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[Dietary patterns and its relation with overweight and obesity in Chilean girls of medium-high socioeconomic level].

The aim of the present study was to identify dietary patterns in girls and to assess their association with obesity or overweight. A school-based sample of 108 girls between 8 and 11 years of medium-high socioeconomic level was selected in Santiago, Chile. The body mass index was calculated and a quantified food frequency and physical activity questionnaires (validated in the FAO/MINEDUC/INTA Project Nutritional Education in primary schools) were applied. Four distinct dietary factors or patterns were obtained explaining 54% of the total variation using factorial analysis. The first factor was characterized by an energy-dense diet (high consumption of fat foods, ice creams, chocolates, French fries, snacks). The second factor represented a healthy diet (dairy products, fruits and salads). The third factor represented intake of soft drinks (either with or without sugar). The fourth factor represented a diet rich in calories and sugars (bread, sausages, sweets). The association between the four dietary factors and overweight/obesity was assessed through logistic regression models. The first factor, energy-dense foods, was the only one significantly associated with the presence of obesity (OR = 1.86; 95% CI: 1.12 - 3.09). The results of this research about dietary patterns are consistent with studies carried out in other countries.

Beverages↗

MedDietScore: a computer program that evaluates the adherence to the Mediterranean dietary pattern and its relation to cardiovascular disease risk.

Mediterranean dietary traditions have long been associated with lower mortality rates and better health status. The Mediterranean dietary pattern has become customary to be represented in the form of a pyramid, the base of which refers to foods which are suggested to be consumed most frequently and the top of the pyramid to those foods consumed rarely. Recently, an index (diet score) that estimates the adherence level to Mediterranean diet was developed and associated with cardiovascular disease risk and biomarkers. In this work we present a computer program that can easily calculate this diet score, as well as its association with cardiovascular disease risk. The application of this software to the general public might be a useful tool for the reduction of the disease burden related with nutritional habits at population level.

Biomarkers↗

Dietary patterns, gastrointestinal complaints, and nutrition knowledge of recreational triathletes.

Dietary habits, nutrition knowledge, and gastrointestinal complaints were evaluated in 21 female and 50 male triathletes; 30 completed hemoccult slides to determine the frequency of gastrointestinal bleeding. Triathletes trained 11 h/wk with weekly distances of 5.3, 116.5, and 40.9 km for swimming, biking, and running, respectively. Mean daily energy intake averaged 9058 and 11,591 kJ for women and men, respectively; 53.8% of the energy was from carbohydrates. Mean intakes of vitamins and most minerals exceeded the Recommended Dietary Allowances (RDAs), but many had intakes below RDAs for some nutrients; greater than 60% had low zinc and copper intakes. Because 39% took a daily multivitamin-mineral supplement, some had intakes 200-600% above the RDA. Although there were notable misconceptions about nutrition, nutrition knowledge was high. Upper-gastrointestinal complaints, reported by 50%, included bloating and abdominal gas; the incidence of positive hemoccult slides was 27%. The relation among performance, dietary patterns, nutrition knowledge, and gastrointestinal function remains to be established.

Adult↗

Food preferences and aversions and dietary pattern in anorexia nervosa patients.

Food intake, meal frequency and occurrence of vomiting and purging were assessed in 20 female patients with anorexia nervosa (AN) by two dietitians by means of a dietary history over the past month. Ten lean healthy women and 10 of normal weight served as two groups of controls. Two self-administered questionnaires, consisting of 51 questions each were developed and applied: one to get an insight into food preference and food aversion, another to evaluate the dietary pattern. A significant difference in energy intake was found between the patient group and both control groups, but not between the two control groups. Self-induced vomiting and weekly laxative use was only mentioned by the patients with AN. Between the patients and the controls significant differences were found in preference and aversion for several food products such as sugar, potatoes, meat, dates and bananas as well as in eating habits. Stepwise discriminant analysis of the data of the two questionnaires resulted in eight food items and three dietary pattern statements which specify group differences. It is concluded that the questionnaires used reveal important differences between anorexia patients and control subjects in attitudes towards foodstuffs, and can be a useful tool for early diagnosis when validated in larger samples of patients and controls.

Adolescent↗

A study of dietary patterns of elite Australian football players.

