Diet Quality and Upper Gastrointestinal Cancers Risk: A Meta-Analysis and Critical Assessment of Evidence Quality.

We aimed to assess the effect of a high-quality diet on the risk of upper gastrointestinal cancer and to evaluate the overall quality of our findings by searching PubMed, EMBASE, Web of Science, Cochrane, and the references of related articles to February 2020. Two reviewers independently retrieved the data and performed the quality assessments. We defined the highest-quality diet as that with the lowest Diet Inflammatory Index category and the highest Mediterranean Diet Score category. Overall odds ratios and 95% confidence intervals were estimated for upper gastrointestinal cancer risk comparing the highest- versus lowest-diet quality. A random-effects meta-analysis was then applied with Review Manager, and the quality of the overall findings was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation approach. The highest-quality diets were significantly associated with reduced risk of upper gastrointestinal cancers, achieving odds ratios of 0.59 (95% confidence interval: 0.48-0.72) for the Diet Inflammatory Index, pooling the findings from nine studies, and 0.72 (95% confidence interval: 0.61-0.88) for the Mediterranean Diet Score, pooling the findings from 11 studies. We observed a minimum of 69% heterogeneity in the pooled results. The pooled results were graded as low quality of evidence. Although it may be possible to offer evidence-based general dietary advice for the prevention of upper gastrointestinal cancers, the evidence is currently of insufficient quality to develop dietary recommendations.

Assessment of Three Diet Types on Constitutive Immune Parameters in Captive Budgerigar (Melopsittacus undulatus).

Proper diet and nutrition are essential for maintaining the health of captive birds, but specific nutritional requirements can vary by species. Our knowledge of avian nutrition is predominantly based on data collected from gallinaceous birds, which is the primary basis for the dietary recommendations for companion birds, such as budgerigars (Melopsittacus undulatus) and other psittacine birds, potentially leading to a higher risk of malnutrition. In the wild, budgerigars eat predominantly Australian grass seed of the Astrebla genus, which may not be similar to the commercially available food fed to captive budgerigars, both in nutrient content and in their physiologic effects. In this study, we examined the relationship between diet type and immune function by separating 36 budgerigars into 3 dietary treatments: 1) Roudybush formulated pellet diet (Roudybush BirdFood Inc, Woodland, CA, USA), 2) Kaytee Forti-Diet Pro Health seed mix (Kaytee Products Inc, Chilton, WI, USA), and 3) a natural seed diet containing fresh canary grass, flax, nyger, oat groats, and white millet seeds. We monitored body weight, measured the microbial killing ability of whole blood by Escherichia coli and Candida albicans, and collected blood smears to assess white blood cell counts during a period of 8 weeks. Overall, we observed no significant effects of the 3 different diets on bird microbial killing ability or on white blood cell counts, suggesting similar health outcomes for budgerigars that consume mixed seed and those that receive pellet-based diets during this relatively short-term study.

Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. METHODS: By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. FINDINGS: In 2017, 11 million (95% uncertainty interval [UI] 10-12) deaths and 255 million (234-274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1-5] deaths and 70 million [34-118] DALYs), low intake of whole grains (3 million [2-4] deaths and 82 million [59-109] DALYs), and low intake of fruits (2 million [1-4] deaths and 65 million [41-92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. INTERPRETATION: This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. FUNDING: Bill & Melinda Gates Foundation.

Calculating Intake of Dietary Risk Components Used in the Global Burden of Disease Studies from the What We Eat in America/National Health and Nutrition Examination Surveys.

