Relationships between Dietary Patterns and Indices of Arterial Stiffness and Central Arterial Wave Reflection in 9-11-Year-Old Children.

Arterial stiffness is an important marker of vascular damage and a strong predictor of cardiovascular diseases (CVD). Given that pathophysiological processes leading to an increased arterial stiffness begin during childhood, the aim of this clustered observational study was to determine the relationship between modifiable factors including dietary patterns and indices of aortic arterial stiffness and wave reflection in 9-11-year-old children. Data collection was conducted between April and December 2015 in 17 primary schools in Dunedin, New Zealand. Dietary data were collected using a previously validated food frequency questionnaire and identified using principal component analysis method. Arterial stiffness (carotid-femoral pulse wave velocity, PWV) and central arterial wave reflection (augmentation index, AIx) were measured using the SphygmoCor XCEL system (Atcor Medical, Sydney, Australia). Complete data for PWV and AIx analyses were available for 389 and 337 children, respectively. The mean age of children was 9.7 ± 0.7 years, 49.0% were girls and 76.0% were classified as "normal weight". The two identified dietary patterns were "Snacks" and "Fruit and Vegetables". Mean PWV and AIx were 5.8 ± 0.8 m/s and -2.1 ± 14.1%, respectively. There were no clinically meaningful relationships between the identified dietary pattern scores and either PWV or AIx in 9-11-year-old children.

Short-term high-intensity interval training exercise does not affect gut bacterial community diversity or composition of lean and overweight men.

NEW FINDINGS: What is the central question of this study? Does short-term high-intensity interval training alter the composition of the microbiome and is this associated with exercise-induced improvements in cardiorespiratory fitness and insulin sensitivity? What is the main finding and its importance? Although high-intensity interval training increased insulin sensitivity and cardiovascular fitness, it did not alter the composition of the microbiome. This suggests that changes in the composition of the microbiome that occur with prolonged exercise training might be in response to changes in metabolic health rather than driving exercise training-induced adaptations. ABSTRACT: Regular exercise reduces the risk of metabolic diseases, and the composition of the gut microbiome has been associated with metabolic function. We investigated whether short-term high-intensity interval training (HIIT) altered the diversity and composition of the bacterial community and whether there were associations with markers of insulin sensitivity or aerobic fitness. Cardiorespiratory fitness ( V̇O2peak ) and body composition (dual energy X-ray absorptiometry scan) were assessed and faecal and fasted blood samples collected from 14 lean (fat mass 21 ± 2%, aged 29 ± 2 years) and 15 overweight (fat mass 33 ± 2%, aged 31 ± 2 years) men before and after 3 weeks of HIIT training (8-12 × 60 s cycle ergometer bouts at V̇O2peak power output interspersed by 75 s rest, three times per week). Gut microbiome composition was analysed by 16S rRNA gene amplicon sequencing. The HIIT significantly increased the aerobic fitness of both groups (P < 0.001) and improved markers of insulin sensitivity (lowered fasted insulin and HOMA-IR; P < 0.001) in the overweight group. Despite differences in the abundance of several bacterial taxa being evident between the lean and overweight group, HIIT did not affect the overall bacterial diversity or community structure (α-diversity or ß-diversity). No associations were found between the top 50 most abundant bacterial genera and cardiorespiratory fitness markers; however, significant associations (P < 0.05) were observed between the abundance of the bacterial species Coprococcus_3, Blautia, Lachnospiraceae_ge and Dorea and insulin sensitivity markers in the overweight group. Our results suggest that short-term HIIT does not greatly impact the overall composition of the gut microbiome, but that certain microbiome genera are associated with insulin sensitivity markers that were improved by HIIT in overweight participants.

Measuring Diet Intake and Gastrointestinal Symptoms in Irritable Bowel Syndrome: Validation of the Food and Symptom Times Diary.

