Twenty-year trends in dietary patterns in French-speaking Switzerland: toward healthier eating

Trends and determinants of prevalence, awareness, treatment and control of dyslipidaemia in canton of Geneva, 2005-2019: Potent statins are underused

We assessed 1) trends in prevalence, awareness, treatment and control rates of dyslipidaemia and associated factors, 2) the effect of statin generation/potency on control levels and 3) the effect of ESC lipid guidelines, on lipid management. Data from multiple cross-sectional, population-based surveys conducted between 2005 and 2019 in the canton of Geneva, Switzerland, were used. Prevalence, awareness, treatment and control rates of dyslipidaemia were 46.0% and 34.9% (p < 0.001), 67.0% and 77.3% (p = 0.124), 40.0% and 19.9% (p < 0.001), and 68.0% and 84.0% (p = 0.255), in 2005 and 2019, respectively. After multivariable adjustment, only the decrease in treatment rates was significant. Increasing age, higher BMI, history of hypertension or diabetes were positively associated with prevalence, while female sex was negatively associated. Female sex, history of diabetes or CVD were positively associated with awareness, while increasing age was negatively associated. Increasing age, smoking, higher BMI, history of hypertension, diabetes or CVD were positively associated with treatment, while female sex was negatively associated. Female sex was positively associated with control, while increasing age was negatively associated. Highly potent statins increased from 50.0% to 87.5% and third generation statins from 0% to 47.5% in 2009 and 2015, respectively. Increased statin potency was borderline (p = 0.059) associated with dyslipidaemia control. ESC guidelines had no effect regarding the prescription of more potent or higher generation statins. We conclude that in the canton of Geneva, treatment of diagnosed dyslipidaemia is low, but control is adequate. Women are undertreated but better controlled than men. The most potent hypolipidemic drugs are underused.

Dietary Intake of Adult Residents in Luxembourg Taking Part in Two Cross-Sectional Studies-ORISCAV-LUX (2007-2008) and ORISCAV-LUX 2 (2016-2017)

Background: A balanced diet is an important lifestyle component and has been associated with a reduced risk of chronic diseases. Objectives: To assess dietary intake of adult residents in Luxembourg taking part in two population-based cross-sectional studies (ORISCAV-LUX, 2007–2008 and ORISCAV-LUX 2, 2016–2017). Methods: Dietary intake of the study participants (1242 in 2007/08 and 1326 in 2016/17), 25–69 years old, were evaluated using food-frequency questionnaires (134 items in 2007/2008 and 174 items in 2016/2017) according to the French ANSES-CIQUAL food composition database. Both food-group- and nutrient-based analyses were conducted. Results: Dietary patterns in ORISCAV-LUX 2, 2016–2017, were characterized by an increase in the estimated marginal means (EMM) of the intake of energy, total fat, saturated fatty acids, alcohol, and decreased EMM of total carbohydrates, magnesium, and calcium compared to 2007/08. We also observed an increased EMM of the intake of protein-rich food items and ready-to-eat foods/fast foods, together with a decreased intake of grains, dairy products, and vegetables (all p-values <0.05, linear mixed models). The intake of most micronutrients was stable or slightly increased in ORISCAV-LUX 2 vs. ORISCAV-LUX, except for the drop in magnesium and calcium, and generally met recommendations, in particular, EFSA population reference intakes (PRI), except for vitamin D. Conclusions: Though most micronutrient recommendations were met, nutrient consumption in terms of high energy, total fat, and sodium, as well as low carbohydrates, were not aligned with recommendations for balanced eating.

Retirement is associated with a decrease in dietary quality

BACKGROUND AND AIM

Retirement has been associated with changes in dietary intake. We evaluated dietary intake and compliance to dietary guidelines after retirement in a population-based survey.

METHODS

Data from a prospective study conducted in Lausanne, Switzerland. Dietary intake was assessed using a validated food frequency questionnaire in 2009-2012 (first survey) and 2014-2017 (second survey). Total energy intake (TEI), macro and micronutrients, foods, dietary scores and compliance to dietary guidelines were assessed. Three approaches were used comparing changes in dietary intake: 1) before and after retiring (paired analysis); 2) in participants who retired with gender- and age-matched participants who did not retire (two-group comparison), and 3) in participants who retired, who did not retire or who were retired at both surveys (analysis of variance).

