801
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Rebro SM, Patterson RE, Kristal AR, Cheney CL. The effect of keeping food records on eating patterns. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:1163-5. [PMID: 9787724 DOI: 10.1016/s0002-8223(98)00269-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- S M Rebro
- Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Wash., USA
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802
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Hunt MK, Stoddard AM, Peterson K, Sorensen G, Hebert JR, Cohen N. Comparison of dietary assessment measures in the Treatwell 5 A Day worksite study. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:1021-3. [PMID: 9739803 DOI: 10.1016/s0002-8223(98)00233-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- M K Hunt
- Dana-Farber Cancer Institute, Center for Community-based Research, Boston, MA 02115, USA
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803
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Surrao J, Sawaya AL, Dallal GE, Tsay R, Roberts SB. Use of food quotients in human doubly labeled water studies: comparable results obtained with 4 widely used food intake methods. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:1015-20. [PMID: 9739802 DOI: 10.1016/s0002-8223(98)00232-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Information on the macronutrient composition of the diet is needed in doubly labeled water studies to convert measured rates of carbon dioxide production into values for total energy expenditure. There is no general consensus, however, about the best method to determine food intake for this purpose. Four common methods of measuring food intake (7-day weighed food intake, 24-hour recall, and Fred Hutchinson Cancer Research Center/Block and Willett food frequency questionnaires) were tested for their ability to provide comparable food quotient and total energy expenditure data in doubly labeled water studies in 10 young and 10 older women. All methods gave mean values for total energy expenditure that were within 1% of each other. Individual values obtained using the 24-hour recall and food frequency questionnaires were within +/- 3% (standard deviation) of values determined using data from the 7-day weighed food record. These results suggest that it is not necessary to use time-consuming and expensive 7-day food records in doubly labeled water studies; instead, food intake data obtained more easily by 24-hour recall or food frequency questionnaire can provide comparable data.
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Affiliation(s)
- J Surrao
- Energy Metabolism Laboratory, Jean Mayer US Dpartment of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
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804
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Hebert JR, Hurley TG, Chiriboga DE, Barone J. A comparison of selected nutrient intakes derived from three diet assessment methods used in a low-fat maintenance trial. Public Health Nutr 1998; 1:207-14. [PMID: 10933420 DOI: 10.1079/phn19980032] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In the vast majority of surveys and research in humans, dietary data are obtained from self-reports: recalls; records; or historical methods, usually food frequency questionnaires (FFQ). This study provides a rare opportunity to compare data derived from all three methods. DESIGN A crossover study of dietary fat in which data were collected using an average of 11.4 food records and 11.7 24-h diet recalls. Using simple subtraction and correlation, energy and nutrient intakes derived from the three methods were compared to each other and with those derived from a single FFQ. Analysis of variance was used to evaluate sources of variability in nutrient intakes estimated from the individual days of records and recalls. SETTING An independent, free-standing medical research institute. SUBJECTS 13 men who were compliant with study procedures. RESULTS FFQ-derived estimates of energy and nutrient intake were highest (e.g. 1967 kcal versus 1858 kcal and 1936 kcal for the records and recalls, respectively). Mean differences in energy and nutrient intakes and their variances were lowest and correlation coefficients highest in comparing the records and recalls (e.g. for fat the mean difference was 5.0 g, and r = 0.85). Analysis of variance of individual days of record- and recall-derived data (n = 300) revealed that there was no effect due to either method (record or recall) or the sequence of administration. CONCLUSIONS Results of this study indicate that the FFQ overestimated dietary intake. Energy and nutrient results obtained from the records and recalls were interchangeable. However, based on smaller SDs around the means, it appears that the recalls may perform slightly better in estimating dietary intake in groups such as these well-educated, highly compliant men.
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Affiliation(s)
- J R Hebert
- Department of Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
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805
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Schaffer DM, Velie EM, Shaw GM, Todoroff KP. Energy and nutrient intakes and health practices of Latinas and white non-Latinas in the 3 months before pregnancy. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:876-84. [PMID: 9710657 DOI: 10.1016/s0002-8223(98)00202-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To describe the health practices and energy and nutrient intakes from diet and supplements of foreign- and US-born Latinas and white non-Latinas in the 3 months before pregnancy. DESIGN A descriptive study in which data were obtained retrospectively from 2 questionnaires: an interviewer-administered questionnaire on the subject's medical, reproductive, family, occupational, and lifestyle history and a subject-administered (and interviewer-assisted) 100-item food frequency questionnaire. SUBJECTS/SETTING A population-based sample of California women (n = 462) who gave birth between 1989 and 1991 to single, live-born infants. One third of women were Latinas, of whom 58.1% were foreign born. STATISTICAL ANALYSES Means, standard deviations, and percentiles were computed for energy and nutrient intakes of the total population and for white non-Latinas; US-born Latinas; and foreign-born Latinas. One-way analysis of variance was used to compare group means. RESULTS Mean and median energy intake in all ethnic groups exceeded 2,000 kcal/day, although less than half of the population consumed 5 servings of fruit and vegetables per day. For iron, half of the women were below the Recommended Dietary Allowance. In contrast to the dietary intake of white non-Latinas and US-born Latinas, foreign-born Latinas had the lowest contribution of fat to total energy intake and the highest dietary intake of carbohydrate, cholesterol, fiber, grain products, protein foods, folate, vitamin C, iron, and zinc. CONCLUSIONS A woman's ethnicity, as well as whether her place of birth was within or outside of the United States, may be predictors of her dietary and health practices before pregnancy. Vitamin, mineral, and food supplementation and consumption of cold breakfast cereal may be avenues for improving perinatal micronutrient intake.
