Changes in food habits and food-related satisfaction before and during the COVID-19 pandemic in dual-earner families with adolescents

Introduction: Food habits have been associated with positive outcomes during the COVID-19 pandemic. Family members may share protective factors, but each member may also respond differently to the pandemic. Aim: To examine food habits in different-sex dual-earner parents with adolescents, comparing reports from late 2019 before the pandemic (T1) and mid- 2020 during the pandemic (T2) in Temuco, Chile. Method: A sample of 193 families composed of mother, father, and one adolescent aged 10 to 15 responded to a questionnaire at T1 and T2. Non-parametric tests were used to compare family food-related habits and the satisfaction with food-related life of each family member at T1 and T2. An Actor-Partner Interdependence Model was conducted to explore relations between T1 and T2 variables and between family members. Results: Frequency of family meals increased during the pandemic, and mothers increased their cooking hours. All family members improved their diet quality during the pandemic. Perceived family meal atmosphere and satisfaction with food-related life did not change. T1 food habits were not associated with T2 satisfaction with food-related life. Conclusion: These families changed their food-related habits during the pandemic, but their food-related life assessment was similar before and during the pandemic.

Introducción: Las prácticas alimentarias se han asociado con mayor bienestar durante la pandemia por COVID-19. Aunque en una familia se comparten condiciones de vida, cada miembro puede responder de modo diferente a la pandemia. Objetivo: Examinar las prácticas alimentarias en parejas con doble ingreso e hijos adolescentes, comparando reportes antes de la pandemia (finales de 2019, T1) y durante la pandemia (mediados de 2020, T2) en Temuco, Chile. Método: 193 familias compuestas por madre, padre y un hijo adolescente de 10 a 15 años respondieron un cuestionario en T1 y T2. Se utilizaron pruebas no-paramétricas para comparar hábitos alimentarios y satisfacción con la alimentación para cada miembro de la familia en T1 y T2. Se exploraron las relaciones entre variables en T1 y T2, y entre miembros de la familia usando el modelo de interdependencia de actor-compañero. Resultados: La frecuencia de las comidas familiares y las horas que la madre dedicó diariamente a cocinar aumentaron durante la pandemia. Los tres miembros de la familia mejoraron la calidad de su dieta durante la pandemia. La atmósfera percibida de comidas familiares y la satisfacción con la alimentación no cambiaron. Los hábitos alimentarios del T1 no incidieron en la satisfacción con la alimentación en T2. Conclusión: Los hábitos alimenticios de estas familias cambiaron durante la pandemia, pero la evaluación de su vida alimentaria fue similar antes y durante la pandemia.

¿La Calidad De La Alimentación En Individuos Que Realizan Actividad Física Regular, Se Ve Afecta Por Conocimientos Y Prácticas Nutricionales?: Un Estudio Transversal

Antecedentes: Este estudio tuvo como objetivo determinar la relación entre la calidad de la dieta y el conocimiento sobre nutrición (CN) y las prácticas de nutrición (PN) de las personas que realizan actividad física (AF) con regularidad. Métodos: Se estudiaron 200 individuos sanos que acudían al gimnasio al menos tres veces por semana. La calidad de la dieta se calculó utilizando el Índice de Alimentación Saludable-2015 (HEI-2015). Se utilizaron modelos de regresión lineal múltiple para evaluar las asociaciones entre las puntuaciones de CN y PN y las variables de la dieta. Resultados: De los participantes, el 47,0 % tenía CN deficiente y el 48,0 % tenía PN pobre. Se determinó que las puntuaciones de PN se asociaron significativamente con los granos integrales, los mariscos y las proteínas a base de hierbas y la calidad total de la dieta (p0,05). Un aumento en una unidad en la puntuación CN resultó en un aumento del 26,7 % en el consumo de refrigerios ajustado por edad, sexo, nivel educativo, índice de masa corporal (IMC), tabaquismo, consumo de alcohol y actividad física (AF)(p<0,001). La evaluación del puntaje PN se relacionó con las comidas principales (β=0,065±0,013; IC 95% 0,04-0,09; p<0,001), consumo de refrigerios (β=0,029±0,014, IC 95% 0,01-0,06; p<0,05) y la calidad total de la dieta (β=0,894±0,329; IC95% 0,24-1,54; p<0,05). Además, alrededor del 17% de la variabilidad en la puntuación PN podría explicarse por las puntuaciones CN. Conclusiones: CN elevada se asoció con un aumento en las puntuaciones de PN e indirectamente con un aumento en la calidad de la dieta. Para ver los efectos beneficiosos de la AF en la salud, las personas deben apoyarse en una dieta saludable, aumentando su CN.

Background: This study aimed to determine the relationship between diet quality and nutrition knowledge (CN) and nutrition practices (NP) of people who perform physical activity (PA) regularly. Methods: Two hundred healthy individuals who attended the gym at least three times a week were studied. The quality of the diet is calculated using the Healthy Eating Index-2015 (HEI-2015). Linear regression models were used multiplex to assess associations between NC and PN scores and dietary variables. Results: Of the participants, 47.0% had poor NK and 48.0% were found to have poor NPs.It was determined that NP scores were significantly associated with whole grains, seafood, and herbal proteins and total diet quality (p0.05). A one-unit increase in the NK score resulted in a 26.7% increase in the consumption of snack meals adjusted for age, gender, educational level, body mass index(BMI), smoking status, alcohol consumption, and physical activity(PA)(p< 0.001). Assessment of the NP score was related to the main meals (β=0.065±0.013; 95%CI 0.04-0.09; p<0.001), consumption of snack meals (β=0.029±0.014, 95%CI 0.01-0.06; p<0.05), and total diet quality(β=0.894±0.329; 95%CI 0.24-1.54; p<0.05). Moreover, about 17% of the variability in the NP score could be explained by the NK scores. Conclusions: Elevated NK was associated with an increase in the NP scores and indirectly with an increase in diet quality. In order to see the beneficial effects of PA on health, individuals should be supported by a healthy diet, by increasing their NK.

