The International Diet-Health Index: a novel tool to evaluate diet quality for cardiometabolic health across countries

IntroductionDiet is a major modifiable risk factor for cardiometabolic disease; however, interpretable measures capturing impacts of overall diet on health that can be easily used by policymakers at the global/national levels are not readily available.MethodsWe developed the International Diet-Health Index (IDHI) to measure health impacts of dietary intake across 186 countries in 2010, using age-specific and sex-specific data on country-level dietary intake, effects of dietary factors on cardiometabolic diseases and country-specific cardiometabolic disease profiles. The index encompasses the impact of 11 foods/nutrients on 12 cardiometabolic diseases, the mediation of health effects of specific dietary intakes through blood pressure and body mass index and background disease prevalence in each country–age–sex group. We decomposed the index into IDHIbeneficial for risk-reducing factors, and IDHIadverse for risk-increasing factors. The flexible functional form of the IDHI allows inclusion of additional risk factors and diseases as data become available.ResultsBy sex, women experienced smaller detrimental cardiometabolic effects of diet than men: (females IDHIadverse range: −0.480 (5th percentile, 95th percentile: −0.932, –0.300) to −0.314 (−0.543, –0.213); males IDHIadverse range: (−0.617 (−1.054, –0.384) to −0.346 (−0.624, –0.222)). By age, middle-aged adults had highest IDHIbeneficial (females: 0.392 (0.235, 0.763); males: 0.415 (0.243, 0.949)) and younger adults had most extreme IDHIadverse (females: −0.480 (−0.932, –0.300); males: −0.617 (−1.054, –0.384)). Regionally, Central Latin America had the lowest IDHIoverall (−0.466 (−0.892, –0.159)), while Southeast Asia had the highest IDHIoverall (0.272 (−0.224, 0.903)). IDHIoverall was highest in low-income countries and lowest in upper middle-income countries (−0.039 (−0.317, 0.227) and −0.146 (−0.605, 0.303), respectively). Among 186 countries, Honduras had lowest IDHIoverall (−0.721 (−0.916, –0.207)), while Malaysia had highest IDHIoverall (0.904 (0.435, 1.190)).ConclusionIDHI encompasses dietary intakes, health effects and country disease profiles into a single index, allowing policymakers a useful means of assessing/comparing health impacts of diet quality between populations.

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A Novel Diet-Health Index Reveals Worsening Trends and Widening Disparities in the Health Impacts of Diet in the United States

Current Developments in Nutrition ◽

10.1093/cdn/nzab035_009 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 101-101

Author(s):

Yan Bai ◽

Mengxi Du ◽

JIfan Wang ◽

Elena Naumova ◽

Fang Fang Zhang ◽

...

Keyword(s):

Diet Quality ◽

Metabolic Diseases ◽

Total Mortality ◽

The United States ◽

Healthy Eating Index ◽

Dietary Factors ◽

Health Impacts ◽

Health Index ◽

Individual Level ◽

Funding Sources

Abstract Objectives Poor diets are associated with poor health outcomes, but existing metrics of diet quality do not directly include the health effects of diet. Using a novel international diet-health index (IDHI), we can measure diet-related health impacts from multiple dietary factors simultaneously, given a population's health status and most prevalent causes of death and disability. Methods We obtained individual-level data on intake of 12 dietary factors and exposure to 2 metabolic risk factors from the National Health and Nutrition Examination Survey (NHANES), 2003–2014, and computed the IDHI for 12 cardio-metabolic diseases and 15 cancers in the U.S. by sex, race, education, and income. We then compared IDHI to a modified Alternative Healthy Eating Index (mAHEI) using 10 of the 12 dietary factors and validated the indices using the National Center for Health Statistics (NCHS) linked dataset for total mortality through 2015. Results IDHI declined from −0.314 (95% CI: −0.323, −0.305) in 2003/04 to −0.325 (−0.334, −0.316) in 2013/14 (P = 0.007 for trend). Non-Hispanic Black Americans have persistently lower IDHI than other groups, and disparities in IDHI have widened over time by level of income (P = 0.004 for interaction), and education (P = 0.047 for interaction). IDHI was more closely correlated with the mAHEI at higher levels of diet quality, and both indices were strongly associated with total mortality. Conclusions The IDHI is a valid tool for measuring diet-related health impacts in the context of a population's most prevalent diseases, potentially offering tailored guidance regarding how best to reduce diet-related health disparities. Funding Sources No funding.