Disability adjusted life years (DALYs) is a health burden metric that combines years of life lost due to disease disability and premature mortality. The Global Burden of Disease (GBD) has been using DALYs to determine the health burden associated with numerous health risks, including risks associated with dietary intakes, at the global and national level. To translate such information at the food level in the U.S., variables in What We Eat in America (WWEIA) need to be aligned with those in the GBD. In this paper, we develop the necessary new variables needed to account for differences in definitions and units between WWEIA and the GBD. We use the Food Patterns Equivalents Database, Food Patterns Equivalents Ingredient Database, Food and Nutrient Database for Dietary Studies, and Standard Reference databases that provide data for WWEIA to develop food group and nutrient variables that align with definitions and units used in the GBD. Considerable effort was needed to disaggregate mixed dishes to GBD components. We also developed a new "non-starchy" vegetable variable, since the GBD vegetables do not include potatoes and corn, and we report fruits and vegetables in grams instead of household measures. New fiber variables were created to avoid double counting of fiber from legumes, whole grains, fruits, and vegetables. Regression analyses were used to predict trans-fat content for foods in WWEIA with missing or incomplete information. The majority of foods in various U.S. Department of Agriculture (USDA) categories contain multiple GBD food groups (e.g., vegetables, whole grains, and processed meat). For most nutrients considered in the GBD, composition is more evenly distributed across the main food categories; however, seafood omega-3 fats were predominantly from either protein foods or mixed dishes and sugar sweetened beverages were from a single category. Dietary intakes in the U.S. fall short of recommendations for all food groups/nutrients with established theoretical minimum-risk targets in GBD. To our knowledge, this is the first approach that aligns WWEIA intake variables with those used in the health burden-based GBD reports. These methods will facilitate researchers to begin comparing data from the U.S. with that from other countries, as well as assess food sustainability performances by concomitantly evaluating DALYs for environmental and nutritional impacts.

Speech2Health: A Mobile Framework for Monitoring Dietary Composition From Spoken Data.

Diet and physical activity are known as important lifestyle factors in self-management and prevention of many chronic diseases. Mobile sensors such as accelerometers have been used to measure physical activity or detect eating time. In many intervention studies, however, stringent monitoring of overall dietary composition and energy intake is needed. Currently, such a monitoring relies on self-reported data by either entering text or taking an image that represents food intake. These approaches suffer from limitations such as low adherence in technology adoption and time sensitivity to the diet intake context. In order to address these limitations, we introduce development and validation of Speech2Health, a voice-based mobile nutrition monitoring system that devises speech processing, natural language processing (NLP), and text mining techniques in a unified platform to facilitate nutrition monitoring. After converting the spoken data to text, nutrition-specific data are identified within the text using an NLP-based approach that combines standard NLP with our introduced pattern mapping technique. We then develop a tiered matching algorithm to search the food name in our nutrition database and accurately compute calorie intake values. We evaluate Speech2Health using real data collected with 30 participants. Our experimental results show that Speech2Health achieves an accuracy of 92.2% in computing calorie intake. Furthermore, our user study demonstrates that Speech2Health achieves significantly higher scores on technology adoption metrics compared to text-based and image-based nutrition monitoring. Our research demonstrates that new sensor modalities such as voice can be used either standalone or as a complementary source of information to existing modalities to improve the accuracy and acceptability of mobile health technologies for dietary composition monitoring.

Early life socioeconomic determinants of dietary score and pattern trajectories across six waves of the Longitudinal Study of Australian Children.

