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... Even though the separate role of key nutrients, or foods, on bone health has been reported previously, these associations might be confounded by any change in the other dietary components. Dietary pattern (DP) approaches describe and quantify the whole diet and consider contributions from various dietary aspects [6]. Findings from DP studies could complement those from studies of single nutrients and foods on bone accrual and may be translated into public health recommendations, which better suit real world dietary habits. ...
... The DPs were identified using factor analysis via principal component analysis (PCA). The PCA aggregates the food groups into a smaller number of the distinct factors based on inter-correlation between them [6,29]. To achieve a simpler structure with higher interpretability, orthogonal rotation (Varimax option) was applied. ...
... To our knowledge, there are only four studies that evaluated the DPs during adolescence in association with bone health [21][22][23][24]. Even though three of these studies were similar to our study in their prospective design (follow-up period ranged from 22 months to 6 years) [21,23,24], identified DPs are not directly comparable, because of the differences in DP approaches, food groupings and dietary habits and other characteristics of the study population [3,6]. However, our findings of a positive association between "Vegetarian-style" DP and bone measurements are in accordance with the results from two studies which used reduced-rank regression (RRR) to derive DPs. ...
Abstract Background The amount of bone accrued during adolescence is an important determinant of later osteoporosis risk. Little is known about the influence of dietary patterns (DPs) on the bone during adolescence and their potential long-term implications into adulthood. We examined the role of adolescent DPs on adolescent and young adult bone and change in DPs from adolescence to young adulthood. Methods We recruited participants from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991–2011). Data from 125 participants (53 females) for adolescent analysis (age 12.7 ± 2 years) and 115 participants (51 females) for adult analysis (age 28.2 ± 3 years) were included. Bone mineral content (BMC) and areal bone mineral density (aBMD) of total body (TB), femoral neck (FN) and lumbar spine (LS) were measured using dual-energy X-ray absorptiometry. Adolescent dietary intake data from multiple 24-h recalls were summarized into 25 food group intakes and were used in the principal component analysis to derive DPs during adolescence. Associations between adolescent DPs and adolescent or adult BMC/BMD were analyzed using multiple linear regression and multivariate analysis of covariance while adjusting for sex, age, the age of peak height velocity, height, weight, physical activity and total energy intake. Generalized estimating equations were used for tracking DPs. Results We derived five DPs including “Vegetarian-style”, “Western-like”, “High-fat, high-protein”, “Mixed” and “Snack” DPs. The “Vegetarian-style” DP was a positive independent predictor of adolescent TBBMC, and adult TBBMC, TBaBMD (P
... Interestingly, among the obese population, " Meats and Cheese " and " Snacks and Alcohol " patterns, which includes foods with high fat content and alcoholic drinks as dominant groups, were identified. The " Prudent " pattern did not show a protective effect on obesity in our work, which is in contrast to other studies on dietary patterns and BMI in adult populations [41,42]. In line with our results, it has been suggested that significant weight loss is unlikely if there increased fruit and vegetable consumption is not accompanied by compensatory reduction in total energy intake [43]. ...
... In line with our results, it has been suggested that significant weight loss is unlikely if there increased fruit and vegetable consumption is not accompanied by compensatory reduction in total energy intake [43]. In addition, Kant reported that the protective effects of healthy diet patterns in most published studies were relatively modest, suggesting that these dietary patterns are reported along with other desirable health behaviors, thereby confounding pattern and health association [41]. Although we considered potential confounders in the risk analysis, other factors not considered (such as likely dieting and preparation methods) may be causing confusion. ...
... In addition, selection bias was minimized through rigorous design of the multistage population random sample [10,11]. Regarding the index-based dietary patterns approach, several weaknesses have been described, such as subjectivity in naming of patterns, differences in dietary variables, and analytic decisions that limit its replication and comparability across studies [41]. However, dietary habits differ across populations. ...
BACKGROUND/OBJECTIVES
In Argentina, obesity prevalence rose from 14.6% in 2005 to 20.8% in 2013. Although the number of studies on noncommunicable diseases and dietary patterns as a unique dietary exposure measure has increased, information on this topic remains scarce in developing countries. This is the first population-based study investigating the association between diet and obesity using a dietary pattern approach in Argentina. We aimed (a) to identify current dietary patterns of the population of Córdoba city, (b) to investigate its association with obesity prevalence, and (c) to identify and describe dietary patterns from the subgroup of people with obesity.
SUBJECTS/METHODS
The Córdoba Obesity and Diet Study (CODIES) was conducted in Córdoba city by using a random sample of n = 4,327 subjects between 2005 and 2012. Empirically derived dietary patterns were identified through principal component factor analysis. A multiple logistic regression analysis was used to investigate the association of dietary patterns with obesity.
RESULTS
Four dietary patterns were identified, called “Starchy-Sugar”, “Prudent”, “Western”, and “Sugary drinks”. High scores for the “Western” pattern (with strongest factor loading on meats/eggs, processed meats, and alcohol) showed a positive association with obesity (OR: 1.33, 95% CI: 1.06-1.67, for third versus first tertile of factor score). “Meats/Cheeses” and “Snacks/Alcohol” patterns emerged in people with obesity.
CONCLUSIONS
The findings suggest that high adherence to the “Western” pattern promoted obesity in this urban population. In addition, people with obesity showed characteristic dietary patterns that differ from those identified in the overall population.
... This indicates that young people may engage in a mixture of different behaviours (healthy/unhealthy) and a more holistic approach is needed to evaluate which behaviours tend to cluster and which do not; if the clustering exists, what is the potential explanation? Recent approaches in studying clustering of healthrelated behaviours have been to identify the patterns of behaviours rather than investigating individual exposures , i.e., particular foods intakes [23, 24]. One of the statistical methods used in examining behavioural patterns is Principal Component Analysis (PCA). ...
... For example, Pearson et al. [34] found that unhealthy dietary behaviours were clustering with low levels of physical activity, while Ottevaere et al. [31] found two clusters in the studied population that would appear to be contradictory, i.e., 'active, low quality diet' and 'inactive, high quality diet'. The inconsistencies in previous studies may have been a result of using hypothesis-driven (a priori) approach which is based on existing evidence and prior knowledge [24]. For example, dietary patterns were examined in relation to predefined exposures, such as sedentary behaviour or screen time rather than the patterning of activities, either proving or disapproving the hypothesis [14]. ...
... For example, dietary patterns were examined in relation to predefined exposures, such as sedentary behaviour or screen time rather than the patterning of activities, either proving or disapproving the hypothesis [14]. In contrast to previous studies we have applied an exploratory approach and identified the two groups of patters using statistical methods [24]. We believed that using this data-driven (a posteriori) approach in finding the associations between diet and physical activity can bring some novel findings, which may not have been examined before. ...
Abstract Background Similar to other countries, trends of decreasing levels of physical activity (PA) and an increasing prevalence of unhealthy dietary patterns are observed among girls in Poland. Better understanding of potentially inter-related behaviours within this population can help to design tailored interventions. The purpose of this study was to determine associations between PA patterns and dietary patterns in a representative sample of Polish girls. Methods Girls aged 13-21 years (n = 1107) were randomly selected for the study. PA was assessed using International Physical Activity Questionnaire – Long (IPAQ-L). Dietary data were collected with food frequency questionnaires. PA patterns and dietary patterns were drawn separately by Principal Component Analysis (PCA). Logistic regression was used to find the associations between PA patterns and dietary patterns. Results Four major PA patterns (‘School/work activity’, ‘Active recreation’, ‘Yard activity’ and ‘Walking and domestic activity’) and four dietary patterns (‘Traditional Polish’, ‘Fruit & vegetables’, ‘Fast food & sweets’ and ‘Dairy & fats’) were identified. Level of PA was the highest in the upper tertile of ‘School/work activity’ pattern (mean 1372.2 MET-minutes/week, 95 % Confidence Intervals [CI]: 1285.9–1458.5). Girls in upper tertiles of ‘Yard activity’, ‘Active recreation’ and ‘School/work activity’ patterns had significantly higher chances of being in the upper tertile of the ‘Fruit and vegetables’ dietary pattern (odds ratio [OR] 2.17, 95 % CI: 1.50–3.14, p
... A posteriori method uses statistical techniques such as principal component analysis (PCA), factor analysis or cluster analysis to derive dietary patterns. A priori method is theoretical while a posteriori method is empirical and uses multivariate techniques [9]. A priori method reflects the health effect of a broader definition of food items using pre-established food groups based on the most common food groups (i.e. ...
... We further created two a posteriori dietary patterns that were derived using PCA. This is a well-grounded method in the study of dietary patterns [8, 9]. The two uncorrelated empirically derived dietary patterns were " vegi-fruit dietary pattern " which was characterized by high intake of vegetables and fruits and " meat-processed dietary pattern " which was characterized by high meat and processed foods intake. ...
... Principal component analysis. The PCA (orthogonal varimax rotation with retention of two factors), a linear combination of optimally-weighted observed variables, was used to derive the two uncorrelated patterns from the 22 food groups in the FFQ [8, 9, 28] . Generally, five different methods used in the retention of a particular number of principal components or factors included: (1) Kaiser method that allows retention of components with eigenvalues greater than 1.0, however, there are reasons given by Streiner and Norman [29] and Field et al. [30] why this is not an altogether good idea, (2) the scree test where components in the steep curve are retained before the initial point beginning the flat line trend, (3) the number of non-trivial components which involves retention of components with two or more variables loading above the cut-offpoint (often 0.30), (4) a priori criterion where a specific number of components are set by the researcher in replication of a previous research, and (5) the percent of cumulative variance which involves retention of components that cumulatively explains the variation (usually 95%) [31][32][33]. ...
