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Chen H, Avgerinou C. Association of Alternative Dietary Patterns with Osteoporosis and Fracture Risk in Older People: A Scoping Review. Nutrients 2023; 15:4255. [PMID: 37836538 PMCID: PMC10574803 DOI: 10.3390/nu15194255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/01/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
PURPOSE Although the Mediterranean diet has been associated with a lower risk of hip fracture, the effect of other dietary patterns on bone density and risk of fracture is unknown. This scoping review aims to investigate the association between adherence to alternative dietary patterns (other than the traditional Mediterranean diet) and osteoporosis or osteoporotic fracture risk in older people. METHODS A systematic search was carried out on three electronic databases (Medline, EMBASE, and Scopus) to identify original papers studying the association between alternative dietary patterns (e.g., Baltic Sea Diet (BSD), modified/alternative Mediterranean diet in non-Mediterranean populations, Dietary Approaches to Stop Hypertension (DASH)) assessed using 'prior' methods (validated scores) and the risk of osteoporotic fracture or Bone Mineral Density (BMD) in people aged ≥50 (or reported average age of participants ≥ 60). Results from the included studies were presented in a narrative way. RESULTS Six observational (four prospective cohort and two cross-sectional) studies were included. There was no significant association between BMD and BSD or DASH scores. Higher adherence to DASH was associated with a lower risk of lumbar spine osteoporosis in women in one study, although it was not associated with the risk of hip fracture in another study with men and women. Higher adherence to aMED (alternative Mediterranean diet) was associated with a lower risk of hip fracture in one study, whereas higher adherence to mMED (modified Mediterranean diet) was associated with a lower risk of hip fracture in one study and had no significant result in another study. However, diet scores were heterogeneous across cohort studies. CONCLUSIONS There is some evidence that a modified and alternative Mediterranean diet may reduce the risk of hip fracture, and DASH may improve lumbar spine BMD. Larger cohort studies are needed to validate these findings.
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Affiliation(s)
- Huiyu Chen
- Division of Medicine, University College London, London WC1E 6BT, UK;
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
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Agnihotri N, Rudjord Hillesund E, Bere E, Wills AK, Brantsaeter AL, Øverby NC. Development and description of New Nordic Diet scores across infancy and childhood in the Norwegian Mother, Father and Child Cohort Study (MoBa). Matern Child Nutr 2021; 17:e13150. [PMID: 33528109 PMCID: PMC8189223 DOI: 10.1111/mcn.13150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/17/2022]
Abstract
In recent years, examining dietary patterns has become a more common way of investigating potential associations between diet and adverse health outcomes. The New Nordic Diet (NND) is a potentially healthy and sustainable dietary pattern characterized by foods that are locally available and traditionally consumed in the Nordic countries. The diet has been typically examined in adult populations, and less is known about compliance to the NND from infancy throughout childhood. In the current study, we therefore aimed to develop and describe child age‐specific NND scores. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). We have previously developed a NND score for the maternal diet during pregnancy, and the development of the child diet scores was based on the rationale of this score. Food frequency data from n = 89 715 at child age 6 months, n = 76 432 at 18 months, n = 58 884 at 3 years, and n = 35 978 at 7 years were used to construct subscales in accordance with the maternal diet score. Subscales were composed of responses to a selection of food and drink items or other questions and were dichotomized by the median, yielding four age‐specific diet scores where the possible scoring ranged from 0 to 6 at 6 months and 3 years and from 0 to 9 at 18 months and 7 years. The developed scores will be used to examine associations with childhood overweight and cognitive and mental development in future studies.