BACKGROUND: Social patterning of dietary-related diseases may partly be explained by population disparities in children's diets. This study aimed to determine which early life socioeconomic factors best predict dietary trajectories across childhood. METHODS: For waves 2-6 of the Baby (B) Cohort (ages 2-3 to 10-11 years) and waves 1-6 of the Kindergarten (K) Cohort (ages 4-5 to 14-15 years) of the Longitudinal Study of Australian Children, we constructed trajectories of dietary scores and of empirically derived dietary patterns. Dietary scores, based on the Australian Dietary Guidelines, summed children's consumption frequencies of seven groups of foods or drinks over the last 24 hours. Dietary patterns at each wave were derived using factor analyses of 12-16 food or drink items. Using multinomial logistic regression analyses, we examined associations of baseline single (parental education, remoteness area, parental employment, income, food security and home ownership) and composite (socioeconomic position and neighbourhood disadvantage) factors with adherence to dietary trajectories. RESULTS: All dietary trajectory outcomes across both cohorts showed profound gradients by composite socioeconomic position but not by neighbourhood disadvantage. For example, odds for children in the lowest relative to highest socioeconomic position quintile being in the 'never healthy' relative to the 'always healthy' score trajectory were OR=16.40, 95% CI 9.40 to 28.61 (B Cohort). Among the single variables, only parental education consistently predicted dietary trajectories. CONCLUSION: Child dietary trajectories vary profoundly by family socioeconomic position. If causal, reducing dietary inequities may require researching underlying pathways, tackling socioeconomic inequities and targeting health promoting interventions to less educated families.

Dietary patterns, overweight and obesity from 1961 to 2011 in the socioeconomic and political context of Argentina.

To analyse the changes in eating patterns in Argentina from 1961 to 2011, and to assess changes in overweight and obesity in their socioeconomic and political context, we performed a hierarchical cluster analysis. We used the information from Food Balance Sheets of the United Nations Food and Agriculture Organisation to identify dietary patterns of apparent consumption. Years were grouped into five patterns. The food group with the highest apparent consumption was cereals (30% of total kcal/person/day) although this decreased slightly. Meats were second and their contribution decreased by 12%. The following foods contribution increased during the period: Sugar and milk by 2% and vegetable oils by 6%. The changes observed in the number of kcal/person/day were in line with changes in real wage, and coincided with economic and political crises that Argentina experienced during that period. Changes in eating patterns allow us to interpret that they relate to the increase in overweight and obesity.

Assessment of diet-related GHG emissions using the environmental hourglass approach for the Mediterranean and new Nordic diets.

Food production and preparation affect the environment in many ways, with effects on greenhouse gases, use of land, biodiversity, etc. The impact is influenced by consumer demand and eating habits. Two different recommended dietary models were considered, the Mediterranean Diet and the New Nordic Diet, with quantitative analysis of GHG emissions through LCA. An environmental hourglass (EH) approach based on LCA was introduced to help translate health-promoting dietary recommendations that consider regional circumstances and cultural diversity into practical eating habits, to promote sustainable and environmentally friendly consumption. Using the environmental hourglass approach, we examined whether dietary choices based on nutritional recommendations can minimise certain negative effects on the food production environment. Using two examples of health-enhancing, regionally-oriented and culturally appropriate dietary patterns - the Mediterranean Diet and the New Nordic Diet - we showed that consumption of high protein foods has a similar and comparable environmental impact to fruit and vegetable consumption. The results of this work may provide a starting point for integrated policy addressing issues related to the healthy diet of the population, aware food choices and sustainable agriculture.

Beyond Wishful Thinking: Integrating Consumer Preferences in the Assessment of Dietary Recommendations.

Convenience, taste, and prices are the main determinants of food choices. Complying with dietary recommendations therefore imposes a "taste cost" on consumers, potentially hindering adoption of those recommendations. The study presents and applies a new methodology, based on economic theory, to quantify this taste cost and assess the health and welfare effects of different dietary recommendations. Then, by comparison of those effects, we identify socially desirable recommendations that are most compatible with consumer preferences (i.e., that best balance health benefits against"taste cost") and should be prioritized for promotion. The methodology proceeds in three-steps: first, an economic-behavioral model simulates how whole diets would change if consumers complied with dietary recommendations; second, an epidemiological model estimates the number of deaths avoided (DA) due to the dietary change; third, an efficiency analysis weighs the health benefits against the taste and policy costs of each recommendation. The empirical model is calibrated using French data. We find that recommendations to reduce consumption of red meat and soft-drinks, or raise consumption of milk products and fish/seafood impose relatively moderate taste costs. By comparison, recommendations related to F&V consumption and, to a lesser extent, butter/cream/cheese, snacks, and all meats impose larger taste costs on consumers. The F&V recommendation is the costliest for consumers to comply with, but it also reduces diet-related mortality the most, so that a large budget could be allocated to promoting F&V consumption while keeping this policy cost-beneficial. We conclude that promotion of most dietary recommendations improves social welfare. Our framework complements the programming models available in nutrition and public health: those models are best used to identify dietary targets, following which our framework identifies cost-beneficial ways of moving towards those targets.

