Semi-quantitative Food Frequency Questionnaire Research Articles

Lower intake of plant-derived nitrate is associated with higher odds of frailty: a cross- sectional study in community-dwelling older women

Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves, and is associated with declines across sensory, neurological, cardiovascular, and musculoskeletal systems(1). Previously, relationships have been identified between high dietary nitrate intake and several components of frailty including muscle strength and cognitive function, as well as vascular disease(2). However, little is known about the relationship between dietary nitrate intake and frailty in older adults. We investigated if higher habitual nitrate intake, derived from plant (e.g., vegetables, grains, beans, and fruits) and animal foods (e.g., meats, cheese, yoghurt) was associated with frailty in older women.1390 community-dwelling older women (mean age 75.1 ± 2.7 years) from the Perth Longitudinal Study of Ageing Women completed a validated semi-quantitative food frequency questionnaire (FFQ) at baseline (1998). Nitrate concentrations in food were obtained from our recently published international plant and animal nitrate databases and applied to each of the plant and animal foods within the FFQ (described in3). Frailty was operationalised using a standardised frailty index (FI) of cumulative deficits from 33 variables across multiple health domains (physical, mental, comorbidities), with a score ≥0.25 indicating frailty. Cross-sectional associations between dietary nitrate derived from plant and animal foods (separately) with frailty were analysed using multivariable-adjusted logistic regression models as part of restricted cubic splines. Models were adjusted for lifestyle and dietary factors (not used in the FI) that included age, smoking history, protein, alcohol, and energy intake.Frailty was observed in 276 (19.9 %) women. Median (IQR) daily plant and animal nitrate were 72.1 (55.6-90.0) mg/day and 3.5 (2.2-5.1) mg/day, respectively. A significant non-linear relationship was observed between higher plant nitrate intake and frailty, with a nadir recorded once intakes of ~64 mg/day were achieved (median of quartile [Q]2). Specifically, compared to women with the lowest intake of plant-derived nitrate (Q1, median 45 mg/day), women in Q2 (OR 0.69 95%CI 0.56-0.84), Q3 (OR 0.67 95%CI 0.50-0.90) and Q4 (OR 0.66 95%CI 0.45-0.98) had lower odds for frailty (all p<0.05). Additional adjustment for diet quality (Nutrient Rich Food Index per 1000 kJ) or total plasma 25-hydroxyvitamin D did not alter the findings. Nitrate derived specifically from vegetables and grains were found to drive these results. No relationship was observed between animal-derived nitrate and frailty.Community-dwelling older women consuming higher amounts of nitrate derived primarily from plants were less likely to present with frailty. Consuming 1-2 servings (75-150 g) per day of nitrate- rich green leafy vegetables, as part of total vegetable intake, will provide adequate nitrate levels (>70 mg/day) that could serve as a novel intervention to limit frailty.

Nutritional status, dietary habits, and their relation to cognitive functions: A cross-sectional study among the school aged (8-14 years) children of Bangladesh.

Limited research addressed links between nutritional status, dietary habits, and cognitive functions in young children. This study assessed the status of cognitive functions and their association with nutritional status and dietary habits of school age children of Bangladesh. This cross-sectional multi-centre study was conducted on 776 participants in 11 conveniently selected educational institutions. A printed questionnaire with three sections (Section 1: background information, section 2: PedsQL™ Cognitive Functioning Scale, and section 3: semi-quantitative food-frequency questionnaire) was utilized for the data collection purpose. Sections 1 and 3 were self-reported by parents, and trained volunteers completed section 2 in-person along with the anthropometric measurements. Statistical analyses were done in Stata (v.16). Mean with standard deviation and frequencies with percentages were used to summarize quantitative and qualitative variables, respectively. Pearson's chi-square test and Spearman's rank correlation coefficient were used to explore bivariate relationships. The mean age of the participants was 12.02±1.88 years, and the majority (67%) were females. The prevalence of poor cognitive function was 46.52%, and among them, 66.02% were females. In terms of body mass index (BMI), 22.44% possessed normal weight, 17.51% were overweight, and 5.19% were obese. This study found a statistically significant relationship between BMI and cognitive functions. Furthermore, different dietary components (e.g., protein, carbohydrate, fat, fiber, iron, magnesium) showed a significant (p<0.05 for all) weak positive correlation with cognitive function. BMI and dietary habits were associated with the cognitive function of young children in Bangladesh. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research.

