Energy-dense dietary patterns high in free sugars and saturated fat and associations with obesity in young adults.

PURPOSE: To derive dietary patterns based on dietary energy density (DED), free sugars, SFA, and fiber and investigate association with odds of overweight/obesity in young adults. METHODS: Cross-sectional data from 625 young Australian adults (18-30 years) were used. Dietary patterns were derived using reduced rank regression based on dietary data from a smartphone food diary using DED, free sugars, SFA, and fiber density as response variables. Multivariable logistic regression was used to investigate associations between dietary patterns and odds of self-reported overweight/obesity (BMI ≥ 25 kg/m2). RESULTS: Two dietary patterns were identified (DP1 and DP2). DP-1 was positively correlated with DED, free sugars, and SFA, and inversely correlated with fiber density. It was characterized by higher sugar-sweetened beverages intake and lower vegetable intake, and associated with higher odds of overweight/obesity (OR: 1.22; 95% CI 1.05, 1.42). DP-2 was positively correlated with fiber density and free sugars, and inversely correlated with DED and SFA. It was characterized by higher sugar-sweetened beverages intake and lower non-lean red meat intake, and was not significantly associated with overweight/obesity. CONCLUSION: An energy-dense dietary pattern high in free sugars and SFA and low in fiber was associated with higher odds of obesity in young adults. These findings support dietary interventions that target reductions in energy-dense foods and sugar-sweetened beverages.

A Case-CrossovEr study deSign to inform tailored interventions to prevent disease progression in Acute Pancreatitis (ACCESS-AP) - study design and population.

BACKGROUND/OBJECTIVES: Alcohol is the most common etiology of recurrent acute pancreatitis and chronic pancreatitis. The extent and timing of drinking that increases the transient risk of acute pancreatitis is yet unknown. METHODS: We designed a case-crossover study to determine the effective hazard period of drinking in relation to episodes of pancreatitis. We aim to evaluate the dose-response relationship between excess drinking and pancreatitis comparing the extent of drinking during case and control periods from the same individual. We aim to recruit 160 patients hospitalized with acute pancreatitis, whose AUDIT-C score reaches 3 or higher. Interviews of each enrolled patient to define their 15-day history of alcohol consumption employing the timeline follow-back method. Long-term drinking and smoking will be investigated as modifiers of the impact of short-term excess drinking. Patients are followed-up for evaluation of usual alcohol consumption during asymptomatic periods following the index hospitalization. Blood and urine specimens are collected while the patients are hospitalized and during a standard-of-care follow-up visit. RESULTS: We have recruited 31 patients to date, with a median age of 33 years. Females and non-White participants make up 26% and 35% of the enrolled population, respectively. Forty-eight % of patients have had a prior history of acute pancreatitis. CONCLUSIONS: Our study will shed light on the impact of short-term changes in drinking on triggering acute pancreatitis. It will provide data on other covarying factors of drinking and behaviors changes after acute pancreatitis.

Individual, social-environmental and physical-environmental correlates of diet quality in young adults aged 18-30 years.

Many young adults eat a poor-quality diet. However, understanding of the social-ecological correlates of diet quality in young adults is limited. The aim of the present study was to examine the correlates of diet quality in a cohort of young Australian adults. Data from the cross-sectional Measuring EAting in everyday Life Study were used. Young adults (n = 625; 18-30 years; 73% female) were included if they provided dietary data over three or four non-consecutive days using 'FoodNow', a real-time food diary smartphone application. Diet quality was estimated using the 2013 Dietary Guidelines Index (DGI). Thirty correlates from three levels of the social-ecological framework were collected using an online questionnaire: individual (e.g., self-efficacy), social-environmental (e.g., social support) and physical-environmental (e.g., living situation). Linear regression analyses were used to examine associations between correlates and DGI. Six individual-level correlates were associated with DGI: perceived time scarcity (b = -0.664, CI: 1.160, -0.168), food insecurity (b = -0.962, CI: 1.746, -0.178), self-efficacy (b = 0.230, CI: 0.137, 0.323), being born in Australia (b = -3.165, CI: 5.521, -0.808), being employed in non-trade roles (b = -4.578, CI: 8.903, -0.252) and preparing a meals with vegetables daily (b = 4.576, CI: 1.652, 7.500). No social-environmental or physical-environmental correlates were associated with DGI. Overall, this study showed that young adults had a higher diet quality if they had higher self-efficacy, perceived themselves to be less time scarce and less food insecure, were born in Australia, were employed in non-trade roles and prepared a meal with vegetables daily. Healthy eating policies and interventions in young adults may benefit from targeting individual-level correlates.

