Native Youth Participating in the Together on Diabetes 12-Month Home-Visiting Program Reported Improvements in Alternative Healthy Eating Index-2010 Diet Quality Domains Likely to Be Associated With Blood Pressure and Glycemic Control

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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Lung function, COPD and Alternative Healthy Eating Index (AHEI-2010) in US adults

ERJ Open Research ◽

10.1183/23120541.00927-2020 ◽

2021 ◽

pp. 00927-2020

Author(s):

Kirstie Ducharme-Smith ◽

Gustavo Mora-Garcia ◽

Francisca de Castro Mendes ◽

Maria Stephany Ruiz-Diaz ◽

Andre Moreira ◽

...

Keyword(s):

Lung Function ◽

Healthy Eating ◽

Diet Quality ◽

The United States ◽

Forced Expiratory Volume ◽

Healthy Eating Index ◽

Chronic Obstructive ◽

P Value ◽

Lower Odds ◽

Alternative Healthy Eating Index

BackgroundThere is a large burden of chronic obstructive pulmonary disease (COPD) in the United States (US). The purpose of this study was to investigate the association between diet quality with lung function, airway restriction, and spirometrically defined COPD in a nationally representative sample of US adults.MethodsAdults (19–70 years of age) from the National Health and Nutrition Examination Survey (NHANES) 2007–2012 cycles were included (N=10 428). Diet quality was determined using the Alternative Healthy Eating Index (AHEI-2010). Pre-bronchodilator measurements of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and the FEV1/FVC were described. Calibrated lower limit of normal (LLN) estimates were derived to determine prevalence of airway restriction (FVC<LLN) and COPD (FEV1/FVC Ratio<LLN). Population-weighted linear and logistic regression models were used to investigate the association of AHEI-2010 and respiratory outcomes.ResultsThe average AHEI was 45.3 (±12.2), equivalent to meeting 41% of the daily recommendations for optimal diet quality. Those in the highest quartile of AHEI had better FEV1 (adjusted [a]β:47.92, 95% CI 2.27, 93.57) and FVC (aβ: 80.23, 95% CI 34.03, 126.42; p-value interaction (*) of AHEI and smoking >0.05) compared to those in quartile 1. Higher AHEI was also associated with lower odds of airway restriction (OR: 0.23, 95% CI 0.08, 0.67; p-value AHEI*ethnicity >0.05).ConclusionsDiet quality was independently associated with better FEV1, FVC, and with lower odds of spirometric restriction. These findings highlight the need for research to further elucidate the possible beneficial role of diet in the preservation of lung function.

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Quality of Diet and Cardio-Metabolic Outcomes in Native American Adolescents Participating in the Together on Diabetes Home-Visiting Program

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_031 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 180-180

Author(s):

Kirstie Ducharme-Smith ◽

Summer Rosenstock ◽

Vanessa Garcia-Larsen ◽

Francene Larzelere ◽

Rachel Chambers ◽

...

Keyword(s):

