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Dietary fatty acid composition likely affects prediabetic conditions such as isolated impaired fasting glucose (IFG) or impaired glucose tolerance (IGT); however, this risk has not been evaluated in a large population nor has it been followed prospectively.
Design
Diet, physical activity, anthropometric, socio-economic and blood glucose data from the Atherosclerosis Risk in Communities (ARIC) study were obtained from BioLINCC. Cox proportional hazards regression models were used to evaluate associations of dietary SFA, MUFA, PUFA, n-3 fatty acid (FA) and n-6 FA intakes with incidence of one (isolated IFG) or two (IFG with IGT) prediabetic conditions at the end of 12-year follow-up.
Setting
Study volunteers were from counties in North Carolina, Mississippi, Minnesota and Maryland, USA.
Subjects
Data from 5288 volunteers who participated in the ARIC study were used for all analyses reported herein.
Results
The study population was 62% male and 84 % white, mean age 53·5 (sd 5·7) years and mean BMI 26·2 (sd 4·6) kg/m2. A moderately high intake of dietary MUFA (10–15 % of total daily energy) was associated with a 10 % reduced risk of isolated IFG incidence, while a high intake of n-3 FA (>0·15 % of total daily energy) was associated with a 10 % increase in risk. Curiously, moderately high intake of n-6 PUFA (4–5 % of total daily energy) was associated with a 12 % reduction in IFG and IGT incidence.
Conclusions
MUFA, n-3 and n-6 FA contribute differently to the development of isolated IFG v. IFG with IGT; and their mechanism may be more complex than originally proposed.
Abdominal obesity is associated with obesity-related health risks regardless of body weight. The present study aimed to determine whether alcohol drinking pattern is associated with abdominal obesity in normal-weight, middle-aged adults.
Design
Cross-sectional study using complex sampling design analyses.
Setting
The Korea National Health and Nutrition Examination Survey, which was conducted from 2008 to 2013.
Subjects
Normal-weight participants aged 40–69 years with BMI of 18·5–25·0 kg/m2 (n 11 289, 4491 men and 6798 women) were included. Abdominal obesity was defined as waist circumference ≥90 cm for men or ≥85 cm for women. Alcohol drinking pattern was assessed by self-report on questionnaires.
Results
Among 11 289 normal-weight participants, 7·9 % (n 379) of men and 7·6 % (n 609) of women had abdominal obesity. Both men and women who consumed a higher quantity of alcohol per drinking occasion had higher odds (OR; 95 % CI) for abdominal obesity compared with individuals who consumed fewer than 2 drinks (1·86; 1·04, 3·32 for ≥10 drinks/typical occasion in men; and 3·28; 1·13, 9·46 in women). Men who binge drink every day had higher odds for abdominal obesity (2·10; 1·21, 3·63). In both sexes, frequency of alcohol drinking was not associated with normal-weight abdominal obesity.
Conclusions
Our study showed that the amount of alcohol drinking per occasion influenced abdominal obesity in normal-weight, middle-aged individuals that may have impacted obesity-related health risks. Healthy alcohol drinking habits need to be controlled for prevention of abdominal obesity even among persons with normal weight.
The present research aimed to study the multidimensionality of the link between dietary intake and socio-economic position (SEP) in a representative sample of French children and adolescents, using a variety of SEP indicators.
Design
Data from the second French national food consumption survey (INCA2) were used. Information on food consumption was collected using a 7d food record and SEP data (occupation, education, income, household wealth indices) using questionnaires. Multivariable linear regression analyses were performed separately in children and adolescents to assess the relationships between dietary components (food groups and macronutrients) and each dimension of SEP.
Setting
The INCA2 survey, France.
Subjects
A representative sample of French children (3–10 years of age; n 574) and adolescents (11–17 years of age; n 881).
Results
Compared with children from a higher SEP, those from a lower SEP had lower intakes of fruit and vegetables, yoghurts and confectionery and higher intakes of starchy foods, meat, milk, sugar-sweetened beverages and pizzas/sandwiches. Similar results were observed in adolescents for fruit and vegetables, yoghurts and sugar-sweetened beverages. Adolescents also had lower intakes of cakes/pastries and higher intakes of processed meat and dairy desserts. Neither energy nor protein intake was associated with SEP. Adolescents from a lower SEP had higher carbohydrate and lower lipid intakes. Overall, these findings were consistent across the various dimensions of SEP, but the gradient was steeper depending on the caregiver’s educational level.
