Food Group Recommendations Research Articles

Food choice, embodied knowledge and circumscribed agency: factors influencing adolescent girls' and boys' dietary practices in three states in northern Nigeria.

The objective of this study was to explore adolescent dietary practices, related norms and acceptable communication platforms in northern Nigeria to inform future nutrition project design. This was a qualitative formative research study. We used purposive sampling and conducted thirty focus group discussions with male and female adolescents aged 10-14 and 15-19 years (n 180) and six with adult influencers (n 36). We also administered a 24-h dietary recall with the adolescents using the Diet Quality Questionnaire. The study was conducted in urban and rural areas in three states in northern Nigeria. Adolescents reported consuming six nutritious food groups the previous day on average. However, there was a wide disparity and only half consumed all five recommended food groups. Adolescents' food choices were influenced by perceptions of the functional and physical benefits of nutritious foods and preferences for satisfying foods. Diverse foods were available in the food environment, but affordability constrained access to nutritious foods. Limited access to income and gender norms constrained adolescent agency over food choice. Girls, particularly those who were pregnant, had less agency related to food than boys. Adolescents thought that peers should be reached through group discussions, radio and phones, among other communication platforms. Adolescents consumed relatively diverse diets. Adolescent food choice was influenced by their embodied experience and knowledge related to nutrition and taste, home food environment and circumscribed agency. Opportunities exist to support healthy diets for adolescents by strengthening adolescents' embodied knowledge, food environments and social support.

Healthiness, processing, and price discounts of foods advertised in supermarket flyers in Buenos Aires, Argentina

Introduction: The food environment, encompassing factors such as food availability, advertising, and promotions, can significantly impact dietary choices. The main objective of this study was to characterize the profile of the advertised products in relation to the food groups defined by the Dietary Guidelines for the Argentine Population (GAPA), the degree of processing and their price discounts. Methods: This cross-sectional study analyzed 4355 promotions of foods and beverages in supermarket circulars from seven supermarket chains over an 8-week period in Buenos Aires. Foods were classified into four categories based on the GAPA: 1) core food groups and water, 2) "optional" products (those to be limited), 3) alcoholic beverages, and 4) other foods. Additionally, NOVA classification was used to assess the degree and purpose of processing. The minimum purchase amount required for the discount and the unit price discount were analyzed by food group and degree of processing. Results: Only 37.0% of advertised food products were from the core recommended food groups, while 45.3% and 11.7% were "optional/discretionary" products and alcoholic beverages. In addition, 56% of the food and non-alcoholic beverage promotions included ultra-processed (UP) products. The minimum purchase amount to obtain a discount and relative discounts were higher for "optional" products (p<0.001) and UP (p<0.001) compared to staple food groups and unprocessed or minimally processed foods, respectively. Conclusions: Most advertisements and price promotions found in supermarket circulars were for UP and items that the GAPA recommend limiting, suggesting an environment that is conducive to promoting unhealthy eating behaviors. Funding: International Development Research Center (IDRC; grant Number IDRC 108643-001).

Baseline diet quality of participants in AU‐ARROW trial based on adherence to the MIND diet recommendations

