Unhealthy foods may attenuate the beneficial relation of a Mediterranean diet to cognitive decline.

INTRODUCTION: It is unclear whether eating Western diet food components offsets the Mediterranean diet's (MedDiet) potential benefits on cognitive decline. METHODS: The study includes 5001 Chicago Health and Aging Project participants (63% African American, 36% males, 74 ± 6.0 years old), with food frequency questionnaires and ≥ two cognitive assessments over 6.3 ± 2.8 years of follow-up. Mixed-effects models were adjusted for age, sex, education, race, cognitive activities, physical activity, and total calories. RESULTS: Stratified analysis showed a significant effect of higher MedDiet on cognitive decline only with a low Western diet score (highest vs lowest MedDiet tertile: ß = 0.020, P = .002; p trend = 0.002) and not with a high Western diet score (highest vs lowest MedDiet tertile: ß = 0.010, P = .11; p trend = 0.09). CONCLUSION: This prospective study found that high consumption of Western diet components attenuates benefits of the MedDiet on cognition.

Westernization of Lifestyle and Atherosclerosis in the Japanese: Lessons from the Hawaii - Los Angeles - Hiroshima Study.

Japanese Americans include Japanese individuals migrating from Japan to the United States (first-generation Japanese Americans [JA-1]) and their offspring (second- or later-generation Japanese Americans [JA-2]). Although Japanese Americans share their genetic predisposition with the Japanese, their lifestyles have been westernized rapidly and extensively. We conducted a medical survey for atherosclerosis among Japanese Americans living in Hawaii and Los Angeles and native Japanese living in Hiroshima for 50 years since 1970 (the Hawaii-Los Angeles-Hiroshima Study) and obtained the following results:(1) In the 1990s, a westernized lifestyle induced hyperlipidemia among Japanese Americans, and based on the evaluation of the carotid artery intima-media wall thickness (IMT), atherosclerosis was apparently more advanced in Japanese Americans than in native Japanese. In addition, the advancement of atherosclerosis corresponded to the degree of westernization of lifestyles in JA-1 and JA-2.(2) In the 2010s, the serum total cholesterol and low-density lipoprotein cholesterol levels in native Japanese were significantly higher than those in Japanese Americans, and the difference in the progression of carotid artery IMT was smaller between native Japanese and Japanese Americans.(3) Maintaining a healthy Japanese lifestyle since childhood may suppress future worsening of risk factors for atherosclerosis (such as obesity and diabetes mellitus) and contribute to atherosclerosis prevention in the Japanese.

Effect of multi-component school-based program on body mass index, cardiovascular and diabetes risks in a multi-ethnic study.

BACKGROUND: Mexico occupies one of the first places worldwide in childhood obesity. Its Mestizo and Indigenous communities present different levels of westernization which have triggered different epidemiological diseases. We assessed the effects of a multi-component school-based intervention program on obesity, cardiovascular and diabetes risk factors. METHODS: A physical activity, health education and parent involvement (PAHEPI) program was developed and applied in six urban (Mestizo ethnic group) and indigenous (Seri and Yaqui ethnic groups) primary schools for 12 weeks. A total of 320 children aged 4-12 years participated in intervention program; 203 under Treatment 1 (PAHEPI program) and 117, only from Mestizo groups, under Treatment 2 (PAHEPI+ school meals). For Body Mass Index (BMI), cardiovascular and diabetes factors, pairwise comparisons of values at baseline and after treatments were done using Wilcoxon signed rank test. Generalized linear models were applied to assess the intervention effect by age, sex and nutritional status in relation to ethnicity and treatment. RESULTS: We observed improvements on BMI in children with overweight-obesity and in triglycerides in the three ethnic groups. The Mestizo ethnic group showed the largest improvements under Treatment 2. While Seris showed improvements only in cardiovascular risk factors, Yaquis also showed improvements in diabetes risk factors, though not in BMI. CONCLUSIONS: This study showed that the same intervention may have positive but different effects in different ethnic groups depending on their lifestyle and their emerging epidemiological disease. Including this type of intervention as part of the school curriculum would allow to adapt to ethnic group in order to contribute more efficiently to child welfare. TRIAL REGISTRATION: This study was retrospectively registered under the identifier NCT03768245 .

