Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study

Background Food biodiversity, encompassing the variety of plants, animals, and other organisms consumed as food and drink, has intrinsic potential to underpin diverse, nutritious diets and improve Earth system resilience. Dietary species richness (DSR), which is recommended as a crosscutting measure of food biodiversity, has been positively associated with the micronutrient adequacy of diets in women and young children in low- and middle-income countries (LMICs). However, the relationships between DSR and major health outcomes have yet to be assessed in any population. Methods and findings We examined the associations between DSR and subsequent total and cause-specific mortality among 451,390 adults enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study (1992 to 2014, median follow-up: 17 years), free of cancer, diabetes, heart attack, or stroke at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires (DQs). DSR of an individual’s yearly diet was calculated based on the absolute number of unique biological species in each (composite) food and drink. Associations were assessed by fitting multivariable-adjusted Cox proportional hazards regression models. In the EPIC cohort, 2 crops (common wheat and potato) and 2 animal species (cow and pig) accounted for approximately 45% of self-reported total dietary energy intake [median (P10–P90): 68 (40 to 83) species consumed per year]. Overall, higher DSR was inversely associated with all-cause mortality rate. Hazard ratios (HRs) and 95% confidence intervals (CIs) comparing total mortality in the second, third, fourth, and fifth (highest) quintiles (Qs) of DSR to the first (lowest) Q indicate significant inverse associations, after stratification by sex, age, and study center and adjustment for smoking status, educational level, marital status, physical activity, alcohol intake, and total energy intake, Mediterranean diet score, red and processed meat intake, and fiber intake [HR (95% CI): 0.91 (0.88 to 0.94), 0.80 (0.76 to 0.83), 0.69 (0.66 to 0.72), and 0.63 (0.59 to 0.66), respectively; PWald < 0.001 for trend]. Absolute death rates among participants in the highest and lowest fifth of DSR were 65.4 and 69.3 cases/10,000 person-years, respectively. Significant inverse associations were also observed between DSR and deaths due to cancer, heart disease, digestive disease, and respiratory disease. An important study limitation is that our findings were based on an observational cohort using self-reported dietary data obtained through single baseline food frequency questionnaires (FFQs); thus, exposure misclassification and residual confounding cannot be ruled out. Conclusions In this large Pan-European cohort, higher DSR was inversely associated with total and cause-specific mortality, independent of sociodemographic, lifestyle, and other known dietary risk factors. Our findings support the potential of food (species) biodiversity as a guiding principle of sustainable dietary recommendations and food-based dietary guidelines.

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Modelling the Association between Core and Discretionary Energy Intake in Adults with and without Obesity

Nutrients ◽

10.3390/nu11030683 ◽

2019 ◽

Vol 11 (3) ◽

pp. 683 ◽

Cited By ~ 1

Author(s):

Mackenzie Fong ◽

Ang Li ◽

Andrew Hill ◽

Michelle Cunich ◽

Michael Skilton ◽

...

Keyword(s):

Energy Intake ◽

Weight Control ◽

Weight Status ◽

Weight Maintenance ◽

Dietary Guidelines ◽

Healthy Weight ◽

Dietary Recommendations ◽

Food Diary ◽

Core Energy ◽

The Impact

Background: Many dietary recommendations for weight control rely on the assumption that greater core food intake will displace intake of energy-dense discretionary foods and beverages. However, there is little evidence to support these assumptions. This study examined the naturalistic relationship between daily core and discretionary energy intake, and with discretionary food and discretionary beverage intake, separately. The impact of weight status on these associations was also examined. Method: One hundred participants completed a four-day (non-consecutive) estimated food diary. Discretionary foods and beverages were identified by reference to the Australian Dietary Guidelines. Non-discretionary items were considered core items. Simultaneous-equation random effects models using disaggregated dietary data controlling for sociodemographic variables were used to determine the association between various dietary components. Result: Core energy intake correlated negatively with discretionary energy intake (cross-equation correlation, ρ = −0.49 (95% CI: −0.57, −0.39)). Its correlation with discretionary foods (−0.47 (−0.56, −0.37)) was stronger than that with discretionary beverages (−0.19 (−0.30, −0.07)) The correlation between core energy intake and discretionary energy intake was significantly stronger in participants who did not have obesity (−0.67 (−0.71, −0.50)) than those with obesity (−0.32 (−0.46, −0.17)) (p = 0.0002). Conclusions: Core and discretionary energy intake share an inverse and potentially bidirectional, relationship that appears to be stronger with discretionary foods than discretionary beverages. These relationships were significantly weaker in participants with obesity which may indicate less precise dietary compensation in these individuals. While strategies that promote greater intake of core foods may assist with weight maintenance in individuals of healthy weight, its impact in individuals with obesity may be limited. These strategies should be accompanied by direct messages to reduce commensurately the intake of discretionary items, with special attention paid to discretionary beverage consumption.

