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Background: Sustainable dietary practices can help reduce greenhouse gas emissions and promote planetary health. The importance of investigating how to promote sustainable dietary practices is therefore crucial. Nature Relatedness measures an individual’s connection to nature and can predict environmental concern and stewardship. While emerging research has suggested those with a higher degree of Nature Relatedness report the intention to follow more sustainable dietary practices, the relationship between actual dietary intake and Nature Relatedness has yet to be fully explored. Therefore, the purpose of this pilot study was to assess the relationship between diet quality and Nature Relatedness. Methods: In this cross-sectional study, participants across the United States completed the online survey from September to November 2023. Diet History Questionnaire II and Nature Relatedness scale were completed by the participants. Diet quality was assessed using the Healthy Eating Index (HEI)-2020 total and component scores. Nature Relatedness total and subscale scores were computed. Pearson and Spearman Rho correlation coefficients assessed associations between HEI-2020 and Nature Relatedness. Simple linear regression models examined the relationships between HEI-2020 total and component scores and Nature Relatedness (controlling for age, gender, race, and education). Results: Three hundred adults completed the study. HEI-2020 total score was positively associated with Nature Relatedness (p

Objectives: This study aimed to map and describe the available evidence on dietary characteristics and diet-related health conditions among Haitian immigrants across the globe. Study design: Scoping review. Methods: This review was based on the international guide Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The searches were conducted in several electronic databases in July 2023. Reports focusing on diet, nutrition, and diet-related health conditions among international Haitian immigrants published in English, Portuguese, French, or Spanish with no year limit were included. The data extracted was tabulated and presented in a narrative summary. Results: Database search retrieved 502 records, of which 30 met the inclusion criteria. The categories that emerged from the analysis were: food consumption patterns and trends, food and nutrition insecurity, cultural identity, and diet-related health conditions. Findings suggest: available evidence underrepresents Latin America and the Caribbean context; research gaps related to adolescents and the elderly and also to noncommunicable diseases except obesity; changes in food consumption after immigration towards less healthy eating; the Haitian immigrant's preference for healthy and traditional eating patterns; many experiences of food insecurity related to poverty, unemployment, and lack of social support, especially in host countries in Latin America and the Caribbean; and a high prevalence of obesity, especially among women. Conclusions: Further research is required in countries in Latin America, mainly. Diet-related chronic diseases, adolescents, and the elderly should be targeted for further research. We recommend: longitudinal and qualitative research; field action reports describing local and global strategies to manage Haitian migration-related food and nutrition issues; culturally appropriate dietary interventions; and policies to protect and support the most vulnerable Haitian immigrants to have their fundamental right to adequate food guaranteed, reducing health inequalities.

Near-infrared spectroscopy (NIRS) is a non-invasive and fast technology that has been increasingly used to analyse livestock diet quality. The objective of this study was to conduct a systematic review of the literature to examine the utilisation of NIRS technology for analysing livestock diet quality, with a focus on identifying trends, methodologies, and challenges in recent research. We conducted a systematic search of the literature on five electronic databases and retrieved 718 studies that have been published on the subject. Fifty-four studies were subsequently selected and investigated in depth. These studies were categorised into two groups, namely benchtop and portable, based on the types of NIRS devices utilised, with a majority employing the reflectance spectra mode. Our analysis found that standard normal variate (SNV), detrend (DT), and multiplicative scatter correction (MSC) are the most commonly used spectral data processing methods. The findings indicate that NIRS technology can provide accurate and reliable measurements of key livestock diet quality parameters such as crude protein, fibre, and moisture content. Additionally, we discuss the challenges associated with NIRS technology and provide recommendations for future research directions to further advance the use of NIRS technology in the livestock industry.

Background: With advancing age, the worsening of cognitive and physical disabilities may lead older adults to seek help in their daily living activities. Community/senior centers support older adults during aging, offering a wide variety of services, including meal programs. Using data from the National Health and Nutrition Examination Surveys (2009–2018), we aimed to examine whether community/senior center meal programs were associated with an improved nutritional exposure in U.S. adults aged 60 years or older. Methods: Nutrient exposure and nutrient-based dietary indexes, including the Diet Quality Score (DQS) and the Food Nutrient Index (FNI) were compared between those eating meals at community/senior centers and the general population. Nutrient intakes were contrasted to the daily nutritional goals from the Dietary Guidelines for Americans. Results: This study included 6261 participants aged ≥60 years, thereof n = 421 reporting community/senior center meals. The latter were predominantly female and almost 45% were widowed or divorced. Eating at community/senior centers did not result in a better diet quality in crude analyses. After adjustment for potential sociodemographic confounders as well as alcohol, smoking and energy intake, however, sex-specific differences emerged, revealing significantly higher FNI scores in males eating at community/senior centers (adjusted FNI predictions: 61.71 [CI:58.55–64.88] vs 57.64 [CI:56.86−58.41] points). Conclusions: Eating at community/senior centers was associated with an improved nutrient exposure in older men, whereas no better diet quality was found in women. Community/senior centers may play a pivotal role when it comes to the diet quality of a particularly vulnerable group of the population.

Objective: The aim was to examine the association between social frailty and diet quality in adults over 65 years of age, and whether results differed by sex. Design: Population-based cross-sectional study using data from the Spanish National Health Survey. Participants: 5,071 community-dwelling people ≥65 years from Spain. Measurements: Social frailty was deemed to exist when the person both lived alone and had low social support, measured with the Duke-UNC scale. Diet was assessed with the Spanish Healthy Eating Index (S-HEI), ranging from 0 to 100 points (highest diet quality). Means and 95% confidence intervals of the S-HEI score for each social frailty group were calculated using linear regressions, with socially robust people as reference. Analyses were adjusted for main confounders, including sociodemographic, lifestyle and morbidity variables. Results: There were no differences in the S-HEI adjusted mean of socially frail (74.3 points, 95%CI: 73.4−75.2) compared to socially robust older adults (75.4 points; 95%CI: 75.1−75.7). In sex-stratified analyses, the S-HEI adjusted mean of socially frail men (71.9 points; 95%CI: 70.6−73.2) was lower than robust men (74.8 points; 95%CI: 74.4−75.3). Specifically, social frailty was associated with lower consumption of vegetables, fruits, dairy and lower diet variety in men. Differences were not observed according to social frailty among older women. Conclusions: Social frailty was associated with poor diet quality in community-dwelling older men, but not in women in Spain. Gender differences in self-care could partly explain this association. Sex-specific interventions are required to minimize the impact of social frailty on diet quality.

Objective: To examine geographic disparities in the nutritional quality of food purchases during the COVID-19 public health crisis in North Carolina (NC). Methods: Using shopper-level longitudinal transaction records between October 2019– and December 2020 from NC’s largest grocery retailer, we fit mixed-effect models to examine disparities in the nutritional quality of food purchases among shoppers in counties with different levels of socioeconomic development and how such disparities changed after March 2020, accounting for other observed and contextual factors. Results: Shoppers in counties with lower development levels purchased a larger share of calories from least healthy foods and a smaller share from healthier foods compared to shoppers in counties with higher development levels. These disparities were slightly attenuated for the least healthy foods and did not change for healthier foods after the onset of the COVID crisis. Conclusion: Despite existing nutritional disparities among shoppers in counties with different levels of socioeconomic development, we did not observe a large-scale accentuation of inequities in dietary quality during the COVID-19 crisis. This pattern may have resulted from programmatic responses to mitigate the adverse effects of the COVID crisis on vulnerable populations. Future work should further explore the role of such responses.

Background: Food insecurity is a pivotal determinant of health outcomes. Little evidence exists on the association between food insecurity and health behaviors and outcomes, including diet quality, among graduate students or postdoctoral trainees. Objectives: This study aimed to examine the association between food insecurity and diet quality among graduate students and postdoctoral trainees at 3 health-focused graduate schools (public health, medical, and dental medicine) within Harvard University. Methods: Between April and June 2023, 1287 graduate students and 458 postdoctoral trainees at the health-focused schools within Harvard University completed a web-based survey. The primary exposure was food security status, assessed using the United States Household Food Security Survey Module. The primary outcome was diet quality, measured using the 30-day Prime Diet Quality Score screener (ranges from 0 to 126, with higher scores indicating healthier diets). The associations between food insecurity and diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates. Results: Among graduate students, compared with those with high food security, diet quality was significantly lower among those experiencing marginal food security [β: −4.7; 95% confidence interval (CI): −6.5, −2.9], low food security (β: −5.4; 95% CI: −7.6, −3.3), and very low food security (β: −4.4; 95% CI: −7.4, −1.4). Poor diet quality included lower intake frequencies of vegetables, fruits, beans/peas/soy products, nuts/seeds, poultry, fish, low-fat dairy, and liquid oils, and higher intake frequencies of refined grains/baked products, sugar-sweetened beverages, and fried foods. Among postdoctoral trainees, compared with those with high food security, diet quality was significantly lower among those experiencing low food security (β: −5.1; 95% CI: −8.8, −1.4), and very low food security (β: −5.2; 95% CI: −10.2, −0.2). Poor diet quality included lower intake frequencies of dark green leafy vegetables, other fruits, and whole grains. Conclusions: Graduate students and postdoctoral trainees who experienced degrees of food insecurity reported lower diet quality. These observations underscore the need for policies and interventions to simultaneously reduce food insecurity and improve diet quality.

