Self-administered Food Frequency Questionnaire Research Articles

Validity of the Intake of Sugars, Amino Acids, and Fatty Acids Estimated Using a Self-administered Food Frequency Questionnaire in Middle-aged and Elderly Japanese: The Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) Protocol Area.

The Japanese database of food composition was revised in 2020, during which both the number of food items and the number of food items measured for sugars, amino acids, and fatty acids were increased. We evaluated the validity of estimated intakes of sugars, amino acids and fatty acids using a long food frequency questionnaire (long-FFQ) among middle-aged and elderly Japanese. From 2012 to 2013, 240 men and women aged 40-74 years from five areas in the JPHC-NEXT protocol were asked to respond to the long-FFQ and provide a 12-day weighed food record (WFR) as reference. The long-FFQ, which included 172 food and beverage items and 11 seasonings, was compared with a 3-day WFR, completed during each distinct season, and validity was assessed using Spearman's correlation coefficients. Percentage differences based on the long-FFQ with the 12-day WFR in men and women varied from -84.4% to 419.6%, and from -75.8% to 623.1% for sugars, -17.5% to 3.8% and -5.8% to 19.6% for amino acids, and -58.5% to 78.8% and -43.4% to 129.3% for fatty acids, respectively. Median values of correlation coefficients for the long-FFQ in men and women were 0.52 and 0.42 for sugars, 0.38 and 0.37 for amino acids, and 0.42 and 0.42 for fatty acids, respectively. The long-FFQ provided reasonable validity in estimating the intakes of sugars, amino acids, and fatty acids in middle-aged and elderly Japanese. Although caution is warranted for some nutrients, these results may be used in future epidemiological studies.

Validity and reproducibility of food group intakes in a self-administered food frequency questionnaire for genomic and omics research: the Tohoku Medical Megabank Project.

The Tohoku Medical Megabank Project (TMM) was established to realize personalized healthcare and medicine using genomic and omics data. This study evaluated the validity and reproducibility of food group intakes derived from a self-administered food frequency questionnaire (TMM-FFQ) that included the response option "constitutionally unable to eat/drink it" among community-dwelling Japanese adults. Participants comprised 89 men and 124 women aged ≥20 years from Miyagi Prefecture. Participants completed weighed food records (WFRs) for 3 consecutive days per season as reference intake and FFQs in 2019 (FFQ1) and 2021 (FFQ3). Spearman's rank correlation coefficients (CCs) were calculated for correlations between food group intakes estimated from the 12-day WFR and FFQ3 (validity), and for correlations between those estimated from the FFQ1 and FFQ3 (reproducibility). Cross-classification according to quintiles using FFQ and WFR data was also performed. The percentage of participants who chose the "constitutionally unable to eat/drink it" option was non-negligible for some food groups. In the validity analysis, CCs were >0.40 for many food groups; the median across 21 food groups was 0.49 in men and 0.45 in women. The median percentages of cross-classification into exact plus adjacent quintiles were 73.0% in men and 66.9% in women. In the reproducibility analysis, CCs were >0.50 for many food groups; the median across 21 food groups was 0.60 in men and 0.51 in women. The validity of the TMM-FFQ compared with 12-day WFR and the reproducibility of the TMM-FFQ were reasonable for food groups in the TMM cohort studies.

ARE ADOLESCENTS CONSUMING MORE SALT THAN RECOMMENDED?

Objective: To study and compare the amount and pattern of sodium (Na) consumption in urban and rural school-going adolescents in Western India and identify high risk groups for conducting awareness programs. Design and method: 1850 subjects (urban- 935; rural- 915; Males-1012, Females -838) aged 14 - 17 years were recruited with prior permission from 5 schools in and around Mumbai. Data pertaining to demography, anthropometry and eating habits was collected. A self-administered semi-quantitative Food Frequency Questionnaire was used to record consumption pattern of 22 high salt containing food items, divided into 5 categories (bakery, fried, packed, preserved and fast foods). Each participant‘s sodium consumption from these food items was calculated. Additional sodium consumption from regular meals was excluded. Data was analyzed using standard growth charts and MS Excel. Results: Only 13% of subjects added table salt. 67% and 81% brought homemade food for snacks and lunch respectively. Median Sodium consumption of the study population was 573 mg/day (∼ 1.5 g salt) (Q1-Q3:254 - 851 mg/day). There was no statistically significant difference (p> 0.05) in the Median Na consumption of girls (454 mg/day) and boys (489 mg/day). Daily Median Na consumption was not significantly different (p < 0.05) in urban students (624 mg/day) as compared to rural (592 mg/day). Bakery and fried foods together comprised 51% of sodium consumption among the rural population, whereas all five food categories had almost equal representation in the urban population. 54% subjects’ BMI (34% urban, 20% rural) was above the normal range. Higher BMI values correlated significantly with higher daily Na consumption (p =0.001, Mann-Whitney test). Conclusions: The salt intake over and above the usual dietary salt consumption was high (∼ 2 g per day for urban and ∼1.8 g/day for rural adolescents). Nearly half the study population was found to be either overweight or obese. This double whammy has a singular potential for producing future hypertensives. Thus, targeted awareness and counselling programs for salt reduction in adolescents is the urgent need of the hour.

