Do Temporal Eating Patterns Differ in Healthy Versus Unhealthy Overweight/Obese Individuals?

This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41–13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11–5.13) (OR = 2.33, 95% CI 1.03–5.32) (OR = 4.45, 95% CI 1.71–11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.

Association of Hours of Paid Work with Dietary Intake and Quality in Japanese Married Women: A Cross-Sectional Study

This study investigated the association of hours of paid work with dietary intake and diet quality among Japanese married women. This cross-sectional study was a secondary analysis of a nationwide population survey in 2013. The analytic sample included 644 married women aged 20–59 years. The participants were categorized into five groups according to hours of paid work per week: 0 (housewives), 1–14, 15–34, 35–42, and ≥43 h. Dietary intake was assessed by a self-administered diet history questionnaire. The Nutrient-Rich Food Index 9.3 (NRF9.3) was used to measure the dietary quality. The association of hours of paid work with dietary intake and NRF9.3 score was assessed using a multivariable general linear regression analysis with adjustments for confounders. Hours of paid work were associated with a higher intake of rice and lower intake of vegetables, potatoes, soy products, and seaweeds and nutrients including protein, dietary fiber, and most vitamins and minerals. Hours of paid work were negatively associated with the NRF9.3 score. This study showed that Japanese married women engaging in paid work, especially those who work long hours, have less healthy diets. Efforts to improve the dietary intake of married women with paid work might be needed.

Evaluation of energy intake by brief-type self-administered diet history questionnaire among male patients with stable/at risk for chronic obstructive pulmonary disease

Background and objectiveWeight loss and reduced fat-free mass are independent risk factors for mortality among patients with chronic obstructive pulmonary disease (COPD). These factors are important for determining diet therapy and examining the validity of assessment for energy intake (EI). We assessed the agreement of EI between a brief-type self-administered diet history questionnaire (BDHQ) and the doubly labelled water (DLW) method among male patients with stable/at risk for COPD.MethodIn this cross-sectional observational study, data for 33 male patients were analysed. At the first visit, EI was estimated using a BDHQ (EIBDHQ). Total energy expenditure (TEE) was measured during 13–15 days by the DLW method, while corrected EI was calculated using the TEE and weight change during the DLW period (EIDLW). The difference between EIBDHQ and EIDLW was evaluated by the Bland-Altman method. Multiple regression analysis was used to determine the proportion of variance in the difference between EIBDHQ and EIDLW, as determined by the patient’s characteristics.ResultsEIBDHQ was 2100 (95% CI: 1905 to 2295) kcal/day in the total population. A fixed bias was observed between EIBDHQ and EIDLW as −186 (95% CI: −422 to 50) kcal/day, while a proportional bias was not detected by the Bland-Altman analysis. Age, weight, anxiety and interleukin 6 were responsible for 61.7% of the variance in the difference between both EIs in a multiple regression model.ConclusionsThe BDHQ underestimated EI among male patients with stable/at risk for COPD, but this estimation error was within an acceptable range compared with previous studies. EIBDHQ precision might be improved by considering common COPD traits, including inflammatory condition and mental state.

Assessment of Foods Associated with Sodium and Potassium Intake in Japanese Youths Using the Brief-Type Self-Administered Diet History Questionnaire

The identification of sodium and potassium intake in youths is an important step to preventing the increase of blood pressure in childhood. We examined food intake and estimated mineral intake using a brief-type self-administered diet history questionnaire (BDHQ) to test its validity as a comparison with urinary excretion in Japanese youths. The subjects were 5th and 8th graders (n = 2377), who completed the BDHQ and permitted the use of their overnight urine specimens. Sodium intake was poorly associated with sodium excretion (Rho = 0.048), and the coefficients of dietary potassium and a sodium-to-potassium molar ratio were 0.091–0.130. Higher soybean paste (miso) intake and pickles were significantly associated with higher sodium excretion (p ≤ 0.005). However, these foods were positively associated with potassium excretion (p = 0.002–0.012), and not associated with an excreted sodium-to-potassium ratio. Fruits and dairy products were positively associated (p ≤ 0.048), whereas beverages were negatively associated with potassium excretion (p ≤ 0.004). The association of the sodium-to-potassium ratio was opposite to that of potassium (p ≤ 0.001). The choice of foods, potassium, and the sodium-to-potassium ratio assessed using the BDHQ are available as part of health education for youths, but the assessment of sodium intake in population levels should be carefully conducted.

Dietary Anti-Oxidant Capacity, Dietary Inflammation Index, and the Risk of Stroke in a Large Prospective Cohort Study.

