Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease.

Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary behaviors contribute to elevated CVD risk among young adults who are born prematurely.

Characterizing and improving the sensory and hedonic responses to polyphenol-rich aronia berry juice.

Interest in nutrient-rich berry juices is growing, but their high polyphenol levels render them sensorily unappealing. Fifty adults, who were assessed for sensory phenotype and dietary behaviors, provided sensory and palatability ratings of juices from 'Viking' aronia berries for each of seven harvest weeks. By peak harvest, juice preference increased two-fold, averaging neither like/dislike. This hedonic shift was associated with: increases in juice sugars paralleling increases in perceived sweetness (maximum = weak); reductions in percent acidity paralleling reductions in sourness (minimum = moderate), astringency (minimum = to just above weak) and bitterness (minimum = just below weak). About 25% of adults liked the aronia juice, including adults who also liked an aqueous citric acid solution (average rating = moderately sour) or those who reported adventurous eating behaviors. Bitter taste phenotype, measured by propylthiouracil or quinine bitterness, failed to explain significant variation in juice sensation or preference. We also collected sensory and preference ratings from juice collected at peak harvest blended with sugar and/or sweet olfactory flavoring (10 ppm ethyl butyrate). Increasing juice sweetness by adding 5% sucrose decreased sourness and improved preference from weak dislike to weak like. Adding sweet olfactory flavoring decreased juice sourness without changing preference. Adding sweet flavoring and 3% sucrose resulted in reduction of sourness and improvements in preference ratings comparable to 5% added sucrose. Neither added sugar nor flavoring blocked juice astringency. In summary, these findings suggest that aronia juice, even from berries picked at peak harvest, appealed to only a few adults (sour likers or adventurous eaters). Although enhanced sweetness, with added sugar and sweet olfactory flavoring, improved aronia juice preference, broader sensory approaches are required to blunt astringency for greater consumer appeal.

Food Preference Patterns in a UK Twin Cohort.

Food liking-disliking patterns may strongly influence food choices and health. Here we assess: (1) whether food preference patterns are genetic/environmentally driven; and (2) the relationship between metabolomics profiles and food preference patterns in a large population of twins. 2,107 individuals from TwinsUK completed an online food and lifestyle preference questionnaire. Principle components analysis was undertaken to identify patterns of food liking-disliking. Heritability estimates for each liking pattern were obtained by structural equation modeling. The correlation between blood metabolomics profiles (280 metabolites) and each food liking pattern was assessed in a subset of 1,491 individuals and replicated in an independent subset of monozygotic twin pairs discordant for the liking pattern (65 to 88 pairs). Results from both analyses were meta-analyzed. Four major food-liking patterns were identified (Fruit and Vegetable, Distinctive Tastes, Sweet and High Carbohydrate, and Meat) accounting for 26% of the total variance. All patterns were moderately heritable (Fruit and Vegetable, h(2)[95% CI]: 0.36 [0.28; 0.44]; Distinctive Tastes: 0.58 [0.52; 0.64]; Sweet and High Carbohydrate: 0.52 [0.45, 0.59] and Meat: 0.44 [0.35; 0.51]), indicating genetic factors influence food liking-disliking. Overall, we identified 14 significant metabolite associations (Bonferroni p < 4.5 × 10(-5)) with Distinctive Tastes (8 metabolites), Sweet and High Carbohydrate (3 metabolites), and Meat (3 metabolites). Food preferences follow patterns based on similar taste and nutrient characteristics and these groupings are strongly determined by genetics. Food preferences that are strongly genetically determined (h(2) ≥ 0.40), such as for meat and distinctive-tasting foods, may influence intakes more substantially, as demonstrated by the metabolomic associations identified here.

A Simple Liking Survey Captures Behaviors Associated with Weight Loss in a Worksite Program among Women at Risk of Type 2 Diabetes.

