Associations between Maternal Dietary Patterns and Infant Birth Weight in the NISAMI Cohort: A Structural Equation Modeling Analysis

The mother’s diet during pregnancy is associated with maternal and child health. However, there are few studies with moderation analysis on maternal dietary patterns and infant birth weight. We aim to analyse the association between dietary patterns during pregnancy and birth weight. A prospective cohort study was performed with pregnant women registered with the prenatal service (Bahia, Brazil). A food frequency questionnaire was used to evaluate dietary intake. Birth weight was measured by a prenatal service team. Statistical analyses were performed using factor analysis with a principal component extraction technique and structural equation modelling. The mean age of the pregnant women was 27 years old (SD: 5.5) and the mean birth weight was 3341.18 g. It was observed that alcohol consumption (p = 0.05) and weight-gain during pregnancy (p = 0.05) were associated with birth weight. Four patterns of dietary consumption were identified for each trimester of the pregnancy evaluated. Adherence to the “Meat, Eggs, Fried Snacks and Processed foods” dietary pattern (pattern 1) and the “Sugars and Sweets” dietary pattern (pattern 4) in the third trimester directly reduced birth weight, by 98.42 g (Confidence interval (CI) 95%: 24.26, 172.59) and 92.03 g (CI 95%: 39.88, 165.30), respectively. It was also observed that insufficient dietary consumption in the third trimester increases maternal complications during pregnancy, indirectly reducing birth weight by 145 g (CI 95%: −21.39, −211.45). Inadequate dietary intake in the third trimester appears to have negative results on birth weight, directly and indirectly, but more studies are needed to clarify these causal paths, especially investigations of the influence of the maternal dietary pattern on the infant gut microbiota and the impacts on perinatal outcomes.     

Dietary Pattern Accompanied with a High Food Variety Score Is Negatively Associated with Frailty in Older Adults

Proper nutrition is a modifiable factor in preventing frailty. This study was conducted to identify the association between dietary patterns and frailty in the older adult population. The cross-sectional analysis was performed on 4632 subjects aged ≥65 years enrolled in the Korea National Health and Nutrition Examination Survey from 2014–2018. Food variety score (FVS) was defined as the number of foods items consumed over a day. Three dietary patterns were identified using factor analysis: “white rice and salted vegetables,” “vegetables, oils, and fish,” and “noodles and meat.” The higher “white rice and salted vegetables” pattern score was related to significantly lower FVS, whereas higher “vegetables, oils, and fish” and “noodles and meat” pattern scores were associated with a higher FVS. Participants with higher FVS showed a low risk of frailty (odds ratio (OR) (95% confidence interval, CI) = 0.44 (0.31–0.61), p-trend = 0.0001) than those with lower FVS. Moreover, the “vegetables, oils, and fish” pattern score was significantly associated with a low risk of frailty (OR (95% CI) = 0.55 (0.40–0.75), p-trend = 0.0002). These results suggested that consuming a dietary pattern based on vegetables, oils, and fish with high FVS might ameliorate frailty in older adults.     

A Priori and a Posteriori Dietary Patterns among Pregnant Women in Johannesburg,South Africa: The NuPED Study

Dietary pattern analyses allow assessment of the diet as a whole. Limited studies include both a priori and a posteriori dietary pattern analyses. This study aimed to explore the diet of pregnant women in urban South Africa through both a priori and a posteriori dietary pattern analyses and associated maternal and household factors. Dietary data were collected during early pregnancy using a quantified food frequency questionnaire from 250 pregnant women enrolled in the Nutrition During Pregnancy and Early Development (NuPED) cohort. A priori dietary patterns were determined using the Diet Quality Index-International (DQI-I), and a posteriori nutrient patterns using exploratory factor analysis. Based on the DQI-I, the study population followed a borderline low-quality diet. Three a posteriori nutrient patterns were identified: Pattern 1 “plant protein, iron, thiamine, and folic acid”; pattern 2 “animal protein, copper, vitamin A, and vitamin B₁₂”; pattern 3 “fatty acids and sodium”. Pattern 1 was associated with higher dietary quality (p < 0.001), lower maternal educational level (p = 0.03) and socioeconomic status (p < 0.001). Pattern 3 was significantly associated with lower dietary quality. The low dietary quality among pregnant women residing in urban South Africa should be addressed to ensure optimal maternal and offspring health outcomes.     

