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Diet Quality and Health Outcomes

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 November 2018) | Viewed by 70783

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Dr. Michel Lucas

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Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
Department of Social & Preventive Medicine, Laval University, Québec, QC, Canada
Population Health and Optimal Health Practices Research Unit, CHU de Québec – Laval University, Québec, QC, Canada
Interests: diet quality Indices; cardiometabolic diseases; aging; infant and adolescent

Special Issue Information

Dear Colleagues,

Studying dietary patterns rather than specific foods or nutrients that make up the diet, takes into account the synergy of foods and nutrients, rendering the approach more relevant and effective to health research. The 2013 Global Burden of Disease Study identifies poor diet quality as the primary cause of premature death worldwide. Much more attention should be given to Diet Quality Indices (DQi) and the capacity they have to better reflect the complexity of nutrition and to improve our understanding of the global role of diet in contributing to chronic disease. Several studies have found that a better diet quality, as measured by a DQi, is associated with beneficial effects in cardiometabolic diseases (e.g., cardiovascular, diabetes, obesity, metabolic syndrome) and cognition. DQi are practical and tangible tools reflecting the overall effect of diet—one of the most important modifiable determinants of health. Moreover, they lend themselves well to the identification of effective messages for communications purposes, enable tracing of population trends, and comparison of disparities by socio-demographic characteristics. To do so well, however, DQi must be able to differentiate between healthy and unhealthy foods and to rigorously assess associations with health outcomes. To this end, more research is needed on DQIs, particularly in infant and adolescent populations.

Dr. Michel Lucas
Guest Editor

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Keywords

Diet quality Indices
Diet pattern
Cardiometabolic diseases
Aging
Infant and adolescent

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Published Papers (9 papers)

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Research

14 pages, 420 KiB

Open AccessArticle

Effects of Mediterranean Diet and Physical Activity on Pulmonary Function: A Cross-Sectional Analysis in the ILERVAS Project

by Liliana Gutiérrez-Carrasquilla, Enric Sánchez, Marta Hernández, Dinora Polanco, Jordi Salas-Salvadó, Àngels Betriu, Anna Michela Gaeta, Paola Carmona, Francesc Purroy, Reinald Pamplona, Cristina Farràs, Carolina López-Cano, Elvira Fernández and Albert Lecube

Nutrients 2019, 11(2), 329; https://doi.org/10.3390/nu11020329 - 3 Feb 2019

Cited by 24 | Viewed by 5322

Abstract

A few studies showed that both adherence to Mediterranean diet (MedDiet) and physical activity practice have a positive impact on pulmonary function in subjects with lung disease. These associations are not well studied in subjects free from lung disease. In a cross-sectional study conducted in 3020 middle-aged subjects free of lung disease, adherence to the MedDiet using the Mediterranean Diet Adherence Screener, and physical activity practice using the International Physical Activity Questionnaire short form were recorded. Respiratory function was assessed using forced spirometry and the results were evaluated according to the Global initiative for Chronic Obstructive Lung Disease. Logistic regression models were used to analyze the associations between adherence to the MedDiet and physical activity practice with the presence of ventilatory defects. Participants with a high adherence to MedDiet, in comparison to those with low adherence, had both higher forced vital capacity (FVC; 100 (87–109) vs. 94 (82–105) % of predicted, p = 0.003) and forced expired volume in the first second (FEV1; 100 (89–112) vs. 93 (80–107) % of predicted, p < 0.001). According to their degree of physical activity, those subjects with a high adherence also had both higher FVC (100 (88–107) vs. 94 (83–105) % of predicted, p = 0.027) and FEV1 (100 (89–110) vs. 95 (84–108) % of predicted, p = 0.047) in comparison with those with low adherence. The multivariable logistic regression models showed a significant and independent association between both low adherence to MedDiet and low physical activity practice, and the presence of altered pulmonary patterns, with differences between men and women. However, no joint effect between adherence to MedDiet and physical activity practice on respiratory function values was observed. Low adherence to MedDiet and low physical activity practice were independently associated with pulmonary impairment. Therefore, the lung mechanics seem to benefit from heart-healthy lifestyle behaviors. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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23 pages, 742 KiB

Open AccessArticle

Associations of Dietary Patterns and Metabolic-Hormone Profiles with Breast Cancer Risk: A Case-Control Study

by Beata Krusinska, Lidia Wadolowska, Malgorzata Anna Slowinska, Maciej Biernacki, Marek Drozdowski and Tomasz Chadzynski

