Search

Objective: This cross-sectional study investigated associations among the Healthy Eating Index (HEI)-2015, Dietary Inflammatory Index (DII), and body composition in female collegiate athletes. Participants: Female NCAA Division I student-athletes (n = 41, 18–21 years old) were included from various sports and did not report any diagnosed chronic diseases. Methods: Demographics, dietary intake, anthropometrics, and body composition, including bone mineral density, were collected utilizing a questionnaire, three interview-based multiple-pass 24-h dietary recalls, and dual-energy X-ray absorptiometry. Results: Mean HEI-2015 and DII scores (using 39 of 45 components) were 56.2 ± 13.5 and −0.1 ± 1.9, respectively. Athletes did not meet recommended intake levels for servings of fruit, vegetables, fiber, calcium, vitamin D, omega-3, and omega-6. Saturated fat and added sugar intake exceeded the recommended intakes. Diet quality indices and body composition measures were not correlated. Conclusions: Although female collegiate athletes consumed poor-quality diets, this was not associated with body composition or bone health. [ABSTRACT FROM AUTHOR]

Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18–25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students. [ABSTRACT FROM AUTHOR]

Rationale: The change of IgG of COVID‐19 vaccine was thought to be an effect of diet quality or daily habits. Aims and Objectives: This study aimed to correlate diet quality and healthy living factors with serum IgG response in the blood. Methods: Participants were selected from volunteers who had their first vaccination and did not have COVID‐19 disease (Male = 21 Female = 40). Serum IgG levels were measured on average (avg) 28 days after the COVID‐19 vaccine. Information was obtained directly from the participants by questionnaire method (Food consumption record, frequency of food consumption, Diet Quality Index [(DQI], etc.). Results: A significant difference was observed in the IgG levels of the second measurement of age (young/middle) and gender (male/female) (p < 0.05). A significant difference was found in the first measurement of serum IgG levels and IgG avgs of those with medium diet quality and those who did not drink alcohol (p < 0.05). When the IgG2/1 ratio was examined between alcohol users and nonalcohol, a significant increase was observed about two times in non‐alcohol users (p = 0.039). There is a positive significant moderate strength relationship between the second measurements of IgG and anthropometric measurements and the first, second, and avg measurements of IgG with DQI. It was found that there was a negative significant medium‐strength relationship between individuals' amount of alcohol consumption and IgG avg (r = −0.535, p = 0.009). Conclusions: Medium diet quality has been seen to affect antibody levels positively. At the same time, it is thought that alcohol use negatively affects serum IgG antibody response in the long term. Other than that, there was shown to be a correlation between IgG levels and DQI. [ABSTRACT FROM AUTHOR]

Purpose: (i) Characterize ultra-processed food (UPF) intakes in toddlerhood and mid-childhood, including identifying principal UPF sub-groups and associations with nutrient profile; (ii) explore stability and change in UPF intake between toddlerhood and mid-childhood. Methods: Data were from children in the UK Gemini twin cohort at 21 months (n = 2,591) and 7 years (n = 592) of age. UPF intakes were estimated using diet diaries and Nova classification. Complex samples general linear or logistic regression models were used to explore associations between UPF intake, UPF sub-groups and nutrients, and changes in intake over time. Results: The contribution of UPF to total energy was 46.9% (± 14.7) at 21 months and 59.4% (± 12.5) at 7 years. Principal UPF sub-groups were yogurts, higher-fiber breakfast cereals, and wholegrain breads in toddlerhood, and puddings and sweet cereal products and white breads in mid-childhood. At both ages, mean free sugar and sodium intakes exceeded recommended maximums and higher UPF consumption was associated with consuming more of each nutrient (P < 0.001). UPF intake was negatively associated with fat, saturated fat and protein intake in toddlerhood, and fiber intake in mid-childhood (P < 0.001). Being in the highest UPF intake quintile in toddlerhood was predictive of being in the highest quintile in mid-childhood (OR 9.40, 95%CI 3.94–22.46). Conclusions: UPF accounted for nearly half of toddlers' energy, increasing to 59% in mid-childhood. Higher UPF consumers had higher intakes of free sugar and sodium. UPF intake in toddlerhood was predictive of mid-childhood intake. Effective policies are needed to reduce UPF intakes in the early years. [ABSTRACT FROM AUTHOR]

Background: A low-fat vegan diet, supplemented with soybeans, has been shown effective in reducing postmenopausal hot flashes. This secondary analysis assessed the association of a plant-based index (PDI), healthful (hPDI), and unhealthful (uPDI), with changes in hot flashes in postmenopausal women. Methods: Participants (n = 84) were randomly assigned to a low-fat vegan diet supplemented with soybeans (n = 42) or a control group (n = 42) for 12 weeks. Three-day dietary records were analyzed and PDI indices were calculated. A repeated measures analysis of variance (ANOVA) was used for statistical analysis. Results: All three scores increased in the vegan group, compared with no change in the control group; the effect sizes were: PDI + 9.8 (95% CI + 5.8 to + 13.8; p < 0.001); hPDI + 10.9 (95% CI + 6.4 to + 15.3; p < 0.001); and uPDI + 3.6 (95% CI + 0.5 to + 6.6; p = 0.02). The change in all three scores negatively correlated with change in body weight (PDI: r=-0.48; p < 0.001; hPDI: r=-0.38; p = 0.002; and uPDI: r=-0.31; p = 0.01). The changes in PDI and uPDI were negatively associated with changes in severe hot flashes (r=-0.34; p = 0.009; and r=-0.43; p < 0.001, respectively), and associations remained significant after adjustment for changes in body mass index (r=-0.31; p = 0.02; and r=-0.41; p = 0.001, respectively). Conclusions: These findings suggest that minimizing the consumption of animal products and oil may be an effective strategy to reduce hot flashes in postmenopausal women, and that categorization of plant foods as "healthful" or "unhealthful" may be unwarranted. Trial registration: ClinicalTrials.gov, NCT04587154, registered on Oct 14, 2020. [ABSTRACT FROM AUTHOR]

Background: The Non-Healthy Diet Index (NHDI) and the Pro-Healthy Diet Index (PHDI) are two novel indices that evaluate the healthiness of a diet based on the consumption of several food groups. This study aimed to evaluate the association between adherence to the PHDI and NHDI and colorectal cancer (CRC) risk in the Iranian population. Methods: The current study was conducted as a hospital-based research using a case (n = 71)- matched-controls (n = 142) design in Tehran, Iran. A semi-quantitative food frequency questionnaire was utilized to determine participants' dietary intake after confirming the diagnosis of CRC and at the time of the interview. The PHDI-10 was employed to assess the consumption of foods with positive health effects, which is linked to the frequency of consuming 10 food groups, and the NHDI-14 was used to assess the consumption of foods that have detrimental effects on health, based on the frequency of 14 food groups. Logistic regression was used to evaluate the association between continuous PHDI and NHDI scores and their tertiles with CRC. Results: The results indicated that individuals in the highest tertile of the PHDI showed a lower CRC risk compared to those in the lowest tertile (adjusted model- odds ratio (OR) = 0.25; 95% confidence interval (CI): 0.10–0.61; P = 0.002). Also, lower odds of CRC risk were seen with each unit change in the total score of PHDI in the adjusted model (OR = 0.86; 95% CI: 0.76–0.96; P = 0.009). In contrast, individuals in the highest tertile of the NHDI showed a higher risk of CRC compared to those in the lowest tertile (OR = 2.62; 95% CI: 1.09–6.27; P = 0.030) in the adjusted model. Also, higher odds of CRC risk were observed with each unit increase in the total score of NHDI in the adjusted model (OR = 1.13; 95% CI: 1.03–1.25; P = 0.008). Conclusions: The present study showed that higher adherence to PHDI and NHDI is associated with lower and higher CRC risk, respectively. These results provide valuable insights into the roles of healthy and unhealthy diets in CRC prevention. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Sample Measurements Results Conclusion This study examined the influence of nutrition literacy and neighborhood on diet quality within the Mexican‐origin population residing in the United States, addressing a gap in existing literature that lacks focus on specific Latinx subgroups.This study used a descriptive, correlational design to examine the relationships between nutrition literacy, neighborhood ranking, and diet quality.A total of 130 Mexican origin participants living in the United States completed all components of this study.Participants completed demographics, the Nutrition Literacy Assessment Instrument (NLit), Area Deprivation Index (ADI), and Diet History Questionnaire III (DHQ3).Compared to the national average of 59, participants’ average score was 63.16. When examining subgroups of diet quality, participants scored poorly compared to the national average for saturated fats, seafood, and plant proteins. Nutrition literacy was a predictor of total protein foods, seafood, and plant proteins, while the ADI was a predictor of increased refined grains score.The present study provides insights about the influencing factors of diet quality in this population. Given the essential role diet has in shaping health outcomes and preventing chronic illness, addressing dietary subgroups within the Latinx population is critical to accurately informing nursing interventions and patient education. [ABSTRACT FROM AUTHOR]

