The effects of grazing on daily caloric intake and dietary quality

Abstract Background The duration and frequency of eating occasions has been identified as a factor contributing to poor dietary quality among U.S. adults. The objective of this study is to examine whether grazing, defined as eating more than three times a day, affects total daily caloric intake and dietary quality measured by the 2015 Healthy Eating Index (HEI-2015). Methods We used a multivariate individual fixed-effects model to compare the caloric intake and dietary quality of individuals who grazed on 1 day but not another. This allowed us to control for differences in individual food intake and diet quality preferences among study participants. We use the National Health and Nutrition Examination Survey (NHANES), 2007-2018, and include data for adults aged 18 years or older who reported 2 days of dietary intake and were not pregnant or lactating (n = 27,775). Results Grazing increased total daily caloric intake by 205 cal and increased the daily HEI score by 0.59 points. Grazing increased HEI component scores for total fruit, whole fruit, and refined grains, and decreased HEI component scores for saturated fats. Morning grazing increased total daily caloric intake by 159 cal and increased the daily HEI score by 0.87 points — primarily by increasing component scores for total fruit, whole fruit, whole grains, total dairy, seafood and plant proteins, and sodium. Evening grazing increased daily caloric intake by 76 cal and decreased the daily HEI score by 0.41 points — primarily by decreasing the component scores for total fruit, whole grains, fatty acids, and saturated fats. Evening grazing increased HEI component scores for sodium and refined grains. Conclusions Grazing increases daily caloric intake and can decrease dietary quality (particularly when grazing in the evening).

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The Relationship Between the Frequency of Meals Consumed Away-From-Home on the Total Diet Quality and Weight Status

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_099 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 248-248

Author(s):

Ana Moyeda Carabaza ◽

Phrashiah Githinji ◽

Bong Nguyen ◽

Mary Murimi

Keyword(s):

Fatty Acids ◽

Dietary Fiber ◽

Diet Quality ◽

Trans Fatty Acids ◽

Weight Status ◽

Healthy Eating Index ◽

Dietary Quality ◽

Linear Regression Models ◽

Saturated Fats ◽

Total Diet

Abstract Objectives To assess factors that contribute to the total diet quality and the associated body mass index (BMI) among adults. Methods A cross-sectional study was conducted to assess dietary quality using the Healthy Eating Index (HEI)-2015 among faculty and staff (N = 152) of a public university. The Food Frequency Questionnaire from the Health and Retirement Study was administered via Qualtrics. Dietary quality was determined using the HEI-2015. Weight, height, number of meals consumed away-from-home per week were self-reported. Descriptive statistics were used to analyze demographic characteristics, number of meals consumed away-from-home, dietary intake, and associated HEI score was calculated. Linear regression models were used to measure associations between the total diet quality, nutrient intakes and the number of away-from-home meals consumed with BMI. Results The average age of participants was 34.3 ± 12.3 years. A majority were female and white Americans (74.3%) and had post-secondary education (79.6%). Approximately, one-third of participants (32.2%) reported having a BMI equal or greater than 30 kg/m2. More than half of the participants exceeded the recommended limit for the consumption of saturated fats (69.7%), and sodium (52.6%); and a majority did not meet the minimum recommended intakes of dietary fiber (96.1%). The average HEI score was 66.34 on a 100-point scale. Only 14.5% had a good dietary quality with a HEI score equal or higher than 80. The number of away-from-home meals consumed per week were associated with an increased intake of trans fatty acids (P < .05), while, increased the consumption of trans fatty acids was associated with an increase in BMI (P < .001) in this study. On the contrary, an increase in the HEI score was associated with a reduction in BMI (P < .05). Conclusions This study found that a high percentage of participants had a low diet quality that was characterized by excessive intake of both saturated fats and sodium and inadequate intake of dietary fiber. In addition, the consumption of meals away-from-home was associated with an increase in the amount of trans fatty acids consumed. Concurrently, the consumption of trans fatty acids was associated with an increase in BMI. These results underscore the importance of eating meals prepared at home in an effort to control weight gain. Funding Sources TTU Transdisciplinary Research Academy.