Dietary patterns in the French adult population: a study from the second French national cross-sectional dietary survey (INCA2) (2006-2007).

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.

Electronic Dietary Intake Assessment (e-DIA): relative validity of a mobile phone application to measure intake of food groups.

Automation of dietary assessment can reduce limitations of established methodologies, by alleviating participant and researcher burden. Designed as a research tool, the electronic Dietary Intake Assessment (e-DIA) is a food record in mobile phone application format. The present study aimed to examine the relative validity of the e-DIA with the 24-h recall method to estimate intake of food groups. A sample of eighty university students aged 19-24 years recorded 5 d of e-DIA and 3 d of recall within this 5-d period. The three matching days of dietary data were used for analysis. Food intake data were disaggregated and apportioned to one of eight food groups. Median intakes of food groups were similar between the methods, and strong correlations were found (mean: 0·79, range: 0·69-0·88). Cross-classification by tertiles produced a high level of exact agreement (mean: 71 %, range: 65-75 %), and weighted κ values were moderate to good (range: 0·54-0·71). Although mean differences (e-DIA-recall) were small (range: -13 to 23 g), limits of agreement (LOA) were relatively large (e.g. for vegetables, mean difference: -4 g, LOA: -159 to 151 g). The Bland-Altman plots showed robust agreement, with minimum bias. This analysis supports the use of e-DIA as an alternative to the repeated 24-h recall method for ranking individuals' food group intake.

Industry Approach to Nutrition-Based Product Development and Reformulation in Asia.

In the recent years there has been a proliferation of initiatives to classify food products according to their nutritional composition (e.g., high in fat/sugar) to better guide consumer choices and regulate the food environment. This global trend, lately introduced in Asia as well, utilizes nutrient profiling (NP) to set compositional criteria for food products. Even though the use of NP to set targets for product reformulation has been proposed for years, to date only two NP systems have been specifically developed for that purpose. The majority of the NP applications, especially in Asia, focus on marketing and/or health claim regulation, as well as front-of-pack labeling. Product reformulation has been identified, by the World Health Organization and other official bodies, as a key tool for the food industry to help address public health nutrition priorities and provide support towards the reduction of excessive dietary sugar, salt and fats. In the United Kingdom, the Responsibility Deal is an excellent example of a public-private collaborative initiative that successfully reduced the salt content of products available in the supermarkets by 20-30%, resulting in an estimated 10% reduction in salt intake at the population level. Validation of NP systems targeted towards reformulation supports the hypothesis that, by adopting them, the industry can actively support existing policies in the direction of lowering consumptions in public health-sensitive nutrients. The symposium presented a discussion on the current NP landscape in Asia, the importance of reformulation for public health and the Nestlé approach to improve the food environment in Asia through NP.

[Diet quality and associated factors among the elderly: a population-based study in Campinas, São Paulo State, Brazil]. / Qualidade da dieta e fatores associados entre idosos: estudo de base populacional em Campinas, São Paulo, Brasil.

The aim of this study was to assess the quality of diet among the elderly and associations with socio-demographic variables, health-related behaviors, and diseases. A population-based cross-sectional study was conducted in a representative sample of 1,509 elderly participants in a health survey in Campinas, São Paulo State, Brazil. Food quality was assessed using the Revised Diet Quality Index (DQI-R). Mean index scores were estimated and a multiple regression model was employed for the adjusted analyses. The highest diet quality scores were associated with age 80 years or older, Evangelical religion, diabetes mellitus, and physical activity, while the lowest scores were associated with home environments shared with three or more people, smoking, and consumption of soft drinks and alcoholic beverages. The findings emphasize a general need for diet quality improvements in the elderly, specifically in subgroups with unhealthy behaviors, who should be targeted with comprehensive strategies.

Qualidade da dieta e fatores associados entre idosos: estudo de base populacional em Campinas, São Paulo, Brasil / Diet quality and associated factors among the elderly: a population-based study in Campinas, São Paulo State, Brazil / Calidad de la dieta y sus factores asociados en ancianos: estudio de base poblacional en Campinas, São Paulo, Brasil

O objetivo foi avaliar a qualidade da dieta de idosos segundo variáveis sociodemográficas, comportamentos relativos à saúde e morbidades. Trata-se de estudo transversal de base populacional em amostra de 1.509 idosos, obtida por inquérito de saúde conduzido em 2008-2009, em Campinas, São Paulo, Brasil. A qualidade alimentar foi avaliada pelo Índice de Qualidade da Dieta Revisado (IQD-R). Foram estimadas médias do IQD-R segundo as variáveis independentes e desenvolvido modelo de regressão linear múltipla para as análises ajustadas. Os segmentos de idosos que apresentaram escores superiores de qualidade da dieta foram os de 80 anos e mais, evangélicos, que praticavam atividade física de lazer e os diabéticos; escores inferiores foram observados nos que residiam com três ou mais pessoas, nos tabagistas e nos que relataram preferência por refrigerantes e bebidas alcoólicas. Os achados apontam para a necessidade de melhora da qualidade da dieta dos idosos em geral, mas especialmente nos segmentos com outros comportamentos não saudáveis, indicando, ainda, a relevância de intervenções integradas e não focadas em um fator.

The aim of this study was to assess the quality of diet among the elderly and associations with socio-demographic variables, health-related behaviors, and diseases. A population-based cross-sectional study was conducted in a representative sample of 1,509 elderly participants in a health survey in Campinas, São Paulo State, Brazil. Food quality was assessed using the Revised Diet Quality Index (DQI-R). Mean index scores were estimated and a multiple regression model was employed for the adjusted analyses. The highest diet quality scores were associated with age 80 years or older, Evangelical religion, diabetes mellitus, and physical activity, while the lowest scores were associated with home environments shared with three or more people, smoking, and consumption of soft drinks and alcoholic beverages. The findings emphasize a general need for diet quality improvements in the elderly, specifically in subgroups with unhealthy behaviors, who should be targeted with comprehensive strategies.

El objetivo es evaluar la calidad de la dieta en ancianos, a partir de las variables sociodemográficas, comportamientos relacionados con la salud y morbilidad. Se trata de un estudio transversal con una muestra de 1.509 ancianos, obtenidos de la encuesta de salud de Campinas, São Paulo, Brasil, en 2008-2009. La calidad de los alimentos se evaluó mediante el Índice de Calidad de la Dieta Revisado (IQD-R). Se estimaron las medias del IQD-R, de acuerdo con las variables independientes y un modelo de regresión lineal múltiple. Los grupos con una puntuación mayor de calidad de dieta fueron los mayores de 80 años, los evangélicos, los que hacen actividad física como hobby, y los diabéticos. Los puntajes más bajos fueron observados entre los que viven con tres o más personas, los fumadores y aquellos que informaron preferir refrescos y bebidas alcohólicas. Los resultados destacan la necesidad de mejorar la calidad de la dieta de ancianos en general y, más específicamente, para los grupos que tienen otros comportamientos no saludables, indicando la importancia de intervenciones integradas y no centralizadas.

