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Population-Based Nutrition Epidemiology

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 57734

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Prof. Dr. Demosthenes Panagiotakos

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Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
Interests: chronic disease epidemiology; nutritional epidemiology; public health; Mediterranean diet
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Dear Colleagues,

Nutritional epidemiology examines dietary or nutritional factors in relation to the occurrence of disease in various populations. It is a fact that substantial progress has been made in recent years in nutritional epidemiology. Compared to the practice during the 1990s, and with the improvements in data analytics, several new approaches are gaining ground. Results from a variety of large-scale studies in the field of nutrition epidemiology have substantially contributed toward the evidence used in guiding dietary recommendations for prevention of cardiovascular diseases, metabolic disorders, some types of cancer, and other morbidities.

In this Special Issue, we would like to bring readers closer to the state-of-the-art in the field by gathering papers covering different aspects of nutrition epidemiology from population-based observational studies. Topics of the submitted articles may, but not necessarily, include eating habits of various populations, especially of those not well-studied, such as in Africa, Oceania, South Americas, immigrants, minorities, as well as a variety of associations between nutrients/foods/food patterns and chronic diseases, like cardiovascular, diabetes, obesity, cancer, etc., and gene–nutrient and epigenome–nutrient interactions related to human health at all ages. Articles on the study of nutrition on healthy aging, longevity, and well-being are more than welcome. In addition, methodology articles in the field of nutrition assessment in population-based studies, or data-analytics of large databases in nutrition epidemiology may also be submitted. Original research articles and reviews (systematic reviews and meta-analyses) are welcome.

Dr. Demosthenes Panagiotakos
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

Population-based
Nutrition
Diet
Chronic disease

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Published Papers (11 papers)

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Editorial

Jump to: Research, Review

4 pages, 547 KiB

Open AccessEditorial

Towards a Better Primary Healthcare in Europe: Shifts in Public Health Nutrition Policies

by Demosthenes B. Panagiotakos, Matina Kouvari and Kyriakos Souliotis

Nutrients 2020, 12(11), 3308; https://doi.org/10.3390/nu12113308 - 29 Oct 2020

Viewed by 2657

Abstract

The interrelated challenges of suboptimal dietary habits and abnormal weight status have never been as high on the global and European public health agenda as nowadays [...] Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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Research

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19 pages, 704 KiB

Open AccessArticle

Anthropometric, Familial- and Lifestyle-Related Characteristics of School Children Skipping Breakfast in Jeddah, Saudi Arabia

by Hazzaa M. Al-Hazzaa, Amani A. Al-Rasheedi, Rayan A. Alsulaimani and Laura Jabri

Nutrients 2020, 12(12), 3668; https://doi.org/10.3390/nu12123668 - 29 Nov 2020

Cited by 10 | Viewed by 4202

Abstract

Breakfast is a vital meal that provides children with important nutrients and energy. This study examined the anthropometric, familial- and lifestyle-related characteristics of school children skipping breakfast. A total of 1149 children (boys: 45.5%), 6 to 12 years old (mean and SD: 9.3 ± 1.7 years), were randomly selected from elementary schools in Jeddah. Weight and height were measured. Breakfast eating frequency, socio-demographics, and lifestyle behaviors were assessed using a specifically designed self-report questionnaire reported by the parents. Nearly 80% of the children skipped daily breakfast at home with no significant age or gender differences. The most common reasons for skipping breakfast at home included not feeling hungry and waking up late for school. Fried egg sandwiches and breakfast cereals were most frequently consumed for breakfast. Strong parental support for breakfast as the main daily meal was significantly associated with daily breakfast intake. Logistic regression analyses, adjusted for age, gender, and socio-demographics, revealed that paternal education (aOR = 1.212, 95% CI = 1.020–1.440, p = 0.029), maternal education (aOR = 1.212, 95% CI = 1.003–1.464, p=0.046), insufficient sleep (aOR = 0.735, 95% CI = 0.567–0.951, p = 0.019), and BMI <25 kg/m² (aOR = 1.333, 95% CI = 1.015–1.752, p = 0.039) were significantly associated with breakfast intake. The findings have implications for children’s health and school performance. Concerted effort is required to promote breakfast consumption among Saudi children. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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13 pages, 631 KiB

