Whole Grain Intake Research Articles

Global diet and health: old questions, fresh evidence, and new horizons

Global diet and health: old questions, fresh evidence, and new horizons

Non-Destructive Determination of Alkylresorcinol (ARs) Content on Wheat Seed Surfaces and Prediction of ARs Content in Whole-Grain Flour.

Alkylresorcinols (ARs) are beneficial for human health and can be used as biomarkers for whole-grain cereal intake. In previous studies, ARs content in whole-grain flour was determined by milling the seeds into powder, thus destroying their structure. In this paper, we adopted a non-destructive extraction approach. Chloroform and ethyl acetate extraction methods were carried out to extract lipids from the seed surface and whole-grain flour of 36 wheat varieties in China, respectively. GC-MS analysis identified chemical compounds in which ARs were the major compounds for all the samples. The average total content of ARs (624.223 µg/g) in whole grains was much higher than that on seed surfaces (4.934 µg/g), with a positive correlation (r = 0.863, p < 0.001) between these two parameters. The results suggested that the total ARs content on the seed surface can be used to predict their content in whole-grain flour. Without affecting the seed germination rate and damaging seed structure, we demonstrate that a non-destructive extraction approach is an appropriate and useful method, facilitating the development of rapid screening methods suitable for use in wheat breeding.

The effect of introducing a free breakfast club on eating habits among students at vocational schools

BackgroundUnhealthy eating habits are a major problem among adolescents. The objective of the study was to assess the effect of a free breakfast club intervention on dietary habits among students at vocational schools.MethodsThe study included students (n = 318) from four vocational schools in Denmark. Food frequency questionnaires were used to measure eating habits at baseline, first, and second follow-up, after 7 and 14 weeks respectively, in a clustered randomized controlled intervention of four months. The effect of the intervention was evaluated through self-reported frequencies of breakfast intake, intake of whole grain products for breakfast and intake of unhealthy snacking in the morning. The outcome measures were daily breakfast intake (yes/no), daily intake of whole grain for breakfast (yes/no), and unhealthy snacking on school day mornings (yes/no).ResultsThe proportion of students who had breakfast every school day increased significantly in the intervention schools from baseline to the first follow-up compared to the control group (OR: 3.77; P = 0.0149). The effect was attenuated at the second follow-up. The intake of whole grain products for breakfast increased significantly more among students in intervention schools compared to students in control schools both at first (OR: 4.13; P = 0.0079) and second follow-up (OR: 3.27; P = 0.0317). No significant change in unhealthy snacking was found.ConclusionProvision of free breakfast at vocational schools can improve the dietary quality of breakfast and decrease breakfast skipping. However, the sustainability of the intervention is a critical issue that needs to be further studied and addressed.Trial registrationISRCTN11265280. Registered 20 November 2018 (retrospectively registered).

Brazilian Children's Dietary Intake in Relation to Brazil's New Nutrition Guidelines: a Systematic Review.

This systematic review reports the latest scientific evidence, from cross-sectional and cohort studies, describing the dietary intake of children and adolescents from Brazil. The goal of the review was to describe intakes according to Brazil's new food classification system (NOVA) which classifies foods according to the degree of processing, i.e., unprocessed/minimally processed, processed culinary ingredients, processed food, and ultra-processed food. Due to a paucity of data using the NOVA classification system, studies with other intake descriptors were included. Results using the NOVA system showed a somewhat high intake of (ultra-)processed items, than of minimally processed items. Studies using other methods of dietary assessment showed not only high intake of sources rich in fat, sugar, and sodium, most of them processed items (e.g., savory snacks and sweets) but also intake of fruit, vegetables, and whole grains. Overall, the literature was marred by inconsistencies and variation in study definitions and methods making it hard to make firm conclusions regarding the dietary intake of Brazilian children. The development of tools to evaluate the complexities of dietary intake is much needed. Such a tool needs to be accepted and adopted by numerous study groups, to describe dietary status among Brazilian children and devise the most effective, and to evaluate the success of nutrition education programs.

