Compliance with the WCRF/AICR Recommendations in Qualitative Adaptation and the Occurrence of Breast Cancer: A Case-Control Study.

PURPOSE: The aim of the study was twofold: (1) the qualitative adaptation of the 2018 WCRF/AICR (QAd-WCRF/AICR) score, and (2) the assessment of the association between the level of compliance with the WCRF/AICR recommendations and the occurrence of breast cancer in peri- and postmenopausal women. METHODS: This case-control study involved 420 women, aged 40-79 years, from northeastern Poland, including 190 newly diagnosed breast cancer cases. Data related to the WCRF/AICR recommendations were collected in face-to-face interviews with 409 women, including 179 women with breast cancer. The frequency of food consumption data were collected using the FFQ-6® and KomPAN® questionnaires. Body weight, height, and waist circumference were measured. The QAd-WCRF/AICR score (range: 0-8 points) was calculated on the basis of eight components, including two components from to the WCRF/AICR recommendations: (1) body mass index (BMI), and (2) waist circumference, with six components expressed qualitatively: (3) overall physical activity, as well as the frequency of the consumption of (4) vegetables/fruits/whole grains/nuts/seeds/legumes, (5) highly processed foods, including fast foods/sweets/instant soups, (6) red/processed meat, (7) sweetened/energy drinks, and (8) alcohol. Logistic regression analysis was performed to assess the occurrence of breast cancer. RESULTS: The moderate (4-5 points) and maximal (6-8 points) compliance with the qualitative adaptation of the WRCF/AICR recommendations reduced the odds of breast cancer by 54% and 72%, respectively, compared to the results noted for minimal compliance (≤3 points). Lower odds of breast cancer were associated with moderate or high physical activity, consumption of a minimum of four serving per day of vegetables/fruits/whole grains/nuts/seeds/legumes, and limiting the consumption of highly processed food/fast foods and red/processed meat to a maximum of 1-3 times/month. Higher odds of breast cancer were associated with a higher waist circumference and alcohol abstinence. CONCLUSIONS: These findings may prove useful in establishing cancer prevention recommendations based on simple suggestions regarding the frequency of food consumption.

Position statement of the Polish Academy of Sciences Committee Human Nutrition Science on the principles for the nutrition of children aged 1-3 years.

The Position Statement on the principles of nutrition for children aged 1-3 years emphasizes that proper nutrition of children at this age determines their optimal psychometric development and has beneficial effects on the process nutritional programming, which reduces the risk of diet-related diseases in adulthood. Continued breastfeeding in the post-infancy period, together with the proper introduction of complementary foods, supplies all the nutritional needs of the child. A varied selection of food products is important to balance out the diet of a child in the context of energy and nutrient needs. Attention should be paid to products not recommended for frequent consumption, due to the possibility of the early development of improper eating habits that can lead to undesirable health consequences. Due to the potential risk of deficiency, adequate intake of iron, iodine, calcium and vitamin D, as well as of n-3 PUFAs (which is often insufficient) should be provided. Adequate dietary energy and protein intake protects children against protein-energy undernutrition and is crucial for their proper growth and development. An important element in the assessment of the development of children involves monitoring their nutritional status and physical development by systematically measuring their body weight and length/height and analyzing their weight gain. It is necessary to diagnose the causes of being underweight/overweight in children. Physical activity (such as outdoor walks, plays, and games) and healthy sleep hygiene are recommended. Physical activity, an adequate number of hours of sleep, and the quality of sleep in early childhood may improve immunity, reduce the risk of excessive weight gain, and consequently reduce the risk of obesity later in life. Other issues discussed include the functioning of the digestive system as one of the determinants of the nutrition of young children, basics of proper nutrition, risk of nutrient deficiencies and development of proper eating habits in early childhood.

Associations of Dietary-Lifestyle Patterns with Obesity and Metabolic Health: Two-Year Changes in MeDiSH® Study Cohort.

