Association between Socio-demographic Factors, Involvement Status in Gardening and Diet Quality among B40 Households in Taman Keramat, Kuala Lumpur

@#Introduction: COVID-19 pandemic has impacted the livelihood of Malaysians and gardening activities have contributed positively to the diet quality. This study aimed to determine the factors associated with diet quality among adults in AU2 Keramat, Kuala Lumpur. Methods: The cross-sectional study involved adults aged 18 to 59 via convenience sampling. The socio-demographic, physical activity level and involvement status in gardening were obtained through a questionnaire, while food intake was from a single-day 24-hour diet recall. The diet quality was determined through Malaysian Healthy Eating Index (MHEI) and dietary misreporting was calculated using the Goldberg cut-off method. Results: A total of 117 respondents (65.8% females, 35.2% males) with a mean age of 40.98 were involved in this study. Findings showed that most respondents did not engage in gardening activities (72.6%) and the prevalence of poor diet quality in this study was 89.7%, with a mean score of 44.51. The older respondents (r= 0.20, p= 0.034) and community gardeners (t= -2.63, p= 0.011) had a significantly higher diet quality but not home gardeners (t= 0.12, p= 0.902). The respondents involved in gardening activity also had a significantly higher fruit serving intake, Mann-Whitney U= 1045.00, p= 0.036) and lower total fat intake (t= 2.27, p= 0.025). Conclusion: The diet quality of the respondents remains poor but community gardeners had significantly higher diet quality and fruit intake while lower total fat intake. Interventions need to be developed to address the persistent poor diet quality of adults in the community.

Association between metabolic syndrome and Chinese healthy eating index in a community population of Shanghai / 上海预防医学

Objective:To study the association between metabolic syndrome （MS） and Chinese healthy eating index （CHEI）， and to identify the beneficial or adverse effects of diets on MS in a community population of Shanghai. Methods:Based on the inclusion and exclusion criteria， the data of 4 856 subjects from a community in Shanghai was collected by interview. Total CHEI score and its component score were calculated based on the frequency of food consumption. Physical examination and blood biochemical tests were used to diagnose MS. The logistic regression model was used to analyze the relationship between MS or relative indexes and the total CHEI score or its component score. Results:The study showed the overall prevalence of MS was 24.71%. There were significant differences between MS group and controls （P<0.05） in age， BMI， waist circumference， fasting blood glucose， triglycerides， total cholesterol， systolic blood pressure， diastolic blood pressure， glycated hemoglobin， high-density lipoprotein and energy intake. After adjusting for potential confounders， it showed that the higher total CHEI score， the lower risk of central obesity， increased diastolic blood pressure， increased glycated hemoglobin， hyperglycemic and MS （P<0.05）. The increase in component score of potatoes， milk， beans， dark vegetables， fruits， oil and sodium reduced risk of obesity， hypertension， hyperglycemia， dyslipidemia and MS （P<0.05）. Conclusion:The quality of healthy diet （CHEI score more than 80） and increased intake of specific dietary components （potatoes， milk， beans， dark vegetables， fruits） reduce the risk of MS effectively.

Changes of the Diet Quality for Coronary Heart Disease Patients in Bogor, West Java, Indonesia

@#Introduction: Compliance of Alternate Healthy Eating Index (AHEI) 2010 relates to the reduction of mortality risks due to Coronary Heart Disease (CHD). In Indonesia, AHEI has not been widely used to evaluate diet quality especially for CHD. This study aims to analyse the diet quality changes for CHD. Methods: This study used the secondary data of Cohort Study of Non-Communicable Disease Risk Factors from the Indonesian Ministry of Health. The diet quality was assessed by using modified AHEI 2010 USA, adjusted to the Indonesian portion. Single 24-hour dietary was performed once prior to CHD and once after CHD. The CHD sufferers were assessed based on the result of ECG and 124 new cases. This study used the longitudinal repeated measures. Results: The total score for diet quality a year prior to CHD was 58.6 point and a year after CHD was 63.6 point. After the improvement, the diet quality score a year after CHD increased five points, 66.9% which shows score improvement (improved diet quality) and 33.1% which shows score deterioration (deteriorating diet quality). There are some differences and the significant improvement diet quality is at the total score, specifically fruits, nuts and sodium score (P<0.05). Conclusion: The CHD diet quality had improved up to five points, in which the points of fruits components were 2.8, nuts and sodium were one. Although, it was significantly improved, the intake had not achieved the recommendation.

