The 7-day Beverage Intake Questionnaire for Latino Children: Validation of a Culturally Tailored Tool

ObjectiveTo validate a culturally tailored 7-day beverage intake questionnaire for Latino children (BIQ-L).DesignCross-sectional.SettingFederally qualified health center in San Francisco, CA.ParticipantsLatino parents and their children aged 1–5 years (n = 105).Variables MeasuredParents completed the BIQ-L for each child and three 24-hour dietary recalls. Participants’ height and weight were measured.AnalysisCorrelations between the mean intake of beverages in 4 categories as determined by the BIQ-L and three 24-hour dietary recalls were assessed. Multivariable linear regression examined the association between sugar-sweetened beverages (SSB) servings as determined by the BIQ-L and child body mass index z-score.ResultsMean daily intake of SSB (r = 0.52, P < 0.001), 100% fruit juice (r = 0.45, P < 0.001), flavored milk (r = 0.7, P < 0.001), and unflavored milk (r = 0.7, P < 0.001) from the BIQ-L were correlated with intake assessed via three 24-hour dietary recalls. In the multivariable model, weekly servings of SSBs were associated with child body mass index z-score (β = 0.15, P = 0.02). Culturally specific beverages comprised 38% of the SSB intake reported on the BIQ-L.Conclusions and ImplicationsThe BIQ-L is a valid tool for assessing beverage intake among Latino children aged 1–5 years. The inclusion of culturally specific beverages is critical for accurately assessing beverage intake among Latino children.     

Consumption of Dried Fruits Is Associated with Greater Intakes of Underconsumed Nutrients,Higher Total Energy Intakes,and Better Diet Quality in US Adults: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2007-2016

BackgroundDried fruits are shelf-stable alternatives to fresh fruit that avert common barriers to consuming fruit. Consumption of dried fruits may facilitate greater fruit consumption and contribute to better diet quality and nutrient intakes.ObjectiveOur aims were to assess differences in diet quality and cardiometabolic health between dried fruit consumers and nonconsumers, and evaluate differences in nutrient intakes on days when dried fruits were consumed vs not consumed.DesignThis is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2007-2016.Participants/settingMean dried fruit intakes were estimated in adults 20 years and older (n = 25,590) who completed a dietary recall. Dried fruit consumers (one-quarter cup-equivalent/day or more) were defined in respondents with 2 complete dietary recalls (n = 22,311). Within-person differences in nutrient intakes were assessed in respondents who consumed dried fruit on 1 of 2 dietary recalls (n = 1,233).Main outcome measuresCardiometabolic risk factors, diet quality scored using the Healthy Eating Index 2015, and nutrient intakes were assessed.Statistical analysesDiet quality and cardiometabolic health were compared in consumers vs nonconsumers using multivariate linear regression, adjusted for demographic and lifestyle factors. Within-person differences in nutrient intakes on days when dried fruits were consumed vs not were assessed using multivariate linear regression.ResultsMean ± standard error dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented 3.7% of total fruit consumed. Consumers (7.2% of adults) had higher quality diets than nonconsumers (mean ± standard error Healthy Eating Index 2015 score = 60.6 ± 0.5 vs 52.6 ± 0.3; P < 0.001) and lower mean body mass index, waist circumference, and systolic blood pressure (P < 0.01). Total carbohydrate, dietary fiber, potassium, and polyunsaturated fat intakes were greater on days when dried fruits were consumed vs not consumed (P < 0.001). Total calorie intakes were also greater (208-215 kcal; P ≤ 0.002) when dried fruits were consumed.ConclusionsDried fruit consumption is associated with higher diet quality and greater intakes of underconsumed nutrients. However, dried fruits do not appear to displace other calorie sources on days when consumed.     

Reliability and Validity of Digital Imaging as a Measure of Schoolchildren's Fruit and Vegetable Consumption