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Affiliation(s)
- D M Schaffer
- Division of Research, Kaiser Permanente Medical Care Program of Northern California, Oakland, USA
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806
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Blair SN, Applegate WB, Dunn AL, Ettinger WH, Haskell WL, King AC, Morgan TM, Shih JA, Simons-Morton DG. Activity Counseling Trial (ACT): rationale, design, and methods. Activity Counseling Trial Research Group. Med Sci Sports Exerc 1998; 30:1097-106. [PMID: 9662679 DOI: 10.1097/00005768-199807000-00012] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Activity Counseling Trial (ACT) is a multicenter, randomized controlled trial to evaluate the effectiveness of interventions to promote physical activity in the primary health care setting. ACT has recruited, evaluated, and randomized 874 men and women 35-75 yr of age who are patients of primary care physicians. Participants were assigned to one of three educational interventions that differ in amount of interpersonal contact and resources required: standard care control, staff-assisted intervention, or staff-counseling intervention. The study is designed to provide 90% power in both men and women to detect a 1.1 kcal.kg-1.day-1 difference in total daily energy expenditure between any two treatment groups, and over 90% power to detect a 7% increase in maximal oxygen uptake, the two primary outcomes. Primary analyses will compare study groups on mean outcome measures at 24 months post-randomization, be adjusted for the baseline value of the outcome measure and for multiple comparisons, and be conducted separately for men and women. Secondary outcomes include comparisons between interventions at 24 months of factors related to cardiovascular disease (blood lipids/lipoproteins, blood pressure, body composition, plasma insulin, fibrinogen, dietary intake, smoking, heart rate variability), psychosocial effect, and cost-effectiveness, and at 6 months for primary outcome measures. ACT is the first large-scale behavioral intervention study of physical activity counseling in a clinical setting, includes a generalizable sample of adult men and women and of clinical setting, and examines long-term (24 months) effects. ACT has the potential to make substantial contributions to the understanding of how to promote physical activity in the primary health care setting.
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Affiliation(s)
- S N Blair
- Cooper Institute for Aerobics Research, University of Tennessee, Memphis, USA
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807
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Nagata C, Takatsuka N, Inaba S, Kawakami N, Shimizu H. Association of diet and other lifestyle with onset of menopause in Japanese women. Maturitas 1998; 29:105-13. [PMID: 9651899 DOI: 10.1016/s0378-5122(98)00012-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the cross-sectional relationships of dietary and other lifestyle variables to menopause. METHODS A total of 4186 female residents aged 45-55 in Takayama City, Japan, responded to a self-administered questionnaire (the response rate was 89.3%). Diet in the past year was assessed by semiquantitative food frequency questionnaire. Using the logistic regression model, associations between study variables and menopausal status were estimated in terms of odds ratio (OR). RESULTS Nulliparity and lower relative weight were significantly associated with menopause after controlling for age (P < 0.05). The association of smoking with menopause was marginally significant after controlling for age (P = 0.06). Higher intakes of fat, cholesterol, and coffee were inversely and significantly associated with later menopause after controlling for age, total energy, parity, menarche age, and relative weight (ORs for the highest tertiles of fat, cholesterol and coffee intakes were 0.78, 0.79, and 0.70, respectively, P < 0.05). The highest tertiles of calcium and soy product intakes were significantly associated with menopause after controlling for the covariates (ORs = 1.25 and 1.42, respectively, P < 0.05), but postmenopausal women who had menopause at later age showed higher calcium intake than those who had menopause at early age. CONCLUSION Dietary factors appear to be associated with onset of menopause.
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Affiliation(s)
- C Nagata
- Department of Public Health, Gifu University School of Medicine, Japan.
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808
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Landig J, Erhardt JG, Bode JC, Bode C. Validation and comparison of two computerized methods of obtaining a diet history. Clin Nutr 1998; 17:113-7. [PMID: 10205327 DOI: 10.1016/s0261-5614(98)80004-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to validate two computerized methods of obtaining a diet history (DH and EBIS). The food consumption of 12 men and eight women was calculated by weighing each food item over a period of 8 days. Thereafter the diet history was taken over this period by using both programs alternatively. The intake of energy, protein, fat and carbohydrates, and 10 further nutrients was evaluated and the percentage difference calculated. In general, the intake of nutrients calculated from the diet history tended to be underestimated by most of the people interviewed. The mean daily intake of the nutrients calculated from the DH program deviates from -34% to +20% (mean SD = 48.1) and -35% to +15% for EBIS (mean SD = 28.1). In conclusion, both computerized methods proved useful for epidemiological studies, but not for the determination of deficiencies in individuals.
