The Healthy Eating Index-2015 (HEI-2015) was created to assess conformance of dietary intake with the Dietary Guidelines for Americans (DGA) 2015-2020. We assessed the association between the ...HEI-2015 and mortality from all-cause, cardiovascular disease (CVD), and cancer in the Multiethnic Cohort (MEC). White, African American, Native Hawaiian, Japanese American, and Latino adults (
> 215,000) from Hawaii and California completed a quantitative food-frequency questionnaire at study enrollment. HEI-2015 scores were divided into quintiles for men and women. Radar graphs were used to demonstrate how dietary components contributed to HEI-2015 scores. Mortality was documented over 17-22 years of follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox proportional hazards models. High HEI-2015 scores were inversely associated with risk of mortality from all-cause, CVD, and cancer for men and women (
-trend <0.0001 for all models). For men, the HRs (CIs) for all-cause, CVD, and cancer comparing the highest to the lowest quintile were 0.79 (0.76, 0.82), 0.76 (0.71, 0.82), and 0.80 (0.75, 0.87), respectively. For women, the HRs were 0.79 (0.76, 0.82), 0.75 (0.70, 0.81), and 0.84 (0.78, 0.91), respectively. These results, in a multiethnic population, demonstrate that following a diet aligned with the DGAs 2015-2020 recommendations is associated with lower risk of mortality from all-cause, CVD, and cancer.
The Dietary Patterns Methods Project (DPMP) was initiated in 2012 to strengthen research evidence on dietary indices, dietary patterns, and health for upcoming revisions of the Dietary Guidelines for ...Americans, given that the lack of consistent methodology has impeded development of consistent and reliable conclusions. DPMP investigators developed research questions and a standardized approach to index-based dietary analysis. This article presents a synthesis of findings across the cohorts. Standardized analyses were conducted in the NIH-AARP Diet and Health Study, the Multiethnic Cohort, and the Women's Health Initiative Observational Study (WHI-OS). Healthy Eating Index 2010, Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension (DASH) scores were examined across cohorts for correlations between pairs of indices; concordant classifications into index score quintiles; associations with all-cause, cardiovascular disease (CVD), and cancer mortality with the use of Cox proportional hazards models; and dietary intake of foods and nutrients corresponding to index quintiles. Across all cohorts in women and men, there was a high degree of correlation and consistent classifications between index pairs. Higher diet quality (top quintile) was significantly and consistently associated with an 11-28% reduced risk of death due to all causes, CVD, and cancer compared with the lowest quintile, independent of known confounders. This was true for all diet index-mortality associations, with the exception of AHEI-2010 and cancer mortality in WHI-OS women. In all cohorts, survival benefit was greater with a higher-quality diet, and relatively small intake differences distinguished the index quintiles. The reductions in mortality risk started at relatively lower levels of diet quality. Higher scores on each of the indices, signifying higher diet quality, were associated with marked reductions in mortality. Thus, the DPMP findings suggest that all 4 indices capture the essential components of a healthy diet.
We propose a method for dietary assessment to automatically identify and locate food in a variety of images captured during controlled and natural eating events. Two concepts are combined to achieve ...this: a set of segmented objects can be partitioned into perceptually similar object classes based on global and local features; and perceptually similar object classes can be used to assess the accuracy of image segmentation. These ideas are implemented by generating multiple segmentations of an image to select stable segmentations based on the classifier's confidence score assigned to each segmented image region. Automatic segmented regions are classified using a multichannel feature classification system. For each segmented region, multiple feature spaces are formed. Feature vectors in each of the feature spaces are individually classified. The final decision is obtained by combining class decisions from individual feature spaces using decision rules. We show improved accuracy of segmenting food images with classifier feedback.
