scholarly journals Development and validation of a meal quality index with applications to NHANES 2005-2014

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244391
Author(s):  
Fabio Mainardi ◽  
Daniela Prozorovscaia ◽  
Gary Sweeney ◽  
Hilary Green
Keyword(s):  
Nutritional Quality ◽  
Energy Content ◽  
Pearson Correlation ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Health And Nutrition ◽  
Meal Quality ◽  
The Us ◽  
Development And Validation

The Meal Balance Index (MBI) assesses the nutritional quality and balance of meals. It is a score between 0 and 100 that takes into account both shortfall and excess nutrients, adjusted for the energy content of the meal. In the present study the score was applied to 147849 meals reported in the National Health and Nutrition Examination Surveys (NHANES) 2005-2014 in order to evaluate its validity and compare against exemplary meals designed as part of 24h diets that meet US dietary guidelines. Meals from exemplary menu plans developed by nutrition experts scored on average 76±14 (mean ± standard deviation) whereas those of NHANES participants scored 45±14. Scores of breakfast, lunch, dinner, snack, considered jointly as independent variables, were moderately but positively and significantly associated with the Healthy Eating Index (Pearson correlation 0.6). MBI scores were significantly associated with the density of positive micronutrients (e.g. Vit A, Vit C) and favorable food groups (e.g. fruits, whole grains) not directly included in the MBI algorithm. The MBI is a valid tool to assess the nutritional quality of meals reported in the US population and if applied to culinary recipe websites could potentially help users to understand which meals are nutritionally balanced. Choice of more balanced individual meals can guide healthier cooking and eating.

Abstract P355: Development and Validation of a Nutrient Density Score That Includes Foods Groups

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jessica D Smith ◽  
Victor Fulgoni ◽  
Adam Drewnowski
Keyword(s):  
Diet Quality ◽  
Saturated Fat ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Unsaturated Fat ◽  
Nutrient Density ◽  
Density Score ◽  
Considerable Work ◽  
Development And Validation

Introduction: There has been considerable work performed on nutrient profiling to assess the nutritional contribution of a food to a healthy dietary pattern. Most profiling approaches have focused on nutrients to limit and nutrients to encourage. A few profiling approaches have also included certain food groups in the profiling algorithm. Objectives: The objective of this study was to develop a nutrient density score, based on the Nutrient Rich Food Index (NRF) 6.3, that includes food groups and validate the score against a gold-standard marker of diet quality, the Healthy Eating Index (HEI) 2015. Methods: Stepwise regression was used to develop a nutrient density score based on the day 1 total dietary intake of the U.S. population 2 years and older (excluding pregnant and lactating women) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016 (n=23,743). Intake of food groups was taken from the Food Patterns Equivalent Database (FPED) 2011-2016. Sixteen nutrients (as a percent of the Daily Value) as well as five food groups (as a percentage of recommended intake in 2015-2020 Dietary Guidelines) were considered in the score. Results: When only the 16 nutrients were included in the score, 66% of the variability in the HEI 2015 could be accounted for (R 2 = 0.66). When only the five food groups were considered, the maximum R 2 with the HEI 2015 was 0.50. However, when both nutrients and foods groups were considered, the model explained 74% of the variability in the HEI 2015 (Table). The increase in the R 2 begins to plateau after the inclusion of 10 elements: 3 nutrients to encourage (fiber, potassium and unsaturated fat), 4 food groups (dairy, fruit, whole grains, and nuts and seeds) and 3 nutrients to limit (added sugar, saturated fat, sodium). Conclusion: A nutrient density score that includes both nutrients and foods groups best predicts diet quality as measured by the HEI 2015.

scholarly journals Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015–2016

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2952
Author(s):  
Yong Zhu ◽  
Neha Jain ◽  
Vipra Vanage ◽  
Norton Holschuh ◽  
Anne Hermetet Agler ◽  
...  
Keyword(s):  
United States ◽  
Dietary Intake ◽  
National Health ◽  
Diet Quality ◽  
The United States ◽  
Healthy Eating Index ◽  
Nutrition Examination Survey ◽  
Food Groups ◽  
Dietary Recall ◽  
Health And Nutrition

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.

scholarly journals Defining Diet Quality: A Review of Diet Metrics as Applied to the Double Burden of Malnutrition (OR17-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Fruits And Vegetables ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Healthy Diet ◽  
Food Groups ◽  
Policy Action ◽  
Double Burden ◽  
Meta Analyses

