Associations of Early Parental Concerns and Feeding Behaviors with Child’s Diet Quality through Mid-Childhood

Parental feeding practices have been associated with children’s dietary intakes, yet the directionality of these associations remains unclear. Among 1172 mother-child pairs from Project Viva, we aimed to examine associations of parental concerns and feeding behaviors at 2 years (behaviors dichotomized as yes vs. no), with diet quality (Youth Healthy Eating Index; YHEI) in early (mean 3.2, SD 0.3 years; n = 1076) and mid-childhood (mean 7.8, SD 0.7 years; n = 993). We used multivariable linear regression models adjusted for sociodemographic characteristics, parental body mass index (BMI), maternal diet quality in pregnancy, and child’s BMI z-score and diet quality at 2 years. Early parental concerns about their child becoming overweight (15%) was associated with lower YHEI (β −1.54 points; 95%CI −2.75, −0.33; fully adjusted model) in early childhood. Early parental concerns about their child becoming underweight (7%) was associated with lower YHEI (−2.19 points; −4.31, −0.07) in early childhood, but the association was attenuated after adjustment for child’s BMI z-score and diet quality at 2 years. We did not find associations of parental restrictive feeding (8%) and parental pressure to eat (47%) with child’s YHEI through mid-childhood. In conclusion, we found no evidence that early parental concerns and feeding behaviors independently contribute to child’s diet quality through childhood.

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Abstract P210: Associations Of Early Parental Feeding Concerns And Behaviors With Child’s Dietary Intakes Throughout Childhood

Circulation ◽

10.1161/circ.141.suppl_1.p210 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Veronique Gingras ◽

Karen M Switkowski ◽

Sheryl L Rifas-Shiman ◽

Sabrina Faleschini ◽

Emily Oken ◽

...

Keyword(s):

Early Childhood ◽

Healthy Eating ◽

Diet Quality ◽

Weight Status ◽

Healthy Eating Index ◽

Index Score ◽

Processed Meat ◽

Dietary Intakes ◽

Feeding Behaviors ◽

Parental Feeding

Introduction: Parental feeding behaviors have been found to be associated with dietary intakes and weight status in children, although the longitudinal associations of parental feeding behaviors in early life with diet later in childhood have been scarcely studied. Hypothesis: We hypothesized that parental feeding restriction, pressure to eat, and concerns about child’s weight would be associated with poorer diet quality throughout childhood. Methods: Among 1172 mother-child pairs from Project Viva, we examined associations of parental feeding behaviors at 2 years assessed via questions from the Child Feeding Questionnaire (behaviors dichotomized as yes vs. no) with diet quality in early (mean: 3.2, SD 0.2 years; n=1076) and mid-childhood (mean: 7.8, SD 0.7 years; n=993) assessed via food frequency questionnaires. We used linear regression models adjusted for socio-demographic characteristics, maternal and paternal body mass index, and maternal diet quality in pregnancy. Results: At 2 years postpartum, 47% of parents pressured/encouraged their child to eat more, 8% restricted their intakes, 15% were concerned about their child being overweight and 7% about their child being underweight. Parental pressure to eat at 2 years was associated with higher child intake of fruit juice (β 0.17 serving/day; 95% CI 0.01, 0.34) and snack foods (0.12 serving/day; 0.01, 0.22) in early childhood and with lower youth healthy eating index score (-1.32 points; -2.54, -0.10; score from 0 to 85 points) in mid-childhood. Parental feeding restriction at 2 years was associated with lower intake of sugar-sweetened beverages (-0.17 serving/day; -0.27, -0.06) in early childhood and with lower intake of dairy (-0.29 serving/day; -0.56, -0.02) in mid-childhood. Parental concerns about their child being underweight was associated with lower youth healthy eating index score (-2.18 points; -4.30, -0.05; score from 0 to 95 points) in early childhood while concerns about their child being overweight was associated with higher intakes of red and processed meat (0.14 serving/day; 0.04, 0.23) in early childhood and higher intake of baked products in mid-childhood (0.07 serving/day; 0.01, 0.13). Conclusions: We found that early parental feeding behaviors may have a modest contribution to dietary intakes throughout childhood. However, only a few associations persisted after adjusting for socio-economic and parental characteristics and effect sizes were modest. Strategies to improve diet quality in children might need to focus on the broader family and socio-economic context.

