Does the Healthy Eating Index and Mediterranean Diet Score Identify the Nutritional Adequacy of Dietary Patterns in Chronic Pancreatitis?

During the last decades the gut microbiota has been identified as a key mediator in the diet-health interaction. However, our understanding on the impact of general diet upon microbiota is still limited. Dietary indices represent an essential approach for addressing the link between diet and health from a holistic point of view. Our aim was to test the predictive potential of seven dietary ratings on biomarkers of inflammation, oxidative stress and on the composition and metabolic activity of the intestinal microbiota. A cross-sectional descriptive study was conducted on a sample of 73 subjects aged >50 years with non-declared pathologies. Dietary inflammatory index (DII), Empirical Dietary Inflammatory Index (EDII), Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), Mediterranean adapted Diet Quality Index-International (DQI-I), Modified Mediterranean Diet Score (MMDS) and relative Mediterranean Diet Score (rMED) were calculated based on a Food Frequency Questionnaire. Major phylogenetic types of the intestinal microbiota were determined by real time polymerase chain reaction (qPCR) and fecal short chain fatty acids (SCFAs) by gas chromatography. While DII, HEI, DQI-I and MMDS were identified as predictors of Faecalibacterium prausnitzii levels, AHEI and MMDS were negatively associated with Lactobacillus group. HEI, AHEI and MMDS were positively associated with fecal SCFAs. In addition, DII and EDII explained lipoperoxidation level and Mediterranean scores the serum IL-8 concentrations. The lower detection of IL-8 in individuals with higher scores on Mediterranean indices may be partially explained by the increased levels of the anti-inflammatory bacterium F. prausnitzii in such individuals.

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Mediterranean Diet and Healthy Eating in Subjects with Prediabetes from the Mollerussa Prospective Observational Cohort Study

Nutrients ◽

10.3390/nu13010252 ◽

2021 ◽

Vol 13 (1) ◽

pp. 252

Author(s):

Mireia Falguera ◽

Esmeralda Castelblanco ◽

Marina Idalia Rojo-López ◽

Maria Belén Vilanova ◽

Jordi Real ◽

...

Keyword(s):

Glucose Tolerance ◽

Mediterranean Diet ◽

Healthy Eating ◽

Dietary Patterns ◽

Normal Glucose Tolerance ◽

Healthy Eating Index ◽

Study Cohort ◽

Cross Sectional ◽

Normal Glucose ◽

Multivariable Analyses

We aimed to assess differences in dietary patterns (i.e., Mediterranean diet and healthy eating indexes) between participants with prediabetes and those with normal glucose tolerance. Secondarily, we analyzed factors related to prediabetes and dietary patterns. This was a cross-sectional study design. From a sample of 594 participants recruited in the Mollerussa study cohort, a total of 535 participants (216 with prediabetes and 319 with normal glucose tolerance) were included. The alternate Mediterranean Diet score (aMED) and the alternate Healthy Eating Index (aHEI) were calculated. Bivariable and multivariable analyses were performed. There was no difference in the mean aMED and aHEI scores between groups (3.2 (1.8) in the normoglycemic group and 3.4 (1.8) in the prediabetes group, p = 0.164 for the aMED and 38.6 (7.3) in the normoglycemic group and 38.7 (6.7) in the prediabetes group, p = 0.877 for the aHEI, respectively). Nevertheless, women had a higher mean of aMED and aHEI scores in the prediabetes group (3.7 (1.9), p = 0.001 and 40.5 (6.9), p < 0.001, respectively); moreover, they had a higher mean of aHEI in the group with normoglycemia (39.8 (6.6); p = 0.001). No differences were observed in daily food intake between both study groups; consistent with this finding, we did not find major differences in nutrient intake between groups. In the multivariable analyses, the aMED and aHEI were not associated with prediabetes (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.75–1.87; p = 0.460 and OR: 1.32, 95% CI: 0.83–2.10; p = 0.246, respectively); however, age (OR: 1.04, 95% CI: 1.02–1.05; p < 0.001), dyslipidemia (OR: 2.02, 95% CI: 1.27–3.22; p = 0.003) and body mass index (BMI) (OR: 1.09, 95% CI: 1.05–1.14; p < 0.001) were positively associated with prediabetes. Physical activity was associated with a lower frequency of prediabetes (OR: 0.48, 95% CI: 0.31–0.72; p = 0.001). In conclusion, subjects with prediabetes did not show a different dietary pattern compared with a normal glucose tolerance group. However, further research is needed on this issue.

