The Association between Diet Quality and Metabolic Syndrome among Older African American Women.

Diet is a modifiable lifestyle factor that could impact the development of Metabolic Syndrome (MetS) and its components. MetS prevalence is high and diet quality is suboptimal among older African American women. MetS has been associated with many individual food groups, however, emerging research suggests that analyzing overall diet quality provides insight into the synergistic effects of food groups on health outcomes. In the current cross-sectional study, we examined the relationship between diet quality and MetS, and investigated associations between diet quality and MetS components among older African American women. This study was based on 357 African American women between 45 and 65 years from the NHANES 2011-2018 datasets. This analysis utilized the NCEP ATP III (2001) criteria for women to diagnose MetS. MetS was dichotomized in addition to a MetS z-score being calculated for each participant using a sex- and race-specific equation. Participants' diet quality was measured using the HEI-2015. Linear and logistic regressions were performed to assess the association between HEI-2015 diet quality and metabolic syndrome and its components. 65% of African American women aged 45-65 in the NHANES 2011-2018 had MetS. Study participants had an average HEI-2015 score of 55.4 out of 100. As HEI-2015 quartiles increased, the mean MetS z-score decreased (p-value: 0.0011). Age-adjusted models demonstrated statistically significant inverse relationships between HEI-2015 and waist circumference (ß: -0.217; 95% CI: -0.372, -0.063), systolic blood pressure (ß: -0.215; 95% CI: -0.359, -0.072), blood glucose (ß: -0.344; 95% CI: -0.681, -0.0066), and triglycerides (ß: -0.652; 95% CI: -1.05, -0.251). Significant associations could not be established between MetS and diet quality, assessed with the HEI-2015, among African American women aged 45-65 enrolled in NHANES 2011-2018. However, statistically significant relationships were observed between increased HEI-2015 scores and lowered risks of abdominal obesity, hyperglycemia, hypertriglyceridemia, and systolic hypertension. The findings of this study affirm the necessity of public health strategies to improve diet quality among African-American women which could help to reduce their risks of chronic diseases.

Dietary counseling, meal patterns, and diet quality in patients with type 2 diabetes mellitus with/without chronic kidney disease.

BACKGROUND: Aim to this study is to investigate the association of Dietary Counseling, Meal Patterns, and Diet Quality (DietQ) in Patients with Type 2 Diabetes Mellitus (T2DM) with/without chronic kidney disease (CKD) in primary healthcare. METHODS: Cross-sectional study acquired data on dietary counseling and meal patterns by direct interview with a food-frequency questionnaire and one 24-h food-recall. The Healthy Eating Index (HEI) was used to classify DietQ ["good" DietQ (GDietQ, score ≥ 80) and "poor" DietQ (PDietQ, score < 80)]. PARTICIPANTS/SETTING: This study included 705 patients with T2DM: 306 with normal kidney function; 236 with early nephropathy, and 163 with overt nephropathy (ON). STATISTICAL ANALYSES PERFORMED: Multivariate linear-regression models for predicting HEI and χ2 tests for qualitative variables and one-way ANOVA for quantitative variables were employed. Mann-Whitney U and independent Student t were performed for comparisons between GDietQ and PDietQ. RESULTS: Only 18 % of the population was classified as GDietQ. Patients with ON and PDietQ vs. with GDietQ received significantly less dietary counseling from any health professional in general (45 % vs 72 %, respectively), or from any nutrition professional (36 % vs. 61 %, respectively). A better HEI was significantly predicted (F = 42.01; p = 0.0001) by lower HbA1C (ß -0.53, p = 0.0007) and better diet diversity (ß 8.09, p = 0.0001). CONCLUSIONS: Patients with more advanced stages of CKD had less nutritional counseling and worse dietary patterns, as well as more frequent PDietQ. Our findings reinforce the need for dietitians and nutritionists in primary healthcare to provide timely nutritional counseling.

Diet quality from early pregnancy through one year postpartum: a prospective cohort study.