Objective: Whether employees’ health status is associated with the effectiveness of workplace health promotion programs is unknown. The objective of this study was to determine if the effect of a workplace healthy eating intervention differed by baseline chronic disease status. Methods: This was a secondary analysis of a randomized controlled trial conducted September 2016 to February 2018 among US hospital employees to test the effect of a 12-month behavioral intervention (personalized feedback, peer comparisons, and financial incentives) on diet and weight. Participants were classified as having chronic disease (yes/no) based on self-reported hypertension, hyperlipidemia, heart disease, stroke, pre-diabetes, diabetes, cancer or another serious illness. BMI was measured at study visits and calories purchased were measured from cafeteria sales data over 24 months. Mixed models with random effects assessed heterogeneity of treatment effects by chronic disease. Results: Participants (N = 548) were mostly female (79.7 %) and white (81.2 %); 224 (40.9 %) had chronic disease. Among those with chronic disease, intervention participants reduced caloric intake by 74.4 [22.3] kcal more than control, with a smaller difference between intervention and control (−1.9 [18.7] kcal) (three-way p-interaction = 0.02). The effect on BMI for those with chronic disease (0.47 [0.21] kg/m2) indicated weight stability among intervention participants and weight gain among controls while the effect (−0.56 [0.18] kg/m2) for those without chronic disease was the opposite (three-way p-interaction

Background: A common assumption is that adolescents have poor eating habits. However, there is minimal data regarding adolescents’ intake of macronutrients (i.e. protein, carbohydrate, and fats) and micronutrients (i.e. vitamins and minerals). In addition, few studies have used the Healthy Eating Index-2010 (HEI-2010) to assess diet quality of well adolescents. Objective: To determine diet quality among patients presenting for well care by using NDSR (Nutrition Data Systems for Research) nutrition analysis software and by calculating HEI-2010 scores. Methods: A convenience sample of adolescents presenting to clinic for well care was recruited. Participants completed a 24 hour dietary recall using the multiple pass method, a validated interviewing technique. Results for each participant were entered into NDSR version 2014, which provides a detailed nutrition analysis, and these results were also used to calculate a HEI-2010 score, which measures how well dietary intake conforms to the Dietary Guidelines for Americans in terms of amounts consumed from each food group. Results: Data from 48 adolescents (30 female, 18 male; mean age 16.5, range 12–20 years; 18 Hispanic, 11 Black, 5 White, 14 other) were analyzed. Body-mass-index (BMI) ranged from 16.0 to 38.1. Average total calories were 2054 (but there was a wide range of 683 to 4801 calories). Average calories for females and males were 1723 and 2604, respectively. Average percentages of calories from macronutrients were 33.2% from fat, 50.5% from carbohydrate, and 16.3% from protein. Micronutrient content was very low (< 53% of recommended Daily Values) for vitamins E and D; moderately low (61–76%) for zinc, magnesium, potassium and copper; minimally low (86–97%) for calcium, iron and vitamin B12; and normal (≥100%) for thiamin, riboflavin, niacin, folic acid, phosphorus, manganese, selenium and vitamins C, K, and B6. HEI scores were 80 (“good”). Conclusion: On some measures (distribution of macronutrients, intake of most vitamins and minerals), the adolescents in this study had sufficient diets by NDSR calculations. However, no subject had an HEI score indicative of good diet quality. It is possible that adolescents are consuming adequate macro- and micronutrients in the setting of processed, fortified foods, but that optimal consumption from each food group is lacking, resulting in lower diet quality scores on the HEI.

Background: The traditional cultural food practices of Indigenous people and adults from racial/ethnic minority groups may be eroded in the current food system where nutrient-poor and ultra-processed foods (UPF) are the most affordable and normative options, and where experiences of racism may promote unhealthy dietary patterns. We quantified absolute and relative gaps in diet quality and UPF intake of a nationally representative sample of adults in Canada by Indigenous status and race/ethnicity, and trends between 2004 and 2015. Methods: Adults (≥18 years) in the Canadian Community Health Survey-Nutrition self-reported Indigenous status and race/ethnicity and completed a 24-h dietary recall in 2004 (n = 20,880) or 2015 (n = 13,970) to calculate Healthy Eating Index-2015 (HEI-2015) scores from 0 to 100 and proportion of energy from UPF. Absolute and relative dietary gaps were quantified for Indigenous people and six racial/ethnic minority groups relative to White adults and trends between 2004 and 2015. Results: Adults from all six racial/ethnic minority groups had higher mean HEI-2015 scores (58.7–61.9) than White (56.3) and Indigenous adults (51.9), and lower mean UPF intake (31.0%–41.0%) than White (45.9%) and Indigenous adults (51.9%) in 2015. As a result, absolute gaps in diet quality were positive and gaps in UPF intake were negative among racial/ethnic minority groups—indicating more favourable intakes—while the reverse was found among Indigenous adults. Relative dietary gaps were small. Absolute and relative dietary gaps remained largely stable. Conclusions: Adults from six racial/ethnic minority groups had higher diet quality and lower UPF intake, whereas Indigenous adults had poorer diet quality and higher UPF intake compared to White adults between 2004 and 2015. Absolute and relative dietary gaps remained largely stable. Findings suggest racial/ethnic minority groups may have retained some healthful aspects of their traditional cultural food practices while highlighting persistent dietary inequities that affect Canada's Indigenous people.

Objective: N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is a marker of cardiac wall stress and is a predictor of cardiovascular disease. Higher diet quality is associated with lower risk of cardiovascular disease. The association between diet quality and subclinical cardiovascular disease assessed by NT-proBNP is uncharacterized. We investigated the associations between diet quality, using Healthy Eating Index-2015 (HEI-2015), and NT-proBNP from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Methods: We included 9,782 adults from NHANES 1999-2004 without self-reported cardiovascular disease. The HEI-2015 ranges from 0 to 100, with higher scores indicating better diet quality. The HEI-2015 was categorized into sex-specific quintiles. Regression models were used to quantify associations between the overall HEI-2015 score and its 13 components with log-transformed NT-proBNP. The beta coefficients were converted to percent differences. Results: Among 9,782 participants, mean age was 45 years, 48% were men, and 72% were non-Hispanic White adults. After adjusting for sociodemographic characteristics, lifestyle factors, and medical history, those in the highest vs. lowest HEI-2015 quintile had an 8.5% (95% CI: -14.6% to -2.0%) lower NT-proBNP level. There was a dose-response association between HEI-2015 and NT-proBNP (P value for trend = 0.01). Each 1-unit higher in sodium and added sugars score indicating lower intake was associated with lower NT-proBNP by 7.7% (95% CI: -12.8% to -2.2%) and 6.5% (95% CI: -12.0% to -0.7%), respectively. Conclusion: Higher diet quality, especially lower intakes of sodium and added sugars, was associated with lower serum levels of NT-proBNP.

