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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: closed (10 June 2020) | Viewed by 118267

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Dr. Aurora Bueno-Cavanillas

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Guest Editor

1. Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain
2. CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
3. Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain
Interests: women’s health; lifestyle intervention; patient safety
Special Issues, Collections and Topics in MDPI journals

Dr. Sandra Martin-Pelaez

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Co-Guest Editor

Department of Preventive Medicine and Public Health, University of Granada, 18010 Granada, Spain
Interests: gut microbiota; human nutrition; animal nutrition; food bioactive compounds; probiotics; prebiotics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diet quality is a key determinant of health. The general population are frequently confused by contradictory messages in advertisements and on social media. In addition, the health practitioners are also often misinformed, being influenced by fashionable trends or prominent authors. Recently, we have seen an astonishing recommendation regarding red meat and processed meat consumption, which has generated a strong movement of rejection. In this context, it is time we put an emphasis on the relationship between diet quality and health. As guest editor, I suggest considering every vital human life stage, from birth to the end of life. The quality of one’s diet is related to a lower risk for maternal obstetric and foetal complications, it influences growth and physical and mental development in offspring, contributes to avoiding obesity and metabolically-related diseases, and preserves body functions. The focus should be on the positive effects of diet over health promotion, versus diet-related pathologies. Nevertheless, diet intervention is a very important issue for many diseases’ treatment. From this point of view, diet quality is also a key factor in preventing diseases progression and complications. In addition, it should not be forgotten that to measure and compare diet quality is a controversial issue methodologically. Diet-quality scores have been developed to be adapted to age, nationality, and diet preferences, but without any minimum requirement for nutrients adequacy. In spite of evidence, social changes and food industry work together towards continuously worsening diet quality. Last, but not least, this Special Issue should include a vision for a public health politics, which will positively influence a populations diet quality. It should be able to make healthier eating options cheap and easy for all ages and social scales of people. It is time for action!

Dr. Aurora Bueno-Cavanillas
Dr. Sandra Martin-Pelaez
Guest Editors

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Keywords

Diet quality
Nutritional status
Maternal health
Infant health
Child health
Primary prevention
Ageing
Health impact assessment
Nutrition assessment
Nutritive value
Healthy diet
Healthy people programs

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Published Papers (10 papers)

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Research

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11 pages, 923 KiB

Open AccessArticle

Ultra-Processed Food Consumption Is Associated with Abdominal Obesity: A Prospective Cohort Study in Older Adults

by Helena Sandoval-Insausti, Manuel Jiménez-Onsurbe, Carolina Donat-Vargas, Jimena Rey-García, José R. Banegas, Fernando Rodríguez-Artalejo and Pilar Guallar-Castillón

Nutrients 2020, 12(8), 2368; https://doi.org/10.3390/nu12082368 - 7 Aug 2020

Cited by 49 | Viewed by 7781

Abstract

Introduction and objectives. Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults. Methods. The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables. Results. Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99–2.44) for the second tertile of UPF consumption and 1.62 (1.04–2.54) for the third tertile; p for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet. Conclusions. A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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12 pages, 1698 KiB

Open AccessArticle

Mediterranean Diet, Physical Activity and Gut Microbiome Composition: A Cross-Sectional Study among Healthy Young Italian Adults

by Francesca Gallè, Federica Valeriani, Maria Sofia Cattaruzza, Gianluca Gianfranceschi, Renato Liguori, Martina Antinozzi, Beatriz Mederer, Giorgio Liguori and Vincenzo Romano Spica

Nutrients 2020, 12(7), 2164; https://doi.org/10.3390/nu12072164 - 21 Jul 2020

Cited by 46 | Viewed by 5854

Abstract

Background. This cross-sectional study aimed to explore the microbial composition of the gut and its possible association with the Mediterranean diet (MD) after adjusting for demographic and anthropometric characteristics in a sample of healthy young Italian adults. Methods. Gut microbiota, demographic information, and data on adherence to MD and physical activity (PA) habits were collected in a sample of 140 university students (48.6% males, mean age 22.5 ± 2.9) with a mean body mass index (BMI) of 22.4 ± 2.8 kg/m² (15.2–33.8) and a mean PA level of 3006.2 ± 2973.6 metabolic equivalent (MET)-minutes/week (148–21,090). Results. A high prevalence of Firmicutes and Bacteroidetes was found in all the fecal samples. Significant dissimilarities in the microbiota composition were found on the basis of MD adherence and PA levels (p = 0.001). At the genus level, Streptococcus and Dorea were highly abundant in overweight/obese individuals, Ruminococcus and Oscillospira in participants with lower adherence to MD, and Lachnobacterium in subjects with low levels of PA (p = 0.001). A significantly higher abundance of Paraprevotella was shown by individuals with lower BMI, lower MD adherence, and lower PA levels (p = 0.001). Conclusions. This study contributes to the characterization of the gut microbiome of healthy humans. The findings suggest the role of diet and PA in determining gut microbiota variability. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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12 pages, 362 KiB

