An obesity dietary quality index predicts abdominal obesity in women: potential opportunity for new prevention and treatment paradigms.

Background. Links between dietary quality and abdominal obesity are poorly understood. Objective. To examine the association between an obesity-specific dietary quality index and abdominal obesity risk in women. Methods. Over 12 years, we followed 288 Framingham Offspring/Spouse Study women, aged 30-69 years, without metabolic syndrome risk factors, cardiovascular disease, cancer, or diabetes at baseline. An 11-nutrient obesity-specific dietary quality index was derived using mean ranks of nutrient intakes from 3-day dietary records. Abdominal obesity (waist circumference >88 cm) was assessed during follow-up. Results. Using multiple logistic regression, women with poorer dietary quality were more likely to develop abdominal obesity compared to those with higher dietary quality (OR 1.87; 95% CI, 1.01, 3.47; P for trend = .048) independent of age, physical activity, smoking, and menopausal status. Conclusions. An obesity-specific dietary quality index predicted abdominal obesity in women, suggesting targets for dietary quality assessment, intervention, and treatment to address abdominal adiposity.

Nutrient database development: a historical perspective from the Framingham Nutrition Studies.

Food frequency questionnaires (FFQs) are commonly used in nutritional epidemiology to assess habitual eating habits. Development of an appropriate food and nutrient database is required for translating information derived from FFQs into estimates of nutrient intake, dietary quality, or for absolute or rank-ordered nutritional risk assessment. We discuss the procedures used recently in designing a historical nutrient database to analyze an FFQ administered in 1984-1988 to Framingham Offspring-Spouse Study members. This systematic approach should inform other research in the field. The self-administered 145-item Framingham FFQ is semi-quantitative with seven nonoverlapping response categories to determine annual consumption frequency. The database development process included selection of the US Department of Agriculture's Nutrient Database for Standard Reference as the primary raw data source, expansion of the 145 FFQ line items to code individual foods to assign nutrient values, a selection process to match foods to appropriate nutrition codes for nutrient information, and a statistical model to calculate nutrient intakes. The historical database contains 449 foods and nutrient data for all 29 nutrients available in 1985. The adequacy with which an FFQ can provide reliable diet assessment data depends on the integrity of the underlying database. We outlined a systematic protocol to derive usual dietary intake from an FFQ using a robust nutrient database that is appropriate for the Framingham Offspring-Spouse Study FFQ and its assessment time-frame. The database can be updated to accommodate changes in the food supply and eating behaviors and creates a foundation for future nutrition research.

Diet quality and obesity in women: the Framingham Nutrition Studies.

Obesity affects one in three American adult women and is associated with overall mortality and major morbidities. A composite diet index to evaluate total diet quality may better assess the complex relationship between diet and obesity, providing insights for nutrition interventions. The purpose of the present investigation was to determine whether diet quality, defined according to the previously validated Framingham nutritional risk score (FNRS), was associated with the development of overweight or obesity in women. Over 16 years, we followed 590 normal-weight women (BMI < 25 kg/m2), aged 25 to 71 years, of the Framingham Offspring and Spouse Study who presented without CVD, cancer or diabetes at baseline. The nineteen-nutrient FNRS derived from mean ranks of nutrient intakes from 3 d dietary records was used to assess nutritional risk. The outcome was development of overweight or obesity (BMI > or = 25 kg/m2) during follow-up. In a stepwise multiple logistic regression model adjusted for age, physical activity and smoking status, the FNRS was directly related to overweight or obesity (P for trend = 0.009). Women with lower diet quality (i.e. higher nutritional risk scores) were significantly more likely to become overweight or obese (OR 1.76; 95 % CI 1.16, 2.69) compared with those with higher diet quality. Diet quality, assessed using a comprehensive composite nutritional risk score, predicted development of overweight or obesity. This finding suggests that overall diet quality be considered a key component in planning and implementing programmes for obesity risk reduction and treatment recommendations.