AbstractBackgroundThe Mediterranean‐Dietary Approaches to Stop Hypertension (MIND) diet is rich in leafy green vegetables, legumes, berries, wholegrains, fish, nuts, and olive oil and low in red and processed meats and discretionary foods (high in saturated fat, added sugar and added salt). Following a MIND diet is associated with a reduction in risk of cognitive decline and dementia. The lifestyle intervention known as the AUstralian multidomain Approach to Reduce dementia Risk by prOtecting brain health With lifestyle intervention study (AU‐ARROW) is undergoing recruitment of participants. Here we report on the dietary quality of participants to date, based on their adherence to the MIND diet.MethodA self‐administered MIND diet questionnaire was completed by participants in the online REDCap platform as part of the screening surveys to determine participant eligibility into the AU‐ARROW trial. Eligible participants were required to have a ‘poor diet’, which was a MIND diet score of ≤9 out of a maximum MIND diet score of 14. Comparative statistical analyses were conducted to determine the differences in dietary quality between eligible and ineligible participants.ResultFrom the 39 participants who were screened to date, 16 participants were ineligible, and 23 were eligible. Ineligible participants had a higher total MIND diet score (mean = 10.5(SD = 0.6)) compared with eligible participants (mean = 7.5(SD = 1.8)). For ineligible participants, there was greater proportion adhering to MIND diet recommendations for fish, nuts, and poultry. No eligible participants adhered to MIND diet recommendations for leafy green vegetables, berries, and wholegrains. There was general compliance to recommendations for red meat and butter intake among both groups, but a smaller proportion of eligible participants adhered to the MIND diet recommendations for fried foods, sweets, and cheese, compared to ineligible participants.ConclusionOverall, improvements to the diet quality of both eligible and ineligible participants are required. Particularly for participants eligible to the AU‐ARROW trial, a focus on improving adherence to core food group recommendations are required not only for cognitive health but also for general health and prevention of other chronic diseases. Education and counselling from dietitians are critical for supporting participants in dietary behaviour change.

Dietary supplements, guideline alignment and biochemical nutrient status in pregnancy: Findings from the Queensland Family Cohort pilot study.

In high-income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate.

Association of category of dietary intake and physical activity with the risk of mortality in patients with type 2 diabetes mellitus: a prospective cohort study

Objective: To investigate the association between dietary intake and physical activity category and their combined effects on all-cause and cause-specific mortality risk in patients with type 2 diabetes mellitus (T2DM). Methods: Between December 2013 and December 2021, a prospective cohort study was conducted on 19 863 T2DM patients in Changshu City, Qingjiangpu District (formerly Qinghe District), and Huai'an District, included in the national basic health service management. Information on deaths and underlying causes of death was obtained from the Jiangsu Provincial CDC and Prevention Death Surveillance System. Cox proportional hazards models were used to estimate the intensity of associations between dietary intake, physical activity, and their combined effects with all-cause and cause-specific mortality in patients with T2DM. Results: As of December 31, 2021, the research subjects had been followed up for 150 283 person-years, with a median follow-up time of 8.15 years. During the follow-up period, 3 293 people died, including 1 124 deaths from cardiovascular disease (CVD) and 875 deaths from cancer. Cox regression analysis showed that compared with the population of 0-1 recommended food group, those having more than five recommended food groups had a 19% lower risk of all-cause mortality [hazard ratio (HR)=0.81, 95%CI: 0.70-0.94] and a 33% lower risk of all-cause mortality (HR=0.67, 95%CI: 0.52-0.87). Compared with the T2DM population in the physical activity Q1 group, the risk of all-cause mortality, CVD mortality, and cancer mortality among the physical activity Q4 group reduced by 50% (HR=0.50, 95%CI: 0.45-0.56), 50% (HR=0.50, 95%CI: 0.41-0.61), and 27% (HR=0.73, 95%CI: 0.60-0.88), respectively. The combined effect showed that compared with the population in the intake of food categories 0-2 and low physical activity groups, the risk of all-cause, CVD mortality, and cancer mortality in the intake of food categories 4-9 and high physical activity groups reduced by 55% (HR=0.45, 95%CI: 0.38-0.53), 56% (HR=0.44, 95%CI: 0.32-0.59), and 40% (HR=0.60, 95%CI: 0.44-0.82), respectively. Conclusion: Type of dietary intake, physical activity, and their combined effects are associated with a reduced mortality risk in patients with T2DM.

P14-037-23 Are Recommended Food Groups Adequately Represented in Commercial Meal Kits in the US?

P14-037-23 Are Recommended Food Groups Adequately Represented in Commercial Meal Kits in the US?

Dietary Patterns of Competitive Swimmers with Moderate-to-Severe Cerebral Palsy: A 3-Year Longitudinal Evaluation.

