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Nohara J, Muraki I, Sobue T, Tamakoshi A, Iso H. Development of a Concise Healthy Diet Score for Cardiovascular Disease among Japanese; The Japan Collaborative Cohort Study. J Atheroscler Thromb 2024:64629. [PMID: 38735755 DOI: 10.5551/jat.64629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
AIMS Several diet quality indicators have been developed primarily for cardiovascular disease (CVD) prevention in Western countries. However, those previous indicators are complicated and less feasible in clinical and health-promoting settings. Therefore, we aimed to develop a concise dietary risk score for CVD prevention in Japanese. METHODS Using the self-administered food frequency questionnaire with 35 food items, we developed a concise healthy diet score (cHDS) ranging from 0 to 5 points. We examined the association of cHDS with risks of all-cause and cause-specific mortality among 23,115 men and 35,557 women who were free of CVD and cancer. RESULTS During 19.2 years of median follow-up, 6,291 men and 5,365 women died. In men, the multivariable hazard ratios (95% confidence intervals) for the highest cHDS (5 points) compared to the lowest (0-1 points) were 0.74 (0.60-0.91, P-trend=0.008) for CVD and 0.86 (0.77-0.95, P-trend=0.05) for all causes. No significant associations were found for stroke, coronary heart disease, and other causes in men. The corresponding hazard ratio in women was 0.65 (0.52-0.81, P-trend<0.001) for CVD, 0.63 (0.45-0.88, P-trend<0.001) for stroke, 0.48 (0.30-0.78, P-trend=0.008) for coronary heart disease, 0.67 (0.54-0.84, P-trend<0.001) for other causes, and 0.75 (0.66-0.85, P-trend<0.001) for all causes. CONCLUSION We developed a concise diet quality score named cHDS in the Japanese population and found the inverse association of cHDS with mortality from CVD and all causes for both men and women.
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Affiliation(s)
- Junko Nohara
- Environmental Medicine, Department of Social Medicine, Osaka University Graduate School of Medicine
- Department of Nutrition, Faculty of Health Sciences, Kio University
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Tomotaka Sobue
- Environmental Medicine, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine
| | - Hiroyasu Iso
- Institute for Global Health Medicine, Bureau of International Health Cooperation, National Center for Global Health and Medicine
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Rochefort G, Robitaille J, Lemieux S, Provencher V, Lamarche B. Are the 2019 Canada's Food Guide Recommendations on Healthy Food Choices Consistent with the EAT-Lancet Reference Diet from Sustainable Food Systems? J Nutr 2024; 154:1368-1375. [PMID: 38367810 PMCID: PMC11007739 DOI: 10.1016/j.tjnut.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/26/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND The diet proposed by the EAT-Lancet Commission, which supports both health and environmental sustainability, provides an opportunity to assess the sustainability of food-based dietary guidelines. OBJECTIVES The primary objective was to assess the alignment of the 2019 Canada's Food Guide (CFG) with the EAT-Lancet diet. To do so, an index assessing adherence to the EAT-Lancet diet was developed and evaluated. METHODS Data from 1147 adults were used from the cross-sectional PRÉDicteurs Individuals, Sociaux et Environnementaux (PREDISE) study conducted between 2015 and 2017 in the province of Québec. The EAT-Lancet Dietary Index (EAT-I) was developed to evaluate adherence to the EAT-Lancet diet. Adherence to the 2019 CFG was assessed using the Healthy Eating Food Index (HEFI)-2019. Associations between the HEFI-2019 score and component scores and the EAT-I score were examined using linear regression models. RESULTS The mean EAT-I score (/80) in this population was 33.4 points [95% confidence interval (CI): 32.2, 34.6]. EAT-I scores were consistent with expected differences in diet quality between females and males (+6.9 points, 95% CI: 4.8, 9.0) and between adults aged 50-65 y and 18-34 y (+4.3 points, 95% CI: 1.6, 7.0). The mean HEFI-2019 (/80) score was 44.9 points (95% CI: 44.1, 45.7). The HEFI-2019 was strongly associated with the EAT-I (ß = 0.76, 95% CI: 0.72, 0.80). Among the 10 components of the HEFI-2019, components such as the whole-grain foods (ß =4.01, 95% CI: 3.49, 4.52), grain foods ratio (ß =3.65, 95% CI: 3.24, 4.07), plant-based protein foods (ß =2.41, 95% CI: 2.03, 2.78), and fatty acids ratio (ß =3.12, 95% CI: 2.72, 3.51) showed the strongest associations with the EAT-I. CONCLUSIONS These results suggest that recommendations in the 2019 CFG are largely coherent with the EAT-Lancet diet underscoring the complementarity and compatibility of the 2019 CFG for sustainability and health promotion purposes.
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Affiliation(s)
- Gabrielle Rochefort
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada; École de Nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Julie Robitaille
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada; École de Nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada; École de Nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Véronique Provencher
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada; École de Nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Benoît Lamarche
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada; École de Nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada.