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Abstract 13: Adherence to Various Dietary Patterns and Risk of Recurrent Coronary Heart Disease and Mortality in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.135.suppl_1.13 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

James M Shikany ◽

Monika M Safford ◽

Joanna Bryan ◽

PK Newby ◽

Joshua S Richman ◽

...

Keyword(s):

Racial Differences ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Dietary Pattern ◽

Lower Risk ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Mediterranean Diet Score ◽

The Mediterranean ◽

Diet Score

Background: We have shown that the Southern dietary pattern, characterized by added fats, fried foods, organ and processed meats, and sugar-sweetened beverages, is associated with a greater risk of incident CHD in REGARDS, a national, population-based, longitudinal cohort. We sought to determine if the Southern pattern, other dietary patterns, and the Mediterranean diet score were associated with CHD events and mortality in REGARDS participants who previously reported CHD. Methods: REGARDS enrolled white and black adults aged ≥45 years between 2003-2007. Data were analyzed from 3,562 participants with CHD at baseline. Participants completed an FFQ at baseline, from which 5 dietary patterns were derived through factor analysis (Table). The Mediterranean diet score was calculated for each participant. Expert-adjudicated CHD events included myocardial infarction and CHD death. Cox proportional hazards regression was used to model the association of the dietary patterns and score with CHD events and death, adjusting for sociodemographics, lifestyle factors, energy intake, anthropometrics, and medical conditions. Results: Over 7 years of follow-up, there were 581 recurrent CHD events and 1,098 deaths. In fully-adjusted analyses, the highest quartile of adherence to the alcohol/salads pattern and highest group of the Mediterranean diet score were associated with lower risk of recurrent CHD compared to the lowest quartile/group (HR: 0.76; 95% CI: 0.59 – 0.98, HR: 0.78; 95% CI: 0.62 – 0.98, respectively). The highest quartile of adherence to the Southern pattern was associated with higher mortality (HR: 1.57; 95% CI: 1.28 – 1.91), while the highest group of the Mediterranean diet score was associated with lower mortality (HR: 0.80; 95% CI: 0.68 – 0.95). Conclusions: While the Southern dietary pattern was not related to risk of recurrent CHD, it was associated with higher mortality in REGARDS participants with existing CHD. Greater adherence to a Mediterranean diet was associated with lower risk of recurrent CHD and mortality.

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Healthy dietary patterns from food diaries and FFQ are not associated with colorectal cancer risk: results from the UKWCS

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000348 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Petra Jones ◽

