Total Protein Foods Research Articles

The UnProcessed Pantry Project (UP3): A Community-Based Intervention Aimed to Reduce Ultra-Processed Food Intake Among Food Pantry Clients.

Low-income populations are more likely to experience food and nutrition insecurity and suffer a greater burden of noncommunicable disease than the general population. The UnProcessed Pantry Project (UP3) is an intervention aimed to reduce ultra-processed food availability and consumption of food pantry clients accessing the emergency food system. The pilot study included nutrition education, food boxes, and social support for 16 weeks at 2 food pantries. Data collection included the ASA24 dietary recall to calculate Healthy Eating Index-2015 (HEI-2015) scores, biomarkers (hemoglobin A1c, total cholesterol, blood pressure, waist circumference, body mass index [BMI]), and a demographic and psychosocial survey. Dietary quality among 43 participants significantly (P < .05) improved as measured by the HEI-2015 for total HEI-2015, whole grains, total protein foods, and added sugars scores. BMI, total cholesterol, and waist circumference also significantly improved across study participants. Findings indicate that the emergency food system may be an effective access point to apply frameworks including UP3 to address ultra-processed food consumption, dietary quality, and noncommunicable chronic disease risk among food-insecure populations. Programs and policies that limit the amount of ultra-processed food in the emergency food system should be further tested and could be efficacious in addressing inequities among vulnerable populations.

Diet Quality Assessment in Wheelchair Users with Multiple Sclerosis.

Background: Diet quality has not been distinctively examined in wheelchair users with multiple sclerosis (MS). Methods: This cross-sectional study examined the Diet History Questionnaire (DHQ) III and the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool in 128 wheelchair users with MS. Participants were prompted to complete the DHQ-III and 3 ASA24 recalls during a seven-day data collection period. Healthy Eating Index (HEI)-2015 scores were calculated for DHQ-III and ASA24, and scores were compared with normative values. Spearman’s correlation analyses (rs) estimated the associations between DHQ-III and ASA24 HEI-2015 total and component scores with supportive paired sample t-tests. Results: HEI-2015 scores for DHQ-III and ASA24 were significantly higher than normative values for total score, total protein foods, and added sugar. Correlations between HEI-2015 scores generated using ASA24 and DHQ-III were all statistically significant (range rs = 0.23–0.69); however, significant differences between ASA24 and DHQ-III values were noted for HEI-2015 total score, total fruits, whole fruit, total vegetable, greens and beans, whole grains, seafood and plant protein, refined grains, and saturated fats. Conclusion: This study provided a novel description of diet quality in wheelchair users with MS for guiding future research promoting healthy eating in this population.

Healthy eating index-2015 and breast cancer: a case-control study

PurposeRecently, evidences have suggested that healthy eating index (HEI), an index-based dietary pattern, may be a predictor for the risk of cancer. This paper aims to examine the association of HEI-2015 and its all components scores with the risk of breast cancer (BC), separately, among Iranian women.Design/methodology/approachIn the present hospital-based, case-control study, 150 age-matched of cases (newly diagnosed female) and 150 controls were recruited. Data of dietary habits and anthropometric measures were obtained, and eventually, the HEI-2015 score was calculated. Multivariate odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the relationship between the risk of BC across tertiles (Ts) of total HEI-2015 and its all component scores.FindingsThe results presented that in adjusted model, there was no significant difference between total HEI-2015 (p = 0.14) and its all component scores (p > 0.09) of healthy subjects and females with BC. Moreover, multivariable logistic regression analyses indicated that HEI-2015 score was not associated with the risk of BC in either crude (p-trend = 0.94) or adjusted (p-trend = 0.73) analyses. In the analyses of HEI-2015 components scores, it was observed that the scores of grains (OR, 0.53; 95% CI, 0.30–0.94) and total protein foods (OR, 0.13; 95% CI, 0.02–0.58) may have a relation with BC risk in crude model but after adjusting for BC risk factors, the mentioned associations changed to non-significant.Originality/valueThe findings of current study suggested that there was no significant association of total HEI-2015 and its components scores, independently, with BC incidence among Iranian women.

Patterns of Egg Consumption Can Help Contribute to Nutrient Recommendations and Are Associated with Diet Quality and Shortfall Nutrient Intakes.