BACKGROUND: Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined. OBJECTIVE: This study investigated diet quality from early pregnancy through 12 months postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States. METHODS: Participants completed 24-hour dietary recalls at six study visits (each pregnancy trimester and 6 weeks, 6 months, and 12 months postpartum) (n=383). Between-visit mean HEI scores (Healthy Eating Index-2015; min=0, max=100) were compared using the population ratio method (PR). The NCI usual intakes method estimated the distribution of HEI scores in pregnancy and postpartum; unpaired t-tests compared usual mean HEI scores by covariates; paired t-tests compared differences between mean pregnancy and postpartum. RESULTS: The total HEI mean ± SE scores (NCI method) were 61.4 ± 0.8 in pregnancy and 61.7 ± 0.9 in postpartum. Mean HEI scores differed by sociodemographic characteristics, particularly education, marital status, and federal assistance participation. The highest scores were observed in participants with at least a bachelor's degree (64.1 ± 0.9 in pregnancy, 64.5 ± 1.0 in postpartum, n = 257) and those with other non-Hispanic white race/ethnicity (64.7±1.8 in pregnancy, 66.4±2.2 in postpartum). There were no between-visit differences in mean total HEI scores (PR). While differences were observed in some mean HEI component scores between pregnancy and postpartum visits, they were small (mostly < 1 point) in magnitude and in inconsistent directions. CONCLUSIONS: Stable total HEI mean scores suggest adherence to dietary guidelines was consistent throughout pregnancy and postpartum in this sample. While some sociodemographic characteristics may identify individuals at greater risk of diet-related pregnancy complications, low diet quality was pervasive throughout all subgroups and reflect an urgent need for widespread improvement.

The relationship between diet quality and 21-year cumulative healthcare costs among women in the Australian Longitudinal Study on Women's Health.

BACKGROUND: The relationships between diet quality and healthcare costs have not been explored beyond 15-years. OBJECTIVE: To investigate relationships between both baseline diet quality and change in diet quality over time with cumulative data on healthcare claims and costs over 21-years among Australian Women. DESIGN: This is a secondary analysis of data from a cohort study, the Australian Longitudinal Study on Women's Health. PARTICIPANTS/SETTING: Data for women born 1946-51 included diet quality data at baseline (2001, n=8,228), change in diet quality (2001-2013, n=6,553) and cumulative administrative healthcare data (2001-2021). MAIN OUTCOMES: Diet quality was assessed using the Australian Recommended Food Score (ARFS) and the Fruit and Vegetable Variety Score. Twenty-one-year cumulative Medicare Benefits Schedule data (number of claims; total charges [$USD]), Australia's universal healthcare coverage, were reported by baseline ARFS quintile and category of diet quality change ('diet quality worsened' [ARFS decrease≤-4 points], 'remained stable' [-3≤change in ARFS≤3 points] or 'improved' [ARFS increase≥4 points]). STATISTICAL ANALYSIS: Linear regression analyses were conducted and adjusted for socioeconomic, health and lifestyle factors. RESULTS: Higher baseline vegetable ARFS were correlated with fewer 21-year cumulative Medicare claims (ß= -4.9, 95%CI -7.3,-2.4) and charges (ß= -$USD214, 95%CI -$USD341,-$USD88). Baseline higher dairy scores were correlated with higher Medicare claims (ß= 17.2, 95%CI 11.1,23.3) and charges (ß= $USD762, 95%CI $USD448,$USD1,076). Compared to women whose diet quality score remained stable, those whose diet quality worsened over time made significantly more claims and higher charges; median [Q1,Q3] 413 [277,588] claims, $USD17,868 [$USD11,037,$USD27,808] cumulative charges, compared to 387 [259,559] claims and $USD16,953 [$USD10,033,$USD26,604] cumulative charges. Change in total ARFS and ARFS subscales were predictors of 21-year cumulative healthcare claims. For each 1-point increase in ARFS over time, 1.2 fewer healthcare claims were made (95% CI 0.3-2.2). Increasing vegetable and dairy ARFS scores were correlated with significantly fewer claims. CONCLUSIONS: Baseline greater variety of vegetables was correlated with fewer 21-year healthcare claims and costs. Worsening diet quality over time was correlated with greater cumulative healthcare claims and costs. Consideration of dietary quality/variety in national policy is suggested to potentially reduce national healthcare claims/costs.