Association of Habitual Green Tea Consumption with Sarcopenia Assessed Using SARC-F in Community-Dwelling Japanese Older People: A Cross-Sectional Study.

To ascertain whether habitual green tea consumption is associated with sarcopenia among Japanese older adults, using the screening tool for sarcopenia (SARC-F). This cross-sectional study in Mukawa, Hokkaido, Japan, was conducted between June and September 2022 and included 364 Japanese participants older than 65 y. Habitual green tea consumption and energy intake were ascertained using a validated self-administered food frequency questionnaire. Sarcopenia was evaluated using the SARC-F. Multivariable logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of sarcopenia risk across participant tertiles of green tea consumption, with adjustments for age, sex, body mass index, living alone, habitual exercise, walking hours, current smoking status, current alcohol consumption status, energy intake, protein intake, vegetable intake, and fruit intake. In this study of 364 participants (154 men and 210 women), the prevalence of sarcopenia risk was 9.3%. The multivariable-adjusted OR [95% CI] of green tea consumption for ≥1 cup/d compared with that of <1 cup/wk of sarcopenia was 0.312 [0.129-0.752]. Higher habitual green tea consumption was inversely associated with sarcopenia among Japanese older adults. Further longitudinal studies are required to confirm these findings.

Individual and family factors correlated with children's fruit consumption.

Fruits are essential for health, yet their consumption in children is inadequate, with unclear influencing factors. A cross-sectional study was conducted among students in grades 3-12 in Beijing, China, from September 2020 to June 2021. Fruit consumption in children was surveyed using a self-administered food frequency questionnaire. Additionally, children's food and nutrition literacy and family food environments were assessed using the "Food and Nutrition Literacy Questionnaire for Chinese School-age Children" and the "Family Food Environment Questionnaire for Chinese School-age Children," respectively. Out of 10,000 participating children, 62.5% consumed fruit daily, with a lower frequency among boys (59.3%) compared to girls (65.8%), and among senior students (48.6%) compared to junior (63.6%) and primary students (71.2%). Fruit consumption was positively associated with other healthy foods (vegetables, whole grains, etc.) and negatively with unhealthy foods (sugared soft drinks). Children with higher food and nutrition literacy consumed fruits daily more frequently (82.4% vs. 59.9%, ORs = 2.438, 95%CI: 2.072-2.868). A significant positive correlation was found between children's fruit consumption and a healthy family food environment (66.4% vs. 50.2%, OR = 1.507, 95%CI: 1.363-1.667). The results indicate that individual food and nutrition literacy and family food environment are key positive predictors of children's fruit consumption. Future interventions should focus on educating children and encouraging parents to foster supportive family environments.

Associations Between Dietary Patterns and Kidney Health Assessed in the Population-Based CHRIS Study Using Reduced Rank Regression

ObjectiveWhile diet plays a key role in CKD management, the potential for diet to impact CKD prevention in the general population is less clear. Using a priori knowledge, we derived disease-related dietary patterns (DPs) through reduced rank regression (RRR) and investigated associations with kidney function, separately focusing on generally healthy individuals and those with self-reported kidney diseases, hypertension or diabetes mellitus. Methods8,686 participants from the population-based Cooperative Health Research in South Tyrol (CHRIS) study were split into a group free of kidney disease, hypertension and diabetes (n=6,133) and a group with any of the three conditions (n=2,553). Diet was assessed through the self-administered GA2LEN food frequency questionnaire (FFQ) and DPs were derived through RRR selecting FFQ-derived sodium, potassium, phosphorus and protein intake as mediators. Outcomes were creatinine-based estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), CKD and microalbuminuria. Multiple linear and logistic models were used to assess associations between RRR-based DPs and kidney outcomes separately in the two analytic groups. ResultsWe identified three DPs, where high adherence reflected high levels of all nutrients (DP1), high potassium-phosphorus and low protein-sodium levels (DP2), and low potassium-sodium and high protein-phosphorus levels (DP3), respectively. We observed heterogeneous associations with kidney outcomes, varying by analytic group and sex. Kidney outcomes were much more strongly associated with DPs than with single nutrients. ConclusionRRR is a feasible approach to estimate disease-related DPs and explore the combined effects of nutrients on kidney health. Heterogeneous associations across kidney outcomes suggest possible specificity to kidney function or damage. In individuals reporting kidney disease, hypertension or diabetes, specific dietary habits were associated with better kidney health, indicating that disease-specific dietary interventions can be effective for disease control.