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Comparison of children's dietary intake patterns with US dietary guidelines

British Journal Of Nutrition ◽

10.1017/s0007114500001641 ◽

2000 ◽

Vol 84 (3) ◽

pp. 361-367 ◽

Cited By ~ 60

Author(s):

Louise M. Brady ◽

Christine H. Lindquist ◽

Sara L. Herd ◽

Michael I. Goran

Keyword(s):

Dietary Intake ◽

Nutrition Education ◽

The United States ◽

Dietary Guidelines ◽

United States Department ◽

Adult Health ◽

Dietary Intakes ◽

Food Groups ◽

Dietary Recommendations ◽

American Children

Monitoring dietary intake patterns among children is important in order to explore and prevent the onset of adult health problems. The aim of the present study was to compare children's dietary intakes with national recommendations and to determine whether sex or ethnic differences were evident. This was done using a methodology that allows assessment of intake from the major components of the Food Guide Pyramid developed by the United States Department of Agriculture (USDA: ). The sample studied included 110 African-American and Caucasian males and females (mean age 9·9 years, BMI 20·1 kg/m2) from Birmingham, AL, USA, who were participating in a study investigating the development of obesity. Dietary data were based on three 24 h recalls and food group intake was determined using the USDA Pyramid Servicing Database. The results indicated that a high percentage of subjects failed to meet the recommended number of servings from each of the food groups. For example, only 5 % and 9 % met fruit and dietary group recommendations respectively. Consumption of foods from the Pyramid ‘tip’ (including discretionary fat and added sugar) contributed almost 50 % of the diet. African-Americans were more likely to meet requirements for the meat group, with a higher proportion of Caucasians meeting dietary recommendations. Males were more likely to meet the vegetable group guidelines although females consumed more energy per day from discretionary fat. In conclusion, these results suggest that implementation of nutrition education programmes may be important for promoting healthy nutrition among American children.

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Findings from What We Eat in America, National Health and Nutrition Examination Survey 2011–2014 support salad consumption as an effective strategy for improving adherence to dietary recommendations

Public Health Nutrition ◽

10.1017/s1368980018003695 ◽

2019 ◽

Vol 22 (06) ◽

pp. 976-987 ◽

Cited By ~ 2

Author(s):

Rhonda S Sebastian ◽

Cecilia Wilkinson Enns ◽

Joseph D Goldman ◽

M Katherine Hoy ◽

Alanna J Moshfegh

Keyword(s):

National Health ◽

Vegetable Intake ◽

Vegetable Consumption ◽

Smoking Status ◽

Dietary Guidelines ◽

Nutrition Examination Survey ◽

Effective Strategy ◽

Dietary Recommendations ◽

Health And Nutrition ◽

Study Results

AbstractObjectiveTo verify the previously untested assumption that eating more salad enhances vegetable intake and determine if salad consumption is in fact associated with higher vegetable intake and greater adherence to the Dietary Guidelines for Americans (DGA) recommendations.DesignIndividuals were classified as salad reporters or non-reporters based upon whether they consumed a salad composed primarily of raw vegetables on the intake day. Regression analyses were applied to calculate adjusted estimates of food group intakes and assess the likelihood of meeting Healthy US-Style Food Pattern recommendations by salad reporting status.SettingCross-sectional analysis of data collected in 2011–2014 in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey.ParticipantsUS adults (n 9678) aged ≥20 years (excluding pregnant and lactating women).ResultsOn the intake day, 23 % of adults ate salad. The proportion of individuals reporting salad varied by sex, age, race, income, education and smoking status (P<0·001). Compared with non-reporters, salad reporters consumed significantly larger quantities of vegetables (total, dark green, red/orange and other), which translated into a two- to threefold greater likelihood of meeting recommendations for these food groups. More modest associations were observed between salad consumption and differences in intake and likelihood of meeting recommendations for protein foods (total and seafood), oils and refined grains.ConclusionsStudy results confirm the DGA message that incorporating more salads in the diet is one effective strategy (among others, such as eating more cooked vegetables) to augment vegetable consumption and adherence to dietary recommendations concerning vegetables.

