Relationships Among the Physical and Social Home Food Environments,Dietary Intake,and Diet Quality in Mothers and Children

BackgroundBoth the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together.ObjectiveThe purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children.DesignThis was a cross-sectional substudy of a larger study.Participants/settingThe study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018.Main outcome measuresThe outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score.Statistical analysisPearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses.ResultsIn mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = –0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother’s fruit intake.ConclusionsBoth the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.     

Dietary Quality and Usual Intake of Underconsumed Nutrients and Related Food Groups Differ by Food Security Status for Rural,Midwestern Food Pantry Clients

BackgroundFood pantry users represent a predominantly food insecure population, yet dietary intake may differ among food secure (FS), low FS, and very low FS clients. Usual intake of food groups and nutrients by food security status has not previously been compared among food pantry clients.ObjectiveThis study aimed to estimate the usual intakes of underconsumed nutrients (ie, potassium; dietary fiber; choline; magnesium; calcium; vitamins A, D, E, and C; and iron) and related food groups (ie, vegetables, fruits, whole grains, and dairy) and dietary quality, and to evaluate their relationship with food security status.DesignThis cross-sectional, secondary analysis used baseline data from a prior intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected.Participants/settingThis community-based study included a convenience sample of adult, midwestern food pantry clients (N=579) recruited from August to November 2014.Main outcome measuresMain outcomes evaluated were Healthy Eating Index-2010 scores and usual intakes of underconsumed nutrients and related food groups.Statistical analyses performedLinear regression models and the National Cancer Institute method, adjusting for confounders, were used to estimate associations of food security with diet quality and usual intake, respectively.ResultsBeing FS was associated with a higher whole grains HEI-2010 score and higher mean usual intake of whole grains compared with being low FS. Being FS was associated with higher usual intakes of iron and dairy compared with being very low FS. Being FS was associated with a higher mean usual intake of dark green vegetables compared with being low FS and very low FS. Usual intakes were below federal guidance for all subgroups of food security.ConclusionsAlthough food security status may differentiate dietary intake among food pantry clients, improvements are needed among all clients.     

The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake,Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies

Prospective cohort studies show that higher intakes of ultra-processed food (UPF) increase the risk of obesity and obesity-related outcomes, including cardiovascular disease, cancer and type 2 diabetes. Whether ultra-processing itself is detrimental, or whether UPFs just have a lower nutritional quality, is debated. Higher UPF intakes are inversely associated with fruit, vegetables, legumes and seafood consumption. Therefore, the association between UPFs and poor health could simply be from excess nutrient intake or from a less healthful dietary pattern. If so, adjustment for dietary quality or pattern should explain or greatly reduce the size of the significant associations between UPFs and health-related outcomes. Here, we provide an overview of the literature and by using a novel approach, review the relative impact of adjusting for diet quality/patterns on the reported associations between UPF intake and health-related outcomes in prospective cohort studies. We find that the majority of the associations between UPFs, obesity and health-related outcomes remain significant and unchanged in magnitude after adjustment for diet quality or pattern. Our findings suggest that the adverse consequences of UPFs are independent of dietary quality or pattern, questioning the utility of reformulation to mitigate against the obesity pandemic and wider negative health outcomes of UPFs.     

Consumption of Ultra-Processed Food and Its Association with Sociodemographic Characteristics and Diet Quality in a Representative Sample of French Adults

The present study aims to describe ultra-processed food (UPF) consumption in a representative sample of French adults and to evaluate the association between UPF consumption and socioeconomic characteristics and nutritional profile of the diet. This is a cross-sectional study using food consumption data from the Étude Nationale Nutrition Santé (ENNS), conducted with 2642 participants (18–74 years old), between February 2006 and March 2007 in France. Dietary data were collected through three 24-h dietary recalls. All food and beverages were classified according to the NOVA classification. The energy contribution of NOVA food groups to total energy intake was presented by categories of sociodemographic characteristics. Linear and logistic regression models were used to estimate the association between the percentage of UPF in the diet with nutritional indicators. The mean daily energy consumption of the adult French population was 2111 kcal, of which 31.1% came from UPF. This percentage was higher among younger individuals, and in the urban area, and lower among individuals with incomplete high school and individuals who were retired. The consumption of UPF was positively associated with the dietary energy density and the dietary contents of total carbohydrates, free sugar, and total and saturated fat, as well as with inadequate dietary energy density, saturated fat, free sugar, and fiber intakes.     