Background: Consumption of locally produced foods is generally perceived as being part of a healthy dietary pattern. Accordingly, in 2020, the provincial government of Québec (Canada) promoted the purchase of local foods for economic and health benefits. The present cross-sectional study aimed to document the association between the behavior of local food procurement and overall diet quality in a sample of adults from the province of Québec. Methods: Data were collected in a sample of 834 adults (86.6% females) from the NutriQuébec project, a web-based longitudinal population study that aims to document the lifestyle and eating habits of adults in Québec, Canada. Dietary intakes were measured using a validated web-based 24-h recall tool and diet quality was assessed using the Healthy Eating Food Index (HEFI-2019), which measures adherence to the 2019-Canada's Food Guide recommendations on healthy food choices. Local food procurement behavior was measured using the Locavore-I-SF score, which assesses the frequency of short food supply chain use as well as the geographical origin of three locally produced foods. Results: The Locavore-I-SF score was weakly correlated with the HEFI-2019 score (r = 0.08, p < 0.02). Positive correlations were observed for the Vegetables and fruits (r = 0.09, p = 0.005), Beverages (r = 0.08, p = 0.04) and Free sugars (r = 0.14, p < 0.001) components of the HEFI-2019. Associations between the Locavore-I-SF and the HEFI-2019 scores were found in specific subgroups of participants: males (r = 0.33, p < 0.001), participants aged between 50 and 70 years (r = 0.16, p = 0.003), participants with a greater education level (r = 0.13, p = 0.003) and higher income (r = 0.12, p = 0.02), non-vegetarian participants (r = 0.10, p = 0.008) and participants living in Census Metropolitan Areas (r = 0.11, p = 0.004). Conclusion: These results suggest that the behavior of local food procurement is only weakly associated with better overall diet quality among a sample of adults from Québec, raising doubts on the relevance of promoting local food procurement as an effective public health measure for improving diet quality in Québec. Study registration number: NCT04140071. [ABSTRACT FROM AUTHOR]

Food insecurity disproportionately affects smallholder farming households and within them women, who bear primary caregiving responsibilities and contend with time and resource constraints that heighten their vulnerability to adverse nutrition‐related health outcomes. This study cross‐sectionally investigates the association between food production practices, household consumer behaviour, and the experience of food insecurity with women's waist‐hip ratio (WHR), a key indicator of abdominal obesity, in a coastal community in Kenya. In total, 394 households were randomly selected from a list of farming households in Kaloleni and Rabai sub‐counties of Kilifi. Trained enumerators administered questionnaires to adult female family members who play a pivotal role in household management. Household dietary diversity scores (HDDS) were computed from 16 food groups consumed in the 7 days preceding the survey. Waist‐hip measurements focused on these females, representing vulnerable populations. Pathway‐based regression models were constructed using STATA version 13 (p < 0.05). Most households practised mixed farming (59.9%) and monocropping (73.2%) and most female respondents were widowed (75.1%) with limited education (73.1% had no formal education) and over 20 years of farming experience. Food insecurity was prevalent, affecting 80.7% of households. Limited dietary diversity was noted with an average HDDS of 9. The most commonly consumed foods were cereals, spices, condiments and beverages, while meat, eggs and fruits were infrequently eaten. An inverse association was observed between HDDS and WHR (standardised regression coefficient = −0.1328; p = 0.026) but while food insecurity was inversely associated with both HDD and WHR, these associations did not reach statistical significance (HDDS‐standardised regression coefficient −0.0294; p = 0.592: WHR‐standardised regression coefficient −0.0155; p = 0.791). Existing research has primarily addressed the undernutrition and hunger‐related impacts of food insecurity. The findings underscore the need to better understand the complex interplay between food insecurity and nutritional health, including markers of adiposity, to effectively promote health. [ABSTRACT FROM AUTHOR]

Athletes competing in weight categories (e.g., powerlifters) often restrict food intake approaching competition, which may be detrimental to health and performance. Our purpose was to assess the effect of nutrition knowledge, sex, and time (off-season versus precompetition, when athletes often cut weight) on dietary adequacy in powerlifters. Twenty-three powerlifters (10 females; 30.7 6 11.2 years) completed questionnaires to assess nutrition knowledge and dietary adequacy. Athletes with higher nutrition knowledge consumed more fruits and nuts and less vitamin B2, B3 across all time points (p< 0.05) and a greater number (73%) were above the recommended dietary allowance for vitamin D compared with athletes with lower nutrition knowledge (50%) (p< 0.05). Male powerlifters with higher nutrition knowledge consumed less alcohol and vitamin A than male powerlifters with lower nutrition knowledge (p< 0.05). Female powerlifters with higher nutrition knowledge consumed less sugar and beverage calories than female powerlifters with lower nutrition knowledge (p>0.05). Intake of alcohol and carbohydrate decreased, and meat calories increased from off-season to precompetition (p, 0.05). Male powerlifters increased B-vitamins, whereas female powerlifters decreased B-vitamin and sugar consumption approaching competition (p< 0.05). Male powerlifters increased water consumption versus female powerlifters approaching competition (sex 3 time, p< 0.05). There was no effect of nutrition knowledge on dietary changes approaching competition. Nutrition knowledge, sex, and competitive season affect dietary intake of powerlifters. A higher nutrition knowledge predicts a higher intake of some foods and nutrients important for health and performance. Female powerlifters should pay close attention to the intake of B-vitamins and water before competitions when many are trying to cut weight. [ABSTRACT FROM AUTHOR]

Objective: The study explored food items that contribute most toward increased fermentable carbohydrate (FC) intake and its association with diet quality in college students. Method: This cross-sectional study included 571 consented college students (≥18 years) with reported energy intakes (500–3500 kcal/day for women; 800–4000 kcal/day for men). FC intake and healthy eating index-2015 (HEI-2015) scores were assessed by diet history questionnaire-II. Data were analyzed by unadjusted bivariate linear regression and Pearson correlation tests. Results: The mean intakes of total FC (β = 1.24; 95% Confidence Interval: 1.02, 1.47) significantly predicted HEI-2015 scores. Positive correlations were found between FC intake and red and orange vegetables (r = 0.62), whole fruits (r = 0.63), and dark green vegetables (r = 0.58). Conclusions: Higher FC intake was associated with higher diet quality; vegetables and fruits are primary contributors to FC content. Efforts are required to promote these food items to improve diet quality and FC intake to shape eating choices in college students. [ABSTRACT FROM AUTHOR]

Aims High diet quality is related to better health outcomes in general. During pregnancy, a high-quality diet is of paramount importance to promote optimal maternal and neonatal outcomes. This is a scoping review of research available on diet quality indexes (DQIs) for use during pregnancy that summarizes the DQIs in terms of development, country of origin, population used, components, scoring and weighting of components, and evaluation. Furthermore, the DQIs are discussed narratively to inform and direct the development of improved and country-specific DQIs for pregnancy. Methods The EBSCOhost database was used to identify English-language, peer-reviewed articles published between 2000 and 2023, from which 11 publications were identified that describe the development of pregnancy-specific DQIs. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews model. Results Almost all DQIs (n = 9 of 11) were developed in high-income countries, using dietary intake data from food frequency questionnaires. Several DQIs (n = 5 of 11) used the US Healthy Eating Index as basis and modified it in various ways. Almost all DQIs included both foods and nutrients as components (n = 9 of 11), with vegetables being the most commonly included component alone (n = 8 of 11) or combined with fruit (n = 2 of 11). Conclusion Because most DQIs were developed using dietary guidelines, recommendations, and dietary intake data from high-income countries, it is recommended that pregnancy-specific DQIs be developed and validated to reflect the nutrition guidelines for lower-income and culturally diverse countries. [ABSTRACT FROM AUTHOR]