Foods Contributing to Macronutrient Intake of Women Living in Puerto Rico Reflect Both Traditional Puerto Rican and Western-Type Diets.

Lack of variability in dietary intake within a population makes identification of relationships between diet and disease difficult. Studies in populations with greater interindividual variation can provide important insights. The Puerto Rican diet is in transition from a traditional to a more Western-type diet, resulting in greater interindividual variability. We identified foods contributing to absolute intake and variability in the intake of macronutrients among Puerto Rican women. One hundred women, aged 30⁻79, residents of San Juan, Puerto Rico, completed three, interviewer-administered, 24-h dietary recalls from which foods contributing to absolute intake and intake variability in intake of energy, fat, protein, carbohydrate and dietary fiber were determined. The overall prevalence of intake of foods was also calculated. Traditional Puerto Rican foods such as legumes, rice, and plantains were important contributors to the intake of calories and macronutrients as were foods more typical of Western diets including white bread and sweetened carbonated beverages. Identification of food sources of nutrients for this population with a diet in transition can contribute to the development of instruments to measure dietary intake and to understand the contribution of diet to the etiology of chronic disease among Puerto Rican women.

Dietary acculturation among black immigrant families living in Ottawa-a qualitative study.

The study explores the dietary acculturation process among first-generation immigrant families from sub-Saharan Africa or the Caribbean living in Ottawa (Canada). In-depth qualitative interviews were conducted with 12 mothers. The interaction between accelerating factors and other mediating factors resulted in a spiral of dietary changes triggered by immigration. The spiral evolved at different paces from traditional to acculturated and toward healthy or unhealthy diets and was hard to stop or to change in its direction once it started. Findings call for enhancing immigrant mothers' food access, food literacy and nutrition-related parenting skills, and their children's school food environment.

Consistency and Generalizability of Dietary Patterns in a Multiethnic Working Population.

BACKGROUND: Dietary pattern analysis is a complementary method to nutrient analysis in evaluating overall diet-disease hypotheses. Although studies have been conducted to derive dietary patterns among Malaysians, their consistency across subgroups has not been examined. OBJECTIVE: The study aimed to derive dietary patterns empirically and to examine the consistency and generalizability of patterns across sex, ethnicity, and urban status in a working population. DESIGN: This was a cross-sectional study using data from the Clustering of Lifestyle Risk Factors and Understanding its Association with Stress on Health and Well-Being among School Teachers in Malaysia study collected between August 2014 and November 2015. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were derived using factor analysis. PARTICIPANTS/SETTING: Participants were teachers from selected public schools from three states in Peninsular Malaysia (n=4,618). MAIN OUTCOME MEASURES: Dietary patterns derived using factor analysis. STATISTICAL ANALYSES PERFORMED: Separate factor analysis was conducted by sex, ethnicity, and urban status to identify dietary patterns. Eigenvalue >2, scree plot, Velicer's minimum average partial analysis, and Horn's parallel analysis were used to determine the number of factors to retain. The interpretability of each dietary pattern was evaluated. The consistency and generalizability of dietary patterns across subgroups were assessed using the Tucker congruence coefficient. RESULTS: There was no subgroup-specific dietary pattern found. Thus, dietary patterns were derived using the pooled sample in the final model. Two dietary patterns (Western and Prudent) were derived. The Western dietary pattern explained 15.4% of total variance, characterized by high intakes of refined grains, animal-based foods, added fat, and sugar-sweetened beverages as well as fast food. The Prudent dietary pattern explained 11.1% of total variance and was loaded with pulses, legumes, vegetables, and fruits. CONCLUSIONS: The derived Western and Prudent dietary patterns were consistent and generalizable across subgroups of sex, ethnicity, and urban status. Further research is needed to explore associations between these dietary patterns and chronic diseases.

Validation of a Dietary Screening Tool in a Middle-Aged Appalachian Population.

Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45-64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls. The Healthy Eating Index (HEI) was calculated to describe overall diet quality. Adults identified by the DST with a nutrition risk had lower HEI scores (50 vs. 64, p < 0.001) and were much more likely to also be considered at dietary risk by the HEI (OR 11.6; 3.2-42.6) when compared to those not at risk. Those at risk had higher energy-adjusted total fat, saturated fat, and added sugar intakes and lower intakes of dietary fiber, and several micronutrients than those classified as not at risk by the DST. Similarly, the at-risk group had significantly lower serum levels of α-carotene, ß-carotene, cryptoxanthin, lutein, and zeaxanthin but did not differ in retinol or methylmalonic acid compared with those not at risk. The DST is a valid tool to identify middle-aged adults with nutritional risk.

