Pro-Vegetarian Food Patterns and Cancer Risk among Italians from the Moli-Sani Study Cohort.

Besides the Mediterranean diet, there is a paucity of studies examining plant-based diets in relation to cancer outcomes in Mediterranean populations. We analyzed 22,081 apparently cancer-free participants (mean age 55 ± 12 year) from the Moli-sani study (enrollment period 2005-2010; Italy). A general pro-vegetarian food pattern was computed by assigning positive or negative scores to plant- or animal-derived foods, respectively from a 188-item FFQ. A priori healthful or unhealthful pro-vegetarian food patterns distinguished between healthy plant foods (e.g., fruits, vegetables) and less-healthy plant foods (e.g., fruit juices, refined grains). Cancer incidence was defined as the earliest diagnosis of cancer from hospital discharge records over a median follow-up of 12.9 years. In multivariable-adjusted analyses, a general pro-vegetarian food pattern was associated with a lower rate of cancer incidence (HR = 0.85; 95%CI 0.75-0.97 for Q5 vs. Q1); no association was observed between the healthful or unhealthful pro-vegetarian food patterns and overall cancer incidence. A healthful pro-vegetarian pattern, however, was inversely associated with digestive cancer (HR = 0.76; 95%CI 0.58-0.99 for Q5 vs. Q1), while the unhealthful pro-vegetarian pattern was directly linked to respiratory cancer (HR = 1.68; 95%CI 1.06-2.68 for Q5 vs. Q1). Our findings in a Mediterranean population support the hypothesis that some, but not all pro-vegetarian diets, might prevent some cancers.

Impact on Diet Quality and Burden of Care in Sapropterin Dihydrochloride Use in Children with Phenylketonuria: A 6 Month Follow-Up Report.

INTRODUCTION: In phenylketonuria (PKU) changes in dietary patterns and behaviors in sapropterin-responsive populations have not been widely reported. We aimed to assess changes in food quality, mental health and burden of care in a paediatric PKU sapropterin-responsive cohort. METHODS: In an observational, longitudinal study, patient questionnaires on food frequency, neophobia, anxiety and depression, impact on family and burden of care were applied at baseline, 3 and 6-months post successful sapropterin-responsiveness testing (defined as a 30% reduction in blood phenylalanine levels). RESULTS: 17 children (10.8 ± 4.2 years) completed 6-months follow-up. Patients body mass index (BMI) z-scores remained unchanged after sapropterin initiation. Blood phenylalanine was stable. Natural protein increased (p < 0.001) and protein substitute intake decreased (p = 0.002). There were increases in regular cow's milk (p = 0.001), meat/fish, eggs (p = 0.005), bread (p = 0.01) and pasta (p = 0.011) intakes but special low-protein foods intake decreased. Anxiety (p = 0.016) and depression (p = 0.022) decreased in caregivers. The impact-on-family, familial-social impact (p = 0.002) and personal strain (p = 0.001) lessened. After sapropterin, caregivers spent less time on PKU tasks, the majority ate meals outside the home more regularly and fewer caregivers had to deny food choices to their children. CONCLUSION: There were significant positive changes in food patterns, behaviors and burden of care in children with PKU and their families after 6-months on sapropterin treatment.

Social Network, Food Patterns, Physical Activity and Associations with Overweight and Obesity in Adolescents from a School in Rural Brazil.

The objective of this study was to evaluate the social network, food patterns, physical activity, and their associations with overweight/obesity in adolescents from a school in rural Brazil. Students from a rural school in Northeast Brazil (n = 90) completed questionnaires on sociodemographic characteristics, food consumption, physical activity, and a name generator. Social networks were constructed using students' social proximity ties. Principal component analysis was performed to determine food patterns, and logistic models were used to investigate variables associated with overweight/obesity. Most participants were girls (62.9%), and the proportion of overweight/obesity was 30% among adolescents. Students cited 2070 people from their networks (family, friends at school, friends outside of school, and others). Among them, the family had the highest degree of influence (61%) in the network and had the most shared meals with adolescents (47%). Adolescents' perception of their family members' body size as obese, compared to normal or underweight, was prevalent (51%). Adolescents with unhealthy food patterns were 72% more likely to be categorized as overweight/obese, and eigenvector centrality was also associated with overweight/obesity (OR = 5.88, 95% CI = 1.08-32.03). Adolescents presented a social network with strong family influence, in which a high percentage of overweight/obesity was observed. Adolescents with high eigenvector centrality were more likely to be in the overweight/obesity category. Additionally, overweight/obesity was associated with unhealthy food patterns in the family network.