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Affiliation(s)
- Neha Agnihotri
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | | | - Elling Bere
- Department of Health and Inequalities and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.,Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Anne Lise Brantsaeter
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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McCullough ML, Maliniak ML, Stevens VL, Carter BD, Hodge RA, Wang Y. Metabolomic markers of healthy dietary patterns in US postmenopausal women. Am J Clin Nutr 2019; 109:1439-1451. [PMID: 31051511 DOI: 10.1093/ajcn/nqy385] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/17/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Healthy diet patterns are associated with lower risk of cancer and other chronic diseases. Metabolomics has the potential to expand dietary biomarker development to include dietary patterns, which may provide a complement or alternative to self-reported diet. OBJECTIVE This study examined the correlation of serum untargeted metabolomic markers with 4 diet pattern scores-the alternate Mediterranean diet score (aMED), alternate Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet, and the Healthy Eating Index (HEI)-2015-and used multivariate methods to identify discriminatory metabolites for each pattern. METHODS Among 1367 US postmenopausal women with serum metabolomic data in the Cancer Prevention Study-II Nutrition Cohort, we conducted partial correlation analysis, adjusted for demographic and lifestyle variables, to examine cross-sectional correlations between serum metabolomic markers and healthy diet pattern scores. In a randomly selected "training" set (50%), we conducted orthogonal partial least-squares discriminant analysis to identify metabolites that discriminated the top from bottom diet score quintiles. Combinations of metabolites with a variable importance in projection (VIP) score ≥2.5 were tested for predictability in the "testing" set based on the use of receiver operating characteristic curves. RESULTS Out of 1186 metabolites, 32 unique metabolites were considered discriminatory based on a VIP score ≥2.5 in the training dataset with some overlap across scores (aMED = 16; AHEI = 17; DASH = 13; HEI = 12). Spearman partial correlation analyses, applying a cut-point (|r| ≥ 0.15) and Bonferroni correction (P < 1.05 × 10-5), identified similar key metabolites. The top 5 metabolites for each pattern mostly distinguished high compared with low scores; 4 of the 5 (fish-derived) metabolites were the same for aMED and AHEI, 2 of which were identified for HEI; 4 DASH metabolites were unique. CONCLUSIONS Metabolomic methods that used a split-sample approach identified potential biomarkers for 4 healthy diet patterns. Similar metabolites across scores reflect fish consumption in healthy dietary patterns. These findings should be replicated in independent populations.
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Affiliation(s)
| | - Maret L Maliniak
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Victoria L Stevens
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Brian D Carter
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Rebecca A Hodge
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Ying Wang
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
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Ding M, Ellervik C, Huang T, Jensen MK, Curhan GC, Pasquale LR, Kang JH, Wiggs JL, Hunter DJ, Willett WC, Rimm EB, Kraft P, Chasman DI, Qi L, Hu FB, Qi Q. Diet quality and genetic association with body mass index: results from 3 observational studies. Am J Clin Nutr 2018; 108:1291-1300. [PMID: 30351367 PMCID: PMC6290366 DOI: 10.1093/ajcn/nqy203] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/24/2018] [Indexed: 12/21/2022] Open
Abstract
Background It is unknown whether dietary quality modifies genetic association with body mass index (BMI). Objective This study examined whether dietary quality modifies genetic association with BMI. Design We calculated 3 diet quality scores including the Alternative Healthy Eating Index 2010 (AHEI-2010), the Alternative Mediterranean Diet score (AMED), and the Dietary Approach to Stop Hypertension (DASH) diet score. We examined the interactions of a genetic risk score (GRS) based on 97 BMI-associated variants with the 3 diet quality scores on BMI in 30,904 participants from 3 large cohorts. Results We found significant interactions between total GRS and all 3 diet scores on BMI assessed after 2-3 y, with an attenuated genetic effect observed in individuals with healthier diets (AHEI: P-interaction = 0.003; AMED: P = 0.001; DASH: P = 0.004). For example, the difference in BMI (kg/m2) per 10-unit increment of the GRS was smaller among participants in the highest tertile of AHEI score compared with those in the lowest tertile (0.84; 95% CI: 0.72, 0.96 compared with 1.14; 95% CI: 0.99, 1.29). Results were consistent across the 3 cohorts with no significant heterogeneity. The interactions with diet scores on BMI appeared more significant for central nervous system GRSs (P < 0.01 for 3 diet scores) than for non-central nervous system GRSs (P > 0.05 for 3 diet scores). Conclusions A higher diet quality attenuated genetic predisposition to obesity. These findings underscore the importance of maintaining a healthful diet for the prevention of obesity, particularly for those individuals with a strong genetic predisposition to obesity. This trial was registered with the Clinical Trial Registry as NCT03577639.