Obtaining accurate food portion estimation automatically is challenging since the processes of food preparation and consumption impose large variations on food shapes and appearances. The aim of this ...paper was to estimate the food energy numeric value from eating occasion images captured using the mobile food record. To model the characteristics of food energy distribution in an eating scene, a new concept of "food energy distribution" was introduced. The mapping of a food image to its energy distribution was learned using Generative Adversarial Network (GAN) architecture. Food energy was estimated from the image based on the energy distribution image predicted by GAN. The proposed method was validated on a set of food images collected from a 7-day dietary study among 45 community-dwelling men and women between 21-65 years. The ground truth food energy was obtained from pre-weighed foods provided to the participants. The predicted food energy values using our end-to-end energy estimation system was compared to the ground truth food energy values. The average error in the estimated energy was 209 kcal per eating occasion. These results show promise for improving accuracy of image-based dietary assessment.
Recent reports have asserted that, because of energy underreporting, dietary self-report data suffer from measurement error so great that findings that rely on them are of no value. This commentary ...considers the amassed evidence that shows that self-report dietary intake data can successfully be used to inform dietary guidance and public health policy. Topics discussed include what is known and what can be done about the measurement error inherent in data collected by using self-report dietary assessment instruments and the extent and magnitude of underreporting energy compared with other nutrients and food groups. Also discussed is the overall impact of energy underreporting on dietary surveillance and nutritional epidemiology. In conclusion, 7 specific recommendations for collecting, analyzing, and interpreting self-report dietary data are provided: (1) continue to collect self-report dietary intake data because they contain valuable, rich, and critical information about foods and beverages consumed by populations that can be used to inform nutrition policy and assess diet-disease associations; (2) do not use self-reported energy intake as a measure of true energy intake; (3) do use self-reported energy intake for energy adjustment of other self-reported dietary constituents to improve risk estimation in studies of diet-health associations; (4) acknowledge the limitations of self-report dietary data and analyze and interpret them appropriately; (5) design studies and conduct analyses that allow adjustment for measurement error; (6) design new epidemiologic studies to collect dietary data from both short-term (recalls or food records) and long-term (food-frequency questionnaires) instruments on the entire study population to allow for maximizing the strengths of each instrument; and (7) continue to develop, evaluate, and further expand methods of dietary assessment, including dietary biomarkers and methods using new technologies.
•X-ray imaging used to accurately determine apparent density of foods.•Apparent density determined directly using X-ray linear attenuation coefficients.•Apparent density measured for porous and ...non-porous foods via X-ray imaging compared within 10% to traditional methods.
Density of foods is an important physical property, which depends on structural properties of food. For porous foods such as baked foods, accurate measurement of density is challenging since traditional density measurement techniques are tedious, operator-dependent and incapable of precise volume measurement of foods. To overcome such limitations, a methodology was developed using both digital radiography (DR) and computed tomography (CT) X-ray imaging to directly determine density of foods. Apparent density was determined directly from X-ray linear attenuation coefficients by scanning at 40, 60, 80kVp on DR and 45, 55, 70kVp on CT. The apparent density can be directly determined using CT however sample thickness is needed to determine density using DR. No significant difference (p<0.05) was observed between density obtained from traditional methods, with density determined from X-ray linear attenuation coefficients. Density determined on CT for all foods with mean 0.579g/cm3 had a standard deviation, SD=0.0367g/cm3. Density determination using X-ray linear attenuation was found to be a more efficient technique giving results comparable with conventional techniques.
Background: Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and ...mortality are limited. Objective: We assessed the ability of the following 4 diet-quality indexes the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH) to predict the reduction in risk of mortality from all causes, cardiovascular disease (CVD), and cancer. Design: White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quintiles for men and women. Mortality was documented over 13–18 y of follow-up. HRs and 95% CIs were computed by using adjusted Cox models. Results: High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P -trend < 0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95% CI: 0.71, 0.79), CVD (HR: 0.74; 95% CI: 0.69, 0.81), and cancer (HR: 0.76; 95% CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reductions for all-cause mortality (HR: 0.78; 95% CI: 0.74, 0.82), the AHEI showed large reductions for CVD (HR: 0.76; 95% CI: 0.69, 0.83), and the aMED showed large reductions for cancer (HR: 0.84; 95% CI: 0.76, 0. 92). Conclusion: These results, in a US multiethnic population, suggest that consuming a dietary pattern that achieves a high diet-quality index score is associated with lower risk of mortality from all causes, CVD, and cancer in adult men and women.
