Investigating Items to Improve the Validity of the Five-Item Healthy Eating Score Compared with the 2015 Healthy Eating Index in a Military Population

IntroductionPsychological disorders have a major role in the incidence of chronic diseases and may result in reductions in the cost-effectiveness of the Armed Forces. Previous civilian studies have shown a protective association between healthy eating guidelines and mental disorders, but evidence to support this for a military population is limited. The aim of this study was to examine the association of Alternative Healthy Eating Index (AHEI-2010) with depression, stress and anxiety among Iranian military personnel.MethodA cross-sectional study was conducted on 246 male Army soldiers. Stress, anxiety, depression and dietary intakes were assessed. The association between variables was determined using multivariate logistic regression.ResultsThe prevalence of depression, stress and anxiety in study participants was 15.9%, 10.6% and 27.2% respectively. Participants with the highest adherence to the AHEI-2010 had an 80% lower odds of depression than those with the lowest adherence (OR: 0.20; 95% CI 0.04 to 0.78). Such an association was also found between adherences to the AHEI-2010 and anxiety (OR: 0.28; 95% CI 0.05 to 0.95). No significant association between adherence to the AHEI-2010 and stress was found.ConclusionAn inverse association between adherence to the AHEI-2010 and odds of depression and anxiety was found. Further studies are required to clarify this relationship.

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Neural Substrates of Food Valuation and Its Relationship With BMI and Healthy Eating in Higher BMI Individuals

10.31234/osf.io/2se6v ◽

2020 ◽

Author(s):

Junaid Salim Merchant ◽

Danielle Cosme ◽

Elliot Berkman ◽

Nicole Giuliani ◽

Bryce Dirks

Keyword(s):

Eating Behavior ◽

Healthy Eating ◽

Bayes Factor ◽

Assessment Tool ◽

Community Sample ◽

Healthy Eating Index ◽

Unhealthy Food ◽

Potential Mechanism ◽

Imaging Data ◽

Subjective Valuation

Considerable evidence points to a link between body mass index (BMI), eating behavior, and the brain's reward system. However, much of this research focuses on food cue reactivity without examining the subjective valuation process as a potential mechanism driving individual differences in BMI and eating behavior. The current pre-registered study (https://osf.io/n4c95/) examined the relationship between BMI, healthy eating, and subjective valuation of healthy and unhealthy foods in a community sample of individuals with higher BMI who intended to eat more healthily. Particularly, we examined: (1) alterations in neurocognitive measures of subjective valuation related to BMI and healthy eating; (2) differences in the neurocognitive valuation for healthy and unhealthy foods and their relation to BMI and healthy eating; (3) and whether we could conceptually replicate prior findings demonstrating differences in neural reactivity to palatable vs. plain foods. To this end, we scanned 105 participants with BMIs ranging from 23 to 42 using fMRI during a willingness-to-pay task that quantifies trial-by-trial valuation of 30 healthy and 30 unhealthy food items. We measured out of lab eating behavior via the Automated Self-Administered 24 H Dietary Assessment Tool, which allowed us to calculate a Healthy Eating Index (HEI). We found that our sample exhibited robust, positive linear relationships between self-reported value and neural responses in regions previously implicated in studies of subjective value, suggesting an intact valuation system. However, we found no relationship between valuation and BMI nor HEI, with Bayes Factor indicating moderate evidence for a null relationship. Separating the food types revealed that healthy eating, as measured by the HEI, was inversely related to subjective valuation of unhealthy foods. Imaging data further revealed a stronger linkage between valuation of healthy (compared to unhealthy) foods and corresponding response in the ventromedial prefrontal cortex (vmPFC), and that the interaction between healthy and unhealthy food valuation in this region is related to HEI. Finally, our results did not replicate reactivity differences demonstrated in prior work, likely due to differences in the mapping between food healthiness and palatability. Together, our findings point to disruptions in the valuation of unhealthy foods in the vmPFC as a potential mechanism influencing healthy eating.

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Health Literacy Is Associated with Healthy Eating Index Scores and Sugar-Sweetened Beverage Intake: Findings from the Rural Lower Mississippi Delta

Journal of the American Dietetic Association ◽

10.1016/j.jada.2011.04.010 ◽

2011 ◽

Vol 111 (7) ◽

pp. 1012-1020 ◽

Cited By ~ 80

Author(s):

Jamie Zoellner ◽

Wen You ◽

Carol Connell ◽

Renae L. Smith-Ray ◽

Kacie Allen ◽

...