Daily Diet and Nutrition Risk Factors for Gastric Cancer Incidence in a Japanese Population.

: Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC. : This was a post hoc analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis. : Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days. GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence. : Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.

Associations of central obesity and habitual food consumption with saliva microbiota and its enzymatic profiles - a pilot study in Finnish children.

Variation in diversity and composition of saliva microbiota has been linked to weight status, but findings have been inconsistent. Focusing on clinically relevant conditions such as central obesity and using advanced sequencing techniques might fill in the gaps of knowledge. We investigated saliva microbiota with shallow metagenome sequencing in children with (n = 14) and without (n = 36) central obesity. Additionally, we examined the role of habitual food consumption on microbial enzymatic repertoire. Data comprised 50 children (50% male) with a mean age of 14.2 (SD 0.3) years, selected from the Finnish Health in Teens (Fin-HIT) cohort. Dietary scores for consumption frequency of sweet treats (STI), dairy products (DCI) and plants (PCI) were derived based on a self-administered food frequency questionnaire. Central obesity was defined based on waist-height ratio using the cut-off 0.5. Saliva samples were subjected to whole-metagenome shotgun sequencing, and taxonomic and functional profiling was achieved with METAnnotatorX2 bioinformatics platform. Groups had an average 20 (95% CI 14-27) cm difference in waist circumference. We identified the lack of Pseudomonas guguagenesis and Prevotella scopos, oulorum and oris as putative biomarkers associated with central obesity and observed a total of 16 enzymatic reactions differing between the groups. DCI was associated with the highest number of enzyme profiles (122), followed by STI (60) and DCI (25) (Pearson correlation p < 0.05). Intriguingly, STI showed a high positive/negative correlation ratio (5.09), while DCI and PCI showed low ratios (0.54 and 0.33, respectively). Thus, the main driver of enzymatic reactions was STI, and the related pathways involved nitrate metabolism induced by Haemophilus parainfluenzae and Veilonella dispar among others. Clinically relevant differences in central obesity were only modestly reflected in the composition of saliva microbiota. Habitual consumption of sweet treats was a strong determinant of enzymatic reactions of saliva microbiota in children with and without central obesity. The clinical relevance of these findings warrants further studies.

Development of a Concise Healthy Diet Score for Cardiovascular Disease among Japanese; The Japan Collaborative Cohort Study.

Several diet quality indicators have been developed primarily for cardiovascular disease (CVD) prevention in Western countries. However, those previous indicators are complicated and less feasible in clinical and health-promoting settings. Therefore, we aimed to develop a concise dietary risk score for CVD prevention in Japanese. Using the self-administered food frequency questionnaire with 35 food items, we developed a concise healthy diet score (cHDS) ranging from 0 to 5 points. We examined the association of cHDS with risks of all-cause and cause-specific mortality among 23,115 men and 35,557 women who were free of CVD and cancer. During 19.2 years of median follow-up, 6,291 men and 5,365 women died. In men, the multivariable hazard ratios (95% confidence intervals) for the highest cHDS (5 points) compared to the lowest (0-1 points) were 0.74 (0.60-0.91, P-trend=0.008) for CVD and 0.86 (0.77-0.95, P-trend=0.05) for all causes. No significant associations were found for stroke, coronary heart disease, and other causes in men. The corresponding hazard ratio in women was 0.65 (0.52-0.81, P-trend＜0.001) for CVD, 0.63 (0.45-0.88, P-trend＜0.001) for stroke, 0.48 (0.30-0.78, P-trend=0.008) for coronary heart disease, 0.67 (0.54-0.84, P-trend＜0.001) for other causes, and 0.75 (0.66-0.85, P-trend＜0.001) for all causes. We developed a concise diet quality score named cHDS in the Japanese population and found the inverse association of cHDS with mortality from CVD and all causes for both men and women.

