scholarly journals Urinary sodium to potassium ratio: A simple and useful indicator of diet quality in population-based studies

2019 ◽  
Author(s):  
Parvin Mirmiran ◽  
Zahra Gaeini ◽  
Zahra Bahadoran ◽  
Asghar Ghasemi ◽  
Norouzirad Reza ◽  
...  
Keyword(s):  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Population Based ◽  
Urinary Sodium ◽  
Dash Score ◽  
Dietary Intakes ◽  
Linear Regression Models ◽  
Significant Positive Association ◽  
Spot Urine

Abstract Background Urinary sodium (Na) and potassium (K) are related to dietary intakes of Na and K, and well-known risk factors of hypertension and cardiovascular events. This study aimed to evaluate the associations between urinary Na/K ratio and different dietary patterns. Methods we recruited 1864 adult men and women (aged 18-93 years), participated in the sixth examination of Tehran Lipid and Glucose Study. Fasting spot urine samples were collected and concentrations of Na and K were determined. The principle component analysis (PCA) was conducted to drive major dietary patterns among population. Mediterranean dietary pattern score, as well as DASH score, were calculated. Linear regression models adjusted for potential confounding variables were used to assess associations between dietary patterns scores and urinary Na/K ratio. Results Mean age of participants was 43.7±13.9 years, and 47% were men. Mean urinary Na and K concentrations were 139±41.0 and 57.9±18.6 mmol/L, respectively. Mean urinary Na/K was 2.40±0.07. A significant positive association was found between Western dietary pattern and urinary Na/K ratio (β=0.06; 95% CI= 0.01, 0.16). Traditional dietary pattern derived from usual dietary intakes of Iranian adults, as well as Mediterranean and DASH dietary pattern scores were inversely associated to urinary Na/K ratio (β= –0.14; 95% CI= –0.24, –0.11, β=–0.07; 95% CI= –0.09, –0.01, β=–0.12; 95% CI= –0.05, –0.02, respectively). Conclusions Urinary Na/K ratio may suggest as a simple, inexpensive and helpful method to monitor and improve diet quality in population-based studies.

scholarly journals Urinary sodium-to-potassium ratio: a simple and useful indicator of diet quality in population-based studies

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Parvin Mirmiran ◽  
Zahra Gaeini ◽  
Zahra Bahadoran ◽  
Asghar Ghasemi ◽  
Reza Norouzirad ◽  
...  
Keyword(s):  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Principal Component ◽  
Population Based ◽  
Urinary Sodium ◽  
Current Evidence ◽  
Dash Score ◽  
Dietary Intakes ◽  
Spot Urine

Abstract Background Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population. Methods This study was conducted in the framework of the Tehran Lipid and Glucose Study (2014–2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio. Results Mean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = − 0.14; 95% CI − 0.24, − 0.11, β = − 0.07; 95% CI − 0.09, − 0.01, β = − 0.12; 95% CI − 0.05, − 0.02, respectively). Conclusions Spot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.

scholarly journals Association between dietary patterns and adiposity from 4 to 7 years of age

2017 ◽  
Vol 20 (11) ◽  
pp. 1973-1982 ◽  
Author(s):  
Catarina Durão ◽  
Milton Severo ◽  
Andreia Oliveira ◽  
Pedro Moreira ◽  
António Guerra ◽  
...  
Keyword(s):  
Fat Mass ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Latent Class ◽  
Population Based ◽  
Linear Regression Models ◽  
Height Ratio ◽  
Waist To Height Ratio ◽  
Current Sample ◽  
Main Meals

