Diet and Respiratory Infections: Specific or Generalized Associations?

Background: Based on our recently reported associations between specific dietary behaviors and the risk of COVID-19 infection in the UK Biobank (UKB) cohort, we further investigate whether these associations are specific to COVID-19 or extend to other respiratory infections. Methods: Pneumonia and influenza diagnoses were retrieved from hospital and death record data linked to the UKB. Baseline, self-reported (2006–2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Logistic regression estimated the odds of pneumonia/influenza from baseline to 31 December 2019 with each dietary component, adjusting for baseline socio-demographic factors, medical history, and other lifestyle behaviors. We considered effect modification by sex and genetic factors related to pneumonia, COVID-19, and caffeine metabolism. Results: Of 470,853 UKB participants, 4.0% had pneumonia and 0.2% had influenza during follow up. Increased consumption of coffee, tea, oily fish, and fruit at baseline were significantly and independently associated with a lower risk of future pneumonia events. Increased consumption of red meat was associated with a significantly higher risk. After multivariable adjustment, the odds of pneumonia (p ≤ 0.001 for all) were lower by 6–9% when consuming 1–3 cups of coffee/day (vs. <1 cup/day), 8–11% when consuming 1+ cups of tea/day (vs. <1 cup/day), 10–12% when consuming oily fish in higher quartiles (vs. the lowest quartile—Q1), and 9–14% when consuming fruit in higher quartiles (vs. Q1); it was 9% higher when consuming red meat in the fourth quartile (vs. Q1). Similar patterns of associations were observed for influenza but only associations with tea and oily fish met statistical significance. The association between fruit and pneumonia risk was stronger in women than in men (p = 0.001 for interaction). Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections.     

Socioeconomic,Eating- and Health-Related Limitations of Food Consumption among Polish Women 60+ Years: The ‘ABC of Healthy Eating’ Project

The study aimed at identifying the socioeconomic, eating- and health-related limitations and their associations with food consumption among Polish women 60+ years old. Data on the frequency of consumption of fruit, vegetables, dairy, meat, poultry, fish, legumes, eggs, water and beverages industrially unsweetened were collected with the Mini Nutritional Assessment (MNA^®) and were expressed in the number of servings consumed per day or week. Three indexes: the Socioeconomic Status Index (SESI), the Eating-related Limitations Score (E-LS) and the Health-related Limitations Score (H-LS) were developed and applied. SESI was created on the base of two variables: place of residence and the self-reported economic situation of household. E-LS included: difficulties with self-feeding, decrease in food intake due to digestive problems, chewing or swallowing difficulties, loss of appetite, decrease in the feeling the taste of food, and feeling satiety, whereas H-LS included: physical function, comorbidity, cognitive function, psychological stress and selected anthropometric measurements. A logistic regression analysis was performed to assess the socioeconomic, eating-, and health-related limitations of food consumption. Lower socioeconomic status (vs. higher) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.25) or consuming dairy ≥ 1 serving/day (OR = 0.32). The existence of multiple E-LS limitations (vs. few) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.72), consuming dairy ≥ 1 serving/day (OR = 0.55) or consuming water and beverages industrially unsweetened ≥6 cups/day (OR = 0.56). The existence of multiple H-LS limitations was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.79 per 1 H-LS point increase) or consuming dairy ≥ 1 serving/day (OR = 0.80 per 1 H-LS point increase). Limitations found in the studied women were related to insufficient consumption of selected groups of food, which can lead to malnutrition and dehydration. There is a need for food policy actions, including practical educational activities, to eliminate barriers in food consumption, and in turn to improve the nutritional and health status of older women.     