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Replacing the nutrients in dairy foods with non-dairy foods will increase cost, energy intake and require large amounts of food: National Health and Nutrition Examination Survey 2011–2014

2020 ◽  
pp. 1-12
Author(s):  
Christopher J Cifelli ◽  
Nancy Auestad ◽  
Victor L Fulgoni
Keyword(s):  
National Health ◽  
Tap Water ◽  
Phase 1 ◽  
Dietary Guidelines ◽  
Nutrition Examination Survey ◽  
Dairy Foods ◽  
Health And Nutrition ◽  
The Us ◽  
Dietary Guidelines For Americans ◽  
Nationally Representative

Abstract Objective: The US Dietary Guidelines for Americans recommends increased consumption of the dairy group to three daily servings for ages 9+ years to help achieve adequate intakes of prominent shortfall nutrients. Identifying affordable, consumer-acceptable foods to replace dairy’s shortfall nutrients is important especially for people who avoid dairy. Design: Linear programming identified food combinations to replace dairy’s protein and shortfall nutrients. We examined cost, energy and dietary implications of replacing dairy with food combinations optimised for lowest cost, fewest kJ or the smallest amount of food by weight. Setting: National Health and Nutrition Examination Survey (2011–2014). Participants: Nationally representative sample of US population; 2 years and older (n 15 830). Results: Phase 1 (only dairy foods excluded): when optimised for lowest cost or fewest kJ, all non-dairy food replacements required large amounts (2·5–10 cups) of bottled/tap water. Phase 2 (dairy and unreasonable non-dairy foods excluded (e.g. baby foods; tap/bottled water): when intake of non-dairy foods was constrained to <90th percentile of current intake, the lowest cost food combination replacements for dairy cost 0·5 times more and provide 5·7 times more energy; the lowest energy food combinations cost 5·9 times more, provide 2·5 times more energy and require twice the amount of food by weight; and food combinations providing the smallest amount of food by weight cost 3·5 times more and provide five times more energy than dairy. Conclusions: Identifying affordable, consumer-acceptable foods that can replace dairy’s shortfall nutrients at both current and recommended dairy intakes remains a challenge.

scholarly journals Nutritional quality of foods and beverages on child-care centre menus in Mexico

2012 ◽  
Vol 16 (11) ◽  
pp. 2014-2022 ◽  
Author(s):  
Sara E Benjamin Neelon ◽  
Hortensia Reyes-Morales ◽  
Jess Haines ◽  
Matthew W Gillman ◽  
Elsie M Taveras
Keyword(s):  
Child Care ◽  
Nutritional Quality ◽  
Energy Content ◽  
High Energy ◽  
Whole Grains ◽  
Nutrition Intervention ◽  
Food Groups ◽  
Child Care Centre ◽  
Food Category

AbstractObjectiveThe purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico.DesignFor this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards.SettingMenus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico.SubjectsThere were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months.ResultsMenus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2·76 MJ for infants, 4·77 MJ for children aged 13–23 months, 5·36 MJ for children aged 24–47 months and 5·87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein.ConclusionsMenus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

scholarly journals Adherence to dietary guidelines and 15-year risk of all-cause mortality

2012 ◽  
Vol 109 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Joanna Russell ◽  
Victoria Flood ◽  
Elena Rochtchina ◽  
Bamini Gopinath ◽  
Margaret Allman-Farinelli ◽  
...  
Keyword(s):  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Food Groups ◽  
Multiple Data ◽  
All Cause Mortality ◽  
The Relationship ◽  
Reduced Risk

Past investigation of diet in relation to disease or mortality has tended to focus on individual nutrients. However, there has been a recent shift to now focus on overall patterns of food intake. The present study aims to investigate the relationship between diet quality reflecting adherence to dietary guidelines and mortality in a sample of older Australians, and to report on the relationship between core food groups and diet quality. This was a population-based cohort study of persons aged 49 years or older at baseline, living in two postcode areas west of Sydney, Australia. Baseline dietary data were collected during 1992–4, from 2897 people using a 145-item Willett-derived FFQ. A modified version of the Healthy Eating Index for Australians was developed to determine diet quality scores. The Australian National Death Index provided 15-year mortality data using multiple data linkage steps. Hazard risk (HR) ratios and 95 % CI for mortality were assessed for diet quality. Subjects in quintile 5 (highest) of the Total Diet Score had a 21 % reduced risk of all-cause mortality (HR 0·79, 95 % CI 0·63, 0·98, Ptrend= 0·04) compared with those in quintile 1 (lowest) after multivariate adjustment. The present study provides longitudinal support for a reduced risk of all-cause mortality in an older population who have greater compliance with published dietary guidelines.

