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High-sensitivity C-reactive protein (hs-CRP) is a widely used clinical biomarker of systemic inflammation, implicated in many chronic conditions, including type 1 diabetes (T1D). Despite the increasing emphasis on dietary intake as a modifiable risk factor for systemic inflammation, the association of hs-CRP with fruit and vegetable consumption is relatively underexplored in T1D. To address this gap, we investigated the longitudinal associations of dietary pattern-derived fruit and vegetable scores with hs-CRP in adults with and without T1D. Additionally, we examined the impact of berry consumption as a distinct food group. Data were collected in the Coronary Artery Calcification in Type 1 Diabetes study over two visits that were three years apart. At each visit, participants completed a food frequency questionnaire, and hs-CRP was measured using a particle-enhanced immunonephelometric assay. Mixed effect models were used to examine the three-year association of fruit and vegetable scores with hs-CRP. Adjusted models found a significant inverse association between blueberry intake and hs-CRP in the nondiabetic (non-DM) group. Dietary Approaches to Stop Hypertension- and Alternative Healthy Eating Index-derived vegetable scores were also inversely associated with hs-CRP in the non-DM group (all p-values ≤ 0.05). Conversely, no significant associations were observed in the T1D group. In conclusion, dietary pattern-derived vegetable scores are inversely associated with hs-CRP in non-DM adults. Nonetheless, in T1D, chronic hyperglycemia and related metabolic abnormalities may override the cardioprotective features of these food groups at habitually consumed servings.

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BACKGROUND: The role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition. OBJECTIVE: To evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain. METHODS: Cross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake. RESULTS: The prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48-0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49-0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition. CONCLUSION: Adherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.

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INTRODUCTION: Maternal obesity is a significant risk factor for hypertensive disorders of pregnancy. High diet quality may protect against this, yet data regarding the relationship between diet quality and blood pressure among pregnant women with raised body mass index (BMI) is limited. MATERIAL AND METHODS: This is a secondary analysis (n = 543) of women with BMI ≥25 kg/m2 from two randomized controlled trials; PEARS (Pregnancy Exercise and nutrition Research Study with smartphone application support) and ROLO (Randomized cOntrol trial of LOw glycemic index diet to prevent macrosomia in euglycemic women). Blood pressure was measured at 10-18 weeks and 28 weeks of pregnancy. Mean arterial pressure was calculated as (diastolic blood pressure + 1 3 × [systolic blood pressure - diastolic blood pressure]). Diet quality was assessed using 3-day food diaries, and Alternative Healthy Eating Index for Pregnancy (AHEI-P) scores were generated, quantifying alignment of food intakes with dietary guidelines in first and early third trimesters. The cohort was divided based on AHEI-P tertiles to explore differences at an alpha significance value of <0.05. RESULTS: The mean age of the group was 32.21 ± 4.39 years with a median body mass index (BMI) of 28.13 (IQR 3.47) kg/m2. Mean arterial pressures in the first and third trimesters were 81.07 ± 9.00 mmHg and 82.33 ± 7.53 mmHg, respectively. Rates of elevated blood pressure (≥120/80 mmHg) were 22.33% in trimester 1 and 24.48% in early trimester 3. Mean AHEI-P scores in trimester 1 and early trimester 3 were 53.90 ± 10.43 and 54.05 ± 10.76, respectively. There was no correlation between AHEI-P score and blood pressure and no differences in blood pressure between AHEI-P tertiles at either timepoint (all P-values <0.05). A higher proportion of those with elevated early third trimester blood pressure had a BMI of ≥30 kg/m2 compared with those with normal blood pressure (40.31% vs 28.64%, P = 0.016). CONCLUSIONS: While diet remains an important factor in maternal health and wellbeing, we did not find a relationship between diet quality as measured by AHEI-P and blood pressure among pregnant women with BMI ≥25 kg/m2. High BMI remains a risk factor for hypertensive disorders of pregnancy.

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OBJECTIVE: The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome. DESIGN: This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score. SETTING: Hinds, Madison and Rankin counties, Mississippi, USA. PARTICIPANTS: African American adults, ages 21-94 years, 60·9 % female. RESULTS: Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03). CONCLUSION: These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.

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BACKGROUND: There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. METHODS: Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). RESULTS: The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. CONCLUSIONS: Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.