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Compher CW, Quinn R, Haslam R, Bader E, Weaver J, Dudek S, Ritchie MD, Lewis JD, Wu GD. Penn Healthy Diet survey: pilot validation and scoring. Br J Nutr 2024; 131:156-162. [PMID: 37519237 DOI: 10.1017/s0007114523001642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Though diet quality is widely recognised as linked to risk of chronic disease, health systems have been challenged to find a user-friendly, efficient way to obtain information about diet. The Penn Healthy Diet (PHD) survey was designed to fill this void. The purposes of this pilot project were to assess the patient experience with the PHD, to validate the accuracy of the PHD against related items in a diet recall and to explore scoring algorithms with relationship to the Healthy Eating Index (HEI)-2015 computed from the recall data. A convenience sample of participants in the Penn Health BioBank was surveyed with the PHD, the Automated Self-Administered 24-hour recall (ASA24) and experience questions. Kappa scores and Spearman correlations were used to compare related questions in the PHD to the ASA24. Numerical scoring, regression tree and weighted regressions were computed for scoring. Participants assessed the PHD as easy to use and were willing to repeat the survey at least annually. The three scoring algorithms were strongly associated with HEI-2015 scores using National Health and Nutrition Examination Survey 2017-2018 data from which the PHD was developed and moderately associated with the pilot replication data. The PHD is acceptable to participants and at least moderately correlated with the HEI-2015. Further validation in a larger sample will enable the selection of the strongest scoring approach.
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Affiliation(s)
- Charlene W Compher
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Science, Philadelphia, PA, USA
| | - Ryan Quinn
- University of Pennsylvania School of Nursing, Department of Biostatistics, Philadelphia, PA, USA
| | - Richard Haslam
- University of Dublin, School of Medicine, Dublin, Republic of Ireland
| | | | - Joellen Weaver
- University of Pennsylvania Health System, Penn Medicine Biobank, Philadelphia, PA, USA
| | - Scott Dudek
- Department of Genetics and Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marylyn D Ritchie
- Department of Genetics and Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - James D Lewis
- University of Pennsylvania Perelman School of Medicine, Division of Gastroenterology and Hepatology, Philadelphia, PA, USA
| | - Gary D Wu
- University of Pennsylvania Perelman School of Medicine, Division of Gastroenterology and Hepatology, Philadelphia, PA, USA
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Hoffmann L, Egert S, Allgaier J, Kohlenberg-Müller K. Review of Validated Methods to Evaluate Diet History in Diet Therapy and Counselling: An Overview and Analysis of Screeners Based on Food-Based Dietary Guidelines. Nutrients 2023; 15:4654. [PMID: 37960307 PMCID: PMC10647684 DOI: 10.3390/nu15214654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Evidence-based dietetic practice calls for systematically developed assessment methods for nutritional assessment in dietetic counselling and therapy (DCT). Screeners can provide a quick and easy way to determine a client's diet quality and contribute to quality assurance in DCT. The aim of this systematic review was to give a comparative overview of screeners based on national food-based dietary guidelines (FBDGs) and to derive recommendations for developing an FBDG-based screener for DCT. The literature search in PubMed (MEDLINE), embase and Web of Science was conducted between May and July 2022, and updated in March 2023, in accordance with the consensus-based standards for the selection of health measurement instruments (COSMIN). The analysis focused on characteristics of screener design and measurement properties for screener testing. In total, 13 studies on 11 screeners based on FBDGs were included; 7 screeners were targeted to DCT. The content and scoring of screeners were based on the corresponding national FBDGs. The validity and/or reliability of screeners were investigated in 11 studies; responsiveness was not tested for any screener and practicality was considered in all studies. Based on the screeners reviewed, a systematic rationale to develop, enhance and test screeners based on national FBDGs was established.
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Affiliation(s)
- Laura Hoffmann
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Sarah Egert
- Institute of Nutritional and Food Science, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany;
| | - Joachim Allgaier
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Kathrin Kohlenberg-Müller
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
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Hutchinson JM, Williams TE, Westaway AM, Bédard A, Pitre C, Lemieux S, Dodd KW, Lamarche B, Guenther PM, Haines J, Wallace A, Martin A, Louzada MLDC, Jessri M, Olstad DL, Prowse R, Simpson JR, Vena JE, Kirkpatrick SI. Development of the Canadian Food Intake Screener to assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations. Appl Physiol Nutr Metab 2023; 48:603-619. [PMID: 37094383 DOI: 10.1139/apnm-2023-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
NOVELTY The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18-65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible.