Various foods and nutrients are linked with higher or lower risk of rheumatoid arthritis (RA), yet these associations are inconsistent across studies. Limited research has been done evaluating the association between diet quality and RA in a larger-scale prospective study on postmenopausal women. The objective of this study was to evaluate the association between dietary quality and risk of incident RA in postmenopausal women. This was a prospective cohort study as part of the Women's Health Initiative (WHI), with an average follow-up time of 8.1 years. Baseline diet was measured using a food frequency questionnaire (FFQ). Diet quality was evaluated by the Healthy Eating Index (HEI)-2015 total score. In addition, intake of food groups and nutrients that align with HEI-2015 components was assessed. Postmenopausal women (N = 109 591) were included in this study, which was conducted at various clinical centers across the United States with recruitment from 1993 to 1998. Women's Health Initiative participants who were missing outcome data, had unreliable/missing FFQ data, or had RA at baseline were excluded. The primary outcome measure was incident RA. Statistical analyses performed Multivariable Cox proportional regression analysis was performed evaluating the association of diet quality with self-reported physician-diagnosed RA after adjusting for age, race, ethnicity, education status, income, and body mass index (BMI). During 857 517 person-years of follow-up, 5823 incident RA cases were identified. After adjustment for multiple comparisons, compared with quartile 1, quartiles 2, 3, and 4 of the HEI-2015 total scores were associated with lower RA risks of 1%, 10%, and 19%, respectively (P -trend <.001). Greater consumption of total fruits (P -trend =.014), whole fruits (P -trend <.0002), total vegetables (P -trend =.008), greens and beans (P -trend <.0002), whole grains (P -trend =.008), and dairy (P -trend =.018) were significantly associated with lower rates of incident RA. Conversely, higher consumption of saturated fat (P -trend =.002) was significantly associated with higher rates of incident RA. A higher-quality diet reflected by higher HEI-2015 total scores was inversely associated with incident RA in postmenopausal women. [ABSTRACT FROM AUTHOR]

Few studies have examined whether diet quality is lower in women with body weight dissatisfaction compared with women without body weight dissatisfaction. (1) Examine the association between body weight dissatisfaction and diet quality among women (18–65 years old) in the healthy weight body mass index (BMI) category, and (2) explore dietary and behavioral patterns among women with body weight dissatisfaction. Data were extracted from the cross-sectional 2014–2015 Swiss National Nutrition Survey. Population-based sample of 507 women with BMI ≥ 18.5 and < 25. Dietary intakes assessed by registered dietitians using 2 nonconsecutive computer-assisted multi-pass 24-hour dietary recalls. Diet quality was measured with a slightly modified version of the Healthy Eating Index (HEI)-2020. Multiple linear regressions were performed to test the association between body weight dissatisfaction and total HEI-2020 score. Hierarchical cluster analysis was used to identify subgroups of women with body weight dissatisfaction. Body weight dissatisfaction was not found to be associated with diet quality (β = –1.73 [–4.18; 0.71], P =.16). However, women who were dissatisfied with their body weight had lower scores for the HEI-2020 total fruits (P =.050) and whole grains (P =.014) components than women who were satisfied with their body weight. Four profiles with different dietary patterns were identified among women with body weight dissatisfaction: "Unhealthy diet with dairy," "Protein and fat," "Vegetables without protein," and "Healthier diet without dairy." Among women with a BMI in the healthy weight category, overall diet quality was not observed to differ between those with or without body weight dissatisfaction. More research is needed to explore the different profiles of dietary intake in women with body weight dissatisfaction. [ABSTRACT FROM AUTHOR]

Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology. This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging. A cross-sectional data analysis was used to examine the association between three diet quality scores based on self-reported food frequency questionnaire data and five measures of epigenetic aging based on DNA methylation (DNAm) data from peripheral blood. This study included 4,500 postmenopausal women recruited from multiple sites across the United States (1993-98), aged 50 to 79 years, with food frequency questionnaire and DNAm data available from the Women's Health Initiative baseline visit. Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE. Linear mixed models were used to test for associations between three diet quality scores (Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores) and epigenetic aging measures, adjusted for age, race and ethnicity, education, tobacco smoking, physical activity, Women's Health Initiative substudy from which DNAm data were obtained, and DNAm-based estimates of leukocyte proportions. Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores were all inversely associated with AgeAccelPheno, AgeAccelGrim, and DunedinPACE (P < 0.05), with the largest effects with DunedinPACE. A one standard deviation increment in diet quality scores was associated with a decrement (β ± SE) in DunedinPACE z score of –0.097 ± 0.014 (P = 9.70 x 10-13) for Healthy Eating Index, –0.107 ± 0.014 (P = 1.53 x 10-14) for Dietary Approaches to Stop Hypertension, and –0.068 ± 0.013 (P = 2.31 x 10-07) for the alternate Mediterranean diet. In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE. [ABSTRACT FROM AUTHOR]

Background: Diet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though longitudinal evidence for how diet associates with sleep is scarce. This study aimed to determine the prospective association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS). Methods: This prospective study included 593 BHS subjects with dietary assessment at the 2001–2002 visit and sleep questionnaire responses from the 2013–2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested. Results: Higher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower probability of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower probability of insomnia symptoms at follow-up (RR [95% confidence interval CI]: 0.85 [0.77, 0.93]), those in Q5 of AHEI had 0.54 times the probability as those in Q1 (95% CI: 0.39, 0.75), and there was a significant trend across quintiles (trend p = 0.001). There were no significant associations between young adult diet quality and having a high sleep apnea risk or a healthy sleep pattern at follow-up. Conclusions: A healthy diet was associated with a lower probability of future insomnia symptoms. If replicated, these findings could have implications for chronic disease prevention strategies incorporating the lifestyle behaviors of sleep and diet. [ABSTRACT FROM AUTHOR]