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Affiliation(s)
| | - Christina Ellervik
- Division of Preventive Medicine,Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA
| | - Tao Huang
- Epidemiology Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Majken K Jensen
- Departments of Nutrition,Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Gary C Curhan
- Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Louis R Pasquale
- Channing Division of Network Medicine,Harvard Medical School, Boston, MA,Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Jae H Kang
- Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Janey L Wiggs
- Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - David J Hunter
- Departments of Nutrition,Epidemiology,Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Walter C Willett
- Departments of Nutrition,Epidemiology,Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Eric B Rimm
- Departments of Nutrition,Epidemiology,Channing Division of Network Medicine,Harvard Medical School, Boston, MA
| | - Peter Kraft
- Epidemiology,Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
| | - Daniel I Chasman
- Division of Preventive Medicine,Division of Genetics, Brigham and Women's Hospital, Boston, MA,Broad Institute of MIT and Harvard, Cambridge, MA
| | - Lu Qi
- Departments of Nutrition,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Frank B Hu
- Departments of Nutrition,Epidemiology,Channing Division of Network Medicine,Harvard Medical School, Boston, MA,Address correspondence to FBH (e-mail: )
| | - Qibin Qi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY,Address correspondence to QQ (e-mail: )
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Tangney CC. Diet to beat the odds of prodromal Parkinson's disease? Mov Disord 2018; 34:2-3. [PMID: 30397942 DOI: 10.1002/mds.27520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/09/2018] [Accepted: 09/14/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Christy C Tangney
- Professor, Departments of Clinical Nutrition & Preventive Medicine and Associate Dean for Research, College of Health Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Fallaize R, Livingstone KM, Celis-Morales C, Macready AL, San-Cristobal R, Navas-Carretero S, Marsaux CFM, O'Donovan CB, Kolossa S, Moschonis G, Walsh MC, Gibney ER, Brennan L, Bouwman J, Manios Y, Jarosz M, Martinez JA, Daniel H, Saris WHM, Gundersen TE, Drevon CA, Gibney MJ, Mathers JC, Lovegrove JA. Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study. Nutrients 2018; 10:nu10010049. [PMID: 29316612 PMCID: PMC5793277 DOI: 10.3390/nu10010049] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/22/2017] [Accepted: 12/28/2017] [Indexed: 12/26/2022] Open
Abstract
Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.
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Affiliation(s)
- Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK.
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK.
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK.
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK.
| | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
- CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain.
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands.
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Silvia Kolossa
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany.
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Marianne C Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Jildau Bouwman
- Microbiology and Systems Biology Group, TNO, 3704HE Zeist, The Netherlands.
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Miroslaw Jarosz
- National Food & Nutrition Institute (IZZ), 02-903 Warsaw, Poland.
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
- CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain.
- Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, 28049 Madrid, Spain.
| | - Hannelore Daniel
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany.
| | - Wim H M Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands.
| | | | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway.
| | - Michael J Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK.
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK.
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Fung TT, Isanaka S, Hu FB, Willett WC. International food group-based diet quality and risk of coronary heart disease in men and women. Am J Clin Nutr 2018; 107:120-129. [PMID: 29381797 PMCID: PMC5972643 DOI: 10.1093/ajcn/nqx015] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [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] [Received: 02/07/2017] [Accepted: 11/01/2017] [Indexed: 12/18/2022] Open
Abstract
Background Standard diet quality assessment tools, which measure micronutrient sufficiency and food consumption related to disease and applicable to different populations, are needed to track progress in meeting the Sustainable Development Goals related to hunger, food security, and nutrition. Diet quality scores have been constructed for high- and low-income countries, but none are simple to administer or applicable internationally. Objective We prospectively examined the association between the Food Group Index (FGI), the Minimal Diet Diversity Score for Women (MDDW), and a new Prime Diet Quality Score (PDQS), and the risk of ischemic heart disease (IHD) in 3 US cohorts. Design In total, 75,045 women (baseline age 43-63 y), 43,966 men (aged 40-75 y), and 93,131 younger women (aged 27-44 y) without a history of cardiovascular disease were followed up to 28 y. Diet was assessed multiple times using food frequency questionnaires and the 3 diet quality scores were computed for each individual. The association with IHD was modeled with Cox proportional hazard models, controlling for potential confounders. Results During follow-up, we ascertained 2908 incident IHD cases in the Nurses' Health Study, 3722 in the Health Professionals Follow-up Study, and 505 in the Nurses' Health Study II. The FGI was not associated with total IHD in any cohort. The PDQS was significantly associated with IHD in all 3 cohorts separately and the pooled RR for each SD increase was 0.89 (95% CI: 0.87, 0.91). This was significantly different than the pooled RR of 0.93 for MDDW (95% CI: 0.90, 0.96) and the RR of 0.98 for the FGI (95% CI: 0.95, 1.01). The association did not appear to differ by age. Conclusion We found that the PDQS with the most detailed differentiation of healthy and unhealthy foods was associated with a lower risk of IHD in a high-income country. On the other hand, diet quality scores that do not account for unhealthy foods had a limited association with IHD.