Dietary Changes and Anxiety during the Coronavirus Pandemic: Differences between the Sexes

The SARS-CoV-2 (COVID-19) pandemic has been associated with both increased anxiety, deterioration in diet and weight gain. These associations may differ by sex. The present report examines differences by sex in diet quality in order to determine whether associations between diet and psychological stress during the initial phase of the COVID-19 pandemic differed by sex. This online study is available internationally in seven languages. The Mediterranean Diet Score was used to measure diet quality, while the General Anxiety Disorder 7-point scale (GAD-7) was used to measure anxiety. Findings were compared by self-reported sex (male vs. female). A total of 3797 respondents provided informed consent and met eligibility criteria, of whom 526 women were omitted due to being pregnant or six months or less post-partum, or due to reproductive status not being reported. Thus, 3271 individuals are included in the present report, of whom 71.2% were women. The median age of women was 30 (interquartile range (IQR) = 16) years vs. 31 (IQR = 19) years, p = 0.079. The median diet quality score was 9 (IQ = 3) in both women and men (p = 0.75). Despite the overall similarity in diet score, several components of the score differed significantly by sex. Women reported consuming significantly more olive oil, daily servings of vegetables, and weekly servings of sweet baked goods. Men reported consuming significantly more sweetened/carbonated drinks, red meat, alcohol, legumes, and hummus/tahini. Women reported a GAD-7 score of 6 (IQR = 8), while men reported 3 (6), p < 0.001. An inverse association was detected between the Mediterranean diet score and the GAD-7 score in both women (rho = −0.166, p < 0.001) and men (rho = −0.154, p < 0.001), and the correlation coefficients did not differ by sex (p = 0.76). Mediterranean diet score and age both reduced the odds of elevated anxiety (GAD-7 ≥ 10), while female sex, deterioration of diet quality during the outbreak, unemployment, and completing the survey in English increased the odds of this outcome. During the COVID-19 lockdowns, overall diet quality did not differ by sex; however, some differences by sex in components of the total score were detected. Moderate to severe anxiety was positively associated with female sex and poorer diet quality even after controlling for age, employment status, and the language in which the survey was performed.     

Does Food Intake of Australian Toddlers 12–24 Months Align with Recommendations: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Food-based dietary guidelines promote population health and well-being through dietary patterns that reduce chronic disease risk while providing adequate energy and nutrients. In Australia, recommended dietary patterns based on servings per day from the five food groups—fruits, vegetables, cereals and grains, meats and alternatives, and dairy—have been developed for toddlers 1–2 years of age. However, no study has assessed the intake of the five food groups in this age group nationally. (2) Aim: To compare daily servings and the percentage of energy from the five food groups and discretionary foods in toddlers 1–2 years old to the Australian Dietary Guidelines. (3) Methods: Dietary intake was assessed using a one-day food record for 475 toddlers. (4) Results: Apart from fruit and dairy, servings of the five food groups were below the recommendations. Two-thirds of toddlers did not consume enough vegetables, and only 10% consumed the recommended number of servings for cereals and grains. On average, toddlers consumed only half the recommended servings of meat and alternatives. Nearly all toddlers (89%) consumed discretionary foods, which accounted for ~12% of total energy. Forty-five percent of toddlers received breastmilk. On average, breastfed toddlers consumed fewer servings from the five food groups than non-breastfed toddlers. Dairy contributed 20% of daily energy in all toddlers; however, this food group accounted for 13% in breastfed and 32% in non-breastfed toddlers on the day of the food record. (4) Conclusions: Compared to the recommendations, alignment with the servings of the five food group foods was not achieved by most toddlers, except for fruit and dairy. Discretionary foods may have displaced nutritious family foods. Consistent with Australian Infant Feeding Guidelines, many toddlers in this study continued to receive breastmilk but the recommended dietary patterns do not include breastmilk. Dietary modeling, including breastmilk as the primary milk source, is urgently needed, along with practical advice on incorporating breastmilk in a toddler’s diet while optimizing food consumption.     

