scholarly journals Diet quality, change in diet quality and risk of incident CVD and diabetes

2019 ◽  
Vol 23 (2) ◽  
pp. 329-338 ◽  
Author(s):  
Zhe Xu ◽  
Lyn M Steffen ◽  
Elizabeth Selvin ◽  
Casey M Rebholz
Keyword(s):  
Diet Quality ◽  
Cox Regression ◽  
Healthy Eating Index ◽  
Quality Score ◽  
Diabetes Risk ◽  
Cvd Risk ◽  
Community Based ◽  
Prospective Association ◽  
Diet Score

AbstractObjective:The objective of this study was to assess the prospective association between diet quality, as well as a 6-year change in diet quality, and risk of incident CVD and diabetes in a community-based population.Design:We used Cox regression models to estimate the prospective association between diet quality, assessed using the Healthy Eating Index (HEI)-2015 and the Alternative HEI (AHEI)-2010 scores, as well as change in diet quality, and incident CVD and diabetes.Setting:The ARIC Study recruited 15 792 black and white men and women (45–64 years) from four US communities.Participants:We included 10 808 study participants who reported usual dietary intake via FFQ at visit 1 (1987–1989) and who had not developed CVD, diabetes, or cancer at baseline.Results:Overall, 3070 participants developed CVD (median follow-up of 26 years) and 3452 developed diabetes (median follow-up of 22 years) after visit 1. Higher diet score at the initial visit was associated with a significantly lower risk of CVD (HR per 10 % higher HEI-2015 diet quality score: 0·90 (95 % CI: 0·86, 0·95) and HR per 10 % higher AHEI-2010 diet quality score: 0·96 (95 % CI: 0·93, 0·99)). We did not observe a significant association between initial diet score and incident diabetes. There were no significant associations between change in diet score and CVD or diabetes risk in the overall study population.Conclusions:Higher diet quality assessed using HEI-2015 and AHEI-2010 was strongly associated with lower CVD risk but not diabetes risk within a middle-aged, community-based US population.

scholarly journals Proteins as Mediators of the Association Between Diet Quality and Incident Cardiovascular Disease and All‐Cause Mortality: The Framingham Heart Study

2021 ◽  
Author(s):  
Youjin Kim ◽  
Sophia Lu ◽  
Jennifer E. Ho ◽  
Shih‐Jen Hwang ◽  
Chen Yao ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Healthy Eating ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Quality Score ◽  
Median Proportion ◽  
Heart Study ◽  
All Cause Mortality ◽  
Related Proteins ◽  
Diet Score

Background Biological mechanisms underlying the association of a healthy diet with chronic diseases remain unclear. Targeted proteomics may facilitate the understanding of mechanisms linking diet to chronic diseases. Methods and Results We examined 6360 participants (mean age 50 years; 54% women) in the Framingham Heart Study. The associations between diet and 71 cardiovascular disease (CVD)‐related proteins were examined using 3 diet quality scores: the Alternate Healthy Eating Index, the modified Mediterranean‐style Diet Score, and the modified Dietary Approaches to Stop Hypertension diet score. A mediation analysis was conducted to examine which proteins mediated the associations of diet with incident CVD and all‐cause mortality. Thirty of the 71 proteins were associated with at least 1 diet quality score ( P <0.0007) after adjustment for multiple covariates in all study participants and confirmed by an internal validation analysis. Gene ontology analysis identified inflammation‐related pathways such as regulation of cell killing and neuroinflammatory response (Bonferroni corrected P <0.05). During a median follow‐up of 13 years, we documented 512 deaths and 488 incident CVD events. Higher diet quality scores were associated with lower risk of CVD ( P ≤0.03) and mortality ( P ≤0.004). After adjusting for multiple potential confounders, 4 proteins (B2M [beta‐2‐microglobulin], GDF15 [growth differentiation factor 15], sICAM1 [soluble intercellular adhesion molecule 1], and UCMGP [uncarboxylated matrix Gla‐protein]) mediated the association between at least 1 diet quality score and all‐cause mortality (median proportion of mediation ranged from 8.6% to 25.9%). We also observed that GDF15 mediated the association of the Alternate Healthy Eating Index with CVD (median proportion of mediation: 8.6%). Conclusions Diet quality is associated with new‐onset CVD and mortality and with circulating CVD‐related proteins. Several proteins appear to mediate the association of diet with these outcomes.