BackgroundAs more and more interventions aim to increase schoolchildren's fruit and vegetable (FV) consumption, less resource-intensive yet valid alternatives to weighed plate waste (WPW) are needed for assessing dietary intake.ObjectivesWe aimed to test the reliability and validity of digital imaging (DI) and digital imaging with observation (DI+O) in assessing children's FV consumption during school lunch.DesignFV consumption (in grams) was assessed on lunch trays from third- to fifth-grade children over eight visits (31 to 68 trays collected per visit) to compare WPW with DI and DI+O.SettingTwo elementary schools (327 and 631 students enrolled, respectively).Main outcome measuresInterobserver reliability of DI. Validity of DI and DI+O compared against WPW.Statistical analysesReliability was assessed by percent agreement and intraclass correlation coefficients (ICCs). Validity was assessed by Pearson correlations, paired t tests, and Bland-Altman plots.ResultsReliability was acceptable for DI; percent agreement was 96% and the ICC was 0.92. FV consumption assessments by DI and WPW (n=159) were highly correlated (r=0.96; P<0.001). Mean FV consumption using DI (96.7 g) was within 1.0 g of WPW and not significantly different from WPW (P=0.56), and Bland-Altman limits of agreement for individual-tray FV consumption were –32.9 to 31.3 g. FV consumption assessments by DI+O and WPW were highly correlated (r=0.98; P<0.001). Mean FV consumption using DI+O (99.3 g) was within 1.0 g of WPW and not significantly different from WPW (P=0.38), and limits of agreement for individual-tray FV consumption were –25.0 to 26.8 g.ConclusionsDI was reliable for assessing children's FV consumption during school lunch. DI and DI+O were valid for assessing mean consumption but less precise for estimating individual-tray consumption. Valid estimations of mean FV consumption were achieved using DI without cafeteria observations, thereby reducing labor and time. Thus, DI is especially promising for assessing children's mean FV consumption during school lunch.     

Sexual Minority College Undergraduate Students Have Worse Health-Related Quality of Life,Diet Quality,and Weight Dissatisfaction Than Their Heterosexual Peers

ObjectiveAssess the health-related quality of life (HRQOL), diet quality (DQ), and weight dissatisfaction in sexual minority (SM) undergraduates.MethodsUndergraduates (n = 690) at 2 universities completed a survey assessing HRQOL, body mass index, DQ, and weight dissatisfaction. A multivariate analysis of covariance assessed HRQOL between SM and heterosexual students. Chi-square tests and independent t tests measured weight dissatisfaction and DQ. P < 0.05 was considered statistically significant.ResultsSignificant differences in HRQOL were observed (F[6,584] = 8.89; P < 0.001; Wilk's Λ = 0.916; partial η² = 0.084). Sexual minority students experienced more days per month feeling sad/blue/depressed (12.0 ± 9.7 vs 6.3 ± 7.8 days; P < 0.001) and worried/tense/anxious (18.1 ± 10.2 vs 10.9 ± 9.8 days; P < 0.001); and fewer days feeling healthy and full of energy (6.8 ± 6.5 vs 11.4 ± 8.7 days; P < 0.001). Sexual minority students consumed more sugar (14.4 ± 7.9 g vs 10.2 ± 7.1 g; P = 0.020), had higher body mass indexes (25.8 ± 6.1 vs 24.4 ± 4.8; P = 0.005), and were less satisfied with their weight (30.7% vs 44.0%; P = 0.001).Conclusions and ImplicationsSexual minority undergraduates experience similar health disparities as other SM populations and have indicators of poorer DQ.     

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.     

Soda Consumption during Ad Libitum Food Intake Predicts Weight Change

Soda consumption may contribute to weight gain over time. Objective data were used to determine whether soda consumption predicts weight gain or changes in glucose regulation over time. Subjects without diabetes (128 men, 75 women; mean age 34.3±8.9 years; mean body mass index 32.5±7.4; mean percentage body fat 31.6%±8.6%) self-selected their food from an ad libitum vending machine system for 3 days. Mean daily energy intake was calculated from food weight. Energy consumed from soda was recorded as were food choices that were low in fat (<20% of calories from fat) or high in simple sugars (>30%). Food choices were expressed as percentage of daily energy intake. A subset of 85 subjects had measurement of follow-up weights and oral glucose tolerance (57 men, 28 women; mean follow-up time=2.5±2.1 years, range 6 months to 9.9 years). Energy consumed from soda was negatively related to age (r=−0.27, P=0.0001) and choosing low-fat foods (r=-0.35, P<0.0001), but positively associated with choosing solid foods high in simple sugars (r=0.45, P<0.0001) and overall average daily energy intake (r=0.46, P<0.0001). Energy intake from food alone did not differ between individuals who did and did not consume beverage calories (P=0.11). Total daily energy intake had no relationship with change in weight (P=0.29) or change in glucose regulation (P=0.38) over time. However, energy consumed from soda correlated with change in weight (r=0.21, P=0.04). This relationship was unchanged after adjusting for follow-up time and initial weight. Soda consumption is a marker for excess energy consumption and is associated with weight gain.     

