Diet Quality and the Fecal Microbiota in Healthy Adults in the American Gut Project

Abstract Objectives The human gastrointestinal microbiota contributes to the relationship between diet and health via microbial metabolism of undigested food components. Thus, it is valuable to understand the relations between gut microorganisms and diet quality. Herein, we examined the associations between compliance to the Dietary Guidelines for Americans, as measured by the Healthy Eating Index (HEI) 2010 scores, and the fecal microbiota in a subset of healthy adults in the American Gut Project cohort. Methods This was a cross-sectional observational study of healthy adults (n = 1,573 (984 females); BMI:18.5-29.9 kg/m2; 20–90 years of age) from the American Gut Project cohort who provided a stool sample and completed a Food Frequency Questionnaire (FFQ; VioScreen). Fecal samples were processed using Earth Microbiome Project protocols. Briefly, DNA was extracted from the stool samples and the V4 region of the 16S rRNA gene was amplified and sequenced. Taxonomies were determined using Greengenes 13_8. HEI-2010 scores were calculated by VioScreen, and for the purposes of this study, further divided into tertiles. Bacterial genera that were present in at least 50% of the cohort were assessed. Bacterial relative abundances between high and low tertiles of HEI total score were compared using the Mann-Whitney test. Corrections for multiple comparisons were made using a false discovery rate of 5%. Results Greater abundances of the genera Faecalibacterium, Coprococcus, and Lachnospira were detected among participants within the highest HEI total score tertile (q < 0.03). Alternatively, the relative abundances of Bacteroides, Alistipes, Bilophila, and Collinsella were greatest among those with the lowest HEI total score (q < 0.03). Conclusions These results reveal that higher HEI-2010 total scores were associated with greater abundances of SCFA-producing microorganisms but inversely associated with bile-tolerant taxa. Ongoing analyses include further examination of relations between the 12 different components of the HEI-2010, as well as examining differences among demographic groups. Funding Sources USDA National Institute of Food and Agriculture, Hatch Project 1009249.

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Diet Quality and the Fecal Microbiota in Healthy Adults in the American Gut Project

Current Developments in Nutrition ◽

10.1093/cdn/nzab054_004 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1149-1149

Author(s):

Alexis Baldeon ◽

Jordan Lovett ◽

Ziyang Pan ◽

Hannah Holscher

Keyword(s):

Diet Quality ◽

Cross Sectional Study ◽

Fecal Microbiota ◽

Whole Grains ◽

Healthy Eating Index ◽

Healthy Adults ◽

Rrna Gene ◽

Gastrointestinal Microbiota ◽

Cross Sectional ◽

Saturated Fats

Abstract Objectives The human gastrointestinal microbiota contributes to the relationship between diet and health via microbial metabolism of undigested food components. Thus, it is valuable to understand the relations between gut microorganisms and diet quality. Herein, we examined the associations between the Healthy Eating Index (HEI)-2015 and the fecal microbiota in a subset of healthy adults in the American Gut Project (AGP) cohort. Methods This was a cross-sectional study of healthy adults (n = 1162 (759 females); BMI: 18.5–29.9 kg/m2; 18–65 years of age) from the AGP cohort who provided a stool sample and a time-matched Food Frequency Questionnaire (FFQ; VioScreen). Fecal samples were processed by the AGP lab. Briefly, DNA was extracted from the stool samples, and the V4 region of the 16S rRNA gene was amplified and sequenced. HEI-2015 scores were calculated using VioScreen's report of HEI-2010 scores and nutrient component percentages. The cohort was divided into tertiles based on Total Score, and components Whole Grains, Dairy, Fatty Acids, Sodium, and Saturated Fats. Differential abundance analysis was conducted using ANCOM-BC, comparing the high (T3) tertile to the low (T1) tertile for all categories. Comparisons that were statistically significant following FDR corrections are reported (q < 0.05). Results Comparing T3 to T1, there were greater abundances of Bifidobacterium across all HEI-2015 categories. Similarly, Dialister, Haemophilus, and Veillonella were greater across Total Score, Whole Grains, and Dairy; Streptococcus was greater across Total Score and Dairy; and Lachnospira, and Coprococcus were greater in Total Score. There was a lower abundance of Ruminococcus from the Lachnospiraceae family in the T3 group for Total Score and Whole Grains; and of Peptococcaceae rc4–4, and an unknown genus of the Mogibacteriaceae family in Saturated Fats. Conclusions These results reveal that individuals that consume a higher quality diet, as evidenced by higher HEI-2015 Total Score, and Whole Grains, Dairy, and Saturated Fats component scores, have greater abundances of bacteria linked with carbohydrate fermentation and lower abundances of bacteria related to inflammation and a Western dietary pattern. Funding Sources USDA National Institute of Food and Agriculture, Hatch Project 1009249.