scholarly journals Oatmeal-Containing Breakfast is Associated with Better Diet Quality and Higher Intake of Key Food Groups and Nutrients Compared to Other Breakfasts in Children

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 964 ◽  
Author(s):  
Victor L. Fulgoni ◽  
Mary Brauchla ◽  
Lisa Fleige ◽  
YiFang Chu
Keyword(s):  
Diet Quality ◽  
Nutrient Intake ◽  
Healthy Eating Index ◽  
Food Groups ◽  
Whole Grain ◽  
Study Objective ◽  
Health And Nutrition ◽  
Childhood Diet ◽  
Food Patterns ◽  
Breakfast Food

Oatmeal is a whole grain (WG) food rich in fiber and other nutrients. The study objective was to compare diet quality and nutrient intake of children consuming oatmeal breakfasts to those of children consuming other breakfasts using the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Dietary intake data from 5876 children aged 2–18 years were divided by breakfast food consumption: oatmeal breakfasts, “Doughnuts, sweet rolls, pastries”, “Pancakes, waffles, French toast”, “Eggs and omelets”, “Ready-to-eat cereal, lower sugar”, and “Ready-to-eat cereal, higher sugar” were used to assess diet quality and intake of food groups and nutrients using the USDA Healthy Eating Index-2015 (HEI-2015), Food Patterns Equivalents Database, and Food and Nutrient Database for Dietary Studies, respectively. As compared to consumers of other breakfasts or breakfast skippers, oatmeal consumers had consistently higher diet quality (4–16 points higher HEI 2015 total score, p < 0.05), higher WG intake (0.6–1.6 oz eq. higher, p < 0.05), and higher fiber and magnesium intakes compared to consumers of most other breakfasts or breakfast skippers. The results show that children consuming oatmeal breakfasts have better diet quality and increased intake of key nutrients compared to breakfast skippers and other breakfast consumers and suggest oatmeal may represent an important component of a healthy childhood diet.

scholarly journals Field Interviewer– Administered Dietary Recalls in Participants’ Homes: A Feasibility Study Using the US Department of Agriculture’s Automated Multiple-Pass Method

2021 ◽  
Author(s):  
Laura DiGrande ◽  
Sue Pedrazzani ◽  
Elizabeth Kinyara ◽  
Melanie Hymes ◽  
Shawn Karns ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Data Entry ◽  
Computer Assisted ◽  
Food Groups ◽  
Dietary Recall ◽  
Health And Nutrition ◽  
Multiple Pass ◽  
The Us ◽  
English Speaking ◽  
Food Model

Objective: The purpose of this study was to assess the feasibility of administering the Automated Multiple-Pass Method (AMPM), a widely used tool for collecting 24-hour dietary recalls, in participants’ homes by field interviewers. Design: The design included computer-assisted personal interviews led by either a nutritionist (standard) or field interviewer. Portion estimators tested were a set of three-dimensional food models (standard), a two-dimensional food model booklet, or a tablet with digital images rendered via augmented reality. Setting: Residences in central North Carolina. Participants: English-speaking adults. Pregnant women and individuals who were fasting were excluded. Results: Among 133 interviews, most took place in living rooms (52%) or kitchens (22%). Mean interview time was 40 minutes (range 13–90), with no difference by interviewer type or portion estimator, although timing for nutritionist-led interviews declined significantly over the study period. Forty-five percent of participants referenced items from their homes to facilitate recall and portion estimation. Data entry and post-interview coding was evaluated and determined to be consistent with requirements for the National Health and Nutrition Examination Survey. Values for the number of food items consumed, food groups, energy intake (average of 3,011 kcal for men and 2,105 kcal for women), and key nutrients were determined to be plausible and within reasonably expected ranges regardless of interviewer type or portion estimator used. Conclusions: AMPM dietary recall interviews conducted in the home are feasible and may be preferable to clinical administration because of comfort and the opportunity for participants to access home items for recall. AMPMs administered by field interviewers using the food model booklet produced credible nutrition data that was comparable to AMPMs administered by nutritionists. Training field interviewers in dietary recall and conducting home interviews may be sensible choices for nutrition studies when response rates and cost are concerns.