Dietary Patterns Associated with Lower 10-Year Atherosclerotic Cardiovascular Disease Risk among Urban African-American and White Adults Consuming Western Diets.

The study's objective was to determine whether variations in the 2013 American College of Cardiology/American Heart Association 10-year risk for atherosclerotic cardiovascular disease (ASCVD) were associated with differences in food consumption and diet quality. Findings from the baseline wave of Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study 2004-2009, revealed participants consumed a Western diet. Diet quality measures, specifically the Healthy Eating Index (HEI)-2010, Dietary Approaches to Stop Hypertension (DASH) diet and the Mean Adequacy Ratio (MAR), based on two 24-h recalls collected during follow-up HANDLS studies from 2009-2013, were used. Reported foods were assigned to 27 groups. In this cross-sectional analysis, the participants (n = 2140) were categorized into tertiles based on their 10-year ASCVD risk. Lower and upper tertiles were used to determine significantly different consumption rates among the food groups. Ten groups were used in hierarchical case clustering to generate four dietary patterns (DPs) based on group energy contribution. The DP with the highest HEI-2010 score included sandwiches along with vegetables and cheese/yogurt. This DP, along with the pizza/sandwiches DP, had significantly higher DASH and MAR scores and a lower 10-year ASCVD risk, compared to the remaining two DPs-meats/sandwiches and sandwiches/bakery products; thus, Western dietary patterns were associated with different levels of ASCVD 10-year risk.

Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

OBJECTIVE: Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight. SETTING: Four multiethnic birth cohorts based in Canada (the NutriGen Alliance). PARTICIPANTS: 3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data. RESULTS: No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (ß=-67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (ß=-65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (ß=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption. CONCLUSIONS: Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.

Dietary food patterns and glucose/insulin homeostasis: a cross-sectional study involving 24,182 adult Americans.

AIM: To investigate the association of major dietary patterns with glucose and insulin homeostasis parameters in a large American sample. The association between dietary patterns (DP) derived via principal components analysis (PCA), with glucose/insulin homeostasis parameters was assessed. The likelihood of insulin resistance (IR) across the DPs quarters was also explored. METHOD: The United States National Health and Nutrition Examination Survey (NHANES) participants during 2005-2012 were included if they underwent measurement of dietary intake as well as glucose and insulin homeostasis parameters. Analysis of covariance (ANCOVA) and adjusted logistic and linear regression models were employed to account for the complex survey design and sample weights. RESULTS: A total of 24,182 participants were included; 48.9% (n = 11,815) were men. Applying PCA revealed three DP (56.8% of variance): the first was comprised mainly of saturated fat (SFA), total fat, mono-unsaturated fatty acids (MUFA) and carbohydrate (CHO); the second is highly enriched with vitamins, trace elements and dietary fiber; and the third was composed of polyunsaturated fatty acids (PUFA), cholesterol and protein. Among the total population, after adjustment for age, sex, race, C-reactive protein, smoking, and physical activity, glucose homeostasis factors, visceral adiposity index and lipid accumulation product improved across the quarters of the first and third DP; and a reverse pattern with the second DP. The same trend was observed for the non-diabetic subjects. Moreover, subjects with higher adherence to the first and third DP had higher likelihood for developing IR, whereas there was a lower likelihood for the second DP. CONCLUSION: This study shows that the DP heavily loaded with CHO, SFA, PUFA, protein, total fat and MUFA as well as high-cholesterol-load foods is associated with impaired glucose tolerance; in contrast, the healthy pattern which is high in vitamins, minerals and fiber may have favourable effects on insulin sensitivity and glucose tolerance.

Trends in dietary fat and fatty acid intakes and related food sources among Chinese adults: a longitudinal study from the China Health and Nutrition Survey (1997-2011).

