Are Dietary Indices Associated with Polycystic Ovary Syndrome and Its Phenotypes? A Preliminary Study

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder which impairs ovarian function. The adherence to healthy dietary patterns and physical exercise are the first line of recommended treatment for PCOS patients, but it is yet unclear what type of diet is more adequate. In this case-control study, we explored associations between adherence to five dietary quality indices and the presence of PCOS. We enrolled 126 cases of PCOS and 159 controls living in Murcia (Spain). Diagnostic of PCOS and its phenotypes were established following the Rotterdam criteria (hyperandrogenism (H), oligoanovulation (O), polycystic ovaries morphology (POM)). We used a validated food frequency questionnaires to calculate the scores of five dietary indices: alternate Healthy Eating index (AHEI), AHEI-2010, relative Mediterranean Dietary Score (rMED), alternate Mediterranean Dietary Score (aMED) and Dietary Approaches to Stop Hypertension (DASH). We used multivariable logistic regression to estimate adjusted odds ratios and confidence intervals. In the multivariable analysis, AHEI-2010 index was inversely associated with Hyperandrogenism + Oligoanovulation PCOS phenotype (OR_Q3 vs. _Q1 = 0.1; 95% CI: (0.0; 0.9); P_{for trend} = 0.02). We did not find any statistical significant association between dietary indices and total anovulatory or ovulatory PCOS. However, further studies with higher sample sizes exploring these associations among the diverse phenotypes of PCOS are highly warranted.     

Overall Diet Quality and Age-Related Macular Degeneration

Purpose: To examine overall diet quality in relation to advanced age-related macular degeneration (AMD).

Methods: This case-control study identified 437 advanced AMD patients and 259 unrelated controls using stereoscopic color fundus photographs. Participants were predominantly non-Hispanic White men and women from North Carolina and Tennessee. A 97-item Block food frequency questionnaire was used to gather diet information, and overall diet quality was measured using the Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI).

Results: Participants in the highest quartile of diet quality had significantly reduced odds of AMD according to the AHEI score (0.54, 95% confidence interval 0.30–0.99) and non-significantly reduced odds of AMD according to the HEI (0.75, 0.41–1.38). Odds of AMD were also 51% lower in the highest quartile of fish intake compared to the lowest quartile (odds ratio = 0.49, 0.26–0.90).

Conclusions: We found that advanced AMD was significantly related to overall diet quality. The AHEI score may be a useful instrument for assessing AMD risk due to diet, and it could potentially be improved by incorporating more specific information regarding micronutrient intake.     

Psychosocial factors associated with diet quality in a working adult population

The associations between specific intra‐ and inter‐personal psychosocial factors and dietary patterns were explored in a healthy, working adult sample of university and health center employees (N = 640) who were enrolled in a prospective predictive health study. Participants had a mean age of 48 (SD = 11) years and were 67% women and 30% minority. Baseline psychosocial measures of perceived stress, depressive symptoms, social support, and family functioning were examined for their relationships with three diet quality indices—AHEI, DASH, and the Mediterranean. Dietary intake was of moderate quality in this high‐income, well‐educated, psychosocially healthy population. Social support was positively associated with better diet quality for all three indices (p < .01). Further research should focus on socio‐environmental factors associated with diet quality. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36:242–256, 2013     

Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

Background

Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke.

Methods

A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20–70 years recruited into the EPIC-NL study during 1993–1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk.

Results

After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk.

Conclusion

The HDI and the DHD-index were not associated with CVD risk, while the DASH diet was significantly associated with a lower risk of developing CVD, CHD and stroke.     

Influence of Lifestyle on Incident Cardiovascular Disease and Mortality in Patients With Diabetes Mellitus

Background

Evidence is limited regarding the impact of healthy lifestyle practices on the risk of subsequent cardiovascular events among patients with diabetes.

Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender,race, adult psychosocial risk and health behaviors

Objective

This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of “modifiable” risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity.

Materials/Methods

210 Black/African Americans and White/European Americans, mean age = 45.8; ± 3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist–hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise).

Results

Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI.

Conclusions

Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning.     

Diet Quality Is Associated with Higher Nutrient Intake and Self-Rated Health in Mid-Aged Women

Objective: To develop a diet quality score reflecting adherence to national dietary recommendations for the Australian Longitudinal Study on Women's Health (ALSWH) and to compare this against energy standardized nutrient intakes and indices of health.

Design: Cross-sectional survey in a nationally representative sample of mid-aged women participating in a cohort study.

Subjects: Data from 9,895 women aged 50–55 who participated in the 2001 survey and had four or less missing values on their food frequency questionnaires were used to calculate the Australian Recommended Food Score (ARFS) based on adherence to Australian Dietary Guidelines.

Measure of Outcome: Correlates of ARFS were investigated including, mean nutrient intakes and indices of self-rated health and health service use. Associations were examined using ANOVA for continuous variables and Chi-squared tests for categorical variables. Area of residence and educational attainment were used as covariates in all modeling, to adjust for sampling frame and socioeconomic status.

Results: The maximum ARFS was 74, with a mean of 33.0 ± 9.0 and 21% achieving a score > 40. Higher ARFS was associated with indicators of higher socio-economic status, better self-rated health and lower health service use, p<0.0001, higher intakes of micronutrients and lower percentage of energy as total or saturated fat, p<0.0001.

Conclusions: The Australian Recommended Food Score can be used to rank mid-aged women in terms of diet quality and nutrient intake and is associated with indices of self-rated health and health service use. The ARFS can be used to measure future associations with health outcomes and mortality.