Janet Cade ◽

Charlotte Evans ◽

Neil Hancock ◽

Darren Greenwood

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Dietary Pattern ◽

Colorectal Cancer Risk ◽

Mediterranean Diet Score ◽

Bland Altman Method ◽

The Mediterranean ◽

Diet Score

AbstractDietary pattern analyses have most commonly used food frequency questionnaire (FFQ) data for large population studies, whilst food diaries (FD) tend to be used with smaller datasets and followed up for shorter terms, restricting the possibility of a direct comparison. Studies comparing dietary patterns derived from two different assessment methods, in relation to diet and disease are limited. The aims of this study are to assess the agreement between dietary patterns derived from FFQ and FDs and to compare the associations between the Mediterranean dietary pattern and the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) dietary pattern in relation to colorectal cancer incidence.The study population included 2276 healthy middle-aged women – participants of the UK Women's Cohort Study. Energy and nutrient intakes, derived from 4-day FDs and from a 217-item FFQ were compared. A 10 and an 8-component score indicating adherence to the Mediterranean diet and to the 2007 WCRF/AICR cancer prevention recommendations respectively were generated. Agreement was assessed by weighted Kappa statistics and the Bland-Altman method. Cox regression was used to estimate hazard ratios (HRs) for colorectal cancer risk for both the FD and the FFQ patterns, for each score separately.The Bland-Altman method showed that the FFQ gave a higher energy intake compared to the FD with a bias of -525 kcal (95% CI -556, -493) between the two methods. Agreement was slight for the Mediterranean diet score (Κ = 0.15; 95% CI: 0.14, 0.16) and fair for the WCRF/AICR score (Κ = 0.38; 95% CI: 0.37, 0.39). A total of 173 incident cases of colorectal cancer were documented. In the multi-variable adjusted models, the estimates for an association with colorectal cancer were weak: HR = 0.94 (95% CI: 0.83 to 1.06) for a 1-unit increment in the Mediterranean diet score using FD and HR = 1.01 (95% CI: 0.83 to 1.24) for a 1-unit increment in the WCRF/AICR score using FD. For scores derived from the FFQ, estimates were inverse, but weak (HR = 0.80 (95% CI: 0.90 to 1.00) for a 1-unit increment in the Mediterranean diet score using FFQ and HR = 0.84 (95% CI: 0.67 to 1.05) for a 1-unit increment in the WCRF/AICR score using FFQ.There is insufficient evidence of an association of colorectal cancer risk with the Mediterranean dietary pattern or with the WCRF/AICR cancer prevention recommendations, irrespective of the dietary assessment method in this sample. Further studies with larger sample sizes, using FD for diet assessment are warranted.

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Dietary Patterns And Risk Of Cancer: Current Evidence And Future Directions

10.2310/im.9017 ◽

2018 ◽

Author(s):

Fang Fang Zhang

Keyword(s):

Healthy Eating ◽

Cancer Incidence ◽

Diet Quality ◽

Dietary Patterns ◽

Healthy Eating Index ◽

Quality Indices ◽

Alternative Healthy Eating Index ◽

Incidence And Mortality ◽

Risk Of Cancer ◽

Diet Score

Dietary patterns capture the overall diet and its constituent foods and nutrients, representing a powerful approach to identifying the effect of nutrition on health and disease. In this review, we describe the two main approaches being used to characterize dietary patterns: a prior approach that defines dietary patterns using predefined diet quality indices, and a posterior approach that derives dietary patterns using factor or cluster analysis. Methods to define diet quality indices (Healthy Eating Index, Alternative Healthy Eating Index, Alternative Mediterranean Diet Score, Dietary Approaches to Stop Hypertension Score) are presented, and their similarities and differences are discussed among the different approaches. We review the recent evidence on the relationships between dietary patterns and cancer outcomes, including all-cancer incidence and mortality and the incidence of colorectal, breast, prostate, and lung cancers. Despite the different methods that are used to characterize dietary patterns in different studies, results consistently suggest that adherence to existing dietary guidelines is associated with a reduced risk of cancer incidence and mortality. Given the important role of dietary patterns in cancer prevention, clinicians need to consider providing appropriate nutrition counseling to improve patients’ dietary patterns. Continuous efforts need to be devoted to better characterize the relationships between dietary patterns and cancer risk by studying specific cancer types, different cancer subtypes, and population subgroups, with a better approach that can accurately assess dietary patterns throughout the life cycle. This review contains 3 figures, 6 tables and 91 references Key words: Alternative Healthy Eating Index, breast cancer, cancer incidence, cancer mortality, cluster analysis, colorectal cancer, Dietary Approaches to Stop Hypertension, dietary patterns, diet quality index, factor analysis, Healthy Eating Index, lung cancer, Mediterranean Diet Score, prostate cancer, Recommended Food Score

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Diet quality and attention capacity in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

British Journal Of Nutrition ◽

10.1017/s0007114517001441 ◽

2017 ◽

Vol 117 (11) ◽

pp. 1587-1595 ◽

Cited By ~ 10

Author(s):

Pontus Henriksson ◽

Magdalena Cuenca-García ◽

Idoia Labayen ◽

Irene Esteban-Cornejo ◽

Hanna Henriksson ◽

...