Subtypes and Severity of Irritable Bowel Syndrome Are Not Related to Patients’ Self-Reported Dietary Triggers: Results From an Online Survey in Dutch Adults

BackgroundDiet plays an important role in symptom management of irritable bowel syndrome (IBS). However, current diet therapies are not optimal nor successful for everyone.ObjectiveTo investigate whether subgroups based on IBS subtypes or severity identify different self-reported dietary triggers, and whether these are associated with severity and psychological factors.DesignOnline cross-sectional surveyParticipantsPatients with IBS (n = 1601) who fulfilled the Rome IV criteria or had an IBS diagnosis.Main outcomesSelf-reported response to 44 preselected dietary triggers, IBS quality of life, and anxiety and depression. Subgroups were based on subtypes or severity.Statistical analysisResponse to dietary triggers was analyzed using multiple correspondence analysis. Moreover, a food score was calculated to quantify the number and severity of responses to dietary triggers.ResultsResponse to greasy foods, onions, cabbage, and spicy and fried foods were mentioned most often (ranging between 55% and 65%). Response to dietary triggers differed between subtypes and severity groups, but absolute differences were small. Multiple correspondence analysis did not reveal clustering between dietary triggers, and ellipses for the subtypes overlapped. Some clustering was seen when ellipses were drawn for severity, which indicates that severity explained a fraction of the variation in response to dietary triggers, and subtypes did not. The food score was not significantly different between subtypes but was significantly higher with higher levels of severity (mild = 20.9 ± 17, moderate = 29.2 ± 19, severe = 37.9 ± 20, P < .001), having depressive (no = 31.4 ± 20, yes = 37.4 ± 20, P < .001) or anxious symptoms (no = 30.7 ± 20, yes = 35.2 ± 20, P < .001), and lower quality of life (lower quality of life = 38.5 ± 19, higher quality of life = 26.5 ± 19, P < .001).ConclusionPatients with different IBS subtypes or IBS severity do not identify different self-reported dietary triggers. Patients with more severe IBS and who experience anxiety or depression tend to have severe responses to more dietary triggers. IBS severity seems a better classifier than Rome IV criteria regarding diet. Dietary treatment needs to be individualized under guidance of a dietitian.     

Les taux sériques des lipides,de l’insuline,de la leptine et de la résistine chez des enfants tunisiens obèses et non obèses

BackgroundObesity in children is a public health problem around the world. Its pathogenesis is not yet elucidated. The fatty tissue, a long time considered as a structure of storage, is now recognized as an endocrine structure, secreting adipokines which would participate in the genesis of obesity. The correlation between the leptin and obesity is largely known. On the other hand, the role of the resistin and its implication in the comorbidities of obesity, inter alia the insulinoresistance, remain a controversial subject.ObjectivesThe main objective of our study is to compare the serum concentrations of glucose, lipidic parameters, resistin, leptin and insulin between two samples of obese and non-obese children, and to search correlations between resistin on the one hand and leptin, insulin, BMI, age and sex on the other hand.ResultsWe note that 92 obese children and 72 non-obese children aged between 6 to 10 years old were included in the study. Serum levels of leptin, insulin and resistin were significantly higher in the obese sample. Among obese children, resistin was correlated significantly with BMI (r = 0.798; P < 0.001), leptin (r = 0.635; P < 0.001) and insulin (r = 0.760; P < 0.001). Among non-obese, resistin was significantly correlated with BMI (r = 0.686; P < 0.001), leptin (r = 0.329; P < 0.001) and insulin (r = 0.844; P < 0.01). We did not find any significant correlation between either resistin and age or lipidic parameters neither in the first group nor in the second. In multivariate analysis, resistin did not appear to be related directly with obesity, only leptin was related with this status.ConclusionOur results prove that resistin is correlated with BMI. However, it is not related directly to obesity. Its action seems to be modulated and controlled by leptin.     

