Search Results (28)

Background/Objectives: Adolescence is a critical life stage characterized by rapid growth, increased nutrient requirements, and the establishment of long-term healthy behaviors. Growing evidence suggests that nutritional inadequacies may persist even when conventional indicators such as body mass index (BMI) appear normal, reflecting hidden malnutrition, a condition characterized by micronutrient inadequacy despite adequate energy intake. This issue may be particularly relevant in structurally constrained environments. This study aimed to compare dietary intake and nutrient adequacy between adolescents residing in residential care institutions (RCIs) and those in the general population in Taiwan. Methods: A total of 248 adolescents were included in the analysis. Institutional data were collected in 2018 and compared with nationally representative data from the Nutrition and Health Survey in Taiwan (NAHSIT 2010–2012). To improve comparability, 1:1 propensity score matching (PSM) was applied based on age, sex, and geographic region. Nutrient intakes were evaluated according to the Taiwan Dietary Reference Intakes (DRIs). Results: Adolescents in RCIs demonstrated significantly lower energy and protein adequacy than their counterparts in the general population. Among boys aged 13–15 years, the proportion meeting protein adequacy was substantially lower in RCIs than in the general population (34.0% vs. 84.0%). Similarly, among girls aged 13–15 years, energy adequacy was markedly lower in RCIs (25.0% vs. 63.9%). In addition, inadequate intake of multiple micronutrients, particularly B vitamins and essential minerals, was observed. Despite these differences, BMI remained largely comparable between groups, indicating a mismatch between anthropometric status and underlying nutritional quality. Conclusions: These findings suggest that hidden nutritional vulnerability may persist even within structured institutional environments designed to ensure stable food provision. The results highlight the limitations of relying solely on anthropometric indicators to assess nutritional status and underscore the need for targeted nutritional strategies to improve dietary quality and reduce health inequalities in residential care settings. Full article

Objective: This study aimed to examine the mediating and moderating roles of quality of life, mindfulness, and savoring in the relationship between sugar intake and depression among women with breast cancer undergoing active treatment. Methods: This prospective observational study recruited seventy-eight women diagnosed with breast cancer within six months from a medical center in Taiwan. The participants completed patient-reported health surveys and dietary recalls. Results: Sugar consumption (β = 0.22, p < 0.01) and breast symptoms (β = 0.28, p < 0.01) were significantly associated with depressive symptoms. Simple mediation analysis indicated that quality of life fully mediated the relationship between sugar intake and depression (indirect effect = 0.15, 95% CI = 0.05 to 0.25), while breast symptoms played a partial mediating role (indirect effect = 0.10, 95% CI = 0.02 to 0.18). Moderated mediation analysis revealed that after-event savoring moderated the path between quality of life and depression (interaction effect = −0.04, 95% CI = −0.08 to −0.01). Furthermore, non-judgment mindfulness significantly attenuated the indirect effect of sugar consumption on depression via quality of life functions (moderated mediation index = −0.03, 95% CI = −0.06 to −0.00). Conclusions: Mindfulness and momentary savoring may act as protective factors, moderating the relationship between sugar consumption and depression. These findings support the proposal to integrate nutrition and mindfulness-based support into clinical care for women receiving active breast cancer treatment. Full article

Background: Exploring emerging dietary patterns, such as plant-based diets (PBD), often requires considerable effort to rebuild new systems or adapt existing food classification frameworks, presenting a substantial challenge for dietary research. Current systems were not originally designed for this purpose and vary in standardization and interoperability, complicating cross-study comparisons. This study aimed to adopt the harmonized, food description-incorporated, food classification system (HFDFC system) to develop a plant-based diet food classification system (PBDFC system), and to evaluate dietary intake and nutritional status among adults in Taiwan. Methods: A repeated cross-sectional design was applied using 24 h dietary recall data from the Nutrition and Health Survey in Taiwan (2013–2016 and 2017–2020), accessed via the national food consumption database. Adults aged 20–70 years were included. Data were processed through the HFDFC system to generate the PBDFC system. For each participant, the Plant-Based Diet Index (PDI), Body Mass Index (BMI), and Nutrient-Rich Food Index (NRF) were calculated and analyzed by age group. Results: Adults aged 46–70 had significantly higher O-PDI and H-PDI scores, lower Lh-PDI scores (all p < 0.0001), and higher NRF values. Despite higher average BMI, those in the highest H-PDI tertile had significantly lower BMI (p < 0.02). Conclusions: The HFDFC-based PBDFC system offers a flexible, scalable framework for plant-based diet classification and supports future cross-national research. Full article