AbstractLifestyle habits seem interconnected and extant studies suggest that a lifestyle-related modification can impact other related behaviors. For instance, interventions targeting physical activity (PA) could potentially impact dietary patterns and quality. Therefore, we hypothesized that a web-based intervention to increase PA would lead to changes in diet quality without explicit dietary guidance. Our aim was to evaluate changes in diet quality, measured by the Healthy Eating Index 2020 (HEI-2020), following a 12-week web-based PA intervention in adults with obesity. The study consisted of secondary analysis of a 12-week pilot randomized controlled trial, wherein participants (N = 82) were randomized to the Physical Activity for The Heart (PATH) intervention group, which included workout videos and virtual coaching, or a wait-list control group. Diet quality was assessed at baseline and post-intervention using the HEI-2020 based on recalls collected through the Automated Self-Administered 24-h recall (ASA-24) system. Baseline characteristics were similar across groups. Both groups showed small improvements in HEI-2020 total scores after 12 wk (PATH: 65.11 vs. Control: 62.24). Stratification by moderate to vigorous physical activities increase (<60 min. vs. ≥60 min.) revealed greater improvements in specific HEI-2020 components in the ≥60 min group, though overall changes remained modest. The PA intervention led to small improvements in certain diet quality components, suggesting potential interconnectedness between PA and dietary habits. However, overall changes in HEI-2020 scores were modest. Future research with larger samples should explore the effects of PA intervention alone vs. combined with dietary guidance on diet quality in adults with obesity. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported associations between individual nutrients or specific foods and the risk of age-related macular degeneration (AMD). However, the relationship between overall dietary quality, specifically the alternative Mediterranean diet (aMED) score, and AMD remains unclear. Therefore, this study aimed to investigate the association between the aMED score, as an indicator of overall diet quality, and AMD in the Korean population. Methods: We conducted a cross-sectional analysis using nationally representative samples of older adults aged ≥ 65 years (895 men and 1,191 women) from the Korea National Health and Nutrition Examination Survey (2017–2018). Food intake and the aMED score were estimated using 24-h recall. AMD was diagnosed by an ophthalmologist based on fundus photography. The associations of aMED score tertiles with AMD were determined using odds ratios (ORs) from multivariate logistic regressions. Results: Multiple logistic regression analysis revealed a significantly negative association between the aMED score and AMD (adjusted ORs = 0.58; 95% confidence interval = 0.39–0.88; p-trend = 0.021) in older men after adjusting for confounding factors such as age, body mass index, family monthly income, current smoking, alcohol consumption, physical activity, chronic disease status, and energy intake. Notably, this association was exclusively observed in men, and no significant association was observed between the aMED score and AMD in women (adjusted OR = 0.88; 95% CI = 0.61–1.29; p-trend = 0.691). Conclusions: This study's findings suggest that a high aMED score may be associated with a reduced risk of AMD in older men. Future studies with larger sample sizes and a prospective or interventional design are required to enhance current understanding regarding the association between diet quality and AMD. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) and diet quality have each been shown to be inversely associated with mortality but their combined impact on longevity has been less explored, particularly when considering their changes over time. This study aimed to examine the separate and combined associations of PA, diet quality and their changes over time with mortality outcomes. Methods: A prospective cohort study was performed on 9349 adults aged 40 to 79 years from the population-based European Prospective Investigation into Cancer in Norfolk Study, with repeated measurements of PA and diet (from 1993 till 2004) and subsequent follow-up till 2022 (median follow-up 18.8 years). Validated questionnaires were used to derive physical activity energy expenditure (PAEE) as a proxy of total PA and adherence to the Mediterranean diet score (MDS, range 0–15 points) as an indicator of overall diet quality, and their changes over time (∆PAEE and ∆MDS). Cox regression models adjusted for potential confounders and mediators were used to estimate hazard ratios (HRs) and 95% CIs. Results: Over 149,681 person-years of follow-up, there were 3534 deaths. In adjusted models, for each 1-SD difference in baseline PAEE (4.64 kJ/kg/day), ∆PAEE (0.65 kJ/kg/day per year), baseline MDS (1.30 points) and ∆MDS (0.32 points per year), HRs (95% CI) for all-cause mortality were 0.90 (0.86 to 0.94), 0.89 (0.85 to 0.93), 0.95 (0.91 to 0.99) and 0.93 (0.90 to 0.97), respectively. Compared with participants with sustained low PAEE (< 5 kJ/kg/day) and low MDS (< 8.5 points), those with sustained high PAEE and high MDS had lower all-cause mortality (HR 0.78; 95% CI: 0.68–0.91), as did those who improved both PAEE and MDS (0.60; 0.44–0.82). There was no evidence of interaction between PA and diet quality exposures on mortality risk. Population impact estimates suggested that if all participants had maintained high levels of PA and diet quality consistently, cumulative adjusted mortality rate would have been 8.8% (95% CI: 2.4 to 15.3%) lower. Conclusions: These findings suggest that adopting and maintaining higher levels of PA and diet quality are associated with lower mortality. Significant public health benefits could be realised by enabling active living and healthy eating through adulthood. [ABSTRACT FROM AUTHOR]

Snacking is a common dietary behaviour among adolescents contributing to more than one quarter of their total energy intake; however, the relationship between snacks and diet quality remains unclear. Hence, this study aimed to examine the characteristics of snacks among adolescents with different levels of diet quality. Dietary data collected from a nationally representative sample of Australian adolescents (12–18 years old, n = 935) using one 24-hour dietary recall in the National Nutrition and Physical Activity Survey were analysed. Snacks were defined based on participant-identified eating occasions, and diet quality was assessed using the Dietary Guideline Index for Children and Adolescents (DGI-CA). Marginal means and proportion of snack characteristics including snack frequency, snack energy density (ED), and commonly consumed foods at snack from the five food groups and discretionary foods at snack across DGI-CA tertiles (highest tertile indicating high guideline adherence) were estimated for both boys and girls using linear regression and logistic regression. Differences in means were tested using the F-test. The results showed no significant differences in the mean frequency of snacks across tertiles of DGI-CA scores. The mean ED of snacks decreased as DGI-CA scores increased in both boys (lowest tertile = 8.4, 95% CI [7.1, 10.0] kJ/g, highest tertile = 6.3 [5.4, 7.4] kJ/g) and girls (lowest tertile = 9.0 [7.8, 10.3] kJ/g, highest tertile = 5.9 [5.1, 6.9] kJ/g). As diet quality improved, the proportion of adolescents consuming discretionary (i.e., unhealthy) foods and foods from the five food group foods as snacks decreased and increased, respectively. In conclusion, adolescents with higher diet quality consumed snacks with a lower ED while lower proportion of them consume discretionary foods, and higher proportion of them consume from the five food groups. Encouraging the consumption of foods from the five food groups with lower ED as snacks presents an opportunity to enhance adolescent diet quality. [ABSTRACT FROM AUTHOR]

• Better diet quality had a direct (beneficial) effect on pain. • Higher consumption of core foods was related to less pain in women, but not men. • Adiposity did not mediate the relationship between diet quality and pain. • Strategies for pain management should consider diet quality. Dietary intake has been associated with pain and physical function, but it is unclear if these relationships are mediated by adiposity. Data were derived from the Whyalla Intergenerational Study of Health (n = 654, 57% women). Structural equation modelling tested the hypotheses that adiposity (body mass index (BMI), waist circumference (WC), or body fat (BF, dual energy x-ray absorptiometry)) would mediate the relationship between diet quality (Dietary Guideline Index (DGI) total, core, or non-core scores) and pain (Short Form-36 bodily pain scale (SF36-BPS)), or physical function (grip-strength), overall, and by gender. Adiposity did not mediate a relationship between DGI scores and pain. Direct effects were observed between DGI total scores and SF36-BPS accounting for BMI (β = 0.170, 95% CI 0.002, 0.339), and between DGI core food scores and SF36-BPS (BMI, β = 0.278, 95% CI 0.070, 0.486; WC, β = 0.266, 95% CI 0.058, 0.474; BF, β = 0.266, 95% CI 0.060, 0.473). In women, direct effects existed between DGI scores and SF36-BPS (DGI total scores, BMI, β = 0.388, 95% CI 0.162, 0.613; WC, β = 0.372, 95% CI 0.146, 0.598; BF, β = 0.382, 95% CI 0.158, 0.605, and DGI core scores, BMI, β = 0.482, 95% CI 0.208, 0.757; WC, β = 0.472, 95% CI 0.197, 0.747; BF, β = 0.467, 95% CI 0.195, 0.739), and DGI total scores and grip-strength (BMI, β = 0.075, 95% CI 0.008, 0.142; WC, β = 0.076, 95% CI 0.009, 0.143; BF, β = 0.079, 95% CI 0.011, 0.146). Better diet quality is associated with lower bodily pain, irrespective of adiposity. Findings highlight the potential role of diet quality in pain management and function, particularly in women. A cross-sectional study of 654 Australian adults (57% women) from the WISH found better diet quality, particularly the intake of core foods, assessed via the DGI, was associated with lower body pain. These findings were most pronounced in women. Mediation analyses did not show any influence of adiposity in this relationship. Abbreviations: BMI, body mass index; DGI, Dietary Guideline Index; WISH, Whyalla Intergenerational Study of Health. [Display omitted] [ABSTRACT FROM AUTHOR]

Peru is one of the most diverse countries in the world in terms of food production, but also suffers a wide range of food security challenges, including malnutrition, the impact of natural hazards, and rising food prices. People living in poverty conditions are the main victims of these problems, which trigger undernutrition, obesity, and diet‐related non‐transmittable diseases. Despite these challenges, Peru lacks historical food intake data. Therefore, in the current study, we assess the diet quality evolution in the period 2008–2021 based on apparent household purchases extracted from the National Household Survey. The results reveal significant variations in the consumption of certain food items and groups, and the consequences of these changes are discussed in environmental and human health terms. The consumption of lower environmental impact animal protein, such as chicken, eggs, and marine fish, has increased by 37%, 69%, and 29%, respectively; whereas the consumption of high environmental impact foods, such as beef and other red meat, has decreased. Moreover, consumption of less processed carbohydrate sources (e.g., legumes, fruits, and vegetables) has risen, while refined sugar and sugar‐sweetened beverages have decreased significantly (almost 45%). Regional differences were also visible; hence, cities on the Northern coast and the Amazon basin had similar consumption habits, whereas Central/Southern coastal and Andean cities had closer consumption patterns. On average, this improvement was reflected in the increase in calories (9.9%) and macronutrient intake (up to 15%), but at the socioeconomic level, food inequality persists, with consumption of many food groups below minimum thresholds in lower socioeconomic strata. This article met the requirements for a gold/gold JIE data openness badge described at http://jie.click/badges. [ABSTRACT FROM AUTHOR]