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Imaging and lipidomics methods for lipid analysis in metabolic and cardiovascular disease

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174417000496 ◽

2017 ◽

Vol 8 (5) ◽

pp. 566-574 ◽

Cited By ~ 3

Author(s):

K. G. Stevens ◽

C. A. Bader ◽

A. Sorvina ◽

D. A. Brooks ◽

S. E. Plush ◽

...

Keyword(s):

Cell Biology ◽

Cell Function ◽

Lipid Analysis ◽

Dietary Factors ◽

Imaging Modalities ◽

Signalling Pathways ◽

Cardiometabolic Disease ◽

Poor Growth ◽

Cardiometabolic Diseases ◽

Intracellular Lipids

Cardiometabolic diseases exhibit changes in lipid biology, which is important as lipids have critical roles in membrane architecture, signalling, hormone synthesis, homoeostasis and metabolism. However,Developmental Origins of Health and Diseasestudies of cardiometabolic disease rarely include analysis of lipids. This short review highlights some examples of lipid pathology and then explores the technology available for analysing lipids, focussing on the need to develop imaging modalities for intracellular lipids. Analytical methods for studying interactions between the complex endocrine and intracellular signalling pathways that regulate lipid metabolism have been critical in expanding our understanding of how cardiometabolic diseases develop in association with obesity and dietary factors. Biochemical methods can be used to generate detailed lipid profiles to establish links between lifestyle factors and metabolic signalling pathways and determine how changes in specific lipid subtypes in plasma and homogenized tissue are associated with disease progression. New imaging modalities enable the specific visualization of intracellular lipid traffic and distributionin situ. These techniques provide a dynamic picture of the interactions between lipid storage, mobilization and signalling, which operate during normal cell function and are altered in many important diseases. The development of methods for imaging intracellular lipids can provide a dynamic real-time picture of how lipids are involved in complex signalling and other cell biology pathways; and how they ultimately regulate metabolic function/homoeostasis during early development. Some imaging modalities have the potential to be adapted forin vivoapplications, and may enable the direct visualization of progression of pathogenesis of cardiometabolic disease after poor growth in early life.

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Dietary Protein is the Strong Predictor of Coronary Artery Disease; A Data Mining Approach

10.21203/rs.3.rs-63637/v1 ◽

2020 ◽

Author(s):

Sara Saffar Soflaei ◽

Elham Shamsara ◽

Toktam Sahranavard ◽

Habibollah Esmaily ◽

Mohsen Moohebati ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Dietary Intake ◽

Strong Predictor ◽

Dietary Factors ◽

Training Dataset ◽

Dietary Intakes ◽

Mortality And Morbidity ◽

Artery Disease ◽

Cad Risk

Abstract Backgrounds and aims: Coronary artery disease (CAD) is the major cause of mortality and morbidity globally. Diet is known to contribute to CAD risk, and the dietary intake of specific macro- or micro-nutrients might be potential predictors of CAD risk. Machine learning methods may be helpful in the analysis of the contribution of several parameters in dietary including macro- and micro-nutrients to CAD risk. Here we aimed to determine the most important dietary factors for predicting CAD.Methods: Total 273 cases with more than 50% obstruction in at least one coronary artery and 443 healthy controls who completed a food frequency questionnaire (FFQ) were entered into the study. All dietary intakes were adjusted for energy intake. QUEST method was applied to determine the diagnosis pattern of CAD.Results: Total 34 dietary variables obtained from FFQ were entered the study that 23 of these variables were significantly associated with CAD according to t-test. Out of 23 dietary input variables adjusted protein, manganese, biotin, zinc and cholesterol remained in the model. According to our tree, only protein intake could identify the patients with coronary artery stenosis according to angiography from healthy participant up to 80%. Manganese dietary intake was the second important variable after protein. The accuracy of the tree was 84.36% for training dataset and 82.94% for testing dataset.Conclusion: Among different macro- and micro-nutrients in the dietary, a combination of protein, manganese, biotin, zinc and cholesterol could predict the presence of CAD.

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Circulating adiponectin mediates the association between omentin gene polymorphism and cardiometabolic health in Asian Indians

PLoS ONE ◽

10.1371/journal.pone.0238555 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0238555

Author(s):

Karani Santhanakrishnan Vimaleswaran ◽

Dhanasekaran Bodhini ◽

Juanjie Jiang ◽

Kandaswamy Ramya ◽

Deepa Mohan ◽

...