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Affiliation(s)
- Teresa T Fung
- Department of Nutrition, Simmons College, Boston, MA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Sheila Isanaka
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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Collins CE, Patterson A, Fitzgerald D. Higher diet quality does not predict lower Medicare costs but does predict number of claims in mid-aged Australian women. Nutrients 2011; 3:40-8. [PMID: 22254075 DOI: 10.3390/nu3010040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 12/07/2010] [Accepted: 01/06/2011] [Indexed: 11/16/2022] Open
Abstract
Optimal dietary quality, indicated by higher diet quality index scores, reflects greater adherence to National dietary recommendations and is also associated with lower morbidity and mortality from chronic disease. Whether this is reflected in lower health care cost over time has rarely been examined. The aim of this study was to examine whether higher diet quality, as measured by the Australian Recommended Food Score (ARFS), was associated with lower health care costs within the mid-aged cohort of the Australian Longitudinal Study on Women's Health. We found that there was a statistically significant association between five year cumulative costs and ARFS, but in the opposite direction to that predicted, with those in the highest quintiles of ARFS having higher health care costs. However the number of Medicare claims over the six year period (2002-2007) was lower for those in the highest compared with the lowest quintile, p = 0.002. There is a need to monitor both costs and claims over time to examine health care usage in the longer term in order to determine whether savings are eventually obtained for those with the dietary patterns that adhere more closely to National recommendations.
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Abstract
We assessed the association of four diet quality scores with multiple cardio-metabolic outcomes among Guatemalan young adults experiencing the nutrition transition. We obtained cross-sectional dietary, demographic, anthropometric and cardio-metabolic risk factor data from 1220 Guatemalan adults (mean age 32.7 (sd 5.8) years) in 2002-4, and computed a Recommended Food Score (RFS), Not Recommended Food Score (NRFS), Food Variety Score (FVS) and the Dietary Quality Index-International (DQI-I). All four scores were correlated with energy intake (r 0.23-0.49; all P < 0.01), but had varying associations with socio-demographic characteristics, lifestyle factors and nutrient intakes. None of the scores was inversely associated with the metabolic syndrome or its components; rather some were positively associated with risk factors. Among both men and women the DQI-I was positively associated with BMI (kg/m2; beta = 0.10, 95 % CI 0.003, 0.21 (men); beta = 0.07, 95 % CI 0.01, 0.14 (women)) and waist circumference (cm; beta = 0.02, 95 % CI 0.01, 0.03 (men); beta = 0.02, 95 % CI = 0.01, 0.02 (women)). Among men, the RFS was positively associated with TAG (mg/l; beta = 0.11, 95 % CI 0.02, 0.21) and glucose (mg/l; beta = 0.13: 95 % CI 0.03, 0.22). We conclude that indices of diet quality are not consistently associated with chronic disease risk factor prevalence in this population of Guatemalan young adults.
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Affiliation(s)
- Cria O. Gregory
- Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, 1462 Clifton Road, NE, Atlanta, GA 30322, USA
| | - Marjorie L. McCullough
- Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, 1462 Clifton Road, NE, Atlanta, GA 30322, USA
- Epidemiology and Surveillance Research, American Cancer Society, 250 Williams Street, Atlanta, GA 30303, USA
| | - Manuel Ramirez-Zea
- Institute of Nutrition of Central America and Panama (INCAP), PO Box 1188, Calzada Roosevelt, Zona 11, Guatemala City, Guatemala 01011
| | - Aryeh D. Stein
- Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, 1462 Clifton Road, NE, Atlanta, GA 30322, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA
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