Correlates of sleep disturbance in Veterans with traumatic brain injury and chronic pain: A cross-sectional study

BackgroundFew studies have investigated sleep in Veterans with comorbid traumatic brain injury (TBI) and chronic pain.ObjectiveTo describe mood and cognitive correlates with sleep disturbance in a sample of Veterans with both TBI and chronic pain.Research methodCross-sectional, correlational analyses were completed using baseline data from a randomized controlled trial comparing psychosocial treatments for pain in Veterans with TBI. Enrollment occurred between July 2015 and January 2017. Self-report measures of hours slept, insomnia severity, depression and PTSD symptoms were collected along with a brief neuropsychological assessment.ResultsParticipants (n = 221) were an average age of 37.2 years (SD = 8.2) and mostly male (89%). Participants reported sleeping an average of 4.9 h a night (SD = 1.4) with an average Insomnia Severity Index (ISI) score of 17.4 (SD = 5.4) suggesting moderate insomnia symptoms. Fewer hours slept was associated with higher depression scores (r = ?0.28, p < 0.001) and slower processing speed (r = 0.23, p < 0.001). Increasing insomnia severity was associated with greater depression (r = 0.57, p < 0.001) and PTSD symptoms (r = 0.44, p < 0.001), and slower processing speed (r = ?0.22, p < 0.001).ConclusionsThe average ISI score was above the clinical cut off for insomnia diagnosis. Results suggest that those with more severe insomnia symptoms report higher depression and PTSD symptoms as well as exhibit slower processing speed. Improving sleep in this population may be important for improving outcome following TBI.     

Élaboration et qualités psychométriques d’une échelle de bien-être au travail. Étude SERENAT auprès de salariés vus en médecine du travail

BackgroundWell-being at work is nowadays a major public health challenge. It includes, among others, absence of psychological (anxio-depressive) symptoms, perceived positive work conditions (environment and organization), happiness and good quality of life at work. Many studies have shown that social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for anxiety and depression. There is currently no global indicator to measure both the state of mental health and social working conditions. The main objective of this work is to construct and explore the psychometric properties of scale of well-being at work called “Serenat” in order to validate it.MethodsThe Serenat Scale is a self-report questionnaire composed of 20 items. All items are scored on a four-point Likert scale ranging from 0 (strongly disagree) to 3 (strongly agree) resulting in a range of 0 to 60. It was constructed from data collected from the literature and from consultations in an Occupational Health Unit. From January 2014 to May 2017 193 subjects who have consulted an occupational doctor are included in this cross sectional survey. Validation included item quality and data structure diagnosis, internal consistency, intraobserver reliability evaluation and external consistency.ResultsThe Serenat scale showed very good item quality, with a maximal non-response rate of 0.01 % per item, and no floor effect. Factor analysis concluded that the scale can be considered unidimensional. Cronbach's alpha of internal consistency was 0.89. The intraclass correlation coefficient for intraobserver reliability was 0.89. Serenat scale was correlated with HADS (r = −0.54; P < 0.001), STAI-Y (r = −0.78; P < 0.001) and BDI-13 (r = −0.57; P < 0.001).ConclusionSerenat's well-being at work scale shows good psychometric properties for final validation. It could be useful to occupational physicians for individual and collective screening.Trial RegistrationClinicalTrials.gov ID: NCT02905071.     

Food Insecurity and Dietary Intake among College Students with Unlimited Meal Plans at a Large,Midwestern University

BackgroundFood insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown.ObjectivesThis study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university.DesignThe study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention.Participants/settingThe sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018.Main outcome measuresFood security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15.Statistical analyses performedGeneralized linear regression models were used to examine differences in dietary intake by students’ food security status, adjusting for students’ sociodemographic characteristics.ResultsIn the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001).ConclusionsDespite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.     

Taste sensitivity to 6-n-propylthiouracil is associated with endocannabinoid plasma levels in normal-weight individuals

ObjectiveA decreased sensitivity to 6-n-propylthiouracil (PROP) has been shown to be associated with increased energy intake and therefore an increased body mass index, although other studies have not confirmed this association, suggesting the involvement of other factors. We investigated whether the endocannabinoid system, which also modulates hunger/satiety and energy balance, plays a role in modulating eating behavior influenced by a sensitivity to PROP.MethodsThe plasma profile of the endocannabinoids 2-arachidonoylglycerol (2-AG), anandamide (AEA), and congeners of AEA, palmitoylethanolamide and oleylethanolamide (OEA), was determined in normal-weight PROP supertasters (STs) and PROP non-tasters (NTs). A cognitive eating behavior disorder was assessed by the Three-Factor Eating Questionnaire, which estimates dietary restraint, disinhibition, and perceived hunger.ResultsThe disinhibition score of NTs was higher than those of STs (P = 0.02). Moreover, in NTs, OEA was inversely correlated to the perceived hunger score (r = ?0.7, P = 0.002), and AEA was positively correlated to the restraint score (r = 0.5, P = 0.04) and negatively to the perceived hunger score, although the latter correlation was at the limit of statistical significance (r = ?0.47, P = 0.05). In addition, we found lower concentrations of AEA and 2-AG in the plasma of NT compared with ST subjects (AEA, P = 0.034; 2-AG, P = 0.003).ConclusionsOur data suggest that a higher disinhibition behavior in NTs may be compensated in part, in normal-weight subjects, by the decrease of peripheral endocannabinoids to downregulate the hunger–energy intake circuitry.     