Open AccessArticle

Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Recommendations and Breast Cancer in the SUN Project

by Rocio Barrios-Rodríguez, Estefanía Toledo, Miguel Angel Martinez-Gonzalez, Inmaculada Aguilera-Buenosvinos, Andrea Romanos-Nanclares and José Juan Jiménez-Moleón

Nutrients 2020, 12(7), 2076; https://doi.org/10.3390/nu12072076 - 13 Jul 2020

Cited by 23 | Viewed by 3717

Abstract

A proportion of breast cancer cases are attributable to combined modifiable risk factors. The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has recently updated the recommendations for cancer prevention and a standard scoring system has been published. The aim of this study was to evaluate the association between compliance with the 2018 WCRF/AICR cancer prevention recommendations (Third Expert Report) and the risk of breast cancer in the SUN (“Seguimiento Universidad de Navarra”) prospective cohort. Spanish female university graduates, initially free of breast cancer, were included (n = 10,930). An 8-item score to measure compliance to the recommendations was built: body fat, physical activity, consumption of wholegrains/vegetables/fruit/beans, “fast foods”, red/processed meat consumption, sugar-sweetened drinks consumption, alcohol intake, and breastfeeding. A stratified analysis was conducted according to menopausal status. A non-significant inverse association was observed for overall breast cancer. The inverse association became statistically significant for post-menopausal breast cancer after multivariable adjustment (hazard ratio for > 5 vs. ≤ 3 points = 0.27; 95% CI: 0.08-0.93). The results suggested that the possible inverse association with breast cancer was attributable to the combined effects of the different nutritional and lifestyle components. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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15 pages, 749 KiB

Open AccessArticle

NHANES 2011–2014 Reveals Cognition of US Older Adults may Benefit from Better Adaptation to the Mediterranean Diet

by Matthew K. Taylor, Jonathan D. Mahnken and Debra K. Sullivan

Nutrients 2020, 12(7), 1929; https://doi.org/10.3390/nu12071929 - 29 Jun 2020

Cited by 31 | Viewed by 4342

Abstract

Although the Mediterranean diet (MedD) has gained interest for potential Alzheimer’s disease (AD) prevention, it is unknown how well US older adults follow a MedD. We used two National Health and Nutrition Examination Survey (NHANES) cycles (2011–2014) to conduct our primary aim of reporting population estimates of MedD adherence among older adults (60+ years) in the US (n = 3068). The mean MedD adherence score for US older adults was 5.3 ± 2.1 (maximum possible = 18), indicating that older adults in the US do not adhere to a MedD. There were various differences in MedD scores across demographic characteristics. We also assessed the cross-sectional relationship between MedD adherence and cognitive performance using survey-weighted ordinary least squares regression and binary logistic regression models adjusted for 11 covariates. Compared to the lowest MedD adherence tertile, the highest tertile had a lower odds ratio of low cognitive performance on three of five cognitive measures (p < 0.05 for each). Sensitivity analyses within participants without subjective memory complaints over the past year revealed similar results on the same three cognitive measures. We conclude that MedD interventions are a departure from usual dietary intake of older adults in the US and are a reasonable approach for AD prevention trials. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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11 pages, 585 KiB

Open AccessArticle

Association of Adherence to Specific Mediterranean Diet Components and Cardiorespiratory Fitness in Young Adults

by Mª José Santi-Cano, José Pedro Novalbos-Ruiz, María Ángeles Bernal-Jiménez, María del Mar Bibiloni, Josep A. Tur and Amelia Rodriguez Martin

