Nutrient intake and dietary quality changes within a personalized lifestyle intervention program for metabolic syndrome in primary care

Abstract

A team-based 12-month lifestyle program for the treatment of metabolic syndrome (MetS) (involving physicians, registered dietitians (RDs), and kinesiologists) was previously shown to reverse MetS in 19% of patients (95% confidence interval, 14% to 24%). This work evaluates changes in nutrient intake and diet quality over 12 months (n = 205). Individualized diet counselling was provided by 14 RDs at 3 centres. Two 24-h recalls, the Canadian Healthy Eating Index (HEI-C), and the Mediterranean Diet Score (MDS) were completed at each time point. Total energy intake decreased by 145 ± 586 kcal (mean ± SD) over 3 months with an additional 76 ± 452 kcal decrease over 3–12 months. HEI-C improved from 58 ± 15 to 69 ± 12 at 3 months and was maintained at 12 months. Similarly, MDS (n = 144) improved from 4.8 ± 1.2 to 6.2 ± 1.9 at 3 months and was maintained at 12 months. Changes were specific to certain food groups, with increased intake of fruits, vegetables, and nuts and decreased intake of “other foods” and “commercial baked goods” being the most prominent changes. There was limited change in intake of olive oil, fish, and legumes. Exploratory analysis suggested that poorer diet quality at baseline was associated with greater dietary changes as assessed by HEI-C. Novelty Multiple dietary assessment tools provided rich information on food intake changes in an intervention for metabolic syndrome. Improvements in diet were achieved by 3 months and maintained to 12 months. The results provide a basis for further dietary change implementation studies in the Canadian context.

Evaluation of Latent Models Assessing Physical Fitness and the Healthy Eating Index in Community Studies: Time-, Sex-, and Diabetes-Status Invariance

“…While these food groups are important for general health, if intake did not vary among the participants with low vs. high HEI scores at baseline and did not change with intervention, they will not contribute to the model. Examination of the data from the original study provides indirect evidence to support this interpretation [50]. Mean HEI scores for meat and alternates were high at baseline (8/10 possible points) and remained high throughout the 12-month intervention.…”

“…To calculate the Canadian version of the HEI (HEI-C) [50,51], a FFQ was developed to assess the average number of servings of food groups eaten over the past month and then scored according to specific age and sex criteria based on Canada's Food Guide (CFG) 2007 recommendations and serving sizes [52] (see Supplement Table S1). The scores for the moderation components, energy (kcal) from saturated fat and other foods (as a percentage of total energy), and sodium (in milligrams) were calculated from the results of two 24-h recalls, done about one week apart, at baseline, 3-months and 12-months, as previously described [50]. The dietary intake data were collected by the RDs at each centre and analyzed centrally to maintain quality control using a comprehensive nutrient analysis program (ESHA Food Processor-Canadian Version 10, Salem, OR, USA) and double data entry.…”

Development and validation of a photographic atlas of food portions for accurate quantification of dietary intakes in China

“…Rapid economic growth and urbanisation have brought remarkable changes in China, impacting diet and leading to an increasing prevalence of overweight and obese individuals, as well as diet-related non-communicable diseases 16,17,18,19 . Thus, locally relevant dietary assessment tools for determining the dietary structure and energy and nutrient intake of the Chinese population are essential 20,21 . Many auxiliary tools have been used in dietary surveys in China, including tableware (bowls, cups, spoons, etc.)…”

The Adherence of Singaporean Students in Different Educational Institutions to National Food-Based Dietary Guidelines

“…Such methodologies frequently compare estimates of dietary intake against food or nutrient based dietary guidelines [ 26 , 27 ], providing a single numeric indicator from complex dietary data [ 28 , 29 ]. Such approaches have been used to provide feedback to individuals on overall dietary habits [ 30 , 31 ] and could help focus future public health efforts for specific populations [ 32 ]. Such approaches may also be less prone to confounding factors than an evaluation of intake of single or multiple nutrients and food groups [ 33 ].…”