Background: The sustainability of diets consumed by African populations under socio-economic transition remains to be determined. This study developed and characterized a multi-dimensional Sustainable Diet Index (SDI) reflecting healthfulness, climate-friendliness, sociocultural benefits, and financial affordability using individual-level data of adults in rural and urban Ghana and Ghanaian migrants in Europe to identify the role of living environment in dietary sustainability. Methods: We used cross-sectional data from the multi-centre Research on Obesity and Diabetes among African Migrants Study (N = 3169; age range: 25–70 years). For the SDI construct (0–16 score points), we used the Diet Quality Index-International, food-related greenhouse gas emission, the ratio of natural to processed foods, and the proportion of food expenditure from income. In linear regression analyses, we estimated the adjusted ß-coefficients and 95% confidence intervals (CIs) for the differences in mean SDI across study sites (using rural Ghana as a reference), accounting for sociodemographic and lifestyle factors. Results: The overall mean SDI was 8.0 (95% CI: 7.9, 8.1). Participants in the highest SDI-quintile compared to lower quintiles were older, more often women, non-smokers, and alcohol abstainers. The highest mean SDI was seen in London (9.1; 95% CI: 8.9, 9.3), followed by rural Ghana (8.2; 95% CI: 8.0, 8.3), Amsterdam (7.9; 95% CI: 7.7, 8.1), Berlin (7.8; 95% CI: 7.6, 8.0), and urban Ghana (7.7; 95% CI: 7.5, 7.8). Compared to rural Ghana, the differences between study sites were attenuated after accounting for age, gender and energy intake. No further changes were observed after adjustment for lifestyle factors. Conclusion: The multi-dimensional SDI describes four dimensions of dietary sustainability in this Ghanaian population. Our findings suggest that living in Europe improved dietary sustainability, but the opposite seems true for urbanization in Ghana. [ABSTRACT FROM AUTHOR]

Background: Substantial variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome score (Gurka/MetS). Methods: All study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score. A change of 0.4 in z-score defined clinically relevant change in line with results of previous studies. Repeated measures analysis of variance was used to examine cardiovascular disease risk and individual clinical indicators of MetS over 12 months, looking for differences in response over time by the five groups. Results: Of 176 participants, 50% (n = 88) had stable scores, 10% (n = 18) had relevant change scores in the first 3 months only and reverted toward baseline, 20% (n = 35) achieved meaningful change over the whole study, 11% (n = 20) had a delayed response at 3–12 months, and 9% (n = 15) demonstrated worsening scores. Significant differential patterns were noted for groups over the duration of the intervention (p <.001). Improvement in diet quality and fitness scores were similar across all groups. Other available variables were tested and did not account for the differences. Conclusion: Work is needed to identify key factors that account for differences in responses to lifestyle interventions that can be used to guide treatment decisions for intensive lifestyle interventions for this common condition. Trial Registration: ClinicalTrials.gov Identifier: NCT01616563; first registered June 12, 2012. [ABSTRACT FROM AUTHOR]

Background: A sleeve gastrectomy (SG) is a lifelong treatment that improves health and better outcomes are associated with follow‐up. However, there is lack of access or high attrition to aftercare. This potentially contributes to sub‐optimal dietary intake and a lack of evidence for nutrition interventions. The present study assessed the feasibility and preliminary efficacy of a nutrition intervention to improve diet quality in Australian adults living with a SG. Methods: Adults (n = 96) post‐SG were recruited into a cross‐sectional diet quality study, with 68 eligible for randomisation to an intervention or wait‐list control group. Over 10 weeks, a Facebook group was used to post daily nutrition education. Feasibility outcomes included participant recruitment, engagement, retention and acceptability. Preliminary efficacy was assessed using change in Australian Recommended Food Score (ARFS). Linear mixed models were used to measure differences in mean outcome between the experimental groups over time. Results: Sixty‐eight participants (97% female) aged 48.2 ± 9.8 years, body mass index 33.1 ± 5.8 kg/m2, and mean ± SD ARFS 39 ± 9 points were randomised to the intervention, with 66% retention at 10 weeks. At follow‐up, diet quality increased for the intervention group (mean ARFS, 95% confidence interval = 0.2 [−1.5 to 1.9]) and decreased for the control group (mean ARFS, 95% confidence interval= −2.0 [−5.2 to 1.2]) with no between group difference (p = 0.2). Participants (n = 30) rated the intervention positively. Conclusions: Recruiting and retaining adults post‐SG into a nutrition intervention is feasible. Low‐cost recruitment attracted strong interest from women to identify greater support to know what to eat following SG. A future fully powered trial to assess intervention efficacy is warranted. Highlights: An online nutrition education intervention for Australian adults' post‐sleeve gastrectomy has been found to be effective and feasibleThe interventions attracted strong interest, especially from women, who were looking for greater support in understanding what to eat after a sleeve gastrectomy.Researchers recommend conducting a fully powered trial to assess the efficacy of this intervention further. [ABSTRACT FROM AUTHOR]

Summary Adolescence is an important period of increasing independence, when adolescents experience changing influences of family and friends on their diets as they transition into adulthood. We conducted a scoping review to map the literature on interpersonal determinants of diet quality and eating behaviors among individuals aged 13–30 years. We searched seven literature databases, and following screening, 329 papers were included. Determinants were grouped according to sub‐categories of the Determinants of Nutrition and Eating framework: family structure (n = 122), social influences (n = 121), parental behaviors (n = 90), family food culture (n = 83), social support (n = 69), parental feeding styles (n = 24), parental attitudes/beliefs (n = 8), and parental resources/risk factors (n = 6), and we added two new sub‐categories: parenting style (n = 74) and partner behaviors (n = 6). Fruit/vegetable (n = 143) and sugar‐sweetened beverage (n = 102) intake were the most commonly measured diet outcomes, and breakfast consumption (n = 41) and fast food/takeaway intake (n = 39) the most commonly examined eating behaviors. This review highlights the gaps in the literature, both across the determinant sub‐categories and also the relative paucity of longitudinal evidence and lack of evidence in emerging adults, particularly outside of university settings. Future research should focus on these areas to provide stronger evidence to support better design of interventions for this age group. [ABSTRACT FROM AUTHOR]

Recent studies suggest that shift working may trigger health issues through disrupted circadian rhythms and altered eating habits. This study aimed to examine the possible associations of shift work with sleep quality, diet quality and obesity-related parameters. This study was conducted with 150 males (75 shift and daytime workers) aged 24–50 years. Dietary intake was determined using the 24-hour recall method, and dietary quality was evaluated using the Healthy Eating Index-2010 (HEI-2010). Anthropometrical measurements and body composition were assessed. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Fasting and postprandial glucose and insulin, and fasting lipid levels were analyzed. HOMA-IR was calculated, and blood pressure was measured. The total HEI-2010 score of shift workers (52.6 [45.4–58.8]) was lower than the daytime workers (55.9 [49.1–64.9]) (p = 0.016). Among individuals with good sleep quality, the total HEI-2010 score, seafood and plant proteins, fatty acids, and sodium scores were lower in shift workers compared to others (p < 0.05 for each). Non-obese shift workers had higher body weight, waist circumference, waist/hip ratio, VLDL-cholesterol, triglyceride, postprandial glucose, and insulin levels compared to daytime workers (p < 0.05 for each). This study demonstrates that shift working is associated with lower diet quality independent of sleep quality. [ABSTRACT FROM AUTHOR]

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

Purpose: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines. Methods: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm. Results: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star). Conclusions: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices. [ABSTRACT FROM AUTHOR]