Malaysian Healthy Diet Online Survey (MHDOS): Study rationale and methodology

@#Introduction: Access to accurate and timely dietary information is of paramount importance in evaluating and developing well-targeted public health nutrition interventions. However, nationwide nutrition surveys are conducted infrequently because they are very costly to design, conduct and analyse. Dietary assessment tools, which are quick and cost- effective, are needed for population research and regular monitoring of Malaysians’ dietary habits. This paper describes the rationale and methodology of the Malaysian Healthy Diet Online Survey (MHDOS) project, which aims to bridge this knowledge gap on dietary intake of Malaysian adults. The main objective of the two-year project is to develop MHDOS as a valid tool to measure compliance with the Malaysian Dietary Guidelines 2020. Methods: The MHDOS project has three study phases, namely (i) adaptation of an online survey and established diet quality scoring system for Malaysia, (ii) usability, validity and reliability testing of the online survey; and (iii) online survey administration in a nationwide study. The survey will be administered to approximately 10,000 Malaysian adults aged 18-59 years. Discussion: MHDOS consists of 38 questions that measures the quantity, quality and variety of foods consumed. Individuals will receive a diet quality score that reflects their overall compliance with the Malaysian Dietary Guidelines and feedback on how to improve their scores. The findings of the online survey, which serve to complement information between larger surveys, will be useful to measure compliance of Malaysians to national dietary guidelines and inform public health interventions.

Eating self-regulatory skill, diet quantity, and diet quality of Malaysian healthcare university students: A cross-sectional study

@#Introduction: The ability to self-regulate eating can improve health. This study aimed to determine the relationship between eating self-regulatory skills, diet quantity, and diet quality among Malaysian university students. Methods: This cross-sectional study involved 132 university students. Eating self-regulatory skill was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Dietary intakes from two 24-hour dietary recalls were used to assess diet quantity and quality. Diet quantity was measured as energy and macronutrient intakes, analysed using NutritionistPro. Diet quality was measured using the Malaysian Healthy Eating Index (M-HEI). The relationship between eating self-regulatory skills, diet quantity, and diet quality were evaluated using tests for differences between means and multiple linear regression. Results: Male participants (n=47) consumed more energy than female participants (n=85) (Male: 1850±570 kcal/day, Female: 1596±567 kcal/day, p=0.015). Participants from the Nutrition and Dietetics (N&D) course (n=49) had better M-HEI scores than participants from other health courses (n=83) (N&D course: 52.7±10.5, non-N&D course: 47.2±10.7, p=0.005). The predictors of energy intake were gender (β=-0.193, p=0.023) and SREBQ score (β=- 0.223, p=0.009). Being female and having higher eating self-regulatory skills were associated with lower energy intake. The predictors of diet quality were university course (β=0.240, p=0.005) and SREBQ score (β=0.181, p=0.033). Studying N&D and having higher eating self-regulatory skills were associated with higher M-HEI scores. Conclusion: Higher self-regulation of eating behaviour score is a factor that contributes to lower daily energy intake and higher diet quality score.

Factors Associated with Diet Quality during COVID-19 Pandemic among Undergraduate Students in Universiti Putra Malaysia

@#Introduction: The COVID-19 preventive and restriction measures may disrupt an individual’s daily diet quality, potentially leading to obesity and other non-communicable diseases. This study aims to assess and determine factors associated with diet quality during the COVID-19 pandemic among undergraduate students at Universiti Putra Malaysia. Methods: 130 eligible undergraduate students, who participated in this cross-sectional study were assessed using Global Physical Activity Questionnaire (GPAQ), Depression, Anxiety, Stress Scale (DASS-21), and Rapid Eating Assessment for Participants short version (REAP-S). Self-reported sociodemographic characteristics, body weight status, and nutrition knowledge were evaluated. Statistical analysis was conducted using IBM SPSS 26.0 and p<0.05 was denoted as statistically significant. Results: Most of the respondents were female (76.2%), aged between 20-22 years old (64.6%), Bumiputera (80.0%), funded by loan or scholarship (73.1%), low socioeconomic status (60.0%), residing in the family household (57.7%), consumed home-cooked meals (58.5%), and used the e-hailing food services for 0-3 days/week (63.1%). There was an equal distribution in the year and program of study in every selected faculty. Most were having normal BMI status (54.6%), good nutrition knowledge (66.9%), sedentary (48.5%), less severe mental health status (85.4%), and good diet quality (62.3%). Nonetheless, throughout the study, only the anxiety subscale was associated with diet quality (r= -0.20, p<0.05). Conclusion: Perceived anxiety may lead to poor diet quality. Future studies could determine the food environment and food security faced by the students as these factors vary among individuals. It is also recommended to measure diet quality differences before, during, or after the pandemic.

Prevalence of Mental Health Problems Among University Students and Association With Body Mass Index (BMI) and Diet Quality

@#Introduction: Numerous factors contributed to the susceptibility of university students to develop mental health issues. Objective: This study aimed to assess the prevalence of mental health problems among International Islamic University Malaysia (IIUM) students and their relationships with diet quality and body mass index (BMI). Methods: A cross-sectional study was conducted among 104 students. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess students’ depression, anxiety, and stress levels. The Malaysian Healthy Eating Index (M-HEI) was used to assess diet quality. Spearman Rho was used to determine the relationships between variables. Results: Approximately 69.4% (n = 34), 71.4% (n = 35), and 48.9% (n = 34) of male students experienced moderate to extremely severe symptoms of depression, anxiety, and stress, respectively. In contrast, 85.4% (n = 47), 89.1% (n = 49), and 54.6% (n = 30) of female students had moderate to extremely severe symptoms of depression, anxiety, and stress, respectively. No correlations were found between diet quality and BMI with students’ mental health problems. For male students, there were negative significant associations reported between fat-rich foods (r = -0.447, p-value = 0.001) and sugar-rich foods (r = -0.332, p-value = 0.020) intake with depression; a positive significant relationship between fruit intake and anxiety (r = 0.284, p-value = 0.048); a positive relationship between fruit intake and stress (r = 0.300, p-value = 0.036); and a negative relationship between fat-rich foods and stress (r = -0.293, p-value = 0.041). Female students only had a significant negative correlation between fish intake and anxiety (r = -0.376, p-value = 0.005). Conclusion: No associations were found between diet quality, BMI, and mental health problems. A more profound comprehension of the connections between risk factors and mental health could lead to new intervention strategies.