Comparison of Dietary Intake and Dietary Inflammatory Index in Patients with Chronic Lymphocytic Leukemia By Treatment Status to Cohabitating Controls

Chronic lymphocytic leukemia (CLL) is an incurable disease with a varied presentation ranging from indolent and asymptomatic to morbid and life-limiting. As tumor biology insufficiently explains this variability, we hypothesized that behavioral and environmental factors including diet and the gut microbiome, where diet is a key influence, may influence CLL pathogenesis and response to therapy. We performed a cross-sectional sample and survey collection study of the gut microbiome, blood, and diet in patients with CLL treated at the University of Nebraska Medical Center between 2021-2023. Eligible subjects included 1) untreated CLL with Rai stage 2-4 disease (untreated CLL), 2) CLL treated with a Bruton's tyrosine kinase inhibitor (BTKi), and 3) individuals without cancer cohabitating with enrolled CLL subjects (control). All subjects provided stool samples for microbial analysis, and subjects with CLL provided blood for serum cytokine analysis. All subjects completed the Diet History Questionnaire version 3.0 (DHQ-3). The DHQ-3 is a self-administered food frequency questionnaire, where participants complete 135 questions on food/beverages and 26 on dietary supplements consumed in the past month. A total and component healthy eating index (HEI) score was derived from the DHQ-3 and represents how well diet intake corresponds to the dietary guidelines recommended by the United States Department of Agriculture and Health and Human Services. The HEI is based on 13 individual components (Figure 1) and scored from 0-100, where higher scores indicate healthier diets. Inflammatory capacity of the diet was assessed by the Dietary Inflammatory Index (DII) (Shivappa et al, Public Health Nutrition, 2013), a measure of dietary components associated with serum markers of inflammation. The DII has a range of scores up to 7.98 suggestive of greater systemic inflammation (median DII score 0.23), and a minimum of -8.87, suggestive of consumption of anti-inflammatory foods. The DII was calculated and compared between each cohort. Statistical analysis was performed using ANOVA. A total of 58 subjects enrolled on the study, 42 with CLL and 16 cohabitating controls. A total of 27 subjects were included in the analysis after data cleaning. Fifteen subjects (56%) were treated with a BTKi, 5 (19%) had untreated Rai stage 2 disease, and 7 (26%) were cohabitating controls. Median ages (72 vs 67 vs 71 for BTKi, untreated, control, respectively) were similar. Median absolute lymphocyte count was 3.2 cells x10^3/µL (1.3 - 131 range) in the BTKi and 55 cells x10^3/µL (13-134 range) in the untreated cohort. There were 5/15 (33%) with 17p deletion and/or p53 mutation in the BTKi cohort and 2/5 (40%) in the untreated cohort. Median time from diagnosis to study entry was 30 months (range 3-151 months) in the untreated cohort, and median time on BTKi therapy was 30 months (range 2-92 months). Within the BTKi cohort, 33% received ibrutinib, 20% received zanubrutinib, and 47% received acalabrutinib. Overall dietary habits were largely similar between the 3 cohorts (Table 1). The mean total HEI score was higher in the untreated (66) and control (66) populations compared to the BTKi cohort (59) ( p = 0.23), although not significantly different. These scores are similar to the 2020 median score of 61 for Americans 60 years and above. Added sugar intake was highest in the untreated cohort (HEI component score of 9.6, 6.3, 8.6 untreated, BTKi, control p = 0.005, respectively) (Figure 1). After calculating the DII for each cohort, no statistically significant differences were observed (Table 1). The range of DII scores across subjects was -5.2 - 4.0, within the expected range for DII calculations. DII scores were 0.44, 0.2, 0.82 p = 0.89 for BTKI, untreated CLL, and control cohorts respectively. To our knowledge, this study is the first to analyze dietary patterns in well-defined homogenous CLL populations (BTKi vs Rai stage 2+ CLL cohort) and compare them to cohabitating individuals. Although overall dietary patterns and DII were similar across cohorts, slight differences in added sugar intake was observed between the cohorts, suggestive that subtle yet important dietary differences may be observed. These data provide a baseline to study personalize dietary approaches to patients with CLL, who increasingly ask clinicians for nutritional interventions as part of their comprehensive cancer care.