To evaluate the longitudinal dietary patterns of three adolescents with moderate-to-severe cerebral palsy (CP) participating in a performance-focused swimming training intervention. Participants were three previously inactive adolescents with CP (15-16 years, GMFCS IV) who had recently (<6 months) enrolled in a swimming training program. Diet quality from diet histories was calculated at 10-time points over 3.25 years using the Dietary Guidelines Index for Children and Adolescents (DGI-CA) and the Healthy Eating Index for Australian Adults (HEIFA-2013). A food group analysis was compared to the Australian Guide to Healthy Eating recommendations. Trends were considered in the context of dietary advice given and the training load. Longitudinal diet quality scores were consistent and ranged from 40 to 76 (DGI-CA) and 33 to 79 (HEIFA-2013). Food group intake remained stable; participants rarely met the recommendations for fruit, vegetables, dairy, grain, and meat but frequently achieved discretionary serves. Participants with moderate-to-severe CP who were enrolled in a performance-focused swimming training intervention and were monitored frequently maintained diet quality throughout a period where it conventionally declined. Scores were higher than the general population and were maintained irrespective of the training load. Participants frequently met food group recommendations for discretionary foods and were comparable to the general population for other food groups.

Eating Patterns of Young Women (18-25 y) with Overweight and Obesity: A Preliminary Investigation.

Overweight and obesity impact up to 40% of young women in Australia; however, young women are challenging to recruit to research and are rarely the focus of weight loss interventions. This study aimed to examine dietary patterns in young women (18-25 years; BMI > 25 kg/m2). An analysis of participants' (mean age: 22.6 year; BMI: 32.2 kg/m2) 3-day food records found young women with overweight/obesity consumed a diet characterised by total energy intake of 9174 (2526) kJ/day, with the first meal at 9:12 am (range: 4:30 am-12:40 pm), the last at 10:43 pm (range: 2:40 pm-2:00 am), and an average eating window of 11.5 h. Young women had poor quality diets, which did not meet dietary recommendations for most core food groups, and high intake of refined carbohydrates. They also reported consuming at least one takeaway meal per day and >30% of total energy intake was from discretionary items. The findings showed that young women with overweight or obesity consume most of their energy intake in the afternoons and late into the evenings and have poor-quality diets with high-discretionary intake, each of which have been shown in previous work to be associated with increased weight and risk of metabolic comorbidities. While these findings require further examination in larger groups with both qualitative and longitudinal data collection to verify the impact of these eating patterns on weight maintenance, the eating behaviours identified here may present a suitable target for novel weight loss interventions in young women, who are an understudied population group in need of tailored weight management solutions.

Adherence to Federal Dietary Recommendations for Total Fruit Consumption and the Intake of Underconsumed Nutrients: Findings from the National Health and Nutrition Examination Survey, 2015 to 2018

BackgroundA persistent gap exists between U.S. consumers’ actual fruit consumption and Federal dietary recommendations for fruit. Individuals who most deviate from recommendations may be at a greater risk of underconsuming some nutrients. ObjectiveWe investigated how widely total fruit consumption varies across adult consumers and whether those who most deviate from recommendations also consume less vitamins A and C, calcium, magnesium, and potassium. The 2020 Dietary Guidelines Advisory Committee has identified each of these nutrients as being underconsumed by the U.S. population in general. MethodsData used were from the NHANES, 2015 to 2016 and 2017 to 2018 cycles. For 9832 adults (age >18), we compared their total fruit consumption to recommendations for their age and sex. We also calculated 2015 Healthy Eating Index (HEI-2015) scores. Component scores for Total Fruit and Whole Fruit were subtracted from the total HEI-2015 scores to measure adherence with dietary recommendations outside the fruit group. Two-way and 3-way contingency tables were then used to measure the association between adherence to fruit recommendations and the intake of underconsumed nutrients before and after controlling for adherence to other food group recommendations, respectively. ResultsAbout two-thirds of adults eat less than half the recommended amount of fruit on any given day. Those who routinely unconsume fruit may be at a greater risk of underconsuming potassium and vitamin C. Calcium, magnesium, and vitamin A consumption do not show a consistent relationship with fruit intake relative to recommendations after controlling for diet quality outside the fruit group. ConclusionsThere is much variation across the U.S. population in fruit consumption relative to recommendations. The present study suggests that individuals who deviate the most are at a particularly increased risk of underconsuming vitamin C and potassium.