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Postoperative Dietary Quality is Poor after Major Musculoskeletal Trauma

Current Developments in Nutrition ◽

10.1093/cdn/nzaa055_022 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1137-1137

Author(s):

Aspen Miller ◽

John Davison ◽

Nathan Hendrickson ◽

Brandon Koch ◽

Michael Willey ◽

...

Keyword(s):

Young Adults ◽

Dietary Intake ◽

Whole Grains ◽

Healthy Eating Index ◽

Diet Analysis ◽

Dietary Quality ◽

Dietary Reference Intake ◽

Acute Fracture ◽

Operative Fixation ◽

Musculoskeletal Trauma

Abstract Objectives Musculoskeletal trauma often leads to prolonged functional deficits. Adequate dietary intake and supplementation improves clinical outcomes after surgical fixation of hip fracture in older adults. The role of post-operative nutrition after acute fracture has not been elucidated. Our objective was to describe dietary deficiencies after operative fixation of acute fracture in young adults. Methods An observational, cohort study identified patients aged 18–55 years presenting to a Level 1 trauma center with pelvic or extremity fracture indicated for operative fixation. Dietary intake was measured using Automated Self- Administered 24-hour dietary recall (ASA24®) in weeks 1, 2, and 4 postoperatively. Individual macro- and micro-nutrients for each subject were summarized using arithmetic means. Inadequate nutritional intake was determined using Dietary Reference Intake (DRI) values reported by the Institute of Medicine. The Healthy Eating Index 2015 (HEI-2015) score was calculated based on ASA24® data as described by the USDA. Results Most subjects were healthy preoperatively, 98% had ≤1 comorbidity. Eighty-four % of injures were to the lower extremities, and 59% were isolated. The majority of subjects (78%) discharged home. An average of 3.9 surveys were filled out per subject. Dietary intake overall was inadequate; 72% did not meet calorie needs. Protein intake was inadequate in 66%. All subjects did not meet DRIs for fiber, vitamin E, or potassium. More than 50% did not meet DRI for calcium, iron, magnesium, folate, vitamins C, A, or K. Added sugar and saturated fat intake exceeded recommendations in 38% and 41% of subjects respectively. Intake of beneficial foods such as whole grains and vegetables were inadequate in 100% of subjects; fruit intake was inadequate in 88%. The mean HEI-2015 score was 44.7 (±11.4 SD) across all time points. Conclusions In a population of previously healthy, young adults with major musculoskeletal trauma, dietary quality was poor compared to the average for the US population, 44.7 vs 59 HEI-2015. Diet analysis revealed a concerning lack of vegetables, whole grains, multiple micronutrients, and total calories. This data provides goals for adequate nutritional supplementation after musculoskeletal trauma. Funding Sources No payments were received to conduct this research study.

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Application of the Healthy Eating Index-2010 to the hunger relief system

Public Health Nutrition ◽

10.1017/s136898001600118x ◽

2016 ◽

Vol 19 (16) ◽

pp. 2906-2914 ◽

Cited By ~ 18

Author(s):

Marilyn S Nanney ◽

Katherine Y Grannon ◽

Colin Cureton ◽

Courtney Hoolihan ◽

Mark Janowiec ◽

...