This study aimed to evaluate changes in diet, adiposity, and metabolic outcomes after two years. In all, 358 Polish men aged 19-40 years old participated in the study. Data regarding dietary and lifestyle characteristics as well as family, socio-economic, and demographic status were collected using the food frequency questionnaire KomPAN®. Dietary lifestyle patterns were previously derived from data for 358 men by principal component analysis (PCA). Changes over time were examined in 95 men who returned after two years by calculating relative differences (RD, %) in mean values and markers distribution. Diet quality was described with two predefined scores: pro-Healthy-Diet-Index (pHDI) and non-Healthy-Diet-Index (nHDI). After two years, changes were observed in diet quality and metabolic health markers. No significant changes were observed in family, socio-economic, and demographic status, as well as other lifestyle factors. In the "sandwiches and convenience foods" pattern, an nHDI decrease (RD = -25.3%) was associated with a fasting blood glucose decrease (RD = -6.1%). In the "protein food, fried-food and recreational physical activity" and the "healthy diet, activity at work, former smoking" patterns, pHDI decreases (RD = -13.6% and -14.6%, respectively,) were associated with an adiposity increase. In the "fast foods and stimulants" pattern, no changes in pHDI and nHDI were observed, while adiposity markers and systolic blood pressure worsened. Conclusion: in the two-year perspective, dietary improvement was associated with improved glycemic control, despite no changes in body weight, while worsening of the diet quality or maintenance of unhealthy dietary behaviours were associated with the deterioration of metabolic health.

Lung Cancer Risk in Men and Compliance with the 2018 WCRF/AICR Cancer Prevention Recommendations.

Lung cancer is the most common and deadly form of cancer worldwide, especially in men. The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) updated cancer prevention recommendations, and a standard scoring system (2018 WCRF/AICR Score) was published. The purpose of this study was to develop the adapted version of the 2018 WCRF/AICR Score with respect to lung cancer prevention recommendation (Ad-LC WCRF/AICR Score) and to examine the association between lung cancer risk in men and the Ad-LC WCRF/AICR Score as well as its single components. A case-control study was conducted among 439 men aged 45-80 years (187 controls, 252 primary lung cancer cases). Lifestyle and dietary data were collected with a questionnaire including the 62-item food frequency questionnaire (FFQ-6®). The Ad-LC WCRF/AICR Score was used as a categorized and continuous variable. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for lung cancer risk were calculated with the partly and fully adjusted model. One component of the score was independently associated with a lower risk of lung cancer in men, regardless of the set of confounders used. In the fully adjusted model following the recommendation "Limit smoking" was associated with a lower risk of lung cancer-in the never smokers by 87% (OR: 0.13; 95% CI: 0.04-0.37; p = 0.0002) and in the moderate smokers by 45% (OR: 0.55; 95% CI: 0.33-0.91; p = 0.0189) compared with the heavy smokers as a reference. By adding the single components making up the Ad-LC WCRF/AICR Score, the combination of three components or more, reducing the risk of lung cancer compared to lower compliance as a reference by 45% to 78% and by 39% to 66% for intermediate compliance (except two models out of seven) and higher compliance, respectively. In the fully adjusted model, the risk of lung cancer for the total Ad-LC WCRF/AICR Score was lower by 47% (OR: 0.53; 95% CI: 0.32-0.88; p = 0.0129) in higher compliance with the score compared to those with the lower compliance. Each one-point increase in the Ad-LC WCRF/AICR Score reduced lung cancer risk by 34% (OR: 0.66; 95% CI: 0.45-0.95; p = 0.0267). The results support previous evidence that limiting smoking reduces the risk of lung cancer in men. It also provides an insight into cancer research by showing that following the combined 2018 cancer prevention recommendations related to diet, lifestyle and body fatness was associated with a lower risk of lung cancer in men.

Dietary-Physical Activity Patterns in the Health Context of Older Polish Adults: The 'ABC of Healthy Eating' Project.