Keyword(s):

Health Literacy ◽

Healthy Eating ◽

Mississippi Delta ◽

Healthy Eating Index ◽

Sugar Sweetened Beverage ◽

Sweetened Beverage

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Evaluation of a novel biomarker of added sugar intake (δ13C) compared with self-reported added sugar intake and the Healthy Eating Index-2010 in a community-based, rural US sample

Public Health Nutrition ◽

10.1017/s136898001500107x ◽

2015 ◽

Vol 19 (3) ◽

pp. 429-436 ◽

Cited By ~ 12

Author(s):

Valisa E Hedrick ◽

Brenda M Davy ◽

Grace A Wilburn ◽

A Hope Jahren ◽

Jamie M Zoellner

Keyword(s):

Healthy Eating ◽

Economic Status ◽

Healthy Eating Index ◽

Dietary Quality ◽

Community Based ◽

Cross Sectional ◽

Added Sugar ◽

Sugar Sweetened Beverage ◽

Sugar Intake ◽

C Value

AbstractObjectiveThe δ13C value of human blood is an emerging novel biomarker of added sugar (AS) intake for adults. However, no free-living, community-based assessments of comparative validity of this biomarker have been conducted. The purpose of the present investigation was to determine if Healthy Eating Index-2010 (HEI-2010) score, SoFAAS score (HEI-2010 sub-component for solid fat, alcohol and AS), AS and sugar-sweetened beverage (SSB) intakes were associated with δ13C value of fingerstick blood in a community-based sample of adults, while controlling for relevant demographics.DesignA cross-sectional analysis of data obtained from assessments of BMI, dietary intake using 24 h recalls and a fingerstick blood sample was completed. Statistical analyses included descriptive statistics, multiple linear regression and one-way ANOVA.SettingRural Southwest Virginia, USA.SubjectsAdults (n 216) aged >18 years who consumed at least 837 kJ/d (200 kcal/d) from SSB.ResultsThis sample of adult participants with low socio-economic status demonstrated a mean HEI-2010 score of 43·4 (sd 12·2), mean SoFAAS score of 10·2 (sd 5·7), mean AS intake of 93 (sd 65) g/d and mean blood δ13C value of −18·88 (sd 0·7) ‰. In four separate regression models, HEI-2010 (R2=0·16), SoFAAS (R2=0·19), AS (R2=0·15) and SSB (R2=0·14) predicted δ13C value (all P≤0·001). Age was also predictive of δ13C value, but not sex or race.ConclusionsThese findings suggest that fingerstick δ13C value has the potential to be a minimally invasive method for assessing AS and SSB intake and overall dietary quality in community-based settings. Strengths, limitations and future areas of research for using an objective δ13C biomarker in diet-related public health studies are discussed.

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Neural Substrates of Food Valuation and Its Relationship With BMI and Healthy Eating in Higher BMI Individuals

Frontiers in Behavioral Neuroscience ◽

10.3389/fnbeh.2020.578676 ◽

2020 ◽

Vol 14 ◽

Author(s):

Junaid S. Merchant ◽

Danielle Cosme ◽

Nicole R. Giuliani ◽

Bryce Dirks ◽

Elliot T. Berkman

Keyword(s):

Eating Behavior ◽

Healthy Eating ◽

Bayes Factor ◽

Assessment Tool ◽

Community Sample ◽

Healthy Eating Index ◽

Unhealthy Food ◽

Potential Mechanism ◽

Imaging Data ◽

Subjective Valuation

Considerable evidence points to a link between body mass index (BMI), eating behavior, and the brain's reward system. However, much of this research focuses on food cue reactivity without examining the subjective valuation process as a potential mechanism driving individual differences in BMI and eating behavior. The current pre-registered study (https://osf.io/n4c95/) examined the relationship between BMI, healthy eating, and subjective valuation of healthy and unhealthy foods in a community sample of individuals with higher BMI who intended to eat more healthily. Particularly, we examined: (1) alterations in neurocognitive measures of subjective valuation related to BMI and healthy eating; (2) differences in the neurocognitive valuation for healthy and unhealthy foods and their relation to BMI and healthy eating; (3) and whether we could conceptually replicate prior findings demonstrating differences in neural reactivity to palatable vs. plain foods. To this end, we scanned 105 participants with BMIs ranging from 23 to 42 using fMRI during a willingness-to-pay task that quantifies trial-by-trial valuation of 30 healthy and 30 unhealthy food items. We measured out of lab eating behavior via the Automated Self-Administered 24 H Dietary Assessment Tool, which allowed us to calculate a Healthy Eating Index (HEI). We found that our sample exhibited robust, positive linear relationships between self-reported value and neural responses in regions previously implicated in studies of subjective value, suggesting an intact valuation system. However, we found no relationship between valuation and BMI nor HEI, with Bayes Factor indicating moderate evidence for a null relationship. Separating the food types revealed that healthy eating, as measured by the HEI, was inversely related to subjective valuation of unhealthy foods. Imaging data further revealed a stronger linkage between valuation of healthy (compared to unhealthy) foods and corresponding response in the ventromedial prefrontal cortex (vmPFC), and that the interaction between healthy and unhealthy food valuation in this region is related to HEI. Finally, our results did not replicate reactivity differences demonstrated in prior work, likely due to differences in the mapping between food healthiness and palatability. Together, our findings point to disruptions in the valuation of unhealthy foods in the vmPFC as a potential mechanism influencing healthy eating.

