Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: an analysis from the PREVENT dementia study

BACKGROUND

The Eatwell guide reflects the UK government's recommendations for a healthy and balanced diet. Previous research has identified associations between healthy eating patterns and both cardiovascular and brain health, although there is little evidence specifically focusing on the Eatwell Guide. To date no research has investigated associations between the Eatwell Guide and risk for future dementia.

METHODS

Data from the PREVENT dementia cohort study baseline visit was used in this analysis. Binary and graded Eatwell Guide scores (BEWG, GEWG) were created from a self-reported Food Frequency Questionnaire. The CAIDE score was included as the primary outcome measure to represent risk for future Alzheimer's disease. Secondary outcome measures included cardiometabolic health measures and brain health measures. Generalised additive models were run in R.

RESULTS

A total of 517 participants were included in the analysis, with a mean BEWG score of 4.39 (± 1.66) (out of a possible 12 points) and GEWG score of 39.88 (± 6.19) (out of a possible 60 points). There was no significant association between either Eatwell Guide score and the CAIDE score (BEWG β: 0.07, 95% confidence interval (CI): -0.07, 0.22; GEWG β: 0.02, 95% CI: -0.02, 0.06) or any measures of brain health. There was a significant association between higher GEWG score and lower systolic and diastolic blood pressure and body mass index (BMI) (systolic β: -0.24, 95% CI: -0.45, -0.03; diastolic β: -0.16, 95% CI: -0.29, -0.03; BMI β: -0.09, 95% CI: -0.16, -0.01).

CONCLUSIONS

Although not directly associated with the CAIDE score, the Eatwell Guide dietary pattern may be beneficial for dementia prevention efforts through the modification of hypertension and obesity, which are both known risk factors for dementia. Future work could replicate these findings in other UK-based cohorts as well as further development of Eatwell Guide scoring methodologies.

Prospective association between adherence to UK dietary guidelines in school-age children and cardiometabolic risk markers in adolescence/early adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

Research into how alignment to UK dietary guidelines during childhood affects cardiometabolic health is limited. The association between adherence to UK dietary guidelines during childhood and overall cardiometabolic risk (CMR) in adolescence/early adulthood was explored using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC children with diet diaries completed at 7, 10 and 13 years of age, and data on CMR markers at 17 years (n 1940) and 24 years (n 1957) were included. A children's Eatwell Guide (C-EWG) score was created by comparing dietary intakes at each age to UK dietary guidelines for nine foods/nutrients. Cardiometabolic health at 17 and 24 years was assessed using a composite CMR score. Multivariable linear regression models examined associations between C-EWG scores at 7, 10 and 13 years and the CMR score at 17 and 24 years, adjusting for confounders. C-EWG scores were generally low. However, a higher score (adherence to more dietary guidelines) at 7 years old was associated with a lower CMR score at 17 and 24 years: β -0·13 (95 % CI -0·25, -0·01) and β -0·25 (95 % CI -0·38, -0·13) for a 1-point increase in C-EWG score, respectively. A higher C-EWG score at 10 years was also associated with a lower CMR z-score at 24 years. No clear associations were evident at other ages. Greater adherence to UK dietary guidelines during mid-childhood was associated with a better overall cardiometabolic profile, suggesting that encouraging children to eat in this way has long-term benefits to health.

Association between adherence to the Mediterranean Diet and the Eatwell Guide and changes in weight and waist circumference in post-menopausal women in the UK Women's Cohort Study

OBJECTIVE

This study investigated the associations between adherence to the Mediterranean Diet and the Eatwell Guide (EWG) and changes in weight and waist circumference in post-menopausal women.

STUDY DESIGN

Post-hoc analysis of post-menopausal women from the UK Women's Cohort Study.

MAIN OUTCOME MEASURES

Changes in weight, waist circumference and the risk of abdominal and general obesity.

RESULTS

4162 post-menopausal women were selected. Higher adherence to both the EWG and the Mediterranean Diet was associated with smaller increases in waist circumference over 4 years (EWG: β -0.47, CI -0.75, -0.20 per 1 tertile increase in score), (Mediterranean Diet: β -0.29, CI -0.58, -0.01 per 1 tertile increase in score); and lower risk of abdominal obesity (EWG: OR 0.55, CI 0.43, 0.70 third versus the first tertile), (Mediterranean Diet: OR 0.60, CI 0.46, 0.76 third versus the first tertile), but was not associated with weight changes (EWG: β 0.14, CI -0.07, 0.36 per 1 tertile increase in score), (Mediterranean Diet: β 0.03, CI -0.19, 0.25 per 1 tertile increase in score) or risk of becoming overweight or obese (EWG: OR 1.09, CI 0.77, 1.52 third versus the first tertile), (Mediterranean Diet: OR 0.91, CI 0.65, 1.27 third versus the first tertile).

CONCLUSIONS

The results suggest that adherence to either the Mediterranean Diet or the EWG can help to prevent abdominal obesity in post-menopausal women.

Can healthy motivated British adults achieve the revised UK government fibre recommendations of 30 g per day? Results from a preliminary study

BACKGROUND:

UK Government recommendations for dietary fibre intakes have recently increased to 30 g per day, well below current population intakes.

AIM:

This study aimed to explore whether the target for dietary fibre intake could be achieved and the effects on markers of cardiometabolic health.

METHODS:

In this 4-week high-fibre intervention study, 15 participants were instructed to achieve dietary fibre intakes of 30 g/day.

RESULTS:

Dietary fibre intakes significantly increased post intervention (16.0 ± 8.1 g/day, p < 0.001). No significant changes in glucose and triglyceride concentrations were observed and there was a significant increase in average body weight (0.7 ± 1.2 kg, p = 0.025).

CONCLUSIONS:

This study shows that achieving the new dietary fibre recommendations of 30g/day is achievable, in the short term, in a sample of British adults without any observed effect on health markers.

UK Dietary Policy for the Prevention of Cardiovascular Disease

Nutrition advice is devolved within each of the four UK countries, but share a common evidence base provided through the Scientific Advisory Committee on Nutrition (SACN). Current UK dietary recommendations to prevent cardiovascular disease (CVD) is based upon recommendations from SACN and its predecessor committee. Dietary advice in the UK has recently been revised in relation to intakes of free sugar and fibre. This paper highlights current UK recommendations for the prevention of CVD, in particular related to energy intake, saturated fat, free sugars, salt, fruit, vegetables, oily fish and fibre. It describes how this advice is promulgated including the refresh of the Eatwell Guide and wider action that will impact on CVD.