Low Dietary Diversity for Recommended Food Groups Increases the Risk of Obesity among Children: Evidence from a Chinese Longitudinal Study.

The association between dietary diversity and childhood obesity remains unclear; therefore, this longitudinal study was conducted to analyze the effect of dietary diversity on childhood obesity. One year after the first investigation, a follow-up was completed in 2010. A total of 4538 participants were included for analysis. Dietary diversity scores were calculated based on the consumption of nine recommended food groups which were categorized in accordance with the 2013 United Nations Food and Agriculture Organization guidelines. After a one-year follow-up, the low-score group underwent a significantly more considerable change in weight, body mass index, and body fat percentage than the high-score group (4.62 vs. 4.06 kg, 0.76 vs. 0.51 kg/m2, and 1.99% vs. 1.13%, respectively). Furthermore, in the low-score group, the odds ratios for overweight, obese, and overweight and obese were 1.76 (95% CI: 1.17, 2.65), 0.99 (95% CI: 0.67, 1.46), and 1.35 (95% CI: 1.01, 1.81), and the relative risks were 1.81 (95% CI: 1.03, 3.19), 2.31 (95% CI: 0.81, 6.59), and 1.98 (95% CI: 1.20,3.28), respectively. Low dietary diversity for the recommended food groups was associated with a high weight, high body mass index, and high body fat, which was associated with an increased risk of being overweight or obese in Chinese children.

Spatial variation and determinates of dietary diversity among children aged 6–23 months in Ethiopia: spatial and multilevel analysis using Ethiopian Demography Health Survey (EDHS) 2019

BackgroundMinimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6–23 months children in Ethiopia.MethodsSecondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6–23 months was included for this study. The Global Moran’s I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association.ResultsOverall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples’ regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman.ConclusionAccording to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children's dietary diversity was distributed non-randomly in different districts across Ethiopia's regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.

Commonalities Among Dietary Guidelines for Chronic Disease Prevention and Health Promotion: A Meta-Epidemiological Study From the American College of Lifestyle Medicine

ObjectivesLifestyle recommendations, specifically diet, are foundational components of many clinical practice guidelines from major medical professional and other stakeholder associations. To support clinicians in appropriate treatment pathways, this study aims to identify commonalities among dietary recommendations of current practice guidelines. MethodsUsing a systematic review approach, this meta-epidemiological study (no clinical outcomes; guidelines as unit of analysis) assessed practice guidelines containing dietary pattern, food group, or food item recommendations for adults from general populations or with major chronic diseases. Search strategies were implemented in 5 databases for publications from January 2010 to 2022 and were augmented by hand searches in point-of-care resource databases and relevant stakeholder websites. Two investigators independently screened guidelines and extracted or checked data. Disagreements were resolved by consensus. ResultsOf 2,435 screened records, 88 guidelines were included; preliminary results from 82 guidelines published by Nov. 2020 are presented. Most (95%) targeted adults with chronic diseases, and 45% focused on prevention or treatment of heart disease. Mediterranean-style diets, Dietary Approaches to Stop Hypertension (DASH) or low-sodium diets, and a “healthy diet” (various definitions) were each recommended by about 30% of guidelines. Food groups most commonly recommended for daily intake were vegetables (74%), fruit (71%), whole grains (59%), and legumes (46%). Those most commonly recommended to limit/exclude/decrease were red (34%) and processed meats (30%). Fish/seafood was recommended by 51% of guidelines with many suggesting 1–2 servings a week. Food components most commonly recommended to limit/exclude/decrease were alcohol (65%), salt (50%), sugar sweetened beverages or added sugars (43%), and refined grains or "processed” foods (30%). ConclusionsGuidelines aimed at preventing or treating major chronic diseases are closely aligned in their dietary recommendations for daily intakes of unrefined plant foods with limited alcohol and salt. Based on current evidence, clinicians should feel confident making these recommendations in accordance with their respective clinical practice guidelines. Funding SourcesSupported by the American College of Lifestyle Medicine.