The Association of Food Groups and Consumption Time with Hyperuricemia: The U.S. National Health and Nutrition Examination Survey, 2005-2018.

Hyperuricemia (HUA) is associated with a wide range of diseases and increases the public health burden on society as a whole. In addition to genetic variation, diet plays a crucial role in the prevention and treatment of HUA as an important modifiable behavior. The purpose of this study is to investigate whether food groups and consumption time are associated with HUA. A total of 41,230 participants from the National Health and Nutrition Examination Survey between 2005 and 2018 were included in the study. All meals, including breakfast, lunch, and dinner, were obtained according to their corresponding Food Patterns Equivalents Database dietary data. The binary logistic regression model was used to analyze the relationship between food groups, food consumption time and HUA. We found that the intake of fruit (mixed in various forms) (OR = 0.942, 95% CI: 0.909-0.976) or freshly squeezed juices (OR = 0.915, 95% CI: 0.859-0.975), milk (OR = 0.839, 95% CI: 0.808-0.872), and eggs (OR = 0.881, 95% CI: 0.839-0.924), poultry (OR = 1.055, 95% CI: 1.033-1.077) and seafood high in n-3 fatty acids (OR = 1.068, 95% CI: 0.1.018-1.120) at dinner, eating refined grains at breakfast (OR = 0.954, 95% CI: 0.924-0.985) and dinner (OR = 0.962, 95% CI: 0.944-0.980), eating whole grains (OR = 0.908, 95% CI: 0.845-0.976) at lunch, consuming alcoholic beverages or foods at breakfast (OR = 0.748, 95% CI: 0.564-0.990)/lunch (OR = 1.118, 95% CI: 1.008-1.240)/dinner (OR = 1.127, 95% CI: 1.073-1.185) were associated with HUA. Eating particular meals at particular times of the day was related to a lower risk of HUA.

Associação entre capital social e padrões alimentares em mulheres do Sul do Brasil / Association between social capital and food patterns in women from Southern Brazil

Resumo O presente estudo objetivou verificar a associação entre aspectos psicossociais (capital social) e padrões alimentares em mulheres adultas. Realizou-se um estudo transversal, de base populacional, com uma amostra representativa de 1.128 mulheres, de 20 a 69 anos de idade, residentes na área urbana do município de São Leopoldo, Rio Grande do Sul, em 2015. Os padrões alimentares foram identificados com base na frequência de consumo alimentar e classificados em: saudável (frutas, vegetais e alimentos integrais), de risco (alimentos ultraprocessados) e brasileiro (arroz e feijão), enquanto o capital social foi avaliado por meio de uma escala de eficácia coletiva. Observou-se que 18,9% da amostra foi classificada com alta eficácia coletiva. Após ajuste para potenciais fatores de confusão, observou-se uma probabilidade 44% maior para adesão ao padrão saudável (RP [razão de prevalência] = 1,44; IC95% [intervalo de confiança de 95%]: 1,01-2,03; p = 0,040) e 71% maior para o padrão brasileiro (RP = 1,71; IC95%: 1,18-2,47; p = 0,004) entre as mulheres com um maior nível de eficácia coletiva, quando comparadas às com baixo nível de eficácia coletiva. Assim, este estudo verificou uma relação significativa entre aspectos psicossociais e consumo alimentar em mulheres.

Abstract The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.

Dietary patterns and the risk of Alzheimer's disease in an elderly Iranian population: a case-control study.

