Association between diet-quality scores, adiposity, total cholesterol and markers of nutritional status in European adults: findings from the Food4Me study

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

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: The food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products

Objectively measured physical activity in european adults: cross-sectional findings from the Food4Me study

Introduction Physical inactivity has been estimated to be responsible for more than 5.3 million deaths worldwide [1]. Moreover, among European men and women, approximately 7.3% of all deaths in 2008 might be attributable to inactivity compared with 3.7% to obesity [2] and there is strong evidence to suggest that even small increases in physical activity (PA) would lower the risk for many non-communicable diseases [1–3]. Yet, levels of PA across populations remain low [4]. To tackle this public health issue, the US Centers for Disease Control and Prevention and the American College of Sports Medicine produced standardized PA guidelines 20 years ago [5]. Since then, the World Health Organization (WHO), the European Union, and most countries around the world, have included PA guidelines in their health policies. Guidelines for Americans and Europeans have been updated to include recommendations for adolescents and for older adults [6–9]. For adults aged 18–64 years old, the WHO recommends a minimum of 150 min of moderate intensity PA per week, 75 min of vigorous intensity PA or an equivalent amount of moderate and vigorous PA (MVPA) [9]. In 2008, 34.8% of adults 15 years or older were insufficiently active in Europe [4]. Regular surveillance is needed to update these prevalence estimates and to evaluate the effectiveness of PA policies and promotion programs in European countries. In this context, the objective assessment of PA is a key issue. Prevalence of physical inactivity has been mainly derived from self-reported measures such as the Baecke questionnaire [10] or the International Physical Activity Questionnaire (IPAQ) [11]. These questionnaires have been, and still are, widely used due to their simple administration and low cost [12]. However, PA is frequently misreported, which leads to considerable measurement error [13–15]. Accelerometers offer a potential solution because they measure PA objectively. Given that they are small and easy to wear, store data up to several weeks and are acceptable in terms of reliability, these devices are now used increasingly in large studies to assess PA in children, adolescents and adults [16]. Although some European countries have reported adherence to PA guidelines using accelerometers in large cohorts [17–19], comparisons between European countries measured according to the same standardized protocols and concurrently are lacking. Between 2012 and 2014, PA was assessed objectively by accelerometry in the participants of the Food4Me Proof-of-Principle (PoP) study. The Food4Me Study was a web-based randomized controlled trial on personalized nutrition, across seven European countries: Germany, Greece, Ireland, The Netherlands, Poland, Spain and the United Kingdom. The aim of the current paper is to describe and compare PA in adults from these countries, and evaluate adherence to PA guidelines, using baseline data from the Food4Me PoP study

FTO genotype and weight loss: systematic review and meta-analysis of 9563 individual participant data from eight randomised controlled trials

Objective To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. Design Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. Data sources Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. Eligibility criteria for study selection Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after dietary, physical activity, or drug based interventions. Gene by treatment interaction models were fitted to individual participant data from all studies included in this review, using allele dose coding for genetic effects and a common set of covariates. Study level interactions were combined using random effect models. Metaregression and subgroup analysis were used to assess sources of study heterogeneity. Results We identified eight eligible randomised controlled trials for the systematic review and meta-analysis (n=9563). Overall, differential changes in body mass index, body weight, and waist circumference in response to weight loss intervention were not significantly different between FTO genotypes. Sensitivity analyses indicated that differential changes in body mass index, body weight, and waist circumference by FTO genotype did not differ by intervention type, intervention length, ethnicity, sample size, sex, and baseline body mass index and age category. Conclusions We have observed that carriage of the FTO minor allele was not associated with differential change in adiposity after weight loss interventions. These findings show that individuals carrying the minor allele respond equally well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions. Systematic review registration PROSPERO CRD42015015969

Mediterranean Diet Adherence and Genetic Background Roles within a Web-Based Nutritional Intervention: The Food4Me Study

Mediterranean Diet (MedDiet) adherence has been proven to produce numerous health benefits. In addition, nutrigenetic studies have explained some individual variations in the response to specific dietary patterns. The present research aimed to explore associations and potential interactions between MedDiet adherence and genetic background throughout the Food4Me web-based nutritional intervention. Dietary, anthropometrical and biochemical data from volunteers of the Food4Me study were collected at baseline and after 6 months. Several genetic variants related to metabolic risk features were also analysed. A Genetic Risk Score (GRS) was derived from risk alleles and a Mediterranean Diet Score (MDS), based on validated food intake data, was estimated. At baseline, there were no interactions between GRS and MDS categories for metabolic traits. Linear mixed model repeated measures analyses showed a significantly greater decrease in total cholesterol in participants with a low GRS after a 6-month period, compared to those with a high GRS. Meanwhile, a high baseline MDS was associated with greater decreases in Body Mass Index (BMI), waist circumference and glucose. There also was a significant interaction between GRS and the MedDiet after the follow-up period. Among subjects with a high GRS, those with a high MDS evidenced a highly significant reduction in total carotenoids, while among those with a low GRS, there was no difference associated with MDS levels. These results suggest that a higher MedDiet adherence induces beneficial effects on metabolic outcomes, which can be affected by the genetic background in some specific markers

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: The food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products

