An index measuring adherence to New Zealand Infant Feeding Guidelines has convergent validity with maternal socio-demographic and health behaviours and with children's body size.

Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort's adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI's convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort (n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio > 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8·2 (sd 2·1). Maternal characteristics explained 29·1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1·46, 1·03, 2·06 and 1·56, 1·09, 2·23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1·53, 1·02, 2·30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children's overweight/obesity/central adiposity, were in the expected directions and confirm the IFI's convergent construct validity.

Pre-pregnancy dietary pattern is associated with newborn size: results from ProcriAr study.

Babies born small-for-gestational age (SGA) have an increased risk of mortality, morbidity and adverse functional consequences. Studies suggest that pre-pregnancy maternal diet may influence newborns' size. This study aimed to determine whether maternal pre-pregnancy dietary patterns (DP) are associated with delivering SGA newborns in the ProcriAr Cohort Study, Sao Paulo-Brazil. Pre-pregnancy DP of 299 women were investigated using factor analysis with principal component's estimation, based on intake reported on a validated 110-item FFQ. Newborns were classified as SGA if their weight and/or length, adjusted by gestational age and sex, were below the 10th percentile of the INTERGROWTH-21st standards. Multivariate Poisson regression modelling with robust error variance was performed to examine associations between the different DP (in quintiles) and SGA. In a model adjusted by maternal sociodemographic and health behaviours, women who scored in the highest quintile of the DP 'Snacks, sandwiches, sweets and soft drinks' (in relation to the women who scored in the lowest quintile) were significantly more likely to deliver SGA babies (relative risk 1·92; 95 % CI 1·08, 3·39). This study verified that women's pre-pregnancy dietary behaviour characterised by an energy-dense nutrient-poor food intake was a risk factor for delivering SGA newborns. Investments in education and improved access to healthful food and nutritional information before pregnancy should be prioritised due to their potential positive impact on child health. However, further studies are warranted to identify specific metabolic pathways that may be underlying these associations.

Dietary patterns associated with subclinical atherosclerosis: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study.

OBJECTIVE: To identify dietary patterns associated with subclinical atherosclerosis measured as coronary artery calcification (CAC). DESIGN: Cross-sectional analysis of data from the Brazilian Longitudinal Study of Adult Health. Dietary data were assessed using a FFQ, and a principal component factor analysis was used to derive the dietary patterns. Scree plot, eigenvalues > 1 and interpretability were considered to retain the factors. CAC was measured using a computed tomography scanner and an electrocardiography-gated prospective Ca score examination and was categorised into three groups based on the CAC score: 0, 1-100 and >100 Agatston units. Multinomial regression models were conducted for dietary patterns and CAC severity categories. SETTING: Brazil, São Paulo, 2008-2010. PARTICIPANTS: Active and retired civil servants who lived in São Paulo and underwent a CAC exam were included (n 4025). RESULTS: Around 10 % of participants (294 men, 97 women) had a detectable CAC (>0), 6·5 % (182 men, 73 women) had a CAC of 1-100 and 3·5 % (110 men, 23 women) had a CAC > 100. Three dietary patterns were identified: convenience food, which was positively associated with atherosclerotic calcification; plant-based and dairy food, which showed no association with CAC; and the traditional Brazilian food pattern (rice, legumes and meats), which was inversely associated with atherosclerotic calcification. CONCLUSIONS: Our results showed that a dietary pattern consisting of traditional Brazilian foods could be important to reducing the risk of atherosclerotic calcification and prevent future cardiovascular events, whereas a convenience dietary pattern was positively associated with this outcome.

Effects of folic acid food fortification scenarios on the folate intake of a multi-ethnic pregnant population.