Association between dietary quality and perceived stress based on the CHNS database / 公共卫生与预防医学

Objective To explore the association between dietary quality and perceived stress among adult Chinese. Methods The China Health and Nutrition Survey (CHNS) was used to investigate the association between dietary quality and perceived stress in Chinese adults. The Chinese Perceived Stress Scale (CPSS) was used to assess the perceived stress in Chinese adults. Binary logistic regression models were utilized to explore the relationship between diet quality and perceived stress. Restricted cubic splines (RCS) were utilized to clarify the dose response relationship between diet quality and perceived stress. Results Binary logistic regression models revealed that adults with CHEI score ranged from P25 to P50 and higher than P75 had 15.1% (OR=0.849，95%CI：0.738-0.977) and 23.0% (OR=0.770，95%CI：0.666-0.891) reduced risk of high perceived stress after multivariable adjustment when compared with adults with CHEI score less than P25. RCS results showed that the OR value of high perceived stress risk decreased gradually with increasing CHEI score in the overall population, but this association was not statistically significant in adults with lower CHEI score. Conclusion High dietary quality is associated with a reduced risk of high perceived stress. This study provides a theoretical reference for the health effects of high dietary quality on high perceived stress risk reduction.

Determinants of diet quality among mothers of young children in an urban slum area in Jakarta: Mother’s age, vegetables availability, and eating out frequency

@#Introduction: Poor diet quality is a major issue, and health concerns may be related to diet. Mothers with young children usually have their meals at home; thus, home food environment plays a role in determining dietary behaviours. This study examined the association between health concerns and diet quality among mothers; additionally, the effect of home food environment on this relationship was assessed. Methods: This cross-sectional study comprising 229 mothers (aged 19–49 years) with young children was conducted in an urban slum area in North Jakarta. Data were collected via interviews using a structured questionnaire. The General Health Interest Scale and Consumer Behaviour Questionnaire were used to assess health concern and home food environment, respectively. The 24-hour dietary recall method was used to calculate the Diet Quality Index-International (DQI-I) score. Spearman’s correlation, multiple linear regression, and path analysis were used to analyse the data. Results: Majority of the mothers had poor diet quality (mean DQI-I score, 41.44/100). No significant correlation between health concern and diet quality was observed. After adjusting for age, the relationship between health concern and diet quality was not mediated by vegetables availability or eating out frequency (indirect effect=0.012; p=0.096). Multiple linear regression analysis revealed age as a significant predictor of diet quality (B=0.196; p=0.024). Conclusion: Diet quality among mothers of young children differed with age and was related to both health concerns and home food environment. Thus, the development of strategies to promote healthy eating based on different age groups is warranted.

¿Cómo comen los argentinos? Consumos, brechas y calidad de dieta / How do argentines eat? Consumption, gaps and diet quality

Resumen El objetivo del trabajo fue analizar los consumos alimentarios de la población argentina, identificar sus principales brechas alimentarias, determinar su magnitud e intensidad y analizar la calidad de dieta resultante. Se trabajó con la base de datos de la Encuesta Nacional de Gastos de los Hogares (ENGHo) 2017/2018. Se extrajeron y analizaron registros de compras de 383 alimentos y bebidas; los consumos se expresaron en energía y nutrientes (tabla SARA) y se calcularon medidas de Índice de Densidad de Nutrientes (IDN) y brechas alimentarias con relación a las recomendaciones de una dieta saludable (brecha promedio, magnitud de hogares con brechas e intensidad de la brecha). El patrón alimentario hallado refleja consumos bajos en alimentos protectores y preventivos de enfermedades crónicas y monotonía de la dieta. Las brechas reflejan déficits (promedio 60%) en hortalizas no feculentas, frutas, legumbres, granos y cereales integrales y leche, yogur y quesos. Harinas y otros productos feculentos, alimentos ocasionales y carnes registran brechas excedentarias en hogares de todos los niveles de ingreso, excepto el 1° quintil en carnes y en alimentos ocasionales. Solo 11% de los hogares presenta una calidad de dieta alta. Todos los resultados hallados son peores en los quintiles de ingresos más bajos y en hogares con presencia de niños, niñas y adolescentes. Las principales conclusiones se refieren a la monotonía alimentaria, las amplias brechas, su magnitud e intensidad en los alimentos de mejor densidad nutricional y su expresión en una calidad de dieta apenas intermedia. El exceso y desequilibrio en la ingesta de alimentos fuente de hidratos de carbono, con un balance desfavorable hacia legumbres, granos y cereales integrales, así como el exceso de alimentos ocasionales y la necesidad de disminuir los altos consumos de carnes en amplios sectores de la población.

Abstract The objective of this research was to analyze the food consumption of the Argentine population, identify its main food gaps, determine its magnitude and intensity and analyze the resulting quality of diet. We analyzed the database of the National Household Expenditure Survey (ENGHo) 2017/2018. Purchase records of 383 food and beverages were extracted and analyzed; consumptions were expressed in energy and nutrients (SARA table) and Nutrient Density (IDN) measures and food gaps were calculated in relation to the recommendations of a healthy diet (average gap, magnitude of households with gaps and intensity of the gap). The dietary pattern found reflects low intakes of protective and preventive foods for chronic diseases and monotony of the diet. The gaps reflect deficits (average 60% ) in non-starchy vegetables, fruits, legumes, grains and whole grains, milk, yogurt and cheeses. Flour and other starchy products, occasional foods and meats register surplus gaps in households of all income levels, except for the 1st quintile in meats and occasional foods. Only 11% of households have a high quality of diet. All the results found are worse in the lowest income quintiles and in households with children and adolescents. The main conclusions refer to food monotony, wide gaps, its magnitude and intensity in foods with the best nutritional density and its expression in a barely intermediate quality of diet. The excess and imbalance in the intake of carbohydrates source foods, with an unfavourable balance towards legumes, grains and whole grains, as well as the excess of occasional foods and the need to reduce the high consumption of meat in large sectors of the population.