Background
Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults.
Methods
Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, “vegi-fruits” and “meat-processed”, were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression.
Results
The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p < 0.001, model 3), but not with triacylglycerol. In addition, high intake of vegi-fruit dietary pattern (Q5) was negatively associated with CVD risk factors (p < 0.001), but not with high-density lipoprotein, while high consumption of meat-processed dietary pattern (Q5) was positively associated with CVD risk factors (p < 0.001), but negatively related with triacylglycerol in Q3 level and no association with C-reactive protein.
Conclusion
A negative association was observed between Taiwanese or vegi-fruit dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk factors.
... Two widely used diet quality scores are the Alternate Heathy Eating Index (AHEI), which aims to assess the adherence to the Dietary Guidelines for Americans, and the Mediterranean Diet Score (MDS), which investigates the adherence to the traditional Mediterranean diet [8,9]. A high diet quality, as assessed by both the AHEI and the MDS, was associated with a lower risk for morbidity and mortality of major chronic diseases [3,4,10,11]. Although the two diet quality scores are highly similar with respect to some components, they include a unique dietary combination and are computed differently. ...
... These patterns are indeed directly derived from dietary data, usually by principal component or cluster analyses [12]. The complementarity of these methods and the importance of using various approaches to investigate the overall diet quality is often emphasized in the literature [10,12,50]. In fact, both a priori and a posteriori dietary patterns have strengths and limitations [12]. ...
Sociodemographic differences in dietary consumption were observed in different populations. The current study aimed to identify sociodemographic and lifestyle determinants of diet quality and to investigate the differences in diet quality between the three main language regions of Switzerland. Using data of the Swiss National Nutrition Survey menuCH (n = 2057), two diet quality scores—Alternate Healthy Eating Index and Mediterranean Diet Score—were computed. Linear regression models were used to investigate the determinants of diet quality and chi-square tests were used to test for differences in single score components between language regions. Significantly higher diet quality scores were observed for individuals who were female, older, normal weight, non-Swiss, with tertiary education or moderate-to-high physical activity level. Additionally, residents of the French- and Italian-speaking parts of Switzerland scored higher than residents of the German-speaking region. More specifically, the higher diet quality observed in the French- and Italian-speaking regions was mediated by higher scores in the components of alcohol, dairy products, fat, fish, sugar-sweetened beverages and whole grains. The present results may help to better characterize population groups requiring specific dietary recommendations, enabling public health authorities to develop targeted interventions.
... In order to further evaluate the influence of the dietary share of ultra-processed foods on the nutritional dietary quality we need to study its relationship with the overall nutrient profile of diets. As several authors have pointed out [19][20][21][22], studying nutrients one at a time has a number of drawbacks, which may be overcome by focusing on dietary patterns [19,[23][24][25][26][27][28][29][30] . Yet, to date, population studies assessing the impact of ultra-processed food consumption on the nutritional quality of diets have focused on the dietary content of individual nutrients. ...
... Also, as some authors have highlighted, the number of food items reported in NHANES is smaller than the number available in the marketplace, and national food composition data are not updated as required to include all brand-specific products and to examine dietary profiles sensitive to brand preferences [48]. The PCA method also has limitations such as subjective decisions regarding the number of extracted components, method of rotation, naming of components, and cutoffs for factor loadings [23, 31, 49]. ...
Background
Recent population dietary studies indicate that diets rich in ultra-processed foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients, individually and overall. Methods
We evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-processed foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-processed foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment. ResultsThe average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-processed foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose–response association was found between ultra-processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars. Conclusions
This study suggests that decreasing the dietary share of ultra-processed foods is a rational and effective way to improve the nutritional quality of US diets.
... Human health is greatly influenced by a person's dietary habits and decisions. Dietary factors and other lifestyle factors such as physical inactivity, cigarette use, and alcohol use have all been linked to a variety of noncommunicable chronic illnesses (NCDs) and death [5]. ...
Depression being the psychiatric condition with the highest societal costs in industrialized nations, it is necessary to collect research information on the role of nutrition in depression in order to provide recommendations and guide future health treatment. Observance of healthy dietary practices has been linked to decreased depression symptoms; however, it is unknown whether this is attributable to some or all of the components.
The aim of this study was to conduct a systematic review of observational and systematic studies analyzing the association between dietary habits and depression in adolescents, adults, and older people. A variety of noncommunicable chronic illnesses and deaths have been linked to dietary and other lifestyle factors such as physical inactivity, cigarette use, and alcohol use.
Several studies have found that older people are more likely to be malnourished and depressed, which can hurt their overall health and well-being. Early in life, proper nutrition is suggested as a factor that may have a significant impact on one's mental health. It is critical to identify changes in primary care practices in order to improve the quality of life and prevent complications.
The systematic review included papers presenting human studies and published in English until January 2021, analyzing the association between dietary habits and mental health, while we studied a group of people of mixed ages. We included three systematic reviews, three cross-sectional studies, two cohorts, and one meta-analysis. According to the findings of our systematic review of observational
studies, observational evidence suggests that both following a healthy diet, in particular incorporating vegetables and fruits, and avoiding a pro-inflammatory diet like junk foods, fast foods, and high meat intake may lower the risk of developing depressive symptoms or clinical depression. As a result, we recommend that the relationship between diet and depression should be investigated in prospective cohorts and randomized controlled studies that are well-designed and have more conclusive evidence regarding dietary involvement and depression.
... While access to cheap staple grains may ensure calorie security for future generations, there is evidence to suggest that greater dietary diversity has larger benefits for health and well-being (Arimond and Ruel, 2004;Guo et al., 2004;Kant, 2004). Given that diets are expected to diversify in the future, increasing access to fresh foods and reducing price differentials between staples and nonstaples will be key to meeting new demand and maintaining the health and well-being of future populations (Gómez and Ricketts, 2013). ...
... Above the level of gender, culture plays an overarching role in impacting dietary practices [11] and patternsdi.e., the number of meals, snacking behaviors, individual food or nutrient consumption [12], regular meal locations, food product selections, consumption of specific food types, and to an extent, health-conscious behaviors [13]. The consumption of food types is often upheld consistently over certain events and festive periods [14], and food customs have been observed to prevail even when apart from the place of origin, where for example, Southeast Asian refugee families in the United States continue to maintain their cultural diet of native foods [15]. ...
Background: Dietary quality, biological health, culture, religiosity, and perceived stress are co-related.However, there is a dearth of research conducted on Asian populations in secularized and harmonious multicultural societies.
Methods: This study addresses these gaps by conducting an investigation in the multicultural and
multireligious Singapore to examine the parameters of culture and gender and the associations with (1) dietary quality, (2) biological health indicators, (3) religiosity, and (4) perceived stress. One hundred fifty participants (18- 60 years old) were recruited, and their blood pressure (BP), body mass index (BMI), and body fat percentage (BF%) were also measured along with a 5-part questionnaire on demographics, dietary practice, food frequency, religiosity, and perceived stress.
Results and conclusion: Results showed that cultural differences are associated with certain dietary practices, where the three ethnic groups of Chinese, Malays, and Indians significantly differed in their choices of meal locations such as Western fast food restaurants (H ¼ 12.369, p ¼ .002061*). Our analysisrevealed that perceived stress significantly correlated with fat intake (rs ¼ .169, N ¼ 150, p ¼ .03865) and sugar intake (rs ¼ .172, N ¼ 150, p ¼ .03575). On the other hand, biological parameters such as diastolic BP (rs ¼ �.0473, N ¼ 150, p ¼ .565), systolic BP (rs ¼ �.00972, N ¼ 150, p ¼ .906), BMI (rs ¼ �.0403, N ¼ 150, p ¼ .6246), and BF% (rs ¼ �.110, N ¼ 150, p ¼ .1811) did not have significant correlations with perceived
stress. Similarly, religiosity did not significantly correlate with perceived stress (rs ¼ �.025, N ¼ 150, p ¼ .7616). In conclusion, our findings provide insights into the changing intersection of food practices mitigated by ethnicity, religiosity, stress, and gender in the harmonious multiracial and multicultural Singapore.
... 10,[13][14][15][16][17][18][19] Scores reflecting overall diet quality can help assess nutrient-and food-specific variables, providing diet assessments that incorporate nutrient and food interactions assumed to be biologically important. 1,[20][21][22] Dietquality indices provide a new tool for diet evaluation and are more advantageous in resolving diet complexity than traditional assessments of a single nutrients or food groups. 23 In China exists an index for diet-quality assessment relative to the Chinese Dietary Guidelines, i.e., based on consumption recommendations within the main food groups. ...
Background and objectives:
Poor adherence to dietary guidelines is related to physical and mental disorders, as reflected in self-reported health statuses. This study evaluates the association between diet quality and selfreported health within the Shanghai Diet and Health Study.
Methods and study design:
We used Chinese Dietary Guidelines Adherence scores to assess diet quality in a cross-sectional study of 4487 subjects above 15 years of age, who completed three-day 24h diet recalls and responded to self-reported health questionnaires. A composite health score was calculated based on Item Response Theory, using the Rasch model. Multiple linearregression models were evaluated to assess the relationship between self-reported health status and diet quality.
Results:
Based on the various adherence scores, we divided our sample into fifths. Based on these divisions and with the exception of a single instance, our results show a significant trend: self-reported health declines with declining adherence to official dietary guidelines. This trend was even significant when controlling for a large number of potential confounders.
Conclusions:
This study shows that consumption of a healthy and balanced diet, as reflected in adherence to the Chinese Dietary Guidelines, is related to increased levels of overall health among Shanghai residents.