This report describes the dietary patterns of 56 elite Australian Rules football players. Data collected included an anthropometric profile, training information, and measurements of haemoglobin and blood lipids. Information on dietary practices, for training and game preparation, was collected by interview and food diary. Analysis of training diets showed a mean energy intake of 14.2 MJ/day (0.17 MJ/kg/day). Mean protein intake was 126 g/day (1.5 g/kg/day). The proportions of dietary energy contributed by the macronutrients were carbohydrate, 44%; fat, 37%; protein, 15%; and alcohol, 4%. Mean daily intake of selected vitamins and minerals from food sources was: retinol activity, 1439 mg; thiamin, 1.7 mg; riboflavin, 2.8 mg; niacin equivalents, 45.1 mg; vitamin C, 139 mg; iron, 19.6 mg; and calcium, 1016 mg. Carbohydrate intake was considered low, but overall intake of nutrients studied was adequate.

Adult↗

Application of a new statistical method to derive dietary patterns in nutritional epidemiology.

Because foods are consumed in combination, it is difficult in observational studies to separate the effects of single foods on the development of diseases. A possible way to examine the combined effect of food intakes is to derive dietary patterns by using appropriate statistical methods. The objective of this study was to apply a new statistical method, reduced rank regression (RRR), that is more flexible and powerful than the classic principal component analysis. RRR can be used efficiently in nutritional epidemiology by choosing disease-specific response variables and determining combinations of food intake that explain as much response variation as possible. The authors applied RRR to extract dietary patterns from 49 food groups, specifying four diabetes-related nutrients and nutrient ratios as responses. Data were derived from a nested German case-control study within the European Prospective Investigation into Cancer and Nutrition-Potsdam study consisting of 193 cases with incident type 2 diabetes identified until 2001 and 385 controls. The four factors extracted by RRR explained 93.1% of response variation, whereas the first four factors obtained by principal component analysis accounted for only 41.9%. In contrast to principal component analysis and other methods, the new RRR method extracted a significant risk factor for diabetes.

Alcohol Drinking↗

The impact of usual dietary patterns, selection of significant foods and cuisine choices on changing dietary fat under 'free living' conditions.

Dietary guidelines for the general population and for the management of obesity, diabetes and heart disease suggest a reduction in dietary fat, and in particular dietary saturated fatty acids (SFA). In order to achieve the recommended levels, changes in food choice patterns are required. Foods are consumed in combination with other foods, and these combinations are often recognizable as cuisine patterns. In this study we examined the food choice patterns of a group of 63 adults with existing type 2 diabetes mellitus who completed a 12 month dietary intervention trial aimed at changing dietary fat under 'free living' conditions. In both lower fat (LF, 27%) and modified fat (MF, 37%E) groups, a reduction in dietary SFA and an increase in polyunsaturated fat were required, with an additional requirement to increase dietary monounsaturated fat in the MF group. The usual diets of the study sample were on average low in total fat (27%E), but high in saturated fat (12%E). Those already consuming total fat at the level concordant with their allocation (LF or MF) achieved targets faster than those with a discordant allocation, but there was no significant effect of usual diet on time of target achievement at 12 months. At 6 months, those achieving dietary fat targets had changed to low fat dairy products and leaner meats, were having more spreads, oils, and nuts and were consuming takeaway meals less than twice a week. Contributions to dietary fat shifted from takeaway foods, meat, dairy products and cakes to spreads, oils and nuts. The modified fat and low fat groups chose more Mediterranean and South East Asian cuisines respectively. In this study sample, usual dietary patterns had an initial impact on change in the diet, but identifiable changes in food choice patterns and the adoption of certain cuisines that combined foods indicative of the dietary guidelines resulted in successful achievement of dietary fat targets.

Diet↗

Dietary patterns of elderly Boston-area residents defined by cluster analysis.

The dietary patterns of 680 noninstitutionalized, predominantly white, elderly volunteers from the Boston area (447 women and 233 men) were examined by cluster analysis of food contribution to energy intake. Data were derived from 3-day dietary records. The four major patterns identified corresponded to high consumption of (a) alcohol, (b) milk, cereals, and fruits, (c) bread and poultry, and (d) meat and potatoes. The resulting clusters of subjects differed significantly in gender, education, income, and frequency of smoking. Those with diets high in milk, cereals, and fruits had the highest intakes of micronutrients and the best hematologic profile. Those with high meat and potato intakes had the lowest intakes of micronutrients and lowest levels of plasma folate and vitamin B-6. High alcohol consumers had lowest blood levels of riboflavin and vitamin B-12 and highest levels of high-density-lipoprotein cholesterol. Those with high bread and poultry intakes had lowest reported energy intakes, but, paradoxically, they had the highest mean body mass index. Neither total serum cholesterol nor cholesterol intake varied significantly among groups. Our findings suggest that the nutritional status of the elderly may be improved by promoting food patterns rich in milk, fruit, and cereals and by counseling the elderly to limit consumption of alcohol and meats high in saturated fats.

