OP82 Performance of substitution models in nutritional epidemiology

Abstract The advantage of using specified substitution analysis in nutritional epidemiology has been clearly demonstrated in studies of macronutrient intake and disease risk. However, the method has not been widely applied in studies of food intake. The aim of this article is to describe and compare the interpretation and application of different food substitution models in epidemiologic studies on diet and disease development. Both theoretically and in the context of a specific example, we discuss methodologic issues to be considered, including modeling of food substitutions using diet at a single time point or at multiple time points (focusing on dietary changes), choice of substitution unit, adjustment for total energy intake, and adjustment for confounding. We argue that specified food substitution analyses can be used to identify optimal food composition of the diet and that these analyses are thus highly relevant to inform public health policy decision makers.

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Faculty Opinions recommendation of Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.721272254.793532925 ◽

2017 ◽

Author(s):

Pagona Lagiou

Keyword(s):

Nutritional Epidemiology ◽

Innovative Technologies

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A North–South-South partnership in higher education to develop health research capacity in the Democratic Republic of the Congo: the challenge of finding a common language

Health Research Policy and Systems ◽

10.1186/s12961-021-00728-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Christiane Horwood ◽

Sphindile Mapumulo ◽

Lyn Haskins ◽

Vaughn John ◽

Silondile Luthuli ◽

...

Keyword(s):

Higher Education ◽

Low Income ◽

Health Research ◽

Democratic Republic ◽

Academic Staff ◽

Research Capacity ◽

Nutritional Epidemiology ◽

Low Income Countries ◽

Republic Of The Congo ◽

English Speaking

Abstract Background Globally, increasing numbers of higher education institutions (HEIs) in non-English-speaking countries have adopted English as a medium of instruction (EMI), because of the perception that this provides opportunities to attract high-calibre students and academic staff, and engage with the international research community. We report an evaluation of a North–South-South collaboration to develop health research capacity in the Democratic Republic of the Congo (DRC) by establishing a postgraduate programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), where EMI was adopted. We report experiences and perceptions of stakeholders, facilitators and students about using EMI. Methods In-depth qualitative interviews were conducted between October and December 2019 among convenience sampled stakeholders (8), facilitators (11) and students (12) involved in the programme from all three partner institutions (University of Kinshasa; University of KwaZulu-Natal, South Africa; University of Bergen, Norway). Interviews were conducted in participants’ language of preference (English or French), audio-recorded, transcribed verbatim and translated into English when required. Analysis employed a thematic approach. Results Most participants viewed EMI positively, reporting that studying in English created opportunities to access relevant literature, improve interactions with the scientific community and advance their careers. As a result of adopting EMI, some students had opportunities to present research findings at international conferences and publish their research in English. English-speaking researchers from partner institutions were able to participate in supervision of students’ research. However, inadequate English competency, particularly among students, was challenging, with some students reporting being unable to understand or interact in class, which negatively affected their academic performance. Further, EMI created barriers at KSPH among academic staff who were not proficient in English, leading to poor participation among non-English-speaking staff and lack of integration with other postgraduate programmes. Participants suggested additional English language support for EMI. Conclusion Partnerships between HEIs could be a powerful tool to develop research capacity in low-income countries in line with United Nations Sustainable Development Goals. EMI could be a solution to language barriers faced by many such partnerships, but wide-ranging support to develop English proficiency among staff and students is essential to ensure that the challenges do not outweigh the benefits.

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Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19

Medicina ◽

10.3390/medicina57080739 ◽

2021 ◽

Vol 57 (8) ◽

pp. 739

Author(s):

Ronald B. Brown

Keyword(s):

Polycystic Ovary ◽

Sodium Intake ◽

Dietary Factors ◽

Nutritional Epidemiology ◽

Dietary Sodium ◽

Ovary Syndrome ◽

Nasal Sinus ◽

Lower Socioeconomic ◽

Sodium Toxicity ◽

Nutritional Immunology

Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple sclerosis, systemic sclerosis, and polycystic ovary syndrome. This article synthesizes evidence from epidemiology, pathophysiology, immunology, and virology literature linking sodium toxicological mechanisms to COVID-19 and SARS-CoV-2 infection. Sodium toxicity is a modifiable disease determinant that impairs the mucociliary clearance of virion aggregates in nasal sinuses of the mucosal immune system, which may lead to SARS-CoV-2 infection and viral sepsis. In addition, sodium toxicity causes pulmonary edema associated with severe acute respiratory syndrome, as well as inflammatory immune responses and other symptoms of COVID-19 such as fever and nasal sinus congestion. Consequently, sodium toxicity potentially mediates the association of COVID-19 pathophysiology with SARS-CoV-2 infection. Sodium dietary intake also increases in the winter, when sodium losses through sweating are reduced, correlating with influenza-like illness outbreaks. Increased SARS-CoV-2 infections in lower socioeconomic classes and among people in government institutions are linked to the consumption of foods highly processed with sodium. Interventions to reduce COVID-19 morbidity and mortality through reduced-sodium diets should be explored further.