Open AccessArticle

A Cross-Sectional Survey of Salty Snack Consumption among Serbian Urban-Living Students and Their Contribution to Salt Intake

by Jasmina B. Timic, Jelena Kotur-Stevuljevic, Heiner Boeing, Dušanka Krajnovic, Brizita Djordjevic and Sladjana Sobajic

Nutrients 2020, 12(11), 3290; https://doi.org/10.3390/nu12113290 - 27 Oct 2020

Cited by 4 | Viewed by 3050

Abstract

This study investigated the behavior of urban-living students related to the salty snacks consumption, and their contribution to salt daily intake. A cross-sectional survey on 1313 urban-living students (16–25 years, 61.4% university students and 38.6% high school students) used a pre-verified questionnaire created specifically for the study. The logistic regression analysis was performed to investigate the factors influencing snack consumption. The results of salt content and the snack consumption frequency were used to evaluate snack contribution to salt intake. All subjects consumed salty snacks, on average several times per week, more often at home and slightly more during periods of intensive studying, with 42% of the participants reporting to consume two or more packages per snacking occasion. Most of the participants consumed such products between main meals, but 10% of them took snacks immediately after the main meal. More high-school students than university students were in the “high snack group” (p < 0.05). The most frequently consumed salty snacks were those with the highest content of salt. Salt intake from snack products for a majority of participants ranged between 0.4 and 1 g/day. The research revealed younger age, home environment and significant contribution to salt intake as critical points in salty snack consumption among urban-living students important for the better understanding of their dietary habits. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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15 pages, 939 KiB

Open AccessArticle

Eating Competence Associated with Food Consumption and Health Outcomes among Brazilian Adult Population

by Fabiana Lopes Nalon de Queiroz, Eduardo Yoshio Nakano, Raquel Braz Assunção Botelho, Verônica Cortez Ginani, André Luiz Fernandes Cançado and Renata Puppin Zandonadi

Nutrients 2020, 12(10), 3218; https://doi.org/10.3390/nu12103218 - 21 Oct 2020

Cited by 12 | Viewed by 3507

Abstract

This study aimed to associate Eating Competence (EC) with food consumption and health outcomes in the Brazilian adult population. Researchers developed a questionnaire to associate EC with sociodemographic information, health outcomes, and food consumption. Data on body weight and height was referred to by participants in the questionnaire, and body mass index (BMI) was calculated and classified. A question to evaluate the perception of body size was included. After constructing the questionnaire items, content validation and semantic evaluation were performed following the Delphi method with a group of judges composed of 26 health professionals. The judges evaluated the sociodemographic information, health outcomes, and food consumption items associated with the eating competence instrument (previously validated in Brazilian-Portuguese). The final version of the questionnaire was composed of 33 items. Our results confirmed good reliability, responsiveness, and internal consistency. A total of 1810 Brazilians answered the questionnaire. Most of the participants were female, up to 40 years old, with a high education level and high income. Most of the participants did not report diabetes or hypertension. The EC total score did not differ among males and females. Individuals up to 40 years old presented a lower total score. The increase in educational level and income also increased EC total score. Excess weight individuals showed lower EC compared to the normal weight/underweight. Individuals who consumed fruits and/or vegetables five or more days/week presented the best scores for total EC. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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14 pages, 2080 KiB

Open AccessArticle

Nutritional Status and Oral Frailty: A Community Based Study

by Yoshiaki Nomura, Yoshimasa Ishii, Shunsuke Suzuki, Kenji Morita, Akira Suzuki, Senichi Suzuki, Joji Tanabe, Yasuo Ishiwata, Koji Yamakawa, Yota Chiba, Meu Ishikawa, Kaoru Sogabe, Erika Kakuta, Ayako Okada, Ryoko Otsuka and Nobuhiro Hanada