Divergent trends in lifetime drinking and smoking between Black and White Americans diagnosed with chronic pancreatitis.

BACKGROUND/OBJECTIVES: Black Americans are at increased risk of chronic pancreatitis (CP) compared to their White counterparts. We aimed to describe the race-specific smoking history and lifetime drinking in patients diagnosed with CP. METHODS: We analyzed data on 334 Black and White CP participants of the North American Pancreatitis Study 2 Continuation and Validation Study and Ancillary Study. Lifetime drinking history and lifetime smoking history were collected through in-person interviews. Intensity, frequency, duration and current status of drinking and smoking were compared between Black and White CP participants, stratified by physician-defined alcohol etiology. In addition, drinking levels at each successive decades in life (20s, 30s, 40s) were compared by race and graphically portrayed as heat diagrams. RESULTS: Among patients with alcoholic CP, current smoking levels were not different by race (67-70%), but a smaller proportion of Black patients reported having smoked 1 or more packs per day in the past (32%) as compared to White patients (58%, p < 0.0001). Black patients were more likely to report current consumption of alcohol (31%), as opposed to White patients (17%, p = 0.016). Black patients also reported more intense drinking at age 35 and 45 years as compared to White patients, while age at CP onset were similar between the two groups. CONCLUSION: We found more intense drinking but less intense smoking history in Black CP patients as compared to White CP patients. Effective alcohol abstinence and smoking cessation program with sustained impact are needed in CP patients.

Eating occasion situational factors and sugar-sweetened beverage consumption in young adults.

BACKGROUND: Young adulthood represents an influential transitional period marked by poor dietary habits and excess weight gain. Sugar-sweetened beverages (SSB) are a major source of excess caloric intake among young adults, yet little is known about the correlates of SSB consumption. This study examines the individual and situational correlates of SSB consumption, using real-time assessment of Australian young adults' eating occasions. METHODS: Dietary, sociodemographic and health behaviour data were collected during the Measuring EAting in Everyday Life (MEALS) study (n = 675 adults, 18-30 y). Participants reported all foods and beverages consumed over 3-4 non-consecutive days using a real-time Smartphone food diary application ("FoodNow"). For every eating occasion, food and beverage intake was recorded along with situational characteristics (eating location, purchase location, presence of others and activities while eating). A beverage occasion was defined as any eating occasion where a beverage was consumed and a SSB occasion was defined as any eating occasion where a SSB was consumed. Multilevel logistic regression was used to examine individual and situational characteristics with SSB intake at beverage occasions (i.e. factors associated with choosing a SSB over other non-alcoholic beverages) and to examine factors associated with consuming a SSB at any occasion where food and/or beverages were consumed. RESULTS: Thirty-five percent of participants consumed SSBs during the recording period (n = 237). Of the 2185 beverage eating occasions reported by SSB consumers, 481 (20%) contained a SSB. SSB were rarely consumed on their own (i.e. other foods were present). Having a lower than tertiary education (odds ratio [95% confidence interval]: 1.53 [1.16, 2.01]; p < 0.01); eating in a café/restaurant, compared to at home (3.02 [1.58, 5.78]; p < 0.001), and purchasing beverages from a convenience outlet, compared to a supermarket/grocery store (4.58 [2.85, 7.38]; p < 0.001) were associated with SSB intake at beverage eating occasions. Similar associations were also found when all food and/or beverage eating occasions were examined. CONCLUSION: In this study, SSB were often consumed with other foods and intake was associated with individual and situational factors. Further studies are needed to confirm these findings and explore how SSB are consumed in relation to their accompanying foods.