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BACKGROUND: Identifying lipidomic markers of diet quality is needed to inform the development of biomarkers of diet, and to understand the mechanisms driving the diet- coronary heart disease (CHD) association. OBJECTIVES: This study aimed to identify lipidomic markers of diet quality and examine whether these lipids are associated with incident CHD. METHODS: Using liquid chromatography-mass spectrometry, we measured 1542 lipid species from 1694 American Indian adults (aged 18-75 years, 62% female) in the Strong Heart Family Study. Participants were followed up for development of CHD through 2020. Information on the past year diet was collected using the Block Food Frequency Questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI). Mixed-effects linear regression was used to identify individual lipids cross-sectionally associated with AHEI. In prospective analysis, Cox frailty model was used to estimate the hazard ratio (HR) of each AHEI-related lipid for incident CHD. All models were adjusted for age, sex, center, education, body mass index, smoking, alcohol drinking, level of physical activity, energy intake, diabetes, hypertension, and use of lipid-lowering drugs. Multiple testing was controlled at a false discovery rate of <0.05. RESULTS: Among 1542 lipid species measured, 71 lipid species (23 known), including acylcarnitine, cholesterol esters, glycerophospholipids, sphingomyelins and triacylglycerols, were associated with AHEI. Most of the identified lipids were associated with consumption of ω-3 (n-3) fatty acids. In total, 147 participants developed CHD during a mean follow-up of 17.8 years. Among the diet-related lipids, 10 lipids [5 known: cholesterol ester (CE)(22:5)B, phosphatidylcholine (PC)(p-14:0/22:1)/PC(o-14:0/22:1), PC(p-38:3)/PC(o-38:4)B, phosphatidylethanolamine (PE)(p-18:0/20:4)/PE(o-18:0/20:4), and sphingomyelin (d36:2)A] were associated with incident CHD. On average, each standard deviation increase in the baseline level of these 5 lipids was associated with 17%-23% increased risk of CHD (from HR: 1.17; 95% CI: 1, 1.36; to HR: 1.23; 95% CI: 1.05, 1.43). CONCLUSIONS: In this study, lipidomic markers of diet quality in American Indian adults are found. Some diet-related lipids are associated with risk of CHD beyond established risk factors.

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Background: Since the association between dietary quality scores and semen quality remains unclear, we carried out a hospital-based cross-sectional study to investigate the association of Dietary Total Antioxidant Capacity (dTAC), Dietary Inflammatory Index (DII), and Alternative Healthy Eating Index (AHEI) scores with semen quality in men seeking infertility treatment. Methods: This study enrolled 210 men with unexplained or idiopathic infertility. Semen samples were collected and analyzed according to the WHO 2010 criteria. Dietary data was collected using a 168-item semi-quantitative food frequency questionnaire (FFQ) developed for Tehran Lipid and Glucose Study. Multivariable logistic regression models were used to estimate the relationship between dTAC, AHEI, and DII scores with abnormal semen in crude and adjusted models. Results: There were no significant differences across quartile categories of the dTAC, AHEI, and DII scores regarding semen parameters. There was a trend toward a significant direct association between DII and abnormal semen risk (p = 0.01). Infertile men in the highest quartile of DII had a 2.84 times higher risk of abnormal semen in the crude model (OR: 3.84; 95% CI: 1.64-8.95); such that remained after adjusting for several potential confounders. There was no significant association between dTAC or AHEI and the risk of abnormal semen in infertile men, either before or after adjusting for potential confounders. Total energy (p = 0.05), fat (p = 0.02), saturated fat (p = 0.02), mono-saturated fat (p = 0.009), Thiamine (Vitamin B1) (p = 0.02), Niacin (Vitamin B3) (p = 0.03), Calcium (p = 0.01), and Selenium (p = 0.01) were inversely associated with semen normality. Discussion: The study suggests that certain dietary factors may affect semen quality, and the mechanisms underlying the observed associations are likely multifactorial, involving complex interactions between diet, oxidative stress, inflammation, and hormone levels. Further research is required to confirm the results, fully elucidate the mechanisms underlying the associations, and identify specific dietary interventions that may improve male fertility outcomes.