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Affiliation(s)
- Joy M Hutchinson
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Tabitha E Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Ailish M Westaway
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
| | - Camille Pitre
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Kevin W Dodd
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Angela Wallace
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Alicia Martin
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, ON, Canada
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health; Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems; Centre for Health Services and Policy Research, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
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Robitaille É, Paquette MC, Durette G, Bergeron A, Dubé M, Doyon M, Mercille G, Lemire M, Lo E. Implementing a Rural Natural Experiment: A Protocol for Evaluating the Impacts of Food Coops on Food Consumption, Resident's Health and Community Vitality. Methods Protoc 2022; 5:33. [PMID: 35448698 DOI: 10.3390/mps5020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Local food environments are recognized by experts as a determinant of healthy eating. Food cooperatives (coop) can promote the accessibility to healthier foods and thus improve the health of the population, particularly in remote rural communities. Objective: To measure the effects of implementing a food coop in a disadvantaged community with poor access to food. We have two main research questions: (1). Does the establishment of a food coop in rural areas described as food deserts have an impact on accessibility, frequency of use, food consumption, food quality, and ultimately the health of individuals? (2). Does the establishment of a food coop in rural areas described as food deserts have an impact on food security and community vitality? Design: A natural experiment with a mixed pre/post method will be used. The sample is composed of households that came from geographically isolated communities (population: 215 to 885 inhabitants) which qualified as food deserts and located in rural areas of Quebec (Canada). All communities plan to open a food coop (in the years 2022–2023), and as their opening will be staggered over time, participants from communities with a new food coop (intervention) will be compared to communities awaiting the opening of their food coop (control). Data collection was carried out at three time points: (1) before; (2) 1 to 5 months after; and (3) 13 to 17 months after the opening of the coop. Questionnaires were used to measure sociodemographic variables, dietary intake, residents’ health, and community vitality. Semi-structured interviews were conducted with community stakeholders. Results: Few natural experiments have been conducted regarding the impact of implementing food coops. Gathering concrete data on the effectiveness and processes surrounding these interventions through natural experiments will help to quantify their impact and guide knowledge users and policymakers to make more informed decisions.
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Tseng LY, Xie W, Pan W, Lyu H, Yu Z, Shi W, He Y, Chen W, Li T, Hsieh E. Validation of a six-item dietary calcium screening tool among HIV patients in China. Public Health Nutr 2021;:1-10. [PMID: 33820577 DOI: 10.1017/S1368980021001427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Individuals with HIV are at increased risk for osteoporosis. A healthy diet with adequate Ca is recommended to promote bone health. However, lengthy nutritional assessments pose barriers to routine screenings in clinical practice. This study aimed to examine the validity and reproducibility of a six-item dietary Ca screening tool among Chinese individuals with HIV. DESIGN We conducted a two time-point study in an outpatient setting. Volunteers self-administered the six-item tool upon enrolment and again at 1-month follow-up. At baseline, participants also completed a validated FFQ and surveys regarding demographic and clinical risk factors. SETTING Beijing, China; Shenzhen, Guangdong, China. PARTICIPANTS Upon enrolment, 127 individuals with HIV participated in the study, of whom 83 completed the follow-up screening. RESULTS Mean age of participants was 35·2 (sd 9·3) years, average BMI was 22·8 (sd 3·8) kg/m2 and 89 % were men. Among the participants, 54·7 % reported Ca intake less than 800 mg/d. The six-item tool demonstrated fair-to-moderate relative validity with a correlation of 0·39 and 75·7 % of subjects classified in same/adjacent quartiles as the reference, and moderate-to-good reproducibility with a correlation of 0·60 and 83·1 % of subjects classified in same/adjacent quartiles. Finally, receiver operating characteristic analyses yielded a sensitivity of 87·0 % and a specificity of 39·4 % with optimised cut-off level. CONCLUSIONS The six-item tool presented adequate validity and reproducibility to identify individuals with low Ca intake among the target population, providing a convenient instrument for categorising Ca intake in clinical practice, prompting referrals for further assessment, and raising awareness of dietary Ca in bone disease prevention.
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Vadiveloo M, Lichtenstein AH, Anderson C, Aspry K, Foraker R, Griggs S, Hayman LL, Johnston E, Stone NJ, Thorndike AN. Rapid Diet Assessment Screening Tools for Cardiovascular Disease Risk Reduction Across Healthcare Settings: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2020; 13:e000094. [PMID: 32762254 DOI: 10.1161/hcq.0000000000000094] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is critical that diet quality be assessed and discussed at the point of care with clinicians and other members of the healthcare team to reduce the incidence and improve the management of diet-related chronic disease, especially cardiovascular disease. Dietary screening or counseling is not usually a component of routine medical visits. Moreover, numerous barriers exist to the implementation of screening and counseling, including lack of training and knowledge, lack of time, sense of futility, lack of reimbursement, competing demands during the visit, and absence of validated rapid diet screener tools with coupled clinical decision support to identify actionable modifications for improvement. With more widespread use of electronic health records, there is an enormous unmet opportunity to provide evidence-based clinician-delivered dietary guidance using rapid diet screener tools that must be addressed. In this scientific statement from the American Heart Association, we provide rationale for the widespread adoption of rapid diet screener tools in primary care and relevant specialty care prevention settings, discuss the theory- and practice-based criteria of a rapid diet screener tool that supports valid and feasible diet assessment and counseling in clinical settings, review existing tools, and discuss opportunities and challenges for integrating a rapid diet screener tool into clinician workflows through the electronic health record.
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