Calidad de la dieta según el Índice de Alimentación Saludable: Análisis en la población adulta de la ciudad de Rosario, Argentina / Diet quality according to the Healthy Eating Index: Analysis in the adult population of Rosario City, Argentina

Introducción: el Índice de Alimentación Saludable (IAS) fue desarrollado en base a las recomendaciones de las guías alimentarias para la población americana y es de utilidad para identificar los grupos de alimentos que presentan menor consumo en relación a las recomendaciones y los grupos poblacionales con alimentación de baja calidad. Objetivo: estimar la calidad de la dieta en la población adulta de la ciudad de Rosario, e identificar su relación con variables sociodemográficas, indicadores antropométricos y del estilo de vida. Materiales y Método: investigación observacional, descriptiva y transversal de una muestra por cuotas estratificada de 1200 adultos entre 18 a 70 años. Se empleó la metodología actualizada en el 2010 para el cálculo de IAS, a partir de la información obtenida del recordatorio de 24 horas. Se utilizó un cuestionario para relevar las variables sociodemográficas y el consumo de tabaco, se realizaron mediciones antropométricas, la actividad física se midió con el cuestionario IPAQ y el consumo de alcohol por frecuencia de consumo. Las asociaciones se evaluaron mediante test Chi cuadrado y la diferencia de medias por Anova, considerando p<0,05. Resultados: los adultos evaluados tenían en promedio 39±15 años, el 69% fueron mujeres, el 32% con estudios terciarios completos o más, 56% tenía un IMC≥25 kg/m², 34% presentaba riesgo según circunferencia de cintura, 54% realizaba <150 min/sem de actividad física, 67% consumía alcohol y 26% era fumador actual. El IAS alcanzó un promedio de 48,5±15,1 puntos, los valores más alejados del ideal se encontraron en los pescados, mariscos y proteínas vegetales (0,7/5); granos enteros (1,5/10); granos y cereales refinados (2/10); frutas (1,7/5); vegetales verdes y legumbres (1,7/5); ácidos grasos (3,7/10) y lácteos (4,3/10). El 58,6% tuvo una dieta de pobre calidad (IAS <50). Se observó una alimentación menos saludable en los hombres (p<0,05), adultos jóvenes (p<0,01), aquellos con menor nivel educativo (p<0,01), los individuos que realizan <150 minutos semanales de actividad física moderada o intensa (p<0,01) y los que fuman en la actualidad (p<0,01). Conclusión: La alimentación de la población estudiada demuestra características poco saludables. La identificación de grupos de mayor riesgo permitirá orientar mejor las acciones educativas y sanitarias tendientes a modificar estilos de vida y hábitos alimentarios.

Introduction: The Healthy Eating Index (HEI) was developed based on the recommendations of the dietary guidelines for the American population and is useful to identify food groups that have lower consumption in relation to recommendations and population groups with low diet quality. Objective: To estimate the quality of the diet in the adult population of the city of Rosario, and to identify its relationship with sociodemographic, anthropometric indicators and lifestyle variables. Materials and Methods: Observational, descriptive and cross-sectional research of a stratified sample of 1200 adults aged 18 to 70 years. The updated methodology of HEI 2010 was used, based on the information obtained from the 24-hour recall. A questionnaire was used to collect sociodemographic variables and tobacco consumption, alcohol consumption was assessed by frequency of consumption, anthropometric measurements were measured and physical activity was assessed with the IPAQ questionnaire. The associations were evaluated by Chi square test and the difference of means by Anova (p<0,05). Results: The average age of adults evaluated was 39±15 years, 69% were women, 32% had completed tertiary studies or more, 56% with BMI≥25 kg/m², 34% had risk according to waist circumference, 54% realized <150 min/week of physical activity, 67% consumed alcohol and 26% were current smokers. The HEI reached an average of 48.5±15.1 points, the values farthest from the ideal were found in fish, shellfish and vegetable proteins (0.7/5); whole grains (1.5/10); refined grains and cereals (2/10); fruit (1.7/5); green vegetables and legumes (1.7/5); fatty acids (3.7/10) and dairy (4.3/10). The 58.6% had a poor quality diet (HEI <50). In men (p<0,05), young adults (p<0,01), those with a lower educational level (p<0,01), individuals who perform <150 minutes per week of moderate or intense physical activity (p<0,01) and those who smoke have observed a less healthy diet (p<0,01). Conclusion: The diet of the studied population shows unhealthy characteristics. The identification of groups of greater risk will allow to orient better the educative and sanitary actions tending to modify styles of life and alimentary habits.

Análise crítica do índice de qualidade da dieta revisado para a população brasileira (IQD-R): aplicação no ELSA-Brasil / Critical analysis of the revised diet quality index for the Brazilian population (DQI-R): its application in ELSA-Brasil

Resumo O objetivo deste estudo foi analisar criticamente a aplicação do Índice de Qualidade da Dieta - Revisado (IQD-R), explicitar facilidades e dificuldades em seu cálculo, sugerir adaptações e comparar sua distribuição segundo variáveis sociodemográficas entre os 15.105 servidores públicos participantes do Estudo Longitudinal de Saúde do Adulto, no período de 2008 a 2010. O consumo alimentar foi aferido com base em Questionário de Frequência Alimentar e o IQD-R foi estimado de quatro maneiras: original; ponderado para frequência de consumo de frutas e hortaliças; modificado considerando leguminosas separado dos demais vegetais e adaptado abrangendo as duas alterações anteriores. Os resultados indicaram que independentemente da adaptação realizada, as mulheres, os indivíduos com mais de 65 anos e os indivíduos de menor escolaridade apresentaram escores médios mais altos indicando dieta de melhor qualidade. Acredita-se que as adaptações propostas podem ser úteis para estudos futuros que apliquem o IQD-R.