Monthly Variations in Dietary Intake of Women Participating in the Supplemental Nutrition Assistance Program

Background

Households participating in the Supplemental Nutrition Assistance Program (SNAP) have been shown to spend the majority of their program benefits within the first 3 days of receipt. Hence, it is important to investigate dietary intakes of SNAP participants based on time since receipt of benefits.

Ultra-Processed Food Intake and Associations With Demographic Factors in Young New Zealand Children

BackgroundChildren consume ultra-processed food (UPF) from a young age, but the proportional contribution of UPF to young children’s total energy intakes has not been evaluated in developed countries.ObjectivesTo describe UPF intake and associations with demographic factors in young children from 12 to 60 months of age.DesignCohort study comprising a secondary analysis of data from a randomized controlled trial. Demographic data were collected by questionnaire. At 12, 24, and 60 months of age validated food frequency questionnaires estimated percentage of energy intake from UPF (%kcal UPF).Participants/settingThe 669 children were born in Dunedin, New Zealand, between May 2009 and December 2010.Main outcome measuresMean percentage of energy intake from UPF at 12, 24, and 60 months of age, mean differences in %kcal UPF by demographic variables.Statistical analyses performedMixed effects regression models were used to estimate relationships between demographics and %kcal UPF. Multiple imputation methods were used to impute missing UPF data.ResultsUPF contributed mean (95% confidence interval) 45% (44%, 47%), 42% (41%, 44%), and 51% (50%, 52%) of energy intake to the diets of children at 12, 24, and 60 months of age, respectively. Energy intake from UPF was moderately correlated between 24 and 60 months (r = 0.36). No demographic factors were associated with mean %kcal UPF across time points, except for maternal obesity predicting higher UPF intake at 12 months. Bread, yoghurt, crackers, whole-wheat breakfast cereal, sausages, and muesli bars were among the 10 foods making the greatest contribution to mean %kcal UPF intakes at all time points.ConclusionsUPF contribute a substantial proportion of energy to the diets of young children. A range of foods with varying nutritional profiles contribute to these high intakes.     

海宁市农村居民膳食结构与营养素摄入情况分析

目的了解我市农村居民的膳食结构和制定与之相关的营养卫生政策。方法采用3日称重、24h膳食回顾和食物频率问卷相结合的膳食调查方法，由专业人员入户进行食品称重，问卷询问和记录。结果我市调查人群的膳食结构中存在着核黄素、钙、钾、镁、锌、硒、膳食纤维等营养素摄入量不足；钠等超过参考摄入量：蔬菜、水果、蛋、奶类和豆类的摄入偏低，油脂、盐等摄入过量等问题。结论应加强营养干预和膳食指南的健康教育，加快制定改善农村居民膳食结构和营养的相关政策，促进农村居民形成健康的饮食习惯，提高健康水平和生活质量。     

Associations Between Perceived Stress and Dietary Intake in Adults in Puerto Rico