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BACKGROUND: According to some studies, diet can be interaction with CRY1 polymorphism and may be related to obesity and the risk of cardiovascular diseases (CVD). So, this study examined the interaction between CRY1 polymorphism and AHEI on cardiovascular risk factors in overweight women and women with obesity. METHODS: This cross-sectional study was performed on 377 Iranian women with overweight and obesity aged 18-48(BMI ≥ 25 kg/m2). Dietary intake was evaluated by the use of a food frequency questionnaire (FFQ) with 147 items. The AHEI was calculated based on previous studies. Anthropometric and biochemical measurements were assessed and the bioelectrical impedance analysis method was used for body analysis. The rs2287161 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. Objects were divided into three groups based on rs2287161 genotypes. RESULTS: Our findings determined that the prevalence of the C allele was 51.9% and the G allele was 48.0%. The mean age and BMI were 36.6 ± 9.1years and 31 ± 4 kg/m2 respectively. After controlling for confounders (BMI, age, total energy intake, and physical activity), this study demonstrated that there was a significant interaction between CC genotype and adherence to AHEI on odds of hyper LDL (OR = 1.94, 95% CI = 1.24-3.05, P for interaction = 0.004), hypertension (OR = 1.80, 95% CI = 1.11-2.93, P for interaction = 0.01) and hyperglycemia (OR = 1.56, 95% CI = 0.98-2.47, P for interaction = 0.05). CONCLUSIONS: This study indicated that adherence to AHEI can reduce the odds of hyper LDL, hypertension, and hyperglycemia in the CC genotype of rs2287161.

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BACKGROUND: An individual's dietary pattern contributes in different ways to the prevention and control of recurrent cardiovascular events. However, the quality of the diet is influenced by several factors. The present study aimed to evaluate the quality of the diet of individuals with cardiovascular diseases and determine whether there is an association between sociodemographic and lifestyle factors. METHODS: This is a cross-sectional study carried out with individuals with atherosclerosis (coronary artery disease, cerebrovascular disease or peripheral arterial disease) recruited from 35 reference centres for the treatment of cardiovascular disease in Brazil. Diet quality was assessed according to the Modified Alternative Healthy Eating Index (mAHEI) and stratified into tertiles. For comparing two groups, the Mann-Whitney or Pearson's chi-squared tests were used. However, for comparing three or more groups, analysis of variance or Kruskal-Wallis was used. For the confounding analysis, a multinomial regression model was used. p < 0.05 was considered statistically significant. RESULTS: In total, 2360 individuals were evaluated: 58.5% male and 64.2% elderly. The median (interquartile range [IQR]) of the mAHEI was 24.0 (20.0-30.0), ranging from 0.4 to 56.0 points. When comparing the odds ratios (ORs) for the low (first tertile) and medium (second tertile) diet quality groups with the high-quality group (third tertile), it was observed that there was an association between diet quality with a family income of 1.885 (95% confidence intervals [CI] = 1.302-2.729) and 1.566 (95% CI = 1.097-2.235), as well as physical activity of 1.391 (95% CI = 1.107-1.749) and 1.346 (95% CI = 1.086-1.667), respectively. In addition, associations were observed between diet quality and region of residence. CONCLUSIONS: A low-quality diet was associated with family income, sedentarism and geographical area. These data are extremely relevant to assist in coping with cardiovascular disease because they enable an assessment of the distribution of these factors in different regions of the country.

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BACKGROUND: Higher dietary quality is associated with lower disease risks and has not been examined extensively with lipidomic profiles. OBJECTIVES: Our goal was to examine associations of the Healthy Eating Index (HEI)-2015, Alternate HEI-2010 (AHEI-2010), and alternate Mediterranean Diet Index (aMED) diet quality indices with serum lipidomic profiles. METHODS: We conducted a cross-sectional analysis of HEI-2015, AHEI-2010, and aMED with lipidomic profiles from 2 nested case-control studies within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (n = 627) and the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (n = 711). We used multivariable linear regression to determine associations of the indices, derived from baseline food-frequency questionnaires (Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial: 1993-2001, Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: 1985-1988) with serum concentrations of 904 lipid species and 252 fatty acids (FAs) across 15 lipid classes and 28 total FAs, within each cohort and meta-analyzed results using fixed-effect models for lipids significant at Bonferroni-corrected threshold in common in both cohorts. RESULTS: Adherence to HEI-2015, AHEI-2010, or aMED was associated positively with 31, 41, and 54 lipid species and 8, 6, and 10 class-specific FAs and inversely with 2, 8, and 34 lipid species and 1, 3, and 5 class-specific FAs, respectively. Twenty-five lipid species and 5 class-specific FAs were common to all indices, predominantly triacylglycerols, FA22:6 [docosahexaenoic acid (DHA)]-containing species, and DHA. All indices were positively associated with total FA22:6. AHEI-2010 and aMED were inversely associated with total FA18:1 (oleic acid) and total FA17:0 (margaric acid), respectively. The identified lipids were most associated with components of seafood and plant proteins and unsaturated:saturated fat ratio in HEI-2015; eicosapentaenoic acid plus DHA in AHEI-2010; and fish and monounsaturated:saturated fat ratio in aMED. CONCLUSIONS: Adherence to HEI-2015, AHEI-2010, and aMED is associated with serum lipidomic profiles, mostly triacylglycerols or FA22:6-containing species, which are related to seafood and plant proteins, eicosapentaenoic acid-DHA, fish, or fat ratio index components.