Nutrients 2018, 10(12), 2013; https://doi.org/10.3390/nu10122013 - 19 Dec 2018

Cited by 17 | Viewed by 6098

Abstract

Breast cancer is the most diagnosed cancer in women worldwide. Studies regarding complex breast cancer aetiology are limited and the results are inconclusive. We investigated the associations between dietary patterns (DPs), metabolic-hormone profiles (M-HPs), and breast cancer risk. This case-control study involved 420 women aged 40–79 years from north-eastern Poland, including 190 newly-diagnosed breast cancer cases. The serum concentration of lipid components, glucose, and hormones (oestradiol, progesterone, testosterone, prolactin, cortisol, insulin) was marked in 129 post-menopausal women (82 controls, 47 cases). The food frequency consumption was collected using a validated 62-item food frequency questionnaire. A posteriori DPs or M-HPs were derived with a Principal Component Analysis (PCA). Three DPs: ‘Non-Healthy’, ‘Prudent’, and ‘Margarine and Sweetened Dairy’ and two M-HPs: ‘Metabolic-Syndrome’ and ‘High-Hormone’ were identified. The ‘Polish-adapted Mediterranean Diet’ (‘Polish-aMED’) score was calculated. The risk of breast cancer risk was three-times higher (odds ratio (OR): 2.90; 95% confidence interval (95% Cl): 1.62–5.21; p < 0.001) in the upper tertile of the ‘Non-Healthy’ pattern (reference: bottom tertile) and five-times higher (OR: 5.34; 95% Cl: 1.84–15.48; p < 0.01) in the upper tertile of the ‘High-Hormone’ profile (reference: bottom tertile). There was a positive association of ‘Metabolic-Syndrome’ profile and an inverse association of ‘Polish-aMED’ score with the risk of breast cancer, which disappeared after adjustment for confounders. No significant association between ‘Prudent’ or ‘Margarine and Sweetened Dairy’ DPs and cancer risk was revealed. Concluding, a pro-healthy diet is insufficient to reduce the risk of breast cancer in peri- and postmenopausal women. The findings highlight the harmful effect of the ‘High-Hormone’ profile and the ‘Non-Healthy’ dietary pattern on breast cancer risk. In breast cancer prevention, special attention should be paid to decreasing the adherence to the ‘Non-Healthy’ pattern by reducing the consumption of highly processed food and foods with a high content of sugar and animal fat. There is also a need to monitor the concentration of multiple sex hormones in the context of breast cancer risk. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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13 pages, 335 KiB

Open AccessArticle

Low Adherence to the Mediterranean Diet in Isolated Adolescents: The Mediation Effects of Stress

by Rosario Ferrer-Cascales, Natalia Albaladejo-Blázquez, Nicolás Ruiz-Robledillo, María Rubio-Aparicio, Ana Laguna-Pérez and Ana Zaragoza-Martí

Nutrients 2018, 10(12), 1894; https://doi.org/10.3390/nu10121894 - 3 Dec 2018

Cited by 18 | Viewed by 4739

Abstract

Loneliness perception during adolescence has been increased dramatically in recent years. Changes in lifestyle and difficulties in social interaction could explain this increased phenomenon. As described in previous research, this fact has been associated with the development of high stress levels and dysfunctional lifestyles, in which eating habits play a main role. In this regard, loneliness has been classically associated with poor eating habits, fundamentally the consumption of processed food with little nutritional value. However, the relationship between loneliness and healthy eating patterns, such as the Mediterranean Diet (MD), has not been previously analyzed. The main aim of the present study was to identify the relationship between perceived loneliness, stress, dietary habits, and adherence to the MD in a sample of 527 Spanish adolescents. The obtained results show a significant association between high perceived loneliness and high stress levels with lower MD adherence. Hence, adolescents with high perceived loneliness exhibit poor dietary habits in comparison to those counterparts with low perceived loneliness. Mediation analyses demonstrated an indirect effect of the loneliness on adherence to the MD through the mediation effect of stress. These findings point out a possible mechanism that underlies the classic association between loneliness and health deterioration, based on a poor adherence to a healthy dietary pattern, such as the MD. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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12 pages, 271 KiB

Open AccessArticle

The Dietary Inflammatory Index and All-Cause, Cardiovascular Disease, and Cancer Mortality in the Multiethnic Cohort Study

by Song-Yi Park, Minji Kang, Lynne R. Wilkens, Yurii B. Shvetsov, Brook E. Harmon, Nitin Shivappa, Michael D. Wirth, James R. Hébert, Christopher A. Haiman, Loïc Le Marchand and Carol J. Boushey