Aged↗

High body mass index and dietary pattern are associated with childhood asthma.

The increasing prevalence of asthma has coincided with an increase of body mass index (BMI) in both children and adults. We investigated the relationship between BMI and the symptom prevalence of asthma and the possible influences of dietary pattern. This was a community-based, cross-sectional study of 24,260 school children aged 6-12 years. Prevalences of asthma and potential confounding factors were assessed using a Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire which was completed by parents. We analyzed the relationship between BMI and symptoms of asthma and the possible influences of dietary pattern. A significant positive association between high BMI and previous 12-month prevalence of wheeze remained in boys (adjusted odds ratio, 1.610; 95% confidence interval, 1.274-2.033) but not in girls. In addition, there were significant associations between high BMI and lifetime prevalence of wheeze, previous 12-month wheeze, exercise-induced wheeze, diagnosis, and treatment of asthma. There were significant associations between high BMI and previous 12-month wheeze regardless of breast-milk feeding or whole-milk feeding. Frequent intake of fresh seafood, fresh fruits, and vegetables was associated with reduced prevalence of current asthma symptoms and was also associated with decreased BMI. These results indicate that BMI may be an independent risk factor for the development of asthma symptoms in boys. Intake of fresh seafood, fresh fruit, and vegetables, which may be associated with decreased BMI, may contribute to protect against the development of asthma symptoms in Korean elementary schoolchildren.

Asthma↗

Effect of dietary patterns on serum homocysteine: results of a randomized, controlled feeding study.

BACKGROUND: Elevated blood levels of homocysteine are associated with an increased risk of atherosclerotic cardiovascular disease. Although numerous studies have assessed the impact of vitamin supplements on homocysteine, the effect of dietary patterns on homocysteine has not been well studied. METHODS AND RESULTS: During a 3-week run-in, 118 participants were fed a control diet, low in fruits, vegetables, and dairy products, with a fat content typical of US consumption. During an 8-week intervention phase, participants were then fed 1 of 3 randomly assigned diets: the control diet, a diet rich in fruits and vegetables but otherwise similar to control, or a combination diet rich in fruits, vegetables, and low-fat dairy products and reduced in saturated and total fat. Between the end of run-in and intervention periods, mean change in homocysteine was +0.46 micromol/L in the control diet, +0.21 micromol/L in the fruits and vegetables diet (P=0.47 compared with control), and -0.34 micromol/L in the combination diet (P=0.03 compared with control, P=0.12 compared with the fruits and vegetables diet). In multivariable regression models, change in homocysteine was significantly and inversely associated with change in serum folate (P=0.03) but not with change in serum vitamin B(12) (P=0.64) or pyridoxal 5' phosphate, the coenzyme form of vitamin B(6) (P=0.83). CONCLUSIONS: Modification of dietary patterns can have substantial effects on fasting levels of total serum homocysteine. These results provide additional insights into the mechanisms by which diet might influence the occurrence of atherosclerotic cardiovascular disease.

Adult↗

Dietary patterns and the odds of carotid atherosclerosis in women: the Framingham Nutrition Studies.

BACKGROUND: We prospectively examined the relationship between dietary patterns, assessed using cluster analysis and a food frequency questionnaire, and the presence of carotid artery stenosis, a subclinical marker of atherosclerotic disease. METHODS: Analyses were conducted among 1,423 Framingham Study women without cardiovascular disease (CVD) at baseline (1984-1988). Carotid atherosclerosis (stenosis > or =25%) was measured by ultrasound 12 years later. RESULTS: Baseline differences in risk factor profiles were notable across five dietary subgroups. Compared to the more desirable profiles of women with Heart Healthy eating patterns, women who had Light Eating, High Fat, or Empty Calorie diets had higher rates of dyslipidemia and smoking and lower levels of physical activity. At follow-up, the prevalence of carotid atherosclerosis ranged from 6.8% in the Heart Health group to 17.8% in the Empty Calorie group. Compared with Heart Health women, all other groups displayed higher age-adjusted odds for carotid stenosis. In multivariate analyses, those with Empty Calorie diets had more than twofold increased odds of carotid atherosclerosis compared to Heart Health women (OR 2.28, 95% CI [1.12, 4.62]; P < 0.05). CONCLUSION: The association among unique dietary patterns, CVD risk factor profiles, and the presence of subclinical atherosclerosis identifies candidates and strategies for preventive behavioral interventions to promote the primary prevention of heart disease.