... Incidence of obesity is also on the rise as a result of excessive consumption of processed foods, high fat diets, and less exercise [1, 2]. Dietary pattern of a population group is generally governed by its socioeconomic and cultural characteristics along with their exposure to outside world [3]. Weight related conditions like disordered eating behaviours adversely affect the growth process, psychosocial development, and physical health of young people [4]. ...
Growing consciousness about ideal body image leads to dietary modifications and consequent eating disorders among girls in
developing countries like India. The present study aims to (i) assess the prevalence of body weight consciousness and related
behaviours among a group of adolescent girls; (ii) assess the sociodemographic correlates of weight related behaviours; and (iii)
compare weight related behaviours of the girls of two religious groups residing in Howrah. The study is the outcome of a crosssectional
school based survey involving 280 (159 Hindu and 121 Muslim) girls from standards 8 to 11. Significant differences
exist between two religious groups with respect to their family size, socioeconomic profile, and media exposures (in terms of
watching television). Consciousness about body weight among girls shows significant difference with respect to religion, family
size (𝜒
2
= 64.77), father’s occupation (𝜒
2
= 60.28), level of education of both the parents, and media exposure (𝑃 < 0.05).
Consciousness about body weight drives them to adopt several behavioural measures like calorie restriction, food avoidance, and
dieting. Sociodemographic correlates of all these behaviours have been analyzed. The study documents that concern over body
image and weight loss is quite important among these urban girls.
... Studies based on nutritional epidemiology have traditionally focused on the relationship between disease and specific nutrients and/or foods, however, the analysis of patterns focuses on the study of the combinations of nutrients and/or foods that the population usually consumes [2,3]. Thus, it has the advantage of allowing a more complete view of the diet, and how it affects health and disease [4]. Currently, food patterns have been identified by using statistical techniques that reduce and/or aggregate components such as the exploratory factor analysis followed by principal component analysis. ...
Objective
To examine the relationship between dietary patterns and abdominal adiposity among adults living in the urban area of Viçosa, Minas Gerais, Brazil.
Methods
A population-based, cross-sectional study of 959 adults of both sexes. Information on sociodemographic characteristics and dietary intake was collected through questionnaires. Abdominal adiposity was evaluated using waist circumference and the anthropometric indices waist-to-hip ratio and waist-to-height ratio. Food patterns were identified by factor analysis. Poisson regression was used for multivariate analysis.
Results
Abdominal adiposity was identified by waist circumference in 59.06% (95%CI=52.77–65.08) of the sample, by waist-to-hip ratio in 54.65% (95%CI=47.92–61.21), and by waist-to-height ratio in 9% (95%CI=54.61–69.03). Two dietary patterns, named as traditional Brazilian and bar, were identified in the sample, but only the latter was statistically associated with abdominal adiposity determined by the three parameters.
Conclusion
The study identified two eating patterns in the population, a healthy and an unhealthy pattern, the latter being associated with greater odds of abdominal adiposity. Thus, it is important to take measures to reverse this trend.
... These common approaches have methodological and conceptual limitations [9,10], in the sense that they can detect the effects of only a single nutrient or food on overall health but would not explain the interactions among nutrients and foods [11]. In addition, such studies do not provide tangible practical dietary advice, as nobody normally consumes just a single food or nutrient [10,12]. Dietary pattern (DP) analysis has emerged as an alternative approach to nutritional epidemiology [13,14]. ...
Background
To investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD). Methods
National Health and Nutrition Examination Survey (NHANES) data for the years 1999–2002 were used. PAD was diagnosed by ankle brachial index assessment. Plasma concentrations of vitamins were measured using high performance liquid chromatography. Vitamin D levels were measured by radioimmunoassay. Analysis of covariance, principal components analysis (PCA) and adjusted logistic regression were applied, accounting for the survey design and sample weights. ResultsOf the 4864 eligible participants, 2482 (51.0%) were men and 269 (5.5%) had prevalent PAD. PCA uncovered three DPs which accounted for 56.8% of the variance in dietary nutrients consumption including DP1 (fatty acids and cholesterol), DP2 (minerals, vitamins and fiber), and DP3 (polyunsaturated fatty acids [PUFA]). PAD patients had a significantly higher serum concentrations of trans 9-octadecenoic acid and trans 9, trans 12-octadienoic acid as well as lower plasma levels of vitamin D, retinol, retinyl stearate and retinyl palmitate (p < 0.001 for all comparisons). In models adjusted for age, race, diabetes, cholesterol, hypertension, smoking and energy intake, individuals in the highest quartile of the DP1 had higher odds for PAD compared with those in the lowest quartile [(odds ratio (OR): 6.43, 95% confidence interval (CI): 2.00–20.63 p < 0.001], while those in the highest quartile of DP2 and DP3 had lower odds of PAD relative to those in the lowest quartile (OR:0.28, OR:0.44, respectively; p < 0.001 for both comparisons). Conclusion
We found that quality of diet, plasma vitamins and TFAs are associated with the likelihood of PAD. If confirmed in prospective studies, the possibility that dietary factors, plasma vitamins and TFAs might be valuable for preventing or delaying the clinical progression of PAD, should be investigated in intervention trials.
... Two uncorrelated dietary patterns were derived from the FFQ using PCA with orthogonal varimax rotation and retention of two factors [26,27], and defined as vegetablefruit (9 foods or food groups) and meat-processed (12 foods or food groups) dietary patterns to reflect dietary consumption with high intake in vegetables and fruits or meats and processed foods, respectively (Additional file 1: Table S1). The food groups of legumes and soy products as well as seafood had a factor loading ≥0.30 in both factors, and were classified as vegetable-fruit or meat-processed dietary pattern, respectively. ...
Background
Diet has been associated with differences in weight and nutritional status of an individual. The prevalence of overweight and obesity increased among adults in Taiwan. Hence, we examined the relationship between dietary patterns and weight status by gender among middle-aged and older adults in Taiwan. Methods
The cross-sectional data of 62,965 participants aged ≥40 years were retrieved from the Mei Jau health screening institutions’ database collected from 2001 and 2010. Diet information was evaluated using a food frequency questionnaire, while the dietary patterns were derived using principal component analysis before summing up and dividing into quintiles of consumption. The association between dietary patterns and weight status among adult men and women was explored using multinomial logistic regression models. Three models were analyzed before stratifying data by gender. ResultsTwo dietary patterns were derived with one reflecting a high consumption of vegetables and fruits (vegetable-fruit dietary pattern) and the other a high consumption of meat and processed foods (meat-processed dietary pattern). After adjustment, highest consumption of vegetables and fruits (Q5) reduced the likelihood of being overweight (OR = 0.91; 95% CI, 0.85–0.97) or obese (OR = 0.85; 95% CI, 0.78–0.92), while highest consumption of meat and processed foods increased the likelihood of being overweight (OR = 1.50; 95% CI, 1.40–1.59) or obese (OR = 1.94; 95% CI, 1.79–2.10). Women were less likely to be overweight or obese with the highest intake of fruits and vegetables (Q5) while both genders were more likely to be overweight or obese with high consumption of meat and processed foods. Conclusions
High intake of vegetables and fruits is associated with lower odds of being overweight or obese, especially among women. But, high intake of meat and processed foods is associated with higher odds of overweight and obesity in both genders.
... Long term complications such as coronary heart disease which can lead to a heart attack, cerebrovascular disease which can lead to stroke, retinopathy (disease of the eye) which can lead to blindness, nephropathy (disease of the kidney) which can lead to kidney failure and the need for dialysis, and neuropathy (disease of the nerves) which increases the chance of foot ulcers, infection and the eventual need for limb amputation may be attenuated by dietary interventions [2]. Dietary patterns is an approach that has been used to investigate diet-disease relations [7][8][9]. Dietary pattern is potentially useful in making dietary recommendations because overall dietary patterns might be easy for the public to interpret or translate into diets [10]. The etiology of T2DM complications is poorly understood [11]. ...
Background
The prevalence of diabetes mellitus is rising worldwide. When diabetes is uncontrolled, it has dire consequences for health and well-being. However, the role of diet in the origin of diabetes complications is not understood well. This study identifies major dietary patterns among type 2 diabetes patients and its association with diabetes complications in Gaza Strip, Palestine. Methods
This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20–64 years), patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Additional information regarding demographic and medical history variables was obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 20. ResultsTwo major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the lowest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruit had a lower odds for (High BP, kidney problems, heart problems, extremities problems and neurological problems), (OR 0.710 CI 95% (.506–.997)), (OR 0.834 CI 95% (.700–.994)), (OR 0.730 CI 95% (.596–.895)), (OR 0.763 CI 95% (.667–.871)) and (OR 0.773 CI 95% (.602–.991)) respectively, (P value <0.05 for all). No significant association was found between the sweet-soft drinks snacks pattern with diabetes complications. Conclusion
The Asian-like pattern may be associated with a lower prevalence of diabetes complications among type 2 diabetes patients.
... To get information about the diet quality, the international literature increasingly refers to dietary patterns [5,6]. When the patterns are empirically derived they provide information about which foods are often combined by the consumers [7,8]. Because not individual foods but the combination of foods determines people's supply of energy and nutrients a dietary pattern approach is particularly appropriate in describing diet quality [5]. ...
Background
Empirically derived food purchase patterns provide information about which combinations of foods were purchased from households. The objective of this study was to identify what kinds of patterns exist, which level of diet quality they represent and which factors are associated with the patterns.