Association between social vulnerability and COVID-19 vaccination hesitancy and vaccination in pregnant and postpartum individuals

ObjectiveTo evaluate the association of community-level social vulnerability with COVID-19 vaccine hesitancy and vaccination among pregnant and postpartum individuals.MethodsProspective cohort study assessing COVID-19 vaccine hesitancy among pregnant and postpartum individuals. We performed a baseline survey on COVID-19 vaccine hesitancy from 03/22/21 to 04/02/21, and a follow-up survey on COVD-19 vaccination status 3- to 6-months later. The primary exposure was the Centers for Disease Control and Prevention SVI (Social Vulnerability Index), measured in quartiles. Higher SVI quartiles indicated greater community-level social vulnerability with the lowest quartile (quartile 1) as the referent group. The primary outcome was COVID-19 vaccine hesitancy on the baseline survey (uncertainty or refusal of the vaccine), and the secondary outcome was self-report of not being vaccinated (unvaccinated) for COVID-19 on the follow-up survey.ResultsOf 456 assessed individuals, 46% reported COVID-19 vaccine hesitancy on the baseline survey; and of 290 individuals (290/456, 64%) who completed the follow-up survey, 48% (140/290) were unvaccinated. The frequency of baseline vaccine hesitancy ranged from 25% in quartile 1 (low SVI) to 68% in quartile 4 (high SVI), and being unvaccinated at follow-up ranged from 29% in quartile 1 to 77% in quartile 4. As social vulnerability increased, the risk of COVID-19 vaccine hesitancy at baseline increased (quartile 2 aRR (adjusted relative risk): 1.46; 95% CI:0.98 to 2.19; quartile 3 aRR: 1.86; 95% CI:1.28 to 2.71; and quartile 4 aRR: 2.24; 95% CI:1.56 to 3.21), as did the risk of being unvaccinated at follow-up (quartile 2 aRR: 1.00; 95% CI:0.66 to 1.51; quartile 3 aRR: 1.68; 95% CI:1.17 to 2.41; and quartile 4 aRR: 1.82; 95% CI:1.30 to 2.56).ConclusionsPregnant and postpartum individuals living in an area with higher community-level social vulnerability were more likely to report COVID-19 vaccine hesitancy and subsequently to be unvaccinated at follow-up.     

COVID-19-Related Quarantine Effect on Dietary Habits in a Northern Italian Rural Population: Data from the Brisighella Heart Study

North of Italy was severely hit by the COVID-19 (Coronavirus disease 19) pandemic. This induced the government to adopt severely restrictive measures to reduce the contagion risk, forcing most of the population to stop working and from leisure activities, and to remain at home for several weeks. Our study aimed to evaluate the effect of COVID-related quarantine on smoking and dietary habits of a well-characterized northern Italian rural population. For this purpose, while lockdown restrictions were in place (February–April 2020), 359 subjects from the Brisighella Heart Study cohort underwent a phone interview about their lifestyle habit changes during COVID-19-related quarantine. Quarantine did not significantly modify smoking habit nor body mass index. Subjects significantly increased daily carbohydrates consumption, all fresh vegetables, healthy vegetable oils, milk and yogurt, alcoholic drinks, sugars and sweets, and coffee. The weekly consumption of low-fat meat, cured meat other than ham, cheeses, eggs, nuts and mixed seed oils significantly increased, while the weekly intake of fish, mussels, and legumes significantly decreased during lockdown. The Dietary Quality Index was reduced from 42.4 ± 4.1 to 37.8 ± 4.7 (p < 0.03). In accordance with our findings, COVID-19-related quarantine might worsen the quality of diet, also leading to an increased intake of almost all food categories.     