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Affiliation(s)
- J Landig
- Hohenheim University, Department of Physiology of Nutrition, Stuttgart, Germany
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809
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Hebert JR, Gupta PC, Bhonsle RB, Murti PR, Mehta H, Verghese F, Aghi M, Krishnaswamy K, Mehta FS. Development and testing of a quantitative food frequency questionnaire for use in Kerala, India. Public Health Nutr 1998; 1:123-30. [PMID: 10933409 DOI: 10.1079/phn19980019] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To develop and test a food frequency questionnaire (FFQ) for use in rural areas of Kerala, India. DESIGN Based on food use and market surveys of the study area, a quantitative 81-item interviewer-administered FFQ was developed. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 8 days randomly selected over an entire year and two administrations of the FFQ, one at the beginning of the 1-year period and the other at the end. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by examining differences in the nutrient scores. SETTING Rural villages in Ernakulum district, Kerala, South India. SUBJECTS In each of 30 households, the male head of household and female food preparer were enrolled. RESULTS Pearson (parametric) correlation coefficients (r(p)) averaged about 0.50 in comparing nutrient scores derived from the 24HR with those from the first FFQ and about 0.55 in comparing the second FFQ. On average, Spearman correlation coefficients (r(s)) were slightly lower than the r(p) in comparing the scores derived from the first FFQ, but virtually identical for the second FFQ. Regression analyses indicated better agreement in the comparison of the 24HR-derived scores with the first FFQ than the second FFQ. Difference scores, however, tended to be larger in comparing the first FFQ scores with the 24HR. CONCLUSIONS This FFQ produces results broadly comparable to those used in Europe and North America, indicating its suitability for comparing exposures within a study population in reference to health-related endpoints.
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Affiliation(s)
- J R Hebert
- Department of Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
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810
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Jin A, Teschke K, Marion SA. Diet Survey of Two Cultural Groups in a Coastal British Columbia Community. Canadian Journal of Public Health 1998. [DOI: 10.1007/bf03404473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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811
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Knol LL, Haughton B. Fruit and juice intake associated with higher Dietary Status Index in rural east Tennessee women living in public housing. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:576-9. [PMID: 9597034 DOI: 10.1016/s0002-8223(98)00130-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- L L Knol
- Knox County Health Department Nutrition Services, Knoxville, Tenn., USA
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812
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Shick SM, Wing RR, Klem ML, McGuire MT, Hill JO, Seagle H. Persons successful at long-term weight loss and maintenance continue to consume a low-energy, low-fat diet. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:408-13. [PMID: 9550162 DOI: 10.1016/s0002-8223(98)00093-5] [Citation(s) in RCA: 128] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To describe the dietary intakes of persons who successfully maintained weight loss and to determine if differences exist between those who lost weight on their own vs those who received assistance with weight loss (eg, participated in a commercial or self-help program or were seen individually by a dietitian). Intakes of selected nutrients were also compared with data from the third National Health and Nutrition Examination Survey (NHANES III) and the 1989 Recommended Dietary Allowances (RDAs). SUBJECTS Subjects were 355 women and 83 men, aged 18 years or older, primarily white, who had maintained a weight loss of at least 13.6 kg for at least 1 year, and were the initial enrollees in the ongoing National Weight Control Registry. On average, the participants had lost 30 kg and maintained the weight loss for 5.1 years. METHODS A cross-sectional study in which subjects in the registry completed demographic and weight history questionnaires as well as the Health Habits and History Questionnaire developed by Block et al. Subjects' dietary intake data were compared with that of similarly aged men and women in the NHANES III cohort and to the RDAs. Adequacy of the diet was assessed by comparing the intake of selected nutrients (iron; calcium; and vitamins C, A, and E) in subjects who lost weight on their own or with assistance. RESULTS Successful maintainers of weight loss reported continued consumption of a low-energy and low-fat diet. Women in the registry reported eating an average of 1,306 kcal/day (24.3% of energy from fat); men reported consuming 1,685 kcal (23.5% of energy from fat). Subjects in the registry reported consuming less energy and a lower percentage of energy from fat than NHANES III subjects did. Subjects who lost weight on their own did not differ from those who lost weight with assistance in regards to energy intake, percent of energy from fat, or intake of selected nutrients (iron; calcium; and vitamins C, A, and E). In addition, subjects who lost weight on their own and those who lost weight with assistance met the RDAs for calcium and vitamins C, A, and E for persons aged 25 years or older. APPLICATIONS Because continued consumption of a low-fat, low-energy diet may be necessary for long-term weight control, persons who have successfully lost weight should be encouraged to maintain such a diet.
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Affiliation(s)
- S M Shick
- Department of Epidemiology, University of Pittsburgh School of Medicine, PA 15213, USA
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813
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Abstract
A diet rich in carotenoid-containing foods is associated with a number of health benefits. Lycopene provides the familiar red color to tomato products and is one of the major carotenoids in the diet of North Americans and Europeans. Interest in lycopene is growing rapidly following the recent publication of epidemiologic studies implicating lycopene in the prevention of cardiovascular disease and cancers of the prostate or gastrointestinal tract. Lycopene has unique structural and chemical features that may contribute to specific biological properties. Data concerning lycopene bioavailability, tissue distribution, metabolism, excretion, and biological actions in experimental animals and humans are beginning to accumulate although much additional research is necessary. This review will summarize our knowledge in these areas as well as the associations between lycopene consumption and human health.
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Affiliation(s)
- S K Clinton
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
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814
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Caan B, Quesenberry CP, Coates AO. Differences in fertility associated with caffeinated beverage consumption. Am J Public Health 1998; 88:270-4. [PMID: 9491020 PMCID: PMC1508200 DOI: 10.2105/ajph.88.2.270] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The effect of caffeine consumption on fertility was examined prospectively in 210 women. METHODS Women reported on caffeinated beverage consumption and pregnancy status monthly. Odds ratios for becoming pregnant were calculated for both high and moderate vs low consumption. RESULTS No significant association was found for any of the caffeinated beverages except tea. Drinking one-half cup or more of tea daily approximately doubled the odds of conception per cycle. CONCLUSIONS These data suggest that caffeine may not be the responsible agent for variation in fertility associated with consumption of the beverages examined.