Limited data are available on how eggs are consumed in the typical American eating pattern and the contribution to usual intakes, diet quality and in meeting recommendations. The objectives of the present analysis included identifying how eggs are consumed within U.S. dietary patterns and how these patterns are associated with the usual intakes of shortfall nutrients and diet quality (Healthy Eating Index 2015) using data from the combined National Health and Nutrition Examination Survey (NHANES) from 2001–2016. An additional objective included assessing the differences between egg consumers and egg non-consumers in nutrient intakes and nutrient adequacy. Several egg-containing dietary patterns were identified, and two egg patterns were associated with a greater diet quality compared to a no egg pattern (p < 0.0001). Most egg patterns identified were similar in diet quality scores when compared to the no egg pattern; however, the two egg patterns had lower diet quality scores. Egg consumption combined with a greater intake of total protein foods, seafood and plant protein, total vegetables, total fruit, whole fruit, whole grains and dairy foods, and a lower intake of refined grains and added sugars contributed to an improved diet quality, supporting that no one food is responsible for a healthy dietary pattern. Egg consumers demonstrated significantly higher intakes of dietary fiber, calcium, magnesium, potassium, total choline, vitamin A, vitamin C, vitamin D and vitamin E when compared to egg non-consumers. A comparison of egg consumers and egg non-consumers found egg consumers had significantly less percentages of the population below the EAR for calcium, iron, magnesium, vitamin A, vitamin C and vitamin E. Similarly, the percentage of the population above the recommendations for potassium and choline were greater for egg consumers vs. egg non-consumers. In egg consumers, 24.4% of the population was above the AI for dietary choline when compared to 4.3% of egg non-consumers (p < 0.0001). Findings from the present analysis demonstrate that eggs and egg-containing foods can be an important part of a healthy dietary pattern when balanced accordingly with other nutrient-dense foods.

Egg Consumption in the Context of Plant-Based Diets and Diet Quality in Adults at Risk for Type 2 Diabetes: A Randomized Single Blind Cross-over Controlled Trial

Background: Lifestyle changes that emphasis on plant-based diets (PBD) are typically recommended for those at risk for type 2 diabetes mellitus (T2DM) to mitigate their cardo-metabolic risk. We examined the impact of the inclusion of eggs compared with their exclusion from PBD on diet quality among adults at risk for T2DM. Methods: This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age 60.7 years; 25 women, 10 men; 34 Caucasians, 1 African-American) at risk for T2DM (i.e., pre- diabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two treatments (PBD with eggs and exclusively PBD), with a 4-week washout period. Participants received dietary counseling from a dietitian to exclude or to include 2 eggs daily in the context of PBD for a 6-week period. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) at baseline and 6 weeks. Results: Compared with the exclusion of eggs, the inclusion of eggs in the context of PBD improved the diet quality score for intake of total protein foods (1.0 ± 1.1 vs. −0.4 ± 1.0; p <.0001); seafood and plant proteins (0.2 ± 1.2 vs. −0.4 ± 1.1; p = 0.0338); and fatty acids (0.8 ± 2.5 vs. −0.7 ± 2.7; p = 0.0260). Overall diet quality score depreciated with the adoption of exclusively PBD without eggs (−3.1 ± 8.3; p = 0.0411), while it was unaffected with the adoption of a PBD with the inclusion of eggs (−0.6 ± 7.9; p = 0.6892). Conclusions: Eggs could be used as an adjuvant to enhance the diet quality among those at risk for T2DM who adopt plant-based dietary patterns.

Compliance with dietary guidelines and its relationship with symptoms and clinical outcomes in patients with advanced cancer in early-phase oncology clinical trials.

199 Background: We examined compliance with the Dietary Guidelines for Americans and its association with symptom burden and clinical outcomes in patients with advanced cancer in early-phase clinical trials testing novel immunotherapeutic and targeted agents. Methods: Patients starting an early-phase clinical trial (ECOG-PS = 0-1) were recruited into a prospective, longitudinal design with assessments at baseline and at the end of Cycle 1. Diet and symptom burden were assessed using the validated National Cancer Institute Diet History Questionnaire (NCI-DHQ) and the MD Anderson Symptom Inventory, respectively. Compliance with the Dietary Guidelines for Americans recommendations was measured via the Healthy Eating Index (HEI) (a measure of dietary intake per total energy), computed from NCI-DHQ food group and nutrient scores; higher HEI scores indicate greater compliance with dietary guidance recommendations (possible range = 0–100). Statistical tests included Spearman rank correlations (rho), and Cox proportional hazards models. Results: Among early-phase clinical trial patients [N = 40; 50% female; 80% Non-Hispanic White; 80% ECOG = 1; 36% on trials including an immunotherapeutic agent and 64% on targeted therapy trials; mean age = 55y; mean BMI = 28], mean HEI was 69, compared to 59 for the US general population. The proportion of phase I clinical trial patients who met adequacy guidelines were 80% for whole fruit, 73% for total protein foods, 55% for seafood and plant proteins, 55% for total fruit, 50% for greens and beans, 28% for total vegetables, 15% for fatty acids [(PUFAs + MUFAs)/SFAs ≥2.5], 13% for dairy, and 0% for whole grains. The proportion of patients who met moderation guidelines were 28% for refined grains, 28% for added sugar, 13% for saturated fat, and 0% for sodium. Female patients had higher HEI scores than male patients (73 vs. 65, P = 0.004). Patients who were normal weight (BMI &lt; 25) had higher scores for meeting the moderation in sugar intake guideline than overweight patients (BMI≥25) (7.7 vs. 5.5, P = 0.031). Higher intakes of cooked lean meat from beef, pork, veal, lamb, and game were linked to prolonged overall survival (HR = 0.5, 95%CI = 0.26, 0.96, P = 0.039). In immunotherapy patients, greater compliance with seafood and plant protein recommendations was associated with less fatigue at end of Cycle 1 (rho = -0.7, P = 0.008); in targeted therapy patients, higher glycemic load was associated with worse pain (rho = 0.7, P = 0.004). Conclusions: Diets of these early-phase clinical trial patients overall were congruent with recommendations in the Dietary Guidelines for Americans. However, increasing intakes of whole grains and reducing sodium intakes may be useful dietary goals for this population. Also, dietary factors may influence symptoms, such as fatigue and pain, in early-phase clinical trial patients with advanced cancer.

