While it is widely perceived that the diet consumed by Japanese is healthy, empirical evidence supporting this notion is limited. In this cross-sectional study, we assessed the overall diet quality ...of Japanese using the Healthy Eating Index-2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3), and compared diet quality scores between Japanese and Americans.
We used 1-d dietary record data from 19,719 adults (aged ≥20 y) in the Japanese National Health and Nutrition Survey 2012 and the first 24-h dietary recall data from 4614 adults in the US NHANES 2011-2012.
As expected, a higher total score of the HEI-2015 and NRF9.3 was associated with favorable patterns of overall diet in the Japanese population. The range of total score was wide enough for both HEI-2015 (5th percentile 37.2; 95th percentile 67.2) and NRF9.3 (5th percentile 257; 95th percentile 645). Both HEI-2015 and NRF9.3 distinguished known differences in diet quality between sex, age, and smoking status. The mean total scores of HEI-2015 and NRF9.3 were similar between Japanese (51.9 and 448, respectively) and US adults (52.8 and 435, respectively). However, component scores between the 2 populations were considerably different. For HEI-2015, Japanese had higher scores for whole fruits, total vegetables, green and beans, total protein foods, seafood and plant proteins, fatty acids, added sugars, and saturated fats, but lower scores for total fruits, whole grains, dairy, refined grains, and sodium. For NRF9.3, the intakes of vitamin C, vitamin D, potassium, added sugars, and saturated fats were more favorable in Japanese, while those of dietary fiber, vitamin A, calcium, iron, magnesium, and sodium were less favorable.
This study suggests the usefulness of HEI-2015 and NRF9.3 for assessing the diet quality of Japanese, as well as for highlighting different nutritional concerns between Japan and the US.
Using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2012, we investigated the prevalence and characteristics of under-reporting and over-reporting of energy intake (EI) ...among 19 693 US adults ≥20 years of age. For the assessment of EI, two 24-h dietary recalls were conducted using the US Department of Agriculture Automated Multiple-Pass Method. Under-reporters, acceptable reporters and over-reporters of EI were identified by two methods based on the 95 % confidence limits: (1) for agreement between the ratio of EI to BMR and a physical activity level for sedentary lifestyle (1·55) and (2) of the expected ratio of EI to estimated energy requirement (EER) of 1·0. BMR was calculated using Schofield's equations. EER was calculated using equations from the US Dietary Reference Intakes, assuming 'low active' level of physical activity. The risk of being an under-reporter or over-reporter compared with an acceptable reporter was analysed using multiple logistic regression. Percentages of under-reporters, acceptable reporters and over-reporters were 25·1, 73·5 and 1·4 %, respectively, based on EI:BMR, and 25·7, 71·8 and 2·5 %, respectively, based on EI:EER. Under-reporting was associated with female sex, older age, non-Hispanic blacks (compared with non-Hispanic whites), lower education, lower family poverty income ratio and overweight and obesity. Over-reporting was associated with male sex, younger age, lower family poverty income ratio, current smoking (compared with never smoking) and underweight. Similar findings were obtained when analysing only the first 24-h recall data from NHANES 1999-2012 (n 28 794). In conclusion, we found that misreporting of EI, particularly under-reporting, remains prevalent and differential in US adults.
Inconsistent associations between eating frequency (EF) and adiposity may be mainly due to measurement errors of EF.
This cross-sectional study examined the association of EF with body mass index ...(BMI) and waist circumference (WC), by focusing on the confounding of energy misreporting and the effect of exclusion of underreporters (URs).
Dietary intake was assessed using a 7-day weighed dietary record in 1487 British adults aged 19-64 years. EF was calculated based on all eating occasions (EF(all)), after excluding those providing no energy (EF(energy)), and after excluding those providing <210 kJ of energy (EF(⩾210 kJ)). Energy misreporting was assessed as reported energy intake divided by estimated energy requirement (EI:EER).
The mean values (1st and 99th percentiles) of EF(all), EF(energy) and EF(⩾210 kJ) were, respectively, 7.8 (3.1, 15.3), 7.2 (2.9, 12.7), and 5.6 (2.3, 10.7) times/day in men and 7.6 (3.0, 13.9), 6.7 (2.7, 12.1), and 4.8 (1.9, 9.1) times/day in women. In the univariate analyses of the entire male population, EF(⩾210 kJ), but not EF(all) and EF(energy), was inversely associated with BMI and WC. After full adjustment (including EI:EER), all three measures of EF were positively associated with BMI and WC. In the univariate analyses of the entire female population, all three measures of EF were inversely associated with BMI and WC. After full adjustment, EF(⩾210 kJ) was positively associated with BMI and WC while EF(all) and EF(energy) showed null associations. When URs (EI:EER <0.665) were excluded, the multivariate analyses showed that EF(all) and EF(energy) were positively associated with BMI in men while EF(⩾210 kJ) was positively associated with BMI and WC in both sexes.