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Affiliation(s)
- B Caan
- Division of Research, Kaiser Permanente Medical Care Program of Northern California, Oakland 94611, USA
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815
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Tsubono Y, Kobayashi M, Takahashi T, Iwase Y, Iitoi Y, Akabane M, Tsugane S. Within- and between-person variations in portion sizes of foods consumed by the Japanese population. Nutr Cancer 1998; 29:140-5. [PMID: 9427977 DOI: 10.1080/01635589709514615] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
There has been considerable controversy about the utility of asking separate questions on portion sizes in addition to items on consumption frequencies in food frequency questionnaires. One argument against this type of inquiry is that, for most foods, within-person variation of portion size is greater than between-person variation, making it difficult to characterize "usual" or long-term average serving sizes. The authors studied the relative effects of within- and between-person variances in portion sizes of 69 food items using three-day food record data collected from 335 Japanese men and women. Total variance in the portion size for each food was partitioned into within- and between-person components by analysis of variance. Although the ratios of within- to between-person variances in log(e)-transformed portion sizes were > 1.0 for the majority of foods (50 of 69 items, median = 1.7), they were smaller than or close to unity for subgroups of foods that were the major sources of nutrient variables of relevance to diet-cancer associations, such as total energy (rice, calcium (milk), sodium (pickled vegetables), and alcohol (beer, shochu, whiskey). These results indicate that the relative contributions of within- and between-person variations in portion size may vary among foods, and therefore investigators should consider the balance between the advantages and disadvantages of obtaining portion size data separately from intake frequencies when designing food frequency questionnaires.
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Affiliation(s)
- Y Tsubono
- Epidemiology and Biostatistics Division, National Cancer Center Research Institute East, Kashiwa, Japan.
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816
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Joachim G. The influence of time on dietary data: differences in reported summer and winter food consumption. Nutr Health 1997; 12:33-43. [PMID: 9403880 DOI: 10.1177/026010609701200104] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A pilot study was conducted to test whether or not the time of data collection affected subjects' responses to a dietary questionnaire and could therefore bias the results of a study. A 117 item food frequency questionnaire was administered to 43 subjects--16 in the summer and 27 in the winter. The summer and winter consumption per person per month was calculated and compared. Of the 117 foods, 105 (89%) showed differences between summer and winter consumption. While differences in summer fruit and hot cereal might be expected, this study showed that many other foods not usually thought of as seasonal were seasonally consumed by the population tested. Since food consumption is affected by supply and demand factors, and the reported memory of food intake is biased toward the present, the time of data collection could greatly influence reported intake for a great number of foods. Recommendations for enhancing dietary studies are given. These recommendations include the development of a gold standard of consumption for each food in a given population, incorporating the elements of person, place and time into study design, building the rate and length of data collection into the study plan and using the gold standard and improved design to produce a new generation of dietary studies.
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Affiliation(s)
- G Joachim
- University of British Columbia School of Nursing, Canada
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817
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Howard-Pitney B, Winkleby MA, Albright CL, Bruce B, Fortmann SP. The Stanford Nutrition Action Program: a dietary fat intervention for low-literacy adults. Am J Public Health 1997; 87:1971-6. [PMID: 9431286 PMCID: PMC1381239 DOI: 10.2105/ajph.87.12.1971] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This study was undertaken to test the effectiveness of the Stanford Nutrition Action Program, an experimental trial to reduce dietary fat intake among low-literacy, low-income adults. METHODS Twenty-four paired adult education classes (351 participants, 85% women, mean age = 31 years) were randomly assigned to receive a newly developed dietary fat curriculum (the Stanford Nutrition Action Program) or an existing general nutrition curriculum. Food frequency and nutrition-related data, body mass index, and capillary blood cholesterol were collected at baseline and at two postintervention follow-ups. RESULTS The Stanford Nutrition Action Program classes showed significantly greater net improvements in nutrition knowledge (+7.7), attitudes (/0.2), and self-efficacy (-0.2) than the general nutrition classes; they also showed significantly greater reductions in the percentage of calories from total (-2.3%) and saturated (-0.9%) fat. There were no significant differences in body mass index or blood cholesterol. All positive intervention effects were maintained for 3 months postintervention. CONCLUSIONS The Stanford Nutrition Action Program curriculum, tailored to the cultural, economic, and learning needs of low-literacy, low-income adults, was significantly more effective in achieving fat-related nutritional changes than the general nutrition curriculum.