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.     

Diet Quality of Frequent Fast-Food Consumers on a Non-Fast Food Intake Day Is Similar to a Day with Fast Food,What We Eat in America,NHANES 2013-2016

BackgroundFrequent fast food (FF) consumers may make more healthful food choices at eating occasions without FF. However, it is not clear if poor diet quality of frequent FF consumers is a function of FF consumption or less healthful food choices overall.ObjectiveThe objective of this study was to compare diet quality, energy, and nutrient intakes of infrequent FF consumers (INFREQ) with that of frequent FF consumers on an intake day with FF (FREQ-FF) or without FF (FREQ_NO FF).DesignThis study is a cross-sectional analysis of 1 day dietary intake data from What We Eat in America, National Health and Nutrition Examination Survey 2013-2016, the dietary intake component of National Health and Nutrition Examination Survey.Participants/settingParticipants included adults aged 20 years and older (N = 4,012), who, during the previous 7 days, reported no consumption of FF or pizza (n = 2,142 INFREQ) or reported FF or pizza three or more times and either had FF/pizza (n = 1,455 FREQ_FF) or did not have FF/pizza (n = 415 FREQ_NO FF) on the intake day.Main outcome measuresMain outcomes were energy, nutrient density (nutrient intake per 1,000 kcal), and diet quality evaluated using Healthy Eating Index (HEI) 2015.Statistical analyses performedGroup comparisons were made using t tests. Differences were considered significant at P < 0.001.ResultsCompared with INFREQ consumers, FREQ_FF consumers had higher intakes of energy and fat per 1,000 kcal, lower scores for total HEI and most components, and lower nutrient densities of most micronutrients (P < 0.001). HEI component scores of INFREQ consumers for vegetables, fruit, whole grains, and added sugars were higher than FREQ_FF consumers (P < 0.001). Energy intake, most nutrient densities, and total HEI and component scores of FREQ_NO FF consumers were not significantly different from FREQ_FF consumers with the exception of fruit but were different from INFREQ consumers for some nutrients and HEI components.ConclusionsResults suggest diet quality and nutrient intake of frequent FF consumers on a non-FF intake day is not markedly different from a day with FF.     

Healthy Eating Score–7 as a Measure of Diet Quality in a Military Population

ObjectiveIdentify potential revisions to the Healthy Eating Score (HES–5) that improve associations with the Healthy Eating Index (HEI) –2015 total and component scores.MethodsPearson r correlations were determined from soldiers’ (n = 433) survey data, including the HES, proposed additional questions, and the Block Food Frequency Questionnaire.ResultsAdding sugar-sweetened beverages and energy drink questions (HES–7) strengthened the HES and HEI–2015 correlation (HES–5; r = 0.42, n = 433, r² = 0.18, P < 0.001) (HES–7; r = 0.52, r² = 0.27, P < 0.001). The HES components and Block Food Frequency Questionnaire consumption correlations were as follows: quantity of fruit (r = 0.37, r² = 0.14, P < 0.001), vegetables (r = 0.41, r² = 0.17, P < 0.001), whole grains (r = 0.35, r² = 0.12 P < 0.001), dairy (r = 0.34, r² = 0.12, P < 0.001), fish (r = 0.31, r² = 0.10, P < 0.001), and energy drink (r = 0.59, r² = 0.35, P < 0.001).Conclusions and ImplicationsHES–7 had the strongest correlation with HEI–2015. Future studies can explore if including consumption quantity in the HES improves its representation of diet quality.     

