scholarly journals The New Hybrid Nutrient Density Score NRFh 4:3:3 Tested in Relation to Affordable Nutrient Density and Healthy Eating Index 2015: Analyses of NHANES Data 2013–16

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1734
Author(s):  
Adam Drewnowski ◽  
Jessica Smith ◽  
Victor L. Fulgoni
Keyword(s):  
Energy Density ◽  
Healthy Eating ◽  
Energy Cost ◽  
Whole Grains ◽  
Healthy Eating Index ◽  
Partial Replacement ◽  
Food Groups ◽  
Nutrient Density ◽  
Rich Food ◽  
The Impact

Background: Hybrid nutrient density scores are based on both nutrients and selected food groups. Objective: To compare the new hybrid nutrient-rich food NRFh 4:3:3 score to other nutrient-rich food (NRF) scores, energy density, and energy cost and to model the impact on the Healthy Eating Index (HEI-2015) of partially replacing less nutrient-rich with more nutrient-rich foods. Methods: Analyses were based on 5870 foods and beverages in the Food and Nutrient Database for Dietary Studies and on 24 h dietary recalls from the National Health and Nutrition Examination Survey (NHANES 2013–16). The NRFh 4:3:3 model was based on four nutrients to encourage (protein fiber, potassium, MUFA + PUFA); three food groups to encourage (dairy, fruit, whole grains); and three nutrients to limit (saturated fat, added sugar, sodium). Ratings generated by NRFh 4:3:3 and by other NRF models were correlated with score components, energy density (kcal/100 g), and energy cost (USD/100 kcal). The impact on HEI-2015 of replacing foods in the lowest nutrient density tertile (T1) with top tertile (T3) foods at 10%, 20%, 30%, and 100% equicaloric replacement was modeled using NHANES 2013–16 dietary data by population subgroups. Results: The NRFh 4:3:3 model awarded higher scores to foods containing dairy, fruit, and whole grains and proportionately lower scores to vegetables when compared to the NRF 9.3 model. Higher NRF and NRFh nutrient density scores were linked to lower energy density and higher energy cost; however, both correlations were lower for the NRFh 4:3:3. Isocaloric replacement of bottom tertile with top tertile foods as rated by both models led to significantly higher HEI-2105 values, based on complete (100%) and on partial (10–30%) replacement. Conclusion: The new NRFh 4:3:3 model provides the basis for developing new metrics of affordable nutrient density. The model identified “best value” food categories that were both affordable and nutrient-rich. Total and partial replacement of low nutrient density with high nutrient density foods was associated with higher HEI-2015 scores, suggesting that even partial inclusion of more nutrient dense foods in the diet may have an important impact on total diet quality.

scholarly journals Evaluation of a nutrient-rich food index score in the Netherlands

2015 ◽  
Vol 4 ◽  
Author(s):  
Diewertje Sluik ◽  
Martinette T. Streppel ◽  
Linde van Lee ◽  
Anouk Geelen ◽  
Edith J. M. Feskens
Keyword(s):  
Energy Density ◽  
Saturated Fat ◽  
Dietary Guidelines ◽  
Dietary Quality ◽  
Cereal Products ◽  
Nutrient Density ◽  
Rich Food ◽  
The Individual ◽  
Methodological Considerations ◽  
Development And Validation

AbstractNutrient-rich food (NRF) index scores are dietary quality indices based on nutrient density. We studied the design aspects involved in the development and validation of NRF index scores, using the Dutch consumption data and guidelines as an example. We evaluated fifteen NRF index scores against the Dutch Healthy Diet Index (DHD-index), a measure of adherence to the Dutch dietary guidelines, and against energy density. The study population included 2106 adults from the Dutch National Food Consumption Survey 2007–2010. The index scores were composed of beneficial nutrients (protein, fibre, fatty acids, vitamins, minerals), nutrients to limit (saturated fat, sugar, Na) or a combination. Moreover, the influence of methodological decisions was studied, such as the choice of calculation basis (100 g or 100 kcal (418 kJ)). No large differences existed in the prediction of the DHD-index by the fifteen NRF index scores. The score that best predicted the DHD-index included nine beneficial nutrients and three nutrients to limit on a 100-kcal basis, the NRF9.3 with a model R2 of 0·34. The scores were quite robust with respect to sex, BMI and differences in calculation methods. The NRF index scores were correlated with energy density, but nutrient density better predicted the DHD-index than energy density. Consumption of vegetables, cereals and cereal products, and dairy products contributed most to the individual NRF9.3 scores. In conclusion, many methodological considerations underlie the development and evaluation of nutrient density models. These decisions may depend upon the purpose of the model, but should always be based upon scientific, objective and transparent criteria.