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Reproducibility and Relative Validity of the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3 Estimated by Comprehensive and Brief Diet History Questionnaires in Japanese Adults

Nutrients ◽

10.3390/nu11102540 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2540 ◽

Cited By ~ 4

Author(s):

Kentaro Murakami ◽

M. Barbara E. Livingstone ◽

Aya Fujiwara ◽

Satoshi Sasaki

Keyword(s):

Healthy Eating ◽

Pearson Correlation ◽

Dietary Assessment ◽

Intraclass Correlation ◽

Healthy Eating Index ◽

Relative Validity ◽

Rich Food ◽

Dietary Records ◽

Diet History Questionnaire ◽

Diet History

We examined the reproducibility and relative validity of two measures of overall diet quality, the Healthy Eating Index-2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3), as estimated by well-established self-administered dietary assessment questionnaires for the Japanese, namely the comprehensive diet history questionnaire (DHQ) and the brief diet history questionnaire (BDHQ). Diet was assessed separately by two DHQs and two BDHQs at a 1-year interval and by 16-day weighed dietary records (DRs) in 121 women and 121 men aged 31–81 years. HEI-2015 and NRF9.3 were calculated from each method. The reproducibility correlation for the two questionnaires (intraclass correlation) ranged from 0.53 (HEI-2015 from BDHQ in men) to 0.77 (NRF9.3 from BDHQ in women). The validity correlation between the first questionnaires and DR (Pearson correlation) ranged from 0.37 (NRF9.3 from BDHQ in men) to 0.61 (NRF9.3 from DHQ and BDHQ in women). Bland–Altman plots showed poor agreement between the DHQ or BDHQ and DR, as well as the presence of weak proportional bias. Overall, these data indicate reasonable reproducibility and ranking ability of the DHQ and BDHQ for assessing the HEI-2015 and NRF9.3 and support their usefulness in future epidemiological research on the overall effects of Japanese diets on various health outcomes.

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Fighting to eat healthfully: measurements of the military food environment

Journal of Social Marketing ◽

10.1108/jsocm-02-2014-0013 ◽

2014 ◽

Vol 4 (3) ◽

pp. 223-239 ◽

Cited By ~ 10

Author(s):

Julia Carins ◽

Sharyn Rundle-Thiele

Keyword(s):

Social Marketing ◽

Healthy Eating ◽

Food Environment ◽

Assessment Tool ◽

Eating Behaviour ◽

Military Population ◽

Content Type ◽

Nutrition Environment ◽

Food Outlets ◽

The Military

Purpose – The purpose of this paper is to report on a quantitative study of the food environment designed to measure aspects of support for healthy eating. Design/methodology/approach – An ecological view of eating behaviour was taken by examining the food environment that surrounded a military population of interest. Food outlets (n = 34) were assessed using the Nutrition Environment Measures Survey in store (NEMS-S), Nutrition Environment Measures Study in restaurants (NEMS-R) and military Nutrition Environment Assessment Tool (mNEAT) instruments to determine how well food outlets supported healthy eating. Findings – Despite better-than-average provision of healthy options on-base, the total environment surrounding the military base barely supports healthy eating. Average support to healthy eating was 45 per cent (NEMS) or 27 per cent (mNEAT) of support that could be measured. Individuals accessing this food environment would find few healthy alternatives, little information directing them to healthy choices and pricing and promotion that drives unhealthy eating behaviours. Research limitations/implications – This study focused on one food environment; replication is recommended to establish foundation data for benchmarking outlets, and further develop these measures for Australian settings. Future studies may assess the media environment to further extend the ecological model used. Practical implications – A method to measure the food environment is demonstrated which provides formative research insights for use when planning social marketing interventions. Consideration of these influences together with intra- and inter-personal influences offer the potential to better design social marketing healthy eating interventions, by addressing multiple levels within an ecological framework. Originality/value – This paper answers calls for social marketers to consider the influence of the surrounding environment, using methods not previously used in Australian settings.