Keyword(s):

Healthy Eating ◽

Whole Grains ◽

Healthy Eating Index ◽

Decision Makers ◽

Food Banks ◽

Front Line ◽

Initial Development ◽

Relief System ◽

Component Scores

AbstractObjectiveTo demonstrate the feasibility of applying the Healthy Eating Index-2010 (HEI-2010) to the hunger relief setting, specifically by assessing the nutritional quality of foods ordered by food shelves (front-line food provider) from food banks (warehouse of foods).DesignThis Healthy FOOD (Feedback On Ordering Decisions) observational study used electronic invoices detailing orders made by 269 food shelves in 2013 and analysed in 2015 from two large Minnesota, USA food banks to generate HEI-2010 scores. Initial development and processing procedures are described.ResultsThe average total HEI-2010 score for the 269 food shelves was 62·7 out of 100 with a range from 28 to 82. Mean component scores for total protein foods, total vegetables, fatty acids, and seafood and plant proteins were the highest. Mean component score for whole grains was the lowest followed by dairy, total fruits, refined grains and sodium. Food shelves located in micropolitan areas and the largest food shelves had the highest HEI-2010 scores. Town/rural and smaller food shelves had the lowest scores. Monthly and seasonal differences in scores were detected. Limitations to this approach are identified.ConclusionsCalculating HEI-2010 for food shelves using electronic invoice data is novel and feasible, albeit with limitations. HEI-2010 scores for 2013 identify room for improvement in nearly all food shelves, especially the smallest agencies. The utility of providing HEI-2010 scores to decision makers in the hunger relief setting is an issue requiring urgent study.

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The effects of skipping a meal on daily energy intake and diet quality

Public Health Nutrition ◽

10.1017/s1368980020000683 ◽

2020 ◽

Vol 23 (18) ◽

pp. 3346-3355

Author(s):

Eliana Zeballos ◽

Jessica E Todd

Keyword(s):

Food Intake ◽

Energy Intake ◽

Diet Quality ◽

Energy Content ◽

Whole Grains ◽

Healthy Eating Index ◽

Daily Energy Intake ◽

Daily Energy ◽

Skipping Breakfast ◽

Component Scores

AbstractObjective:To examine whether skipping breakfast or lunch increased the next meal’s energy content and changed total daily energy content and the quality of food intake measured by the 2010 Healthy Eating Index (HEI-2010).Design:Means were compared across intake days and meal patterns. Multivariate individual fixed-effects model was used to account for individual food intake and diet quality preferences.Setting:National Health and Nutrition Examination Survey, 2007–2016.Participants:Adults aged 18 years or older who reported 2 d (24-h periods) of dietary intake and were not pregnant or lactating (n 23 488).Results:Adults consumed 193 more kJ at lunch after skipping breakfast and 783 more kJ at dinner after skipping breakfast and lunch. Skipping at least one meal reduced total daily intake between 1053 (breakfast) and 1464 (dinner) kJ and reduced the daily HEI score. Skipping breakfast or skipping lunch reduced the HEI component scores for fruit, whole grains, dairy and empty energy; skipping lunch reduced the component scores for fruit, vegetables, whole grain, dairy, seafood and plant protein, and empty energy. Skipping dinner reduced component scores for vegetables, greens and beans, dairy, protein food, seafood and plant proteins, and empty energy. Skipping one or more meals increased component scores for total vegetables (breakfast), whole grains (dinner), Na (lunch or dinner) and refined grains (breakfast, lunch or dinner).Conclusions:Skipping meals (particularly dinner) reduces daily energy intake, but the reduction in daily diet quality (particularly when skipping breakfast) may impact health negatively over time.

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The Association Between Diet Quality and Fasting Blood Glucose in People Living with HIV (P08-051-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p08-051-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Heather Stanner ◽

Diane Rigassio Radler ◽

Joachim Sackey

Keyword(s):

