Presentation
Modeled substitution of isocaloric foods for increased adherence to a Mediterranean style diet pattern in U.S. Adults
International Society of Behavioral Nutrition and Physical Activity: Annual conference 2023
(2023)
Abstract
Purpose: Studies suggest Americans could benefit from greater adherence to a Mediterranean Diet (MedD) pattern for chronic disease management. A study assessing adherence to dietary prescriptions noted participants were more likely to continue substituting nutrient-dense options 6-months post intervention than to follow diet prescriptions. The purpose of this study is to provide targeted intervention data supporting simple isocaloric food substitutions for Americans to help increase adherence to a MedD pattern.
Methods: A validated scoring index for non-Mediterranean populations determined alignment to a MedD pattern in 19,978 adults from the National Health and Nutrition Examination Survey (2007–2018). The study population was divided into two groups based on their score: top quartile (TQ) vs. lower quartiles (LQ). Differentiation in adherence guided foods most predictive of improved alignment, optimizing the substitutions. Isocaloric food substitution modeling via multiple regression identified key dietary swaps to improve MedD alignment. Targeted intervention groups were determined via highest substitution frequency.
Results: The mean MedD score was significantly different in the LQ (7.1±0.05) than the TQ (16.5±0.09)(p<0.0001). Four individual food substitutions increased LQ and TQ MedD score independently: olive oil from no use to partial use, leafy greens for starchy vegetables, whole grains for refined grains, or whole fruit in place of fruit juice (all substitutions p<0.0001); however, a synergistic effect was seen asthe mean MedD score increased to 10.5±0.05 in the LQ and 20.5±0.09 in the TQ when all substitutions were added to the model (within-group t-test p-values all <0.0001). The dietary substitutions for fruit, olive oil, and whole grains applied to a greater proportion of 30-49 year olds, females, individuals identifying as white, individuals that are obese, or those with some college education. Leafy greens showed similar demographic data, however, males or those in the age range of 50-59 were more likely to receive the dietary substitution.
Conclusions: Using foods that are already part of the average American diet underscores wide-spread acceptability to elicit behavior change. Simple dietary substitutions can help Americans more closely align with a MedD pattern to reduce chronic disease risk.
Disciplines
Publication Date
June, 2023
Location
Uppsala, Sweden
Citation Information
Ambria Crusan and Francine Overcash. "Modeled substitution of isocaloric foods for increased adherence to a Mediterranean style diet pattern in U.S. Adults" International Society of Behavioral Nutrition and Physical Activity: Annual conference 2023 (2023) Available at: http://works.bepress.com/ambria-crusan/32/