Scientific evidence suggests a relation between dietary factors and sleep. Several studies show that higher adherence to the Mediterranean diet is associated with better sleep quality, but the relation with chronotype has been only recently explored. The aim of this study was to better understand the relation between chronotype and Mediterranean diet adherence. For this purpose, an analysis of 1936 adults (age 18–90 y) living in Italy was performed to investigate the association between chronotype (assessed with a short form of the morningness-eveningness questionnaire) and adherence to the Mediterranean diet (assessed through a 110-item food frequency questionnaire and the Medi-Lite literature-based Mediterranean adherence score). A multivariate logistic regression analysis was conducted to calculate odds ratios (OR) and 95 % confidence intervals (CIs) describing the association between chronotypes and high adherence to the Mediterranean diet (>14 points). Moreover, a systematic review of other observational studies published so far was performed. Individuals reporting having intermediate (n = 614) and evening (n = 173) chronotypes were less likely to have high adherence to the Mediterranean diet compared to morning chronotype (OR = 0.28, 95 % CI: 0.18, 0.42 and OR = 0.08, 95 % CI: 0.03, 0.27, respectively). When the analysis was conducted in subgroups of age, the results were similar in mid-age (>50 y) participants (for intermediate and evening chronotypes, OR = 0.21, 95 % CI: 0.10, 0.43 and OR = 0.92, 95 % CI: 0.01, 0.69, respectively) while the association with high adherence to the Mediterranean diet of evening compared to morning chronotype lost significance in older (>60 y) participants (for intermediate and evening chronotypes, OR = 0.27, 95 % CI: 0.09, 0.82 and OR = 0.22, 95 % CI: 0.02, 1.92, respectively). Out of 10 studies (date range of publication 2020–2022) included in the systematic review, there was a general consistence of findings showing higher adherence to the Mediterranean diet among morning chronotypes, although few studies reported null results. In conclusion, current evidence suggests that an intermediate and evening chronotype could be associated with lower adherence to a Mediterranean diet, but the association could be modified by other factors when considering older individuals.

Nutrition education is selected as a method which often used to change eating behaviour, yet, the effectiveness of this method in adolescents who live in household with food insecurity status is rarely investigated. The purpose of this study was to assess the impact of a combination of nutritional education held at school and home visits for increasing the nutritional literacy and its effect on the quality of adolescent diet, so that the result can be used as a strategy to improve nutritional literacy dan diet quality in those adolescents who live in food-insecure households in post-disaster areas. The De-Nulit Study is a Cluster Randomized Controlled Trial (CRCT) with an intervention from a combination of nutritional education given at school and home visits conducted for three months for adolescents who live in food-insecure households with ages ranging from 15 to 17 years old. A randomization sampling was carried out at four schools located the nearest locations which were affected heavily by the major natural disasters in 2018. The nutritional education intervention groups in schools were given in eight sessions, whereas home visits with an interview approach for students with a motivational interview approach were carried out four times. The control group will receive leaflets three times a month for three months, and each group will receive a food stamp $ 7.6 per month for three months. The trial research has been recorded in Thai Clinical Trials Registry (TCTR) with identification number of TCTR 20220203003 issued on 03 February 2022.

Summary: Millions of people will now suffer from long-term smell loss as a result of infection with the SARS-CoV-2 virus. Smell is an integral component of the flavor of foods, which is one of the primary drivers of ingestive behavior. When individuals lose their sense of smell, they find food to be less flavorful and less enjoyable, which negatively impacts their quality of life. To compensate, many individuals alter their diet by focusing on tastes, chemesthesis (e.g., chili pepper heat, menthol cooling), and the texture of foods to make it more palatable. Some diet alterations, such as increasing salt use, can result in a lower diet quality, and an increased risk for chronic disease. Sensory nutrition is an area of research that focuses on how the chemical senses (e.g. taste, smell, chemesthesis) and oral somatosensation) affect dietary choices and health. Sensory nutrition strategies designed for individuals with smell loss may help improve the flavor and liking of foods while improving diet quality, and are a necessary area of future research to help improve health and quality of life in the growing population with smell loss.

Whether exposure to organophosphate esters (OPEs) is associated with metabolic dysfunction-associated fatty liver disease (MAFLD) and nonalcoholic fatty liver disease (NAFLD) remains unclear. A healthy diet is crucial to metabolic health and dietary intake is also an important route for OPEs exposure. However, the joint associations of OPEs, diet quality, and the effect modification by diet quality remain unknown. This study comprised 2618 adults with complete data on 6 urinary OPEs metabolites, 24 h dietary recalls, and definitions of NAFLD and MAFLD from the 2011–2018 National Health and Nutrition Examination Survey cycles. Multivariable binary logistic regression was applied to assess the associations of OPEs metabolites with NAFLD, MAFLD, and components of MAFLD. We also adopted the quantile g-Computation method to examine the associations of OPEs metabolites mixture. Our results revealed that OPEs metabolites mixture and three individual metabolites [i.e., bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), bis(2-chloroethyl) phosphate, and diphenyl phosphate] were significantly and positively associated with NAFLD and MAFLD (P-trend

Background: Fermentable carbohydrates (FC) improve health, but data are lacking on their presence and relationships with dietary quality in self-selected diets. Types of foods chosen within different dietary patterns may vary, which could impact the FC distribution and overall diet quality, but these relationships have not been examined to date. Objective: This cross-sectional study compared intakes of FC and subclasses [soluble dietary fibers (SDF) and polyols] and diet quality in plant-based (PB) and western-style (WS) diets. Methods: Dietary data were collected from 84 adults (26.8 + 11.5y; 23.0 kg/m2) through diet history questionnaire-III; dietary quality was assessed by the 2015 Healthy Eating Index (HEI-2015). Independent sample t-tests compared FC and subclasses (in grams and g/1000 kcal) in PB and WS diets. Multiple regression analyzed HEI-2015 of PB and WS adjusting for confounders. Analysis of variance evaluated if diet influences relationships between diet group and FC and subclasses intakes. Results: The average intakes of FC [PB (9.8 ± 5.2g); WS (7.3 ± 3.6g), p = 0.014*], SDF [8.3 ± 4.4g; 6.4 ± 3.1g, p = 0.02] and polyols [1.5 ± 1.0g; 1.0 ± 0.6g, p = 0.008] were higher in PB than WS. Similarly, the average intake of FC (gram/1000 kcal) [6.5 ± 5.9 vs 4.6 ± 3.9, p = 0.0001*], SDF (g/1000 kcal) [4.5 ± 2.0vs 4.0 ± 1.6, p = 0.0003*] and polyol (g/1000 kcal) [1.0 ± 0.6 vs 0.6 ± 0.3, p = 0.0006*] was significantly higher in PB than WS. The mean HEI-2015 score for PB was higher than WS [77.9 ± 9.1; 64.7 ± 11.4, p

Depression is one of the leading health problems, and >300 million people have a major depressive disorder and this number is getting increasing. Depression complicates the management of existing chronic diseases and the management of complications that may arise. A person's mental state can affect their food preferences, and food preferences can also affect their mental state. In this paper, depression and eating behavior, diet quality, folic acid, vitamin B12, vitamin B6, vitamin D, omega-3 fatty acids, magnesium, selenium, zinc and copper, prebiotics and probiotics are discussed. Research on the subject emphasizes that diet quality may also affect the occurrence of depression. However, studies also indicated that dietary nutrients such as folic acid, vitamin B12, vitamin B6, omega-3 fatty acids, zinc, selenium, and magnesium might be associated with the risk of depression.

Objective: Foods are a potential source of lead but also contain nutrients that counteract the intestinal absorption of lead. Translatable evidence is needed to better understand the relationship between whole diets and blood lead levels (BLLs) in children. In this cross-sectional study we investigated the association between dietary variety, adequacy, moderation, and overall diet quality with children's BLLs., Methods: First graders (~ 7 years) from Montevideo, Uruguay were evaluated in years 2009-13 (Phase I, n = 303) and 2015-19 (Phase II, n = 443). Lead was measured in fasting blood via atomic absorption spectrometry and primary caregivers completed two non-consecutive 24-h recalls. Indices of dietary variety (maximum score of 20), adequacy (maximum 40), moderation (maximum 30), and overall diet quality were calculated from food and nutrient intakes averaged over two recall days. The indices were adapted from the Diet Quality Index-International based on dietary recommendations for children. Missing covariate data were imputed. The associations between diet quality measures and BLLs were modeled separately in Phase I and II with multivariable linear models, testing for sex differences via interaction terms and stratified models., Results: The median[IQR] BLLs were 3.8[2.6, 4.9] and 1.3[0.7, 3.6] μg/dL in study Phases I and II, respectively. All diet quality scores were <60 % of the maximum values and daily intakes of key food groups fell below recommended levels. There was little evidence of an association between measures of diet quality and children's BLLs overall. On the other hand, higher diet variety, adequacy, and overall diet quality were associated with slightly higher BLLs among girls in Phase I only., Conclusions: In the context of low lead exposure and food consumption patterns that fall short of recommended levels, the relation of diet quality to children's BLLs may depend on lead exposure levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Mindful eating, a practice that encourages attention to sensations and awareness during the eating experience, has shown effectiveness in inducing positive behavioral changes. Mindful eating practices have been examined in relation to energy intake (i.e., quantity of food) but to a lesser extent to the quality of that food, hence, it is crucial to comprehensively understand the association between mindful eating and diet quality., Objective: The objective of this study is to examine the association between mindful eating and diet quality among United States (U.S.) adults with lower incomes and to examine heterogeneity in the associations by gender identity., Design: This study employs a cross-sectional study design., Participants/setting: In December 2022, a national convenience sample of 1,798 U.S. adults with lower incomes, recruited through Prime Panels, completed a web-based survey., Main Outcome Measures: Diet quality was measured using the 30-day Prime Diet Quality Score screener (ranges from 0-126). A higher score reflects higher diet quality., Statistical Analyses Performed: Associations between the Mindful Eating Questionnaire (MEQ) (ranges from 1-4) and its four factors (Awareness, External Cues, Emotional Response, and Distraction) in relation to diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates., Results: The mean MEQ score was 2.30; the mean PDQS-30D score was 50.2. The associations between MEQ scores and PDQS-30D scores were significantly modified by gender identity. Among men, a higher MEQ score reflecting more mindful eating (β=3.81, 95% CI: 2.19, 5.43) was associated with higher PDQS-30D scores. In addition, a higher Awareness factor score (β=3.21, 95% CI: 2.48, 3.93), a higher External Cues factor score indicating less response to external cues (β=0.76, 95% CI: 0.01, 1.52), and a higher Distraction factor score indicating less distraction (β=1.09, 95% CI: 0.28, 1.90) were all associated with higher PDQS-30D scores. Among women, a higher Awareness factor score was associated with higher PDQS-30D scores (β=2.50, 95% CI: 1.78, 3.22); and a higher Emotional response factor score (i.e., eating less in response to emotional eating) was associated with lower PDQS-30D scores (β=-0.85, 95% CI: -1.58, -0.12)., Conclusions: Mindful eating and its factors are associated with a higher diet quality among U.S. adults with lower incomes, particularly among men. Future longitudinal and intervention studies are warranted to better understand these associations among adults with lower incomes, as an understudied population in the mindful eating literature., (Copyright © 2024. Published by Elsevier Inc.)