The study aimed to analyze the dietary-physical activity patterns (D-PAPs) in the health context of Polish people aged 60+ years. A total of 418 respondents across Poland were recruited; however, the final analysis included 361 women and men aged 60-89 years old. D-PAPs were derived using a principal component analysis (PCA); input variables were the frequency of consumption of 10 food groups and physical activity. Finally, three D-PAPs were identified: 'Pro-healthy eating and more-active', 'Sweets, fried foods and sweetened beverages', and 'Juices, fish and sweetened beverages'. We developed the Functional Limitations Score (FLS) using the Mini Nutritional Assessment (MNA®). A logistic regression was applied to verify the association between the D-PAPs and health-condition outcomes. Older adults were more likely to adhere to the upper tertile of the 'Pro-healthy eating and more-active' pattern, with good/better self-reported health status in comparison with their peers (OR = 1.86) or with good/very good self-assessed appetite (OR = 2.56), while this was less likely for older adults with malnutrition risk (OR = 0.37) or with a decrease in food intake (OR = 0.46). Subjects with a decrease in food intake (OR = 0.43), who declared a recent weight loss (OR = 0.49), or older adults in the upper tertile of the FLS (OR = 0.34) were less likely to adhere to the upper tertile of the 'Sweets, fried foods and sweetened beverages' pattern. The decrease in food intake due to a loss of appetite or chewing or swallowing difficulties was inversely associated with the 'Pro-healthy eating and more-active' pattern characterized by a relatively high frequency of consumption of vegetables, fruit, water, dairy, and grains and a high physical activity. In the interest of the good nutritional status and health of older adults, special attention should be paid to removing limitations in meal consumption, including improved appetite.

The 72-Item Semi-Quantitative Food Frequency Questionnaire (72-Item SQ-FFQ) for Polish Young Adults: Reproducibility and Relative Validity.

The food frequency questionnaires (FFQs) are the most common tools used in dietary research. Each newly developed, modified, or adapted FFQ should be validated in the target population. The aim of this study was to assess the reproducibility and relative validity of the 72-item semi-quantitative food frequency questionnaire (72-item SQ-FFQ) for Polish adults. The 72-item SQ-FFQ was developed based on a non-quantitative FFQ covering 62 food items (62-item FFQ-6®). The study was conducted among 186 university students aged 19-26 years (47.8% of females). The FFQ was administered on two occasions (FFQcrude and FFQretest) to assess the test-retest reproducibility, and the FFQcrude was compared with the estimated food record (FRcrude) to evaluate the relative validity of the FFQ in assessing the intake of energy, 38 nutrients, and alcohol. The energy intake obtained with both methods was standardized to 2000 kcal/day (FFQstand, FRstand). The dietary intake obtained with FFQcrude was adjusted using linear regression analysis (FFQreg). The reproducibility and relative validity of the FFQ were assessed by comparing the mean values of energy and nutrient intake and using Spearman's correlation coefficient, the cross-classification analysis, and the Bland-Altman method. Spearman's correlation coefficient between both administrations of the FFQ ranged from 0.631 to 0.878 (the intraclass correlation coefficient: 0.583-0.935), for FFQcrude and FRcrude ranged from -0.025 to 0.390, for FFQstand and FRstand ranged from 0.021 to 0.546, and for FFQreg and FRcrude ranged from 0.028 to 0.391. The percentage of respondents classified into the same or adjacent quartiles of nutrient intake obtained from two administrations of the FFQ ranged from 84.9% to 97.8%, for FFQcrude and FRcrude ranged from 61.3% to 76.9%, for FFQstand and FRstand ranged from 63.4% to 83.9%, and for FFQreg and FRcrude ranged from 60.2% to 76.9%. In conclusion, our findings showed good reproducibility and acceptable relative validity of the 72-item SQ-FFQ. This tool can be recommended for assessing dietary intake among Polish young adults. However, the intake of certain nutrients should be interpreted with caution.

Dietary Fat Intake: Associations with Dietary Patterns and Postmenopausal Breast Cancer-A Case-Control Study.

