Poor Diet Quality in Children with Cancer During Treatment

2021 ◽  
pp. 104345422110110
Author(s):  
Jennifer Cohen ◽  
Emma Goddard ◽  
Mary-Ellen Brierley ◽  
Lynsey Bramley ◽  
Eleanor Beck

Background: With improved long-term health outcomes and survivorship, the long-term nutritional management of childhood cancer survivors, from diagnosis to long-term follow-up, has become a priority. The aim of this study was to examine the diet quality of children receiving treatment for cancer. Methods: Participants were parents of children with cancer who were receiving active treatment and not receiving supplementary nutrition. A 24-h dietary recall assessed food and nutrient intake. Serves of food group intakes and classification of core and discretionary items were made according to the Australian Dietary Guidelines and compared with age and sex recommendations. Results: Sixty-four parents participated (75% female). Most children were not consuming adequate intake of vegetables (94% of patients), fruit (77%), and milk/alternatives (75%). Of the vegetables that were consumed, half were classified as discretionary foods (e.g., chips/fries). Nearly half (49%) of children exceeded recommendations for total sugar intake and 65% of patients had an excessive sodium intake. Discussion: Children receiving cancer treatment are consuming diets of reasonable quantity, but poor quality. Information provided during treatment should focus on educating parents on a healthy diet for their child, the importance of establishing healthy eating habits for life, and strategies to overcome barriers to intake during treatment.

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1491-1491
Author(s):  
Valerie Sullivan ◽  
Muzi Na ◽  
Penny Kris-Etherton ◽  
Kristina Petersen

Abstract Objectives The 2015–2020 Dietary Guidelines for Americans recognize dried fruits as acceptable alternatives to fresh fruit but caution that, consumed in excess, they can contribute excess calories. The aim of this study was to characterize dried fruit consumption and the contribution of dried fruits to nutrient intakes and diet quality. Methods A cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES), 2007–2016 was performed. Survey-weighted analyses were used to estimate mean dried fruit intakes in adults 20 years or older (n = 25,590) who completed a dietary recall. Dried fruit consumers (≥1/4 cup-equivalent/day) were defined in respondents with two complete dietary recalls (n = 22,311). Regression analyses compared cardiometabolic health and diet quality in consumers and non-consumers, with adjustment for demographic and lifestyle factors. Within-person differences in nutrient and food group intakes on days when dried fruits were consumed versus not were assessed in respondents who consumed dried fruit on only one of two dietary recalls (n = 1222) using multivariate linear regression. Results Mean dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented 3.6% of total fruit consumed by adults. The major food source was plain dried fruit (49%), followed by cereals (19%). Consumers (7.2% of adults) had higher quality diets than non-consumers (HEI-2015 score 60.6, versus 52.6; P < 0.001) and lower mean BMI, waist circumference, and systolic blood pressure (P ≤ 0.001), after adjustment for potential confounders. Total fruit, nuts and seeds, total carbohydrates, dietary fiber, potassium, and polyunsaturated fat intakes were greater on days when dried fruits were consumed versus not consumed (P < 0.01). In women, total and monounsaturated fat and protein intakes were also greater, while men consumed more whole grains and added sugars on dried fruits consumption days. Total calorie intakes were higher in men and women (205–209 kcal, P ≤ 0.002) when dried fruits were consumed. Conclusions Dried fruit consumption is associated with higher diet quality and greater intakes of shortfall nutrients. However, dried fruits do not appear to displace other calorie sources when consumed. Funding Sources None.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2667
Author(s):  
Kevin B. Comerford ◽  
Yanni Papanikolaou ◽  
Julie Miller Jones ◽  
Judith Rodriguez ◽  
Joanne Slavin ◽  
...  

Carbohydrate-containing crops provide the bulk of dietary energy worldwide. In addition to their various carbohydrate forms (sugars, starches, fibers) and ratios, these foods may also contain varying amounts and combinations of proteins, fats, vitamins, minerals, phytochemicals, prebiotics, and anti-nutritional factors that may impact diet quality and health. Currently, there is no standardized or unified way to assess the quality of carbohydrate foods for the overall purpose of improving diet quality and health outcomes, creating an urgent need for the development of metrics and tools to better define and classify high-quality carbohydrate foods. The present report is based on a series of expert panel meetings and a scoping review of the literature focused on carbohydrate quality indicators and metrics produced over the last 10 years. The report outlines various approaches to assessing food quality, and proposes next steps and principles for developing improved metrics for assessing carbohydrate food quality. The expert panel concluded that a composite metric based on nutrient profiling methods featuring inputs such as carbohydrate–fiber–sugar ratios, micronutrients, and/or food group classification could provide useful and informative measures for guiding researchers, policymakers, industry, and consumers towards a better understanding of carbohydrate food quality and overall healthier diets. The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1943
Author(s):  
Melissa C. Kay ◽  
Emily W. Duffy ◽  
Lisa J. Harnack ◽  
Andrea S. Anater ◽  
Joel C. Hampton ◽  
...  