scholarly journals Role of alternate healthy eating index (AHEI) in communicating the quality of diet

2020 ◽  
Vol 11 (2) ◽  
pp. 96-102
Author(s):  
Krishna Mohandas ◽  
L. Prema
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Dietary Habits ◽  
Mean Value ◽  
Healthy Eating Index ◽  
Overweight And Obesity ◽  
Food Groups ◽  
Good Tool ◽  
The Difference

The food habits of global population has been evolving in such a way that makes unhealthy foods cheaper and widely available and healthy foods costly and less available. Being surrounded by such foods and living in an environment with lesser requirement for physical activity is the primary reason for the pandemic explosion in overweight and obesity. This study is an attempt to analyze the quality of diet with an aim to study the significance of Alternate Healthy Eating Index (AHEI) in predicting the quality of dietary intake. Methodology: The study was conducted in 66 respondents (44 females and 22 males) aged 18-65 years with BMI between 23 kg/m2 to 50 kg/m2. The respondent’s data were collected using a pretested standard questionnaire. The nutrient consumption was calculated from the 24 hour recall and the AHEI scores were derived from recall and food use frequency data. The data were analysed using SAS software. Results: The intake of Energy, protein, fat and carbohydrates were more than their requirement while intake of fibre was not meeting the requirement. The AHEI scores obtained ranged from 36 to 76 with a mean value of 55.6 ± 9.54. A positive linear association for AHEI with BMI (0.0362) and energy intake (0.13) was established through Pearson’s correlation while the association was negative with BMR (-0.14). Paired t test comparing AHEI against the difference between intake and requirement of macronutrients revealed that when the diet quality was good (as indicated by AHEI>51), the difference in intake exhibited a significant linear relationship with p values <0.001 while no relation was established when the diet quality was poor. Conclusion: AHEI encompasses all nutrients and food groups relevant to metabolic health and it can be used as a good tool to assess the quality of dietary habits of overweight and obese subjects.

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

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

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

scholarly journals Healthy Eating Index: Assessment of the Diet Quality of a Brazilian Elderly Population

2018 ◽  
Vol 11 ◽  
pp. 117863881881884
Author(s):  
Dalila Pinto de Souza Fernandes ◽  
Maria Sônia Lopes Duarte ◽  
Milene Cristine Pessoa ◽  
Sylvia do Carmo Castro Franceschini ◽  
Andréia Queiroz Ribeiro
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Saturated Fat ◽  
Population Based ◽  
Cross Sectional Study ◽  
Whole Grains ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Global Quality

Background: The food consumption assessment is necessary to monitor elderly’s nutritional status because it allows detecting nutrition deficits and guiding the elaboration of effective conducts. Objective: The objective of this study is to assess the global quality of the elderly’s diet in Viçosa—MG, Brazil. Methods: This is a population-based cross-sectional study, involving noninstitutionalized elderly. Diet quality was assessed through the Brazilian Healthy Eating Index-Revised (BHEI-R) validated to the Brazilian population. Results: The study comprised 620 elderly individuals. The mean total BHEI-R score was 64.28. The worse consumption scores concerned the components Whole grains, Milk and derivatives, Sodium, Total fruit, and Whole fruit. Approximately 82% scored zero (0%) for Whole grains and 67% for Sodium. Men presented significantly lower scores than women, who have presented maximal score in the same items. Women’s scores were not only significantly higher for Total fruit, Whole fruit, Milk and derivatives, but also significantly lower for Saturated fat. Discussion: Most elderly need to improve their diet quality. Strategies heading toward the improvement of diet quality must be priority in policies to health promotion toward the healthy and active aging.