Changes in Selected Food Groups Consumption and Quality of Meals in Japanese School Children during the COVID-19 Pandemic

In 2020, a state of emergency was declared to control the devastating impact of coronavirus, leading to temporary school closures in Japan, meaning that school lunches were not provided to the majority of schoolchildren. Using questionnaires completed by participants’ guardians, we examined the relationship between household income and the quality of meals in Japanese schoolchildren before, during, and after the state of emergency. Participants (1111 children, 10–14 years old) were chosen to form a nationally representative sample of the Japanese population. “Well-balanced dietary intake” was defined as the intake of (i) meat, fish, or eggs and (ii) vegetables. The desired prevalence was defined as equal to or more than twice a day. Household income was divided into quartiles. “Well-balanced dietary intake” was lower in all households during the state of emergency compared with before. The proportion of those with a “well-balanced dietary intake” at least twice a day was notably low in both Q3 and Q4 during the state of emergency compared with before the declared state of emergency; relative risk increase (95% CI) were Q1: −19.0% (−19.6% to −18.4%), p < 0.001, Q2: −21.3% (−22.1% to −20.6%) p < 0.001, Q3: −25.4% (−26.1% to −24.7%), p < 0.001, and Q4: −34.8% (−35.6% to −34.0%), p < 0.001. The interaction p (vs. Q1) of Q2, Q3, and Q4 were all <0.001. Guardians from low-income households had significantly higher rates of having less: time, psychological room, and financial position to prepare meals during the state of emergency. Our results suggest that schoolchildren’s quality of meals worsened during the state of emergency, especially in low-income households, because school lunches were not provided.     

Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity

(1) Background: Energy intake (EI) underreporting is a widespread problem of great relevance to public health, yet is poorly described among pregnant women. This study aimed to describe and predict error in self-reported EI across pregnancy among women with overweight or obesity. (2) Methods: Participants were from the Healthy Mom Zone study, an adaptive intervention to regulate gestational weight gain (GWG) tested in a feasibility RCT and followed women (n = 21) with body mass index (BMI) ≥25 from 8–12 weeks to ~36 weeks gestation. Mobile health technology was used to measure daily weight (Wi-Fi Smart Scale), physical activity (activity monitor), and self-reported EI (MyFitnessPal App). Estimated EI was back-calculated daily from measured weight and physical activity data. Associations between underreporting and gestational age, demographics, pre-pregnancy BMI, GWG, perceived stress, and eating behaviors were tested. (3) Results: On average, women were 30.7 years old and primiparous (62%); reporting error was −38% ± 26 (range: −134% (underreporting) to 97% (overreporting)), representing an ~1134 kcal daily underestimation of EI (1404 observations). Estimated (back-calculated), but not self-reported, EI increased across gestation (p < 0.0001). Higher pre-pregnancy BMI (p = 0.01) and weekly GWG (p = 0.0007) was associated with greater underreporting. Underreporting was lower when participants reported higher stress (p = 0.02) and emotional eating (p < 0.0001) compared with their own average. (4) Conclusions: These findings suggest systemic underreporting in pregnant women with elevated BMI using a popular mobile app to monitor diet. Advances in technology that allow estimation of EI from weight and physical activity data may provide more accurate dietary self-monitoring during pregnancy.     