scholarly journals The Framingham risk score is associated with incident frailty, or is it?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Shi ◽  
Mei-Ling Ge ◽  
Birong Dong ◽  
Qian-Li Xue
Keyword(s):  
Older Adults ◽  
Risk Score ◽  
Cox Regression ◽  
Activity Level ◽  
Cvd Risk ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Adverse Health Outcomes ◽  
Comorbidity Burden

Abstract Backgrounds Cardiovascular disease (CVD) risk factors are individually associated with frailty. This study examined whether Framingham CVD risk score (FRS) as an aggregate measure of CVD risk is associated with incident frailty among Chinese older adults. Methods This study used data from the China Health and Retirement Longitudinal Study. A sample of 3,618 participants aged 60 to 95 years and without CVD at baseline were followed for four years. FRS was calculated at baseline. Frailty status was defined as not-frail (0–2 criteria) or frail (3–5 criteria) based on the physical frailty phenotype consisting of five binary criteria (weakness, slowness, exhaustion, low activity level, and weight loss). After excluding subjects who were frail (n = 248) at baseline, discrete-time Cox regression was used to evaluate the relationship between FRS and incident frailty. Results During a median follow-up of 4.0 years, 323 (8 %) participants developed CVD and 318 (11 %) subjects had frailty onset. Higher FRS was associated with greater risk of incident frailty (HR: 1.03, 95 % CI: 1.00 to 1.06) after adjusting for education, marital status, obesity, comorbidity burden, and cognitive function. This association however was no longer significant (HR: 1.00, 95 % CI: 0.97 to 1.03) after additionally adjusting for age. These findings remained essentially unchanged after excluding subjects with depression (n = 590) at baseline or incident CVD (n = 323) during the 4-year follow-up. Conclusions The FRS was not independently associated with incident frailty after adjusting for chronological age. More research is needed to assess the clinical utility of the FRS in predicting adverse health outcomes other than CVD in older adults.

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

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.

scholarly journals Prospective association between adherence to dietary recommendations and incident depressive symptoms in the French NutriNet-Santé cohort

2018 ◽  
Vol 120 (3) ◽  
pp. 290-300 ◽  
Author(s):  
Moufidath Adjibade ◽  
Cédric Lemogne ◽  
Chantal Julia ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depression Scale ◽  
Healthy Eating Index ◽  
Continuous Variables ◽  
Dietary Recommendations ◽  
Nutritional Recommendations ◽  
Dietary Record ◽  
Prospective Association ◽  
Incident Cases

AbstractA posteriorihealthier dietary patterns and several nutrients have been associated with lower risks of depression in various studies; however, evidence is lacking with regard to the prospective association between adherence to nutritional recommendations (food-based and nutrient-based recommendations) and incident depression or depressive symptoms. In this study, we investigate such associations in the NutriNet Santé cohort. The study sample included 26 225 participants (aged 18–86 years) who were initially free of depressive symptoms. Adherence to nutritional recommendations was measured by four scores namely modified French Programme National Nutrition Santé-Guideline Score (mPNNS-GS), Alternative Healthy Eating Index-2010 (AHEI-2010), Probability of Adequate Nutrient Intake Dietary Score (PANDiet) and Diet Quality Index-International (DQI-I), using non-consecutive dietary record data during the first 2 years of follow-up (mean number of recording days=8,sd2). Depressive symptoms were defined by a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥17 for men and ≥23 for women. We used Cox proportional hazards models to estimate hazard ratios and 95 % CI, modelling the dietary scores as standardised continuous variables and as tertiles. Over a mean follow-up of 6 years, we identified 2166 incident cases of depressive symptoms. All dietary scores with the exception of the AHEI-2010 were significantly inversely associated with incident depressive symptoms. In the fully adjusted model, an increase of 1sdin the mPNNS-GS, PANDiet and DQI-I was, respectively, associated with an 8 % (95 % CI 4, 13), 5 % (95 % CI 1, 9) and 9 % (95 % CI 5, 13) reduction in the risk of depressive symptoms. Overall, these findings suggest that diet in accordance with national or international guidelines could have beneficial effects with regard to mental health.