Difference in diet quality trends between children and adults in the United States: A serial cross-sectional study from 1999 to 2018.

Previous studies had shown that trends in diet quality between children and adults may vary but lack quantitative comparisons. We aimed to compare diet quality and its trends between US children and adults in this research. Children aged 2 to 18 and adults aged 19 to 59 years old in the US were enrolled the serial cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) cycles from 1999 to 2018. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), and trends were analyzed by joinpoint regression model. This study included 31988 children and 34317 adults. From 1999 to 2018, there was a trend-change among 5 children's components trends (including total fruits in 2011-2012, whole fruits in 2005-2006, greens and beans in 2013-2014, dairy in 2013-2014, and total protein foods in 2013-2014, p for joinpoint <0.05 for each) and overall trend in 2013-2014, whereas no significant trend-change in adults' trend. The trends of overall HEI-2015 between children (average annual percent change 0.3%; 95% CI: -0.1% to 0.8%) and adults (0.3%; 95%CI: 0.0% to 0.6%) showed no significant difference in parallelism (p for parallelism=0.60), but a significant difference in coincidence (intercept -7.7±3.7 among children; -2.3±2.5 among adults; p for coincidence <0.05). Children had a different trend with more trend-changes in diet quality compared with adults, and the diet quality of children was worse than that of adults during 1999-2018 in the US.

Dietary Intakes of Children Enrolled in US Early Child-Care Programs During Child-Care and Non-Child-Care Days

BackgroundEarly-child-care (ECE) programs may substantially influence child diet quality. ObjectiveThe Study of Nutrition and Activity in Child Care Settings describes the usual food group intake of preschool-aged children attending ECE programs relative to Dietary Guidelines for Americans (DGA) recommendations, comparing intakes during child-care and non-child-care days. DesignMeal observations and parent-completed food diaries in a cross-sectional nationally representative multistage cluster sample of Child and Adult Care Food Program-participating ECE programs. Participants/settingOne thousand four hundred sixty-eight children aged 3 to 5 years attending 217 Child and Adult Care Food Program-participating ECE programs (eg, child-care centers and Head Start) during 2017. Main outcome measuresDaily energy intake, daily US Department of Agriculture Food Pattern Food Group intakes, and percentage of daily intakes meeting 2015-2020 DGA Food Pattern recommendations. Statistical analyses performedRegression-adjusted usual intakes and percentage of children meeting recommendations were estimated using the National Cancer Institute method. Single-day mean intakes were used to test for statistical differences between child-care and non-child-care days. ResultsMean usual energy intake was 1,524 ± 19.3 kcal during child-care days and exceeded the recommended range at 1,702 ± 30.2 kcal during non-child-care days; single-day means indicated significantly lower energy intake on child-care days (P < 0.001). The percent of children meeting DGA recommendations on a child-care day varied by DGA food group: fruits (51.4%), grains (50.1%), dairy (42.5%), vegetables (6.5%), whole grains (4.6%), and protein foods (0.1%). Recommended limits on calories from added sugar and solid fats were met by 28.2% and 14.6% of children, respectively. Compared with mean food group intakes during a single child-care day, non-child-care day intakes were similar for fruits and vegetables, lower for dairy and whole grains, and higher for total grains, protein foods, and calories from added sugars and solid fats. ConclusionsAlthough there is room to increase nutrient density inside and outside of child care, intakes on child-care days more closely align to DGAs.

Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001-2018 Analysis.