Evaluation of dietary patterns of nutrition undergraduates

Objective: In an era in which chronic non-communicable diseases predominate, promoting healthy lifestyles and lifestyle-modifying therapies dominate the language of health professionals. However, epidemiological data on the prevalence of obesity and overweight remain alarming for young people. This is also true for shocking eating habits were fast-food dominates the choices of the younger [1]. Knowing that it will be the current young students of health courses who will work in this hostile environment, where obesity and associated comorbidities prevail [2,3], our objective was to evaluate the nutritional intake of nutrition students as literature seems to point to some level of disordered eating amongst Nutrition Students. Material and methods: This was a cross-sectional study enrolling students from the Nutrition Undergraduation of a Private University, developed in the context of two disciplines: Evaluation of Food intake, and Introduction to Research Methods. Students were invited to participated by personal contact. Food intake was assessed using a validated Food Frequency Questionnaire (FFQ), developed to estimate dietary intake across Europe. This FFQ comprises seven options to report food consumption frequency: 2+ per day, once per day, 5–6 per week, 2–4 per week, once per week, 1–3 times per week, and rarely or never. Analysis of food groups in terms of frequency of intake was performed. Study performed according to Helsinki Declaration. Results: From a total of 86 students, 62 agreed to participated in the study (age range 20-43 years, 53 females). It was observed that in terms of frequency of the main food groups, this sample is accomplishing some of the objectives of the Portuguese Food Wheel as evidenced in Figure 1. Surprisingly, we found higher intakes of whole grains than those observed for the general population, as well as lower intake report of fast food, alcoholic drinks, chocolate and soft drinks. However, frequency intakes reported for fish and legumes are worrisome. Also, there is a considerable percentage of students who reported to rarely eat carbohydrate-rich and protein-rich foods. 27,4% of students are using supplements. Figure 1. Frequency of intake of principal food groups. Conclusion: We observed that nutrition undergraduates reported high intakes of some healthy foods, particularly whole grains, vegetables and fruits and low intake of fast-foods and softs drinks. These results may be explained by intrinsic knowledge on food and nutrition provided by the Undergraduation, greater awareness of the impact of nutrition on health, bias of the methodology by responding to what is desirable, or a combination of all these possibilities. However, intakes of legumes and fish are lower than desired. These results raise a pertinent question: are nutrition undergraduates eating healthier than the general population or do they respond to some items according to what they believe to be expected of them?

Abstract 043: Self-Identified Hispanic/Latino Dietary Identity is Differentially Associated With Diet Quality and Food Intake Across Ethnic Heritages in the Hispanic Community Health Study/Study on Latinos

