The independent association between diet quality and body composition

The effects of resistance based post-activation performance enhancement on reaction time and change of direction in basketball players

The aim of this study was to investigate the effect of post-activation performance enhancement (PAPE) intervention with 80% one repetition maximum (1RM) resistance on change of direction (COD) and reaction time (RT) in basketball players. This study sixteen male basketball players (mean age: 20.25 years, height: 1.88 m, weight: 80.75 kg, training age: 10.12 years) were included. For this study, participants attended 3 experimental sessions in the laboratory. Firstly, anthropometric measurements of the participants were taken, then RT and COD were familiarized respectively, and then 1RMs were determined. Then, the participants randomly completed the first and second sessions. In the first session, a 20-minute standard warm-up (Wup) was performed. After the participants rested passively for 3 minutes after the Wup, RT and COD tests were measured at 1-minute intervals, respectively. The results obtained were considered as the control condition. In the second session, participants rested passively for 3 minutes after performing the PAPE (80% of 1RM - 5 rep) protocol. After the rest period, participants performed RT and COD with a 1-minute interval, respectively. The data were analyzed separately for RT (visual, auditory, and mixed) and COD test results in terms of Wup and Wup+PAPE. At least 48 hours of rest was allowed between the first and second sessions to ensure that fatigue from the previous test session did not affect the results. Wilcoxon test results showed that PAPE significantly reduced visual RT (p < .005), mixed RT (p < 0.013), and COD (p < 0.001), but not auditory RT (p < 0.068). The findings showed that PAPE is an effective method to improve COD and RT performance in sports such as basketball, where success is achieved through fast-paced play.

Relationship Between Mediterranean Diet Adherence and Body Composition Parameters in Older Adults from the Mediterranean Region

In recent decades, the rapid spread of various communication media has led to changes in traditional eating habits. In the Mediterranean region, the classic (Mediterranean) dietary pattern has been lost as a result. This has led to a shift in eating habits towards unhealthy eating patterns, which in turn has resulted in an inadequate distribution of body composition. It is known that, among other things, the number of non-communicable diseases increases with the inadequate distribution of body composition. The aim of our study was to examine the level of adherence to the Mediterranean diet (MD) of older adults in the Mediterranean region in relation to specific body composition parameters. This study included 521 older adults with a mean age of 69.6 ± 6.3 years. Body composition was measured using the BIA 101 Anniversary device (Akern s.r.l., Florence, Italy) and adherence to the MD was assessed using the MEDLIFE index questionnaire. This study found significant differences in body composition between males and females. The mean adherence to the MD was 17.0 ± 3.3 points among the participants and there was higher adherence in females (p = 0.002, ηp2 = 0.019). A multiple linear regression was performed to assess the relationship between the body composition parameters and MD. Multiple linear regression models were significant for reactance, fat mass (%), fat-free mass (%), skeletal muscle index, and total body water (%), with specific individual MEDLIFE items such as the consumption of processed meat, meat, white meat, fruit, vegetables, olive oil and limiting snacks between meals. Moreover, promising correlations were found between certain MD characteristics and BIA parameters, but the overall health effects of the MD remain unclear.

Combined associations of obesity and physical activity with pain, fatigue, stiffness and anxiety in adults with spondyloarthropathies: UK Biobank study

Objective

Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies.

Methods

The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (n = 1577). BMI categories were normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obese (≥30 kg/m2). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories.

Results

Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, P < 0.001) than overweight (OR ≥ 1.37, P ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, P ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, P ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, P ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent.

Conclusion

National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.

Gender differences in diet quality and the association between diet quality and BMI: an analysis in young Australian adults who completed the Healthy Eating Quiz

BACKGROUND

Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI.

METHODS

Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18-35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two-sample t-test, chi-squared and one-way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders.

RESULTS

The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males.

CONCLUSION

Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings.

Evaluation of a mobile behavior change program for weight loss in breast cancer survivors

Post-diagnosis weight gain is common in early-stage breast cancer and is associated with increased risk of recurrence and mortality. Intentional weight loss is difficult to maintain, and digital lifestyle interventions may provide a scalable approach to address this challenge. In this prospective single-arm study (ClinicalTrials.gov NCT04753268; February 15, 2021), key eligibility criteria included: stage I-III breast cancer, body mass index (BMI) ≥ 27.5 kg/m2, and completion of cancer treatment ≥6 months before study enrollment. Participants were provided with a behavioral change mobile application (Noom®). The primary endpoint was a change in self-reported weight from baseline to 26 weeks. Secondary endpoints included engagement, changes in physical activity, dietary patterns, and patient-reported outcomes (PRO). In total, 31 patients were enrolled (mean age 56.8 ± 9.9, mean baseline BMI 33.5 kg/m2 ± 6.5). The mean weight change was -4.8 kg ( ± 4.4, P < 0.001), mean percent weight change was -5.6% ( ± 5.0%); 11/31 patients (35.5%) lost ≥5% of their initial weight. Metrics of digital application engagement associated with weight loss ≥5% included articles read (P = 0.012), weights logged (P = 0.006), food records logged (P = 0.001), messages sent (P = 0.001), and application open count (P = 0.014). Significant increases were seen in mean daily step count (P = 0.004), GPAQ scores (P = 0.002), and Body Image Scale scores (P < 0.001). Mean energy intake remained consistently in a calorie-restricted range of 1300-1400 kcal/day. In this study, breast cancer survivors were highly engaged with a behavioral change smartphone application which led to clinically significant weight loss, increased physical activity, maintenance of an energy-restricted diet, and improvements in body image.

Association of diet quality and body mass index in Mexican adults: a pseudo-panel analysis

Introduction

Introduction: most studies that analyze the relationship between diet quality and obesity have a cross-sectional design; an alternative with repeated cross-sectional data is a pseudo-panel design. Objective: to estimate the association between trends in dietary patterns, defined by a diet quality index, and body mass index (BMI) of Mexican adults between 2006 and 2016. Methodology: a pseudo-panel analysis was performed using data from cross-sectional surveys: National Health and Nutrition Surveys of Mexico (ENSANUTs) 2006 and 2012 and the Midway National Health and Nutrition Survey 2016 (ENSANUTMC). Cohorts (n = 108) were constructed by grouping adults 20-59 years old by sex (men n = 6,081 and women n = 11,404), education level, and year of birth. The association between diet quality (defined with the Healthy Eating Index-2015) and BMI was estimated using a fixed effects model, adjusting for sociodemographic characteristics. Results: a one-point increase in the proportion of women with high diet quality was associated with 4.1 points lower BMI (p = 0.014) compared with women with low diet quality when excluding sub-reporters of energy, the same association is observed when physical activity is included in the model. No association was found between diet quality and BMI in men, possibly because of the existence of latent classes within sociodemographic strata, therefore diet qualiy is inversely associated with BMI only in some categories of sociodemographic strata. Conclusions: these results contribute to the evidence in the longitudinal analysis between diet and BMI, highlighting the importance of differentiating the population by sex and sociodemographic characteristics. These results are input for public policy creation that promotes improving the quality of the population's diet as part of multisectoral strategies to reduce overweight and obesity in Mexican adults.

My Diet Study: protocol for a two-part observational, longitudinal, psycho-biological study of dieting in Australian youth

Introduction

Self-directed dieting (i.e., unsupervised) is very common among adolescents and young adults but has had almost no direct research. This paper describes the protocol for the My Diet Study, a two-arm observational investigation of the natural progression of dieting among young people over a period of 6-months. The study aims to examine the links between self-directed dieting, general physiological and psychological metrics of wellbeing (e.g., depressive symptoms) and biomarkers of gut-brain axis functions (e.g., microbiome and hormones) that are predicted to influence diet adherence through appetite, mood and metabolism regulation.