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AIMS: To evaluate the associations of dietary indices and quantitative cardiorespiratory fitness (CRF) measures in a large, community-based sample harnessing metabolomic profiling to interrogate shared biology. METHODS AND RESULTS: Framingham Heart Study (FHS) participants underwent maximum effort cardiopulmonary exercise tests for CRF quantification (via peak VO2) and completed semi-quantitative food frequency questionnaires. Dietary quality was assessed by the Alternative Healthy Eating Index (AHEI) and Mediterranean-style Diet Score (MDS), and fasting blood concentrations of 201 metabolites were quantified. In 2380 FHS participants (54 ± 9 years, 54% female, body mass index 28 ± 5 kg/m2), 1 SD higher AHEI and MDS were associated with 5.2% (1.2 mL/kg/min, 95% CI 4.3-6.0%, P < 0.0001) and 4.5% (1.0 mL/kg/min, 95% CI 3.6-5.3%, P < 0.0001) greater peak VO2 in linear models adjusted for age, sex, total daily energy intake, cardiovascular risk factors, and physical activity. In participants with metabolite profiling (N = 1154), 24 metabolites were concordantly associated with both dietary indices and peak VO2 in multivariable-adjusted linear models (FDR < 5%). Metabolites that were associated with lower CRF and poorer dietary quality included C6 and C7 carnitines, C16:0 ceramide, and dimethylguanidino valeric acid, and metabolites that were positively associated with higher CRF and favourable dietary quality included C38:7 phosphatidylcholine plasmalogen and C38:7 and C40:7 phosphatidylethanolamine plasmalogens. CONCLUSION: Higher diet quality is associated with greater CRF cross-sectionally in a middle-aged community-dwelling sample, and metabolites highlight potential shared favourable effects on cardiometabolic health.

This study seeks to address whether healthy dietary patterns relate to gold-standard measures of physical fitness in community-dwelling adults and how circulating metabolites can demonstrate biological relationships between diet and fitness. Healthy diet is associated with greater physical fitness in middle-aged adults. The beneficial relationship between diet and fitness may be partly explained by favourable metabolic health.

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BACKGROUND: Nutrition, a modifiable risk factor, presents a low-cost prevention strategy to reduce the burden of cognitive impairment and dementia. However, studies examining the effects of dietary patterns on cognition are lacking in multi-ethnic Asian populations. We investigate the association between diet quality, measured with the Alternative Healthy Eating Index (AHEI)-2010, and cognitive impairment in middle-aged and older adults of different ethnicities (Chinese, Malay, Indian) in Singapore. METHODS: This cross-sectional study (n = 3138; mean age: 50.4 ± 9.8, 58.4% women) was based on data from the Singapore Multi-Ethnic Cohort. Dietary intake collected with a validated semi-quantitative Food Frequency Questionnaire was converted into AHEI-2010 scores. Cognition, assessed with the Mini-Mental State Examination (MMSE), was analysed as a continuous or binary outcome (cognitively impaired or not, using cut-offs of ≥ 24, 26 or 28 for no education, primary school education and secondary school education and above). Multivariable linear and logistic regression models were used to examine associations between AHEI-2010 and cognition, adjusting for covariates. RESULTS: A total of 988 (31.5%) participants had cognitive impairment. Higher AHEI-2010 scores were significantly associated with higher MMSE scores [ß = 0.44; 95% confidence interval (CI) 0.22-0.67 highest vs. lowest quartile; p-trend < 0.001] and lower odds of cognitive impairment [OR 0.69; 95% CI 0.54-0.88; p-trend = 0.01] after adjusting for all the covariates. No significant associations were observed for individual dietary components of the AHEI-2010 with MMSE or cognitive impairment. CONCLUSION: Healthier dietary patterns were associated with better cognitive function in middle-aged and older Singaporeans. These findings could inform better support to promote healthier dietary patterns in Asian populations.