Dietary Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus

Maternal dietary patterns before and during pregnancy play important roles in the development of gestational diabetes mellitus (GDM). We aimed to identify dietary patterns during pregnancy that are associated with GDM risk in pregnant U.S. women. From a 24 h dietary recall of 253 pregnant women (16–41 years) included in the National Health and Nutrition Examination Survey (NHANES) 2003–2012, food items were aggregated into 28 food groups based on Food Patterns Equivalents Database. Three dietary patterns were identified by reduced rank regression with responses including prepregnancy body mass index (BMI), dietary fiber, and ratio of poly- and monounsaturated fatty acids to saturated fatty acid: “high refined grains, fats, oils and fruit juice”, “high nuts, seeds, fat and soybean; low milk and cheese”, and “high added sugar and organ meats; low fruits, vegetables and seafood”. GDM was diagnosed using fasting plasma glucose levels ≥5.1 mmol/L for gestation <24 weeks. Multivariable logistic regression models were used to estimate adjusted odds ratio (AOR) and 95% confidence intervals (CIs) for GDM, after controlling for maternal age, race/ethnicity, education, family poverty income ratio, marital status, prepregnancy BMI, gestational weight gain, energy intake, physical activity, and log-transformed C-reactive protein (CRP). All statistical analyses accounted for the appropriate survey design and sample weights of the NHANES. Of 249 pregnant women, 34 pregnant women (14%) had GDM. Multivariable AOR (95% CIs) of GDM for comparisons between the highest vs. lowest tertiles were 4.9 (1.4–17.0) for “high refined grains, fats, oils and fruit juice” pattern, 7.5 (1.8–32.3) for “high nuts, seeds, fat and soybean; low milk and cheese” pattern, and 22.3 (3.9–127.4) for “high added sugar and organ meats; low fruits, vegetables and seafood” pattern after controlling for maternal sociodemographic variables, prepregnancy BMI, gestational weight gain, energy intake and log-transformed CRP. These findings suggest that dietary patterns during pregnancy are associated with risk of GDM after controlling for potential confounders. The observed connection between a high consumption of refined grains, fat, added sugars and low intake of fruits and vegetables during pregnancy with higher odds for GDM, are consistent with general health benefits of healthy diets, but warrants further research to understand underlying pathophysiology of GDM associated with dietary behaviors during pregnancy.     

Dietary Patterns Modulate the Risk of Non-Alcoholic Fatty Liver Disease in Chinese Adults

Although previous studies reported the associations between the intakes of individual foods or nutrients and the risk of non-alcoholic fatty liver disease (NAFLD), the relationship between dietary patterns and NAFLD in the Chinese population has been rarely studied to date. This study aimed to investigate the associations between dietary patterns and the risk of NAFLD in a middle-aged Chinese population. The Study subjects were 999 Chinese adults aged 45–60 years in the Anhui province who participated in the Hefei Nutrition and Health Study. Dietary intake was collected by a semi-quantitative food frequency questionnaire. NAFLD was defined as the presence of moderate-severe hepatic steatosis (by B-ultrasonic examination); the absence of excessive alcohol use (>20 g day⁻¹ in men and 10 g day⁻¹ in women); no use of steatogenic medications within the past six months; no exposure to hepatotoxins; and no history of bariatric surgery. Log-binomial regression analysis was used to examine the association between dietary patterns and NAFLD with adjustment of potential confounding variables. Out of 999 participants, 345 (34.5%) were classified as having NAFLD. Four major dietary patterns were identified: “Traditional Chinese”, “Animal food”, “Grains-vegetables” and “High-salt” dietary patterns. After adjusting for potential confounders, subjects in the highest quartile of the “Animal food” pattern scores had greater prevalence ratio for NAFLD (prevalence ratio (PR) = 1.354; 95% confidence interval (CI): 1.063–1.724; p < 0.05) than did those in the lowest quartile. After adjustment for body mass index (BMI), compared with the lowest quartile of the “Grains-vegetables” pattern, the highest quartile had a lower prevalence ratio for NAFLD (PR = 0.777; 95% CI: 0.618–0.977, p < 0.05). However, the “traditional Chinese” and “high-salt” dietary patterns showed no association with the risk of NAFLD. Our findings indicated that the “Animal food” dietary pattern was associated with an increased risk of NAFLD.     