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Affiliation(s)
- B Howard-Pitney
- Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA 94304-1825, USA
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818
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Sanchez-Lugo L, Mayer-Davis EJ, Howard G, Selby JV, Ayad MF, Rewers M, Haffner S. Insulin sensitivity and intake of vitamins E and C in African American, Hispanic, and non-Hispanic white men and women: the Insulin Resistance and Atherosclerosis Study (IRAS). Am J Clin Nutr 1997; 66:1224-31. [PMID: 9356542 DOI: 10.1093/ajcn/66.5.1224] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Elevated fasting insulin concentrations and insulin resistance have been associated with non-insulin-dependent diabetes mellitus (NIDDM), obesity, atherosclerosis, and hypertension. Vitamin E supplementation in persons with and without NIDDM may be related to greater insulin sensitivity (SI). The cross-sectional associations of the intake of vitamins E and C with SI and insulin concentrations were evaluated among African American, Hispanic, and non-Hispanic white men and women with a wide spectrum of glucose tolerance included in the Insulin Resistance and Atherosclerosis Study (IRAS) (n = 1151). Insulin sensitivity was measured by minimal model analysis of a 12-sample, insulin-modified, frequently sampled intravenous glucose tolerance test. Nutrient intake (including vitamin supplement use) was assessed with a food-frequency questionnaire modified to include foods consumed by the three ethnic groups. Linear-regression models were used, including rank of SI and the log of fasting insulin as the outcome variables. Pearson correlation coefficients for vitamins E and C in relation to rank SI were r = 0.07 (P = 0.01) and r = 0.07 (P = 0.02), respectively. After adjustment for total energy and BMI these associations were no longer statistically significant and did not differ between ethnic groups. Results were similar when vitamins E and C were combined in categories of low and high antioxidant intake. Models replicated with log of fasting insulin as the outcome variable also did not produce significant associations with vitamins E or C. Thus, these cross-sectional analyses do not support the hypothesis of improved SI with increased intake of vitamins E and C.
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Affiliation(s)
- L Sanchez-Lugo
- Department of Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC, USA
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819
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Winkleby MA, Howard-Pitney B, Albright CA, Bruce B, Kraemer HC, Fortmann SP. Predicting achievement of a low-fat diet: a nutrition intervention for adults with low literacy skills. Prev Med 1997; 26:874-82. [PMID: 9388800 DOI: 10.1006/pmed.1997.0231] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This paper identifies factors that predict achievement of a low-fat diet among 242 California adults with low literacy skills, following their participation in the Stanford Nutrition Action Program (SNAP), a randomized classroom-based nutrition intervention trial (1993-1994). METHODS The intervention classes received a newly developed curriculum that focuses on reducing dietary fat intake (SNAP); the control classes received an existing general nutrition (GN) curriculum. Data were collected at baseline and 3 months postintervention. This hypothesis-generating analysis uses a signal detection method to identify mutually exclusive groups that met the goal of a low fat diet, defined as < 30% of calories from total fat, at 3 months postintervention. RESULTS Three mutually exclusive groups were identified. Twenty-three percent of Group 1, participants with high baseline dietary fat (> 60 g) who received either the GN or the SNAP curriculum, met the postintervention goal of < 30% of calories from total fat. Thirty-four percent of Group 2, participants with moderate baseline dietary fat (< or = 60 g) who received the GN curriculum, were successful. Sixty percent of Group 3, participants with moderate baseline dietary fat who received the SNAP curriculum, were successful. Members of Group 3 also significantly increased their intake of vegetables, grains, and fiber. CONCLUSIONS Within this population of adults with low literacy skills, a large proportion of those with moderate baseline dietary fat who participated in the SNAP classes met the postintervention criteria for a low-fat diet. A much smaller proportion of those with high baseline dietary fat were successful, suggesting that this group may benefit from different, more intensive, or longer-term interventions.
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Affiliation(s)
- M A Winkleby
- Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, California 94304, USA
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820
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Shaw GM, Velie EM, Schaffer DM. Is dietary intake of methionine associated with a reduction in risk for neural tube defect-affected pregnancies? TERATOLOGY 1997; 56:295-9. [PMID: 9451752 DOI: 10.1002/(sici)1096-9926(199711)56:5<295::aid-tera1>3.0.co;2-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Results from experimental animals and other laboratory data have suggested a role for methionine, an essential amino acid, in normal closure of the neural tube. We hypothesized that women who had higher dietary intakes of methionine would be at lower risk for neural tube defect (NTD)-affected pregnancies. Data were derived from a population-based case-control study of fetuses and liveborn infants with NTDs among a 1989-1991 California birth cohort. Interviews, which included a 100-item food frequency questionnaire, were conducted with mothers of 424 NTD cases and 440 nonmalformed controls. Risk for having an NTD-affected pregnancy was estimated according to quartiles (established from intakes among control mothers) of average daily maternal dietary intake of methionine in the 3 months before conception. We observed an approximately 30-40% reduction in NTD-affected pregnancies among women whose average daily dietary intake of methionine was above the lowest quartile of intake (> 1,341.86 mg/ day). These reductions in NTD risk were observed for both anencephaly and spina bifida; remained after adjustment for maternal race/ethnicity and education; and were observed irrespective of maternal level of folate intake. Although we were unable to establish whether the observed reductions in NTD risk were attributable to maternal periconceptional methionine intake or to another highly correlated nutrient, these data add to the growing body of evidence that maternal diet plays a role in neural tube closure.
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Affiliation(s)
- G M Shaw
- March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville 94608, USA
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821
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Schaffer DM, Coates AO, Caan BJ, Slattery ML, Potter JD. Performance of a shortened telephone-administered version of a quantitative food frequency questionnaire. Ann Epidemiol 1997; 7:463-71. [PMID: 9349913 DOI: 10.1016/s1047-2797(97)00079-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE We evaluated the performance of a telephone-administered food frequency questionnaire in a study of 190 men and women, 30-79 years of age, who participated as controls in a study of colon cancer. METHODS The telephone version of the questionnaire was modified from a longer food frequency questionnaire originally administered in person to each of the participants. One month later, the telephone questionnaire was administered to a subgroup of 190 participants and readministered to 169 members of the subgroup two weeks later to assess the reproducibility and comparative validity of the instrument. RESULTS The unadjusted correlation for energy between the original in-person full food frequency questionnaire and the abbreviated telephone version was 0.69. The median energy intake from the telephone version was 17% lower in men and 23% lower in women. The energy and sex-adjusted correlation coefficients for other nutrients ranged from 0.45 for vitamin E to 0.78 for fiber. The intraclass correlation coefficients to measure reproducibility ranged from 0.62 for animal protein to 0.83 for folate. CONCLUSIONS These data indicate that this brief, telephone-administered questionnaire is reproducible and provides a ranking of nutrient intake comparable to that provided by a full in-person interview.