Nutrients 2020, 12(9), 2886; https://doi.org/10.3390/nu12092886 - 21 Sep 2020

Cited by 26 | Viewed by 5929

Abstract

Compromised oral health can alter food choices. Poor masticatory function leads to imbalanced food intake and undesirable nutritional status. The associations among nutritional status, oral health behavior, and self-assessed oral functions status were investigated using a community-based survey. In total, 701 subjects more than 50 years old living Ebina city located southwest of the capital Tokyo were investigated. The number of remaining teeth was counted by dental hygienists. Oral health behavior and self-assessed oral functions were evaluated by oral frailty checklist. Nutritional status was evaluated by the brief-type self-administered diet history questionnaire using Dietary Reference Intakes for Japanese as reference. More than 80% of subjects’ intakes of vitamin B₁₂, pantothenic acid, copper, and proteins were sufficient. In contrast, only 19% of subjects’ intake of vitamin A was sufficient and 35.5% for vitamin B₁. More than 90% of subjects’ intakes of vitamin D and vitamin K were sufficient. Only 35.5% of subjects’ intakes of dietary fiber were sufficient. Overall, 88.9% of subjects had excess salt. The number of remaining teeth was not correlated with nutritional intakes. Oral health behavior significantly correlated with nutritional intakes. Oral functions are important for food choice; however, oral functions were not directly correlated with nutritional intakes. Comprehensive health instructions including nutrition and oral health education is necessary for health promotion. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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15 pages, 609 KiB

Open AccessArticle

Circulating Short-Chain Fatty Acids Are Positively Associated with Adiposity Measures in Chinese Adults

by Yiqing Wang, Huijun Wang, Annie Green Howard, Katie A. Meyer, Matthew C. B. Tsilimigras, Christy L. Avery, Wei Sha, Shan Sun, Jiguo Zhang, Chang Su, Zhihong Wang, Bing Zhang, Anthony A. Fodor and Penny Gordon-Larsen

Nutrients 2020, 12(7), 2127; https://doi.org/10.3390/nu12072127 - 17 Jul 2020

Cited by 25 | Viewed by 4059

Abstract

Epidemiological studies suggest a positive association between obesity and fecal short-chain fatty acids (SCFAs) produced by microbial fermentation of dietary carbohydrates, while animal models suggest increased energy harvest through colonic SCFA production in obesity. However, there is a lack of human population-based studies with dietary intake data, plasma SCFAs, gut microbial, and anthropometric data. In 490 Chinese adults aged 30–68 years, we examined the associations between key plasma SCFAs (butyrate/isobutyrate, isovalerate, and valerate measured by non-targeted plasma metabolomics) with body mass index (BMI) using multivariable-adjusted linear regression. We then assessed whether overweight (BMI ≥ 24 kg/m²) modified the association between dietary-precursors of SCFAs (insoluble fiber, total carbohydrates, and high-fiber foods) with plasma SCFAs. In a sub-sample (n = 209) with gut metagenome data, we examined the association between gut microbial SCFA-producers with BMI. We found positive associations between butyrate/isobutyrate and BMI (p-value < 0.05). The associations between insoluble fiber and butyrate/isobutyrate differed by overweight (p-value < 0.10). There was no statistical evidence for an association between microbial SCFA-producers and BMI. In sum, plasma SCFAs were positively associated with BMI and that the colonic fermentation of fiber may differ for adults with versus without overweight. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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19 pages, 1132 KiB

Open AccessArticle

Breakfast Consumption in Low-Income Hispanic Elementary School-Aged Children: Associations with Anthropometric, Metabolic, and Dietary Parameters

by Matthew R. Jeans, Fiona M. Asigbee, Matthew J. Landry, Sarvenaz Vandyousefi, Reem Ghaddar, Heather J. Leidy and Jaimie N. Davis