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A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households

Nutrition Journal ◽

10.1186/s12937-020-00646-5 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Sara Ebrahimi ◽

Sarah A. McNaughton ◽

Rebecca M. Leech ◽

Morteza Abdollahi ◽

Anahita Houshiarrad ◽

...

Keyword(s):

Diet Quality ◽

Urban Areas ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

World Health ◽

Future Research ◽

Quality Indices ◽

Cross Sectional ◽

Nutrient Adequacy ◽

Household Heads

Abstract Background Iranian diet quality has been evaluated using indices that have not been created based on Iranian dietary guidelines. This study aimed to examine the applicability of two diet quality indices by examining their associations with nutrient adequacy, nutrient intakes and sociodemographics. Methods Dietary data were collected using three 24-h dietary recalls from Iranian households. Nutrient adequacy was assessed using World Health Organization/Food and Agriculture Organization 2002 (WHO/FAO) cut points. Household diet quality was calculated using the Healthy Eating Index (HEI) and Diet Quality Index-International (DQI-I). Sociodemographics of the household members were assessed. Regression analyses were used to examine associations between diet quality and nutrient adequacy, and between sociodemographics and diet quality. Results A total of 6935 households were included in the analysis. Higher household diet quality was associated with adequate intake of calcium (HEI: OR 1.11, 95% CI: 1.10, 1.13; DQI-I: OR 1.14, 95% CI: 1.13, 1.16), vitamin C (HEI: OR 1.19, 95% CI: 1.17, 1.20; DQI-I: OR 1.12, 95% CI: 1.11, 1.12) and protein (HEI: OR 1.01, 95% CI: 1.00, 1.02; DQI-I: OR 1.09, 95% CI: 1.08, 1.09). Higher household diet quality was associated with household heads who were older (> 56 years old) (HEI: β 2.06, 95% CI: 1.63, 2.50; DQI-I β 2.90, 95% CI: 2.34, 3.45), higher educated (college/university completed) (HEI: β 4.54, 95% CI: 4.02, 5.06; DQI-I: β 2.11, 95% CI: 1.45, 2.77) and living in urban areas (HEI: β 2.85, 95% CI: 2.54, 3.16; DQI-I: β 0.72, 95% CI: 0.32, 1.12). Conclusions Based on associations with nutrient adequacy and sociodemographics, the applicability of two diet quality indices for assessing the diet quality of Iranian households was demonstrated. Results also indicated DQI-I may be more applicable than HEI for evaluating Iranian nutrient adequacy. Findings have implications for the design and assessment of diet quality in Iranian populations. Future research should examine the link between these diet quality indices and health outcomes.

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Is The Healthy Eating Index-2015 Associated With Rheumatoid Arthritis?

10.21203/rs.3.rs-1061469/v1 ◽

2021 ◽

Author(s):

Atiyeh Nayebi ◽

Davood Soleimani ◽

Shayan Mostafaei ◽

Negin Elahi ◽

Homayoun Elahi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Healthy Eating ◽

Diet Quality ◽

Linear Trend ◽

Cross Sectional Study ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

P Value ◽

Cross Sectional

Abstract Objective: Healthy Eating Index-2015 (HEI-2015) is a multidimensional criterion of diet quality utilized to evaluate how well people’s dietary behaviors align with major recommendations of the 2015–2020 Dietary Guidelines for Americans. We aim to investigate the association between the diet quality and Rheumatoid arthritis (RA) activity.Design: Cross-sectional studySetting: This study was done on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall quality diet was extracted from a validated 168-item food frequency questioner (FFQ) to calculate the HEI-2015 score. RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. One-way ANOVA and ANCOVA were done to find the associations.Participants: RA patientsResults: Individuals in the highest HEI-2015 quartile had a lower mean Erythrocyte Sedimentation Rate (ESR) than those in the lowest quartiles of the HEI scores (P-value: 0.014). A linear trend towards decreasing waist circumference in patients was observed with increasing quartiles of the HEI-2015 scores (P-value= 0.005). After controlling for all potential confounders, patients in the highest HEI-2015 quartile had the lowest DAS28 scores than those in the lowest quartile of the HEI-2015 scores (Q1= 3.65; 95% CI= 3.29 – 4.02 vs. Q4= 2.35; 95% CI= 1.94 - 2.67; P-value<0.001).Conclusion: Our results indicated that following a high diet quality might be one of the therapeutic strategies to control or reduce the disease activity in RA patients.