Television watching during meals is associated with higher ultra-processed food consumption and higher free sugar intake in childhood.

The consumption of ultra-processed foods (UPFs) is associated with an increased risk of noncommunicable diseases and mortality in adults. The aim of this study was to analyse the association between mealtime television (TV) watching and UPF consumption in childhood. Participants in the SENDO project recruited in 2015-2023 were classified into three categories based on the frequency at which they watched TV during meals. Dietary information was collected with a validated 147-item semi-quantitative food frequency questionnaire. Generalized mixed models were used to compare mean UPF consumption between groups after accounting for the main confounders. The predictive margins of participants who had a free sugar intake >10% of their energy intake in each category were also calculated. Totally 970 subjects (482 girls) with a mean age of 5.00 years (SD = 0.85) were studied. Children who watched TV during meals ≥4 times/week consumed a mean of 4.67% more energy from UPF than those who watch TV <3 times/month. The adjusted proportions of children who had a free sugar intake >10% of their energy intake in the categories of <3 times/month, 1-3 times/week and ≥4 times/week exposure to TV during meals were 44.9%, 45.9% and 58.7%, respectively. TV watching during meals is associated with higher consumption of UPFs and a higher risk of exceeding 10% of TEI in free sugar intake in childhood.

Dietary inflammatory index and lower glomerular filtration rate in Mexican adults

We hypothesized that higher scores on the dietary inflammatory index (DII) would be associated with a lower glomerular filtration rate (GFR). This cross-sectional study included 2098 participants from Mexican Teachers Cohort Study, the Health Workers Cohort Study, and the Comitán Study belonging to the RenMex consortium. Energy-adjusted DII scores were estimated using a semi-quantitative food frequency questionnaire (FFQ). eGFR was estimated by the CKD Epidemiology Collaboration equation. Quantile regression models and ordered regression models were estimated to assess the associations of interest. Median age of study participants was 47 years, median eGFR was 102.9 mL/min/1.73m2, and the median energy-adjusted DII was 0.89 (range, -2.25, +4.86). The median eGFR was lower in participants in the highest percentile of DII compared to those in the lowest percentile (103.8 vs 101.4). We found that continuous and categorical energy-adjusted DII scores were associated with lower eGFR, especially at the lower percentiles. In adjusted ordered logistic regression, we found that the highest DII category was associated with 1.80 times the odds of belonging to the mildly decreased eGFR category or moderately decreased eGFR category compared lowest DII category (OR: 1.80, 95%CI 1.35, 2.40). A high DII score was associated with a lower eGFR among the Mexican population. Additional studies are crucial to validate these findings and explore potential strategies to reduce the consumption of pro-inflammatory foods as a preventive approach for chronic kidney disease (CKD).

Association between nut consumption and metabolic syndrome in Korean adults: results from the Korean Genome and Epidemiology Study–Health Examinees

BackgroundThe epidemiological evidence regarding nut consumption and metabolic diseases focuses on Western populations. Nut consumption among Koreans is relatively low, and the prevalence of metabolic syndrome is rapidly increasing, highlighting the need for more focused studies in this population. This cross-sectional study aimed to investigate the relationship between nut consumption and metabolic syndrome in Korean adults.MethodsA total of 112,501 adults (39,481 men and 73,020 women) aged 40–79 years were selected from baseline data of the Korean Genome and Epidemiology Study–Health Examinees. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized as non-consumers, &amp;lt;1 serving/week, ≥1 to &amp;lt;2 servings/week, or ≥2 servings/week (15 g per serving). Metabolic syndrome and its components were defined according to the Korean Society of CardioMetabolic Syndrome criteria. Associations between nut consumption and metabolic syndrome and its components were examined using multiple logistic regression with adjustments for potential confounders.ResultsIn the study population, the prevalence of metabolic syndrome was 21.4% (26.9% in men and 18.4% in women), and the mean nut intake was 0.8 serving/week (0.7 serving/week in men and 0.8 serving/week in women). After adjusting for confounders, higher nut consumption was associated with a lower odds ratio (OR) of metabolic syndrome in individuals consuming ≥2 servings/week compared with non-consumers [OR = 0.85, 95% confidence interval (CI) = 0.80–0.91, p for trend &amp;lt;0.001]. Specifically, in men, this level of consumption was associated with a 14% reduction in the OR of metabolic syndrome (OR = 0.86, 95% CI = 0.77–0.95, p for trend = 0.028). In women, a similar reduction of 14% was observed (OR = 0.86, 95% CI = 0.80–0.93, p for trend &amp;lt;0.001). Among the metabolic syndrome components, nut consumption was inversely associated with abdominal obesity, low high-density lipoprotein-cholesterol, and elevated triglycerides in men and women, whereas no associations were observed for elevated blood pressure or elevated fasting blood glucose.ConclusionOur findings suggest that higher nut consumption is inversely associated with metabolic syndrome and its components in Korean adults. Further studies are needed to examine the longitudinal association between nut consumption and metabolic diseases in this population.