Dietary Behaviors and Social Determinants of Health Among Adults Living with Sickle Cell Disease

Background: Social determinants of health (SDoH) may impact outcomes in sickle cell disease (SCD), and recent literature reports that particular SDoH, such as food insecurity and housing insecurity, may impact diet choices for individuals with SCD. Notably, health outcomes in SCD are linked to diet choices through increased protein and caloric needs, and through nutrients, such as polyphenols, omega fatty acids and micronutrients, which are involved in SCD pathophysiology. The connection between SDoH and diet quality may occur through multiple pathways including access to food, affordability, chronic pain and psychosocial factors at the individual and family level. Importantly, the impact of this connection may relate to outcomes such as pain frequency, hospitalizations, and SCD pathophysiologic biomarkers, such as inflammation. Study Design and Methods: The Diet and SCD Study (NCT: 05170412) is an observational mixed-methods study initiated in 2021 at the National Institutes of Health Clinical Center (NIH CC) in Bethesda MD with a target sample of 75 adults living with SCD in the United States. The purpose of the study is to evaluate associations between SDoH (food insecurity, neighborhood food access, education, employment, healthcare access), dietary intake, and population health related outcomes among adults living with SCD. Study inclusion criteria consists of adults (≥18 years of age) residing within the United States at the time of screening who have a confirmed diagnosis of sickle cell disease with any genotype, and are not hospitalized at the time of enrollment. To ensure participation from adults in diverse regions of the United States, the study has a hybrid design of in-person and telehealth procedures. In-person protocol visits are conducted at the NIH CC. The CC clinical visit includes a clinical assessment, anthropometric measurements, phlebotomy, as well as monitored/proctored electronic surveys that collect SDoH and disease severity variables. The telehealth protocol visit includes a virtual clinical assessment, phlebotomy at a local laboratory center, as well as the same monitored/proctored electronic surveys completed by CC clinical visit participants. A dietary behavior semi-structured interview is conducted at both the CC clinical visit and telehealth protocol visit to garner participants' personal stories related to food choices and diet. Laboratory variables include SCD disease specific markers, amino acid levels, and measurement of inflammatory cytokine markers. All participants undergo two unannounced phone-administered 24-hour dietary recall interviews with trained NIH nutrition staff to measure recent dietary intake. Data from 24-hour recall interviews are used to determine fluid, caloric, macro and micronutrient, and polyphenol intake. Usual dietary intake of foods of potentially related to SCD pathophysiology (cruciferous vegetables and thiocyanate-rich foods) is measured through self-administered electronic 12-month food frequency questionnaires. Primary objectives are to evaluate social determinants of health related to food security and access relevant to disease severity among adults living with sickle cell disease in the U.S. Secondary outcomes are to evaluate the association of dietary quality, specific dietary nutrient intake and serum levels, including amino acids and polyphenols, with disease severity. Tertiary outcomes include evaluating inflammatory and glucometabolic biomarkers with measures of social determinants of health. When completed, the Diet and SCD study will provide important information on the associations between SDoH, dietary quality, inflammatory biomarkers and disease severity for adults living with SCD and provide initial data for future cohort and intervention studies.

The Association between Oxidative Balance Score and Urinary Levels of 8-Hydroxydeoxyguanosine among Japanese Adults.

The oxidative balance score (OBS), wherein higher OBSs indicate lower oxidative stress, was designed to assess a composite measure of multiple pro-oxidant and antioxidant effects on an individual's oxidative stress status. This study aimed to evaluate whether OBSs were inversely associated with urinary levels of 8-hydroxydeoxyguanosine (8-OHdG)-an oxidative stress marker-among Japanese adults. This cross-sectional study was based on data obtained during 2010-2012. Overall, 7552 participants from the J-MICC Study Saga who answered a self-administered food frequency questionnaire were recruited for the final analysis. OBSs were calculated from 11 pro-oxidant and antioxidant lifestyle factors, including dietary intake, physical activity, and alcohol and smoking status. Urinary 8-OHdG values were corrected by creatinine level (ng/mg creatinine). Our findings revealed a higher total OBS was significantly associated with lower urinary 8-OHdG/creatinine levels after adjustment for covariates in men and women (p for trend < 0.01 in both sexes). We performed a multiple regression analysis of the association between OBSs and urinary 8-OHdG/creatinine levels stratified by age, body mass index (BMI), and menopausal status and found consistent negative associations in most groups for both sexes. No significant differences in the 60-64 age group for women (standardized β = -0.09, p = 0.13) or BMI < 18.5 kg/m2 for men (standardized β = -0.18, p = 0.17) were observed. A higher OBS had a strong inverse association with urinary 8-OHdG/creatinine levels in men and women among Japanese adults. The OBS might be a useful tool for evaluating the roles of oxidative stress-related lifestyle factors, including diet.