AbstractObjectiveThe present study aimed to evaluate the association of 4-year-old children’s dietary patterns with adiposity at 7 years, according to child’s sex, using a conceptual model.DesignProspective cohort study. Diet was assessed using an FFQ. Age- and sex-specific BMI standard deviation scores (Z-scores) were defined according to the WHO. Fat mass percentage (FM%), fat mass index (FMI) and waist-to-height ratio (WHtR) were also considered, converted into Z-scores using sex-specific means and standard deviations of the current sample. Dietary patterns were identified by latent class analysis and their association with adiposity was estimated by linear regression models.SettingPopulation-based birth cohort Generation XXI (Porto, Portugal, 2005–2006).SubjectsChildren (n 3473) evaluated at both 4 and 7 years of age.ResultsThree dietary patterns were identified: high in energy-dense foods (EDF); low in foods typically consumed at main meals and intermediate in snacks (Snacking); and higher in vegetables and fish and lower in EDF (Healthier, reference). The EDF dietary pattern at 4 years of age was positively associated with later BMI only in girls (β=0·075, 95 % CI 0·009, 0·140, P-interaction=0·046). The EDF dietary pattern was also associated with other adiposity indicators only in girls (FMI: β=0·071, 95 % CI 0·000, 0·142; WHtR: β=0·094, 95 % CI 0·023, 0·164). Snacking was not significantly associated with any marker of adiposity in either girls or boys.ConclusionsAlthough dietary patterns and adiposity persisted across the two ages in both sexes, EDF at 4 years of age increased adiposity at 7 years of age only in girls.

Cardiorespiratory fitness is positively associated with both healthy and western dietary pattern in Iranian middle-aged

2020 ◽  
pp. 1-10
Author(s):  
Hossein Shahinfar ◽  
Farhang Djafari ◽  
Nadia Babaei ◽  
Samira Davarzani ◽  
Mojdeh Ebaditabar ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Principal Component ◽  
Total Sample ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Anthropometric Measures ◽  
Western Dietary Pattern ◽  
Healthy Dietary Pattern

Abstract. Background: The association between dietary patterns and cardiorespiratory fitness (CRF) is not well established. Objective: We sought to investigate association between a posteriori dietary pattern and CRF in middle-aged adults. Design: Adults (n = 276), aged 20–74 years, who were residents of Tehran, Iran were recruited. Diet was assessed by using a validated 168-item semi-quantitative food frequency questionnaire. Principal component analysis was used to derive dietary patterns. Socio-economic status, anthropometric measures, body composition, and blood pressure were recorded. CRF was assessed by using a graded exercise treadmill test. Analysis of variance and linear regression models were used to discern the association between dietary patterns and CRF. Results: Higher scores of the healthy dietary pattern had no association with VO2max (p = 0.13 ). After controlling for potential confounders, VO2max was positively associated across tertiles of healthy dietary patterns (p < 0.001). Higher adherence to the “mixed” dietary pattern was inversely related to VO2max (p < 0.01). After adjusting for confounders, the significant association disappeared (p = 0.14). Higher scores of the “Western” dietary pattern was not associated with VO2max (p = 0.06). However, after controlling for potential confounders, VO2max was positively associated with the “Western” dietary pattern (p = 0.01). A positive linear association between the “healthy” dietary pattern and CRF for the total sample (R2 = 0.02; p < 0.01) were presented. Conclusions: Overall, our findings suggest that higher adherence to a “healthy” and “Western” dietary pattern was positively associated with CRF. However, further studies are required to examine and clarify the causal relationship between dietary patterns and CRF.

scholarly journals A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women

2013 ◽  
Vol 110 (10) ◽  
pp. 1926-1933 ◽  
Author(s):  
Sangah Shin ◽  
Hyojee Joung
Keyword(s):  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Health Examination ◽  
Dietary Intakes ◽  
Mineral Density ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
White Rice

The aim of the present study was to identify the association of dietary patterns with osteoporosis in Korean postmenopausal women from the Korean Health and Nutrition Examination Survey 2008–10. The present cross-sectional analysis included 3735 postmenopausal women who completed a health interview, nutrition survey and a health examination including bone mineral density (BMD) measurements. The general characteristics and dietary intakes of the participants were obtained using a standardised questionnaire and a 24 h recall method, respectively. The BMD of the femoral neck and lumbar spine was measured using dual-energy X-ray absorptiometry; osteoporosis was defined based on the WHO T-score criteria. Overall, we identified four dietary patterns using factor analysis as follows: ‘meat, alcohol and sugar’, ‘vegetables and soya sauce’, ‘white rice, kimchi and seaweed’ and ‘dairy and fruit’, which accounted for 30·9 % of the total variance in food intake (11·3, 7·7, 6·0 and 5·9 %, respectively). The subjects in the highest quintile of the ‘dairy and fruit’ pattern showed a decreased risk of osteoporosis of the lumbar spine (53 %) compared with those in the lowest quintile, after adjusting for covariates (OR 0·47, 95 % CI 0·35, 0·65, P for trend < 0·0001). In contrast, the ‘white rice, kimchi and seaweed’ dietary pattern was negatively associated with bone health (OR 1·40, 95 % CI 1·03, 1·90, P for trend = 0·0479). The present results suggest that an increased intake of dairy foods and fruits in the traditional Korean diet, based on white rice and vegetables, may decrease the risk of osteoporosis in Korean postmenopausal women.