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Genetic and Environmental Influences of Dietary Indices in a UK Female Twin Cohort

Twin Research and Human Genetics ◽

10.1017/thg.2020.84 ◽

2020 ◽

Vol 23 (6) ◽

pp. 330-337

Author(s):

Olatz Mompeo ◽

Rachel Gibson ◽

Paraskevi Christofidou ◽

Tim D. Spector ◽

Cristina Menni ◽

...

Keyword(s):

Healthy Eating ◽

Menopausal Status ◽

Healthy Eating Index ◽

Healthy Diet ◽

Nutritional Epidemiology ◽

Best Fitting ◽

Heritability Estimates ◽

Fitting Model ◽

Dietary Indices ◽

Health Parameters

AbstractA healthy diet is associated with the improvement or maintenance of health parameters, and several indices have been proposed to assess diet quality comprehensively. Twin studies have found that some specific foods, nutrients and food patterns have a heritable component; however, the heritability of overall dietary intake has not yet been estimated. Here, we compute heritability estimates of the nine most common dietary indices utilized in nutritional epidemiology. We analyzed 2590 female twins from TwinsUK (653 monozygotic [MZ] and 642 dizygotic [DZ] pairs) who completed a 131-item food frequency questionnaire (FFQ). Heritability estimates were computed using structural equation models (SEM) adjusting for body mass index (BMI), smoking status, Index of Multiple Deprivation (IMD), physical activity, menopausal status, energy and alcohol intake. The AE model was the best-fitting model for most of the analyzed dietary scores (seven out of nine), with heritability estimates ranging from 10.1% (95% CI [.02, .18]) for the Dietary Reference Values (DRV) to 42.7% (95% CI [.36, .49]) for the Alternative Healthy Eating Index (A-HEI). The ACE model was the best-fitting model for the Healthy Diet Indicator (HDI) and Healthy Eating Index 2010 (HEI-2010) with heritability estimates of 5.4% (95% CI [−.17, .28]) and 25.4% (95% CI [.05, .46]), respectively. Here, we find that all analyzed dietary indices have a heritable component, suggesting that there is a genetic predisposition regulating what you eat. Future studies should explore genes underlying dietary indices to further understand the genetic disposition toward diet-related health parameters.

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Establishing a postgraduate programme in nutritional epidemiology to strengthen resource capacity, academic leadership and research in the democratic republic of Congo

BMC Medical Education ◽

10.1186/s12909-021-02557-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mapatano Mala Ali ◽

Lyn Haskins ◽

Vaughn John ◽

Anne Hatløy ◽

Silondile Luthuli ◽

...

Keyword(s):

Democratic Republic ◽

Democratic Republic Of Congo ◽

Lessons Learned ◽

Academic Leadership ◽

Nutritional Epidemiology ◽

Rural Site ◽

Educational Approach ◽

Financial Barriers ◽

Republic Of Congo ◽

Health And Nutrition

Abstract Background Low- and Middle-income countries (LMIC) face considerable health and nutrition challenges, many of which can be addressed through strong academic leadership and robust research translated into evidence-based practice. A North-South-South partnership between three universities was established to implement a master’s programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC). The partnership aimed to develop academic leadership and research capacity in the field of nutrition in the DRC. In this article we describe the educational approach and processes used, and discuss successes, challenges, and lessons learned. Methods Self-administered questionnaires, which included both open and closed questions, were sent to all graduates and students on the master’s programme to explore students’ experiences and perceptions of all aspects of the educational programme. Quantitative data was analysed using frequencies, and a thematic approach was used to analyse responses to open-ended questions. Results A two-year master’s programme in Nutritional Epidemiology was established in 2014, and 40 students had graduated by 2020. Key elements included using principles of authentic learning, deployment of students for an internship at a rural residential research site, and support of selected students with bursaries. Academic staff from all partner universities participated in teaching and research supervision. The curriculum and teaching approach were well received by most students, although a number of challenges were identified. Most students reported benefits from the rural internship experience but were challenged by the isolation of the rural site, and felt unsupported by their supervisors, undermining students’ experiences and potentially the quality of the research. Financial barriers were also reported as challenges by students, even among those who received bursaries. Conclusion The partnership was successful in establishing a Master Programme in Nutritional Epidemiology increasing the number of nutrition researchers in the DRC. This approach could be used in other LMIC settings to address health and nutrition challenges.