OBJECTIVE: To simulate effects of different scenarios of folic acid fortification of food on dietary folate equivalents (DFE) intake in an ethnically diverse sample of pregnant women. DESIGN: A forty-four-item FFQ was used to evaluate dietary intake of the population. DFE intakes were estimated for different scenarios of food fortification with folic acid: (i) voluntary fortification; (ii) increased voluntary fortification; (iii) simulated bread mandatory fortification; and (iv) simulated grains-and-rice mandatory fortification. SETTING: Ethnically and socio-economically diverse cohort of pregnant women in New Zealand.ParticipantsPregnant women (n 5664) whose children were born in 2009-2010. RESULTS: Participants identified their ethnicity as European (56·0 %), Asian (14·2 %), Maori (13·2 %), Pacific (12·8 %) or Others (3·8 %). Bread, breakfast cereals and yeast spread were main food sources of DFE in the two voluntary fortification scenarios. However, for Asian women, green leafy vegetables, bread and breakfast cereals were main contributors of DFE in these scenarios. In descending order, proportions of different ethnic groups in the lowest tertile of DFE intake for the four fortification scenarios were: Asian (39-60 %), Others (41-44 %), European (31-37 %), Pacific (23-26 %) and Maori (23-27 %). In comparisons within each ethnic group across scenarios of food fortification with folic acid, differences were observed only with DFE intake higher in the simulated grains-and-rice mandatory fortification v. other scenarios. CONCLUSIONS: If grain and rice fortification with folic acid was mandatory in New Zealand, DFE intakes would be more evenly distributed among pregnant women of different ethnicities, potentially reducing ethnic group differences in risk of lower folate intakes.

Determinants of folic acid supplement use outside national recommendations for pregnant women: results from the Growing Up in New Zealand cohort study.

OBJECTIVE: To evaluate the sociodemographic and lifestyle factors associated with insufficient and excessive use of folic acid supplements (FAS) among pregnant women. DESIGN: A pregnancy cohort to which multinomial logistic regression models were applied to identify factors associated with duration and dose of FAS use. SETTING: The Growing Up in New Zealand child study, which enrolled pregnant women whose children were born in 2009-2010. SUBJECTS: Pregnant women (n 6822) enrolled into a nationally generalizable cohort. RESULTS: Ninety-two per cent of pregnant women were not taking FAS according to the national recommendation (4 weeks before until 12 weeks after conception), with 69 % taking insufficient FAS and 57 % extending FAS use past 13 weeks' gestation. The factors associated with extended use differed from those associated with insufficient use. Consistent with published literature, the relative risks of insufficient use were increased for younger women, those with less education, of non-European ethnicities, unemployed, who smoked cigarettes, whose pregnancy was unplanned or who had older children, or were living in more deprived households. In contrast, the relative risks of extended use were increased for women of higher socio-economic status or for whom this was their first pregnancy and decreased for women of Pacific v. European ethnicity. CONCLUSIONS: In New Zealand, current use of FAS during pregnancy potentially exposes pregnant women and their unborn children to too little or too much folic acid. Further policy development is necessary to reduce current socio-economic inequities in the use of FAS.

Dietary intake of selected nutrients and persistence of HPV infection in men.

Human papillomavirus (HPV) infection is a common sexually transmitted disease. Although often transitory, persistent oncogenic HPV infection may progress to a precursor lesion and, if not treated, can further increase the risk of cancer. The purpose of this study was to investigate the relation between dietary intake and HPV persistent infection in men of a Brazilian cohort. The study population consisted of 1,248 men from the Brazilian cohort of the HIM (HPV in Men) Study, ages 18 to 70 years, who completed a quantitative food frequency questionnaire. U Mann-Whitney test was used to assess differences in median nutrient intake of selected nutrients. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models. The prevalence of any HPV infection at baseline was 66.6%. Of 1,248 participants analyzed, 1,211 (97.0%) were HPV positive at one or more times during the 4 years of follow-up and 781 (62.6%) were persistently HPV positive. Men with nonpersistent oncogenic HPV infections had higher median intake of retinol (p = 0.008), vitamin A (p < 0.001) and folate (DFE; p = 0.003) and lower median intake of energy (p = 0.005) and lycopene (p = 0.008) in comparison to men with persistent oncogenic infections. No significant association was found between selected nutrients and persistent oncogenic HPV infection. For nononcogenic persistent infections, only vitamin B12 intake was significantly associated (p = 0.003, test for trend). No association was observed between dietary intake and persistent oncogenic-type HPV infection; however, vitamin B12 intake was inversely associated with nononcogenic HPV persistence.