Telephone counseling promotes dietary change in healthy adults: results of a pilot trial

Telephone counseling is increasingly reported to be an effective behavior change strategy, but more studies in broader populations are needed. This uncontrolled pilot trial investigated whether a 3-month/eight-call telephone counseling intervention could promote dietary changes associated with reduced chronic disease risk in adults consuming <5.0 servings of vegetables and fruits daily. Between 2002 and 2004, 97 adults (mean age 46 years; range 21 to 84 years) completed the intervention and a follow-up assessment at 6 months. Approximately half were of nonwhite ethnicity (53%). The majority were women (95%) and had never had cancer (89%). The intervention promoted daily intakes of three to five vegetable servings, two to four fruit servings, and three whole-grain and/or beans/legumes servings. Average total daily intake of vegetables, fruits, whole grains, beans/legumes, fiber, and fat were assessed at baseline and at 6 months, each by a set of three 24-hour recalls. Plasma carotenoids were measured on a subsample (n=41) as an objective biomarker of vegetable and fruit intake. Change in mean self-reported dietary intake (ie, vegetables, fruit, whole grains, beans/legumes, fiber, and fat) and plasma carotenoids were compared by paired t tests. The intervention was associated with a significant (P<0.001) increase in vegetable servings per day (baseline 2.1 servings per day, 6 months 3.5 servings per day; 67% increase), fruit servings per day (baseline 1.4 servings per day, 6 months 2.4 servings per day; 71% increase), and whole-grain and/or bean servings per day (baseline 1.0 serving per day, 6 months 1.4 servings per day; 40% increase). These changes were corroborated by a significant (P<0.001) increase in total plasma carotenoids. This 3-month/eight-call telephone counseling intervention was associated with dietary change in healthy adults consuming fewer than five servings per day of vegetables and fruit at study entry.     

Increasing fruits and vegetables in midlife women: a feasibility study

The positive link between bone health and fruit/vegetable consumption has been attributed to the lower renal acid load of a diet high in alkaline-forming fruit/vegetables. Other important dietary determinants of bone health include micronutrients and bioactives found in fruit/vegetables. We hypothesized that increased intake of fruit/vegetables to 9 or more servings a day would lower net endogenous acid production (NEAP) significantly (~20 mEq/d) and increase urine pH (0.5 pH units). This 8-week feasibility study investigated if 21 midlife women (age, 40-65 years) currently consuming 5 or less servings a day of fruit/vegetables could increase their intake to 9 or more servings a day to substantially lower NEAP and include specific vegetables daily. Three-day diet diaries were completed at baseline and the end of the study and assessed for NEAP (estimated) and number of servings from all food groups. Urine pH dipsticks were provided for the participants to assess and record their fasting urine pH daily (second void). Seventy-six percent of women achieved the study aim, which was to increase to 9 or more servings of fruit/vegetables for at least 5 d/wk. There was a reduction in the number of bread/cereal servings. Net endogenous acid production (estimated) was reduced significantly, with a mean urine pH increase of 0.68 pH units (95% confidence interval, 0.46-1.14); however, daily urine pH measures showed high variability. This study demonstrated that a group of midlife women can change their diet for 8 weeks by significantly increasing fruit/vegetable servings and include specific “bone friendly” vegetables daily, resulting in a significant decrease in estimated dietary NEAP and an increase in urine pH.     

COVID-19 Pandemic and Remote Education Contributes to Improved Nutritional Behaviors and Increased Screen Time in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study