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Dietary intake is a determining factor in the morbidity and mortality of chronic disorders. However, not many documents have investigated this relationship. The aim of this study was to evaluate the associations of the Mediterranean dietary score (MDS), Alternative Healthy Eating Index (AHEI), Dietary Inflammatory Index (DII), DASH score, and dietary acid load with cardiovascular disease (CVD) mortality. A total of 2158 CVD patients (mean age of 54.73 ± 8.62 years) from the Fasa cohort study, Iran, participated in the current study. Diet quality indices including DII, AHEI, MDS, DASH, and dietary acid load (NEAP score) were computed using a validated 125-item Food Frequency Questionnaire (FFQ). Cox regression analyses were used to determine HRs and 95% CIs. During a follow-up of 3 years, we documented 59 CVD deaths. After adjusting for relevant confounders (age, gender, family history of CVD, smoking, physical activity, alcohol intake, and HTN) in the final model, we found that higher DII scores and dietary acid load were significantly related to increased mortality due to CVD (HR = 1.11; 95% CI = 1.01-1.24; and HR = 1.02; 95% CI = 1.01-1.03). However, the DASH score was insignificantly associated with decreased CVD mortality by 20.4% (HR = 0.79; 95% CI = 0.57-1.09). There was no significant relationship among AHEI score, MDS, and CVD mortality. This study showed that increasing dietary acidity and the use of inflammatory food compounds could contribute to CVD mortality. Also, adherence to the DASH diet may be associated with reduced CVD mortality.

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For many years, dietary quality among Canadians has been assessed using an index that gives criticized scores and does not allow for comparison with Americans. In Canadians aged ≥19 years, we aimed to (1) determine the dietary quality by using a more widely used evidence-based index that has shown associations with health outcomes, the alternative Healthy Eating Index (aHEI-2010); (2) assess changes in aHEI-2010 score and its components between 2004 and 2015; and (3) identify factors associated with aHEI-2010 score. We relied on the Canadian Community Health Survey 2004 (n = 35,107) and 2015 (n = 20,487). We used adjusted linear models with a time effect to compare the total aHEI-2010 score and its components. The overall aHEI-2010 score increased from 36.5 (95%CI: 36.2-36.8) in 2004 to 39.0 (95%CI: 38.5-39.4) in 2015 (p < 0.0001). Participants with less than a high school diploma showed the lowest score and no improvement from 2004 to 2015 (34.8 vs. 35.3, p = 0.4864). In each period, higher scores were noted among immigrants than non-immigrants (38.3 vs. 35.9 in 2004, p < 0.0001; 40.5 vs. 38.5 in 2015 p < 0.0001), and lower scores were observed in current smokers (33.4 vs. 37.1 in 2004, p < 0.0001; 34.5 vs. 39.9 in 2015, p < 0.0001). The use of the aHEI-2010 tool suggests a lower score among Canadians than the previous index, more comparable to the score among Americans.

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BACKGROUND: Data on the association of Alternative Healthy Eating Index-2010 (AHEI-2010) with sarcopenia are scarce. We aimed to evaluate the association between adherence to AHEI-2010 and sarcopenia and its components including low muscle mass, low muscle strength, and low muscle performance among elderly people. METHODS: In this cross-sectional study, which was conducted on 300 older people (150 men and 150 women) aged ≥55 years. Dietary information was done using a valid 117-item food frequency questionnaire (FFQ). To construct AHEI-2010 score, earlier studies were used. Sarcopenia and its components were described based on both former and new European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. RESULTS: We found no significant association between AHEI-2010 score and odds of EWGSOP2-sarcopenia, either before (OR for the highest vs. lowest tertiles: 0.55; 95% CI: 0.19, 1.55) or after (OR: 0.44; 95% CI: 0.14, 1.34) adjustment for confounders. In gender-stratified analyses, we found a significant protective association between adherence to the AHEI-2010 score and odds of EWGSOP2-sarcopenia among women after controlling for confounders (0.20; 95%CI: 0.04, 0.91). CONCLUSIONS: In conclusion, healthy eating was inversely associated with odds of sarcopenia among women, but not in men. Further studies with a large sample size and prospective design are needed to examine this association.