Methods

Young people aged 16-25, intending to start a diet will be invited to participate in this observational study. For Part 1 (psychological arm), participants will be asked to complete a set of questionnaires and diaries at the beginning of every month for 6 months, to assess overall mental (e.g., psychological distress, disordered eating) and physical (e.g., weight) health, perceived diet success, food intake and gastrointestinal movements. For Part 2 (biological arm), a subsample of 50 participants will be asked to provide feces, blood and saliva for bio-sampling each month for the first 3-months of their participation in Part 1.

Discussion

The My Diet Study will be the first longitudinal, observational study of dieting in young people combining in-depth psychological and biological data. It is anticipated that the findings will yield psychological & biological information about the impacts and effectiveness of self-directed dieting in young people, inform a framework for advice on safety in dieting among young people and help to establish the potential for biomarkers for risk management and improvement of diet-based lifestyle interventions.

A Cross-Sectional Analysis of Dietary Patterns in Healthy Adolescents: Energy Balance, Nutrient Intake, Body Mass, and Serum Marker Alterations

(1) Background: With shifts in daily dietary habits, concerns have arisen regarding potential impacts on metabolic health. This study sought to investigate the interplay between nutrient intake and its effects on the anthropometric and inflammatory profiles of young individuals. (2) Methods: Our approach examined the interrelation of caloric, macronutrient, and vitamin intakes with inflammatory markers, serum cholesterol, triglycerides, and other key metrics. The impact of these factors on body mass and inflammation was evaluated. (3) Results: This study found that while increased caloric intake corresponded to a rise in body fat mass, it did not significantly alter body weight, total protein, or fat profile. A dominant carbohydrate intake negatively correlated with vitamin B consumption. Interestingly, only vitamin K showcased a direct association with IL-6, while IL-8 remained unassociated with dietary intake and body mass metrics. (4) Conclusions: Dietary intake undeniably influences nutrient consumption and subsequently affects body mass metrics. Though an escalation in body fat mass was evident with increased food intake, the relationship between vitamins and inflammatory markers, based on macronutrient and caloric intake, remains inconclusive. The findings point to the potential regulatory roles of proteins and select vitamins in inflammation, emphasizing the need for deeper longitudinal studies to further validate these connections.

The association between the Healthy Eating Index (HEI-2015) score and body composition among Iranian soccer players and referees: a cross-sectional study

For an optimal performance, soccer players and referees need to consume a high-quality diet. The Healthy Eating Index (HEI) is a tool that can estimate diet quality and has been shown to be associated with body composition. The aims of the present study were first to determine the HEI-2015 score of the diets consumed by athletes and second its association with different body composition parameters of athletes. We conducted a cross-sectional study on 198 soccer players and referees. Dietary intakes were recorded using a validated food frequency questionnaire (FFQ), and HEI scores were calculated. Body composition parameters were measured using the bioelectrical impedance analysis. The mean score for the HEI-2015 was 65⋅04. A multiple linear regression model showed significant associations of the HEI-2015 score with percent body fat (PBF), percent muscle mass (PMM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in male soccer players aged <18 years, body mass index (BMI) in male soccer players aged ≥18 years and BMI and waist-to-height ratio (WHtR) in male soccer referees after adjustment for covariates (P < 0⋅05). The mean overall score for the HEI-2015 shows that Iranian soccer players and referees have an acceptable quality of diet. We also found significant associations between the HEI-2015 score and different body composition parameters in male soccer players and referees but we did not find any significant association in female athletes (P > 0⋅05).

High Diet Quality Is Linked to Low Risk of Abdominal Obesity among the Elderly Women in China

How diet as a whole impacts the risk of general overweight and abdominal obesity among the Chinese elderly is unclear. The present study aimed to examine the association of overall diet quality with general overweight and abdominal obesity in the Chinese elderly. Using data from the China Health and Nutrition Survey (CHNS) from 1993 to 2015, an ongoing cohort study, we selected participants aged 60 and older who were not generally overweight, but who had abdominal obesity at baseline and who had participated in at least two waves of the survey as subjects. The China Elderly Dietary Guidelines Index (CDGI-E) was used, based on the critical diet-related recommendations of the 2016 Chinese Dietary Guideline (CDG-2016), to assess overall diet quality. Consecutive 3 d, 24 h recalls and household weighing for seasonings and edible oils were used to collect dietary data and calculate the CDGI-E scores. Three-level (community-individual-wave) random intercept logistic regression models were used to analyze the impact of diet quality on the risk of general overweight and abdominal obesity in the elderly. The results showed that the older women in the top sixtiles of the CDGI-E scores had a 38% reduction -0.62, 95% CI (0.41, 0.92)-in the risk of abdominal obesity, as compared to those in the bottom sixtiles after adjusting for all potential confounders, while the null association was observed in the older men. The relationship between CDGI-E score and the risk of overweight/general obesity in the Chinese elderly has not been found. It was concluded that a high diet quality was associated with a reduced risk of abdominal obesity among elderly women in China. Our findings will help to improve the understanding of the relationship between the overall effect of diet and health. It may provide a new avenue for obesity intervention policy formulation from the aspect of improving overall dietary quality.

Dietary acculturation of international students in Pune, India: a cross-sectional study

BACKGROUND

Dietary acculturation refers to how a migrant group adopts the eating patterns of the host country. It results in changes in dietary behavior, dietary intake, and nutritional status of this vulnerable group.

AIM

To study dietary acculturation of international students in Pune, India.

METHODS

International students from three Universities in Pune were enrolled. Information on demography, dietary behavior, and dietary intake (using a food frequency questionnaire) was recorded using an interviewer-administered questionnaire. The height and weight of the students were measured using standard, calibrated equipment. The data were analyzed using descriptive and analytical statistics.

RESULTS

A total of 100 international students from Iran, Africa, and South Korea were grouped by nationality. Considerable variation was detected in the daily number of meals consumed, skipping meals, portion size changes, packaged food consumption, and supplement intake following migration between the groups. The intake of non-vegetarian food had declined drastically for all groups. However, the specific non-vegetarian item showing the greatest change differed according to the group's nationality. The intake of biscuits and cake had increased among all groups. African students showed an increase of 3.33 kg in body weight following migration. The intake of protein and micronutrients declined for all groups.

CONCLUSIONS

This study highlights the changes in dietary behavior, dietary intake, and nutritional status of international students of different nationalities following migration to Pune, India. Thus, it emphasizes the need for nutrition interventions in international students in India.

The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents

INTRODUCTION

This study aimed to investigate the association of diet quality (DQ) and dietary acid load (DAL) with insulin resistance (IR) in overweight children and adolescents.

MATERIALS AND METHODS

The study was conducted on 135 overweight participants aged 6-17 years. DQ was assessed using the Healthy Eating Index 2015 (HEI-2015) and the HEI-2015-TUBER, revised in accordance with the Turkey Dietary Guidelines (TUBER). Estimation of DAL was made calculating the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores.

RESULTS

The HEI-2015-TUBER score was lower in those with IR than in those without IR (p=0.021). Higher PRAL and NEAP scores were found in those with IR (p=0.060 and p=0.044, respectively). Moreover, a one-unit increase in the HEI-2015-TUBER score and the DAL score was associated with a reduction of 4.2% and a rise of approximately 3% in IR risk, respectively.

CONCLUSIONS

Healthy eating habits in overweight paediatric groups may help to reduce the IR risk, improving DQ and decreasing DAL.

Healthy Eating Score-7 as a Measure of Diet Quality in a Military Population

OBJECTIVE

Identify potential revisions to the Healthy Eating Score (HES-5) that improve associations with the Healthy Eating Index (HEI) -2015 total and component scores.

METHODS

Pearson r correlations were determined from soldiers' (n = 433) survey data, including the HES, proposed additional questions, and the Block Food Frequency Questionnaire.