INTRODUCTION: Patients with irritable bowel syndrome (IBS) identify food as a trigger for the onset or worsening of gastrointestinal symptoms. Despite this, there is no published validated contemporaneous food and symptom diary to investigate the association between diet and IBS symptoms. The objective of this prospective observational study was to assess the construct validity of a novel food diary and symptom questionnaire, the Food and Symptom Times (FAST) diary, and the predictive validity of the food diary component with relation to fiber and fermentable oligosaccharides, disaccharides, monosaccharides, and polyols consumption and subsequent gastrointestinal symptoms. METHODS: Fifty-one participants with IBS completed the FAST diary and several legacy instruments. The relationship between the FAST gastroenterological symptoms and legacy instruments was examined using Spearman correlation coefficients. Further statistical analysis investigated the relationship between diet and postprandial gastrointestinal symptoms. RESULTS: Consistent with a priori predictions, the FAST symptoms showed moderate correlations with the most similar Patient-Reported Outcome Measurement Information System gastrointestinal scales (0.328-0.483, P < 0.05) and the most similar Gastrointestinal Symptom Rating Scale questions (0.303-0.453, P < 0.05), with the exception of the weakly correlated subscale constipation for both instruments (-0.050 to -0.119, P > 0.05). The IBS-Quality of Life instrument showed moderate correlations with the FAST symptom abdominal swelling/distension (0.313-0.416, P < 0.05). The consumption of a high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols meal was associated with participants with IBS-D experiencing abdominal bloating and participants with IBS-C not experiencing abdominal swelling (P < 0.05). The consumption of fiber was correlated with abdominal fullness and bloating in participants with IBS-C (P < 0.05). DISCUSSION: The FAST diary validly measures gastrointestinal symptoms as they occur in people with IBS and correlates these symptoms with specific aspects of diet.

What Do We Know about Diet and Markers of Cardiovascular Health in Children: A Review.

Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur in children, evidence shows that the manifestation of CVD risk factors begins in childhood, preceding clinical complications of CVD in adulthood. Dietary intake is a modifiable risk factor that has been shown to make a substantial contribution to the risk of CVD in adulthood. However, less is known about the association between dietary intake and markers of cardiovascular health in children. This review summarises the current evidence on the relationship between dietary intake and markers of cardiovascular health including traditional CVD risk factors, physical fitness, and indices of arterial stiffness and wave reflection in children. Original research published in English, between January 2008 and December 2018 fulfilling the objective of this review were screened and included. Findings show that adaptation of a healthy lifestyle early in life can be beneficial for reducing the risk of CVD later in life. Furthermore, keeping arterial stiffness low from a young age could be a potential CVD prevention strategy. However, limited studies are available on diet-arterial stiffness relationship in children, and future research is required to better understand this association to aid the development and implementation of evidence-based strategies for preventing CVD-related complications later in life.

Dietary Patterns, Cardiorespiratory and Muscular Fitness in 9⁻11-Year-Old Children from Dunedin, New Zealand.

Research shows that cardiorespiratory (CRF) and muscular fitness in childhood are associated with a healthier cardiovascular profile in adulthood. Identifying factors associated with measures of fitness in childhood could allow for strategies to optimize cardiovascular health throughout the lifecourse. The aim of this study was to examine the association between dietary patterns and both CRF and muscular fitness in 9⁻11-year-olds. In this study of 398 children, CRF and muscular fitness were assessed using a 20-m shuttle run test and digital hand dynamometer, respectively. Dietary patterns were derived using principal component analysis. Mixed effects linear regression models were used to assess associations between dietary patterns and CRF and muscular fitness. Most children had healthy CRF (99%, FITNESSGRAM) and mean ± SD muscular fitness was 15.2 ± 3.3 kg. Two dietary patterns were identified; “Snacks” and “Fruit and Vegetables”. There were no significant associations between either of the dietary patterns and CRF. Statistically significant but not clinically meaningful associations were seen between dietary patterns and muscular fitness. In an almost exclusively fit cohort, food choice is not meaningfully related to measures of fitness. Further research to investigate diet-fitness relationships in children with lower fitness levels can identify key populations for potential investments in health-promoting behaviors.

Pilot Testing a Photo-Based Food Diary in Nine- to Twelve- Year Old- Children from Dunedin, New Zealand.