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Awareness and use of nutrition information predict measured and self-rated diet quality of older adults in the USA

Public Health Nutrition ◽

10.1017/s1368980020004681 ◽

2020 ◽

pp. 1-11

Author(s):

Anna Vaudin ◽

Edwina Wambogo ◽

Alanna Moshfegh ◽

Nadine R Sahyoun

Keyword(s):

Older Adults ◽

Diet Quality ◽

Economic Status ◽

Adult Population ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Nutrition Information ◽

Cross Sectional ◽

Nutrition Assistance

Abstract Objectives: To examine: (1) diet quality of older adults, using the Healthy Eating Index 2010 (HEI-2010) and self-rated diet quality, (2) characteristics associated with reported awareness and use of nutrition information and (3) factors associated with HEI score and self-rated diet quality. Design: Cross-sectional study. Based on Day 1 and/or Day 2 dietary recalls, the Per-Person method was used to estimate HEI-2010 component and total scores. T-tests and ANOVA were used to compare means. Logistic and linear regressions were used to test for associations with diet quality, controlling for potential confounders. Setting: National Health and Nutrition Examination Survey, 2009–2014. Participants: Three thousand and fifty-six adults, aged 60 years and older, who completed at least one 24-h recall and answered questions on awareness and use of nutrition information. Results: Mean HEI score for men was significantly lower than for women (56·4 ± 0·6 v. 60·2 ± 0·6, P < 0·0001). Compared with men, more women were aware of (44·8 % v. 33·7 %, P < 0·05) and used (13·7 % v. 5·9 %, P < 0·05) nutrition information. In multivariable analyses, awareness and use of nutrition information were significant predictors of both HEI and self-rated diet quality for both women and men. Groups with lower nutrition awareness included men, non-Whites, participants in nutrition assistance programmes and those with lower education and socio-economic status. Conclusions: Nutrition awareness and use of nutrition information are associated with diet quality in adults 60 years and older. Gaps in awareness of dietary guidelines in certain segments of the older adult population suggest that targeted education may improve diet quality for these groups.

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Dietary Saturated Fats from Different Food Sources Show Variable Associations with the 2015 Healthy Eating Index in the Canadian Population

Journal of Nutrition ◽

10.1093/jn/nxaa300 ◽

2020 ◽

Vol 150 (12) ◽

pp. 3288-3295

Author(s):

Stéphanie Harrison ◽

Didier Brassard ◽

Simone Lemieux ◽

Benoît Lamarche

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Nutritive Value ◽

Meat Products ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Food Sources ◽

Dietary Intakes ◽

Cross Sectional ◽

Tier System

ABSTRACT Background Although mostly food-based, the majority of dietary guidelines also recommend limiting the consumption of foods high in SFAs. Yet, the association between the consumption of SFAs from different food sources and overall diet quality remains uncertain. Objectives The objective of this study was to examine the associations between SFAs from various food sources and the 2015 Healthy Eating Index (HEI-2015) as a proxy of overall diet quality. Methods The study sample included 11,106 respondents between 19 and 70 y of age from the 2015 Canadian Community Health Survey. Dietary intakes as well as the HEI-2015 were calculated using data from a single 24-h recall. An HEI-2015 from which the SFA subscores were subtracted was also calculated. Low nutritive value foods were defined using Health Canada's 4-Tier system. Associations were investigated using multivariable linear regressions with restricted cubic splines. Results Major sources of SFAs in this population were low nutritive value foods [4.4% of total energy intake (%E)], dairy (2.7%E), and meat products (1.9%E). The associations between SFA consumption (total and from different food sources) and the HEI-2015 were generally inverse and nonlinear (P for the nonlinearity test <0.03 for all). Total SFA intake showed no association with the SFA-subtracted HEI-2015 (P = 0.29). SFAs from dairy tended to be associated with an increase in the SFA-subtracted HEI-2015 (P < 0.001). Removing the SFA subscore from the HEI-2015 did not materially modify its association with SFAs from meat. SFAs from low nutritive value foods remained significantly and inversely associated with the SFA-subtracted HEI-2015 (P < 0.001). Conclusions These cross-sectional data in Canadian adults suggest that intake of SFAs from low nutritive value foods, but not total SFA intake, is captured by an index of healthy eating that does not account for SFA intake.