Association of Maternal Dietary Patterns during Pregnancy and Offspring Weight Status across Infancy: Results from a Prospective Birth Cohort in China

Literature on maternal dietary patterns during pregnancy and offspring weight status have been largely equivocal. We aimed to investigate the association of maternal dietary patterns with infant weight status among 937 mother–infant dyads in a Chinese birth cohort. We assessed maternal diet during pregnancy using food frequency questionnaires (FFQ) and three-day food diaries (TFD) and examined infants’ body weight and length at birth, 1, 3, 6, 8 and 12 months. Maternal adherence to the “protein-rich pattern (FFQ)” was associated with lower infant body mass index z-scores (BMIZ) at birth, 3 and 6 months and lower odds of overweight and obesity (OwOb) across infancy (quartile 3 (Q3) vs. quartile 1 (Q1): odds ratio (OR): 0.50, (95% confidence interval: 0.27, 0.93)). Maternal adherence to the “vegetable–fruit–rice pattern (FFQ)” was associated with higher BMIZ at birth, 3 and 6 months and higher odds of OwOb across infancy (Q3 vs. Q1: OR: 1.79, (1.03, 3.12)). Maternal adherence to the “fried food–bean–dairy pattern (TFD)” was associated with lower BMIZ at 3, 6, 8 and 12 months and lower odds of OwOb (Q3 vs. Q1: OR: 0.54, (0.31, 0.95)). The study results may help to develop interventions and to better define target populations for childhood obesity prevention.     

Dietary Pattern Associated with the Risk of Hyperuricemia in Chinese Elderly: Result from China Nutrition and Health Surveillance 2015–2017

Our current study aimed to estimate the relationship between dietary patterns and hyperuricemia among the Chinese elderly over 60 years old. All the data were obtained from China Nutrition and Health Surveillance during 2015–2017. A total of 18,691 participants who completed the whole survey were included in our statistical analysis. The definition of hyperuricemia was 420 μmmol/L (7 mg/dL) for male and 360 μmmol/L (6 mg/dL) for female. Exploratory factor analysis was applied to explore posterior dietary patterns in our samples, and five dietary patterns were recognized, namely “Typical Chinese”, “Modern Chinese”, “Western”, “Animal products and alcohol”, and “Tuber and fermented vegetables”. After multiple adjusted logistic regression, participants in the highest quartile of “typical Chinese” (Q4 vs. Q1, OR = 0.32, 95% CI: 0.28–0.37, p-trend < 0.0001), “modern Chinese” (Q4 vs. Q1, OR = 0.81, 95% CI: 0.71–0.93, p-trend = 0.0021) and “tuber and fermented vegetables” (Q4 vs. Q1, OR = 0.78, 95% CI: 0.69–0.88, p-trend < 0.0001) showed a lower risk of hyperuricemia, while animal products and alcohol was positively associated with hyperuricemia (Q4 vs. Q1, OR = 1.49, 95% CI: 1.31–1.7, p-trend < 0.0001). We also found that participants who mainly ate a modern Chinese diet tended to meet the RNI/AI of nutrients we discuss in this paper, which may supply some information for hyperuricemia prevention and management by dietary methods.     

Dietary Patterns of 479 Indonesian Adults and Their Associations with Sodium and Potassium Intakes Estimated by Two 24-h Urine Collections

