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Nutrition
Measures of nutrition based on the Food Frequency Questionnaire (FFQ)
Subcategories
Food frequency questionnaire (FFQ)
The FFQ is a modified version of the Harvard semiquantitative FFQ that is validated for use in older Chicago community residents. Participants record their usual frequency of intake of 144 food items over the previous 12 months. Items include vitamins and mineral supplements, beverages, diary products, main dishes, miscellaneous foods, bread and cereals, fruits and vegetables, snack foods/desserts, and changes in food use over the last 10 years. Completed questionnaires are sent to Harvard University for optical scanning.
Dietary components
Green leafy vegetable intake
Green leafy vegetable consumption is based on 3 items from the FFQ (lettuce/tossed salad; spinach; greens/kale/collards). Item responses are coded to represent servings per week and then summed to yield total green leafy vegetable intake.
Reference under review
Fish and seafood intake
Fish and seafood consumption is based on 4 items from the FFQ (tuna sandwich; fish sticks, cakes, or sandwich; fresh fish as a main dish; shrimp, lobster, scallops). Item responses are coded to represent servings per week and then summed to yield total fish and seafood intake.
Reference: Morris MC, Brockman J, Schneider JA, Wang Y, Bennett DA, Tangney CC, van de Rest O: Association of seafood consumption, brain mercury level, and APOE epsilon4 status with brain neuropathology in older adults. JAMA 2016, 315(5):489-497.
The following dietary components will be available following publication in MAP:
Fruit intake
Fruit consumption is based on 11 items from the FFQ (raisins; grapes; bananas; cantaloupe, melons; apples or applesauce; pears; oranges, grapefruit; strawberries; peaches, plums, apricots; orange juice; apple juice and other fruit juices). Item responses are coded to represent servings per week and then summed to yield total fruit intake.
Chicago Health and Aging Project (CHAP) reference: Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS: Associations of vegetable and fruit consumption with age-related cognitive change. Neurology 2006, 67(8): 1370-6.
Vegetable intake
Vegetable consumption is based on 17 items from the FFQ (potatoes; tomatoes; tomato/spaghetti sauce; string beans; broccoli; beets (not greens); corn; peas or lima beans; mixed vegetables; green/red peppers; yams/sweet potatoes; zucchini, summer squash, eggplant; cooked carrots; raw carrots; celery; coleslaw; potato salad). Item responses are coded to represent servings per week and then summed to yield total vegetable intake.
CHAP reference: Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS: Associations of vegetable and fruit consumption with age-related cognitive change. Neurology 2006, 67(8): 1370-6.
Diet scores
DASH diet score
The Dietary Approach to Stop Hypertension (DASH) diet score measures participants' adherence to DASH diet guidelines of the Exercise and Nutrition Interventions for Cardiovascular Health (ENCORE) trial. The DASH diet is low in fats and cholesterol and promotes fruit, vegetable, and low-fat dairy product consumption.
Participants' nutritional information is recorded using the FFQ. See the FFQ subcategory description for details. Food items on the FFQ are assigned to 7 DASH food groups and 3 components using the Harvard nutrient database. Servings in each component are scored 0, 0.5, and 1. The DASH diet adherence score ranges from 0 to 10 and is the sum of the 10 component scores. Higher scores indicate greater diet concordance.
Dietary component servings and scores:
| Diet component | 0 | 0.5 | 1 |
|---|---|---|---|
| Total grains (servings/day) | ≤5 | >5 to 6.5 | >6.5 |
| Vegetables (servings/day) | ≤2 | >2 to 3.5 | >3.5 |
| Fruits (servings/day) | ≤2 | >2 to 3.5 | >3.5 |
| Dairy (servings/day) | ≤1 | >1 to 2 | >2 |
| Meat, poultry, and fish (servings/day) | >3.5 | >2 to 3.5 | ≤2 |
| Nuts, seeds, and dry beans (servings/week) | ≤2 | >2 to 3.5 | >3.5 |
| % kcal from fat | >29.5 | >27.5 to 29.5 | ≤27.5 |
| % kcal from saturated fat | >7.5 | >6 to 7.5 | ≤6 |
| Sweets (servings/week) | >7 | >5.5 to 7 | ≤5.5 |
| Sodium (mg/day) | >3,000 | >2,400 to 3,000 | ≤2,400 |
Reference: Tangney CC, Li H, Wang Y, Barnes LL, Schneider JA, Bennett DA, Morris MC. Relation of DASH- and Mediterranean-like dietary patterns to cognitive decline in older persons. Neurology. 2014; 83(16):1410-1416. PubMed PMID: 25230996
Mediterranean diet score
The Mediterranean diet score (MedDiet score) measures participants' adherence to Mediterranean diet guidelines. The Mediterranean diet promotes the almost exclusive use of olive oil as the primary fat, high consumption of fish, and moderate consumption of wines with meals.