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Dietary Intake and Its Determinants Among Adults Living in the Metropolitan Area of Puerto Rico

Nutrients ◽

10.3390/nu11071598 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1598 ◽

Cited By ~ 3

Author(s):

Mattei ◽

Tamez ◽

Bigornia ◽

Noel ◽

Xiao ◽

...

Keyword(s):

Puerto Rico ◽

Dietary Intake ◽

Metropolitan Area ◽

Diet Quality ◽

Lifestyle Factors ◽

Healthy Eating Index ◽

Dietary Intakes ◽

Linear Regression Models ◽

Convenience Sample ◽

Sugary Beverages

There is scarce information regarding the dietary intake of adults living in Puerto Rico (PR). We aimed to assess intake of nutrients and foods, adherence to recommended intake of nutrients and diet quality, and sociodemographic and lifestyle factors correlated with diet quality among adults in the San Juan metropolitan area of PR. Data were obtained from participants of the cross-sectional convenience-sample Puerto Rico Assessment of Diet, Lifestyle, and Diseases (n = 248; ages 30–75 years). Diet quality was defined using the Alternate Healthy Eating Index 2010 (AHEI; range 0–110 indicating lower–higher quality). Linear regression models were used to relate AHEI to sociodemographic and lifestyle factors. Most participants met the Estimated Average Requirement (EAR) for iron, folate, and vitamins B12 and B6; 61% met the EAR for magnesium and 56% for calcium. Only 4% met the EAR for vitamin D, and 7% met the adequate intake for potassium. The main contributors to total energy intake were sugary beverages (11.8%), sweets/desserts (10.2%), dairy (8.5%), mixed dishes (7.6%), starches (6.3%), fast foods (5.5%), and rice (4.9%). The mean (SD) AHEI score was 59.8 (11.0). The lowest AHEI components for which recommended servings were met were red/processed meats, fruit, sodium, sugary beverages, and polyunsaturated fats, and the highest were nuts/legumes, omega-3 fats, and whole grains. Significantly higher AHEI scores were noted for older adults, other ethnicities (vs. Puerto Rican), being single, having some college or higher education, and never/formerly smoking. Adults living in PR report healthy and unhealthy dietary intakes, providing an opportunity to improve diet at the population level.

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Pre-Pregnancy Diet Quality Is Associated with Lowering the Risk of Offspring Obesity and Underweight: Finding from a Prospective Cohort Study

Nutrients ◽

10.3390/nu13041044 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1044

Author(s):

Dereje G. Gete ◽

Michael Waller ◽

Gita D. Mishra

Keyword(s):