Identification of dietary patterns of adolescents attending public schools / Identificação de padrões alimentares de adolescentes de escolas públicas

OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis. RESULTS: the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR = 1.66; 95% CI = 1.07-2.56), and overweight adolescents had lower chances of eating the "healthy" food pattern (OR = 0.56, 95% CI = 0.35-0.91). CONCLUSIONS: deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them. .

OBJETIVOS: identificar os padrões de consumo alimentar de adolescentes de escolas públicas do norte de Minas Gerais e testar a associação desses padrões com variáveis socioeconômicas e estado nutricional. MÉTODOS: estudo analítico e transversal com amostra aleatória de 474 adolescentes de ambos os sexos, 11 a 17 anos de idade, matriculados do 6º ao 9º ano de escolas públicas municipais da zona urbana de Montes Claros, MG. Os pais forneceram informações demográficas e econômicas. Nas escolas, avaliou-se o estado nutricional dos adolescentes (índice de massa corporal - IMC) e investigou-se seus hábitos alimentares aplicando-se um Questionário de Frequência Alimentar para Adolescentes (QFAA). Com base em 26 categorias de alimentos extraídas do QFAA, aplicou-se uma análise fatorial de componentes principais (ACP) para identificar os padrões alimentares, que foram associados a fatores antropométricos e socioeconômicos por análise de regressão múltipla. RESULTADOS: os três padrões alimentares identificados, ''junk food'', ''saudável'' e ''tradicional'', explicaram 23,26%, 6,90% e 5,24% da variabilidade dos dados, respectivamente. Adolescentes com renda familiar per capita superior a 1/2 salário mínimo apresentaram maior chance de aderir ao padrão ''junk food'' (OR = 1,66; IC 95% = 1,07-2,56), enquanto aqueles com excesso de peso possuíram menor chance de aderir ao padrão ''saudável'' (OR = 0,56; IC95% = 0,35-0,91). CONCLUSÕES: desvios do padrão alimentar ''saudável'' não estão relacionados à baixa renda, mas sim aos maus hábitos alimentares da população estudada. Adolescentes com sobrepeso não aderiram ao padrão ''saudável'', reforçando a necessidade da implementação ...

Identification of dietary patterns of adolescents attending public schools.

OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis. RESULTS: the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR=1.66; 95% CI=1.07-2.56), and overweight adolescents had lower chances of eating the "healthy" food pattern (OR=0.56, 95% CI=0.35-0.91). CONCLUSIONS: deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them.

Midlife dietary patterns and mortality in the population-based study of Swedish twins.

BACKGROUND: We examined midlife dietary patterns in relation to (1) sociodemographic and health-related characteristics and (2) survival. METHODS: A two-step cluster analysis of a 12-item food questionnaire was used to derive dietary patterns in a cohort of 16 649 members of the Swedish Twin Registry, a prospective, population-based study of twins. The average age at baseline (1967) was 55.5 years; the follow-up for all-cause mortality extended until 2011 (26.8±12.35 years or 345,127 person-years) via death records. RESULTS: Four dietary patterns (classes) distinguishable by demographic and health characteristics emerged: Moderate Intake and Starch Diet (Class 1), Moderate Intake Diet with Low Flour-Based Foods (Class 2), Meat and Starch Diet (Class 3) and Low Meat Intake Diet (Class 4). Membership in Class 3 was associated with 7% increased risk of mortality compared with Class 2 independent of baseline age, cohort, sex and body mass index. These results were mostly explained by sociodemographic and lifestyle factors. When follow-up was restricted to those in the study for 20+ years, both Classes 1 and 3 conferred increased risk of mortality compared with Class 2, independent of covariates. Analyses conducted within twin pairs revealed similar results. CONCLUSIONS: Midlife diet over-represented by meat and starch-based foods may increase the risk of mortality, whereas the diet low in starch may be beneficial. These results appear to be independent of factors shared by twins, as well as at least partially a function of social and lifestyle factors, particularly marital status and smoking.