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Walter C Willett - One of the best experts on this subject based on the ideXlab platform.
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association between Healthy Eating patterns and risk of cardiovascular disease
JAMA Internal Medicine, 2020Co-Authors: Zhilei Shan, Megu Y Baden, Shilpa N Bhupathiraju, Dong D Wang, Qi Sun, Kathryn M Rexrode, Eric B Rimm, Walter C WillettAbstract:Importance The 2015-2020 Dietary Guidelines for Americans recommend multiple Healthy Eating patterns. However, few studies have examined the associations of adherence to different dietary patterns with long-term risk of cardiovascular disease (CVD). Objective To examine the associations of dietary scores for 4 Healthy Eating patterns with risk of incident CVD. Design, Setting, and Participants Prospective cohort study of initially Healthy women from the Nurses’ Health Study (NHS) (1984-2016) and the NHS II (1991-2017) and men from the Health Professionals Follow-up Study (HPFS) (1986-2012). The dates of analysis were July 25 to December 4, 2019. Exposures Healthy Eating Index–2015 (HEI-2015), Alternate Mediterranean Diet Score (AMED), Healthful Plant-Based Diet Index (HPDI), and Alternate Healthy Eating Index (AHEI). Main Outcomes and Measures Cardiovascular disease events, including fatal and nonfatal coronary heart disease (CHD) and stroke. Results The final study sample included 74 930 women in the NHS (mean [SD] baseline age, 50.2 [7.2] years), 90 864 women in the NHS II (mean [SD] baseline age, 36.1 [4.7] years), and 43 339 men in the HPFS (mean [SD] baseline age, 53.2 [9.6] years). During a total of 5 257 190 person-years of follow-up, 23 366 incident CVD cases were documented (18 092 CHD and 5687 stroke) (some individuals were diagnosed as having both CHD and stroke). Comparing the highest with the lowest quintiles, the pooled multivariable-adjusted hazard ratios (HRs) of CVD were 0.83 (95% CI, 0.79-0.86) for the HEI-2015, 0.83 (95% CI, 0.79-0.86) for the AMED, 0.86 (95% CI, 0.82-0.89) for the HPDI, and 0.79 (95% CI, 0.75-0.82) for the AHEI (Pfor trend Conclusions and Relevance In 3 large prospective cohorts with up to 32 years of follow-up, greater adherence to various Healthy Eating patterns was consistently associated with lower risk of CVD. These findings support the recommendations of the 2015-2020 Dietary Guidelines for Americans that multiple Healthy Eating patterns can be adapted to individual food traditions and preferences.
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current evidence on Healthy Eating
Annual Review of Public Health, 2013Co-Authors: Walter C Willett, Meir J StampferAbstract:Large nutritional epidemiology studies, with long-term follow-up to assess major clinical end points, coupled with advances in basic science and clinical trials, have led to important improvements in our understanding of nutrition in primary prevention of chronic disease. Although much work remains, sufficient evidence has accrued to provide solid advice on Healthy Eating. Good data now support the benefits of diets that are rich in plant sources of fats and protein, fish, nuts, whole grains, and fruits and vegetables; that avoid partially hydrogenated fats; and that limit red meat and refined carbohydrates. The simplistic advice to reduce all fat, or all carbohydrates, has not stood the test of science; strong evidence supports the need to consider fat and carbohydrate quality and different protein sources. This article briefly summarizes major findings from recent years bearing on these issues.
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essentials of Healthy Eating a guide
Journal of Midwifery & Women's Health, 2010Co-Authors: P J Skerrett, Walter C WillettAbstract:Enough solid evidence now exists to offer women several fundamental strategies for Healthy Eating. They include emphasizing healthful unsaturated fats, whole grains, good protein “packages,” and fruits and vegetables; limiting consumption of trans and saturated fats, highly refined grains, and sugary beverages; and taking a multivitamin with folic acid and extra vitamin D as a nutritional safety net. A diet based on these principles is Healthy through virtually all life stages, from young adulthood through planning for pregnancy, pregnancy, and on into old age.
