Demographic and lifestyle characteristics of functional food consumers and dietary supplement users

Functional foods and/or supplements may be used in the context of a healthy lifestyle or as a means to compensate for an unhealthy lifestyle. Adverse long-term and/or cumulative effects of functional food or supplement intake are of public health concern; it is therefore important to identify functional food and supplement users. The present study compared Dutch functional food and supplement consumers with non-consumers with regard to demographic and lifestyle factors. The consumption of the most common functional foods and supplements in 2000 was studied (yoghurt with extra lactic acid bacteria, cholesterol-lowering margarine, lemonade and sweets with extra vitamins and minerals, milk and margarine with extra Ca, Ca tablets, multivitamin and mineral supplements, and Echinacea supplements). Data were obtained from self-administered questionnaires filled in by a consumer panel, aged 19-91 years (response rate 76 %, n 1183), representative of the Dutch population. The number of daily consumers of functional foods or supplements appeared to be relatively low (daily use of multivitamin and mineral supplements, 20 %; all other products, 3-9 %). Explanatory variables depended on the type of product; but gender, age, education, and vegetable intake were significant factors in the logistic regression model. Consumption of cholesterol-lowering margarines was more likely to be reported by individuals with a poorer subjective health (odds ratio 2.62 (95 % CI 1.15, 6.05)) and by smokers (odds ratio 2.93 (95 % CI 1.34, 6.40)). In conclusion, determinants of functional food or supplement use depended on the type of product, so generalisation of consumer characteristics over different foods is not legitimate. In addition to research on lifestyle factors, surveys about consumers' attitudes, norms and knowledge regarding functional foods in relation to actual dietary patterns and health risk profiles are necessary.     

Patterns of Change in Dietary Habits and Physical Activity during Lockdown in Spain Due to the COVID-19 Pandemic

Background: Lockdown due to COVID-19 influenced food habits and lifestyles with potential negative health impact. This study aims to identify patterns of change in eating habits and physical activity during COVID-19 lockdown in Spain and to identify associations with sociodemographic factors and usual habits. Methods: This cross-sectional study included 1155 adults recruited online to answer a 10-section questionnaire. The protocol assessed usual diet by means of a semi-quantitative food frequency questionnaire, usual physical activity (PA) and supplement use, dietary changes, sedentary time, PA, exposure to sunlight, sleep quality, and smoking during confinement. Patterns of dietary change were identified by factor analysis. Factor scores were included in cluster analysis together with change in PA. Results: Six patterns of dietary change were identified that together with PA changes during lockdown defined three clusters of lifestyle change: a cluster less active, a more active cluster, and a third cluster as active as usual. People who were usually less active were more likely to be classified in the cluster that increased physical activity in confinement. Scores of the Healthy Mediterranean-Style dietary pattern were higher in this group. Conclusions: Different patterns of change in lifestyles in confinement suggest the need to tailor support and advice to different population groups.     

Comparison of cluster and principal component analysis techniques to derive dietary patterns in Irish adults

The aims of the present study were to examine and compare dietary patterns in adults using cluster and factor analyses and to examine the format of the dietary variables on the pattern solutions (i.e. expressed as grams/day (g/d) of each food group or as the percentage contribution to total energy intake). Food intake data were derived from the North/South Ireland Food Consumption Survey 1997-9, which was a randomised cross-sectional study of 7 d recorded food and nutrient intakes of a representative sample of 1379 Irish adults aged 18-64 years. Cluster analysis was performed using the k-means algorithm and principal component analysis (PCA) was used to extract dietary factors. Food data were reduced to thirty-three food groups. For cluster analysis, the most suitable format of the food-group variable was found to be the percentage contribution to energy intake, which produced six clusters: 'Traditional Irish'; 'Continental'; 'Unhealthy foods'; 'Light-meal foods & low-fat milk'; 'Healthy foods'; 'Wholemeal bread & desserts'. For PCA, food groups in the format of g/d were found to be the most suitable format, and this revealed four dietary patterns: 'Unhealthy foods & high alcohol'; 'Traditional Irish'; 'Healthy foods'; 'Sweet convenience foods & low alcohol'. In summary, cluster and PCA identified similar dietary patterns when presented with the same dataset. However, the two dietary pattern methods required a different format of the food-group variable, and the most appropriate format of the input variable should be considered in future studies.     