For the first time, the 2020–2025 Dietary Guidelines for Americans include recommendations for infants and toddlers under 2 years old. We aimed to create a diet quality index based on a scoring system for ages 12 to 23.9 months, the Toddler Diet Quality Index (DQI), and evaluate its construct validity using 24 h dietary recall data collected from a national sample of children from the Feeding Infants and Toddlers Study (FITS) 2016. The mean (standard error) Toddler DQI was 49 (0.6) out of 100 possible points, indicating room for improvement. Toddlers under-consumed seafood, greens and beans, and plant proteins and over-consumed refined grains and added sugars. Toddler DQI scores were higher among children who were ever breastfed, lived in households with higher incomes, and who were Hispanic. The Toddler DQI performed as expected and offers a measurement tool to assess the dietary quality of young children in accordance with federal nutrition guidelines. This is important for providing guidance that can be used to inform public health nutrition policies, programs, and practices to improve diets of young children.


Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3678
Author(s):  
Evan J. Reister ◽  
Lynn N. Belote ◽  
Heather J. Leidy

Over the last decade, hummus has become an increasingly popular food. Given the ingredients (i.e., primarily chickpeas and tahini), nutrient composition, versatility, and acceptability, hummus can play a unique role when included in the American diet, to promote diet quality and improve health. The purpose of this paper is to provide a comprehensive review of the scientific evidence examining the effects of acute and long-term consumption of hummus and hummus ingredients on diet quality and risk factors related to type 2 diabetes, cardiovascular disease, and obesity. In addition, food pattern/menu modeling is included to illustrate the potential nutritional impact of consuming hummus to meet dietary guidelines. In general, the consumption of hummus and/or its respective ingredients has been shown to improve postprandial glycemic control, fasting lipids, appetite control, and daily food intake compared to other commonly consumed foods. The incorporation of hummus into the American diet can also improve diet quality by replacing foods higher in saturated fats, sodium, or added sugars. Collectively, these findings support the addition of hummus and/or hummus ingredients as an important component of a healthy dietary pattern.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ruopeng An ◽  
Sharon Nickols-Richardson ◽  
Reginald Alston ◽  
Sa Shen ◽  
Caitlin Clarke

Abstract Objectives This study assessed the influence of beef consumption on nutrient intakes and diet quality among U.S. adults. Methods Nationally-representative sample (N = 27,117) from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 waves were analyzed. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g., eating habits, taste preferences) by using within-individual variations in beef consumption between 2 nonconsecutive 24-hour dietary recalls. Results Approximately 53.6%, 11.6%, and 6.7% of American adults consumed beef, fresh beef, lean beef, and fresh lean beef, respectively. An increase in lean beef and fresh lean beef consumption by one ounce-equivalent per day was associated with an increase in the Health Eating Index-2010 score by 0.20 (95% CI = 0.10, 0.29) and 0.29 (95% CI = 0.03, 0.55), respectively. Prevalence of beef, fresh beef, lean beef, and fresh lean beef consumption differed by sex, age, race/ethnicity, education level, and obesity status. An increase in beef, fresh beef, lean beef, and fresh lean beef consumption by one ounce-equivalent per day was found to be associated with an increase in intakes of total energy by 46.1, 39.6, 34.3, and 23.3 kcal, protein by 5.0, 4.1, 4.9, and 4.2 g, sodium by 66.6, 63.4, 35.8, and 39.1 mg, choline by 18.9, 18.1, 19.4, and 18.9 mg, iron by 0.6, 0.6, 0.5, and 0.5 mg, selenium by 3.8, 3.4, 3.6, and 3.8 µg, zinc by 1.4, 1.2, 1.3, and 1.1 mg, phosphorus by 37.1, 37.5, 32.4, and 34.4 mg, vitamin B2 by 0.03, 0.05, 0.02, and 0.04 mg, vitamin B3 by 0.9, 0.6, 0.9, and 0.6 mg, and vitamin B6 by 0.1, 0.06, 0.1, and 0.07 mg, respectively. An increase in beef, fresh beef, and lean beef consumption by one ounce-equivalent per day was found to be associated with an increase in daily intakes of saturated fat by 0.9, 0.8, and 0.6 g, and vitamin B12 by 0.4, 0.3, and 0.4 µg, respectively. No association linking fresh lean beef consumption with daily intakes of saturated fat and vitamin B12 was identified. Conclusions Beef consumers are advised to increase their share of fresh and lean beef over total beef intake in an effort to maximize their nutritional gains from beef consumption while minimize the resultant increase in energy, saturated fat, and sodium intake. Funding Sources National Cattlemen's Beef Association.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rebecca Rivera ◽  
Yumin Zhang ◽  
Qi Wang ◽  
Melissa Maulding ◽  
Regan Bailey ◽  
...  