Effects of nutrition education given to persons with multiple sclerosis and their families on diet quality and anthropometric and biochemical measurements / Efeito da educação nutricional dada a pessoas com esclerose múltipla e suas famílias em relação a qualidade da dieta, medidas antropométricas e bioquímicas

ABSTRACT Objective: In this study, it was aimed to investigate the effects of nutrition education given to persons with multiple sclerosis and their families on anthropometric and biochemical measurements and diet quality. Methods: Data from 51 persons with multiple sclerosis were analysed in this intervention study. The study was conducted with 3 groups. The education group consisted of only persons with multiple sclerosis, the family education group consisted of persons with multiple sclerosis and a family member living with them, and the control group consisted of persons with multiple sclerosis who had not received an education. Anthropometric and biochemical measurements and dietary quality assessments were made before (T1) and immediately after education (T2) and also 3 months after education (follow-up, T3). Results: The distribution of family education group diet quality scores showed a significant increase from "poor" to "needs improvement" at T3 compared to T1. The upper middle arm circumference measurements of the female control group were decreased at T2 and T3 [from 29.0 (23-34) cm to 28.0 (22-31) cm and to 27.5 (22-31) cm]. Women in family education group, levels of serum haemoglobin and haematocrit were higher than in control group at T2 and T3. Also, men in family education group, levels of alanine aminotransferase were lower than those in education group at follow up. Levels of total cholesterol and low-density lipoprotein cholesterol in education group were higher than those control group at T1, T2, and T3. Conclusion: This study indicates that nutrition education affects some biochemical and anthropometric measurements in persons with multiple sclerosis. Diet quality improved when receiving education together with families.

RESUMO Objetivo: Objetivou-se investigar os efeitos da educação nutricional dada a pessoas com esclerose múltipla e seus familiares, avaliação de medidas antropométricas, bioquímicas e da qualidade da dieta. Métodos: Dados de 51 participantes com esclerose múltipla foram analisados neste estudo de intervenção. O estudo foi dividido em 3 grupos, sendo o primeiro composto por indivíduos que obtiveram educação nutricional, o segundo, composto por indivíduos mais um membro da família que morava com eles e obtiveram educação nutricional, e o terceiro, grupo controle, composto por indivíduos que não obtiveram educação nutricional. Medidas antropométricas, bioquímicas e avaliações da qualidade da dieta foram feitas antes (T1) imediatamente após a educação nutricional (T2) e também 3 meses após a educação nutricional (T3). Resultados: A distribuição dos escores de qualidade da dieta do grupo de educação familiar mostrou um aumento significativo de "ruim" para "precisa melhorar" no T3 em comparação ao T1. As medidas da circunferência do braço médio do grupo controle feminino foram menores em T2 e T3 [de 29,0 (23-34) cm para 28,0 (22-31) cm e para 27,5 (22-31) cm]. Nas mulheres do grupo família, os níveis séricos de hemoglobina e hematocrito foram maiores do que no grupo controle em T2 e T3. Também nos homens do grupo família, os níveis de alanina aminotransferasa foram mais baixos do que os do grupo educação no seguimento. Os níveis de CT e LDL-C no grupo educação foram superiores aos do grupo controle em T1, T2 e T3. Conclusão: Este estudo observou que a educação nutricional afeta algumas medidas bioquímicas antropométricas em pessoas com esclerose múltipla. A qualidade da dieta melhorou quando recebeu educação junto com as famílias.

Evaluation on the dietary quality of patients with Type 2 diabetes mellitus in the community by adjusted Chinese diet balance index / 中华健康管理学杂志

Objective:To evaluate the diet quality of patients with Type 2 diabetes mellitus (T2DM) in the community with the Chinese Dietary Balance Index (DBI-16) and to provide a scientific basis for nutrition education.Methods:A random cluster sampling method was adopted to conduct a questionnaire survey of 332 T2DM patients in a community of Bengbu City to obtain demographic sociology and dietary intake information. DBI-16 was used to score and evaluate dietary structure and diet quality.Results:There are low-level under-intake (low bound score =14.0) and excessive intake (high bound score =14.0) in the diet of this population. The degree of excessive intake of men (high bound score =15.0) was higher than that of women (high bound score=13.0) ( Z=-3.12, P<0.01), and the degree of insufficient diet (low bound score =13.0) was lower than that of women (low bound score=15.5)( Z=-2.05, P<0.05). Those with monthly income<1 000 (low bound score =15.5) patients ( χ2 =6.34, P<0.05) and disease course>10 years (low bound score =16.0) had the highest degree of insufficient dietary intake ( χ2 =9.40, P<0.01). Those who did not participate in community health education lectures had significantly higher dietary intake (low bound score =15.0) and imbalance (diet quality distance= 29.0) than those who participated in community health education (low bound score=13.0)(diet quality distance=27.0)( Z=-2.46, P<0.01). According to the score distribution of the DBI-16 index, 73.6% of patients had a severe over-intake of cereals, and only 27.4% and 27.7% had intake of vegetables, fruits, and milk beans that reached the recommended intake. The dietary pattern mainly reflects the existence of a certain degree of excessive dietary intake pattern D. Conclusion:The dietary quality of T2DM patients in Bengbu′s community is in a state of low imbalance. Insufficient and excessive dietary intake coexist and urgently need to be improved.

Case-control study on relationship between diet quality and thyroid nodules / 环境与职业医学

Background Both domestic and foreign studies on the diet quality of patients with thyroid nodules are rare at present, and the relationship between thyroid nodules and diet quality is still unclear. Objective This study aims to evaluate the diet quality of thyroid nodules with the China Healthy Diet Index (CHDI) and to explore the relationship between diet quality and thyroid nodules. Methods We conducted a hospital-based case-control study in which 387 patients with thyroid nodules were matched individually (1∶1) by gender and age (±3 years) to the controls who ordered a routine physical examine and with negative thyroid nodules reported by B-ultrasound in the same hospital. A structured questionnaire was applied to collect data on general characteristics and diet. CHDI was employed to evaluate the diet quality of the two groups. CHDI is based on the Dietary Guidelines for Chinese Residents and the recommended food intake in the balanced diet pagoda, combined with the dietary nutritional status of Chinese population. The index contains 13 scoring components, and the highest total score is 100, with a higher score representing better dietary quality. CHDI scores < 60, 60-<80, and ≥80 are recognized as unqualified, qualified, and good diet quality, respectively. Results The scores of the thyroid nodule cases were lower than the scores of the controls in total vegetables, dark vegetables, fruits, and fish/shrimps (all Ps<0.05). The nonparametric test results found that there were significant differences in the distributions of scores in total vegetables, dark vegetables, fruits, soybeans, and fish/shrimps between the case and the control groups (all Ps<0.05). The percentages reaching the full scores in food variety, meat and eggs, and empty calories in both groups exceeded 60%, while the percentages reaching the full scores in whole grains/beans/tubers, dairy, soybeans, and sodium were lower than 30% in the two groups. The median CHDI scores of the thyroid nodule cases and the controls were 69.1 and 72.9, respectively; the cases' CHDI score was lower than the controls' (P<0.05). The proportions of unqualified diet in the case and the control groups accounted for 23.0% and 13.7% respectively (P=0.001). After being adjusted for education level, marital status, occupation, monthly household income per capita, body mass index, hypertension/diabetes, energy, and iodine intake, the results of logistic regression analysis showed that the risk for thyroid nodules was negatively associated with CHDI score (CHDI qualified group vs. CHDI unqualified group, OR=0.484, 95%CI: 0.291-0.804; CHDI good dietary quality group vs. CHDI unqualified group, OR=0.414, 95%CI: 0.230−0.746). Conclusion The diet quality of patients with thyroid nodules is lower than that of the control group, as the former reported lower consumptions of total vegetables, dark vegetables, fruits, and fish/shrimps. Those who have good or qualified diet quality show a reduced risk of thyroid nodules than those with unqualified dietary quality.