BACKGROUND: An increasing number of studies in Western countries have shown that healthy eating patterns have a protective effect against cognitive decline and dementia, however, information about this relationship among non-western populations with different cultural environments is scarce. The present study investigated the association between dietary patterns (DPs) and cognitive function in the Iranian elderly. METHODS: In this case-control study, the data of 290 elderly people in two groups of case and control (Mean age in case: 74.2 ± 8.6, in control: 67.3 ± 7.3 year) were analyzed. Two DPs of healthy and unhealthy were extracted from a 142-item dish-based food frequency questionnaire, and patterns driven by principal components analysis (PCA) of 25 food groups. Multivariate binary logistic regression calculated the odds ratio (OR) of cognitive impairment with adjustment for potential confounding factors. RESULTS: A healthy DP, characterized by high consumption of fruits and vegetables, legumes, and nuts, was related to a decrease in the odds of Alzheimer's disease in Iranian elderly people. Also, moderate adherence to an unhealthy food pattern was associated with an increase in the probability of the disease; however, the association was not statistically significant. CONCLUSION: In this elderly population, a healthy eating pattern was associated with reducing the risk of Alzheimer's disease. Further prospective studies are recommended.

Impact of nutritional diet therapy on premenstrual syndrome.

Premenstrual syndrome (PMS) is one of the most common disorders faced by women of reproductive age. More than 200 symptoms of varying severity associated with PMS have been identified. Because of the broad spectrum of action of PMS and its impact on quality of life, symptom relief is the main challenge of treating PMS and premenstrual dysphoric disorder (PMDD). The review aims to analyze and identify the potential impact of dietary and nutritional therapies on PMS and, respectively, for its better management. The study was conducted by accessing Internet databases such as PubMed, ScienceDirect, and Scopus and using relevant keywords such as PMS, symptoms, dietary patterns (DPs), macro and micronutrients, and supplements. The results showed that diet is an essential modulating factor in reducing and managing PMS symptoms. But research on the actual effect of foods and nutrients on PMS is sparse, sporadic, and studied with insufficient scientific rigor. No correlations were identified between the consumption of macronutrients and PMS: protein, fat, carbohydrates, and fiber, but the effectiveness of micronutrients, especially calcium, magnesium, vitamin D, B vitamins, and herbal supplements, was demonstrated. Researchers remain unanimous that the evidence is insufficient and limited to support their use as an effective treatment. Nevertheless, the results could contribute to providing quality information to help women and girls make evidence-based decisions regarding premenstrual health and the adoption of dietary and nutritional therapies.

[Application of digital transformations of dietary microdata and factor analysis to study the nutritional patterns of breakfast and its significance in providing the nutritional value of the diet of adults].

Eating disorders with skipping meals are considered as a risk factor for chronic non-communicable diseases. Frequent skipping of meals is associated with the risk of developing metabolic syndrome, type 2 diabetes, and obesity. Breakfast is considered to be the most important meal of the day. However, studies on the impact of skipping breakfast on the risk of overweight and obesity are highly controversial. The aim of this study was to analyze the prevalence of skipping the morning breakfast meal and its impact on the actual daily intake of nutrients and energy in the Russian adult population. Material and methods. The data from a sample survey of dietary intake conducted in 2013 by the Russian Federal State Statistics Service have been used. The analysis included adult respondents (19 years and older) in the amount of 163 000 people in 2 stages of the survey (in April and September). The dietary intake of all members of the surveyed households was studied using the 24-hour recall method. Since the survey questionnaires did not contain information about type of meals, therefore, with the help of binning in thзe SPSS program, time intervals of the maximum food energy intake by the respondents were established, which were taken as evidence of the main meals and snacks. Results. Of the main meals, the largest proportion of respondents skipped dinner (23.1%), then breakfast (13.0%), and the smallest proportion skipped lunch (5.7%).The proportion of men and women who skipped breakfast was 12.6 and 13.3%, respectively, a greater frequency of skipping breakfast was observed at a young age (19-30 years, 19.3%) and at an old age (75 years and older, 16.1%). With an increase in the average monthly income of a family, the percentage of those who skip breakfast increases. Adult members of families with many children (3 or more children), whose average per capita income is lower than those in families with 2 children, skip breakfast less frequently. The smallest share of people skipping breakfast was found in the North Caucasian and Southern districts, and the maximum in the Siberian and Far Eastern districts. Adults who skipped breakfast had a higher percentage of malnourished (BMI <18.5 kg/m2) and normal nutritional status (BMI 18.5-24.9 kg/m2). At the same time, the proportion of people who consumed breakfast was significantly higher in overweight people (25.0-29.9 kg/m2), and no differences were found among obese people. It is shown that skipping breakfast is accompanied by a decrease in the energy value of the daily diet by an average of 200 kcal. Despite the increase in the caloric content of the 2nd breakfast, afternoon snack and evening snack in absolute terms (р<0.01), there was no compensation for the loss of energy value in the absence of breakfast. A decrease in the absolute values of nutrient intake associated with a decrease in energy consumption was established. However, skipping breakfast showed a decrease in added sugar intake as a per cent of total calorie intake (12.1±8.6 vs 13.2±9.1%, р<0.01), while the contribution of other macronutrients to energy intake did not change significantly. In connection with the heterogeneity of the actual dietary intake of the population, factor analysis was used to describe the main food models of the breakfast using the principal component method. 6 factors were identified that determine the eating patterns of breakfasts and correlate with 2-4 individual food items of actual dietary intake. Conclusion. The results obtained are consistent in a number of positions with the literature data, in particular, indicating a decrease in daily energy consumption when skipping breakfast.

