ItemDietary quality determined by the Healthy Eating Index-2015 and biomarkers of chronic low-grade inflammation: a cross-sectional analysis in middle-to-older aged adults(MDPI, 2021-01) Millar, Seán R.; Navarro, Pilar; Harrington, Janas M.; Perry, Ivan J.; Phillips, Catherine M.; Health Research Board; Breakthrough Cancer ResearchLow-grade systemic inflammation is associated with a range of chronic diseases. Diet may modulate inflammation and represents a promising therapeutic target to reduce metabolic dysfunction. To date, no study has examined Healthy Eating Index-2015 (HEI-2015) diet score associations with biomarkers of inflammation. Thus, our objective was to assess relationships between the HEI-2015 score and a range of inflammatory biomarkers in a cross-sectional sample of 1989 men and women aged 46-73 years, to test the hypothesis that better dietary quality would be associated with more favourable circulating levels of inflammatory biomarkers. Pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cell counts were determined. Correlation and linear regression analyses were used to test HEI-2015 diet score relationships with biomarker concentrations. Higher dietary quality as determined by the HEI-2015 was associated with lower c-reactive protein (CRP) and interleukin 6 concentrations, white blood cell (WBC) counts and its constituents, adjusting for sex and age. Associations with CRP concentrations and WBC counts persisted in the fully adjusted models. No associations with complement component 3, tumour necrosis factor alpha, adiponectin, leptin, resistin or plasminogen activator inhibitor-1 levels were identified. Our data suggest that dietary quality, determined by the HEI-2015 score, in middle-to-older aged adults is associated with inflammatory biomarkers related to cardiometabolic health. ItemAssociations between the nutrient profiling system underlying the nutri-score nutrition label and biomarkers of chronic low-grade inflammation: a cross-sectional analysis of a middle- to older-aged population(MDPI, 2022) Millar, Seán R.; Navarro, Pilar; Harrington, Janas M.; Perry, Ivan J.; Phillips, Catherine M.; Health Research BoardLow-grade systemic inflammation is associated with a range of conditions. Diet may modulate inflammation and public health strategies are needed to guide consumers' dietary choices and help prevent diet-related disease. The Food Standards Agency nutrient profiling system (FSAm-NPS) constitutes the basis of the five-colour front-of-pack Nutri-Score labelling system. No study to date has examined FSAm-NPS dietary index associations with biomarkers of inflammation. Therefore, our objective was to test relationships between the FSAm-NPS and a range of inflammatory biomarkers in a cross-sectional sample of 2006 men and women aged 46-73 years. Individual participant FSAm-NPS scores were derived from food frequency questionnaires. Pro-inflammatory cytokine, adipocytokine, acute-phase response protein, coagulation factor and white blood cell count concentrations were determined. Correlation and linear regression analyses were used to examine FSAm-NPS relationships with biomarker levels. In crude and adjusted analyses, higher FSAm-NPS scores, reflecting poorer nutritional quality, were consistently and positively associated with biomarkers. In fully adjusted models, significant associations with concentrations of complement component 3, c-reactive protein, interleukin 6, tumour necrosis factor alpha, resistin, white blood cell count, neutrophils, eosinophils and the neutrophil-to-lymphocyte ratio persisted. These results suggest that dietary quality, determined by Nutri-Score rating, is associated with inflammatory biomarkers related to health. ItemComparing dietary score associations with lipoprotein particle subclass profiles: a cross-sectional analysis of a middle-to older-aged population(Elsevier, 2021-06) Millar, Seán R.; Navarro, Pilar; Harrington, Janas M.; Shivappa, Nitin; Hébert, James R.; Perry, Ivan J.; Phillips, Catherine M.; Health Research Board; Breakthrough Cancer ResearchBackground and objectives: Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile. Materials and methods: This was a cross-sectional study of 1862 men and women aged 46–73 years, randomly selected from a large primary care centre in Ireland. DASH, HEI-2015, MD and E-DII scores were derived from food frequency questionnaires. Lipoprotein subclass particle concentrations and size were determined using nuclear magnetic resonance spectroscopy. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with lipoprotein particle subclasses. Results: In fully adjusted models, higher diet quality or a more anti-inflammatory diet was associated with less large and medium very low-density lipoprotein (VLDL) (DASH and HEI-2015), intermediate-density lipoprotein (IDL) (DASH, MD and E-DII) and small high-density lipoprotein (HDL) (DASH, HEI-2015 and E-DII) particles. After accounting for multiple testing, relationships with large VLDL (DASH: β = -0.102, p = .037), IDL (DASH: β = -0.089, p = .037) and small HDL (DASH: β = -0.551, p = .014 and E-DII: β = 0.483, p = .019) concentrations persisted. Conclusions: These findings provide evidence that better diet quality, determined by the DASH score, may be more closely associated with a more favourable lipoprotein particle subclass profile in middle-to older-aged adults than the HEI-2015, MD and E-DII scores. A less pro-atherogenic lipoprotein status may be a potential mechanism underlying the cardioprotective effects of higher dietary quality. ItemExploring engagement with health apps: the emerging importance of situational involvement and individual characteristics(Emerald, 2021-05-06) Flaherty, Sarah Jane; McCarthy, Mary; Collins, Alan M.; McCafferty, Claire; McAuliffe, Fionnuala M.Purpose: Health apps offer a potential approach to support healthier food behaviours but a lack of sufficient engagement may limit effectiveness. This study aims to use a user engagement theoretical lens to examine the factors that influence app engagement over time and may prompt disengagement. Design/methodology/approach: A phenomenological exploration of the lived experience was used. Women from a lower socioeconomic background (based on the occupation and employment status of the household’s primary income earner) were randomly assigned to use one of two apps for a minimum of eight weeks. Multiple data collection methods, including accompanied shops, researcher observations, interviews, participant reflective accounts and questionnaires, were used at different time-points to examine engagement. Theoretical thematic analysis was conducted to explore the engagement experience and relevant social, personal and environmental influences. Findings: Healthy food involvement appears to drive app engagement. Changes in situational involvement may contribute to fluctuation in engagement intensity over time as the saliency of personal goals change. Negatively valenced engagement dimensions may contribute to the overall expression of engagement. A lack of congruency with personal goals or an imbalance between perceived personal investment and value was expressed as the primary reasons for disengagement. Research limitations/implications: Situational involvement may act as a trigger of different engagement phases. There is a need to better distinguish between enduring and situational involvement in engagement research. Practical implications: Individual characteristics may shape engagement and propensity for disengagement, which highlights the practical importance of incorporating tailored features into app design. Originality/value: Findings broaden the current conceptualisation of engagement within the digital space and prompt a reconsideration of the role of situational involvement and negatively valenced dimensions throughout the engagement process. ItemHealthy eating habit: A role for goals, identity, and self-control?(Wiley, 2017-08-05) McCarthy, Mary; Collins, Alan M.; Flaherty, Sarah Jane; McCarthy, Sinéad N.; Department of Agriculture, Food and the Marine, IrelandSupporting healthier eating habits is crucial for improving population health outcomes. Underpinning everyday eating patterns are recurring actions that may lead to positive or negative health outcomes depending on the healthfulness of such actions. The aim of this research was to explore individual-level determinants of a healthy eating habit and consider to what extent personal goals and self-control are linked to a healthy eating habit. One thousand one hundred nine adults completed a survey focusing on a range of factors that potentially sway food choice behaviors. A structural model, developed based on a review of existing literature, was tested using self-reported healthy eating habit (Verplanken & Orbell, 2003 ) as the dependent variable. Analysis suggests that along with health-conscious identity and food hedonism, self-control was one of the strongest determinants of a healthy eating habit. Furthermore, while healthy eating goals had a direct significant effect, other goals, economizing and emotional, did not. However, all three goals along with food hedonism had a significant indirect effect that was mediated through self-control. In revealing the role of self-control, this work questions the underlying assumption of automaticity in a healthy eating habit. This leads to the questions: what is a healthy eating habit and to what extent can healthy eating behaviors ever be truly characterized as controlled by heuristics and automaticity? This analysis suggests that healthy eating is an ongoing behavioral project that requires the continued engagement of deliberative processes; thus habit within this context, and as measured using self-reported habit, may be a misnomer. The use of healthy eating routines, as opposed to habits, may be more appropriate to acknowledge the role of both automatic and deliberative processes with self-control being central in everyday decision making. Important practical and theoretical implications are discussed along with potential approaches for health and food sectors to support healthier eating behavior in the future.