Nutrients 2018, 10(12), 1844; https://doi.org/10.3390/nu10121844 - 1 Dec 2018

Cited by 41 | Viewed by 4715

Abstract

Diet quality based on inflammatory potential, assessed by the Dietary Inflammatory Index (DII^®), has been related to mortality, but studies from racially/ethnically diverse populations are scarce. Using data from the Multiethnic Cohort Study in Hawaii and California, we investigated the association of the DII with all-cause, cardiovascular disease (CVD) and cancer mortality, both overall and by race/ethnicity. The analysis included 150,405 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 47,436 deaths during an average follow-up of 18.2 ± 4.9 years. In multivariable-adjusted Cox models, the hazard ratios (95% confidence intervals) for the highest vs. lowest quintile of the DII in men and women were 1.15 (1.09–1.21) and 1.22 (1.14–1.28) for all-cause, 1.13 (1.03–1.23) and 1.29 (1.17–1.42) for CVD, and 1.10 (1.00–1.21) and 1.13 (1.02–1.26) for cancer mortality. In men, an increased risk of all-cause mortality with higher DII scores was found in all racial/ethnic groups except for Native Hawaiians (P for heterogeneity < 0.001). Similarly, in women, an increased risk of CVD mortality was found in the four racial/ethnic groups, but not in Native Hawaiians. These findings support the association of a pro-inflammatory diet with a higher risk of mortality and suggest the association may vary by race/ethnicity. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

16 pages, 980 KiB

Open AccessArticle

Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention

by Ana Ojeda-Rodríguez, Itziar Zazpe, Lydia Morell-Azanza, María J. Chueca, Maria Cristina Azcona-sanjulian and Amelia Marti

Nutrients 2018, 10(10), 1500; https://doi.org/10.3390/nu10101500 - 13 Oct 2018

Cited by 84 | Viewed by 15931

Abstract

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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14 pages, 463 KiB

Open AccessArticle

Adherence to the Chinese or American Dietary Guidelines is Associated with a Lower Risk of Primary Liver Cancer in China: A Case-Control Study

by Pei-Yan Chen, Ai-Ping Fang, Xiao-Yan Wang, Qiu-Ye Lan, Gong-Cheng Liao, Zhao-Yan Liu, Dao-Ming Zhang, Yao-Yun Zhang, Yu-Ming Chen and Hui-Lian Zhu

Nutrients 2018, 10(8), 1113; https://doi.org/10.3390/nu10081113 - 17 Aug 2018

Cited by 23 | Viewed by 5441

Abstract

Adherence to healthy dietary guidelines has been related to a lower risk of several cancers, but its role in primary liver cancer (PLC) has not been fully investigated, especially among Eastern populations. This study enrolled 720 PLC patients and 720 healthy controls who were frequency-matched by age and sex between September 2013 and October 2017 in South China. Dietary quality was assessed by the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index 2015 (HEI-2015), which manifests as scores of adhering to the 2016 Dietary Guidelines for Chinese and adhering to the 2015–2020 Dietary Guidelines for Americans, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models, adjusting for potential confounders. Higher scores in both the CHEI and HEI-2015 were associated with a lower risk of PLC (per 5-points increment of the total scores: OR: 0.43, 95% CI: 0.38–0.50 for CHEI; OR: 0.47, 95% CI: 0.40–0.55 for HEI-2015). The protective associations persisted significantly in the stratified analyses by sex, smoker status, alcohol consumption, HBV infection, and histological types of PLC, without statistical evidence for heterogeneity (p-interaction > 0.05). Closer adherence to the most recent dietary guidelines for Chinese or Americans may protect against PLC. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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10 pages, 247 KiB

Open AccessFeature PaperArticle

Mediterranean Diet and Bladder Cancer Risk in Italy

by Francesca Bravi, Maria-Eleni Spei, Jerry Polesel, Matteo Di Maso, Maurizio Montella, Monica Ferraroni, Diego Serraino, Massimo Libra, Eva Negri, Carlo La Vecchia and Federica Turati

Nutrients 2018, 10(8), 1061; https://doi.org/10.3390/nu10081061 - 10 Aug 2018

Cited by 27 | Viewed by 7249

Abstract

Previous studies have reported that Mediterranean diet is inversely related to the risk of several neoplasms; however, limited epidemiological data are available for bladder cancer. Thus, we examined the association between Mediterranean diet and this neoplasm in an Italian multicentric case-control study consisting of 690 bladder cancer cases and 665 controls. We assessed the adherence to the Mediterranean diet via a Mediterranean Diet Score (MDS), which represents the major characteristics of the Mediterranean diet and ranges from 0 to 9 (from minimal to maximal adherence, respectively). We derived odds ratios (ORs) of bladder cancer according to the MDS score from multiple logistic regression models, allowing for major confounding factors. The ORs of bladder cancer were 0.72 (95% confidence interval, CI, 0.54–0.98) for MDS of 4–5 and 0.66 (95% CI, 0.47–0.93) for MDS of 6–9 (p for trend = 0.02) compared to MDS = 0–3. Results were similar in strata of sex, age, and education, while the risk appeared somewhat lower in never-smokers and patients with pT1–pT4 bladder carcinomas. Among individual components of the MDS, we observed inverse associations for greater consumption of legumes, vegetables, and fish. In our study, which was carried out on an Italian population, the higher adherence to the Mediterranean diet was related to a lower risk of bladder cancer. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