Adherence to Pro-Vegetarian Food Patterns and Risk of Oesophagus, Stomach, and Pancreas Cancers: A Multi Case-Control Study (The PANESOES Study).

We aimed to evaluate the association between three previously defined pro-vegetarian (PVG) food patterns and the cancers of the oesophagus, stomach, and pancreas in a multi case-control study. We analyzed data from a multi-case hospital-based study carried out in two Mediterranean provinces in Spain. A total of 1233 participants were included in the analyses: 778 incident cancer cases, histologically confirmed (199 oesophagus, 414 stomach, and 165 pancreas) and 455 controls. A dietary assessment was performed using a validated food frequency questionnaire (FFQ). Three PVG food patterns (general, healthful, and unhealthful) were estimated using 12 food groups for the general PVG (gPVG), scoring positive plant-based foods and negative animal-based foods, and 18 food groups, for the healthful (hPVG) and unhealthful (uPVG) food patterns. Multinomial logistic regression was used to estimate relative risk ratios (RRR) and confidence intervals (95% CI) for quintiles of adherence to PVG patterns and as a continuous variable. The RRR (95% CI) for the highest vs. the lowest quintile of gPVG were, RRR = 0.37 (0.32, 0.42) for the oesophagus, RRR = 0.34 (0.27, 0.43) for the stomach, and RRR = 0.43 (0.35, 0.52) for pancreas cancer. For the hPVG, the RRR were RRR = 0.72 (0.58, 0.90) for the oesophagus, RRR = 0.42 (0.34, 0.52) for the stomach, and RRR = 0.74 (0.59, 0.92) for pancreas cancer. The uPVG was associated with a higher risk of stomach cancer RRR = 1.76 (1.42, 2.18). Higher adherence to gPVG and hPVG food patterns is associated with a lower risk of oesophageal, stomach, and pancreas cancers, while a higher adherence to a uPVG food pattern is associated with a higher risk of stomach cancer.

A Comparison of the Mediterranean Diet and Current Food Patterns in Italy: A Life Cycle Thinking Approach for a Sustainable Consumption.

The transition toward more sustainable food systems, which already represents a central element of the European Farm to Fork and Green Deal strategies, could be an effective measure to contribute to global decarbonization and greenhouse gas (GHGs) reduction goals; concurrently, it could improve the health status and nutrition of the global population. In this context, the Mediterranean diet (MD) could play a considerable role, as it is generally recognized as a more balanced, healthy, and sustainable eating pattern than Western consumption patterns, which are characterized by excess food and high energy content, thus causing undesirable effects on both human health and the environment. Although traditionally linked to MD, Italy sees relatively moderate adherence by its citizens, as they consume about +75% of the daily caloric intake recommended by MD. Therefore, this study aims to quantitatively assess the potential environmental, economic, and health impacts of this lower adherence to MD by Italians. Current Italian Food Patterns (CIFP) in 2019 were analyzed and compared to the MD recommended amounts through a Life Cycle Thinking (LCT) approach (LCA) and carbon footprint (CF) analysis. The results show that CIFP, compared to MD, has +133% greater impacts on the environmental macro-area, +100% greater impacts on the human health macro-area, and +59% greater impacts on the economic macro-area (with annual fossil and mineral resource savings of $53.35 per person, $3.2 billion per year). The analysis also shows that CIFP has a CF of 6.54 × 101 kg CO2 eq, +142% over MD (2.7 × 101 kg CO2 eq), resulting in a lower environmental impact of the Mediterranean diet.