Validity and Reproducibility of an Electronic Food Frequency Questionnaire in Argentinian Adults.

This study aimed to validate a semiquantitative electronic food frequency questionnaire (eFFQ) in estimating the intake of a comprehensive list of nutrients and bioactive compounds among adults from six regions of Argentina using multiple 24 h dietary recall (24HR) as a reference. A total of 163 adults completed two administrations of the eFFQ and four 24HRs. The paired t-test/Wilcoxon signed-rank test, Spearman/Pearson correlations, cross-classification, weighted kappa statistics, and Bland-Altman plots were employed to determine relative validity. To determine reproducibility, intraclass correlations (ICC), cross-classification, and weighted kappa statistics were calculated. For relative validity, crude correlations ranged from 0.15 to 0.57; energy adjustment and de-attenuation slightly improved most of these correlations. In cross-classification analysis, agreements within one quintile adjacent to exact agreement (EA ± 1) ranged from 52.2% to ~74%; extreme misclassifications were < 7%. For reproducibility, the crude ICC ranged from 0.29 to 0.85, showing moderate to good correlations for most nutrients. Cross-classification analysis showed agreement levels for the EA ± 1 quintile of 70.6% to 87.7%. Weighted kappa values ranged from 0.21 to 0.62. The results show that this eFFQ is relatively valid in ranking adults according to their nutrient intake and has an acceptable reproducibility, yet it slightly overestimates the intake of most nutrients.

Association of Egg Intake With Alzheimer’s Dementia Risk in Older Adults: The Rush Memory and Aging Project

BackgroundAlzheimer’s disease (AD) is a neurodegenerative disorder with increasing prevalence due to population aging. Eggs provide many nutrients important for brain health, including choline, omega-3 fatty acids, and lutein. Emerging evidence suggests that frequent egg consumption may improve cognitive performance on verbal tests, but whether consumption influences the risk of Alzheimer’s dementia and AD is unknown. ObjectivesTo examine the association of egg consumption with Alzheimer’s dementia risk among the Rush Memory and Aging Project cohort. MethodsDietary assessment was collected using a modified Harvard semiquantitative food frequency questionnaire. Participants’ first food frequency questionnaire was used as the baseline measure of egg consumption. Multivariable adjusted Cox proportional hazards regression models were used to investigate the associations of baseline egg consumption amount with Alzheimer’s dementia risk, adjusting for potential confounding factors. Subgroup analyses using Cox and logistic regression models were performed to investigate the associations with AD pathology in the brain. Mediation analysis was conducted to examine the mediation effect of dietary choline in the relationship between egg intake and incident Alzheimer’s dementia. ResultsThis study included 1024 older adults {mean [±standard deviation (SD)] age = 81.38 ± 7.20 y}. Over a mean (±SD) follow-up of 6.7 ± 4.8 y, 280 participants (27.3%) were clinically diagnosed with Alzheimer’s dementia. Weekly consumption of >1 egg/wk (hazard ratio [HR]: 0.53; 95% confidence interval [CI]: 0.34, 0.83) and ≥2 eggs/wk (HR: 0.53; 95% CI: 0.35, 0.81) was associated with a decreased risk of Alzheimer’s dementia. Subgroup analysis of brain autopsies from 578 deceased participants showed that intakes of >1 egg/wk (HR: 0.51; 95% CI: 0.35, 0.76) and ≥2 eggs/wk (HR: 0.62; 95% CI: 0.44, 0.90) were associated with a lower risk of AD pathology in the brain. Mediation analysis showed that 39% of the total effect of egg intake on incident Alzheimer’s dementia was mediated through dietary choline. ConclusionsThese findings suggest that frequent egg consumption is associated with a lower risk of Alzheimer’s dementia and AD pathology, and the association with Alzheimer’s dementia is partially mediated through dietary choline.