Background: Implications of life-long, perceived discrimination on nutrient intake during the preconception period are unclear., Objective: The objective is to identify associations between perceived discrimination and consumption of specific nutrients associated with risk of adverse pregnancy outcomes., Design: This is a secondary data analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (NuMom2b) cohort. Participants completed a Block Food Frequency Questionnaire assessing diet in the three months prior to pregnancy and a Krieger Experiences of Discrimination Scale assessing personal encounters of discrimination., Participants/setting: Participants were recruited from eight clinical centers across the US between 2010-2013. Each participant completed the Food Frequency and Krieger questionnaires and self-identified as belonging to a minoritized racial or ethnic group for this analysis (n=2457)., Main Outcome Measures: Main outcomes include reported total energy and macronutrient intake, percent of energy from macronutrients, saturated and unsaturated fatty acids (FA), added sugar, sodium, dietary fiber, and Healthy Eating Index-2010 Seafood and Plant Proteins component score., Statistical Analyses Performed: Participants were grouped as reporting fewer (<3) or more (≥3) circumstances of discrimination on the Krieger Scale. Multivariable regression models examined associations between discrimination group and nutrient intake. Variables with non-normal distributions were log transformed. Associations were adjusted for total energy intake. Primary outcomes underwent false discovery rate correction (FDR)., Results: Those reporting three or more circumstances of discrimination had higher reported energy intake (p=0.002) and higher reported intake of total fat, saturated fat, unsaturated fats, protein, added sugar and sodium after FDR (all p<0.05) as compared to those reporting fewer circumstances. After adjustment for total energy intake, reporting three or more circumstances was associated with greater reported intake of saturated fat and n-3 polyunsaturated FA, and lower reported intake of dietary fiber (all p<0.05)., Conclusion: Reporting three or more circumstances of discrimination was associated with higher reported total energy intake. After adjustment for total energy, reporting three or more circumstances of perceived discrimination was associated with less nutritious intake for some (higher saturated fat and lower dietary fiber) but not all (higher eicosapentaenoic and docosahexaenoic acids) nutrients., (Copyright © 2024. Published by Elsevier Inc.)

Background: Healthy diets have been inversely associated with biological aging. However, the nutritional content is only one aspect of the overall food health potential, and more recently, increasing attention has been paid to nonnutrient food characteristics, such as food processing., Objectives: To examine the association of ultra-processed food (UPF) consumption with biological aging measured by circulating blood biomarkers., Methods: Cross-sectional analyses were conducted on 22,495 participants enrolled in the Moli-sani Study (2005-2010, Italy). Food intake was assessed by a 188-item food frequency questionnaire. UPF was defined according to the Nova classification and calculated as the ratio (weight ratio; %) between UPF (g/d) and total food eaten (g/d). Diet quality was assessed by the Mediterranean Diet Score (MDS; ranging 0-9). A deep neural network approach based on 36 circulating biomarkers was used to compute biological age (BA), and the resulting difference (Δage = BA - chronological age)-an index of biological aging-was tested as dependent variable in multivariable linear regression analyses including known risk factors., Results: The mean Δage in this population was -0.70 (standard deviation ±7.70) years. In multivariable-adjusted analyses, higher intake of UPF was associated with accelerated Δage [β = 0.34 years; 95% confidence interval (CI): 0.08, 0.61 for the last fifth compared with the first). This association was not linear (P value for overall association <0.001; P value for nonlinearity = 0.049). Inclusion of the MDS into the model slightly attenuated this association by 9.1% (β = 0.31 years; 95% CI: 0.04, 0.59)., Conclusions: A diet rich in UPF was associated with an acceleration of biological aging in a large sample of Italian adults. The poor nutritional composition of highly processed foods weakly accounted for this association, suggesting that biological aging could be adversely influenced by nonnutrient characteristics of these foods., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined., Objectives: This study investigated diet quality from early pregnancy through 1 y postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States., Methods: Participants completed 24-h dietary recalls at 6 study visits (each pregnancy trimester and 6 wk, 6 mo, and 1 y postpartum) (n = 383). Between-visit mean Healthy Eating Index-2015 (HEI) scores (min = 0, max = 100) were compared using the population ratio (PR) method. The NCI usual intakes method estimated the distribution of HEI scores in pregnancy and postpartum; unpaired t-tests compared usual mean HEI scores by covariates; paired t-tests compared differences between mean pregnancy and postpartum., Results: The total HEI mean ± standard error scores (NCI method) were 61.4 ± 0.8 in pregnancy and 61.7 ± 0.9 in postpartum. Mean HEI scores differed by sociodemographic characteristics, particularly education, marital status, and federal assistance participation. The highest scores were observed in participants with at least a bachelor's degree (64.1 ± 0.9 in pregnancy, 64.5 ± 1.0 in postpartum, n = 257) and those with other non-Hispanic White race/ethnicity (64.7 ± 1.8 in pregnancy, 66.4 ± 2.2 in postpartum). There were no between-visit differences in mean total HEI scores (PR). Although differences were observed in some mean HEI component scores between pregnancy and postpartum visits, they were small (mostly <1 point) in magnitude and in inconsistent directions., Conclusions: Stable total HEI mean scores suggest that adherence to dietary guidelines was consistent throughout pregnancy and postpartum in this sample. Although some sociodemographic characteristics may identify individuals at greater risk of diet-related pregnancy complications, low diet quality was pervasive throughout all subgroups and reflects an urgent need for widespread improvement., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Published by Elsevier Inc.)