Mediterranean-Like Dietary Pattern Associations With Gut Microbiome Composition and Subclinical Gastrointestinal Inflammation.

BACKGROUND & AIMS: Case-control studies have shown that patients with Crohn's disease (CD) have a microbial composition different from healthy individuals. Although the causes of CD are unknown, epidemiologic studies suggest that diet is an important contributor to CD risk, potentially via modulation of bacterial composition and gut inflammation. We hypothesized that long-term dietary clusters (DCs) are associated with gut microbiome compositions and gut inflammation. Our objectives were to identify dietary patterns and assess whether they are associated with alterations in specific gut microbial compositions and subclinical levels of gut inflammation in a cohort of healthy first-degree relatives (FDRs) of patients with CD. METHODS: As part of the Genetic, Environmental, Microbial (GEM) Project, we recruited a cohort of 2289 healthy FDRs of patients with CD. Individuals provided stool samples and answered a validated food frequency questionnaire reflecting their habitual diet during the year before sample collection. Unsupervised analysis identified 3 dietary and 3 microbial composition clusters. RESULTS: DC3, resembling the Mediterranean diet, was strongly associated with a defined microbial composition, with an increased abundance of fiber-degrading bacteria, such as Ruminococcus, as well as taxa such as Faecalibacterium. The DC3 diet was also significantly associated with lower levels of subclinical gut inflammation, defined by fecal calprotectin, compared with other dietary patterns. No significant associations were found between individual food items and fecal calprotectin, suggesting that long-term dietary patterns rather than individual food items contribute to subclinical gut inflammation. Additionally, mediation analysis demonstrated that DC3 had a direct effect on subclinical inflammation that was partially mediated by the microbiota. CONCLUSIONS: Overall, these results indicated that Mediterranean-like dietary patterns are associated with microbiome and lower intestinal inflammation. This study will help guide future dietary strategies that affect microbial composition and host gut inflammation to prevent diseases.

Pro-vegetarian food patterns and cardiometabolic risk in the PREDIMED-Plus study: a cross-sectional baseline analysis.

PURPOSE: We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study. METHODS: We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders. RESULTS: A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were - 0.16 (95% CI: - 0.33 to 0.01) for gPVG (p trend: 0.015), and - 0.23 (95% CI: - 0.41 to - 0.05) for hPVG (p trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (p trend: 0.019). CONCLUSION: Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk.

Addressing nutrient shortfalls in 1- to 5-year-old Irish children using diet modeling: development of a protocol for use in country-specific population health.

BACKGROUND: Dietary habits formed in early childhood can track into later life with important impacts on health. Food-based dietary guidelines (FBDGs) may have a role in improving population health but are lacking for young children. OBJECTIVES: We aimed to establish a protocol for addressing nutrient shortfalls in 1- to 5-y-old children (12-60 mo) using diet modeling in a population-based sample. METHODS: Secondary analysis of 2010-2011 Irish National Pre-School Nutrition Survey data (n = 500) was conducted to identify typical food consumption patterns in 1- to 5-y-olds. Nutrient intakes were assessed against dietary reference values [European Food Safety Authority (EFSA) and Institute of Medicine (IOM)]. To address nutrient shortfalls using diet modeling, 4-d food patterns were developed to assess different milk-feeding scenarios (human milk, whole or low-fat cow milk, and fortified milks) within energy requirement ranges aligned with the WHO growth standards. FBDGs to address nutrient shortfalls were established based on 120 food patterns. RESULTS: Current mean dietary intakes for the majority of 1- to 5-y-olds failed to meet reference values (EFSA) for vitamin D (≤100%), vitamin E (≤88%), DHA (22:6n-3) + EPA (20:5n-3) (IOM; ≤82%), and fiber (≤63%), whereas free sugars intakes exceeded recommendations of <10% energy (E) for 48% of 1- to 3-y-olds and 75% of 4- to 5-y-olds. "Human milk + Cow milk" was the only milk-feeding scenario modeled that predicted sufficient DHA + EPA among 1- to 3-y-olds. Vitamin D shortfalls were not correctable in any milk-feeding scenario, even with supplementation (5 µg/d), apart from the "Follow-up Formula + Fortified drink" scenario in 1- to 3-y-olds (albeit free sugars intakes were estimated at 12%E compared with ≤5%E as provided by other scenarios). Iron and vitamin E shortfalls were most prevalent in scenarios for 1- to 3-y-olds at ≤25th growth percentile. CONCLUSIONS: Using WHO growth standards and international reference values, this study provides a protocol for addressing nutrient shortfalls among 1- to 5-y-olds, which could be applied in country-specific population health.