Introduction: Characterizing the food intake and dietary quality of diverse Hispanics/Latinos remains challenging given the ethnic-specific sociocultural influences. A construct indicating self-identified dietary identity as traditional Hispanic/Latino versus US-American diet could help identify dietary preferences in this population. Hypothesis: We hypothesized that 1) self-identified foods differed by identity status and country of origin (ethnic heritage), and 2) dietary identity was associated with higher diet quality among Hispanics/Latinos. Methods: We used baseline data from the population-based Hispanic Community Health Study/Study of Latinos cohort of adults 18-74y (n=16,275). Dietary identity was self-assessed by rating foods usually consumed as more akin to Hispanic/Latino or to US-American in a scale of 1-5 (higher score denotes more US diet). Dietary intake was assessed with two 24-hour recalls. Diet quality was measured via the Alternate Healthy Eating Index (AHEI; range 0-110: higher score denotes higher quality). Linear regression models were run to estimate means of AHEI and its components adjusted for demographic, socioeconomic, acculturation, and behavioral factors. We estimated the proportional contribution of food groups to total energy intake using PROC RANK in SAS v9.4. Results: Overall, 42.9% self-identified their diet as mostly Hispanic/Latino, 33.2% as mainly Hispanic/Latino, and 23.8% as equal or mostly/mainly US (last three categories combined as ‘slightly Hispanic/Latino’). AHEI did not differ by dietary identity in the overall cohort, but a significant interaction with heritage was detected (p&lt;0.0001). Analyses by heritage found higher adjusted means (SE) of AHEI among Mexicans with mostly [51.9 (0.40)] and mainly [51.9 (0.40)] Hispanic/Latino dietary identity than slightly Hispanic/Latino [50.9 (0.41); p&lt;0.001)]; but lower AHEI among South Americans with mainly Hispanic/Latino dietary identity [47.6 (0.75)] than slightly Hispanic/Latino [49.2 (0.62); p&lt;0.01)]. In Mexicans, a mostly Hispanic/Latino dietary identity was associated with higher intake of whole grains, and nuts and legumes, and lower intake of sodium; while in Puerto Ricans, it was associated with higher intake of nuts and legumes and lower intake of vegetables without potatoes. The ranking of food groups contributing to total energy intake varied by dietary identity category and across heritages, with the top three foods usually being grains (mostly refined), animal products, and sugars, except for Cubans who ranked fats higher than sugars. Conclusions: Self-identified dietary identity is differentially associated with diet quality in Hispanic/Latino ethnic groups. Ethnic-specific foods that Hispanics/Latinos self-identify as traditional may help tailor nutritional messages and programs for this community that mostly prefers cultural foods.

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Gastrointestinal NursingVol. 17, No. 2 NewsnewsMelissa McAleesMelissa McAleesFreelance journalistSearch for more papers by this authorMelissa McAleesPublished Online:19 Mar 2019https://doi.org/10.12968/gasn.2019.17.2.6AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Cancer Research UK. Binge watching TV could increase bowel cancer risk in men. 2018. https://tinyurl.com/y52akd87 (accessed 26 February 2019) Google ScholarScienceDaily. Common acid reflux medications linked to increased kidney disease risk. 2019. https://tinyurl.com/y6grpqdg (accessed 26 February 2019) Google ScholarKahrs CR, Chuda K, Tapia G et al.. Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort. BMJ. 2019; (epub ahead of print):1231. https://doi.org/10.1136/bmj.l231 Google ScholarNational Institute for Health Research. Patients' own cells could be the key to treating Crohn's disease. 2019. https://tinyurl.com/y4gy6ja9 (accessed 26 February 2019) Google ScholarPozzobon D, Ferreira PH, Dario AB et al.. Is there an association between diabetes and neck and back pain? A systematic review with meta-analyses. PLoS ONE. 2019; 14(2):e0212030. https://doi.org/10.1371/journal.pone.0212030 Crossref, Google ScholarYang W, Ma Y, Liu Y et al.. Association of intake of whole grains and dietary fiber with risk of hepatocellular carcinoma in US adults. JAMA Oncol. 2019; (epub ahead of print). https://doi.org/10.1001/jamaoncol.2018.7159 Crossref, Google ScholarNational Institute for Health and Care Excellence. NICE updates guideline on alcohol education in schools. 2019. www.nice.org.uk/news/article/nice-updates-guideline-on-alcohol-education-in-schools (accessed 26 February 2019) Google Scholar FiguresReferencesRelatedDetails 2 March 2019Volume 17Issue 2ISSN (print): 1479-5248ISSN (online): 2052-2835 Metrics History Published online 19 March 2019 Published in print 2 March 2019 Information© MA Healthcare LimitedPDF download

Sociodemographic, Lifestyle, Environmental and Pregnancy-Related Determinants of Dietary Patterns during Pregnancy.