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Affiliation(s)
- D M Schaffer
- Division of Research, Kaiser Permanente Medical Care Program of Northern California, Oakland 94611, USA
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822
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Leveille SG, LaCroix AZ, Koepsell TD, Beresford SA, Van Belle G, Buchner DM. Dietary vitamin C and bone mineral density in postmenopausal women in Washington State, USA. J Epidemiol Community Health 1997; 51:479-85. [PMID: 9425455 PMCID: PMC1060531 DOI: 10.1136/jech.51.5.479] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STUDY OBJECTIVE To examine the relationship between dietary vitamin C and hip bone mineral density (BMD) in postmenopausal women. DESIGN This was a cross sectional study using retrospective diet and vitamin supplement data. SETTING The Seattle area of Washington State. PARTICIPANTS Screenees for a clinical trial of a drug to prevent osteoporotic fractures; 1892 women aged 55-80 years who had hip bone densitometry and osteoporosis risk factor information. MAIN RESULTS Mean energy adjusted dietary intake of vitamin C was 113 mg/day; including supplement use, mean intake was 407 mg/day. There were no differences in BMD according to diet-only vitamin C intake or combined dietary and supplemental vitamin C intake. Longer duration of vitamin C supplement use was associated with higher BMD in women who had not used oestrogen replacement therapy (trend p = 0.02) and among women aged 55-64 years (trend p = 0.01). Women aged 55-64 years who used vitamin C supplements for > or = 10 years had a higher BMD than non-users aged 55-64 years (multivariate adjusted mean BMD 0.699 (0.017) g/cm2 versus 0.655 (0.007) g/cm2, p = 0.02). Benefits were not evident in older age groups or in women who had used oestrogen in the past. Frequent intake of foods rich in vitamin C was not associated with BMD. CONCLUSION There was no evidence that vitamin C from the diet was associated with BMD, although long term use of vitamin C supplements was associated with a higher BMD in the early postmenopausal years and among never users of oestrogen.
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Affiliation(s)
- S G Leveille
- Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA
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823
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Wang MC, Crawford PB, Bachrach LK. Intakes of nutrients and foods relevant to bone health in ethnically diverse youths. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1997; 97:1010-3. [PMID: 9284881 DOI: 10.1016/s0002-8223(97)00243-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M C Wang
- Department of Nutrition and Food Science, San Jose State University, Calif. 95192, USA
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824
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Measures of overall diet quality from a food frequency questionnaire: National Health Interview Survey, 1992. Nutr Res 1997. [DOI: 10.1016/s0271-5317(97)00135-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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825
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Harnack L, Block G, Subar A, Lane S, Brand R. Association of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1997; 97:957-65. [PMID: 9284871 DOI: 10.1016/s0002-8223(97)00231-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the relationship of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior. SUBJECTS/SETTING Noninstitutionalized US adults aged 18 years and older. METHODS Data collected in the 1992 National Health Interview Survey Cancer Epidemiology Supplement were analyzed. The supplement included questions to ascertain knowledge, beliefs, and attitudes and a food frequency questionnaire to ascertain nutrient intake. STATISTICS Multivariate linear regression modeling was conducted to assess the hypothesized relationships. RESULTS After adjustment for relevant covariates (age, sex, education, total energy, perceived barriers to eating a more healthful diet), knowledge and belief constructs were predictive of dietary behavior. Specifically, fat, fiber, and fruit and vegetable intakes more closely approximated dietary recommendations for persons with more cancer-prevention knowledge. The strength of the associations between these constructs and dietary behavior varied in some cases according to level of education and perceived barriers to eating a healthful diet. Of the perceived barriers to eating a healthful diet, perceived ease of eating a healthful diet was most strongly and consistently predictive of intake. CONCLUSIONS Research findings challenge dietetics practitioners to design diet- and health-promotion programs and activities that not only educate the public about the importance of diet to health, but also address barriers to dietary change.
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Affiliation(s)
- L Harnack
- Public Health Nutrition Program, University of California at Berkeley, USA
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826
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827
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Martin LJ, Lockwood GA, Kristal AR, Kriukov V, Greenberg C, Shatuck AL, Boyd NF. Assessment of a food frequency questionnaire as a screening tool for low fat intakes. CONTROLLED CLINICAL TRIALS 1997; 18:241-50. [PMID: 9204224 DOI: 10.1016/s0197-2456(96)00240-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study tested the ability of a self-administered food frequency questionnaire (FFQ) to identify women with low fat intakes. FFQs were completed by 95 control participants of a dietary trial at a mean 2.9 +/- 0.8 years post-randomization. Subjects were selected in approximately equal numbers from women who were low-fat eaters (< or = 30% of energy from fat) and high-fat eaters (> 30% of energy from fat). Percentage energy from fat derived from food records and FFQ were similar in both the low- and high-fat eaters. Percentage of energy from carbohydrate and total grams of carbohydrate (low-fat eaters only) were slightly higher measured by FFQ than by food records, and percentage of energy from protein was slightly lower. The correlation between nutrient intake measured by FFQ and food records for the whole group was 0.74 for percentage of energy from fat, 0.50 for total fat, 0.59 for percentage of energy from carbohydrate, 0.43 for total carbohydrate, 0.53 for percentage of energy from protein, 0.27 for total protein, and 0.32 for energy intake. Correlations were slightly lower when the low- and high-fat eaters were examined separately. The area under the receiver operating characteristic (ROC) curve, 0.83, was significantly above 0.5 (p < < 0.001), indicating that the FFQ discriminated between low- and high-fat eaters significantly better than chance. The FFQ cutoff point of 30% of energy from fat had a true positive rate of 0.63 and false positive rate of 0.24. The use of this cutoff point for screening would result in the loss of 36% of potential subjects and an estimated increase in baseline percentage of energy from fat intake of 2.3 percentage points.
