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Longitudinal study of age and cohort influences on dietary patterns.

Dietary data from weighed food intake records were obtained from 35 women 29 years old and older during 4 studies from 1948 to 1966. Longitudinal data were analyzed by the use of a multiple linear-regression model with year of birth and age as independent variables. With increasing age, mean intakes declined significantly for fat, saturated fatty acids, and oleic acid, and increased significantly for calcium. After accounting for cohort effects, no significant changes occurred in mean intakes of food energy, carbohydrate, protein, phosphorus, iron, thiamin, riboflavin, preformed niacin, vitamin A, and ascorbic acid. For successive year of birth, mean intakes increased significantly for protein, calcium, phosphorus, riboflavin, preformed niacin, and linoleic acid. The regression model used explained approximately 20% of the variability in intakes of food energy and most nutrients examined.

Adult

Insulinemic and inflammatory dietary patterns and colorectal cancer risk: a dietary data harmonization study of one million participants in the Consortium of Metabolomics Studies (COMETS).

BACKGROUND: Inflammatory and insulinemic dietary patterns have been associated with colorectal cancer (CRC) risk, but generalizability across diverse populations with heterogeneous food supplies and dietary behaviors has not been established. OBJECTIVES: We harmonized disparate dietary and covariate data on a large scale to compute the reverse Empirical Dietary Index for Hyperinsulinemia (rEDIH), reverse Empirical Dietary Inflammatory Pattern (rEDIP), and Healthy Eating Index (HEI)-2015 scores, and tested their associations with CRC risk. METHODS: We leveraged data among 501,892 women and 407,390 men from 6 cohorts across the United States (NIH-AARP, Multi-Ethnic Study of Atherosclerosis, Prostate, Lung, Colorectal, and Ovarian, SCCS) and Europe (EPIC, ATBC) with varying sociodemographic characteristics, participating in the Consortium of Metabolomics Studies. We harmonized nomenclature and nutritional information of >800 unique food items across cohorts. We used multivariable-adjusted Cox regression, adjusting for demographic, clinical, and lifestyle factors, to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between the dietary indices and CRC risk per cohort, then meta-analyzed the estimates. RESULTS: During a median follow-up of 14.9 y, 16,525 incident CRC cases were diagnosed. Participants in the highest quintile of rEDIH (low-insulinemic diet) had an 18% reduced risk of CRC (HR: 0.82; 95% CI: 0.78, 0.86) compared with those in the lowest quintile. For the same comparison, similar risk reductions were observed for rEDIP (anti-inflammatory diet) (HR: 0.84; 95% CI: 0.80, 0.89) and HEI-2015 (overall dietary quality) (HR: 0.80; 95% CI: 0.76, 0.85). Heterogeneity between cohorts in the meta-analyzed estimates was low for rEDIH (I2 = 22.3%) compared with rEDIP (I2 = 62.5%) and HEI-2015 (I2=83.9%). CONCLUSIONS: Using carefully harmonized data from nearly 1 million individuals in the United States and Europe, we observed significant CRC risk reduction with habitual intake of low-insulinemic and anti-inflammatory dietary patterns, comparable with higher overall dietary quality. Study findings underscore the utility of these dietary patterns for global cancer prevention efforts.

Humans

High-risk health behaviors associated with various dietary patterns.

We have previously identified dietary patterns among 1,475 male and 780 female normal healthy control subjects in a case-control study of cancer at various sites. In this paper we examine the presence, among persons exhibiting these dietary patterns, of individual health behaviors that may contribute to risks for cancer. Specifically we examine trimming of separable fat from meats, fats used in cooking and as additions to foods, alcohol consumption, and smoking. Results indicate that men and women differ in possession of these high-risk behaviors. Women are more likely to trim fat from meat, consume less alcohol, and have lower exposures to smoking. Their dietary patterns are more independent of the fats used. Several eating patterns are positively associated with total fat intake but differ in their associations with high-risk behaviors. These data suggest that assessing risk associated with dietary patterns sheds more light on disease relationships than studies of single nutrients.