Nutrients 2020, 12(7), 2038; https://doi.org/10.3390/nu12072038 - 9 Jul 2020

Cited by 11 | Viewed by 3679

Abstract

Breakfast consumption is associated with lower obesity prevalence and cardiometabolic risk and higher dietary quality (DQ) in children. Low-income, Hispanic populations are disproportionately affected by obesity and cardiometabolic risks. This study examined the relationship between breakfast consumption groups (BCG) on anthropometric, metabolic, and dietary parameters in predominately low-income, Hispanic children from 16 Texas schools. Cross-sectional data were from TX Sprouts, a school-based gardening, nutrition, and cooking randomized controlled trial. Anthropometric measurements included height, weight, body mass index, body fat percent via bioelectrical impedance, waist circumference, and blood pressure. Metabolic parameters included fasting plasma glucose, insulin, glycated hemoglobin, cholesterol, and triglycerides. DQ and BCG were assessed via two 24-h dietary recalls. Multivariate multiple regression examined relationships between BCG and anthropometric, metabolic, and dietary parameters. This study included 671 students (mean age 9 years, 58% Hispanic, 54% female, 66% free/reduced lunch, 17% breakfast skippers). No relationships were observed between BCG and anthropometric or metabolic parameters. BCG had higher DQ; higher daily protein, total sugar, and added sugar intake; and lower daily fat intake. Skipping breakfast was associated with lower DQ; higher daily fat intake; and lower daily protein intake. Longitudinal research examining breakfast quality on cardiometabolic outcomes in low-income, Hispanic children is warranted. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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26 pages, 8714 KiB

Open AccessArticle

Diet and Nutrition Status of Mongolian Adults

by Sabri Bromage, Tselmen Daria, Rebecca L. Lander, Soninkhishig Tsolmon, Lisa A. Houghton, Enkhjargal Tserennadmid, Nyamjargal Gombo, Rosalind S. Gibson and Davaasambuu Ganmaa

Nutrients 2020, 12(5), 1514; https://doi.org/10.3390/nu12051514 - 22 May 2020

Cited by 24 | Viewed by 10746

Abstract

(1) Background: Aspects of the Mongolian food supply, including high availability of animal-source foods and few plant foods, are plausibly associated with disease in the population. Data on Mongolian diets are lacking, and these risks are poorly quantified. The purpose of this study was to provide a multifaceted nutritional analysis of the modern Mongolian diet. (2) Methods: The study population consisted of 167 male and 167 female healthy non-pregnant urban and nomadic adults (22–55 years) randomly selected from lists of residents in 8 regions. From 2011–2016, 3-day weighed diet records and serum were collected twice from each participant in summer and winter; anthropometry was collected once from each participant. Serum was analyzed for biomarkers, and nutrient intake computed using purpose-built food composition data and adjusted for within-person variation. Exploratory dietary patterns were derived and analyzed for associations with diet and nutrition measurements. (3) Results: We collected 1838 of an expected 1986 diet records (92.5%), 610/658 serum samples (92.7%), and 315/334 height and weight measurements (94.3%). Sixty-one percent of men and 51% of women were overweight or obese. Consumption of red meat, refined grains, and whole-fat dairy was high, while that of fruits, non-tuberous vegetables, eggs, nuts and seeds, fish and poultry, and whole grains was low. Dairy and red meat were more consumed in summer and winter, respectively. Dietary inadequacy of 10 of 21 assessed nutrients, including fiber, folate, and vitamin D were >50% prevalent, while protein, zinc, and vitamin B12 inadequacy were low. Biochemical evidence of iron and vitamin A deficiency was also low. Three dietary patterns (Urban, Transitional, Nomadic) explained 41% of variation in food consumption. The Urban pattern was positively associated with BMI in multivariate analysis. (4) Conclusions: Results indicate a high prevalence of key dietary inadequacies and overweight among Mongolian adults. Prior studies by our group have suggested that expanded supplementation and food fortification would be effective in addressing micronutrient inadequacies; these strategies should be coupled with measures to mitigate the growing burden of chronic disease. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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13 pages, 588 KiB