Meal kit delivery services in the UK: An evaluation of the nutritional composition of meals.

OBJECTIVE: To examine meals provided by meal kit delivery services (MKDS) and to evaluate their nutritional composition. RESEARCH METHODS AND PROCEDURES: In this cross-sectional study, the nutritional composition of meals (n 497) from MKDS in the UK, was considered. Energy and nutrient content were compared to dietary guidelines; meals were profiled for fat, saturated fat, total sugars, and salt content. RESULTS: There was a large range in the energy and nutrient content of meals. The levels of saturated fat per serving ranged from 0.4 to 28.0 g (Mdn = 9.0 g), and salt content ranged from 0.2 to 6.4 g (Mdn = 2.2 g). Over half of the meals were profiled as high for fat (51.3%), saturated fat (62.2%) and salt (64.4%). Notably, protein content per portion was high (Mdn = 34.0 g), and dietary fiber content was low (Mdn = 6.4 g). Meals, which had been distinguished by the providers with "health-based" descriptors or tags, had a better nutritional profile for fat, saturated fat, and salt, than other meals; nevertheless, many "health-based" meals profiled high for salt (46.5%) and saturated fat (40.4%). CONCLUSIONS: Recipes from MKDS should be revised to improve their nutritional composition; specifically, reductions in salt and saturated fat content and an increase in dietary fiber are needed. Given the variation in the nutritional composition of meals, work is also needed to ascertain the main factors influencing selections made by consumers, and the relevance of guidance and information to support this.

Association Between Periconceptional Diet Quality and Hypertensive Disorders of Pregnancy: The Japan Environment and Children's Study.

BACKGROUND: Little is known about the relationship of healthy diets, which are widely recommended to prevent diseases in general populations, with the risk of hypertensive disorders of pregnancy (HDP), particular among non-Western populations with different dietary habits. We aimed to investigate the association between periconceptional diet quality and the risk of HDP among pregnant Japanese women. METHODS AND RESULTS: Dietary intake over 1 year before the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81 113 pregnant Japanese women who participated in a prospective cohort of the Japan Environment and Children's Study. Overall diet quality was assessed by the Balanced Diet Score (BDS) based on adherence to the country-specific dietary guidelines and the Dietary Approaches to Stop Hypertension (DASH) score. Cases of HDP were identified by medical record transcription. The association between diet quality and HDP risk was examined using Bayesian logistic regression models with monotonic effects. We identified 2383 (2.9%) cases of HDP. A higher BDS was associated with a lower risk of HDP. When comparing the highest with the lowest quintile of the BDS, the adjusted odds ratio (aOR) of HDP was 0.83 (95% credible interval [CrI], 0.73-0.94). The DASH score and HDP risk were inversely associated in a monotonic dose-response manner (aOR per 1-quintile increase in the DASH score, 0.92 [95% CrI, 0.89-0.95]). CONCLUSIONS: A high-quality diet, which is recommended for disease prevention in general populations, before conception may also reduce the risk of HDP among pregnant Japanese women.

Dietary Interventions for Cancer Prevention: An Update to ACS International Guidelines.

Cancer, the second leading cause of death worldwide, demands the identification of modifiable risk factors to optimize its prevention. Diet has emerged as a pivotal focus in current research efforts. This literature review aims to enhance the ACS guidelines on diet and cancer by integrating the latest findings and addressing unresolved questions. The methodology involved an advanced PubMed search with specific filters relevant to the research topic. Topics covered include time-restricted diet, diet quality, acid load, counseling, exercise and diet combination, Mediterranean diet, vegetarian and pescetarian diets, weight loss, dairy consumption, coffee and tea, iron, carbohydrates, meat, fruits and vegetables, heavy metals, micronutrients, and phytoestrogens. The review highlights the benefits of the Mediterranean diet in reducing cancer risk. Adherence to overnight fasting or carbohydrate consumption may contribute to cancer prevention, but excessive fasting may harm patients' quality of life. A vegetarian/pescetarian diet is associated with lower risks of general and colorectal cancer compared to a carnivorous diet. High heme and total iron intake are linked to increased lung cancer risk, while phytoestrogen intake is associated with reduced risk. Coffee and tea have a neutral impact on cancer risk. Finally, the roles of several preventive micronutrients and carcinogenic heavy metals are discussed.

No Money No Time Culinary Nutrition Website eHealth Challenge: A Pre-Post Evaluation of Impact on Diet Quality, Food Expenditure, and Engagement.

No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.

Patients with Inflammatory Bowel Disease Show Fewer Sex-Related Differences in Their Dietary Behavior Than the General Population: A Qualitative Analysis.

BACKGROUND: Since diet is generally recognized as an important factor directly modulating the gut microbiome, it is also considered a potential environmental triggering factor for the pathogenesis and onset of inflammatory bowel disease (IBD). While the habitual and sex-related dietary behavior of the general population has been the subject of extensive study and reporting, data on IBD patients' dietary behavior and especially its sex-related differences are underrepresented. However, as diet is an important factor in the course of IBD, we hypothesized that men and women with IBD have a different dietary profile than the general population. METHODS: We performed a cohort analysis of a monocentric, cross-sectional study and compared the sex-related dietary behavior of 82 IBD patients (n = 40 women) to a sex- and age-matched cohort of the general German population [n = 328 (n = 160 women)]. Further on, disease-related quality of life and fecal calprotectin were correlated to the IBD patients' dietary behavior. RESULTS: While sex-related dietary behavior was frequently of statistical difference in the general population within the IBD cohort, only minor numerical differences were observed between the sexes, which were rarely statistically significant. However, correlation analyses of disease-related quality of life (IBDQ) and diet revealed significant differences in male IBD patients but not in female IBD patients (p = 0.007; r = 0.409 for energy intake (kJ/d); p = 0.003, r = 0.449 for adherence to Mediterranean diet). CONCLUSION: The dietary behavior of IBD patients showed more similarity between the sexes than the general German population. Distinct sex-related trends and differences in correlation with disease parameters demonstrated a significant difference for an adaptive dietary behavior, especially in IBD men.

Single Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

CONTEXT: Understanding former professional football players engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population. OBJECTIVE: Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players. DESIGN: Cross-sectional. SETTING: Online or hard-copy survey. PATIENTS OR OTHER PARTICIPANTS: Former NFL players. MAIN OUTCOME MEASURES: Self-reported health-promoting behaviors (exercise frequency, diet quality, sleep duration and disturbance) and factors related to well-being (PROMIS ® Meaning and Purpose [MP], Self-Efficacy [SE], Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <30 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; and 70+ years. RESULTS: A total of 1,784 former NFL players (aged 52.3±16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (ß[standard error]=-0.196[0.024]), SE (ß[standard error]=-0.185[0.024]), and SRA (ß[standard error]=-0.137[0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (ß[standard error]=0.068[0.025]) and SRA (ß[standard error]=0.151[0.065]) in the full sample, and with better MP, SE, and SRA among select middle-aged groups (between 40-69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full-group and sparse significant associations were observed in individual age group models. CONCLUSIONS: Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.

Better diet quality is associated with reduced body pain in adults regardless of adiposity: Findings from the Whyalla Intergenerational Study of Health.

Dietary intake has been associated with pain and physical function, but it is unclear if these relationships are mediated by adiposity. Data were derived from the Whyalla Intergenerational Study of Health (n = 654, 57% women). Structural equation modelling tested the hypotheses that adiposity (body mass index (BMI), waist circumference (WC), or body fat (BF, dual energy x-ray absorptiometry)) would mediate the relationship between diet quality (Dietary Guideline Index (DGI) total, core, or non-core scores) and pain (Short Form-36 bodily pain scale (SF36-BPS)), or physical function (grip-strength), overall, and by gender. Adiposity did not mediate a relationship between DGI scores and pain. Direct effects were observed between DGI total scores and SF36-BPS accounting for BMI (ß = 0.170, 95% CI 0.002, 0.339), and between DGI core food scores and SF36-BPS (BMI, ß = 0.278, 95% CI 0.070, 0.486; WC, ß = 0.266, 95% CI 0.058, 0.474; BF, ß = 0.266, 95% CI 0.060, 0.473). In women, direct effects existed between DGI scores and SF36-BPS (DGI total scores, BMI, ß = 0.388, 95% CI 0.162, 0.613; WC, ß = 0.372, 95% CI 0.146, 0.598; BF, ß = 0.382, 95% CI 0.158, 0.605, and DGI core scores, BMI, ß = 0.482, 95% CI 0.208, 0.757; WC, ß = 0.472, 95% CI 0.197, 0.747; BF, ß = 0.467, 95% CI 0.195, 0.739), and DGI total scores and grip-strength (BMI, ß = 0.075, 95% CI 0.008, 0.142; WC, ß = 0.076, 95% CI 0.009, 0.143; BF, ß = 0.079, 95% CI 0.011, 0.146). Better diet quality is associated with lower bodily pain, irrespective of adiposity. Findings highlight the potential role of diet quality in pain management and function, particularly in women.

Diet Quality Scores, Obesity and Metabolic Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis.

PURPOSE OF REVIEW: We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents. RECENT FINDINGS: Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores. A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m2, 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93). Additionally, in the meta-regression analysis, boys showed stronger associations for BMI, z-score BMI and WC (ß = 19.82, 95% CI: 17.62, 22.03, ß = 0.64, 95% CI: 0.33, 0.96 and ß = 67.03, 95% CI: 57.29, 76.77, respectively). Studies in this review suggest an association between high adherence to different diet quality scores and low BMI. Meta-analysis assessing the association between adherence to the MD and BMI, and WC, showed a protective effect of the MD pattern against obesity outcomes. This systematic review and meta-analyses provided evidence on the effect of the diet quality on obesity and MetS in children and adolescents.

Dietary factors and DNA methylation-based markers of ageing in 5310 middle-aged and older Australian adults.

The role of nutrition in healthy ageing is acknowledged but details of optimal dietary composition are still uncertain. We aimed to investigate the cross-sectional associations between dietary exposures, including macronutrient composition, food groups, specific foods, and overall diet quality, with methylation-based markers of ageing. Blood DNA methylation data from 5310 participants (mean age 59 years) in the Melbourne Collaborative Cohort Study were used to calculate five methylation-based measures of ageing: PCGrimAge, PCPhenoAge, DunedinPACE, ZhangAge, TelomereAge. For a range of dietary exposures, we estimated (i) the 'equal-mass substitution effect', which quantifies the effect of adding the component of interest to the diet while keeping overall food mass constant, and (ii) the 'total effect', which quantifies the effect of adding the component of interest to the current diet. For 'equal-mass substitution effects', the strongest association for macronutrients was for fibre intake (e.g. DunedinPACE, per 12 g/day - 0.10 [standard deviations]; 95%CI - 0.15, - 0.05, p < 0.001). Associations were positive for protein (e.g. PCGrimAge, per 33 g/day 0.04; 95%CI 0.01-0.08, p = 0.005). For food groups, the evidence tended to be weak, though sugar-sweetened drinks showed positive associations, as did artificially-sweetened drinks (e.g. DunedinPACE, per 91 g/day 0.06, 95%CI 0.03-0.08, p < 0.001). 'Total effect' estimates were generally very similar. Scores reflecting overall diet quality suggested that healthier diets were associated with lower levels of ageing markers. High intakes of fibre and low intakes of protein and sweetened drinks, as well as overall healthy diets, showed the most consistent associations with lower methylation-based ageing in our study.

The Physical Home Food Environment in Relation to Children's Diet Quality and Cardiometabolic Health.

BACKGROUND: Home food availability has been identified as an important influence on dietary intake. Less is known about the relationship between the physical home food environment (HFE) and factors of cardiometabolic health in children. OBJECTIVE: The purpose was to explore the relationship between the physical HFE and diet quality and factors of cardiometabolic health (weight, blood biomarkers). DESIGN: This was a cross-sectional secondary analysis with one or more children per household. PARTICIPANTS/SETTING: This study included 44 children aged 6-12 years old from 29 households in the Newark, DE, area between August 2020 to August 2021. MAIN OUTCOME MEASURES: The Home Food Inventory provides an obesogenic score (score indicative of the presence of energy-dense foods) for the overall HFE and HFE subcategories scores; z-BMI scores were calculated using measured height and weight; diet quality was measured using the Healthy Eating Index (HEI)-2020 total scores; and cardiometabolic biomarkers were obtained from serum blood samples. STATISTICAL ANALYSES PERFORMED: Unadjusted and adjusted linear mixed model regressions were used to test the association between the physical HFE and each of the outcome variables: z-BMI, HEI-2020, and cardiometabolic biomarkers. HFE subcategories (e.g., fruits and vegetables (FV)) were also examined with each outcome using linear mixed model regression. RESULTS: Children were 9.5±1.9 years with 61.4% female, 59.1% identifying as White, and 90.9% non-Hispanic. Obesogenic score was significantly associated with z-BMI (b=0.03, p=0.029), but not HEI-2020 or cardiometabolic biomarkers. As HFE FV subcategory increased HEI-2020 significantly increased (ß=0.73, p=0.005) while total-cholesterol (ß=-1.54, p=0.014) and LDL-cholesterol levels (ß=-1.31, p=0.010) significantly decreased. Increased availability of sweet and salty snack food and availability of sugar sweetened beverages was associated with increased fasting blood glucose (ß=0.65, p=0.033) and insulin levels (ß=5.60, p=0.035) respectively. CONCLUSIONS: There is evidence of a relationship between the subcategories of the physical HFE and cardiometabolic factors. Future interventions are needed to understand if altering the overall HFE or specific subcategories within the HFE can improve cardiometabolic health.

Examination of diet quality and alcohol on serum IgG levels after first and second COVID-19 vaccines.

RATIONALE: The change of IgG of COVID-19 vaccine was thought to be an effect of diet quality or daily habits. AIMS AND OBJECTIVES: This study aimed to correlate diet quality and healthy living factors with serum IgG response in the blood. METHODS: Participants were selected from volunteers who had their first vaccination and did not have COVID-19 disease (Male = 21 Female = 40). Serum IgG levels were measured on average (avg) 28 days after the COVID-19 vaccine. Information was obtained directly from the participants by questionnaire method (Food consumption record, frequency of food consumption, Diet Quality Index [(DQI], etc.). RESULTS: A significant difference was observed in the IgG levels of the second measurement of age (young/middle) and gender (male/female) (p < 0.05). A significant difference was found in the first measurement of serum IgG levels and IgG avgs of those with medium diet quality and those who did not drink alcohol (p < 0.05). When the IgG2/1 ratio was examined between alcohol users and nonalcohol, a significant increase was observed about two times in non-alcohol users (p = 0.039). There is a positive significant moderate strength relationship between the second measurements of IgG and anthropometric measurements and the first, second, and avg measurements of IgG with DQI. It was found that there was a negative significant medium-strength relationship between individuals' amount of alcohol consumption and IgG avg (r = -0.535, p = 0.009). CONCLUSIONS: Medium diet quality has been seen to affect antibody levels positively. At the same time, it is thought that alcohol use negatively affects serum IgG antibody response in the long term. Other than that, there was shown to be a correlation between IgG levels and DQI.

Cost of a healthy diet: A population-representative comparison of three diet cost methods in Canada.

INTRODUCTION: Different food price sources and dietary assessment tools may impact the estimation of diet costs and hamper our understanding of the relationship between diet costs and dietary intakes. We investigated the effect of three diet cost derivation methods, with increasing numbers of food prices and geographic specificity, holding consistent the dietary assessment, on the estimation of diet costs overall and by food group. METHODS: We matched 24-hour dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) to food price data from three Canadian Consumer Price Index (CPI) food price lists; national short list, national long list, and provincial long list. We compared the daily ($/day) and energy-adjusted ($/2,000kcal) diet costs overall and by food groups for the overall population (4+), children (4-18), and adults (19+). RESULTS: The proportion of dietary intakes (g) that were covered by CPI prices significantly increased from the national short list to the national long list but did not significantly differ from the national long list to the provincial long list. The national short list resulted in the highest daily and energy-adjusted diet costs overall. No difference in diet costs was noted between the national and provincial long lists. Diet costs for four food groups-additions, sweets, fruits, and vegetables, which were poorly covered by the national short list-significantly differed using the national and provincial long lists. All three diet cost methods were significantly correlated with energy intakes; however, a strong/very strong correlation was detected for children, and a weak/moderate correlation for adults. CONCLUSION: The choice of food price data may introduce bias in the diet cost estimate, as well as limiting our understanding of how individuals allocate their diet costs. Refinement of diet cost estimation methodology and measures can strengthen future studies of how consumers allocate their purchases to their diets.

Comparison of sleep quality, diet quality, and weight change between COVID-19-recovered patients and healthy controls: A matched case-control study.

Background and Aim: Literature suggests that individuals who have recovered from COVID-19 may experience post-COVID conditions, including sleep problems and alterations in smell or taste. Thus, this study aims to compare the sleep quality, diet quality, and weight change between COVID-19-recovered patients and healthy controls. Methods: A matched case-control study involving young adults aged 18-30 years was conducted in the Klang Valley of Malaysia. The young adults were matched in a 1:1 ratio based on their sociodemographic characteristics, including gender, age, marital status, ethnicity, educational attainment, employment status, and monthly earned income. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality, and the Diet Quality for Malaysia was used to determine the diet quality of all young adults. The young adults retrospectively recalled their prepandemic body weight in February 2020, while their current body weight in February 2023 was measured using a TANITA HD-314 digital weighing scale. Results: Emerging findings suggest that sleep quality and weight change were comparable between COVID-19-recovered patients and healthy controls. However, healthy controls were reported to have a more diversified diet than COVID-19-recovered patients. Nevertheless, no significant main effects or interaction effects of sleep and diet quality on weight change were observed in COVID-19-recovered patients or healthy controls. In this study, young adults also reported suffering from sleep deprivation and deficiency due to the pandemic. Conclusion: Intervention programs that emphasize avoiding stimulants before bedtime for healthy controls, promoting the importance of having a diversified and balanced diet among the COVID-19-recovered patients, and achieving an ideal body weight for all young adults should be conducted after the COVID-19 pandemic.

Exploring Multidimensional and Within-Food Group Diversity for Diet Quality and Long-Term Health in High-Income Countries.

Dietary diversity is a crucial component of healthy eating patterns because it ensures nutritional adequacy. Yet, concerns have been raised about the potential risks of its increase, which may reflect excessive consumption of unhealthy foods and higher obesity or cardiometabolic risk, particularly in high-income countries. However, the links between dietary diversity and different health outcomes remain inconclusive because of methodological differences in assessing dietary diversity. Numerous studies, mostly cross-sectional, have assessed dietary diversity using different indicators usually based only on the number of foods or food groups consumed. In this perspective, we emphasize that dietary diversity is a multidimensional concept encompassing the number of foods in the diet (food coverage) but also their relative proportions (food evenness) and the nutritional dissimilarity of foods consumed over time (food complementarity). Consequently, a comprehensive assessment of dietary diversity reflecting all its dimensions, both between and within-food groups, is needed to determine the optimal level of complementarity between and within-food groups required to improve health and diet quality. Moreover, given the prevailing context of abundant highly processed and energy-dense foods in high-income countries, promoting dietary diversity should prioritize nutrient-dense food groups. Until recently, within-food group diversity has received limited attention in research and public health recommendations. Still, it may play a role in improving diet quality and long-term health. This perspective aims to clarify the concept of dietary diversity and suggest research avenues that should be explored to better understand its associations with nutritional adequacy and health among adults in high-income countries.

Sleep apnoea symptoms and sleepiness associate with future diet quality: a prospective analysis in the Bogalusa Heart Study.

Sleep apnoea is a known risk factor for cardiometabolic diseases (CMD), but it is unknown whether sleep apnoea or its symptoms contribute to increased CMD through an association with diet quality. This study assessed the association between sleep apnoea symptoms on future diet quality in the Bogalusa Heart Study (BHS). This prospective study included 445 participants who completed a sleep apnoea questionnaire in 2007-2010 and a FFQ in 2013-2016 (mean follow-up: 5·8 years; age 43·5 years; 34 % male; 71 % White/29 % Black persons). Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015 and the alternate Mediterranean diet score. Adjusted mean differences in dietary patterns by sleep apnoea risk, excessive snoring and daytime sleepiness were estimated with multivariable linear regression. Models included multi-level socio-economic factors, lifestyle and health characteristics including BMI, physical activity and depressive symptoms. Those with high sleep apnoea risk, compared with low, had lower diet quality 5·8 years later (percentage difference in AHEI (95 % CI -2·1 % (-3·5 %, -0·7 %)). Daytime sleepiness was associated with lower diet quality. After adjusting for dietary pattern scores from 2001 to 2002, having high sleep apnoea risk and excessive sleepiness were associated with 1·5 % (P < 0·05) and 3·1 % (P < 0·001) lower future AHEI scores, respectively. These findings suggest that individuals with sleep apnea or excessive sleepiness should be monitored for diet quality and targeted for dietary interventions to improve CMD risk.

Associations between the nutritional quality of snacks, overall diet quality and adiposity: findings from a nationally representative study of Australian adolescents.

The primary aim of this study was to examine the association between snack nutritional quality, overall diet quality and adiposity among Australian adolescents. The secondary aim was to assess the distribution of discretionary foods (i.e. energy-dense and nutrient-poor foods and beverages) and intakes from the five food groups at different levels of snack nutritional quality. Dietary data collected from nationally representative adolescents (12-18 years old) during a 24-h dietary recall in the National Nutrition and Physical Activity Survey were analysed (n 784). Snacks were defined based on participant-identified eating occasions. Snack nutritional quality was assessed using the Nutrient Profiling Scoring Criterion (NPSC), whereas diet quality was evaluated using the Dietary Guideline Index for Children and Adolescents. Adiposity was assessed through BMI Z-score waist circumference and waist:height ratio (WHtR). Higher nutritional quality of snacks, as assessed by the NPSC, has been associated with higher diet quality among both boys and girls (P < 0·001). However, there is no association between snacks nutritional quality with BMI Z-score, waist circumference and WHtR. Among both boys and girls, the consumption of fruits, vegetables and legumes/beans at snacks increased with improvement in snack nutritional quality. Conversely, the consumption of discretionary foods at snack decreased with improvement in snack nutritional quality. In conclusion, improved snack quality was associated with better diet quality in adolescents. However, there was no association between snack nutritional quality and adiposity. Future, snack nutrition quality indices should consider optimum snack characteristics related with adiposity and diet quality.