Associação entre padrões alimentares com fatores socioeconômicos e ambiente alimentar em uma cidade do Sul do Brasil / Association between dietary patterns and socioeconomic factors and food environment in a city in the South of Brazil

Resumo Objetivou-se estudar a associação entre padrão alimentar, fatores demográficos, socioeconômicos e o ambiente alimentar em uma população de adultos e idosos de uma cidade do Sul do Brasil. Estudo transversal com pessoas de ambos os sexos e idade entre 20 e 70 anos. Os padrões alimentares foram identificados por meio da análise de componentes principais. A regressão de Poisson foi utilizada para estimar as razões de prevalência brutas e ajustadas e os intervalos de 95% de confiança (IC 95%). Quatro padrões alimentares foram identificados: saudável, tradicional, carboidratos e açúcares refinados e fast food. Encontraram-se associações positivas entre: sexo feminino e maior renda com o padrão alimentar saudável; cor da pele preta ou parda e domicílios com seis ou mais moradores com padrões alimentares tradicional e carboidratos e açúcares refinados; maior escolaridade com o padrão fast food. Realizar as principais refeições em casa associou-se ao padrão tradicional, e almoço ou jantar fora do domicílio com os padrões carboidratos e açúcares refinados e fast food. Posição socioeconômica mais baixa leva ao maior consumo do padrão alimentar tradicional e/ou rico em carboidratos e açúcares, e uma posição socioeconômica mais elevada parece permitir uma escolha entre padrão saudável ou fast food.

Abstract The aim of this study was to investigate the association between dietary patterns and demographic and socioeconomic factors and the food environment among adults and older persons in a city in the south of Brazil. We conducted a cross-sectional study with people of both sexes aged between 20 and 70 years. Dietary patterns were identified using principal component analysis. Poisson regression was used to estimate crude and adjusted prevalence ratios and 95% confidence intervals. Four dietary patterns were identified: Healthy; Traditional; Refined Carbs and Sugars; and Fast Food. Positive associations were found between being female and higher income and the Healthy dietary pattern; being black or brown and living in a household with at least six members and the Traditional and Refined Carbs and Sugars patterns; and higher education and the fast-food dietary pattern. Having main meals at home was associated with the Traditional pattern and having lunch or dinner away from home was the associated with Refined Carbs and Sugars and fast-food patterns. Lower socioeconomic status leads to higher consumption of the Traditional and/or Refined Carbs and Sugars dietary patterns, while higher socioeconomic status appears to enable individuals to choose between healthy or fast-food patterns.

The Consumption of Food-Based Iodine in the Immediate Pre-Pregnancy Period in Madrid Is Insufficient. San Carlos and Pregnancy Cohort Study.

A pre-gestational thyroid reserve of iodine is crucial to guarantee the increased demand for thyroid hormone production of early pregnancy. An iodine intake ≥150 µg/day is currently recommended. The objective of this study was to assess average pre-gestational food-based iodine consumption in pregnant women at their first prenatal visit (<12 gestational weeks), and its association with adverse materno-fetal events (history of miscarriages, early fetal losses, Gestational Diabetes, prematurity, caesarean sections, and new-borns large/small for gestational age). Between 2015-2017, 2523 normoglycemic women out of 3026 eligible had data in the modified Diabetes Nutrition and Complication Trial (DNCT) questionnaire permitting assessment of pre-gestational food-based iodine consumption, and were included in this study. Daily food-based iodine intake was 123 ± 48 µg, with 1922 (76.1%) not reaching 150 µg/day. Attaining this amount was associated with consuming 8 weekly servings of vegetables (3.84; 3.16-4.65), 1 of shellfish (8.72; 6.96-10.93) and/or 2 daily dairy products (6.43; 5.27-7.86). Women who reached a pre-gestational intake ≥150 µg had lower rates of hypothyroxinemia (104 (17.3%)/384 (21.4%); p = 0.026), a lower miscarriage rate, and a decrease in the composite of materno-fetal adverse events (0.81; 0.67-0.98). Reaching the recommended iodine pre-pregnancy intake with foods could benefit the progression of pregnancy.