Adherence to Healthy and Unhealthy Plant-Based Diets and the Risk of Gout

Plant-based diets are increasing in popularity due, in part, to their health benefits for selected cardiometabolic diseases as well as favorable environmental impact. Little is known about how such a diet is related to gout risk. To examine associations between adherence to a plant-based diet (including healthy and unhealthy versions of this diet), as well as its 18 individual food groups, and incident gout. This prospective cohort study used data from population-based cohorts of US men and women enrolled in the Health Professionals Follow-Up Study (1986-2012) and Nurses' Health Study (1984-2010). Participants were men and women free of gout at baseline. Statistical analyses were performed over March 2020 to August 2023. An overall plant-based diet index (PDI), as well as healthy (hPDI) and unhealthy (uPDI) versions of this index that emphasize healthy and less healthy plant-based foods, respectively. These diet indices were comprised of 18 food groups, assessed using a validated semiquantitative food frequency questionnaire. Incident cases of gout that were confirmed with a supplementary questionnaire to meet the preliminary American College of Rheumatology survey criteria for gout. Cox proportional hazards regression models were used to evaluate multivariable-adjusted associations of all 3 PDIs with incident gout using quintiles (Q) of adherence. Among a total of 122 679 participants (mean [SD] age, 53.8 [9.8] years among 43 703 men; mean [SD] age, 50.9 [7.2] years among 78 976 women) over 2 704 899 person-years of follow-up, 2709 participants experienced incident gout. The overall PDI was not significantly associated with gout in either cohort (Q5 vs Q1 pooled hazard ratio [HR], 1.02 [95% CI, 0.89-1.17]; P for trend = .63). In the pooled analysis, hPDI was significantly inversely associated with risk of gout (Q5 vs Q1 HR, 0.79 [95% CI, 0.69-0.91]; P for trend = .002), while the uPDI was positively associated with risk of gout (Q5 vs Q1 HR, 1.17 [95% CI, 1.03-1.33]; P for trend = .02), particularly in women (Q5 vs Q1 HR, 1.31 [95% CI, 1.05-1.62]; P for trend = .01). In analysis of individual food groups, higher intakes of certain healthy plant foods, such as whole grains (pooled HR per 1 serving/d, 0.93 [95% CI, 0.89-0.97]) and tea and coffee (pooled HR per 1 serving/d, 0.95 [95% CI, 0.92-0.97]), as well as dairy (pooled HR per 1 serving/d, 0.86 [95% CI, 0.82-0.90]), were independently associated with a lower risk of gout, while selected unhealthy plant foods, such as fruit juice (pooled HR per 1 serving/d, 1.06 [95% CI, 1.00-1.13]) and sugar-sweetened beverages (pooled HR per 1 serving/d, 1.16 [95% CI, 1.07-1.26]) were associated with increased risk of gout. The findings of this prospective cohort study of PDIs and gout support current dietary recommendations to increase consumption of healthy plant foods while lowering intake of unhealthy plant foods to mitigate gout risk.

Dietary nutrient intake study among older adults: baseline Malaysian pure study

IntroductionThe older adults (OA) is vulnerable to malnutrition, which may affect their health and quality of life. This study assesses the prevalence of deficiencies in dietary nutrients among the Malaysian OA stratified by residency, genders, socioeconomic status (SES) and body mass index (BMI).MethodologyA cross-sectional study was conducted, utilizing purposive sampling, recruiting 2,299 Malaysian people aged 60 years old and above who agreed to be interviewed via a comprehensive semi-quantitative food frequency questionnaire. The nutrients intake was calculated based on the Malaysian food composition and US Department of Agriculture food composition databases. Then, the nutrients intake was compared with the Malaysian Recommended Nutrients Intake guidelines, and the prevalence of deficiencies in dietary nutrients were calculated. The median (interquartile ranges) intakes of nutrients were compared between residency (urban and rural), genders (male and female), and SES (low and middle-high) using the Mann-Whitney U test. The differences in nutrient intake between BMI categories (underweight, normal, and overweight) were identified using the Kruskal-Wallis test followed by Dunn’s post hoc test.ResultsThe response rate was 70.3% (n = 2,299), predominantly were females (50.8%), received primary education (76.6%), were currently married (84.3%), were middle–high SES (57.7%), and had a normal BMI (59.8%). There was a notable inadequate intake prevalence of magnesium (100.0%), manganese (97.9%), zinc (95.6%), vitamin B6 (98.4%), potassium (91.0%), calcium (89.3%), vitamin B12 (80.2%), vitamin E (91.2%), and vitamin K (81.5%) among Malaysian OA. Additionally, significant differences were observed in nutrients intake levels across gender, residency, SES, and BMI within this population.ConclusionsThis study shows a high prevalence of dietary nutrients deficiency (> 80%) among the Malaysian OA, particularly for magnesium, manganese, potassium, zinc, vitamin B6, vitamin E, calcium, vitamin B12, and vitamin K. To improve the nutritional status of OA and safeguard against adverse health effects, it is necessary to formulate and execute strategies to enhance their dietary nutrient intakes. The strategies may involve intervention such as nutrient supplementation and promotion of consuming nutrient-rich foods.