Aged

Infant Dietary Patterns and Early Childhood Weight Outcomes: A Secondary Analysis from the Starting Early Program Trial.

BACKGROUND: The Starting Early Program (StEP) promotes healthy nutrition during early life and leads to healthier child weight, but whether dietary patterns contribute to weight or mediate StEP weight outcomes has not been studied. OBJECTIVES: This secondary analysis identified infant dietary patterns in StEP, determined associations between dietary patterns and child weight outcomes, and examined whether dietary patterns mediated the relationship between StEP and child weight. METHODS: Data were from 377 mother-infant dyads in a randomized trial testing the efficacy of StEP. Dietary patterns at 10 months were identified using latent class analysis. Child weights were abstracted from medical records at 12, 24, and 36 months. Associations between infant dietary patterns and weight-for-age z-score (WFAz) and likelihood of being classified as overweight (WFA ≥85th percentile) were assessed using linear and logistic multivariable regression models. Mediation was used to assess intervention effects on WFAz via impacts on infant dietary patterns. RESULTS: Four classes of infant dietary patterns were identified: Breastfed-High variety, Formula fed-High variety, Formula fed-Low variety, and Mixed fed-Low variety. Compared to the Breastfed-High variety class, infants in the Formula fed-Low variety class had higher WFAz and were more likely to be classified as overweight at 24 and 36 months. Participation in StEP increased membership in Breastfed-High variety, which mediated the association between StEP and lower WFAz at 24 months. CONCLUSIONS: Infant dietary patterns were identified, and some were associated with child overweight. StEP was associated with a dietary pattern most consistent with guidelines, which mediated intervention effects on child weight.

Humans

Dietary patterns and colon cancer in western New York.

Seven dietary patterns were identified among control subjects in the Western New York Diet Study (1975-1986) by application of principal components analysis to data from a 95-item food frequency interview. The results of case-control analyses of colon cancer risk for these patterns are presented. Cases were matched with neighborhood controls on the bases of age and sex; 205 colon case-control male and 223 female pairs were obtained. The dietary patterns and intakes of energy, total fat, and dietary fiber were examined with logistic regression for their individual contributions to risk. In males, three of these dietary patterns were associated positively with fat and energy consumption; they elevated risk for colon cancer and accounted for more risk than did the specific nutrients. Control for energy and fat intakes allowed the protective influences of additional dietary patterns to be expressed. No patterns elevated risk in women; two patterns were protective for colon cancer. Controlling for energy and fat intake enhanced the protection afforded by one of these patterns but had no influence on that of the other. Measures of foods rather than single nutrients may be more inclusive of dietary exposures to risk as well as being related more directly to underlying health behaviors. Therefore they may be better able to account for risk in diseases with multiple causation.

Case-Control Studies

[The effects of individual milk-drinking habits on nutrient intake and dietary patterns in men and women in Tottori Prefecture].

This study was performed to determine the actual conditions of milk-drinking habits in men and women, and to ascertain their effects on nutrient intake and dietary patterns. The 809 subjects were over 20 years of age and were obtained from the Tottori Prefecture Dietary Survey. The results are summarized as follows: 1. Over 40 percent of the subjects did not consume any milk during the three days of the dietary survey. Furthermore, only 38 percent of men and 46 percent of women have daily milk-drinking habits according to the results of the questionnaire. 2. Calcium and Vitamin B2 intake level and total serum cholesterol level were higher in milk-drinkers than non-milk-drinkers, in both men and women. The regression of total calcium intake from 6 groups of food was analyzed by multiple regression analysis. For both men and women who were milk-drinkers, total calcium intake was determined mostly by milk. In the case of non-milk-drinkers, total calcium intake came mostly from green vegetables for men, and other vegetables for women. 3. The ratios of both animal proteins and animal fats were higher in milk-drinkers. For women, energy percentage of fats was high and that of carbohydrates was low in milk-drinkers. The results seem to suggest that differences in dietary patterns is based on milk-drinking habits. Using the Hayashi's quantification method 3, dietary patterns were classified into two groups based on milk-drinking habits. Dietary patterns of milk-drinkers included the characteristic of eating bread, meats, and fats more frequently in men, fresh vegetables, eggs, fats and bread in women. In men, milk-drinking habits had a lesser influence on diet than in women.