RESULTS

Using the first approach, newly retired participants (n = 215) increased their intake of total (median and [interquartile range]: 15.2 [13.7-17.5] vs. 14.9 [13.3-17.1] % of TEI) and animal (11.1 [9.1-13.0] vs. 10.0 [8.5-12.6] %TEI) protein; total (35.8 [32.1-40.7] vs. 34.6 [30.0-39.1] %TEI), saturated and monounsaturated fat; alcohol; cholesterol; vitamin D and fish, and decreased their intake of vegetable protein; total carbohydrates and monosaccharides, and of the Mediterranean diet score. Those findings were confirmed for total and saturated fat, alcohol, total carbohydrates and monosaccharides; vitamin D and fish intake, and of the Mediterranean diet score in the other two approaches.

CONCLUSION

Retirement was associated with an unhealthier dietary intake.

Older People's Health-Related Behaviors: Evidence from Three Cohorts of the Lc65+ Study

Baby-boomers might be more health-conscious than earlier birth cohorts, but limited evidence has been produced so far. To investigate such changes, this study compared health-related behaviors at age 65 to 70 among three successive five-year birth cohorts (pre-war: born 1934-1938; war: born 1939-1943 and baby-boom: born 1944-1948) representative of the community-dwelling population. Information about alcohol use, smoking, physical activity, and nutrition was compared across the three cohorts (n = 4,270 participants) using Chi-squared test. Alcohol and the mean nutritional intake score did not vary across cohorts, whereas the consumption of nonalcoholic drinks increased significantly from pre-war to war and to baby-boom cohort (p<.001). Other differences across cohorts were observed only in women: the proportion of women who never or rarely engaged in sports decreased from 52.9% in the pre-war cohort to around 43% in subsequent cohorts (p<.001), while the proportion of women who had never smoked was higher in the pre-war cohort (56.1%) than in the war and the baby-boom cohorts (49.8% and 46.8%, respectively, p<.001). Overall, these results show some positive changes in older persons' health behaviors over time. Nevertheless, considerable room remains for improving lifestyles through public health interventions.

Does diet map with mortality? Ecological association of dietary patterns with chronic disease mortality and its spatial dependence in Switzerland

We investigated the associations between dietary patterns and chronic disease mortality in Switzerland using an ecological design and explored their spatial dependence, i.e. the tendency of near locations to present more similar and distant locations to present more different values than randomly expected. Data of the National Nutrition Survey menuCH (n 2057) were used to compute hypothesis- (Alternate Healthy Eating Index (AHEI)) and data-driven dietary patterns. District-level standardised mortality ratios (SMR) were calculated using the Swiss Federal Statistical Office mortality data and linked to dietary data geographically. Quasipoisson regression models were fitted to investigate the associations between dietary patterns and chronic disease mortality; Moran’s I statistics were used to explore spatial dependence. Compared with the first, the fifth AHEI quintile (highest diet quality) was associated with district-level SMR of 0·95 (95 % CI 0·93, 0·97) for CVD, 0·91 (95 % CI 0·88, 0·95) for ischaemic heart disease (IHD), 0·97 (95 % CI 0·95, 0·99) for stroke, 0·99 (95 % CI 0·98, 1·00) for all-cancer, 0·98 (95 % CI 0·96, 0·99) for colorectal cancer and 0·93 (95 % CI 0·89, 0·96) for diabetes. The Swiss traditional and Western-like patterns were associated with significantly higher district-level SMR for CVD, IHD, stroke and diabetes (ranging from 1·02 to 1·08) compared with the Prudent pattern. Significant global and local spatial dependence was identified, with similar results across hypothesis- and data-driven dietary patterns. Our study suggests that dietary patterns partly contribute to the explanation of geographic disparities in chronic disease mortality in Switzerland. Further analyses including spatial components in regression models would allow identifying regions where nutritional interventions are particularly needed.

Dietary patterns according to vitamin supplement use. A cross-sectional study in Switzerland

