Dietary Quality Determined by the Healthy Eating Index-2015 and Biomarkers of Chronic Low-Grade Inflammation: A Cross-Sectional Analysis in Middle-to-Older Aged Adults

Low-grade systemic inflammation is associated with a range of chronic diseases. Diet may modulate inflammation and represents a promising therapeutic target to reduce metabolic dysfunction. To date, no study has examined Healthy Eating Index-2015 (HEI-2015) diet score associations with biomarkers of inflammation. Thus, our objective was to assess relationships between the HEI-2015 score and a range of inflammatory biomarkers in a cross-sectional sample of 1989 men and women aged 46–73 years, to test the hypothesis that better dietary quality would be associated with more favourable circulating levels of inflammatory biomarkers. Pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cell counts were determined. Correlation and linear regression analyses were used to test HEI-2015 diet score relationships with biomarker concentrations. Higher dietary quality as determined by the HEI-2015 was associated with lower c-reactive protein (CRP) and interleukin 6 concentrations, white blood cell (WBC) counts and its constituents, adjusting for sex and age. Associations with CRP concentrations and WBC counts persisted in the fully adjusted models. No associations with complement component 3, tumour necrosis factor alpha, adiponectin, leptin, resistin or plasminogen activator inhibitor-1 levels were identified. Our data suggest that dietary quality, determined by the HEI-2015 score, in middle-to-older aged adults is associated with inflammatory biomarkers related to cardiometabolic health.

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Lower Healthy Eating Index-2005 dietary quality scores in older women with rheumatoid arthritis v. healthy controls

Public Health Nutrition ◽

10.1017/s136898001000008x ◽

2010 ◽

Vol 13 (8) ◽

pp. 1170-1177 ◽

Cited By ~ 17

Author(s):

Megan E Grimstvedt ◽

Kathleen Woolf ◽

Brandy-Joe Milliron ◽

Melinda M Manore

Keyword(s):

Rheumatoid Arthritis ◽

Nutritional Status ◽

Older Women ◽

Healthy Eating ◽

Healthy Eating Index ◽

High Risk Group ◽

Dietary Guidelines ◽

Dietary Quality ◽

Healthy Controls ◽

Cross Sectional

AbstractObjectiveTo assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.DesignCross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.SettingArizona, USA.SubjectsOlder (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).ResultsThere were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).ConclusionsThis is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.

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Dietary quality differs among cannabis use groups: data from the National Health and Nutrition Examination Survey 2005–16

Public Health Nutrition ◽

10.1017/s1368980020001846 ◽

2020 ◽

pp. 1-9

Author(s):

Amy R Gelfand ◽

Christy C Tangney

Keyword(s):

Healthy Eating ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Cannabis Use ◽

Dietary Quality ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Adult Participants

Abstract Objective: To describe diet quality (Healthy Eating Index 2010 (HEI-2010) and Healthy Eating Index 2015 (HEI-2015)) according to self-reported cannabis use among the National Health and Nutrition Examination Survey (NHANES) adult participants. Design: Utilizing cross-sectional data, we assessed diet quality with up to two 24-h diet recalls from NHANES participants. Usual intakes were estimated via the multivariate Markov Chain–Monte Carlo method. Diet quality scores were compared among never users, previous users and current users of cannabis. Setting: NHANES surveys from 2005 to 2016. Participants: Adult NHANES participants (17 855) aged 20–59 years with valid data for dietary recalls and drug use questionnaires. Results: Current adult cannabis users (ages 20–59 years) had significantly lower total diet quality (HEI-2010) scores (51·8 ± 0·7) compared with previous (56·2 ± 0·4) and never users (57·7 ± 0·4). Similar differences in total and individual HEI-2015 scores were observed. For the HEI-2015 scores, cannabis users had a significantly higher (better) sodium scores (4·1 ± 0·2) compared with never users (3·3 ± 0·1) and previous users (3·2 ± 0·1). Cannabis users scored lower compared with never users on total vegetables (3·1 ± 0·1 v. 3·7 ± 0·0), total fruit (2·1 ± 0·1 v. 3·0 ± 0·1) and whole fruit (2·2 ± 0·1 v. 3·3 ± 0·1) for the HEI-2015 index. Conclusions: Current cannabis users’ usual intakes reflect lower diet quality compared with never or previous users, particularly lower subcomponent scores of total vegetables, greens and beans, total fruit and whole fruit. Cannabis users should increase their intake of fruit and vegetables to improve overall diet quality.