Examining the correlates of meal skipping in Australian young adults.

BACKGROUND: Meal skipping is associated with diet-related chronic disease risk and is highly prevalent in young adults. Despite this, the correlates of meal skipping in this population group are unknown. Therefore, the aim of this study was to examine the prevalence and correlates of meal skipping in young adults. METHODS: Young adults aged 18-30 years (n = 578) (24% male, 76% female) used 'FoodNow', a purpose designed real-time smartphone application to record food and beverage consumption over four non-consecutive days. The day following each reporting day, participants were asked about their previous day's eating occasions; if any eating occasions were not reported or if any were skipped. These data were used to categorise participants into specific meal skippers (breakfast, lunch and/or dinner skipper). Participants also completed an online questionnaire, which contained measures of correlates from the social-ecological framework across the individual, social-environmental and physical-environment domains. Logistic regression analyses were used to examine associations between specific meal skipping behaviours and measured correlates. RESULTS: Individual domain correlates (education status, smoking status and time scarcity) were associated with varying meal skipping behaviours, while no correlates from the social-environmental or physical-environmental domains of the social-ecological framework were associated with any meal skipping behaviours. Participants with a university education were less likely to be a meal skipper (any meal) (OR = 0.46; 95%CI: 0.22, 0.95; p = 0.035), while those who previously or currently smoked cigarettes were more likely to be breakfast skippers (OR = 1.10; 95%CI: 1.15, 3.86; p = 0.016) compared to those who had never smoked before. Those who are time scarce were more likely to be either breakfast (OR = 1.12; 95%CI: 1.00, 1.26; p = 0.036) or lunch skippers (OR = 1.11; 95% CI: 1.01, 1.23; p = 0.033). No variables were significantly associated with dinner skipping. CONCLUSIONS: The findings suggest that the correlates of meal skipping vary according to the specific meal skipped. University education status needs to be considered when designing interventions aimed at the reduction of meal skipping among young adults, while correlates such as time management and smoking status may offer potential behaviour change targets within these interventions.

Novel Online or Mobile Methods to Assess Eating Patterns.

PURPOSE OF REVIEW: Recent developments in technology-based dietary assessment allow real-time data collection of eating occasions, yet their application to assessing eating pattern constructs has not been evaluated. The purpose of this review was to examine existing electronic and mobile food diary methods in relation to their ability to assess eating patterns constructs (e.g. patterning, format and context of eating occasions). RECENT FINDINGS: A systematic search of electronic databases identified 18 dietary assessment methods. Multiple methods with diverse technological capabilities have been developed, yet few studies report on their ability to assess all eating pattern constructs, particularly eating occasion context. Validity of the methods to assess overall dietary intake was found to be similar to traditional dietary assessment methods. SUMMARY: A diverse range of methods are available for examining the patterning and format/content, but not context, of eating occasions. Further consideration of eating pattern constructs is required when developing dietary assessment methods.

Evaluation of a smartphone food diary application using objectively measured energy expenditure.

BACKGROUND: Dietary assessment methods are limited in their ability to adequately measure food and beverage consumption. Smartphone applications may provide a novel method of dietary assessment to capture real-time food intake and the contextual factors surrounding eating occasions. The aim of this study is to evaluate the capability of a Smartphone meal diary app ("FoodNow") to measure food intake using a validated objective method for assessing energy expenditure among young adults. METHODS: Participants (18-30 years) used FoodNow over four non-consecutive days recording all eating occasions through a combination of written text, and/or optional images and voice recordings. A series of contextual questions were also completed. Participants wore the validated SenseWear Armband (BodyMedia Inc, USA) during the same period to measure free-living energy expenditure. Intra-class correlation coefficients (ICC) estimated the reliability of FoodNow to measure estimated energy intake compared to measured energy expenditure. RESULTS: Ninety participants (71 female, 19 male; mean age = 24.9 ± 4.1 years) were recruited to use the FoodNow app to record their eating occasions. Thirteen were excluded as they did not meet minimum requirements for number of reporting days (n = 3) or SenseWear Armband wear time (5 days of 11 h), while 21 participants were excluded after being identified as mis-reporters (Huang method). Among the remaining sample (n = 56), reliability between estimated energy intake and measured energy expenditure was high (ICC, 95% CI: 0.75, 0.61-0.84). CONCLUSIONS: FoodNow is a suitable method for capturing estimated energy intake data from young adults. Despite wide levels of agreement at the individual level (-3709 kJ to 2056 kJ), at the group level, FoodNow appears to have potential as a dietary assessment tool. This new dietary assessment method will offer an alternative and novel method of dietary assessment which is capable of collecting both estimated energy intake and contextual factors surrounding eating occasions. Information collected may be used to inform future public health messages or research interventions.