Keyword(s):

Executive Functions ◽

Mediterranean Diet ◽

Diet Quality ◽

Dietary Patterns ◽

Quality Index ◽

Maternal Education ◽

Healthy Lifestyle ◽

Mediterranean Diet Score ◽

Diet Quality Index ◽

Diet Score

AbstractAdolescence represents an important period for the development of executive functions, which are a set of important cognitive processes including attentional control. However, very little is known regarding the associations of nutrition with components of executive functions in adolescence. Thus, the aim of this study was to investigate associations of dietary patterns and macronutrient composition with attention capacity in European adolescents. This cross-sectional study included 384 (165 boys and 219 girls) adolescents, aged 12·5–17·5 years, from five European countries in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Attention capacity was examined using the d2 Test of Attention. Dietary intake was assessed through two non-consecutive 24 h recalls using a computer-based self-administered tool. Three dietary patterns (diet quality index, ideal diet score and Mediterranean diet score) and macronutrient/fibre intakes were calculated. Linear regression analysis was conducted adjusting for age, sex, BMI, maternal education, family affluence scale, study centre and energy intake (only for Mediterranean diet score). In these adjusted regression analyses, higher diet quality index for adolescents and ideal diet score were associated with a higher attention capacity (standardised β=0·16, P=0·002 and β=0·15, P=0·005, respectively). Conversely, Mediterranean diet score or macronutrient/fibre intake were not associated with attention capacity (P>0·05). Our results suggest that healthier dietary patterns, as indicated by higher diet quality index and ideal diet score, were associated with attention capacity in adolescence. Intervention studies investigating a causal relationship between diet quality and attention are warranted.

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Metabolomic markers of healthy dietary patterns in US postmenopausal women

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy385 ◽

2019 ◽

Vol 109 (5) ◽

pp. 1439-1451 ◽

Cited By ~ 9

Author(s):

Marjorie L McCullough ◽

Maret L Maliniak ◽

Victoria L Stevens ◽

Brian D Carter ◽

Rebecca A Hodge ◽

...

Keyword(s):

Postmenopausal Women ◽

Healthy Eating ◽

Dietary Patterns ◽

Partial Correlation ◽

Healthy Eating Index ◽

Healthy Diet ◽

Diet Patterns ◽

Diet Pattern ◽

Risk Of Cancer ◽

Diet Score

ABSTRACT Background Healthy diet patterns are associated with lower risk of cancer and other chronic diseases. Metabolomics has the potential to expand dietary biomarker development to include dietary patterns, which may provide a complement or alternative to self-reported diet. Objective This study examined the correlation of serum untargeted metabolomic markers with 4 diet pattern scores—the alternate Mediterranean diet score (aMED), alternate Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet, and the Healthy Eating Index (HEI)-2015—and used multivariate methods to identify discriminatory metabolites for each pattern. Methods Among 1367 US postmenopausal women with serum metabolomic data in the Cancer Prevention Study-II Nutrition Cohort, we conducted partial correlation analysis, adjusted for demographic and lifestyle variables, to examine cross-sectional correlations between serum metabolomic markers and healthy diet pattern scores. In a randomly selected “training” set (50%), we conducted orthogonal partial least-squares discriminant analysis to identify metabolites that discriminated the top from bottom diet score quintiles. Combinations of metabolites with a variable importance in projection (VIP) score ≥2.5 were tested for predictability in the “testing” set based on the use of receiver operating characteristic curves. Results Out of 1186 metabolites, 32 unique metabolites were considered discriminatory based on a VIP score ≥2.5 in the training dataset with some overlap across scores (aMED = 16; AHEI = 17; DASH = 13; HEI = 12). Spearman partial correlation analyses, applying a cut-point (|r| ≥ 0.15) and Bonferroni correction (P < 1.05 × 10−5), identified similar key metabolites. The top 5 metabolites for each pattern mostly distinguished high compared with low scores; 4 of the 5 (fish-derived) metabolites were the same for aMED and AHEI, 2 of which were identified for HEI; 4 DASH metabolites were unique. Conclusions Metabolomic methods that used a split-sample approach identified potential biomarkers for 4 healthy diet patterns. Similar metabolites across scores reflect fish consumption in healthy dietary patterns. These findings should be replicated in independent populations.

