Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016

Associations and predictive power of dietary patterns on metabolic syndrome and its components

BACKGROUND AND AIMS

Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance.

METHODS AND RESULTS

The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables.

CONCLUSIONS

The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.

Advancing nutrition risk assessment in middle-aged and older individuals with diverse food cultures: A data-driven personalized approach to predict incident hypertension, diabetes and mortality

BACKGROUND

Personalized nutrition risk assessment is crucial in addressing the association between healthy dietary habits across the life course and the development of disease, functional capacity, and healthy aging, as specific dietary pattern recommendations may not be suitable for diverse food cultures.

OBJECTIVE

To develop a data-driven, personalized nutrition risk assessment algorithm linked to incident hypertension, diabetes, and all-cause mortality utilizing the food frequency questionnaire among middle-aged and older individuals.

METHODS

A retrospective, population-based cohort study conducted between 1999 and 2015 utilized the nationally representative Taiwan Longitudinal Study on Aging (TLSA) survey to examine personalized dietary risk clusters and their associations with health outcomes. Latent class analysis was performed to derive the dietary diversity clusters among community-dwelling middle-aged and older individuals. Outcomes were defined as new-onset hypertension, diabetes mellitus and all-cause mortality at 4-, 8-, 12- and 16-year follow-ups.

RESULTS

Data from 1,811 participants (58.14% males, 43.90% aged 50-64 years) showed that around one-third of participants reported being illiterate, 21.98% widowed, and 51.46% engaging in regular physical exercise. Four dietary diversity clusters were identified: "least diverse", "fish and meat", "dairy, fruit, and vegetable", and "most diverse". The "most diverse" cluster was characterized by a high consumption of protein-rich foods, while the "dairy, fruit, and vegetable" cluster had the highest consumption of dairy products and beans/legumes. The "least diverse" cluster had the lowest intake of protein-rich foods, and dark-colored vegetables and fruits. The "most diverse" cluster had a significantly lower risk of hypertension development at the 4-year (aOR 0.58; p < 0.02) and 8-year (aOR 0.57; p < 0.01) follow-up and diabetes at the 4-year (aOR 0.44; p < 0.03) follow-up. Participants in the "most diverse" clusters exhibited lower risks of 8-year, 12-year, and 16-year mortality than those in the "least diverse" cluster (aOR 0.67, p < 0.05; 0.67, p < 0.03; and 0.50, p < 0.01, respectively).

CONCLUSION

The personalized nutrition risk assessment algorithm from the food frequency questionnaire can effectively stratify personal health risks among diverse middle-aged and older individuals, making it a valuable tool in lifestyle modification and intervention studies.

Different sedentary behavior domains present distinct associations with eating-related indicators

BACKGROUND

Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults.

METHODS

Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA.

RESULTS

The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile.

CONCLUSIONS

Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Sugar-Rich Food Intake Is Negatively Associated with Plasma Pentraxin 3 Levels

Background

Levels of pentraxin 3 (PTX3), an anti-inflammatory cardioprotective protein, increase after weight loss in obese men and aerobic exercise in non-obese adults. However, the effect of nutritional characteristics on PTX3 levels remains unclear. This population-based, cross-sectional study investigated the association between circulating PTX3 levels and food intake in Japanese adults.

Methods

We hypothesized that the consumption of high amounts of high-sugar foods would lead to low plasma PTX3 levels, resulting in obesity. This study included 327 participants categorized depending on the consumption of the recommended amount of confectionary and sugar-sweetened beverages (CSSB) into high and low groups.

Results

PTX3 levels were significantly lower in the high CSSB group than in the low CSSB group. Biological sex was the strongest effector of PTX3 levels. Moreover, the intake of Tsukudani and CSSB, as well as some metabolic syndrome factors, also affect PTX3 levels. In the groups categorized by sex and age, the determinants of PTX3 levels differed. Body mass index, waist circumference (WC), and high-density lipoprotein cholesterol (HDL-C) were significantly associated with PTX3 levels in women. Tsukudani, HDL-C, heart rate, saturated fatty acids, systolic blood pressure, and CSSB were associated with PTX3 levels in individuals aged >65 years.

Conclusion

Our results show that circulating PTX3 levels are affected by sex, sugar-rich foods, and metabolic syndrome characteristics (WC, HDL-C).

Identifying temporal sensory drivers of liking of biscuit supplemented with brewer's spent grain for young consumers

Brewer's spent grain (BSG), a by-product of the brewing industry, has great potential as food additive. BSG is particularly rich in protein and fibre content which makes it an ideal nutritional fortifier for biscuits. However, adding BSG to biscuits can lead to changes in sensory perception and consumer acceptance. This study explored the temporal sensory profiles and drivers/inhibitors of liking in BSG-fortified biscuits. Six biscuit formulations were obtained from a design with factors oat flake particle size (three levels: 0.5 mm, small commercial flakes, large commercial flakes) and baking powder (two levels: with, without). Consumers (n = 104) tasted the samples, described their dynamic sensory perception using the Temporal Check-All-That-Apply (TCATA) method, and rated their liking on a 7-point categorical scale. The Clustering around Latent Variables (CLV) approach was used to group consumers into two clusters based on their preferences. The temporal sensory profiles and drivers/inhibitors of liking were investigated within each cluster. Foamy and Easy-to-swallow were sensory drivers of liking for both groups of consumers. However, inhibitors of liking were different in the two clusters: Dense and Hard-to-swallow for one cluster and Chewy, Hard-to-swallow and Hard for the other cluster. These findings give evidence that manipulating oat particle size and presence/absence of baking powder changes BSG-fortified biscuits' sensory profiles and consumer preferences. A complementary analysis of the area-under-curve of the TCATA data and inspection of individual temporal curves showed the dynamics of perception and showed how oat particle size and presence/absence of baking powder affected consumer perception and acceptance of BSG-fortified biscuits. The methods proposed in this paper can be further applied to understand how enriching products with ingredients that would otherwise go to waste affects acceptance in different consumer segments.

Adherence to Mediterranean Diet in Individuals on Renal Replacement Therapy

Patients on renal replacement therapy are typically subject to several dietary restrictions; however, this approach has been questioned in recent years, with some suggesting that the Mediterranean diet might be beneficial. Data on the adherence to this diet and factors that influence it are scarce. We conducted a web survey among individuals on renal replacement therapy (dialysis or kidney transplant, KT) using the MEDI-LITE questionnaire to assess adherence to the Mediterranean diet and dietary habits in this population. Adherence to the Mediterranean diet was generally low, and significantly lower among participants on dialysis versus KT recipients (19.4% vs. 44.7%, p < 0.001). Being on dialysis, adopting fluid restrictions, and having a basic level of education were predictors of low adherence to the Mediterranean diet. Consumption of foods typically included in the Mediterranean diet, including fruit, legumes, fish, and vegetables, was generally low, particularly among those on dialysis. There is a need for strategies to improve both the adherence to and the quality of the diet among individuals on renal replacement therapy. This should be a shared responsibility between registered dietitians, physicians, and the patient.