Adult

Participation in school physical education and selected dietary patterns among high school students--United States, 1991.

Inadequate physical activity and unhealthy dietary patterns (particularly diets high in fat and low in fruits, vegetables, and grains) established during youth may extend into adulthood and may increase risk for chronic diseases, such as coronary heart disease and cancer (1-5). This report examines the prevalence of self-reported enrollment, attendance, and participation in school physical education (PE) and examines selected dietary patterns among students in grades 9-12 from two school-based components of CDC's Youth Risk Behavior Surveillance System (6): 1) the national Youth Risk Behavior Survey (conducted during April-May 1991) and 2) individual state and local Youth Risk Behavior Surveys (conducted by departments of education in 23 states and 10 cities during the same time).

Adolescent

The Association of Diabetes-Related Dietary Patterns with Pancreatic Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study.

BACKGROUND: Pancreatic cancer is relatively rare but remains one of the most lethal tumors. Identifying modifiable risk factors is a crucial step to reduce disease burden. Evidence suggests a potential role of type 2 diabetes mellitus in its pathogenesis. OBJECTIVES: The objective of this study is to examine the association between dietary patterns related to diabetes and pancreatic cancer risk in a European population. METHODS: A total of 367,395 participants from the European Prospective Investigation into Cancer and Nutrition study were included. After a median follow-up of 14.9 y, 926 incident cases were identified. The Diabetes Risk Reduction Diet (DRRD), the Empirical Dietary Index for Hyperinsulinemia (EDIH), and the Empirical Dietary Index for Insulin Resistance (EDIR) were estimated from food frequency questionnaires at recruitment. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between dietary patterns and pancreatic cancer were calculated using multivariable Cox proportional hazards regression models, adjusted for relevant confounders. RESULTS: Adherence to DRRD showed no association with risk of pancreatic cancer (HRT3vsT1: 0.94; 95% CI: 0.79, 1.12). Higher adherence to EDIH was associated with a borderline 19% increased pancreatic cancer risk (HRT3vsT1: 1.19; 95% CI: 0.99, 1.44). No significant associations were observed in relation to EDIR. No heterogeneity was observed among the subgroups. CONCLUSIONS: Higher adherence to a hyperinsulinemic dietary pattern may contribute to risk of developing pancreatic cancer in our population. Further research is warranted to elucidate the potential role of dietary factors in cancer risk prevention.

Humans

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

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

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 (β = -0.402, P = .022), cheese (β = -0.364, P = .001), dried fruit (β = -0.710, P = .0002), weekly red wine (β = -0.507, P = .024), and calcium supplements (β = -3.994, P = .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

Socioeconomic, social behaviour and dietary patterns among Malaysian aborigines and rural native Malays.

The socioeconomic, social behaviour and dietary pattern of 100 Aborigines and Malays, aged 7 years and above from Kuala Pangsoon, Selangor Malaysia were studied by using pretested questionnaires. The individual's dietary intake was estimated using 24 hour recall for 3 days within one week which was chosen at random. The household's food consumption pattern was evaluated using food frequency questionnaires. There was no difference in the total income per month for both communities, as well as the educational attainment of the head of household and property ownership. The proportion of smokers among the Aborigines and the Malays was almost similar (33%) but the percentage of heavy smokers was higher among Aborigines compared to Malays. One third of the Aborigines regularly consume alcohol. The main energy source for both communities was rice, sugar and cooking oil whilst fish and eggs were the main sources of protein. More than 50% of the Aborigines take tapioca or tapioca leaves at least once a week compared to less than 20% among the Malays. There was no significant different in the intake of energy, protein and carbohydrate between the groups. However, the Aborigines take less fats and iron compared to the Malays. The difference in terms of smoking, drinking habit and dietary intake may determine the distribution of disease in both communities.