The aim of this study was to assess the associations of dietary fat intake with BC occurrence and dietary patterns. This case-control study involved 420 women aged 40−79 years from northeastern Poland, including 190 newly diagnosed BC cases. Dietary data were collected using a food frequency questionnaire (62-item FFQ-6®). The Quick Food Scan of the National Cancer Institute and the Percentage Energy from Fat Screener scoring procedures were used to estimate the percentage energy from dietary fat (Pfat). The odds of BC occurrence was three times higher in the Pfat > 32%. The Pfat > 32% was positively associated with the 'Non-Healthy' DP and inversely associated with the Polish-aMED® score, 'Prudent' DP, and 'Margarine and Sweetened Dairy' DP. This case-control study suggests that a higher dietary fat intake (>32%) may contribute to an increased occurrence of peri- and postmenopausal breast cancer in women. Given the obtained results, an unhealthy dietary pattern characterized by the consumption of highly processed, high in sugar foods and animal fat foods should be avoided to reduce fat intake. Instead, the frequent consumption of low-processed plant foods, fish, and moderate consumption of low-fat dairy should be recommended since this pro-healthy diet is inversely associated with dietary fat intake.

Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences on the use of dietary supplements containing vitamins and minerals by adults.

The use of dietary supplements (supplementation) is the individual enrichment of the diet with ingredients naturally occurring in food. As a rule, dietary supplements should be used periodically. In nutritional practice, there are many indications for dietary supplementation, but the decision to take dietary supplements should be made by consumers wisely and only in justified situations, when there is a risk that the usual diet does not provide vitamins and minerals in an amount adequate to meet dietary recommendations. However, we should remember about the real dangers of taking too large doses of vitamins and minerals. Many people using dietary supplements, especially several types at the same time, may experience undesirable side effects and deterioration of health, and in addition, people taking medicines may seriously disrupt or weaken the effect of the drug, or even lack the therapeutic effect of the drug. The document presents 10 steps and rules for the use of dietary supplements available on the market, which are addressed to the general population.

Dietary recommendations during the Covid-19 pandemic. Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences.

During the COVID-19 pandemic, care for an adequate diet, well adapted to the body's needs and the current level of physical activity, becomes of particular importance. Many dietary compounds participate in the functioning of the immune system, while vitamins D, C, A (including beta-carotene), E, B6, B12, folic acid, zinc, copper, selenium, iron, amino acids, n-3 and n-6 polyunsaturated fatty acids and intestinal microbiota are crucial in various types of defence processes. There has been no evidence that consumed food and its compounds, including those with pro-/prebiotic properties, play a significant role in preventing SARS-CoV-2 infection or alleviating its course. However, in terms of the nutritional value of food and the prevention of dysbiosis, recommending a varied diet with a high proportion of plant-based foods and an adequate amount of animal-based foods has a sound scientific basis. Malnutrition, underweight and obesity are considered independent and prognostic risk factors of severe SARS-CoV-2 infection, which reduce a patient's chances of survival. Therefore, ensuring good nutritional status, including healthy body weight, is a reasonable approach in the prevention of viral infection SARS-CoV-2 or alleviating its course. The document is accompanied by two catalogues of practical nutritional recommendations during the COVID-19 pandemic, addressed to the general population and children.

Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after Three Months and Nine Months: The Socioeconomic Context in Improving Nutrition Knowledge in Polish Teenagers.

The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11-12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group-three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80-7.31 and 2.99, 1.60-5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.

Socioeconomic, Eating- and Health-Related Limitations of Food Consumption among Polish Women 60+ Years: The 'ABC of Healthy Eating' Project.