Participants' nutritional information is recorded using the FFQ. See the FFQ subcategory description for details. Food items on the FFQ are categorized into 11 dietary components, each scored 0 to 5. The total MedDiet score ranges from 0 to 55 and is the sum of the 11 component scores. Higher scores indicate greater diet concordance.
Dietary component servings and scores:
| Diet component | 0 | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|---|
| Non-refined cereals (servings/week) | 0 | >0 to 6 | >6 to 12 | >12 to 18 | >18 to 31 | >31 |
| Potato (servings/week) | 0 | >0 to 4 | >4 to 8 | >8 to 12 | >12 to 18 | >18 |
| Fruits (servings/week) | 0 | >0 to 4 | >4 to 8 | >8 to 15 | >15 to 21 | >21 |
| Vegetables (servings/week) | 0 | >0 to 6 | >6 to 12 | >12 to 20 | >20 to 32 | >32 |
| Legumes (servings/week) | 0 | >0 to <1 | 1 to 2 | >2 to 4 | >4 to 6 | >6 |
| Fish (servings/week) | 0 | >0 to <1 | 1 to 2 | >2 to 4 | >4 to 6 | >6 |
| Meat (servings/week) | >10 | >7 to 10 | >5 to 7 | >3 to 5 | >1 to 3 | ≤1 |
| Poultry (servings/week) | >10 | >8 to 10 | >6 to 8 | >5 to 6 | >3 to 5 | ≤3 |
| Cheese (servings/week) | >30 | >28 to 30 | >20 to 28 | >15 to 20 | >10 to 15 | ≤10 |
| Olive oil in cooking (times/week) | 0 | 0.5 | 1 | >1 to 3 | >3 to 5 | >5 |
| Alcohol (mL/day) | ≥700 to 0 | 600 to <700 | 500 to <600 | 400 to <500 | 300 to <400 | <300 |
Reference: Tangney CC, Li H, Wang Y, Barnes LL, Schneider JA, Bennett DA, Morris MC. Relation of DASH- and Mediterranean-like dietary patterns to cognitive decline in older persons. Neurology. 2014; 83(16):1410-1416. PubMed PMID: 25230996
MIND diet score
The Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet score measures participants' adherence to the MIND diet. The MIND diet is modeled after the Mediterranean and DASH (Dietary Approach to Stop Hypertension) diets with modifications based on findings in the diet-dementia field. For example, the MIND diet emphasizes consumption of green leafy vegetables and berries but does not score other types of fruit.
Participants' nutritional information is recorded using the food frequency questionnaire (FFQ). See the FFQ subcategory description for details. Food items on the FFQ are categorized into 10 brain healthy food groups and 5 unhealthy food groups. Each diet component is scored from 0 to 1 based on frequency of consumption of each food item portion associated with that component. The total MIND diet score ranges from 0 to 15 and is the sum of the 15 component scores. Higher scores indicate greater diet concordance.
Dietary component servings and scores:
| Diet component | 0 | 0.5 | 1 |
|---|---|---|---|
| Green leafy vegetables | ≤2 servings/week | >2 to <6 servings/week | ≥6 servings/week |
| Other vegetables | <5 servings/week | 5-6 servings/week | ≥1 serving/day |
| Berries | <1 servings/week | 1 serving/week | ≥2 servings/week |
| Nuts | <0.5 servings/week | 0.5-4 servings/week | ≥5 servings/week |
| Olive oil | Not primary oil | x | Primary oil used |
| Butter, margarine | >2 teaspoons/day | 1-2 teaspoons/day | <1 teaspoon/day |
| Cheese | ≥7 servings/week | 1-6 servings/week | <1 serving/week |
| Whole grains | <1 serving/day | 1-2 servings/day | ≥3 servings/day |
| Fish (not fried) | <1 meal/month | 1-3 meals/month | ≥1 meals/week |
| Beans | <1 meal/week | 1-3 meals/week | >3 meals/week |
| Poultry (not fried) | <1 meal/week | 1 meal per week | ≥2 meals/week |
| Red meat and products | >6 meals/week | 4-6 meals/week | <4 meals/week |
| Fast fried foods | >3 times/week | 1-3 times/week | <1 time/week |
| Pastries and sweets | ≥7 servings/week | 5-6 servings/week | <5 servings/week |
| Wine | <1 glass/month or ≥2 glasses/day | 1 glass/month to 1 glass/week | 2-7 glasses/week |
Reference: Morris MC, Tangney CC, Wang Y, Sacks FM, Barnes LL, Bennett DA, Aggarwal NT. MIND diet slows cognitive decline with aging. Alzheimer's & dementia: the journal of the Alzheimer's Association. 2015; 11(9):1015-1022.
Dietary nutrients
Nutrient measures are calculated by Harvard University from FFQ responses. See the FFQ subcategory description for details. Nutrient levels and total energy of each food item are based either on natural portion sizes or according to age-specific portion sizes from national dietary surveys.