The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with limited research in this area. Therefore, the objective of this study was to examine the cross‐sectional associations between diet quality and common mental disorders (CMD) such as depression and anxiety in UK undergraduate students. A cross‐sectional survey consisting of demographic information and validated questionnaires (the Short‐Form Food Frequency Questionnaire [SFFFQ] and the Hospital Anxiety and Depression Scale [HADS]) was conducted to measure diet quality and anxiety and depression in young adults in 44 UK‐based universities. Multiple regression analysis adjusting for confounding factors was used to assess the associations between them. Undergraduate university students (n = 202, 67% female) with a mean age of 20.9 ± 3.6 years and a mean body mass index (n = 170) of 22.6 ± 3.2 kg/m2 took part in the study. Prevalence of anxiety was high, with 40% of the sample having an anxiety score in the severe range (≥12 points) while the prevalence of depression was lower, with 6% of the population having a depression score in the severe range (≥12 points). Diet quality was significantly higher for females than males (p = 0.034) and was poor for 38% of the sample, being more common in males compared to females, although not significantly so (43% and 36%, respectively). Diet quality was inversely associated with anxiety (β = −0.427; p = 0.029) and was more likely to be associated with anxiety in females than males (β = 0.743; p = 0.043). No significant relationship between diet quality and depression was found. Better self‐reported health, father's qualification and smoking status were also associated with less anxiety and depression. This research supports other research suggesting that UK universities should explore whether the implementation of dietary interventions and improving the food environment would be a cost‐effective option to reduce the high prevalence of anxiety among students. [ABSTRACT FROM AUTHOR]

Purpose: Use qualitative and quantitative methods to explore factors influencing the adoption of guideline-based physical activity (PA) and dietary recommendations among participants enrolled in a lifestyle intervention during and after chemotherapy for breast cancer. Methods: Among women with stage I-III breast cancer who participated in the intervention arm of the Lifestyle, Exercise, and Nutrition early after diagnosis (LEANer) trial, we used stratified, purposeful sampling to interview women who met both, one, or neither intervention goal after the 1-year intervention: (1) 150 min/week moderate-to-vigorous intensity exercise via a self-reported PA questionnaire and (2) improved self-reported diet quality measured by the Healthy Eating Index-2015. Semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Results: The 29 women interviewed were 52 ± 11 years old on average, with a mean body mass index of 29.6 ± 7.7 kg/m2. Three themes emerged regarding aspects of the LEANer intervention that facilitated behavior change: (1) providing a conduit of trustworthy, timely, and personalized support and education; (2) shifting mindsets and enhanced understanding of the benefits of PA and nutrition during chemotherapy; and (3) fostering a sense of control and alternative focus. Factors described as hindering adoption of goals included: (1) adverse effects of chemotherapy and (2) competing priorities. Conclusions: Women reported the external support, tailored education, and experiencing the physical and mental benefits of the LEANer intervention facilitated the adoption of the interventions’ behavioral goals. Addressing chemotherapy-related symptoms and competing priorities may facilitate adherence to lifestyle interventions during chemotherapy for breast cancer. [ABSTRACT FROM AUTHOR]

The academic success of children contributes to their income, social status, and public health. This study was conducted with 217 elementary school students from western China. Scores on the Chinese Children Dietary Index (CCDI), Dietary Approaches to Stop Hypertension (DASH), adjusted DASH, and KIDMED index were calculated to evaluate diet quality. Eating behavior and sleep quality were assessed using the Children's Eating Behavior Questionnaire (CEBQ) and Children's Sleep Habits Questionnaire (CHSQ), respectively. Academic achievement was measured using school-provided average grades. Higher CCDI scores, longer sleep time, lower total CHSQ scores, and lower subscores on "satiety responsiveness," "slowness in eating," "emotional undereating," and "food fussiness" dimensions of the CEBQ were associated with high academic achievement. In conclusion, good diet quality, sleep quality, healthy eating behaviors, and adequate sleep duration were associated with better academic performance. Interventions are recommended to be developed in education system to improve healthy diets and lifestyles, enhancing academic achievement. [ABSTRACT FROM AUTHOR]

Purpose: A healthy diet reduces the risk of non-alcoholic fatty liver disease (NAFLD) in the general population, especially in individuals who are genetically predisposed to NAFLD. Little is known in patients who suffered from a myocardial infarction (MI). We examined the interaction between diet quality and genetic predisposition in relation to NAFLD in post-MI patients. Methods: We included 3437 post-MI patients from the Alpha Omega Cohort. Diet quality was assessed with adherence to the Dutch Healthy Diet index 2015 (DHD15-index). A weighted genetic risk score (GRS) for NAFLD was computed using 39 genetic variants. NAFLD prevalence was predicted using the Fatty Liver Index. Prevalence ratios (PR) with 95% confidence intervals of DHD15-index and GRS in relation to NAFLD were obtained with multivariable Cox proportional hazards models. The interaction between DHD15-index and GRS in relation to NAFLD was assessed on an additive and multiplicative scale. Results: Patients had a mean age of 69 (± 5.5) years, 77% was male and 20% had diabetes. The DHD15-index ranged from 28 to 120 with a mean of 73. Patients with higher diet quality were less likely to suffer from NAFLD, with a PR of 0.76 (0.62, 0.92) for the upper vs lower quintile of DHD15-index. No association between the GRS and NAFLD prevalence was found (PR of 0.92 [0.76, 1.11]). No statistically significant interaction between the DHD15-index and GRS was observed. Conclusion: In Dutch post-MI patients, adherence to the Dutch dietary guidelines was associated with a lower prevalence of NAFLD, as assessed by the FLI. This association was present regardless of genetic predisposition in this older aged cohort. [ABSTRACT FROM AUTHOR]

Purpose: This study examined maternal diet quality trajectories from pregnancy to 3.5 years postpartum and associated maternal factors. Methods: Data of 473 Australian women from the Healthy Beginnings Trial were used. A food frequency questionnaire collected dietary intake in pregnancy and 1, 2 and 3.5 years postpartum. Diet quality scores were calculated using the 2013 Dietary Guideline Index (DGI-2013) and RESIDential Environments Guideline Index (RDGI). Group-based trajectory modelling identified diet quality trajectories from pregnancy to 3.5 years postpartum. Multivariable logistic regression investigated factors associated with maternal diet quality trajectories. Results: Two stable trajectories of low or high diet quality were identified for the DGI-2013 and RDGI. Women who smoked had higher odds of following the low versus the high DGI-2013 (OR 1.77; 95%CI 1.15, 2.75) and RDGI (OR 1.80; 95%CI 1.17, 2.78) trajectories, respectively. Women who attended university had lower odds of following the low versus the high DGI-2013 (OR 0.41; 95%CI 0.22, 0.76) and RDGI (OR 0.38; 95%CI 0.21, 0.70) trajectories, respectively. Women who were married had lower odds of following the low versus the high DGI-2013 trajectory (OR 0.39; 95%CI 0.17, 0.89), and women who were unemployed had higher odds of following the low versus the high RDGI trajectory (OR 1.78; 95%CI 1.13, 2.78). Maternal age, country of birth, household composition and pre-pregnancy body mass index were not associated with diet quality trajectories. Conclusion: Maternal diet quality trajectories remained stable from pregnancy to 3.5 years postpartum. Women who smoked, completed high school or less, were not married or were unemployed tended to follow low, stable diet quality trajectories. [ABSTRACT FROM AUTHOR]

Introduction: The Healthy Eating Index (HEI) is a comprehensive measure to assess diet quality. Because of the various factors that influence the nutritional status of older adults, there is a need to adapt an index that assesses the quality of the diet considering the dietary requirements of aging and health promotion. This study aimed to adapt the HEI for older adults, considering their needs for healthy eating. Methods: Food consumption data was collected by means of three non-consecutive 24-hour food recalls (R24h). For the adaptation of the Healthy Eating Index for Older Adults (HEI-OA), the components and scoring methodology of HEI-2015 were maintained and Brazilian food intake recommendations for the older population were used, which are in line with international recommendations. The validity of the HEI-OA was assessed by four ideal diets, Mann-Whitney's test, Spearman's correlation analysis and Cronbach's coefficient. Results: Content validity of the HEI-OA was confirmed by the maximum score for diets recommended to older adults and by the score between groups with known differences in diet quality. The HEI-OA total score did not correlate with total energy intake (TEI - total energy value: r = -0.141, p > 0.05). The total HEI-OA score showed a statistically significant correlation with several nutrients. These correlations allowed identifying that these nutrients are closely related to the components of the HEI-OA. The internal consistency value for the HEI-OA total score was 0.327, similar to the 2005 and 2010 versions of the HEI. Conclusion: The HEI was successfully adapted for use with older adults, presenting validity and reliability. The HEI-OA can be used to assess diet quality in line with international dietary guidelines for healthy aging. [ABSTRACT FROM AUTHOR]