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Theoretical Food and Nutrient Composition of Whole-Food Plant-Based and Vegan Diets Compared to Current Dietary Recommendations

Nutrients ◽

10.3390/nu11030625 ◽

2019 ◽

Vol 11 (3) ◽

pp. 625 ◽

Cited By ~ 9

Author(s):

Micaela Karlsen ◽

Gail Rogers ◽

Akari Miki ◽

Alice Lichtenstein ◽

Sara Folta ◽

...

Keyword(s):

Nutrient Composition ◽

Dietary Guidelines ◽

Food Plant ◽

Leafy Vegetables ◽

Dietary Quality ◽

Vegan Diet ◽

Future Research ◽

Dietary Intakes ◽

Sources Of Information ◽

Dietary Recommendations

Public interest in popular diets is increasing, in particular whole-food plant-based (WFPB) and vegan diets. Whether these diets, as theoretically implemented, meet current food-based and nutrient-based recommendations has not been evaluated in detail. Self-identified WFPB and vegan diet followers in the Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey reported their most frequently used sources of information on nutrition and cooking. Thirty representative days of meal plans were created for each diet. Weighted mean food group and nutrient levels were calculated using the Nutrition Data System for Research (NDSR) and data were compared to DRIs and/or USDA Dietary Guidelines/MyPlate meal plan recommendations. The calculated HEI-2015 scores were 88 out of 100 for both WFPB and vegan meal plans. Because of similar nutrient composition, only WFPB results are presented. In comparison to MyPlate, WFPB meal plans provide more total vegetables (180%), green leafy vegetables (238%), legumes (460%), whole fruit (100%), whole grains (132%), and less refined grains (−74%). Fiber level exceeds the adequate intakes (AI) across all age groups. WFPB meal plans failed to meet the Recommended Dietary Allowances (RDA)s for vitamin B12 and D without supplementation, as well as the RDA for calcium for women aged 51–70. Individuals who adhere to WFBP meal plans would have higher overall dietary quality as defined by the HEI-2015 score as compared to typical US intakes with the exceptions of calcium for older women and vitamins B12 and D without supplementation. Future research should compare actual self-reported dietary intakes to theoretical targets.

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Demographic and socio-economic factors related to food intake and adherence to nutritional recommendations in a cohort of pre-school children

Public Health Nutrition ◽

10.1017/s1368980010003769 ◽

2011 ◽

Vol 14 (6) ◽

pp. 1096-1104 ◽

Cited By ~ 20

Author(s):

Lise Dubois ◽

Anna Farmer ◽

Manon Girard ◽

Daniel Burnier ◽

Marion Porcherie

Keyword(s):

Food Intake ◽

Energy Intake ◽

Healthy Eating ◽

School Children ◽

Demographic Factors ◽

Dietary Guidelines ◽

Care Staff ◽

Food Groups ◽

Dietary Recommendations ◽

The Mean

AbstractObjectiveTo examine: (i) children's food intake and adherence to both Canada's Food Guide for Healthy Eating and Dietary Reference Intakes; and (ii) the social and demographic factors related to children's food intake.DesignA cross-sectional study.SettingData were obtained through the Quebec Longitudinal Study of Child Development 1998–2010, a representative sample (n 2103) of children born in 1998 in the province of Quebec, Canada. Information on energy, macronutrient and food consumption was derived from responses to a 24 h dietary recall interview addressed to children's mothers and day-care staff when the children were 4 years old.SubjectsA total of 1549 children aged 4 years who participated in a nutritional sub-study.ResultsThe mean daily total energy intake was 6360 kJ (1520 kcal) for girls and 6916 kJ (1653 kcal) for boys. For boys and girls alike, energy intake was comprised of approximately 54 % carbohydrates, 31 % fats and 15 % proteins. The mean number of servings consumed from each of the four essential food groups closely approached the dietary recommendations made by Canada's Food Guide for Healthy Eating; however, <2 % of the children in the present study actually met the full dietary guidelines. The dietary intake of pre-school children was associated with socio-economic and demographic factors, most notably mother's level of education, mother's immigrant status and sex of the child.ConclusionsDiet-related disparities associated with socio-economic and demographic factors exist from as early as 4 years of age.