OBJECTIVE: Few studies have evaluated the intake trends of fatty acids in China. The present study aimed to describe the profile of longitudinal dietary fat and fatty acid intakes and their related food sources in Chinese adults. DESIGN: A longitudinal study using data from the China Health and Nutrition Survey (1997-2011) was conducted. Dietary intake was estimated using 24 h recalls combined with a food inventory for three consecutive days. Linear mixed models were used to calculate the adjusted mean intake values. SETTING: Urban and rural communities in nine provinces (autonomous regions), China. SUBJECTS: Adults (n 19 475; 9420 men and 10 055 women). RESULTS: Fat intake among men in 1997 was 73·4 g/d (28·1 % of total energy (%TE)), while in 2011 it increased to 86·3 g/d (33·2 %TE). Similarly, for women, this intake increased from 62·7 g/d (28·4 %TE) in 1997 to 74·1 g/d (33·7 %TE) in 2011. Energy intake from SFA grew from 6·8 to 7·6 %TE for both sexes. PUFA intake increased from 18·4 to 22·5 g/d for men and from 15·7 to 19·7 g/d for women, and was above 6 %TE in all survey periods. Intakes of 18:2 and 18:3 fatty acids showed significant upward trends in both sexes. Participants consumed less animal fats and more vegetable oils, with more PUFA intake and less energy from SFA. EPA and DHA intakes fluctuated around 20 mg/d. CONCLUSIONS: Fatty acid intakes and profile in Chinese adults are different from those reported in other countries.

A combined high-sugar and high-saturated-fat dietary pattern is associated with more depressive symptoms in a multi-ethnic population: the HELIUS (Healthy Life in an Urban Setting) study.

OBJECTIVE: To identify a high-sugar (HS) dietary pattern, a high-saturated-fat (HF) dietary pattern and a combined high-sugar and high-saturated-fat (HSHF) dietary pattern and to explore if these dietary patterns are associated with depressive symptoms. DESIGN: We used data from the HELIUS (Healthy Life in an Urban Setting) study and included 4969 individuals aged 18-70 years. Diet was assessed using four ethnic-specific FFQ. Dietary patterns were derived using reduced rank regression with mono- and disaccharides, saturated fat and total fat as response variables. The nine-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms by using continuous scores and depressed mood (identified using the cut-off point: PHQ-9 sum score ≥10). SETTING: The Netherlands. RESULTS: Three dietary patterns were identified; an HSHF dietary pattern (including chocolates, red meat, added sugars, high-fat dairy products, fried foods, creamy sauces), an HS dietary pattern (including sugar-sweetened beverages, added sugars, fruit (juices)) and an HF dietary pattern (including high-fat dairy products, butter). When comparing extreme quartiles, consumption of an HSHF dietary pattern was associated with more depressive symptoms (Q1 v. Q4: ß=0·18, 95 % CI 0·07, 0·30, P=0·001) and with higher odds of depressed mood (Q1 v. Q4: OR=2·36, 95 % CI 1·19, 4·66, P=0·014). No associations were found between consumption of the remaining dietary patterns and depressive symptoms. CONCLUSIONS: Higher consumption of an HSHF dietary pattern is associated with more depressive symptoms and with depressed mood. Our findings reinforce the idea that the focus should be on dietary patterns that are high in both sugar and saturated fat.

Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women.

The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM) among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women (n = 1026), aged 18-45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and reliable food frequency questionnaire. Consumption of total fast foods including hamburgers, sausages, bologna (beef), pizza and French fries was calculated. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3 h oral glucose tolerance test. GDM was defined according to the American Diabetes Association definition. The mean age and pre-pregnancy body mass index BMI of participants were 26.7 ± 4.3 years and 25.4 ± 4.5 Kg/m², respectively. A total of 71 women developed GDM. After adjustment for confounders, the OR (95% CI) for GDM for total fast food consumption was 2.12 (1.12-5.43) and for French fries it was 2.18 (1.05-4.70). No significant association was found between hamburgers, sausages, bologna (beef), pizza and GDM. Fast food consumption in women of reproductive age was found to have undesirable effects in the prevalence of GDM.

Genetic ancestry in relation to the metabolic response to a US versus traditional Mexican diet: a randomized crossover feeding trial among women of Mexican descent.