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Diet quality in a sample of adults from Cuiabá (MT), Brazil: association with sociodemographic factors

Revista de Nutrição ◽

10.1590/s1415-52732013000400005 ◽

2013 ◽

Vol 26 (4) ◽

pp. 431-441 ◽

Cited By ~ 6

Author(s):

Anarlete da Silva Loureiro ◽

Regina Maria Veras Gonçalves da Silva ◽

Paulo Rogério Melo Rodrigues ◽

Rosângela Alves Pereira ◽

Loiva Lide Wendpap ◽

...

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Poisson Regression ◽

Formal Education ◽

Household Head ◽

Healthy Eating Index ◽

Alcoholic Beverages ◽

Dietary Quality ◽

Cross Sectional ◽

Mato Grosso

OBJECTIVE: To analyze the dietary quality of adults and to identify associated factors. METHODS: Cross-sectional study carried out in a sample of adults (n=195), aged 20-50 years, of both genders, from a population-based study in Cuiabá, Mato Grosso, Brazil. Food consumption data was collected by a food frequency questionnaire. Sociodemographic, lifestyle, anthropometric, and body composition data were also collected. Diet quality was analyzed by the Brazilian Healthy Eating Index-Revised. The associations were estimated by Poisson regression. RESULTS: The mean Brazilian Healthy Eating Index-Revised score was 75.2 points (CI95%=74.2-76.1), which differed significantly between the genders (p=0.03). Women had higher scores for whole fruit and sodium (p<0.01), while men had higher scores for oils, nuts, and fish fat (p=0.02). Individuals aged >30 years had higher total Brazilian Healthy Eating Index-Revised score and higher scores for the groups whole fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugar (p<0.01). The Poisson regression between high Brazilian Healthy Eating Index-Revised and the independent variables showed that high Brazilian Healthy Eating Index-Revised was associated with being female, being aged 30 years or more, and being from families whose household head had 8 or more years of formal education. CONCLUSION: The factors associated with high Brazilian Healthy Eating Index-Revised were age, gender, and education level of the household head.

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Diet quality on meatless days: National Health and Nutrition Examination Survey (NHANES), 2007–2012

Public Health Nutrition ◽

10.1017/s136898001700026x ◽

2017 ◽

Vol 20 (9) ◽

pp. 1564-1573 ◽

Cited By ~ 9

Author(s):

Zach Conrad ◽

Micaela Karlsen ◽

Kenneth Chui ◽

Lisa Jahns

Keyword(s):

Healthy Eating ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Dietary Quality ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Game Birds

AbstractObjectiveTo compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality.DesignCross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested usingpost hocWald tests andztests.SettingThe National Health and Nutrition Examination Survey (NHANES), 2007–2012.SubjectsThe sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual.ResultsNon-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (P<0·05). Among non-meat eaters, mean consumption across HEI-2010 quintiles demonstrated different (P<0·05) amounts of empty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (P<0·05) amounts of nuts and legumes, vegetables and PUFA.ConclusionsPublic health messages targeted at vegetarians and others who may choose to eat meat-free on certain days should emphasize decreased consumption of empty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

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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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Diet Quality Index for older adults (DQI-65): development and use in predicting adherence to dietary recommendations and health markers in the UK National Diet and Nutrition Survey

British Journal Of Nutrition ◽

10.1017/s0007114521005043 ◽

2021 ◽

pp. 1-39

Author(s):