Open AccessArticle

Food Involvement, Eating Restrictions and Dietary Patterns in Polish Adults: Expected Effects of Their Relationships (LifeStyle Study)

by Marzena Jezewska-Zychowicz, Jerzy Gębski and Milena Kobylińska

Nutrients 2020, 12(4), 1200; https://doi.org/10.3390/nu12041200 - 24 Apr 2020

Cited by 22 | Viewed by 5267

Abstract

Understanding the factors that coexist with healthy and unhealthy eating behaviors is prevalent and important for public health. The aim of this study was to investigate the associations between food involvement, eating restrictions, and dietary patterns in a representative sample of Polish adults. The study was conducted among a group of 1007 adults. Questions with the answers yes or no were used to obtain the data regarding eating restrictions. Data relating to food involvement were obtained with the Food Involvement Scale (FIS). Questions from the Beliefs and Eating Habits questionnaire were used to measure the frequency of consumption of different food groups. Five dietary patterns (DPs) were derived using principal component analysis (PCA), i.e., ‘Fruit and vegetables’, ‘Wholemeal food’, ‘Fast foods and sweets’, ‘Fruit and vegetable juices’ and “Meat and meat products’. In each of the DPs, three groups of participants were identified based on tertile distribution with the upper tertile denoting the most frequent consumption. Nearly two-thirds of the study sample declared some restrictions in food consumption. The probability of implementing restrictions in consumption of foods high in sugar, fat and high-fat foods increased in the upper tertile of ‘Fruit and vegetables’ and ‘Wholemeal’ DPs. Moreover, the probability of implementing restrictions in consumption of meat and high-starch products increased in ‘Wholemeal’ DP. The probability of using eating restrictions decreased in the upper tertile of ‘Fast foods and sweets’ and Meat and meat products’ DPs. In conclusion, individuals characterized by high food involvement were more inclined to use eating restrictions than individuals with lower food involvement. Their DPs were also healthier compared to those of individuals manifesting low food involvement. Therefore, promoting personal commitment to learning about and experiencing food may be an effective way of inducing a change of eating habits, and therefore a healthier diet. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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15 pages, 1897 KiB

Open AccessArticle

Traditional Dietary Patterns and Risk of Mortality in a Longitudinal Cohort of the Salus in Apulia Study

by Roberta Zupo, Rodolfo Sardone, Rossella Donghia, Fabio Castellana, Luisa Lampignano, Ilaria Bortone, Giovanni Misciagna, Giovanni De Pergola, Francesco Panza, Madia Lozupone, Andrea Passantino, Nicola Veronese, Vito Guerra, Heiner Boeing and Gianluigi Giannelli

Nutrients 2020, 12(4), 1070; https://doi.org/10.3390/nu12041070 - 12 Apr 2020

Cited by 29 | Viewed by 4024

Abstract

There is still room for further studies analyzing the long-term health impact of specific dietary patterns observable in regions belonging to the Mediterranean area. The aim of the study is to evaluate how much a diet practiced in southern Italy is associated to a risk of mortality. The study population included 2472 participants first investigated in 1985, inquiring about their frequencies of intake of 29 foods using a self-administered questionnaire covering the previous year. The population was followed up for mortality until 31 December 2017. Cox-based risk modeling referred to single foods, food groups, the results of principal component analysis (PCA), and a priori indexes. Single food analysis revealed eggs, fatty meat, and fatty/baked ham to be inversely associated with mortality. Furthermore, one of the 5 PCA derived dietary patterns, the “Farmhouse” pattern, showed a higher hazard ratio (HR), mostly driven by dairy products. In subsequent analyses, the increased risk of mortality for fresh cheese and decreased risk for fatty ham and eggs were confirmed. The a priori diet indexes (Italian Meddiet, Meddietscore, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean–DASH Intervention for Neurodegenerative Delay diet (MIND) indexes) showed borderline inverse relationships. In a Mediterranean population with an overall healthy diet, foods such as eggs and fatty meat, reflecting dietary energy and wealth, played a role in prolonging the life of individuals. Our study confirms that some dairy products might have a detrimental role in mortality in the Mediterranean setting. Full article