Abstract 13168: Food Quality Score and the Risk of Coronary Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Teresa Fung ◽  
An Pan ◽  
Tao Hou ◽  
Dariush Mozzafarian ◽  
Shilpa Bhupathiraju ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Food Quality ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Quality Score ◽  
Health Study ◽  
Standard Deviation Increase ◽  
Chd Risk ◽  
History Of

Introduction: We have previously derived a food based diet quality score associated with weight change. In this analysis, we prospectively assessed the association between this score and risk of coronary heart disease (CHD). Methods: We followed 74,667 women in the Nurse’ Health Study (baseline age 35-55 y), 28,977 men in the Health Professionals Follow-up Study (baseline age 50-72), and 92,513 women in the Nurses’ Health Study 2 (baseline age 25-42) without a history of cardiovascular disease for up to 26 years between 1984 and 2011. Diet was assessed up to 7 times using repeated food frequency questionnaires. We computed the Food Quality Score (FQS) for each individual. A higher FQS score represents a healthier diet. The association between the FQS and CHD risk was assessed using Cox proportional hazard model controlling for potential confounders. We also compared the strength of association of FQS with other diet quality scores. Results: We ascertained 6497 incident CHD events, including 4594 nonfatal myocardial infarct (MI) and 2055 fatal cases. Comparing top to bottom deciles, the pooled RR was 0.66 (95% CI=0.58-0.74, p trend<0.001) for total CHD, 0.63 (0.54-0.73, p trend<0.001) for non-fatal MI, and 0.73 (0.59-0.90, p trend=0.001) for fatal MI. The association for CHD was significant in lean (BMI<25) and overweight (BMI>=25) individuals, those with or without a family history of MI, and physical activity above or below the median. When comparing the FQS with other diet quality scores that have previously been associated to lower CHD risk, one standard deviation increase in the FQS was not significantly different from the Alternate Mediterranean Diet score, the Alternate Healthy Eating Index-2010 or the Dietary Approaches to Stop Hypertension score in its association with CHD risk. Conclusion: A higher FQS was associated with lower CHD risk. The FQS was comparable to food and nutrient based diet quality score that have previously been associated with lower CVD risk and indicates a potential to develop a simple food only diet quality for public health applications of assessing diet quality.

Abstract P108: Metabolic Profile Of Diet Quality In The Multi-Ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Meghana Gadgil ◽  
Alexis F Wood ◽  
Ibrahim Karaman ◽  
Goncalo Gomes Da Graca ◽  
Ioanna Tzoulaki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Diet Quality ◽  
Spectral Feature ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Elastic Net ◽  
Dietary Quality ◽  
Spectral Features ◽  
Ethnic Study ◽  
Diet Score

Introduction: Poor dietary quality is a well-known risk factor for diabetes and cardiovascular disease (CVD), however metabolites marking adherence to U.S. dietary guidelines are unknown. Our goal was to determine a pattern of metabolites associated with the Healthy Eating Index-2015 (HEI-2015). We hypothesize that there will be metabolites positively and negatively associated with the HEI-2015 score, including those previously linked to diabetes and CVD. Methods: Sample: 2269 adult men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study without known cardiovascular disease or diabetes. Data/specimens: Fasting serum specimens, diet and demographic questionnaires at baseline. Metabolomics: Untargeted 1 H NMR CPMG spectroscopy (600 MHz) annotated by internal and external reference data sets. Statistical analysis: Metabolome-wide association study (MWAS) using linear regression models specifying each spectral feature as the outcome in separate models, HEI-2015 score as the predictor, and adjustment for age, sex, race, and study site, accounting for multiple comparisons. Elastic net regularized regression was used to select an optimal subset of features associated with HEI-2015 score. Separately, hierarchical clustering defined discrete groups of correlated NMR features also tested for association with HEI-2015 score. Results: MWAS identified 1914 spectral features significantly associated with the HEI-2015 diet score. After elastic net regression, 35 metabolomic spectral features remained associated with HEI-2015 diet score. Cluster analysis identified seven clusters, three of which were significantly associated with HEI-2015 score after Bonferroni correction. (Table) Conclusions: Cholesterol moieties, proline betaine, proline/glutamate and fatty acyls chains were significantly associated with higher diet quality in the MESA cohort. Further analysis may clarify the link between dietary quality, metabolites, and pathogenesis of diabetes and CVD.