Conclusions
This research highlights the need for specific messages to help poorly educated families adopt good eating habits.
To determine the associations of sociodemographic characteristics, diet and outdoor activity as an indicator of sun exposure with serum 25-hydroxyvitamin D (25(OH)D) concentrations in children and their parents from Mesoamerica. We also quantified family aggregation of serum 25(OH)D.
Design
Cross-sectional study. Serum 25(OH)D concentrations were quantified using immunoassay. We compared the distribution of 25(OH)D concentrations in adults and children by levels of each correlate with the use of linear regression. Family aggregation was estimated using Pearson and intraclass correlation coefficients.
Setting
Capital cities of Guatemala, El Salvador, the Dominican Republic, Honduras, Nicaragua, Costa Rica, Panama and Belize, and Tuxtla Gutiérrez in Mexico.
Subjects
Children (n 223) aged 7–12 years and 492 parents.
Results
Mean (sd) 25(OH)D concentrations in adults and children were 81·3 (21·1) and 79·5 (18·1) nmol/l, respectively. Prevalence of vitamin D deficiency (VDD; 25(OH)D <50 nmol/l) was 3·9 % among adults and 3·6 % among children. In adults, adjusted mean 25(OH)D concentrations were highest in Nicaragua (P<0·0001). Serum 25(OH)D was positively related to time spent gardening (P=0·03). Among children, 25(OH)D concentrations were positively associated with male sex (P=0·005), dairy intake (P=0·03) and mother’s serum 25(OH)D concentrations (P<0·0001); and inversely associated with mother’s BMI (P=0·02) and number of home assets (P=0·04). Family membership explained 31 % of the variability in 25(OH)D concentrations; aggregation was highest between mothers and children.
Conclusions
VDD prevalence was low in this study. Sociodemographic characteristics, diet and outdoor activity predict serum 25(OH)D. Family aggregation of serum 25(OH)D is high between mothers and children.
To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.
Design
The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.
Setting
Selected urban and rural areas of Bangladesh.
Subjects
A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.
Results
A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.
Conclusions
Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women’s chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.
Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type.
Design
Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store.
Setting
Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA.
Subjects
Customers (n 661) from 105 food retailers.
Results
Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4.
Conclusions
Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.
We carried out de novo recruitment of a population-based cohort (MANOLIS study) and describe the specific population, which displays interesting characteristics in terms of diet and health in old age, through deep phenotyping.
Design
Cross-sectional study where anthropometric, biochemical and clinical measurements were taken in addition to interview-based completion of an extensive questionnaire on health and lifestyle parameters. Dietary patterns were derived through principal component analysis based on a validated FFQ.
Setting
Geographically isolated Mylopotamos villages on Mount Idi, Crete, Greece.
Subjects
Adults (n 1553).
Results
Mean age of the participants was 61·6 years and 55·8 % were women. Of the population, 82·7 % were overweight or obese with a significantly different prevalence between overweight men and women (43·4 v. 34·7 %, P=0·002). The majority (70·6 %) of participants were married, while a larger proportion of women were widowed than men (27·8 v. 3·5 %, P<0·001). Smoking was more prevalent in men (38·7 v. 8·2 %, P<0·001), as 88·8% of women had never smoked. Four dietary patterns emerged as characteristic of the population; these were termed ‘local’, ‘high fat and sugar, ‘Greek café/tavern’ and ‘olive oil, fruits and vegetables’. Individuals more adherent to the local dietary pattern presented higher blood glucose (β=4·026, P<0·001). Similarly, individuals with higher compliance with the Greek café/tavern pattern had higher waist-to-hip ratio (β=0·012, P<0·001), blood pressure (β=1·015, P=0·005) and cholesterol (β=5·398, P<0·001).
Conclusions
Profiling of the MANOLIS elderly population identifies unique unhealthy dietary patterns that are associated with cardiometabolic indices.
The present study aimed to examine the association between household income and the intake of foods and nutrients by Japanese schoolchildren, and any differences between days with and without school lunch.