Abstract P109: Plasma Metabolomic Signature Of Healthy Dietary Patterns In The Chronic Renal Insufficiency Cohort (CRIC) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Hyunju Kim ◽  
Cheryl A Anderson ◽  
Emily A Hu ◽  
Zihe Zheng ◽  
Lawrence J Appel ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Healthy Eating ◽  
Dietary Patterns ◽  
Healthy Eating Index ◽  
Plasma Metabolites ◽  
Dietary Intakes ◽  
Linear Regression Models ◽  
Omega 3 ◽  
Double Bonds ◽  
Disease Associations

Introduction: In individuals with chronic kidney disease (CKD), healthy dietary patterns are inversely associated with CKD progression. Metabolomics, an approach which measures many small molecules in biofluids, can identify biomarkers of healthy dietary patterns and elucidate metabolic pathways underlying diet-disease associations. Hypothesis: We hypothesized that adherence to 4 healthy dietary patterns would be associated with a set of known metabolites in CKD patients. Methods: We examined associations between 634 plasma metabolites assessed using the Broad platform at year 1 and Healthy Eating Index (HEI)-2015, Alternative Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet, and alternate Mediterranean diet (aMED), and their food components in 1,117 participants in the CRIC Study. Usual dietary intakes were assessed using a food frequency questionnaire at baseline and year 2. We conducted multivariable linear regression models to study associations between diet scores and individual plasma metabolites, adjusting for sociodemographic characteristics, health behaviors, and clinical factors. Results: After Bonferroni correction, we identified a total of 362 diet-metabolite associations (HEI=78; AHEI=127; DASH=97; aMED=60), and 101 metabolites were associated with more than 1 dietary pattern. The most common metabolite categories were triacylglycerols and diacylglycerols. Most lipids were negatively associated with healthy dietary patterns, except for cholesterols esters and triacylglycerols with ≥7 double bonds. Triacylglycerols with high number of double bonds were positively associated with healthy fat intake (e.g., higher monounsaturated and polyunsaturated fatty acid, omega-3 fatty acid, fish) within HEI, AHEI, and aMED ( Table ). Conclusions: We identified many metabolites associated with healthy dietary patterns, indicative of food consumption. If replicated, they may be considered biomarkers of healthy dietary patterns in CKD patients.

scholarly journals Cross-Sectional, Short-, Medium- and Long-Term Effects of Dietary Pattern on Frailty in Taiwan

2021 ◽  
Vol 18 (18) ◽  
pp. 9717
Author(s):  
Mei-Huey Shiau ◽  
Meng-Chih Lee ◽  
Fang-Ling Lin ◽  
Baai-Shyun Hurng ◽  
Chih-Jung Yeh
Keyword(s):  
Dietary Patterns ◽  
Dietary Pattern ◽  
Multinomial Logistic Regression ◽  
Population Based ◽  
Long Term Effects ◽  
Reduced Rank Regression ◽  
Cross Sectional ◽  
Protein Rich ◽  
Healthy Dietary Pattern

This study examined the association between dietary patterns and the development of frailty during 4-, 8-, 12-year follow-up periods in the population-based Taiwan Study. We used the data of an elderly population aged 53 years and over (n = 3486) from four waves of the Taiwan Longitudinal Study on Aging. Frailty was identified by using the modified Fried criteria and the values were summed to derive a frailty score. We applied reduced rank regression to determine dietary patterns, which were divided into tertiles (healthy, general, and unhealthy dietary pattern). We used multinomial logistic regression models to assess the association between dietary patterns and the risk of frailty. The healthy dietary pattern was characterized by a higher intake of antioxidant drinks (tea), energy-rich foods (carbohydrates, e.g., rice, noodles), protein-rich foods (fish, meat, seafood, and eggs), and phytonutrient-rich foods (fruit and dark green vegetables). Compared with the healthy pattern, the unhealthy dietary pattern showed significant cross-sectional, short-term, medium-term, and long-term associations with a higher prevalence of frailty (odds ratios (OR) 2.74; 95% confidence interval (CI) 1.94–3.87, OR 2.55; 95% CI 1.67–3.88, OR 1.66; 95% CI 1.07–2.57, and OR 2.35; 95% CI 1.27–4.34, respectively). Our findings support recommendations to increase the intake of antioxidant drinks, energy-rich foods, protein-rich foods, and phytonutrient-rich foods, which were associated with a non-frail status. This healthy dietary pattern can help prevent frailty over time in elderly people.