Background: Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. Methods: The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). Results: Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (β = 0.2; p < 0.01), higher educational level (β = 0.3; p < 0.01), and socioeconomic status (SES) (β = 0.2; p < 0.01), overweight/obesity before (β = 0.3; p < 0.01), as well as physical activity during pregnancy (β = 0.2; p = 0.01) were positive determinants of a healthier diet (increasing Prudent–Western difference in dietary pattern scores). On the other hand, parity (β = −0.2; p = 0.04) and living in small cities (β = −0.3; p = 0.02) were significantly related to a rather Western dietary pattern. Conclusions: The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.

Longitudinal trajectories and prevalence of meeting dietary guidelines during the transition from adolescence to young adulthood

Establishing healthy dietary habits during adolescence and young adulthood is critical for long-term health. This study assessed the prevalence of meeting US Dietary Guidelines and trajectories in dietary intake for 4 MyPlate food groups during the transition from adolescence to young adulthood. Three waves of surveys and food frequency questionnaires were collected as part of Project EAT (Eating and Activity in Teens and Young Adults), a 15-y longitudinal study. Adolescents (n=1177, 57% female, mean ± SD age 15.0±1.5 y) were recruited in 1998-1999 in Minneapolis-St Paul, Minnesota public schools and were resurveyed twice in young adulthood at mean ± SD ages 25.3±1.5 and 31.1±1.5 y. The prevalence of meeting guidelines for each MyPlate food group was calculated at each time point. Mean daily servings were compared over 5 y in young adulthood through the use of paired t tests. Adjusted least-squares means were calculated to compare dietary intake in young adulthood across quartiles of adolescent intake. Adolescents had the highest prevalence of meeting dietary guidelines for fruit (37% for females and 30% for males) and dairy (53% for females and 61% for males); young adults >30 y had the highest prevalence of meeting dietary guidelines for vegetables (19% for females and 8% for males) and whole grains (23% for females and 17% for males). From the mid-twenties to early thirties, vegetable intake increased, whereas dairy intake decreased. Dietary intake generally tracked over time with individuals in the lower quartiles of intake at adolescence generally continuing to have low intake in young adulthood. Although the prevalence of meeting dietary guidelines for whole grains and vegetables, and daily servings of vegetables increased with age, improving intake of whole fruit, whole grains, dairy, and vegetables remains key during the transition fromadolescence to young adulthood.

Differences in the Quantity and Types of Foods and Beverages Consumed by Canadians between 2004 and 2015.

This study examined differences in food and beverage intake estimated from nationally representative surveys of Canadians in 2004 and 2015 collected through the Canadian Community Health Surveys. Differences in mean daily energy intake and amounts of food consumed were compared between 2004 and 2015 and across age groups for all energy reporters (aged 2 years+) and among only plausible energy reporters. From 2004 to 2015, mean energy intake decreased by 228 kcal/day (all energy reporters) and 74 kcal/day (plausible energy reporters). Canadians reported consuming more daily servings of meat and alternatives but fewer servings of vegetables and fruit and milk and alternatives in 2015 compared to 2004. Analyses of food subgroups revealed that Canadians reported consuming more daily servings of dark green and orange vegetables, dairy products, legumes, nuts and seeds, and eggs but fewer servings of potatoes, other vegetables, fruit juices, fluid milk, and sugar-sweetened beverages in 2015 compared to 2004. While some aspects of the Canadian diet have improved, daily mean intake of other nutritious foods either stagnated or worsened over time. Continued attention is needed to improve population-level intakes of vegetables, fruit, whole grains, and protein foods such as legumes, nuts, seeds, and lower fat dairy products.