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Affiliation(s)
- L J Martin
- Division of Epidemiology and Statistics, Ontario Cancer Institute, Toronto, Canada
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828
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Mayer-Davis EJ, Monaco JH, Marshall JA, Rushing J. Vitamin C intake and cardiovascular disease risk factors in persons with non-insulin-dependent diabetes mellitus. From the Insulin Resistance Atherosclerosis Study and the San Luis Valley Diabetes Study. Prev Med 1997; 26:277-83. [PMID: 9144749 DOI: 10.1006/pmed.1997.0145] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Persons with non-insulin-dependent diabetes mellitus (NIDDM) are at increased risk for cardiovascular disease, partly due to concomitant worsening of traditional risk factors including dyslipidemia and hypertension. Based on evidence from small, controlled clinical trials, we hypothesized that increased intake of vitamin C would be associated with improved cardiovascular disease (CVD) risk factor status among community-dwelling persons with NIDDM. METHODS In separate but parallel statistical analyses, hypotheses were evaluated among persons with NIDDM confirmed by WHO criteria from the Insulin Resistance Atherosclerosis Study (IRAS, n = 520) and from the San Luis Valley Diabetes Study (SLVDS, n = 422). For IRAS, diet and vitamin supplement use was assessed by food frequency interview and for SLVDS, by 24-hr dietary recall interview. RESULTS Mean vitamin C intake (mg/day) was 275 for IRAS and 133 for SLVDS, including supplements. In cross-sectional regression models from each data set, vitamin C intake was not associated with systolic or diastolic blood pressure nor with HDL-C, LDL-C, or triglycerides (P values > 0.10; adjusted for calories, demographic and lifestyle variables, obesity, diabetes duration, and medications). In prospective analyses including 285 SLVDS participants, baseline vitamin C intake was not related to any of these CVD risk factors measured an average of 4 years later nor to change in CVD risk factor status during the follow-up period. CONCLUSIONS We conclude that, across a wide range of intake, vitamin C does not appear to be associated with improved CVD risk factor status among community-dwelling persons with diabetes.
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Affiliation(s)
- E J Mayer-Davis
- Department of Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1063, USA.
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829
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Norris J, Harnack L, Carmichael S, Pouane T, Wakimoto P, Block G. US trends in nutrient intake: the 1987 and 1992 National Health Interview Surveys. Am J Public Health 1997; 87:740-6. [PMID: 9184499 PMCID: PMC1381043 DOI: 10.2105/ajph.87.5.740] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study examined US trends in nutrient intake, using almost identical methods and nutrient databases in two time periods. METHODS An extensive dietary intake questionnaire was included in supplements to the 1987 and 1992 National Health Interview Surveys. Dietary data from approximately 11,000 persons in each of those years were analyzed. RESULTS The total and saturated fat intake and the percentage of energy from fat declined among Whites and Hispanics, but only minimal changes were seen in Black Americans. The changes in fat intake were attributable principally to behavioral changes in frequency and type of fat-containing foods consumed rather than to the increased availability of leaner cuts of meat. Dietary cholesterol showed one of the largest declines of the nutrients examined. Less desirable changes were also seen. Cereal fortification played an important role in the observed changes in several micronutrients. CONCLUSIONS Educational campaigns on dietary fat and cholesterol have been moderately effective, but not in all racial/ethnic groups. Future campaigns should emphasize maintaining or increasing micronutrient intake.
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Affiliation(s)
- J Norris
- School of Public Health, University of California at Berkeley 94720, USA
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830
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Scheider WL, Hershey LA, Vena JE, Holmlund T, Marshall JR. Dietary antioxidants and other dietary factors in the etiology of Parkinson's disease. Mov Disord 1997; 12:190-6. [PMID: 9087977 DOI: 10.1002/mds.870120209] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
It has been suggested that dietary antioxidants reduce Parkinson's disease (PD) risk by neutralizing free radicals, thus preventing injury to neurons in the substantia nigra. This case-control study examined the possible role of long-term dietary antioxidant intake in PD etiology. Cases (n = 57) were males 45-79 years old with at least two cardinal signs of PD and no evidence of other forms of parkinsonism or dementia. Age-matched friend controls (n = 50) were chosen from lists provided by the cases. Usual dietary intake 20 years ago, including vitamins E and C and carotenoids, was assessed by a 102-item food frequency questionnaire. Odds ratios and 95% confidence intervals were calculated using conditional logistic regression. Antioxidant intake, adjusted for age, education, smoking, rural living, and total energy intake, was not associated with reduced PD risk. Trends toward greater PD risk were associated with higher intakes of vitamin C and carotenoids, especially xanthophylls, reflecting higher intakes by PD cases of fruit and certain vegetables. Intakes of sweet foods, including fruit, were associated with higher PD risk, suggesting that the observed trends may be due to a preference for sweet foods. This study does not provide support for a protective effect of long-term dietary antioxidant intake on PD risk.