Keyword(s):

Health Status ◽

Gene Polymorphism ◽

Asian Indians ◽

Molecular Mechanisms ◽

Direct Sequencing ◽

Dietary Factors ◽

Serum Adiponectin ◽

Cardiometabolic Health ◽

Cardiometabolic Diseases ◽

Increased Risk

Background Plasma omentin levels have been shown to be associated with circulating adiponectin concentrations and cardiometabolic disease-related outcomes. In this study, we aim to examine the association of omentin gene polymorphism with serum adiponectin levels and cardiometabolic health status using a genetic approach, and investigate whether these associations are modified by lifestyle factors. Methods The study included 945 normal glucose tolerant and 941 unrelated individuals with type 2 diabetes randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), in southern India. Study participants were classified into cardiometabolically healthy and unhealthy, where cardiometabolically healthy were those without hypertension, diabetes, and dyslipidemia. Fasting serum adiponectin levels were measured by radioimmunoassay. The omentin A326T (rs2274907) single nucleotide polymorphism (SNP) was screened by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Results The ‘A’ allele of the omentin SNP was significantly associated with lower adiponectin concentrations after adjusting for age, sex, body mass index (BMI), waist circumference (WC) and cardiometabolic health status (p = 1.90 x 10−47). There was also a significant association between circulating adiponectin concentrations and cardiometabolic health status after adjusting for age, sex, BMI, WC and Omentin SNP (p = 7.47x10-10). However, after adjusting for age, sex, BMI, WC and adiponectin levels, the association of ‘A’ allele with cardiometabolic health status disappeared (p = 0.79) suggesting that adiponectin serves as a mediator of the association between omentin SNP and cardiometabolic health status. There were no significant interactions between the SNP and dietary factors on adiponectin levels and cardiometabolic health status (p>0.25, for all comparisons). Conclusions Our findings show that adiponectin might function as a mechanistic link between omentin SNP and increased risk of cardiometabolic diseases independent of common and central obesity in Asian Indians. Before strategies to promote adiponectin modulation could be implemented, further studies are required to confirm the molecular mechanisms involved in this triangular relationship between omentin gene, adiponectin and cardiometabolic diseases.

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Dietary protein is the strong predictor of coronary artery disease; a data mining approach

10.21203/rs.3.rs-57487/v1 ◽

2020 ◽

Author(s):

Sara Saffar Soflaei ◽

Elham Shamsara ◽

Toktam Sahranavard ◽

Habibollah Esmaily ◽

Mohsen Moohebati ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Dietary Intake ◽

Strong Predictor ◽

Dietary Factors ◽

Training Dataset ◽

Dietary Intakes ◽

Mortality And Morbidity ◽

Artery Disease ◽

Cad Risk

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Dietary protein is the strong predictor of coronary artery disease; a data mining approach

10.21203/rs.3.rs-63637/v2 ◽

2020 ◽

Author(s):

Sara Saffar Soflaei ◽

Elham Shamsara ◽

Toktam Sahranavard ◽

Habibollah Esmaily ◽

Mohsen Moohebati ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Dietary Intake ◽

Strong Predictor ◽

Dietary Factors ◽

Training Dataset ◽

Dietary Intakes ◽

Mortality And Morbidity ◽

Artery Disease ◽

Cad Risk

Abstract Backgrounds: Coronary artery disease (CAD) is the major cause of mortality and morbidity globally. Diet is known to contribute to CAD risk, and the dietary intake of specific macro- or micro-nutrients might be potential predictors of CAD risk. Machine learning methods may be helpful in the analysis of the contribution of several parameters in dietary including macro- and micro-nutrients to CAD risk. Here we aimed to determine the most important dietary factors for predicting CAD.Methods: A total of 273 cases with more than 50% obstruction in at least one coronary artery and 443 healthy controls who completed a food frequency questionnaire (FFQ) were entered into the study. All dietary intakes were adjusted for energy intake. The QUEST method was applied to determine the diagnosis pattern of CAD.Results: A total of 34 dietary variables obtained from the FFQ were entered into the initial study analysis, of these variables 23 were significantly associated with CAD according to t-tests. Of these 23 dietary input variables, adjusted protein, manganese, biotin, zinc and cholesterol remained in the model. According to our tree, only protein intake could identify the patients with coronary artery stenosis according to angiography from healthy participant up to 80%. The dietary intake of manganese was the second most important variable. The accuracy of the tree was 84.36% for the training dataset and 82.94% for the testing dataset.Conclusion: Among several dietary macro- and micro-nutrients , a combination of protein, manganese, biotin, zinc and cholesterol could predict the presence of CAD in individuals undergoing angiography.

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Dietary Intake and Its Determinants Among Adults Living in the Metropolitan Area of Puerto Rico

Nutrients ◽

10.3390/nu11071598 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1598 ◽

Cited By ~ 3

Author(s):

Mattei ◽

Tamez ◽

Bigornia ◽

Noel ◽

Xiao ◽

...