The study aimed at identifying the socioeconomic, eating- and health-related limitations and their associations with food consumption among Polish women 60+ years old. Data on the frequency of consumption of fruit, vegetables, dairy, meat, poultry, fish, legumes, eggs, water and beverages industrially unsweetened were collected with the Mini Nutritional Assessment (MNA®) and were expressed in the number of servings consumed per day or week. Three indexes: the Socioeconomic Status Index (SESI), the Eating-related Limitations Score (E-LS) and the Health-related Limitations Score (H-LS) were developed and applied. SESI was created on the base of two variables: place of residence and the self-reported economic situation of household. E-LS included: difficulties with self-feeding, decrease in food intake due to digestive problems, chewing or swallowing difficulties, loss of appetite, decrease in the feeling the taste of food, and feeling satiety, whereas H-LS included: physical function, comorbidity, cognitive function, psychological stress and selected anthropometric measurements. A logistic regression analysis was performed to assess the socioeconomic, eating-, and health-related limitations of food consumption. Lower socioeconomic status (vs. higher) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.25) or consuming dairy ≥ 1 serving/day (OR = 0.32). The existence of multiple E-LS limitations (vs. few) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.72), consuming dairy ≥ 1 serving/day (OR = 0.55) or consuming water and beverages industrially unsweetened ≥6 cups/day (OR = 0.56). The existence of multiple H-LS limitations was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.79 per 1 H-LS point increase) or consuming dairy ≥ 1 serving/day (OR = 0.80 per 1 H-LS point increase). Limitations found in the studied women were related to insufficient consumption of selected groups of food, which can lead to malnutrition and dehydration. There is a need for food policy actions, including practical educational activities, to eliminate barriers in food consumption, and in turn to improve the nutritional and health status of older women.

Data-Driven Dietary Patterns and Diet Quality Scores: Reproducibility and Consistency in Sex and Age Subgroups of Poles Aged 15-65 Years.

This study aimed to assess: (i) the test-retest reproducibility of identification of data-driven dietary patterns (DPs) derived using a Principal Component Analysis (PCA) and hypothesis-driven DPs (diet quality scores); (ii) the consistency of data-driven DPs with diet quality scores in sex and age subgroups of Poles aged 15-65 years. The study involved 504 subjects (55.6% of females). Data on food consumption frequency (33 food items) were collected twice with a two-week interval using the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN®) in a self-administered version (test and retest). Two major data-driven DPs ('Prudent' and 'Western') were identified in the total sample, sex groups and four age groups separately from test and retest data. Two diet quality scores were analysed: Pro-Healthy-Diet-Index-10 (pHDI-10) and Non-Healthy-Diet-Index-14 (nHDI-14). Tucker's congruence coefficient indicated fair-to-good similarity of data-driven DPs between test and retest for all study subgroups, except for males. Across study subgroups, the intraclass correlation coefficient (ICC) between the test and retest ranged from 0.56 to 0.86 for 'Prudent' DP and 0.57 to 0.82 for 'Western' DP, with the lowest values in males. The ICC (test vs. retest) ranged from 0.84 to 0.88 for pHDI-10 and 0.75 to 0.88 for nHDI-14. Comparing the data-driven DPs and diet quality scores, the Spearman's correlations ranged from 0.63 to 0.93 between 'Prudent' DP and pHDI-10, and from 0.60 to 0.81 between 'Western' DP and nHDI-14. The test-retest reproducibility of data-driven DPs and diet quality scores and their consistency were acceptable in most of the study subgroups, with a tendency to be higher for pro-health than unhealthy DPs. Data-driven DPs were more reproducible in females than males. The reproducibility of diet quality scores tended to be better in males than females and was the highest in 25-44-year-olds. The KomPAN® questionnaire can be recommended to use data-driven DPs and diet quality scores to describe the habitual diet in people aged 15-65 years.

Adherence to Prudent and Mediterranean Dietary Patterns Is Inversely Associated with Lung Cancer in Moderate But Not Heavy Male Polish Smokers: A Case-Control Study.