Aged↗

Selected tobacco-use behaviors and dietary patterns among high school students--United States, 1991.

In the United States, 30% of all cancer deaths and 87% of lung cancer deaths are attributable to tobacco use (1); approximately 35% of all cancer deaths are associated with diet (2). Because tobacco-use behaviors and dietary patterns (particularly diets high in fat and low in fruits, vegetables, and grains) established during youth may extend into adulthood and may increase the risk for cancer and other chronic diseases, these behaviors should be monitored and addressed among youth (1,3). This article presents self-reported data on the prevalence of selected tobacco-use behaviors and dietary patterns associated with risk for cancer and other chronic diseases among U.S. students in grades 9-12 during 1991.

Adolescent↗

Community water fluoride levels, preschool dietary patterns, and the occurrence of fluoride enamel opacities.

Three hundred seventy-four 12- to 14-year-old children were examined to determine modified tooth surface index of fluorosis (TSIF) scores, and to assess the association among fluoride enamel opacities and water fluoride levels, preschool dietary patterns, and dentifrice consumption. The subjects included boys and girls of both black and white races who reported life-long residence in either Augusta or adjoining Richmond County. "City" children had communal water consistently fluoridated at levels of 0.9 to 1.2 ppm. "County" children had water variably fluoridated at levels of 0.2 to 0.9 ppm. TSIF scores were recorded on each included tooth and the highest TSIF tooth score was noted for each subject. The frequency of TSIF scores in all subjects was analyzed for dental arch symmetry and for association with city/county residence. The frequency of TSIF scores then was analyzed separately for "city" children and "county" children for an association with race, gender, preschool dietary habits, and dentifrice ingestion. Chi-square analysis revealed that higher TSIF scores were associated with city children significantly more than with county children. There was no association of TSIF scores either in the city children or the county children with respect to gender, race, preschool dietary patterns, or dentifrice ingestion. TSIF scores were bilaterally symmetrical, but were higher in the maxillary arch than in the mandibular arch.

Adolescent↗

Evaluation of dietary patterns in dogs with cardiac disease.

OBJECTIVE: To determine the dietary patterns and intake of nutrients of concern in dogs with cardiac disease. DESIGN: Prospective study. ANIMALS: 82 dogs with dilated cardiomyopathy (DCM) or chronic valvular disease. PROCEDURE: Owners of dogs were contacted and given a standardized telephone questionnaire regarding diet and a 24-hour food recall to determine daily intake of calories, protein, fat, sodium, potassium, and magnesium. RESULTS: Among the 82 dogs, 71% had no congestive heart failure (CHF), and 29% had CHF or a history of CHF. Sixty-one percent of dogs had concurrent diseases. Anorexia was or had been evident in 34% of dogs and was significantly more common in the CHF group and in dogs with DCM. Most dogs (92%) received some treats and table food, with a median percentage of daily calories from treats of 19% (range, 0% to 100%). Most owners (57%) that administered pills used human or pet foods for pill administration. Most dogs ate more than the Association of American Feed Control Officials (AAFCO) minimum values for fat and protein. Daily sodium intake varied from 14 to 384 mg/100 kcal, compared with the AAFCO minimum of 17 mg/100 kcal. A median of 25% of total daily sodium came from treats and table food (range, 0% to 100%). Dogs with CHF ate significantly more sodium, compared with dogs with no CHF. CONCLUSIONS AND CLINICAL RELEVANCE: Dietary intake for dogs with cardiac disease is highly variable and often not optimal.

Animal Feed↗

Dietary patterns of third-year secondary schoolgirls in Glasgow.

The dietary pattern of 270 third-year secondary schoolgirls in Glasgow was investigated by means of a 24-hour recall. Subjects were asked to indicate any food which they had bought themselves and to answer questions relating to fat, sugar and fibre. Most ate at normal mealtimes including breakfast but additional snacking was prevalent especially in the evening. There was a distinct lack of fruit and vegetables in the diet. The subjects could exercise reasonable influence over their own intake by virtue of their purchasing power. The roles of fat, sugar and fibre in the diet were variably understood and sources of fibre not well recognised.

Adolescent↗

Dietary patterns and risk of ischemic stroke: A two-sample Mendelian randomization study.