Diet Quality ◽

Sodium Intake ◽

Multinomial Logistic Regression ◽

Maternal Diet ◽

Critical Role ◽

Healthy Eating Index ◽

Overweight And Obesity ◽

Relative Risk Ratio ◽

Dietary Intakes ◽

Weight Outcomes

Maternal diet plays a critical role in epigenetic changes and the establishment of the gut microbiome in the fetus, which has been associated with weight outcomes in offspring. This study examined the association between maternal diet quality before pregnancy and childhood body mass index (BMI) in offspring. There were 1936 mothers with 3391 children included from the Australian Longitudinal Study on Women’s Health (ALSWH) and the Mothers and their Children’s Health (MatCH) study. Maternal dietary intakes were assessed using a semi-quantitative and validated 101-item food-frequency questionnaire (FFQ). The healthy eating index (HEI-2015) score was used to explore preconception diet quality. Childhood BMI was categorized as underweight, normal, overweight, and obese based on sex and age-specific BMI classifications for children. Multinomial logistic regression with cluster-robust standard errors was used for analyses. Greater adherence to maternal diet quality before pregnancy was associated with a lower risk of offspring being underweight after adjustment for potential confounders, highest vs. lowest quartile (relative risk ratio (RRR) = 0.68, 95% confidence interval (CI): 0.49, 0.96). Higher adherence to preconception diet quality was also inversely linked with the risk of childhood obesity (RRR = 0.49, 95% CI: 0.24, 0.98). This association was, however, slightly attenuated by pre-pregnancy BMI in the full adjusted model. Sodium intake was significantly associated with decreased risk of childhood overweight and obesity (RRR = 0.18, 95% CI: 0.14, 0.23) and (RRR = 0.21, 95% CI: 0.17, 0.26), respectively. No significant association was detected between preconception diet quality and offspring being overweight. This study suggests that better adherence to maternal diet quality before pregnancy is associated with a reduced risk of childhood underweight and obesity.

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Estimated Causal Effects of Complementary Feeding Behaviors on Diet Quality in Early Childhood Using Birth Cohort Data

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_157 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1085-1085

Author(s):

Karen Switkowski ◽

Izzuddin Aris ◽

Véronique Gingras ◽

Emily Oken ◽

Jessica Young

Keyword(s):

Early Childhood ◽

Diet Quality ◽

Fruit Juice ◽

Complementary Feeding ◽

Linear Regression Analysis ◽

Peanut Butter ◽

Healthy Eating Index ◽

Fish Eggs ◽

Introduced Fish ◽

Feeding Behaviors

Abstract Objectives We aimed to examine effects of 3 complementary feeding behaviors on later diet quality using a causal inference framework. Methods Using data from 1041 mother-child pairs from the Boston, MA-area Project Viva cohort, we estimated effects on the mean Youth Healthy Eating Index (YHEI) score, a measure of diet quality in early childhood, of hypothetical interventions that expose (vs. do not expose) to the following: 1) introduce sweets and fruit juice at ≥12 m and provide no daily fruit juice at age ∼1 y; 2) introduce varied, non-sweet flavors (at least 2/3 of fish, eggs and peanut butter) at <12 m; and 3) continue offering foods initially refused by the child. Mothers reported complementary feeding behaviors (exposures) at 1y and completed food frequency questionnaires for children in early childhood (median age 3.2 y). We estimated average treatment effects (ATEs) using inverse probability weighted linear regression analysis with stabilized weights to adjust for both confounding and selection bias due to censored outcomes. For each effect, we adjusted for child race/ethnicity, maternal socio-demographics, BMI, and diet quality, and the other 2 exposures, and examined effect modification by child sex and infant feeding mode (breastfed at 6 m [BF group] vs. not [FF group]). Results Of 1041 pairs, 12% delayed introducing sweets/fruit juice and provided no daily fruit juice at 1y, 68% introduced fish, eggs and peanut butter before 12 m, and 93% continued to offer refused foods. We estimated that mean YHEI score was higher under “delay sweets and fruit juice” (1.8 points, 95% CI: −1.0, 5.5), particularly among the BF group (ATE 5.1 points, 95% CI: 0.0, 8.7) and females (ATE 4.4 points, 95% CI: −2.0, 9.0). ATEs for the “early flavor variety” exposure were 1.7 points (95% CI: 0.2, 3.0) and similar among males and females but stronger (2.6 points, 95% CI: 0.4, 4.8) among the FF group. Mean YHEI score was also higher (2.6 points, 95% CI: −1.1, 6.5) under the “continue offering refused foods” exposure, particularly among females (ATE 5.7 points, 95% CI: 1.2, 9.6). Conclusions Delayed introduction of sweets and fruit juice, early introduction of varied, non-sweet flavors, and continued offering of initially refused foods may result in better diet quality in early childhood. Effects may differ by child sex and breastfeeding status. Funding Sources US NIH.