scholarly journals Studying Impact of Nutrition on Growth (SING): a prospective cohort for comparing the health outcomes of young children with the dietary quality score

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018380
Author(s):  
Albert Lee ◽  
Calvin Ka-man Cheung ◽  
Kenneth Lo ◽  
Vera Mei-wan Keung ◽  
Lancelot Wai-ho Mui ◽  
...  
Keyword(s):  
Hong Kong ◽  
Prospective Cohort ◽  
Prenatal Development ◽  
Healthy Eating Index ◽  
Quality Score ◽  
The Body ◽  
Dietary Quality ◽  
Outcome Variable ◽  
Food Diary ◽  
Prospective Association

IntroductionThis study aims to explore the prospective association between the dietary quality (DQ) of preschoolers and their health status in Hong Kong, with the body mass index as the main outcome variable.Methods and analysisThis prospective cohort study has recruited 3539 children aged between 2 and 4 years old, with a follow-up period of 4 years. Their diet was reported by their parents by a 3-day food diary, and their body weight and height were measured yearly with standardised instruments. Questionnaires were administered to parents to acquire information of the children’s prenatal development and dietary intake before their age of 2 years and of their baseline lifestyle and family backgrounds. The DQ was measured by the Healthy Eating Index as a continuous scale, while the exposure was defined as having a higher dietary quality score. Data were analysed using SPSS V.24. Linear and logistic regressions were used to examine the association of those predictive factors to the outcomes. Generalised estimating equations will be used to examine the longitudinal changes of the outcomes. A pilot study has been conducted, the preliminary results from which are presented in this cohort profile.Ethics and disseminationThis study has been approved by the Joint Chinese University of Hong Kong and New Territory East Cluster Clinical Research Ethics Committee (CREC Ref No: 2013–632). Written informed consent was obtained from all subjects. The results will be published in due course.

scholarly journals Association Between Diet Quality and Food Waste in South Florida

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 143-143
Author(s):  
Vanessa Mijares ◽  
Jair Alcivar ◽  
Cristina Palacios
Keyword(s):  
Food Waste ◽  
Diet Quality ◽  
Inverse Correlation ◽  
Cross Sectional Study ◽  
Healthy Eating Index ◽  
Quality Score ◽  
South Florida ◽  
Grocery Stores ◽  
Cross Sectional ◽  
Florida International University

Abstract Objectives In 2015, the USDA/EPA set a goal of reducing food waste in 50% by 2030. This goal will not only lower U.S. methane gas emissions but also redirect food to millions of food insecure Americans. Little is known on food waste and its association with diet quality. Therefore, our objective was to explore the associations between diet quality and food waste. Methods This was a cross sectional study among adults ³18 years in south Florida who are the primary household food provider conducting a primary shopping event for the week. Participants were recruited outside of local grocery stores and asked to fill out a quick food waste survey. Pictures of the participants’ grocery receipts were taken to analyze diet quality using the Grocery Purchase Quality Index 2016 (GPQI-2016). The GPQI-2016 is based on the Healthy Eating Index (HEI)– 2010 and has 11 different components (each with a maximum score of 5 or 10) for a total score of 75. Correlations were used to determine the associations between diet quality and amount of food waste (Pearson) or reasons for food waste (Point-biserial). Results A total of 109 participants were recruited but 103 had complete data. Mean age was 44.6 ± 13.6 years, most were females (74%) and Hispanics (79%). Most usually grocery shop in a main event and then go back for smaller items (44%) once (36%) or twice (28%) a week. Mean diet quality score was 40.9 ± 9.64 out of 75 points and mean amount of food waste was 17.7 ± 19.9 handfuls. Most reported throwing away food mainly because it went bad (90%) or it was past it's due date (80%). Handfuls of bread/rice waste were significantly inversely correlated with diet quality (r = −2.60; p = 0.013). Also, we found a significant inverse correlation between diet quality and food thrown away because it had gone past it's use by date (r = −.196; p = 0.049). Conclusions A lower diet quality score was related to higher amount of bread/rice wasted and with throwing away foods that has past it's use date. These results could justify directing reducing food waste efforts in the community by educating individuals on purchasing frozen products or on proper storage to prolong shelf life, as well as on understanding the different dates placed on products by manufacturers. Funding Sources Internal funds from Florida International University.