RESULTS

Adding sugar-sweetened beverages and energy drink questions (HES-7) strengthened the HES and HEI-2015 correlation (HES-5; r = 0.42, n = 433, r² = 0.18, P < 0.001) (HES-7; r = 0.52, r² = 0.27, P < 0.001). The HES components and Block Food Frequency Questionnaire consumption correlations were as follows: quantity of fruit (r = 0.37, r² = 0.14, P < 0.001), vegetables (r = 0.41, r² = 0.17, P < 0.001), whole grains (r = 0.35, r² = 0.12 P < 0.001), dairy (r = 0.34, r² = 0.12, P < 0.001), fish (r = 0.31, r² = 0.10, P < 0.001), and energy drink (r = 0.59, r² = 0.35, P < 0.001).

CONCLUSIONS AND IMPLICATIONS

HES-7 had the strongest correlation with HEI-2015. Future studies can explore if including consumption quantity in the HES improves its representation of diet quality.

Healthy Eating Index Scores, Body Mass Index and Abdominal Obesity Among Asian Americans: NHANES 2011-2018

Objective

Obesity rates are increasing among Asian Americans so, the objective of this study was to examine associations between Healthy Eating Index scores (a measure of adherence to the Dietary Guidelines for Americans (DGAs)) and body mass index (BMI) and waist circumference (measure of abdominal obesity) among Asian American adults.

Methods

Included in these analyses were Asian Americans ≥20 years from the National Health and Nutrition Examination Survey (2011-18) who had: (1) two 24 h diet recalls to calculate HEI and HEI subcomponent scores, (2) height and weight data to calculate BMI overweight ≥25 kg/m2 and obese ≥ 30kg/m (2), and (3) waist circumference data (high risk ≥ 80 cm for women and ≥ 90 cm for men; n = 1024 women and n = 904 men). Multinomial logistic regression models were run with BMI as the outcome and logistic regression models were run with waist circumference as the outcome, controlling for age, income, marital status, education, and physical activity.

Results

Among women, a diet with greater adherence to the DGAs for total fruit, fatty acids and total protein was associated with lower likelihood of developing obesity, but a diet with greater adherence to the DGAs in terms of whole grains and sodium (i.e., lower sodium intake) was associated with a higher likelihood of obesity. Among men, greater adherence to the DGAs for fatty acids was associated with a lower likelihood of obesity but greater adherence to the DGAs in terms of whole grains and sodium (i.e., lower sodium intake) was associated with a greater likelihood of obesity.

Conclusions

Future research is needed to examine associations between consumption of specific foods and beverages and how they are associated with BMI and waist circumference among Asian American adults. Furthermore, there is a need culturally relevant obesity prevention interventions for Asian American adults, especially interventions that take into consideration cultural food norms of specific Asian American subgroups.

Associations between diet quality and obesity in a nationally representative sample of Iranian households: A cross-sectional study

OBJECTIVE

Research examining associations between diet quality and obesity in Iranian adults is limited by small and non-representative samples. This study examined associations between two diet quality indices and obesity risk in a nationally representative sample of Iranian adults and interactions by sex and area of residence.

METHODS

Data on 18,307 adults (mean age 37 [SD 15.2] years) were used from the Iranian National Survey 2001-2003. Two diet quality indices (Healthy Eating Index 2015, HEI-2015, and Diet Quality Index International, DQI-I) were calculated from household 24-h dietary recalls. Multi-level regression analyses were used to examine the association between household diet quality and individual-level obesity risk, with interaction terms for sex and area of residence.

RESULTS

Higher household HEI-2015 and DQI-I were associated with higher risk of obesity (HEI-2015: relative risk ratio: 1.04, 95% CI: 1.03, 1.05; DQI-I: relative risk ratio: 1.02, 95% CI: 1.01, 1.02), with stronger effect sizes in adults living in rural areas.

CONCLUSIONS

Higher diet quality (HEI-2015 and DQI-I) was associated with higher obesity risk, which was stronger in adults living in rural areas. Due to the complexity of examining these associations in a Middle Eastern country undergoing a nutrition transition, longitudinal research is needed to confirm these findings.

Does the use of mobile applications or mobile health technology improve diet quality in adults? A protocol for a systematic literature review

Background: Mobile technology has grown at an exceptional rate and is now a huge part of our daily living. This use of mobile technology has opened up new possibilities in treating health, with almost half of the current applications linked to the mHealth sector. In particular, dietary measurement, applications have become very accessible and very popular. As dietary issues have become more prevalent, more mobile and mHealth applications offer various solutions. This systematic review aims to address if the use of such mobile applications or mobile health technology can improve diet quality in adults that interact with them. Methods: A systematic review of randomised controlled trials (RCTs) and non-randomised controlled trials (NRCTs) will be conducted. The Cumulative Index to Nursing and Allied Health Literature (Cinahl), The American Psychological Association’s (APA Psycinfo), and PubMed will be searched from January 2010 to November 2021. Primary outcomes will include identifying if adults who use mobile applications and health technology improve their diet quality compared to adults who do not use this technology. Study selection will follow the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines. The methodological appraisal of the studies will be assessed independently by two different reviewers (AS and JR) using the Cochrane Risk-of-Bias Tool for RCTs and the Risk-of Bias In Non-Randomised Studies Tool for NRCTs. Ethics and dissemination: Ethical approval is not essential for this systematic review. Only data from studies that are publically available from previously published studies will be used. The findings of this systematic review will be submitted for publication in a peer-reviewed journal and presented at relevant conferences. PROSPERO registration: CRD42021240224 (01/03/2021).

Associations between Avocado Consumption and Diet Quality, Dietary Intake, Measures of Obesity and Body Composition in Adolescents: The Teen Food and Development Study

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12-18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.

Adherence to index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence: the EPOCH study

BACKGROUND

In the United States, one in five adolescents are obese. Index-based dietary patterns are measures of the overall diet that have the potential to serve as valuable obesity risk stratification tools. However, little is known about the association between adherence to index-based dietary patterns in childhood and BMI during the transition from childhood to adolescence.

OBJECTIVE

To prospectively examine the relationship between adherence to three index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence.

METHODS

The study included 581 children enrolled in a Colorado prospective cohort study conducted between 2006 and 2015. Dietary intake was assessed with the Block Kids Food Frequency Questionnaire at age 10 years. Scores were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternate Mediterranean (aMED) diet, and the Dietary Approaches to Stop Hypertension (DASH) diet. Weight and height were assessed via anthropometry at two research visits (ages 10 and 16 years), with interim clinical measurements extracted from Kaiser Permanente medical records. Separate mixed models were used to assess the association between each diet index score and BMI over a 6-year period. Models were stratified by sex and adjusted for age, race/ethnicity, income, and exposure to gestational diabetes.

RESULTS

Median (IQR) number of BMI assessments was 14 (10-18). Among girls, for every ten-unit increase in HEI-2010 score, there was an average 0.64 kg/m² decrease (p = 0.007) in BMI over time, after adjustment for covariates. Among girls, there was no association between BMI and aMED (β = -0.19, p = 0.24) or DASH (β = 0.28, p = 0.38). Among boys, there was no statistically significant association between BMI and HEI-2010 (0.06, p = 0.83), aMED (0.07, p = 0.70), or DASH (0.42, p = 0.06).

CONCLUSIONS

Efforts to prevent adolescent obesity could benefit from considering the degree of adherence to federal dietary guidance, as assessed by the HEI, in the period preceding adolescence, especially among girls.

Impact of COVID-19 pandemic on glycemic control among outpatients with type 2 diabetes in Japan: A hospital-based survey from a country without lockdown

AIMS

Some studies have reported changes in glycemic control of patients with diabetes mellitus under lockdown. However, no previous study examined the impact of the pandemic on glycemic control in patients with diabetes in countries that did not introduce a lockdown such as Japan. This study aimed to assess changes in glycemic control during the pandemic in patients with type 2 diabetes treated at a Japanese clinic.