Blood Glucose ◽

Diet Quality ◽

Fasting Blood Glucose ◽

Healthy Eating Index ◽

People Living With Hiv ◽

Refined Grains ◽

Component Score ◽

Cardiovascular Assessment ◽

Component Scores ◽

Care Study

Abstract Objectives The purpose of this study was to examine the association between diet quality (utilizing Healthy Eating Index-2010 [HEI-2010] total scores) and fasting blood glucose in people living with human immunodeficiency virus (PLHIV). The associations between refined grains and total fruit consumption (HEI-2010 component scores) and fasting blood glucose were also explored. Methods This was a cross-sectional analysis (N = 191) of an existing dataset from the Cardiovascular Assessment Risk Examination (CARE) study at Tufts Medical Center, Boston, MA between 2007 and 2013. It was hypothesized that there would be no association between diet quality and fasting blood glucose. Multiple linear regression was used to test the hypothesis adjusting for several a priori variables (age, race, sex, employment status, use of highly active antiretroviral therapy [HAART], living situation, body mass index, family history of type 2 diabetes [T2D] and year of enrollment). Results The mean age of the subjects was 41.1 years (SD = 7.1 years). Approximately half were white (50.8%, n = 97) and the majority were male (74.9%, n = 143). Subjects had a mean total HEI-2010 score of 49.3 out of 100 possible points with a range of 10–88 points. This is indicative of poor diet quality in this sample of PLHIV. Total protein foods and refined grains represented the component scores with the highest median scores (5.0 out of 5 possible points and 7.6 out of 10 possible points, respectively). Components with low median scores were total fruit (1.6 out of 5 possible points), whole fruit (1.4 out of 5 possible points), greens & beans (0.9 out of 5 possible points) and whole grains (1.5 out of 10 possible points). No significant associations were found between total HEI-2010 score and fasting blood glucose. No significant associations were found between the refined grains HEI-2010 component score or total fruit HEI-2010 component score and fasting blood glucose. Conclusions Overall diet quality was low in this study and the hypothesis of no association between diet quality and fasting blood glucose was supported. Additional studies are needed to determine the relationship between diet quality and fasting blood glucose in PLHIV and how to improve diet quality in this population. Funding Sources The CARE study was supported by the National Institutes of Health (R01HL065947).

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Changes in Maternal Diet Quality Across Pregnancy and Postpartum and Associations with Sociodemographic Characteristics

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_177 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1105-1105

Author(s):

Breanne Wright ◽

Leah Lipsky ◽

Anna Maria Siega-Riz ◽

Aiyi Liu ◽

Tonja Nansel

Keyword(s):

Diet Quality ◽

Healthy Eating Index ◽

Ratio Method ◽

Sociodemographic Characteristics ◽

Full Time ◽

College Degree ◽

Refined Grains ◽

Time Points ◽

Pregnancy And Postpartum ◽

Component Scores

Abstract Objectives This study described diet quality across the perinatal continuum and investigated associations of sociodemographic characteristics with diet quality change from pregnancy to postpartum. Methods Pregnant women (n = 365) in a prospective cohort study completed a demographic questionnaire at recruitment and six 24-hour dietary recalls (one in each pregnancy trimester and 2, 6, and 12 months postpartum). Sample-level diet quality (Healthy Eating Index-2015, HEI total and component scores) at each of the six time points was quantified using the population ratio method and compared using bootstrapping and permutation tests. Individual-level HEI scores during the pregnancy (pooling 3 pregnancy recalls) and postpartum (pooling 3 postpartum recalls) periods were quantified using the by-person method and compared using paired t-tests. Multiple linear regression models examined independent associations of sociodemographic characteristics with change in HEI (postpartum subtracted from pregnancy score). Results Sample-level HEI total and component scores were generally consistent among time points within pregnancy and within postpartum but showed varied changes between periods. Within-person analyses indicated both positive (total protein, fatty acids, refined grains, saturated fat) and negative (total fruit, whole fruit, dairy) changes in HEI from pregnancy to postpartum. Greater improvements in HEI total score were observed in white non-Hispanic versus black non-Hispanic participants (β ± SEM: 6.7 ± 3.2), participants with at least a college degree versus less than a college degree (6.8 ± 2.7), and participants who were not working by choice versus working full time (7.0 ± 2.6). In addition to associations with change in HEI total score, race/ethnicity was associated with change in greens and beans, seafood and plant proteins, and added sugars component scores, education was associated with change in total fruit and refined grains scores, and employment was associated with change in refined grains score. Age, smoking status, and body mass index were also associated with changes in HEI component scores. Conclusions Perinatal decreases in fruit and dairy intake and sociodemographic disparities in dietary changes may represent critical intervention targets. Funding Sources This research was supported by the NICHD Intramural Research Program.