Design
This was a cross-sectional study. Children, with the support of their parents, kept dietary records with photographs for 4 d (2 d with school lunch and 2 d without). The socio-economic status of each family was obtained from a questionnaire completed by the parents.
Setting
Japan.
Subjects
All students in 5th grade (10–11 years old) at nineteen schools in four prefectures and their parents (1447 pairs of students and parents) were invited to take part in the study; 836 pairs of complete data sets were analysed.
Results
The average results of four days of dietary records showed that lower income level was associated with a lower intake of fish/shellfish, green vegetables and sugar at the food group level, a lower intake of protein and several micronutrients, and a higher energy intake from carbohydrates at the nutrient level among the children. These associations between income and food/nutrient intake were not significant on days with school lunches, but were significant on days without school lunch.
Conclusions
Our study confirmed an association between household income and the amount of foods and nutrients consumed by Japanese schoolchildren, and suggested that school lunches play a role in reducing disparities in the diets of children from households with various incomes.
To investigate students’ tuck shop buying behaviour, choices of lunchbox items and healthy eating perceptions and attitudes at a school with a nutritionally regulated tuck shop and a school with a conventional tuck shop.
Design
Mixed-methods research comprising a cross-sectional survey and focus groups.
Setting
Bloemfontein, South Africa.
Subjects
Randomly selected grade 2 to 7 students from a school with a nutritionally regulated tuck shop (school A; n 116) and a school with a conventional tuck shop (school B; n 141) completed a self-administered questionnaire about perceptions, attitudes, buying behaviours and lunchbox content. Six students per grade (n 72) in each school took part in focus group discussions to further explore concepts pertaining to healthy eating.
Results
In school A, older students had a negative attitude towards their ‘healthy’ tuck shop, while younger students were more positive. School B students were positive towards their conventional tuck shop. In both schools students wanted their tuck shop to allow them to choose from healthy and unhealthy items. School A students mostly bought slushies, iced lollies and baked samoosas, while school B students mostly bought sweets and crisps. The lunchboxes of school A students contained significantly (P<0·05) more healthy items but also significantly more unhealthy items.
Conclusions
A single intervention such as having a nutritionally regulated tuck shop at a primary school cannot advance the healthy school food environment in its totality. A multi-pronged approach is recommended and awareness must be created among all role players, including parents who are responsible for preparing lunchboxes.
To assess vitamin D dietary sources, intake and 25-hydroxyvitamin D status and their association with individual and sociodemographic characteristics in Mexican children.
Design
Data obtained from 2695 children aged 1–11 years from the Mexican National Health and Nutrition Survey (2012) were analysed. Diet was assessed by a 141-item FFQ. 25-Hydroxyvitamin D was measured by a chemiluminescent assay.
Results
Mean vitamin D intake was 3·38 (se 0·09) µg/d (135·2 (se 3·6) IU/d) among pre-school children and 2·85 (se 0·06) µg/d (114·0 (se 2·4) IU/d) in school-age children. Milk accounted for 64·4 % of vitamin D intake in pre-school children and 54·7 % in school-age children. Vitamin D deficiency (serum 25-hydroxyvitamin D<50 nmol/l) was 25·9 % in pre-schoolers and 36·6 % in school-age children. Overweight/obese school-age children had a higher risk of vitamin D deficiency compared with normal-weight children (OR=2·23; 95 % CI 1·36, 3·66; P<0·05).
Conclusions
Vitamin D intakes are low in Mexican children, and milk is the main source of the vitamin. Vitamin D deficiency is common and associated with overweight in school-age children.
To test Koctürk’s model of dietary change among South-Asian Surinamese in the Netherlands. The model categorizes foods into staple, complementary and accessory foods and postulates that dietary change after migration begins with accessory foods while foods associated with ethnic identity (staple foods) change at a slower rate.
Design
Cross-sectional data from the HELIUS study. Dietary intake was assessed with an FFQ. Acculturation was based on social contacts and sense of belonging and was translated into four strategies of acculturation: assimilation, integration, separation and marginalization. Other indicators of acculturation included residence duration, age at migration and migration generation status.
Setting
Amsterdam, the Netherlands.
Subjects
Participants of Dutch (n 1456) and South-Asian Surinamese origin (n 968).