METHODS

We conducted a historical cohort study, using electronic medical records of patients with type 2 diabetes who visited our clinic between January 2019 and August 2020. Differences in HbA1c values before and after the outbreak of COVID-19 were the primary outcome, examined using the linear mixed model.

RESULTS

HbA1c values significantly increased from 7.45% to 7.53% after the state of emergency was introduced (n = 1,009). Furthermore, a deterioration in HbA1c values was observed in particular among women, patients aged ≥ 65 years, those with body mass index of ≥ 25 kg/m², and those that were not using insulin.

CONCLUSIONS

Glycemic control deteriorated in patients with type 2 diabetes during the pandemic even in a country without a national lockdown.

Almond consumption decreases android fat mass percentage in adults with high android subcutaneous adiposity but does not change HbA1c in a randomised controlled trial

The purpose of this study was to determine if the mixed evidence of almond consumption on HbA1c stems from testing people with different body fat distributions (BFD) associated with different risks of glucose intolerance. A 6-month randomised controlled trial in 134 adults was conducted. Participants were randomly assigned to the almond (A) or control (C) group based on their BFD. Those in the almond group consumed 1·5 oz of almonds with their breakfast and as their afternoon snack daily. Those in the control group continued their habitual breakfast and afternoon snack routines. Body weight and composition were measured and blood samples were collected for determination of HbA1c, glycaemia and lipaemia at 0 and 6 months. Appetite ratings, energy intake and diet quality were collected at 0, 2, 4 and 6 months. Participants consuming almonds ingested 816 (sem 364) kJ/d more than participants in the control group (P = 0·03), but this did not result in any differences in body weight (A: –0·3 (sem 0·4), C: –0·4 (sem 0·4); P > 0·3). Participants in the almond, high android subcutaneous adipose tissue (SAT) group had a greater reduction in android fat mass percentage (A: –1·0 (sem 0·6), C: 1·1 (sem 0·6); P = 0·04), preserved android lean mass percentage (A: 0·9 (sem 0·6), C: –1 (sem 0·6); P = 0·04) and tended to decrease android visceral adipose tissue mass (A: –13 (sem 53) g, C: 127 (sem 53) g; P = 0·08) compared with those in the control, high SAT group. There were no differences in HbA1c between groups (A: 5·4 (sem 0·04), C: 5·5 (sem 0·04); P > 0·05). Thus, BFD may not explain the mixed evidence on almond consumption and HbA1c. Long-term almond consumption has limited ability to improve cardiometabolic health in those who are overweight and obese but otherwise healthy.

Established diet quality indices are not universally associated with body composition in young adult women

OBJECTIVE

To determine which established diet quality indices best predict weight-related outcomes in young women.

DESIGN

In this cross-sectional analysis, we collected dietary information using the Harvard FFQ and measured body fat percentage (BF%) by dual-energy X-ray absorptiometry. We used FFQ data to derive five diet quality indices: Recommended Food Score (RFS), Healthy Eating Index 2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet Score (aMED) and Healthy Plant-Based Diet Index (HPDI).

SETTING

University of Massachusetts at Amherst.

PARTICIPANTS

Two hundred sixty healthy women aged 18-30 years.

RESULTS

The AHEI-2010 and HPDI were associated with BMI and BF%, such that a ten-point increase in either diet score was associated with a 1·2 percentage-point lower BF% and a 0·5 kg/m2 lower BMI (P < 0·05). Odds of excess body fat (i.e. BF% > 32 %) were 50 % lower for those in the highest v. lowest tertile of the AHEI-2010 (P = 0·04). Neither the RFS nor HEI-2015 was associated with BMI or BF%; the aMED was associated with BMI but not BF%.

CONCLUSIONS

These results suggest that diet quality tends to be inversely associated with BMI and BF% in young women, but that this association is not observed for all diet quality indices. Diet indices may have limited utility in populations where the specific healthful foods and food groups emphasised by the index are not widely consumed. Future research should aim to replicate these findings in longitudinal studies that compare body composition changes over time across diet indices in young women.

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

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

Estimated dietary sodium intake in Thailand: A nationwide population survey with 24-hour urine collections

Thailand has committed to reducing population sodium intake by 30% by 2025. However, reliable nationally representative data are unavailable for monitoring progress toward the goal. We estimated dietary sodium consumption using 24‐hour urinary analyses in a nationally representative, cross‐sectional population‐based survey. We selected 2388 adults (aged ≥ 18 years) from the North, South, North‐east, Central Regions, and Bangkok, using multi‐stage cluster sampling. Mean sodium excretion was inflated by 10% to adjust for non‐urinary sources. Multivariate logistic regression was performed to assess factors associated with sodium consumption ≥ 2000 mg. Among 1599 (67%) who completed urine collection, mean age was 43 years, 53% were female, and 30% had hypertension. Mean dietary sodium intake (mg/day) was 3636 (±1722), highest in South (4108 ± 1677), and lowest in North‐east (3316 ± 1608). Higher sodium consumption was independently associated with younger age (Adjusted Odds Ratio (AOR) 2.81; 95% Confidence interval (CI): 1.53‐5.17; p = .001); higher education (AOR 1.79; 95% CI: 1.19‐2.67; p = .005), BMI ≥ 25 (AOR 1.55; 95% CI: 1.09‐2.21; p=.016), and hypertension (AOR 1.58; 95% CI: 1.02‐2.44; p = .038). Urine potassium excretion was 1221 mg/day with little variation across Regions. Estimated dietary sodium consumption in Thai adults is nearly twice as high as recommended levels. These data provide a benchmark for future monitoring.

Healthy Eating Index and Nutrition Biomarkers among Army Soldiers and Civilian Control Group Indicate an Intervention Is Necessary to Raise Omega-3 Index and Vitamin D and Improve Diet Quality

Diet quality and nutrition status are important for optimal health and military performance. Few studies have simultaneously evaluated diet quality and biochemical markers of nutritional status of military service members. The Healthy Eating Index (HEI) can be used to assess dietary quality and adherence to federal nutrition guidelines. The aim of this study was to assess soldiers' diet quality and nutritional status and compare results to a civilian control group.

METHODS

A cross-sectional study was conducted with 531 soldiers. A food frequency questionnaire was used to calculate HEI scores. A blood sample was collected for analysis of select nutrition biochemical markers. Non-parametric analyses were conducted to compare the diet quality and nutritional status of soldiers and controls. Differences in non-normally distributed variables were determined by using the Wilcoxon signed-rank test.

RESULTS

Soldiers had an HEI score of 59.9 out of 100, marginally higher than the control group (55.4). Biochemical markers of interest were within normal reference values for soldiers, except for the omega-3 index and vitamin D.

CONCLUSIONS

This study identified dietary components that need improvement and deficits in biochemical markers among soldiers. Improving diet quality and nutritional status should lead to better health, performance, and readiness of the force.

Relationships of Physical Activity and Diet Quality with Body Composition and Fat Distribution in US Adults

OBJECTIVE

This study aimed to investigate the relationships among physical activity (PA), diet quality, body composition, and fat distribution in a representative sample of US adults.

METHODS

A cross-sectional analysis was conducted using publicly accessible data from the 2011 to 2016 National Health and Nutrition Examination Survey and the Food Patterns Equivalents Database (n = 7,423). Variables from the data sets were analyzed for this study, including PA, two 24-hour dietary recalls, and dual-energy x-ray absorptiometry outputs.