Abstract The scope of this study was to conduct a critical analysis of the application of the Brazilian Healthy Eating Index - Revised (BHEI-R), to explain the ease and difficulties in its calculation, to suggest adaptations and to compare its distribution. This was done in accordance with sociodemographic variables among the 15,105 public servants participating in the Longitudinal Study of Adult Health from 2008 to 2010. Food consumption was assessed based on a Food Frequency Questionnaire and BHEI-R was estimated in four ways: original; weighted for frequency of consumption of fruits and vegetables; modified considering legumes separated from other vegetables, and adapted covering the two previous changes. The results indicated that irrespective of the adaptation performed, women, individuals over 65 years of age and individuals with lower schooling had higher mean scores indicating a better quality diet. It is believed that the proposed adaptations may be useful for future studies that apply BHEI-R.

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.

Evaluation of Dietary Quality Using Malaysian Healthy Eating Index and Its Relationships With Cardiometabolic Risk Factors in Malaysian Adolescents

@#Introduction: This cross-sectional study aimed to investigate relationships between diet quality assessed by Malaysian Healthy Eating Index (HEI) and cardiometabolic risk factors in adolescents aged 13 years. Methods: 336 adolescents from various public secondary schools provided information on sociodemography and their anthropometric measurements including height (cm), weight (kg) and waist circumference (cm) were measured. Body mass index (BMI) was estimated thereafter. Dietary intakes assessed using a validated adolescent food frequency questionnaire (FFQ) was used to estimate Malaysian HEI. Biomarker parameters including lipid profile, fasting glucose, insulin and insulin resistance were also assessed. Associations of diet quality indicators to cardiometabolic risk factors were examined using regression models. Results: The overall diet quality of the adolescents was rather poor (49%), with a greater percentage of males were found to have low dietary quality score compared to females (56% vs. 39%; p<0.05). While males were more obese, a higher number of females (46.7%) were found to have at least one risk factors for cardiometabolic health compared to males (37.7%). After adjusting for covariates, no significant associations were observed among adolescents in the lowest quartile compared to those in the highest quartile of HEI score for obesity and abdominal obesity, as well as other cardiometabolic risk factors, in both males and females. Conclusion: Despite of poor dietary quality, no significant associations were observed between dietary quality assessed by Malaysia HEI and cardiometabolic risk factors in adolescents. Prospective studies are needed to establish a causal link between dietary patterns and cardiometabolic risk factors during adolescence.

Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia

BACKGROUND/OBJECTIVES: This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS: The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS: Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS: The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.

Diet Quality of patients with chronic Chagas disease in a tertiary hospital: a case-control study

Abstract INTRODUCTION: Nutritional status has been implicated in the modulation of the immune response, possibly augmenting the pathogenesis of Chagas disease (Cd). We evaluated diet quality and nutritional status in adults and elderly patients with chronic Cd in a tertiary hospital. METHODS: A case-control study of Cd patients was conducted, paired for gender, age, and co-morbidities with non-Cd patients. Anthropometric measurements and food frequency questionnaire was used, and diet quality was assessed by the Brazilian Healthy Eating Index-Revised (BHEI-R). The Estimated Average Requirement cut-off points were used to determine the dietary micronutrient adequacy. The Cd group was further grouped according to Los Andes classification. RESULTS: The study participants were 67 ± 10 years old, 73.6% elderly and 63% female. The prevalence of overweight/obesity and abdominal fat was high in both groups; however, Cd group showed a lower prevalence of obesity and increased risk of disease according to waist circumference classification. There was no difference in BHEI-R score between groups (p=0.145). The Cd group had sodium and saturated fat intake above recommendations and low intake of unsaturated fat, vitamin D, E, selenium, magnesium, and dairy products; but higher intake of iron. According to Los Andes classification, group III presented lower intake of whole fruit and dietary fiber. CONCLUSIONS: Patients with Cd were overweight and the quality of their diet was unsatisfactory based on the recommended diet components for age and sex.

Aspectos metodológicos da avaliação da qualidade da dieta no Brasil: revisão sistemática / Methodological aspects of dietary quality assessment in Brazil: systematic review

Resumo Esta revisão sistemática objetivou analisar metodologias de estudos brasileiros que utilizam índices para avaliação da qualidade da dieta. Realizou-se busca sistemática em bases eletrônicas de dados (Lilacs, Medline, SciELO e Scopus), sem fazer restrição ao ano de publicação dos estudos. Foram selecionados artigos originais, nacionais, que avaliassem a qualidade da dieta pelo Healthy Eating Index (HEI) ou suas versões revisadas. Utilizou-se os descritores: qualidade da dieta, índice de alimentação saudável, índice de qualidade da dieta e respectivos termos em inglês. Foram selecionados 45 artigos, dos quais, 60% analisaram a qualidade da dieta por instrumento denominado índice de alimentação saudável e o restante por índice de qualidade da dieta. Dos estudos analisados, 68,9% classificaram a qualidade da dieta. A maioria dos estudos utilizou 10 itens para avaliação da qualidade da dieta e não apresentaram padronização quanto às metodologias. Dos estudos, 33,3% relacionaram o índice com fatores socioeconômicos e demográficos, itens alimentares e condições de saúde. Diferenças de nomeação e metodologias dificultam comparações entre os estudos de avaliação da qualidade da dieta.