Lunch quality and sociodemographic conditions between Brazilian regions.

The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF). The lunch quality was evaluated by applying the main meal quality index (MMQI), comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300), and the meal quality score mean was 57 points (SE = 0.30). The North Region had the worst MMQI score (56 points, SE = 0.07), while the Central had the best MMQI adjusted score (59 points, SE = 0.05). The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.

Lunch quality and sociodemographic conditions between Brazilian regions / Qualidade do almoço e condições sociodemográficas entre as macrorregiões brasileiras / Calidad del almuerzo y condiciones sociodemográficas entre regiones brasileñas

The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF). The lunch quality was evaluated by applying the main meal quality index (MMQI), comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300), and the meal quality score mean was 57 points (SE = 0.30). The North Region had the worst MMQI score (56 points, SE = 0.07), while the Central had the best MMQI adjusted score (59 points, SE = 0.05). The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.

O estudo teve como objetivo avaliar a qualidade do almoço consumido por adultos brasileiros e os determinantes sociodemográficos em cada macrorregião brasileira, com delineamento transversal e uma amostra representativa das populações regionais. A amostra incluiu 16.096 adultos, participantes do Inquérito Nacional de Alimentação, um componente da Pesquisa de Orçamentos Familiares. A qualidade do almoço foi avaliada através do main meal quality index (MMQI), com 10 itens de pesos iguais que resultaram em um escore que variava entre zero e 100 pontos. Nas análises, modelos de regressão linear mediram a associação entre a qualidade do almoço e fatores sociodemográficos. O consumo energético médio no almoço foi 704kcal (DP = 300), e o escore médio da qualidade do almoço foi 57 pontos (DP = 0,30). A Região Norte teve o pior MMQI (56 pontos, DP = 0,07), enquanto o Centro-oeste teve o melhor MMQI ajustado (59 pontos, DP = 0,05). O escore final do MMQI mostrou associação positiva com o gênero masculino e idade de 20-39 anos, e associação negativa com escolaridade de oito anos ou mais, renda per capita de pelo menos três salários mínimos e consumo de refeições preparadas fora de casa. Apesar das diferenças entre fatores sociodemográficos, em todas a macrorregiões brasileiras os adultos consumiam um almoço rico em alimentos com alto teor de açúcar e gordura e com porções insuficientes de frutas e verduras, resultando em um almoço de baixa qualidade alimentar.

El objetivo de este estudio fue evaluar la calidad del almuerzo que consumen los adultos en Brasil y sus determinantes sociodemográficos en cada región brasileña. Se trata de un estudio transversal con una muestra representativa de las poblaciones regionales. La muestra comprendió a 16.096 adultos de la Encuesta Nacional sobre Dieta, Encuesta sobre Presupuestos Familiares en Brasil. La calidad del almuerzo fue evaluada aplicando el main meal quality index (MMQI), que comprendía 10 ítems de pesos equivalentes que resultaron en un marcador que abarcaba de cero a 100 puntos. El análisis se realizó mediante modelos de regresión lineal que midieron la asociación entre el almuerzo de calidad y sus factores sociodemográficos. El promedio de consumo de calorías en el almuerzo fue 704kcal (SD = 300), y la media del índice de calidad de la comida fue 57 puntos (SE = 0,30). La región Norte tuvo el peor índice de MMQI (56 puntos, SE = 0,07), mientras que el Centro-oeste tuvo el mejor índice de MMQI ajustado (59 puntos, SE = 0,05). El índice final de MMQI se asoció positivamente al género masculino y edades comprendidas entre los 20-39 años, y fue inversamente asociado con contar con ocho años o más de educación, unos ingresos per cápita de al menos tres salarios mínimos, y un consumo de comidas preparadas fuera de casa. A pesar de las diferencias entre los factores sociodemográficos, todas las regiones brasileñas contaron con un almuerzo compuesto por comidas ricas en azúcares y grasas, con insuficiente porciones de frutas y verduras, constituyendo una comida de baja calidad.