BackgroundWhilst the Western and Mediterranean/prudent diets have long been associated with the risk of stroke, it is less clear if increased inflammation and reduction of oxidations are their respective mechanisms. This study aimed to understand the associations between the dietary inflammatory index (DII), and total anti-oxidant capacity of the diet (TAC), with regards to stroke risk.MethodsThe study population included 71,460 women free of cardiovascular disease at baseline from the E3N cohort, who completed a diet history questionnaire which was used to estimate the dietary pattern scores. Scores were considered grouped as quintiles and as splines in order to determine the dose-response shape. Hazard ratios (HRs) and 95% confidence intervals (95% CI) for hypertension were estimated with multivariate Cox models with age as the time scale, and adjusted for potential confounding factors. After Bonferroni correction, a p-value of 0.013 was considered significant.ResultsOver 14.5 years of follow-up, 414 cases of incident stroke were identified. The Western, and Prudent dietary patterns were both highly associated with the risk of stroke (Western HRQ1Q4 = 1.85 [1.27: 2.69], p-trend = 0.002, Prudent HRQ1Q4 = 0.59 [0.44: 0.78], p-trend < 0.001), as was TAC from non-coffee sources (HRQ1Q4 = 0.47 [0.33: 0.68], p-trend < 0.001). All three showed a clear dose-response, and the associations with the Western and Prudent scores were consistent in sensitivity analysis. Weaker evidence was observed for DII (HRQ1Q4 = 1.33 [1.01: 1.78], p-trend = 0.03), which did not show a clear dose-response. TAC from coffee was not associated with the risk of stroke.ConclusionThese results suggest that diets high in anti-oxidants are associated with a reduced risk of stroke, but that inflammation from the diet does not play as large a part in the risk of stroke. Factors other than inflammation may be driving associations with stroke and western diet.

Validity and Reproducibility of a Food Frequency Questionnaire to Assess Macro and Micro-Nutrient Intake among a Convenience Cohort of Healthy Adult Qataris

This study aimed at developing a valid culture-sensitive quantitative food frequency questionnaire (FFQ) for Qatari adults. A convenient sample of healthy Qataris (n = 107) were recruited from family members of Qatar University students. The Diet History Questionnaire II of the US National Cancer Institute was translated to Arabic language, back-translated to English, pilot tested, and then modified accordingly to be used in Qatari setting. Participants were asked to complete the translated version of the FFQ. This FFQ was then validated against three 24 h diet recall (24 hDR) including a weekend day. Participants were asked to complete the FFQ again after one-month period to measure its repeatability. Dietary data were analyzed using the dietary analysis software ESHA. The validity and reliability of FFQ were assessed by comparing the median intake of nutrients and foods and by calculating the Pearson correlation coefficients. The median nutrient intakes assessed by the second FFQ were higher than that reported in the baseline FFQ1 except for fat. The percentage of increase varies between 1.5% and 96%. Results of the second FFQ indicated an overestimation of intake for most nutrients (macro and micro). Macronutrient intakes assessed by the two FFQ and 24 hDR were strongly correlated. The correlation coefficients for micronutrient intakes between FFQ2 and 24hDR were lower than that of the two FFQs except for calcium (r = 0.55) and sodium (r = 0.643). They ranged from (−0.17) for fluorine to (0.643) for sodium. The agreement rates for classifying macronutrient intakes into same or adjacent quartile were between 79.4% and 100% for the two FFQs and between 71% and 100% for the second FFQ and 24hDR. The reported consumption of food groups estimated by FFQ2 was significantly higher than that reported by FFQ1. In conclusion, the developed FFQ was sufficiently valid to assess energy and macronutrients but not micronutrients. The reliability was adequate for most nutrients.

Data-driven development of the Meal-based Diet History Questionnaire for Japanese adults

Food frequency questionnaires, the primary method of dietary assessment in large-scale nutritional epidemiologic studies, preclude an informed evaluation of the timing of dietary intake and meal-specific dietary intake. In this study, we developed the Meal-based Diet History Questionnaire (MDHQ), a self-administered questionnaire designed for estimating food and nutrient intakes for each meal type separately. The development was done based on a 16-day dietary record obtained from 242 Japanese adults. The MDHQ consisted of the three different parts, with a total of 196 items. Part 1 of the MDHQ asks about consumption frequency of generic food groups (n 24) for each meal type: breakfast, morning snack, lunch, afternoon snack, dinner, and night snack. Part 2 of the MDHQ asks about relative consumption frequency of sub-food groups within one of the generic food groups which are asked in Part 1. Combining information derived from Parts 1 and 2 enables to increase the number of foods we can estimate efficiently but within a limited number of questions. Part 3 of the MDHQ asks about general eating behaviors, which are intended to use in a variety of ways during dietary intake calculation. A series of calculation algorithms for food groups, energy, and nutrients were also prepared. Given that the MDHQ was empirically developed based on comprehensive information on actual food consumption, this innovative tool may be promising for future epidemiological research on meal patterns and time of day of dietary intake, or chrono-nutrition research. A rigorous evaluation of validity of the MDHQ is warranted.

Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self‐reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow‐up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high‐normal BMI range (BMI, 22.5–24.9) (HR Quartile 1–Quartile 4 , 0.89; 95% CI, 0.79–0.99). An inverse relationship was observed between sports (HR sports >2 hours , 0.87; 95% CI, 0.83–0.93), walking (HR walk >6.5 hours , 0.94; 95% CI, 0.90–1.00), and gardening (HR gardening >2.5 hours , 0.94; 95% CI, 0.89–0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.