Results
Across all acculturation strategies, South-Asian Surinamese participants reported significantly higher intakes of rice (staple food) and chicken (complementary food) and significantly lower intakes of red meat and vegetables (complementary foods) and cookies and sweets (accessory food) than Dutch participants. Men, second-generation and assimilated South-Asian Surinamese were inclined towards Dutch foods such as potato, pasta and red meat. Accessory foods like fruits showed variation across acculturation strategies.
Conclusions
Consistent with the Koctürk model, the intake of staple foods was stable among South-Asian Surinamese irrespective of acculturation strategy while the intake of accessory foods like fruit varied. Contrary to expectations, South-Asian Surinamese showed consistently high intakes of complementary foods like chicken and fish irrespective of acculturation strategy. Public health practitioners should take into consideration the complex and dynamic nature of dietary acculturation.
The study aimed to investigate, for the first time, the association between diet quality (food variety and dietary diversity), intakes of anti-inflammatory nutrients and food groups, and subclinical inflammation as assessed by categories of high-sensitivity C-reactive protein (hs-CRP).
Design
Cross-sectional study.
Setting
Resource-poor, rural children in the Eastern Cape, South Africa.
Subjects
A sample size formula determined a representative sample of 235. Five schools were purposively selected and cluster sampling used to select 240 participants. Measurements included 24 h recall and dietary diversity questionnaires, anthropometric and biochemical measurements.
Results
The sample consisted of 50·4 % (n 118) girls and 49·6 % (n 116) boys. No obesity was found, but overweight was prevalent in 4·2 % of the children. The hs-CRP concentration (median (25th, 75th percentile)) of the low, medium and high risk inflammatory categories was 0·6 (0·4, 0·7), 1·6 (1·2, 2·2) and 4·2 (3·4, 6·4) mg/l, respectively. Body composition parameters did not differ between hs-CRP groups. Most of the anti-inflammatory nutrient intakes (dietary Fe, Zn, Mg, vitamin C, folate, linolenic acid, linoleic acid, MUFA and PUFA) differed significantly between the hs-CRP groups, with intakes increasing from low to high hs-CRP groups, with similar results for linolenic acid (P=0·022) intake. No significant relationships between hs-CRP and any of the food groups could be established, but significant relationships were established between hs-CRP levels and the high density of living arrangements and unhygienic ablution facilities.
Conclusions
Although no link could be established between overnutrition and hs-CRP levels, an association was found between hs-CRP and dietary quality, as well as socio-economic status.
To review articles on the relationship of dietary and circulating micronutrients with sleep patterns, and to identify issues surrounding implications for future research and public health practice.
Design
A systematic review was conducted. PubMed, Embase and Scopus were searched through January 2016.
Setting
Both experimental and observational studies were included. However, studies that focused on secondary sleep impairment due to comorbidities were excluded.
Subjects
Individuals in different age groups, from infants to older adults.
Results
A total of twenty-six articles were selected. In the articles reviewed, researchers generally supported a potential role of micronutrients, particularly Fe and Mg, in the development of sleep stages among infants and in reversing age-related alterations in sleep architecture in older adults. Micronutrient status has also been linked to sleep duration, with sleep duration positively associated with Fe, Zn and Mg levels, and negatively associated with Cu, K and vitamin B12 levels. The mechanisms underlying these relationships include the impact of micronutrients on excitatory/inhibitory neurotransmitters and the expression of circadian genes.
Conclusions
Although the number of studies on the relationship between micronutrient status and sleep remains low, evidence has emerged that suggests a link between dietary/circulating micronutrients and sleep. Future research is needed to investigate the dose-dependent as well as the longitudinal relationships between micronutrient levels and human sleep across populations, test the interactions among micronutrients on sleep outcomes, and ultimately examine the clinical relevance of micronutrients on sleep health.
The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality.
Design
The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries.
Setting
Sub-Saharan Africa with high diarrhoea mortality.
Subjects
Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)).
Results
Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF.
Conclusions
Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.
To determine whether a cardioprotective dietary intervention based on UK dietary guidelines was more expensive than a conventional UK diet.
Design
Cost analysis of food records collected at baseline and after a 12-week dietary intervention of a cardioprotective diet v. conventional UK diet.