A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program

Maintaining an adequate micronutrient status can be achieved by following a complete, diverse diet. Yet, food trends in Western countries show suboptimal consumption of healthy nutrients. In this study, we explored the prevalence of vitamin and mineral imbalances in a general population cohort of Dutch adults and evaluated the effect of a digital lifestyle program on the nutritional status and nutrition health behaviors of these individuals. A micronutrient panel was measured in 348 participants, alongside a dietary assessment. One hundred users subsequently underwent a remeasurement. We identified at least one nutritional imbalance in 301 individuals (86.5%). A total of 80% improved and normalized B6, 67% improved folate, 70% improved B12, and 86% improved vitamin D. Iron abnormalities were corrected in 75% of the participants. In conclusion, this study found that micronutrient deficiencies of easily obtainable vitamins through diet or supplementation such as B vitamins and vitamin D were more prevalent than expected in a Dutch population. This can partly be explained by insufficient consumption of food groups rich in B vitamins. Our preliminary results in those remeasured after a digitally enabled lifestyle intervention show these imbalances can be corrected with adequate behavioral support complemented with supplementation where needed.     

Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study

Conflicting findings have been reported about dairy food consumption and risk for cardiovascular disease. Furthermore, few studies have examined dairy food intake in relation to cardiovascular health and the incorporation of lifestyle factors such as diet and physical activity. This study examined whether dairy food consumption was associated with cardiovascular health, recently defined by the American Heart Association. Data were analyzed from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg survey. A validated food frequency questionnaire was used to measure intakes of milk, yogurt, cheese, dairy desserts, ice cream, and butter. Seven cardiovascular health metrics were assessed: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose. A total cardiovascular health score (CHS) was determined by summing the total number of health metrics at ideal levels. It was hypothesized that greater dairy food consumption (both low fat and whole fat) would be associated with better global cardiovascular health, as indicated by a higher CHS. Total dairy food intake was positively associated with the CHS. Higher intakes of whole fat milk, yogurt, and cheese were associated with better cardiovascular health. Even when controlling for demographic and dietary variables, those who consumed at least 5 servings per week of these dairy products had a significantly higher CHS than those who consumed these products less frequently. Higher total whole fat dairy food intake was also associated with other positive health behaviors, including being a nonsmoker, consuming the suggested dietary intakes of recommended foods, and having a normal body mass index. Increased dairy food consumption was associated with better cardiovascular health.     

Patients With Mitochondrial Disease Have an Inadequate Nutritional Intake

Background: Mitochondrial disease (MD) is a group of disorders caused by dysfunctional mitochondria, the organelles that generate energy for the cell. Malnutrition in patients with MD may lead to increased mitochondrial dysfunction, which may enhance already existing symptoms. The aim of this study was to investigate whether patients with MD have an insufficient or unbalanced food intake and to establish which nutrients and product groups are particularly compromised in this patient group. Methods: In this observational, cross‐sectional, retrospective study, sixty 3‐day nutrition diaries of adult patients with MD were analyzed and compared with the Dutch recommended daily allowance and the Dutch National Food Consumption Survey (DNFCS). Results: The intake of all macronutrients and micronutrients of patients with MD was significantly different from Dutch recommended daily allowance values with the exception of fat and iron. In particular, protein and calcium intake in patients with MD was significantly lower when compared with the DNFCS. Interindividual differences were high. Also, intake of fiber, sugars, saturated fat, and vitamin D differed from recommendations for the overall population. In comparison with DNFCS, the intake of dairy products and drinks was significant lower in patients. Conclusions: Our study demonstrates that many patients with MD have an inadequate diet. Specifically, intake of protein, calcium, dairy products, and fluids were low. Overall, eating a healthy diet seems as difficult for patients with MD as for the general population. Since interindividual differences are high, individual diet counseling is recommended for all adult patients with MD.     