Nicole Dorrington ◽

Rosalind Fallaize ◽

Ditte A. Hobbs ◽

Michelle Weech ◽

Julie A. Lovegrove

Keyword(s):

Physical Activity ◽

Older Adults ◽

Healthy Eating ◽

Diet Quality ◽

Healthy Eating Index ◽

Dietary Quality ◽

Validity And Reliability ◽

Dietary Recommendations ◽

Nutrition Survey ◽

Cross Sectional

Abstract Diet quality indexes (DQIs) are useful tools for assessing diet quality in relation to health and guiding delivery of personalised nutritional advice, however existing DQIs are limited in their applicability to older adults (aged ≥65 years). Therefore, this research aimed to develop a novel evidence-based DQI specific to older adults (DQI-65). Three DQI-65 variations were developed to assess the impacts of different component quantitation methods and inclusion of physical activity. The variations were: Nutrient and Food-based DQI-65 (NFDQI-65), NFDQI-65 with Physical Activity (NFDQI-65+PA) and Food-based DQI-65 with Physical Activity (FDQI-65+PA). To assess their individual efficacy, the NFDQI-65, NFDQI-65+PA and FDQI-65+PA were explored alongside the validated Healthy Eating Index-2015 (HEI-2015) and Alternative Healthy Eating Index-2010 (AHEI-2010) using data from the cross-sectional UK National Diet and Nutrition Survey (NDNS) rolling programme. Scores for DQI-65 variations, the HEI-2015 and AHEI-2010 were calculated for adults ≥65 years from years 2-6 of the NDNS (n=871). Associations with nutrient intake, nutrient status and health markers were analysed using linear and logistic regression. Higher DQI-65s and HEI-2015 scores were associated with increased odds of meeting almost all of our previously proposed age-specific nutritional recommendations, and with health markers of importance for older adults, including lower body mass index, lower medication use and lower C-reactive protein (P<0.01). Few associations were observed for the AHEI-2010. This analysis suggests value of all three DQI-65s as measures of dietary quality in UK older adults. However, methodological limitations mean further investigations are required to assess validity and reliability of the DQI-65s.

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Increased sugar-sweetened beverage consumption is associated with poorer dietary quality: A cross-sectional population-based study

Revista de Nutrição ◽

10.1590/1678-9865201932e180121 ◽

2019 ◽

Vol 32 ◽

Author(s):

Amanda Silva FONTES ◽

Ana Carolina PALLOTTINI ◽

Diva Aliete dos Santos VIEIRA ◽

Lais Duarte BATISTA ◽

Mariane de Mello FONTANELLI ◽

...

Keyword(s):

Healthy Eating ◽

Population Based ◽

Healthy Eating Index ◽

Dietary Quality ◽

Age Group ◽

Sugar Sweetened Beverages ◽

Cross Sectional ◽

Population Based Study ◽

Sweetened Beverages ◽

Urban City

ABSTRACT Objective To evaluate the association between sugar-sweetened beverages consumption and dietary quality in adolescents, adults, and older adults living in São Paulo, Brazil. Methods Data were drawn from a cross-sectional population-based study conducted in 2008 in a representative urban city sample involving 1494 consumers of sugar-sweetened beverages. Dietary intake was evaluated through two 24-Hour Dietary Recalls, and the usual sugar-sweetened beverages consumption was estimated using the Multiple Source Method. Dietary quality was evaluated using the Brazilian Healthy Eating Index – Revised. The association between total score of the revised index and components with sugar-sweetened beverages consumption tertiles was assessed using multiple linear regression models for each age group, considering the sample design. Results Regardless of age group, the increase of sugar-sweetened beverages consumption was associated with a decrease in the total Healthy Eating Index – Revised score and in the components “total fruit”; “whole fruit”; “meat, eggs and legumes”, and the “solid fat, alcohol and added sugar”. Conclusion The results of our study suggest that higher sugar-sweetened beverages consumption was associated with poorer dietary quality. Planning public health policies aimed at decreasing sugar-sweetened beverages consumption is essential to increase dietary quality and reduce the incidence of noncommunicable diseases.