Association of Intake of Whole Grains and Dietary Fiber With Risk of Hepatocellular Carcinoma in US Adults

Increased intake of whole grain and dietary fiber has been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for hepatocellular carcinoma (HCC). Therefore, we hypothesized that long-term intake of whole grains and dietary fiber may be associated with lower risk of HCC. To assess the associations of whole grain and dietary fiber intake with the risk of HCC. Cohort study of the intake of whole grains, their subcomponents (bran and germ), and dietary fiber (cereal, fruit, and vegetable) in 125 455 participants from 2 cohorts from the Nurses' Health Study and the Health Professionals Follow-up Study. Intake of whole grains, their subcomponents (bran and germ), and dietary fiber (cereal, fruit, and vegetable) were collected and updated almost every 4 years using validated food frequency questionnaires. Multivariable hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression model after adjusting for most known HCC risk factors. After an average follow-up of 24.2 years, we identified 141 patients with HCC among 125 455 participants (77 241 women and 48 214 men (mean [SD] age, 63.4 [10.7] years). Increased whole grain intake was significantly associated with lower risk of HCC (the highest vs lowest tertile intake: HR, 0.63; 95% CI, 0.41-0.96; P = .04 for trend). A nonsignificant inverse HCC association was observed for total bran (HR, 0.70; 95% CI, 0.46-1.07; P = .11 for trend), but not for germ. Increased intake of cereal fiber (HR, 0.68; 95% CI, 0.45-1.03; P = .07 for trend), but not fruit or vegetable fiber, was associated with a nonsignificant reduced risk of HCC. Increased intake of whole grains and possibly cereal fiber and bran could be associated with reduced risk of HCC among adults in the United States. Future studies that carefully consider hepatitis B and C virus infections are needed to replicate our findings, to examine these associations in other racial/ethnic or high-risk populations, and to elucidate the underlying mechanisms.

Whole grain, bran and cereal fibre consumption and CVD: a systematic review.

Whole grain intake is associated with lower CVD risk in epidemiological studies. It is unclear to what extent cereal fibre, located primarily within the bran, is responsible. This review aimed to evaluate association between intake of whole grain, cereal fibre and bran and CVD risk. Academic databases were searched for human studies published before March 2018. Observational studies reporting whole grain and cereal fibre or bran intake in association with any CVD-related outcome were included. Studies were separated into those defining whole grain using a recognised definition (containing the bran, germ and endosperm in their natural proportions) (three studies, seven publications) and those using an alternative definition, such as including added bran as a whole grain source (eight additional studies, thirteen publications). Intake of whole grain, cereal fibre and bran were similarly associated with lower risk of CVD-related outcomes. Within the initial analysis, where studies used the recognised whole grain definition, results were less likely to show attenuation after adjustment for cereal fibre content. The fibre component of grain foods appears to play an important role in protective effects of whole grains. Adjusting for fibre content, associations remained, suggesting that additional components within the whole grain, and the bran component, may contribute to cardio-protective association. The limited studies and considerable discrepancy in defining and calculating whole grain intake limit conclusions. Future research should utilise a consistent definition and methodical approach of calculating whole grain intake to contribute to a greater body of consistent evidence surrounding whole grains.

Study protocol: optimized complementary feeding study (OTIS): a randomized controlled trial of the impact of a protein-reduced complementary diet based on Nordic foods

BackgroundWhat we eat as infants and children carries long-term consequences. Apart from breastfeeding, the composition of the complementary diet, i.e. the foods given to the infant during the transition from breast milk/infant formula to regular family foods affects the child’s future health. A high intake of protein, a low intake of fruits, vegetables and fish and an unfavorable distribution between polyunsaturated and saturated fats are considered to be associate with health risks, e.g. obesity, type 2 diabetes and dyslipidemia later in life.MethodsIn a randomized, controlled study from 6 to 18 months of age we will compare the currently recommended, Swedish complementary diet to one based on Nordic foods, i.e. an increased intake of fruits, berries, vegetables, tubers, whole-grain and game, and a lower intake of sweets, dairy, meat and poultry, with lower protein content (30% decrease), a higher intake of vegetable fats and fish and a systematic introduction of fruits and greens. The main outcomes are body composition (fat and fat-free mass measured with deuterium), metabolic and inflammatory biomarkers (associated with the amount of body fat) in blood and urine, gut microbiota (thought to be the link between early diet, metabolism and diseases such as obesity and insulin resistance) and blood pressure.We will also measure the participants’ energy and nutrient intake, eating behavior and temperament through validated questionnaires, acceptance of new and unfamiliar foods through video-taped test meals and assessment of cognitive development, which we believe can be influenced through an increased intake of fish and milk fats, notably milk fat globule membranes (MFGM).DiscussionIf the results are what we expect, i.e. improved body composition and a less obesogenic, diabetogenic and inflammatory metabolism and gut microbiota composition, a more sustainable nutrient intake for future health and an increased acceptance of healthy foods, they will have a profound impact on the dietary recommendations to infants in Sweden and elsewhere, their eating habits later in life and subsequently their long-term health.Trial registrationNCT02634749. Registration date 18 December 2015.