scholarly journals Diet Quality and All-Cause and Cancer-Specific Mortality in Older Adults with Invasive Cancer: The Multiethnic Cohort Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 555-555
Author(s):  
Song-Yi Park ◽  
Yurii Shvetsov ◽  
Minji Kang ◽  
V Wendy Setiawan ◽  
Carol Boushey ◽  
...  
Keyword(s):  
Older Adults ◽  
Diet Quality ◽  
Cancer Mortality ◽  
Healthy Eating Index ◽  
Invasive Cancer ◽  
Japanese American ◽  
Multiethnic Cohort ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Abstract Objectives We examined the association of postdiagnostic diet quality with all-cause and cancer-specific mortality in older adults diagnosed with invasive cancer, in comparison with those without invasive cancer, in the Multiethnic Cohort. Methods Data were from 66,374 African American, Native Hawaiian, Japanese American, Latino, and White men and women, who had no prevalent cancer, heart disease, or stroke at baseline (1993–1996, 45–75 years) and completed a quantitative food frequency questionnaire at both baseline and 10-year follow-up (2003–2007). Overall diet quality was measured by the Healthy Eating Index (HEI)-2015, the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH) scores. Invasive cancer cases between the baseline and 10-year surveys and deaths after the 10 year survey were identified through linkage to cancer registries and to state death files and the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in multivariate Cox models for the dietary indexes at 10-year follow-up with subsequent mortality. Results Age-adjusted mean scores of the 4 dietary indexes at baseline (prediagnosis) and 10-year follow-up (postdiagnosis) were similar or slightly lower in participants with cancer (n = 5998), compared to those without cancer (n = 60,376). Among participants with cancer (71.5 ± 8.0 years), 2006 all-cause and 1005 cancer-specific deaths were identified during a mean follow-up of 8 years after the 10-year survey. Postdiagnostic scores from all 4 indexes were associated with lower risk of all-cause and cancer mortality: for the highest vs. lowest quartiles, HR (95% CI) for all-cause mortality was 0.72 (0.62–0.82) for HEI-2015, 0.84 (0.73–0.96) for AHEI-2010, 0.74 (0.63–0.86) for aMED, and 0.76 (0.66–0.87) for DASH. The corresponding HRs (95% CIs) for cancer mortality were 0.81 (0.66–0.99), 0.81 (0.66–0.99), 0.72 (0.58–0.89), and 0.79 (0.65–0.97). These HRs were similar to those for participants without cancer. Conclusions Postdiagnostic high-quality diet was related to lower all-cause and cancer mortality in older adults with invasive cancer, with risk reduction comparable to that among participants without cancer. Funding Sources National Cancer Institute.

scholarly journals Associations between Diet Quality and Body Composition in Young Children Born with Very Low Body Weight

2020 ◽  
Vol 150 (11) ◽  
pp. 2961-2968
Author(s):  
Meghan McGee ◽  
Sharon Unger ◽  
Jill Hamilton ◽  
Catherine S Birken ◽  
Zdenka Pausova ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Neurodevelopmental Outcomes ◽  
Donor Milk ◽  
Added Sugars ◽  
Air Displacement Plethysmography ◽  
Z Scores

ABSTRACT Background Very low birth weight (VLBW; &lt;1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals. Objective The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity. Methods This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds. Results Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: −0.5 SD; 95% CI: −0.7, −0.2) and subscapular (−0.3 SD; 95% CI: −0.6, −0.06) z-scores. Conclusions Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.

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