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Association between Nutritional Awareness and Diet Quality: Evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) Study

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Luxembourg Institute of Health L.I.H. (formerly Centre de Recherche Public Santé), Centre d'Etudes en Santé, 1A Rue Thomas Edison, L-1445 Strassen, Grand-Duchy of Luxembourg
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Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa
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Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University
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Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
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Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia SC 29208, USA
*
Author to whom correspondence should be addressed.
Nutrients 2015, 7(4), 2823-2838; https://doi.org/10.3390/nu7042823
Received: 26 November 2014 / Revised: 5 March 2015 / Accepted: 27 March 2015 / Published: 14 April 2015
This study examined the association between nutritional awareness and diet quality, as indicated by energy density, dietary diversity and adequacy to achieve dietary recommendations, while considering the potentially important role of socioeconomic status (SES). Data were derived from 1351 subjects, aged 18–69 years and enrolled in the ORISCAV-LUX study. Energy density score (EDS), dietary diversity score (DDS) and Recommendation Compliance Index (RCI) were calculated based on data derived from a food frequency questionnaire. Nutritional awareness was defined as self-perception of the importance assigned to eating balanced meals, and classified as high, moderate, or of little importance. Initially, a General Linear Model was fit that adjusted for age, sex, country of birth, and body mass index (BMI). Furthermore, simultaneous contributions to diet quality of individual-level socioeconomic factors, education, and household income were examined across levels of nutritional awareness. Attributing high importance was associated inversely with energy density (p = 0.02), positively with both dietary diversity (p < 0.0001), and adequacy to dietary recommendations (p < 0.0001), independent of demographic factors, weight status and SES. Further adjustment for household income in the EDS-related multivariable model, reduced the β coefficient by 47% for the “moderate importance” category and 36% for the “high importance” category. Likewise, the β coefficient decreased by 13.6% and 10.7% in the DDS-related model, and by 12.5%, and 7.1% in the RCI-related model, respectively, across awareness categories. Nutritional awareness has a direct effect on diet quality, with a minor component of variance explained by improved income. The impact of nutritional awareness on diet quality seems to be a promising area for both health promotion and health policy research. View Full-Text
Keywords: nutritional awareness; diet quality; socio-economic status; dietary energy density; food diversity nutritional awareness; diet quality; socio-economic status; dietary energy density; food diversity
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Alkerwi, A.; Sauvageot, N.; Malan, L.; Shivappa, N.; Hébert, J.R. Association between Nutritional Awareness and Diet Quality: Evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) Study. Nutrients 2015, 7, 2823-2838.

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