Carbohydrate quality and human health: a series of systematic reviews and meta-analyses

Previous systematic reviews and meta-analyses explaining the relationship between carbohydrate quality and health have usually examined a single marker and a limited number of clinical outcomes. We aimed to more precisely quantify the predictive potential of several markers, to determine which markers are most useful, and to establish an evidence base for quantitative recommendations for intakes of dietary fibre. We did a series of systematic reviews and meta-analyses of prospective studies published from database inception to April 30, 2017, and randomised controlled trials published from database inception to Feb 28, 2018, which reported on indicators of carbohydrate quality and non-communicable disease incidence, mortality, and risk factors. Studies were identified by searches in PubMed, Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, and by hand searching of previous publications. We excluded prospective studies and trials reporting on participants with a chronic disease, and weight loss trials or trials involving supplements. Searches, data extraction, and bias assessment were duplicated independently. Robustness of pooled estimates from random-effects models was considered with sensitivity analyses, meta-regression, dose-response testing, and subgroup analyses. The GRADE approach was used to assess quality of evidence. Just under 135 million person-years of data from 185 prospective studies and 58 clinical trials with 4635 adult participants were included in the analyses. Observational data suggest a 15-30% decrease in all-cause and cardiovascular related mortality, and incidence of coronary heart disease, stroke incidence and mortality, type 2 diabetes, and colorectal cancer when comparing the highest dietary fibre consumers with the lowest consumers Clinical trials show significantly lower bodyweight, systolic blood pressure, and total cholesterol when comparing higher with lower intakes of dietary fibre. Risk reduction associated with a range of critical outcomes was greatest when daily intake of dietary fibre was between 25 g and 29 g. Dose-response curves suggested that higher intakes of dietary fibre could confer even greater benefit to protect against cardiovascular diseases, type 2 diabetes, and colorectal and breast cancer. Similar findings for whole grain intake were observed. Smaller or no risk reductions were found with the observational data when comparing the effects of diets characterised by low rather than higher glycaemic index or load. The certainty of evidence for relationships between carbohydrate quality and critical outcomes was graded as moderate for dietary fibre, low to moderate for whole grains, and low to very low for dietary glycaemic index and glycaemic load. Data relating to other dietary exposures are scarce. Findings from prospective studies and clinical trials associated with relatively high intakes of dietary fibre and whole grains were complementary, and striking dose-response evidence indicates that the relationships to several non-communicable diseases could be causal. Implementation of recommendations to increase dietary fibre intake and to replace refined grains with whole grains is expected to benefit human health. A major strength of the study was the ability to examine key indicators of carbohydrate quality in relation to a range of non-communicable disease outcomes from cohort studies and randomised trials in a single study. Our findings are limited to risk reduction in the population at large rather than those with chronic disease. Health Research Council of New Zealand, WHO, Riddet Centre of Research Excellence, Healthier Lives National Science Challenge, University of Otago, and the Otago Southland Diabetes Research Trust.

Rural-Urban Differences in Baseline Dietary Intake and Physical Activity Levels of Adolescents.