Some Ultra-Processed Foods Are Needed for Nutrient Adequate Diets: Linear Programming Analyses of the Seattle Obesity Study.

Typical diets include an assortment of unprocessed, processed, and ultra-processed foods, along with culinary ingredients. Linear programming (LP) can be used to generate nutritionally adequate food patterns that meet pre-defined nutrient guidelines. The present LP models were set to satisfy 22 nutrient standards, while minimizing deviation from the mean observed diet of the Seattle Obesity Study (SOS III) sample. Component foods from the Fred Hutch food frequency questionnaire comprised the market basket. LP models generated optimized 2000 kcal food patterns by selecting from all foods, unprocessed foods only, ultra-processed foods only, or some other combination. Optimized patterns created using all foods contained less fat, sugar, and salt, and more vegetables compared to the SOS III mean. Ultra-processed foods were the main sources of added sugar, saturated fat and sodium. Ultra-processed foods also contributed most vitamin E, thiamin, niacin, folate, and calcium, and were the main sources of plant protein. LP models failed to create optimal diets using unprocessed foods only and ultra-processed foods only: no mathematical solution was obtained. Relaxing the vitamin D criterion led to optimized diets based on unprocessed or ultra-processed foods only. However, food patterns created using unprocessed foods were significantly more expensive compared to those created using foods in the ultra-processed category. This work demonstrates that foods from all NOVA categories can contribute to a nutritionally adequate diet.

Organic food use, meat intake, and prevalence of gestational diabetes: KOALA birth cohort study.

PURPOSE: To evaluate whether consumption of organic food and reduced intake of meat products in pregnancy are associated with lower prevalence of gestational diabetes (GD). METHODS: Women participating in the KOALA Birth Cohort Study with valid informed consent, a singleton pregnancy and information on their food intake were considered in this cross-sectional analysis. Participants with and without GD were compared with each other in terms of dietary characteristics (n = 37 and n = 2766, respectively). Multivariable logistic regression (LR) was used to adjust for relevant covariates. RESULTS: Organic food consumption tended to be lower, although not significantly, in women with GD compared to women without GD, whereas consumption of meat was positively associated with GD prevalence. LR modelling showed that GD was significantly associated with higher consumption of meat and, in addition, also of cheese, after adjustment for other relevant covariates. GD was associated with some indicators of animal product intake, namely dietary animal to plant protein ratio and maternal plasma arachidonic acid (for the latter, data available for n = 16 and n = 1304, respectively). Food patterns of participants with GD were characterised by more meat products and less vegetarian products. CONCLUSIONS: Due to the low number of participants with GD, results have to be interpreted cautiously. Consumption of organic food during pregnancy does not seem to be markedly associated with a lower GD prevalence; lower intake of meat and cheese, irrespective of its origin (organic or conventional), does. The latter supports previous studies suggesting a causal association between consumption of animal products and GD.

Breastfeeding and infant feeding guidelines: dietary patterns and potential effects on the health and nutrition of children under two years / Amamentação e orientações sobre alimentação infantil: padrões alimentares e potenciais efeitos na saúde e nutrição de menores de dois anos