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Abstract P211: Diet Quality Declines and Differs by Race in Early Childhood

Circulation ◽

10.1161/circ.135.suppl_1.p211 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Kelly Reynolds ◽

Heidi Kalkwarf ◽

Suzanne Summer ◽

Philip Khoury ◽

Marcia Gavin ◽

...

Keyword(s):

Fatty Acids ◽

Early Childhood ◽

Healthy Eating ◽

Diet Quality ◽

Dietary Intervention ◽

Healthy Eating Index ◽

Final Visit ◽

White Children ◽

Refined Grains ◽

Component Scores

Introduction: Diet quality is an important determinant of health in children, but little is known about how diet quality progresses during early childhood. We hypothesized that overall diet quality, assessed by the 2010 Healthy Eating Index, would decline during early childhood. Methods: Three hundred seventy-two (372) healthy 3-year-old children were recruited from the Greater Cincinnati area and assessed every 4 months until age 7 at in-person clinical visits, for a total of 13 visits. Parents completed 3-day diet diaries at each visit which were analyzed for nutrient composition using the Nutrition Data Systems for Research system (NDSR). The 2010 Healthy Eating Index (HEI) total and food-group component scores were calculated and averaged by year of study. Longitudinal mixed modeling was used to evaluate longitudinal trends. Results: The population was 52% (195/372) male, 78% (290/372) white and 83% (308/372) completed the final visit. HEI total scores at age 3 were poor (mean±SE: 45.2±0.4) and declined significantly between ages 3-7 (p<0.0001). None of the participants had “good” quality diet (HEI>80) at any point in the study. HEI total scores differed by race, with white children having significantly higher scores (p=0.05, Figure). HEI component scores showed a mixed pattern, with some significantly improving (protein, vegetables and fatty acids), some significantly worsening (dairy, refined grains, sodium, whole fruit and total fruit); other component scores did not change. Differences by race also varied, with African-Americans having consistently better scores for vegetables, greens and beans, protein and fatty acids (all p<0.0001), while white children had better scores for dairy, sodium and refined grains (all p<0.0005). Conclusions: The average HEI scores for young children showed poor baseline diet quality at age 3 that became gradually worse throughout early childhood. The varying patterns in HEI component scores indicate specific areas of focus for early dietary intervention, which may differ by race.

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Fast-food menu offerings vary in dietary quality, but are consistently poor

Public Health Nutrition ◽

10.1017/s1368980012005563 ◽

2013 ◽

Vol 17 (4) ◽

pp. 924-931 ◽

Cited By ~ 44

Author(s):

Sharon I Kirkpatrick ◽

Jill Reedy ◽

Lisa L Kahle ◽

Jennifer L Harris ◽

Punam Ohri-Vachaspati ◽

...

Keyword(s):

Low Income ◽

Fast Food ◽

Poor Quality ◽

Whole Grains ◽

Healthy Eating Index ◽

Dietary Quality ◽

Food Chains ◽

Added Sugars ◽

The Usa ◽

Fast Food Restaurants

AbstractObjectiveTo evaluate five popular fast-food chains’ menus in relation to dietary guidance.DesignMenus posted on chains’ websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids’ menus and sets of items promoted as healthy or nutritious were also assessed.SettingFive popular fast-food chains in the USA.SubjectsNot applicable.ResultsFull menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids’ menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points.ConclusionsThe poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.

