Ethiopia announced its first food-based dietary guidelines (FBDGs) on 15 March 2022. The present study aims to develop and evaluate the Ethiopian Healthy Eating Index (Et-HEI) based on the FBDG. Data were collected from 494 Ethiopian women of reproductive age sampled from households in five different regions. The Et-HEI consists of eleven components, and each component was scored between 0 and 10 points, the total score ranging from 0 to 110, with maximum adherence to the FBDG. The Et-HEI score was evaluated against the Minimum Dietary Diversity for Women (MDD-W) and the probability of nutrient adequacy. The average Et-HEI score for women of reproductive age was 49 out of 110. Adherence to the recommendations for grains, vegetables, legumes, fat and oils, salt, sugar and alcohol contributed the most to this score. Most women had low scores for fruits, nuts and seeds, and animal-sourced foods, indicating low intake. The Cronbach's alpha coefficient, indicating the reliability of the Et-HEI to assess its diet quality, was 0⋅53. The low mean Et-HEI score agreed with a low mean score of the MDD-W (3⋅5 out of 10). Also, low nutrient adequacies confirmed poor adherence to nutrient-dense components of the FBDG. The Et-HEI was not associated with the intake of vitamin B12, vitamin C and calcium in this study population. Women who completed secondary school and above had relatively lower Et-HEI scores. The newly developed Et-HEI is able to estimate nutrient adequacy while also assessing adherence to the Ethiopian FBDG though there is room for improvement.

Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort’s adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI’s convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort (n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio > 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8·2 (sd 2·1). Maternal characteristics explained 29·1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1·46, 1·03, 2·06 and 1·56, 1·09, 2·23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1·53, 1·02, 2·30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children’s overweight/obesity/central adiposity, were in the expected directions and confirm the IFI’s convergent construct validity.

Non-communicable diseases, such as cancers and CVD, represent a major public health concern, and diet is an important factor in their development. French dietary recommendations were updated in 2017, and an adherence score, the Programme National Nutrition Santé Guidelines Score (PNNS-GS2), has been developed and validated using a standardised procedure. The present study aimed to analyse the prospective association between PNNS-GS2 and the risk of death, cancer and CVD. Our sample consisted of French adults included in the prospective NutriNet-Santé cohort (n 67 748, 75 634 and 80 269 for the risk of death, cancer and CVD, respectively). PNNS-GS2 (range: –∞ to 14·25) was calculated from the 24-h dietary records of the first 2 years of monitoring. Association between PNNS-GS2 (in quintiles, Q) and the risk of death, cancer and CVD was studied using Cox models adjusted for the main confounding factors. The sample included 78 % of women, aged on average 44·4 years (sd 14·6) with on average 6·6 (sd 2·3) dietary records. Average PNNS-GS2 was 1·5 (sd 3·4) and median follow-up was 6·6 years for cancers and 6·2 years for CVD and deaths. PNNS-GS2 was significantly associated with the risk of death (hazard ratio (HR)Q5vsQ1: 0·77 (95 % CI 0·60, 1·00), 828 cases), cancer (HRQ5vsQ1 = 0·80 (95 % CI 0·69, 0·92), 2577 cases) and CVD (HRQ5vsQ1 0·64 (95 % CI 0·51, 0·81), 964 cases). More specifically, PNNS-GS2 was significantly associated with colorectal and breast cancer risks but not prostate cancer risk. Our results suggest that strong adherence to the 2017 French dietary recommendations is associated with a lower risk of death, cancer or CVD. This reinforces the validity of these new recommendations and will help to promote their dissemination.