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Association Between White Blood Cell Counts and Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults: A Cross-Sectional Study

Angiology ◽

10.1177/00033197211021199 ◽

2021 ◽

pp. 000331972110211

Author(s):

Buyun Jia ◽

Chongfei Jiang ◽

Yun Song ◽

Chenfangyuan Duan ◽

Lishun Liu ◽

...

Keyword(s):

Arterial Stiffness ◽

Blood Cell ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

White Blood Cell ◽

Pulse Wave ◽

Final Analysis ◽

Cross Sectional ◽

Cell Counts ◽

Wbc Count

Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.

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Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

Public Health Nutrition ◽

10.1017/s1368980021002196 ◽

2021 ◽

pp. 1-29

Author(s):

Amy H. Auchincloss ◽

Jingjing Li ◽

Kari A. B. Moore ◽

Manuel Franco ◽

Mahasin S. Mujahid ◽

...

Keyword(s):

Healthy Eating Index ◽

Dietary Quality ◽

Longitudinal Analyses ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Eating Out ◽

Restaurant Meals ◽

Sectional Analysis ◽

Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

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Mediterranean Diet and Healthy Eating in Subjects with Prediabetes from the Mollerussa Prospective Observational Cohort Study

Nutrients ◽

10.3390/nu13010252 ◽

2021 ◽

Vol 13 (1) ◽

pp. 252

Author(s):

Mireia Falguera ◽

Esmeralda Castelblanco ◽

Marina Idalia Rojo-López ◽

Maria Belén Vilanova ◽

Jordi Real ◽

...

Keyword(s):

Glucose Tolerance ◽

Mediterranean Diet ◽

Healthy Eating ◽

Dietary Patterns ◽

Normal Glucose Tolerance ◽

Healthy Eating Index ◽

Study Cohort ◽

Cross Sectional ◽

Normal Glucose ◽

Multivariable Analyses

We aimed to assess differences in dietary patterns (i.e., Mediterranean diet and healthy eating indexes) between participants with prediabetes and those with normal glucose tolerance. Secondarily, we analyzed factors related to prediabetes and dietary patterns. This was a cross-sectional study design. From a sample of 594 participants recruited in the Mollerussa study cohort, a total of 535 participants (216 with prediabetes and 319 with normal glucose tolerance) were included. The alternate Mediterranean Diet score (aMED) and the alternate Healthy Eating Index (aHEI) were calculated. Bivariable and multivariable analyses were performed. There was no difference in the mean aMED and aHEI scores between groups (3.2 (1.8) in the normoglycemic group and 3.4 (1.8) in the prediabetes group, p = 0.164 for the aMED and 38.6 (7.3) in the normoglycemic group and 38.7 (6.7) in the prediabetes group, p = 0.877 for the aHEI, respectively). Nevertheless, women had a higher mean of aMED and aHEI scores in the prediabetes group (3.7 (1.9), p = 0.001 and 40.5 (6.9), p < 0.001, respectively); moreover, they had a higher mean of aHEI in the group with normoglycemia (39.8 (6.6); p = 0.001). No differences were observed in daily food intake between both study groups; consistent with this finding, we did not find major differences in nutrient intake between groups. In the multivariable analyses, the aMED and aHEI were not associated with prediabetes (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.75–1.87; p = 0.460 and OR: 1.32, 95% CI: 0.83–2.10; p = 0.246, respectively); however, age (OR: 1.04, 95% CI: 1.02–1.05; p < 0.001), dyslipidemia (OR: 2.02, 95% CI: 1.27–3.22; p = 0.003) and body mass index (BMI) (OR: 1.09, 95% CI: 1.05–1.14; p < 0.001) were positively associated with prediabetes. Physical activity was associated with a lower frequency of prediabetes (OR: 0.48, 95% CI: 0.31–0.72; p = 0.001). In conclusion, subjects with prediabetes did not show a different dietary pattern compared with a normal glucose tolerance group. However, further research is needed on this issue.

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