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Diet Quality Is Low and Differs by Sex in People with HIV

Journal of Nutrition ◽

10.1093/jn/nxy241 ◽

2019 ◽

Vol 149 (1) ◽

pp. 78-87 ◽

Cited By ~ 1

Author(s):

Julian J Weiss ◽

Laura Sanchez ◽

Jane Hubbard ◽

Janet Lo ◽

Steven K Grinspoon ◽

...

Keyword(s):

Diet Quality ◽

Immune Activation ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Food Record ◽

Cross Sectional ◽

Hiv Serostatus ◽

Modifiable Factor ◽

Immune Activation Marker ◽

Sectional Analysis

ABSTRACT Background People with HIV (PWH) are at risk for developing metabolic comorbidities driven, in part, by immune activation/inflammation. Little is known about diet quality, a potential modifiable factor in PWH. Objectives This study aimed to explore diet quality in terms of conformance with US dietary guidelines by calculating Healthy Eating Index-2010 (HEI) scores among adults with and without HIV in Boston, MA, and determine associations with HEI and markers of immune activation/inflammation. Methods One-hundred and three HIV-infected [50 women, 53 men; mean ± SD age: 47 ± 7 y; body mass index (BMI, in kg/m2): 26 ± 5] and 38 uninfected adults (17 women, 21 men; age: 46 ± 7 y; BMI: 28 ± 4) were included in this cross-sectional analysis. Participants who completed a 4-d food record from which HEI could be calculated were included. HEI was compared between participants with and without HIV, within HIV-infected participants stratified by sex, and by HIV serostatus and sex. In the HIV group, predictors of HEI were determined in multivariable modeling. Univariate associations with diet quality and inflammation/immune markers were assessed. Results The HEI score was 51.3 in the HIV-infected participants and 57.3 in the HIV-uninfected participants (P = 0.052). In the comparison by HIV serostatus and sex, HIV-infected women had significantly lower HEI (49.2) compared with HIV-infected men (55.7) (P = 0.005) and HIV-uninfected men (61.8) (P = 0.002). Adjusting for potential confounding factors, sex remained an independent predictor of HEI in HIV (P = 0.02). In the HIV group, higher log HEI was associated with lower concentration of the immune activation marker sCD14 (P = 0.009). Conclusions Diet quality tended to be lower in HIV-infected individuals compared with HIV-uninfected individuals and was lower among HIV-infected women compared with HIV-infected men, and HIV-uninfected men. There may also be an association with diet quality and sCD14 in PWH. Future prospective studies are needed to confirm these findings and determine whether improving diet quality is a useful strategy to reduce metabolic abnormalities in this population. This study was registered at clinicaltrials.gov as NCT00455793.

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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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Caregiver Status and Diet Quality in Community-Dwelling Adults

Nutrients ◽

10.3390/nu13061803 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1803

Author(s):

Sharmin Hossain ◽

May A. Beydoun ◽

Michele K. Evans ◽

Alan B. Zonderman ◽

Marie F. Kuczmarski

Keyword(s):