The Coronavirus-19 disease (COVID-19) pandemic has influenced the nutrition of individuals, including the diet followed, food availability, and food security. However, thus far, only a few studies have been published regarding the diet and activity of children and adolescents. The aim of the present study was to analyze the influence of the COVID-19 pandemic and remote education in this period on the diet and physical activity in a Polish population-based sample of primary school adolescents. In June 2020, the Diet and Activity of Youth during COVID-19 (DAY-19) Study was conducted on a population recruited based on stratified random sampling from all regions (schools sampled from counties, and counties from voivodeships). The sample consisted of a total of 1334 adolescents aged 10–16 years. The study assessed the diet and physical activity of the participants using a validated questionnaire which included questions about the period of remote education and the period before the COVID-19 pandemic. The participants were asked about the following: consumption of fruit, vegetables, soft drinks, water, French fries, and fast food; eating meals in front of the television; and the number of days they are physically active and the number of hours they spend watching television. The obtained data were analyzed by stratifying the respondents by the gender, age, size of the city and total COVID-19 morbidity in the voivodeship. It was observed that, during the pandemic and the resultant remote education, the proportion of respondents who declared the recommended intake of fruits and vegetables had increased compared to that before the pandemic—a higher proportion consumed at least three portions of fruit per day (19.0% before pandemic vs. 27.4% during pandemic; p < 0.0001), as well as three and four or more portions of vegetables per day (11.9% vs. 14.5% and 7.5% vs. 11.1%; p = 0.0004). At the same time, the proportion of respondents consuming at least three cups of water per day had increased (41.1% vs. 47.9%; p = 0.0020), whereas the proportion of respondents who never or rarely eat their meals in front of the television had decreased (35.6% vs. 28.9%; p < 0.0001), and the proportion watching television for more than 2 h a day had increased (78.3% vs. 88.4%; p < 0.0001). Based on the results, it may be concluded that, during the period of remote education due to the COVID-19 pandemic, the dietary behaviors of the studied population of Polish adolescents were more beneficial, which included a higher intake of fruit, vegetables, and water, compared to before the pandemic. In spite of the increasing screen time, including eating in front of the television, there was no reduction in the number of days the respondents were physically active.     

A comparison of two methods of measuring food group intake: grams vs servings

Different measurements can be used to quantify food group intake, such as servings, cups, or grams. Dietary recommendations are given in terms of servings (recently expressed as cup and ounce measurements), but research on disease risks often uses grams as the intake measure. Because serving sizes vary among foods within a food group, the method of expressing food group intake (grams vs servings) may impact disease risk analyses. Daily consumption of eight food groups was calculated as both Food Guide Pyramid servings and grams for 206,721 participants in the Multiethnic Cohort Study who completed a quantitative food frequency questionnaire between 1993 and 1996. Mean grams per serving ranged from 25 g for red meat to 172 g for dairy products. Spearman correlation coefficients between intakes as grams per day and servings per day were 0.85 for grains, 0.97 for vegetables, 0.99 for fruit, 0.95 for dairy products, 0.98 for red meat, 0.93 for processed meat, 1.00 for poultry, and 1.00 for fish. Because there was little effect on the ranking of study participants' intakes due to the method of calculating food group consumption, the two measures are interchangeable in disease risk models.     

Reported Changes in Eating Habits Related to Less Healthy Foods and Beverages during the COVID-19 Pandemic among US Adults

Background: The COVID-19 pandemic has triggered stress, anxiety, and disruption to many individuals’ daily lives, which might impact eating habits. Objective: To examine changes in eating habits related to less healthy foods and beverages during the early phase of the COVID-19 pandemic among US adults. Design: Cross-sectional study. Participants/setting: Authors used SummerStyles data gathered in June 2020 among 3916 US adults (≥18 years). Main outcome measures: The outcome of interest was the reported frequency of consuming more (1) unhealthy snacks and desserts including chips, cookies, and ice cream and (2) sugar-sweetened beverages (SSBs) like regular soda, fruit drinks, sports/energy drinks, sweetened coffee/teas during the COVID-19 pandemic. Responses were categorized as Never/Rarely, Sometimes, or Often/Always. Explanatory variables were sociodemographics, weight status, and census regions. Statistical analyses performed: We used multinomial regressions to calculate adjusted odds ratios (AOR) for Sometimes or Often/Always consuming more unhealthy snacks/desserts (vs. Never/Rarely); and Sometimes or Often/Always more SSBs (vs. Never/Rarely). Results: Overall, 36% of adults reported sometimes consuming more unhealthy snacks/desserts; 16% did so often/always. Twenty-two percent of adults reported sometimes drinking more SSBs; 10% did so often/always. Factors significantly associated with higher odds of reporting often/always consuming more unhealthy snacks/desserts were younger adults (AOR range = 1.51–2.86 vs. adults ≥65 years), females (AOR = 1.58 vs. males), non-Hispanic Black (AOR = 1.89 vs. non-Hispanic White), lower household income (AOR = 2.01 for <USD 35,000 vs. ≥USD 100,000), and obesity (AOR = 1.56 vs. underweight/healthy weight). Factors significantly associated with odds of Often/Always drinking more SSBs were being younger (AOR range = 2.26–4.39 vs. adults ≥65 years), non-Hispanic Black (AOR = 3.25 vs. non-Hispanic White), Hispanic (AOR = 1.75 vs. non-Hispanic White), non-Hispanic Other race/ethnicity (AOR = 2.41 vs. non-Hispanic White), lower education (AOR = 2.03 for ≤high school; AOR = 1.80 for some college vs. college graduate), lower household income (AOR range = 1.64–3.15 vs. ≥USD 100,000), and obesity (AOR = 1.61 vs. underweight/healthy weight). Conclusions: Consuming more sugary foods and SSBs during the first phase of the pandemic was higher in younger adults, lower-income adults, people of racial/ethnic minority groups, and adults with obesity. Dietary shifts to less healthy foods and drinks may influence metabolic health if sustained long-term. Implementing strategies to support individual’s healthy eating habits during the ongoing pandemic and the pandemic recovery may benefit health and wellness.     

