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Goode JP, Smith KJ, Breslin M, Kilpatrick M, Dwyer T, Venn AJ, Magnussen CG. Modelling the replacement of red and processed meat with plant-based alternatives and the estimated effect on insulin sensitivity in a cohort of Australian adults. Br J Nutr 2024; 131:1084-1094. [PMID: 37981891 PMCID: PMC10876457 DOI: 10.1017/s0007114523002659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023]
Abstract
Dietary guidelines are increasingly promoting mostly plant-based diets, limits on red meat consumption, and plant-based sources of protein for health and environmental reasons. It is unclear how the resulting food substitutions associate with insulin resistance, a risk factor for type 2 diabetes. We modelled the replacement of red and processed meat with plant-based alternatives and the estimated effect on insulin sensitivity. We included 783 participants (55 % female) from the Childhood Determinants of Adult Health study, a population-based cohort of Australians. In adulthood, diet was assessed at three time points using FFQ: 2004–2006, 2009–2011 and 2017–2019. We calculated the average daily intake of each food group in standard serves. Insulin sensitivity was estimated from fasting glucose and insulin concentrations in 2017–2019 (aged 39–49 years) using homoeostasis model assessment. Replacing red meat with a combination of plant-based alternatives was associated with higher insulin sensitivity (β = 10·5 percentage points, 95 % CI (4·1, 17·4)). Adjustment for waist circumference attenuated this association by 61·7 %. Replacing red meat with either legumes, nuts/seeds or wholegrains was likewise associated with higher insulin sensitivity. Point estimates were similar but less precise when replacing processed meat with plant-based alternatives. Our modelling suggests that regularly replacing red meat, and possibly processed meat, with plant-based alternatives may associate with higher insulin sensitivity. Further, abdominal adiposity may be an important mediator in this relationship. Our findings support advice to prioritise plant-based sources of protein at the expense of red meat consumption.
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Affiliation(s)
- James P. Goode
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
| | - Kylie J. Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
| | - Monique Breslin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
- Heart Research Group, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| | - Alison J. Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS7000, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Al Hourani H, Alkhatib B, Al-Shami I, Olaimat AN, Al-Holy M, Al-Awwad NJ, Abughoush M, Saleh NA, AlHalaika D, Alboqai O, Al-Jawaldeh A. Energy and macronutrient intakes in Jordan: a population study. Sci Rep 2023; 13:12736. [PMID: 37543630 PMCID: PMC10404255 DOI: 10.1038/s41598-023-39900-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/01/2023] [Indexed: 08/07/2023] Open
Abstract
Jordan has never conducted a nutrition survey to determine nutrient and energy intakes. The current study aimed to describe the energy and macronutrient consumed by the Jordanian population. A cross-sectional food consumption study was conducted, including a sample of Jordanians using two non-consecutive 24-h dietary recalls (24-h DR) between October 2021 and March 2022. A total of 2145 males and females aged 8 to 85 years old living in households were studied. The average of two 24-h DRs for each individual was converted into energy and nutrient intakes. After measuring weight, height, and waist circumference, the body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The percentage of under-reporters was higher in women than men (58.2% vs. 45.9%). Adults and older adult women had the highest prevalence of obesity (29.6%), while adults and older adult men had the highest prevalence of overweight (41.4%). There is a significant increase in energy intake in children, boys, and all adults, compared to the recommended calories. The mean energy percentage (E %) of total fat was 38%, exceeding the upper limit of the Acceptable Macronutrient Distribution Range (AMDR). At the same time, the mean daily dietary fiber intake fell below the recommended levels (ranging from 13.5 g in children to 19.5 g in older adults). The study population consumes more fat and less fiber than the recommended levels. Actions must be taken across all age groups to correct the deviation of energy and macronutrient intakes from the recommended dietary allowances.
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Affiliation(s)
- Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan.
| | - Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Amin N Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Murad Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Narmeen Jamal Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Mahmoud Abughoush
- Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, 64141, Abu Dhabi, United Arab Emirates
| | - Nada A Saleh
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Dima AlHalaika
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Omar Alboqai
- Department of Nutrition and Food Science, Faculty of Agriculture and Sciences, Jerash University, Jerash, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, 7608, Egypt
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Goode JP, Smith KJ, Breslin M, Kilpatrick M, Dwyer T, Venn AJ, Magnussen CG. A healthful plant-based eating pattern is longitudinally associated with higher insulin sensitivity in Australian adults. J Nutr 2023; 153:1544-1554. [PMID: 36931561 DOI: 10.1016/j.tjnut.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND A healthful plant-based eating pattern is associated with lower type 2 diabetes risk; however, the association with its preceding state, compromised insulin sensitivity, is less well-established, particularly in younger populations with repeated measures of diet over time. OBJECTIVE We aimed to examine the longitudinal relationship between a healthful plant-based eating pattern and insulin sensitivity in young to middle-aged adults. METHODS We included 667 participants from the Childhood Determinants of Adult Health (CDAH) study, a population-based cohort in Australia. Healthful plant-based diet index (hPDI) scores were derived from food frequency questionnaire data. Plant foods considered 'healthful' were scored positively (e.g., whole grains, fruit, vegetables), with all remaining foods scored reversely (e.g., refined grains, soft drinks, meat). Updated homeostatic model assessment (HOMA2) estimated insulin sensitivity from fasting insulin and glucose concentrations. We used linear mixed-effects regression to analyse data from two time points: CDAH-1 (2004-06, aged 26-36 years) and CDAH-3 (2017-19, aged 36-49 years). hPDI scores were modelled as between- and within-person effects (i.e., a participant's overall mean and their deviation from said mean at each time point, respectively). RESULTS The median follow-up duration was 13 years. In our primary analysis, each 10-unit difference in hPDI score was associated with higher log-HOMA2 insulin sensitivity [95% confidence interval], with between-person (β = 0.11 [0.05, 0.17], P < .001) and within-person effects (β = 0.10 [0.04, 0.16], P = .001). The within-person effect persisted despite accounting for compliance with dietary guidelines. Adjustment for waist circumference attenuated the between-person effect by 70% (P = .26) and the within-person effect by 40% (P = .04). CONCLUSIONS In young to middle-aged Australian adults, a healthful plant-based eating pattern (determined using hPDI scores) was longitudinally associated with higher insulin sensitivity, and therefore, potentially lower type 2 diabetes risk later in life.