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (I). A cluster analysis of food consumption

OBJECTIVE: To describe the food consumption patterns of Italian elderly subjects and the factors associated with different dietary habits. DESIGN: Cross-sectional study. SETTING: Population-based study. SUBJECTS: A total of 847 men and 1465 women aged 65 y or older, living in rural areas in the province of Pavia (Northern Italy) and near Cosenza (Southern Italy) in 1992-1993. INTERVENTIONS: The dietary information was collected by means of a quantitative food-frequency questionnaire, with cluster analysis being used to segregate the subjects on the basis of similarities in their food consumption. A generalised logistic regression model including residence, age, living status, education, physical activity and degree of disability was fitted to assess the factors associated with different food consumption habits. RESULTS: Six dietary clusters were selected for men and seven for women. The largest cluster for both genders was "small eaters" (46% of men and 51% of women); "big eaters", "light diet" and "alcohol" clusters were also identified for both genders. The men were also grouped into "balanced diet" and "cheese" clusters, and the women into "sweet", "greens" and "butter" clusters. CONCLUSIONS: In addition to the influence of the area of residence--residents in Northern Italy consume greater amounts of animal fats, sugar and alcoholic beverages, and those living in Southern Italy have a greater intake of fruit, vegetables, fish and olive oil--all of the other studied variables predicted the probabilities of falling into a specific dietary cluster. SPONSORSHIP: National Research Council (Italy)--Invecchiamento Project No. 95.01048. PF40.     

Validation of a dietary pattern approach for evaluating nutritional risk: the Framingham Nutrition Studies

OBJECTIVE: To validate the use of cluster analysis for characterizing population dietary patterns. DESIGN: Cluster analysis was applied to a food frequency questionnaire to define dietary patterns. Independent estimates of nutrient intake were derived from 3-day food records. Heart disease risk factors were assessed using standardized protocols in a clinic setting. SETTING: Adult women (n = 1,828) participating in the Framingham Offspring-Spouse study. STATISTICAL ANALYSES: Age-adjusted mean nutrient intakes were determined for each cluster. Analysis of covariance was used to evaluate pairwise differences in intake across clusters. Compliance with published recommendations was determined for selected heart disease risk factors. Differences in age-adjusted compliance across clusters were evaluated using logistic regression. RESULTS: Cluster analysis identified 5 distinct dietary patterns characterized by unique food behaviors and significantly different nutrient intake profiles. Patterns rich in fruits, vegetables, grains, low-fat dairy, and lean protein foods resulted in higher nutrient density. Patterns rich in fatty foods, added fats, desserts, and sweets were less nutrient-dense. Women who consumed an Empty Calorie pattern were less likely to achieve compliance with clinical risk factor guidelines in contrast to most other groups of women. CONCLUSIONS: Cluster analysis is a valid tool for evaluating nutrition risk by considering overall patterns and food behaviors. This is important because dietary patterns appear to be linked with other health-related behaviors that confer risk for chronic disease. Therefore, insight into dietary behaviors of distinct clusters within a population can help to design intervention strategies for prevention and management of chronic health conditions including obesity and cardiovascular disease.     

Are awareness of dietary fat intake and actual fat consumption associated?--a Dutch-American comparison