scholarly journals Association between energy-dense food consumption at 2 years of age and diet quality at 4 years of age

2013 ◽  
Vol 111 (7) ◽  
pp. 1275-1282 ◽  
Author(s):  
Sofia Vilela ◽  
Andreia Oliveira ◽  
Elisabete Ramos ◽  
Pedro Moreira ◽  
Henrique Barros ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Soft Drinks ◽  
Inverse Association ◽  
Food Groups ◽  
Dietary Recommendations ◽  
Daily Consumption ◽  
Energy Dense Food

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake ( ≥ median) of soft drinks (incidence rate ratio (IRR) = 0·74, 95 % CI 0·58, 0·95), salty snacks (IRR = 0·80, 95 % CI 0·65, 1·00) and sweets (IRR = 0·73, 95 % CI 0·58, 0·91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age ( ≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0·75, 95 % CI 0·58, 0·96; IRR = 0·56, 95 % CI 0·41, 0·77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

scholarly journals Choice of Foods and Ingredients for Moderately Malnourished Children 6 Months to 5 Years of Age

2009 ◽  
Vol 30 (3_suppl3) ◽  
pp. S343-S404 ◽  
Author(s):  
Kim F. Michaelsen ◽  
Camilla Hoppe ◽  
Nanna Roos ◽  
Pernille Kaestel ◽  
Maria Stougaard ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Energy Density ◽  
Cost Effective ◽  
Child Growth ◽  
Severe Malnutrition ◽  
Research Needs ◽  
Food Groups ◽  
Bioactive Substances ◽  
Nutrient Density ◽  
Moderate Malnutrition

There is consensus on how to treat severe malnutrition, but there is no agreement on the most cost-effective way to treat infants and young children with moderate malnutrition who consume cereal-dominated diets. The aim of this review is to give an overview of the nutritional qualities of relevant foods and ingredients in relation to the nutritional needs of children with moderate malnutrition and to identify research needs. The following general aspects are covered: energy density, macronutrient content and quality, minerals and vitamins, bioactive substances, antinutritional factors, and food processing. The nutritional values of the main food groups—cereals, legumes, pulses, roots, vegetables, fruits, and animal foods—are discussed. The special beneficial qualities of animal-source foods, which contain high levels of minerals important for growth, high-quality protein, and no antinutrients or fibers, are emphasized. In cereal-dominated diets, the plant foods should be processed to reduce the contents of antinutrients and fibers. Provision of a high fat content to increase energy density is emphasized; however, the content of micronutrients should also be increased to maintain nutrient density. The source of fat should be selected to supply optimal amounts of polyunsaturated fatty acids (PUFAs), especially n-3 fatty acids. Among multiple research needs, the following are highlighted: to identify the minimum quantity of animal foods needed to support acceptable child growth and development, to examine the nutritional gains of reducing contents of antinutrients and fibers in cereal- and legume-based diets, and to examine the role of fat quality, especially PUFA content and ratios, in children with moderate malnutrition.

scholarly journals Healthy Eating Index-2015 Is Associated with Grip Strength among the US Adult Population

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3358
Author(s):  
Galya Bigman ◽  
Alice S. Ryan
Keyword(s):  
Grip Strength ◽  
Healthy Eating ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Whole Grains ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Cross Sectional ◽  
Lower Odds ◽  
Nationally Representative