Background: Family interactions play a pivotal role in shaping well-being across physical, psychological, and social domains. While substantial research has focused on the nutritional and physical health benefits of family meals, the impact of shared cooking and dining practices on psychological flourishing and overall family well-being remains underexplored. Objectives: This study examines the relationships among family function, shared culinary practices, psychological flourishing, and family well-being, with particular emphasis on the mediating and moderating roles of psychological flourishing. Methods: A cross-sectional survey was conducted involving 461 participants from Chinese families with diverse family structures in Taipei, Taiwan. Data were analyzed using multiple regression analysis, as well as mediation and moderation analyses, to assess the interrelationships between family function, shared cooking and dining practices, and family well-being. Results: The findings indicate that family function significantly enhances psychological flourishing, which, in turn, mediates the association between family function and family well-being. Furthermore, shared cooking and dining practices were found to positively influence family well-being, underscoring their critical role in strengthening emotional bonds, fostering communication, and improving family cohesion. Conclusions: This study contributes to family nursing science and positive psychology by highlighting shared cooking and dining practices as effective interventions for enhancing family well-being. By incorporating the concept of psychological flourishing, this research expands our understanding of how family dynamics and shared culinary activities contribute to emotional resilience and life satisfaction. Implications: Given the cross-sectional nature of the study, future research should employ longitudinal designs to explore causal relationships and the long-term effects of family interactions on well-being. Practical recommendations include the promotion of family-centered nutrition education programs and the development of public policies that encourage shared family meals as a strategy to enhance both emotional health and physical well-being. Full article

The EAT-Lancet commission advocated a planetary health diet in 2019. Some have raised concerns about its nutrient adequacy. This study used data from recent Nutrition and Health Surveys in Taiwan—from 2017 to 2020 (n = 6538)—to assess food intake and nutrient adequacy among three red meat consumption levels (low/medium/high). The low red meat group, whose diet was similar to the EAT-Lancet reference, showed significantly higher/better levels of vitamins C and E, calcium, magnesium, sodium, dietary fiber, and the polyunsaturated to saturated fatty acids ratio. However, protein, B vitamins, phosphorus for females, and zinc were slightly compromised, but they were still near or above 100% of the Daily Reference Intakes (DRIs), except for zinc (74~75%). The intake levels of vitamin D, calcium, and dietary fiber in all three groups at times did not reach 70% of the DRIs, but this was more pronounced in the high red meat group compared to the low red meat group. Replacing ultra-processed foods (UPFs) with whole/healthy foods improved levels of zinc, calcium, and dietary fiber, but not vitamin D. Finally, a proposed local planetary health dietary construct was provided, suggesting maintaining the original distribution of the food groups recommended by the Taiwan Food Guide while specifying amounts of protein sources in line with the EAT-Lancet principles. The proposed diet, according to our estimation and comparison with Taiwanese DRIs, was nearly perfect in its nutrient composition. Full article

(1) Background: According to the 2005~2008 Nutrition and Health Survey in Taiwan (NAHSIT), more than half of Taiwanese women (57.3%) had metabolic syndrome during menopause. Metabolic syndrome is a set of risk factors for cardiovascular disease (CVD) that increase the risk of cardiovascular disease, diabetes, and mortality. Epidemiological studies suggest that the consumption of tomato-based foods might reduce the risk factors for CVD. The aim of this study is to examine the effects of tomato consumption on lowering the metabolic syndrome risk factors among overweight postmenopausal women. (2) Methods: We conducted a randomized controlled trial using 8-week open-label dietary intervention. Overweight postmenopausal women aged 45–70 years old were recruited from Taipei Medical University in October 2013. They were randomly assigned into two groups (a control diet vs. a tomato diet). Blood samples were collected at the baseline and at the 4th and 8th weeks. The lipid profile, blood sugar, and antioxidant biomarkers, i.e., the ferric-reducing ability of plasma (FRAP) and serum carotenoids, were analyzed. Blood pressure, body weight, and body fat were also measured every week. (3) Results: After the 8-week dietary intervention, body weight, body mass index, waist circumference, and hip circumference were significantly lower in both groups (p < 0.05). Body fat mass, body fat percentage, waist circumference, and hip circumference were significantly lower in the tomato diet group than in the control diet group. The tomato diet group had significantly lower serum total cholesterol, triglyceride, systolic blood pressure and blood sugar, and higher high-density lipoprotein cholesterol than the control diet group. The antioxidant biomarkers, FRAP, beta-carotenoids, and lycopene were significantly higher in the tomato diet group than in the control diet group. (4) Conclusions: Fresh tomato consumption can increase antioxidant biomarkers to reduce risks of metabolic syndrome in postmenopausal women. Full article