BackgroundPsychological stress may influence health by negatively affecting dietary intake. However, there are few studies on the connection between stress and dietary intake in Puerto Rico (PR), a population with documented poor diet quality.ObjectiveTo explore the association between perceived stress and intake of macronutrients and diet quality among adults in PR.DesignCross-sectional data came from the Puerto Rico Assessment of Diet, Lifestyle, and Diseases study (2015).ParticipantsThis analysis included data from 238 adults (30-75 years old) in the San Juan metro area.Main outcome measuresDietary intake was measured with a food frequency questionnaire adapted and validated to the PR population. The Alternate Healthy Eating Index (AHEI) score was calculated to measure diet quality.Statistical analysesMultivariate linear models adjusted for sociodemographics, anthropometrics, behavioral factors, and social support were used to determine adjusted mean macronutrient intake and AHEI scores by perceived stress category.ResultsIn models adjusted for sociodemographic characteristics, high perceived stress was significantly associated with higher intake of total energy, added sugars, and saturated fats; lower intake of dietary fiber and vegetable protein; and lower AHEI score compared with low perceived stress (all P < .05). With further adjustment for lifestyle behaviors, central obesity, and social support, high perceived stress remained significantly associated with added sugars, saturated fats, and vegetable protein only.ConclusionsHigher perceived stress was associated with unhealthy dietary intake in adults residing in the San Juan area, PR. Future longitudinal studies with larger sample size are needed to build on these findings and to test the potential mediating and moderating roles of behavioral and social support factors in this population.     

超加工食品摄入与代谢综合征关系的研究进展

目的 分析超加工食品摄入与代谢综合征之间关系的流行病学证据.方法 检索中国知网、万方数据库、PubMed数据库和Web of Science核心合集数据库中截止至2020年6月10日有关超加工食品摄入与代谢综合征关系相关文献,并进行综述.结果 经检索共发现4篇关于超加工食品摄入与代谢综合征关系的流行病学研究,3篇研究结...     

Consumption of ultra-processed foods is associated with obesity,diabetes and hypertension in Canadian adults

ObjectiveTo assess the association between consumption of ultra-processed foods and obesity, diabetes, hypertension and heart disease in a nationally representative sample of Canadian adults.MethodsThis study used cross-sectional data from 13,608 adults (aged 19+ years) from the 2015 Canadian Community Health Survey–Nutrition. The survey provided data on food consumption (from 24-h recall) and prevalent obesity (BMI ≥ 30 kg/m²) and self-reported diabetes, hypertension and heart disease. All foods and drinks consumed were classified according to the extent and purpose of industrial processing using the NOVA classification. Ultra-processed food consumption was estimated as proportion of total daily energy intake. Multivariable logistic regression models assessed the association between ultra-processed food consumption and obesity, diabetes, hypertension and heart disease, adjusting for a range of socio-demographic and lifestyle factors.ResultsIn 2015, ultra-processed food contributed, on average, to 24% of total daily energy intake in the lowest tertile of ultra-processed food consumption and 73% in the highest tertile. Compared with those in the lowest tertile, adults in the highest tertile of ultra-processed food consumption had 31% higher odds of obesity (OR = 1.31, 95% CI: 1.06–1.60), 37% higher odds of diabetes (OR = 1.37, 95% CI: 1.01–1.85) and 60% higher odds of hypertension (OR = 1.60, 95% CI: 1.26–2.03), adjusting for a range of covariates.ConclusionHigher consumption of ultra-processed foods is associated with higher prevalence of obesity, diabetes and hypertension among Canadian adults. A comprehensive set of strategies and policies is needed to discourage consumption of ultra-processed foods in Canada and to make unprocessed or minimally processed foods more affordable, available and appealing.Electronic supplementary materialThe online version of this article (10.17269/s41997-020-00429-9) contains supplementary material, which is available to authorized users.     

Estimation of Intake of Critical Nutrients Associated with Noncommunicable Diseases According to the PAHO/WHO Criteria in the Diet of School-Age Children in Montevideo,Uruguay