Background: consumers of dietary supplements (DS) or vitamin-mineral supplements (VMS) have a better health profile than nonconsumers; whether this also applies to healthier dietary patterns has seldom been assessed. We aimed to assess the dietary intake of subjects according to their consumption of DS or VMS. Methods: Cross-sectional, population-based studies conducted in 2009-2012 (3773 participants, 52.4% women, 57.0 ± 10.0 years) and 2014-2017 (2536 participants, 52.4% women, 60.0 ± 10 years) in Lausanne, Switzerland. Dietary intake was assessed via a 97-item food frequency questionnaire. Nutrients, consumption of specific food groups, dietary scores, and compliance with the Swiss nutritional guidelines were compared between VMS/DS consumers and nonconsumers. Results: In 2009-2012, after multivariable adjustment for gender, age, body mass index, education, smoking, country of birth, sedentariness, diet and total energy intake, VMS/DS consumers had a higher score for the "Fruits & vegetables"(-0.09 ± 0.02 vs. 0.15 ± 0.05) dietary pattern and a lower score for the "Fatty & sugary" dietary pattern (0.02 ± 0.02 vs. -0.14 ± 0.04) and had a lower likelihood to comply with the guideline on total fat [odds ratio and 95 %CI: 0.72 (0.57-0.89)] than nonconsumers. In 2014-2017, after multivariable adjustment, no differences (at p < 0.005) were found between VMS/DS consumers and nonconsumers. Conclusion: VMS/DS consumers tend to have healthier dietary choices than nonconsumers. The beneficial effect of VMS and/or DS consumption is decreased, as it does not target subjects who really need them.

Combining Recent Nutritional Data with Prospective Cohorts to Quantify the Impact of Modern Dietary Patterns on Disability-Adjusted Life Years: A Feasibility Study

Unhealthy diets are commonly associated with increased disability-adjusted life years (DALYs) from noncommunicable diseases. The association between DALYs and dietary patterns can be quantified with individual longitudinal data. This assessment, however, is often based on dietary data collected once at cohort entry, therefore reflecting the impact of “old” dietary habits on morbidity and mortality. To overcome this limitation, we tested the association of contemporary diets with DALYs. First, we defined contemporary dietary patterns consumed in Switzerland with the national nutrition survey menuCH (2014–2015). Second, we identified individuals who consumed similar diets in the NRP–MONICA census-linked cohort (1977–2015). In this cohort, individual data on disease and mortality were used to calculate the DALYs-dietary patterns association using a mixed regression model. A total of 58,771 DALYs from NCDs were recorded in a mean follow-up time of 25.5 years. After multivariable adjustments, the “Swiss traditional” pattern was not associated with an increase in DALYs compared to the “Prudent” pattern. However, individuals following a “Western” pattern had, on average 0.29 DALYs (95% CI 0.02, 0.56) more than those following a “Prudent” pattern, equating to a loss of healthy life of more than three months. These data highlight the feasibility of quantifying the impact of contemporary diets on DALYs without the establishment of new cohorts or the use of nationally aggregated data.

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CoLaus: Diet, the Forgotten Key to Preventing Cardiovascular Diseases Abstract. Healthy eating is paramount for the prevention and management of cardiovascular diseases. Still, data from the CoLaus study show that dietary management of cardiovascular risk factors and cardiovascular disease is little implemented. Less than one fifth of participants with dyslipidemia reported being on a hypolipidemic diet, and only half of participants with diabetes reported being on an antidiabetic diet. Further, the occurrence of a myocardial infarction was not associated with an improvement in dietary quality.

Overlapping spatial clusters of sugar-sweetened beverage intake and body mass index in Geneva state, Switzerland

Background

Obesity and obesity-related diseases represent a major public health concern. Recently, studies have substantiated the role of sugar-sweetened beverages (SSBs) consumption in the development of these diseases. The fine identification of populations and areas in need for public health intervention remains challenging. This study investigates the existence of spatial clustering of SSB intake frequency (SSB-IF) and body mass index (BMI), and their potential spatial overlap in a population of adults of the state of Geneva using a fine-scale geospatial approach.

Methods

We used data on self-reported SSB-IF and measured BMI from residents aged between 20 and 74 years of the state of Geneva (Switzerland) that participated in the Bus Santé cross-sectional population-based study (n = 15,423). Getis-Ord Gi spatial indices were used to identify spatial clusters of SSB-IF and BMI in unadjusted models and models adjusted for individual covariates (education level, gender, age, nationality, and neighborhood-level median income).

Results

We identified a significant spatial clustering of BMI and SSB-IF. 13.2% (n = 2034) of the participants were within clusters of higher SSB-IF and 10.7% (n = 1651) were within clusters of lower SSB-IF. We identified overlapping clusters of SSB-IF and BMI in specific areas where 11.1% (n = 1719) of the participants resided. After adjustment, the identified clusters persisted and were only slightly attenuated indicating that additional neighborhood-level determinants influence the spatial distribution of SSB-IF and BMI.

Conclusions

Our fine-scale spatial approach allowed to identify specific populations and areas presenting higher SSB-IF and highlighted the existence of an overlap between populations and areas of higher SSB-IF associated with higher BMI. These findings could guide policymakers to develop locally tailored interventions such as targeted prevention campaigns and pave the way for precision public health delivery.