scholarly journals Skipping Breakfast Is Associated with Diet Quality and the Distribution of Food Intake Throughout the Day: NHANES 2005–20016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 534-534
Author(s):  
Owen Kelly ◽  
Stephanie Fanelli ◽  
Sara Thomas ◽  
Jessica Krok-Schoen ◽  
Satya Jonnalagadda ◽  
...  
Keyword(s):  
Food Intake ◽  
Healthy Eating ◽  
Diet Quality ◽  
Diabetes Management ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Intakes ◽  
Nutrient Intakes ◽  
Diabetes Status ◽  
Skipping Breakfast

Abstract Objectives Distribution of carbohydrate intakes (carb choices) throughout the day are an important aspect to diabetes management and reducing blood glucose spikes. Skipping breakfast represents a behavior of concern, providing an extension of the overnight fast and may result in elevated sugar levels later in the day. Therefore, the purpose of this study was to evaluate dietary intake differences, including carbohydrates, based on consuming breakfast or not, and by diabetes status. Methods Adults over 30 years from NHANES 2005–2016 were classified into nondiabetes (HbA1c &lt;5.7%, n = 14,701), prediabetes (HbA1c 5.7–6.4%, n = 5855) and diabetes (HbA1c (≥6.5%, n = 2881). Dietary intakes were assessed using a multiple pass 24-hour recall to estimate intakes from the foods and beverages reported as consumed on the day prior to the NHANES visit. Breakfast was self-defined by participants. Total population-based means (95% CI) of nutrient intakes, MyPlate equivalents, and Healthy Eating Index 2015 scores from the day of intake were calculated across levels of glycemic control and skipping breakfast status. Results Across all groups, adults who reported breakfast consumption had a significantly better overall diet quality, while total intakes of whole grains and fiber were significantly lower in those who skipped breakfast. Intakes of added sugars were not significantly different between those who skipped versus consumed breakfast. Conclusions The absence of breakfast on the day of intake was related to differential intakes of several nutrients related to healthy eating and glycemic management, resulting in a poorer overall diet quality. Healthcare professionals could evaluate meal skipping patterns and its impact on overall nutrient intakes, and the distribution of food intake throughout the day, in people with diabetes, to help improve disease management. Funding Sources Abbott Nutrition.

scholarly journals Sociodemographic, Lifestyle, Environmental and Pregnancy-Related Determinants of Dietary Patterns during Pregnancy

2019 ◽  
Vol 16 (5) ◽  
pp. 754 ◽  
Author(s):  
Ewelina Wesołowska ◽  
Agnieszka Jankowska ◽  
Elżbieta Trafalska ◽  
Paweł Kałużny ◽  
Mariusz Grzesiak ◽  
...  
Keyword(s):  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Whole Grains ◽  
Processed Meat ◽  
Small Cities ◽  
Western Dietary Pattern ◽  
Mother And Child ◽  
Specific Factors

Background: Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. Methods: The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). Results: Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (β = 0.2; p < 0.01), higher educational level (β = 0.3; p < 0.01), and socioeconomic status (SES) (β = 0.2; p < 0.01), overweight/obesity before (β = 0.3; p < 0.01), as well as physical activity during pregnancy (β = 0.2; p = 0.01) were positive determinants of a healthier diet (increasing Prudent–Western difference in dietary pattern scores). On the other hand, parity (β = −0.2; p = 0.04) and living in small cities (β = −0.3; p = 0.02) were significantly related to a rather Western dietary pattern. Conclusions: The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.

scholarly journals A posteriori dietary patterns and metabolic syndrome in adults: a systematic review and meta-analysis of observational studies