Blood Pressure ◽

Native American ◽

Diet Quality ◽

Home Visiting ◽

Healthy Eating Index ◽

Metabolic Health ◽

P Value ◽

Quartile Score

Abstract Objectives 1) Examine the impact of the Together on Diabetes (TOD) program on diet quality using the Alternative Healthy Eating Index (AHEI); 2) Determine the association of diet quality with outcomes of cardio-metabolic health (systolic and diastolic blood pressure, hemoglobin A1c, and zBMI). Methods TOD was a 12-month home-visiting diabetes prevention/management program, evaluated using a pre/post study design, conducted in four rural, reservation-based Native American communities in the southwestern United States. Participants were 10 to 19 years of age and were identified as pre-diabetic, T2DM or “at risk” based on body mass index (zBMI) and a qualifying laboratory test. Diet information was collected via an adapted Block food-frequency questionnaire (FFQ). Diet quality was calculated using the AHEI, broken into quartiles based on distribution of the sample. Changes in AHEI-score and associations with cardio-metabolic measures were tested, over time, using adjusted linear mixed effects models. Results The majority of the sample (n = 240) completed the FFQ at baseline and reported an average energy intake of 2016.18 Kcal/day (±1260.45) and AHEI-score (Range: 0–110, higher = better diet quality) of 47.37 (±7.36), indicating low diet quality. At 12 months follow-up, there was a reduction in calories (m = –345.75 Kcal/day (P < 0.001)), sugar-sweetened beverages (SSB) (m = –2 fluid ounces/day (P = 0.032)), red-processed meat (m = –1.5 ounces/day (P = 0.008)), and sodium (m = –650.37 mg/day (P < 0.001)) but no change in overall AHEI-score (p-value = 0.600). At baseline, the HbA1c of diabetic participants with the highest quartile AHEI-score was significantly lower (m = –1.43% (p-value = 0.048)) than those with the lowest quartile score. At 12-months the systolic blood pressure of participants with the highest quartile AHEI-score was significantly lower (m = –5.71 mm Hg (p-value = 0.038)) than those with the lowest quartile score. Conclusions Despite stable AHEI-scores during follow-up, there were improvements in diet quality domains most likely to be associated with poor cardio-metabolic health (e.g., overall calories, SSB consumption, and sodium intake). Home-visiting programs, like TOD, are promising interventions for decreasing dietary intake of poor quality foods. Funding Sources The Bristol Meyers Squibb Foundation funded the TOD Program.

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Body Mass of U.S. Hispanics/Latinos From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): How Do Diet Quality and Sedentary Time Relate?

Hispanic Health Care International ◽

10.1177/1540415319874809 ◽

2019 ◽

Vol 18 (2) ◽

pp. 55-63

Author(s):

Marisa J. Perera ◽

Diana A. Chirinos ◽

Carrie E. Brintz ◽

Neil Schneiderman ◽

Martha Daviglus ◽

...

Keyword(s):

Community Health ◽

Body Mass ◽

Healthy Eating ◽

Diet Quality ◽

Sedentary Time ◽

Healthy Eating Index ◽

Health Study ◽

Length Of Residence ◽

Hispanic Community ◽

Alternative Healthy Eating Index

Little evidence exists on diet quality- and sedentary time-related differences in body mass index (BMI) among immigrant and nonimmigrant Hispanics/Latinos with different lengths of U.S. residence. A total of 13,962 (80.2% foreign-born) Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants aged 18 to 60 from four U.S. cities (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA) underwent standardized interviews and fasting blood tests. Diet quality was total Alternative Healthy Eating Index score. Sedentary time was number of <100 counts/minute over 3 to 6 days. BMI was examined using regression models adjusted for age, income, Hispanic/Latino background, HCHS/SOL site, and tobacco use. Two three-way interactions (diet or sedentary time length of residence sex) were tested to examine health behavior-related differences in BMI among immigrant and nonimmigrant males and females. The diet length of residence sex interaction was significant ( b = .005, 95% confidence interval [−.003, .008]). For a 10-unit Alternative Healthy Eating Index difference, the BMI difference was greater among immigrant females in the United States longer (0 years = .84 kg/m2; 10 years = 1.64 kg/m2). Diet-related obesity prevention efforts may start soon after migration, particularly for immigrant women.