Potatoes are nutrient rich white vegetables, however, research on their impact on public health is limited. The objective of this study was to provide updated evaluation of the cross-sectional association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four hour diet recall data from adolescents (n = 16,633; age 9–18 years) were used to assess intakes. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures, fried potatoes, and potato chips) had higher (p < 0.05) HEI-2015 total score and subcomponent scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers also had higher (p < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus, potassium, selenium, sodium, zinc, niacin, vitamin B6, vitamin C, vitamin K and total choline; and higher (p < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine, niacin, vitamin B6, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore encouraging their consumption may be an effective strategy for improving nutritional status.

Abstract 2586: Association between healthy eating index score and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO)

Abstract Pancreatic cancer is one of the deadliest malignancies in the US. Most cases are diagnosed in the late, non-resectable stages largely due to lack of effective screening tests. There is an urgent need to identify modifiable risk factors for primary prevention of this malignancy. To date, only a few risk factors (family history, smoking, and type-2 diabetes) have been identified for pancreatic cancer. Although several lines of evidence suggest that nutrition plays a role in pancreatic cancer, few nutrients have been consistently associated with its risk in epidemiologic studies. Therefore, the present study sought to investigate the association between the 2015 Healthy Eating Index (HEI-2015) score and pancreatic cancer risk among participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). The HEI-2015 is a measure of overall diet quality used to assess how well a diet conforms to key recommendations of the 2015-2020 Dietary Guidelines for Americans. The HEI score is made up of 13 food components, with higher scores (ranged 0-100 points) indicating better dietary quality. In the present study, the HEI-2015 scores were calculated from participant responses to two food frequency questionnaires, dietary questionnaire (DQX) and dietary history questionnaire (DHQ) administered at baseline and the three-year anniversary of enrollment, respectively. During a median follow-up of 12.2 years, 279 cases of pancreatic cancer were identified among 58,477 participants who completed the DQX, while 101,721 participants who responded to the DHQ gave rise to 380 cases of pancreatic cancer over a median follow-up of 8.9 years. Hazard ratios (HR) and 95% confidence internals (CI) were estimated using Cox proportional hazards regression for total HEI score and individual score components, classified into adequacy components (total fruit, whole fruits, total vegetables, greens and beans, whole grains, dairy, total protein foods, seafood and plant proteins, and fatty acids) and moderation components (refined grains, sodium, added sugars, and saturated fats). After adjustment for confounders, no significant association between total HEI score and pancreatic cancer was identified [HR (95% CI) for quartile (Q) 4 vs. Q1: 0.86 (0.60, 1.09) for DQX and 1.03 (0.77, 1.39) for DHQ]. The individual component scores for total vegetables and added sugar in the DHQ analysis and whole grain score in the DQX analysis were inversely associated with pancreatic cancer risk [HR (95% CI) for one-point score increase: 0.89 (0.81, 0.98), 0.95 (0.91, 0.99), and 0.94 (0.89, 0.99), respectively]. In summary, our study did not find a significant association between overall diet quality and pancreatic cancer risk but revealed significant associations with total vegetables, added sugar, and whole grains in the PLCO trial. Citation Format: Margaret L. Hoyt, Jianjun Zhang. Association between healthy eating index score and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2586.

Delineating the Nutritional Contribution of Animal Protein to Total Intakes Among Adults in the US

Abstract Objectives Recent health recommendations emphasize plant proteins and limiting animal proteins. Animal-based protein foods contribute to key micronutrient intakes beyond protein, such as zinc, iron, and vitamin B12. This study aimed to identify the contributions of foods containing meat, poultry, or seafood (MPS) in comparison to the day's total intakes. Methods Complete dietary data via 24-hour recalls from the 2005–2018 NHANES were analyzed among adults aged &amp;gt;19 years (n = 35,309). The Food and Nutrients Database for Dietary Studies and Food Patterns Equivalents Database were used to estimate nutrient intakes and food categories, respectively. Foods containing MPS were identified as those that included meats, cured meats, organ meats, poultry, and seafood. The contribution of nutrients from all foods containing MPS were aggregated for each participant. Nutrient intakes from the total day and from MPS intakes were assessed for the total population, as well as across sex and age categories (20–35, 36–50, 51–70, 71 + years). Data were weighted to produce nationally representative estimates of nutrient intakes. Results Over half of dietary protein consumed on the day of intake originated from foods containing MPS in all groups besides adults aged 71 years and older (48%). MPS foods contributed to the majority (&amp;gt;50%) of cholesterol, selenium, vitamin B12, niacin, zinc, and lycopene intakes, and moderately (&amp;gt;30%) contributed to sodium, choline, unsaturated and saturated fatty acids, phosphorus, vitamins B1 and B6, and iron intakes. On average, males consumed greater quantities and proportions of both total protein and MPS-specific protein foods, with a greater % of the day's micronutrient intakes from MPS foods. Conclusions While recent recommendations have emphasized the consumption of plant proteins, the nutritional contribution of MPS foods to total dietary intakes indicates a greater role in nutritional intakes than protein. MPS containing foods served as key contributors to essential nutrients. Promoting dietary guidelines that reduce the consumption of these foods should account for the intakes of such nutrients in making targeted efforts to balance nutritional status with other foci of health and disease. Funding Sources This research was supported by the Beef Checkoff program.