Background: Given the growing popularity of plant‐based diets, this study investigated the dietary habits and self‐reported health outcomes of health‐conscious adults consuming plant‐based diets. Methods: A cross‐sectional online survey (n = 315) was distributed to members of Plant‐Based Health Professionals UK, a community interest company. Dietary intake was assessed through a food frequency questionnaire. Data were summarised descriptively. Dietary habits among respondents following a whole food plant‐based (WFPB) and vegan diet were compared using hypothesis tests. Results: Respondents reported following a WFPB (61%), vegan (28%) and semi plant‐based (11%) diet. Median time on current dietary pattern was 5 years. Daily or more frequent consumption was reported for the following foods: fruits 77%, berries 51%, green vegetables 48%, cruciferous vegetables 45%, other vegetables 64%, beans/legumes 41%, whole grains 62%, nuts and all seeds 63%. Consumption of ultra‐processed foods and plant‐based meat alternatives was low. About 93% of those on a WFPB or vegan diet supplemented with vitamin B12 and 61% with vitamin D. The median body mass index was 22.4 kg/m2. Fifty per cent of participants reported weight loss after adopting a plant‐based diet, with a median loss of 6.4 kg. Thirty‐five per cent reported reversing or improving an underlying health condition, and 15% were able to stop or reduce prescribed medication use as a result of dietary changes. Conclusions: This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. How to best encourage such sustainable diets among the broad population requires further research. Key points: Dietary intakes were consistent with a high‐quality diet, with a variety of whole plant foods consumed and minimal ultraprocessed foods, refined grains, sugar‐sweetened beverages and meat alternatives.Whole food plant‐based (WFPB) participants followed, on average, healthier diets than vegan participants and engaged in more physical activity.In this plant‐based population, there were indicators of favourable health outcomes such as low body mass index (BMI) and low levels of common chronic conditions.Participants reported improvements in a range of health conditions and a reduction in medication as a result of adopting plant‐based diets, with some requiring further research.This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. [ABSTRACT FROM AUTHOR]

Background: Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI. Methods: Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18–35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two‐sample t‐test, chi‐squared and one‐way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders. Results: The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males. Conclusion: Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings. Key points: Young male and female adults (18–35 years) demonstrate significantly different diet quality, with females scoring higher.Diet quality and body mass index (BMI) were inversely associated in both males and females, but the impact of diet quality on BMI varies by gender.Dietary interventions in young adults are needed to improve diet quality and the contribution to BMI status. [ABSTRACT FROM AUTHOR]

Diet plays an essential role in health and disease. Therefore, its determination is an important component of many investigations. The aim of the study was to evaluate the effect of a nutritional intervention on the urinary metabolome in children aged 6–12 years. Also, it was intended to identify biomarkers of diet quality and dietary intake. A 2‐month, randomized, controlled, parallel trial was conducted in Spanish children. The analyses focused on the ALINFA group, which followed a full‐fixed meal plan including healthy products, ready‐to‐eat meals, and healthy recipes. Diet quality was assessed by the KIDMED index and dietary intake by a food frequency questionnaire. Untargeted metabolomic analysis on urine samples was carried out, and multivariate analyses were performed for pattern recognition and characteristic metabolite identification. PLS‐DA and Volcano plot analyses were performed to identify the discriminating metabolites of this group. 12 putative metabolites were found to be the most relevant to this intervention. Most of them were products derived from protein and amino acid metabolism (N‐Ribosylhistidine, indolacrylic acid, and peptides) and lipid metabolism (3‐oxo‐2‐pentylcyclopentane‐1‐hexanoic acid methyl, Suberoyl‐L‐carnitine, and 7‐Dehydrodichapetalin E). All these metabolites decreased after the intervention, which was mainly associated with a decrease in the consumption of fatty meat and total fat, especially saturated fat. In turn, N‐Ribosylhistidine and Suberoyl‐L‐carnitine were negatively associated with diet quality, as well as able to predict the change in KIDMED index. In conclusion, the changes observed in urinary metabolome demonstrate the effectiveness of the ALINFA nutritional intervention. [ABSTRACT FROM AUTHOR]

Insect herbivore diet mediates interactions with entomopathogens, yet this is relatively unexplored for microsporidia. Here, we examine a diet‐mediated tri‐trophic interaction between an outbreaking forest defoliator, forest tent caterpillar (FTC) Malacosoma disstria Hübner and Nosema sp. microsporidia.We conducted two experiments where diet quality was manipulated by incorporating lyophilized aspen (Populus tremuloides Michaux) foliage into an artificial diet, which was compared to a standard artificial diet. Diet quantity varied between fully fed and partially starved conditions, simulating an outbreak scenario. Microsporidia infection occurred naturally or was induced via experimental inoculation. We assessed FTC survival, microsporidia infection and load, and sublethal effects of treatments on FTC traits.Plant secondary metabolite concentrations in aspen‐augmented diets varied between experiments. In Experiment 1, the aspen‐augmented diet contained lyophilized aspen foliage with low concentrations of secondary metabolites, which increased FTC survival and reduced microsporidia infection. Diet quality and infection load also interactively influenced adult wing traits in Experiment 1. In Experiment 2, the aspen‐augmented diet contained lyophilized aspen foliage with higher concentrations of secondary metabolites, which negatively affected FTC. No diet‐mediated interactions with microsporidia were observed in Experiment 2.Diet quality (Experiments 1 and 2), diet quantity (Experiment 2) and microsporidia infection (Experiments 1 and 2) directly influenced FTC survival and/or had sublethal effects on FTC that may have cascading effects on population dynamics and dispersal.We demonstrated that diet quality can mediate interactions between FTC and microsporidia, but these interactions depend on the defensive chemistry of the FTC diet. To our knowledge, this is the first study to report diet‐mediated interactions between an outbreaking forest pest and microsporidia and one of only a few studies to examine this tri‐trophic interaction among Lepidoptera. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to carry out a systematic review based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to assess the adherence to the Mediterranean dietary pattern (MDP) in workers. Design/methodology/approach: Three electronic databases were searched up to March 2022. The population was restricted to adults, workers in any professional area, without special diets and no specific health conditions. Their adherence to the MDP was assessed by any a priori method/instrument. Two reviewers independently applied the eligibility criteria and performed the data extraction from each study included. In case of disagreement, a third reviewer was consulted. Findings: Of the 590 studies found, 46 were included. Most of the studies were carried out in Europe, between the years 2019 and 2022 and were cross-sectional studies. The minimum sample size was 38, and the maximum was 1,74,638 participants. Most studies included both males and females; six included only females and nine only males. The three most prevalent types of workers under study were health professionals, factory workers and firefighters. The most used method for assessing adherence to the MDP was the Mediterranean diet score. Overall, workers showed low or moderate adherence to the MDP. Originality/value: This systematic review conducted to assess the adherence to the MDP in workers displays an urgent need to improve diet quality in the workplaces. [ABSTRACT FROM AUTHOR]

To understand the perspectives of individuals living within food swamps and how they may perceive their access to healthy vs. unhealthy foods before and during the COVID-19 pandemic. Additionally, we examine how they may navigate their food environment to feed themselves and their families. We recruited women of color living within a food swamp neighborhood to share their perspectives on healthy and unhealthy food access, healthy eating, neighborhood resources, and community support. We employed the Photovoice model to engage participants to take photographs and document their experiences through two surveys. A focus group was completed to identify solutions and priorities to improve healthy food access. Nine themes related to food access including marketing, food quality, and affordability were identified. Participants conveyed the “saddening” or “frustrating” experience of taking images, which allowed them to document what they feel is the unfair experience of purchasing food in their own neighborhood. Participants highlighted goals they believed would improve outcomes for their neighborhood while discussing potential stakeholders who may assist the community. Participants identified several existing community assets such as local markets and schools that should be leveraged and expanded to enhance the overall health-promoting aspects of their neighborhood. Community members are able to identify the prevalence of unhealthy foods in their neighborhoods and work diligently to combat issues of food access. After completion of the Photovoice study, participants felt more confident about their ability to influence community. [ABSTRACT FROM AUTHOR]