The purpose of the study was to investigate if an Evernote app-based electronic food diary is an acceptable method to measure nutrient intake in children aged 9-12 years. A convenience sample of 16 nine- to twelve-year-olds from Dunedin, New Zealand, completed a paper-based food dairy on four days, followed by four more days using a photo-based diary on an iPod. This photo-based diary used a combination of photographs and short written descriptions of foods consumed. The photo-based diaries produced similar results to written diaries for all macronutrients and major micronutrients (e.g., calcium, fibre, vitamin C). Spearman correlation coefficients between the two methods for all nutrients, except sugars, were above 0.3. However, burden on researchers and participants was reduced for the photo-based diary, primarily due to the additional information obtained from photographs. Participating children needed less help from parents with completing the electronic diaries and preferred them to the paper version. This electronic diary is likely to be suitable, after additional formal validity testing, for use in measuring nutrient intake in children.

Sleep timing is associated with diet and physical activity levels in 9-11-year-old children from Dunedin, New Zealand: the PEDALS study.

It is well documented that short sleep duration is associated with excess body weight and poor food intake in children. It has been suggested that sleep timing behaviour may also be an important predictor of weight and other related behaviours, independent of sleep duration; however, there is a lack of research investigating these relationships. The present study investigated sleep timing in association with diet and physical activity levels in 439 children aged 9-11 years old from New Zealand. Sleep and physical activity data were collected using accelerometry, and food choice using a short food-frequency questionnaire. Participants were classified into one of four sleep timing behaviour categories using the median split for sleep-onset and -offset times. Differences between sleep timing groups for weekly consumption frequency of selected food groups, dietary pattern scores and minutes of moderate-to-vigorous physical activity were examined. Children in the late sleep/late wake category had a lower 'Fruit & Vegetables' pattern score [mean difference (95% CI): -0.3 (-0.5, -0.1)], a lower consumption frequency of fruit and vegetables [mean weekly difference (95% CI): -2.9 (-4.9, -0.9)] and a higher consumption frequency of sweetened beverages [mean weekly difference (95% CI): 1.8 (0.2, 3.3)] compared with those in the early sleep/early wake category. Additionally, children in the late sleep/late wake category accumulated fewer minutes of moderate-to-vigorous physical activity per day compared with those in the early sleep/early wake category [mean difference (95% CI): -9.4 (-15.3, -3.5)]. These findings indicate that sleep timing, even after controlling for sleep duration, was associated with both food consumption and physical activity.

Prediction Equations Overestimate the Energy Requirements More for Obesity-Susceptible Individuals.

Predictive equations to estimate resting metabolic rate (RMR) are often used in dietary counseling and by online apps to set energy intake goals for weight loss. It is critical to know whether such equations are appropriate for those susceptible to obesity. We measured RMR by indirect calorimetry after an overnight fast in 26 obesity susceptible (OSI) and 30 obesity resistant (ORI) individuals, identified using a simple 6-item screening tool. Predicted RMR was calculated using the FAO/WHO/UNU (Food and Agricultural Organisation/World Health Organisation/United Nations University), Oxford and Miflin-St Jeor equations. Absolute measured RMR did not differ significantly between OSI versus ORI (6339 vs. 5893 kJ·d-1, p = 0.313). All three prediction equations over-estimated RMR for both OSI and ORI when measured RMR was ≤5000 kJ·d-1. For measured RMR ≤7000 kJ·d-1 there was statistically significant evidence that the equations overestimate RMR to a greater extent for those classified as obesity susceptible with biases ranging between around 10% to nearly 30% depending on the equation. The use of prediction equations may overestimate RMR and energy requirements particularly in those who self-identify as being susceptible to obesity, which has implications for effective weight management.

Gastrointestinal Symptoms and FODMAP Intake of Aged-Care Residents from Christchurch, New Zealand.