Potato Consumption and All-Cause and Cardiovascular Disease Mortality – A Long-Term Follow-Up of a Norwegian Cohort

BackgroundPotatoes are a staple food in many traditional cuisines, yet their impact on long-term risk of cardiovascular disease (CVD) and mortality is unclear, hampering evidence-based dietary guidelines. ObjectivesThis study aimed to examine the association between potato consumption and all-cause and CVD-specific death over a substantial follow-up period within a cohort predominantly consuming boiled potatoes. MethodsAdults from 3 Norwegian counties were invited to 3 health screenings in 1974–1988 (>80% attendance). Dietary data were collected using semiquantitative food frequency questionnaires at each screening to categorize weekly potato consumption (≤6, 7–13, or ≥14 potatoes/wk) and calculate daily cumulative mean intakes (grams/day). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression to estimate HRs and 95% CIs for the association between potato consumption and risk of death from all causes, CVD, ischemic heart disease (IHD), and acute myocardial infarction (AMI). ResultsAmong 77,297 participants with a mean baseline age of 41.1 y (range: 18.0–63.9 y), we observed 27,848 deaths, including 9072 deaths due to CVD, over a median follow-up of 33.5 y. Participants who consumed ≥14 potatoes/wk had a lower risk of all-cause death compared with those consuming ≤6 potatoes/wk (HR: 0.88; 95% CI: 0.84, 0.93). Potato consumption was associated with a minor, inverse risk of death due to CVD, IHD, and AMI. In continuous analyses of cumulative intakes, each 100 g/d increment was associated with 4% lower risk of death from all causes (HR: 0.96; 95% CI: 0.94, 0.98), CVD (HR: 0.96; 95% CI: 0.93, 0.99), IHD (HR: 0.96; 95% CI: 0.91, 1.00), and AMI (HR: 0.96, 95% CI: 0.91, 1.01). ConclusionsIn this cohort with a generally high consumption of predominantly boiled potatoes, we find modest, inverse associations between potato consumption and death from all causes, CVD, and IHD.

Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women

PurposeDietary nitrate intake is inversely related to numerous contributors towards frailty, including cardiovascular disease and poor physical function. Whether these findings extend to frailty remain unknown. We investigated if habitual nitrate intake, derived from plants or animal-based foods, was cross-sectionally associated with frailty in women.MethodsCommunity-dwelling older Australian women (n = 1390, mean age 75.1 ± 2.7 years) completed a validated semi-quantitative food frequency questionnaire (FFQ). Nitrate concentrations in food were obtained from international nitrate databases. We adopted the Rockwood frailty index (FI) of cumulative deficits comprising 33 variables across multiple health domains (scored 0 to 1), which predicts increased hospitalisation and mortality risk. A FI ≥ 0.25 indicated frailty. Cross-sectional associations between nitrate intake (total plant and animal nitrate, separately) and frailty were analysed using multivariable-adjusted logistic regression models (including lifestyle factors), as part of restricted cubic splines.ResultsA non-linear inverse relationship was observed between total plant nitrate intake and frailty. Compared to women with the lowest plant nitrate intake (Quartile [Q]1), women with greater intakes in Q2 (OR 0.69 95%CI 0.56–0.84), Q3 (OR 0.67 95%CI 0.50–0.90) and Q4 (OR 0.66 95%CI 0.45–0.98) had lower odds for frailty. A nadir in the inverse association was observed once intakes reached ~ 64 mg/d (median Q2). No relationship was observed between total animal nitrate and frailty.ConclusionCommunity-dwelling older women consuming low amounts of plant-derived nitrate were more likely to present with frailty. Consuming at least one daily serving (~ 75 g) of nitrate-rich green leafy vegetables may be beneficial in preventing frailty.

