Dietary patterns: from nutritional epidemiologic analysis to national guidelines

Cespedes, Elizabeth M.; Hu, Frank B.

doi:10.3945/ajcn.115.110213

Cited by 302 publications

(228 citation statements)

References 10 publications

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“…This cross-sectional study was undertaken to examine the association of diet patterns derived by cluster analysis with the prevalence of CVD risk factors (mainly obesity, lipid biomarkers, SBP and FBS) in Pakistani adults aged 40 years and older. Identification of overall diet trends that incorporates the interaction of different food items in a specific population is a more appropriate method to examine the relationship between diet and disease risk than focusing on individual foods or nutrients [7,36]. Dietary pattern studies tend to identify at least one pattern or cluster that can be defined a healthier eating pattern, however, in some populations a typical healthy or unhealthy diet pattern may not exist but dietary behaviors might be characterized by different types of foods categorized as healthy or unhealthy within the similar diet patterns.…”

Section: Discussionmentioning

confidence: 99%

Do dietary patterns explain high prevalence of cardiovascular risk factors among Pakistani urban adults? A cross-sectional study

et al. 2016

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Background: The prevalence of cardiovascular disease (CVD) in South Asia is higher than in any other developing countries. The diversity of diets in populations among developing countries may be one explanation for the differences in CVD. This study was carried out to explore the association between dietary patterns and the presence of cardiovascular risk factors among Pakistani low income urban adults. Methods: Socio demographic, physical activity and dietary information was collected from 1546 Pakistani subjects aged ≥40 years from the Control of Hypertension and Risk Attenuation (COBRA) study. Anthropometric, clinical and biomarker measures were assessed. Cluster analysis was used to identify dietary patterns from a food frequency questionnaire (FFQ) and multinomial regression was employed to investigate the association between dietary clusters and cardiovascular risk factors, using one of the dietary clusters as a reference category. Results: The most prevalent CVD risk factors among participants were elevated low density lipoprotein-cholesterol (LDL-C) (69.8 %) and systolic blood pressure (SBP) (68.2 %), followed by central obesity (57.1 %), low levels of high density lipoprotein-Cholesterol (HDL-C) (56.3 %), overall obesity (46.0 %), high total cholesterol (32.3 %), and elevated fasting blood sugar (FBS) (34.9 %). The cluster analysis generated 3 non-overlapping diet patterns. Cluster 1(Traditional Pakistani Diet), was dominated by fruits, vegetables, milk products and chicken, included participants with high mean body mass index (BMI), waist circumference (WC), HDL-C and low mean SBP. Cluster 2 (Moderate Diet) reflected a moderate intake of most food items and included participants with significantly higher mean SBP. Cluster 3 (Fatty Diet) was characterized by high intake of beef, whole milk, paratha and lentils and those following this cluster had a low mean HDL-C and high SBP. In analyses controlling for age, gender, tobacco use and physical activity, participants in the Traditional diet cluster were more likely to be overweight (OR 1.39, 95 % CI 1.08 to 1.78) and high central adiposity (1.33, 95 % CI 1.04 to 1.71) than participants in the Moderate diet cluster, though less likely to have elevated SBP (OR 0.67, 95 % CI 0.51 to 0.86). LDL-C levels were higher in both the traditional Pakistani diet and Fatty diet cluster compared to the Moderate diet cluster. Low HDL-C was also more prevalent among the Traditional Pakistani diet cluster. Conclusion: Among Pakistani population discernable diet patterns can be derived using clusters analysis. CVD risk factors prevalence differed by cluster membership, though relations for specific CVD risk are not consistent across clusters.