Nutrients 2020, 12(3), 776; https://doi.org/10.3390/nu12030776 - 15 Mar 2020

Cited by 16 | Viewed by 3690

Abstract

Objective: Cardiorespiratory fitness (CRF) and a healthy diet may be part of an overall healthy lifestyle. The association between cardiorespiratory fitness and adherence to an overall Mediterranean Diet (MedD) pattern and specific MedD foods has been assessed. Design: Subjects completed a lifestyle survey and dietary pattern, using the validated MedD Adherence 14-item questionnaire and two self-reported 24-h dietary recalls. Participants’ height, body weight, waist circumference (WC), and CRF (maximum oxygen uptake, VO_2max, ml/kg/min) were measured. Setting: University of Cádiz, Spain. Subjects: A sample of young adults (n = 275, 22.2 ± 6.3 years). Results: Mean VO_2max was 43.9 mL/kg/min (SD 8.5 mL/kg/min). Most participants had healthy CRF (75.9%). The average MedD score was 6.2 points (SD 1.8 points). Participants who consumed more servings of nuts had higher VO_2max. Those who showed low CRF performed less physical activity (PA) and had a higher body mass index (BMI) and WC compared with those classified as having healthy CRF. Nut consumption was positively associated with VO_2max (β = 0.320; 95% CI 2.4, 10.7; p < 0.002), adjusting for sex, age, smoking PA, BMI, WC, and energy intake, showing the subjects who consumed more nuts were fitter than young adults who consumed less. Conclusions: CRF is positively associated with nut consumption but not with the overall MedD pattern and all other MedD foods in the young adults. The subjects who consumed more servings of nuts were fitter than young adults who consumed less. Moreover, fitter subjects performed more PA and had a lower BMI and WC than those who had lower fitness levels. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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11 pages, 958 KiB

Open AccessFeature PaperArticle

Binge Drinking and Risk of Breast Cancer: Results from the SUN (‘Seguimiento Universidad de Navarra’) Project

by Rodrigo Sánchez-Bayona, Alfredo Gea, Itziar Gardeazabal, Andrea Romanos-Nanclares, Miguel Ángel Martínez-González, Maira Bes-Rastrollo, Marta Santisteban and Estefanía Toledo

Nutrients 2020, 12(3), 731; https://doi.org/10.3390/nu12030731 - 10 Mar 2020

Cited by 7 | Viewed by 4619

Abstract

Alcohol intake is associated with the risk of breast cancer. Different patterns of alcohol-drinking may have different effects on breast cancer even when keeping constant the total amount of alcohol consumed. We aimed to assess the association between binge drinking and breast cancer risk. The SUN Project is a Spanish dynamic prospective cohort of university graduates initiated in 1999. In the 556-item lifestyle baseline questionnaire a validated food-frequency questionnaire was embedded. Participants completed biennial follow-up questionnaires. Cox regression models were used to estimate the hazard ratio (HR) for breast cancer associated with the exposure to binge drinking. A stratified analysis was performed according to menopausal status. We included 9577 women (mean age = 34 years, SD = 10 years), with a median follow-up of 11.8 years. Among 104,932 women-years of follow-up, we confirmed 88 incident cases of breast cancer. Women in the binge drinking group showed a higher risk of breast cancer (HR = 1.76; 95% CI: 1.03–2.99) compared to women in the non-binge drinking category. In the stratified analysis, a 2-fold higher risk for premenopausal breast cancer was associated with binge drinking habit (HR = 2.06; 95% CI: 1.11–3.82). This study adds new evidence on the association of binge drinking with breast cancer risk. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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Review

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15 pages, 289 KiB

Open AccessReview

Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review

by Sandra Martín-Peláez, Montse Fito and Olga Castaner

Nutrients 2020, 12(8), 2236; https://doi.org/10.3390/nu12082236 - 27 Jul 2020

Cited by 176 | Viewed by 38528

Abstract

The search for a quality diet has grown over the past decade. Diet is considered one of the pillars for the prevention and progression of several diseases, among them: diabetes. Type 2 diabetes (T2D) is an epidemic of western countries that increases the vulnerability of other diseases, such as cardiovascular and cancer. T2D is associated with lifestyle and diet. The traditional Mediterranean diet has proven its benefits over several cardiovascular risk factors, and specifically on diabetes. This review compiles recent published evidence on the effects of the Mediterranean diet on the incidence and progression of type 2 diabetes (T2D) and its relation with several other cardiovascular healthy diets. We will also focus on how the Mediterranean diet could play a role in T2D-related mechanisms, such as anti-inflammatory or antioxidant compounds, glucagon-like peptide agonist compounds, and changes in gut microbiota. Each component of the Mediterranean diet could be involved in processes related to diabetes homeostasis, many of them sharing common physio-pathological pathways. The importance of this diet within the set of habits of a healthy lifestyle must be emphasized. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