Greater adherence to the Healthy Nordic Food Index is associated with lower all-cause mortality in a population-based sample from northern Germany

PurposeDietary pattern scores reflecting a high intake of beneficial food groups were associated with reduced mortality risk. Data on associations of such dietary pattern scores in population-based samples from northern Germany are lacking. Therefore, we examined the association of three dietary pattern scores with all-cause mortality in a moderate-sized prospective sample from northern Germany.MethodsThe study sample comprised 836 participants (43.8% females, median age 62.4 years). Based on a validated, self-administered Food Frequency Questionnaire, the dietary scores Dietary Approaches to Stop Hypertension (DASH), Modified Mediterranean Diet Score (MMDS), and Healthy Nordic Food Index (HNFI) were calculated. Cox proportional hazard regression models, adjusted for age, sex, body mass index, waist to hip ratio, education, smoking status, total energy intake, and physical activity, were used to separately relate DASH, MMDS, and HNFI to all-cause mortality.ResultsDuring a median follow-up period of 11 years, 93 individuals died. While DASH and MMDS scores were not associated with all-cause mortality, greater adherence to HNFI was associated with lower mortality hazards (HR: 0.47 [95% CI 0.25–0.89] when comparing the highest score quartile to the lowest; HR: 0.79 [95% CI 0.64–0.98] for HNFI modeled as a 1-Standard Deviation increment). Among different HNFI components, higher intake of oats and cereals displayed the most conclusive association with all-cause mortality (HR: 0.59 [95% CI 0.38–0.91] when comparing high and low intake).ConclusionIn an elderly general population sample from northern Germany, we observed greater adherence to HNFI to be associated with lower all-cause mortality.

Baseline characteristics of a prospective cohort study of aging and cardiovascular diseases among people living with HIV.

Our objective was to report the baseline characteristics of participants in the Canadian HIV and Aging Cohort Study (CHACS) and present amendments to the initial protocol. CHACS is a multi-centred prospective cohort study that was initially set from 2011 to 2016 and will now continue recruitment until 2024. Four additional years of follow-up have been added, and additional outcomes and covariates will be prospectively collected. Frailty will be assessed using a modified version of the Fried's frailty phenotype. The four interrelated aspects of gender-gender roles, gender identity, gender relationships, and institutionalized gender-will be measured using the GENESIS-PRAXY questionnaire. Diet will be assessed using a validated, web-based, self-administered food frequency questionnaire. A total of 1049 participants (77% people living with HIV) were recruited between September 2011 and September 2019. Median age at baseline was 54 years (interquartile range 50-61). Most participants were male (84%) and white (83%). Compared with participants without HIV, those with HIV were more likely to be male; to report lower education levels and incomes; to be more sedentary; to use tobacco, recreational, and prescription drugs; to report a personal history of cardiovascular diseases; and to be frail. The new assessments added to the CHACS protocol will allow for an even more detailed portrait of the pathways leading to accentuated aging for people living with HIV. Participants in the CHACS cohort display important differences in socio-economic and cardiovascular risk factors according to HIV serostatus. These imbalances must be taken into account for all further inferential analyses.

Maternal dietary patterns during pregnancy and the risk of infantile eczema during the first year of life: a cohort study in northeast China

BackgroundThere are few studies on the relationship between diet during pregnancy and infantile eczema and the conclusions are inconsistent. The aim of the present study was to explore the impact of dietary patterns during pregnancy on infantile eczema.MethodsA total of 495 mother–child pairs from a prospective cohort in Shenyang, China was recruited. Information on maternal dietary intake during pregnancy was assessed with a validated self-administered food frequency questionnaire. The data of infantile eczema was assessed using a structured questionnaire. Factor analysis to derive dietary patterns. The relationship between the dietary pattern and infantile eczema was examined by the logistic regression analysis.ResultsThe cumulative incidence of eczema in 6 months and 12 months in northeast China was 45.7% and 57.8%, respectively. Three dietary patterns were identified. There was a tendency for an expose-response relationship between the maternal high-protein dietary pattern during pregnancy and the risk of infantile eczema within 12 months (P for trend = 0.023): the adjusted odds ratio (95% confidence interval) in the Q1, Q2, Q3, Q4 were 1.00 (reference), 1.63 (0.96–2.76), 1.81 (1.06–3.06), and 1.87 (1.09–3.20), respectively. No association between Western and plant-based patterns during pregnancy and infantile eczema within 12 months was found. Infantile eczema within 6 months was not associated with any of the three dietary patterns.ConclusionThe maternal high-protein pattern during pregnancy may be a risk factor for infantile eczema during the first year of life.