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Cross-sectional Relationships between Alternate Healthy Eating Index (AHEI) with General and Abdominal Obesity and Blood Pressure in Iranian Hospital Employees

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666210810144259 ◽

2021 ◽

Vol 21 ◽

Author(s):

Shahrzad Mirashrafi ◽

Marzieh Kafeshani ◽

Akbar Hassanzadeh ◽

Mohammad Hassan Entezari

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Healthy Eating ◽

Diet Quality ◽

Healthy Eating Index ◽

Cross Sectional ◽

Hospital Employees ◽

The Mean ◽

The Relationship

Background and Aims: Due to the increasing prevalence of obesity and related disorders, there is an urgent need to examine the relationship between diet quality and public health. The Alternative Healthy Eating Index (AHEI) is one of the indices that is used to assess diet quality. Therefore, we investigated the relationship between AHEI and anthropometric measurements and blood pressure. Methods: In this cross-sectional study, 127 male and female hospital employees were examined. The AHEI was calculated by a 168 items Food Frequency Questionnaire. Body weight, height, Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR) and blood pressure were measured by skilled nutritionists. Physical activity level was also obtained by International Physical Activity Questionnaire (IPAQ). Results : The mean total AHEI score in participants was reported as 47.1±6.9 (min=31.9, max=60.3). The mean differences of total AHEI score across the obese/non-obese employees were not statistically significant (P>0.05). Furthermore, there was no significant correlation between total AHEI score and BMI (r=0.019), WC (r=0.022), WHR (r=-0.102), systolic (r=-0.133) and diastolic blood pressure (r=-0.040) (P>0.05). The score of nuts and soybeans was inversely related to the WHR (P=0.008) and systolic blood pressure (P=0.030). Cereal fiber score had a negative relationship with BMI (P=0.02), WC (P=0.03), WHR (P=0.004) and systolic (P<0.001) and diastolic blood pressure (P=0.012). Conclusion: Consumption of nuts and soybeans -one serving per day- can be associated with WHR and systolic blood pressure reduction. More studies with a larger scale are needed to examine diet quality.

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Adaptation and Validation of Alternative Healthy Eating Index in Hemodialysis Patients (AHEI-HD) and Its Association with all-Cause Mortality: A Multi-Center Follow-Up Study

Nutrients ◽

10.3390/nu11061407 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1407 ◽

Cited By ~ 1

Author(s):

Tuyen Van Duong ◽

I-Hsin Tseng ◽

Te-Chih Wong ◽

Hsi-Hsien Chen ◽

Tso-Hsiao Chen ◽

...

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Discriminant Validity ◽

Hemodialysis Patients ◽

Healthy Eating Index ◽

Alternative Healthy Eating Index ◽

All Cause Mortality ◽

Dietary Records ◽

A Prospective Study

A valid diet quality assessment scale has not been investigated in hemodialysis patients. We aimed to adapt and validate the alternative healthy eating index in hemodialysis patients (AHEI-HD), and investigate its associations with all-cause mortality. A prospective study was conducted on 370 hemodialysis patients from seven hospital-based dialysis centers. Dietary data (using three independent 24-hour dietary records), clinical and laboratory parameters were collected. The construct and criterion validity of original AHEI-2010 with 11 items and the AHEI-HD with 16 items were examined. Both scales showed reasonable item-scale correlations and satisfactory discriminant validity. The AHEI-HD demonstrated a weaker correlation with energy intake compared with AHEI-2010. Principle component analysis yielded the plateau scree plot line in AHEI-HD but not in AHEI-2010. In comparison with patients in lowest diet quality (tertile 1), those in highest diet quality (tertile 3) had significantly lower risk for death, with a hazard ratio (HR) and 95% confidence intervals (95%CI) of HR: 0.40; 95%CI: 0.18 – 0.90; p = 0.028, as measured by AHEI-2010, and HR: 0.37; 95%CI: 0.17–0.82; p = 0.014 as measured by AHEI-HD, respectively. In conclusion, AHEI-HD was shown to have greater advantages than AHEI-2010. AHEI-HD was suggested for assessments of diet quality in hemodialysis patients.