BALANCE Dietary Index in Patients with Heart Failure, and Its Adherence in Sergipe, Brazil.

Background: “The effective treatment of Heart Failure (HF) involves care with food intake. Recently, the Ministry of Health created the Brazilian Cardioprotective Diet and its dietary index, BALANCE, which assesses adherence to the standard’s recommendations”. Methods: This observational prospective study is part of the Congestive Heart Failure Registry (VICTIM-CHF) of Aracaju/SE. Observations and data collection took place from April 2018 to February 2021. Sociodemographic and clinical aspects and food consumption were evaluated. Food intake was determined using the food frequency questionnaire. Foods were categorized using the BALANCE dietary index into green, yellow, blue and red food groups. The BALANCE dietary index was obtained using median and interquartile ranges, scores of the Mann–Whitney U test, and associations between clinical variables and the index, through linear regression. Results: Participants included 240 patients with HF (61.12 ± 1.06 years), who were assisted by the Unified Health System (67.5%). Individuals with a partner showed greater adherence to the green food group recommendations (0.09; 0.00–0.17). The lowest adherence to recommendations regarding the blue food group was observed in individuals with excess weight, who had a higher consumption of foods rich in animal protein (0.54; 0.38–0.78). As for the red food group (ultra-processed foods) the highest adherence was observed by patients with diabetes mellitus (0.41; 0.05–0.77). The greatest adherence to the yellow food group, and a higher score, was observed in patients with the smallest left ventricular systolic diameter (LVSD). Conclusions: Being married was directly associated with the consumption of foods in the green group, while being overweight and having diabetes were inversely associated with adherence to the blue and red food groups, respectively. Greater adherence to the yellow food group recommendations was inversely associated with less change in the DSFVE.

Adherence to Dietary Guidelines among Women with and without Gestational Diabetes: Evidence from the Growing up in New Zealand Study.

Diet is thought to play a role in the development and management of gestational diabetes mellitus (GDM). Dietary guidelines provide practical recommendations for achieving nutrient requirements and mitigating the risk of chronic disease. The aim of this study was to describe the adherence to dietary guidelines by women with and without GDM and determine whether adherence is associated with the development of GDM. Adherence to Ministry of Health food group recommendations was assessed in 5391 pregnant women participating in the Growing Up in New Zealand study. A food frequency questionnaire (FFQ) administered during pregnancy provided dietary data. The presence of GDM was determined using diagnostic coding in clinical data and blood glucose results. A quarter of women did not meet any food group recommendations. There were no significant differences in the number of food group targets met by women with or those without GDM. Meeting food group recommendations was not associated with odds of having GDM in adjusted analyses. This study found adherence to dietary recommendations is poor in both women with and without GDM and no association between adherence to food group recommendations and the development of GDM. Greater support is required to assist women to achieve food and nutrition recommendations.

Improving quality of antenatal care services in a high case load tertiary care teaching hospital (Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College) in Kanpur, Uttar Pradesh, India

In India, half of all pregnant women between the ages of 15 and 49 years are anaemic. In Uttar Pradesh (UP), this figure is slightly higher at 51%. Unfortunately, only...

Food and nutrient intake of school-aged children in Lebanon and their adherence to dietary guidelines and recommendations