Correlates of meal skipping in young adults: a systematic review.

BACKGROUND: Meal skipping rates may be highest during young adulthood, a period of transition and development. Although these dietary behaviours may increase future risk of chronic disease, limited research has investigated correlates of meal skipping in young adults. METHODS: A systematic literature search was conducted to identify studies that investigated correlates of meal skipping behaviours in young adults (aged 18-30 years). EBSCO host, MEDLINE Complete, Global Health, Scopus, EMBASE, Web of Science and Informit platforms were searched for eligible articles. Correlates were defined as any factor that was either associated with meal skipping or was self-reported by the participant to have an influence on meal skipping. Randomised controlled trials, prospective cohort studies, case-control studies, nested case-control studies, cross-sectional studies, and longitudinal studies were eligible for inclusion. RESULTS: Three-hundred and thirty-one articles were identified, 141 full-text articles assessed for eligibility, resulting in 35 included studies. Multiple methodological and reporting weaknesses were apparent in the reviewed studies with 28 of the 35 studies scoring a negative rating in the risk of bias assessment. Meal skipping (any meal), defined as the skipping of any meal throughout the day, was reported in 12 studies with prevalence ranging between 5 and 83%. The remaining 25 studies identified specific meals and their skipping rates, with breakfast the most frequently skipped meal 14-88% compared to lunch 8-57% and dinner 4-57%. Lack of time was consistently reported as an important correlate of meal skipping, compared with correlates such as cost and weight control, while sex was the most commonly reported associated correlate. Breakfast skipping was more common among men while lunch or dinner skipping being more common among women. CONCLUSIONS: This review is the first to examine potential correlates of meal skipping in young adults. Future research would benefit from stronger design and reporting strategies, using a standardised approach for measuring and defining meal skipping.

Postprandial Responses to Lipid and Carbohydrate Ingestion in Repeated Subcutaneous Adipose Tissue Biopsies in Healthy Adults.

Adipose tissue is a primary site of meta-inflammation. Diet composition influences adipose tissue metabolism and a single meal can drive an inflammatory response in postprandial period. This study aimed to examine the effect lipid and carbohydrate ingestion compared with a non-caloric placebo on adipose tissue response. Thirty-three healthy adults (age 24.5 ± 3.3 year (mean ± standard deviation (SD)); body mass index (BMI) 24.1 ± 3.2 kg/m2, were randomised into one of three parallel beverage groups; placebo (water), carbohydrate (maltodextrin) or lipid (dairy-cream). Subcutaneous, abdominal adipose tissue biopsies and serum samples were collected prior to (0 h), as well as 2 h and 4 h after consumption of the beverage. Adipose tissue gene expression levels of monocyte chemoattractant protein-1 (MCP-1), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) increased in all three groups, without an increase in circulating TNF-α. Serum leptin (0.6-fold, p = 0.03) and adipose tissue leptin gene expression levels (0.6-fold, p = 0.001) decreased in the hours following the placebo beverage, but not the nutrient beverages. Despite increased inflammatory cytokine gene expression in adipose tissue with all beverages, suggesting a confounding effect of the repeated biopsy method, differences in metabolic responses of adipose tissue and circulating adipokines to ingestion of lipid and carbohydrate beverages were observed.