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Affiliation(s)
- James P Goode
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Monique Breslin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
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Abstract
The impact of change in socio-economic status (SES) from childhood to adulthood (SES mobility) on adult diet is not well understood. This study examined associations between three SES mobility variables (area disadvantage, education, occupation) and adult diet quality. 1482 Australian participants reported childhood area-level SES in 1985 (aged 10-15 years) and retrospectively reported highest parental education and main occupation (until participant age 12) and own area-level SES, education, occupation and dietary intake in 2004-2006 (aged 26-36 years). A Dietary Guidelines Index (DGI) was calculated from food frequency and habit questionnaires. A higher score (range 0-100) indicated better diet quality. Sex-stratified linear regression models adjusted for confounders. Area-level SES mobility was not associated with diet quality. Compared with stable high (university) education, stable low (school only) was associated with lower DGI scores (males: β = -5·5, 95 % CI: -8·9, -2·1; females: β = -6·3, 95 % CI: -9·3, -3·4), as was downward educational mobility (participant's education lower than their parents) (males: β = -5·3, 95 % CI: -8·5, -2·0; females: β = -4·5, 95 % CI: -7·2, -1·7) and stable intermediate (vocational) education among males (β = -3·9, 95 % CI: -7·0, -0·7). Compared with stable high (professional/managerial) occupation, stable low (manual/out of workforce) males (β = -4·9, 95 % CI: -7·6, -2·2), and participants with downward occupation mobility (males: β = -3·2, 95 % CI: -5·3, -1·1; females: β = -2·8, 95 % CI: -4·8, -0·8) had lower DGI scores. In this cohort, intergenerational low education and occupation, and downward educational and occupational mobility, were associated with poor adult diet quality.
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Vega-Salas MJ, Curi-Quinto K, Hidalgo-Aréstegui A, Meza-Carbajal K, Lago-Berrocal N, Arias L, Favara M, Penny M, Sánchez A, Vimaleswaran KS. Development of an online food frequency questionnaire and estimation of misreporting of energy intake during the COVID-19 pandemic among young adults in Peru. Front Nutr 2022; 9:949330. [PMID: 36091243 PMCID: PMC9449423 DOI: 10.3389/fnut.2022.949330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background The Young Lives longitudinal study switched to remote data collection methods including the adaptation of dietary intake assessment to online modes due to the physical contact restrictions imposed by the COVID-19 pandemic. This study aimed to describe the adaptation process and validation of an online quantitative food frequency questionnaire (FFQ) for Peruvian young adults. Methods A previously validated face-to-face FFQ for the adult Peruvian population was adapted to be administered through an online self-administered questionnaire using a multi-stage process. Questionnaire development was informed by experts' opinions and pilot surveys. FFQ validity was assessed by estimating misreporting of energy intake (EI) using the McCrory method, and the FFQ reliability with Cronbach alpha. Logistic regressions were used to examine associations of misreporting with sociodemographic, body mass index (BMI), and physical activity covariates. Results The FFQ was completed by 426 Peruvian young adults from urban and rural areas, among whom 31% were classified as misreporters, with most of them (16.2%) overreporting daily EI. Men had a lower risk of under-reporting and a higher risk of over-reporting (OR = 0.28 and 1.89). Participants without a higher education degree had a lower risk of under-reporting and a higher risk of over-reporting (OR = 2.18 and 0.36, respectively). No major difference in misreporting was found across age groups, areas, studying as the main activity, being physically active or sedentary, or BMI. Results showed good internal reliability for the overall FFQ (Cronbach alpha = 0.82). Conclusion Misreporting of EI was mostly explained by education level and sex across participants. Other sociodemographic characteristics, physical activity, sedentary behavior, and BMI did not explain the differences in EI misreporting. The adapted online FFQ proved to be reliable and valid for assessing dietary intakes among Peruvian young adults during the COVID pandemic. Further studies should aim at using and validating innovative dietary intake data collection methods, such as those described, for informing public health policies targeting malnutrition in different contexts after the COVID-19 pandemic.
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Affiliation(s)
- María Jesús Vega-Salas
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | | | - Alessandra Hidalgo-Aréstegui
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | | | | | - Lena Arias
- World Food Programme of United Nations in Peru, Lima, Peru
| | - Marta Favara
- Oxford Department of International Development, University of Oxford, Oxford, United Kingdom
| | - Mary Penny
- Instituto de Investigación Nutricional (IIN), Lima, Peru
| | - Alan Sánchez
- Group for the Analysis of Development, Lima, Peru
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.,The Institute for Food, Nutrition, and Health, University of Reading, Reading, United Kingdom
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Praxedes DRS, Pureza IROM, Vasconcelos LGL, Silva Júnior AE, Macena MDL, Florêncio TMDMT, Melo ISVD, Bueno NB. Association between energy intake under‐reporting and previous professional nutritional counselling in low‐income women with obesity: A cross‐sectional study. NUTR BULL 2021. [DOI: 10.1111/nbu.12513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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