BackgroundLebanon, an Eastern Mediterranean country, is witnessing a remarkable nutrition transition, and the diets of school-aged children may be amongst those most affected. However, limited studies have examined the food consumption patterns and nutrient adequacy in this age group.ObjectivesThe present study aimed to evaluate the dietary intakes of school-aged children in Lebanon and assess their adherence to nutrition guidelines and recommendations.MethodsThis study used data for 4–13 y-old children (n = 711) from a national cross-sectional survey conducted in 2014–2015 on a representative sample of Lebanese households with children. Dietary intake was assessed using single 24-h recall method. Estimated food group and nutrient intakes were compared to dietary recommendations and age-specific dietary reference intakes (DRI), including Estimated Average Requirements (EAR) and Acceptable Macronutrient Distribution Range (AMDR). Food group, energy, macro- and micro-nutrient intakes were presented for all children in the sample and stratified by age (4–8 y and 9–13 y) and sex.ResultsMean energy intake of 4–13-year-old children was 1804 kcal/d. Almost half of the energy was provided by carbohydrates while 12% of children had protein intakes below EAR. Approximately three-quarters of children (4–13 y) exceeded the AMDR for total fat and saturated fats, and a similar proportion over consumed added sugars. The main sources of energy intake (EI) among children were the sweets, sweetened beverages and desserts followed by grains and mixed dishes. No significant differences were noted in %EI from different food groups, by sex, in either age groups. The highest adherence of children to food group recommendations was observed for the grains’ food group (47.2–54.4%EI), while the lowest adherence was found for vegetables (3.1–14.1%EI). A high prevalence of vitamin and mineral inadequacies was noted amongst 4–13 y old children for key micronutrients, including vitamin D (99%), calcium (81%), and vitamin A (69.5%). Risk of inadequate micronutrient intakes was significantly increased among the older age group (p-value < 0.05).ConclusionNutrient intakes of school-aged children in Lebanon reflect suboptimal nutrition. Educational and public health interventions are needed to promote healthier diets among children and prevent micronutrient deficiencies during this critical phase.

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (

ABSTRACTBackgroundThe transition from a predominantly milk-based diet to a diverse family diet is a window of opportunity for optimal child growth and development.ObjectivesThe study aims to examine the nutritional status and food-consumption patterns of children under 4 y of age in the United Arab Emirates (UAE) and their adherence to nutrient and dietary recommendations.MethodsA population-based cross-sectional survey of 525 children aged 0–47.9 mo was conducted in 3 major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometric measurements were obtained, and dietary assessment was conducted using the 24-h dietary recall approach. Usual intakes of energy, macronutrient, and micronutrients, including from supplements, were assessed using PC-SIDE software. Adherence to food-group recommendations was evaluated based on the American Heart Association/American Academy of Pediatrics dietary guidelines.ResultsAmong 0–4-y-old children, 10% were stunted, 6% were wasted, 17% were at risk of overweight, 5% were overweight, and 3% were obese. The contribution of sweets and sugar sweetened beverages to energy intake increased from 5% in 6–11.9-mo-old children to 17% in 36–47.9-mo-old children. Compared with dietary guidelines, the lowest adherence was for fruit (13–18%) and vegetables (7–12%), while protein was within the recommendations, and 92% and 89% of children (aged 24 to 35.9 mo and 36 to 47.9 mo, respectively) had high intakes of saturated fat. Almost all toddlers failed to meet the Adequate Intake for fiber. The proportions of children exceeding the free-sugar upper limit increased from 10.6% in infants (0–5.9 mo) to 56.7% in toddlers (12– 23.9 mo). Micronutrient inadequacies were observed, particularly for calcium, zinc, folate, and vitamins A and D.ConclusionsThis study suggests a triple burden of malnutrition among infants and young children in the UAE. Results call for national nutrition intervention strategies aimed at improving dietary quality in the pediatric population.

Associations of Ready-to-Eat Cereal Consumption and Income With Dietary Outcomes: Results From the National Health and Nutrition Examination Survey 2015-2018.