The Metabolic Benefits of Menopausal Hormone Therapy Are Not Mediated by Improved Nutritional Habits. The OsteoLaus Cohort

Menopause alters body composition by increasing fat mass. Menopausal hormone therapy (MHT) is associated with decreased total and visceral adiposity. It is unclear whether MHT favorably affects energy intake. We aimed to assess in the OsteoLaus cohort whether total energy intake (TEI) and/or diet quality (macro- and micronutrients, dietary patterns, dietary scores, dietary recommendations)—evaluated by a validated food frequency questionnaire—differ in 839 postmenopausal women classified as current, past or never MHT users. There was no difference between groups regarding TEI or consumption of macronutrients. After multivariable adjustment, MHT users were less likely to adhere to the unhealthy pattern ‘fat and sugar: Current vs. never users [OR (95% CI): 0.48 (0.28–0.82)]; past vs. never users [OR (95% CI): 0.47 (0.27–0.78)]. Past users exhibited a better performance in the revised score for Mediterranean diet than never users (5.00 ± 0.12 vs. 4.63 ± 0.08, p < 0.04). Differences regarding compliance with dietary recommendations were no longer significant after adjustment for covariates. Overall, these results argue against a major role of TEI and diet quality as possible mediators of the MHT metabolic benefits. Future research on this relationship should focus on other potential targets of MHT, such as resting energy expenditure and physical activity.

Dietary patterns and their relationships to sarcopenia in Portuguese patients with gastrointestinal cancer: An exploratory study

OBJECTIVES

The purpose of this exploratory study was to identify the main dietary patterns of a Portuguese population of patients with gastrointestinal cancer and to analyze their association with sarcopenia.

METHODS

This was a prospective study with a consecutive sample of 100 patients with gastrointestinal cancer enrolled at diagnosis. Dietary intake was assessed with a semiquantitative Food Frequency Questionnaire, and dietary patterns were obtained with principal component analysis. Nutritional assessment was done using the Patient-Generated Subjective Global Assessment, and body composition was evaluated with anthropometric measures and computed tomography image processing obtained at the third lumbar vertebrae. Sex and body mass index specific cutoffs were used to define sarcopenia.

RESULTS

Four major patterns were identified: high-fat dairy products, fried snacks, and processed meat diet; legumes, vegetables, and fruit diet; fat and fish diet; and alcohol, cereal, and animal protein diet. On simple logistic regression, the occurrence of sarcopenia in participants in the second tertile (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.10-0.83; P = 0.02) and third tertile (OR 0.24; 95% CI 0.08-0.69; P = 0.01) of adherence to the high-fat and fish diet was reduced compared with the first tertile. On multiple logistic regression, the second tertile (OR 0.38, 95% CI 0.11-1.19; P = 0.10) of the fat and fish dietary pattern maintained a trend toward a reduction of the odds of sarcopenia compared with the first tertile, independently of calorie intake, age, disease location, and stage.

CONCLUSIONS

The fat and fish dietary pattern was associated with lower odds of sarcopenia in this population of patients with gastrointestinal cancer.

Cultural Differences in Diet and Determinants of Diet Quality in Switzerland: Results from the National Nutrition Survey menuCH

Sociodemographic differences in dietary consumption were observed in different populations. The current study aimed to identify sociodemographic and lifestyle determinants of diet quality and to investigate the differences in diet quality between the three main language regions of Switzerland. Using data of the Swiss National Nutrition Survey menuCH (n = 2057), two diet quality scores—Alternate Healthy Eating Index and Mediterranean Diet Score—were computed. Linear regression models were used to investigate the determinants of diet quality and chi-square tests were used to test for differences in single score components between language regions. Significantly higher diet quality scores were observed for individuals who were female, older, normal weight, non-Swiss, with tertiary education or moderate-to-high physical activity level. Additionally, residents of the French- and Italian-speaking parts of Switzerland scored higher than residents of the German-speaking region. More specifically, the higher diet quality observed in the French- and Italian-speaking regions was mediated by higher scores in the components of alcohol, dairy products, fat, fish, sugar-sweetened beverages and whole grains. The present results may help to better characterize population groups requiring specific dietary recommendations, enabling public health authorities to develop targeted interventions.