Background: Different food price sources and dietary assessment tools may impact the estimation of diet costs and hamper our understanding of the relationship between diet costs and dietary intakes., Objectives: We aimed to investigate the effect of 3 diet cost derivation methods, with increasing numbers of food prices and geographic specificity, holding consistent the dietary assessment tool, on the estimation of diet costs overall and by food group., Methods: We matched 24-h dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) to food price data from 3 Canadian Consumer Price Index (CPI) food price lists; national short list, national long list, and provincial long list. We compared the daily ($/day) and energy-adjusted ($/2000 kcal) diet costs overall and by food groups for the overall population (4+), children (4-18), and adults (19+)., Results: The proportion of dietary intakes (grams) that were covered by CPI prices significantly increased from the national short list to the national long list but did not significantly differ from the national long list to the provincial long list. The national short list resulted in the highest daily and energy-adjusted diet costs overall. No difference in diet costs was noted between the national and provincial long lists. Diet costs for 4 food groups-additions, sweets, fruits, and vegetables, which were poorly covered by the national short list-significantly differed using the national and provincial long lists. All 3 diet cost methods were significantly correlated with energy intakes; however, a strong/very strong correlation was detected for children, and a weak/moderate correlation for adults., Conclusions: The choice of food price data may introduce bias in the diet cost estimate, as well as limiting our understanding of how individuals allocate their diet costs. Refinement of diet cost estimation methodology and measures can strengthen future studies of how consumers allocate their purchases to their diets., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: 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., Objective: The objective of this study was to evaluate the association between dietary quality and risk of incident RA in postmenopausal women., Design: 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., Participants/setting: 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., Main Outcome Measures: 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)., Results: 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., Conclusion: A higher-quality diet reflected by higher HEI-2015 total scores was inversely associated with incident RA in postmenopausal women., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Few studies have examined whether diet quality is lower in women with body weight dissatisfaction compared with women without body weight dissatisfaction., Objectives: (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., Design: Data were extracted from the cross-sectional 2014-2015 Swiss National Nutrition Survey., Participants/setting: Population-based sample of 507 women with BMI ≥ 18.5 and < 25., Outcome Measures: 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., Statistical Analyses Performed: 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., Results: 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.", Conclusions: 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., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: 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., Objective: This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging., Design: 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., Participants/setting: 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., Main Outcome Measures: Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE., Statistical Analyses Performed: 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., Results: 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., Conclusions: In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Diet plays critical roles in modulating maternal metabolic health in pregnancy, but is also a source of metabolic-disrupting phthalates and their replacements. We aimed to evaluate whether the effects of better diet quality on favorable maternal metabolic outcomes could be partially explained by lower exposure to phthalates/replacements., Methods: At 13 weeks gestation, 295 Illinois women (enrolled 2015-2018) completed a three-month food frequency questionnaire that we used to calculate the Alternative Healthy Eating Index (AHEI)-2010 to assess diet quality. We quantified 19 metabolites, reflecting exposure to 10 phthalates/replacements, in a pool of five first-morning urine samples collected monthly across pregnancy. We measured 15 metabolic biomarkers in fasting plasma samples collected at 17 weeks gestation, which we reduced to five uncorrelated principal components (PCs), representing adiposity, lipids, cholesterol, inflammation, and growth. We used linear regression to estimate associations of diet quality with [1] phthalates/replacements and [2] metabolic PCs, as well as [3] associations of phthalates/replacements with metabolic PCs. We estimated the proportion of associations between diet quality and metabolic outcomes explained by phthalates/replacements using a causal mediation framework., Results: Overall, every 10-point improvement in AHEI-2010 score was associated with -0.15 (95% CI: -0.27, -0.04) lower adiposity scores, reflecting lower glucose, insulin, C-peptide, leptin, C-reactive protein, but higher adiponectin biomarker levels. Every 10-point increase in diet quality was also associated with 18% (95%CI: 7%, 28%) lower sum of di-2-ethylhexyl terephthalate urinary metabolites (∑DEHTP). Correspondingly, each 18% increase in ∑DEHTP was associated with 0.03 point (95% CI: 0.01, 0.05) higher adiposity PC scores. In mediation analyses, 21% of the inverse relationship between diet quality and adiposity PC scores was explained by lower ∑DEHTP., Conclusions: The favorable impact of diet quality on maternal adiposity biomarkers may be partially attributed to lower metabolite concentrations of DEHTP, a plasticizer allowed to be used in food packaging materials., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Braun served as an expert witness in litigation related to perfluorooctanonic acid contamination in drinking water in New Hampshire. The other authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The rapid growth of dollar stores as retail sources of food in the United States is a phenomenon with implications for diets, nutrition, and well-being. We convened a broadly interdisciplinary group of researchers and experts from government and academia at the 2-day Food Access at Dollar Stores (FADS) workshop, held in Boston, MA in 2022. The event brought together economists, social scientists, public health researchers, and advocates to discuss the concerns and research questions raised by the growth of dollar stores and their increased role in food retail and access. In-person, moderated discussions on day 2 of the workshop generated a range of topics considered important for future research. A subsequent survey, using a modified Delphi approach, identified priority research areas. Nine research area categories emerged as a result of discussion at the FADS workshop and received prioritization from the experts: Local community impacts; Health and nutrition impacts; Policy and programs; Systemic issues - racism, poverty, and food access; Store offerings and locations; Shoppers and customers; Employees and employment; Corporate distribution, strategy, and marketing; and Dollar stores compared with other food sources. The growth of dollar stores as food retailers remains an under-researched area of study for food access and nutrition that requires interdisciplinary expertise and collaboration to understand., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Type 2 diabetes mellitus (T2DM) disproportionately affects African American (AA) populations. Despite the importance of diet in diabetes management, the association of diet quality and/or the degree of food processing with glycemic control in AA adults with T2DM remains unclear., Objective: This study aimed to examine associations between diet quality scores and the degree of processing in the diet with glycosylated hemoglobin (HbA1c) level in AA adults with T2DM., Design: This cross-sectional study used baseline data from participants in Texas Strength Through Resilience in Diabetes Education, an ongoing clinical trial., Participants/setting: Participants involved in this analysis (N = 273) were AA adults with T2DM recruited through local churches in Austin, TX, and the surrounding areas from August 2020 through April 2023., Main Outcome Measures: Participants provided 2 24-hour dietary recalls (1 weekend and 1 weekday) and a blood sample to measure HbA1c level. Healthy Eating Index 2015, Alternative Healthy Eating Index 2010, and Alternate Mediterranean Diet scores were calculated. The NOVA method was used to calculate the percentage of grams and calories that came from ultraprocessed foods and unprocessed or minimally processed foods., Statistical Analyses Performed: Linear regression and analysis of variance models tested associations between the diet quality scores and degree of food processing with HbA1c level, adjusting for demographic covariates. Models were stratified by insulin use after finding a significant interaction with ultraprocessed foods and unprocessed or minimally processed foods., Results: Regression analyses revealed that the percentage of grams in the total diet from ultraprocessed foods was positively associated with HbA1c level (β adj  = .015; P adj  = .032), whereas unprocessed or minimally processed foods were inversely associated with HbA1c level (β adj  = -.014; P adj  = .043). There was no significant association between any diet quality score and HbA1c level., Conclusions: In AA adults with T2DM, only the degree of food processing was associated with HbA1c level. Future research should explore whether a causal relationship exists between food processing and HbA1c level and investigate mechanisms by which ultraprocessed foods may affect glycemic control., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Better diet quality regardless of community food access was associated with a higher likelihood of glycemic control in early pregnancy among nulliparous individuals with pregestational diabetes. These findings highlight the need for interventions that address nutrition insecurity for pregnant individuals living with diabetes., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Childhood represents a critical period of nutritional risk in the programming of later chronic disease. Few longitudinal studies have explored repeated measures of nutrition throughout the first decade of life in relation to preteen cardiometabolic outcomes., Objectives: This research aimed to explore associations of early feeding practices (human milk exposure and duration and timing of introduction to solids) and childhood dietary quality and inflammatory scores (at 5 and 9-11 y and change during childhood) on preteen cardiometabolic outcomes., Methods: This is an analysis of children from the ROLO longitudinal birth cohort study (n = 399). Information on early feeding practices were obtained at postnatal study visits. Food frequency questionnaires collected maternal-reported dietary intakes for each child at 5 and 9-11 y of age. Healthy Eating Index (HEI)-2015 and the Children's Dietary Inflammatory Index (C-DII) scores were calculated. Anthropometry, body composition, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9-11 y. Crude and adjusted linear regression models examined nutritional exposure associations with preteen cardiometabolic outcomes., Results: In the adjusted model, any human milk exposure was associated with lower body fat (%) at 9-11 y (β: -2.86; 95% confidence interval [CI]: -5.46, -0.27; P = 0.03), than never receiving human milk. At 5 y, diet scores were favorably associated with lean mass at 9-11 y (P < 0.05 for both). Higher preteen HEI-2015 scores were associated with lower preteen leptin levels (tertile 3 compared with tertile 1-β: -2.92; 95% CI: -5.64, -0.21; P = 0.03). Diet quality significantly deteriorated (HEI-2015 score decreased) and became more proinflammatory (C-DII score increased) from 5 to 9-11 y of age. Diet quality/inflammation deterioration (compared with improvement) or overall change in dietary scores were not related to preteen cardiometabolic outcomes., Conclusions: Exposure to human milk in early life was associated with lower preteen adiposity, irrespective of duration. Diet quality/inflammatory potential deteriorated between early childhood and the preteen years, highlighting a potential period for intervention., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Maternal diet quality, obesity, and abdominal obesity are known risk factors for hypertension in women. Objectives: This study assessed the factors associated with hypertension in women of child-bearing age in Odeda local government area communities, Abeokuta. Methods: A cross-sectional survey was conducted on 250 women (18–49 years) using systematic random sampling. Information on dietary intake was obtained using a 24-h dietary recall questionnaire. Food consumption (FCS), food variety (FVS), and dietary diversity scores (DDS) were assessed using validated questionnaires. Blood pressure, weight, height, waist and hip circumferences were assessed using standard procedures. Data were presented with frequency, percentage, median, interquartile range, and binary logistic regression was used to test for associated factors with hypertension at p