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Section: Discussionmentioning

confidence: 99%

Do dietary patterns explain high prevalence of cardiovascular risk factors among Pakistani urban adults? A cross-sectional study

et al. 2016

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“…There has been growing interest in examining overall maternal diet quality (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) by using index scores such as the Healthy Eating Index (HEI) (7)(8)(9)(10), the Mediterranean diet score (10)(11)(12)(13)(14)(15)(16), the New Nordic diet score (17,18), and the Dietary Approaches to Stop Hypertension (DASH) score (19). This is because these take into account the multiplex interactions among nutrients and foods (22), an approach congruent with recommendations of the 2015 Dietary Guidelines Advisory Committee (23). Although each dietary index captures adherence to slightly different dietary guidelines, in general, these indexes indicate a good-quality diet as one that is high in vegetables, fruit, fish, and unsaturated fats and low in red and processed meat and saturated fats (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

Chia

Tint

Han

et al. 2018

The American Journal of Clinical Nutrition

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Background: Evidence linking maternal diet quality during pregnancy with infant birth outcomes is limited in Asia. Objective: We investigated the association of maternal diet quality with the risk of preterm birth, offspring birth size, and adiposity in a multiethnic Asian birth cohort. Design: Dietary intakes of 1051 pregnant women were ascertained at 26-28 wk of gestation with the use of 24-h recalls and 3-d food diaries, from which diet quality (score range: 0-100) was measured by the Healthy Eating Index for pregnant women in Singapore (HEI-SGP). Gestational age was established by first-trimester ultrasound dating scan. Neonatal weight and length were measured at birth. Body composition was assessed by air displacement plethysmography in a subset of infants (n = 313) within 72 h after birth, and abdominal adiposity was assessed by MRI (n = 316) within the first 2 wk of life. Associations were assessed by multivariable linear regression for continuous outcomes and logistic regression for preterm birth. Results: The mean ± SD maternal HEI-SGP score was 52.1 ± 13.6. Maternal diet quality during pregnancy was not associated with preterm birth or birth weight. Greater adherence to the HEI-SGP (per 10-point increment in HEI-SGP score) was associated with longer birth length [β (95% CI): 0.14 (0.03, 0. Conclusions:Higher maternal diet quality during pregnancy was associated with longer birth length and lower neonatal adiposity but not with birth weight and preterm birth. These findings warrant further investigation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.Am J Clin Nutr 2018;107:71-79.

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“…It is a public health priority globally to identify optimal diets for preventing chronic diseases [33]. Yet, very few studies have assessed empirical dietary patterns among Ghanaians [34,35] with no published evidence on typical dietary patterns among Ghanaian school-age children.…”

Section: Introductionmentioning

confidence: 99%

Dietary patterns and associated risk factors among school age children in urban Ghana

Alangea¹,

Aryeetey²,

Gray³

et al. 2018

BMC Nutr

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Background: Understanding dietary patterns in the study of diet-disease relationships is crucial for designing dietary behaviour interventions. This study aimed to determine associations between dietary patterns and background characteristics among school age children (9-15 years) in Ghana. Methods: A cross-sectional sample of 487 urban-dwelling children age 9-15 years was recruited using simple random sampling from 24 schools (12 private and 12 public) in the Ga-East Municipality in Southern Ghana. A 7-day food frequency questionnaire was used to record children's consumption of over 100 unique food items. Principal component analyses based on 14 food groups was used to describe emerging dietary patterns (DP). BMI-for-age z-scores segregated by sex were derived using WHO Anthro plus software. Linear regression was used to test associations between 'diet factor' scores, and weight status controlling for age. Results: Four DPs were identified that explained 53.2% of variation in the diets of children: (1) energy dense; (2) starchy root staple and vegetables; (3) cereal-grain staples and poultry; and (4) fish & seafoods. Energy dense DP characterised by processed meat, fried foods, and sugary foods was associated with child overweight/obese status after controlling for age, sex, SES and school type [F(5, 484) = 6.868, p < 0.001]. Starchy root with vegetable DP was negatively associated with overweight/obese status, private school attendance and higher SES after controlling for age at bivariate level. However, relationship between 'starchy root staples and vegetables' DP and overweight/obese status lost significance after controlling for other covariates. Conclusion: Our data identified energy-dense dietary pattern to be significantly associated with childhood overweight and obesity. Targeted dietary messages are required to address energy-dense dietary patterns among school-age children.

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Dietary patterns: from nutritional epidemiologic analysis to national guidelines

Cited by 302 publications

References 10 publications

Do dietary patterns explain high prevalence of cardiovascular risk factors among Pakistani urban adults? A cross-sectional study

Do dietary patterns explain high prevalence of cardiovascular risk factors among Pakistani urban adults? A cross-sectional study

Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

Dietary patterns and associated risk factors among school age children in urban Ghana

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