Thirteen-Year Trends in Dietary Patterns among Japanese Adults in the National Health and Nutrition Survey 2003⁻2015: Continuous Westernization of the Japanese Diet

We examined 13-year trends in dietary patterns, using data from the National Health and Nutrition Survey, Japan 2003–2015. In repeated, independent cross-sectional studies, dietary intake was assessed with a one-day weighed dietary record in 88,527 Japanese adults aged ≥20 years. Using principal component analysis based on the daily consumption of 31 food groups, we identified three dietary patterns, the “plant food and fish”, “bread and dairy”, and “animal food and oil” patterns. In the whole sample, the “plant food and fish” pattern score decreased while the “bread and dairy” and “animal food and oil” pattern scores increased. The decreasing trends in the “plant food and fish” pattern were observed in all subgroups considered. The increasing trends in the “bread and dairy” pattern were similar across sexes and by current smoking status. However, in terms of age, occupation, and weight status, the increasing trends were only evident in particular subgroups (i.e., age 50–64 and ≥65 years; security/transportation/labor occupation and nonworker; and normal weight and overweight participants). For the “animal food and oil” pattern, the increasing trends were observed in all subgroups, except for the youngest age group (20–34 years old). This study suggests continuous Westernization of the Japanese diet.

Trends and determinants of change in compliance to dietary guidelines in a Swiss community-dwelling sample

Adherence to dietary guidelines is associated with significantly better health outcomes. Studies across the world shows that compliance with the guidelines was low, but data in Switzerland are lacking. Hence, we aimed to assess the 5-year trends in dietary compliance regarding food guidelines in Switzerland in a prospective, population-based observational study. Data from 2882 participants (1591 women, 35-75 years), from the first (2009-2012) and second (2014-2017) follow-up. Dietary intake was assessed using a validated food frequency questionnaire. Compliance with the guidelines of the Swiss society of nutrition was assessed at baseline and 5.5 years afterwards. Prevalence rates for compliance were calculated using the exact Poisson method. Factors associated with changes in compliance (never, shifter or maintainer) were assessed by multinomial logistic regression using "Never compliers" as reference. Overall, improvements in compliance to fruits (42.4% to 45.1%) vegetables (6.9% to 8.6%) and fish (66.6% to 60.5%) were found, while compliance to meat decreased (61.1% to 58.5%). The prevalence of participants complying with at least three dietary recommendations did not change (24.1% to 25.2%). During follow-up, only 11.6% of participants maintained compliance to at least three dietary recommendations, and 62.4% never managed to comply. Female gender and older age were associated with maintaining compliance during the two study periods. In conclusion, compliance with dietary guidelines is a dynamic status, and only a small fraction of the population achieves sustained compliance with at least three guidelines. Almost two thirds of the population never achieve compliance with three guidelines.

Socio-demographic and lifestyle determinants of dietary patterns in French-speaking Switzerland, 2009-2012

Background

Food intake is a complex behaviour which can be assessed using dietary patterns. Our aim was to characterize dietary patterns and associated factors in French-speaking Switzerland.

Methods

Cross-sectional study conducted between 2009 and 2012 in the city of Lausanne, Switzerland, including 4372 participants (54% women, 57.3 ± 10.3 years). Food consumption was assessed using a validated food frequency questionnaire. Dietary patterns were assessed by principal components analysis.

Results

Three patterns were identified: “Meat & fries”; “Fruits & Vegetables” and “Fatty & sugary”. The “Meat & fries” pattern showed the strongest correlations with total and animal protein and cholesterol carbohydrates, dietary fibre and calcium. The “Fruits & Vegetables” pattern showed the strongest correlations with dietary fibre, carotene and vitamin D. The “Fatty & sugary” pattern showed the strongest correlations with total energy and saturated fat. On multivariate analysis, male gender, low educational level and sedentary status were positively associated with the “Meat & fries” and the “Fatty & sugary” patterns, and negatively associated with the “Fruits & Vegetables” pattern. Increasing age was inversely associated with the “Meat & fries” pattern; smoking status was inversely associated with the “Fruits & Vegetables” pattern. Being born in Portugal or Spain was positively associated with the “Meat & fries” and the “Fruits & Vegetables” patterns. Increasing body mass index was positively associated with the “Meat & fries” pattern and inversely associated with the “Fatty & sugary” pattern.

Conclusions

Three dietary patterns, one healthy and two unhealthy, were identified in the Swiss population. Several associated modifiable behaviours were identified; the information on socio- demographic determinants allows targeting of the most vulnerable groups in the context of public health interventions.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5045-1) contains supplementary material, which is available to authorized users.