Case-control study on relationship between diet quality and papillary thyroid carcinoma / 环境与职业医学

Background There are few studies on the diet quality of patients with thyroid cancer, and the relationship between diet quality and thyroid cancer remains uncertain. Objective This study aims to assess the diet quality with the Chinese Health Diet Index (CHDI) and to explore the relationship between diet quality and papillary thyroid carcinoma (PTC). Methods A 1∶1 gender- and age-matched hospital-based case-control study included newly diagnosed PTC patients and matched controls from Shanghai Cancer Hospital and Renji Hospital (East) in Shanghai, China. A structured questionnaire was applied to collect data on general characteristics, history of diseases, dietary intakes, and lifestyles. Food intakes in the past one year were assessed using a validated food frequency questionnaire, from which the CHDI score was calculated. The CHDI, according to the Dietary Guidelines for Chinese Residents, was employed to evaluate the diet quality of the two groups. A multiple conditional logistic regression model was conducted to explore the relationship between diet quality and PTC. Results A total of 350 pairs of cases and controls were recruited. The overall median CHDI score of the cases was lower than that of the controls (67.8 vs. 73.4, P<0.001). The cases had lower median scores of fruits (6.8 vs. 9.5), dairy products (3.6 vs. 5.6), and soybeans (4.6 vs. 5.5) than the controls (P<0.05); the cases had a higher median score of refined grains than the controls (5.0 vs. 4.9), and the percentage of the cases that met diet recommendations for refined grains was higher than the percentage of the controls (65.4% vs. 48.6%) (P<0.05); the cases showed lower median scores of whole grains/beans/tubers, total vegetables, dark vegetables, and fish/shrimps (0.9 vs. 1.4, 3.1 vs. 4.4, 3.6 vs. 5.0, and 3.3 vs. 4.0, respectively), and the percentages of the cases meeting their diet recommendations were lower than the percentages of the controls (6.3% vs. 8.6%, 32.6% vs. 42.0%, 38.6% vs. 50.6%, and 34.0% vs. 40.3%, respectively, P<0.05). The results of multiple conditional logistic regression analysis suggested that qualified and good diet quality were associated with a reduced the risk of PTC (qualified diet quality, OR=0.37, 95%CI: 0.23−0.62; good diet quality, OR=0.19, 95%CI: 0.10−0.36); the statistical significance remained after excluding patients who had a history of benign thyroid conditions (qualified diet quality, OR=0.28, 95%CI: 0.15−0.52; good diet quality, OR=0.20, 95%CI: 0.09−0.43). Conclusion Those with qualified or good diet quality have a lower risk of PTC. PTC patients have insufficient intakes of fruits, dairy, soybeans, whole grains/beans/tubers, vegetables, and fish/shrimps.

Evolução do consumo de nutrientes e de alimentos segundo a classificação NOVA em frequentadores de serviço de promoção da saúde da atenção primária / Evolution of nutrient and food consumption according to the NOVA classification among users of health promotion service in primary health care