Lung cancer is the most commonly diagnosed cancer in men worldwide. Studies regarding dietary patterns (DPs) and lung cancer are limited, with results remaining inconclusive, and the association of DPs with lung cancer in smokers is unclear. This study analyzed the associations between DPs, including the Polish-adapted Mediterranean diet (Polish-aMED) score, and lung cancer risk in Polish adult male smokers. This case-control study involved 439 men aged 45-80 years from northeastern Poland, including 187 newly diagnosed lung cancer cases. Dietary data was collected with a 62-item food frequency questionnaire (FFQ-6). Two approaches were applied to identify dietary patterns. The Polish-aMED score was calculated (hypothesis-driven approach) and a principal component analysis (PCA) was used to identify PCA-driven DPs (data-driven approach). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the lung cancer risk associated with the adherence to DPs overall as well as for moderate (2.5-11 pack-years) and heavy (>11 pack-years) smokers. Among moderate smokers, the risk of lung cancer was lower by 41% (OR: 0.59; 95% CI: 0.39-0.90; p < 0.05; adjusted model) in the higher adherence to the prudent DP when compared to the lower adherence, and by 66% (OR: 0.34; 95% CI: 0.15-0.76; p < 0.05; adjusted model) in the high adherence (7-9 points) to the Polish-aMED score when compared to the low adherence (0-3 points). No significant association between the westernized traditional DP or the sweet dairy DP and lung cancer was revealed. In conclusion, the current study suggests that pro-healthy dietary patterns, including the Mediterranean pattern, may favour lower risk of lung cancer in moderate smokers, although it was not confirmed in heavy smokers.

Hybrid Dietary-Blood Inflammatory Profiles and Postmenopausal Breast Cancer: A Case-Control Study.

The carcinogenesis process is associated with inflammation, which can be modified by diet. There is limited evidence regarding the inflammatory status and diet in association with breast cancer (BC). The aim of this study was to investigate the association of hybrid dietary-blood inflammatory profiles (HD-BIPs) with postmenopausal breast cancer occurrence. The case-control study was conducted among 420 women (230 controls, 190 primary BC cases) aged 40-79 years from north-eastern Poland. Blood levels of C-reactive protein (CRP), interleukin-6 (IL-6) and leukocyte count were marked in 129 postmenopausal women (82 controls, 47 cases). The 62-item food frequency questionnaire (FFQ-6) was used to the dietary data collection. Two HD-BIPs were found using the Principal Component Analysis (PCA). The "Pro-healthy/Neutral-inflammatory" profile was characterized by the frequent consumption of wholemeal cereals/coarse groats, legumes, vegetables, fruits, nuts/seeds and fish. The "Unhealthy/Pro-inflammatory" profile was characterized by the frequent consumption of red/processed meats, animal fats, sugar/honey/sweets, refined cereals/fine groats, and an increased concentration of CRP, IL-6 and granulocyte-to-lymphocyte ratio. The lower odds ratio (OR) of breast cancer was associated with the higher adherence to the "Pro-healthy/Neutral-inflammatory" profile (OR = 0.38; 95% Cl: 0.18-0.80; p < 0.01 for the higher level vs. lower level, crude model; OR for one-point score increment: 0.61; 95% Cl: 0.42-0.87; p < 0.01, adjusted model). The higher OR of breast cancer was associated with the higher adherence to the "Unhealthy/Pro-inflammatory" profile (OR = 3.07; 95%Cl: 1.27-7.44; p < 0.05 for the higher level v.s. lower level, adjusted model; OR for one-point score increment: 1.18; 95%Cl: 1.02-1.36; p < 0.05, adjusted model). This study revealed that the consumption of highly processed, high in sugar and animal fat foods should be avoided because this unhealthy diet was positively associated with postmenopausal breast cancer occurrence through its pro-inflammatory potential. Instead, the frequent consumption of low-processed plant foods and fish should be recommended since this pro-healthy diet was inversely associated with the cancer occurrence even though its anti-inflammatory potential has not been confirmed in this study sample.

Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study.

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11-13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity-inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11-13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.

Empirically derived dietary-lifestyle patterns and cardiometabolic health in young men: a review.