Purpose: To estimate the effect of the consumption of products with an excessive amount of critical nutrients associated with NCDs, according to the PAHO Nutrient Profile Model on the quality of the diet of Uruguayan school-age children (4 to 12 years). Methods: A 24 h recall of food intake was conducted in a representative sample of 332 participants in the evaluation of the School Feeding Program in 2018 in public schools in Montevideo, Uruguay. Food and preparations were categorized according to the NOVA food classification, according to the nature, extent, and purposes of the industrial processes they undergo. Later, they were analyzed according to the Pan American Health Organization Nutrient Profile Model (PAHO NPM) to identify processed and ultra-processed products with an excessive content of critical nutrients. Results: Only 0.52% of children consumed exclusively natural foods, or culinary ingredients. Twenty-five per cent of children consumed ≥4 products categorized with an excessive content of free sugars, total fat, or saturated fat according to the PAHO NPM; in the case of excessive sodium, this was 40%. In general, children who included products with excessive free sugars, sodium, or saturated fat in their diet exceeded the limits established by the World Health Organization, and, as a result, their diet is of poorer nutritional quality compared to children who did not consume such products. Conclusion: Diets free of ultra-processed and processed products with excess free sugars, total fats, saturated fats, and sodium increased the chances of school-age children in Montevideo of meeting WHO nutrient intake recommendations. Meanwhile, intake of each additional gram of products with excessive critical nutrients according to PAHO NPM, significantly worsens diets, preventing children from meeting WHO recommendations.     

Consumer Awareness of the Degree of Industrial Food Processing and the Association with Healthiness—A Pilot Study

Consumption of ultraprocessed foods (UPFs) has been associated with lower diet quality, obesity, and adverse health effects. Not much is known about how consumers evaluate the degree of processing of a food product and how they relate this to healthiness. An online questionnaire was completed by a total of 277 Dutch, 204 Italian, and 181 Brazilian consumers. Consumers were aged 18–65 year, mean 38 ± 13 year, 31% were males, and 71% were highly educated. Pictures of several common food products were evaluated on the degree of industrial processing and healthiness. Thirteen food categories were included, each including one minimally processed food (MPF), one High NS_UPF (Nutri-Score A or B), and one Low NS_UPF (Nutri-Score D or E). Lastly, knowledge and attitude about UPFs were assessed. Ultraprocessing was perceived as unhealthy by the majority of consumers (Dutch, Italian: 55%; Brazilian: 75%) and contributed to weight gain according to: 38% Dutch, 51% Italian, and 70% Brazilian consumers. Low NS_UPFs were correctly rated toward “processed” and “not healthy” in all countries. High NS_UPF were rated as processed but showed large variations in healthiness scores. In conclusion, consumers rated UPFs relatively low in healthiness compared with MPFs with similar Nutri-Scores within the same food category. These preliminary findings suggest that consumers incorporate, to some extent, the degree of industrial processing while assessing the healthiness of food products.     

Associations Among Food Security,Diet Quality,and Dietary Intake During Pregnancy in a Predominantly African American Group of Women from North Carolina

BackgroundLow food security during pregnancy can negatively affect women’s physical and mental health. Although many women make a greater effort to eat a healthy diet during pregnancy, the influence of low food security during pregnancy on maternal diet is not well understood.ObjectiveThis study aimed to assess the association between adult food security and maternal diet during pregnancy in a sample from North Carolina.DesignThis was a cross-sectional, secondary data analysis of food security (marginal, low, and very low vs high) and maternal diet during pregnancy.Participants and settingThis study included 468 predominantly Black/African American women during pregnancy from the Nurture cohort, enrolled through prenatal clinics in central North Carolina between 2013 and 2016.Main outcome measureDiet quality was assessed using the Alternate Healthy Eating Index-Pregnancy and the Mediterranean Diet Score. Dietary intake from seven food groups included in the Alternate Healthy Eating Index-Pregnancy and/or Mediterranean Diet Score was assessed as well.Statistical analysis performedMultiple linear regression models were used to examine the association between food security and diet quality and dietary intake during pregnancy, adjusting for race/ethnicity; participation in the Special Supplemental Nutrition Program for Women, Infants, and Children; education; prepregnancy body mass index; age; parity; and mean daily energy intake.ResultsIn this study, there was no association between maternal food security status and diet quality during pregnancy. However, researchers observed an association between low and marginal food security and greater intake of red and processed meats (marginal: β = 2.20 [P = 0.03]; low: β = 2.28 [P = 0.04]), as well as an association between very low food security and decreased vegetable consumption (β = –.43; P = 0.03).ConclusionsVery low food security was associated with reduced vegetable intake. In addition, low and marginal food security were associated with greater red and processed meat intake. Future research should focus on nationally representative populations and include longitudinal assessments to allow for the study of the influence of food security on health during pregnancy.     