Methods
The study made use of representative German consumption data in which approximately 12 million food purchases from 13,125 households are recorded. In accordance with healthy diet criteria the food purchases were assigned to 18 food groups of the German Food Pyramid. Based on these groups a factor analysis with a principal component technique was applied to identify food patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between pattern scores and socio-economic as well as attitude variables, reflecting personal statements about healthy eating, were analyzed.
Results
In total, three food purchase patterns could be identified: a natural, a processed and a traditional one. The first one was characterized by a higher purchasing of natural foods, the second by an increased purchasing of processed foods and the third by a meat-oriented diet. In each pattern there were specific diet quality criteria that could be improved whereas others were in line with actual dietary guidelines. In addition to socio-demographic factors, attitudes were significantly associated with the purchase patterns.
Conclusions
The findings of this study are interesting from a public health perspective, as it can be assumed that measures focusing on specific aspects of diet quality are more promising than general ones. However, it is a major challenge to identify the population groups with their specific needs of improvement. As the patterns were associated with both socio-economic and attitude variables these grouping criteria could be used to define target groups.
... Nutrition research has traditionally concentrated on the detailed examination of possible health roles and consequences of dietary components (foods, nutrients, or both) in isolation. However, the effects of individual foods and nutrients on health are usually difficult to estimate, given that they can be small[1]. Additionally, foods and thus nutrients are consumed in combination and their combined effects may be interactive or synergistic[2]. ...
Background:
Studies examining meal and snack eating behaviors in relation to overall diet and health markers are limited, at least partly because there is no definitive consensus about what constitutes a snack, a meal, or an eating occasion. This cross-sectional study examined how nutritional quality of meals and snacks is associated with overall diet quality, body mass index (BMI), and waist circumference.
Methods:
Based on 7-d weighed dietary record data, all eating occasions were divided into meals or snacks based on time (meals: 0600-1000, 1200-1500, and 1800-2100 h; snacks: others) or contribution to energy intake (EI) (meals: ≥15%; snacks: <15%) in 1451 British adults aged 19-64 years participating in the National Diet and Nutrition Survey. Nutritional quality of meals and snacks was assessed as the arithmetic EI-weighted means of the British Food Standards Agency (FSA) nutrient profiling system score of each food and beverage consumed, based on the contents of energy, saturated fatty acid, total sugar, sodium, fruits/vegetables/nuts, dietary fiber, and protein per 100 g.
Results:
Irrespective of the definition of meals and snacks, higher FSA scores (lower nutritional quality) of both meals and snacks were associated with unfavorable profiles of individual components of overall diet, including lower intakes of fruits/vegetables/nuts and higher intakes of biscuits/cakes/pastries, total fat, and saturated fatty acid. The FSA scores of meals and snacks were also inversely associated with overall diet quality assessed by the healthy diet indicator (regression coefficient (β) = -0.22 to -0.17 and -0.06 to -0.03, respectively) and Mediterranean diet score (β = -0.25 to -0.19 and -0.08 to -0.05, respectively) in both sexes (P ≤ 0.005). However, the associations were stronger for meals, mainly due to their larger contribution to total EI (64% to 84%). After adjustment for potential confounders, only the FSA score of snacks based on EI contribution was positively associated with BMI and waist circumference in women (P ≤ 0.005).
Conclusions:
Although lower nutritional quality of both meals and snacks assessed by the FSA score was associated with adverse profiles of overall diet quality (but not necessarily adiposity measures), stronger associations were observed for nutritional quality of meals.
... We observed no association between the key socioeconomic variables: education and working status, and discontinuation or colorectal neoplasia in the present study. Socioeconomic status has been associated with lifestyle (Kant, 2004;Knudsen et al, 2014;Markussen et al, 2016), and a recent European rapport suggests that socioeconomic factors explain health inequalities more than behavioural factors (Eikemo et al, 2016). In our population, smoking and obesity were more prevalent in individuals with low education than in individuals with a high education. ...
Background:
To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening.
Methods:
In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m(-2)), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Results:
Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m(-2) compared with BMI 16.9-24.9 kg m(-2) and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107).
Conclusions:
These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.British Journal of Cancer advance online publication, 13 July 2017; doi:10.1038/bjc.2017.189 www.bjcancer.com.
... The majority of studies showed associations for children aged 12 months and older and not for children in their first year of life. The arbitrary selection of components and cutoffs, as well as determining the contribution of components to the overall index have been highlighted as limitations to predict specific health outcomes or nutritional status[9]. Summary indices that include more information on feeding practices as a whole, in contrast to the diet quality itself, were reported to predict nutritional status[6]. Several evaluations have shown a positive association of such summary indices of child feeding practices with linear growth, i.e. height/length-for-age zscore (HAZ/LAZ) or stunting (HAZ/LAZ < −2)[10][11][12][13][14]. Conversely, the associations between child growth and individual components of the summary feeding index, i.e. breast feeding or bottle feeding alone, were found to be rather incoherent. ...
Background
The use of indices of infant and young child feeding practices to predict growth has generated inconsistent results, possibly through age and seasonal confounding. The aim of this study was to evaluate the association of a dietary diversity score (DDS) and infant and child feeding index (ICFI) with growth among young children in a repeated cross-sectional and a follow-up study in two distinct seasons in rural southwest Ethiopia. Methods
We used a repeated cross-sectional design comparing child feeding practices to nutritional status in 6–12 month old children during harvest (HS; n = 320) and pre-harvest season (PHS; n = 312). In addition, 6–12 month old children from the HS were reassessed 6 months later during PHS. In addition to child anthropometry, child feeding practices were collected using 24-h and 7-day dietary recalls. ResultsThe mean (±SD) length-for-age z-score (LAZ) of the 6–12 month old children was −0.77 (±1.4) and −1.0 (±1.3) in HS and PHS, respectively, while the mean (±SD) of the follow-up children in PHS was −1.0 (±1.3). The median DDS (IQR) was 2.0 (1.0, 3.0.), 2.0 (2.0, 3.0) and 3.0 (2.0, 4.0) for the children in HS, PHS and the follow-up children in PHS, respectively. The DDS in HS was positively associated with LAZ at follow-up (β = 0.16; 95% CI: 0.01, 0.30; P = 0.03) after controlling for confounding factors. ICFI and DDS were not associated with mean LAZ, weight-for-height z-score and weight-for-age z-score within season. However, the odds of being stunted when having a DDS ≤ 2 was 2.3 times (95% CI: 1.10, 4.78; P = 0.03) higher compared to a DDS > 2 child in HS and 1.7 times (95% CI: 1.04, 2.71; P = 0.04) higher for the pooled sample of 6–12 months old children in HS and PHS. Conclusions
The DDS was found to be an indicator for child stunting during the Ethiopian harvest season. The DDS can be an appropriate tool to evaluate the association of child feeding practices with child growth irrespective of season. Inclusion of other dimensions in the construction of ICFI should be considered in future analysis as we found no association with growth.
... Part of this holistic approach is the need to promote dietary diversity. More diverse diets are balanced in calorie, protein, and micronutrient intakes (Arimond et al. 2010, Arsenault et al. 2013, Kant 2004) and lead to better anthropometric outcomes for all age groups (Arimond & Ruel 2004, Busert et al. 2016, Rah et al. 2010) and better overall cognitive outcomes (Clausen et al. 2005, Wengreen et al. 2009). In less productive subsistence agricultural systems, farm production diversity plays a large role in the determination of household dietary diversity (Jones et al. 2014, Pellegrini & Tasciotti 2014, Powell et al. 2015). ...
A nutrition-sensitive food system is one that goes beyond staple grain productivity and places emphasis on the consumption of micronutrient-rich nonstaples through a variety of market and nonmarket interventions. A nutrition-sensitive approach not only considers policies related to macrolevel availability and access to nutritious food, but it also focuses on householdand individual-level determinants of improved nutrition. In addition to agriculture, intrahousehold equity, behavior change, food safety, and access to clean water and sanitation are integral components of the food system. This article provides a detailed review, from an economic perspective, on the multisectoral pathways through which agriculture influences nutrition. A critical challenge is to identify and implement food and nutrition policies that are appropriate to the particular stage of structural transformation in the country of concern. Expected final online publication date for the Annual Review of Resource Economics Volume 9 is October 5, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Most of the associations have relied on the effect that single foods have on eating behaviours, not taking into account the complexity of dietary intake. Dietary patterns have become increasingly accepted as a reliable tool to characterize overall diet [19] by expressing cumulative and interactive effects of foods and nutrients, rather than their individual and non-independent effects [20]. Research on this topic is very scarce; one cross-sectional study [21] assessed the association between dietary patterns (sweet foods, fatty foods, snacks, and F&V) and eating behaviours in school-aged children, but no association was found. ...
Background & aims:
A possible relationship between children's dietary intake and certain aspects of eating behaviours has been documented, but most studies are cross-sectional and do not consider the complexity of the diet. The aim of this study was to quantify the association between dietary patterns established at 4 years old and appetite-related eating behaviours identified at 7 years old.
Methods:
Participants are children from the Generation XXI population-based birth cohort. Trained interviewers collected data at birth, 4 and 7 years old on socio-demographics, health and lifestyles, and anthropometrics. At 4 years old, diet was assessed by a Food Frequency Questionnaire and three dietary patterns were identified by Latent Class Analysis: 'Healthier', 'Snacking' and 'Energy Dense Foods' (EDF). A Portuguese version of the original Children's Eating Behaviour Questionnaire (CEBQ) was self-completed by mothers at 7 year-old. This version has previously shown good psychometric properties and the 8 CEBQ sub-domains were combined into two wider dimensions: Appetite Restraint and Appetite Disinhibition. Generalized linear models were used to estimate the associations after adjustment for maternal characteristics (n = 4358). Interaction effects were tested.