Sex and gender are important factors that impact cardiometabolic traits. Men have lower life expectancy and higher prevalence of fatal chronic conditions at younger age. Lifestyle risk profiles in young men have been rarely studied in the context of cardiometabolic health. This review aimed to summarise the evidence regarding the patterns of dietary-lifestyle behaviours in a population of young men (age <40years) and their associations with cardiometabolic health. Overall, unfavourable clusters of health behaviours are more prominent in men, when compared to women and more prevalent in younger adults, when compared to older age groups. Early signs of cardiometabolic health abnormalities have been reported among men with higher adherence to patterns which consistently shared poor dietary habits as a common denominator, combined with stimulant use, inadequate sleep or insufficient physical activity. In the majority of studies, dietary assessment was limited to the investigation of one or two behaviours, most frequently fruit and vegetable intake. Since young men may engage in a mixture of explicit behaviours, the examination of a singular dietary habit may not represent the overall diet quality. To conclude, the data regarding the synergistic effects of a broad spectrum of dietary and lifestyle behaviours in the context of cardiometabolic health remain scarce in this population. The inclusion of a broader range of dietary and lifestyle variables into the multicomponent pattern analysis might have a greater potential in explaining the association with cardiometabolic health. Defining behavioural clusters can help to develop interventions, tailored to the specific needs of the targeted group.

Regional and socioeconomic variations in dietary patterns in a representative sample of young polish females: a cross-sectional study (GEBaHealth project).

BACKGROUND: Associations between dietary patterns (DPs) and socioeconomic correlates among adolescents from emerging economy countries are not fully understood. The study analysed variations in DPs adherence depending on country regions and family socioeconomic status (SES) among Polish females. METHODS: Data from a representative sample (n = 1107) of Polish females 13-21-year-old was used. Four DPs were previously identified by principal component analysis. Regions were ranked by Gross Domestic Product. A SES index as an overall measure of family SES was developed. Multiple logistic regression models adjusted for age and body mass index were created. RESULTS: Higher adherence to 'Fast-food and sweets' DP was found in the less affluent (North) region when compared to four other regions (Odds ratio (OR): 1.94 to 1.63). Higher adherence to 'Fruit and vegetables' DP was found in more affluent regions when compared to poorer regions: East and North-East (OR 1.71 to 1.81 and 1.69 to 2.23, respectively). Higher adherence to 'Traditional Polish' DP was found in 4 out of 5 regions (OR 2.02 to 2.53) when compared to the East. Higher family SES was associated with higher adherence to 'Fruit and vegetables' DP (OR 2.06) and lower adherence to 'Traditional Polish' DP (OR 0.27). CONCLUSIONS: The study revealed that region's affluence is strongly reflected in dietary behaviours of young females from a transitioning country. Recognising geographical distribution of dietary patterns within the country and shifting the resources to economically disadvantaged regions might be more effective than current national public health interventions.

Dietary-Lifestyle Patterns Associated with Adiposity and Metabolic Abnormalities in Adult Men under 40 Years Old: A Cross-Sectional Study (MeDiSH Project).