Consumption of Ready-to-Eat Cereal and Its Associations With Food Group Intake and Diet Quality in the United States, NHANES 2017–2018

ObjectivesReady-to-eat cereal (RTEC) is a nutrient-dense food that has been associated with better nutrient intake. This study was conducted to examine the association between consumption of RTEC and food group intake and diet quality in the United States using the most recent nationally representative data. MethodsParticipants from National Health and Nutrition Examination Survey (NHANES) 2017–2018 were classified as RTEC eaters or non-eaters depending on whether RTEC was reported in their day-1 dietary recall. Food group intake was estimated from Food Patterns Equivalence Database 2017–2018. Diet quality was assessed by the Healthy Eating Index 2015 (HEI-2015). Differences in food group intake and diet quality by RTEC consumption status were compared by ANOVA for survey, and were analyzed separately in children (2–17 y, N = 2135), adults 18–64 y (N = 3675), and older adults (65 y or older, N = 1221). ResultsConsumption of RTEC was associated with significantly higher intake of whole grains and dairy products, in all age groups examined (all P < 0.01). Children who consumed RTEC had a significantly lower intake of total protein foods (3.7 cup eq. vs 4.6 cup eq., P < 0.001) and vegetables (0.7 cup eq. vs 0.9 cup eq., P < 0.001) than non-eaters, however, intake of these food groups was not significantly different in adults 18–64 y or older adults by RTEC consumption status. Consumption of RTEC was not significantly associated with intake of added sugar in all age groups examined (all P > 0.05). Diet quality, as measured by HEI-2015 total score, was significantly higher in RTEC eaters than non-eaters in children, adults 18–64y, and older adults (all P < 0.01). ConclusionsThe results demonstrated that consumption of RTEC was associated with higher intake of whole grains and dairy products, but not with added sugar in the US population. RTEC consumption was also associated with better diet quality. Funding SourcesThe study was supported by Bell Institute of Health and Nutrition, General Mills, Inc.

Abstract P138: Diet Quality Improvements In Response To Evening Snacks That Differ By Carbohydrate And Fat Composition: A 6-week, Randomized, Crossover Trial In Participants With Impaired Fasting Glucose

Objectives: To examine the effect of consuming one ounce of peanuts (PNUT) as an evening snack on diet quality compared to an isocaloric lower fat higher carbohydrate snack (LFHC), in individuals with impaired fasting glucose IFG. Methods: Fifty-one individuals (48% female; 42 ± 15 y; BMI 28.3 ± 5.6 kg/m 2 ; glucose 100 ± 8 mg/dL; total cholesterol 189 ± 30 mg/dL; LDL-C 121 ± 26 mg/dL; HDL-C 53 ± 14 mg/dL; triglycerides 116 ± 73 mg/dL) were enrolled in this two-period, randomized, crossover trial. In random order, subjects consumed each snack in the evening (after dinner and before bedtime) for 6 weeks (PNUT: 164 kcal, 14 g fat, 2.2 g saturated fat, 6 g carbohydrate, 7 g protein, 2.4 g fiber; LFHC: 165 kcal, 6 g fat, 2 g saturated fat, 22 g carbohydrate, 7 g protein, 3.0 g fiber) with a 4 week compliance break. Subjects were instructed not to consume other caloric foods/beverages after dinner. Participants self-reported being adherent to the protocol on 88% of study days. Dietary intake was assessed using 24-hour recalls (ASA24® Dietary Assessment Tool) conducted at the beginning and end of each diet period. The Healthy Eating Index-2015 (HEI-2015) was calculated using the NCI SAS code. Results: There was no between-condition difference in the HEI-2015 score for PNUT compared to LFHC (mean difference 3.2; 95% CI -1.1, 7.4). Individual mean component scores were significantly different following PNUT compared to LFHC (whole grains: -2.0 [95% CI -3.1, -1.0]; seafood and plant protein: 1.5 [95% CI 0.8, 2.3]; fatty acids: 2.0 [95% CI 0.8, 3.2]; and saturated fat 1.2 [95% CI 0.1, 2.4]). Following PNUT, consumption of polyunsaturated fatty acids (3 g; 95% CI 0.2, 6.6), total protein foods (2.0 oz-eq; 95% CI 0.5, 3.4) and vegetable oils (6.5 g; 95% CI 1.6, 11.5) were higher whereas whole grain (-0.9 oz-eq; 95% CI -1.2, -0.5) consumption was lower compared to LFHC. No other differences in dietary intake were observed. Conclusions: In individuals with IFG, consuming 28g of peanuts as an evening snack increased consumption of total protein foods, oils, and polyunsaturated fatty acids and reduced whole grains compared to the LFHC snack. Overall diet quality was not increased, but fatty acid and total protein food scores improved.