RESULTS

For men, PA and diet quality were inversely associated with the percentage of body fat (β = -0.0042, 95% CI: -0.0084 to -0.0001; β = -0.28, 95% CI: -0.42 to -0.14) and fat mass index (β = -0.0125, 95% CI: -0.0209 to -0.0041; β = -0.56, 95% CI: -0.81 to -0.32); meeting the PA recommendation and having good diet quality provided an additive effect on body fat. A similar pattern was observed in women. Additionally, diet quality was inversely associated with all fat distribution measures in both sexes, whereas PA was positively associated with lean mass measures in men only.

CONCLUSIONS

Increased PA and/or better diet quality were associated with reduced body fat, a healthier fat distribution, and increased lean mass. Further research examining how changes in PA or diet quality influence body composition and fat distribution in adults is warranted.

Associations between Diet Quality and Body Composition in Young Children Born with Very Low Body Weight

BACKGROUND

Very low birth weight (VLBW; <1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals.

OBJECTIVE

The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity.

METHODS

This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds.

RESULTS

Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: -0.5 SD; 95% CI: -0.7, -0.2) and subscapular (-0.3 SD; 95% CI: -0.6, -0.06) z-scores.

CONCLUSIONS

Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.

COVID-19 Lockdown and Changes of the Dietary Pattern and Physical Activity Habits in a Cohort of Patients with Type 2 Diabetes Mellitus

The COVID-19 lockdown clearly affected the lifestyle of the population and entailed changes in their daily habits, which involved potential health consequences, especially on patients with Type 2 Diabetes Mellitus (T2DM). We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on both nutrition and exercise habits, as well as the psychological effects in patients with T2DM, compared to their usual diet and physical activity level previous to the complete home confinement. We also intended to analyse any potential variables that may have influenced these lifestyle modifications. A Food Frequency Questionnaire (FFQ), Physical Activity Questionnaire (IPAQ), Food Craving Questionnaire-State (FCQ-S) and Food Craving Questionnaire-Trait (FCQ-T) were used. Our results showed an increase in vegetable, sugary food and snack consumption. An association between levels of foods cravings and snack consumption was also found. Data also showed a high percentage of physical inactivity before the COVID-19 lockdown, which was exacerbated during the home confinement. These findings emphasise the great importance to do further research with larger study samples to analyse and explore dietary habits and to develop public health policies to promote a healthy lifestyle in terms of diet and physical activity in these patients, especially after this strict period of lockdown.

Trends, prevalence and associated factors of obesity among adults in a rural community in Thailand: serial cross-sectional surveys, 2012 and 2018

Background

Obesity is one principle risk factor increasing the risk of noncommunicable diseases including diabetes, hypertension and atherosclerosis. In Thailand, a 2014 study reported obesity (BMI ≥25 kg/m²) in a Thai population aged ≥15 years was 37.5, 32.9 and 41.8% overall and among males and females, respectively. The study aimed to determine trends in the prevalence of obesity among adults residing in a Thai rural community between 2012 and 2018 and investigate the associations between obesity and behavioral factors.

Methods

Serial cross-sectional studies were conducted in 2012 and 2018 among adults in Na-Ngam rural community. In 2012 and 2018, all 635 and 627 individuals, respectively, were interviewed using structured questionnaires related to demographics, risk behaviors, comorbidities and arthrometric measurement. Spot urine was collected by participants and obesity was defined as BMI ≥25 kg/m². The risk factors for obesity were analyzed in the 2018 survey.

Results

A total of 1262 adults in Na-Ngam rural community were included in the study. The prevalence of obesity was 33.9% in 2012 and 44.8% in 2018 (P < 0.001). The average BMI increased from 23.9 ± 4.2 kg/m² in 2012 to 25.0 ± 4.52 kg/m² in 2018 (P < 0.001). Obesity was associated with higher age (AOR 0.99; 95%CI 0.97–0.99), smoking (AOR 0.52; 95%CI 0.28–0.94), instant coffee-mix consumption > 1 cup/week (AOR 1.44; 95%CI 1.02–2.04), higher number of chronic diseases (≥1 disease AOR 1.82; 95%CI 1.01–2.68, > 2 diseases AOR 2.15; 95%CI 1.32–3.50), and higher spot urine sodium level (AOR 1.002; 95%CI 0.99–1.01).

Conclusion

Our data emphasized that obesity constituted a serious problem among adults residing in a rural community. A trend in significant increase was found regarding the prevalence of obesity and average BMI in the rural community over 6 years. Effective public health interventions should be provided at the community level to reduce BMI. Moreover, modifiable risk factors for obesity should be attenuated to inhibit the progression of metabolic syndrome, noncommunicable diseases and their complications.

Hubungan Magnesium Serum Dengan Kadar Glukosa Darah Pada Dewasa Overweight Dan Obesitas

Background:Fat deposits in obesity can trigger oxidative stress and systemic inflammation that cause insulin resistance, which increases the risk of diabetes mellitus. Magnesium is a cofactor of various enzymes in glucose metabolism that plays a role in the process of glucose uptake in the muscles and also acts as an anti-inflammatory. Good intake of nutrients can prevent the metabolic diseases.Objectives:to evaluate the correlation among serum magnesium,energy, macro nutrient and magnesium intake with fasting blood glucose levels in overweight and obese adults.Methods: A cross-sectional study was conducted on 93 overweight(BMI ≥ 25-29.9 kg/m2) and obese (BMI ≥30 kg/m2) adults in February to May 2019 in Serengan District, Surakarta City. The measurement of serum magnesium using kalorimetri and fasting blood glucose using hexokinase method. Energy, macro nutritionand magnesium intake was assessed using 2x24 hour food recall. The bivariate analysis was carried out using Pearson correlation with p value of <0.05 followed by multivariable multiple linear regression analysis with 95% CI.Results:There was no significant correlation of energy, macro nutrient and magnesium intake with blood glucose level. There was a significant negative correlation between serum magnesium and fasting blood glucose in overweight and obese adults (p=0.009; r=-0.286; CI95%=-71.321–(-10.480)).Conclusions: Serum magnesium are the factors most associated with blood glucose in overweight and obese adults. Blood glucose will increase along with decreasing level of serum magnesium.ABSTRAKLatar Belakang: Timbunan lemak pada obesitas menjadi pemicu terjadinya stress oksidatif dan inflamasi sitemik penyebab resistensi insulin sehingga risiko terjadinya diabetes mellitus akan meningkat. Magnesium merupakan kofaktor berbagai enzim dalam metabolisme glukosa yang berperan dalam proses ambilan glukosa di otot dan juga sebagai antiinflamasi. Asupan zat gizi yang baik dapat mencegah terjadinya penyakit metabolik.Tujuan: untuk mengevaluasi hubungan magnesium serum, asupan energi, zat gizi makro dan magnesium dengan glukosa darah puasa pada dewasa overweight dan obesitas.Metode: Penelitian crossectional terhadap 93 orang dewasa dengan status gizi lebih atau overweight (IMT ≥ 25-29,9 kg/m2) dan obesitas (IMT ≥30 kg/m2) pada bulan Februari hingga Mei 2019 di Kecamatan Serengan Kota Surakarta. Pemeriksaan magnesium serum dengan metode kalorimetri dan glukosa darah puasa dengan metode heksokinase. Penilaian asupan energi, zat gizi makro dan magnesium dengan food recall 2x24 jam. Analisis bivariat menggunakan korelasi Pearson dengan nilai p < 0,05 dilanjutkan analisis multivariabel regresi linier ganda dengan CI 95%.Hasil: Tidak ada korelasi signifikan asupan energi, zat gizi makro dan magnesium dengan glukosa darah. Adanya korelasi negatif yang signifikan antara kadar serum magnesium dengan glukosa darah puasa pada dewasa overweight dan obesitas (p=0,009; r=-0,286; CI95%=-71,321–(-10,480)).Kesimpulan: Kadar magnesium serum merupakan faktor yang paling berhubungan dengan glukosa darah pada orang dewasa overweight dan obesitas di Kecamatan Serengan Kota Surakarta. Glukosa darah akan meningkat seiring dengan penurunan kadar magnesium serum.