In a secondary analysis, we assessed the ability of dietary and physical activity surveys to explain variability in weight loss within a worksite-adapted Diabetes Prevention Program. The program involved 58 overweight/obese female employees (average age = 46 ± 11 years SD; average body mass index = 34.7 ± 7.0 kg/m2 SD) of four long-term care facilities who survey-reported liking and frequency of dietary and physical activity behaviors. Data were analyzed using a latent variable approach, analysis of covariance, and nested regression analysis to predict percent weight change from baseline to intervention end at week 16 (average loss = 3.0%; range-6% gain to 17% loss), and follow-up at week 28 (average loss = 2.0%; range-8% gain to 16% loss). Using baseline responses, restrained eaters (reporting liking but low intakes of high fat/sweets) achieved greater weight loss at 28 weeks than those reporting high liking/high intake (average loss = 3.5 ± 0.9% versus 1.0 ± 0.8% S.E., respectively). Examining the dietary surveys separately, only improvements in liking for a healthy diet were associated significantly with weight loss (predicting 44% of total variance, p < 0.001). By contrasting liking versus intake changes, women reporting concurrent healthier diet liking and healthier intake lost the most weight (average loss = 5.4 ± 1.1% S.E.); those reporting eating healthier but not healthier diet liking (possible misreporting) gained weight (average gain = 0.3 ± 1.4% S.E.). Change in liking and frequency of physical activity were highly correlated but neither predicted weight loss independently. These pilot data support surveying dietary likes/dislikes as a useful measure to capture dietary behaviors associated with weight loss in worksite-based programs. Comparing dietary likes and intake may identify behaviors consistent (appropriate dietary restraint) or inconsistent (misreporting) with weight loss success.

Effects of 12-Week Multivitamin and Omega-3 Supplementation on Micronutrient Levels and Red Blood Cell Fatty Acids in Pre-menopausal Women.

The purpose of this study was to validate the efficacy of a customized vitamin-mineral supplement on blood biomarkers in pre-menopausal females. Women (21-40 years old) who were apparently healthy were recruited from the local community (ClinicalTrials.gov trial registration NCT03828097). Pretesting (PRE) occurred in the morning 5 ± 2 days following each participant's menses and involved a fasted blood draw, body mass assessment, and blood pressure assessment. Participants were then randomly assigned in a double-blinded fashion to either the multivitamins (MV) (n = 43) or placebo group (n = 51). Participants consumed two capsules per day with breakfast for 12 weeks. Following the trial, participants reported to the laboratory for POST assessments, which replicated PRE procedures. Red blood cell fatty acid and serum micronutrient analyses were performed in a blinded fashion at hematology laboratories. A group × time interaction was observed for serum vitamin D levels (p < 0.001). MV increased levels from PRE to POST (+43.7%, p < 0.001), whereas no change occurred in the placebo group. Additionally, 78% of MV participants at PRE exhibited inadequate vitamin D levels (<40 ng/dl), whereas only 30% exhibited levels below this threshold at POST. An interaction was also observed for serum folate levels (p < 0.001). MV increased serum folate from PRE to POST (p < 0.001), whereas no change occurred in the placebo group. Red blood cell omega-3 fatty acid content increased from PRE to POST in the MV group (p < 0.001) and placebo group (p < 0.05), although POST values were greater in the MV group (p < 0.001). An interaction was observed for serum HDL cholesterol levels (p = 0.047), and a non-significant increase in this variable from PRE to POST occurred in the MV group (p = 0.060). Four-day food recalls indicated MV increased intake of omega-3 fatty acids, vitamin D, folate, and other micronutrients. In summary, MV supplementation increased serum vitamin D, serum folate, and red blood cell omega-3 fatty acid levels. However, these data are limited to healthy females, and more research is needed to examine if MV can affect metabolic disturbances in individuals with micronutrient deficiencies.

Effect of a High-Protein, High-Fiber Beverage Preload on Subjective Appetite Ratings and Subsequent Ad Libitum Energy Intake in Overweight Men and Women: A Randomized, Double-Blind Placebo-Controlled, Crossover Study.