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Advances in dietary pattern analysis in nutritional epidemiology

European Journal of Nutrition ◽

10.1007/s00394-021-02545-9 ◽

2021 ◽

Author(s):

Christina-Alexandra Schulz ◽

Kolade Oluwagbemigun ◽

Ute Nöthlings

Keyword(s):

Synergistic Effects ◽

Hybrid Approach ◽

Transformation Method ◽

Narrative Review ◽

Nutritional Epidemiology ◽

Food Groups ◽

Related Factors ◽

Exploratory Approach ◽

Recent Developments ◽

Dietary Pattern Analysis

Abstract Background and Purpose It used to be a common practice in the field of nutritional epidemiology to analyze separate nutrients, foods, or food groups. However, in reality, nutrients and foods are consumed in combination. The introduction of dietary patterns (DP) and their analysis has revolutionized this field, making it possible to take into account the synergistic effects of foods and to account for the complex interaction among nutrients and foods. Three approaches of DP analysis exist: (1) the hypothesis-based approach (based on prior knowledge regarding the current understanding of dietary components and their health relation), (2) the exploratory approach (solely relying on dietary intake data), and (3) the hybrid approach (a combination of both approaches). During the recent past, complementary approaches for DP analysis have emerged both conceptually and methodologically. Method We have summarized the recent developments that include incorporating the Treelet transformation method as a complementary exploratory approach in a narrative review. Results Uses, peculiarities, strengths, limitations, and scope of recent developments in DP analysis are outlined. Next, the narrative review gives an overview of the literature that takes into account potential relevant dietary-related factors, specifically the metabolome and the gut microbiome in DP analysis. Then the review deals with the aspect of data processing that is needed prior to DP analysis, particularly when dietary data arise from assessment methods other than the long-established food frequency questionnaire. Lastly, potential opportunities for upcoming DP analysis are summarized in the outlook. Conclusion Biological factors like the metabolome and the microbiome are crucial to understand diet-disease relationships. Therefore, the inclusion of these factors in DP analysis might provide deeper insights.

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Identification of an Obesogenic Dietary Pattern Using Partial Least Squares in a Nationally-Representative Sample of Canadian Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_052 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 552-552

Author(s):

Alena Ng ◽

Mahsa Jessri ◽

Mary L'Abbé

Keyword(s):

Least Squares ◽

Partial Least Squares ◽

Dietary Pattern ◽

Fast Food ◽

Representative Sample ◽

Hybrid Methods ◽

Nutritional Epidemiology ◽

Obesogenic Diet ◽

Dietary Components ◽

Nationally Representative

Abstract Objectives Hybrid methods of dietary patterns analysis have emerged as a unique and informative way to study diet-disease relationships in nutritional epidemiology research. The objectives of this research were to identify an obesogenic dietary pattern using weighted PLS in nationally-representative Canadian survey data, and to identify key foods and/or beverages associated with the defined obesogenic pattern. Methods Data from one 24-hr dietary recall data from the cross-sectional Canadian Community Health Survey-Nutrition (CCHS) 2015 (n = 12,110 adults) were used. Weighed partial least squares (wPLS) was used to identify an obesogenic dietary pattern from 40 standardized food and/or beverage categories using the variables energy density, fibre density, and total fat as outcomes. The association between the derived dietary pattern and likelihood of obesity was examined using weighted multivariate logistic regression. Key dietary components highly associated with the derived pattern were identified. Results Compared to quartile one (i.e., those least adherent to an obesogenic dietary pattern), those in quartile four had a 2.40-fold increased odds of being obese (OR = 2.40, 95% CI = 1.91, 3.02, P-trend < 0.0001) with a monotonically increasing trend. Using a factor loading significance cut-off of ≥|0.17|, three food/beverage categories loaded positively for the derived obesogenic dietary pattern: fast food, carbonated drinks and salty snacks. Seven food/beverage categories loaded negatively (i.e., in the protective direction): consumption of whole fruits, orange vegetables, “other” vegetables (including vegetable juice), whole grains, dark green vegetables, legumes and soy, and pasta and rice. Conclusions This study pinpoints key dietary components that are associated with obesity and consumed among a nationally-representative sample of Canadians adults. Compared to a similarly-defined obesogenic diet identified by our research group in 2004, the top contributors to a Canadian-specific obesogenic diet in 2015 have remained consistent. This evidence may aid in developing targeted policies and dietary interventions for obesity and chronic disease prevention. Funding Sources Supported by grants from the Burroughs Wellcome Fund Innovation in Regulatory Science Award and the Canadian Institutes of Health Research.

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