Setting
A randomized controlled dietary intervention study (CRESSIDA; ISRCTN 92382106) investigating the impact of following a diet consistent with UK dietary guidelines on CVD risk.
Subjects
Participants were healthy UK residents aged 40–70 years. A sub-sample of participants was randomly selected from those who completed the cardioprotective dietary intervention (n 20) or the conventional UK dietary intervention (n 20).
Results
Baseline diet costs did not differ between groups; mean daily food cost for all participants was £6·12 (sd £1·83). The intervention diets were not more expensive: at end point the mean daily cost of the cardioprotective diet was £6·43 (sd £2·05) v. the control diet which was £6·53 (sd £1·53; P=0·86).
Conclusions
There was no evidence that consumption of a cardioprotective diet was more expensive than a conventional dietary pattern. Despite the perception that healthier foods are less affordable, these results suggest that cost may not be a barrier when modifying habitual intake and under tightly controlled trial conditions. The identification of specific food groups that may be a cost concern for individuals may be useful for tailoring interventions for CVD prevention for individuals and populations.
To investigate dietary intake, BMI and supermarket access at varying geographic scales and transport modes across areas of socio-economic disadvantage, and to evaluate the implementation of an urban planning policy that provides guidance on spatial access to supermarkets.
Design
Cross-sectional study used generalised estimating equations to investigate associations between supermarket density and proximity, vegetable and fruit intake and BMI at five geographic scales representing distances people travel to purchase food by varying transport modes. A stratified analysis by area-level disadvantage was conducted to detect optimal distances to supermarkets across socio-economic areas. Spatial distribution of supermarket and transport access was analysed using a geographic information system.
Setting
Melbourne, Australia.
Subjects
Adults (n 3128) from twelve local government areas (LGA) across Melbourne.
Results
Supermarket access was protective of BMI for participants in high disadvantaged areas within 800 m (P=0·040) and 1000 m (P=0·032) road network buffers around the household but not for participants in less disadvantaged areas. In urban growth area LGA, only 26 % of dwellings were within 1 km of a supermarket, far less than 80–90 % of dwellings suggested in the local urban planning policy. Low public transport access compounded disadvantage.
Conclusions
Rapid urbanisation is a global health challenge linked to increases in dietary risk factors and BMI. Our findings highlight the importance of identifying the most appropriate geographic scale to inform urban planning policy for optimal health outcomes across socio-economic strata. Urban planning policy implementation in disadvantaged areas within cities has potential for reducing health inequities.
The beneficial role of breast-feeding for maternal and child health is now well established. Its possible role in helping to prevent diabetes and obesity in children in later life means that more attention must be given to understanding how patterns of infant feeding are changing. The present study describes breast-feeding profiles and associated factors in Kuwait.
Design/Setting/Subjects
Interviews with 1484 recent mothers were undertaken at immunisation clinics across Kuwait. Descriptive analysis and binary logistic regression of results were performed.
Results
Rates of breast-feeding initiation in Kuwait were high (98·1 %) but by the time of discharge from hospital, only 36·5 % of mothers were fully breast-feeding, 37·0 % were partially breast-feeding and 26·5 % were already fully formula-feeding. Multiple social and health reasons were given for weaning the child, with 87·6 % of mothers who had stopped breast-feeding completely doing so within 3 months postpartum. Nationality (P<0·001), employment status 6 months prior to delivery (P<0·001), mode of delivery (P=0·01), sex of the child (P=0·026) and breast-feeding information given by nurses (P=0·026) were all found to be significantly associated with breast-feeding. Few women (5·6 %) got information on infant nutrition and feeding from nursing staff, but those who did were 2·54 times more likely to be still breast-feeding at discharge from hospital. Over 70 % of mothers had enjoyed breast-feeding and 74 % said they would be very likely to breast-feed again.
Conclusions
In Kuwait where the prevalence of both obesity and type 2 diabetes is growing rapidly, the public health role of breast-feeding must be recognised and acted upon more than it has in the past.
To determine if 7 d physical activity (PA) predicts energy intake over the same days and if PA on a given day predicts energy intake on the same day, the next day or subsequent days.
Design
A 7 d prospective investigation. PA was measured using accelerometers worn for seven consecutive days. During the same week, total energy intake (including alcohol) was assessed using weighed food records.