BACKGROUND: Dietary protein and fiber have been shown to independently improve subjective measures of appetite control. OBJECTIVE: The aim of this study was to determine the acute effects of a high-protein, high-fiber (HP/HFb) beverage taken as a preload compared with an isocaloric lower-protein, lower-fiber (LP/LFb) placebo beverage on subjective appetite ratings and subsequent energy intake at an ad libitum meal in healthy adults. METHODS: A total of 50 overweight/obese men and women [n = 25 men, 25 women; age 30 ± 2 y; body mass index (BMI) 29.6 ± 0.3 kg/m2] received a 160 kcal HP/HFb beverage containing 17 g protein and 6 g fiber on one occasion and an isocaloric LP/LFb placebo beverage containing 1 g protein and 3 g fiber on another occasion in a randomized, double-blind, crossover design. Thirty min after consumption of the beverage preload, an ad libitum pizza meal was provided to be consumed over a 30-min period. Visual analog scales (VAS) were used to assess subjective appetite ratings throughout the testing period. The Revised Restraint Scale (RRS) was used to classify participants as restrained or unrestrained eaters. RESULTS: HP/HFb led to greater reductions in postprandial desire to eat and hunger compared with LP/LFb (both, P < 0.05) but did not significantly affect postprandial fullness or prospective food consumption. Subsequent meal energy intake tended to be lower after HP/HFb compared with LP/LFb (P = 0.09). A subanalysis showed lower energy intake after HP/HFb in older participants (≥25 y) compared with LP/LFb, which was not observed in the younger participants (<25 y). CONCLUSIONS: Compared with LP/LFb, a HP/HFb beverage preload reduced hunger, desire to eat, and tended to reduce subsequent food intake. Dietary restraint and age appear to influence subsequent energy intake and should be taken into account when designing nutrition interventions for weight reduction and/or maintenance. This trial was registered at clinicaltrials.gov as NCT02979717.

Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling.

Sensations from foods and beverages drive dietary choices, which in turn, affect risk of diet-related diseases. Perception of these sensation varies with environmental and genetic influences. This observational study aimed to examine associations between chemosensory phenotype, diet and cardiovascular disease (CVD) risk. Reportedly healthy women (n = 110, average age 45 ±â€¯9 years) participated in laboratory-based measures of chemosensory phenotype (taste and smell function, propylthiouracil (PROP) bitterness) and CVD risk factors (waist circumference, blood pressure, serum lipids). Diet variables included preference and intake of sweet/high-fat foods, dietary restraint, and diet quality based on reported preference (Healthy Eating Preference Index-HEPI) and intake (Healthy Eating Index-HEI). We found that females who reported high preference yet low consumption of sweet/high-fat foods had the highest dietary restraint and depressed quinine taste function. PROP nontasters were more likely to report lower diet quality; PROP supertasters more likely to consume but not like a healthy diet. Multivariate structural models were fitted to identify predictors of CVD risk factors. Reliable latent taste (quinine taste function, PROP tasting) and smell (odor intensity) variables were identified, with taste explaining more variance in the CVD risk factors. Lower bitter taste perception was associated with elevated risk. In multivariate models, the HEPI completely mediated the taste-adiposity and taste-HDL associations and partially mediated the taste-triglyceride or taste-systolic blood pressure associations. The taste-LDL pathway was significant and direct. The HEI could not replace HEPI in adequate models. However, using a latent diet quality variable with HEPI and HEI, increased the strength of association between diet quality and adiposity or CVD risk factors. In conclusion, bitter taste phenotype was associated with CVD risk factors via diet quality, particularly when assessed by level of food liking/disliking.

Preschool-Adapted Liking Survey (PALS): A Brief and Valid Method To Assess Dietary Quality of Preschoolers.

BACKGROUND: Feasible, valid, and reliable tools are needed to assess dietary quality among preschoolers. We aimed to test construct-/criterion-related validity and reliability of a dietary quality index generated from a liking survey and novel dietary patterns for characterizing food hedonism and parental feeding practices. METHODS: Participants included 416 economically disadvantaged, diverse preschoolers (41% overweight/obese) from educational centers and their parents. Parents completed liking and frequency surveys; the liking survey took half as long to complete. Preschoolers' skin carotenoid status (measured by Resonance Raman spectroscopy) and BMI percentile (measured weight/height) were assessed. The Healthy Eating Preference Index (HEPI) was constructed from weighted averages of liking scores for food groups and healthy variety score and Healthy Eating Index 2010 (HEI) from nutrient analysis of the frequency survey. RESULTS: The HEPI was normally distributed and showed construct validity and adequate internal reliability. In hierarchical regression analyses, the HEPI explained carotenoid status and adiposity as alternative or value-added predictors to HEI, supporting criterion-related validity of HEPI. Parental reporting of children's liking of high-fat/sweet/salty foods in excess of pleasurable activities (food hedonism) predicted heavier preschoolers, as did discord between HEI and HEPI (potential parental pressure toward healthy eating). HEPI alone or with HEI explained variability in carotenoid status and adiposity in path models with adequate to good fits. CONCLUSIONS: With simple collection and processing, the liking survey can generate a valid/reliable dietary quality index in child care settings to identify preschoolers at risk for lower nutritional status. Using liking and frequency-based screeners could improve understanding of parental feeding behaviors and precision of predicting nutritional status.