Abstract MP02: Diet Quality Comparisons In Hispanic/Latino Siblings And The Role Of Social And Environmental Determinants: Results From The Hispanic Community Children's Health Study/Study Of Latino Youth (SOL Youth)

Introduction: Hispanic/Latino youth in the United States are disproportionately burdened by obesity. Siblings are important determinants of each other’s health behaviors, particularly in Hispanic/Latino families whose cultural values are distinctive for stressing close and supportive family relationships. However, no study in Hispanic/Latino youth has examined how overall diet quality correlates between siblings. Objective: To determine how well Hispanic/Latino siblings’ diet quality correlates with each other and whether social and environmental factors explain potential differences. Methods: Hispanic/Latino 8-16-year-olds from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth) with at least one sibling enrolled in the study were examined ( n =749). The Healthy Eating Index 2010 (HEI-2010) was calculated from two 24-hour recalls to assess overall diet quality. All analyses used mixed effect models with HEI-2010 score as the outcome. Individual and family-level socio-demographic variables were fixed effects, and family and intercept were random effects. Correlations between siblings’ diet quality were assessed with intraclass correlation coefficients (ICCs). All models were examined stratified by age and sex, and the ICCs were compared across groups using Fisher’s z-transformation. Diet-related social and environmental measures were added as fixed effects in a secondary analysis. Results: Overall HEI-2010 score was 53.7. The ICC for siblings’ HEI-2010 score was 0.31, indicating slight correlation. Separate examination of the twelve HEI-2010 components showed that siblings’ intake of empty calories and sodium had the highest correlation (ICC=0.31), while intake of total protein foods had the lowest correlation (ICC=0.13). Siblings who were born &lt;3 years apart (vs. ≥3 years apart) or all male or female (vs. of different sexes) had stronger correlations in overall diet quality (ICC=0.45 vs. 0.21 and 0.39 vs. 0.19, respectively, p&lt;0.05). Individuals who reported greater peer support for fruit and vegetable intake or more frequent use of healthy school vending machines/the school salad bar than their siblings had higher HEI-2010 scores (β=1.79 [95% CI: 0.38, 2.76]) and β=1.57 [95% CI: 0.38, 2.76], respectively). Individuals who reported greater away from home food consumption than their siblings had lower HEI-2010 scores (β=-1.12 [95% CI: -2.06, -0.18]). Frequenting unhealthy school vendors did not explain differences in siblings’ diet quality. Conclusions: Overall diet quality scores of Hispanic/Latino siblings in this study were modestly correlated, with stronger correlations among siblings closer in age and of concordant sex. Differences in peer support and foods consumed outside the home may explain differences in siblings’ diet quality. Future studies should examine additional psychosocial determinants of siblings’ diets.

Comparison of diet quality of US adults based on primary motivation for following a vegetarian diet: A cross-sectional online study

Adults adopt a vegetarian diet for various motivations, but it is unknown their overall diet quality based on a primary motivation. The purpose of the study was to compare overall diet quality, nutrient intake and related food groups based on primary motivation for following a vegetarian diet. It was hypothesized that vegetarians who chose the diet for health-related motivations would have a higher diet quality based on the Healthy Eating Index (HEI)-2015 scores compared to those following the diet for other motivations. A cross-sectional study was conducted online in the United States. Participants (n = 511) completed an 18-item questionnaire and a 24-hour recall using the Automated Self-Administered 24-hour Dietary Recall (ASA24-2018) and were divided into one of three groups (Health, Animal, Other [family, religious beliefs, or environment]) based on their primary motivation for following a vegetarian diet. Total HEI-2015 scores were determined and Kruskal-Wallis ANOVA on Ranks with a Dunn's Method for all pairwise comparisons (p < 0.05) were conducted. Results showed that total HEI-2015 scores differed among groups (p = 0.022) with the Health group having a higher score than the Other group (70.2 [57.0, 79.1] versus 63.6 [52.2, 77.1], median 25th, 75th) but not the animal rights group (66.5 [55.1, 77.0]). Higher component scores for total protein foods, seafood and plant proteins and fatty acids contributed to the significant difference. Adults who were motivated by health to follow a vegetarian diet had a higher diet quality than those who cited Other as their primary motivation. As motivations may impact diet quality of vegetarians, it is necessary to account for them.