The Influence of Nutrition and Physical Activity on Exercise Performance after Mild COVID-19 Infection in Endurance Athletes-CESAR Study

COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (n_male = 43, n_female = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m⁻²) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA.     

Analysis of Food Habits during Pandemic in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study

The improper dietary behaviors of children and adolescents during the COVID-19 pandemic, which are associated with lockdowns and reduced physical activity, are a complex problem, potentially resulting in increased risk of diet-related diseases, including overweight and obesity and their consequences. The aim of the study was to assess the food habits during the COVID-19 pandemic and to define their association with physical activity and body mass changes in a Polish population of primary school adolescents within the Diet and Activity of Youth During COVID-19 (DAY-19) Study. The DAY-19 Study was conducted in June 2020 in a national cohort of 1334 primary school students aged 10–16 years, recruited based on a stratified random sampling of schools (sampling counties from voivodeships and schools from counties). The Adolescent Food Habits Checklist (AFHC) was used to assess food habits, associated with food purchase, preparation, and consumption, which in the studied group were analyzed separately for the period before (retrospective data) and during the COVID-19 pandemic (prospective data). The recognizable physical activity changes and recognizable body mass changes were also assessed (retrospective data) and respondents were classified as those declaring that their physical activity and body mass decreased, remained stable, or increased during the COVID-19 pandemic. It was observed that during the COVID-19 pandemic the majority of food habits changed in a statistically significant way (p < 0.05). Within food purchase habits, the number of respondents who declared choosing a low-fat lunch away from home decreased, often buying pastries or cakes decreased, and buying a low-fat crisps brand increased (p < 0.05). Within food preparation habits, the number of respondents who declared trying to keep overall fat intake down increased, trying to keep overall sugar intake down increased, eating at least one serving of vegetables or salad with evening meal increased, and usually including some chocolate and/or biscuits in a packed lunch decreased (p < 0.05). Within food consumption habits, the number of respondents who declared making sure that they eat at least one serving of fruit a day increased, eating at least three servings of fruit most days increased, making sure that they eat at least one serving of vegetables or salad a day increased, trying to ensure that they eat plenty of fruit and vegetables increased, often choosing a fruit when they have a snack between meals increased, eating at least three servings of fruit most days increased, and generally trying to have a healthy diet increased (p < 0.05). It was concluded that in the period of the COVID-19 pandemic and resultant remote education, adolescents in Poland presented different food habits than before, while the majority of changes were positive. The positive food purchase, preparation, and consumption habits were observed mainly in sub-groups of adolescents declaring decreased body mass or increased physical activity during the COVID-19 pandemic. It may be suggested that physical activity may support positive changes of dietary behaviors and while combined positive changes of diet and increased physical activity, they may effectively promote body mass reduction in adolescents.     

Assessing the Association between Important Dietary Habits and Osteoporosis: A Genetic Correlation and Two-Sample Mendelian Randomization Study

Objective: Osteoporosis (OP) is the most common bone disease. The genetic and metabolic factors play important roles in OP development. However, the genetic basis of OP is still elusive. The study aimed to explore the relationships between OP and dietary habits. Methods: This study used large-scale genome-wide association study (GWAS) summary statistics from the UK Biobank to explore potential associations between OP and 143 dietary habits. The GWAS summary data of OP included 9434 self-reported OP cases and 444,941 controls, and the GWAS summary data of the dietary habits included 455,146 participants of European ancestry. Linkage disequilibrium score regression (LDSC) was used to detect the genetic correlations between OP and each of the 143 dietary habits, followed by Mendelian randomization (MR) analysis to further assess the causal relationship between OP and candidate dietary habits identified by LDSC. Results: The LDSC analysis identified seven candidate dietary habits that showed genetic associations with OP including cereal type such as biscuit cereal (coefficient = −0.1693, p value = 0.0183), servings of raw vegetables per day (coefficient = 0.0837, p value = 0.0379), and spirits measured per month (coefficient = 0.115, p value = 0.0353). MR analysis found that OP and PC17 (butter) (odds ratio [OR] = 0.974, 95% confidence interval [CI] = (0.973, 0.976), p value = 0.000970), PC35 (decaffeinated coffee) (OR = 0.985, 95% CI = (0.983, 0.987), p value = 0.00126), PC36 (overall processed meat intake) (OR = 1.035, 95% CI = (1.033, 1.037), p value = 0.000976), PC39 (spirits measured per month) (OR = 1.014, 95% CI = (1.011, 1.015), p value = 0.00153), and servings of raw vegetables per day (OR = 0.978, 95% CI = (0.977, 0.979), p value = 0.000563) were clearly causal. Conclusions: Our findings provide new clues for understanding the genetic mechanisms of OP, which focus on the possible role of dietary habits in OP pathogenesis.     

Comparison of 4 questionnaires for assessment of fruit and vegetable intake.

OBJECTIVE: This study compared fruit and vegetable assessments derived from 4 self-administered questionnaires. METHODS: Among 102 adolescents, servings of fruits and vegetables assessed by 4 questionnaires were compared with estimates from 24-hour recalls. RESULTS: The prevalence of consuming 5 or more servings of fruits and vegetables a day was underestimated by the questionnaires. Questionnaires asking subjects to recall their diet over the previous year were more effective in ranking subjects (r's > or = .42) than those assessing previous-day diet (r's > or = .30). CONCLUSIONS: Brief assessments of fruit and vegetable intake are more useful for ranking subjects than for estimating prevalence of consumption of 5 or more servings per day.     

Dietary patterns and risk of colorectal tumors: a cohort of French women of the National Education System (E3N)

Little is known about the dietary patterns associated with colorectal tumors along the adenoma-carcinoma sequence. Scores for dietary patterns were obtained by factor analysis in women from the French cohort of the European Prospective Investigation into Cancer and Nutrition (1993-2000). Their association with colorectal tumors was investigated in 516 adenoma cases (175 high-risk adenomas) and 4,804 polyp-free women and in 172 colorectal cancer cases and 67,312 cancer-free women. The authors identified four dietary patterns: "healthy" (vegetables, fruit, yogurt, sea products, and olive oil); "Western" (potatoes, pizzas and pies, sandwiches, sweets, cakes, cheese, cereal products, processed meat, eggs, and butter); "drinker" (sandwiches, snacks, processed meat, and alcoholic beverages); and "meat eaters" (meat, poultry, and margarine). For quartile 4 versus quartile 1, an increased risk of adenoma was observed with high scores of the Western pattern (multivariate relative risk (RR) = 1.39, 95% confidence interval: 1.00, 1.94; p(trend) = 0.03) and the drinker pattern (RR = 1.42, 95% confidence interval: 1.10, 1.83; p(trend) = 0.01). The meat-eaters pattern was positively associated with colorectal cancer risk (for quartile 4 vs. quartile 1: RR = 1.58, 95% confidence interval: 0.98, 2.53; p(trend) = 0.02). Dietary patterns that reflect a Western way of life are associated with a higher risk of colorectal tumors.     

Dietary energy density predicts women's weight change over 6 y

BACKGROUND: Dietary energy density (ED) is positively associated with energy intake, but little is known about long-term effects on weight change. OBJECTIVE: We assessed whether dietary ED predicts weight change over 6 y among a sample of non-Hispanic, white women. DESIGN: Participants were part of a 6-y longitudinal study (n = 186), assessed at baseline and biennially. ED (in kcal/g) was calculated from the energy content of all foods (excluding beverages) with the use of three 24-h recalls. Height and weight were measured in triplicate to calculate body mass index (BMI; in kg/m(2)). Repeated measures (PROC MIXED) were used to examine the influence of ED on weight change, before and after adjusting for initial weight status. Food choices were examined among subjects consuming low-, medium-, and high-ED diets at study entry. RESULTS: ED did not change across time for a subject. ED was positively associated with weight gain and higher BMI over time; this association did not vary by BMI classification. Food group data showed that, compared with women consuming higher-ED diets, women consuming lower-ED diets reported significantly lower total energy intakes and consumed fewer servings of baked desserts, refined grains, and fried vegetables and more servings of vegetables, fruit, and cereal. Women consuming lower-ED diets ate more meals at the table and fewer meals in front of the television. CONCLUSIONS: Findings indicate that consumption of a lower-ED diet moderates weight gain, which may promote weight maintenance. Consuming lower ED diets can be achieved by consuming more servings of fruit and vegetables and limiting intake of high-fat foods.     

High-Fiber Diet during Pregnancy Characterized by More Fruit and Vegetable Consumption

Higher dietary fiber intakes during pregnancy may have the potential health benefits of increasing gut microbiome diversity, lowering the risk of glucose intolerance and pre-eclampsia, achieving appropriate gestational weight gain, and preventing constipation. In this observational cohort study, we have assessed the dietary fiber intakes of 804 women in late pregnancy, using a semi-quantitative food frequency questionnaire (SQ-FFQ). Overall, the median (interquartile range) dietary fiber intake was 24.1 (19.0–29.7) grams per day (g/day). Only 237/804 (29.5%) women met the recommended Adequate Intake (AI) of dietary fiber during pregnancy of 28 g/day. Women consuming the highest quartile of fiber intakes (34.8 (IQR 32.1–39.5) g/day) consumed more fruit, especially apples and bananas, than women consuming the lowest quartile of fiber intakes (15.9 (IQR 14.4–17.5) g/day). These women in the highest fiber-intake quartile were older (p < 0.01), more had completed further education after secondary school (p = 0.04), and they also consumed more vegetables (67 g/day) compared to the women in the lowest fiber consumption quartile (17 g vegetables/day). Bread intakes of 39–42 g/day were consistent in quantities consumed across all four fiber-intake quartiles. Our findings suggest that antenatal education advice targeting increased fruit and vegetable consumption before and during pregnancy may be a simple strategy to achieve increased total dietary fiber intakes to reach recommended quantities.     

The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study

Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5–9 years) and adolescents (10–14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation.     

Dietary energy density and successful weight loss maintenance

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27-45kg/m(2)), normal weight adults (NW: BMI=19-24.9 kg/m(2)), and weight loss maintainers (WLM: current BMI=19-24.9kg/m(2) [lost≥10% of maximum body weight and maintained loss for ≥5years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45kcal/g; NW=1.60±0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials.