Association between meal context and meal quality: an ecological momentary assessment in Japanese adults.

PURPOSE: The purpose was to assess the relationship between the quality of meals and its context. METHODS: We conducted a cross-sectional study of 222 Japanese adults aged 30-76 years in 2021. The following information was obtained from the 4-d weighed dietary records: the recording day (working or not), meal type (breakfast, lunch, or dinner), eating companions (alone or with someone), eating location (at home or away from home), and screen-based activity (yes or no). The nutritional quality of each meal was evaluated using the Healthy Eating Index 2020 (HEI-2020). RESULTS: The analysis included 1,295 meals for males and 1,317 for females. The mean HEI-2020 ranged from 43.0 (lunch) to 51.9 (dinner) in males and from 45.7 (breakfast) to 52.0 (dinner) in females. Multilevel linear regression showed that, in males, lunch had a significantly lower HEI-2020 score compared to breakfast (ß = -1.81, 95% confidence interval [CI]: -3.42, - 0.20), while dinner had a significantly higher HEI-2020 score (ß = 6.77, 95% CI: 5.34, 8.20). Eating with someone was significantly associated with a higher HEI-2020 score (ß = 2.22, 95% CI: 0.76, 3.67). Among females, dinner had a higher HEI-2020 score than breakfast (ß = 5.21, 95% CI: 3.72, 6.70). Eating away from home was associated with higher HEI-2020 scores (ß = 2.14, 95% CI: 0.04, 4.24). CONCLUSION: Meal type, location, and eating companions were associated with meal quality in this population, with differences between males and females. Incorporating these factors in nutrition education and interventions can enhance diet quality.

Web-Based Content on Diet and Nutrition Written in Japanese: Infodemiology Study Based on Google Trends and Google Search.

BACKGROUND: The increased availability of content of uncertain integrity obtained through the internet is a major concern. To date, however, there has been no comprehensive scrutiny of the fitness-for-purpose of web-based content on diet and nutrition. OBJECTIVE: This cross-sectional study aims to describe diet- and nutrition-related web-based content written in Japanese, identified via a systematic extraction strategy using Google Trends and Google Search. METHODS: We first identified keywords relevant for extracting web-based content (eg, blogs) on diet and nutrition written in Japanese using Google Trends. This process included identification of 638 seed terms, identification of approximately 1500 pairs of related queries (top) and search terms, the top 10% of which were extracted to identify 160 relevant pairs of related queries (top) and search terms, and identification of 107 keywords for search. We then extracted relevant web-based content using Google Search. RESULTS: The content (N=1703) examined here was extracted following a search based on 107 keywords. The most common themes included food and beverages (390/1703, 22.9%), weight management (366/1703, 21.49%), health benefits (261/1703, 15.33%), and healthy eating (235/1703, 13.8%). The main disseminators were information technology companies and mass media (474/1703, 27.83%), food manufacturers (246/1703, 14.45%), other (236/1703, 13.86%), and medical institutions (214/1703, 12.57%). Less than half of the content (790/1703, 46.39%) clearly indicated the involvement of editors or writers. More than half of the content (983/1703, 57.72%) was accompanied by one or more types of advertisement. The proportion of content with any type of citation reference was 40.05% (682/1703). The themes and disseminators of content were significantly associated with the involvement of editors or writers, accompaniment with advertisement, and citation of reference. In particular, content focusing on weight management was more likely to clearly indicate the involvement of editors or writers (212/366, 57.9%) and to be accompanied by advertisement (273/366, 74.6%), but less likely to have references cited (128/366, 35%). Content from medical institutions was less likely to have citation references (62/214, 29%). CONCLUSIONS: This study highlights concerns regarding the authorship, conflicts of interest (advertising), and the scientific credibility of web-based diet- and nutrition-related information written in Japanese. Nutrition professionals and experts should take these findings seriously because exposure to nutritional information that lacks context or seems contradictory can lead to confusion and backlash among consumers. However, more research is needed to draw firm conclusions about the accuracy and quality of web-based diet- and nutrition-related content and whether similar results can be obtained in other major mass media or social media outlets and even other languages.

Food combination questionnaire for Japanese: relative validity regarding food and nutrient intake and overall diet quality against the 4-day weighed dietary record.

The aim of this cross-sectional study was to examine the relative validity of food and nutrient intakes and overall diet quality scores derived using a newly developed dietary assessment questionnaire (food combination questionnaire, FCQ). Dietary data were collected from 222 Japanese adults (111 for each sex) aged 30-76 years using the online FCQ and then the 4-non-consective-day weighed dietary record (DR). The median of Spearman correlation coefficients for sixteen food groups was 0⋅32 among women and 0⋅38 among men. The median of Pearson correlation coefficients for forty-six nutrients was 0⋅34 among women and 0⋅31 among men. The Pearson correlation coefficient between the total scores of Healthy Eating Index-2015 (HEI-2015) derived from the DR and FCQ was 0⋅37 among women and 0⋅39 among men. The corresponding value for the Nutrient-Rich Food Index 9.3 (NRF9.3) total scores was 0⋅39 among women and 0⋅46 among men. Bland-Altman plots for these diet quality scores showed poor agreement at the individual level, although mean difference was small for the HEI-2015 (but not NRF9.3). Similar results were obtained using the paper version of FCQ, which was answered after conducting the DR, except for somewhat high Pearson correlation coefficients for the total scores of HEI-2015 (0⋅50 among both women and men) and NRF9.3 (0⋅37 among women and 0⋅53 among men). In conclusion, this analysis may lend support to the possible use of the FCQ as a rapid dietary assessment tool in large-scale epidemiologic studies in Japan, but further refinement of this tool should be pursued.

Relative validity of the online Meal-based Diet History Questionnaire for evaluating the overall diet quality and quality of each meal type in Japanese adults.

The aim of this study was to examine the relative validity of the online Meal-based Diet History Questionnaire (MDHQ) for assessing the overall diet quality and quality of each meal type (breakfast, lunch, dinner and snacks). In total, 222 Japanese adults (111 for each sex) aged 30-76 years completed the online MDHQ and then the 4-non-consecutive-day weighed dietary record (DR). The diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3). For the HEI-2015, compared with the DR, the MDHQ provided high median values for breakfast (in women only) and dinner and low median values for snacks. There were no significant differences observed for overall diet and lunch. For the NRF9.3, the MDHQ provided higher median values for breakfast and dinner and a lower median value for overall diet than the DR in women, with no significant differences for lunch and snacks. In men, no significant difference was observed, except for overall diet (the MDHQ providing a lower median value). For the HEI-2015, median Spearman correlation coefficient was 0·43, with a range from 0·12 (snacks in women) to 0·68 (breakfast in men). For the NRF9.3, median Spearman correlation coefficient was 0·47, with a range from 0·26 (snacks in men) to 0·65 (breakfast in men). Bland-Altman plots showed wide limits of agreement and, in some cases, proportional bias. In conclusion, the online MDHQ showed an acceptable ability for ranking individuals according to the quality of overall diet, breakfast, lunch and dinner, but not snacks.

Relative Validity of the Meal-Based Diet History Questionnaire for Estimating Nutrient Intake among Japanese Women and Men aged 30-76 Years.

The purpose of this study was to examine the relative validity of the Meal-based Diet History Questionnaire (MDHQ) for estimating nutrient intake. Dietary data were obtained from 111 Japanese women and 111 Japanese men, using the online MDHQ and the 4-non-consecutive-day weighed dietary record (DR). The number of nutrients (total n = 46) showing no significant mean differences between estimates from the online MDHQ and DR (with energy adjustment by the density model) was 17 among women and 12 among men. The median value (25th and 75th percentiles) of the Pearson correlation coefficients between the online MDHQ and DR estimates was 0.54 (0.35-0.57) among women and 0.45 (0.25-0.53) among men. Bland-Altman plots for energy-providing nutrients indicated wide limits of agreement (and proportional bias for protein) with overall underestimation of protein and fat and overestimation of carbohydrate by the online MDHQ. Similar results were found when the paper version of the MDHQ (completed after the DR) was examined. For example, the median value of the Pearson correlation coefficients was 0.54 for women and 0.45 for men. This study suggests that the MDHQ has an acceptable ability to rank individuals according to intakes of a wide range of nutrients.

Relative Validity of Food Intake in Each Meal Type and Overall Food Intake Derived Using the Meal-Based Diet History Questionnaire against the 4-Day Weighed Dietary Record in Japanese Adults.

We examined the relative validity of food intake for each meal type (breakfast, lunch, dinner, and snacks) and overall food intake obtained through the Meal-based Diet History Questionnaire (MDHQ). In total, 222 Japanese adults (111 for each sex) aged 30-76 years completed the web version of the MDHQ and then the 4-non-consecutive-day weighed dietary record (DR). The number of major food groups (n = 24 in total) for which no statistically significant difference was observed between median intakes estimated using the DR and MDHQ ranged from 8 (snacks) to 12 (dinner) among women, and from 8 (breakfast) to 13 (lunch) among men. The median values of the Spearman's correlation coefficients between the MDHQ and DR estimates ranged from 0.28 (dinner) to 0.54 (breakfast) among women, and from 0.24 (dinner) and 0.60 (breakfast) among men. Bland-Altman analyses generally showed wide limits of agreement and proportional bias. Similar results were obtained using the paper version of the MDHQ, which was completed after conducting the DR. In conclusion, the MDHQ has a satisfactory ability to estimate median intake and rank individuals according to consumption for many food groups, despite a limited ability to estimate food group intakes on an individual level.