Abstract Objectives The goal of the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to assist low-income households to improve diet quality. The objective of this study was to evaluate the long-term effects of SNAP-Ed nutrition education lessons on diet quality and key nutrient and food group outcomes among Indiana SNAP-Ed-eligible adults. Methods The study design was a parallel-arm randomized controlled nutrition education intervention. The intervention consisted of the first 4 lessons of the Indiana adult SNAP-Ed curriculum delivered to participants during the 4 to 10 weeks after their baseline assessment. Participants (≥18 yrs) eligible for SNAP-Ed and interested in receiving nutrition education lessons (direct SNAP-Ed) were recruited from 31 Indiana counties (N = 261) and completed baseline assessments from August 2015 to May 2016. Follow-up assessments were conducted approximately 1-year after baseline from August 2016 to May 2017 (n = 103). Dietary intake was assessed using up to 2 24-hour dietary recalls at each assessment time point. The main outcome measures were mean usual nutrient (calcium; vitamins D, A, C, E; magnesium; folate; potassium; fiber; dairy; fruit; vegetable; whole grains) the proportion meeting Estimated Average Requirements, exceeding Adequate Intakes, or meeting daily recommended servings, and diet quality as measured by the Healthy Eating Index-2010. This study is registered at www.clinicaltrials.gov as NCT03436784. Significance was P ≤ 0.05. Analyses were completed using SAS 9.4. Results No effect of direct SNAP-Ed was found on diet quality, nutrient, or food group intake in the treatment compared to the control group between baseline and the 1-year follow-up assessment (P > 0.05). Conclusions Direct SNAP-Ed did not improve long-term diet quality, nutrient, or food group intake among Indiana SNAP-Ed eligible adults. Funding Sources Funding for this research was provided by Purdue University as part of AgSEED Crossroads funding to support Indiana's Agriculture and Rural Development, Purdue University Frederick N. Andrews Fellowship, Purdue University Center for Families Justice Family Nutrition Award, the Purdue University Nutrition Education Program, and a USDA NIFA Hatch Project.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Henna Vepsäläinen ◽  
Hannele Sorvari ◽  
Elviira Lehto ◽  
Katri Sääksjärvi ◽  
Marja Leppänen ◽  
...  

AbstractIntroductionStudying the link between children's stress and diet is crucial, as early childhood is an important period for the development of eating habits as well as other health behaviours. Among adults, studies have shown that elevated cortisol levels (indicator of long-term stress) might be associated with overweight and a preference for energy-dense foods. However, the association between hair cortisol concentration (HCC) and diet among pre-school-aged children is poorly understood. The aim of this study was to investigate whether HCC, a measure of long-term stress, is associated with diet among 3–6-year-old Finnish children.Materials and methodsThe current cross-sectional study is a part of the DAGIS study conducted in 66 Finnish pre-schools in 2015–2016. Of the 864 participating pre-schoolers, 578 (67%) provided the information needed to examine the association between HCC and diet. HCC was measured from 4-cm hair samples using a chemiluminescence immunoassay, and the HCCs were categorized into fifths. The parents of the participating children filled in a food frequency questionnaire (FFQ) assessing the child's food consumption outside preschool hours. The FFQ items (n = 47) were used as inputs in principal component analysis to derive dietary patterns. The associations between HCC and food group consumption frequencies as well as dietary pattern scores for ‘sweets-and-treats’, ‘health-conscious’ and ‘vegetables-and-processed meats’ patterns were examined with multilevel linear mixed models and adjusted for age, gender and parental education.ResultsThe median HCC was 11.7 pg/mg (min 0.24, max 879.6). Compared to the children who had the lowest HCCs, the children with the highest HCCs consumed vegetables as well as fruits and berries less frequently (β = -1.62, 95% CI -3.14, -0.09; β = -1.49, 95% CI -2.95, -0.04) and scored lower on the ‘health-conscious’ dietary pattern (β = -0.31, 95% CI -0.51, -0.11). After adjustments, the associations between HCC and fruit and berry and sugary beverage consumption as well as ‘health-conscious’ pattern were significant (β = -1.62, 95% CI -3.09, -0.16; β = 1.30, 95% CI 0.06, 2.54; β = -0.33, 95% CI -0.53, -0.14).DiscussionThis study supports the link between long-term stress and lower-quality diet, as it showed that elevated HCCs and less healthful diets were connected already in the early childhood. However, because of the cross-sectional design of the study, we are not able to conclude whether stress affects diet or vice versa. Nevertheless, these results give reason to further investigate the relationship between stress and children's eating habits as well as health in general.