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Population compliance with national dietary recommendations and its determinants: findings from the ORISCAV-LUX study

British Journal Of Nutrition ◽

10.1017/s0007114512000232 ◽

2012 ◽

Vol 108 (11) ◽

pp. 2083-2092 ◽

Cited By ~ 23

Author(s):

Ala'a Alkerwi ◽

Nicolas Sauvageot ◽

Anne Nau ◽

Marie-Lise Lair ◽

Anne-Françoise Donneau ◽

...

Keyword(s):

Nutrition Education ◽

Cardiovascular Health ◽

Smoking Status ◽

Dairy Product ◽

Normal Weight ◽

Dietary Guidelines ◽

Dietary Recommendations ◽

Cross Sectional ◽

Dietary Compliance ◽

Targeted Interventions

The objective of the present study was to determine the proportion of adults meeting national recommendations for food and nutrient intake and to identify the demographic, socio-economic and behavioural factors that may contribute to weaken dietary compliance. ORISCAV-LUX is a cross-sectional study that took place in Luxembourg (2007–8). A representative stratified random sample of 1352 adults aged 18–69 years participated in the nationwide cardiovascular health survey. A FFQ was used to estimate food intake. Radar charts were built to compare graphically the compliance of the participants with different key dietary guidelines on the same set of axes. The thirteen food- and nutrient-based recommendations were scored and summed to create a recommendation compliance index (range − 0·5 to 14). Ordinal logistic regression analyses were performed to determine the factors contributing to poor dietary compliance. Several food- and nutrient-based guidelines were insufficiently respected compared with others. The greatest gaps occurred in the adherence to grain and dairy product consumption guidelines, as well as to total fat and notably to SFA recommendations. Age, country of birth, economic status, smoking status and subject's awareness of the importance of balanced meals emerged as independently associated with weak dietary compliance. Obese subjects conformed more to dietary recommendations compared with normal-weight subjects. The findings underscore the need for specific nutrition education messages along with targeted interventions. Efforts should be continued to increase population awareness of the importance of a healthy lifestyle and a balanced diet.

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Consumption of red meat, white meat and processed meat in Irish adults in relation to dietary quality

British Journal Of Nutrition ◽

10.1079/bjn20051427 ◽

2005 ◽

Vol 93 (6) ◽

pp. 933-942 ◽

Cited By ~ 49

Author(s):

Meadhbh Cosgrove ◽

Albert Flynn ◽

Máiréad Kiely

Keyword(s):

Meat Consumption ◽

Red Meat ◽

Dietary Guidelines ◽

Dietary Quality ◽

Processed Meat ◽

Dietary Recommendations ◽

Food Diary ◽

White Meat ◽

Cross Sectional ◽

Processed Meat Consumption

The aim of the present study was to examine the association of red meat, white meat and processed meat consumption in Irish adults with dietary quality. A cross-sectional study of subjects, randomly selected using the electoral register, estimated habitual food intakes using a 7 d food diary in a nationally representative sample of 662 men and 717 women (not pregnant or lactating) aged 18–64 years. Consumers were classified into thirds, based on the distribution of mean daily intakes for red meat, white meat and processed meat. The mean intakes of red meat, white meat and processed meat were 51, 33 and 26 g/d respectively, and men consumed significantly more (P<0·001) than women for all meat types. In men, red meat consumption was associated with lower (P<0·001) prevalence of inadequacy for Zn, riboflavin and vitamin C intakes. Increasing processed meat intake was associated with a lower (P<0·01) level of compliance with dietary recommendations for fat, carbohydrate and fibre in men. Increasing processed meat consumption was associated with lower (P<0·01) wholemeal bread, vegetables, fruit and fish intakes in men and women. Managerial occupations were associated with lower processed meat intakes. It is important to distinguish between meat groups, as there was a large variation between the dietary quality in consumers of red meat, white meat and processed meat. Processed meat consumption is negatively associated with dietary quality and might therefore be a dietary indicator of poor dietary quality. This has important implications in nutritional epidemiological studies and for the development of food-based dietary guidelines.