Changes in Food and Nutrient Intake and Diet Quality on a Low-Fat Vegan Diet Are Associated with Changes in Body Weight,Body Composition,and Insulin Sensitivity in Overweight Adults: A Randomized Clinical Trial

BackgroundConsuming different food groups and nutrients can have differential effects on body weight, body composition, and insulin sensitivity.ObjectiveThe aim was to identify how food group, nutrient intake, and diet quality change relative to usual-diet controls after 16 weeks on a low-fat vegan diet and what associations those changes have with changes in body weight, body composition, and measures of metabolic health.DesignSecondary analysis of a randomized clinical trial conducted between October 2016 and December 2018 in four replications.Participants/settingParticipants included in this analysis were 219 healthy, community-based adults in the Washington, DC, area, with a body mass index (BMI) between 28 and 40, who were randomly assigned to either follow a low-fat vegan diet or make no diet changes.InterventionA low-fat, vegan diet deriving approximately 10% of energy from fat, with weekly classes including dietary instruction, group discussion, and education on the health effects of plant-based nutrition. Control group participants continued their usual diets.Main outcome measuresChanges in food group intake, macronutrient and micronutrient intake, and dietary quality as measured by Alternate Healthy Eating Index-2010 (AHEI-2010), analyzed from 3-day diet records, and associations with changes in body weight, body composition, and insulin sensitivity were assessed.Statistical analyses performedA repeated-measure analysis of variance model that included the factors group, subject, and time was used to test the between-group differences throughout the 16-week study. Interaction between group and time was calculated for each variable. Within each diet group, paired comparison t tests were calculated to identify significant changes from baseline to 16 weeks. Spearman correlations were calculated for the relationship between changes in food group intake, nutrient intake, AHEI-2010 score, and changes in body weight, body composition, and insulin sensitivity. The relative contribution of food groups and nutrients to weight loss was evaluated using linear regression.ResultsFruit, vegetable, legume, meat alternative, and whole grain intake significantly increased in the vegan group. Intake of meat, fish, and poultry; dairy products; eggs; nuts and seeds; and added fats decreased. Decreased weight was most associated with increased intake of legumes (r = ?0.38; P < 0.0001) and decreased intake of total meat, fish, and poultry (r = +0.43; P < 0.0001). Those consuming a low-fat vegan diet also increased their intake of carbohydrates, fiber, and several micronutrients and decreased fat intake. Reduced fat intake was associated with reduced body weight (r = +0.15; P = 0.02) and, after adjustment for changes in BMI and energy intake, with reduced fat mass (r = +0.14; P = 0.04). The intervention group’s AHEI-2010 increased by 6.0 points on average, in contrast to no significant change in the control group (treatment effect, +7.2 [95% CI +3.7 to +10.7]; P < 0.001). Increase in AHEI-2010 correlated with reduction in body weight (r = 0.14; P = 0.04), fat mass (r = ?0.14; P = 0.03), and insulin resistance as measured by the Homeostasis Model Assessment (HOMA-IR; r = ?0.17; P = 0.02), after adjustment for changes in energy intake.ConclusionsWhen compared with participants’ usual diets, intake of plant foods increased, and consumption of animal foods, nuts and seeds, and added fats decreased on a low-fat vegan diet. Increased legume intake was the best single food group predictor of weight loss. Diet quality as measured by AHEI-2010 improved on the low-fat vegan diet, which was associated with improvements in weight and metabolic outcomes. These data suggest that increasing low-fat plant foods and minimizing high-fat and animal foods is associated with decreased body weight and fat loss, and that a low-fat vegan diet can improve measures of diet quality and metabolic health.     

Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort)

The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.     