Validity of a Competing Food Choice Construct Regarding Fruit and Vegetable Consumption among Urban College Freshmen

ObjectiveThis paper presents the reliability and validity of a “competing food choice” construct designed to assess whether factors related to consumption of less-healthful food were perceived to be barriers to fruit and vegetable consumption in college freshmen.DesignCross-sectional, self-administered survey.SettingAn urban public college with a large, diverse student population.ParticipantsA convenience sample of 408 college freshmen.Variables MeasuredA “competing food choice” construct and fruit and vegetable intake.AnalysesFactor analysis, Cronbach α, and correlation coefficients were used to determine the reliability and validity of the construct.ResultsThree factors were produced from the factor analysis of the 11-item competing food choice construct: “competitive food” barriers (Cronbach α = 0.73), fruit and vegetable–related “time” barriers (Cronbach α = 0.67), and “quality” barriers (Cronbach α = 0.64). Construct validity assessments revealed significant inverse correlations between fruit and vegetable consumption and competitive food barriers (r = -0.15, P < .01 current and r = -0.25, P < .01 prior) and time barriers (r = -0.12, P < .05 current and r = -0.10, P < .05 prior).Conclusions and ImplicationsThis “competing food choice” construct demonstrated satisfactory reliability and construct validity among college freshmen.     

Differences in the Associations between Body Dissatisfaction and Eating Outcomes by Gender? A Lebanese Population Study

BackgroundThe objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults.MethodsThis cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6 ± 11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale.ResultsBody dissatisfaction was positively correlated to restrained eating (r = 0.293, P < 0.001), emotional eating (r = 0.073, P = 0.042) and binge eating (r = 0.250, P < 0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta = 0.01, P < 0.001) and orthorexia nervosa (Beta = ?0.09, P < 0.001), but not with emotional (Beta = ?0.43, P = 0.103) and binge eating (Beta = ?0.08, P = 0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only.ConclusionThe interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.     

Food frequency questionnaire is a valid assessment tool of quercetin and kaempferol intake in Iranian breast cancer patients according to plasma biomarkers

In epidemiological and clinical studies, the most common nutritional tool to assess dietary flavonol intake is the food frequency questionnaire (FFQ), which needs to contain a detailed list of plant-based foods and be previously validated. Our study aimed to assess the accuracy of dietary flavonol (quercetin, kaempferol, and isorhamnetin) intake from a food frequency questionnaire (FFQ) compared to fasting plasma flavonol concentrations, as biomarkers of exposure, in breast cancer patients. In a consecutive case series, newly diagnosed patients with breast cancer (n = 140) were recruited at Nour-Nejat Hospital, Tabriz, Iran. Flavonol intake was assessed using a validated FFQ. Plasma flavonol concentrations were measured using high-performance liquid chromatography-ultraviolet detection. The accuracy of dietary status was evaluated using a receiver operating characteristic (ROC) and area under the ROC curve (AUC). Dietary status was shown in dichotomous using ROC-cutoff point. The plasma concentrations of quercetin were moderately correlated with dietary intake of quercetin (Spearman's correlation coefficient (r_s) = 0.188, P < .05; r_partial= 0.330, P < .01) and plasma concentrations of isorhamnetin (r_s = 0.337, P < .001). A linear correlation between dietary levels and plasma concentrations of kaempferol was attained (r_partial = 0.240, P < .05). Using a ROC-cutoff of 61.9 nmol/L for plasma quercetin (test reference), we were able to differentiate between lower and higher consumers of quercetin with an AUC_{ROC-based reference} =0.65 (P < .01, sensitivity = 61.8%, and specificity = 60.0%). Using a plasma kaempferol concentration of 60.1 nmol/L (ROC-cutoff), it was possible to detect significant differences between higher and lower intakes of kaempferol (AUC_{ROC-based reference} = 0.64, P < .05). The correlations and diagnostic performance with plasma concentrations could present a significant accuracy rate (validity), which seems acceptable for a nutritional questionnaire (FFQ) to assess intakes intake levels of quercetin and kaempferol. An improvement in the accuracy of the flavonol exposure can provide more precise relationship with health outcomes, which may increase their clinical significance.     

Adiposity is not beneficial to bone mineral density in 0–5 year old Chinese children: The Jiangsu bone health study

ObjectiveData on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD.Subjects and methodsThis was a large population-based multicenter study in which the representative children aged 0–5 years were recruited from 13 Children’s Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson’s correlation and further tested using partial correlation in the additive model.ResultsA total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r = 0.711, P < 0.001; r = 0.727, P < 0.001; r = −0.318, P < 0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2 kg, but started to gain slowlyand even decreased when the weight was over 21.2 kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P < 0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β = −47.45, 95%CI = −85.07, −9.83, P = 0.013).ConclusionsAdiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.