Stress and Depressive Symptoms Are Not Associated with Overall Diet Quality, But Are Associated with Aspects of Diet Quality in Pregnant Women in South Carolina

BackgroundPoor mental health may hinder diet quality in pregnancy. ObjectiveThis study 1) examined whether stress and depressive symptoms are associated with diet quality (via Healthy Eating Index [HEI] 2015 total scores and dietary intake of food groups/nutrients that align with HEI-2015 components) and 2) tested race as a moderator in the relationship between mental health and diet quality. DesignThis was a cross-sectional analysis of baseline data from a randomized controlled trial collected January 2015 through January 2019 in Columbia, South Carolina. Trained staff administered demographic and psychosocial questionnaires and conducted anthropometric measures. Participants completed two 24-hour dietary recalls, which were self-administered (one on-site, one at home). ParticipantsThe Health in Pregnancy and Postpartum study was a randomized controlled trial targeting excessive gestational weight gain among pregnant women with overweight/obesity (N = 228). Main outcome measuresThe HEI-2015 total scores and food groups/nutrients that align with HEI-2015 were calculated. Statistical analyses performedMultiple linear regression models were used to estimate the relationship between mental health and HEI-2015 total scores and dietary intake of food groups or nutrients that align with HEI-2015 components. Multiplicative interaction terms of stress or depressive symptoms with race were used to determine moderation. ResultsParticipants’ diet quality was suboptimal (M = 52.0 ± 11.7; range, 27–85). Stress was negatively associated with HEI-2015 total scores (crude but not adjusted model). Stress scores were positively associated with consumption of dairy, refined grains, and added sugars and negatively associated with total protein foods. Depressive symptoms were positively associated with consumption of dairy, refined grains, and saturated fats. Race was not a moderator. ConclusionsDiet quality was poor overall, but stress and depressive symptoms were not associated with HEI-2015 total scores in adjusted models. Excluding dairy, stress and depressive symptoms were associated with the consumption of food groups or nutrients related to worse diet quality. These relationships should be examined longitudinally to help establish causality and inform future interventions.

Association between Healthy Eating Index-2015 scores and probable sarcopenia in community-dwelling Iranian older adults: a cross-sectional study.

Sarcopenia is associated with frailty and disability in older adults. Adherence to current dietary guidelines in addition to physical activity could prevent muscle wasting and weakness. The Healthy Eating Index-2015 (HEI) is a tool to assess diet quality. We aimed to investigate the association between HEI scores and probable sarcopenia (PS) among older adults in Tehran. 201 randomly selected older adults were included in this cross-sectional study between May and October 2019 in Tehran, Iran. A previously validated semi-quantitative food frequency questionnaire was used to estimate HEI scores and dietary intake. Handgrip strength (HGS) was measured to evaluate the PS. Statistical evaluation included descriptive analysis, logistic and linear regression. Those probably suffering from sarcopenia had significantly lower HEI scores (P=0⋅02). After adjusting for confounders, HEI scores and HGS were still significantly associated (adjusted R2=0⋅56, slope β=0⋅03, P=0⋅09). Older adults with a low PS had a higher ratio of monounsaturated and polyunsaturated to saturated fatty acids (P= 0⋅06) and ingested less added sugars and saturated fats (P=0⋅01 and P=0⋅02, respectively). Furthermore, consuming more total protein foods correlated positively with muscle strength (P=0⋅01, R=0⋅18). To sum up, HEI scores were associated with PS, measured by HGS, indicating that adhering to the HEI might improve muscle strength in aging individuals.

Select Food Group Intake of US Children Aged 2 to 4 Years by WIC Participation Status and Income