Incorporating the Dietary Guidelines for Americans Vegetable Recommendations into the Diet Alters Dietary Intake Patterns of Other Foods and Improves Diet Quality in Adults with Overweight and Obesity

BackgroundUnderstanding how vegetables are incorporated into the diet, especially in the types and amounts recommended by the Dietary Guidelines for Americans, and how this alters dietary intake patterns is vital for developing targeted behavior change interventions.ObjectiveTo determine how a provision of vegetables was incorporated into the diet of adults with overweight and obesity; whether or not the provided vegetables displaced other foods; and what, if any, effect this had on diet quality and body weight and composition.DesignThis study investigated secondary outcomes from the Motivating Value of Vegetables Study, a community-based, randomized, parallel, nonblinded controlled trial. Participants were randomly assigned to a provided vegetable intervention or attention control group using a one to one allocation ratio.Participants/settingMen and women with self-reported low vegetable consumption, aged 18 to 65 years, with a body mass index ≥25 were recruited from Grand Forks, ND, between October 2015 and September 2017. Only participants randomized to the provided vegetable intervention group (n = 51; attrition = 8%) were included in this secondary analysis.InterventionDietary Guidelines for Americans recommended types and amounts of vegetables were provided weekly for 8 weeks.Main outcome measuresHow the provided vegetables were incorporated into the diet was measured using daily self-report and 24-hour dietary recalls. Diet quality was assessed via the Healthy Eating Index 2015. Body weight and composition were measured before and after the intervention.Statistical analyses performedData were assessed using generalized linear mixed models where phase (pre, post) was the within-subject factor and subject was the random effect.ResultsParticipants self-reported using 29% of the provided vegetables as substitutes for other foods. With the increase in vegetable consumption, there were decreases in total grains (mean difference ± standard deviation; –0.97 ± 3.23 oz-equivalents; P = 0.02), protein foods (–1.24 ± 3.86 oz-equivalents; P = 0.01), saturated fats (–6.44 ± 19.63 g; P = 0.02), and added sugars (–2.44 ± 6.78 tsp-equivalents; P = 0.02) consumed. Total Healthy Eating Index 2015 scores increased (+4.48 ± 9.63; P = 0.001) and dietary energy density decreased (–0.44 ± 0.52 kcal/g; P < 0.0001). There was no change in total energy intake or body weight and composition.ConclusionsIncreasing vegetable consumption to meet Dietary Guidelines for Americans recommendations alters dietary intake patterns, improving diet quality and energy density. These findings highlight the importance of characterizing how individuals incorporate Dietary Guidelines for Americans recommendations into their diet.     

Geographical and Temporal Variability of Ultra-Processed Food Consumption in the Spanish Population: Findings from the DRECE Study

The consumption of ultra-processed foods (UPFs) has increased in recent decades, worldwide. Evidence on the negative impacts of food processing on health outcomes has also been steadily increasing. The aim of this study is to describe changes in consumption patterns of ultra-processed foods in the Spanish population over time and their geographical variability. Data from four representative cohorts of the Spanish population were used (1991–1996–2004–2008). Dietary information was collected using a validated frequency questionnaire and categorized using the NOVA classification. A total increase of 10.8% in UPF consumption between 1991 and 2008 was found in Spain (p-value < 0.001). The products contributing most to UPF consumption were sugar-sweetened beverages, processed meats, dairy products, and sweets. Those who consumed more ultra-processed foods were younger (p-value < 0.001) and female (p-value = 0.01). Significant differences between the different geographical areas of Spain were found. The eastern part of Spain was the area with the lowest UPF consumption, whereas the north-western part was the area with the highest increase in UPF consumption. Given the negative effect that the consumption of ultra-processed foods has on health, it is necessary to implement public health policies to curb this increase in UPF consumption.     

Assessing the Public’s Comprehension of Dietary Guidelines: Use of MyPyramid or MyPlate Is Associated with Healthier Diets among US Adults

Background

The Dietary Guidelines for Americans (DGA) provide a framework for food and nutrition programming in the United States as well as the foundation for individualized dietary guidance. Public utilization of the DGA, specifically the MyPyramid or MyPlate tool, is not well studied.