Diet Quality ◽

Healthy Aging ◽

Healthy Eating Index ◽

Community Dwelling ◽

Rate Of Change ◽

Least Square ◽

Inverse Association ◽

Linear Regression Models ◽

Middle Aged ◽

Cross Sectional

Objective: We investigated cross-sectional and longitudinal associations of diet quality with middle-aged caregiver status. Methods: Caregiving in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American (AA)) was measured at waves 3 (2009–2013) and 4 (2013–2017) (mean follow-up time 4.1 years). Diet quality was assessed by the Healthy Eating Index 2010 (HEI-2010) derived from two separate 24 h diet recalls. Multivariable ordinary least square regression was performed for cross-sectional analyses of the association of wave 4 caregiving with wave 4 HEI-2010. Wave 3 caregiving was examined both cross-sectionally and with annual rate of change in HEI using mixed-effects linear regression Models. Multivariable models were adjusted for age, sex, and poverty status. Results: Cross-sectional analyses at wave 4 demonstrate an inverse association of frequent caregiving (“Daily or Weekly” vs. “Never”) for grandchildren with HEI-2010 total score (i.e., lower diet quality) among Whites (β = −2.83 ± 1.19, p = 0.03, Model 2) and AAs (β = −1.84 ± 0.79, p = 0.02,). The “cross-sectional” analysis pertaining to grandchildren caregiving frequency suggested that frequent caregiving (i.e., “Daily or Weekly” vs. “Never” (β = −2.90 ± 1.17, p = 0.04)) only among Whites was inversely related to HEI-2010 total score. Total HEI-2010 score was also related to caring (Model 1), for the elderly over “5 years vs. Never” among Whites (−7.31 ± 3.54, p = 0.04, Model 2). Longitudinally, we found slight potential improvement in diet quality over time (“Daily or Weekly” vs. Never by TIME interaction: +0.88 ± 0.38, p = 0.02) with frequent caregiving among Whites, but not so among AAs. Conclusions: Frequent caring for grandchildren had an inverse relationship with the diet quality of White and AA urban middle-aged caregivers, while caring for elderly was inversely linked to diet quality among Whites only. Longitudinal studies should address the paucity of research on caregivers’ nutritional quality.

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Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001–2018 Analysis

Nutrients ◽

10.3390/nu13082614 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2614

Author(s):

Sanjiv Agarwal ◽

Victor L. Fulgoni

Keyword(s):

Vitamin C ◽

Vitamin K ◽

Diet Quality ◽

Vitamin B6 ◽

Nutrient Intake ◽

Healthy Eating Index ◽

Cross Sectional ◽

Recall Data ◽

Fiber Protein ◽

Potato Consumption

Potatoes are nutrient rich white vegetables, however, research on their impact on public health is limited. The objective of this study was to provide updated evaluation of the cross-sectional association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four hour diet recall data from adolescents (n = 16,633; age 9–18 years) were used to assess intakes. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures, fried potatoes, and potato chips) had higher (p < 0.05) HEI-2015 total score and subcomponent scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers also had higher (p < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus, potassium, selenium, sodium, zinc, niacin, vitamin B6, vitamin C, vitamin K and total choline; and higher (p < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine, niacin, vitamin B6, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore encouraging their consumption may be an effective strategy for improving nutritional status.

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Dietary intake and diet quality by weight category among a racially diverse sample of women in Birmingham, Alabama, USA

Journal of Nutritional Science ◽

10.1017/jns.2020.51 ◽

2020 ◽

Vol 9 ◽

Author(s):

Rebecca B. Little ◽

Renee Desmond ◽

Tiffany L. Carson

Keyword(s):

Diet Quality ◽

Weight Status ◽

Vegetable Intake ◽

The United States ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Rank Test ◽

Deep South ◽

Weight Category ◽

Maximum Score

Abstract Diet is a modifiable contributor to health. The lack of adherence to recommended dietary guidelines may contribute to the disproportionate burden of obesity and other chronic conditions observed in the Deep South region of the United States. The objective of this cross-sectional study was to describe food group intake and diet quality by race and weight status of women in the Deep South. Study participants were eighty-nine healthy female volunteers (56 % black, 44 % white, mean age 39⋅7 ± 1⋅4 years) recruited from Birmingham, AL, USA. Body Mass Index (BMI) determined weight status (non-obese/obese). Healthy Eating Index-2010 (HEI-2010) calculated from dietary recalls assessed diet quality. Wilcoxon sum-rank test compared HEI-2010 scores by race and weight status. χ2 analysis compared the percentage of women who achieved maximum points for HEI-2010 index food components by subgroup. Caloric and macronutrient intake did not differ by race or weight status (mean kcal 1863⋅0 ± 62⋅0). Median Total HEI-2010 Score for the sample was 51⋅9 (IQR: 39⋅1–63⋅4). Although there was no statistical difference in diet quality by race, more whites achieved the maximum score for vegetable intake compared to blacks, while blacks reported higher total fruit intake. Non-obese women reported better diet quality (56⋅9 v. 46⋅1; P = 0⋅04) and eating more whole fruits, and more achieved the maximum score for protein from plant and seafood sources. In summary, differences in diet quality were observed by weight status, but not race among this sample. These results point to tailored dietary interventions for women in metropolitan areas of Alabama, USA.

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