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Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

Nutrition Journal ◽

10.1186/s12937-021-00717-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amir Motamedi ◽

Maryam Ekramzadeh ◽

Ehsan Bahramali ◽

Mojtaba Farjam ◽

Reza Homayounfar

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Diet Quality ◽

Dietary Diversity ◽

Antihypertensive Drugs ◽

Healthy Eating Index ◽

Cross Sectional ◽

Common Chronic Disease ◽

History Of ◽

Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

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Association between overall diet quality and postmenopausal breast cancer risk in five Finnish cohort studies

Scientific Reports ◽

10.1038/s41598-021-95773-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Satu Männistö ◽

Kennet Harald ◽

Tommi Härkänen ◽

Mirkka Maukonen ◽

Johan G. Eriksson ◽

...

Keyword(s):

Breast Cancer ◽

Diet Quality ◽

Proportional Hazards ◽

Postmenopausal Breast Cancer ◽

Healthy Eating Index ◽

Cox Proportional Hazards ◽

Healthy Diet ◽

Food Culture ◽

Alternative Healthy Eating Index

AbstractThere is limited evidence for any dietary factor, except alcohol, in breast cancer (BC) risk. Therefore, studies on a whole diet, using diet quality indices, can broaden our insight. We examined associations of the Nordic Diet (mNDI), Mediterranean diet (mMEDI) and Alternative Healthy Eating Index (mAHEI) with postmenopausal BC risk. Five Finnish cohorts were combined including 6374 postmenopausal women with dietary information. In all, 8–9 dietary components were aggregated in each index, higher total score indicating higher adherence to a healthy diet. Cox proportional hazards regression was used to estimate the combined hazard ratio (HR) and 95% confidence interval (CI) for BC risk. During an average 10-year follow-up period, 274 incident postmenopausal BC cases were diagnosed. In multivariable models, the HR for highest vs. lowest quintile of index was 0.67 (95 %CI 0.48–1.01) for mNDI, 0.88 (0.59–1.30) for mMEDI and 0.89 (0.60–1.32) for mAHEI. In this combined dataset, a borderline preventive finding of high adherence to mNDI on postmenopausal BC risk was found. Of the indices, mNDI was more based on the local food culture than the others. Although a healthy diet has beneficially been related to several chronic diseases, the link with the etiology of postmenopausal BC does not seem to be that obvious.

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Higher diet quality is associated with higher diet costs when eating at home and away from home: National Health and Nutrition Examination Survey, 2005-2016

Public Health Nutrition ◽

10.1017/s1368980021002810 ◽

2021 ◽

pp. 1-29

Author(s):

Zach Conrad ◽

Sarah Reinhardt ◽

Rebecca Boehm ◽

Acree McDowell

Keyword(s):

Healthy Eating ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Food Prices ◽

Nutrition Examination Survey ◽

Food Away From Home ◽

Health And Nutrition ◽

Food Consumed ◽

At Home

Abstract Objectives: To evaluate the association between diet quality and cost for foods purchased for consumption at home and away from home. Design: Cross-sectional analysis. Multivariable linear regression models evaluated the association between diet quality and cost for all food, food at home, and food away from home. Setting: Daily food intake data from the National Health and Nutrition Examination Survey (2005-2016). Food prices were derived using data from multiple, publicly available databases. Diet quality was assessed using the Healthy Eating Index-2015 and the Alternative Healthy Eating Index-2010. Participants: 30,564 individuals ≥20 y with complete and reliable dietary data. Results: Mean per capita daily diet cost was $14.19 (95% CI: $13.91-14.48), including $6.92 ($6.73-7.10) for food consumed at home and $7.28 ($7.05-7.50) for food consumed away from home. Diet quality was higher for food at home compared to food away from home (P<0.001). Higher diet quality was associated with higher food costs overall, at home, and away from home (P<0.001 for all comparisons). Conclusions: These findings demonstrate that higher diet quality is associated with higher costs for all food, food consumed at home, and food consumed away from home. This research provides policymakers, public health professionals, and clinicians with information needed to support healthy eating habits. These findings are particularly relevant to contemporary health and economic concerns that have worsened because of the COVID-19 pandemic.

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