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evaluating adherence to recommended diets in adults the alternate Healthy Eating index
Public Health Nutrition, 2006Co-Authors: Marjorie L Mccullough, Walter C WillettAbstract:Harvard School of Public Health, Departments of Nutrition, Epidemiology, and theChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,Boston, MA 02115, USAAbstractObjective: The Healthy Eating Index (HEI), designed to assess adherence to theDietary Guidelines for Americans and the Food Guide Pyramid, was previouslyassociated with only a small reduction in major chronic disease risk in US adult menand women. We assessed whether an alternate index would better predict risk.Design: Dietary intake reported by men and women from two prospective cohortswas scored according to an a priori designed Alternate Healthy Eating Index (AHEI).In contrast with the original HEI, the AHEI distinguished quality within food groupsand acknowledged health benefits of unsaturated oils. The score was then used topredict development of CVD, cancer or other causes of death in the same populationpreviously tested.Subjects: 67271 women from the Nurses’ Health Study and 38615 men from theHealth Professionals’ Follow-up Study.Results: Men and women with AHEI scores in the top vs. bottom quintile had asignificant 20% and 11% reduction in overall major chronic disease, respectively.Reductions were stronger for CVD risk in men (RR ¼ 0.61, 95% CI 0.49–0.75) andwomen (RR ¼ 0.72, 95% CI 0.60–0.86). The score did not predict cancer risk.Conclusions: The AHEI was twice as strong at predicting major chronic disease andCVD risk compared to the original HEI, suggesting thatmajor chronic disease risk canbe further reduced with more comprehensive and detailed dietary guidance.KeywordsAlternate Healthy Eating IndexDietary patternsMediterranean dietCardiovascular diseaseCancerCohort studiesCardiovascular disease (CVD) and cancer are the twoleading causes of death in the USA
Donna Spiegelman - One of the best experts on this subject based on the ideXlab platform.
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facilitators and barriers to Healthy Eating in a worksite cafeteria a qualitative study
BMC Public Health, 2021Co-Authors: Dalia Stern, Archana Shrestha, Josiemer Mattei, Ilian Blanco, Lucy A Olmos, Joel J Valdivia, Donna SpiegelmanAbstract:Worksite-based nutrition interventions can serve as access points to facilitate Healthy Eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for Healthy Eating in a cafeteria at a large worksite in Mexico City. We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. Employees defined Healthy Eating as Eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of Healthy Eating at the worksite were availability of affordable Healthy food options and employees’ high health awareness. Major barriers to Healthy Eating included unavailability of Healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. A broad range of factors affect Healthy Eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of Healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for Healthy Eating, may help improve dietary behaviors and health of employees.
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drivers of Healthy Eating in a workplace in nepal a qualitative study
BMJ Open, 2020Co-Authors: Dipesh Tamrakar, Biraj Man Karmacharya, Archana Shrestha, Vasanti S Malik, Josiemer Mattei, Anjana Rai, Donna SpiegelmanAbstract:Objective To explore the perceptions, enablers and barriers to employees' Healthy Eating in a hospital site. Design A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method. Setting The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu. Participants Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8-12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers. Results The major factors for promoting Healthy Eating were identified as the availability of affordable Healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for Healthy Eating were the unavailability of Healthy options, including the lack of food supply from local market, the higher cost of Healthy foods, individual food preferences and limited human resources in the cafeteria. Conclusion The availability of affordable Healthy foods, supply of Healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote Healthy Eating among employees in a Nepali hospital setting.
Susan Nitzke - One of the best experts on this subject based on the ideXlab platform.
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developing and implementing waupaca Eating smart a restaurant and supermarket intervention to promote Healthy Eating through changes in the food environment
Health Promotion Practice, 2016Co-Authors: Anne L Escaron, Ana P Martinezdonate, Ann Josie Riggall, Amy Meinen, Javier F Nieto, Beverly Hall, Susan NitzkeAbstract:Purpose. Restaurants and food stores are suitable settings for Healthy Eating interventions. A community–academic partnership developed and implemented “Waupaca Eating Smart” (WES), a Healthy eatin...