Studies on fermentable oligo-, di-, and monosaccharides as well as polyols (FODMAPs) intake in older adults are lacking. This study investigated the relationship between gastrointestinal (GI) symptoms and FODMAPs in aged care residents. The Gastrointestinal Symptom Rating Score questionnaire modified for patients with IBS (GSRS-IBS) was used to identify participants with IBS-like symptoms. Dietary intake was assessed for a subgroup of participants with highest total GSRS-IBS score (symptomatic cases) and age, sex, and level of care matched participants with low total GSRS-IBS score (asymptomatic controls). Seventy-four participants with a mean (SD) age of 86 (6.6) years completed the GSRS-IBS questionnaire and dietary data were collected using food diaries from a subsample of 27 symptomatic and 27 asymptomatic participants. The study found many older adults with functional gut symptoms. There were no differences between the groups for FODMAP intake and no significant relationship was found between FODMAP intake and total GSRS-IBS score. Lactose from milk and milk-based desserts was the biggest FODMAP contributor (16 g/day) and a significant relationship between total FODMAP intake and diarrhoea was found. A larger study sample in future studies is required to better capture symptomatic cases and manipulation of dietary FODMAPs may assist with the management of IBS in the elderly.

Vitamin C Status Correlates with Markers of Metabolic and Cognitive Health in 50-Year-Olds: Findings of the CHALICE Cohort Study.

A cohort of 50-year-olds from Canterbury, New Zealand (N = 404), representative of midlife adults, undertook comprehensive health and dietary assessments. Fasting plasma vitamin C concentrations (N = 369) and dietary vitamin C intake (N = 250) were determined. The mean plasma vitamin C concentration was 44.2 µmol/L (95% CI 42.4, 46.0); 62% of the cohort had inadequate plasma vitamin C concentrations (i.e., <50 µmol/L), 13% of the cohort had hypovitaminosis C (i.e., <23 µmol/L), and 2.4% had plasma vitamin C concentrations indicating deficiency (i.e., <11 µmol/L). Men had a lower mean plasma vitamin C concentration than women, and a higher percentage of vitamin C inadequacy and deficiency. A higher prevalence of hypovitaminosis C and deficiency was observed in those of lower socio-economic status and in current smokers. Adults with higher vitamin C levels exhibited lower weight, BMI and waist circumference, and better measures of metabolic health, including HbA1c, insulin and triglycerides, all risk factors for type 2 diabetes. Lower levels of mild cognitive impairment were observed in those with the highest plasma vitamin C concentrations. Plasma vitamin C showed a stronger correlation with markers of metabolic health and cognitive impairment than dietary vitamin C.

Development of a Healthy Dietary Habits Index for New Zealand Adults.

Healthful dietary habits are individually associated with better nutrient intake and positive health outcomes; however, this information is rarely examined together to validate an indicator of diet quality. This study developed a 15-item Healthy Dietary Habits Index (HDHI) based on self-reported dietary habits information collected in the 2008/09 New Zealand Adult Nutrition Survey. The validity of HDHI as a diet quality index was examined in relation to sociodemographic factors, 24-diet recall derived nutrient intakes, and nutritional biomarkers in a representative sample of adults aged 19 years and above. Linear regression models were employed to determine associations between HDHI quintiles and energy-adjusted nutrient data and nutritional biomarkers. Significantly higher HDHI scores were found among women, older age groups, Non-Maori or Pacific ethnic groups, and less socioeconomically-deprived groups (all p < 0.001). Increasing quintiles of HDHI were associated with higher intakes of dietary fibre and seven micronutrients including calcium, iron, and vitamin C, and lower intakes of energy, macronutrients, sodium, zinc, vitamins B6 and B12. Associations in the expected directions were also found for urinary sodium, whole blood folate, serum and red blood cell folate, and plasma selenium (all p < 0.001). The present findings suggest that the HDHI is a valid measure of diet quality as it is capable of discerning quality of diets of subgroups and ranking nutrient intakes among NZ adults.

Reproducibility and Relative Validity of a Short Food Frequency Questionnaire in 9-10 Year-Old Children.

The aim of this study was to assess the reproducibility and validity of a non-quantitative 28-item food frequency questionnaire (FFQ). Children aged 9-10 years (n = 50) from three schools in Dunedin, New Zealand, completed the FFQ twice and a four-day estimated food diary (4DEFD) over a two-week period. Intraclass correlation coefficients (ICC) and Spearman's correlation coefficients (SCC) were used to determine reproducibility and validity of the FFQ, respectively. Weekly intakes were estimated for each food item and aggregated into 23 food items/groups. More than half of the food items/groups (52.2%) had an ICC ≥0.5. The median SCC between FFQ administrations was 0.66 (ranging from 0.40 for processed meat to 0.82 for sweets and non-dairy drinks). Cross-classification analysis between the first FFQ and 4DEFD for ranking participants into thirds showed that breakfast cereals had the highest agreement (54.0%) and pasta the lowest (34.0%). In validity analyses, 70% of food items/groups had a SCC ≥0.3. Results indicate that the FFQ is a useful tool for ranking children according to food items/groups intake. The low respondent burden and relative simplicity of the FFQ makes it suitable for use in large cohort studies of 9-10 year-old children in New Zealand.