Globally, anemia affects 56 million pregnant women, especially women with a low household income. Functional erythropoiesis requires a constant supply of micronutrients, and the demands significantly increase during fetal development. This study aims to identify dietary patterns for preventing gestational erythropoiesis-associated micronutrient deficiencies (e.g., iron, folic acid, and vitamin B₁₂). A Nationwide Nutrition and Health Survey in Pregnant Women, Taiwan (NAHSIT-PW), was conducted between 2017 and 2019. Data on baseline information, diet, anthropometrics, and blood biochemistry were collected during a prenatal visit. Dietary patterns were identified using a reduced rank regression (RRR). Erythropoiesis-related micronutrient deficiencies were defined as single, double, and triple micronutrient deficiencies of an iron deficiency, folate depletion, and a vitamin B₁₂ deficiency. In total, 1437 singleton pregnancies aged ≥20–48 years were included in the analysis. Prevalences of normal nutrition, and single, double, and triple erythropoiesis-related micronutrient deficiencies were 35.7%, 38.2%, 18.6%, and 7.5%, respectively. Anemic pregnant women with a low household income had the highest prevalence rates of double (32.5%) and triple (15.8%) erythropoiesis-related micronutrient deficiencies. Dietary pattern scores were positively correlated with nuts and seeds, fresh fruits, total vegetables, breakfast cereals/oats and related products, soybean products, and dairy products but negatively correlated with processed meat products and liver, organs, and blood products. After adjusting for covariates, the dietary pattern had 29% (odds ratio (OR): 0.71; 95% confidence interval (CI): 0.055–0.091, p = 0.006)) and 43% (OR: 0.57; 95% CI: 0.41–0.80, p = 0.001)) reduced odds of having double and triple erythropoiesis-related micronutrient deficiencies for those pregnant women with a low household income. For those women with anemia, dietary patterns had 54% (OR: 046, 95% CI: 0.27–0.78) and 67% (OR: 0.33; 95% CI: 0.170.64) reduced odds of double and triple erythropoiesis-related micronutrient deficiencies. In conclusion, increased consumption of breakfast cereals and oats, nuts, and seeds, fresh fruits and vegetables, soybean products, and dairy products may protect women against erythropoiesis-related micronutrient deficiencies during pregnancy. Full article

Vitamin D is involved in the pathophysiology of anemia. This cross-sectional study was conducted using the Nationwide Nutrition and Health Survey in Pregnant Women in Taiwan database. We investigated associations among dietary patterns (DPs), vitamin D, and iron-related biomarkers in pregnant women. The principal component analysis revealed four DPs. Linear and logistic regression analyses were performed to investigate the association of DPs with anemia-related biomarkers. Plant-based, carnivore, and dairy and nondairy alternatives DPs were positively associated with serum vitamin D levels. After adjusting covariates, the pregnant women consuming plant-based DPs at the mid-tertile (T2) were associated with reduced risks of low serum folate and vitamin D levels, and those consuming carnivore DPs at higher tertiles (T2 and/or T3) were correlated with an increased risk of low serum iron levels but decreased risks of low serum transferrin saturation, vitamin B₁₂, and vitamin D levels. The pregnant women consuming dairy and nondairy alternatives DPs at the highest tertile (T3) were associated with reduced risks of low serum folate and vitamin B₁₂ levels. However, the processed food DP was not correlated with anemia-related biomarkers. Thus, plant-based, carnivore, and dairy and nondairy alternatives DPs were associated with the risk of low-serum-anemia-related variables. Full article

Depression is a profound public health concern, yet its etiology remains unclear. A body’s magnesium status and low-grade systemic inflammation are associated with depression. However, the interaction of magnesium status and inflammation on depression/depressive symptoms is unknown. We assessed the association between serum magnesium levels and depressive symptoms by analyzing data from the Nutrition and Health Survey in Taiwan 2005–2008. In total, 2196 participants aged ≥20 years were included. Depressive symptoms were assessed using the 5-item Brief-Symptom Rating Scale. We performed logistic regression and multiple linear regression analyses to examine the association. A dose–response analysis was performed using restricted cubic spline models, and stratification by chronic inflammation was also performed. We found that higher serum magnesium levels were associated with lower depression scores and a lower risk of depression. In the subgroup analysis, serum magnesium levels were inversely associated with depressive symptoms more prominently among people with higher CRP levels, with a threshold at 5 mg/L (≥5 vs. <5) showing a greater difference than at 3 mg/L (≥3 vs. <3). Conclusions: Serum magnesium levels were inversely associated with depressive symptoms. This inverse association was affected by inflammation level. A dose–response relationship was also observed. Full article

Depression is a leading cause of the global burden of disease and has a multifactorial etiology that includes nutrients. Magnesium status has been associated with depression with inconclusive results. The impact of chronic latent magnesium deficiency (CLMD, 0.75 ≤ serum magnesium < 0.85 mmol/L) on depression has not yet been investigated. We assessed the association between serum magnesium levels/dietary magnesium intake and depressive symptoms by analyzing nationally representative data from Taiwan (Nutrition and Health Survey in Taiwan, NAHSIT). We used the 5-item Brief Symptom Rating Scale to measure depressive symptoms. Subgroup analysis by sex was also performed. Serum magnesium levels had a low correlation with dietary magnesium intake. Higher serum magnesium levels were associated with lower depressive scores and a lower risk of depressive symptoms, but dietary magnesium intake showed no association. Sex differences were found. Compared with subjects with serum magnesium <0.75 mmol/L, those with ≥0.85 mmol/L had lower depressive scores. In conclusion, serum magnesium was inversely associated with depressive symptoms, but dietary magnesium intake was not. Subjects with CLMD showed similar depressive scores and were at a similar risk of depressive symptoms to those with serum magnesium < 0.75 mmol/L. CLMD should be considered while assessing the association between magnesium status and depressive symptoms. Full article

This study aims to examine whether adherence to the Taiwan Daily Food Guide relates to the risk of type 2 diabetes. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016. Dietary intakes were assessed using a validated food-frequency questionnaire. Type 2 diabetes was defined as a fasting serum HbA1c level of 6.5% or higher or participants who have received treatment for type 2 diabetes or have reported a physician diagnosis of type 2 diabetes. A total of 2534 Taiwanese adults aged 19 and above were included. We found that the Daily Food Guide adherence was negatively associated with the prevalence of type 2 diabetes. The odds ratios (ORs) for those in the fourth quartile of the recommended total servings was 0.67 (95% confidence interval (CI) = 0.45–0.99) compared with those in the first quartile. In addition, those who were men (OR = 1.46, 95% CI = 1.07–1.98), aged more than 50 to 65 (OR = 6.48, 95% CI = 2.57–16.35), or more than 65 (OR = 6.81, 95% CI = 2.56–18.08), with body mass index (BMI) of 24 to less than 27 (OR = 2.08, 95% CI = 1.55–2.79), had BMI of more than 27 (OR = 3.63, 95% CI = 2.73–4.83), had an education level of junior high and high school (OR = 1.68, 95% CI = 1.03–2.74), were divorced, separated, widowed, or refused to answer (OR = 1.39, 95% CI = 1.03–1.88) were associated with an increased prevalence of type 2 diabetes. In conclusion, people who adhere better to the Taiwan Daily Food Guide were found to have a reduced risk of type 2 diabetes. Full article

It is unclear whether low dietary intake accompanied with multiple nutrient deficiencies or specific nutrient inadequacy is associated with geriatric syndrome. This study aimed to examine the nutrition inadequacy profiles associated with frailty and cognitive impairment (CI). With information from the Nutrition and Health Survey in Taiwan, 2014–2017, sex-specific nutrient intakes and intake per kg of body weight (BW) were estimated from 24-hour recall data for two age groups (65–74 years; ≥75 years) regarding the three frailty and three CI subgroups. Total energy intakes were significantly lower with the severity of both frailty and CI in analysis combining both gender and age groups, and in both the 65-to-74-year-old women or the over-75-year-old women. These trends were observed but not significant in either of the two age groups in men. Significantly lower levels of energy intake have been observed when age, sex, and sampling strata were adjusted. Intake levels of multiple nutrients also decreased with the severity of frailty and CI. A greater number of nutrient inadequacies for the frail and the CI was found in the 65-to-74-year-old group than the over-75-year-old age group. However, most of the associations between micronutrients and the two geriatric syndromes disappeared after energy adjustment. The remaining few did not show consistency across age–sex subgroups. In conclusion, frailty or CI was associated with low amounts of food consumption accompanied by multiple nutrient insufficiencies. Dietary intervention to ensure adequate total energy and multiple nutrient intakes should be trialed in the geriatric population to address both the causal and efficacy issues. Full article

The dietary reference intakes (DRIs) were established as guidance for the intake of micronutrients and other nutrients. However, how DRIs affect disease status has not been thoroughly examined. The aim of this study is to examine the associations between adherence to the DRIs of selected micronutrients and type 2 diabetes. A populational and cross-sectional study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016. A total of 14 nutrient intakes, including those for vitamin A, C, D, E, B1, B2, B3, B6, B12, iron, magnesium, zinc, calcium, and phosphorus, were evaluated using the 24 h dietary recall method. Type 2 diabetes was defined as a fasting serum HbA1c level of 6.5% or higher and excluded participants who had received treatments for type 2 diabetes or reported a diagnosis of type 2 diabetes by physicians to avoid the possible inverse association. A total of 2685 participants aged 19 and above were included in the final analysis. After adjusting for confounders, we found that adherence to the DRI of vitamin A was associated with a reduced risk of type 2 diabetes among men. The odds ratio (OR) was 0.64 (95% confidence interval (CI) = 0.42–0.99) compared with men who did not adhere to the DRI. As for women, we found that adherence to the DRI of vitamin B1 was associated with a reduced risk of type 2 diabetes. The OR was 0.59 (95% CI = 0.35–0.97) compared with that for women who did not adhere to the DRI. This study showed that adherence to Taiwan DRIs of vitamin A for men and vitamin B1 for women might have beneficial effects on type 2 diabetes. Full article

Objective: To assess the prospective association between frailty and dietary diversity on mortality. Method: This prospective cohort study used the 2005–2008 Nutrition and Health Survey in Taiwan (N = 330; age ≥ 65 years) and this was linked to the Death Registry where we used the data that was recorded up to 31 January 2020. Dietary intake information was assessed using a 24-h dietary recall and food-frequency questionnaire, which were calculated a dietary diversity score (DDS; range, 0–6) and food consumption frequency. Assessment of frailty phenotypes was based on FRAIL scale which was proposed by the International Academy on Nutrition and Aging. Results: Frail older adults had a higher risk of all-cause mortality when they were compared to those with robust physiologies (hazard ratio [HR]: 3.73, 95% confidence interval [CI]: 2.13–6.52). Frailty and a lower DDS were associated with a higher risk of mortality (joint adjusted HR: 2.30, 95% CI: 1.11–4.75) which, compared with a robust physiology and higher DDS, were associated with a lower risk of mortality. Conclusions: Frailty and a lower DDS were associated with a higher mortality. Prefrailty and frailty with a higher DDS were associated with a lower risk of mortality when compared with those with prefrailty and frailty and a lower DDS. These results suggest that eating a wide variety of foods might reduce the risk of mortality in older adults with prefrailty and frailty. Full article

A healthy dietary pattern review for Asian countries is scarce, which is crucial for guiding healthy eating. We reviewed Taiwanese dietary pattern discovery studies. Included were 19 studies, the majority of which employed dimension reduction methods to find dietary patterns associated with various health conditions. To show what is a high or low intake of foods in Taiwan, we also report the average dietary content and the 25th and 75th percentile values of the adult population for six food groups gathered by the Nutrition and Health Survey in Taiwan, 2017–2020. The healthy Taiwanese dietary approach is cohesive across multiple health outcomes occurring at different ages. It is featured with higher intakes of plant-based foods, aquatic foods, and some beneficial ethnic foods (soy products), drinks (tea), and cooking methods (boiling and steaming); lower intakes of fast foods, fatty and processed meats, sugar, salt rich foods/drinks, and fried foods; but with mixed findings for dairy and egg. Yet, the average Taiwanese person consumed many refined staple foods and livestock, but not sufficient vegetables, fruits, whole grains and roots, beans, and nuts. Dairy consumption remains low. In conclusion, Taiwanese discovery studies point to a mortality-lowering total wellbeing dietary pattern consistent with the current knowledge, which discloses potential benefits of soy product, tea, and boiling and steaming. Full article