A healthy diet is associated with the improvement or maintenance of health parameters, and several indices have been proposed to assess diet quality comprehensively. Twin studies have found that some specific foods, nutrients and food patterns have a heritable component; however, the heritability of overall dietary intake has not yet been estimated. Here, we compute heritability estimates of the nine most common dietary indices utilized in nutritional epidemiology. We analyzed 2590 female twins from TwinsUK (653 monozygotic [MZ] and 642 dizygotic [DZ] pairs) who completed a 131-item food frequency questionnaire (FFQ). Heritability estimates were computed using structural equation models (SEM) adjusting for body mass index (BMI), smoking status, Index of Multiple Deprivation (IMD), physical activity, menopausal status, energy and alcohol intake. The AE model was the best-fitting model for most of the analyzed dietary scores (seven out of nine), with heritability estimates ranging from 10.1% (95% CI [.02, .18]) for the Dietary Reference Values (DRV) to 42.7% (95% CI [.36, .49]) for the Alternative Healthy Eating Index (A-HEI). The ACE model was the best-fitting model for the Healthy Diet Indicator (HDI) and Healthy Eating Index 2010 (HEI-2010) with heritability estimates of 5.4% (95% CI [−.17, .28]) and 25.4% (95% CI [.05, .46]), respectively. Here, we find that all analyzed dietary indices have a heritable component, suggesting that there is a genetic predisposition regulating what you eat. Future studies should explore genes underlying dietary indices to further understand the genetic disposition toward diet-related health parameters.

The role of diet in asthma is still debated. In France, a front-of-pack (FOP) nutrition label based on a modified Food Standards Agency Nutrient Profiling System/High Council for Public Health (FSAm-NPS/HCSP) has recently been implemented to help consumers to make healthier food choices during purchase. At the individual level, the FSAm-NPS dietary index (DI) has been shown to reflect the nutritional quality of the diet. The aim of the present study was to investigate the association between the FSAm-NPS DI and the asthma symptom score. In total, 34 323 participants (25 823 women and 8500 men) from the NutriNet-Santé cohort were included. The overall nutritional quality of the diet was assessed using the FSAm-NPS DI. Increasing FSAm-NPS DI reflects decreasing overall diet quality. Asthma was defined by the asthma symptom score (sum of five questions). Negative binomial regression was used to evaluate the association between the FSA-NPS DI and the asthma symptom score. Overall, mean participant’s age was 54 ± 14 years, and about 27 % reported at least one asthma symptom. We observed a significant positive association between less healthy diet, as expressed by higher FSAm-NPS DI, and the asthma symptom score. The adjusted OR were 1·27 (95 % CI 1·17, 1·38) among women and 1·31 (95 % CI 1·13, 1·53) among men. Unhealthy food choices, as reflected by a higher FSAm-NPS DI, were associated with greater asthma symptoms. These results reinforce the relevance of public health approach to orient consumers towards healthier food choices by using a clear and easy-to-understand FOP nutrition label based on the FSAm-NPS, such as the Nutri-Score.

Colorectal cancer (CRC) is a multi-factorial disease in which diet is believed to play a role. Little is known about the health effects of specific regional diets. The Nordic diet is high in fat and sugar but also includes a range of traditional products with anticipated health-promoting effects. The aim of this cohort study was to determine whether a healthy Nordic food index consisting of fish, cabbage, rye bread, oatmeal, apples, pears and root vegetables was related to CRC incidence. Data were obtained from a prospective cohort study of 57 053 Danish men and women aged 50–64 years, of whom 1025 developed CRC (13 years' follow-up). Incidence rate ratios (IRR) with 95 % CI were calculated from Cox proportional hazard models. Women who strongly adhered to a healthy Nordic food index had a 35 % lower incidence of CRC than women with poor adherence (adjusted IRR, 0·65; 95 % CI 0·46, 0·94); a similar tendency was found for men. Women had a 9 % lower incidence of CRC per point adherence to the healthy Nordic food index, but no significant effect was found for men. A regional diet based on healthy Nordic food items was therefore associated with a lower incidence of CRC in women. The protective effect was of the same magnitude as previously found for the Mediterranean diet, suggesting that healthy regional diets should be promoted in order to ensure health; this will also preserve cultural heredity and the environment.