Abstract This systematic review analyzes the methodologies of Brazilian studies that have used indices to evaluate dietary quality. A systematic search was performed of electronic databases (Lilacs, Medline, SciELO and Scopus) with no restriction on the year of publication of the studies. Original, Brazilian articles were selected that assessed dietary quality using the Healthy Eating Index (HEI) or its revised versions. The descriptors were as follows: dietary quality; healthy eating index; and dietary quality index. Atotal of 45 articles were selected, of which 60% analyzed dietary quality using an instrument called the Healthy Eating Index and the rest used an index of dietary quality. Of the analyzed studies, 68.9% classified dietary quality. Most of the studies used ten items to evaluate dietary quality and were not standardized regarding methodologies. A total of 33.3% of the studies related the index to socioeconomic and demographic factors, food items and health conditions. Differences in terms of nomenclature and methodologies made it difficult to compare these studies of dietary quality.

Association between Healthy Eating Index-2010 and Fetuin-A Levels in Patients with Type 2 Diabetes: a Case-Control Study

The Healthy Eating Index-2010 (HEI-2010) assesses compliance with the 2010 Dietary Guidelines for Americans. Studies suggest that adherence to the HEI-2010 is related to lower the risk of type 2 diabetes (T2D). Fetuin-A, a novel biomarker for T2D, may play a linking role in the inverse association between HEI-2010 and T2D. Thus, a case-control analysis involving 107 patients with T2D and107 healthy subjects was conducted to determine the association between HEI-2010 and serum fetuin-A levels. The results of simple regression analysis showed that fetuin-A levels were positively associated with full name of body mass index (BMI) (p < 0.001), waist circumference (WC) (p < 0.001), fasting blood glucose (FBG) (p < 0.001), triglycerides (TG) (p = 0.003), gamma-glutamyl transferase (GGT) (p < 0.001), and homeostasis model assessment of insulin resistance (HOMA-IR) (p =0.001) and negatively associated with physical activity (PA) (p < 0.001), high-density lipoprotein (HDL) (p = 0.022), and HEI-2010 (p < 0.001) in all subjects. After controlling for confounders, the inverse association between fetuin-A and HEI-2010 remained significant in the subjects with T2D (β = −0.386; p < 0.001), 107 healthy controls (β = −0.237; p = 0.028), and all subjects (β = −0.298; p < 0.001). In conclusion, the present results suggested that higher quality diet assessed by HEI-2010 associates with lower serum fetuin-A levels in people with and without T2D. More studies are needed to confirm these findings.

Association between Healthy Eating Index-2010 and Fetuin-A Levels in Patients with Type 2 Diabetes: a Case-Control Study

The Healthy Eating Index-2010 (HEI-2010) assesses compliance with the 2010 Dietary Guidelines for Americans. Studies suggest that adherence to the HEI-2010 is related to lower the risk of type 2 diabetes (T2D). Fetuin-A, a novel biomarker for T2D, may play a linking role in the inverse association between HEI-2010 and T2D. Thus, a case-control analysis involving 107 patients with T2D and107 healthy subjects was conducted to determine the association between HEI-2010 and serum fetuin-A levels. The results of simple regression analysis showed that fetuin-A levels were positively associated with full name of body mass index (BMI) (p < 0.001), waist circumference (WC) (p < 0.001), fasting blood glucose (FBG) (p < 0.001), triglycerides (TG) (p = 0.003), gamma-glutamyl transferase (GGT) (p < 0.001), and homeostasis model assessment of insulin resistance (HOMA-IR) (p =0.001) and negatively associated with physical activity (PA) (p < 0.001), high-density lipoprotein (HDL) (p = 0.022), and HEI-2010 (p < 0.001) in all subjects. After controlling for confounders, the inverse association between fetuin-A and HEI-2010 remained significant in the subjects with T2D (β = −0.386; p < 0.001), 107 healthy controls (β = −0.237; p = 0.028), and all subjects (β = −0.298; p < 0.001). In conclusion, the present results suggested that higher quality diet assessed by HEI-2010 associates with lower serum fetuin-A levels in people with and without T2D. More studies are needed to confirm these findings.