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Diet Quality of Mothers of Children in NYC Head Start Is Not Associated With Child Adiposity

Current Developments in Nutrition ◽

10.1093/cdn/nzab046_007 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 710-710

Author(s):

Maxine Ashby-Thompson ◽

Inge Goldstein ◽

Isobel Contento ◽

Randi Wolf ◽

Judith Jacobson

Keyword(s):

Weight Loss ◽

African American ◽

Head Start ◽

Diet Quality ◽

Kidney Diseases ◽

Maternal Diet ◽

The United States ◽

Healthy Eating Index ◽

Z Score ◽

Z Scores

Abstract Objectives To assess whether maternal diet quality, measured when child was between ages 3 and 5, is associated with child overweight/obesity at ages 3 to 5. Methods Baseline data from the Endotoxin Obesity and Asthma longitudinal study were used for these analyses. 380 African American and Hispanic mothers of children attending NYC Head Start answered a food frequency questionnaire (FFQ) about their own intake and a demographic questionnaire about themselves and child. FFQ data were converted to Healthy Eating Index (HEI)-2015 total scores (higher scores suggest better diet quality). Anthropometric measurements (weight, height, skinfolds, and waist circumference) were obtained from children. BMI, triceps and subscapular z-scores, and weight-to-height ratio (WHtR) were calculated. Results Mean HEI total score at baseline was 64.3 ± 8.7 of 100 (considered a “D” grade or poor diet quality), but 69.8 ± 8.6 for Dominican and 60.2 ± 6.5 for Mexican mothers. Children were 50% female, 25% Mexican, 18% Dominican, 19% African American, 15% Puerto Rican and 23% Other. Mean age was 49 months. 52% of children fell below the 85th percentile for BMI, 20% between 85th and 95th, and 28% above the 95th percentile. Mother's HEI-2015 total score was not associated with child's BMI z-score (p = 0.830), child's triceps z-score (p = 0.77), child's subscapular z-score (p = 0.29), or child's WHtR (p = 0.83). More weight loss attempts by the mother (p = 0.03) and child's birthplace in (vs. outside) the United States (p = 0.01) were associated with higher BMI z-scores. Mexican ethnicity was associated with greater triceps z-scores (p = 0.03). Child's age was positively associated with subscapular z-score (p = 0.02). Child's age (p < 0.001) and Mexican ethnicity (p < 0.001) were associated with greater WHtR. Conclusions Maternal diet quality was not associated with child adiposity; however, mother's weight loss attempts, child's age and being born in the US, and a child being identified as Mexican were related did. A novel maternal characteristic, number of weight loss attempts, and several child characteristics suggest targets for intervention. Funding Sources National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Diseases.

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Associations of maternal diet with infant adiposity at birth, 6 months and 12 months

BMJ Open ◽

10.1136/bmjopen-2019-030186 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030186

Author(s):