Results:
Children belonging to the 'Snacking' (β = 0.329, 95%CI: 0.265; 0.393) and to the 'EDF' (β = 0.138, 95%CI: 0.098; 0.179) dietary patterns at 4 years old scored increasingly higher, respectively, on Appetite Restraint and Appetite Disinhibition dimensions at 7 years old, comparatively to children in the 'Healthier' dietary pattern. Maternal BMI before pregnancy modified the 'Snacking' pattern associations; they were stronger in children from underweight/normal weight mothers for Appetite Restraint and present only among overweight/obese mothers for Appetite Disinhibition.
Conclusions:
This study suggests that children following less healthy dietary patterns early in life have more often disordered eating behaviours in later childhood. Maternal weight status may influence these associations.
... Furthermore, the association of diet quality indices or models to diverse health outcomes are usually significant, but only moderate [8,9,10,11,12,13]. So, for the evaluation of a single person's dietary quality, especially in another country, the usage of one specific diet quality index doesn't seem to be useful. ...
In this paper the NutriScale-Algorithm is described. NutriScale interprets meals and calculates health related scores. It is based on a food pyramid, which was created by the German Nutrition Society according to existing food related and evidence based medical guidelines. Furthermore various food related mobile phone apps and professional desktop applications were analyzed to figure out, what functionality and data sources are appropriate to create such a promising key figure for food selection like NutriScale.
... In addition to studies evaluating individual nutrients, dietary patterns are now being employed to better understand diet and disease relationships . Dietary pattern analyses integrate consumption of individual foods and nutrients into meaningful groups or patterns [7][8][9]. Cluster analysis is a data-driven analytical method useful to identify dietary patterns within a homogenous group of people; which are then treated as independent variables for analysis of associations with markers of disease risk and health outcomes [10]. Studies using CVD biomarkers can provide important evidence on the relation of dietary patterns and disease risk [11, 12]. ...
Background
The prevalence of cardiovascular disease (CVD) in South Asia is higher than in any other developing countries. The diversity of diets in populations among developing countries may be one explanation for the differences in CVD. This study was carried out to explore the association between dietary patterns and the presence of cardiovascular risk factors among Pakistani low income urban adults. Methods
Socio demographic, physical activity and dietary information was collected from 1546 Pakistani subjects aged ≥40 years from the Control of Hypertension and Risk Attenuation (COBRA) study. Anthropometric, clinical and biomarker measures were assessed. Cluster analysis was used to identify dietary patterns from a food frequency questionnaire (FFQ) and multinomial regression was employed to investigate the association between dietary clusters and cardiovascular risk factors, using one of the dietary clusters as a reference category. ResultsThe most prevalent CVD risk factors among participants were elevated low density lipoprotein- cholesterol (LDL-C) (69.8 %) and systolic blood pressure (SBP) (68.2 %), followed by central obesity (57.1 %), low levels of high density lipoprotein-Cholesterol (HDL-C) (56.3 %), overall obesity (46.0 %), high total cholesterol (32.3 %), and elevated fasting blood sugar (FBS) (34.9 %). The cluster analysis generated 3 non-overlapping diet patterns. Cluster 1(Traditional Pakistani Diet), was dominated by fruits, vegetables, milk products and chicken, included participants with high mean body mass index (BMI), waist circumference (WC), HDL-C and low mean SBP. Cluster 2 (Moderate Diet) reflected a moderate intake of most food items and included participants with significantly higher mean SBP. Cluster 3 (Fatty Diet) was characterized by high intake of beef, whole milk, paratha and lentils and those following this cluster had a low mean HDL-C and high SBP. In analyses controlling for age, gender, tobacco use and physical activity, participants in the Traditional diet cluster were more likely to be overweight (OR 1.39, 95 % CI 1.08 to 1.78) and high central adiposity (1.33, 95 % CI 1.04 to 1.71) than participants in the Moderate diet cluster, though less likely to have elevated SBP (OR 0.67, 95 % CI 0.51 to 0.86). LDL-C levels were higher in both the traditional Pakistani diet and Fatty diet cluster compared to the Moderate diet cluster. Low HDL-C was also more prevalent among the Traditional Pakistani diet cluster. Conclusion
Among Pakistani population discernable diet patterns can be derived using clusters analysis. CVD risk factors prevalence differed by cluster membership, though relations for specific CVD risk are not consistent across clusters.
... Dietary patterns analysis focuses on the study of the diet as a whole concept. Its advantage relies in allowing a more complete vision of the diet and its influence on health outcomes, in addition to facilitate comparison between dietary exposures in different cultural groups and popula- tion [1][2][3]. The most common methods used to analyze dietary patterns are: factor analysis (FA), cluster analysis (CA), reduced rank regression (RRR), and principal component analysis (PCA). ...
Background
The objetive in this study is to determine the relationship between dietary patterns, BMI, type 2 diabetes mellitus family history (T2DMFH) and some lifestyle variables such as smoking and skipping breakfast in a Mexican adolescent population. Methods
Cross-sectional, observational, analytical study.Subjetcts: 14-16 years old male and female adolescents (n 373). A previously validated food frequency questionnaire (FFQ) was used and dietary patterns were derived using principal component analysis (PCA). Scores for dietary patterns were categorized by tertiles. ResultsThree major dietary patterns that explained 47 % of variance were found: westernized, high in protein/fat and prudent pattern. Subjects at the highest tertile of prudent pattern had lower BMI. And was also associated with less T2DMFH and less smoking habit when compared with the lowest tertile. We found a positive correlation between BMI and high scores for westernized and high in protein/fat pattern Conclusions
Dietary patterns of adolescents are a public health concern because there is a direct association between inadequate diet at this early age and obesity
... This approach identified groups of individuals who differed in the number, and groupings, of dietary recommendations they met. Clusters where more individuals met the recommendations were characterised by being slightly older and in more highly educated occupations, which is a well-established characteristic of healthy dietary clusters (32) . Clustering of dietary intakes and adequacies has been investigated in relation to several health outcomes (7,8,33) and can be strong predictors of these outcomes (34) . ...
Objective:
To characterise clusters of individuals based on adherence to dietary recommendations and to determine whether changes in Healthy Eating Index (HEI) scores in response to a personalised nutrition (PN) intervention varied between clusters.
Design:
Food4Me study participants were clustered according to whether their baseline dietary intakes met European dietary recommendations. Changes in HEI scores between baseline and month 6 were compared between clusters and stratified by whether individuals received generalised or PN advice.
Setting:
Pan-European, Internet-based, 6-month randomised controlled trial.
Subjects:
Adults aged 18-79 years (n 1480).
Results:
Individuals in cluster 1 (C1) met all recommended intakes except for red meat, those in cluster 2 (C2) met two recommendations, and those in cluster 3 (C3) and cluster 4 (C4) met one recommendation each. C1 had higher intakes of white fish, beans and lentils and low-fat dairy products and lower percentage energy intake from SFA (P<0·05). C2 consumed less chips and pizza and fried foods than C3 and C4 (P<0·05). C1 were lighter, had lower BMI and waist circumference than C3 and were more physically active than C4 (P<0·05). More individuals in C4 were smokers and wanted to lose weight than in C1 (P<0·05). Individuals who received PN advice in C4 reported greater improvements in HEI compared with C3 and C1 (P<0·05).
Conclusions:
The cluster where the fewest recommendations were met (C4) reported greater improvements in HEI following a 6-month trial of PN whereas there was no difference between clusters for those randomised to the Control, non-personalised dietary intervention.
... Compared with traditional dietary analysis, which simply focused on the relationship between individual nutrients or foods, the analysis of dietary patterns has emerged as a holistic and comprehensive approach [12]. A dietary pattern can take advantage of the intricate dietary data, and take account of total dietary consumption and the potential interaction between many nutrients and foods [13][14][15]. These advantages have led to the analysis of dietary patterns being used widely to determine the association between diet and related chronic diseases in nutritional epidemiology in recent decades [16][17][18][19][20]. Dietary patterns vary according to age, ethnicity, culture and other lifestyle factors [21]. ...
Dietary patterns are linked to obesity, but the gender difference in the association between dietary patterns and obesity remains unclear. We explored this gender difference in a middle-aged and elderly populations in Shanghai. Residents (n = 2046; aged ≥45 years; 968 men and 1078 women) who participated in the Shanghai Food Consumption Survey were studied. Factor analysis of data from four periods of 24-h dietary recalls (across 2012–2014) identified dietary patterns. Height, body weight, and waist circumference were measured to calculate the body mass index. A log binominal model examined the association between dietary patterns and obesity, stratified by gender. Four dietary patterns were identified for both genders: rice staple, wheat staple, snacks, and prudent patterns. The rice staple pattern was associated positively with abdominal obesity in men (prevalence ratio (PR) = 1.358; 95% confidence interval (CI) 1.132–1.639; p = 0.001), but was associated negatively with general obesity in women (PR = 0.745; 95% CI: 0.673–0.807; p = 0.031). Men in the highest quartile of the wheat staple pattern had significantly greater risk of central obesity (PR = 1.331; 95% CI: 1.094–1.627; p = 0.005). There may be gender differences in the association between dietary patterns and obesity in middle-aged and elderly populations in Shanghai, China.
... Previous studies examining diet have focused on single nutrients, such as proteins [38, 39], carbohydrates [40] and/or dietary fats [41] . However, single nutrients do not measure overall diet quality as well as an examination of the overall diet by HEI [42, 43]. Gender differences were apparent in diet quality between those without MetS. ...