Simple Summary: Quality of life significantly affects health outcomes in cancer patients. However, evidence of an association between diet quality and quality of life in cancer survivors is sparse in Mediterranean countries. The aim of this study was to evaluate the associations between an a priori diet quality index, the Healthy Eating Index-2015 (HEI-2015), and quality of life, assessed through a validated questionnaire targeted at women with a breast cancer diagnosis. A higher HEI-2015 score was positively associated with summary quality of life score and inversely associated with symptom scores. Health-related quality of life (HRQoL) represents one of the most concerning aspects for cancer patients. The Healthy Eating Index (HEI) is an a priori diet quality index directly associated with health outcomes and HRQoL in cancer survivors in North American populations. We evaluated, in a Mediterranean population, the baseline associations between HEI-2015 and HRQoL in 492 women with breast cancer recruited in a DEDiCa lifestyle trial. Dietary data were obtained from 7-day food records; HRQoL was assessed through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) and the C30 Summary Score (SumSc). Analysis of variance and multivariable linear and log-gamma regression models were performed. Mean and standard deviation for HEI-2015 score was 68.8 ± 11.2; SumSc was 81.5 ± 12.9. Women with lower HEI-2015 score had higher BMI, were more frequently exposed to tobacco smoke and had fewer years of education. Patients with a HEI-2015 score greater than 68.7 (median value) showed a significant increase in SumSc of 4% (p = 0.02). HEI-2015 components also associated with SumSc were beans and greens (β = 1.04; p = 0.02). Weak associations were found for total vegetables and saturated fats. Higher diet quality in breast cancer survivors was associated with higher overall HRQoL in this cross-sectional analysis. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was the association between the relationship between Dietary Quality Index-International (DQI-I) and Healthy Eating Index (HEI) and the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) was investigated as indicators of oxidative stress. Results: Based on HEI (low, moderate, and good), the diet quality of both groups was classified as moderate. In all participants, HEI (β=-0.29; P = 0.04) and DQI-I (β=-0.46; P = 0.005) were inversely associated with 8-OHdG. Furthermore, a negative correlation was found between HEI (mean β=-3.53; P = 0.04) and DQI-I (mean β=-5.53; P = 0.004) with F2a-IP. The quality of the footballers' diet was higher than that of the control group. Following a high-quality diet, which is rich in antioxidants, is likely to effectively reduce oxidative stress. [ABSTRACT FROM AUTHOR]

Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18–65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR =   1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR =   1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings. [ABSTRACT FROM AUTHOR]

The quality of complementary feeding can have both short‐ and long‐term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non‐quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra‐processed food (UPFs). Up to one‐in‐five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient‐dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes. Key messages: Complementary diets in rural Ethiopia are extremely low in diversity.Consumption of unhealthy foods is more prevalent than the proportion that meets the minimum dietary diversity.Consumption of ultra‐processed foods was not associated with household wealth score.Indicators of unhealthy feeding practices should be integrated into nutrition programme monitoring. [ABSTRACT FROM AUTHOR]

Ensuring diet quality in the first 2 years of life is critical to preventing malnutrition and instilling healthy food preferences. Children's diet quality has changed little over time and inequalities by socioeconomic status, rural–urban residence, but also by food group may exist. Using data from the 2011, 2016 and 2019 demographic and health surveys (DHS), we estimated the prevalence and inequalities in the minimum diet diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). We further assessed food group‐level inequities. In 2019, only 13.5% of children 6–23 months of age met the MDD, 55% met the MMF and only 11% met the MAD indicator. Absolute and relative measures of inequality were calculated. Modest increases in MDD, MMF and MAD were observed over the past decade (2011–2019). These modest improvements were concentrated in limited geographical areas, among children in wealthier households, and urban residents. Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing; whereas, inequities in the consumption of nutrient‐dense foods have widened. Nevertheless, children from the wealthiest quintile also failed to meet the MDD. Multisectoral efforts that span from diversifying the food supply, regulating the marketing of unhealthy foods, and promoting minimal processing of perishables (i.e., to extend shelf‐life) are needed. Context‐adapted behavioural change communication along with nutrition‐sensitive social protection schemes are also needed to equitably improve the diet quality of children in Ethiopia. Key messages: Improvements in child diet quality are concentrated in limited geographical areas, primarily among wealthier households, and urban residents.Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing over the past decade.Inequalities in the consumption of nutrient‐dense foods have been widening in the last decade. [ABSTRACT FROM AUTHOR]

Women empowerment is an underlying factor of child feeding and nutrition. However, the lack of standardized measurements has made it difficult to design interventions that embed women empowerment and measure their impacts. This study aimed to assess temporal trends in women empowerment in Ethiopia and evaluate their contribution towards improving dietary diversity in infants and young children. We used women and child data from the Ethiopian Demographic and Health Survey 2005, 2011, and 2016, yielding a total sample of 6113 mother–child pairs. The survey‐based women's empowerment index (SWPER) developed and validated for use in Africa was used to assess three dimensions of women empowerment: (i) social autonomy, (ii) decision making; and (iii) attitude to violence. We used multiple‐linear and multivariable logistic regression to assess the associations between SWPER and the number of food groups consumed/and the minimum dietary diversity (MDD). To determine drivers of changes over time, a regression decomposition analysis was run. Women empowerment indices have improved over the 2005–2016 period, but a significant proportion of women had low standardized SWPER scores for autonomy/social independence (47%) and attitude to violence (49%) domains in 2016. SWPER autonomy and SWPER decision‐making scores were strongly associated with the odds of meeting MDD. Changes in women empowerment accounted for 17% of the improvements in MDD between 2005 and 2016. SWPER was a stronger predictor of the change in MDD, than known predictors like wealth, child age, and urban residence. As a critical underlying driver of child nutrition, women empowerment should be boldly addressed and integrated in nutrition interventions. [ABSTRACT FROM AUTHOR]

Despite sustained nutrition education, consumption of animal source foods (ASFs) has been hindered by their low availability, accessibility and affordability. Drying eggs into powder can reduce transport/storage costs, increase shelf‐life and allow easier dosage for use of smaller portions. This study aimed to evaluate the contribution of integrating egg powder to the nutrient adequacy and affordability of diets. Using the 'cost of the diet' analysis, we simulated the incorporation of egg powder into households' and children's diet and evaluated its contribution to the nutrient adequacy and affordability of diets. Analysis of the household consumption and expenditure survey (HCES 2016) revealed that only 0.2% of the total consumption expenditure was allocated for eggs, far below the 2.2% and 4.3% required to allow the consumption of one egg a day by the average and the poorest households, respectively. However, the minimum‐cost nutritious diet required only 2.5 g of egg powder/person/day to reduce the cost of the optimized diet by 14% (0–24%), allowing an additional 1.2 million households (~4–6 million individuals) afford the optimized diet. The optimized diet for a child 6–23 months of age could be afforded by all households, except by those in the poorest wealth quintile. But, free distribution of egg powder to households in the poorest wealth quintile, if supplemented by effective nutrition education, can allow them to afford the minimum‐cost nutritious diet for their 6‐ to 23‐month child. The simple dehydration of egg into egg powder can have a substantial contribution towards increased egg consumption by increasing the affordability of the minimum‐cost nutritious diet. [ABSTRACT FROM AUTHOR]

Child undernutrition disproportionally affects children in low‐ and middle‐income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6–23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight‐for‐length Z‐score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to explore the relation between adherence to the Mediterranean diet, adequacy to the Italian dietary recommendations, and several domains of diet quality in a sample of Italian adults. METHODS: The dietary habits of a total of 1936 participants were investigated. Adherence to the Mediterranean diet and diet quality were assessed through the Medi-Lite and the Diet Quality Index-International (DQI-I). RESULTS: The global DQI-I score positively correlated with the Medi-Lite score. Negative coefficients were found for protein intake and calcium in the adequacy category, total fat in the moderation category, and fatty acid ratio in the overall balance category. More than half of the participants were adherent to national recommendations for potatoes, cereals, red meat, and other fats consumption. In contrast, recommendations on legumes, fruit, vegetables, and processed meat were met by about half of the participants while those for dairy products (milk and yogurt) and cheese, eggs, and white meat were rather underrepresented. Higher scores in DQI-I and Medi-Lite well predicted adequacy to recommendations on fruit and vegetables, legumes, processed meat, cereals, and legumes. CONCLUSIONS: Individuals reporting higher adherence to the Mediterranean diet show better diet quality and a higher probability of meeting the dietary recommendations. [ABSTRACT FROM AUTHOR]