Background & Aims Healthy eating patterns assessed by diet quality indexes (DQIs) have been related to lower risk of colorectal cancer—mostly among whites. We investigated the associations between 4 ...DQI scores (the Healthy Eating Index 2010 HEI-2010, the Alternative Healthy Eating Index 2010 AHEI-2010, the alternate Mediterranean diet score aMED, and the Dietary Approaches to Stop Hypertension score) and colorectal cancer risk in the Multiethnic Cohort. Methods We analyzed data from 190,949 African American, Native Hawaiian, Japanese American, Latino, and white individuals, 45 to 75 years old, who entered the Multiethnic Cohort study from 1993 through 1996. During an average 16 years of follow-up, 4770 invasive colorectal cancer cases were identified. Results Scores from all 4 DQIs associated inversely with colorectal cancer risk; higher scores associated with decreasing colorectal cancer risk (all P 's for trend ≤ .003). Associations were not significant for AHEI-2010 and aMED scores in women after adjustment for covariates: for the highest vs lowest quintiles, the hazard ratio for the for the HEI-2010 score in men was 0.69 (95% confidence interval CI, 0.59–0.80) and in women was 0.82 (95% CI, 0.70–0.96); for the AHEI-2010 score the hazard ratio in men was 0.75 (95% CI, 0.65–0.85) and in women was 0.90 (95% CI, 0.78–1.04); for the aMED score the hazard ratio in men was 0.84 (95% CI, 0.73–0.97) and in women was 0.96 (95% CI, 0.82–1.13); for the Dietary Approaches to Stop Hypertension score the hazard ratio in men was 0.75 (95% CI, 0.66–0.86) and in women was 0.86 (95% CI, 0.75–1.00). Associations were limited to the left colon and rectum for all indexes. The inverse associations were less strong in African American individuals than in the other 4 racial/ethnic groups. Conclusions Based on an analysis of data from the Multiethnic Cohort Study, high-quality diets are associated with a lower risk of colorectal cancer in most racial/ethnic subgroups.
Background and Aims
Epidemiological data on dietary risk factors for nonalcoholic fatty liver disease (NAFLD) from population‐based studies, particularly in an ethnically diverse population, are ...scarce. We examined dietary factors in relation to NAFLD risk in African Americans, Japanese Americans, Latinos, native Hawaiians, and whites in the Multiethnic Cohort (MEC).
Approach and Results
A nested case–control analysis was conducted within the MEC, a large prospective study with >215,000 older adult participants in Hawaii and California. NAFLD was identified using Medicare claims data, and controls were selected among participants without liver disease and individually matched to cases by birth year, sex, ethnicity, and length of Medicare enrollment. Diet was assessed at baseline through a validated quantitative food frequency questionnaire. Diet–NAFLD associations were quantified by odds ratios and 95% confidence intervals using multivariable conditional logistic regression. The study consisted of 2,974 NAFLD cases (518 with cirrhosis, 2,456 without cirrhosis) and 29,474 matched controls. Red meat (P trend = 0.010), processed red meat (P trend = 0.004), poultry (P trend = 0.005), and cholesterol (P trend = 0.005) intakes were positively associated with NAFLD, while dietary fiber intake (P trend = 0.003) was inversely associated with risk. Stronger associations were observed between red meat and cholesterol and NAFLD with cirrhosis than without cirrhosis (P heterogeneity ≤0.014).
Conclusions
Dietary factors are independently associated with NAFLD and NAFLD‐related cirrhosis in a multiethnic population. Decreasing the consumption of cholesterol, red and processed meat, and poultry and increasing consumption of fiber may reduce the risk for NAFLD and related advanced liver disease.
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