The aim of this study was to examine the associations of dietary-lifestyle patterns (DLPs) with adiposity and metabolic abnormalities in adult Polish men that were under 40. The cross-sectional study included 358 men that were 19-40-year-old. Dietary and lifestyle data were collected with multicomponent food frequency questionnaire (KomPAN®). DPLs were derived with Principal Component Analysis (PCA) using 25 dietary and six lifestyle as the input variables. Adiposity was determined with the use of: overweight (body mass index 25-29.9 kg/m2), central obesity (waist-to-height ratio ≥ 0.5), general obesity (body fat ≥ 25%), excessive visceral fat tissue (≥ median), and increased skeletal muscle mass (≥ median). The metabolic abnormalities were characterised by elevated: fasting blood glucose (FBG ≥ 100 mg/dL), triglycerides (TG ≥ 150 mg/dL), total cholesterol (TC ≥ 200 mg/dL), or systolic or diastolic blood pressure (≥ 130 or ≥ 85 mmHg, respectively). Four PCA-driven DLPs were derived and labelled accordingly to the most characteristic dietary or lifestyle behaviours that were correlated with each pattern. Multivariate logistic regression revealed that higher adherence (upper vs. bottom tertile as referent) to "Protein food, fried-food, and recreational physical activity" pattern was associated with higher odds of overweight and increased skeletal muscle mass, and lower odds of: general obesity, excessive visceral fat tissue, and elevated TC. Higher adherence to "Healthy diet, active, past smokers" pattern was associated with higher odds of overweight and lower odds of: general obesity, excessive visceral fat tissue, and elevated FBG. Higher adherence to "Sandwiches and convenient diet" pattern was associated with higher odds of: central obesity, general obesity, excessive visceral fat tissue, elevated TC, elevated TG, occurrence at least two metabolic abnormalities, and lower odds of increased skeletal muscle mass. A higher adherence to "Fast foods and stimulants" pattern was associated with higher odds of central obesity, general obesity, excessive visceral fat tissue, and lower odds of increased skeletal muscle mass. The interrelations between diet and lifestyle behaviours were reflected in three out of four patterns. Healthy diet attempts combined with active lifestyle was associated with reduced risk of adiposity and metabolic abnormalities despite some unhealthy components, like former smoking or fried-food consumption. In contrary, patterns that were composed of undesirable dietary behaviours solely, as well as poor diet combined with stimulant use, were associated with higher adiposity and worse metabolic health, despite the relatively young age of the study participants. Accurate mapping of dietary-lifestyle behaviours can serve as a tool for formulating evidence-based recommendations.

Metabolically healthy obese and metabolic syndrome of the lean: the importance of diet quality. Analysis of MAGNETIC cohort.

BACKGROUND: Obesity is considered as an indispensable component of metabolic health assessment and metabolic syndrome diagnosis. The associations between diet quality and metabolic health in lean, young adults have not been yet established whilst data addressing this issue in overweight and obese subjects is scarce. Our analysis aimed to establish the link between diet quality (measured with data-driven dietary patterns and diet quality scores) and metabolic syndrome (MS) in young adults, regardless of their adiposity status. METHODS: A total of 797 participants aged 18-35 years old were included in the study. Participants were assigned into metabolic syndrome (MS) group if at least two abnormalities within the following parameters were present: blood pressure, triglycerides, total cholesterol, HDL cholesterol, blood glucose. Participants with one or none abnormalities were considered as metabolically healthy subjects (MH), Diet quality was assessed with two approaches: 1) a posteriori by drawing dietary patterns (DPs) with principal component analysis (PCA) and 2) a priori by establishing diet quality scores and the adherence to pro-Healthy-Diet-Index (pHDI) and non-Healthy-Diet-Index (nHDI). Logistic regression with backward selection based on Akaike information criterion was carried out, to identify factors independently associated with metabolic health. RESULTS: Within the MS group, 31% were of normal weight. Three PCA-driven DPs were identified, in total explaining 30.0% of the variance: "Western" (11.8%), "Prudent" (11.2%) and "Dairy, breakfast cereals & treats" (7.0%). In the multivariate models which included PCA-driven DPs, higher adherence to middle and upper tertiles of "Western" DP (Odds Ratios [OR] and 95% Confidence Intervals [95% CI]: 1.72, 1.07-2.79 and 1.74, 1.07-2.84, respectively), was associated with MS independently of clinical characteristics including BMI and waist-hip ratio (WHR). Similar results were obtained in the multivariate model with diet quality scores - MS was independently associated with higher scores within nHDI (2.2, 0.92-5.28). CONCLUSIONS: Individuals with MS were more likely to adhere to the western dietary pattern and have a poor diet quality in comparison to metabolically healthy peers, independently of BMI and WHR. It may imply that diet composition, as independent factor, plays a pivotal role in increasing metabolic risk. Professional dietary advice should be offered to all metabolically unhealthy patients, regardless of their body mass status.