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evaluation of a pilot Healthy Eating intervention in restaurants and food stores of a rural community a randomized community trial
BMC Public Health, 2015Co-Authors: Ana P Martinezdonate, Ann Josie Riggall, Amy Meinen, Kristen Malecki, Anne L Escaron, Bev Hall, Anne Menzies, Gary Garske, Javier F Nieto, Susan NitzkeAbstract:Background Research suggests that the food environment influences individual Eating practices. To date, little is known about effective interventions to improve the food environment of restaurants and food stores and promote Healthy Eating in rural communities. We tested “Waupaca Eating Smart ” (WES), a pilot intervention to improve the food environment and promote Healthy Eating in restaurants and supermarkets of a rural community. WES focused on labeling, promoting, and increasing the availability of Healthy foods.
Josiemer Mattei - One of the best experts on this subject based on the ideXlab platform.
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facilitators and barriers to Healthy Eating in a worksite cafeteria a qualitative study
BMC Public Health, 2021Co-Authors: Dalia Stern, Archana Shrestha, Josiemer Mattei, Ilian Blanco, Lucy A Olmos, Joel J Valdivia, Donna SpiegelmanAbstract:Worksite-based nutrition interventions can serve as access points to facilitate Healthy Eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for Healthy Eating in a cafeteria at a large worksite in Mexico City. We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. Employees defined Healthy Eating as Eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of Healthy Eating at the worksite were availability of affordable Healthy food options and employees’ high health awareness. Major barriers to Healthy Eating included unavailability of Healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. A broad range of factors affect Healthy Eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of Healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for Healthy Eating, may help improve dietary behaviors and health of employees.
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strategies for Healthy Eating promotion and behavioral change perceived as effective by nutrition professionals a mixed methods study
Frontiers in Nutrition, 2020Co-Authors: Josiemer Mattei, Charmaine AlfonsoAbstract:Nutrition professionals may recognize ways to improve diet among their clients/patients. This study aimed to survey strategies and foods that nutrition professionals in Puerto Rico perceive as most effective for Healthy Eating promotion and behavioral change. The study was a cross-sectional online mixed-methods survey conducted among registered members of the College of Nutritionists and Dietitians of Puerto Rico. Using close-ended questions, nutrition professionals identified foods that they considered as easy to include or difficult to control in the diet of their clients/patients, and strategies that may work best for Healthy Eating. Frequencies of responses were analyzed. Open-ended questions were qualitatively analyzed in NVivo v11. The response rate was 33.2% (n = 414). The foods deemed as easy to include in the diet were root vegetables (66%), fruit (66%), legumes (57%), water (38%), and yogurt/dairy (37%). The foods deemed as more difficult to control were sugary beverages (63%), sweets and desserts (57%), fats and fried foods (56%), salt (50%), and white rice (44%). The strategies for Healthy Eating deemed effective were personalized orientation (79%), setting short-term goals (61%), making gradual dietary changes (53%), and setting health-oriented (41%), and personal (37%) goals. Emerging themes from qualitative analysis included the intuited key role of nutrition professionals, the need for policy changes, emphasizing prevention, cultural sensitivity, and practical issues. Respondents suggested potential strategies across levels of the socioecological model. In conclusion, Healthy Eating strategies and foods perceived by nutrition professionals as effective may shape optimal nutritional counseling and population-wide approaches to improve Healthy Eating in Puerto Rico.
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drivers of Healthy Eating in a workplace in nepal a qualitative study
BMJ Open, 2020Co-Authors: Dipesh Tamrakar, Biraj Man Karmacharya, Archana Shrestha, Vasanti S Malik, Josiemer Mattei, Anjana Rai, Donna SpiegelmanAbstract:Objective To explore the perceptions, enablers and barriers to employees' Healthy Eating in a hospital site. Design A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method. Setting The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu. Participants Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8-12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers. Results The major factors for promoting Healthy Eating were identified as the availability of affordable Healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for Healthy Eating were the unavailability of Healthy options, including the lack of food supply from local market, the higher cost of Healthy foods, individual food preferences and limited human resources in the cafeteria. Conclusion The availability of affordable Healthy foods, supply of Healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote Healthy Eating among employees in a Nepali hospital setting.
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facilitators and barriers to Healthy Eating in a worksite cafeteria a qualitative study from nepal
Heart Asia, 2017Co-Authors: Archana Shrestha, Prajjwal Pyakurel, Abha Shrestha, Nisha Manandhar, Elizabeth C Rhodes, Dipesh Tamrakar, Biraj Man Karmacharya, Rabin Gautam, Vasanti S Malik, Josiemer MatteiAbstract:Objective Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate Healthy food choices. The study explored perceptions about Healthy Eating as well as potential facilitators and barriers to Healthy Eating among employees in a wire manufacturing factory in Nepal. Methods and materials We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method. Results Most employees defined Healthy Eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to Healthy Eating included unavailability of Healthy foods, difficulty in changing Eating habits, the preference for fried foods in Nepali culture and the high costs of some Healthy foods. The most commonly reported facilitator of Healthy Eating was the availability of affordable Healthy food options in worksite cafeterias. Conclusion Availability of Healthy food options at an affordable price could lead to healthier food choices in the worksite.
Archana Shrestha - One of the best experts on this subject based on the ideXlab platform.
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facilitators and barriers to Healthy Eating in a worksite cafeteria a qualitative study
BMC Public Health, 2021Co-Authors: Dalia Stern, Archana Shrestha, Josiemer Mattei, Ilian Blanco, Lucy A Olmos, Joel J Valdivia, Donna SpiegelmanAbstract:Worksite-based nutrition interventions can serve as access points to facilitate Healthy Eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for Healthy Eating in a cafeteria at a large worksite in Mexico City. We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. Employees defined Healthy Eating as Eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of Healthy Eating at the worksite were availability of affordable Healthy food options and employees’ high health awareness. Major barriers to Healthy Eating included unavailability of Healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. A broad range of factors affect Healthy Eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of Healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for Healthy Eating, may help improve dietary behaviors and health of employees.
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drivers of Healthy Eating in a workplace in nepal a qualitative study
BMJ Open, 2020Co-Authors: Dipesh Tamrakar, Biraj Man Karmacharya, Archana Shrestha, Vasanti S Malik, Josiemer Mattei, Anjana Rai, Donna SpiegelmanAbstract:Objective To explore the perceptions, enablers and barriers to employees' Healthy Eating in a hospital site. Design A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method. Setting The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu. Participants Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8-12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers. Results The major factors for promoting Healthy Eating were identified as the availability of affordable Healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for Healthy Eating were the unavailability of Healthy options, including the lack of food supply from local market, the higher cost of Healthy foods, individual food preferences and limited human resources in the cafeteria. Conclusion The availability of affordable Healthy foods, supply of Healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote Healthy Eating among employees in a Nepali hospital setting.
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facilitators and barriers to Healthy Eating in a worksite cafeteria a qualitative study from nepal
Heart Asia, 2017Co-Authors: Archana Shrestha, Prajjwal Pyakurel, Abha Shrestha, Nisha Manandhar, Elizabeth C Rhodes, Dipesh Tamrakar, Biraj Man Karmacharya, Rabin Gautam, Vasanti S Malik, Josiemer MatteiAbstract:Objective Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate Healthy food choices. The study explored perceptions about Healthy Eating as well as potential facilitators and barriers to Healthy Eating among employees in a wire manufacturing factory in Nepal. Methods and materials We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method. Results Most employees defined Healthy Eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to Healthy Eating included unavailability of Healthy foods, difficulty in changing Eating habits, the preference for fried foods in Nepali culture and the high costs of some Healthy foods. The most commonly reported facilitator of Healthy Eating was the availability of affordable Healthy food options in worksite cafeterias. Conclusion Availability of Healthy food options at an affordable price could lead to healthier food choices in the worksite.