The excess sodium (Na) intake and insufficient potassium (K) intake are frequently observed all over the world, including Indonesia. This study explored the dietary patterns of Indonesian people and evaluated their associations with Na and K intakes. Na and K intakes were assessed by repeated 24-h urine collection. The dietary patterns of the previous month were extracted by factor analysis using the Indonesian Food Frequency Questionnaire. The participants were community-dwelling Indonesian men and women (n = 479) aged 20 years and over. We identified four dietary patterns in each sex. After controlling for confounding factors, the high quantile of ‘Noodle, oil, and salty sea products’ pattern was associated with the high Na intake in both men and women (p = 0.02 and <0.001, respectively). The ‘Meat, vegetable, oil, and fruit’ pattern statistically significantly contributed to the high K intake in men (p = 0.04), but not in women (p = 0.26). The ‘Vegetable, non-oil, and milk’ pattern in men and ‘Meat, vegetable, and fruit’ pattern in women were associated with low Na:K ratios (p = 0.03 and 0.01, respectively). Neither ‘bread’ nor ‘fish’ appeared as a major determinant of any dietary patterns in this population. The ‘Noodle, oil, and salty sea products’ pattern should be avoided to reduce sodium intake.     

Dietary Patterns and Birth Weight—a Review

Being born with low birth weight (LBW) is recognized as a disadvantage due to risk of early growth retardation, fast catch up growth, infectious disease, developmental delay, and death during infancy and childhood, as well as development of obesity and non-communicable diseases (NCDs) later in life. LBW is an indicator of fetal response to a limiting intrauterine environment, which may imply developmental changes in organs and tissue. Numerous studies have explored the effect of maternal intake of various nutrients and specific food items on birth weight (BW). Taking into account that people have diets consisting of many different food items, extraction of dietary patterns has emerged as a common way to describe diets and explore the effects on health outcomes. The present article aims to review studies investigating the associations between dietary patterns derived from a posteriori analysis and BW, or being small for gestational age (SGA). A PubMed search was conducted with the Mesh terms “pregnancy” OR “fetal growth retardation” OR “fetal development” OR “infant, small for gestational age” OR “birth weight” OR “infant, birth weight, low” AND “diet” OR “food habits”. Final number of articles included was seven, all which assessed diet by use of food frequency questionnaire (FFQ). Five studies explored dietary patterns using principal component analyses (PCA), while one study used cluster analyses and one study logistic regression. The studies reported between one and seven dietary patterns. Those patterns positively associated with BW were labeled “nutrient dense”, “protein rich”, “health conscious”, and “Mediterranean”. Those negatively associated with BW were labeled “Western”, “processed”, “vegetarian”, “transitional”, and “wheat products”. The dietary patterns “Western” and “wheat products” were also associated with higher risk of SGA babies, whereas a “traditional” pattern in New Zealand was inversely associated with having a SGA baby. The dietary patterns associated with higher BW or lower risk of having babies born SGA were named differently, but had similar characteristics across studies, most importantly high intakes of fruits, vegetables and dairy foods. Dietary patterns associated with lower BW or higher risk for giving birth to a SGA baby were characterized by high intakes of processed and high fat meat products, sugar, confectionaries, sweets, soft drinks, and unspecified or refined grains. All studies in this review were performed in high-income countries. More research is warranted to explore such associations in low and middle income countries, where underweight babies are a major health challenge many places. Furthermore, results from studies on associations between diet and BW need to be translated into practical advice for pregnant women, especially women at high risk of giving birth to babies with LBW.     

Deprivation Index and Lifestyle: Baseline Cross-Sectional Analysis of the PREDIMED-Plus Catalonia Study

This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 [95% CI 1.06–1.89]; p-value < 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.     

Modifiable Determinants of Postpartum Weight Loss in Women with Obesity: A Secondary Analysis of the UPBEAT Trial