Developing and evaluating the validity and reliability of the Iranian preschool food frequency questionnaire (IP-FFQ)

IntroductionThis study aimed to assess the relative validity and reliability of a semi-quantitative food-frequency questionnaire (FFQ) among preschool children in Iran. MethodsA total of 161 children aged 4–6 years were enrolled in the validation phase, with a subsample of 120 subjects participating in the reliability study. A two-round Delphi study was conducted to assess content validity, and 24-hours dietary recall (24-HR) was used as reference for the criterion validity of the FFQ. Reliability was evaluated by intra-class correlation coefficients (ICCs) between results of two FFQs administered with eight weeks intervals. The Bland–Altman plot was used to examine the agreement between the FFQ-1 vs 24-HRs and FFQ-1 vs FFQ-2 for energy and nutrient intakes. ResultsThe Delphi showed satisfactory levels of Content Validity Ratio (0.84) and Content Validity Index (0.88), respectively. The Pearson’s correlation coefficients between FFQ-1 and 24-HRs showed low to moderate agreement, ranging from 0.06 for vitamin B12 to 0.45 for vitamin D. As for reliability, ICCs showed excellent agreement (>0.75) for all nutrients between repeated FFQs. Findings of the Bland–Altman plots showed that most data points fell within the 95 % limits of agreement (LOA) for all nutrients. The results confirm that the IP-FFQ has acceptable validity and good reliability to assess preschool children’s food intake. ConclusionThis questionnaire could be used in epidemiological studies and health sciences research, to implement evidence-based strategies and policies for optimal growth and heath amongst children.

Dietary patterns and metabolic syndrome in patients with premature heart disease: a cross-sectional study

PurposeDue to the increase in the prevalence of other risk factors of heart diseases, the age of heart disease has decreased and it has led to premature heart disease. One of the main risk factors of this disease is metabolic syndrome (MetS). One of the key ways to control MetS is dietary modification. The purpose of this study is to investigate the relationship between dietary patterns and MetS in patients with premature heart disease.Design/methodology/approachThis study was conducted on 409 people with premature heart disease. The diagnosis of MetS was made based on the ATP III criteria. Dietary intake for the past year was collected using the validated semi-quantitative food frequency questionnaire. Dietary patterns were determined by factor analysis with principal components approach.FindingsThree dietary patterns were identified, including the healthy, western and traditional patterns. The findings showed that people who followed the traditional pattern more than those who followed less had a lower risk of MetS. (OR:0.23; 95% CI: 0.11–0.52). But, no relation was observed between healthy (OR:1.45; 95% CI:0.64–3.25) and western (OR:1.04; 95% CI:0.51–2.13) patterns with MetS.Originality/valueThe findings of this study showed that following a traditional dietary pattern based on high consumption of whole grains, red meat, viscera, fish, eggs, high-fat dairy products, soft drinks, mayonnaise and solid oil was associated with a lower risk of MetS.

Gender differences in dietary intake and physical activity among university students: a post-COVID-19 pandemic study

Purpose Malaysia transitions from a pandemic to an endemic state, beginning on April 1, 2022. The dietary intake and physical activity of university students were altered during the COVID-19 pandemic confinement period, but there is limited information on this topic in the post-COVID-19 period. This cross-sectional study aims to understand gender differences in dietary intake and physical activity among university students and investigate the factors influencing their body mass index (BMI) in the post-COVID-19 period. Design/methodology/approach The questionnaire used in this study comprised three main segments: sociodemographic information, a semiquantitative food frequency questionnaire and the International Physical Activity Questionnaire. Findings Results indicated that males exhibited significantly higher (p &lt; 0.05) mean intakes of total dietary energy and macronutrients compared to females. Compared to the Malaysian Recommended Nutrient Intakes 2017, 76.4% of males and 68.8% of females had a sufficient daily energy intake. The majority of males (52.7%) and females (46.4%) were moderately physically active. Regression analysis revealed that male university students with lower fiber intake (ß = −0.309, p = 0.002) were significantly associated with higher BMI reading after confounding adjustment. However, a similar trend was not observed in female university students. Practical implications Understanding the gender differences in dietary intake and physical activity can provide insights into the development of effective gender-specific health promotion strategies and the formulation of policies aimed at promoting healthier lifestyles among university students in the post-COVID-19 pandemic era. Originality/value This study provides insights into the gender differences in the dietary and physical activity habits of university students, as well as the factors influencing their BMI in the post-COVID-19 pandemic era.

Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study

ObjectiveTo examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality.DesignPopulation based cohort study.SettingFemale registered nurses from 11 US states in the Nurses’ Health Study...

Assessing the reproducibility and validity of a food frequency questionnaire for pregnant women from the Chinese Miao ethnic group.

Currently, no food frequency questionnaire is available to be administered exclusively to ethnic minorities in China. This study aimed to evaluate the reproducibility and validity of a culturally tailored semi-quantitative food frequency questionnaire (FFQ) designed for pregnant women belonging to the Miao ethnic group in China. A total of 74 questions in the FFQ were administered to collect dietary information from Miao women in China during their pregnancy. This study included 153 and 127 pregnant women, respectively, for testing the validity and reproducibility of the results. Baseline FFQ data (FFQ1) were collected initially, followed by the administration of a repeated FFQ 4-6 weeks later (FFQ2). Two 24-h recalls (24HR) were used as references to compare food groups and nutrient intake. Pearson/Spearman's coefficients were used to measure the validity and reproducibility of the FFQ. Quartile cross-classification, weighted kappa coefficients, and Bland-Altman plots were employed to assess the agreement. Most food groups and nutrient intake estimated by the FFQ were higher than those estimated by the 24HR. Food groups and nutrients' correlations for FFQ vs. 24HR after being energy-adjusted and de-attenuated, respectively, were 0.10 (vegetables) to 0.45 (grains/tubers) and 0.15 (iron) to 0.52 (riboflavin). Comparatively, correlation coefficients for FFQ1 vs. FFQ2 ranged from 0.41 (fruit) to 0.71 (vegetables) and from 0.45 (energy) to 0.64 (calcium). The percentage of pregnant women classified in the same or adjacent quartiles ranged from 64.08% (vegetables) to 95.29% (sour soup) and from 68.88% (vitamin E) to 78.81% (energy). Weighted kappa coefficients exceeded 0.2 for food groups and most nutrients, and Bland-Altman plots demonstrated acceptable agreement between the two tools. This study provides novel information on the validation of FFQ. It demonstrates that the FFQ exhibits ideal reproducibility and acceptable validity in estimating and ranking the intake of food groups and most nutrients among pregnant women belonging to the Chinese Miao ethnic group.

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&gt; 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 &lt; 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.

Correlation Among Serum Calcidiol, Sun Index, and Vitamin D Intake in Individuals With Seborrheic Keratoses Living in Coastal Area.

Seborrheic keratoses (SK) are benign epidermal tumors with high sun exposure as a major risk factor. Vitamin D deficiency is also thought to play a role in its pathogenesis. There has been no data regarding SK, calcidiol level, vitamin D intake, and sun index (SI) among people living in coastal areas in Indonesia. To assess the correlation between 1) serum calcidiol levels with SI and vitamin D intake and 2) lesion size with SI and serum calcidiol level among SK patients living in a coastal area. This is a cross-sectional study. We performed interviews using the sun index questionnaire and semiquantitative food frequency questionnaire for vitamin D; physical examination; dermoscopy to determine the largest SK lesion size; and measurement of serum calcidiol levels in participants with SK living in Cilincing District, North Jakarta. Spearman correlation test was used to assess the relationship between variables. Thirty-nine participants with SK aged 19-59 years were analyzed. The median of the SK largest diameter, SI, serum calcidiol, and vitamin D intake was 2 (1-10) mm, 3.95 (1.1-23.52), 14.3 (5.25-35.30) ng/ml, and 4.3 (0.1-30.1) mcg/day, respectively. SI and vitamin D intake were not significantly correlated with calcidiol levels. Similarly, SI and calcidiol levels were not significantly correlated with the largest SK lesion size. We found low calcidiol levels and vitamin D intake in this coastal population. The SI and vitamin D intake had no correlations with calcidiol levels. Furthermore, calcidiol levels and SI had no correlations with the lesion largest diameter.

Biomarker Candidates of Habitual Food Intake in a Swedish Cohort of Pregnant and Lactating Women and Their Infants.