Keyword(s):

Puerto Rico ◽

Dietary Intake ◽

Metropolitan Area ◽

Diet Quality ◽

Lifestyle Factors ◽

Healthy Eating Index ◽

Dietary Intakes ◽

Linear Regression Models ◽

Convenience Sample ◽

Sugary Beverages

There is scarce information regarding the dietary intake of adults living in Puerto Rico (PR). We aimed to assess intake of nutrients and foods, adherence to recommended intake of nutrients and diet quality, and sociodemographic and lifestyle factors correlated with diet quality among adults in the San Juan metropolitan area of PR. Data were obtained from participants of the cross-sectional convenience-sample Puerto Rico Assessment of Diet, Lifestyle, and Diseases (n = 248; ages 30–75 years). Diet quality was defined using the Alternate Healthy Eating Index 2010 (AHEI; range 0–110 indicating lower–higher quality). Linear regression models were used to relate AHEI to sociodemographic and lifestyle factors. Most participants met the Estimated Average Requirement (EAR) for iron, folate, and vitamins B12 and B6; 61% met the EAR for magnesium and 56% for calcium. Only 4% met the EAR for vitamin D, and 7% met the adequate intake for potassium. The main contributors to total energy intake were sugary beverages (11.8%), sweets/desserts (10.2%), dairy (8.5%), mixed dishes (7.6%), starches (6.3%), fast foods (5.5%), and rice (4.9%). The mean (SD) AHEI score was 59.8 (11.0). The lowest AHEI components for which recommended servings were met were red/processed meats, fruit, sodium, sugary beverages, and polyunsaturated fats, and the highest were nuts/legumes, omega-3 fats, and whole grains. Significantly higher AHEI scores were noted for older adults, other ethnicities (vs. Puerto Rican), being single, having some college or higher education, and never/formerly smoking. Adults living in PR report healthy and unhealthy dietary intakes, providing an opportunity to improve diet at the population level.

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Dietary isoflavone intake is associated with a reduced risk of myelodysplastic syndromes

British Journal Of Nutrition ◽

10.1017/s0007114515003931 ◽

2015 ◽

Vol 114 (12) ◽

pp. 2110-2115 ◽

Cited By ~ 1

Author(s):

Ping Liu ◽

C. D’Arcy J. Holman ◽

Jie Jin ◽

Min Zhang

Keyword(s):

Dietary Intake ◽

Myelodysplastic Syndromes ◽

Conditional Logistic Regression ◽

Daily Intake ◽

Dietary Factors ◽

Protective Effects ◽

Dietary Intakes ◽

Department Of Agriculture ◽

Control Study ◽

Reduced Risk

AbstractIsoflavones have been suggested to have protective effects on certain cancers. However, the association of soya foods or dietary isoflavones with the risk of myelodysplastic syndromes (MDS) has not been examined. Thus, the aim of this hospital-based case–control study undertaken in China in 2012–2013 was to investigate the association between dietary isoflavone intake and MDS risk. The analysis included 208 cases aged 19–85 years with MDS and 208 controls individually matched to the cases by sex, birth quinquennium and residential locality. Information on habitual food intakes, including nine items of soya foods, was sought from in-person interviews using a validated 107-item FFQ. Dietary intakes of daidzein, genistein, glycitein and total isoflavones were estimated using the 2008 US Department of Agriculture Isoflavone Database. OR were calculated from conditional logistic regression after adjustment for potential confounding by demographics, lifestyle and dietary factors. The mean daily intake of total isoflavones was 19·0 mg in cases and 23·0 mg in controls. Dietary intake of isoflavones was inversely associated with the risk of MDS. The adjusted OR in the highest tertile compared with the lowest tertile of intake were 0·43 (95 % CI 0·21, 0·85) for daidzein, 0·36 (95 % CI 0·18, 0·74) for genistein, 0·49 (95 % CI 0·25, 0·97) for glycitein and 0·40 (95 % CI 0·20, 0·81) for total isoflavones. The findings suggest that higher dietary intake of isoflavones is associated with a reduced risk of MDS in a Chinese population.

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Dietary intake of fatty acids and risk of pancreatic cancer: Golestan cohort study

Nutrition Journal ◽

10.1186/s12937-021-00723-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Neda Ghamarzad Shishavan ◽

Sahar Masoudi ◽

Ashraf Mohamadkhani ◽

Sadaf G. Sepanlou ◽

Maryam Sharafkhah ◽

...