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Diet Quality Assessment in Wheelchair Users with Multiple Sclerosis

Nutrients ◽

10.3390/nu13124352 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4352

Author(s):

Stephanie L. Silveira ◽

Brenda Jeng ◽

Gary Cutter ◽

Robert W. Motl

Keyword(s):

Multiple Sclerosis ◽

Healthy Eating ◽

Diet Quality ◽

Assessment Tool ◽

Dietary Assessment ◽

Healthy Eating Index ◽

Normative Values ◽

Future Research ◽

Cross Sectional ◽

Wheelchair Users

Background: Diet quality has not been distinctively examined in wheelchair users with multiple sclerosis (MS). Methods: This cross-sectional study examined the Diet History Questionnaire (DHQ) III and the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool in 128 wheelchair users with MS. Participants were prompted to complete the DHQ-III and 3 ASA24 recalls during a seven-day data collection period. Healthy Eating Index (HEI)-2015 scores were calculated for DHQ-III and ASA24, and scores were compared with normative values. Spearman’s correlation analyses (rs) estimated the associations between DHQ-III and ASA24 HEI-2015 total and component scores with supportive paired sample t-tests. Results: HEI-2015 scores for DHQ-III and ASA24 were significantly higher than normative values for total score, total protein foods, and added sugar. Correlations between HEI-2015 scores generated using ASA24 and DHQ-III were all statistically significant (range rs = 0.23–0.69); however, significant differences between ASA24 and DHQ-III values were noted for HEI-2015 total score, total fruits, whole fruit, total vegetable, greens and beans, whole grains, seafood and plant protein, refined grains, and saturated fats. Conclusion: This study provided a novel description of diet quality in wheelchair users with MS for guiding future research promoting healthy eating in this population.

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Five-Year Trends in Sugar-Sweetened Beverage Consumption Among Mothers, Teenagers, Children From SNAP-Ed Eligible Households Indicate Increased Intake Among Children

Current Developments in Nutrition ◽

10.1093/cdn/nzab035_069 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 161-161

Author(s):

Fred Molitor ◽

Celeste Doerr

Keyword(s):

Nutrition Education ◽

Social Services ◽

Assessment Tool ◽

Healthy Eating Index ◽

Portion Size ◽

Poverty Level ◽

California Department ◽

Cross Sectional ◽

Sugar Sweetened Beverage ◽

Sweetened Beverage

Abstract Objectives Previously we reported improved dietary intake from 2015 to 2017 for fruits and vegetables, water, and Healthy Eating Index-2015 scores for mothers, teenagers, and children from households eligible for Supplemental Nutrition Education Program-Education (SNAP-Ed). Sugar-sweetened beverage (SSBs) consumption was unchanged during this three-year period across age groups. Our objective was to now examine trends in SSB intake with data from 2018 and 2019. Methods Cross-sectional surveys of mothers and their teenager or child were conducted from 2015 to 2019. Respondents were randomly sampled from households with reported incomes ≤185% of the federal poverty level. A study introduction letter in English or Spanish was sent to sampled households. Next, bilingual staff confirmed by phone household eligibility, the youngest mother (or caregiver), and one teenager (12 to 17 years) or child (5 to 11 years). During the subsequent interviews, staff administered the Automated Self-administered 24-Hour Dietary Assessment Tool (ASA24) in English or Spanish. The quantity and size of each reported food or beverage item was determined by asking mothers to reference pictures in a portion-size booklet or measuring cups or spoons previously mailed to each household. The procedures were replicated to obtain 24-hour dietary information from the teenager or child. Daily SSB intake was converted to ounces and regressed on year of survey with the covariates age, education for mothers, and gender for children. Significance of difference between means was adjusted by Bonferroni. Results Participants over the five-year period were 22,827 mothers, 5855 teenagers, and 10,778 children. Most (64.2%, 69.2%, and 67.9%) survey participants were Latinx. The trend for SSB intake for children was significant, with ounces per day increasing from 5.7 in 2017 to 7.3 in 2018 and 7.9 in 2019 (P = 0.0055). Conclusions A previous study found that, despite improvements across dietary behaviors, SSB intake was unchanged among mothers and children from SNAP-Ed eligible households. This follow-up study adds two years of data and findings indicate that children's SSB intake has increased. Findings suggest a need for interventions and policy work addressing children's SSB intake. Funding Sources California Department of Social Services.

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