Nutritional intake and overall diet quality of female soccer players before the competition period / Ingestão nutricional e qualidade global da dieta de jogadoras de futebol antes do período de competição

ABSTRACT Objective: To assess the dietary intake and overall diet quality of female soccer players before the competitive games. Methods: This descriptive and cross-sectional study included 21 women aged 20.8±4.5 years from a professional soccer team. Their nutritional status and dietary adequacy during the training period, before competition season, were assessed. Dietary intake was assessed by three 24-hour recalls, one food frequency questionnaire, and the Healthy Eating Index, an overall diet quality index based on food group intake. Results: The athletes have shown proper nutritional status, but a diet deficient in energy due largely to low carbohydrate intake. On the other hand, the intakes of protein, fatty acids, and sodium were above the recommended intakes, even for athletes. Diet quality assessment by the Healthy Eating Index - 2010 resulted in a mean score of 54.6 points of a maximum of 100, indicating a need of improving the overall diet quality. Conclusion: The study found that the dietary patterns of female football players were both quantitatively and qualitatively inappropriate. A nutritional intervention is indicated to improve diet quality, with the inclusion of various foods, such as whole grains, fruits, vegetables, dairy products, and better protein quality, along with a reduction in saturated fats, sodium, and added sugar.

RESUMO Objetivo: Avaliar a ingestão alimentar e a qualidade nutricional global da dieta de jogadoras de futebol antes dos jogos competitivos. Métodos: Estudo descritivo transversal realizado com 21 mulheres, de 20,8±4,5 anos de idade, de uma equipe de futebol profissional. Elas foram avaliadas em relação ao seu estado nutricional e adequação da dieta durante o período de treinamento, antes da temporada de competição. A ingestão alimentar foi avaliada por três recordatórios de 24 horas, um questionário de frequência alimentar e pelo Índice de Alimentação Saudável (2010), um índice de qualidade global da dieta baseada no consumo de grupos de alimentos. Resultados: Verificou-se que as atletas apresentavam estado nutricional adequado, mas tinham uma dieta deficiente em energia devido, em grande parte, à ingestão insuficiente de carboidratos. Por outro lado, o consumo de proteínas, ácidos gordos e de sódio estavam acima da recomendação, mesmo para atletas. A avaliação da qualidade da dieta pelo Índice de Alimentação Saudável (2010) mostrou uma pontuação média de 54,6 de 100, exibindo a necessidade de melhoria da qualidade da dieta. Conclusão: O estudo mostrou padrões alimentares inadequados, tanto quantitativa como qualitativamente, em jogadoras de futebol. A intervenção nutricional é indicada para melhorar a qualidade da dieta com a inclusão de vários itens alimentares, como cereais integrais, frutas, legumes, produtos lácteos e melhor qualidade de proteínas, acompanhado de redução de gorduras saturadas, sódio e açúcar.

Síndrome metabólica em idosos da atenção terciária em Porto Alegre, Rio Grande do Sul: associação com o Índice de Alimentação Saudável / Metabolic syndrome in elderly from tertiary health care in Porto Alegre, Rio Grande do Sul, Brazil: association with the Healthy Eating Index

Objetivos: Avaliar a associação entre síndrome metabólica e Índice de Alimentação Saudável em idosos em atendimento em um serviço de atenção terciária pelo Sistema Único de Saúde. Métodos: Estudo transversal, realizado no ambulatório do Serviço de Geriatria do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, em Porto Alegre, RS, entre novembro de 2009 e novembro de 2010. Foram convidados a participar do estudo todos os idosos atendidos no período, sendo excluídos aqueles com declínio cognitivo, transtornos psiquiátricos severos, grande restrição de mobilidade ou deficiência auditiva severa que comprometessem a avaliação nutricional. O diagnóstico de síndrome metabólica foi estabelecido pelo Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII) revisado e o padrão alimentar foi avaliado por meio do Índice de Alimentação Saudável adaptado para a população brasileira. Resultados: A amostra incluiu 186 idosos, a maioria mulheres (81,7%). A frequência de síndrome metabólica foi de 58,6%. Não houve diferença entre os escores do Índice de Alimentação Saudável de idosos com e sem síndrome metabólica. Na maioria dos idosos, a dieta necessitava de adequações. Idosos com síndrome metabólica tinham escore inferior somente para legumes e verduras (p=0,026). Na amostra total, o escore de cereais, pães, tubérculos e raízes foi diretamente associado com obesidade central (p=0,005); o de legumes e verduras inversamente com triglicerídeos (p=0,002) e diretamente com colesterol ligado a lipoproteínas de alta densidade (HDL-c) (p=0,004); o de frutas, diretamente com obesidade central (p=0,048), glicemia (p=0,024), triglicerídeos (p=0,001) e inversamente com HDL-c (p=0,015); o de leguminosas com glicemia (p=0,019); o de gordura total indiretamente com obesidade central (p=0,004) e glicemia (p=0,041); e variedade da dieta inversamente com glicemia (p=0,002) e pressão arterial diastólica (p=0,031). Conclusões: A dieta dessa amostra de idosos da atenção terciária necessitava de adequação. Não se observou associação entre o escore total do Índice de Alimentação Saudável e síndrome metabólica. Contudo, entre dez componentes do índice, seis mostraram-se associados com os critérios diagnósticos da síndrome metabólica. Assim, destaca-se a necessidade de intensificar o cuidado em relação à adequação nutricional em todos os níveis da atenção à saúde, uma vez que a nutrição é um fator importante na modulação da síndrome metabólica e de seus componentes.