Abstract Objectives: to identify dietary patterns of children under two years of age in primary care, associating them with maternal variables. Methods: cross-sectional study carried out in basic health units. Sample selected for convenience with 321 children under two years old and their mothers. Food consumption was obtained through a 24-hour food record. The method of factor analysis by main components was used to determine dietary patterns. Associations between maternal variables and dietary patterns were tested. Results: "mixed", "porridge" and "snacks" patterns were identified. Receiving guidance on infant feeding was related to greater adherence to the "mixed" (p = 0.02; PR = 2.98; 95% CI95% = 1.49-5.96) and "porridge" (p = 0.026; PR = 2.10; CI95% = 1.09-4.02) patterns. Experience with breastfeeding showed greater adherence to the "porridge" standards (p=0.038; PR = 1.78; CI95%= 1.03-3.08) and "snacks" (p = 0.026; PR = 1.09; CI95% = 1.01-1.18) and children of overweight mothers showed less adherence to the "snacks" pattern (p = 0.042; PR = 0.51; CI95%= 0.26-0.98). Conclusions: patterns found were associated with guidance on infant feeding and breastfeeding, previous experience with breastfeeding, as well as with maternal excess weight, emphasizing the importance of professional guidance for greater adherence to more varied and healthy consumption patterns and that include the different food groups.

Resumo Objetivos: identificar padrões alimentares de crianças menores de dois anos na atenção primária associando-os com variáveis maternas. Métodos: estudo transversal desenvolvido em unidades básicas de saúde. Amostra selecionada por conveniência com 321 menores de dois anos e suas mães. O consumo alimentar foi obtido através de recordatório alimentar de 24 horas. O método de análise fatorial por componentes principais foi utilizado para determinação dos padrões alimentares. Associações entre variáveis maternas e padrões alimentares foram testadas. Resultados: padrões "misto", "mingaus" e "lanches" foram identificados. Receber orientações sobre alimentação infantil relacionou-se a maior aderência aos padrões "misto" (p= 0,02; RP= 2,98; IC95%= 1,49-5,96) e "mingaus" (p= 0,026; RP= 2,10; IC95%= 1,09-4,02). Experiência com aleitamento materno mostrou maior adesão aos padrões "mingaus" (p= 0,038; RP= 1,78; IC95%= 1,03-3,08) e "lanches" (p= 0,026; RP= 1,09; IC95%= 1,01-1,18) e filhos de mães com excesso de peso apresentaram menor aderência ao padrão "lanches" (p= 0,042; RP= 0,51; IC95%= 0,26-0,98). Conclusões: os padrões encontrados associaram-se com orientação sobre alimentação infantil e amamentação, experiência prévia com amamentação, bem como com excesso de peso materno, ressaltando a importância da orientação profissional para maior adesão a padrões de consumo mais variados e saudáveis e que contemplem os diversos grupos de alimentos.

Prospective associations of protein intake parameters with muscle strength and physical performance in community-dwelling older men and women from the Quebec NuAge cohort.

BACKGROUND: Dietary protein has been related to muscle function in aging. Beyond total intake, parameters such as protein distribution across meals might also be important. OBJECTIVES: We aimed to examine prospective associations of different protein intake parameters with muscle strength and physical performance in community-dwelling older men and women. METHODS: In total, 524 men and 574 women aged 67-84 y at baseline (T1) were followed annually for 3 y (T2, T3, T4). Outcomes included handgrip strength (kPa), knee extensor strength (kg), and physical performance (Timed Up and Go, s) at T4, and their 3-y changes (T4 minus T1). Protein intake parameters were assessed using nine 24-h recalls collected over 3 y (T1, T2, T3) and included daily total intake (g/d), number of protein-providing meals and snacks, and protein distribution across meals (expressed as CV). Associations were examined by multivariable linear regression models including all protein intake parameters simultaneously. Also, the optimal protein dose (g) per meal for the maximum effect size of total daily intake was determined. RESULTS: Higher daily protein intake was associated with better knee extensor strength and physical performance at T4 in both sexes and less physical performance decline in women. Optimal protein doses per meal were 30-35 g in men and 35-50 g in women for these outcomes. In men, more uneven protein distribution was associated with better physical performance at T4 and less handgrip strength decline. In women, a higher number of protein-providing snacks was associated with better handgrip strength and knee extensor strength at T4 and less handgrip strength decline. In neither sex was number of protein-providing meals associated with outcomes. CONCLUSIONS: Higher daily protein intake, up to 30-50 g protein/meal, may contribute to better knee extensor strength and physical performance in generally well-functioning older men and women. More aspects of protein intake may contribute to muscle strength and physical performance than solely the daily quantity, notably the protein dose per meal.