Objectively measured physical activity in european adults: cross-sectional findings from the Food4Me study

Introduction Physical inactivity has been estimated to be responsible for more than 5.3 million deaths worldwide [1]. Moreover, among European men and women, approximately 7.3% of all deaths in 2008 might be attributable to inactivity compared with 3.7% to obesity [2] and there is strong evidence to suggest that even small increases in physical activity (PA) would lower the risk for many non-communicable diseases [1–3]. Yet, levels of PA across populations remain low [4]. To tackle this public health issue, the US Centers for Disease Control and Prevention and the American College of Sports Medicine produced standardized PA guidelines 20 years ago [5]. Since then, the World Health Organization (WHO), the European Union, and most countries around the world, have included PA guidelines in their health policies. Guidelines for Americans and Europeans have been updated to include recommendations for adolescents and for older adults [6–9]. For adults aged 18–64 years old, the WHO recommends a minimum of 150 min of moderate intensity PA per week, 75 min of vigorous intensity PA or an equivalent amount of moderate and vigorous PA (MVPA) [9]. In 2008, 34.8% of adults 15 years or older were insufficiently active in Europe [4]. Regular surveillance is needed to update these prevalence estimates and to evaluate the effectiveness of PA policies and promotion programs in European countries. In this context, the objective assessment of PA is a key issue. Prevalence of physical inactivity has been mainly derived from self-reported measures such as the Baecke questionnaire [10] or the International Physical Activity Questionnaire (IPAQ) [11]. These questionnaires have been, and still are, widely used due to their simple administration and low cost [12]. However, PA is frequently misreported, which leads to considerable measurement error [13–15]. Accelerometers offer a potential solution because they measure PA objectively. Given that they are small and easy to wear, store data up to several weeks and are acceptable in terms of reliability, these devices are now used increasingly in large studies to assess PA in children, adolescents and adults [16]. Although some European countries have reported adherence to PA guidelines using accelerometers in large cohorts [17–19], comparisons between European countries measured according to the same standardized protocols and concurrently are lacking. Between 2012 and 2014, PA was assessed objectively by accelerometry in the participants of the Food4Me Proof-of-Principle (PoP) study. The Food4Me Study was a web-based randomized controlled trial on personalized nutrition, across seven European countries: Germany, Greece, Ireland, The Netherlands, Poland, Spain and the United Kingdom. The aim of the current paper is to describe and compare PA in adults from these countries, and evaluate adherence to PA guidelines, using baseline data from the Food4Me PoP study

FTO genotype and weight loss: systematic review and meta-analysis of 9563 individual participant data from eight randomised controlled trials

Objective To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. Design Systematic review and random effects meta-analysis of individual participant data from randomised controlled trials. Data sources Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. Eligibility criteria for study selection Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after dietary, physical activity, or drug based interventions. Gene by treatment interaction models were fitted to individual participant data from all studies included in this review, using allele dose coding for genetic effects and a common set of covariates. Study level interactions were combined using random effect models. Metaregression and subgroup analysis were used to assess sources of study heterogeneity. Results We identified eight eligible randomised controlled trials for the systematic review and meta-analysis (n=9563). Overall, differential changes in body mass index, body weight, and waist circumference in response to weight loss intervention were not significantly different between FTO genotypes. Sensitivity analyses indicated that differential changes in body mass index, body weight, and waist circumference by FTO genotype did not differ by intervention type, intervention length, ethnicity, sample size, sex, and baseline body mass index and age category. Conclusions We have observed that carriage of the FTO minor allele was not associated with differential change in adiposity after weight loss interventions. These findings show that individuals carrying the minor allele respond equally well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions. Systematic review registration PROSPERO CRD42015015969

Association between diet-quality scores, adiposity, total cholesterol and markers of nutritional status in European adults: findings from the Food4Me study

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

Mediterranean Diet Adherence and Genetic Background Roles within a Web-Based Nutritional Intervention: The Food4Me Study

Mediterranean Diet (MedDiet) adherence has been proven to produce numerous health benefits. In addition, nutrigenetic studies have explained some individual variations in the response to specific dietary patterns. The present research aimed to explore associations and potential interactions between MedDiet adherence and genetic background throughout the Food4Me web-based nutritional intervention. Dietary, anthropometrical and biochemical data from volunteers of the Food4Me study were collected at baseline and after 6 months. Several genetic variants related to metabolic risk features were also analysed. A Genetic Risk Score (GRS) was derived from risk alleles and a Mediterranean Diet Score (MDS), based on validated food intake data, was estimated. At baseline, there were no interactions between GRS and MDS categories for metabolic traits. Linear mixed model repeated measures analyses showed a significantly greater decrease in total cholesterol in participants with a low GRS after a 6-month period, compared to those with a high GRS. Meanwhile, a high baseline MDS was associated with greater decreases in Body Mass Index (BMI), waist circumference and glucose. There also was a significant interaction between GRS and the MedDiet after the follow-up period. Among subjects with a high GRS, those with a high MDS evidenced a highly significant reduction in total carotenoids, while among those with a low GRS, there was no difference associated with MDS levels. These results suggest that a higher MedDiet adherence induces beneficial effects on metabolic outcomes, which can be affected by the genetic background in some specific markers