Masking Vegetable Bitterness to Improve Palatability Depends on Vegetable Type and Taste Phenotype.

Consumption of dark green vegetables falls short of recommendations, in part, because of unpleasant bitterness. A laboratory-based study of 37 adults was used to determine bitter and hedonic responses to vegetables (asparagus, Brussels sprouts, kale) with bitter masking agents (1.33 M sodium acetate, 10 and 32 mM sodium chloride, and 3.2 mM aspartame) and then characterized by taste phenotype and vegetable liking. In repeated-measures ANOVA, aspartame was most effective at suppressing bitterness and improving hedonic responses for all sampled vegetables. Among the sodium salts, 32 mM sodium chloride decreased bitterness for kale and sodium acetate reduced bitterness across all vegetables with a tendency to increase liking for Brussels sprouts, as release from mixture suppression increased perceived sweetness. Participants were nearly equally divided into three 6-n-propylthiouracil (PROP) phenotype groups. Those tasting the least PROP bitterness (non-tasters) reported least vegetable bitterness, and the additives produced little change in vegetable liking. Aspartame persisted as the most effective bitter blocker for the PROP tasters (medium, supertasters), improving vegetable liking for the medium tasters but too much sweetness for supertasters. The sodium salts showed some bitter blocking for PROP tasters, particularly sodium acetate, without significant gains in vegetable liking. Via a survey, adults characterized as low vegetable likers reported greater increase in vegetable liking with the maskers than did vegetable likers. These results suggest that bitter masking agents (mainly sweeteners) can suppress bitterness to increase acceptance if they are matched to perceived vegetable bitterness or to self-reported vegetable disliking.

Otitis media exposure associates with dietary preference and adiposity: a community-based observational study of at-risk preschoolers.

Chronic exposure to otitis media (OM) has been linked to risk of overweight/obesity. Here we tested if dietary behaviors explained some of the OM-adiposity relationship among 485 racially-diverse, low-income preschoolers (253 girls, mean age=45±7 months) enrolled in government-supported urban preschool programs. From measured weight/height, 4% were underweight, 17% were overweight and 13% were obese. OM exposure according to parent report varied across nearly equal quartiles-low (never, once) to high (3-5 times, 6+ times) exposure categories. Boys were more likely to be in the high exposure categories. Parents rated their child's liking/disliking of foods (high-fat/added sugar, fruits/juice, vegetables) and non-food activities. In analysis of covariance (ANCOVA), mean liking for vegetables and fruits/juice fell as OM exposure increased, with significant differences between lowest and highest exposure categories (p<.05). Food neophobic versus non-neophobic preschoolers also liked vegetables and fruits less (p<.001). In a two-way ANCOVA, main effects of OM and food neophobia independently predicted vegetable and fruit liking; preschoolers with more OM exposure and neophobia had the lowest liking. Although ANCOVA failed to reveal OM effects on mean liking for fat/sugar foods, the relative ranking of liking for these foods differed by OM category. Fat/sugar foods were ranked as most preferred for the high OM children, particularly the boys, surpassing the ranking of pleasurable non-food items. Conversely, low OM children ranked pleasurable non-food items and fruits/juice as more pleasurable than high OM children. BMI percentile varied with OM exposure, but not neophobia: preschoolers with the greatest exposure averaged the highest percentiles. In multiple regression analyses, liking for vegetables or fruits failed to associate significantly with BMI percentile. There was a small but significant association between greater fat/sugar liking and higher BMI percentile. Overall these findings confirm associations between high OM exposure and elevated adiposity in preschoolers. They also suggest this relationship is explained through lower affinity for vegetables and fruits and greater affinity for fat/sugar foods.