The Healthy Eating Index-2015 (HEI-2015) was designed to reflect adherence to the 2015–2020 Dietary Guidelines for Americans (DGA). The study aims to examine the association between HEI-2015 and grip strength in a nationally representative sample of the U.S. adult population. This cross-sectional study used data from the National Health and Nutrition Examination Surveys of 2011–2014. Low grip strength was defined as <35.5 kg for men and <20 kg for women. HEI-2015 was computed from two days of 24-h dietary recalls and comprised 13 components. Each component was scored on the density out of 1000 calories and summed to a total score divided into quartiles. Weighted logistic regressions examined the study aim while controlling for associated covariates. The sample included 9006 eligible participants, of those, 14.4% (aged 20+ years), and 24.8% (aged ≥50 years) had low grip strength. Mean (±SD) HEI-2015 total score was 54.2 ± 13.6 and in the lowest and highest quartiles 37.3 ± 5.1 and 72.0 ± 6.5, respectively. In the multivariable model, participants in the highest vs. lowest HEI-2015 quartile had 24% lower odds of having low grip strength (Odds Ratio (OR) = 0.76; 95% CI: 0.60–0.96). Specifically, participants who met the DGA for protein intakes, whole grains, greens and beans, vegetables, or whole fruits had 20–35% lower odds of having low grip strength than those who did not. Higher compliance to the DGA might reduce the risk for low grip strength as a proxy measure for sarcopenia among U.S. adults, particularly adequate intakes of proteins, whole grains, greens and beans, vegetables, and whole fruits.

scholarly journals Late Evening Food Patterns of U.S. Adults Are Differentially Associated with Total Energy Intake and Diet Quality: Results from What We Eat in America, NHANES 2013–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 564-564
Author(s):  
Rhonda Sebastian ◽  
Cecilia Wilkinson Enns ◽  
Joseph Goldman ◽  
Theophile Murayi ◽  
Alanna Moshfegh
Keyword(s):  
Energy Intake ◽  
Diet Quality ◽  
Hierarchical Cluster ◽  
Healthy Eating Index ◽  
Food Groups ◽  
Funding Sources ◽  
Nutrient Density ◽  
Food Patterns ◽  
Food And Beverage ◽  
Late Evening

Abstract Objectives Eating later versus earlier in the day has been associated with higher energy intake and lower diet quality. However, since food and beverage choices vary, these relationships may not be true of all late evening (LE) eating patterns. The goal of this study was to identify LE patterns of U.S. adults and determine their associations with energy intake and diet quality. Methods One day of dietary intake collected from 9861 adults 20 + years of age (4829 males and 5032 females) in What We Eat in America, NHANES 2013–2016 was analyzed. LE consumption was any food/beverage intake that began between 8:00 pm and 11:59 pm. Hierarchical cluster analysis was used to develop LE food/beverage patterns based on percentage of LE energy provided by each of 23 food groups with adjustment for gram weight. Adjusted estimates of energy intake and Healthy Eating Index (HEI) score were compared between reporters in each LE pattern and non-reporters. Results Nearly two-thirds (64.4%) of adults were LE reporters. The 11 LE patterns identified accounted for 65.9% of the variance in LE energy intake. The 6 most prevalent LE patterns were characterized by intake of sweets, sandwiches, and beverages (23.0% of adults); mixed dishes, meat, and vegetables (12.3%); savory snacks and alcohol (9.5%); candy, nuts, and seeds (5.2%); fruit and 100% juice (4.1%); and milk and dairy drinks (3.4%). Fewer than 3% of adults fell into each of the 5 remaining patterns (white potatoes, pizza, cereal, cooked grains, and legumes). Compared to non-reporters, LE reporters in 7 of the 11 patterns had higher mean total daily energy intake (P &lt; 0.001), ranging from 12.6% higher for sweets, sandwiches, and beverages to 26.7% higher for pizza. Mean HEI scores were higher in 2 patterns (fruit and 100% juice, 56.5; legumes, 59.4) and lower in 1 pattern (pizza, 44.5) than for non-reporters (50.6). Conclusions LE food/beverage consumption is common among U.S. adults. Although most current LE patterns are associated with higher energy intake and few with better diet quality, exceptions were seen, notably for patterns characterized by fruit and legumes. For the majority of LE reporters, modifying LE food/beverage choices to better align with dietary guidance could considerably improve the nutrient density of the overall diet. Funding Sources ARS, USDA.

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