OBJECTIVES: To compare dietary fat intake, the accuracy of individuals' awareness about their fat intake, and sociodemographic and psychosocial correlates of awareness, in Dutch and American samples of employed adults. A discrepancy between objective dietary intake data and subjective self-evaluation of dietary fat consumption has been recognized in the past and might undermine healthy diet promotion interventions, and this is important because people who believe that their diets are healthful are less likely to be interested in making changes. Further, international comparisons have not been examined to date. DESIGN: Data collected for the baseline surveys of the 'Healthy Bergeijk' study in the Netherlands and the 'Working Well Trial' in the United States were compared. SUBJECTS: Working adults from a Dutch community health intervention study (n = 768) and an American worksite health promotion trial (n = 15,440). MAIN OUTCOME MEASURES: Objectively assessed dietary fat intake, measured by food frequency questionnaires, and subjective ratings of fat intake (self-rated fat intake). RESULTS: Findings show that the Dutch respondents had higher objectively assessed fat intake and lower subjective ratings of fat intake (P < 0.001). American respondents perceived their diets as higher in fat, more often stated their intentions to reduce fat intake, and were slightly more likely to make realistic estimates of their dietary fat. Dutch subjects were significantly more likely to underestimate their fat intakes. In both samples, women were most likely to underestimate their fat consumption and the most educated persons were most likely to be realistic. CONCLUSIONS: A substantial proportion of adults, both in the United States and the Netherlands, lack accurate awareness about how much fat they consume, though errors tend to be in opposite directions in the two countries. This study is an important first step toward broadening our international understanding of human dietary behavior for disease prevention.     

A diet high in fruits and low in meats reduces the risk of colorectal adenomas

Recent evidence suggests overall dietary patterns, rather than specific dietary components, may be a better predictor of colorectal adenomas or cancers. Using cluster analysis, we aimed to assess the association between dietary patterns and colorectal adenomas and whether adjusting for total energy consumption prior to creating clusters affects this relation. Data from a case-control study of 725 individuals undergoing a colonoscopy were utilized. Cases (n = 203) had > or =1 adenoma on colonoscopy, and controls (n = 522) were those who had no adenomas. Dietary data were obtained from an FFQ. Daily intake for 18 different food groups was calculated. The values were transformed into Z-scores. Participants were first clustered without energy adjustment, then again based on their consumption per 1000 kcal (4187 kJ). There was no association between dietary patterns and colorectal adenomas without energy adjustment prior to creating dietary clusters, as clusters formed as a by-product of energy consumption. After adjusting for energy consumption, 3 distinct clusters emerged: 1) high fruit-low meat cluster; 2) high vegetable-moderate meat cluster; and 3) high meat cluster. After adjusting for potential confounders, the high vegetable-moderate meat cluster (odds ratio [OR] 2.17: [95% CI] 1.20-3.90) and high meat cluster (OR 1.70: [95% CI] 1.04-2.80) were at significantly increased odds of having had an adenoma compared with the high fruit-low meat cluster. A high-fruit, low-meat diet appears to be protective against colorectal adenomas compared with a dietary pattern of increased vegetable and meat consumption.     

Dietary Intake of Vegan and Non-Vegan Endurance Runners—Results from the NURMI Study (Step 2)

Nowadays, the growing popularity of distance running has been accompanied by the increasing prevalence of vegan and vegetarian diets, especially among endurance athletes. The present study aimed to examine the association between diet type and dietary intake of distance runners competing at distances longer than 10 km. From a total of 317 participants, 211 endurance runners (57% females) were considered the final sample after applying the exclusion criteria. Runners were assigned to three groups based on the self-reported diet types: 95 omnivores, 40 vegetarians, and 76 vegans. Data collection was conducted using an online survey with questions about sociodemographic information, dietary intake, and dietary-associated motives. A comprehensive food frequency questionnaire with 53 food groups (categorized in 14 basic—plus three umbrella—food clusters) was used to assess dietary intake. Vegan runners had a higher intake of “beans and seeds”, “fruit and vegetables”, and “dairy alternatives”, as well as lower intakes of “oils” than other two groups. Vegetarian runners had a lower intake of “dairy products” and “eggs” than omnivores. A greater intake of “alcohol” and a lower intake of “meat alternatives” was observed in omnivorous runners compared to vegans and vegetarians. Despite the existence of a tendency toward the consumption of health-related food clusters by vegan runners, further investigations are needed to verify the predominance of vegans in health-oriented dietary patterns.     