We showed positive associations of EF with BMI and WC. Adjustment for EI:EER and the exclusion of URs, as well as definitions of EF, radically affected the results of the analysis.
Abstract Background The associations between eating frequency and diet quality are inconclusive, which might be a result of different effects of meal frequency and snack frequency. Objective This ...cross-sectional study examined the associations of eating frequency, meal frequency, and snack frequency with diet quality, based on data from the National Health and Nutrition Examination Survey 2003-2012. Design Dietary intake was assessed in 19,427 US adults aged 20 years or older, using two 24-hour dietary recalls. All eating occasions providing ≥50 kcal were divided into either meals or snacks on the basis of contribution to daily energy intake (≥15% or <15%), self-report, and time (6 am to 10 am, 12 pm to 3 pm , and 6 pm 9 pm or others). Diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Statistical analyses performed Linear regression analyses were performed to explore the associations of eating frequency, meal frequency, and snack frequency (independent variables) with dietary intake variables (dependent variables). Results Higher eating frequency was modestly and positively associated with higher HEI-2010 in both men and women; one additional eating occasion per day increased HEI-2010 by 1.77 points in men and 2.22 points in women (both P <0.0001). All measures of meal frequency and snack frequency were also modestly and positively associated with HEI-2010 in both sexes, irrespective of the definition of meals and snacks. However, the associations were stronger for meal frequency than for snack frequency; one additional meal per day increased HEI-2010 by 2.14 to 5.35 points, and one additional snack per day increased HEI-2010 by 1.25 to 1.97 points (all P <0.0001). Conclusions In a representative sample of US adults, both meal frequency and snack frequency were modestly associated with better diet quality.
Evidence of the association between eating frequency (EF) and adiposity is inconsistent.
With the use of data from the NHANES 2003-2012, this cross-sectional study examined the associations between ...EF, meal frequency (MF), and snack frequency (SF) and overweight/obesity and central obesity.
Dietary intake was assessed with the use of two 24-h dietary recalls in 18,696 US adults ≥20 y of age. All eating occasions providing ≥50 kcal of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15% or <15%), self-report, and time (0600-1000, 1200-1500, 1800-2100, or other). Multivariable logistic regression was used to compute ORs and 95% CIs.
When analyzed without adjustment for the ratio of energy intake to estimated energy requirement (EI:EER), all measures of EF, MF, and SF showed inverse or null associations. After adjustment for EI:EER, however, EF was positively associated with overweight/obesity (body mass index ≥25 kg/m2) and central obesity (waist circumference ≥102 cm in men and ≥88 cm in women). Compared with the lowest category (≤3 times/d), the OR (95% CI) for overweight/obesity in the highest category (≥5 times/d) was 1.54 (1.23, 1.93) in men (P-trend = 0.003) and 1.45 (1.17, 1.81) in women (P-trend = 0.001). The corresponding value for central obesity was 1.42 (1.15, 1.75) in men (P-trend = 0.002) and 1.29 (1.05, 1.59) in women (P-trend = 0.03). The self-report-based MF and time-based MF were positively associated with overweight/obesity, central obesity, or both, although MF based on energy contribution showed no associations. There were positive associations for all SF measures in men and for the energy-contribution-based SF in women.
This cross-sectional study suggests that higher EF, MF, and SF are associated with an increased likelihood of overweight/obesity and central obesity in US adults. Prospective studies are needed to confirm the associations observed in this study.
The association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) ...with adiposity measures in US children aged 6-11 years (n 4346) and adolescents aged 12-19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003-2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours or others). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here.
We report the detection of magnetar-like x-ray bursts from the young pulsar PSR J1846-0258, at the center of the supernova remnant Kes 75. This pulsar, long thought to be exclusively ...rotation-powered, has an inferred surface dipolar magnetic field of 4.9 x 10¹³ gauss, which is higher than those of the vast majority of rotation-powered pulsars, but lower than those of the approximately 12 previously identified magnetars. The bursts were accompanied by a sudden flux increase and an unprecedented change in timing behavior. These phenomena lower the magnetic and rotational thresholds associated with magnetar-like behavior and suggest that in neutron stars there exists a continuum of magnetic activity that increases with inferred magnetic field strength.