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Review

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22 pages, 2010 KiB

Open AccessReview

Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis

by Fotios Barkas, Tzortzis Nomikos, Evangelos Liberopoulos and Demosthenes Panagiotakos

Nutrients 2020, 12(8), 2436; https://doi.org/10.3390/nu12082436 - 13 Aug 2020

Cited by 38 | Viewed by 9248

Abstract

Background: Although a cholesterol-lowering diet and the addition of plant sterols and stanols are suggested for the lipid management of children and adults with familial hypercholesterolemia, there is limited evidence evaluating such interventions in this population. Objectives: To investigate the impact of cholesterol-lowering diet and other dietary interventions on the incidence or mortality of cardiovascular disease and lipid profile of patients with familial hypercholesterolemia. Search methods: Relevant trials were identified by searching US National Library of Medicine National Institutes of Health Metabolism Trials Register and clinicaltrials.gov.gr using the following terms: diet, dietary, plant sterols, stanols, omega-3 fatty acids, fiber and familial hypercholesterolemia. Selection criteria: Randomized controlled trials evaluating the effect of cholesterol-lowering diet or other dietary interventions in children and adults with familial hypercholesterolemia were included. Data collection and analysis: Two authors independently assessed the eligibility of the included trials and their bias risk and extracted the data which was independently verified by other colleagues. Results: A total of 17 trials were finally included, with a total of 376 participants across 8 comparison groups. The included trials had either a low or unclear bias risk for most of the assessed risk parameters. Cardiovascular incidence or mortality were not evaluated in any of the included trials. Among the planned comparisons regarding patients’ lipidemic profile, a significant difference was noticed for the following comparisons and outcomes: omega-3 fatty acids reduced triglycerides (mean difference (MD): −0.27 mmol/L, 95% confidence interval (CI): −0.47 to −0.07, p < 0.01) when compared with placebo. A non-significant trend towards a reduction in subjects’ total cholesterol (MD: −0.34, 95% CI: −0.68 to 0, mmol/L, p = 0.05) and low-density lipoprotein cholesterol (MD: −0.31, 95% CI: −0.61 to 0, mmol/L, p = 0.05) was noticed. In comparison with cholesterol-lowering diet, the additional consumption of plant stanols decreased total cholesterol (MD: −0.62 mmol/L, 95% CI: −1.13 to −0.11, p = 0.02) and low-density lipoprotein cholesterol (MD: −0.58 mmol/L, 95% CI: −1.08 to −0.09, p = 0.02). The same was by plant sterols (MD: −0.46 mmol/L, 95% CI: −0.76 to −0.17, p < 0.01 for cholesterol and MD: −0.45 mmol/L, 95% CI: −0.74 to −0.16, p < 0.01 for low-density lipoprotein cholesterol). No heterogeneity was noticed among the studies included in these analyses. Conclusions: Available trials confirm that the addition of plant sterols or stanols has a cholesterol-lowering effect on such individuals. On the other hand, supplementation with omega-3 fatty acids effectively reduces triglycerides and might have a role in lowering the cholesterol of patients with familial hypercholesterolemia. Additional studies are needed to investigate the efficacy of cholesterol-lowering diet or the addition of soya protein and dietary fibers to a cholesterol-lowering diet in patients with familial hypercholesterolemia. Full article

(This article belongs to the Special Issue Population-Based Nutrition Epidemiology)

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