IntroductionDifferences in dietary intake and physical activity may explain the higher prevalence of obesity among adolescents living in rural versus urban settings. The objective of this cross-sectional secondary analysis was to compare baseline dietary intake and physical activity of adolescents by rurality.MethodsWe analyzed data on 940 adolescents who participated in ACTION PAC (Adolescents Committed to Improvement of Nutrition and Physical Activity), an obesity prevention and management intervention trial conducted from 2014 through 2017 in 8 public high schools in the southwestern United States. Dietary intake was assessed with the Block Food Screener, and participants completed an exercise log and wore an accelerometer to provide data on physical activity. We compared data by rural–urban commuting area (RUCA) codes and log population density by using multilevel models, with students nested within zip code and repeated measures for accelerometer analysis.ResultsAfter adjusting for socioeconomic status and ethnicity, accelerometer data indicated that moderate-to-vigorous physical activity was 8.17 min/d (P = .02) higher and sedentary time was 20.42 min/d (P = .02) lower in moderately urban areas than in the urban reference area. Each 1-unit increase in log population density was associated with higher reported intake of whole grains (0.02 ounce equivalents, P = .03), potatoes (0.01 cup equivalents, P = .02), and added sugar (0.37 tsp, P = .02) after adjusting for socioeconomic status and ethnicity.ConclusionDifferences in reported dietary intake and physical activity level by measures of rurality were small and inconsistent in direction to explain the disparities observed in rural versus urban areas.

A Step toward Understanding Diet Quality in Urban African-American Breast Cancer Survivors: A Cross-sectional Analysis of Baseline Data from the Moving Forward Study

Purpose: Little is known about the dietary behaviors of African-American breast cancer survivors (AABCS). We sought to describe dietary intake and quality in AABCS and examine associations with demographic, social, lifestyle, and body composition factors to potentially inform the development of effective dietary interventions.Methods: Baseline data from a prospective weight loss trial of 210 AABCS were assessed. A food frequency questionnaire was used to evaluate dietary intake and diet quality via the Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 (AHEI-2010). Linear regression analysis was conducted to determine the most influential variables on diet quality.Results: Mean HEI- and AHEI-2010 total scores were 65.11 and 56.83 indicating that diet quality needs improvement. Women were the least adherent to recommendations for intake of whole grains, dairy, sodium, empty calories, sugary beverages, red/processed meats, and trans-fat. Increased self-efficacy for healthy eating behaviors, more years of education (AHEI only), negative smoking status, smaller waist circumference, and increased physical activity (HEI only) were significantly associated with higher diet quality scores.Conclusion: Our findings suggest the diet quality of AABCS needs improvement. Intervention programs may achieve higher diet quality in AABCS by focusing on increasing self-efficacy for healthy eating behaviors.

Association of whole grains, dairy and dietary fibre with neonatal outcomes in women with gestational diabetes mellitus: The WINGS project (WINGS – 12)

Background: Dietary modifications have been shown to lower the risk for gestational diabetes mellitus (GDM). However, there is little evidence whether dietary modifications during pregnancy can improve neonatal outcomes in women with GDM, particularly in low-resource settings. Aim: The aim of the study is to assess the effect of a dietary modification delivered through a low-cost model of care (MOC), on neonatal outcomes in women with GDM in India. Methodology: Dietary intake was assessed in 133 women with GDM enrolled under the women in India with GDM strategy-MOC (WINGS-MOC), from six maternity centres in Chennai, in South India. The WINGS-MOC dietary intervention included one-on-one monthly antenatal diet counselling, providing a dietary guideline booklet and healthy recipe demonstrations. Dietary intake was assessed using 24-h dietary recall and an open-ended diet questionnaire. A ‘healthy diet score’ was derived from the reported intake of whole grains, dairy products and dietary fibre. The effect of healthy diet score on neonatal outcomes (macrosomia, hyperbilirubinaemia, congenital anomalies and neonatal intensive care unit admissions) was evaluated. Results: A six-fold increase in the intake of whole grains (30 vs. 5.1g) and 20% increase in consumption of dairy products (265.4 vs. 225g) and dietary fibre (22.3 vs. 18.2g) were observed after the MOC intervention. Higher consumption of whole grain, dairy products and dietary fibre was inversely associated with adverse neonatal outcomes. Those with the highest healthy diet score had lower risk for adverse neonatal outcomes (odds ratio: 0.2, [95% confidence interval: 0.04–0.9]; P = 0.04) even after adjusting for potential confounders. Conclusions: A low-cost dietary intervention helps to improve neonatal outcomes in women with GDM.