Food insecurity, reflecting a household’s low ability to purchase healthy food, is a public health concern that is associated with poor diet and obesity. Poor food environments, characterized as a neighborhood with low access to healthy, affordable food, may amplify the negative impact of food insecurity on diet and obesity. This study aims to investigate whether food insecurity and food environments are jointly associated with an increased risk of poor diet quality and obesity. We used data from a nationally representative sample of community-dwelling older adults in the Health and Retirement Study Health Care and Nutrition Survey and the National Neighborhood Data Archive to investigate the role of household and neighborhood characteristics on diet and obesity. Weighted regression models were estimated to examine the relationship between food insecurity and food environments as well as their interaction with diet quality and obesity. Food insecure respondents had lower Healthy Eating Index scores and were more likely to be obese than food secure respondents. Living in a poor food environment was associated with lower Healthy Eating Index scores, but not with obesity. We did not find any interaction between food insecurity and food environment in determining either healthy eating or obesity. Reducing food insecurity and increasing access to healthy food environments may encourage healthier eating among older adults, while alleviating food-related hardship may also reduce their obesity risk.

Objectives: Anxiety disorders are common in the general population and can have a major impact on a person's behavior. These disorders may also affect shopping and cooking habits, which may lead to a less healthy diet. Thus, we aimed to assess whether any current anxiety disorder or current specific anxiety disorders were associated with diet quality. Methods: Data of 6392 observations of 3993 participants were retrieved from 2 data waves of a population-based prospective cohort study conducted in an urban area in Switzerland. To assess the associations of anxiety status with diet quality measured by the Alternate Healthy Eating Index (AHEI), we performed cross-sectional multilevel random-effects linear regression analyses, which accounted for potential repeated participation and a series of potential confounders. Results: We observed an association between the presence of any current anxiety disorder and lower diet quality. For the most conclusive model, the AHEI was 1.2 points lower among those with current anxiety disorders compared to those participants with no anxiety disorder (p = 0.016). When specific anxiety disorders were included separately into the model, panic disorder was associated with lower diet quality in the fully adjusted model (p = 0.037). Conclusions: Our findings of reduced diet quality in people with any current anxiety disorder suggest that practical support is needed when it comes to buying and processing food. This might be systematically addressed in psychotherapy and external interdisciplinary support (e.g. occupational therapy and dietary counselling) should be involved. However, further data is needed to strengthen the findings of the present study.

Background: Diet plays a critical role in the prevention and treatment of metabolic syndrome (MetS). In addition to being environmentally sustainable, plant-based diets (PBD) have demonstrated a range of health benefits, including a protective effect against MetS. Most research on this topic has focused on PBDs as a whole, without considering the influence of diet quality. Methods: Data were obtained from 29 individuals with MetS. Subjects were asked to follow a PBD for 13 weeks. PBD quality was assessed using healthful PBD index (hPDI) and unhealthful PBD index (uPDI). Higher hPDI represented greater consumption of healthy plant foods and lower consumption of less-healthy plant foods. Higher uPDI represented greater consumption of less-healthy plant foods and lower consumption of healthy plant foods. For each participant, hPDI and uPDI scores were calculated at baseline and 9-weeks follow-up. Participants were divided into quintiles according to hPDI and uPDI scores. Statistical analyses were performed to determine the association between biomarker measures and PBD quality scores. Results: After 2 weeks, mean weight was lower in hPDI quintile 5 compared to hPDI quintile 1, and higher in uPDI quintile 5 compared to uPDI quintile 1 (p

Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative Healthy Eating Index (AHEI) 2010, dietary behaviors, and related psychosocial and environmental factors among ECE providers. A cluster randomized controlled trial (CRCT) was implemented with baseline surveys administered from October 2019-January 2020, intervention implementation from April-May 2020, and post-intervention from May 2020-August 2020. Centered-based ECE programs under the Pennsylvania Head Start Association (n = 12) were recruited and randomized to intervention (n = 5) or comparison (n = 7) groups. A total of 186 ECE providers completed the post-intervention surveys (retention rate: 86.1%). At baseline, 31.5% of ECE providers were food insecure. Pre-to-post intervention demonstrated no significant within-or-between-group changes in the AHEI-2010 diet quality scores. ECE providers in the intervention group reported a significant decrease from baseline to post-intervention in the number of days eating out (aMD = -0.8, CI:-1.6, −0.1, P = 0.03). Process evaluation showed that 89.9% of the intervention group completed all online module, and 82.9% attended all of wellness session groups. Although the Create Healthy Futures intervention did not improve ECE providers’ diet quality and dietary behaviors, it confirmed critical needs to provide health support to ECE providers. Future studies should employ strategies that improve access to healthy foods and nutrition education, and address social determinants of health such as food insecurity to improve diet quality and health in ECE provider population.

We evaluated the eating pattern, physical activity, and daytime sleepiness level in Chilean shift workers. Fifty, middle-aged adult health workers from a public hospital in Santiago, Chile, were included: a group undergoing shift work (shift workers, including at least one “night shift” and one “long day”, n = 33), and day workers under traditional schedule (from 8:00 to 17:00h, n = 17). Body composition, physical activity, and daytime sleepiness levels, and diet characteristics (diet composition, meals' timing, and diet quality) were assessed. Despite similar total energy intake, shift worker showed lower carbohydrate (% of energy) and higher protein intake (both P

Forests can make important contributions to the diet quality of forest proximate people for example through the direct provision of food. However, ongoing deforestation and forest degradation influence the availability of forest food – potentially decreasing the diet quality of people relying on forest food. Using a combination of food frequency questionnaires, wealth questionnaires, interviews, principal component analysis and land cover maps, this study examines the importance of forest food for diet quality in the two villages of Houay Tom and Maipaksang, Sangthong District, Laos (N = 49 households). We found that 71% of the respondents consumed forest food in the past week – and that a decrease in the forest area appears to have affected local people's diet quality negatively. Overall, forest food contributed to the consumption of six different food groups, and food sourced from the forest resulted in the consumption of minimum one additional food group for 48% of the respondents. Specifically, we found a significant positive association between forest food consumption and the consumption of more meat, poultry, and fish. Also, our findings suggest that the forest was most important for people belonging to the bottom wealth group. That is, this group exhibited higher consumption frequencies of forest food and forest food contributed more to their mean dietary diversity score and total consumption frequency compared to the upper- and middle wealth groups. Finally, the diet quality of households in the bottom wealth group might be more negatively affected by deforestation because these households typically are less engaged in various income-generating activities. These results point to the need of integrating forests into food and nutrition security and agriculture development policies.

This study examines the importance of income in determining the diet quality of Canadian adults measured based on Nutrient Rich Food Index version 9.3. We used the latest available data on Canadians' consumption of foods and nutrients from the Canadian Community Health Survey-Nutrition 2015. The Canada’ Food Guide classification was used for categorizing food groups based on types of food and their healthiness. Unsupervised and supervised machine learning models were employed in order to examine the links between income and the choice of foods. We first employed cluster analysis to identify the dietary patterns among individuals included in the sample and then we examined whether the intakes of various food groups across the identified clusters vary by income levels. Further, we evaluated the association between diet quality and income using Lasso Regression to determine the most important predictors of diet quality among adults in Canada. The results of both cluster analysis and regularized regression model suggested that behavioral factors and cultural backgrounds are more important determinants of diet quality among adults in Canada.