Even though the total SA American population is increasing rapidly, there is a paucity of information on the relationship between diet quality, acculturation and health outcomes such as Metabolic Syndrome (MetS) in the low-income South Asian (SA) sub-population. Our goal was to examine diet quality, degree of acculturation and their potential influence on MetS in a diverse sample of SA Americans. A convenience sample of 401 adult SA men and women were studied using a cross-sectional study design. Volunteers from two low-income community health clinics in Maryland were interviewed by questionnaires. MetS, defined by the consensus harmonized definition by the presence of ≥ 3 of the 5 abnormal indicators, was studied. An interviewer obtained an automated self-administered 24-hour Recall (ASA24) and an acculturation index (using a previously validated (SL-ASIA). SA had a composite HEI2010 score of 68 suggesting an overall need for diet improvements. Males had a higher diet quality (mean HEI2010 score) than females. Males with MetS had lower diet quality (68) than males without MetS (73). The converse was true for females (68 vs. 65). Americanized (more acculturated) subjects had a higher diet quality compared to less acculturated SA. Small differences were found in diet quality scores among SA adults from different countries. Less acculturated females, had a higher percentage of MetS and lower diet quality compared to males. These results suggest that interventions are needed in males and females who were less acculturated because they may have greater MetS and lower diet quality compared to more Americanized SA.
Background
The impact of diet on breast cancer survival remains inconclusive. We assessed associations of all-cause mortality with adherence to the four diet quality indices: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index (AHEI), Alternative Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH).
Methods
Dietary intake data were evaluated for 6,157 North American women enrolled in the Breast Cancer Family Registry who had been diagnosed with invasive breast cancer from 1993 to 2011 and were followed through 2018. Pre-diagnosis (n = 4,557) or post-diagnosis (n = 1,600) dietary intake was estimated through a food frequency questionnaire. During a median follow-up time of 11.3 years, 1,265 deaths occurred. Cox proportional hazards models were used to estimate multivariable-adjusted HR and 95% confidence intervals (CI).
Results
Women in the highest versus lowest quartile of adherence to the HEI-2015, AHEI, aMED, and DASH indices had a lower risk of all-cause mortality. HR (95% CI) were 0.88 (0.74–1.04; Ptrend = 0.12) for HEI-2015; 0.82 (0.69–0.97; Ptrend = 0.02) for AHEI; 0.73 (0.59–0.92; Ptrend = 0.02) for aMED; and 0.78 (0.65–0.94; Ptrend = 0.006) for DASH. In subgroup analyses, the associations with higher adherence to the four indices were similar for pre- or post-diagnosis dietary intake and were confined to women with a body mass index <25 kg/m2 and women with hormone receptor positive tumors.
Conclusions
Higher adherence to the HEI-2015, AHEI, aMED, and DASH indices was associated with lower mortality among women with breast cancer.
Impact
Adherence to a healthy diet may improve survival of women with breast cancer.
This study investigated the relation of diet quality indexes (DQI) with breast cancer incidence among women from the Multiethnic Cohort (MEC). Participants completed a questionnaire with a validated food frequency questionnaire. Scores for Healthy Eating Index 2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean diet score (aMED), and Dietary Approaches to Stop Hypertension (DASH) were divided into quintiles (Q1–Q5). Cox regression was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for DQIs and breast cancer risk adjusted for known risk factors. The respective HRs for Q5 vs. Q1 were: 1.06 (95% CI, 0.98–1.14) for HEI-2015, 0.96 (95% CI, 0.90–1.04) for AHEI-2010, 1.01 (95% CI, 0.94–1.09) for aMED, and 0.95 (95% CI, 0.88–1.02) for DASH (ptrend > 0.05 for all). However, overweight and obesity were significantly associated with breast cancer incidence. Despite the null association for DQIs, diet quality may lower breast cancer risk through its positive influence on weight status.
Background: Prostate cancer is one of the most common types of cancer with a high mortality rate. The current study was conducted to investigate the relationship between dietary patterns and prostate cancer risk among Iranian men.
Methods: This case-control study was conducted in Kermanshah province in western Iran in November 2016. Fifty patients with prostate cancer were selected as cases and 150 healthy men matched for age and body mass index (BMI) were selected as controls. Dietary intake data were collected by a semi-quantitative food frequency questionnaire (FFQ). Food items were grouped according to the similarity of nutrient profiles. The main dietary patterns were identified by factor analysis.
Results: After adjustment for potential confounders, a healthy dietary pattern was associated with decreased risk of prostate cancer (highest versus lowest tertile OR:0.24; 95% CI: 0.07-0.81;trend p: 0.025). An unhealthy dietary pattern was related to increased risk of prostate cancer(highest versus lowest tertile OR:3.4; 95% CI: 1.09-10.32; trend p: 0.037).
Conclusion: This study shows that an unhealthy dietary pattern was associated with increased risk of prostate cancer. However, a healthy dietary pattern was associated with decreased risk of prostate cancer.
Objective
There is evidence to suggest that individual components of dietary intake are associated with depressive symptoms. Studying the whole diet, through dietary patterns, has become popular as a way of overcoming intercorrelations between individual dietary components; however, there are conflicting results regarding associations between dietary patterns and depressive symptoms. We examined the associations between dietary patterns extracted using principal component analysis and depressive symptoms, taking account of potential temporal relationships.
Design
Depressive symptoms in parents were assessed using the Edinburgh Postnatal Depression Scale (EPDS) when the study child was 3 and 5 years of age. Scores >12 were considered indicative of the presence of clinical depressive symptoms. Diet was assessed via FFQ when the study child was 4 years of age.
Setting
Longitudinal population-based birth cohort.
Subjects
Mothers and fathers taking part in the Avon Longitudinal Study of Parents and Children when their study child was 3–5 years old.
Results
Unadjusted results suggested that increased scores on the ‘processed’ and ‘vegetarian’ patterns in women and the ‘semi-vegetarian’ pattern in men were associated with having EPDS scores ≥13. However, after adjustment for confounders all results were attenuated. This was the case for all those with available data and when considering a sub-sample who were ‘disease free’ at baseline.
Conclusions
We found no association between dietary patterns and depressive symptoms after taking account of potential confounding factors and the potential temporal relationship between them. This suggests that previous studies reporting positive associations may have suffered from reverse causality and/or residual confounding.
Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. This study aimed to assess the optimal dietary practices and nutritional knowledge of school adolescent girls in Jimma Zone, South-west Ethiopia. School-based cross-sectional study was conducted among 455 school adolescent girls. Multivariable logistic regression was used to identify independent variables. Majority (61.3%) of students had dietary diversity score less than five and their mean (±SD) dietary diversity score was 4.34 ± 1.41. The majority (55.8%) of adolescent girls had a good knowledge score about nutrition related information which they earned from the school (86.6%). Low dietary diversity of school adolescent girls was positively associated with attending government schools, lack of maternal education and low-economic status. Therefore, both government and non-government organizations need to focus on school and community based nutrition intervention to address the low dietary diversity of school girl adolescents.
Purpose: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. Methods: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. Results: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. Conclusion: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.
Tools, called ‘diet/dietary quality indices’, evaluate the level of adherence to a specified pattern or a set of recommendations in populations. Yet, there are no review studies providing unanimous comprehensive results of dietary indices on obesity. We reviewed observational studies, focusing on the association of diet quality indices with general obesity or abdominal obesity in adults. We systematically conducted a search in all English language publications available on MEDLINE, ISI Web of Science and Embase between January 1990 and January 2016. Among the wide variety of indices and weight-derived variables, studies with dietary-guideline-based indices and mean changes for weight gain or OR for general obesity and abdominal obesity were selected. From a total of 479 articles, thirty-four studies were selected for the current review, ten of which had prospective designs and twenty-six had cross-sectional designs. Associations of weight status with the original Healthy Eating Index (HEI) and other versions of the HEI including alternative HEI, HEI-2005 and HEI-05 were examined in thirteen studies, with ten studies revealing significant associations. The HEI was a better general obesity predictor in men than in women. Diet scores lacked efficacy in assessing overall diet quality and demonstrated no significant findings in developing countries, in comparison with US populations. In addition, indices based on dietary diversity scores were directly associated with weight gain. Despite the insufficient evidence to draw definitive conclusions about the relation between dietary indices and obesity, HEI was found to be inversely associated with obesity and diversity-based indices were positively associated with obesity.
As an indicator of skin health, acidified skin surface pH ranging from 5 to 7 is crucial for maintaining skin barrier. In this study, we evaluated the relationship between skin pH and dietary pattern (DP) as well as nutrient or food intake in 48 healthy middle aged adults. Skin pH was measured in the skin surface of the inner arm, and blood lipid profile was analyzed. Dietary intake data were obtained using 1 day 24 hour recall method, and DP was extracted using factor analysis. Results revealed that skin pH ranged from 5.15 to 6.88 in all subjects. There was no significant difference in skin pH between males and females. When subjects were grouped by tertile of skin pH, the food intake of fruit, and the nutrient intake of omega 6 fatty acid, potassium, vitamin A, vitamin C, {\beta}-carotene, and riboflavin in the first tertile group with skin pH ranging from 5.15 to 5.68 were significantly higher than in the third tertile group with skin pH ranging from 6.26 to 6.88. There was no difference in blood lipid profile between the first and the third tertile group. Among 5 DP extracted by factor analysis, DP5 characterized by a high intake of nuts and fruits as well as a low intake of beverages and alcohol was inversely correlated with skin pH after adjusting for gender and age. DP5 was positively correlated with nutrient intake of carbohydrate, fiber, potassium, iron, vitamin A, vitamin C, {\beta}-carotene, thiamine, and riboflavin but negatively correlated with sodium after adjusting for gender, age, smoking, and energy intake. Therefore, acidified skin pH could be maintained by these DP and nutrients.