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Objectives: There are only limited studies investigating the impact of dietary quality indicators, such as dietary quality index (DQI), dietary diversity score (DDS), and alternative healthy eating index (AHEI), on metabolic dysfunction-associated fatty liver disease (MASLD). Furthermore, these indicators may have different components that could lead to varying results. Therefore, this study aims to assess the nutritional quality indicators and their potential association with MASLD. Methods: The study included 128 recently diagnosed MASLD patients and 256 controls aged between 20 and 60 years. The dietary intake of participants was evaluated using a validated semi-quantitative food frequency questionnaire that consisted of 168 items. In this study, the method used to evaluate dietary diversity was based on five main food groups, specifically bread and grains, vegetables, fruits, meat, and dairy. The AHEI-2010 was computed using data collected from the FFQ. Results: After adjusting for confounders in the fully adjusted model, a significant negative correlation was observed between DDS and the risk of MASLD (OR 0.41, 95% CI 0.20, 0.97). Participants in the top quartile of AHEI had a 76% lower risk of MASLD compared with those in the bottom quartile after controlling for all potential confounders in the fully adjusted model (OR 0.24, 95% CI 0.12, 0.56). Conclusion: The results of our study suggest that there is a significant association between adherence to a high-diversity diet and a reduced likelihood of developing MASLD. Similarly, we observed a similar association between adherence to the AHEI diet and a lower risk of MASLD.

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BACKGROUND: Changing the dietary pattern may be an alternative treatment for bacterial vaginosis, the prevalent vaginal infection in women. METHODS: One hundred and forty-three bacterial vaginosis-affected women diagnosed by Amsel criteria and 151 healthy controls aged 18 to 45 entered the current case-control research. To calculate the alternative healthy eating index and dietary acid load score, food consumption was recorded with an accurate and precise food frequency questionnaire. The dietary acid load was measured by potential renal acid load (PRAL) and net endogenous acid production (NEAP) indices. Using logistic regression models, the association between the alternative healthy eating index and dietary acid load score with bacterial vaginosis was investigated. RESULTS: The last tertile of the alternative healthy eating index had a 75% decreased odds of experiencing bacterial vaginosis in the adjusted model (adjusted odds ratio (aOR) = 0.25, 95% confidence interval (CI) = 0.12-0.53, P for trend = 0.001). Besides, vegetables (aOR = 0.34, 95% CI = 0.17-0.69, P for trend = 0.003), nuts and legumes (aOR = 0.44, 95% CI = 0.23-0.87, P for trend = 0.028), and meats (aOR = 0.31, 95% CI = 0.16-0.60, P for trend = 0.001) intake was linked to a decreased bacterial vaginosis odds. However, sugar-sweetened beverages and fruit juice (aOR = 3.47, 95% CI = 1.68-7.17, P for trend < 0.001), trans fatty acids (aOR = 2.29, 95% CI = 1.18-4.43, P for trend = 0.005), and sodium (aOR = 3.44, 95% CI = 1.67-7.06, P for trend = 0.002) intake were directly associated with bacterial vaginosis odds. There was no evidence of a link between dietary acid load and bacterial vaginosis. CONCLUSION: According to the present study's findings, there is no correlation between dietary acid load and the likelihood of developing bacterial vaginosis. However, following a plant-based dietary pattern based on the healthy eating index may lead to a lower odds of bacterial vaginosis.

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Non-communicable diseases (NCDs) and multimorbidity (≥two chronic conditions), are increasing globally. Diet is a risk factor for some NCDs. We aimed to investigate the association between diet quality (DQ) and incident NCDs. Participants were from the Australian Longitudinal Study on Women's Health 1973-78 cohort with no NCD and completed dietary data at survey 3 (2003, aged 25-30 years) who responded to at least one survey between survey 4 (2006) and survey 8 (2018). DQ was measured by the Alternative Healthy Eating Index-2010 (AHEI-2010). Outcomes included coronary heart disease (CHD), hypertension (HT), asthma, cancer (excluding skin cancer), diabetes mellitus (DM), depression and/or anxiety, multimorbidity, and all-cause mortality. Repeated cross-sectional multivariate logistic regressions were performed to investigate the association between baseline DQ and NCDs over 15 years. The AHEI-2010 mean (±sd) for participants (n = 8017) was 51.6 ± 11.0 (range: 19-91). There was an inverse association between AHEI-2010 and incident asthma at survey 4 (ORQ5-Q1: 0.75, 95% CI: 0.57, 0.99). Baseline DQ did not predict the occurrence of any NCDs or multimorbidity between the ages of 25-45 years. Further well-planned, large prospective studies conducted in young women are needed to explore dietary risk factors before the establishment of NCDs.