INTRODUÇÃO: Consumir alimentos in natura, minimamente processados e preparações culinárias (PC), em detrimento aos ultraprocessados (AUP), pode melhorar o perfil nutricional da dieta e reduzir o risco de desenvolvimento de doenças crônicas não transmissíveis (DCNT). OBJETIVO: Avaliar a evolução do consumo de nutrientes e de alimentos, segundo a classificação NOVA, após intervenção coletiva de incentivo ao consumo de frutas e hortaliças (FH) em usuários do Programa Academia da Saúde (PAS) de Belo Horizonte, Minas Gerais. MÉTODOS: Foram desenvolvidos três artigos com dados oriundos de ensaio comunitário controlado e randomizado (ECCR), conduzido entre 2013 ­ 2015, com amostra representativa das unidades do PAS de Belo Horizonte, sendo 9 unidades pertencentes ao Grupo Controle (GC) e 9 ao Grupo Intervenção (GI). Indivíduos alocados no GC participaram das atividades rotineiras do serviço de saúde (prática regular de exercícios físicos três vezes/semana) e aqueles do GI adicionalmente receberam, durante sete meses, intervenção de incentivo ao consumo de FH, pautada no Modelo Transteórico e na pedagogia dialógica e problematizadora de Paulo Freire. Artigo 1: Estudo transversal realizado com dados da linha de base do ECCR que objetivou analisar o consumo de AUP segundo fatores sociodemográficos, e sua associação com o perfil nutricional da dieta. O perfil nutricional da dieta foi analisado segundo os quintis de contribuição percentual de energia oriunda de AUP mediante análises de associação e de Regressão Linear referente ao consumo de energia total, densidade energética, carboidratos, fibras, proteínas, gorduras totais e subgrupos de gorduras: saturada, monoinsaturada, poli-insaturada, trans, ômega 3 e ômega 6, vitaminas A, B3, B6, B12, Folato e C; e os minerais cálcio, ferro, fósforo, magnésio, potássio e sódio. Além disso, avaliou-se o percentual de inadequação do consumo de nutrientes recomendados para prevenção de DCNT e do consumo de vitaminas por Regressão de Poisson. Artigo 2: ECCR que objetivou verificar a efetividade de intervenção coletiva de incentivo ao consumo de FH sobre o consumo de alimentos, segundo a classificação NOVA, em frequentadores de serviço de promoção da saúde da Atenção Primária em Saúde (APS) brasileira. Os desfechos analisados foram consumo de PC, de alimentos processados (AP) e de AUP por meio de análises de associação e de comparação entre GC e GI, e Equações de Estimações Generalizadas (GEE). Artigo 3: ECCR que objetivou verificar a efetividade de intervenção coletiva de incentivo ao consumo de FH sobre a adequação do consumo de nutrientes, especialmente aqueles voltados para prevenção de DCNT, em frequentadores de serviço de promoção da saúde da APS brasileira. Também foram utilizadas análises de associação e GEE entre os grupos GI e GC. Os nutrientes analisados foram: energia total, carboidratos, fibras, proteínas, gorduras totais e subgrupos de gorduras: saturada, monoinsaturada, poli-insaturada, trans, ômega 3 e ômega 6, vitaminas A, B1, B2, B3, B6, B12, Folato, C, D, E; e os minerais cálcio, ferro, fósforo, magnésio, manganês, potássio, selênio, sódio e zinco. RESULTADOS - Artigo 1: O consumo de AUP contribuiu com 27,7% da energia total da dieta. O seu maior consumo associou a maiores valores de ingestão de energia, densidade de energia, gorduras totais e sódio; e menores de proteínas, gorduras monoinsaturadas, ômega 3 e algumas vitaminas e minerais. A prevalência de inadequação de nutrientes para prevenção de DCNT variou entre 30% e 100% entre o menor e maior quintil de consumo de AUP. Artigo 2: Após 12 meses de acompanhamento, observou-se entre os indivíduos do GI e do GC, aumento no consumo de PC e redução de AUP; além de aumento no consumo de AP entre os indivíduos do GC. Foi observado que a intervenção nutricional contribuiu para redução do consumo de AP para indivíduos alocados no primeiro quartil (RR: 0.861; CI: 0.749; 0.988) e aumento para aqueles alocados no segundo quartil de consumo de AP (RR: 1.145; CI: 1.041; 1.259). Também foi observada relação entre participação na intervenção nutricional e aumento do consumo de AUP para indivíduos alocados no terceiro quartil de consumo de AUP (RR: 1,062; CI: 1,005; 1,122). Artigo 3: Participantes dos grupos GC e GI, após 12 meses, apresentaram redução no consumo de energia, ômega 6 e sódio; e aumento de carboidratos, fibras, vitaminas A, B1, B2, B3, B6, B12, C, D e E, folato, cálcio, magnésio, potássio, selênio, manganês, zinco e ferro. Indivíduos do GC relataram ainda aumento do consumo de fósforo; e aqueles do GI, redução do consumo de gorduras totais, saturadas e poli-insaturadas; e aumento de monoinsaturadas. Em ambos os grupos, observou-se aumento na prevalência de adequação de nutrientes para prevenção de DCNT, exceto para gorduras trans. A participação na intervenção nutricional mostrou relação inversa com o consumo de energia (RR: 0,979; CI: 0,960; 0,999) e proteínas (RR: 0,978; CI: 0,959; 0,997) da dieta, mas não aumentou a chance de adequação dos demais nutrientes, incluindo aqueles voltados para prevenção de DCNT. CONCLUSÃO: Os resultados apontaram para a importância do PAS, um serviço de promoção da saúde do Sistema Único de Saúde, para a promoção da alimentação adequada e saudável, e prevenção das DCNT. A condução de intervenção coletiva de incentivo ao consumo de FH apresentou poucos resultados adicionais, evidenciando a necessidade de se realizar abordagens específicas relativas à classificação NOVA de alimentos visando alcançar melhores resultados.

INTRODUCTION: Consuming fresh, minimally processed foods and culinary preparations (CP), in detriment to ultra-processed foods (UPF), can improve the nutritional profile of the diet and reduce the risk of developing chronic non-communicable diseases (NCD). OBJECTIVE: Evaluating the evolution of nutrient and food consumption, according to the NOVA classification, after conducting a collective intervention to encourage the consumption of fruits and vegetables (FV) among users of the Health Academy Program (Programa Academia da Saúde - PAS) in Belo Horizonte, Minas Gerais. METHODS: Three articles were developed with data from a randomized controlled community trial (ECCR), conducted between 2013 and 2015, with a representative sample of the PAS units in Belo Horizonte, with 9 units belonging to the Control Group (CG) and 9 to the Intervention Group (IG). Individuals allocated to the CG participated in the routine activities of the health service (regular practice of physical exercise three times/week) and those in the IG additionally received, for seven months, an intervention to encourage the consumption of FV, based on the Transtheoretical Model and on the dialogical and problematizing pedagogy of Paulo Freire. Article 1: Cross-sectional study carried out with baseline data from the ECCR, which aimed to analyze the consumption of UPF according to sociodemographic factors, and its association with the nutritional profile of the diet. The nutritional profile of the diet was analyzed according to the quintiles of percentage contribution of energy from UPF through association and Linear Regression analyzes regarding total energy consumption, energy density, carbohydrates, fiber, proteins, total fat and fat subgroups: saturated, monounsaturated, polyunsaturated, trans, omega 3 and omega 6, vitamins A, B3, B6, B12, folate and C; and the minerals calcium, iron, phosphorus, magnesium, potassium and sodium. In addition, the percentage of inadequate consumption of nutrients recommended for the NCD prevention and the consumption of vitamins were evaluated by Poisson Regression. Article 2: ECCR which aimed to verify the effectiveness of collective intervention to encourage the consumption of FV on food consumption, according to the NOVA classification, among users of health promotion services in the Brazilian Primary Health Care (PHC). The outcomes analyzed were consumption of CP, processed foods (PF) and UPF through association and comparison analysis between CG and IG, and Generalized Estimating Equation (GEE) analysis. Article 3: ECCR which aimed to verify the effectiveness of a collective intervention to encourage the consumption of FV on the adequacy of nutrient intake for NCD prevention in health promotion service users of the Brazilian PHC. Association, comparison and GEE analyzes were also used between the GI and CG groups. The analyzed nutrients were total energy, carbohydrates, fiber, protein, total fat and fat subgroups: saturated, monounsaturated, polyunsaturated, trans, omega 3 and omega 6, vitamins A, B1, B2, B3, B6, B12, folate, C, D and E; and the minerals calcium, iron, phosphorus, magnesium, manganese, potassium, selenium, sodium and zinc. RESULTS - Article 1: The consumption of UPF contributed with 27.7% of the total energy of the diet. Its higher consumption was associated with higher values of energy intake, energy density, total fat and sodium; and smaller proteins, monounsaturated fats, omega 3 and some vitamins and minerals. The prevalence of inadequacy of nutrients for the NCD prevention ranged between 30% and 100% between the lowest and highest quintile of consumption of UPF. Article 2: After 12 months of follow-up, there was an increase in CP consumption and a reduction in UPF among individuals in the IG and CG; in addition to an increase in PF consumption among individuals in the CG. It was observed that the nutritional intervention contributed to a reduction in AP consumption for individuals allocated to the first quartile (RR: 0.861; CI: 0.749; 0.988) and an increase for those allocated to the second quartile of AP consumption (RR: 1,145; CI: 1,041; 1,259). A relationship was also observed between participation in the nutritional intervention and increased consumption of UPF for individuals in the third quartile of AUP consumption (RR: 1.062; CI: 1.005; 1.122). Article 3: Participants in the CG and IG groups, after 12 months, showed a reduction in the consumption of energy, omega 6 and sodium; and increased carbohydrates, fiber, vitamins A, B1, B2, B3, B6, B12, C, D and E, folate, calcium, magnesium, potassium, selenium, manganese, zinc and iron. Individuals from the CG showed an increase in phosphorus consumption; and those of the IG, reduction in the consumption of total, saturated and polyunsaturated fats; and increased monounsaturated. In both groups, there was an increase in the prevalence of nutrient adequacy for the NCD prevention, except for trans fats. Participation in nutritional intervention showed an inverse relationship with dietary energy (RR: 0,979; CI:0,960; 0,999) and protein intake (RR: 0,978; CI: 0,959; 0,997), but did not increase the chance of adequacy of nutrient intake for NCD prevention. CONCLUSION: The results pointed to the importance of the PAS, a health promotion service of the Unified Health System, for the promotion of adequate and healthy food, and NCD prevention. The conduction of collective intervention to encourage the consumption of FV showed few additional results, highlighting the need to carry out specific approaches related to the NOVA classification of foods in order to achieve better results.

