Diet Quality Assessed with the “Framingham Nutritional Risk Score”

Diet Quality ◽  
2013 ◽  
pp. 315-326
Author(s):  
Ruth W. Kimokoti ◽  
Barbara E. Millen
Author(s):  
Ilse Bloom ◽  
Anna Pilgrim ◽  
Karen A. Jameson ◽  
Elaine M. Dennison ◽  
Avan A. Sayer ◽  
...  

Abstract Objectives To identify early nutritional risk in older populations, simple screening approaches are needed. This study aimed to compare nutrition risk scores, calculated from a short checklist, with diet quality and health outcomes, both at baseline and prospectively over a 2.5-year follow-up period; the association between baseline scores and risk of mortality over the follow-up period was assessed. Methods The study included 86 community-dwelling older adults in Southampton, UK, recruited from outpatient clinics. At both assessments, hand grip strength was measured using a Jamar dynamometer. Diet was assessed using a short validated food frequency questionnaire; derived ‘prudent’ diet scores described diet quality. Body mass index (BMI) was calculated and weight loss was self-reported. Nutrition risk scores were calculated from a checklist adapted from the DETERMINE (range 0–17). Results The mean age of participants at baseline (n = 86) was 78 (SD 8) years; half (53%) scored ‘moderate’ or ‘high’ nutritional risk, using the checklist adapted from DETERMINE. In cross-sectional analyses, after adjusting for age, sex and education, higher nutrition risk scores were associated with lower grip strength [difference in grip strength: − 0.09, 95% CI (− 0.17, − 0.02) SD per unit increase in nutrition risk score, p = 0.017] and poorer diet quality [prudent diet score: − 0.12, 95% CI (− 0.21, − 0.02) SD, p = 0.013]. The association with diet quality was robust to further adjustment for number of comorbidities, whereas the association with grip strength was attenuated. Nutrition risk scores were not related to reported weight loss or BMI at baseline. In longitudinal analyses there was an association between baseline nutrition risk score and lower grip strength at follow-up [fully-adjusted model: − 0.12, 95% CI (− 0.23, − 0.02) SD, p = 0.024]. Baseline nutrition risk score was also associated with greater risk of mortality [unadjusted hazard ratio per unit increase in score: 1.29 (1.01, 1.63), p = 0.039]; however, this association was attenuated after adjustment for sex and age. Conclusions Cross-sectional associations between higher nutrition risk scores, assessed from a short checklist, and poorer diet quality suggest that this approach may hold promise as a simple way of screening older populations. Further larger prospective studies are needed to explore the predictive ability of this screening approach and its potential to detect nutritional risk in older adults.


2009 ◽  
Vol 103 (8) ◽  
pp. 1223-1229 ◽  
Author(s):  
Dolores M. Wolongevicz ◽  
Lei Zhu ◽  
Michael J. Pencina ◽  
Ruth W. Kimokoti ◽  
P. K. Newby ◽  
...  

Obesity affects one in three American adult women and is associated with overall mortality and major morbidities. A composite diet index to evaluate total diet quality may better assess the complex relationship between diet and obesity, providing insights for nutrition interventions. The purpose of the present investigation was to determine whether diet quality, defined according to the previously validated Framingham nutritional risk score (FNRS), was associated with the development of overweight or obesity in women. Over 16 years, we followed 590 normal-weight women (BMI < 25 kg/m2), aged 25 to 71 years, of the Framingham Offspring and Spouse Study who presented without CVD, cancer or diabetes at baseline. The nineteen-nutrient FNRS derived from mean ranks of nutrient intakes from 3 d dietary records was used to assess nutritional risk. The outcome was development of overweight or obesity (BMI ≥ 25 kg/m2) during follow-up. In a stepwise multiple logistic regression model adjusted for age, physical activity and smoking status, the FNRS was directly related to overweight or obesity (P for trend = 0·009). Women with lower diet quality (i.e. higher nutritional risk scores) were significantly more likely to become overweight or obese (OR 1·76; 95 % CI 1·16, 2·69) compared with those with higher diet quality. Diet quality, assessed using a comprehensive composite nutritional risk score, predicted development of overweight or obesity. This finding suggests that overall diet quality be considered a key component in planning and implementing programmes for obesity risk reduction and treatment recommendations.


2000 ◽  
Vol 72 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Isabelle Sermet-Gaudelus ◽  
Anne-Sylvie Poisson-Salomon ◽  
Virginie Colomb ◽  
Marie-Claire Brusset ◽  
Françoise Mosser ◽  
...  