Objective
To identify dietary patterns of children and adolescents from public schools and their relationship with age, gender, city of residence and socioeconomic class.
Methods
Cross-sectional study with children and adolescents (aged five to 19 years) from 10 public schools. The Food Consumption Markers Form, recommended by the Brazilian Food and Nutrition Monitoring System, was used to identify dietary patterns through cluster analysis. The Pearson’s chi-square test, considering significance at p ≤ 0.05, was used to evaluate the relationship between dietary patterns and age group, gender, socioeconomic class and city of residence.
Results
The final sample included 631 students. Five dietary patterns were identified: “bean/milk/yogurt” (23.3%; n = 147), “restricted” (22.7%; n = 143), “healthy” (22.0%; n = 139), “Brazilian processed” (17.4%; n = 110) and “mixed” (14.5%; n = 92). The healthy pattern was positively associated to lower age (< 10 years, children) and the restricted pattern to adolescence, with p<0.001. Dietary patterns were not associated with the other variables.
Conclusions
Five dietary patterns were identified. The healthy pattern was positively associated to lower age and the restricted pattern to adolescence.
This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian samples of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12–17 years) and Australia (2007 National Children’s Nutrition and Physical Activity Survey, including 1498 adolescents, 12–16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled ‘energy dense, high fat, low fibre’) explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z -scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet–obesity associations, to prevent reverse causality.
Purpose: This study was conducted among 235 children aged 3 up to 11 yrs to examine the relationship between subjects' eating behaviors and obesity. Methods: The subjects were divided into three age groups: preschoolers aged 3 to 5 yrs, early elementary school students aged 6 to 8 yrs, and late elementary school students aged 9 to 11 yrs. As a tool for eating behaviors, the recently developed nutrition quotient (NQ) questionnaire was utilized. By age group, scores were gathered and calculated in the five factors, "Balance", "Diversity", "Moderation", "Regularity", and "Practice", which make up the NQ scores. Results: The NQ scores among those aged 3 to 5, 6 to 8, and 9 to 11 yrs did not exhibit any significant differences. Among the scores for the five factors of the NQ, the Diversity scores of those aged 9 to 11 yrs were significantly higher than the scores of those aged 3 to 5 and those aged 6 to 8 yrs. The scores of those aged 3 to 5 and those aged 6 to 8 yrs were higher than the scores of those aged 9 to 11 yrs in Moderation and Regularity. When the subjects were divided into lowweight/ normal and overweight/obese groups, among those aged 6 to 8 yrs, the NQ scores, Moderation, Regularity, and Practice scores were higher in the overweight/obese group than those in the low-weight/normal group. Among those aged 9 to 11 yrs, the overweight/obese group scored higher than the low-weight/normal group only in the Moderation component. Conclusion: From the results, to prevent obesity in elementary school students, it is practical to focus on training related to eating behavior items included in the Moderation component. Furthermore, personalized instructions on eating behaviors and nutritional education based on age are necessary to prevent obesity in children.
Background: The rates of obesity in the United States continue to rise, particularly with disparities in high stress, low job control occupations such as corrections. Employers are in a unique position to improve employee health through development of Total Worker Health interventions that integrate worker safety and health promotion to improve employee health and well-being.25 Understanding influences on health behaviors in the workplace such as social support, and work schedules as well as family environment, may aide in developing worksite preventive strategies with the anticipation of chronic disease reduction and weight management. Purpose: The purpose of these studies was to explore general health status, health behaviors, and contributing factors to behavior and health outcomes in a sample of correctional supervisors. Measures of burnout, job meaning, job satisfaction, workplace social support, and work schedule (shift, overtime) were explored in relation to nutrition, physical activity, sleep, and health outcomes. A secondary aim was to explore the relationships between work and family health climate on obesity mediated by health behaviors. A multi-level approach was used to explore potential moderating effects of work schedule on the health climate, health behavior, and obesity relationships. Methods: This was a cross-sectional study on a sample of correctional supervisors (n=157) that completed an online healthy workplace survey. General health status, demographics, height/weight, psychosocial work characteristics, and perceived health climate for work and family were self-reported. Descriptive statistics, logistic ordinal regression and ANOVA tests were used to examine the relationships between work characteristics, health behaviors, and health outcome measures. Modeling techniques were used to test the mediating relationships of health behaviors on health climate and BMI. Further, moderated-mediation models were used to assess the multi-level effects of work schedule factors (shift, overtime) on health climate, health behaviors, and BMI. Results: Survey respondents had elevated rates of overweight (37.8%), obesity (50.6%), diabetes (10.2%), elevated cholesterol (24.2%), and anxiety/depression (14.6%) compared to the general population of U.S. adults (33.6%, 34.9%, 9.3%, 13.4%, and 9.8%, respectively). In addition, some of the tested models were supported suggesting that work (β=-0.03, p=0.16; β=-0.04, p=0.12) and family health climate (β=-0.06, p=0.12; β=-0.13, pConclusions: Consistent with previous research in COs,26 correctional supervisors portray elevated rates of chronic disease risk factors, evidenced by poor health behaviors and obesity rates that exceed the general public. Consideration of psychosocial work characteristics such as levels of burnout, job meaning, job satisfaction, workplace social support, and health climate may be one approach to produce sustainable health behavior change. Efforts to improve health climate in the workplace environment and acknowledgement of family health norms may produce behavior changes and thus, lower obesity rates to support economic savings and a public health impact.
Leukemia is the most common pediatric cancer, affecting 3800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia—usually before 5 years of age—and the presence at birth of “pre-leukemic” genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature—in the United States and internationally—that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the preconception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors—including pooled analyses from around the world and systematic reviews—is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children’s health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgment until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.
Several previous studies have shown that a diet score based on the Japanese food guide Spinning Top (the original score) is associated with both favourable and unfavourable dietary intake patterns. We developed a food-based diet quality score (the modified score) and examined associations with nutrient intakes. Subjects were 3963 young (all aged 18 years), 3800 middle-aged (mean age 47·7 ( sd 3·9) years) and 2211 older (mean age 74·4 ( sd 5·2) years) Japanese women. Dietary intakes were assessed using comprehensive (for the young and middle-aged) and brief-type (for the older) diet history questionnaires. The original score was calculated based on intakes of grains, vegetables, fish/meat, milk, fruits, and snacks/alcoholic beverages. The modified score was similarly calculated, but included Na from seasonings and without applying the upper cut-off values for dietary components where increased consumption is advocated for Japanese women (grains, vegetables, fish/meat, milk, and fruits). The original score was positively associated with intakes of carbohydrate, dietary fibre, and all the vitamins and minerals examined including Na and inversely with intakes of fats and alcohol in young and middle-aged women. In older women, the original score was inversely associated with intakes of all nutrients except for carbohydrate and vitamin C. However, the modified score was associated positively with intakes of protein, carbohydrate, dietary fibre, K, Ca, Mg, Fe, vitamins A, C and E, and folate and inversely with intakes of fats, alcohol and Na in all generations. In conclusion, the modified diet score was positively associated with favourable nutrient intake patterns in Japanese women.
Previous studies on maternal nutrition and childhood leukaemia risk have focused on the role of specific nutrients such as folate and have not considered broader measures of diet quality, which may better capture intake of diverse nutrients known to impact fetal development. We examined the relationship between maternal diet quality before pregnancy, as summarised by a diet quality index, and risk of childhood acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in a case–control study in California. Dietary intake in the year before pregnancy was assessed using FFQ in 681 ALL cases, 103 AML cases and 1076 matched controls. Conditional logistic regression was used to estimate OR and 95 % CI for diet quality continuous score and quartiles (Q1–Q4). Higher maternal diet quality score was associated with reduced risk of ALL (OR 0·66; 95 % CI 0·47, 0·93 for Q4 v. Q1) and possibly AML (OR 0·42; 95 % CI 0·15, 1·15 for Q4 v. Q1). No single index component appeared to account for the association. The association of maternal diet quality with risk of ALL was stronger in children diagnosed under the age of 5 years and in children of women who did not report using vitamin supplements before pregnancy. These findings suggest that the joint effects of many dietary components may be important in influencing childhood leukaemia risk.
Dietary patterns are a major risk factor for cardiovascular morbidity and mortality; however, few studies have examined this relationship in older adults. We examined prospective associations between dietary patterns and the risk of CVD and all-cause mortality in 3226 older British men, aged 60–79 years and free from CVD at baseline, from the British Regional Heart Study. Baseline FFQ data were used to generate thirty-four food groups. Principal component analysis identified dietary patterns that were categorised into quartiles, with higher quartiles representing higher adherence to the dietary pattern. Cox proportional hazards examined associations between dietary patterns and risk of all-cause mortality and cardiovascular outcomes. We identified three interpretable dietary patterns: ‘high fat/low fibre’ (high in red meat, meat products, white bread, fried potato, eggs), ‘prudent’ (high in poultry, fish, fruits, vegetables, legumes, pasta, rice, wholemeal bread, eggs, olive oil) and ‘high sugar’ (high in biscuits, puddings, chocolates, sweets, sweet spreads, breakfast cereals). During 11 years of follow-up, 899 deaths, 316 CVD-related deaths, 569 CVD events and 301 CHD events occurred. The ‘high-fat/low-fibre’ dietary pattern was associated with an increased risk of all-cause mortality only, after adjustment for confounders (highest v. lowest quartile; hazard ratio 1·44; 95 % CI 1·13, 1·84). Adherence to a ‘high-sugar’ diet was associated with a borderline significant trend for an increased risk of CVD and CHD events. The ‘prudent’ diet did not show a significant trend with cardiovascular outcomes or mortality. Avoiding ‘high-fat/low-fibre’ and ‘high-sugar’ dietary components may reduce the risk of cardiovascular events and all-cause mortality in older adults.
