Aims: To evaluate relationships between diet quality and cardiovascular outcomes.Methods: Six databases were searched for studies published between January 2007 and October 2021. Eligible studies included cohort studies that assessed the relationship between a priori diet quality and cardiovascular disease mortality and morbidity in adults. The Academy of Nutrition and Dietetics Checklist was used to assess the risk of bias. Study characteristics and outcomes were extracted from eligible studies using standardised processes. Data were summarised using risk ratios for cardiovascular disease incidence and mortality with difference compared for highest versus lowest diet quality synthesised in meta‐analyses using a random effects model.Results: Of the 4780 studies identified, 159 studies (n = 6 272 676 adults) were included. Meta‐analyses identified a significantly lower cardiovascular disease incidence (n = 42 studies, relative risk 0.83, 95% CI 0.82–0.84, p < 0.001) and mortality risk (n = 49 studies, relative risk 0.83, 95% CI 0.82–0.84, p < 0.001) among those with highest versus lowest diet quality. In sensitivity analyses of a high number of pooled studies (≥13 studies) the Mediterranean style diet patterns and adherence to the heart healthy diet guidelines were significantly associated with a risk reduction of 15% and 14% for cardiovascular disease incidence and 17% and 20% for cardiovascular disease mortality respectively (p < 0.05).Conclusions: Higher diet quality is associated with lower incidence and risk of mortality for cardiovascular disease however, significant study heterogeneity was identified for these relationships.

Dietary intakes are commonly assessed by established methods including food frequency questionnaires, food records, or recalls. These self-report methods have limitations impacting validity and reliability. Dietary biomarkers provide objective verification of self-reported food intakes, and represent a rapidly evolving area. This review aims to summarize the urinary biomarkers of individual foods, food groups, dietary patterns, or nutritional supplements that have been evaluated to date. Six electronic databases were searched. Included studies involved healthy populations, were published from 2000, and compared measured dietary intake with urinary markers. The initial search identified 9985 studies; of these, 616 full texts were retrieved and 109 full texts were included. Of the included studies, 67 foods and food components were studied, and 347 unique urinary biomarkers were identified. The most reliable biomarkers identified were whole grains (alkylresorcinols), soy (isoflavones), and sugar (sucrose and fructose). While numerous novel urinary biomarkers have been identified, further validation studies are warranted to verify the accuracy of self-reported intakes and utility within practice.

Young women are gaining weight rapidly. Evidence for effective weight loss interventions targeting young women is lacking. This randomized controlled trial assessed the efficacy and acceptability of a six-month targeted and tailored eHealth weight loss program for young women (Be Positive Be Healthe (BPBH)). Women aged 18–35 years were randomized to BPBH (n = 29) or control (n = 28). BPBH supported participants to modify diet and physical activity behaviours using evidenced-based strategies (e.g., self-monitoring) tailored for young women and delivered using e-health (website, social media, smartphone application, email, text messages). The primary outcome was a change in weight (kg) at six months. Acceptability was assessed via a process evaluation survey and usage of intervention components. No significant between-group differences were observed for weight, with significant mean differences favouring the intervention group observed for body fat (kg) (−3.10 (−5.69, 0.52), p = 0.019) and intakes of alcohol (g) (−0.69 (−1.33, 0.04), p = 0.037), vegetables (% energy/day) (4.71 (−2.20, 7.22), p < 0.001) and energy-dense, nutrient-poor foods (% energy/day) (−9.23 (−16.94, 1.52), p = 0.018). Retention, intervention usage and satisfaction were moderate. BPBH facilitated positive improvements in body fat and dietary intake, but not weight. Intervention acceptability findings support the use of some intervention components (e.g., Facebook, Smartphone app) with young women.

Urinary polyphenol metabolites are potential biomarkers of dietary polyphenol intake. The current study aims to evaluate associations between total diet, vegetable and fruit polyphenol intakes with urinary polyphenol metabolite concentrations in a sample of adults prescribed a diet rich in vegetables and fruit. Thirty-four participants completed a 10-week pre-post study. Participants were asked to consume Australian recommended daily vegetable and fruit serves and attend measurement sessions at baseline and at weeks 2 and 10. Two 24-h diet recalls were collected at each time-point and polyphenol intakes were calculated using the Phenol-Explorer database. Spot urine samples, collected at each time-point, were analyzed for 15 polyphenol metabolites using liquid chromatography-mass spectroscopy. Spearman’s correlation analyzes assessed the strength of relationships between urinary and dietary polyphenols. Linear mixed models were used to investigate relationships between polyphenol excretion and intake. Total urinary polyphenols were significantly correlated with total polyphenol intakes at week 10 (r_s = 0.47) and fruit polyphenols at week 2 (r_s = 0.38). Hippuric acid was significantly correlated with vegetable polyphenols at baseline (r_s = 0.39). Relationships were identified between individual polyphenol metabolites and vegetable and fruit polyphenols. Linear mixed model analyzes identified that for every 1 mg increase in polyphenol intakes, urinary polyphenol excretion increased by 16.3 nmol/g creatinine. Although the majority of relationships were not sufficiently strong or consistent at different time-points, promising relationships were observed between total urinary polyphenols and total polyphenol intakes, and hippuric acid and vegetable polyphenols.