31 pages, 1904 KiB

Open AccessReview

The Impact of Plant-Based Dietary Patterns on Cancer-Related Outcomes: A Rapid Review and Meta-Analysis

by Esther Molina-Montes, Elena Salamanca-Fernández, Belén Garcia-Villanova and Maria José Sánchez

Nutrients 2020, 12(7), 2010; https://doi.org/10.3390/nu12072010 - 6 Jul 2020

Cited by 54 | Viewed by 14429

Abstract

Long-term cancer survivors represent a sizeable portion of the population. Plant-based foods may enhance the prevention of cancer-related outcomes in these patients. We aimed to synthesize the current evidence regarding the impact of plant-based dietary patterns (PBDPs) on cancer-related outcomes in the general population and in cancer survivors. Considered outcomes included overall cancer mortality, cancer-specific mortality, and cancer recurrence. A rapid review was conducted, whereby 2234 original articles related to the topic were identified via Pubmed/Medline. We selected 26 articles, which were classified into studies on PBDPs and cancer outcomes at pre-diagnosis: vegan/vegetarian diet (N = 5), provegetarian diet (N = 2), Mediterranean diet (N = 13), and studies considering the same at post-diagnosis (N = 6). Pooled estimates of the associations between the aforementioned PBDPs and the different cancer outcomes were obtained by applying random effects meta-analysis. The few studies available on the vegetarian diet failed to support its prevention potential against overall cancer mortality when compared with a non-vegetarian diet (e.g., pooled hazard ratio (HR) = 0.97; 95% confidence interval (CI): 0.88–1.06). The insufficient number of studies evaluating provegetarian index scores in relation to cancer mortality did not permit a comprehensive assessment of this association. The association between adherence to the Mediterranean diet and cancer mortality reached statistical significance (e.g., pooled HR = 0.84; 95% CI: 0.79–0.89). However, no study considered the influence of prognostic factors on the associations. In contrast, post-diagnostic studies accounted for prognostic factors when assessing the chemoprevention potential of PBDPs, but also were inconclusive due to the limited number of studies on well-defined plant-based diets. Thus, whether plant-based diets before or after a cancer diagnosis prevent negative cancer-related outcomes needs to be researched further, in order to define dietary guidelines for cancer survivors. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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15 pages, 1027 KiB

Open AccessReview

Nutrients and Dietary Patterns Related to Osteoporosis

by Araceli Muñoz-Garach, Beatriz García-Fontana and Manuel Muñoz-Torres

Nutrients 2020, 12(7), 1986; https://doi.org/10.3390/nu12071986 - 3 Jul 2020

Cited by 151 | Viewed by 25012

Abstract

Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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24 pages, 2504 KiB

Open AccessReview

Effectiveness of Interventions to Promote Healthy Eating Habits in Children and Adolescents at Risk of Poverty: Systematic Review and Meta-Analysis

by Rosario Pastor and Josep A. Tur

Nutrients 2020, 12(6), 1891; https://doi.org/10.3390/nu12061891 - 25 Jun 2020

Cited by 14 | Viewed by 9329

Abstract

The objective of this review was to provide an up-to-date review of trials that include behavioral intervention on the eating habits of children and adolescents at risk of poverty, applying meta-analysis to estimate the size of the intervention effect. A systematic literature search was performed in the following databases: MEDLINE via Pubmed and via EBSCOhost, LILACS and IBECS via VHL. The MeSH terms were used: “social class”, “poverty”, “diet”, “health promotion” (PROSPERO ID: 183900). A total of 14 articles were finally included in this systematic review. The primary results of the included studies were meta-analyzed with the RevMan 5.3 program, assuming a random effects model. Analysis of the overall effect showed combined standardized mean differences (SMD) of 0.16 (CI 95%: [0.03, 0.30], I² = 76%). The p-value for the Z statistic was 0.02, which reflects accuracy in the effect estimation. When establishing subgroups based on the intervention tracking time points, studies that provided longer-term follow-up data showed a combined SMD of 0.15 (CI 95%: [−0.02, 0.32], I² = 81%]). Small effects of behavioral interventions were found to promote healthy eating habits, but better effects were shown in cases where the invention was followed up in the long term. Full article

(This article belongs to the Special Issue Diet Quality and Human Health)

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