19 pages, 4033 KiB

Open AccessArticle

Personalized Nutrition—Genes, Diet, and Related Interactive Parameters as Predictors of Cancer in Multiethnic Colorectal Cancer Families

by S. Pamela K. Shiao, James Grayson, Amanda Lie and Chong Ho Yu

Nutrients 2018, 10(6), 795; https://doi.org/10.3390/nu10060795 - 20 Jun 2018

Cited by 26 | Viewed by 6839

Abstract

To personalize nutrition, the purpose of this study was to examine five key genes in the folate metabolism pathway, and dietary parameters and related interactive parameters as predictors of colorectal cancer (CRC) by measuring the healthy eating index (HEI) in multiethnic families. The five genes included methylenetetrahydrofolate reductase (MTHFR) 677 and 1298, methionine synthase (MTR) 2756, methionine synthase reductase (MTRR 66), and dihydrofolate reductase (DHFR) 19bp, and they were used to compute a total gene mutation score. We included 53 families, 53 CRC patients and 53 paired family friend members of diverse population groups in Southern California. We measured multidimensional data using the ensemble bootstrap forest method to identify variables of importance within domains of genetic, demographic, and dietary parameters to achieve dimension reduction. We then constructed predictive generalized regression (GR) modeling with a supervised machine learning validation procedure with the target variable (cancer status) being specified to validate the results to allow enhanced prediction and reproducibility. The results showed that the CRC group had increased total gene mutation scores compared to the family members (p < 0.05). Using the Akaike’s information criterion and Leave-One-Out cross validation GR methods, the HEI was interactive with thiamine (vitamin B1), which is a new finding for the literature. The natural food sources for thiamine include whole grains, legumes, and some meats and fish which HEI scoring included as part of healthy portions (versus limiting portions on salt, saturated fat and empty calories). Additional predictors included age, as well as gender and the interaction of MTHFR 677 with overweight status (measured by body mass index) in predicting CRC, with the cancer group having more men and overweight cases. The HEI score was significant when split at the median score of 77 into greater or less scores, confirmed through the machine-learning recursive tree method and predictive modeling, although an HEI score of greater than 80 is the US national standard set value for a good diet. The HEI and healthy eating are modifiable factors for healthy living in relation to dietary parameters and cancer prevention, and they can be used for personalized nutrition in the precision-based healthcare era. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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12 pages, 2103 KiB

Open AccessArticle

The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy

by Martina Barchitta, Andrea Maugeri, Annalisa Quattrocchi, Ottavia Agrifoglio, Aurora Scalisi and Antonella Agodi

Nutrients 2018, 10(4), 469; https://doi.org/10.3390/nu10040469 - 11 Apr 2018

Cited by 72 | Viewed by 13460

Abstract

Specific foods and nutrients help prevent the progression of persistent high-risk human papillomavirus (hrHPV) infection to cervical cancer (CC). The aim of this study was to investigate dietary patterns which may be associated with hrHPV status and the risk of high-grade cervical intraepithelial neoplasia (CIN2+). Overall, 539 eligible women, including 127 with CIN2+, were enrolled in a cross-sectional study, and tested for hrHPV infection. Food intake was estimated using a food frequency questionnaire. Logistic regression models were applied. Using the Mediterranean Diet Score, we demonstrated that, among 252 women with a normal cervical epithelium, medium adherence to the Mediterranean diet decreased the odds of hrHPV infection when compared to low adherence (adjOR = 0.40, 95%CI = 0.22–0.73). Using the principal component analysis, we also identified two dietary patterns which explained 14.31% of the variance in food groups intake. Women in the third and fourth quartiles of the “Western pattern” had higher odds of hrHPV infection when compared with first quartile (adjOR = 1.77, 95% CI = 1.04–3.54 and adjOR = 1.97, 95%CI = 1.14–4.18, respectively). Adjusting for hrHPV status and age, women in the third quartile of the “prudent pattern” had lower odds of CIN2+ when compared with those in the first quartile (OR = 0.50, 95%CI = 0.26–0.98). Our study is the first to demonstrate the association of dietary patterns with hrHPV infection and CC and discourages unhealthy habits in favour of a Mediterranean-like diet. Full article

(This article belongs to the Special Issue Diet Quality and Health Outcomes)

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