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 517-517
Author(s):  
Sarah Dobiszewski ◽  
Leslie Mahler ◽  
Ingrid Lofgren

Abstract Objectives To assess the diet quality of people with Parkinson's Disease (PwPD) using two assessment tools: Healthy Eating Index (HEI)-2015 and the Dietary Screening Tool (DST). HEI-2015 and DST scores were compared for alignment to explore associations between HEI-2015 and DST total scores and sub-scores. Methods This secondary data analysis utilized a total of 28 participants from two studies examining PwPD and their informal caregivers. Dietary data was collected with two 24-hour recalls using the multiple pass method and entered into the Nutrition Data System for Research (NDSR). SAS Version 9.4 was used to compute HEI-2015 scores to assess diet quality. The HEI-2015 score is a total of 100 points and is based on the Dietary Guidelines for Americans for 2015–2020. Total HEI-2015 scores and 13 component scores were interpreted using the graded approach (grades A-F). Radar graphs provide a visual representation. Participants also completed the DST. The DST is a 25-item questionnaire used to identify dietary patterns and assess nutritional risk. Total scores were categorized into at risk &lt;60, possibly risk 60–75, and not at risk &gt;75. Sub-scores were calculated with point classifications for specific food categories. These sub-scores were divided into tertials of recommended intakes less than 50%, 50–80% and 80–100%, and compared for alignment between DST sub-scores and HEI-2015 sub-scores by assessing total number of pairs per category. Results The mean total score was 59.4 ± 28.6 for DST and 58.7 ± 22.2 for HEI-2015. HEI-2015 scores fell into grades of A (n = 0) B (n = 3) C (n = 3) D (n = 7) F (n = 14). PwPD who were categorized at risk from the DST scores (n = 18) received an HEI grade of D/F. PwPD who were at possible risk (n = 7) received a grade of B/C/D. PwPD who were not at risk (n = 3) received a grade of B/C/D for sub-scores, vegetable intake had a 50% alignment in scores, fat/sugar 43% alignment, whole grains and dairy 46% alignment and fruit 39% alignment. Conclusions There appeared to be partial alignment between the total HEI-2015 scores and DST nutritional risk scores. Sub-scores differ 50% of the time. Due to differences between the assessment tools, more research is needed to validate the DST in PwPD as this can be a less taxing assessment compared with 24-hour recalls. Funding Sources There was no external funding for this study.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  

Backgrounds: The Get with The Guidelines (GWTG) heart failure (HF) risk score was developed in the GWTG inpatient HF registry to predict in-hospital mortality and has been recently reported to be associated with post-discharge long-term outcomes. Malnutrition is associated with poor outcome in ADHF patients. However, there is no information available on the long-term prognostic significance of the combination of GWTG-HF risk score and malnutrition in patients admitted for ADHF, relating to reduced left ventricular ejection fraction (LVEF). Methods: We studied 303 ADHF patients discharged with survival (HFrEF(LVEF<40%); n=180, HFpEF(LVEF≥40%;n=123). At the admission, we evaluated GWTG-HF score and nutritional status. Variables required for the GWTG-HF risk score were race, age, systolic blood pressure, heart rate, serum levels of blood urea nitrogen and sodium, and the presence of chronic obstructive pulmonary disease. Nutritional status was evaluated by Geriatric Nutritional Risk Index (GNRI) calculated as follows: 14.89 · serum albumin (g/dl) + 41.7 · BMI/22, and malnutrition was defined as GNRI<92. The study endpoint was cardiovascular-renal poor outcome (CVR), defined as cardiovascular death and the development of end-stage renal disease requiring renal replacement therapy. Results: During a follow-up period of 4.2±3.3 yrs, 86 patients had CVR. At multivariate Cox analysis, GWTG-HF risk score and GNRI were significantly and independently associated with CVR, in both HFrEF and HFpEF groups. The patients with both greater GWTG-HF score (>median value=35) and malnutrition had a significantly increased risk of CVR than those with either and none of them ([HFrEF] 60% vs 32% vs 16%, p<0.0001, [HFpEF] 45% vs 18% vs 12%, p<0.0001, respectively) Conclusion: Malnutrition assessed by GNRI would provide the additional long-term prognostic information to GWTG-HF risk score in patients admitted for ADHF, irrespective of the presence of reduced LV function.


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