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Diet quality assessment indexes

Revista de Nutrição ◽

10.1590/1415-52732014000500009 ◽

2014 ◽

Vol 27 (5) ◽

pp. 605-617 ◽

Cited By ~ 10

Author(s):

Kênia Mara Baiocchi de Carvalho ◽

Eliane Said Dutra ◽

Nathalia Pizato ◽

Nádia Dias Gruezo ◽

Marina Kiyomi Ito

Keyword(s):

General Population ◽

Quality Assessment ◽

Healthy Eating ◽

Diet Quality ◽

Dietary Patterns ◽

Nutritional Quality ◽

Quality Index ◽

Healthy Eating Index ◽

Risk Of Disease ◽

Diet Score

Various indices and scores based on admittedly healthy dietary patterns or food guides for the general population, or aiming at the prevention of diet-related diseases have been developed to assess diet quality. The four indices preferred by most studies are: the Diet Quality Index; the Healthy Eating Index; the Mediterranean Diet Score; and the Overall Nutritional Quality Index. Other instruments based on these indices have been developed and the words 'adapted', 'revised', or 'new version I, II or III' added to their names. Even validated indices usually find only modest associations between diet and risk of disease or death, raising questions about their limitations and the complexity associated with measuring the causal relationship between diet and health parameters. The objective of this review is to describe the main instruments used for assessing diet quality, and the applications and limitations related to their use and interpretation.

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Mediterranean Diet Score, Dietary Patterns, and Risk of Sudden Cardiac Death in the REGARDS Study

Journal of the American Heart Association ◽

10.1161/jaha.120.019158 ◽

2021 ◽

Author(s):

James M. Shikany ◽

Monika M. Safford ◽

Orysya Soroka ◽

Todd M. Brown ◽

P. K. Newby ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Dietary Pattern ◽

Cardiac Death ◽

Positive Association ◽

Inverse Association ◽

Mediterranean Diet Score ◽

The Mediterranean ◽

Diet Score

Background Sudden cardiac death (SCD) is a common cause of death in the United States. Few previous studies have investigated the associations of diet scores and dietary patterns with risk of SCD. We investigated the associations of the Mediterranean diet score and various dietary patterns with risk of SCD in participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study cohort. Methods and Results Diet was assessed with a food frequency questionnaire administered at baseline in REGARDS. The Mediterranean diet score was derived based on the consumption of specific food groups considered beneficial or detrimental components of that diet. Dietary patterns were derived previously using factor analysis, and adherence to each pattern was scored. SCD events were ascertained through regular contacts. Cox proportional hazards regression was used to examine the risk of SCD events associated with the Mediterranean diet score and adherence to each of the 5 dietary patterns overall and stratifying on history of coronary heart disease at baseline. The analytic sample included 21 069 participants with a mean 9.8±3.8 years of follow‐up. The Mediterranean diet score showed a trend toward an inverse association with risk of SCD after multivariable adjustment (hazard ratio [HR] comparing highest with lowest group, 0.74; 95% CI, 0.55–1.01; P trend =0.07). There was a trend toward a positive association of the Southern dietary pattern with risk of SCD (HR comparing highest with lowest quartile of adherence, 1.46; 95% CI, 1.02–2.10; P trend =0.06). Conclusions In REGARDS participants, we identified trends toward an inverse association of the Mediterranean diet score and a positive association of adherence to the Southern dietary pattern with risk of SCD.

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