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Frequency of Meals Prepared Away from Home and Nutrient Intakes among US Adolescents (NHANES 2011–2018)

Nutrients ◽

10.3390/nu13114019 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4019

Author(s):

Shauna Golper ◽

Sayaka Nagao-Sato ◽

Francine Overcash ◽

Marla Reicks

Keyword(s):

Diet Quality ◽

Representative Sample ◽

Family Income ◽

Food Group ◽

Whole Grains ◽

Healthy Eating Index ◽

Health And Nutrition ◽

Nationally Representative ◽

Potassium Magnesium ◽

Component Scores

Frequency of consuming foods prepared away from home has been associated with lower diet quality among adults and adolescents in several earlier studies. Nutrient and food group intake and Healthy Eating Index (HEI)-2015 scores were compared among a U.S. nationally representative sample of adolescents (12–19 years, n = 3975) by frequency of consuming food prepared away from home ≤2 times/week (n = 2311) versus >2 times/week (n = 1664) using National Health and Nutrition Examination Survey (NHANES) data from 2011–2018. Regression analyses were used to compare intakes among adolescents by frequency of eating meals prepared away from home adjusting for covariates. Older (16–19 years) vs. younger (12–15 years) adolescents and those from homes with higher vs. lower family income to poverty ratios had greater frequency of eating meals prepared away from home. Intakes of nutrients of concern for adolescents including choline, vitamin D, potassium, magnesium, fiber, phosphorus, folate, iron, and total HEI-2015 scores and component scores for total vegetables, and greens and beans were lower among adolescents who consumed meals prepared away from home more vs. less often. However, no differences were noted among food group intakes considered good sources of nutrients of concern such as total fruit, total vegetables, whole grains, and total dairy, except for beans and peas by frequency of eating foods prepared away from home. Greater frequency of eating foods prepared away from home was associated with lower diet quality among adolescents in a nationally representative sample of U.S. adolescents.

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Novel Healthy Eating Index to Examine Daily Food Guides Adherence and Frailty in Older Taiwanese

Nutrients ◽

10.3390/nu13124210 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4210

Author(s):

Kian-Yuan Lim ◽

I-Chen Chen ◽

Yun-Chun Chan ◽

In-Fai Cheong ◽

Yi-Yen Wang ◽

...

Keyword(s):

Whole Grains ◽

Healthy Eating Index ◽

Dietary Quality ◽

Retirement Home ◽

Frailty Status ◽

Daily Food ◽

Relationship Of ◽

The Relationship ◽

Diet Score ◽

Lower Adherence

This study was conducted to investigate the adherence of Daily Food Guides (DFGs) among older Taiwanese, and the relationship of dietary quality and frailty. 154 functional independent older adults who were retirement home residents or community dwellers involved in congregate meal services were recruited. DFGs adherence was measured using a novel Taiwanese Healthy Index (T-HEI). Dietary quality was further assessed using Dietary Approach to Stop Hypertension (DASH) and Mediterranean Diet Score (MDS). Frailty was defined using modified Fried’s criteria. Of the total participants, 12.3% were considered non-frail individuals, while 77.3% were prefrail, and 10.4% were frail. Compared to non-frail participants, prefrail and frail individuals indicated significantly lower adherence to DFGs (ptrend = 0.025). Intake of dark or orange vegetables (ptrend = 0.010), whole grains (ptrend = 0.007), as well as nuts and seeds (ptrend = 0.029) by non-frail individuals were significantly higher than the levels by prefrail and frail individuals. Linear regression model adjusted for age, gender, and functional ability showed that T-HEI was inversely associated with frailty status (β = −0.16 ± 0, p = 0.047), but additional adjustment for nutritional status attenuated the association (β = −0.14 ± 0, p = 0.103). A similar relationship was observed for DASH but not MDS (DASH: β = −0.18 ± 0.01, p = 0.024; MDS: β = −0.06 ± 0.02, p = 0.465). After adjustment for confounders, the association was not observed. However, the distribution of whole grains component in both DASH and MDS was significantly higher in non-frail than prefrail and frail individuals, indicating the importance of whole grains intake in frailty prevention. In conclusion, higher adherence to DFGs and better dietary quality were associated with a lower prevalence of frailty. Higher nutrient-dense foods intake such as whole grains, dark or orange vegetables, nuts, and seeds mark a watershed in frailty prevention.

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