Aims: To evaluate the association of metabolic syndrome with the Healthy Eating Index in elderly patients treated in a tertiary care facility affiliated with the Brazilian public health system. Methods: A cross-sectional study was performed at the geriatric outpatient clinic of Sao Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil, between November 2009 and November 2010. All elderly patients treated during this period were invited to participate in the study. Those with cognitive decline, severe psychiatric disorders, severe mobility restriction, or severe hearing impairment that could compromise nutritional assessment were excluded. The diagnosis of metabolic syndrome was established according to the revised "Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults" (NCEP-ATPIII), and the dietary pattern was evaluated using the Healthy Eating Index adapted to the Brazilian population. Results: The sample included 186 elderly patients, mostly women (81.7%). The frequency of metabolic syndrome was 58.6%. No difference was found between the Healthy Eating Index scores of elderly individuals with and without metabolic syndrome. The diet had to be adjusted in most of the patients. Elderly patients with metabolic syndrome presented lower scores only for the intake of legumes and vegetables (p=0.026). In the total sample, the score for cereals, breads, tubers, and roots was directly associated with central obesity (p=0.005); the score for legumes and vegetables was inversely associated with triglycerides (p=0.002) and directly with high-density lipoprotein cholesterol (HDL-c) (p=0.004); the score for fruits was directly associated with central obesity (p=0.048), blood glucose (p=0.024), and triglycerides (p=0.001), and inversely associated with HDL-c (p=0.015); the score for pulses was associated with blood glucose (p=0.019); total fat was indirectly associated with central obesity (p=0.004) and blood glucose (p=0.041); and dietary variety was inversely associated with blood glucose (p=0.005) and diastolic blood pressure (p=0.031). Conclusions: The diet of this sample of elderly from tertiary health care needed some adjustment. No association was observed between the total score of the Healthy Eating Index and metabolic syndrome. However, among 10 components of the index, six were associated with some diagnostic criteria of metabolic syndrome. Thus, it is important that nutritional adequacy be met at all levels of health care, since nutrition is an important factor in the modulation of metabolic syndrome and its components.

Análise crítica da qualidade da dieta da população brasileira segundo o Índice de Alimentação Saudável: uma revisão sistemática / Critical analysis of the diet quality of the Brazilian population according to the Healthy Eating Index: a systematic review

Resumo Diante da importância de estudar instrumentos que avaliem a qualidade alimentar da população, este trabalho se propõe realizar uma revisão sistemática sobre o Índice de Alimentação Saudável como instrumento utilizado para avaliar a qualidade da dieta da população brasileira, analisando suas metodologias e resultados. Para a seleção de estudos foram utilizadas as principais bases eletrônicas de dados. Após as buscas com os descritores, foram incluídos 32 artigos. Observou-se o crescente interesse da comunidade científica na abordagem deste tema, sendo recentes os estudos que utilizam esse instrumento no Brasil. Foram avaliadas e discutidas as questões metodológicas dos artigos, considerando as versões revisadas, bem como as adaptações do IAS. Foram destacados alguns resultados comuns entre os estudos como o baixo consumo de frutas, vegetais e/ou leite e derivados e maior consumo dos grupos de carnes e ovos, colesterol, gordura total e gordura saturada. Dentre os artigos que abordaram o IAS e aspectos socioeconômicos, pode-se observar na população estudada que a qualidade da dieta melhora tanto de acordo com o aumento da escolaridade dos pais quanto com a renda da família. O IAS pode ser utilizado para monitorar mudanças no padrão alimentar, bem como ferramenta de educação nutricional e promoção da saúde.

Abstract In light of the importance of studying instruments that assess the food quality of the population, this study sought to conduct a systematic review of the quality of the diet of the Brazilian population using the Healthy Eating Index (HEI) and duly analyzing its methodology and results. The major electronic databases were used for the selection of studies. After the searches with the key words, 32 articles were included in this review. The growing interest of the scientific community in addressing this issue was observed, with recent studies using this instrument in Brazil. Methodological issues of articles were evaluated and discussed taking into consideration the revised versions and adaptations of the HEI. Some common results were highlighted among the studies such as low consumption of fruit, vegetables and/or dairy products, and the wider consumption of meat and eggs, cholesterol, total fat and saturated fat. Among the articles that address the HEI and socioeconomic aspects it was seen that quality of diet improves both in accordance with the increasing level of education of parents and with the family income in the population studied. The HEI can be used to monitor changes in dietary patterns and also as a nutrition education and health promotion tool.

Poor diet quality among Brazilian adolescents with HIV/AIDS / Baixa qualidade de dieta entre adolescentes brasileiros com HIV/AIDS

OBJECTIVE: This study aimed to assess diet quality among adolescents with HIV/AIDS. METHOD: A cross-sectional study was conducted involving patients with HIV/AIDS treated in a referral hospital in Sao Paulo, Brazil. Eighty-eight adolescents (10-19 years of age) participated in the study. Information on disease history and use of medication were obtained from medical records. The participants responded to two 24-hour diet recalls. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005) adapted to the Brazilian population. Pearson's correlation coefficients were calculated. Mean HEI-2005 scores were compared according to the independent variables using either the Student's t-test or the Mann-Whitney test. RESULTS: The mean HEI-2005 score was 51.90 (SE = 0.90). The components with the lowest means were whole grains and sodium. Components with highest means were total grains and oils. No correlations were found between the independent variables and HEI score. Adolescents living in foster homes had higher means for total fruit and lower means for meat and beans in comparison to adolescents living with their families. Girls had higher means for milk and lower means for calories from solid fats, alcoholic beverages, and added sugars in comparison to boys. CONCLUSIONS: Adolescents with HIV/AIDS exhibited a similar eating pattern to that of adolescents in the general population: high consumption of added sugar, saturated fat, and sodium, and insufficient ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, who are at greater risk of developing cardiovascular and other chronic diseases. .