Cardiorespiratory fitness is positively associated with a healthy dietary pattern in New Zealand adolescents.

OBJECTIVE: To examine the association between cardiorespiratory fitness and dietary patterns in adolescents. DESIGN: Food choice was assessed using the validated New Zealand Adolescent FFQ. Principal components analysis was used to determine dietary patterns. Trained research assistants measured participants' height and body mass. Cardiorespiratory fitness was assessed in a subset of participants using the multistage 20 m shuttle run. The level and stage were recorded, and the corresponding VO2max was calculated. Differences in mean VO2max according to sex and BMI were assessed using t tests, while associations between cardiorespiratory fitness and dietary patterns were examined using linear regression analyses adjusted for age, sex, school attended, socio-economic deprivation and BMI. SETTING: Secondary schools in Otago, New Zealand. SUBJECTS: Students (n 279) aged 14-18 years who completed an online lifestyle survey during a class period. RESULTS: Principal components analysis produced three dietary patterns: 'Treat Foods', 'Fruits and Vegetables' and 'Basic Foods'. The 279 participants who provided questionnaire data and completed cardiorespiratory fitness testing had a mean age of 15·7 (sd 0·9) years. Mean VO2max was 45·8 (sd 6·9) ml/kg per min. The 'Fruits and Vegetables' pattern was positively associated with VO2max in the total sample (ß=0·04; 95%CI 0·02, 0·07), girls (ß=0·06; 95% CI 0·03, 0·10) and boys (ß=0·03; 95% CI 0·01, 0·05). CONCLUSIONS: These results indicate that increase in cardiorespiratory fitness was associated with a healthier dietary pattern, suggesting both should be targeted as part of a global lifestyle approach. Longitudinal studies are needed to confirm this association in relation to health outcomes in New Zealand adolescents.

Diet quality is associated with measures of body fat in adolescents from Otago, New Zealand.

OBJECTIVE: To examine the potential associations between diet quality and multiple measures of body composition in a sample of New Zealand adolescents aged 14-18 years. DESIGN: Cross-sectional survey of eleven high schools in Otago, New Zealand. Each participant completed an online FFQ and a New Zealand Diet Quality Index for Adolescents (NZDQI-A) score was calculated based on variety and adequacy of intake for five major food groups. Besides height and waist circumference measurements, body composition was assessed using segmental bio-impedance analysis. Generalized estimating equations were used to examine associations between diet quality and body composition in models adjusted for sex, age, ethnicity and socio-economic status. SETTING: High schools in Otago, New Zealand. SUBJECTS: High-school students (n 681, 56 % male, mean age 16·1 (sd 1·5) years) participating in the Otago School Students Lifestyle Survey Two. RESULTS: Higher NZDQI-A scores were significantly associated with lower body fat percentage (ß=-0·19; 95 % CI -0·35, -0·04; P=0·014), fat-to-lean mass ratio (ß=-0·26; 95 % CI -0·46, -0·05; P=0·016) and lower fat mass index (ß=-0·23; 95 % CI -0·45, -0·004; P=0·046) after multivariate adjustment. No association was found between NZDQI-A and BMI, waist circumference or waist-to-height ratio. CONCLUSIONS: Diet quality, as measured by NZDQI-A, was associated only with measures of body fat, not measures of overall body size. Measures specific to body fat should be used for more accurate ascertainment of body composition in examining the diet-body composition associations in this age group.

Relative validity and reproducibility of a food frequency questionnaire for identifying the dietary patterns of toddlers in New Zealand.