An Exploration of Nutritional Status in Relation to Diet Quality, Functional and Mental Ability among Elderly in Tonk, India

@#Introduction: Ageing is a natural and irreversible process, associated with deterioration of physiological, social and cognitive activities. The nutritional status of the elderly is adversely affected by declining cognitive and functional ability. The association of nutritional status with diet quality, functional and cognitive ability and depression among the elderly is not well understood. This study aimed to compute the association of nutritional status with diet quality, functional and cognitive ability and depression among the elderly. Method: A cross-sectional study was undertaken on 250 elderly (146 men, 104 women) of ≥65 years, residing in Tonk district of Rajasthan (India). Self-developed elderly dietary index (EDI) was used to evaluate diet quality and standardized tools, viz., geriatric depression scale (GDS), activities of daily living (ADL), instrumental activities of daily living (IADL), mini nutritional assessment (MNA), and short portable mental status questionnaire (SPMSQ) were used to assess depression, functional status, nutritional status and cognition respectively. Results: Two-thirds of the elderly in this study were at risk of malnutrition (66.67%, n= 167). MNA scores had significant association with Indian EDI (χ2 = 47.50, p=0.000), ADL (χ2 = 32.37, p= 0.000) and SPMSQ (χ2 =18.61, p= 0.001), whereas MNA scores had non significant association with IADL (χ2 = 14.30, p= 0.006) and GDS scores (χ2 = 5.44, p= 0.066). IADL scores were found to be significantly correlated with GDS (r= -0.255) and SPMSQ (r= -0238) Conclusion: Present study shows that the nutritional status of the elderly is associated with diet quality, functional and cognitive ability, but is not associated with depression in the elderly of Tonk.

Evaluation of the dietary quality of De'ang nationality residents over 18 years old in Yunnan by Diet Balance Index DBI_16 / 公共卫生与预防医学

Objective To evaluate the dietary quality of De'ang nationality residents over 18 years old in Yunnan Provinceusing the new adjusted Diet Balance Index (DBI_16), and to provide scientific basis for improving the nutritional status of De'ang residents and formulating health promotion strategies. Methods A food-frequency questionnaire was used to investigate the diet of De'ang residents, and the new adjusted dietary balance index (DBI_16) was used to evaluate the dietary quality. Results The dietary quality of De'ang nationality residents over 18 years old in Yunnan Province was in a moderately imbalanced state (DQD=42), and the main problem was insufficient dietary intake (LBS = 26). The dietary imbalance among men, 65-79 years old and low-income people was serious. The intake of milk, vegetables, fruits and aquatic products was the most insufficient and people who met the recommended intake levels of these foods were 2%, 34.7%, 31.8%, and 36%, respectively. Meanwhile, there existed the problem of excessive intakes among people studied in the present investigation. Pople who consumed more than recommended amount of Cereal food, livestock and poultry meat, and edible oil accounted for 76.9%, 60.4% and 63.5%, respectively. Conclusion The dietary structure of De'ang residents over 18 years old in Yunnan Province is unreasonable. The problems of both insufficient and excessive dietary intakes exist. Education on balance diet should be conducted to improve nutrition and health status of De'ang nationality residents.

Nutritional status, diet quality and inflammatory markers in adolescents

To evaluate diet quality and relationship between Body Mass Index (BMI), diet quality and inflammatory markers in adolescents of public schools in São Luís-MA. Methodology: A cross-sectional study was conducted with 384 adolescents aged 17 and 18 years. The nutritional status was evaluated through the BMI. The quality of the diet was evaluated through the Revised Diet Quality Index (IQD-R). The inflammatory markers used were C-Reactive Ultrasensitive Protein (hs-CRP), IL-6 (Interleukin-6) and TNF-α (Tumor Necrosis Factor α). Multivariate analysis was performed using a decision tree using the CART (Classification and Regression Trees) algorithm to evaluate the relationship between BMI, diet quality and inflammatory markers. Results: The mean age was 17.3±0.5 years, predominance of females (56.5%) and eutrophic (69.3%). The mean IQD-R score was 55.3±12.7. Adolescents in the lowest tertile of IQD-R (T1) had a higher mean BMI (22.1±4.3 kg/m2 vs 21.5 ± 3.7kg/m2). Higher levels of IL-6 were observed in those located on the IQD-R T1 (1,345 mg/L vs 1,205 mg/L). In the same group (T1), adolescents who had higher IL-6 levels also had a higher mean BMI (23.6±5.1kg/m2 vs 20.8±3.0kg/m2). The adolescents in the largest tertiles of IQD-R (T2 and T3) and who had higher concentrations of IL-6 and CR-us had also a higher mean BMI (23.8±4.9kg/m2). Conclusions: The diet quality of adolescents studied needs modifications. BMI averages varied with diet quality and levels of IL-6 and hs-CRP(AU)

