The first examination of Framingham Nutrition Studies took place between 1984 and 1987 and included 1,828 women and 1,666 men who completed the Framingham semi-quantitative food frequency questionnaire. Five unique dietary patterns for each sex were identified. Here we used Fisher's discriminant functions to create classification algorithms for identifying the dietary patterns of new individuals. Its validity and performance was evaluated using a variety of statistical tools. Results The new Framingham Dietary Pattern algorithm classified about 80% of women or men correctly and κ statistics exceeded 0.70. The cluster-specific sensitivities ranged from 0.70 to 1.00 and specificities were all >0.88. The pooled conditional c statistics were 0.95 and 0.96 for women and men, respectively. Overall, we can be confident that our methodology offers a valid identification of male and female dietary patterns when applied in practice. Conclusions The Framingham Dietary Pattern technique is a valid and reliable method for identifying the unique dietary behavior of adults. Our approach can also be used to guide the development and evaluation of other composite dietary quality indices.

Mortality and incidence trends from esophagus cancer in selected geographic areas of China circa 1970-90.

China was one of the countries with the highest esophagus cancer risk in the world during the 1970s. This report provides data on time trends of esophagus cancer incidence and mortality during the 1970s-90s in selected geographic areas of China. Information on newly diagnosed cancer cases and cancer deaths is based on data collected by local population-based registries and Disease Surveillance Points (DSP). For the whole country, esophagus cancer mortality decreased slightly, 17.4 per 10(5) populations during 1990-92 in contrast to 18.8 per 10(5) populations in 1973-75. In the Linxian area, trends in the incidence and mortality rates for esophagus+gastric cardia cancer reversed over time; incidence rates increased significantly during 1959-72 but were decreased significantly on average -2.26% (95% Confidence Interval [CI]: -1.74, -2.77) and -1.10% (95% CI = -0.58, -1.62) per year for males and females, respectively, during 1972-97. In urban Shanghai, incidence trend for esophagus cancer decreased monotonically and significantly on average by -4.99% (95% CI = -4.28, -5.70) and -5.18% (95% CI = -4.99, -5.70) per year for males and females, respectively. In Nanao islet, esophagus+gastric cardia cancer mortality rates increased during 1970-82 but decreased slowly from 1982-99 (-0.96% per year; 95% CI = -0.14, -1.78). Our study indicates that incidence and mortality rates for esophagus or esophagus+gastric cardia cancer are now decreasing in China. The declines may be due to an unplanned success of prevention, such as changes in population dietary patterns and food preservation methods.

Validation of a Dietary Pattern Approach for Evaluating Nutritional Risk: The Framingham Nutrition Studies

Objective To validate the use of cluster analysis for characterizing population dietary patterns. Design Cluster analysis was applied to a food frequency questionnaire to define dietary patterns. Independent estimates of nutrient intake were derived from 3-day food records. Heart disease risk factors were assessed using standardized protocols in a clinic setting. Setting Adult women (n= 1,828) participating in the Framingham Offspring-Spouse study. Statistical analyses Age-adjusted mean nutrient intakes were determined for each cluster. Analysis of covariance was used to evaluate pairwise differences in intake across clusters. Compliance with published recommendations was determined for selected heart disease risk factors. Differences in age-adjusted compliance across clusters were evaluated using logistic regression. Results Cluster analysis identified 5 distinct dietary patterns characterized by unique food behaviors and significantly different nutrient intake profiles. Patterns rich in fruits, vegetables, grains, low-fat dairy, and lean protein foods resulted in higher nutrient density. Patterns rich in fatty foods, added fats, desserts, and sweets were less nutrient-dense. Women who consumed an Empty Calorie pattern were less likely to achieve compliance with clinical risk factor guidelines in contrast to most other groups of women. Conclusions Cluster analysis is a valid tool for evaluating nutrition risk by considering overall patterns and food behaviors. This is important because dietary patterns appear to be linked with other health-related behaviors that confer risk for chronic disease. Therefore, insight into dietary behaviors of distinct clusters within a population can help to design intervention strategies for prevention and management of chronic health conditions including obesity and cardiovascular disease. J Am Diet Assoc. 2001;101:187-194.

Development of a diet history questionnaire for studies of older persons

This paper describes the criteria of a simplified diet history method and the procedures for developing a dietary questionnaire for studies of older persons. Suggestions are included on selecting food items representative of the population's dietary patterns, designing objective methods to estimate quantitative and frequency intakes of food items, and collecting information on other dietary practices. Potential problems in dietary surveys among older persons are discussed, along with their prevention or alleviation.