Association between green tea and coffee consumption and body iron storage in Japanese men and women: a cross-sectional study from the J-MICC Study Saga.

This study examined the association between daily green tea and coffee consumption and body iron stores among Japanese middle-aged and older adults. This cross-sectional study used data obtained from 2005 to 2007. A total of 10,435 participants were recruited for this study. The participants completed a validated, self-administered food frequency questionnaire on green tea and coffee consumption. A multivariate linear regression analysis was conducted to assess the relationship between green tea and coffee consumption and serum ferritin levels. Additionally, logistic regression analysis was performed to ascertain whether excessive consumption of these beverages was linked to iron deficiency. We observed that higher green tea and coffee consumption was associated with lower ferritin levels in men and postmenopausal women, even after adjusting for covariates (all P for trends <0.05). Among premenopausal women, we found an inverse association between green tea consumption and serum ferritin levels, while no significant association was observed for coffee consumption after adjusting for covariates (green tea, P for trend <0.05; coffee, P for trend = 0.08). Notably, the association between these beverages and iron deficiency was found only in postmenopausal women; the odds ratios (95% confidence intervals) for iron deficiency associated with almost None, <1 cup/day, 1-2 cups/day, and ≥ 3 cups/day were 1.00 (reference), 0.78 (0.26-2.49), 1.29 (0.49-3.39), and 1.59 (0.63-4.04) (P for trend = 0.05), respectively, for green tea and 1.00, 1.32 (0.64-2.73), 1.46 (0.68-3.13), and 2.20 (1.06-4.55) (P for trend <0.01), respectively, for coffee. Higher green tea and coffee consumption was associated with lower serum ferritin levels in men and postmenopausal women. In premenopausal women, consumption of green tea, but not coffee, was associated with lower serum ferritin levels. However, postmenopausal women who ≥3 cups of coffee demonstrated a higher prevalence of iron deficiency compared to those who consumed almost none.

Energy-Adjusted Dietary Inflammatory Index and Diabetes Risk in Postmenopausal Hispanic Women

BackgroundType 2 diabetes is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) are tools that assess dietary inflammation. Previous evidence suggests that obesity can modify the association between inflammation and disease. ObjectiveThe aim of this study was to evaluate the association between the DII/E-DII and incident diabetes in self-identified Hispanic women from the Women’s Health Initiative (WHI). The secondary aim was to evaluate whether obesity modifies the association between the DII/E-DII scores and incident diabetes. DesignParticipants were from the WHI Observational Study and the Clinical Trial Components (except women from the treatment arm in the Dietary Modification Trial) conducted among postmenopausal women in the United States. DII/E-DII scores were calculated from a self-administered food frequency questionnaire at baseline that included 122 food items, of which 12 are representative of Hispanic eating patterns. Participants/settingsParticipants included 3,849 postmenopausal women who self-identified as Hispanic that were recruited for the WHI from 1993 to 1998 at 40 US clinical centers. Main outcome measuresThe outcome was incident diabetes. Statistical analysis performedCox regression models were used to assess the association between DII/E-DII and incident diabetes. Models were adjusted for age at baseline, lifestyle-related risk factors, known type 2 diabetes mellitus (T2DM) risk factors, and neighborhood socioeconomic status. Interaction was tested between the DII/E-DII scores and obesity. ResultsThe incidence of diabetes was 13.1% after a median follow-up of 13 years. Higher E-DII scores were associated with a higher risk of incident diabetes (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.04–1.14). There was no interaction between E-DII scores and obesity (P = 0.73). ConclusionsPro-inflammatory diets, as measured by higher E-DII scores, were associated with a higher risk of incident diabetes. Future research is needed for understanding how the inflammatory potential of diets can be decreased.