OBJETIVO: Avaliar a qualidade da dieta de adolescentes com HIV/Aids. MÉTODO: Estudo transversal que envolveu pacientes com HIV/Aids atendidos em um hospital de referência em São Paulo. Participaram 88 adolescentes (10-19 anos). Informações sobre história clínica e uso de medicamentos foram obtidas dos prontuários médicos. Os participantes responderam a dois recordatórios de 24 horas. A qualidade da dieta foi avaliada pelo índice de qualidade da dieta revisado (IQD-R) adaptado para a população brasileira. Coeficientes de correlação de Pearson foram calculados. As médias do escore do IQD-R foram comparadas de acordo com as variáveis independentes, com o teste t de Student ou o teste de Mann-Whitney. RESULTADOS: A média do IQD-R foi 51,90 (EP = 0,90). Os componentes de menores médias foram: cereais integrais e sódio. Os componentes de maiores médias foram cereais totais e óleos. Não foram encontradas correlações entre as variáveis independentes e o IQD-R. Adolescentes que vivem em casas de apoio tiveram médias maiores para frutas totais e menores para carnes e feijão em comparação com os adolescentes que vivem com suas famílias. As meninas apresentaram médias mais altas para leite e menores médias para calorias provenientes de gorduras sólidas, bebidas alcoólicas e açúcares adicionados, em comparação com os meninos. CONCLUSÕES: Os adolescentes com HIV/Aids apresentaram padrão alimentar semelhante àquele da população geral: alto consumo de açúcar, gordura saturada e sódio e ingestão insuficiente de cereais integrais e frutas. Atenção especial deve ser dada à dieta de adolescentes com HIV/Aids, pois eles estão sob maior risco de desenvolver doenças cardiovasculares e outras doenças crônicas. .

Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data / 한국영양학회지

PURPOSE: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. METHODS: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. RESULTS: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. CONCLUSION: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

Healthy eating index of elderly: description and association with energy, macronutrients and micronutrients intake

The purpose of this study was to define the Healthy Eating Index (HEI) of the elderly of Southern Brazil and its association with energy, macronutrients and micronutrients intake. A cross-sectional study was conducted with 186 elderly aged 60 and older of the Geriatric Service of São Lucas Hospital, Porto Alegre , Brazil. Dietary data were collected by two 24-hour recalls, and diet quality was assessed by HEI adapted to the Brazilian population. The HEI total score was divided into three categories: inadequate diet (below 51 points), diet needs improvement (between 51 and 80 points), and healthy diet (over 80 points). The results showed that the mean HEI score was 58.8±10.5 points (ranging from 31.4 to 79.8). Most elderly (74.2%) showed a diet that needed modification and no elderly individual had a healthy diet. The quality of the diet was associated with greater intake of carbohydrates, and lower intake of total lipids, saturated fatty acids, cholesterol, and sodium. Consumption of vitamins C and D and calcium was shown to be positively correlated with the quality of the diet. Less than 1.1% of the elderly consumed a varied diet. The findings suggest that the diet of the majority of the elderly needs improvement, reinforcing the importance of care in relation to adequate nutrition in this population, and can help in guiding the activities and programs of nutritional education and public policies that stimulate increasingly healthy eating.

Índice de alimentação saudável de idosos: descrição e associação com ingestão de energia, macronutrientes e micronutrientes. O objetivo deste estudo foi descrever o Índice de Alimentação Saudável (IAS) de idosos do Sul do Brasil e sua associação com a ingestão de energia, macronutrientes e micronutrientes. Foi realizado um estudo transversal com 186 idosos com 60 anos ou mais, do Serviço de Geriatria do Hospital São Lucas, Porto Alegre, Brasil. Os dados relativos ao consumo alimentar foram coletados através de dois recordatórios de 24 horas, e a qualidade da dieta foi avaliada pelo IAS, adaptado à população brasileira e o escore total foi dividido em três categorias: dieta inadequada (abaixo de 51 pontos), dieta necessitando de adequação (entre 51 e 80 pontos), e dieta saudável (mais de 80 pontos). Os resultados mostraram que a média do IAS foi 58,8±10,5 pontos (variando de 31,4 a 79,8 pontos). A maioria dos idosos (74,2%) apresentou uma dieta que necessitava de modificação e nenhum idoso tinha uma dieta saudável. A qualidade da dieta foi associada com maior ingestão de carboidrato e baixa ingestão de gordura total, gordura saturada, colesterol e sódio. O consumo de vitaminas C e D e cálcio mostrou-se positivamente correlacionado com a qualidade da dieta. Menos de 1,1% dos idosos consumia uma dieta variada. Os resultados sugerem que a dieta da maioria dos idosos necessita de adequação, reforçando a importância dos cuidados em relação à nutrição adequada desta população e podem auxiliar na orientação de atividades e programas de educação nutricional e políticas públicas que estimulem a prática de uma alimentação mais saudável.