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BACKGROUND: The prodromal phase of Parkinson's disease (PD) is a critical window for prevention by modifying lifestyle factors. However, there is limited knowledge on how diet quality is associated with prodromal PD symptoms in Asian populations. OBJECTIVE: To examine the association between overall diet quality and prodromal PD features. METHODS: A total of 71,640 Chinese participants who were free of PD were included in this cross-sectional study. Diet quality was assessed using the modified Alternative Healthy Eating Index (mAHEI) and alternate Mediterranean Diet (aMED). Five prodromal features including probable rapid eye movement sleep behavior disorder (pRBD), hyposmia, excessive daytime sleepiness, constipation, and depressive symptom were measured using validated questionnaires. Logistic regression was used to calculate the odds ratio (OR) for having a combination of prodromal PD symptoms (1 and 2+ symptoms vs. 0 symptoms), adjusting for age, sex, lifestyle factors, total energy intake, and other potential confounders. RESULTS: In the multivariable-adjusted model, the OR for having 2+ versus 0 prodromal PD features was 0.64 (95% confidence interval [CI]: 0.49, 0.85) comparing the highest versus the lowest mAHEI diet quality quartiles with a significant inverse trend (P-trend = 0.003). For individual prodromal PD features, better diet quality, as assessed by the mAHEI, was associated with lower odds of having excessive daytime sleepiness and constipation (P-trend < 0.05 for both). We observed a marginally significant association between aMED and prodromal PD features (adjusted OR comparing the extreme quartiles = 0.74; 95% CI: 0.55, 0.98; P-trend = 0.09). CONCLUSION: Better diet quality, as assessed by the mAHEI and the aMED, was associated with lower probability of having prodromal PD features in Chinese adults. © 2022 International Parkinson and Movement Disorder Society.

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Background: Gestational diabetes mellitus (GDM) and elevated glucose concentrations below the threshold for GDM diagnosis have been associated with adverse pregnancy and offspring outcomes. Dietary interventions initiated during pregnancy have demonstrated inconsistent beneficial effects. Limited data exist regarding the effects of periconceptional diet on gestational glycemia. Objective: To evaluate independent associations between periconceptional diet quality with GDM frequency and glucose concentrations from GDM screening and diagnostic tests among nulliparous gravidas. Design: This is a secondary analysis of N=7997 participants from the NuMoM2b multicenter, prospective, observational cohort study of first pregnancies. The Alternative Healthy Eating Index (AHEI)-2010 was computed from food frequency questionnaires completed in early pregnancy (6-13 weeks), reporting usual dietary intake over the preceding 3 months. GDM screening was performed either by non-fasting 1-hour 50g glucose load (N=6845), followed by 3-hour 100g glucose tolerance test (GTT) for those with raised glucose concentrations (N=1116; at risk for GDM), or by a single 2-hour 75g GTT (N=569; all GDM risk levels). Logistic and linear regression were used to estimate the associations between the AHEI-2010 score with odds of GDM, having raised blood glucose on the 1-hour screening test, and continuous glucose concentrations on screening and diagnostic tests. All models were adjusted for a priori covariates: maternal age, race/ethnicity, early-pregnancy body mass index, smoking habits, rate of gestational weight gain, energy intake, nausea and vomiting in early pregnancy, study site. Results: Poorer periconceptional diet quality was observed among participants who were younger, with higher BMI, lower income levels, and of non-Hispanic Black or Hispanic ethnicity. The GDM rate was 4%. Each 1-point increase in AHEI-2010 score was associated with a 1% decrease in the odds of being diagnosed with GDM (beta=-0.015, p=0.022, OR=0.986, 95% CI 0.973 to 0.998). Diet quality was inversely associated with each post glucose load concentration on the non-fasting screening test and the 2-hour and 3-hour GTT. Conclusion: Poor periconceptional diet quality is independently associated with an increased risk of GDM and with minor elevations in serum glucose concentrations on GDM screening and diagnostic tests, in a diverse cohort of nulliparas. Periconception intervention studies targeting diet quality are warranted.

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