Background: The relationships between diet quality and health care costs have not been explored beyond 15 years., Objective: To investigate relationships between both baseline diet quality and change in diet quality over time with cumulative data on health care claims and costs over 21 years among Australian women., Design: This is a secondary analysis of data from a cohort study, the Australian Longitudinal Study on Women's Health., Participants/setting: Data for women born between 1946 and 1951 included diet quality data at baseline (2001, n = 8228), change in diet quality (2001-2013, n = 6553), and cumulative administrative health care data (2001-2021)., Main Outcomes: Diet quality was assessed using the Australian Recommended Food Score (ARFS) and the Fruit and Vegetable Variety Score. Twenty-one-year cumulative Medicare Benefits Schedule data (number of claims; total charges [$USD]), Australia's universal health care coverage, were reported by baseline ARFS quintile and category of diet quality change ("diet quality worsened" [ARFS decrease ≤ -4 points], "remained stable" [-3 ≤ change in ARFS ≤ 3 points] or "improved" [ARFS increase ≥ 4 points])., Statistical Analysis: Linear regression analyses were conducted and adjusted for socioeconomic, health, and lifestyle factors., Results: Higher baseline vegetable ARFS were correlated with fewer 21-year cumulative Medicare claims (β = -4.9, 95% CI, -7.3, -2.4) and charges (β = -$214; 95% CI, -$341; -$88). Baseline higher dairy scores were correlated with higher Medicare claims (β = 17.2; 95% CI, 11.1, 23.3) and charges (β = $762; 95% CI, $448, $1076). Compared with women whose diet quality score remained stable, those whose diet quality worsened over time made significantly more claims and higher charges; median (Q1, Q3) 413 (277, 588) claims, $17 868 ($11 037, $27 808) cumulative charges, compared with 387 (259, 559) claims, and $16 953 ($10 033, $26 604) cumulative charges. Change in total ARFS and ARFS subscales were predictors of 21-year cumulative health care claims. For each 1-point increase in ARFS over time, 1.2 fewer health care claims were made (95% CI, 0.3-2.2). Increasing vegetable and dairy ARFS scores were correlated with significantly fewer claims., Conclusions: Baseline greater variety of vegetables was correlated with fewer 21-year health care claims and costs. Worsening diet quality over time was correlated with greater cumulative health care claims and costs. Consideration of dietary quality and variety in national policy is suggested to potentially reduce national health care claims and costs., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Home food availability has been identified as an important influence on dietary intake. Less is known about the relationship between the physical home food environment (HFE) and factors of cardiometabolic health in children., Objective: The purpose of this study was to explore the relationship between the physical HFE and diet quality and factors of cardiometabolic health (eg, weight and blood biomarkers)., Design: This was a cross-sectional secondary analysis with 1 or more children per household., Participants/setting: This study included 44 children aged 6 to 12 years from 29 households in the Newark, DE area between August 2020 and August 2021., Main Outcome Measures: The Home Food Inventory provides an obesogenic score (ie, score indicative of the presence of energy-dense foods) for the overall HFE and HFE subcategories scores; body mass index z-scores were calculated using measured height and weight; diet quality was measured using the Healthy Eating Index 2020 (HEI-2020) total scores; and cardiometabolic biomarkers were obtained from serum blood samples., Statistical Analyses Performed: Unadjusted and adjusted linear mixed model regressions were used to test the association between the physical HFE and each of the outcome variables: body mass index z scores, HEI-2020 total scores, and cardiometabolic biomarkers. HFE subcategories (eg, fruits and vegetables) were also examined with each outcome using linear mixed model regression., Results: Mean ± SD age of the children was 9.5 ± 1.9 years, 61.4% were female, 59.1% identified as White, and 90.9% were non-Hispanic. Obesogenic score was significantly associated with body mass index z scores (β = .03, P = .029), but not HEI-2020 total scores or cardiometabolic biomarkers. As HFE fruits and vegetables subcategory increased, HEI-2020 total scores significantly increased (β = .73, P = .005) and total cholesterol (β = -1.54, P = .014) and low-density lipoprotein cholesterol levels (β = -1.31, P = .010) significantly decreased. Increased availability of sweet and salty snack food and availability of sugar-sweetened beverages was associated with increased fasting blood glucose (β = 0.65, P = .033) and insulin levels (β = 5.60, P = .035) respectively., Conclusions: There is evidence of a relationship between the subcategories of the physical HFE and cardiometabolic factors. Future interventions are needed to understand whether altering the overall HFE or specific subcategories within the HFE can improve cardiometabolic health., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Dietary diversity is a crucial component of healthy eating patterns because it ensures nutritional adequacy. Yet, concerns have been raised about the potential risks of its increase, which may reflect excessive consumption of unhealthy foods and higher obesity or cardiometabolic risk, particularly in high-income countries. However, the links between dietary diversity and different health outcomes remain inconclusive because of methodological differences in assessing dietary diversity. Numerous studies, mostly cross-sectional, have assessed dietary diversity using different indicators usually based only on the number of foods or food groups consumed. In this perspective, we emphasize that dietary diversity is a multidimensional concept encompassing the number of foods in the diet (food coverage) but also their relative proportions (food evenness) and the nutritional dissimilarity of foods consumed over time (food complementarity). Consequently, a comprehensive assessment of dietary diversity reflecting all its dimensions, both between and within-food groups, is needed to determine the optimal level of complementarity between and within-food groups required to improve health and diet quality. Moreover, given the prevailing context of abundant highly processed and energy-dense foods in high-income countries, promoting dietary diversity should prioritize nutrient-dense food groups. Until recently, within-food group diversity has received limited attention in research and public health recommendations. Still, it may play a role in improving diet quality and long-term health. This perspective aims to clarify the concept of dietary diversity and suggest research avenues that should be explored to better understand its associations with nutritional adequacy and health among adults in high-income countries., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Preliminary evidence suggests that meal timing is associated with higher quality diets. Less is known about whether types of food consumed during specific eating episodes (i.e., day-level eating patterns) predict diet quality., Objectives: We investigated the association between day-level eating patterns and diet quality., Methods: Decision tree models were built using 24-h dietary recall data from the National Health and Nutrition Examination Survey 2015 and 2017 cycles in a cross-sectional study. Sixteen food groups and 12 eating episodes (e.g., breakfast, lunch) were included as input parameters. Diet quality was scored using the Healthy Eating Index-2020 and categorized as higher or lower quality diets based on the median score. Mean decrease in impurity (MDI) ± standard deviation determined the relative contribution that day-level eating patterns had on diet quality; higher values represented greater contributions., Results: We analyzed 12,597 dietary recalls from 9347 United States adults who were aged 18 y and older with ≥1 complete recall. Meals (breakfast, lunch, dinner) and respective snacking episodes had the greatest variety of dietary groups that contributed to the Healthy Eating Index-2020 score. Any whole-grain intake at breakfast predicted a higher quality diet (MDI = 0.08 ± 0.00), followed by lower solid fat intake (<8.94 g; MDI = 0.07 ± 0.00) and any plant protein intake at dinner (MDI = 0.05 ± 0.00)., Conclusions: Day-level eating patterns were associated with diet quality, emphasizing the relevance of both food type and timing in relation to a high-quality diet. Future interventions should investigate the potential impact of targeting food type and timing to improve diet quality., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Child diet can influence risk for obesity and other related noncommunicable diseases. Few studies have used the Healthy Eating Index (HEI)-Toddlers-2020 to assess diet quality among toddlers (children aged 12 to 23.9 months)., Objective: The aim of this study was to examine diet quality among toddlers participating in the Feeding Infants and Toddlers Study, 2016, and determine differences by sociodemographic characteristics. Caregiver perception of how their toddler's diet aligns with HEI-Toddlers-2020 diet quality scores was also assessed., Design: This cross-sectional study used 24-hour dietary records collected in 2016., Participants and Setting: Data were collected on toddlers ages 12 to 23.9 months (N = 1133) participating in the Feeding Infants and Toddlers Study, 2016., Main Outcome Measures: Diet quality was assessed using the HEI-Toddlers-2020., Statistical Analyses Performed: The population ratio method was used for all analyses using weighted data to estimate HEI-Toddlers-2020 scores overall and within subgroups. To determine significant differences of the HEI-Toddlers-2020 score between subgroups, pairwise t tests were used. Statistical significance at P < .05 was used as a cutoff for all 2-sided P values., Results: Average HEI-Toddlers-2020 score among toddlers ages 12 to 23.9 months participating in the Feeding Infants and Toddlers Study, 2016, was 71.2 out of a possible 100. Total scores (mean, standard error) varied by race and ethnicity with Hispanic toddlers having higher scores compared with non-Hispanic White toddlers (76.4 ± 2.5 vs 69.0 ± 1.2; P = .03) and by federal poverty level with those >200% of the poverty level having higher scores compared with those <100% of the poverty level (74.7 ± 1.5 vs 67.0 ± 2.6; P = .01)., Conclusions: Opportunities for improvement in dietary intake were identified using the new HEI-Toddlers-2020 to assess diet quality among children ages 12 to 23.9 months. Scores were indicative of toddlers consuming excess added sugars and lower-than-recommended amounts of seafood and plant proteins, greens and beans, whole grains, and vegetables. Interventions to improve diet quality in toddlers may benefit from focusing on foods children should eat more of along with foods to consume in moderation., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Depression is a common mental health disorder., Objective: The objective of this study was to explore the association between diet quality, as measured by the Healthy Eating Index 2020 (HEI-2020), and depression symptoms among US adolescents and young adults aged 12 to 29 years., Design: The study design was a cross-sectional secondary data analysis., Participants: Data from the first 24-hour dietary recall for adolescents and young adults aged 12 to 29 years in the National Health and Nutrition Examination Survey from 2015 to March 2020 (n = 4750) were analyzed., Main Outcome Measure: Depression was defined as a score ≥10 on the Patient Health Questionnaire, reflecting moderate or severe symptoms in the previous 2 weeks., Statistical Analyses Performed: HEI-2020 total (range, 0-100) and component scores were calculated for those with and without depression. Predicted HEI-2020 scores were estimated from linear regression models, adjusting for age, gender, race and Hispanic origin, family income, and seeing a mental health professional in the past year. Statistical analyses accounted for the complex sample design., Results: The prevalence of depression among adolescents and young adults was 7.8% (95% CI 6.3% to 9.5%). Total HEI-2020 score was 45.9 (95% CI 45.0 to 46.7) out of 100 on a given day during 2015 to March 2020. Among young people with depression, total HEI-2020 score was lower than among those without depression (41.7 vs 46.2; P < .001). After adjustment for covariates, the difference was attenuated, but remained significant. In adjusted analyses, HEI-2020 component scores were lower for those with depression compared with those without depression for the adequacy components: total fruits (1.4 vs 1.7; P = .03), whole fruits (1.2 vs 1.7; P < .01), total vegetables (2.1 vs 2.6; P < .01), greens and beans (0.8 vs 1.2; P < .01), and total protein foods (3.6 vs 4.0; P = .02) out of a maximum score of 5. There were no statistically significant differences observed for whole grains, dairy, seafood and plant proteins, fatty acids, saturated fats, refined grains, sodium, or added sugars., Conclusions: Overall diet quality is low among young people. Diet quality, especially consumption of fruits, vegetables, and protein foods was lower among young people with depression compared with those without depression., (Published by Elsevier Inc.)