Dietary Quality among Tehranian Adults in Relation to Lipid Profile: Findings from the Tehran Lipid and Glucose Study.

The prevalence of dyslipidaemia has been increasing in developing countries that are undergoing nutrition transition. However, the association of diet quality and lipid profile has not been well-understood in these countries. The aim of the current study was to compare the ability of three diet quality indices—the Mediterranean diet scale (MDS), healthy eating index-2005 (HEI-2005), and diet quality index-international (DQI-I) in relation to changes in lipid profile between baseline and 6.7 years of follow-up. Baseline data from two 24-hour dietary recalls provided by 469 adults with mean age of 38.7±12.3 years, who were participants of the Tehran Lipid and Glucose Study, were analyzed to describe dietary intakes. Data on anthropometry, sociodemography, physical activity, and other lifestyle variables were recorded, and a comparison of baseline and follow-up data revealed changes in the concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). A general linear model was used in assessing changes in lipid profile depending on adherence to diet quality indices at baseline, after adjustment for age, smoking status, waist-circumference, body mass index, physical activity, and energy intake. A significant interaction was observed between scores and sex, and upon stratification, males in the highest quartile score of the HEI-2005 had significantly lower TG changes than those in the lowest quartile, after adjusting for confounders (-8.8 vs 2.9, p=0.038). No association was apparent in females (-0.2 vs 11.2, p=0.297). In addition, a positive association was found between DQI-I and HDL-C (Q1=0.6 vs Q4=-2.0, p=0.044) in males. In both sexes, all these indices were weakly associated with TC while none was associated with LDL-C. It is concluded: adherence to the HEI-2005 recommendations was weakly associated with reduced TG concentration in an urban Iranian adult population. The MDS and DQI-I were not related to change in lipid profile.

Programa Bolsa-Família: qualidade da dieta de população adulta do município de Curitiba, PR / Bolsa-Família Program: Diet quality of adult population in Curitiba, Paraná

Este estudo avaliou a qualidade da dieta da população beneficiária do Programa Bolsa-Família, em Curitiba, PR. Estudo transversal, de base populacional, realizado no período de julho de 2006 a julho de 2007. Foram entrevistados 747 beneficiários, a partir dos 19 anos de idade, de ambos os sexos. Para avaliação da qualidade da dieta foi aplicado recordatório de 24 horas, e o Índice de Qualidade da Dieta (IQD) foi utilizado como parâmetro para classificação do grupo em níveis de consumo. Estatística descritiva foi utilizada para descrever a qualidade da dieta da população. Para a comparação de médias do índice segundo as variáveis socioeconômicas foram realizados o teste t de Wald e a análise de variância ANOVA, considerando-se um nível de significância de 5%. A amostra foi constituída por 91,4% de mulheres e 8,6 % de homens. A média de idade da população foi de 36,4 ± 13,3 anos, com cerca de 75 % possuindo o ensino fundamental incompleto. A média do IQD foi de 51 pontos, o que caracteriza uma dieta que precisa de ajustes. A população possui uma dieta monótona, com um consumo adequado de leguminosas, porém baixo para frutas, verduras e produtos lácteos. Na comparação entre as categorias de qualidade da dieta dos indivíduos, todos os componentes, com exceção do sódio, apresentaram medianas de pontuação estatisticamente diferentes (p < 0,01). Estudos que avaliem a qualidade da dieta são fundamentais para subsidiar a implantação de programas de educação alimentar direcionados para o cerne do problema nas populações estudadas.

This study evaluated the quality of diet of the population receiving the Bolsa Familia Program in Curitiba, state of Parana, Brazil. It was a population-based cross-sectional study, conducted from July 2006 to July 2007. 747 beneficiaries were interviewed from 19 years of age, of both genders. A 24 hour-recall was implemented in order to assess the quality of the diet and the Healthy Eating Index (HEI) was used as a parameter for the classification of the group in consumption levels. Descriptive statistics were used to describe the diet quality of the studied population. Wald test and ANOVA test were performed to compare the means of the index according to the socio-economic variables, considering a significance level of 5%. The sample comprised 91.4% of women and 8.6% ofmen. The average age of the population was 36.4 ± 13.3 years, with 75% having completed elementary school. The mean HEI was 51 points, which features a diet that needs improvement. The population has a monotonous diet with an adequate intake of legumes, but low for fruits, vegetables and dairy products. Comparing the categories of diet quality of individuals, all components, except sodium, showed statistically different median score (p < 0.01). Studies that evaluate the quality of the diet are essential to support the implementation of nutrition education programs targeted to the core of the problem in the populations studied.