Circulating food metabolites could improve dietary assessments by complementing traditional methods. Here, biomarker candidates of food intake were identified in plasma samples from pregnancy (gestational week 29, N = 579), delivery (mothers, N = 532; infants, N = 348), and four months postpartum (mothers, N = 477; breastfed infants, N = 193) and associated to food intake assessed with semi-quantitative food frequency questionnaires. Families from the Swedish birth cohort Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) were included. Samples were analyzed using untargeted liquid chromatography-mass spectrometry (LC-MS)-based metabolomics. Both exposure and outcome were standardized, and relationships were investigated using a linear regression analysis. The intake of fruits and berries and fruit juice were both positively related to proline betaine levels during pregnancy (fruits and berries, β = 0.23, FDR < 0.001; fruit juice, β = 0.27, FDR < 0.001), at delivery (fruit juice, infants: β = 0.19, FDR = 0.028), and postpartum (fruits and berries, mothers: β = 0.27, FDR < 0.001, infants: β = 0.29, FDR < 0.001; fruit juice, mothers: β = 0.37, FDR < 0.001). Lutein levels were positively related to vegetable intake during pregnancy (β = 0.23, FDR < 0.001) and delivery (mothers: β = 0.24, FDR < 0.001; newborns: β = 0.18, FDR = 0.014) and CMPF with fatty fish intake postpartum (mothers: β = 0.20, FDR < 0.001). No clear relationships were observed with the expected food sources of the remaining metabolites (acetylcarnitine, choline, indole-3-lactic acid, pipecolic acid). Our study suggests that plasma lutein could be useful as a more general food group intake biomarker for vegetables and fruits during pregnancy and delivery. Also, our results suggest the application of proline betaine as an intake biomarker of citrus fruit during gestation and lactation.

Investigation of the interaction between genetic risk score (GRS) and fatty acid quality indices on metabolic syndrome among overweight and obese women

Background and aimMetabolic syndrome is one of the major public-health challenges, affecting one-quarter of the world population. Fatty acid quality indices are novel determinants of this disease and their interactions with genetic factors may have an impact on metabolic syndrome risk. Therefore, we aimed to investigate the interaction between genetic risk score (GRS) and fatty acid quality indices with metabolic syndrome (MetS) among overweight and obese women.MethodsIn the present cross-sectional study, 279 overweight and obese women (18–48 years old) were included. Several anthropometric measurements such as weight, height, body mass index (BMI), waist circumference (WC), and body fat percent (BF%) were measured. Also, systolic and diastolic blood pressure (SBP and DBP) were measured. Biochemical determination was performed for fasting blood glucose (FBS), triglyceride (TG), and high-density lipoprotein (HDL). MetS was determined according to National Cholesterol Education Program (NCEP ATP III) criteria. Dietary intake was evaluated by a validated and reliable 147-item semi-quantitative food frequency questionnaire. Cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (ω-6/ω-3) essential fatty acids were considered as fat quality indices. The salting-out method was used to extract the total DNA. The unweighted GRS was calculated using the risk alleles of the three single nucleotide polymorphisms. The total average GRS value was 2 and the sum of the risk alleles of the 3 polymorphisms was 6.ResultThe results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was a positive interaction between T2 of GRS and T2 of N6/N3 ratio on WC (β = 7.95, 95%CI = 0.83,15.08, P = 0.029), T3 of GRS and T2 of N6/N3 ratio on DBP (β = 5.93, 95%CI= -0.76,12.63, P = 0.083), and FBS (β = 6.47, 95%CI = 0.59,13.53, P = 0.073), T3 of GRS and T3 of N6/N3 ratio on TG (β = 54.42, 95%CI = 1.76,107.08, P = 0.043), and T3 of GRS and T3 of CSI on BF% (β = 3.55, 95%CI= -0.35,7.45, P = 0.075). Also T2 of GRS in the interaction with T3 of CSI leads to an decrease − 8.35 mg/dl in HDL level after adjustment in (β= -8.35, 95%CI= -17.34,0.62, P = 0.068).ConclusionIt seems the interaction of GRS and fatty acid quality indices is positively associated with several components of metabolic syndrome such as WC, TG and BF%. Our findings are of importance to public health, considering the high consumption of foods that are high on fatty acids. Conflicting evidence of many previous studies regarding the effect of fat intake and obesity and cardiovascular diseases could be because of the gene-diet interactions and genetic heterogeneity across various ethnic groups. Hence, the synergism effect of genetic and dietay intakes should be considered in future studies.