Sarah Gonzalez-Nahm ◽

Cathrine Hoyo ◽

Truls Østbye ◽

Brian Neelon ◽

Carter Allen ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Diet Quality ◽

Gestational Age ◽

Maternal Diet ◽

Skinfold Thickness ◽

Healthy Eating Index ◽

Large For Gestational Age ◽

Z Score ◽

Public Health Importance

ObjectivesTo assess associations between maternal prenatal diet quality and infant adiposity.DesignThe design was a prospective birth cohort.SettingWe used data from the Nurture study, a cohort of women and their infants residing in the southeastern USA.Participants and exposure assessmentBetween 2013 and 2015, we enrolled 860 women between 20 and 36 weeks’ gestation. After reconsenting at delivery and excluding women with implausible calorie intakes, we measured dietary intake using the Block food frequency questionnaire, and assessed diet quality using a modified Alternate Healthy Eating Index 2010 (AHEI-2010), which assessed intake of 10 food categories, including fruits, vegetables, whole grains, nuts/legumes, fats, meats, beverages and sodium (excluding alcohol).OutcomesWe assessed birth weight for gestational age z-score, small and large for gestational age, low birth weight and macrosomia. Outcomes at 6 and 12 months were weight-for-length z-score, sum of subscapular and triceps skinfold thickness (SS+TR) and subscapular-to-triceps skinfold ratio (SS:TR).ResultsAmong mothers, 70.2% were black and 20.9% were white; less than half (45.2%) reported having a high school diploma or less. Among infants, 8.7% were low birth weight and 8.6% were small for gestational age. Unadjusted estimates showed that a higher AHEI-2010 score, was associated with a higher birth weight for gestational z-score (β=0.01; 95% CI 0.002 to 0.02; p=0.02) and a greater likelihood of macrosomia (OR=1.04; 95% CI 1.004 to 1.09; p=0.03). After adjustment, maternal diet quality was not associated with infant adiposity at birth, 6 or 12 months.ConclusionsAlthough poor maternal diet quality during pregnancy was not associated with infant adiposity in our study, maternal diet during pregnancy may still be an important and modifiable factor of public health importance.

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Patterns of Complementary Feeding Behaviors Predict Diet Quality in Early Childhood

Nutrients ◽

10.3390/nu12030810 ◽

2020 ◽

Vol 12 (3) ◽

pp. 810

Author(s):

Karen M. Switkowski ◽

Véronique Gingras ◽

Sheryl L. Rifas-Shiman ◽

Emily Oken

Keyword(s):

Early Childhood ◽

Diet Quality ◽

Latent Class ◽

Fruit Juice ◽

Complementary Feeding ◽

Taste Preference ◽

Healthy Eating Index ◽

Dietary Behaviors ◽

Sensitive Period ◽

Feeding Behaviors

Infancy is a time of plasticity in development of taste preference. Complementary feeding (CF) may be a “sensitive period” for learning new taste preferences and establishing healthy dietary behaviors that may track later in life. Among 1162 children in the U.S. prospective cohort study Project Viva, we aimed to identify patterns of CF behaviors around 1 year and examine associations with diet quality in early childhood (median age 3.1y). We identified patterns of CF using latent class analysis (LCA) and examined later diet quality based on scores on the Youth Healthy Eating Index (YHEI). We identified four distinct CF patterns (latent classes). Later YHEI scores were highest in the class characterized by “breast milk and delayed sweets and fruit juice” and lowest in the “picky eaters” class. The classes defined as “late flavor introduction and delayed sweets” and “early flavor introduction and more fruit juice” had similar, moderate scores. Our results suggest that CF patterns that increase food acceptance and discourage the innate preference for sweetness may have persistent influences on diet quality.

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Associations of Maternal Sociodemographic Characteristics and Eating Behaviors with Infant Feeding Behaviors

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_118 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1046-1046

Author(s):

Tonja Nansel ◽

Leah Lipsky ◽

Carolina Schwedhelm ◽

Breanne Wright ◽

Chelsie Temmen ◽

...

Keyword(s):