Alcohol Drinking

Dietary pattern of Finnish children with low high caries experience.

The correlations between dietary patterns and caries were studied in a series consisting of 534, 5-, 9- and 13-year-old Finnish rural children from low-fluoride areas (0.10-0.46 parts/10(6)). The food consumption of the children was assessed by the 24-hour recall method. The consumption of sweets was estimated by the dietary history method. Caries was diagnosed by clinical inspection. Children with a low and children with a high caries experience were compared with regard to food and nutrient intakes per 1000 kcal. The intakes of most foods and nutrients were similar in the low-caries and in the high-caries groups. However, the diet of the high-caries groups of 5- and 13-year-olds contained less iron, thiamine and ascorbic acid than the diet of the low-caries groups. The intake of sugar and sugar-containing products per unit of energy was higher in the high-caries groups. This was true for soft drinks in particular. Among the 9-year-olds the proportion of sugar consumed as such was greater in the high-caries than in the low-caries children. With regard to the total monthly consumption of sweets no significant differences were observed between the high- and low-caries groups. Analysis of the energy-standardized consumption of food and nutrients thus showed that the relative proportion of sugar and sugar-containing products was somewhat greater in the diet of the high-caries children than in the diet of the low-caries children, but not as high as could be expected. These products replaced foods with a higher nutritive value with the result that the diet of the high-caries groups was on the whole more refined than the diet of the low-caries groups.

Adolescent

Comparing genome-wide significant and chemosensory variants as instruments for dietary patterns in Mendelian randomization.

BACKGROUND: Diet is a modifiable risk factor for cardiometabolic disease, yet establishing causality remains challenging. Mendelian randomization (MR) leverages genetic variants as instrumental variables (IVs) to enable causal inference. METHOD: Using two-sample MR, we assessed the causal effects of four principal component-derived dietary patterns (DPs)-Unhealthy, Healthy, Meat-based, Pescatarian-on cardiometabolic outcomes including body mass index, coronary artery disease, blood lipids, blood pressures, type 2 diabetes, fasting glucose and insulin, and glycated haemoglobin. Two sets of IVs were employed: conventional genome-wide significant variants associated with each DP, filtered for pleiotropy and directionality; and biologically informed variants in chemosensory receptor genes, given the role of taste and smell perception in food choice. RESULTS: Using conventional IVs, the Pescatarian DP was associated with reduced fasting insulin (βIVW = -0.10 pmol/L per SD increase in the Pescatarian DP score, 95% confidence interval -0.15, -0.04; P = 1.19 × 10-3), surviving multiple sensitivity analyses. Associations between the Unhealthy DP and elevated blood pressure and glycated haemoglobin should be interpreted cautiously; one of the two filtered IVs was strongly associated with caffeine intake, limiting the attribution of these findings to the DP itself. Chemosensory Receptor IVs yielded null findings, reflecting insufficient power. CONCLUSION: Evidence for causal effects of DPs on cardiometabolic traits was limited, with the strongest support for a protective effect of the Pescatarian DP on fasting insulin. Chemosensory IVs demonstrated limited utility for DPs, likely reflecting the heterogeneous and complex sensory profiles of overall diets. Future efforts should consider guideline-based dietary indices to facilitate interpretability and translation.

Humans

Dietary patterns, eating behaviors, and bone mineral density in women runners.