Whole-grain consumption and its determinants in Malaysian medical students: A cross-sectional study.

Whole-grain consumption is associated with several health benefits. Little is known, however, about whole-grain consumption patterns in medical students in Malaysia. The study was conducted to assess whole-grain intake pattern and factors influencing intake among Malaysian medical students. A cross-sectional study investigating whole-grain intake among 151 medical students in a private medical university in Malaysia was conducted from January to June 2018. A self-administered questionnaire was used to assess sociodemographic variables, the whole-grain intake pattern and the knowledge and attitudes toward whole-grain intake. Data were analyzed using IBM SPSS software. Chi-square test and multivariable logistic regression were used. The prevalence of reported whole-grain intake in the past 3 months was 51%. Chinese ethnicity, readiness to adhere to Malaysian food pyramid, and self-preparation of food, and eating at home were significantly associated with whole-grain consumption. However, the primary determinants of food choice such as education, knowledge, and affordability did not seem to influence whole-grain consumption. Whole-grain consumption is relatively low among Malaysian medical students. Cultural background and self-belief influence this practice despite being from the medical fraternity. Efforts are needed to bridge the knowledge-practice gap by assessing the barriers to whole-grain consumption to design effective initiatives to promote an increase in whole-grain consumption.

Dietary Fiber Intake and Benefit of Colorectal Cancer

Dietary fibre is a type of carbohydrate that can't be digested by using our bodies ’enzymes. It is found in edible plant foods such as cereals, fruits, vegetables, dried peas, nuts, lentils and grains. Fibre is grouped by its physical properties is called soluble, insoluble or resistant starch. Findings advise that excessive compliance with a lowfat, high-fiber food plan is related to decreased threat of colorectal cancer recurrence. Fiber may additionally help protect towards breast cancer, an effect noted mainly with intake of whole grains and wheat bran.

Dietary Pattern and Their Association With Level of Asthma Control Among Patients With Asthma at Al-Shifa Medical Complex in Gaza Strip, Palestine.

Background:This study was conducted to identify major dietary patterns and their association with level of asthma control among patients with asthma in Gaza Strip, Palestine.Methods:This cross-sectional study was conducted among a representative sample of Palestinian patients with asthma (both sex, aged 19-64 years) receiving care in chest department at Al-Shifa Medical Complex. Asthma control level was obtained using asthma control test. Data regarding other variables were obtained using an interview-based questionnaire and a semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20.Results:Two major dietary patterns were identified including (1) Prudent pattern characterized by a high intake of whole grains, beans and legumes, fish and shellfish products, vegetables, tomatoes, fruits, and vegetable oils, and (2) Western pattern characterized by a high intake of refined grains, red meat, poultry, fast foods, eggs, low-fat dairy product, high-fat dairy products, hydrogenated fats, olive, sugar, sweets, desserts, and snacks. After adjustment for confounding variables, patients in the lowest tertile (T1) of Prudent pattern had a lower odds for poorly controlled asthma (odds ratio [OR] = 0.044, 95% confidence interval [CI] = [0.002-1.316], P value < 0.05), whereas patients in the lowest tertile (T1) of Western pattern had a higher odds for poorly controlled asthma (OR = 2.499, 95% CI = [1.288-4.850], P value < 0.05), compared with those in the highest tertile (T3).Conclusion:A Prudent pattern may be associated with a lower prevalence of poorly controlled asthma, whereas a Western pattern may be associated with a higher prevalence of poorly controlled asthma.