BACKGROUND: Dietary patterns provide insight into relationships between diet and disease. Food frequency questionnaires (FFQs) can identify dietary patterns in adults, but similar analyses have not been performed for toddlers. OBJECTIVE: The aim of the Eating Assessment in Toddlers study was to evaluate the relative validity and reproducibility of dietary patterns from an FFQ developed for toddlers aged 12 to 24 months. DESIGN/SETTING: Participants were 160 toddlers aged 12 to 24 months and their primary caregiver who completed an FFQ twice, approximately 5 weeks apart (FFQ1 and FFQ2). A 5-day weighed food record was collected on nonconsecutive days between FFQ administrations. STATISTICAL ANALYSIS: Principal component analysis identified three major dietary patterns similar across FFQ1, FFQ2, and the 5-day weighted food record. RESULTS: The sweet foods and fries pattern was characterized by high intakes of sweet foods, fries and roast potato and kumara (sweet potato), butter and margarines, processed meat, sweet drinks, and fruit or milk drinks. The vegetables and meat pattern was characterized by high intakes of vegetables, meat, eggs and beans, and fruit. The milk and fruit pattern was characterized by high intakes of milk and milk products and fruit, and low intakes of breastmilk and infant and follow-up formula. The FFQ (FFQ1) correctly classified 43.1% to 51.0% of toddlers into the same quartile of pattern score as the 5-day weighted food record, and Pearson correlations ranged from 0.56 to 0.68 for the three patterns. Reliability coefficients ranged from 0.71 to 0.72 for all three dietary patterns. CONCLUSIONS: the Eating Assessment in Toddlers study FFQ shows acceptable relative validity and high reproducibility for identifying dietary patterns in toddlers.

Associations between parental feeding practices, problem food behaviours and dietary intake in New Zealand overweight children aged 4-8 years.

OBJECTIVE: Parents report that children's eating behaviours are a major barrier to providing them with a healthy diet. Links between problem eating behaviours and parental feeding practices are not well established and have not previously been examined in overweight children. The aim of the present study was to assess associations between problem food behaviours, dietary intake and parental feeding practices of overweight children aged 4-8 years. DESIGN: Participants were recruited for a lifestyle intervention (n 203). At baseline, children's BMI was measured and parents completed comprehensive questionnaires about the feeding practices they used, the problem food behaviours their children exhibited and the foods their child consumed. A fussy eating scale was developed and associations were determined using correlations and regression analysis, including interactions. SETTING: Dunedin, New Zealand. SUBJECTS: Overweight children aged 4-8 years. RESULTS: Healthy eating guidance and monitoring by parents were related to the consumption of fewer unhealthy foods (B=-0·4, P=0·001 and B=-0·4, P<0·001). Conversely, a lack of parental control (child control) was related to a higher intake of unhealthy foods (B = 0·5, P<0·001). Parents of children who were fussy eaters monitored their child's food intake less (P<0·001) and allowed the child more freedom over what he/she ate (P<0·001). These children consumed fewer fruit and vegetables than those who were not fussy eaters (P<0·001). However, fussy eaters with food-restrictive parents ate more fruit and vegetables (B=2·9, P<0·001). CONCLUSIONS: These results suggest that a more structured food environment might be beneficial for the diet and food behaviours of young overweight children.

Is the food environment surrounding schools associated with the diet quality of adolescents in Otago, New Zealand?

Using a sample of adolescents from schools in Otago, New Zealand, associations between food outlets around schools and dietary quality were investigated. Food outlet environment data were derived using GIS data. Multivariate regression analysis results showed that outlet density, in an 800m buffer around schools, of cafes and restaurants, supermarkets and takeaways was associated with higher Diet Quality Index scores in boys, and distance to nearest outlet for convenience stores, cafes and restaurants and supermarkets with lower scores for girls. Effect sizes were small, suggesting that the food environment around schools plays a minor role in adolescent diet quality.

Dietary intake in midlife and associations with standard of living, education and nutrition literacy.