Although reduced gonadal steroid hormone concentrations appear to play a major role in lower trabecular bone mineral density (BMD) in women with athletic amenorrhea, dietary deficiencies and eating behaviors may also affect BMD in women runners. To investigate this possibility, dietary patterns (7-d records), eating-disorders inventory (EDI), and BMD were examined in nine nonrunning eumenorrheic control (Contl) and 32 women runners classified as eumenorrheic (n = 19, Eumen) and oligo/amenorrheic (a group in which some were oligomenorrheic and some were amenorrheic; Ol/Am, n = 13). Runner groups had similar cardiorespiratory fitness, body composition, and training characteristics. Lumbar spine BMD was lower in the Ol/Am runners (-12%, P less than 0.05) but proximal femur BMD did not differ. Dietary intake and EDI subscale scores were similar among the groups. However, there was an inverse trend between EDI subscale scores for bulimia and ineffectiveness and femoral BMD in the Ol/Am runners (r = -0.62 to -0.71, P less than 0.05). These results suggest that self-reported dietary intake and/or eating behaviors do not predict reproductive-function alterations in women runners, but eating behaviors may be associated with lower BMD in Ol/Am runners.

Adolescent

Gut bacteria associated with an atherogenic TMAO-dietary pattern and choline-rich foods among aging women.

BACKGROUND AND AIMS: Choline can be metabolized by gut bacteria with a choline utilization gene, CutC, as identified through genome sequencing studies. This metabolism produces trimethylamine, the precursor to the atherosclerotic metabolite trimethylamine N-oxide (TMAO). Bacterial species involved in trimethylamine production in free-living humans have been under-investigated. We previously developed the TMAO dietary pattern (TMAO-DP), which is predictive of plasma TMAO and choline. We evaluated associations between the TMAO-DP, dietary choline, and choline-rich foods (fish, red meat, eggs) with the abundance of species with CutC. We also explored associations between the TMAO-DP and microbiome diversity. METHODS AND RESULTS: This cross-sectional analysis included 287 women (mean age = 79.6 years) from the Women's Health Initiative. Diet was assessed using a food frequency questionnaire. Stool samples were collected and the V3-V4 regions of the 16S ribosomal RNA were sequenced. Adjusted linear regression models evaluated associations between the TMAO-DP with the CLR-transformed abundance of species with CutC and with alpha-diversity indices. For beta-diversity, PERMANOVA examined measures of Aitchison distance within and between quartiles of the TMAO-DP. Associations between dietary choline and choline-rich foods with the abundance of species were evaluated using linear regression. The TMAO-DP was associated with Acidaminococcus intestini [Beta (SE): 0.23 (0.09), p-value = 0.035] and Desulfovibrio desulfuricans [Beta (SE): 0.16 (0.6), p = 0.035]. The TMAO-DP was not associated with alpha- or beta-diversity. CONCLUSION: This study provides evidence that Desulfovibrio desulfuricans and Acidaminococcus intestini, two species identified as having CutC by gene sequencing, may produce trimethylamine from diet in free-living women.

Humans

Who eats what? A comparison of dietary patterns among men and women in different occupational groups.

Dietary data were obtained during a community-based study of risk factors for heart disease in 1983. Results were compared for men and women in broadly defined socioeconomic groups based on occupation and education. People in higher status occupation groups and with more education, and women more than men, had food consumption patterns more consistent with current health promotion messages. For example, they reported eating more wholemeal or brown bread and more fresh fruit and vegetables, drinking more skim or low-fat milk, eating fewer eggs and having less sugar in hot drinks or on cereals. There was some evidence, however, of an interplay of influences of cost and health awareness. For example, retired men were less likely than employed men to eat butter, cream, fresh fruit and vegetables, while men in the upper socioeconomic groups reported relatively higher consumption of butter and cream. The results emphasise the need for a range of strategies aimed at specific subgroups in order to improve national dietary patterns in Australia.

Adult

Dietary patterns and cancer.

The possible role of dietary habits in the aetiology of cancers, and in the differences observed in the prevalence of this group of diseases between populations, should be considered in the context of the competing theories of cancer causation. This paper briefly reviews the historical context in which the contemporary emphasis on nutritional influences in cancer causation is placed and outlines the scope of the evidence currently available.

Animals