Keyword(s):

Pancreatic Cancer ◽

Fatty Acids ◽

Cohort Study ◽

Dietary Intake ◽

Unsaturated Fatty Acids ◽

Saturated Fatty Acids ◽

Cox Proportional Hazards ◽

Dietary Factors ◽

Dietary Intakes ◽

Increased Risk

Abstract Background As pancreatic cancer (PC) is a malignancy with poor prognosis, finding strategies for its prevention became a notable priority. Among all the factors influencing the risk of PC, dietary items especially fats are considered as the most modifiable risk factors.This study is designed to assess the associations of dietary intake of fatty acids with the risk of PC incidence. Methods A total of 50,045 adults between 40 and 75 years old participated in this cohort study in 2004–2008 and were followed up to the present. Intakes of fatty acids was evaluated by validated food-frequency questionnaire (FFQ). Cox proportional hazards regression model was used to estimate hazard ratio (HR) with 95 % confidence interval of differing levels of dietary intakes of fatty acids for incidence of PC. Results At the end of follow-up period, 76 cases of PC were identified and 46,904 participants without history of cancer, acute kidney disorders, fibrosis and cirrhosis were included in the study. Dietary total saturated fatty acids (SFAS) was associated with PC risk (HR = 1.05 (1.01–1.09), Ptrend=0.01), whereas dietary total monounsaturated fatty acids (MUFAS) was inversely associated with the risk of PC (HR = 0.92 (0.86–0.99), Ptrend=0.04). Dietary total polyunsaturated fatty acids (PUFAS) did show a protective but not significant association with the risk of PC (HR = 0.91(0.84-1.00), Ptrend=0.05). Conclusions The amount of total fat intake is not a risk factor for PC in our study and focusing on the intake of specific fatty acids becomes more striking. Unsaturated fatty acids including PUFAS and especially MUFAS are considered as protective dietary factors in PC prevention. In contrast, total SFAS is positively associated with the increased risk of PC. However, very long chain and odd-chain saturated fatty acids intake may be protective against PC.

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Diet quality as a predictor of healthy and cardiometabolic disease-free life expectancy between ages 50 to 85

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001457 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Hanna Lagström ◽

Sari Stenholm ◽

Tasnime Akbararly ◽

Jaana Pentti ◽

Jussi Vahtera ◽

...

Keyword(s):

Life Expectancy ◽

Diet Quality ◽

Dietary Habits ◽

Good Health ◽

Healthy Eating Index ◽

Dietary Quality ◽

Cardiometabolic Disease ◽

Occupational Position ◽

Cardiometabolic Diseases ◽

Disease Free

AbstractPoor dietary quality is one of the leading modifiable risk factor for premature mortality worldwide. People live longer than ever, but spend more years with illness and disability although the ultimate goal is to increase healthy years of life. Less research has considered the role of dietary habits in relation to health or cardiometabolic disesase-free life expectancy (LE). This study investigate the association of diet quality with healthy and cardiometabolic disease-free LE between ages 50 and 85. The study comprised 8,075 participants of the Whitehall II study. Diet quality was assessed with Alternative Healthy Eating Index (AHEI) 2010 at phases 3, 5 and 7 and took the measure of diet closest to age of 50 years for each participant. We utilized repeat measures of self-rated health and cardiometabolic disease from the first observation when participants were aged 50 years or older. In the analyses the AHEI-2010 total score was categorized in to quintiles, where the lowest quintile represents unhealthiest diet quality and highest quintiles healthiest diet. Multistate life table models were used to estimate healthy and cardiometabolic disease-free LE from age 50 to 85 years for each category of AHEI-2010 quintiles and three occupational position group. Participants in the highest AHEI-2010 quintile lived 3.6 years longer in good health and 2.7 years longer without cardiometabolic diseases than participants in the lowest quintile of the AHEI-2010. Higher diet quality associated with an increased healthy and cardiometabolic disease-free LE was observed across different occupational positions: Men in highest occupational position and highest AHEI-2010 quintile lived 9.4 years longer with good health compared to lowest occupational position and lowest AHEI-2010 quintile and for women the corresponding difference was 8.2 years. In terms of proportion of years spent without cardiometabolic diseases ranged from 77% (high occupational position and highest AHEI-2010) to 57% (low occupational position and lowest AHEI-2010) in men and from 82% to 70% in women. The difference in years lived healthy across AHEI-2010 quintiles was most remarkable in persons with low occupation status. Healthier dietary habits are associated with longer healthy and longer cardiometabolic disease-free LE between ages 50 and 85. Attention to poor diet should be paid especially among people in the lowest occupational position.

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