Setting
Twenty cities in the USA.
Subjects
Three hundred middle-aged women.
Results
After controlling for the covariates, energy intake was 36 (se 8) kJ higher for each additional 100000 activity counts (F=19·0, P<0·0001), based on the entire week of monitoring. Women with Low PA (n 75) had a mean energy intake of 8364 (sd 1235) kJ/d (1998 (sd 295) kcal/d), those with Moderate PA (n 150) consumed 8523 (sd 1264) kJ/d (2036 (sd 302) kcal/d) and those with High PA (n 75) consumed 9079 (sd 1473) kJ/d (2169 (sd 352) kcal/d; F=6·4, P=0·0019), a 5023 kJ/d (1200 kcal/d) difference between the High and Low PA groups. PA on a given day was predictive of energy consumption on the same day on four of the seven monitored days, and was predictive of energy intake the next day, with five of six associations significant. PA was not consistently predictive of energy intake on days beyond the next day.
Conclusions
Over 7 d, PA and energy consumption tend to be positively related. Considered day to day, increased PA is weakly associated with increased energy intake the following day and, to a lesser extent, the same day. Therefore, managing weight by increasing PA may not result in the energy deficit expected.
Our aim was to evaluate the relationship between adherence to different Dietary Approaches to Stop Hypertension (DASH) diet indices and the risk of depression.
Design
In a prospective study we assessed 14051 participants of a dynamic (permanently ongoing recruitment) prospective cohort (the Seguimiento Universidad de Navarra (SUN) Project), initially free of depression. At baseline, a validated FFQ was used to assess adherence to four previously proposed DASH indices (Dixon, Mellen, Fung and Günther). To define the outcome we applied two definitions of depression: a less conservative definition including only self-reported physician-diagnosed depression (410 incident cases) and a more conservative definition that required both clinical diagnosis of depression and use of antidepressants (113 incident cases). Cox regression and restricted cubic splines analyses were performed.
Results
After a median follow-up period of 8 years, the multiple-adjusted model showed an inverse association with the Fung DASH score (hazard ratio (HR)=0·76; 95 % CI 0·61, 0·94) when we used the less conservative definition of depression, and also under the more conservative definition (HR=0·63; 95 % CI 0·41, 0·95). We observed a weak inverse association with the Mellen DASH score, but no statistically significant association was found for the other definitions. The restricted cubic splines analyses suggested that these associations were non-linear (U-shaped).
Conclusions
Moderate adherence to the DASH diet as operationalized by Fung and Mellen was related to lower depression risk. Since these associations were non-linear, additional prospective studies are required before the results can be generalized and clinical recommendations can be given.
We aimed to identify sociodemographic, lifestyle and behavioural determinants of consumption of sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB) among adults in Cambridgeshire, UK.
Design
Cross-sectional data were obtained from a cohort of 9991 adults born between 1950 and 1975. An FFQ was used to assess consumption of beverages and other dietary factors. Multivariable logistic regression was used to examine potential determinants of consuming SSB and ASB (≥1 serving/d).
Setting
Recruitment from general practice surgeries to participate in the ongoing population-based Fenland Study.
Subjects
Adults (n 9991) aged 30–64 years from three areas of Cambridgeshire, UK.
Results
Prevalence estimates for daily SSB and ASB consumption were 20·4 % (n 2041) and 8·9 % (n 893), respectively. SSB consumption (OR; 95 % CI) was more common in men than women (1·33; CI 1·17, 1·50) and among those reporting lower income (<£20 000/year) than those reporting higher income (>£40 000/year; 1·31; 1·09, 1·58). In contrast, daily ASB consumption was more common among women than men (1·62; 1·34, 1·96), those on weight-loss diets than those who were not (2·58; 2·05, 3·24) and those reporting higher income than lower income (1·53; 1·16, 2·00). Factors associated with higher consumption of each of SSB and ASB included being a younger adult, being overweight/obese, having shorter education, eating meals or snack foods while watching television, and skipping breakfast (P<0·05 each).
Conclusions
Frequent consumers of SSB and ASB differ by several sociodemographic characteristics. However, increased BMI, younger age and unhealthy eating behaviours are common to both groups.