Fruit and vegetable intake and risk of incident of type 2 diabetes: results from the consortium on health and ageing network of cohorts in Europe and the United States (CHANCES)

BACKGROUND/OBJECTIVES: There is limited information to support definitive recommendations concerning the role of diet in the development of type 2 Diabetes mellitus (T2DM). The results of the latest meta-analyses suggest that an increased consumption of green leafy vegetables may reduce the incidence of diabetes, with either no association or weak associations demonstrated for total fruit and vegetable intake. Few studies have, however, focused on older subjects.

SUBJECTS/METHODS: The relationship between T2DM and fruit and vegetable intake was investigated using data from the NIH-AARP study and the EPIC Elderly study. All participants below the age of 50 and/or with a history of cancer, diabetes or coronary heart disease were excluded from the analysis. Multivariate logistic regression analysis was used to calculate the odds ratio of T2DM comparing the highest with the lowest estimated portions of fruit, vegetable, green leafy vegetables and cabbage intake.

RESULTS: Comparing people with the highest and lowest estimated portions of fruit, vegetable or green leafy vegetable intake indicated no association with the risk of T2DM. However, although the pooled OR across all studies showed no effect overall, there was significant heterogeneity across cohorts and independent results from the NIH-AARP study showed that fruit and green leafy vegetable intake was associated with a reduced risk of T2DM OR 0.95 (95% CI 0.91,0.99) and OR 0.87 (95% CI 0.87,0.90) respectively.

CONCLUSIONS: Fruit and vegetable intake was not shown to be related to incident T2DM in older subjects. Summary analysis also found no associations between green leafy vegetable and cabbage intake and the onset of T2DM. Future dietary pattern studies may shed light on the origin of the heterogeneity across populations.European Journal of Clinical Nutrition advance online publication, 17 August 2016; 

Alcoholic Beverage Preference and Dietary Habits in Elderly across Europe: Analyses within the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES) Project

INTRODUCTION: The differential associations of beer, wine, and spirit consumption on cardiovascular risk found in observational studies may be confounded by diet. We described and compared dietary intake and diet quality according to alcoholic beverage preference in European elderly.

METHODS: From the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES), seven European cohorts were included, i.e. four sub-cohorts from EPIC-Elderly, the SENECA Study, the Zutphen Elderly Study, and the Rotterdam Study. Harmonized data of 29,423 elderly participants from 14 European countries were analyzed. Baseline data on consumption of beer, wine, and spirits, and dietary intake were collected with questionnaires. Diet quality was assessed using the Healthy Diet Indicator (HDI). Intakes and scores across categories of alcoholic beverage preference (beer, wine, spirit, no preference, non-consumers) were adjusted for age, sex, socio-economic status, self-reported prevalent diseases, and lifestyle factors. Cohort-specific mean intakes and scores were calculated as well as weighted means combining all cohorts.

RESULTS: In 5 of 7 cohorts, persons with a wine preference formed the largest group. After multivariate adjustment, persons with a wine preference tended to have a higher HDI score and intake of healthy foods in most cohorts, but differences were small. The weighted estimates of all cohorts combined revealed that non-consumers had the highest fruit and vegetable intake, followed by wine consumers. Non-consumers and persons with no specific preference had a higher HDI score, spirit consumers the lowest. However, overall diet quality as measured by HDI did not differ greatly across alcoholic beverage preference categories.

DISCUSSION: This study using harmonized data from ~30,000 elderly from 14 European countries showed that, after multivariate adjustment, dietary habits and diet quality did not differ greatly according to alcoholic beverage preference.

The influence of socio-demographic, psychological and knowledge-related variables alongside perceived cooking and food skills abilities in the prediction of diet quality in adults: a nationally representative cross-sectional study

Background: Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research.
Methods: A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20–60 years drawn from the Island of Ireland. Surveys were administered in participants’ homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations.
Results: ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10–20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05).
Conclusion: Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed.

The making of professionals: Embedded civil society development in a transition country

The paper addresses the development of non-governmental organisations (NGOs) in transition settings. Caught in the balance of knowledge exchange and translation of ideas from abroad, organisations in turbulent setting legitimise their existence by learning through professional networks. By association, organisational actors gain acknowledgement by their sector by traversing the corridors of influence provided by international partnerships. What they learn is how to conduct themselves as agents of change in society, and how to deliver on stated missions and goals, therefore, legitimising their presence in a budding civil society at home. The paper presents a knowledge production and learning practices framework which indicates a presence of dual identity of NGOs - their “embeddedness” locally and internationally. Selected framework dimensions and qualitative case study themes are discussed with respect to the level of independence of organisational actors in the East from their partners in the West in a post-socialist context. A professional global civil society as organisations are increasingly managed in similar, professional ways (Anheier & Themudo 2002). Here knowledge “handling” and knowledge “translation” take place through partnership exchanges fostering capable and/or competitive change-inducing institutions (Czarniawska & Sevon 2005; Hwang & Suarez 2005). How professional identity presents itself in the third sector, as well as the sector’s claim to expertise, need further attention, adding to ongoing discussions on professions in institutional theory (Hwang & Powell 2005; Scott 2008; Noordegraaf 2011). A conceptual framework on the dynamic involved for the construction professional fields follows: • Multiple case analysis provides a taxonomy for understanding what is happening in knowledge transition, adaptation, and organisational learning capacity for NGOs with respect to their role in a networked civil society. With the model we can observe the types of knowledge produced and learning employed by organisations. • There are elements of professionalisation in third sector work organisational activity with respect to its accreditation, sources and routines of learning, knowledge claims, interaction with the statutory sector, recognition in cross-sector partnerships etc. • It signals that there is a dual embeddedness in the development of the sector at the core to the shaping the sector’s professional status. This is instrumental in the NGOs’ goal to gain influence as institutions, as they are only one part of a cross-sector mission to address complex societal problems The case study material highlights nuances of knowledge production and learning practices in partnerships, with dual embeddedness a main feature of the findings. This provides some clues to how professionalisation as expert-making takes shape in organisations: • Depending on the type of organisations’ purpose, over its course of development there is an increase in participation in multiple networks, as opposed to reliance on a single strategic partner for knowledge artefacts and practices; • Some types of organisations are better connected within international and national networks than others and there seem to be preferences for each depending on the area of work; • The level of interpretation or adaptation of the knowledge artefacts is related to an organisation’s embeddedness locally, in turn giving it more influence within the network of key institutions; An overreaching theme across taxonomy categories (Table 1)is “professionalisation” or developing organisational “expertise”, embodied at the individual, organisational, and sector levels. Questions relevant to the exercise of power arise: Is competence in managing a dual embeddedness signals the development of a dual identity in professionalisation? Is professionalisation in this sense a sign of organisations maturing into more capable partners to the arguably more experienced (Western) institutions, shifting the power balance? Or is becoming more professional a sign of domestication to the agenda of certain powerful stakeholders, who define the boundaries of the profession? Which dominant dynamics can be observed in a broadly-defined transition country civil society, where individual participation in the form of activism may be overtaking the traditional forms of organised development work, especially with the spread of social media?