2018 ◽  
Vol 21 (9) ◽  
pp. 1681-1692 ◽  
Author(s):  
Sakineh Shab-Bidar ◽  
Mahdieh Golzarand ◽  
Mina Hajimohammadi ◽  
Sara Mansouri
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Observational Studies ◽  
Meta Analysis ◽  
A Posteriori ◽  
Significant Positive Association ◽  
Western Dietary Pattern ◽  
Increased Risk

AbstractObjectiveObservational studies reported potential associations between different dietary patterns and the risk of metabolic syndrome (MetS); however, a consistent perspective has not been established to date. The current systematic review and meta-analysis aimed to evaluate the relationship between a posteriori dietary patterns and MetS by pooling available data.DesignMEDLINE and EMBASE databases were searched for relevant articles published up to July 2015 with no time restriction and with English language restriction. Two independent reviewers completed study selection and data extraction. Random-effects models (DerSimonian–Laird method) were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the I2 statistic.ResultsNineteen papers that identified dietary patterns using an a posteriori method were selected and included in the meta-analysis. The ‘Healthy/Prudent’ dietary pattern was inversely associated with risk of MetS (OR=0·89; 95 % CI 0·84, 0·94, P=0·002). In contrast, the ‘Unhealthy/Western’ dietary pattern had a significant positive association with risk of MetS (OR=1·16; 95 % CI 1·11, 1·22, P<0·001).ConclusionsOur findings provide evidence that greater adherence to a healthy/prudent dietary pattern is associated with a lower risk of MetS, while an unhealthy/Western dietary pattern is associated with increased risk of MetS. These data suggest that a diet based on healthy food choices is also beneficial for prevention of MetS.

scholarly journals Dietary Pattern Score, Diet Quality, and Major Neurodegenerative Diseases: A Meta-analysis of Observational Cohort Studies (OR33-07-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yi-Hsuan Liu ◽  
Xiang Gao ◽  
Muzi Na ◽  
Penny Kris-Etherton ◽  
Diane Mitchell ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Neurodegenerative Diseases ◽  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Meta Analysis ◽  
A Priori ◽  
A Posteriori ◽  
Observational Cohort ◽  
Healthy Dietary Pattern

Abstract Objectives Diet is an important lifestyle factor that may prevent or slow the onset and progression of neurodegeneration. Recent studies suggest that adherence to a healthy dietary pattern is associated with reduced risk of cognitive decline. Few studies have examined the relationships between dietary patterns and risk of clinical neurodegenerative disease outcomes. In this meta-analysis, we examined the associations between overall dietary patterns, assessed a priori and a posteriori, and risk of major neurodegenerative disease including dementia, Alzheimer's disease, and Parkinson's disease. Methods We systematically searched in the PubMed, Web of Science, and Cumulative Index for Nursing and Allied Health databases starting from 1981 to October 10, 2018. Observational cohort studies published in English with prospective and case-control designs were included. Diet assessment approaches (a priori or a posteriori) were utilized to assist in determining whether the exposure was dietary pattern score or diet quality. Generic inverse variance method was used to calculate the pooled risk ratios and 95% confidence intervals (CIs) among the highest versus the lowest diet quality/dietary pattern score groups in random effect models. Results Seventeen studies with 173,283 participants were identified. Various diet quality indexes or dietary pattern scores, such as the Healthy Eating Index, the Mediterranean diet score, and dietary pattern scores generated by principal component analysis or reduced rank regression, were used among studies. Our meta-analysis of cohorts showed significant associations between adherence to high diet quality or healthy dietary pattern and lower risk of dementia (pooled risk ratio = 0.70; 95% CI: 0.56-0.86) and Parkinson's disease (pooled risk ratio = 0.72; 95% CI: 0.54-0.97) relative to those with low diet quality or unhealthy dietary pattern. Conclusions Adherence to high diet quality or healthy dietary pattern may provide protective effects on risk of neurodegenerative diseases. Additional observational studies and randomized controlled trials are needed to address our study limitations and provide further evidence about the role of a poor diet on the development and progression of neurodegenerative diseases as well as the benefits of a healthy diet on the prevention of major neurodegenerative diseases. Funding Sources United States Department of Agriculture, Agricultural Research Service agreement. Supporting Tables, Images and/or Graphs

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