Milk and dairy product intakes, intestinal bacteria, and respiratory infections in children of elementary school age and older in Japan

ObjectivesThe aim of this study was to examine the associations between milk and dairy product intakes, intestinal bacteria, and respiratory infections in children of elementary school age and older in Japan. MethodsWe conducted cross-sectional surveys each year from 2013 to 2015 for grades 2, 5, and 8 students of an elementary and junior high school (n = 1020). Exclusion owing to ineligibility regarding data on dietary intake, respiratory infections, and intestinal bacteria led to 922 participants for the analyses. Dietary intake was assessed with a self-administered food frequency questionnaire. Respiratory infections occurring ≥ 4 episodes over the past year were determined based on the caregivers’ reports. Intestinal bacteria (species and counts) were analyzed with real-time polymerase chain reaction. Logistic regression models were used to estimate the odds ratios (ORs) and 95% CIs. ResultsThe odds of ≥ 4 respiratory infection episodes decreased with higher milk intake after adjusting for potential confounders, and the ORs (95% CIs) for the second and third tertile categories, compared with the first tertile category, were 0.91 (0.58–1.42) and 0.48 (0.29–0.77), respectively (P for trend = 0.001). A decreasing trend in the ORs for lactic acid drink intake was observed only in those with a low count of intestinal Faecalibacterium prausnitzii. ConclusionsWe found that higher milk intake was inversely associated with respiratory infections in children older than preschool age. Higher lactic acid drink intake could be inversely associated only in children with a low F. prausnitzii count in the intestine.

1713-P: Dietary Manganese (Mn) Intake Is Independently Associated with a Lower BMI in Younger Japanese with Type 2 Diabetes Mellitus (T2DM)

We analyzed the association between dietary Mn intake and obesity measured by BMI after adjustment for intake of nutrients and food groups in people with T2DM in Japan. Participants were 1567 people, 63% male, aged 30 to 89 y who were in the Japan Diabetes Clinical Data Management Study Group (JDDM), one of the largest cohorts of Japanese with diabetes. Intake of food groups was determined by a validated self-administered food frequency questionnaire based on food groups. Obesity was defined as BMI ≥25 kg/m2. Multivariate logistic regression analysis assessed the relationship between quartiles of dietary Mn intake and obesity stratified by age. Participants aged 30 to 89 y were grouped according to the following quartiles for age: 30-54 y, 55-63 y, 64-71 y, and 72-89 y. Compared to the lowest quartile (Q1) for Mn, a significant negative association between Mn and BMI was found in males for all quartiles of Mn (OR [95%CI] of Q2= 0.643 [0.424 - 0.973], Q3= 0.607 [0.374 - 0.986], Q4= 0.398 [0.218 - 0.728], p trend = 0.028) with adjustment for characteristics such as age, sex, current smoking, drinking, insulin, oral hypoglycemic agents treatment, activity, energy intake and macronutrients intake. However, statistical significance disappeared after adding total fiber as a covariate. Compared to the lowest quartile for Mn, the highest quartile of Mn was inversely associated with BMI in the younger age group (30-54 y [OR= 0.296 [0.088 - 0.996]]) even after total fiber adjustment. Multivariate analysis of food groups (rice, vegetables, soy products) that were highly correlated with Mn as covariates showed that the relationships between Mn intake and obesity were maintained (p trend for rice, vegetables, soy = &amp;lt;0.001, 0.187, 0.010) in all participants. In summary, higher dietary Mn intake was independently associated with a lower BMI, especially in the younger group and males. Future prospective or intervention studies are expected to confirm this result. Disclosure L.Khin: None. H.Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd., Takeda Pharmaceutical Co., Ltd. Jddm study group: n/a. K.Fujihara: None. M.Hatta: None. Y.Takeda: None. S.Y.Morikawa: None. C.Horikawa: None. N.Kato: None. M.Kato: None. H.Maegawa: None.

Association between adherence to the Dietary Approaches to Stop Hypertension diet and serum uric acid

To explore the relationship between Dietary Approaches to Stop Hypertension (DASH) diet and serum uric acid (SUA) levels among the Chinese adult population, and verify the mediating effect of BMI between DASH diet and SUA levels. A total of 1125 adults were investigated using a self-administered food frequency questionnaire. SUA levels were determined by uricase colorimetry. The total DASH score ranged from 9 to 72. The relationship between the DASH diet and SUA levels was examined by multiple adjusted regression analysis. Method of Bootstrap was used to test the mediation effect of BMI in the correlation of the DASH diet and SUA levels. After multivariable adjustment, there was a significant linear relationship between the DASH diet and SUA (P < 0.001). Compared with the lowest group, SUA of participants in group of highest DASH diet score decreased by 34.907 (95% CI − 52.227, − 17.588; P trend < 0.001) μmol/L. The association between the DASH diet scores and SUA levels was partly mediated by BMI (− 0.26, Bootstrap 95% CI − 0.49, − 0.07), with 10.53% of the total effect being mediated. Adopting the DASH diet might be helpful in reducing SUA level, and the effect might be partly mediated by BMI.