Cross-sectional associations of dietary patterns characterized by fat type with markers of cardiometabolic health.

BACKGROUND AND AIMS: Individual dietary fats can differentially impact on cardiometabolic health. However, their impact within a dietary pattern is not well understood, and warrants comparison with diet quality scores with a dietary fat focus. The aim of this study was to investigate cross-sectional associations between a posteriori dietary patterns characterized by fat type and cardiometabolic health markers, and compare these with two diet quality scores. METHODS AND RESULTS: UK Biobank adults with ≥two 24-h dietary assessments and data on cardiometabolic health were included (n = 24 553; mean age: 55.9 y). A posteriori dietary patterns (DP1; DP2) were generated through reduced rank regression (response variables: SFA, MUFA, PUFA). Mediterranean Diet Score (MDS) and Dietary Approaches to Stop Hypertension (DASH) dietary patterns were created. Multiple linear regression analyses were used to investigate associations between standardized dietary patterns and cardiometabolic health (total cholesterol, HDL-C, LDL-C and VLDL-C cholesterol, triglycerides, C-reactive protein [CRP], glycated hemoglobin [HbA1c]). DP1, positively correlated with SFAs, MUFAs and PUFAs, characterized by higher nuts, seeds and vegetables intake and lower fruits and low-fat yoghurt intake, was associated with lower HDL-C (ß: -0.07; 95% CI: -0.10, -0.03) and triglycerides (-0.17; -0.23, -0.10) and higher LDL-C (0.07; 0.01,0.12), CRP (0.01; 0.01, 0.03) and HbA1c (0.16; 0.11,0.21). DP2, positively correlated with SFAs, negatively correlated with PUFAs, characterized by higher butter and high-fat cheese intake and lower nuts, seeds and vegetable intake, was associated with higher total cholesterol (0.10; 0.01, 0.21), VLDL-C (0.05; 0.02, 0.07), triglycerides (0.07; 0.01, 0.13), CRP (0.03; 0.02, 0,04) and HbA1c (0.06; 0.01, 0.11). Higher adherence to MDS and DASH was associated with favorable cardiometabolic health markers concentration. CONCLUSIONS: Irrespective of the method used, dietary patterns that encourage healthy fat consumption were associated with favorable cardiometabolic health biomarkers. This study strengthens the evidence for incorporation of dietary fat type into policy and practice guidelines for CVD prevention.

Identifying effective characteristics of behavioral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis.

People with serious mental illness (SMI) have identified barriers to engaging in behavioral weight management interventions (BWMIs). We assessed whether BWMIs that addressed these barriers were more effective. First, we systematically reviewed qualitative literature and used a thematic analysis to identify the characteristics of BWMIs that promote engagement for adults with SMI. Second, we systematically reviewed randomized controlled trials (RCTs) of BWMIs in adults with SMI. Data on the characteristics that promoted engagement and weight outcomes were extracted. We then used a crisp-set qualitative comparative analysis (CsQCA) to identify which characteristics were associated with weight loss. For the qualitative review, 20 studies in 515 people with SMI were analyzed and nine characteristics were reported to promote engagement in BWMIs. For the systematic review, 34 RCTs testing 36 interventions in 4305 participants were included. The active interventions resulted in more weight loss (mean = -4.37 to +1 kg at 6 weeks to 18 months follow-up) compared with controls (-1.64 to +3.08 kg). The CsQCA showed BWMIs that offered regular contact, tools to support enactment, and tailored materials were associated with effectiveness. As these are all supplementary strategies, it may be possible to augment BWMIs available for the general population to engage people with SMI.

Associations Between Macronutrients From Different Dietary Sources and Serum Lipids in 24 639 UK Biobank Study Participants.

[Figure: see text].

Using Supermarket Loyalty Card Data to Provide Personalised Advice to Help Reduce Saturated Fat Intake among Patients with Hypercholesterolemia: A Qualitative Study of Participants' Experiences.

BACKGROUND: The 'Primary Care SHOPping Intervention for Cardiovascular Disease Prevention' (PCSHOP) trial tested the effectiveness and feasibility of a behavioural intervention to reduce saturated fat in food purchases. The intervention offered feedback from data collected through a supermarket loyalty card to supplement brief advice from a nurse. This qualitative study aimed to describe participants' experiences of receiving this intervention. METHODS: We conducted semi-structured, one-to-one, telephone interviews with participants from the PCSHOP trial. Interviews were audio-recorded and transcribed verbatim. We employed the one sheet of paper technique and a thematic analysis to develop high-level themes in NVivo software. RESULTS: Twenty-four participants were interviewed (mean age: 63 years (SD 12)). They reported that the brief advice did not provide any new information but they welcomed the sense of accountability the nurse provided. The personalised shopping feedback and healthier swap suggestions provided novel information that challenged previously held beliefs about the saturated fat content of food purchases and encouraged some positive dietary changes. However, the taste preferences of the participant or other household members were a barrier to changing food shopping behaviours. CONCLUSION: Harnessing loyalty card data is a novel and acceptable method to offering personalised dietary feedback. Yet, issues on the suitability of the healthier swap suggestions limited the extent of dietary change. TRIAL REGISTRATION: ISRCTN14279335. Registered 1 September 2017.

Caloric beverages were major sources of energy among children and adults in Mexico, 1999-2012.

Mexico, with 1 of the highest obesity prevalences in the world, instituted a 10% excise tax for any sugar-sweetened beverage (SSB) starting on 1 January 2014. Understanding the recent patterns and trends in beverage intake and sales in Mexico provides both background and baseline data for the importance of SSBs and other beverages in the Mexican diet. We analyzed a single 24-h dietary recall from 2 nationally representative surveys: the Mexican Nutrition Survey 1999 (n = 6049) and the National Health and Nutrition Survey 2012 (n = 10,343). To describe trends and patterns in beverages, we calculated the volume and energy intake per capita and per consumer and the proportion of consumers of each beverage group in each survey. A commercial sales dataset was used to describe beverage sales trends from 1999 to 2012. From 1999 to 2012, total daily energy from beverages increased among children aged 5-11 y (+45.3 kcal), females aged 12-19 y (+57.3 kcal), and adult females aged 20-49 y (+96.4 kcal) (P < 0.05). Over the same period, intake of beverages with added sugars increased, specifically flavored milk, agua fresca (fruit water made in stalls or at home, usually with added sugars), and fruit drinks among children aged 5-11 y and females aged 12-19 y and caloric coffee/tea, soda, and agua fresca among adult females aged 20-49 y. In 2012, beverages represented 17.5% (325 kcal) and 19.0% (382 kcal) of the total daily energy intake per capita in children aged 1-19 y and adults aged ≥20 y, respectively. In 2012, flavored milk beverages, caloric soda, and high-fat milk were the top 3 major contributors to total daily energy intake per capita in all children aged 1-19 y. Caloric soda, caloric coffee/tea, and agua fresca were the top 3 major energy contributors in adults aged ≥20 y. From 1999 to 2012, sales of soda, fruit-flavored drinks, and flavored waters increased. In conclusion, consumption of several beverages with added sugars increased among children and adult females in Mexico. Because caloric soda is currently 1 of the top beverages consumed, a 10% tax on SSBs might help to significantly reduce added sugars intake in Mexico.