Childhood prevalence of cardiovascular risk factors

Cardiovascular risk factors were investigated in 356 children 5 to 9 years of age who were treated at a primary care center located in a low-income area in Greater Metropolitan Rio de Janeiro, Brazil. Lipid profile, nutritional status, food intake, and lifestyle were evaluated. 10.7% of the children were overweight, 68.4% had some type of dyslipidemia, and 18.6% showed high LDL-c. To describe the food intake pattern, the answers to the qualitative food questionnaire were submitted to multivariate cluster analysis, producing six basic groups: traditional Brazilian cooking; "modern" food (including diet and light products); fried food; sweets and soft drinks (mixed with other groups); and other poorly defined groups. The high prevalence of cardiovascular risk factors (beginning in childhood) and the evidence of inadequate dietary habits indicate that a preventive family-focused strategy is needed to change the dietary pattern of low-income groups towards healthier eating.     

Socio-economic status,dietary intake and 10 y trends: the Dutch National Food Consumption Survey

OBJECTIVE: To study differences in dietary intake between adults with different socioeconomic status (SES) and trends over time. DESIGN: Cross-sectional study based on data of three Dutch National Food Consumption Surveys (DNFCS-1 1987/88; DNFCS-2 1992; DNFCS-3 1997/98), obtained from a panel by a stratified probability sample of the non-institutionalized Dutch population. SUBJECTS: A total of 6008 men and 6957 women aged 19 y and over. METHODS: Dietary intake was assessed with a 2 day dietary record. Background information was obtained by structured questionnaire. Sociodemographic variables were available from panel information. SES, based on educational level, occupation and occupational position was categorized into (very) low, middle and high. Analysis of variance with age as covariable was used to explore the effects of SES on dietary intake and anthropometry. Statistical tests for trend were carried out with models in which week-weekend-day effects and an interaction term of time with SES were also included. RESULTS: The prevalence of obesity and skipping of breakfast was higher among people with a low SES. In all three surveys, subjects in the (very) low SES group reported having a higher consumption of potatoes, meat and meat products, visible fats, coffee and soft drinks (men only). Subjects with a high SES reported consuming more vegetables, cheese and alcohol. As regards nutrients, in all surveys a higher SES was associated with higher intake of vegetable protein, dietary fibre and most micronutrients. A higher SES was also associated with a lower fat intake but the differences between social classes were rather small and not consistent when the contribution of alcohol to energy intake was taken into account. CONCLUSION: In general, dietary intake among subjects in higher SES groups tended to be closer to the recommendations of the Netherlands Food and Nutrition Council and this phenomenon was quite stable over a period of 10 y.     

Food Groups and Nutrient Intake and Risk of Colorectal Cancer: A Hospital-Based Case-Control Study in Spain

Although evidence supports that colorectal cancer (CRC) has an environmental etiology, the potential influence of diet appears to be one of the most important components. We studied the relation between food groups and nutrient intake and the risk of CRC. A hospital-based case-control study was conducted in Spain between 2007 and 2009. The authors matched 245 patients with incident histologically confirmed CRC by age, gender, and date of admission with 490 controls. Information about nutrient intake was gathered by using a semiquantitative frequency food questionnaire. Univariate analysis was done with individual food items. Odds ratios (ORs) for consecutive tertiles of nutrient intake were computed after allowance for sociodemographic variables and consumption of food groups. Vitamin B6 (OR: 0.26), vitamin D (OR: 0.45), vitamin E (OR: 0.42), polyunsaturated fatty acids (OR: 0.57), and fiber (OR: 0.40) were inversely associated with CRC, whereas carbohydrates (OR: 1.82) were significantly associated with CRC risk for the upper tertile. In multivariate analysis adjusting for major covariables (energy, age, and gender), vitamin D (OR:0.45), vitamin E (OR:0.36), and fiber (OR:0.46) remained associated with CRC. Data suggest that the etiology of colorectal cancer is not due to lifestyle and dietary patterns being important the effect of single nutrients.     

Food groups and nutrient intake and risk of colorectal cancer: a hospital-based case-control study in Spain

Although evidence supports that colorectal cancer (CRC) has an environmental etiology, the potential influence of diet appears to be one of the most important components. We studied the relation between food groups and nutrient intake and the risk of CRC. A hospital-based case-control study was conducted in Spain between 2007 and 2009. The authors matched 245 patients with incident histologically confirmed CRC by age, gender, and date of admission with 490 controls. Information about nutrient intake was gathered by using a semiquantitative frequency food questionnaire. Univariate analysis was done with individual food items. Odds ratios (ORs) for consecutive tertiles of nutrient intake were computed after allowance for sociodemographic variables and consumption of food groups. Vitamin B6 (OR: 0.26), vitamin D (OR: 0.45), vitamin E (OR: 0.42), polyunsaturated fatty acids (OR: 0.57), and fiber (OR: 0.40) were inversely associated with CRC, whereas carbohydrates (OR: 1.82) were significantly associated with CRC risk for the upper tertile. In multivariate analysis adjusting for major covariables (energy, age, and gender), vitamin D (OR:0.45), vitamin E (OR:0.36), and fiber (OR:0.46) remained associated with CRC. Data suggest that the etiology of colorectal cancer is not due to lifestyle and dietary patterns being important the effect of single nutrients.     

Dietary Patterns and Their Association with Sociodemographic and Lifestyle Factors in Filipino Adults

Recent studies have investigated dietary patterns to assess the overall dietary habits of specific populations. However, limited epidemiological research has been conducted to explore the unique dietary intakes in low and middle-income countries. This study aims to examine the dietary patterns of Filipino adults and their association with sociodemographic and lifestyle factors. A total of 10,025 adults (≥20 years old) who participated in the 2013 Philippine National Nutrition Survey were included in the analysis. Dietary patterns were derived using factor analysis of 18 food groups from the dietary survey component. Six dietary patterns were identified, namely (1) rice; (2) cereal, milk, sugar, and oil; (3) fruits and miscellaneous food; (4) fish; (5) vegetables and corn; and (6) meat and beverage. Generalized ordered logistic regression analysis indicated that the dietary patterns were associated with different factors, specifically sex, age, educational attainment, marital status, employment status, household size, wealth quintile, smoking status, alcohol consumption, and physical activity. Our findings showed distinct dietary patterns among Filipino adults that were influenced by various sociodemographic and lifestyle parameters. The results of this study have valuable public health implications and the dietary patterns generated can further be used to analyze the link between diet and health outcomes.     

Mothers of young children cluster into 4 groups based on psychographic food decision influencers

This study explored how mothers grouped into clusters according to multiple psychographic food decision influencers and how the clusters differed in nutrient intake and nutrient content of their household food supply. Mothers (n = 201) completed a survey assessing basic demographic characteristics, food shopping and meal preparation activities, self and spouse employment, exposure to formal food or nutrition education, education level and occupation, weight status, nutrition and food preparation knowledge and skill, family member health and nutrition status, food decision influencer constructs, and dietary intake. In addition, an in-home inventory of 100 participants' household food supplies was conducted. Four distinct clusters presented when 26 psychographic food choice influencers were evaluated. These clusters appear to be valid and robust classifications of mothers in that they discriminated well on the psychographic variables used to construct the clusters as well as numerous other variables not used in the cluster analysis. In addition, the clusters appear to transcend demographic variables that often segment audiences (eg, race, mother's age, socioeconomic status), thereby adding a new dimension to the way in which this audience can be characterized. Furthermore, psychographically defined clusters predicted dietary quality. This study demonstrates that mothers are not a homogenous group and need to have their unique characteristics taken into consideration when designing strategies to promote health. These results can help health practitioners better understand factors affecting food decisions and tailor interventions to better meet the needs of mothers.     

Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: the Norwegian Women and Cancer (NOWAC) study

OBJECTIVE: To identify different dietary patterns in Norway using a combination of cluster and factor analysis. DESIGN: Cross-sectional study. SETTING: Nation-wide, population-based study. SUBJECTS: The Norwegian EPIC cohort is a subcohort of the Norwegian Women and Cancer study (NOWAC), and consist 37.226 women aged 41-56 y who answered a food frequency questionnaire (FFQ) in 1998. INTERVENTIONS: The associations among 50 food variables were first investigated by using principal component analysis. Five important factors were found. The five principal components were then used as input in the cluster analysis. Different socioeconomic and lifestyle variables were examined. RESULTS: Six clusters of dietary patterns were found, and were labelled accordingly: 'traditional fish eaters', 'healthy eaters', 'average, less fish, less healthy', 'Western', 'traditional bread eaters', and 'alcohol users'. The traditional fish eaters and the traditional bread eaters were both highly represented in the north and west of Norway and were more likely to be present among persons with lower income and lower education. The healthy and the alcohol drinkers were found mostly in the south and east and were more likely to have higher income. Persons in the alcohol group were more likely to be current smokers. The western group had the highest percentage of three or more persons in the household and the shortest time since last birth, indicating that families with children dominate this group. CONCLUSION: Our data indicate six different dietary patterns in Norway, each with different socio-demographic and lifestyle characteristics. SPONSORSHIP: The Norwegian Cancer Society (E 04038/006).     

Under-reporting of energy intake is more prevalent in a healthy dietary pattern cluster

The aim of the present study was to determine whether under-reporting rates vary between dietary pattern clusters. Subjects were sixty-five Brazilian women. During 3 weeks, anthropometric data were collected, total energy expenditure (TEE) was determined by the doubly labelled water method and diet was measured. Energy intake (EI) and the daily frequency of consumption per 1000 kJ of twenty-two food groups were obtained from a FFQ. These frequencies were entered into a cluster analysis procedure in order to obtain dietary patterns. Under-reporters were defined as those who did not lose more than 1 kg of body weight during the study and presented EI:TEE less than 0.82. Three dietary pattern clusters were identified and named according to their most recurrent food groups: sweet foods (SW), starchy foods (ST) and healthy (H). Subjects from the healthy cluster had the lowest mean EI:TEE (SW = 0.86, ST = 0.71 and H = 0.58; P = 0.003) and EI - TEE (SW = - 0.49 MJ, ST = - 3.20 MJ and H = - 5.08 MJ; P = 0.008). The proportion of under-reporters was 45.2 (95 % CI 35.5, 55.0) % in the SW cluster; 58.3 (95 % CI 48.6, 68.0) % in the ST cluster and 70.0 (95 % CI 61.0, 79) % in the H cluster (P = 0.34). Thus, in Brazilian women, under-reporting of EI is not uniformly distributed among dietary pattern clusters and tends to be more severe among subjects from the healthy cluster. This cluster is more consistent with both dietary guidelines and with what lay individuals usually consider 'healthy eating'.     

Evaluation of Nutrient Intake and Food Consumption among Dutch Toddlers

Improving dietary habits at a young age could prevent adverse health outcomes. The aim was to gain insight into the adequacy of the dietary intake of Dutch toddlers, which may provide valuable information for preventive measures. Data obtained from the Dutch National Food Consumption Survey 2012–2016 were used, which included 672 children aged one to three years. Habitual intakes of nutrients were evaluated according to recommendations set by the Dutch Health Council. Specific food groups were evaluated according to the Dutch food-based dietary guidelines. For most nutrients, intakes were estimated to be adequate. High intakes were found for saturated fatty acids, retinol, iodine, copper, zinc, and sodium. No statement could be provided on the adequacy of intakes of alpha-linoleic acids, N-3 fish fatty acids, fiber, and iron. 74% of the toddlers used dietary supplements, and 59% used vitamin D supplements specifically. Total median intakes of vegetables, bread, and milk products were sufficient. Consumption of bread, potatoes and cereals, milk products, fats, and drinks consisted largely of unhealthy products. Consumption of unfavorable products may have been the cause of the observed high and low intakes of several nutrients. Shifting towards a healthier diet that is more in line with the guidelines may positively affect the dietary intake of Dutch toddlers and prevent negative health impacts, also later in life.