Randomized Controlled Trial

. 2018 Jan 6;10(1):49.

doi: 10.3390/nu10010049.

Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

Rosalind Fallaize^{1

2}, Katherine M Livingstone³, Carlos Celis-Morales⁴, Anna L Macready⁵, Rodrigo San-Cristobal⁶, Santiago Navas-Carretero^{7

8}, Cyril F M Marsaux⁹, Clare B O'Donovan¹⁰, Silvia Kolossa¹¹, George Moschonis¹², Marianne C Walsh¹³, Eileen R Gibney¹⁴, Lorraine Brennan¹⁵, Jildau Bouwman¹⁶, Yannis Manios¹⁷, Miroslaw Jarosz¹⁸, J Alfredo Martinez^{19

20

21}, Hannelore Daniel²², Wim H M Saris²³, Thomas E Gundersen²⁴, Christian A Drevon²⁵, Michael J Gibney²⁶, John C Mathers²⁷, Julie A Lovegrove²⁸

Affiliations

¹ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. r.fallaize@reading.ac.uk.
² School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK. r.fallaize@reading.ac.uk.
³ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. k.livingstone@deakin.edu.au.
⁴ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. carlos.celis@glasgow.ac.uk.
⁵ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. a.l.macready@reading.ac.uk.
⁶ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. rsan.1@alumni.unav.es.
⁷ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. snavas@unav.es.
⁸ CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain. snavas@unav.es.
⁹ Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands. cyril.marsaux@gmail.com.
¹⁰ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. clare.odonovan@ucd.ie.
¹¹ ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany. silvia.kolossa@tum.de.
¹² Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece. gmoschi@hua.gr.
¹³ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. mwalsh@ndc.ie.
¹⁴ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. eileen.gibney@ucd.ie.
¹⁵ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. lorraine.brennan@ucd.ie.
¹⁶ Microbiology and Systems Biology Group, TNO, 3704HE Zeist, The Netherlands. jildau.bouwman@tno.nl.
¹⁷ Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece. manios@hua.gr.
¹⁸ National Food & Nutrition Institute (IZZ), 02-903 Warsaw, Poland. jarosz@izz.waw.pl.
¹⁹ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. jalfmtz@unav.es.
²⁰ CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain. jalfmtz@unav.es.
²¹ Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, 28049 Madrid, Spain. jalfmtz@unav.es.
²² ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany. hannelore.daniel@tum.de.
²³ Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands. w.saris@maastrichtuniversity.nl.
²⁴ Vitas Analytical Services, Oslo, Norway. teg@vitas.no.
²⁵ Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway. c.a.drevon@medisin.uio.no.
²⁶ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. mike.gibney@ucd.ie.
²⁷ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. john.mathers@newcastle.ac.uk.
²⁸ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. j.a.lovegrove@reading.ac.uk.

PMID: 29316612
PMCID: PMC5793277
DOI: 10.3390/nu10010049

Randomized Controlled Trial

Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

Rosalind Fallaize et al. Nutrients. 2018.

. 2018 Jan 6;10(1):49.

doi: 10.3390/nu10010049.