Avaliar a qualidade da dieta e a relação entre Índice de Massa Corporal (IMC), qualidade da dieta e marcadores inflamatórios em adolescentes de escolas públicas de São Luís-MA. Metodologia: Foi realizado um estudo transversal com 384 adolescentes de 17 e 18 anos. O estado nutricional foi avaliado por meio do IMC. A qualidade da dieta foi avaliada por meio do Índice de Qualidade da Dieta Revisado (IQD-R). Os marcadores inflamatórios utilizados foram Proteína C Reativa Ultrassensível (PCR-us), IL-6 (Interleucina-6) e TNF-α (Fator de Necrose Tumoral α). A análise multivariada foi realizada usando uma árvore de decisão usando o algoritmo CART (Classification and Regression Trees) para avaliar a relação entre IMC, qualidade da dieta e marcadores inflamatórios. Resultados: A média de idade foi de 17,3 ± 0,5 anos, predomínio do sexo feminino (56,5%) e eutrófico (69,3%). A pontuação média do IQD-R foi de 55,3 ± 12,7. Os adolescentes no tercil inferior do IQD-R (T1) tiveram uma média de IMC mais alta (22,1 ± 4,3kg/m2 vs 21,5 ± 3,7kg/m2). Níveis mais elevados de IL-6 foram observados naqueles localizados no IQD-R T1 (1.345 mg/L vs 1.205 mg/L). No mesmo grupo (T1), os adolescentes que apresentaram níveis mais elevados de IL-6 também apresentaram média de IMC mais elevada (23,6 ± 5,1kg/m2 vs 20,8 ± 3,0kg/m2). Os adolescentes nos maiores tercis de IQD-R (T2 e T3) e que apresentaram maiores concentrações de IL-6 e CR-us também apresentaram maior IMC médio (23,8 ± 4,9kg/m2). Conclusões: A qualidade da dieta dos adolescentes estudados necessita de modificações. As médias do IMC variaram com a qualidade da dieta e os níveis de IL-6 e PCR-us(AU)

Consensus among experts on healthy eating and diet quality index / Consenso entre especialistas sobre alimentação saudável e índice de qualidade da dieta

Abstract The article aims to achieve a consensus about Healthy Eating and Diet Quality Index to enable a validation study on the Diet Quality Index. Experts were identified among authors of articles published from 2010 to 2015 that presented the key worlds healthy eating index and diet quality index. The query was carried out by combining the Delphi technique with the Likert method. To determine a consensus, at least three of the following criteria had to be met: minimum score in each statement (≥ 3,00); standard deviation (< 1,5); frequency of agreement (≥ 51%) and differences between interquartile ranges (< 1,0). Topics regarding Highly palatable foods, oilseeds, and Meat and eggs did not arrived at a consensus in the first round. Experts proposed new themes: Gluten, Meal frequency, Alcohol consumption, and Including nutrients in the diet quality index. Although quality and risk markers in diet are periodically studied, it was only possible to reach consensus on subjects such as fruits, vegetables, milk and dairy products, legumes, and oilseeds as quality markers after theoretical justification. Processed and ready-to-eat foods, highly palatable foods, excessive sweets and fats, and alcohol were readily identified as risk factors.

Resumo O objetivo do artigo é elaborar um consenso sobre Alimentação Saudável e Índice de Qualidade da Dieta (IQD) para subsidiar estudo de validação do IQD. Os especialistas foram identificados entre autores de artigos publicados entre 2010 e 2015 com os unitermos healthy eating index e diet quality index. A consulta foi feita por meio da técnica Delphi e do método Likert. Para definição do consenso se considerou o atendimento a pelo menos três critérios: pontuação mínima em cada asserção (≥ 3,00); desvio padrão (≤ 1,5); frequência das respostas concordantes (≥ 51%) e diferença de intervalo interquartil (≤ 1,0). Os temas Alimentos altamente palatáveis, Oleaginosas e Carnes e ovos não alcançaram o consenso na primeira rodada. Os especialistas propuseram novos temas: Glúten, Fracionamento das refeições, Consumo de álcool e Inserção de nutrientes no IQD. Embora os marcadores de qualidade e de risco na alimentação sejam estudados periodicamente, só foi possível estabelecer consenso sobre temas como frutas, hortaliças, leite e derivados, leguminosas e oleaginosas como marcadores de qualidade após fundamentação teórica. Os alimentos processados e prontos para consumo, alimentos altamente palatáveis, doces e gorduras em excesso, e álcool foram prontamente identificados como de risco.

Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults / 대한지역사회영양학회지

OBJECTIVES: This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.METHODS: Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.RESULTS: After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.CONCLUSIONS: A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.

Diet Quality and its Associated Factors among Community Dwelling Older Adults in Urban District in Kuala Lumpur, Malaysia

@#Introduction: Diet quality is an essential factor in determining the adherence towards dietary guidelines. This study aims to assess the diet quality among community-dwelling older adults and identify the factors associated with the diet quality. Method: This is a cross-sectional study, conducted among 138 community-dwelling older adults living in PPR flats, Kuala Lumpur. Subjects were randomly recruited in this study. Diet Quality Index (DQI) was used to identify diet quality index of elderly. The Chi-square Test of Independence and Pearson’s correlation test were used to determine the association between tested covariates with DQI. Results: Majority of the respondents were reported with good diet quality (74.6%), whereas quarter of them (25.6%) had poor diet quality. Significant difference between the diet quality and the adherence on the food groups were observed for all food groups (p<0.05) except for cereal and cereal products and poultry, meat and egg food group The results revealed that increasing age, Malay ethnicity, low education attainment, low financial income, hypertension, low skeletal muscle, high body fat, high visceral fat, high waist circumference, low MUAC and low handgrip strength were associated with the diet quality of the subjects (p<0.05). Conclusion: The results of this study provide a new insight on the diet quality of the elderly with good and poor diet quality. More inclusion of factors that are related to the diet quality needs to be emphasized in future studies among older adults as it would play a beneficiary component in improving their nutritional status.