Infant Feeding ◽

Diet Quality ◽

Maternal Education ◽

Healthy Eating Index ◽

Fruit And Vegetables ◽

Infant Food ◽

Food Groups ◽

Feeding Behaviors ◽

White Race ◽

Maternal Characteristics

Abstract Objectives This study examines associations of maternal characteristics with infant feeding of discretionary and health-promoting foods. Methods Mothers in PEAS, a prospective cohort study, reported maternal and child dietary intake, demographics, and eating competence (EC). Maternal diet quality (Healthy Eating Index-2015, HEI) was calculated combining 24-hour diet recalls at 6 weeks, 6, and 12 months postpartum (n = 209). Infant food frequency questionnaires were completed at 6, 9, and 12 months, assessing age of introduction and intake frequency of food groups. T-tests examined bivariate associations of demographics with feeding of discretionary sweets, discretionary savory foods, fruit, and vegetables. Linear regressions examined associations of maternal EC and HEI with infant feeding controlling for demographics. Results Fruit, vegetables, discretionary sweet, and discretionary savory foods were introduced at 5.8 ± 1.7, 5.9 ± 1.7, 8.0 ± 2.0, and 8.8 ± 1.8 months, respectively. Earlier introduction of fruit and vegetables was associated with higher maternal education, white race, and nulliparity; earlier introduction of vegetables was also associated with higher income. Age of introduction of discretionary sweet and savory foods was not associated with maternal demographics, HEI, or EC. At age 12 months, greater infant intake frequency of fruit and vegetables was associated with higher education and income, white race, and breastfeeding, while greater intake frequency of discretionary sweet and savory foods was associated with lower maternal education and minority race. Greater intake frequency of sweets was also associated with multiparity and greater intake frequency of discretionary savory foods was associated with lower income. Maternal HEI was positively associated with infant intake frequency of fruit, vegetables, and discretionary sweet and savory foods. Maternal EC was positively associated with infant intake frequency of fruit and vegetables. Conclusions Demographic differences in infant feeding behaviors indicates these behaviors as critical intervention targets to address disparities in child diet quality. Associations of maternal HEI and EC with infant feeding behaviors suggest potential pathways of maternal influence on infant diet. Funding Sources This research was supported by the NICHD Intramural Research Program.

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Caregiver Status and Diet Quality in Community-Dwelling Adults

Nutrients ◽

10.3390/nu13061803 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1803

Author(s):

Sharmin Hossain ◽

May A. Beydoun ◽

Michele K. Evans ◽

Alan B. Zonderman ◽

Marie F. Kuczmarski

Keyword(s):

Diet Quality ◽

Healthy Aging ◽

Healthy Eating Index ◽

Community Dwelling ◽

Rate Of Change ◽

Least Square ◽

Inverse Association ◽

Linear Regression Models ◽

Middle Aged ◽

Cross Sectional

Objective: We investigated cross-sectional and longitudinal associations of diet quality with middle-aged caregiver status. Methods: Caregiving in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American (AA)) was measured at waves 3 (2009–2013) and 4 (2013–2017) (mean follow-up time 4.1 years). Diet quality was assessed by the Healthy Eating Index 2010 (HEI-2010) derived from two separate 24 h diet recalls. Multivariable ordinary least square regression was performed for cross-sectional analyses of the association of wave 4 caregiving with wave 4 HEI-2010. Wave 3 caregiving was examined both cross-sectionally and with annual rate of change in HEI using mixed-effects linear regression Models. Multivariable models were adjusted for age, sex, and poverty status. Results: Cross-sectional analyses at wave 4 demonstrate an inverse association of frequent caregiving (“Daily or Weekly” vs. “Never”) for grandchildren with HEI-2010 total score (i.e., lower diet quality) among Whites (β = −2.83 ± 1.19, p = 0.03, Model 2) and AAs (β = −1.84 ± 0.79, p = 0.02,). The “cross-sectional” analysis pertaining to grandchildren caregiving frequency suggested that frequent caregiving (i.e., “Daily or Weekly” vs. “Never” (β = −2.90 ± 1.17, p = 0.04)) only among Whites was inversely related to HEI-2010 total score. Total HEI-2010 score was also related to caring (Model 1), for the elderly over “5 years vs. Never” among Whites (−7.31 ± 3.54, p = 0.04, Model 2). Longitudinally, we found slight potential improvement in diet quality over time (“Daily or Weekly” vs. Never by TIME interaction: +0.88 ± 0.38, p = 0.02) with frequent caregiving among Whites, but not so among AAs. Conclusions: Frequent caring for grandchildren had an inverse relationship with the diet quality of White and AA urban middle-aged caregivers, while caring for elderly was inversely linked to diet quality among Whites only. Longitudinal studies should address the paucity of research on caregivers’ nutritional quality.

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

Circulation ◽

10.1161/circ.143.suppl_1.p109 ◽

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.

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