Substitution Modeling Shows Simple Dietary Changes Increase Mediterranean-Style Diet Pattern Scores for US Adults.

Background: A Mediterranean-style diet pattern (MSDP) is a recommended diet pattern in the 2020-2025 Dietary Guidelines for Americans. Few studies report widespread adherence to the diet, which suggests Americans may benefit from strategies to help them improve alignment to an MSDP. Objectives: The purpose of this study was to assess the impact of isocaloric food substitutions on adherence to an MSDP in US adults. Methods: Using data from NHANES (2007-2018), alignment to an MSDP was determined by calculation of a Mediterranean diet scoring index appropriate for non-Mediterranean populations (0-100 points for the total score, with higher scores indicating greater adherence). The sample was divided into 2 groups, a high-adherence group (HA) and a non-high-adherence group (nHA), to differentiate food groups to be used for isocaloric food substitution modeling. Substitution modeling via multiple regression analyses determined food selections that have the greatest impact on MSDP scores. Honey was added to the substitutions in recipe form and evaluated for its impact on MSDP scores. Results: The study consisted of 19,978 adults, ages 25-65, with complete dietary data. The nHA had a lower mean total MSDP score (7.07 ± 0.04 points) compared to the HA (16.45 ± 0.09 points). Increasing olive oil from nonuse to partial use had the greatest impact (>+2 points) for both groups. Other isocaloric substitutions also improved adherence, albeit to a lesser degree, including substituting 1 oz of whole grains for 1 oz of refined grains, 4 oz of fish for 4 oz of red meat, and 4.9 cups of kale for 0.7 cups of starchy or root vegetables. Improved MSDP scores were sustained when honey was added to the substitutions. Conclusions: Simple dietary substitutions can help a diet more closely align with an MSDP. Adding honey to the simple substitutions may increase palatability without sacrificing nutritional benefits.

Serum ß-carotene concentrations are associated with self-reported fatty acid intake in United States adults from the National Health and Examination Surveys.

Bioavailability of dietary ß-carotene (BC) is dependent on dose, quantity, dispersion, and presence of fat in the diet. Fats are comprised of a variety of fatty acids, which may impact the bioavailability of carotenoids. However, there is a gap in research on whether specific fatty acid classes affect serum BC concentrations in population samples. The primary objective of this study was to assess the association between reported fat and fatty acid intake and serum BC concentrations utilizing data from the National Health and Nutrition Examination Surveys (NHANES) 2003-2006. Data from 3278 NHANES participants 20-85 years old were analyzed to estimate the relationships between serum BC concentrations and reported saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid intakes. Multiple linear regression estimated ln(serum BC) based on reported fatty acid intakes adjusted for age, sex, race/ethnicity, and reported dietary BC intakes. Mean and standard error (SE) for serum BC concentrations were 14.31 ± 0.05 µg/dl. Means and SE for total fat, SFA, MUFA, and PUFA were 85.7 ± 1.3, 26.9 ± 0.4, 31.1 ± 0.5, and 17.8 ± 0.4 g, respectively. There was a significant trend for association between serum BC and reported total fat intakes (r = -0.002, p < 0.0001), but the association was not strong. Multiple linear regression showed positive associations between serum BC concentrations and higher reported dietary PUFA consumption. PUFA alpha-linolenic acid intakes are positively associated with serum BC concentrations, while MUFA palmitoleic acid and SFA stearic acid were inversely associated with serum BC. The inverse association between MUFA and SFA suggests there may be multiple post-digestion factors affecting serum carotenoid concentrations.

Interprofessional education workshop on aging: student perceptions of interprofessional collaboration, aging, and cultural fluency.

Interprofessional education is vital to prepare students in healthcare-related fields for future practice to improve participation in teams and enhance client/patient outcomes. This study aimed to evaluate the impact of a half-day interprofessional education workshop on aging based on students' self-rated confidence in working in interprofessional teams, with aging, and culturally diverse clients/patients. Students from eight healthcare-related disciplines at a private mid-western university attended an interprofessional workshop. Afterward, students completed a reflective survey to evaluate pre- and post-workshop perceptions about interprofessional collaboration and caring for aging and diverse clients/patients. Quantitative methods using paired sample t-tests revealed a statistically significant difference in students' self-reported level of preparedness in the areas of interprofessional education, aging, and cultural fluency (P < .001). In addition, qualitative methods were used to organize data into themes. Additional insights were gained to inform future workshops.