Adherence to dietary guidelines in relation to visceral fat and liver fat in middle-aged men and women: the NEO study

Background

It is unclear to what extent adherence to dietary guidelines may specifically affect visceral fat and liver fat. We aimed to study the association between the Dutch Healthy Diet Index (DHD-index) and total body fat, visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) in middle-aged men and women.

Design

In this cross-sectional study, VAT was assessed by magnetic resonance imaging (MRI) in 2580 participants, and HTGC by proton-MR spectroscopy in 2083 participants. Habitual dietary intake and physical activity were estimated by questionnaire. Adherence to the current Dutch dietary guidelines was estimated by the 2015 DHD-index score based on the thirteen components (vegetables, fruit, wholegrain products, legumes, nuts, dairy, fish, tea, liquid fats, red meat, processed meat, sweetened beverages, and alcohol). The DHD-index ranges between 0 and 130 with a higher score indicating a healthier diet. We used linear regression to examine associations of the DHD-index with VAT and HTGC, adjusted for age, smoking, education, ethnicity, basal metabolic rate, energy restricted diet, menopausal state, physical activity, total energy intake, and total body fat. We additionally excluded the components one by one to examine individual contributions to the associations.

Results

Included participants (43% men) had a mean (SD) age of 56 (6) years and DHD-index score of 71 (15). A 10-point higher DHD-index score was associated with 2.3 cm² less visceral fat (95% CI; −3.5; −1.0 cm²) and less liver fat (0.94 times, 95% CI; 0.90; 0.98). Of all components, exclusion of dairy attenuated the associations with TBF and VAT.

Conclusions

Adherence to the dietary guidelines as estimated by the DHD-index was associated with less total body fat, and with less visceral and liver fat after adjustment for total body fat. These findings might contribute to better understanding of the mechanisms underlying associations between dietary habits and cardiometabolic diseases.

Propionate suppresses hepatic gluconeogenesis via GPR43/AMPK signaling pathway

Short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate are generated by gut microbial fermentation of dietary fiber. SCFAs may exert multiple beneficial effects on human lipid and glucose metabolism. However, their actions and underlying mechanisms are not fully elucidated. In this study, we examined the direct effects of propionate on hepatic glucose and lipid metabolism using human HepG2 hepatocytes. Here, we demonstrate that propionate at a physiologically-relevant concentration effectively suppresses palmitate-enhanced glucose production in HepG2 cells but does not affect intracellular neutral lipid levels. Our results indicated that propionate can decline in gluconeogenesis by down-regulation of glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PEPCK) through activation of AMP-activated protein kinase (AMPK), which is a major regulator of the hepatic glucose metabolism. Mechanistic studies also revealed that propionate-stimulated AMPK phosphorylation can be ascribed to Ca²⁺/calmodulin-dependent protein kinase kinase β (CaMKKβ) activation in response to an increase in intracellular Ca²⁺ concentration. Moreover, siRNA-mediated knockdown of the propionate receptor GPR43 prevented propionate-inducible activation of AMPK and abrogates the gluconeogenesis-inhibitory action. Thus, our data indicate that the binding of propionate to hepatic GPR43 elicits CaMKKβ-dependent activation of AMPK through intracellular Ca²⁺ increase, leading to suppression of gluconeogenesis. The present study suggests the potential efficacy of propionate in preventive and therapeutic management of diabetes.

Diet Quality and Diet Diversity in Eight Latin American Countries: Results from the Latin American Study of Nutrition and Health (ELANS)

This study aimed to assess diet quality score (DQS), considering healthy and unhealthy foods and nutrients, and diet diversity score (DDS) as indicators of risk of noncommunicable diseases in eight Latin American countries, and to verify the possible differences considering country, sex, age, socioeconomic, and nutritional status. A multicenter household population-based cross-sectional survey was conducted with 9218 individuals (age range 15-65 years). Sociodemographic and anthropometric data were collected. Dietary intake was measured using two non-consecutive 24-h recalls and diet quality and diversity were assessed. In the whole sample, scores were observed from 63.0% ± 9.3% to total DQS, 65.0% ± 13.6% to healthy dietary items and 60.2% ± 13.6% to unhealthy items, and 5.6 ± 1.1 out of 9 points to DDS. Women presented lower DDS compared to men (5.5 ± 1.1 vs. 5.6 ± 1.1, p < 0.001). Healthy DQS was higher as the socio-economic level increased, and unhealthy DQS was the opposite (p < 0.05). Total DQS was significantly lower only at the low socio-economic level (p < 0.05). Chile and Venezuela showed the lowest healthy (62.2 ± 15.2 and 61.9 ± 11.7, p < 0.05) and total DQS (61.4 ± 10.3, 61.2 ± 8.7, p < 0.05). No effects were observed when considering the age and anthropometric measurements. Promoting consumption of a diverse and high-quality diet is an essential challenge to accomplish.

Higher Diet Quality is Associated with Lower Odds of Low Hand Grip Strength in the Korean Elderly Population

Single nutrients or food groups have been associated with physical performance. However, little is known about the association of overall diet quality with hand grip strength (HGS), a predictive parameter in the prognosis of chronic disease morbidity and mortality, or quality of life. This study examined the association between HGS and three indices-the Korean Healthy Eating Index (KHEI), the Alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)-using data obtained on Korean elderly persons aged ≥65 years (n = 3675) from a nationally representative database. The cross-sectional data was collected as part of the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2016). Dietary intake data from the 24-h recall method were used to calculate diet quality scores. The cutoff value for low HGS was defined as the value corresponding to the lowest 20th percentile of HGS of the study population (men, 28.6 kg; women, 16.5 kg). Higher index scores for diet quality were associated with 32%-53% lower odds of low HGS. Better overall diet quality may be associated with higher HGS in the elderly Korean population.

Dissimilar Impact of a Mediterranean Diet and Physical Activity on Anthropometric Indices: A Cross-Sectional Study from the ILERVAS Project

There is a close relationship between lifestyle behaviors and excess adiposity. Although body mass index (BMI) is the most used approach to estimate excess weight, other anthropometric indices have been developed to measure total body and abdominal adiposity. However, little is known about the impact of physical activity and adherence to a Mediterranean diet on these indices. Here we report the results of a cross-sectional study with 6672 middle-aged subjects with low to moderate cardiovascular risk from the Ilerda Vascular (ILERVAS) project. The participants' adherence to physical activity (International Physical Activity Questionnaire short form) and MedDiet (Mediterranean Diet Adherence Screener) was evaluated. Measures of total adiposity (BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and Deurenberg's formula), central adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body adiposity index, and body roundness index), and lean body mass (Hume formula) were assessed. Irrespective of sex, lower indices of physical activity were associated with higher values of total body fat and central adiposity. This result was constant regardless of the indices used to estimate adiposity. However, the association between MedDiet and obesity indices was much less marked and more dependent on sex than that observed for physical activity. Lean body mass was influenced by neither physical activity nor MedDiet adherence. No joint effect between physical activity and MedDiet to lower estimated total or central adiposity indices was shown. In conclusion, physical activity is related to lower obesity indices in a large cohort of middle-aged subjects. MedDiet showed a slight impact on estimated anthropometric indices, with no joint effect when considering both lifestyle variables. ClinTrials.gov Identifier: NCT03228459.