Objective:
The present study aimed to identify dietary patterns and explore their associations with blood lipid profiles among Chinese women.
Design:
In a cross-sectional study, we identified dietary patterns using principal component analysis of data from three consecutive 24 h dietary recalls. The China Health and Nutrition Survey (CHNS) collected blood samples in the morning after an overnight fast and measured total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and TAG.
Setting:
Data were from the 2009 wave of the CHNS.
Subjects:
We studied 2468 women aged 18-80 years from the CHNS.
Results:
We identified three dietary patterns: traditional southern (high intakes of rice, pork and vegetables), snack (high intakes of fruits, eggs and cakes) and Western (high intakes of poultry, fast foods and milk). The traditional southern pattern was inversely associated with HDL-C (β=-0·68; 95 % CI -1·22, -0·14; P<0·05). The snack pattern was significantly associated with higher TAG (β=4·14; 95 % CI 0·44, 7·84; P<0·05). The Western pattern was positively associated with TC (β=2·52; 95 % CI 1·03, 4·02; P<0·01) and LDL-C (β=2·26; 95 % CI 0·86, 3·66; P<0·01).
Conclusions:
We identified three dietary patterns that are significantly associated with blood lipid profiles. This information is important for developing interventions and policies addressing dyslipidaemia prevention among Chinese women.
Background:
Considering both diet and energy expenditures possess some influence on weight status, research into dietary determinants of obesity is challenging but essential to rational planning of well-organized interventions to avoid obesity.
Objectives:
This study aimed to determine whether dietary factors were predictive of overweight and obesity in adolescents in the Iranian population.
Patients and methods:
A total of 840 students, ages 15 - 17, from six schools were enrolled in this cross-sectional study. A diet-patterns approach often has been used to describe the eating patterns in adolescents. Height, weight, and waist circumference anthropometric indices, physical activity, waist hip ratio, and BMI measurements were determined. Daily dietary data and weighed food records were collected in 2010 and 2011. Abdominal obesity was defined according to world health organization guidelines, and the relationship between dietary predictor variables and the measures of adiposity were determined by using linear regression. Usual dietary intakes were assessed in an experimental study of Esfahani students.
Results:
In total, 38.5% of girls and 32.2% of boys had a Western dietary pattern as the more prevalent pattern. The diet quality of adolescents with the lowest score on each dietary pattern was compared with those recording the highest scores. Those with the Western dietary pattern score were less likely to exercise and had a higher prevalence of general obesity. Adolescents in the greater quartile of the Mediterranean dietary patterns had the lowest odds of being overweight (OR 0.50, 95%; CI 0.27 - 0.73) and obese (OR 0.48, 95%; CI 0.15 - 0.80) than those in the lower quartile, whereas those in the greater quartile of the Western dietary pattern had the highest odds of being overweight (OR 1.69, 95%; CI 1.10 - 2.04) and obese (OR 1.44, 95% CI 1.05 - 1.84). Higher consumption of a Western dietary pattern and a salty dietary pattern were associated significantly with obesity (P < 0.05). Intake of a Western dietary pattern and a salty-sweet dietary pattern were associated positively with measures of adiposity, namely body mass index and waist circumference.
Conclusions:
This study showed significant associations between the seven dietary patterns and overweight and obesity among adolescents. Using dietary patterns within adolescents can provide important information on dietary consumption, and this approach is clearer and much easier to follow.
Objective
To evaluate associations of fast-food items (FFI) and sugar-sweetened drinks (SSD) with mortality outcomes including deaths due to any cause, CVD and total cancers among a large sample of adults.
Design
Using a prospective design, risk of death was compared across baseline dietary exposures. Intakes of FFI and SSD were quantified using a semi-quantitative FFQ (baseline data collected 2000–2002). Deaths (
n
4187) were obtained via the Washington State death file through 2008, excluding deaths in the first year of follow-up. Causes of death were categorized as due to CVD (I00–I99) or cancer (C00–D48). Cox models were used to estimated hazard ratios (HR) and 95 % CI.
Setting
The Vitamins and Lifestyle (VITAL) study among adults living in Western Washington State.
Subjects
Men and women (
n
69 582) between 50 and 76 years of age at baseline.
Results
Intakes of FFI and SSD were higher among individuals who were younger, female, African-American, American Indian or Alaska Native, Asian-American or Pacific Islander, of lower educational attainment, and of lower income (
P
<0·0001 for all). Higher risk of total mortality was associated with greater intake of FFI (HR=1·16; 95 % CI 1·04, 1·29;
P
=0·004; comparing highest
v
. lowest quartile) and SSD (HR=1·19; 95 % CI 1·08, 1·30;
P
<0·0001; comparing highest
v
. lowest quartile). Higher intake of FFI was associated with greater cancer-specific mortality while an association with CVD-specific mortality was suggested. Associations between intake of SSD and cause-specific mortality were less clear.
Conclusions
Intake of FFI and SSD has a detrimental effect on future mortality risk. These findings may be salient to socially patterned disparities in mortality.
Background & Objectives: Dietary patterns reflect diet and nutritional habits of the individuals in a society. Moreover, dietary patterns help identify subjects who are at risk of chronic disease to propose proper dietary guidelines. The present study aimed to identify the prominent dietary patterns among apparently healthy adults in Tabriz, Iran. Material and Methods: This cross-sectional study was conducted on 670 males and females, aged 25-50 years, selected with simple random sampling from 4 medical centers of Tabriz city including Sheykh-Al-raees clinic, specialist clinics of Imam Reza hospital, clinic of Alinasab hospital and Bu-Ali clinic (Valiasr area). Food intake was evaluated using a 132-item semi quantitative food frequency questionnaire after collecting participants' demographic data. Finally, major dietary patterns were extracted through the method of factor analysis. Results: Four major identified dietary patterns were Western, healthy, mixed and Azerbaijan traditional dietary patterns among which healthy dietary pattern (28.8%) was the most prominent. The proportion of adherence to the Western, mixed and traditional dietary patterns was 25.7%, 24.8%, 20.6%, respectively. Moreover, it was observed that among males, Western dietary pattern (33.7%) and among women, healthy dietary pattern (32.4%) had the most followers. Conclusion: Despite dominance of the healthy dietary pattern, more than one-quarter of subjects follow the Western dietary pattern which plays an important role in the incidence of chronic diseases.
Objective
To determine the contribution of forest foods to dietary intake and estimate their association with household food insecurity.
Design
Cross-sectional survey conducted among 279 households. Using a 7 d recall questionnaire, information on household food consumption was collected from women and used to determine the household dietary diversity score, food variety score and forest food consumption score (FFCS). Household Food Insecurity Access Scale (HFIAS) score was determined and Spearman rank correlation was used to establish the relationship between consumption of forest foods and HFIAS score. Women’s dietary intake was estimated from two 24 h recalls. The contribution of forest foods to women’s nutrient intakes was calculated and women’s nutrient intakes were compared with estimated average nutrient requirements.
Setting
Rural forest-dependent households in twelve villages in eastern and southern Cameroon.
Subjects
Household heads and their non-pregnant, non-lactating spouses.
Results
Forty-seven unique forest foods were identified; of these, seventeen were consumed by 98 % of respondents over the course of one week and by 17 % of women during the two 24 h recall periods. Although forest foods contributed approximately half of women’s total daily energy intake, considerably greater contributions were made to vitamin A (93 %), Na (100 %), Fe (85 %), Zn (88 %) and Ca (89 %) intakes. Despite a highly biodiverse pool of foods, most households (83 %) suffered from high food insecurity based on the HFIAS. A significant inverse correlation was observed between the HFIAS score and the FFCS (
r
2
=−0·169,
P
=0·0006), demonstrating that forest foods play an important role in ensuring food security in these forest-dependent communities.
Conclusions
Forest foods are widely consumed by forest-dependent communities. Given their rich nutrient content, they have potential to contribute to food and nutrition security.
Identification and characterisation of dietary patterns are needed to define public health policies to promote better food behaviours. The aim of this study was to identify the major dietary patterns in the French adult population and to determine their main demographic, socio-economic, nutritional and environmental characteristics. Dietary patterns were defined from food consumption data collected in the second French national cross-sectional dietary survey (2006–2007). Non-negative-matrix factorisation method, followed by a cluster analysis, was implemented to derive the dietary patterns. Logistic regressions were then used to determine their main demographic and socio-economic characteristics. Finally, nutritional profiles and contaminant exposure levels of dietary patterns were compared using ANOVA. Seven dietary patterns, with specific food consumption behaviours, were identified: ‘Small eater’, ‘Health conscious’, ‘Mediterranean’, ‘Sweet and processed’, ‘Traditional’, ‘Snacker’ and ‘Basic consumer’. For instance, the Health-conscious pattern was characterised by a high consumption of low-fat and light products. Individuals belonging to this pattern were likely to be older and to have a better nutritional profile than the overall population, but were more exposed to many contaminants. Conversely, individuals of Snacker pattern were likely to be younger, consumed more highly processed foods, had a nutrient-poor profile but were exposed to a limited number of food contaminants. The study identified main dietary patterns in the French adult population with distinct food behaviours and specific demographic, socio-economic, nutritional and environmental features. Paradoxically, for better dietary patterns, potential health risks cannot be ruled out. Therefore, this study demonstrated the need to conduct a risk–benefit analysis to define efficient public health policies regarding diet.
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