AIM: Cardiovascular disease is a leading cause of death in New Zealand, but risk factors may be decreased by consuming a heart healthy diet. This pilot study investigated whether participants met the guidelines for a heart healthy diet and whether a novel heart healthy dietary pattern could be identified using principal components analysis (PCA). The second aim of this project was to assess if higher education, standard of living and nutrition literacy are associated with a heart healthy dietary pattern. METHOD: This exploratory study was undertaken using data from the first participants enrolled in the Canterbury Health Ageing and Lifecourse study: an observational study of 50 year olds in the Canterbury District Health Board region. Eighty-two people were selected from the General and Maori electoral role and interviewed prior to the 22 February 2011 Christchurch Earthquake. PCA was conducted to identify dietary patterns, based on intake of specific nutrients as indicated by the New Zealand and international heart healthy dietary guidelines. RESULTS: 62 participants completed questionnaires and an estimated food record. No participants met all five of the heart healthy dietary guidelines. One dietary pattern was produced by PCA: a "higher CVD risk" pattern. Regression analysis indicated that higher standard of living, education and nutrition literacy were inversely associated with a "higher CVD risk" pattern. CONCLUSION: Higher standard of living, education and nutrition literacy were associated with a healthier dietary eating pattern. However, as no participants met all the dietary recommendations more education and support is needed to help people meet these.

Healthy dietary habits score as an indicator of diet quality in New Zealand adolescents.

Adoption of optimal dietary habits during adolescence is associated with better health outcomes later in life. However, the associations between a pattern of healthy dietary habits encapsulated in an index and sociodemographic and nutrient intake have not been examined among adolescents. This study aimed to develop a behavior-based diet index and examine its validity in relation to sociodemographic factors, nutrient intakes, and biomarkers in a representative sample of New Zealand (NZ) adolescents aged 15-18 y (n = 694). A 17-item Healthy Dietary Habits Score for Adolescents (HDHS-A) was developed based on dietary habits information from the 2008/2009 NZ Adult Nutrition Survey. Post hoc trend analyses were used to identify the associations between HDHS-A score and nutrient intakes estimated by single 24-h diet recalls and selected nutritional biomarkers. Being female, not of Maori or Pacific ethnicity, and living in the least-deprived socioeconomic quintile were associated with a higher HDHS-A score (all P < 0.001). HDHS-A tertile was associated positively with intake of protein, dietary fiber, polyunsaturated fatty acid, and lactose and negatively with sucrose. Associations in the expected directions were also found with most micronutrients (P < 0.05), urinary sodium (P < 0.001), whole blood (P < 0.05), serum (P < 0.01), and RBC folate (P < 0.05) concentrations. This suggests that the HDHS-A is a valid indicator of diet quality among NZ adolescents.

A comprehensive FFQ developed for use in New Zealand adults: reliability and validity for nutrient intakes.

OBJECTIVE: To evaluate the reliability and relative validity of a semi-quantitative FFQ for assessing the habitual intake of multiple nutrients in New Zealand (NZ) adults over the past 12 months. DESIGN: A 154-item FFQ was developed. After initial pre-testing, reliability was assessed using intra-class correlations. Relative validity was assessed by comparing nutrient intakes derived from the FFQ v. those from an 8 d diet record (8dWDR) collected over 12 months and selected blood biomarkers, using Spearman correlations. Supplementary cross-classification and Bland-Altman analyses were performed to assess validity of the FFQ v. the 8dWDR. SETTING: Dunedin, NZ. SUBJECTS: One hundred and thirty-two males and females aged 30-59 years who completed all FFQ and 8dWDR and provided a blood sample. RESULTS: Reliability coefficients ranged from 0·47 for Ca to 0·83 for alcohol, with most values falling between 0·60 and 0·80. The highest validity coefficients for energy-adjusted data were observed for alcohol (0·74), cholesterol (0·65) and ß-carotene (0·58), and the lowest for Zn (0·24) and Ca (0·28). For all energy-adjusted nutrients mean percentage correct classification was 77·9% and gross misclassification was 4·5%. Results of Bland-Altman analyses showed wide limits of agreement for all micronutrients but high agreement was observed for most macronutrients (99% for protein, 103% for total fat). When compared with biomarkers, energy-adjusted coefficients were 0·34 for ß-carotene and 0·33 for vitamin C. CONCLUSIONS: The FFQ provides highly repeatable measurements and good validity in ranking individuals' intake, suggesting that it will be a useful tool to assess nutrient intake of NZ adults in future research.