Background: The relationship between the retail food environment and diet quality has received minimal investigation among weight loss maintainers., Objective: The aim of this study was to investigate the association between the residential retail food environment and diet quality in weight loss maintainers from WeightWatchers in the United States., Design: Cross-sectional data were collected between January 2018 and February 2020. The Retail Food Environment Index (RFEI), based on geocoded home addresses, classified the environment as follows: RFEI <1.6 = healthiest; RFEI 1.6 to <2.5 = moderately healthy; RFEI 2.5 to <4.0 = moderately unhealthy; RFEI ≥4.0 = least healthy. Dietary data were obtained using a food frequency questionnaire., Participants/setting: Adult participants (n = 1,159) who had lost weight using WeightWatchers and maintained ≥9.1-kg weight loss for ≥1 year (mean 24.7-kg loss for 3.4 years)., Main Outcome Measures: Healthy Eating Index 2015 (HEI-2015) component and total scores (0-100; higher scores indicate better alignment with the 2015-2020 Dietary Guidelines for Americans)., Statistical Analyses Performed: Regression models included RFEI category, the independent variable, and HEI-2015 and component scores (outcomes) controlling for age, sex, race and ethnicity, educational attainment, and household income., Results: Compared with individuals living in the healthiest food environments (mean HEI-2015 score = 71.5) those in the unhealthiest environments had a mean HEI-2015 score of 70.1 (95% CI 68.8 to 71.3), those in moderately unhealthy environments had a score of 71.3 (95% CI 70.3 to 73.1) and those in moderately healthy environments had a score of 70.3 (95% CI 68.9 to 71.2), indicating a nonlinear relationship. Compared with those in the healthiest environments, those in the least healthy environments had an approximately 0.47 lower added sugar HEI-2015 component score (95% CI -0.86 to -0.08), indicating approximately 5% higher added sugar intake., Conclusions: Weight loss maintainers maintained high diet quality in diverse retail food environments. Compared with those in the healthiest food environments, those in the least healthy had a higher consumption of added sugars., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Healthy plant-based diets have been associated with lower risk of type 2 diabetes (T2D). Metabolomics can be leveraged to identify potential pathways through which diet influences disease risk., Objectives: This study aimed to identify profiles of serum metabolites reflective of plant-based diets of varying quality and examine associations with cardiometabolic risk and T2D., Methods: We included data from 687 participants of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort. An overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) were estimated from food frequency questionnaires. Serum metabolites were assayed using ultraperformance liquid chromatography mass spectrometry. Elastic net regression was used to identify sets of metabolites predictive of each diet index, and metabolite profile scores were calculated as the weighted sum of the selected metabolites. Cross-sectional associations between metabolite profile scores and cardiometabolic measures and prospective associations with incident T2D were evaluated with multivariable-adjusted linear and logistic regressions., Results: Metabolite profiles for PDI, hPDI, and uPDI consisted of n = 51, 55, and 45 metabolites, respectively. Metabolites strongly positively correlated with diet indices included phosphatidylcholine (16:0/18:3) for PDI, phosphatidylethanolamine (20:1/20:4) and pantothenate for hPDI, and lysophosphatidylglycerol (18:2/0:0), proline, and lauric acid for uPDI. Higher metabolite profile scores for PDI and hPDI were associated with lower glycemia and lipids measures, whereas a higher uPDI metabolite score was associated with higher triglycerides and lower low density lipoprotein cholesterol and high density lipoprotein cholesterol. A higher metabolite score for hPDI was additionally associated with lower adiposity measures, higher liver fat attenuation, higher adiponectin, lower odds of overweight (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.51, 0.81) and obesity (OR: 0.59; 95% CI: 0.48, 0.74), and lower odds of incident T2D (OR: 0.66; 95% CI: 0.45, 0.97)., Conclusions: Metabolite profiles of different plant-based diets were identified. Metabolite profiles of overall and healthy plant-based diets were associated with favorable cardiometabolic risk profiles., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Poor diet may contribute to high rates of overweight/obesity (OW/OB) in adolescents and young adults with intellectual disabilities (IDs)., Objective: The purpose of this study was to examine diet quality as assessed by Healthy Eating Index 2015 (HEI-2015) scores in adolescents and young adults with IDs and OW/OB and to compare diet quality by ID diagnosis and weight., Design: Three-day image-assisted food records from baseline assessments in an 18-month weight-loss trial for adolescents and young adults with IDs and OW/OB were used to calculate HEI-2015 scores, which were compared between ID diagnoses and weight categories., Participants/setting: A total of 102 adolescents and young adults (aged 13 to 21 years) with IDs (48 with Down syndrome [DS], 40 with autism, and 14 with other/unspecified IDs) and OW/OB at a Midwestern academic medical center completed valid food records from November 2015 to November 2019., Main Outcome Measures: Outcome measures included HEI-2015 scores, energy intake (kcal/d), macronutrient intake as percentage of energy, energy intake per kilogram body weight, and grams protein per kilogram body weight., Statistical Analyses Performed: Differences in HEI-2015 scores and additional dietary measures by weight category and ID diagnosis were examined with analysis of variance or Kruskal-Wallis tests., Results: Participants with DS had a significantly higher mean ± SD HEI-2015 score (53.9 ± 8.4) compared with participants with autism (49.1 ± 9.6; P = .047). Compared with those with autism, participants with DS had a higher percentage of energy from protein, higher energy intake per kilogram body weight, and higher grams of protein intake per kilogram body weight. For HEI-2015 components, participants with DS had higher scores than participants with autism for total fruits, whole fruits, total vegetables, greens and beans, and total protein foods, but lower scores for sodium. Diet quality was not observed to differ by weight classification., Conclusions: Adolescents and young adults with autism had lower overall diet quality scores compared with those with DS. Diet quality was not found to be related to OW/OB. Understanding dietary differences by ID diagnosis may inform intervention strategies., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM 2.5 ). We investigated whether the long-term effects of PM 2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM 2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM 2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM 2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM 2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Thara Govindaraju, Matthew Carroll, Brigitte M. Borg, Catherine L. Smith, Caroline X. Gao, David Brown, David Poland, Shantelle Allgood, Jillian F. Skin, Michael J. Abrasion, Tyler J. Lane reports financial support was provided by Victoria Department of Health. Michael J. Abramson reports a relationship with Pfizer, Boehringer-Ingelheim, Sanofi, GSK that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)