Motivational Interviewing and Fat Consumption in Older Adults: A Meta-Analysis

Diets high in fat increase the risks for obesity and chronic diseases, even for older adults, the largest growing population in the United States. In the current study, a meta-analysis was performed to examine the effects of motivational interviewing (MI) dietary interventions on fat consumption in older adults. Electronic databases, journals, and unpublished literature were searched. Six primary studies were retrieved, providing seven comparisons between intervention and control groups and a total of 1,351 participants. MI had a moderate effect on fat intake in older adults (effect size = 0.354, p < 0.01). Studies with indicators of higher design quality showed greater MI effects. Nurses and providers can incorporate MI into health education and counseling to improve older adults' dietary health behaviors. [Journal of Gerontological Nursing, 44(11), 33-43.].

Adherence to the French Eating Model is inversely associated with overweight and obesity: results from a large sample of French adults

The ‘French Eating Model’ characterised by structured meals and conviviality has received little attention, although it has been suggested as a potential explanation of the French paradox. This study aims at assessing the adherence to this model in French adults and whether it is associated with weight status. Eating behaviour and, in particular, number of meals per day, snacking frequency, meal time, meal duration, number of courses, position (standing, sitting), presence of others and pleasure experienced was assessed in 2014, in 47 219 participants of the NutriNet-Santé study. A global score of adherence to the French Eating Model was computed on the basis of eating behaviour components. Prevalence of the model was assessed on a sample weighted according to Census data. Associations between adherence to the model (and its components) and overweight and obesity were assessed using logistic regression analyses adjusted for individual characteristics. Most individuals followed the French Eating Model: three meals a day, at set times, sitting at a table with other people and considering meals as a moment of pleasure. Individuals who exhibited higher adherence to the model were less likely to be overweight (OR=0·89; 95 % CI 0·87, 0·92 or obese (0·76; 95 % CI 0·74, 0·79). Similar trends were found for the following components: number of meals per day, snacking frequency, meal time, meal duration and pleasure experience, whereas an opposite trend was observed for the eating with others component. Although prospective studies are needed to conclude on a causal relationship, these results suggested the potential role of the French Eating Model, which is still prevailing in France, in obesity prevention.

Diet Quality and Nutrient Intake of Urban Overweight and Obese Primarily African American Older Adults with Osteoarthritis

Diet quality may be a unique target for preventing and managing obesity-related osteoarthritis (OA). Using the Healthy Eating Index-2010 (HEI-2010), this study examined the nutrient intake and diet quality of 400 urban overweight and obese primarily African American older adults with self-reported lower extremity OA. Associations between sociodemographic and health-related factors and diet quality were explored. Participants (mean age 67.8 years, SD 5.9) were included. Habitual dietary intake was assessed using a food frequency questionnaire (FFQ). Nutrient intake and diet quality were calculated from the FFQ. Results indicated that diet quality needs improvement (HEI-2010: 66.3 (SD 10.5)). Age, body mass index, employment (multivariable model only), and OA severity (bivariate model only) were significant predictors of HEI-2010 total score in linear models. Mean intakes for fiber, calcium, and vitamin D were below recommendations, while percentage of calories as total fat exceeded recommendations. These findings can inform future dietary intervention trials and public health messaging for a sub-population at a high risk for obesity-related OA.

Higher Mediterranean Diet Quality Scores and Lower Body Mass Index Are Associated with a Less-Oxidized Plasma Glutathione and Cysteine Redox Status in Adults

Background

Both systemic redox status and diet quality are associated with risk outcomes in chronic disease. It is not known, however, the extent to which diet quality influences plasma thiol/disulfide redox status.

Objective

The purpose of this study was to investigate the influence of diet, as measured by diet quality scores and other dietary factors, on systemic thiol/disulfide redox status.

Methods

We performed a cross-sectional study of 685 working men and women (ages ≥18 y) in Atlanta, GA. Diet was assessed by 3 diet quality scores: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean Diet Score (MDS). We measured concentrations of plasma glutathione (GSH), cysteine, their associated oxidized forms [glutathione disulfide (GSSG) and cystine (CySS), respectively], and their redox potentials (EhGSSG and EhCySS) to determine thiol/disulfide redox status. Linear regression modeling was performed to assess relations between diet and plasma redox after adjustment for age, body mass index (BMI), sex, race, and history of chronic disease.

Results

MDS was positively associated with plasma GSH (β = 0.02; 95% CI: 0.003, 0.03) and total GSH (GSH + GSSG) (β = 0.02; 95% CI: 0.003, 0.03), and inversely associated with the CySS:GSH ratio (β = -0.02; 95% CI: -0.04, -0.004). There were significant independent associations between individual MDS components (dairy, vegetables, fish, and monounsaturated fat intake) and varying plasma redox indexes (P < 0.05). AHEI and DASH diet quality indexes and other diet factors of interest were not significantly correlated with plasma thiol and disulfide redox measures.

Conclusion

Adherence to the Mediterranean diet was significantly associated with a favorable plasma thiol/disulfide redox profile, independent of BMI, in a generally healthy working adult population. Although longitudinal studies are warranted, these findings contribute to the feasibility of targeting a Mediterranean diet to improve plasma redox status.

Temporal eating patterns: associations with nutrient intakes, diet quality, and measures of adiposity

Background: Some evidence suggests that higher energy intake (EI) later in the day is associated with poor diet quality and obesity. However, EI at one eating occasion (EO) is also dependent on EI at surrounding EOs. Studies that examine the distribution of EOs across the day are rare.Objective: The aim of this study was to examine associations between temporal eating patterns, nutrient intakes, diet quality, and measures of adiposity in a representative sample of Australian adults.Design: Dietary data from two 24-h recalls collected during the cross-sectional 2011-2012 Australian National Nutrition and Physical Activity Survey were analyzed (n = 4544 adults, aged ≥19 y). Temporal eating patterns, based on the distribution of EOs across the day, were determined by using latent class analysis. Diet quality estimated adherence to healthy eating recommendations and was assessed by using the 2013 Dietary Guidelines Index (DGI). Multivariate regression models assessed associations between temporal eating patterns, nutrient intakes, diet quality, and adiposity (body mass index, waist circumference, weight status, and central weight status). Models were adjusted for potential confounders and energy misreporting.Results: Three patterns, labeled "conventional," "later lunch," and "grazing," were identified. Compared with a "conventional" or "later lunch" pattern, men and women with a "grazing" pattern had lower DGI scores and higher intakes of discretionary (noncore) foods (P < 0.05). Among women, the "grazing" pattern was associated with overweight or obesity (OR: 1.57; 95% CI: 1.15, 2.13) and central overweight or obesity (OR: 1.73; 95% CI: 1.19, 2.50). These associations were attenuated after the exclusion of energy misreporters and adjustment for total EI.Conclusions: This study found that a "grazing" temporal eating pattern was modestly but significantly associated with poorer diet quality and adiposity among women, after adjustment for covariates and energy misreporting. Future research should consider the impact of energy misreporting on the relation between temporal eating patterns and adiposity. This secondary analysis was registered at anzctr.org.au as ACTRN12617001029381.

Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian National Nutrition Survey

The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada's Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach's α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17-1.71). Closer adherence to Canada's Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada's Food Guide are important and necessary to ensure broader application and usability of dietary quality indexes developed based on this national nutrition guideline.

A systematic review of diet quality indices in relation to obesity

Tools, called ‘diet/dietary quality indices’, evaluate the level of adherence to a specified pattern or a set of recommendations in populations. Yet, there are no review studies providing unanimous comprehensive results of dietary indices on obesity. We reviewed observational studies, focusing on the association of diet quality indices with general obesity or abdominal obesity in adults. We systematically conducted a search in all English language publications available on MEDLINE, ISI Web of Science and Embase between January 1990 and January 2016. Among the wide variety of indices and weight-derived variables, studies with dietary-guideline-based indices and mean changes for weight gain or OR for general obesity and abdominal obesity were selected. From a total of 479 articles, thirty-four studies were selected for the current review, ten of which had prospective designs and twenty-six had cross-sectional designs. Associations of weight status with the original Healthy Eating Index (HEI) and other versions of the HEI including alternative HEI, HEI-2005 and HEI-05 were examined in thirteen studies, with ten studies revealing significant associations. The HEI was a better general obesity predictor in men than in women. Diet scores lacked efficacy in assessing overall diet quality and demonstrated no significant findings in developing countries, in comparison with US populations. In addition, indices based on dietary diversity scores were directly associated with weight gain. Despite the insufficient evidence to draw definitive conclusions about the relation between dietary indices and obesity, HEI was found to be inversely associated with obesity and diversity-based indices were positively associated with obesity.