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Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition

British Journal Of Nutrition ◽

10.1017/s0007114516001859 ◽

2016 ◽

Vol 116 (2) ◽

pp. 316-325 ◽

Cited By ~ 15

Author(s):

Heather A. Ward ◽

Teresa Norat ◽

Kim Overvad ◽

Christina C. Dahm ◽

H. Bas Bueno-de-Mesquita ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Survival ◽

Cox Regression ◽

Red Meat ◽

Dietary Guidelines ◽

Processed Meat ◽

Limited Evidence ◽

All Cause Mortality ◽

Specific Mortality ◽

Prospective Investigation

AbstractImprovements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (Pfor heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.

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The role of meat in the European diet: current state of knowledge on dietary recommendations, intakes and contribution to energy and nutrient intakes and status

Nutrition Research Reviews ◽

10.1017/s0954422419000295 ◽

2020 ◽

Vol 33 (2) ◽

pp. 181-189 ◽

Cited By ~ 2

Author(s):

Chris Cocking ◽

Janette Walton ◽

Laura Kehoe ◽

Kevin D. Cashman ◽

Albert Flynn

Keyword(s):

Meat Consumption ◽

Dietary Guidelines ◽

Present Review ◽

Processed Meat ◽

Dietary Recommendations ◽

Nutrient Intakes ◽

Comprehensive Overview ◽

Processed Meat Consumption ◽

Red And Processed Meat

AbstractThe role of meat in the diet has come under scrutiny recently due to an increased public emphasis on providing healthy diets from sustainable food systems and due to health concerns relating to the consumption of red and processed meat. The present review aimed to summarise dietary guidelines relating to meat, actual meat intakes and the contribution of meat to energy and nutrient intakes of children, teenagers and adults in Europe. The available literature has shown that food-based dietary guidelines for most countries recommend consuming lean meat in moderation and many recommend limiting red and processed meat consumption. Mean intakes of total meat in Europe range from 40 to 160 g/d in children and teenagers and from 75 to 233 g/d in adults. Meat contributes to important nutrients such as protein, PUFA, B vitamins, vitamin D and essential minerals such as Fe and Zn; however, processed meat contributes to significant proportions of saturated fat and Na across population groups. While few data are available on diaggregated intakes of red and processed meat, where data are available, mean intakes in adults are higher than the upper limits recommended by the UK Scientific Advisory Committee on Nutrition (70 g/d) and the World Cancer Research Fund (500 g/week). While there are no recommendations for red and processed meat consumption in children and teenagers, intakes currently range from 30 to 76 g/d. The present review provides a comprehensive overview of the role of meat in the European diet which may be of use to stakeholders including researchers, policy makers and the agri-food sector.

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Do Older Women of Reproductive Age Have Better Diet Quality than Younger Women of Reproductive Age?

Nutrients ◽

10.3390/nu13113830 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3830

Author(s):

Nahal Habibi ◽

Katherine M. Livingstone ◽

Suzanne Edwards ◽

Jessica A. Grieger

Keyword(s):

Older Women ◽

Diet Quality ◽

Food Group ◽

Dietary Guidelines ◽

Reproductive Age ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Women Of Reproductive Age ◽

Younger Women ◽

Reproductive Aged Women

There is increasing recognition of the importance of nutrition for reproductive health, but little is known regarding the diet quality of younger vs. older reproductive aged women, and how their intakes relate to dietary recommendations. The purpose of the study was to examine the diets of younger (19–35 years old) compared to older (35–50 years old) reproductive aged women, and how they align with dietary recommendations. Women aged 19–50 years from the 2011–13 Australian National Nutrition and Physical Activity Survey were included (n = 2323). Dietary intakes were assessed by a single 24-h dietary recall and were compared to (i) Australian Dietary Guidelines; (ii) Acceptable Macronutrient Distribution for protein, carbohydrates, and fat; and (iii) Dietary Guideline Index (DGI). Regression analyses comparing younger and older women against recommendations were undertaken, with confounders determined a priori. There was no difference between older and younger women in meeting food group recommendations, with 26% of all women meeting recommendations for fruit, and meat and alternatives, and <20% meeting recommendations for vegetables and alternatives, grains, and dairy. Although there was no difference between older and younger women in total DGI score (mean (SE) 75.6 (1.7) vs. 74.5 (2.5), p > 0.05), older women had higher component scores in limiting saturated fat, consuming low-fat milk, and limiting adding salt during cooking. Continued health promotion for women of reproductive age should be a key priority to improve their own health and that of future generations.

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