Using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2012, we investigated the prevalence and characteristics of under- and over-reporting of energy intake (EI) among 14 ...044 US children and adolescents aged 2-19 years. For the assessment of EI, two 24-h dietary recalls were conducted with the use of the US Department of Agriculture Automated Multiple-Pass Method. Under-, plausible and over-reporters of EI were identified using two methods: based on the 95 % confidence limits (1) for agreement between the ratio of EI:BMR and a physical activity level for sedentary lifestyle (1·55) and (2) of the expected ratio of EI:estimated energy requirement (EER) of 1·0. BMR was calculated using Schofield's equations. EER was calculated using equations from the US Dietary Reference Intakes, assuming 'low active' level of physical activity. The risk of being an under- or over-reporter compared with a plausible reporter was analysed using multiple logistic regression. Percentages of under-, plausible and over-reporters were 13·1, 81·5 and 5·4 %, respectively, based on EI:BMR and 18·8, 72·3 and 8·8 %, respectively, based on EI:EER. Under-reporting was associated with older age, non-Hispanic blacks (compared with non-Hispanic whites) and overweight and obesity (compared with normal weight). Over-reporting was associated with younger age, lower family poverty income ratio, normal weight and the first survey cycle. Similar findings were obtained when analysing only the first 24-h recall data from NHANES 1999-2012 (n 22 949). In conclusion, we found that EI misreporting remains prevalent and differential in US children and adolescents.
We examined 13-year trends in dietary patterns, using data from the National Health and Nutrition Survey, Japan 2003⁻2015. In repeated, independent cross-sectional studies, dietary intake was ...assessed with a one-day weighed dietary record in 88,527 Japanese adults aged ≥20 years. Using principal component analysis based on the daily consumption of 31 food groups, we identified three dietary patterns, the "plant food and fish", "bread and dairy", and "animal food and oil" patterns. In the whole sample, the "plant food and fish" pattern score decreased while the "bread and dairy" and "animal food and oil" pattern scores increased. The decreasing trends in the "plant food and fish" pattern were observed in all subgroups considered. The increasing trends in the "bread and dairy" pattern were similar across sexes and by current smoking status. However, in terms of age, occupation, and weight status, the increasing trends were only evident in particular subgroups (i.e., age 50⁻64 and ≥65 years; security/transportation/labor occupation and nonworker; and normal weight and overweight participants). For the "animal food and oil" pattern, the increasing trends were observed in all subgroups, except for the youngest age group (20⁻34 years old). This study suggests continuous Westernization of the Japanese diet.
Dietitians are nutrition professionals equipped with specialised skills required to prevent and treat malnutrition in cancer. Optimisation of dietary intake is recommended as the primary nutrition ...strategy for the treatment of cancer-related malnutrition. However, it is unclear whether dietary patterns, described as the combination, quantity, and frequency of food consumption, are considered. This study examined dietitians' current food-based management of malnutrition; explored dietitians' awareness of dietary patterns and assessed barriers and enablers to the use of dietary patterns in clinical practice.
This qualitative study consisted of semi-structured interviews with oncology dietitians. Dietitians were recruited through national nutrition societies, social media, and professional networks. Audio-recorded interviews were transcribed verbatim and analysed using inductive thematic analysis.
Fourteen oncology dietitians from across four Australian states and territories participated. Three themes were identified: (i) principles to guide nutritional care, (ii) dietary patterns as a gap in knowledge and practice, and (iii) opportunities for better care with systems as both a barrier and enabler. Dietetic practice was food-focussed, encouraging energy and protein-rich foods consistent with nutrient-focussed evidence-based guidelines. Dietitians encouraged one of two nutrition-related approaches, either encouraging intake of 'any tolerated food' or 'foods supportive on longer-term health'. Dietitians were generally unaware of dietary patterns and questioned their relevance in certain clinical situations. A multidisciplinary team approach, adequate food service and dissemination of dietary patterns research and education were identified as opportunities for better patient care.
Recommendations for the treatment of malnutrition vary between oncology dietitians and uncertainty exists regarding dietary patterns and their relevance in clinical practice. Further exploration into the role of dietary patterns to treat cancer-related malnutrition and education for dietitians are required prior to implementation of a dietary patterns approach into clinical practice.