Diet quality and its relationship with central obesity among Mexican Americans: findings from National Health and Nutrition Examination Survey (NHANES) 1999-2012

OBJECTIVE

Using the Healthy Eating Index-2010 (HEI-2010), the present study aimed to examine diet quality and the impact of overall diet quality and its components on central obesity among Mexican-American men and women.

DESIGN

Cross-sectional data from NHANES 1999-2012 were used. The HEI-2010 data, including twelve components for a total score of 100, were collected with a 24 h recall interview. Central obesity was defined as a waist circumference of ≥88 cm for women and ≥102 cm for men. Weighted logistic regressions were performed to assess associations between HEI-2010 scores and central obesity.

SETTING

National Health and Nutrition Examination Survey (NHANES) 1999-2012.

SUBJECTS

A total of 6847 Mexican Americans aged ≥20 years with reliable dietary recall status and non-pregnancy status.

RESULTS

Higher HEI-2010 total score was associated with lower odds of central obesity in Mexican-American men (OR; 95 % CI=0·98; 0·98, 1·00). Among all Mexican Americans, one-unit higher score of total fruit and sodium (i.e. lower level of intake) was associated with 4 % (0·96; 0·93, 0·99) and 2 % (0·98; 0·96, 0·99) lower odds of central obesity, respectively. However, a higher total proteins score was associated with higher odds of central obesity (1·08; 1·00, 1·16). In gender-specific analyses, a higher whole fruit or sodium score was inversely associated with central obesity in men but not in women.

CONCLUSIONS

HEI-2010 scores of total fruit and sodium were inversely associated with central obesity among all Mexican Americans. However, total proteins score and central obesity was positively associated. In Mexican-American men, HEI-2010 total and whole fruit scores were inversely associated with central obesity.

Genetic and environmental influences on food preferences in adolescence

BACKGROUND

Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of genes and the environment on food preferences in late adolescence are unknown.

OBJECTIVE

The aim of this study was to quantify the contribution of genetic and environmental influences on food preferences in older adolescents.

DESIGN

Participants were 2865 twins aged 18-19 y from the TEDS (Twins Early Development Study), a large population-based cohort of British twins born during 1994-1996. Food preferences were measured by using a self-report questionnaire of 62 individual foods. Food items were categorized into 6 food groups (fruit, vegetables, meat or fish, dairy, starch foods, and snacks) by using factor analysis. Maximum likelihood structural equation modeling established genetic and environmental contributions to variations in preferences for each food group.

RESULTS

Genetic factors influenced a significant and substantial proportion of the variation in preference scores of all 6 food groups: vegetables (0.54; 95% CI: 0.47, 0.59), fruit (0.49; 95% CI: 0.43, 0.55), starchy foods (0.32; 95% CI: 0.24, 0.39), meat or fish (0.44; 95% CI: 0.38, 0.51), dairy (0.44; 95% CI: 0.37, 0.50), and snacks (0.43; 95% CI: 0.36, 0.49). Aspects of the environment that are not shared by 2 twins in a family explained all of the remaining variance in food preferences.

CONCLUSIONS

Food preferences had a moderate genetic basis in late adolescence, in keeping with findings in children. However, by this older age, the influence of the shared family environment had disappeared, and only aspects of the environment unique to each individual twin influenced food preferences. This finding suggests that shared environmental experiences that influence food preferences in childhood may not have effects that persist into adulthood.

Prospective association between body composition, physical activity and energy intake in young adults

BACKGROUND/OBJECTIVES

Despite considerable research on the association between physical activity (PA) and body composition, there remains limited information on the directionality of the relationship. The present study examined the prospective associations among objectively measured PA, energy intake (EI) and body composition.

SUBJECTS/METHODS

A convenience sample of 430 adults (49% male) between 21 and 35 years of age was followed over 1 year with repeated measurements taken every 3 months. BMI (kg/m(2)) and percent body fat (%BF) were calculated based on anthropometric measurements and dual energy X-ray absorptiometry. A multi-sensor device was worn over a period of 10 days to estimate total daily energy expenditure and time spent in different intensities. EI was calculated based on change in body composition and total daily energy expenditure.

RESULTS

A total of 379 participants provided valid data. On average, participants experienced a significant weight gain of 1.2±4.3 kg during the 12-month observation period, which was associated with an increase in %BF (0.8±3.2 %). Average time spent in moderate-to-vigorous PA (MVPA) decreased significantly, whereas EI remained constant. Optimal linear mixed models, adjusting for age and sex, showed an inverse effect of MVPA on BMI and %BF, whereas EI only directly affected BMI (P<0.001). There was also a significant inverse effect of BMI and %BF on MVPA (P<0.001).

CONCLUSIONS

Results of this study indicate an inverse reciprocal association between MVPA and measures of adiposity. Thus, primary preventive actions are warranted to avoid excess weight gain, which may result in a vicious cycle of weight gain and low PA.

Associations among physical activity, diet quality, and weight status in US adults

PURPOSE

Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of US adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in US adults.

METHODS

Participants included 2587 men and 2412 women age 20 to ≥70 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, body mass index (BMI), and waist circumference were assessed using standard National Health and Nutrition Examination Survey protocols.

RESULTS

Across age groups, MVPA was lower in the older age groups for both men and women, whereas diet quality was higher (P < 0.001). BMI and waist circumference were also higher in the older age groups (P < 0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P < 0.05). Diet quality was inversely associated with the weight status variables only in men age 30-39, 40-49 (BMI only), and 50-59 yr and women age 50-59 yr (P < 0.05).

CONCLUSIONS

We observed clear age-related trends for measures of weight status, physical activity, and diet quality in US men and women. MVPA was very consistently related to weight status in both genders. The relation between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.

High Salt Intake

High salt intake is the major cause of raised blood pressure and accordingly leads to cardiovascular diseases. Recently, it has been shown that high salt intake is associated with an increased risk of obesity through sugar-sweetened beverage consumption. Increasing evidence also suggests a direct link. Our study aimed to determine whether there was a direct association between salt intake and obesity independent of energy intake. We analyzed the data from the rolling cross-sectional study–the UK National Diet and Nutrition Survey 2008/2009 to 2011/2012. We included 458 children (52% boys; age, 10±4 years) and 785 adults (47% men; age, 49±17 years) who had complete 24-hour urine collections. Energy intake was calculated from 4-day diary and misreporting was assessed by Goldberg method. The results showed that salt intake as measured by 24-hour urinary sodium was higher in overweight and obese individuals. A 1-g/d increase in salt intake was associated with an increase in the risk of obesity by 28% (odds ratio, 1.28; 95% confidence interval, 1.12–1.45; P =0.0002) in children and 26% (odds ratio, 1.26; 95% confidence interval, 1.16–1.37; P <0.0001) in adults, after adjusting for age, sex, ethnic group, household income, physical activity, energy intake, and diet misreporting, and in adults with additional adjustment for education, smoking, and alcohol consumption. Higher salt intake was also significantly related to higher body fat mass in both children ( P =0.001) and adults ( P =0.001) after adjusting for age, sex, ethnic group, and energy intake. These results suggest that salt intake is a potential risk factor for obesity independent of energy intake.