BackgroundReady-to-eat (RTE) cereal has been associated with higher diet quality but it is not known if this association differs by income.ObjectiveTo investigate the association of RTE cereal with dietary outcomes in a US population stratified by income [measured using the poverty-to-income ratio (PIR)].MethodsData from children 2–18 years (n = 5,028) and adults 19 years and older (n = 9,813) with 24-h dietary recalls from the cross-sectional, US nationally-representative 2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys (NHANES) were used in a multivariable linear model that included cereal eating status (based on day 1 24 h dietary recall), PIR category (Low-PIR <1.85; Mid-PIR 1.85–3.50; High-PIR >3.50) and their interaction. PIR is based on the ratio of the family household income to the poverty level set by the US Department of Health and Human Services and higher PIR values indicate higher household income.ResultsFor children, there were positive associations between RTE cereal consumption and nutrient (e.g., iron, calcium, fiber, potassium and vitamin D, p < 0.001) and food group (e.g., whole grain and dairy, p < 0.001) intake and 2015-HEI (p < 0.0001) but no association with PIR or RTE cereal-PIR interaction. For adults, PIR category was positively associated with the intake of nutrients (e.g., fiber, magnesium, potassium, and vitamin C, p < 0.001) as was RTE cereal consumption (e.g., fiber, calcium, vitamin D, potassium, vitamin B12, among others, p < 0.001). Both PIR and RTE cereal were positively associated with whole grain, dairy, and fruit (p < 0.001) and 2015-HEI (p < 0.0001) for adults. We also found a significant interaction between PIR and RTE cereal for adults for iron, phosphorus, B vitamins, and dairy (p < 0.001). RTE cereal contributed to one quarter or more of daily intake, across all age and PIR groups, for several B vitamins, iron, zinc, and whole grains. Added sugar intake was not associated with RTE cereal consumption in either children or adults.ConclusionRTE cereal was associated with improved dietary outcomes, including increased intake of under-consumed nutrients, increased intake of recommended food groups, and higher diet quality, at all income levels. This work can help inform future dietary recommendations.

Do Older Women of Reproductive Age Have Better Diet Quality than Younger Women of Reproductive Age?

There is increasing recognition of the importance of nutrition for reproductive health, but little is known regarding the diet quality of younger vs. older reproductive aged women, and how their intakes relate to dietary recommendations. The purpose of the study was to examine the diets of younger (19–35 years old) compared to older (35–50 years old) reproductive aged women, and how they align with dietary recommendations. Women aged 19–50 years from the 2011–13 Australian National Nutrition and Physical Activity Survey were included (n = 2323). Dietary intakes were assessed by a single 24-h dietary recall and were compared to (i) Australian Dietary Guidelines; (ii) Acceptable Macronutrient Distribution for protein, carbohydrates, and fat; and (iii) Dietary Guideline Index (DGI). Regression analyses comparing younger and older women against recommendations were undertaken, with confounders determined a priori. There was no difference between older and younger women in meeting food group recommendations, with 26% of all women meeting recommendations for fruit, and meat and alternatives, and <20% meeting recommendations for vegetables and alternatives, grains, and dairy. Although there was no difference between older and younger women in total DGI score (mean (SE) 75.6 (1.7) vs. 74.5 (2.5), p > 0.05), older women had higher component scores in limiting saturated fat, consuming low-fat milk, and limiting adding salt during cooking. Continued health promotion for women of reproductive age should be a key priority to improve their own health and that of future generations.

The Complementary Roles for Plant-Source and Animal-Source Foods in Sustainable Healthy Diets.

There are approximately 100 countries with food-based dietary guidelines throughout the world, each of which aims to encompass the cultural, geographical, and health considerations unique to their country of origin. Common themes throughout these guides emphasize diverse and balanced intake of food groups from both plant- and animal-sources. With the globally recognized need to shift to more sustainable food systems, several countries and international food and health organizations have begun to incorporate sustainability recommendations into their dietary guidance. These sustainability recommendations are often based on food source (i.e., eat more plant-source and fewer animal-source foods), yet food source may not be the only useful or informative comparator for assessing healthy and sustainable diets. The purpose of this narrative review is to examine the roles of plant-source foods and animal-source foods in the context of sustainable healthy diets—with an emphasis on the contributions of the most commonly recommended food groups from global food-based dietary guidelines (i.e., fruits, vegetables, and dairy foods). Overall, plant and animal agriculture have complementary and symbiotic roles in healthy and sustainable food systems, and these abilities are largely dependent on various contextual factors (e.g., geography, production practices, processing methods, consumption patterns)—not just on whether the food originated from the plant or animal kingdom.