Diet and nutrition critically influence the development and outcomes of ischemic stroke (IS). However, observational studies often yield inconsistent findings due to confounding and measurement error. Mendelian randomization (MR) provides an alternative approach to strengthen causal inference. We conducted a 2-sample MR analysis to evaluate the causal associations between 22 dietary factors and IS risk. Genetic instruments for dietary exposures were derived from the UK Biobank genome-wide association study, and outcome data were obtained from the MEGASTROKE consortium. Inverse-variance weighted analysis served as the primary method, complemented by sensitivity analyses. Consumption of oily fish (&#x3b2;&#x2005;=&#x2005;-0.402, P&#x2005;=&#x2005;.022), cheese (&#x3b2;&#x2005;=&#x2005;-0.364, P&#x2005;=&#x2005;.001), dried fruit (&#x3b2;&#x2005;=&#x2005;-0.710, P&#x2005;=&#x2005;.0002), weekly red wine (&#x3b2;&#x2005;=&#x2005;-0.507, P&#x2005;=&#x2005;.024), and calcium supplements (&#x3b2;&#x2005;=&#x2005;-3.994, P&#x2005;=&#x2005;.015) was associated with reduced risk of IS. Conversely, dietary patterns characterized by high-sugar or high-protein intake showed suggestive associations with increased IS risk, although these did not remain significant after multiple-comparison correction. This 2-sample MR study provides evidence that specific dietary factors, including oily fish, cheese, dried fruit, red wine, and calcium, may reduce IS risk, while high-sugar and high-protein diets may confer increased risk. These findings underscore the importance of dietary management in stroke prevention and highlight the need for further studies to validate the role of potentially harmful dietary patterns.

Humans↗

High monetary costs of dietary patterns associated with lower body mass index: a population-based study.

INTRODUCTION: Food choice is strongly influenced through economic constraints. The monetary costs for foods, especially those foods associated with a lower risk of obesity, have considerably increased during the last years. The purpose of this study was to determine the cost differences between low and high adherence to two dietary patterns which have been inversely associated with body mass index (BMI) and obesity. METHODS: The subjects were Spanish men (n=1547) and women (n=1615) aged 25-74 years who were examined in 1999-2000, in a population-based cross-sectional survey in the northeast of Spain (Girona). Dietary intake was assessed using a food frequency questionnaire. Two dietary quality indices, namely the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), were created. Average food prices were calculated. Anthropometric variables were measured. RESULTS: Adjusted linear regression analysis revealed that an increase in 1 Euro (1.25$) of monetary diet costs per day was associated with a change of 0.46 units (P<0.001) and 2.03 units (P<0.001) in the MDS and HEI, respectively. The magnitude of the association was similar for both scores after standardization. Subjects who closely adhered to the MDS and HEI paid daily 1.2 Euro (1.50$) (P<0.001) and 1.4 Euro (1.75$) (P<0.001) more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Multiple linear regression analysis adjusted for several confounders showed an inverse association of the MDS (P=0.011) and the HEI (P<0.001) with BMI. The risk of obesity (BMI> or =30) significantly decreased across quartile distribution of MDS (P=0.004) and HEI (P=0.001). CONCLUSION: Data showed that a high adherence to the MDS and HEI, both inversely associated with BMI and obesity, led to higher monetary costs as compared to a low adherence. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets preventing weight gain.

Adult↗

Dietary patterns and prostate cancer risk in the National Health and Nutrition Examination Survey Epidemiological Follow-up Study cohort.

Ecological studies implicate a "Western" diet in prostate cancer development, but whether dietary patterns measured in individuals are associated with risk has not been studied previously. We examined this issue using prospective data from the nationally representative United States Health Examination Epidemiological Follow-up Study. Among 3,779 men followed from 1982-84 to 1992, 136 incident cases were identified. Using principal component analysis on responses to a 105-item dietary questionnaire, the following three distinct patterns were identified: a vegetable-fruit pattern; a red meat-starch pattern characterized by red meats, potatoes, cheese, salty snacks, and desserts; and a Southern pattern characterized by such foods as cornbread, grits, sweet potatoes, okra, beans, and rice. In adjusted proportional hazards models, prostate cancer risk was not associated with the vegetable-fruit or red meat-starch pattern, but higher intake of the Southern pattern showed a reduction in risk (3rd versus 1st tertile relative risk, 0.6; 95% confidence interval, 0.4-1.1; trend P = 0.08) that approached statistical significance. The inverse association was observed in black and non-black men and was not attributable to intake of any individual foods or nutrients. A Southern dietary pattern may reflect a history of living in the South and serve as an integrative marker of sunlight exposure and protection through 1,25-dihydroxyvitamin D production. Further evaluation and better characterization of the pattern would offer more information on potentially beneficial features of the diet or its associated lifestyle.

Diet↗