Authors

Affiliations

¹ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. r.fallaize@reading.ac.uk.
² School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK. r.fallaize@reading.ac.uk.
³ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. k.livingstone@deakin.edu.au.
⁴ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. carlos.celis@glasgow.ac.uk.
⁵ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. a.l.macready@reading.ac.uk.
⁶ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. rsan.1@alumni.unav.es.
⁷ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. snavas@unav.es.
⁸ CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain. snavas@unav.es.
⁹ Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands. cyril.marsaux@gmail.com.
¹⁰ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. clare.odonovan@ucd.ie.
¹¹ ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany. silvia.kolossa@tum.de.
¹² Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece. gmoschi@hua.gr.
¹³ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. mwalsh@ndc.ie.
¹⁴ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. eileen.gibney@ucd.ie.
¹⁵ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. lorraine.brennan@ucd.ie.
¹⁶ Microbiology and Systems Biology Group, TNO, 3704HE Zeist, The Netherlands. jildau.bouwman@tno.nl.
¹⁷ Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece. manios@hua.gr.
¹⁸ National Food & Nutrition Institute (IZZ), 02-903 Warsaw, Poland. jarosz@izz.waw.pl.
¹⁹ Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain. jalfmtz@unav.es.
²⁰ CIBERObn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28023 Madrid, Spain. jalfmtz@unav.es.
²¹ Instituto Madrileño de Estudios Avanzados (IMDEA) Alimentacion, 28049 Madrid, Spain. jalfmtz@unav.es.
²² ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, 85354 Munich, Germany. hannelore.daniel@tum.de.
²³ Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, 6200MD Maastricht, The Netherlands. w.saris@maastrichtuniversity.nl.
²⁴ Vitas Analytical Services, Oslo, Norway. teg@vitas.no.
²⁵ Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway. c.a.drevon@medisin.uio.no.
²⁶ UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland. mike.gibney@ucd.ie.
²⁷ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. john.mathers@newcastle.ac.uk.
²⁸ Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AP, UK. j.a.lovegrove@reading.ac.uk.

PMID: 29316612
PMCID: PMC5793277
DOI: 10.3390/nu10010049

Abstract

Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.

Keywords: Dutch Healthy Diet Index; Healthy Eating Index; Mediterranean Diet Score; diet scores; dried blood spots; metabolic health; nutritional biomarkers; personalized nutrition.

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Conflict of interest statement

T.E.G. is founder, stockowner and C.E.O. of Vitas; C.A.D. is founder, board member, stockowner, and consultant for Vitas Ltd. None of the other authors reports a conflict of interest.

Figures

**Figure 1**
(a) Healthy Eating Index (HEI); (b) Alternate Healthy Eating Index (AHEI); (c) MedDietScore (MDS); (d) PREDIMED MDS (P-MDS); and, (e) Dutch Healthy Diet Index (DHDI) according to country recruiting participants to the Food4Me Study. Values represent means ± standard error of mean (SEM). UK, United Kingdom; IE, Ireland; PL, Poland; NL, The Netherlands; GE, Germany; SP, Spain; GR, Greece. Significant differences observed across all diet quality scores (p < 0.001) following general linear models adjusted for age and sex (HEI and AHEI): for (a) UK vs. PL p < 0.001; IE vs. PL p = 0.002; NL vs. PL p < 0.001; IE; SP vs. PL p < 0.001; GR vs. PL p < 0.001, (b) UK vs. PL p < 0.001; UK vs. SP p < 0.001; UK vs. GR p < 0.001; NL vs. PL p = 0.006; NL vs. SP p = 0.030; NL vs. GR p = 0.005; GE vs. PL p = 0.020; GE vs. GR p = 0.014, (c) SP vs. UK p < 0.001, SP vs. IE p < 0.001; SP vs. PL p < 0.001; SP vs. NL p < 0.001; SP vs. GE p < 0.001; GR vs. UK p < 0.001; GR vs. IE p < 0.001; GR vs. PL p < 0.001; GR vs. GE p < 0.001; NL vs. UK p < 0.001; IE vs. PL p = 0.003; GE vs. PL p < 0.001, (d) SP vs. UK p = 0.024; SP vs. IE p < 0.001; SP vs. PL p < 0.001; SP vs. NL p < 0.001, SP vs. GE p < 0.001; SP vs. GR p < 0.001; UK vs. PL p < 0.001; UK vs. IE p = 0.024; GR vs. PL p < 0.001; GR vs. IE p < 0.001; GR vs. GE p < 0.001; IE vs. PL p = 0.001; NL vs. PL p = 0.038, (e) UK vs. PL p < 0.001; UK vs. GE p = 0.002; UK vs. GR p < 0.001; NL vs. IE p = 0.022; NL vs. PL p < 0.001; NL vs. GE p < 0.001; NL vs. GR p < 0.001; SP vs. IE p < 0.001; SP vs. PL p < 0.001; SP vs. GE p < 0.001; SP vs. GR, p < 0.001.

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Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

Affiliations

Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

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