Association of dietary inflammatory potential with risk of overall and cause-specific mortality

2021 ◽  
pp. 1-27
Author(s):  
Xiude Li ◽  
Bo Chen ◽  
Jiawei Zhang ◽  
Meiling Li ◽  
Zhuang Zhang ◽  
...  
Keyword(s):  
Dietary Factors ◽  
Food Groups ◽  
Reduced Rank Regression ◽  
Rank Regression ◽  
Reactive Protein ◽  
Health And Nutrition ◽  
Increased Risk ◽  
The Us ◽  
Specific Mortality ◽  
Using Data

Abstract Inflammation is a central mechanism in metabolic disorders associated with morbidity and mortality and dietary factors can modulate inflammation. We aimed to prospectively investigate the association between an empirically-developed, food-based dietary inflammatory pattern (EDIP) score and the risk of overall and cause-specific mortality, using data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. EDIP score was derived by entering 39 predefined commonly consumed food groups into the reduced rank regression models followed by stepwise linear regression, which was most predictive of 2 plasma inflammation biomarkers including C-reactive protein and white blood cell count among 25 500 US adults. This score was further validated in a testing set of 9466 adults. Deaths from baseline until December 31, 2015 were identified through record linkage to the National Death Index. During a median follow-up of 7.8 years among 40 074 participants, we documented 4904 deaths. Compared to participants in the lowest quintile of EDIP score, those in the highest quintile had a higher risk of overall death (HR=1.19, 95%CI: 1.08-1.32, Ptrend= 0.002), and deaths from cancer (HR=1.41, 95%CI: 1.14-1.74, Ptrend= 0.017) and cardiovascular diseases (HR=1.22, 95%CI: 0.98-1.53, Ptrend= 0.211). When stratified by age, the association of EDIP with overall mortality was stronger among individuals under 65 years of age (Pinteraction= 0.001). Diets with a higher inflammatory potential were associated with increased risk of overall and cancer-specific mortality. Interventions to reduce the adverse effect of pro-inflammatory diets may potentially promote health and longevity.

scholarly journals Evaluating the Consistency of the French Nutri-Score Front-of-Pack Scoring System with Canadian Dietary Guidelines

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1711-1711
Author(s):  
Mavra Ahmed ◽  
Kacie Dickinson ◽  
Laura Vergeer ◽  
Christine Mulligan ◽  
Beatriz Franco-Arellano ◽  
...  
Keyword(s):  
Nutritional Quality ◽  
Saturated Fat ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Food Label ◽  
Dietary Recommendations ◽  
University Of Toronto ◽  
High Consistency

Abstract Objectives Nutrient profiling (NP) models, underpinning front-of-pack (FOP) labelling, can guide consumers towards healthier food choices and should be aligned with food-based dietary guidelines. In France, [the FSAm/HCSP NP model], underpinning the Nutri-Score (NS) FOP, ranks foods on both nutrients-to-limit (saturated fat, sodium, sugar) and nutrients-to-encourage (e.g., protein, fibre, fruits, vegetables, legumes and nuts) and was found to adequately align with dietary recommendations in Europe. However, investigations on the comparable ranking of foods by the FSAm/HCSP NP model with the new Canadian dietary guidelines is lacking. The objective was to assess the ability of the NS to discriminate the nutritional quality of foods and beverages in the Canadian food supply and their consistency with nutritional recommendations according to the Canada's 2019 Food Guidelines (CFG). Methods Using the University of Toronto Food Label Information Program 2017 database (n = 17,360), the nutritional scores for prepackaged foods and beverages were derived using the NS. These scores correspond to five grades of nutritional quality, ranging from green (A; highest quality) to red (E; lowest quality). Scores were assessed as binary where A/B were considered ‘in alignment’ with CFG recommendations while C/D/E were considered ‘not in alignment’. Results The NS system classified 21% of products as A, ranging from 99% of legumes to 0.45% of the sugars/sweets. The NS was able to discriminate the nutritional quality of foods within the same food groups (based on display of three grades represented within the Nutri-Score). Overall, there was 73% agreement between NS and CFG, ranging from 48% for combination dishes to 95% for eggs/egg substitute categories. The classification of foods according to the NS was consistent with the CFG; foods for which consumption is recommended were more favourably classified (e.g., 76% of vegetables were classified as A or B) than foods for which consumption should be limited (e.g., 79% of snacks were classified as C/D/E). Conclusions The NS FOP system is an effective tool to discriminate products across and within food categories. The classification of different food groups in the NS displayed a high consistency with the new Canadian dietary guidelines. Funding Sources Sanofi-Pasteur University of Toronto Université Paris-Descartes Collaborative Grant.

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