Pregnancy can alter a woman’s weight gain trajectory across the life course and contribute to the development of obesity through retention of weight gained during pregnancy. This study aimed to identify modifiable determinants associated with postpartum weight retention (PPWR; calculated by the difference in pre-pregnancy and 6 month postpartum weight) in 667 women with obesity from the UPBEAT study. We examined the relationship between PPWR and reported glycaemic load, energy intake, and smoking status in pregnancy, excessive gestational weight gain (GWG), mode of delivery, self-reported postpartum physical activity (low, moderate, and high), and mode of infant feeding (breast, formula, and mixed). At the 6 month visit, 48% (n = 320) of women were at or above pre-pregnancy weight. Overall, PPWR was negative (−0.06 kg (−42.0, 40.4)). Breastfeeding for ≥4 months, moderate or high levels of physical activity, and GWG ≤9 kg were associated with negative PPWR. These three determinants were combined to provide a modifiable factor score (range 0–3); for each added variable, a further reduction in PPWR of 3.0 kg (95% confidence interval 3.76, 2.25) occurred compared to women with no modifiable factors. This study identified three additive determinants of PPWR loss. These provide modifiable targets during pregnancy and the postnatal period to enable women with obesity to return to their pre-pregnancy weight.     

The Association between Major Dietary Pattern and Low Muscle Mass in Korean Middle-Aged and Elderly Populations: Based on the Korea National Health and Nutrition Examination Survey

Reduced skeletal muscle mass in older populations is independently associated with functional impairment and disability, resulting in increased risk of mortality and various comorbidities. This study aimed to examine the association between major dietary pattern and low muscle mass among Korean middle-aged and elderly populations. A total of 8136 participants aged ≥50 years were included from a cross-sectional study based on the 2008–2011 Korea National Health and Nutrition Examination Survey. The following four distinct dietary patterns were derived using factor analysis: “Condiment, vegetables, and meats”; “wheat flour, bread, fruits, milk, and dairy products”; “white rice, fish, and seaweeds”; and “whole grain, bean products, and kimchi”. A higher “white rice, fish, and seaweeds” pattern score was associated with a lower prevalence of low muscle mass in both men and women, whereas a higher “condiment, vegetables, and meats” pattern score was associated with a higher prevalence of low muscle mass in men. A dietary pattern based on white rice, fish, and seaweeds can be helpful in protecting against loss of skeletal muscle mass in Korean middle-aged and elderly populations. Future research is paramount to confirm the causal association between dietary pattern and the risk of low muscle mass.     

Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study

Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged ≥ 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I) and the Mediterranean Diet Score (MDS) was assessed. Factor analysis identified three a posteriori dietary patterns, namely “vegetables-fruits”, “snacks-drinks-milk products”, and “meat-fish”. Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1%) incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex- and age-adjusted model (odds ratio (OR) (95% confidence interval (CI)): 0.59 (0.42–0.85), p = 0.004). The association attenuated in the multivariate adjusted model (0.69 (0.47–1.02), p = 0.056). No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.     

Are Dietary Patterns of Mothers during Pregnancy Related to Children's Weight Status? Evidence from the Lifeways Cross- Generational Cohort Study

Children''s diet patterns are likely to be influenced by their mothers'' diet pattern. The primary objective of this study was to examine whether children''s adiposity could be influenced by diet patterns of mothers during pregnancy. A secondary objective was to study the relative influence of fathers'' and children''s dietary patterns on childhood adiposity. The design was a prospective cross-generational cohort study initiated with 1,124 mothers recruited during pregnancy. Self-reported questionnaires included a food frequency instrument (FFQ) to assess parental intakes during the perinatal period. Child body mass index (BMI) was measured at 5 years and an age-appropriate FFQ was administered. Dietary patterns for each group were identified by principal components analysis. Pearson''s correlation and logistic regression were used to test for associations. Dietary patterns were described for n = 1,042 mothers during pregnancy and n = 331 fathers during the perinatal period. Dietary patterns and BMI data were available for n = 443 children at age 5 years. The diet patterns identified for mothers correlated with the corresponding diet patterns for fathers. The children''s “pasta & vegetable” pattern was positively correlated with “healthy patterns” in mothers (r = 0.195, p < 0.01) and fathers (r = 0.250, p < 0.01). The children''s “junk” food pattern was correlated with the “processed” pattern in mothers (r = 0.245, p < 0.01) and fathers (r = 0.257, p < 0.01). In multivariate logistic regression analysis the upper tertiles of children''s “cereal and juice” [Tertile 2 (T2): OR 0.44, 95% CI (0.22–0.90); T3: 0.41, (0.19–0.85)] and the middle tertile of the “pasta and veg” patterns [T3: 0.37, (0.18–0.75)] were negatively associated with overweight and obesity. The mothers'' processed pattern during pregnancy was positively associated with offspring overweight and obesity [T2: 2.64, (1.28–5.45); T3: 2.03, (0.87–4.73)]. No significant associations were observed for the paternal diet patterns. This analysis shows that the influence of maternal diet pattern on child obesity is apparent early in the lifecourse.     