BACKGROUND/OBJECTIVES: Certain populations with a large proportion of indigenous American (IA) genetic ancestry may be evolutionarily adapted to traditional diets high in legumes and complex carbohydrates, and may have a detrimental metabolic response to US diets high in refined carbohydrates and added sugars. We tested whether IA ancestry modified the metabolic response to a US versus traditional Mexican diet in a controlled dietary intervention. SUBJECTS/METHODS: First and second generation Mexican immigrant women (n=53) completed a randomized crossover feeding trial testing the effects of a US versus traditional Mexican diet. The metabolic response to the diets was measured by fasting serum concentrations of glucose, insulin, insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3), adiponectin, C-reactive protein, interleukin-6 and computed homeostasis model assessment for insulin resistance (HOMAIR). Blood collected at baseline was used for genotyping, and estimation of African, European and IA ancestries with the use of 214 ancestry informative markers. RESULTS: The genetic ancestral background was 56% IA, 38% European and 6% African. Women in the highest IA ancestry tertile (>62%) were shorter in height, less educated and less acculturated to the US lifestyle, and tended to have higher waist-to-hip ratio compared with women in the middle and lowest IA ancestry tertiles, respectively. Compared with the US diet, the traditional Mexican diet tended to reduce glucose, insulin, IGF-1, IGFBP-3 and HOMAIR among women in the middle IA ancestry group (IA ancestry ⩽45-62%), whereas having no effect on biomarkers related to inflammation. CONCLUSIONS: We observed modest interactions between IA ancestry and the metabolic response to a US versus traditional Mexican diet among Mexican immigrant women.

Association between dietary patterns and low bone mineral density among adults aged 50 years and above: findings from the North West Adelaide Health Study (NWAHS).

Studies on the association between dietary patterns and bone mineral density (BMD) have reported inconsistent findings. Data from the North West Adelaide Health Study, a population-based cohort study undertaken in Australia, were used to assess this association among adults aged 50 years and above. In this specific study, 1182 adults (545 males, 45·9 %) had dietary data collected using a FFQ and also had BMD measurements taken using dual-energy X-ray absorptiometry. Factor analysis with principal component method was applied to ascertain dietary patterns. Two distinct dietary patterns were identified. Pattern 1 ('prudent pattern') was characterised by high intake of fruits, vegetables, sugar, nut-based milk, fish, legumes and high-fibre bread. In contrast, pattern 2 ('Western pattern') was characterised by high levels of processed and red meat, snacks, takeaway foods, jam, beer, soft drinks, white bread, poultry, potato with fat, high-fat dairy products and eggs. Compared with the study participants in the first tertile (T1, lowest consumption) of the prudent pattern, participants in the third tertile (T3) had a lower prevalence of low BMD (prevalence ratio (PR)=0·52; 95 % CI 0·33, 0·83) after adjusting for socio-demographic, lifestyle and behavioural characteristics, chronic conditions and energy intake. Participants in T3 of the Western pattern had a higher prevalence of low BMD (PR=1·68; 95 % CI 1·02, 2·77) compared with those in T1. In contrast to the Western diet, a dietary pattern characterised by high intake of fruits, vegetables and dairy products is positively associated with BMD.

Sex-Specific Sociodemographic Correlates of Dietary Patterns in a Large Sample of French Elderly Individuals.

This cross-sectional analysis provides up-to-date information about dietary patterns (DP) and their sociodemographic correlates in European elderly individuals. We studied 6686 enrollees aged 65+ (55% women) in the ongoing French population-based NutriNet-Santé e-cohort. Diet was assessed via three 24 h records. The sex-specific correlates of factor analysis derived DP were identified with multivariable linear regression. Using 22 pre-defined food groups, three DP were extracted. The "healthy" DP (fruit, vegetables, grains, nuts, fish) was positively associated with education, living alone, and being a former smoker (women), and negatively associated with being overweight, current smoker (men), age 75+ years, having hypertension, and obesity (women). The "western" DP (meat, appetizers, cheese, alcohol) was positively associated with BMI (men) and being a former/current smoker; it was negatively associated with age 75+ years (women) and living alone. The "traditional" DP (bread, potatoes, milk, vegetables, butter, stock) was positively associated with age and negatively associated with being a former/current smoker, education (men), and residing in an urban/semi-urban area. The findings support the diversity of DP among the elderly, highlighting sex-specific differences. The "healthy" DP explained the largest amount of variance in intake. Future studies could replicate the models in longitudinal and international contexts.

The importance of taste on dietary choice, behaviour and intake in a group of young adults.

The 'taste of food' plays an important role in food choice. Furthermore, foods high in fat, sugar and salt are highly palatable and associated with increased food consumption. Research exploring taste importance on dietary choice, behaviour and intake is limited, particularly in young adults. Therefore, in this study a total of 1306 Australian university students completed questionnaires assessing dietary behaviors (such as how important taste was on food choice) and frequency of food consumption over the prior month. Diet quality was also assessed using a dietary guideline index. Participants had a mean age of 20 ± 5 years, Body Mass Index (BMI) of 22 ± 3 kg/m(2), 79% were female and 84% Australian. Taste was rated as being a very or extremely important factor for food choice by 82% of participants. Participants who rated taste as highly important, had a poorer diet quality (p = 0.001) and were more likely to consume less fruit (p = 0.03) and vegetables (p = 0.05). Furthermore, they were significantly more likely to consume foods high in fat, sugar and salt, including chocolate and confectionary, cakes and puddings, sweet pastries, biscuits, meat pies, pizza, hot chips, potato chips, takeaway meals, soft drink, cordial and fruit juice (p = 0.001-0.02). They were also more likely to consider avoiding adding salt to cooking (p = 0.02) and adding sugar to tea or coffee (p = 0.01) as less important for health. These findings suggest that the importance individuals place on taste plays an important role in influencing food choice, dietary behaviors and intake.

Evaluation of the relationship between major dietary patterns and uninvestigated reflux among Iranian adults.

OBJECTIVES: The etiology of uninvestigated reflux is largely unknown. Although diet has been associated with uninvestigated reflux, the role of dietary patterns is not clear yet. The aim of this study was to investigate dietary patterns in relation to uninvestigated reflux among Iranian adults. METHODS: This cross-sectional study was carried out within the framework of SEPAHAN (Study on the Epidemiology of Psychological, Alimentary Health and Nutrition) among Iranian adults. Dietary data were collected using a self-administered, 106-item, dish-based, semiquantitative food frequency questionnaire. Uninvestigated reflux was considered to be present when an individual reported to be suffering from heartburn sometimes or frequently in the preceding 3 mo. Specific dietary patterns were identified using factor analysis. RESULTS: Complete information from 3846 individuals was available for statistical analysis. We identified four major dietary patterns: fast food, traditional, vegetarian, and Western. After controlling for potential confounders, no overall significant associations were found between these dietary patterns and uninvestigated reflux. However, participants in the third quintile of the traditional dietary pattern had greater odds of uninvestigated reflux, either in the crude (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09-1.74) or the adjusted (OR, 1.52; 95% CI, 1.16-2.00) model taking into account different confounders. After controlling for age, men in the second (OR, 1.64; 95% CI, 1.10-2.45) and women in the fourth (OR, 1.47; 95% CI, 1.02-2.11) quintiles of the fast food dietary pattern were more likely to have uninvestigated reflux. Moreover, in the age-adjusted model, men in the second (OR, 1.72; 95% CI, 1.14-2.59) and fourth (OR, 1.56; 95% CI, 1.03-2.35) quintiles, and women in the second (OR, 1.48; 95% CI, 1.08-2.04) quintile of the traditional dietary pattern were at higher risk for being diagnosed with uninvestigated reflux. CONCLUSION: Although the present study showed no statistically significant associations between major dietary patterns and the risk for uninvestigated reflux, relative positive associations were found between uninvestigated reflux and adherence to either fast food or traditional dietary patterns, suggesting that these contribute to the risk for developing reflux.

Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: a randomized crossover feeding trial.

BACKGROUND: Mexican immigrants are disproportionally affected by diet-related risk of metabolic dysfunction. Whether adhering to a traditional Mexican diet or adopting a US diet contributes to metabolic changes associated with future risk of type 2 diabetes and other chronic diseases has not been investigated. OBJECTIVE: The purpose of this study was to test in a randomized crossover feeding trial the metabolic responses to a Mexican diet compared with a commonly consumed US diet. DESIGN: First- and second-generation healthy women of Mexican descent (n = 53) were randomly assigned in a crossover design to consume a Mexican or US diet for 24 d each, separated by a 28-d washout period. Diets were eucaloric and similar in macronutrient composition. The metabolic responses to diets were assessed by measuring fasting serum concentrations of glucose, insulin, insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), adiponectin, C-reactive protein (CRP), and interleukin 6 (IL-6), as well as the homeostasis model assessment of insulin resistance (HOMA-IR) at the beginning and end of each period. Linear mixed models tested the intervention effect on the biomarkers, while adjusting for diet sequence, feeding period, baseline and washout biomarker concentrations, age, acculturation, and BMI. RESULTS: Compared with the US diet, the Mexican diet reduced insulin by 14% [geometric means (95% CIs): 9.3 (8.3, 10.3) compared with 8.0 (7.2, 8.9) µU/mL; P = 0.02], HOMA-IR by 15% [2.0 (1.8, 2.3) compared with 1.7 (1.6, 2.0); P = 0.02], and IGFBP-3 by 6% (mean ± SEM: 2420 ± 29 compared with 2299 ± 29 ng/mL; P < 0.01) and tended to reduce circulating concentrations of IGF-1 by 4% (149 ± 2.6 compared with 144 ± 2.5 ng/mL; P = 0.06). There was no significant intervention effect on serum concentrations of glucose, adiponectin, CRP, or IL-6 in the US compared with the Mexican diet. CONCLUSION: Compared with the commonly consumed US diet, the traditional Mexican diet modestly improved insulin sensitivity under conditions of weight stability in healthy women of Mexican descent, while having no impact on biomarkers of inflammation. This trial was registered at clinicaltrials.gov as NCT01369173.

Diferenças e similaridades na qualidade da refeição do Brasil e Reino Unido: que lições podemos aprender? / Similarities and differences of meal quality between Brazil and United Kingdom what lessons can we learn?

Introdução. Apesar de consumirmos alimentos combinados e estruturados em refeições, a maioria dos estudos ainda se concentra em nutrientes ou alimentos consumidos isoladamente. Além disso, comparar a alimentação entre países em diferentes fases de transição nutricional e epidemiológica pode fornecer informações relevantes relacionadas à prevenção da obesidade e DCNT. Objetivo. Caracterizar e comparar a qualidade nutricional da principal refeição consumida por adultos residentes no Brasil e Reino Unido. Materiais e Métodos. A primeira etapa do estudo consistiu na revisão sistemática da literatura, que subsidiou a etapa seguinte, o desenvolvimento do Main Meal Quality Index. Para comparar a qualidade das refeições utilizou-se dados dos inquéritos alimentares Inquérito Nacional de Alimentação INA-POF 2008-09 e National Diet and Nutrition Survey - NDNS. Para a identificação e avaliação da qualidade da refeição utilizou-se duas diferentes abordagens: (1) abordagem híbrida, com a descrição da composição das refeições por meio da árvore de decisão de classificação, e (2) abordagem dirigida pela hipótese, através da aplicação do Main Meal Quality Index. Além disto foram analisados modelos de regressão múltipla a fim de identificar os fatores associados. Resultados. Considerando o horário de consumo e a contribuição energética, os eventos alimentares definidos como principal refeição foram o almoço, para o Brasil, e jantar, para o Reino Unido.

Introduction. Although individuals consume foods combined and structured at meals, most authors still have studied nutrient or single food. Furthermore, compare countries in different stages of nutritional and epidemiological transition can provide relevant information related to the prevention of obesity and NCDs. Objective. To characterize and compare the nutritional quality of meals consumed by adults living in Brazil and UK. Subjects and methods. The first stage of the study consisted of a systematic review of the literature, which subsidized the next step, the development of the Main Meal Quality Index. Data from food surveys "National Survey of Food - INA - HBS 2008-09" and "National Diet and Nutrition Survey - NDNS" were used to analyzed and compare the main meals quality. Two different approaches for the identification and evaluation of the main meal pattern were used: (1) hybrid approach, to evaluate of the meal patters using data reduction techniques; and (2) hypothesis-driven approach, with the Main Meal Quality Index. Then, regression models were applied to analyzed associated sociodemographic factors. Results. Considering time slot and energy content, the eating events defined as main meal were lunch, for Brazil, and dinner, for UK. Brazilian main meal (58 points) had better nutritional quality, with greater participation of fiber and carbohydrates, and lower content of total and saturated fat, and energy density.