Author(s):  
Hande Nur Onur

A woman’s nutritional status prior to and during pregnancy affects foetal development, the course of the pregnancy and her long-term health. This study aims to determine the diets of pregnant and non-pregnant women using the Healthy Eating Index 2010 (HEI-2010). The study was performed on 43 non-pregnant and 25 pregnant volunteers, who had no chronic diseases, took no diet treatments and had a mean age of 23.0 ± 30.1 years. Their general features were determined through a questionnaire, dietary intake was measured by 24-hour dietary recall method, diet quality was assessed by HEI-2010 and energy and nutrient intake was calculated by the Nutrition Information System programme. The diet quality of 60.3% of the participants was found to be poor, while 39.7% was average. Although pregnant women had a slightly higher HEI-2010 score, the diet quality was low for all; hence, dieticians should provide nutrition education for all child-bearing aged women. Keywords: Diet quality, healthy eating index, pregnancy nutrition.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1323-1323
Author(s):  
Megan Lawless ◽  
Lenka Shriver ◽  
Jessica Dollar ◽  
Susan Calkins ◽  
Susan Keane ◽  
...  

Abstract Objectives Establishing a diet that follows the Dietary Guidelines for Americans has been associated with lower risk of mortality from cardiovascular disease and cancer. Some research has shown that individuals’ desire for weight control is an important factor in determining food choices. The aims of this study were to 1) examine dietary restraint in adolescence as a predictor of overall diet quality in young adulthood and 2) compare selected dietary components by levels of restraint. Methods Data were collected from participants enrolled in a longitudinal study in NC, the Right Track Health Study (n = 112). Dietary restraint was assessed using the 21-item subscale of the Three Factor Eating Questionnaire. Three 24-hour dietary recalls were collected to estimate dietary intake and Healthy Eating Index 2015 (HEI-2015) scores were calculated to determine diet quality. Multiple linear regression tested the association between restraint and diet quality, adjusting for sex, race, Body Mass Index-for-age percentiles and disinhibition in adolescence. Using the mean value for restraint (score of 6.64), “high restraint” and “low restraint” groups were created, and the specific HEI-2015 component scores were compared using t-tests. Level of significance was set at P < 0.05. Results Overall, participants consumed a poor-quality diet (HEI-2015 score = 50.24 ± 13.56). Higher restraint in adolescence (mean age 16.59 ± 0.39 years) was associated with higher total HEI-2015 score in young adulthood (mean age 18.74 ± 0.51) (β = 15.39 (95% CI: 3.44, 27.34) P = 0.01). The high restraint group had significantly higher HEI-component scores for total vegetables, greens and beans, total fruit, whole fruit, seafood and plant proteins, and added sugars. There were no differences between the two groups in the remaining HEI-2015 component scores (e.g., whole grains, fatty acids, sodium). Conclusions Higher dietary restraint in adolescence predicts better overall diet quality in young adulthood. Nevertheless, young adults in our sample failed to meet the federal dietary guidelines. Interventions aimed at improving diet quality should consider an individual's level of dietary restraint to better tailor nutrition advice. Funding Sources This research was supported by funding from NIH-NICHD and NIH-NIDDK.


Author(s):  
Alexis Santiago ◽  
Jacqueline Zimmerman ◽  
Ronald Feinstein ◽  
Martin Fisher

Abstract Purpose To compare the nutritional intake of adolescents with eating disorders (EDs) to recommended Daily Values of macronutrients and micronutrients, using the Nutrition Data Systems for Research (NDSR); to determine if nutritional content varied among the different sub-types of EDs; and to use the Healthy Eating Index 2010 (HEI-2010) as a measurement of diet quality in this population. Methods Forty-six adolescents referred to an ED Program were recruited for inclusion in this study. A detailed 24-h dietary recall from each participant was obtained and a detailed nutritional analysis was generated, allowing for calculation of the HEI-2010. Descriptive statistics were calculated to determine baseline characteristics of the study population and to determine associations and differences between ED subtypes. Results Average daily caloric intake was below recommended values in the study population. Despite this, the distribution of macronutrients was within the ranges recommended for older children and adolescents by the Dietary Guidelines for Americans, 2010. Micronutrient content varied considerably. The study population had a mean HEI-2010 score of 60.1, falling within the “needs improvement” category. A majority of the participants had insufficient caloric intake for the HEI to be applicable. Conclusion Results suggest that adolescents with EDs have a surprisingly normal distribution of macronutrient intake. Although using a diet quality assessment tool such as the HEI-2010 has been helpful in analyzing overall diet quality in the general population, the restrictive caloric intake which characterizes the ED population prevents the utility of such a guide for most patients with EDs.


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