The Reproducibility and Relative Validity of a Food Frequency Questionnaire for Identifying Iron-Related Dietary Patterns in Pregnant Women

Analyzing pregnant women’s iron intake using dietary patterns would provide information that considers dietary relationships with other nutrients and their sources. The objective of this study was to evaluate the reproducibility and relative validity of a Qualitative Food Frequency Questionnaire to identify iron-related dietary patterns (FeP-FFQ) among Mexican pregnant women. A convenience sample of pregnant women (n = 110) completed two FeP-FFQ (FeP-FFQ1 and FeP-FFQ2) and a 3-day diet record (3DDR). Foods appearing in the 3DDR were classified into the same food groupings as the FeP-FFQ, and most consumed foods were identified. Exploratory factor analysis was used to determine dietary patterns. Scores were compared (FeP-FFQ for reproducibility and FeP-FFQ1 vs. 3DDR for validity) through intraclass correlation coefficients (ICC), cross-classification, Bland–Altman analysis, and weighed Cohen kappa (κw), using dietary patterns scores tertiles. Two dietary patterns were identified: “healthy” and “processed foods and dairy”. ICCs (p < 0.01) for “healthy” pattern and “processed foods and dairy” pattern were 0.76 for and 0.71 for reproducibility, and 0.36 and 0.37 for validity, respectively. Cross-classification and Bland–Altman analysis showed good agreement for reproducibility and validity; κw values showed moderate agreement for reproducibility and low agreement for validity. In conclusion, the FeP-FFQ showed good indicators of reproducibility and validity to identify dietary patterns related to iron intake among pregnant women.     

The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45–18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.     

Dietary Pattern and Dietary Energy from Fat Associated with Sarcopenia in Community-Dwelling Older Chinese People: A Cross-Sectional Study in Three Regions of China

Associations between dietary patterns (DPs) and sarcopenia remain controversial, and fewer studies have mentioned the relationship between dietary energy composition and sarcopenia. The present cross-sectional study was conducted in three regions of China, to detect the associations between DPs and sarcopenia, and to identify the influencing nutrients. Exploratory factor analysis was conducted for DP identification. Logistic regressions were performed to explore the associations between DPs and sarcopenia. Dietary nutrients and dietary energy composition were calculated and compared among different DPs. Three DPs were identified from 861 community-dwelling older people. The “mushrooms–fruits–milk” pattern was negatively associated with sarcopenia (OR = 0.33, 95% CI = 0.14~0.77, p-trend = 0.009). Subjects in the highest quartile of the “mushrooms–fruits–milk” pattern showed more abundant intake (1.7 g/kg/d) of dietary protein, and lower percentage (31%) of energy from fat (PEF) than the other two DPs. Further analyses indicated that lower PEF (<30%) was negatively associated with sarcopenia. In conclusion, the “mushrooms–fruits–milk” pattern was negatively associated with sarcopenia in community-dwelling older Chinese people. This pattern showed abundant protein intake and low PEF, which may partially contribute to its protective effect on sarcopenia. Therefore, besides protein, dietary fat and PEF may also be considered in the prevention and management of sarcopenia.     

Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake

Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley’s (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score <−2) within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were “Modern” and “High-animal products”. After controlling for confounding factors, children in the highest quartile of the “High-animal products” dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21–1.04) than those in the lowest quartile. Given that the “High-animal products” dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia.