scholarly journals Caregiver Status and Diet Quality in Community-Dwelling Adults

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1803
Author(s):  
Sharmin Hossain ◽  
May A. Beydoun ◽  
Michele K. Evans ◽  
Alan B. Zonderman ◽  
Marie F. Kuczmarski
Keyword(s):  
Diet Quality ◽  
Healthy Aging ◽  
Healthy Eating Index ◽  
Community Dwelling ◽  
Rate Of Change ◽  
Least Square ◽  
Inverse Association ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Cross Sectional

Objective: We investigated cross-sectional and longitudinal associations of diet quality with middle-aged caregiver status. Methods: Caregiving in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American (AA)) was measured at waves 3 (2009–2013) and 4 (2013–2017) (mean follow-up time 4.1 years). Diet quality was assessed by the Healthy Eating Index 2010 (HEI-2010) derived from two separate 24 h diet recalls. Multivariable ordinary least square regression was performed for cross-sectional analyses of the association of wave 4 caregiving with wave 4 HEI-2010. Wave 3 caregiving was examined both cross-sectionally and with annual rate of change in HEI using mixed-effects linear regression Models. Multivariable models were adjusted for age, sex, and poverty status. Results: Cross-sectional analyses at wave 4 demonstrate an inverse association of frequent caregiving (“Daily or Weekly” vs. “Never”) for grandchildren with HEI-2010 total score (i.e., lower diet quality) among Whites (β = −2.83 ± 1.19, p = 0.03, Model 2) and AAs (β = −1.84 ± 0.79, p = 0.02,). The “cross-sectional” analysis pertaining to grandchildren caregiving frequency suggested that frequent caregiving (i.e., “Daily or Weekly” vs. “Never” (β = −2.90 ± 1.17, p = 0.04)) only among Whites was inversely related to HEI-2010 total score. Total HEI-2010 score was also related to caring (Model 1), for the elderly over “5 years vs. Never” among Whites (−7.31 ± 3.54, p = 0.04, Model 2). Longitudinally, we found slight potential improvement in diet quality over time (“Daily or Weekly” vs. Never by TIME interaction: +0.88 ± 0.38, p = 0.02) with frequent caregiving among Whites, but not so among AAs. Conclusions: Frequent caring for grandchildren had an inverse relationship with the diet quality of White and AA urban middle-aged caregivers, while caring for elderly was inversely linked to diet quality among Whites only. Longitudinal studies should address the paucity of research on caregivers’ nutritional quality.

scholarly journals Starchy Vegetables and Metabolic Syndrome in Costa Rica

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1639
Author(s):  
Zhongyao Li ◽  
Dongqing Wang ◽  
Edward A. Ruiz-Narváez ◽  
Karen E. Peterson ◽  
Hannia Campos ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Regression Models ◽  
Fasting Blood Glucose ◽  
Population Based ◽  
Cross Sectional Study ◽  
Costa Rican ◽  
Least Square ◽  
Inverse Association ◽  
Linear Regression Models ◽  
Cross Sectional

Only a few studies primarily examined the associations between starchy vegetables (other than potatoes) and metabolic syndrome (MetS). We aimed to evaluate the association between starchy vegetables consumption and MetS in a population-based sample of Costa Rican adults. We hypothesized that a higher overall intake of starchy vegetables would not be associated with higher MetS prevalence. In this cross-sectional study, log-binomial regression models were used to estimate prevalence ratios (PRs) of MetS across quintiles of total, unhealthy, healthy starchy vegetables, and individual starchy vegetables (potatoes, purple sweet potatoes, etc.), among 1881 Costa Rican adults. Least square means and 95% confidence intervals (CIs) from linear regression models were estimated for each MetS component by categories of starchy vegetable variables. Higher intakes of starchy vegetables were associated with a higher prevalence of MetS in crude models, but no significant trends were observed after adjusting for confounders. A significant inverse association was observed between total starchy and healthy starchy vegetables consumption and fasting blood glucose. In this population, starchy vegetables might be part of a healthy dietary pattern.

More frequent cooking at home is associated with higher Healthy Eating Index-2015 score

2020 ◽  
Vol 23 (13) ◽  
pp. 2384-2394 ◽  
Author(s):  
Julia A Wolfson ◽  
Cindy W Leung ◽  
Caroline R Richardson
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Lower Income ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Income Status ◽  
The Usa ◽  
At Home

AbstractObjective:To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults.Design:Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and stratified by income.Setting:Nationally representative survey data from the USA.Participants:Adults aged ≥20 years (with 2 d of 24 h dietary recall data) obtained from the 2007 to 2010 National Health and Nutrition Examination Survey (n 8668).Results:Compared with cooking dinner 0–2 times/week, greater cooking frequency was associated with higher HEI-2015 score overall (≥7 times/week: +3·57 points, P < 0·001), among lower-income adults (≥7 times/week: +2·55 points, P = 0·001) and among higher-income adults (≥7 times/week: +5·07 points, P < 0·001). Overall, total HEI-2015 score was higher among adults living in households where dinner was cooked ≥7 times/week (54·54 points) compared with adults living in households where dinner was cooked 0–2 times/week (50·57 points). In households in which dinner was cooked ≥7 times/week, total HEI-2015 score differed significantly based on income status (lower-income: 52·51 points; higher-income: 57·35 points; P = 0·003). Cooking frequency was associated with significant differences in HEI-2015 component scores, but associations varied by income.Conclusions:More frequent cooking at home is associated with better diet quality overall and among lower- and higher-income adults, although the association between cooking and better diet quality is stronger among high-income adults. Strategies are needed to help lower-income Americans consume a healthy diet regardless of how frequently they cook at home.

scholarly journals A lipid-related metabolomic pattern of diet quality

2020 ◽  
Vol 112 (6) ◽  
pp. 1613-1630
Author(s):  
Minoo Bagheri ◽  
Walter Willett ◽  
Mary K Townsend ◽  
Peter Kraft ◽  
Kerry L Ivey ◽  
...  
Keyword(s):  
Diet Quality ◽  
Eating Behaviors ◽  
Principal Component ◽  
Cross Sectional Study ◽  
Healthy Eating Index ◽  
Health Study ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Unhealthy Eating ◽  
Complementary Approach

ABSTRACT Background Adherence to a healthy diet has been associated with reduced risk of chronic diseases. Identifying nutritional biomarkers of diet quality may be complementary to traditional questionnaire-based methods and may provide insights concerning disease mechanisms and prevention. Objective To identify metabolites associated with diet quality assessed via the Alternate Healthy Eating Index (AHEI) and its components. Methods This cross-sectional study used FFQ data and plasma metabolomic profiles, mostly lipid related, from the Nurses’ Health Study (NHS, n = 1460) and Health Professionals Follow-up Study (HPFS, n = 1051). Linear regression models assessed associations of the AHEI and its components with individual metabolites. Canonical correspondence analyses (CCAs) investigated overlapping patterns between AHEI components and metabolites. Principal component analysis (PCA) and explanatory factor analysis were used to consolidate correlated metabolites into uncorrelated factors. We used stepwise multivariable regression to create a metabolomic score that is an indicator of diet quality. Results The AHEI was associated with 83 metabolites in the NHS and 96 metabolites in the HPFS after false discovery rate adjustment. Sixty-three of these significant metabolites overlapped between the 2 cohorts. CCA identified “healthy” AHEI components (e.g., nuts, whole grains) and metabolites (n = 27 in the NHS and 33 in the HPFS) and “unhealthy” AHEI components (e.g., red meat, trans fat) and metabolites (n = 56 in the NHS and 63 in the HPFS). PCA-derived factors composed of highly saturated triglycerides, plasmalogens, and acylcarnitines were associated with unhealthy AHEI components while factors composed of highly unsaturated triglycerides were linked to healthy AHEI components. The stepwise regression analysis contributed to a metabolomics score as a predictor of diet quality. Conclusion We identified metabolites associated with healthy and unhealthy eating behaviors. The observed associations were largely similar between men and women, suggesting that metabolomics can be a complementary approach to self-reported diet in studies of diet and chronic disease.

scholarly journals Diet Quality As It Relates to ADHD and Emotional Dysregulation Symptoms in a Pediatric Population

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 448-448
Author(s):  
Lisa Robinette ◽  
Irene Hatsu ◽  
Jeanette Johnstone ◽  
Gabriella Tost ◽  
Leanna Eiterman ◽  
...  
Keyword(s):  
Conduct Problems ◽  
Diet Quality ◽  
Family Income ◽  
Pediatric Population ◽  
Neurodevelopmental Disorder ◽  
Cross Sectional Study ◽  
Healthy Eating Index ◽  
Emotional Dysregulation ◽  
Linear Regression Models ◽  
Cross Sectional

Abstract Objectives Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a US pediatric prevalence of 10%. It presents with inattention and hyperactivity/impulsivity as well as emotional dysregulation (ED) symptoms such as irritability and defiant behavior, typical of Oppositional Defiance Disorder (ODD) and Disruptive Mood Dysregulation Disorder (DMDD). The etiology of ADHD is multi-factorial with suggested effects related to diet. Building on prior studies, this study examines the association of diet quality with ADHD and ED symptoms among a pediatric population. Methods This cross-sectional study utilized baseline data for 134 children aged 6–12 years with symptoms of ADHD and ED enrolled in an RCT of multinutrient supplementation. Diet quality was based on Healthy Eating Index-2015 (HEI) determined from the Vioscreen FFQ. ADHD, ODD, and DMDD symptoms were assessed using the Child and Adolescent Symptom Inventory-5. Other ED symptoms were assessed using the Strengths and Difficulties Questionnaire. Analysis for association was conducted using linear regression models, adjusting for covariates when necessary. Results Family income level was significantly associated with severity of inattention (P = 0.04), emotional problems (P = 0.01), conduct problems (P = 0.002), along with ODD (P = 0.004) and DMDD (P = 0.005) symptoms. Mean HEI score was 63.4 (SD = 8.8) and it was not significantly associated with any of the outcome symptoms. However, scores of HEI components vegetables (β = −0.118, P = 0.016) and refined grains (β = 0.052, P = 0.017) were both associated with inattention even after adjusting for covariates. Similarly, total fruit (β = −0.423, P = 0.037) was associated with conduct problems after adjusting for covariates. Conclusions While better vegetable and total fruit scores were associated with better symptoms in aspects of ADHD and emotional dysregulation, overall diet quality was not associated with inattention, hyperactivity/impulsivity, and ED symptoms severity among this cohort of children. Our findings could be explained by the fact that our study sample had a good diet quality and were only mildly impaired in their ADHD and ED symptoms. Funding Sources This study was funded by the Foundation for Excellence in Mental Health Care, the Wells Fargo/Gratis Foundation, and OSU CTSA award # UL1TR002733.

158 The Association Between Sleep Spindles and Cognitive Function in Middle-Aged and Older Men: A Population-Based Cohort Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A64-A65
Author(s):  
Jesse Parker ◽  
Sarah Appleton ◽  
Yohannes Melaku ◽  
Angela D’Rozario ◽  
Gary Wittert ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Visual Processing ◽  
Older Men ◽  
Community Dwelling ◽  
Inspection Time ◽  
Sleep Spindles ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract Introduction Sleep spindles are thought to play an important role in learning and memory. The association between sleep spindles and cognitive function and the potential confounding influence of obstructive sleep apnea (OSA) is uncertain. We examined the cross-sectional association between sleep spindles and cognitive function controlled for OSA in a sample of community dwelling middle-aged and older men. Methods Participants of the Florey Adelaide Male Ageing Study (n=477) underwent home-based polysomnography. These participants also completed the inspection time (IT) task, trail-making test part A (TMT-A) and part B (TMT-B), and Fuld object memory evaluation (FOME) test. Spindle metrics derived from sleep electroencephalography (n=356) included occurrence (total number) and fast (13-16 Hz) and slow (11-13 Hz) spindle density (number/minute) during N2 and N3 sleep. Linear regression models were adjusted for age, OSA, education, obesity, cardiovascular disease, diabetes, smoking, and alcohol risk. Results In covariate unadjusted analyses, higher spindle occurrence during N2 sleep was associated with better IT, TMT-A, TMT-B, and FOME performance (all p&lt;0.05). Spindle density (fast and slow) during N2 and N3 sleep (slow spindles only) was associated with better inspection time, TMT-A, and TMT-B performance (all p&lt;0.05). Fast spindle density during N2 sleep was also associated with better FOME performance (B=1.03, 95% CI [0.47, 1.59], p&lt;0.05). In covariate adjusted analyses, higher spindle occurrence during N2 sleep was independently associated with better IT (B=-0.002, 95% CI [-0.004, 0.000], p=0.046), while fast spindle density during N3 sleep was independently associated with worse TMT-B performance (B=0.12, 95% CI [0.03, 0.21], p=0.011). Conclusion Specific sleep spindle metrics during N2 and N3 sleep were independently associated with better visual processing speed and worse executive attention, suggesting a differential association between cognitive function and spindles during N2 and N3 sleep. The utility of sleep spindles for predicting cognitive impairment needs investigation in prospective studies. Support (if any) National Health and Medical Research Foundation, Adelaide Institute for Sleep Health, Hospital Research Foundation, and ResMed Foundation.

Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics

2021 ◽  
pp. 1-5
Author(s):  
Ana Carolina Leme ◽  
Dabrowka Muszynski ◽  
Julia A. Mirotta ◽  
Nicholas Caroll ◽  
Jaimie L. Hogan ◽  
...  
Keyword(s):  
Diet Quality ◽  
Parental Education ◽  
Healthy Eating Index ◽  
Demographic Variables ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Parental Education Level ◽  
Food Records ◽  
Sectional Analysis

Purpose: To examine associations between preschoolers’ diet quality and parent and child socio-demographic variables. Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children’s diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores. Results: A total of 86% of children had an HEI-2015 score in the “needs improvement” category (51–80 out of a maximum of 100). Children’s overall HEI-2015 score was inversely associated with children’s age (β = −0.19, 95% CI −0.37, −0.02). Parental education was positively associated with children’s overall HEI score (β = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (β = 1.00, 95% CI 0.39, 1.76), vegetables (β = 1.11, 95% CI 0.03, 2.18), total protein (β = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (β = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (β = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (β = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (β = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy. Conclusion: Our results suggest that preschoolers’ diet quality needs improvement and that children’s diet quality varies by children’s age and parental education level.

scholarly journals Biochemical and Hematological Correlates of Elevated Homocysteine in National Surveys and a Longitudinal Study of Urban Adults

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 950
Author(s):  
May A. Beydoun ◽  
Hind A. Beydoun ◽  
Peter H. MacIver ◽  
Sharmin Hossain ◽  
Jose A. Canas ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Healthy Aging ◽  
Disease Risk ◽  
Nhanes Iii ◽  
Phase 2 ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Cross Sectional ◽  
Age Related ◽  
Middle Aged Adults

Elevated blood homocysteine (Hcy) among middle-aged adults can increase age-related disease risk, possibly through other biochemical and hematological markers. We selected markers for hyperhomocysteinemia among middle-aged adults, studied time-dependent Hcy-marker associations and computed highly predictive indices of hyperhomocysteinemia, with cross-sectional and longitudinal validations. We used data from the National Health and Nutrition Examination Survey (NHANES III, phase 2, nmax = 4000), the NHANES 1999–2006 (nmax = 10,151) and pooled NHANES (cross-sectional validation). Longitudinal validation consisted of mixed-effects linear regression models (Hcy predicting markers’ annual rates of change), applied to the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS, n = 227–244 participants, k = 2.4 repeats/participant, Agebase: 30–65 years) data. Machine learning detected nine independent markers for Hcy > 14 µmol/L (NHANES III, phase 2): older age; lower folate and B-12 status; higher serum levels of creatinine, uric acid, alkaline phosphatase, and cotinine; mean cell hemoglobin and red cell distribution widths (RDW); results replicated in the 1999–2006 NHANES [AUC = 0.60–0.80]. Indices combining binary markers increased elevated Hcy odds by 6.9–7.5-fold. In HANDLS, first-visit Hcy predicted annual increase in creatinine, RDW and alkaline phosphatase, with third-visit index (2013–2018) directly predicting Hcy (2004–2009). We provide evidence of the internal and external validity of indices composed of several biomarkers that are strongly associated with elevated Hcy.

scholarly journals Several frailty parameters highly prevalent in middle age (50–65) are independent predictors of adverse events

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lauriane Segaux ◽  
Amaury Broussier ◽  
Nadia Oubaya ◽  
Claire Leissing-Desprez ◽  
Marie Laurent ◽  
...  
Keyword(s):  
Adverse Events ◽  
Middle Age ◽  
Executive Dysfunction ◽  
Community Dwelling ◽  
Living Alone ◽  
Middle Aged ◽  
Cross Sectional ◽  
Balance Impairment ◽  
Logistic Regression Models ◽  
Paris Area

AbstractAlthough frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.

scholarly journals Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Motamedi ◽  
Maryam Ekramzadeh ◽  
Ehsan Bahramali ◽  
Mojtaba Farjam ◽  
Reza Homayounfar
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Diet Quality ◽  
Dietary Diversity ◽  
Antihypertensive Drugs ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Common Chronic Disease ◽  
History Of ◽  
Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

scholarly journals Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1641
Author(s):  
Lien T. K. Nguyen ◽  
Binh N. Do ◽  
Dinh N. Vu ◽  
Khue M. Pham ◽  
Manh-Tan Vu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diet Quality ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
World Health ◽  
Short Version ◽  
Linear Regression Models ◽  
Stroke Patients ◽  
Disability Score ◽  
Cross Sectional

Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.

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