BackgroundFood group and nutrient priorities for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Package IV for children aged 2 to 4 years were described in the 2017 review of the WIC Food Package. Research has evaluated priority nutrient intake, but priority food group intake remains unknown. ObjectivesTo compare mean intake of priority food groups/subgroups of WIC children to WIC-eligible nonparticipants and higher income children. Further, we hoped to assess differences in percent contribution of food subgroups to total food group intake by WIC participation status and income. DesignCross-sectional study conducted using data from the 2011-14 National Health and Nutrition Examination Survey. Participants/settingOne thousand forty-seven children aged 2 to 4 years. Main outcome measuresMean intake reported in cup equivalents and ounce equivalents. We also looked at mean percent that food subgroups contributed to total intake within a food group. Analyses were performed for high and low priority food groups/subgroups: high = seafood, total vegetables, dark green vegetables, red/orange vegetables, whole grains, and nuts/seeds/soy; low = total starchy vegetables, other vegetables, legumes computed as vegetables, total dairy, and total protein foods. Statistical analyses performedMultivariable linear regression analysis was used evaluate the relationship between income/WIC participation and mean intake/percent food subgroups contributed to total food group intake. ResultsAmong low-income WIC-eligible children, participation in WIC was associated with greater mean intake of red/orange vegetables (0.18 ± 0.03 vs 0.01 ± 0.06 c equivalents; P < 0.05) and legumes (0.07 ± 0.01 vs 0.01 ± 0.02 c equivalents; P < 0.01). No differences in mean intake were observed between WIC children and higher income children. Grain intake of WIC children was composed of a higher percentage of whole grains (19.1% ± 1.6% vs 13.2% ± 1.5%; P < 0.01) compared with higher income children. The percent vegetable subgroups contributed to total vegetable intake varied by income; no differences were observed for dairy or protein subgroups. ConclusionsAmong low-income children, participation in WIC was associated with greater intake of certain vegetables. Participation in WIC may also help close the diet quality gap between low-income and higher income children for priority foods targeted by the WIC food package. Future research should explore socioeconomic disparities in intake of nutrient-poor foods.

Examining commonalities and differences in food groups, nutrients, and diet quality among popular diets.

The US News and World Report (USNWR) conducts an annual review of popular diets: Moderate (reducing energy intake from all food groups, particularly those high in fat and added sugars); Plant-based (excluding food groups, such as animal products); Low-carbohydrate (excluding/limiting carbohydrate-containing foods); and Meal-replacement diets (replacing foods with pre-made, calorie-controlled portions). The goal of this paper was to examine how these diets differ in nutrients, food groups, and diet quality. This study examined the 40 diets rated by physicians and nutritionists for the 2018 USNWR and assessed differences among diets that were categorized by two independent reviewers: Moderate (n=15), Plant-based (n=12), Low-carbohydrate (n=8), and Meal replacement (n=5). Nutrient, food groups, and diet quality (Dietary Inflammatory Index (DII®), Healthy Eating Index (HEI)) were assessed from the 2018 USNWR. There were significant differences among the four diet types for energy; % energy from saturated fat, carbohydrates, and protein; trans fat; sugars; fiber; magnesium; cholesterol; HEI; fruit; total fruit and vegetables; whole grains; total grains; total meat; nuts and seeds; legumes; and total protein foods. Plant-based and Moderate diets, especially the Macrobiotic, Big Loser and Ornish diets, had strongly anti-inflammatory DII scores (-4.82,-4.85 and-4.06, respectively). Moderate (86.9±7.7) and Plant-based (86.1±10.7) diets had significantly higher HEI scores than Low-carbohydrate diets (70.6±15.0; P=0.01). These findings provide useful information on nutrient adequacy of popular diets. Results indicate that Plant-based and Moderate diets have better dietary quality (HEI, DII) and better nutrient and food group profiles than Low carbohydrate diets.

Fruit and Vegetable Healthy Eating Index Component Scores of Distributed Food Bags Were Positively Associated with Client Diet Scores in a Sample of Rural, Midwestern Food Pantries

BackgroundFood pantries have the potential to improve the quality of clients’ diets. ObjectiveThis study evaluated the relationship between the quality of the mix of foods in pantry inventories and client food bags (separately), as assessed by the Healthy Eating Index-2010 (HEI-2010), with client diet quality and how these relationships varied by food security status. DesignThis cross-sectional, secondary analysis used baseline data from the Voices for Food intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected. Foods available in pantry inventories and distributed in client food bags were recorded at one time point during baseline data collection. Participants and settingA convenience sample of adult food pantry clients (N = 575) from 24 rural, food pantries in the US Midwest was recruited from August to November 2014. Main outcome measuresPantry inventories, client food bags, and client diets were scored using the HEI-2010. Main outcomes were client HEI-2010 scores. Statistical analyses performedLinear regression models estimated associations between HEI-2010 total and component scores for pantry inventories and client food bags (in separate models) and the corresponding scores for client dietary intake. The interaction of client food security status, and potential pantry- and client-level confounders, was considered. ResultsClient food bag HEI-2010 scores were positively associated with client diet scores for total vegetables, greens and beans, and total fruit components, whereas pantry inventory HEI-2010 scores were negatively associated with client diet scores for total fruit, total protein foods, and seafood and plant proteins components. Client food bag whole-grains scores were more strongly associated with very low food secure compared with food secure client diet scores (all P values < 0.05). ConclusionsThe quality of client food bags, but not of pantry inventories, was positively associated with client diet quality in a rural sample in the US Midwest.