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Affiliation(s)
- W L Scheider
- Department of Social and Preventive Medicine, State University of New York at Buffalo 14214, USA
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831
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Koehler KM, Pareo-Tubbeh SL, Romero LJ, Baumgartner RN, Garry PJ. Folate nutrition and older adults: challenges and opportunities. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1997; 97:167-73. [PMID: 9020245 DOI: 10.1016/s0002-8223(97)00044-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Folate fortification of bread and grains has been directed to prevent neural tube birth defects. Research has also challenged previous concepts of folate nutritional status and suggested that folate may play a role in reducing the risk of vascular disease. Although folate status of many elderly people is adequate according to traditional, hematologic criteria, some elderly persons have elevated blood concentrations of the metabolite homocysteine, which indicates subclinical deficiency of folate or vitamin B-12. Higher homocysteine concentrations, even within the normal range, are associated with increased risk of vascular disease. Elderly people with better folate and vitamin B-12 status have lower homocysteine concentrations and may have lower risk for vascular disease. Although the new folate fortification rules provide the benefit of increasing folate in the food supply, they could be a risk for the elderly because excess folate intake can mask vitamin B-12 deficiency, thereby delaying diagnosis. Elderly people have a higher prevalence of vitamin B-12 deficiency as a result of absorption problems. Those deficient in vitamin B-12 should be treated to prevent irreversible neurologic damage. Modern approaches to screening the elderly include using higher cutoff points for serum vitamin B-12 and obtaining blood concentrations of the metabolite methylmalonic acid, which is elevated in deficiency of vitamin B-12 but not folate. To examine current folate intake and food sources, food frequency questionnaires were administered to 308 elderly volunteers aged 65 to 94 years. Mean (+/-standard error) folate intake from food was 299.6+/-5.8 microg/day. Supplements (median dose=400 microg/day) were consumed by 47% of participants. Only 3.2% of the sample had total folate intake greater than 1,000 microg/day, the recommended upper limit, and these were taking high-dose folate supplements (> or = 800 microg/day). Breakfast cereals provided 25.6% of folate intake; vegetables, 23.2%; fruit, 20.8%; refined breads/grains, 6.7%; dark bread, 5.0%; legumes/nuts, 5.9%; dairy products, 5.8%; meat/poultry/fish/eggs, 5.1%; other, 1.9%. Mean folate intake would increase 16.5% if enriched bread and grains were fortified. Such fortification could help some persons to lower serum homocysteine concentration and vascular disease risk. Dietitians should be aware of modern protocols for screening the elderly for vitamin B-12 deficiency.
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Affiliation(s)
- K M Koehler
- Clinical Nutrition Program, University of New Mexico School of Medicine, Albuquerque 87131-5666, USA
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832
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Taaffe DR, Robinson TL, Snow CM, Marcus R. High-impact exercise promotes bone gain in well-trained female athletes. J Bone Miner Res 1997; 12:255-60. [PMID: 9041058 DOI: 10.1359/jbmr.1997.12.2.255] [Citation(s) in RCA: 172] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Maximizing peak bone mass, as well as reducing its loss after menopause, is important for the prevention of osteoporosis. One mode of activity, gymnastics training, invokes high impact loading strains on the skeleton which may have powerful osteogenic effects. To examine the role of athletic activity, specifically gymnastics, on bone mineral density (BMD) accretion, we monitored longitudinal changes in regional and whole body BMD in collegiate women gymnasts and competitive athletes whose skeletons are exposed to differential loading patterns: runners and swimmers. Two cohorts were studied. Cohort I = 26 gymnasts (19.7 +/- 1.2 years), 36 runners (21.1 +/- 2.7 years) and 14 nonathletic women (19.3 +/- 1.7 years) followed over an 8-month period. Cohort II = 8 gymnasts (18.9 +/- 1.1 years), 11 swimmers (20.0 +/- 2.3 years) and 11 nonathletic women (19.0 +/- 1.2 years) followed over a 12-month period. Lumbar spine (L2-4), femoral neck, and whole body BMD (g/cm2) were assessed by dual-energy X-ray absorptiometry. For cohort I, the percent change in lumbar spine BMD after 8 months was significantly greater (p = 0.0001) in the gymnasts (2.8 +/- 2.4%) than in the runners (-0.2 +/- 2.0%) or controls (0.7 +/- 1.3%). An increase in femoral neck BMD of 1.6 +/- 3.6% in gymnasts was also greater (p < 0.05) than runners (-1.2 +/- 3.0%) and approached significance compared with controls (-0.9 +/- 2.2%, p = 0.06). For cohort II, gymnasts gained 2.3 +/- 1.6% at the lumbar spine which differed significantly (p < 0.01) from changes in swimmers (-0.3 +/- 1.5%) and controls (-0.4 +/- 1.7%). Similarly, the change at the femoral neck was greater (p < 0.001) in gymnasts (5.0 +/- 3.4%) than swimmers (-0.6 +/- 2.8%) or controls (2.0 +/- 2.3%). The percent change in BMD at any site did not differ between eumenorrheic and irregularly menstruating athletes. These results indicate that bone mineral at clinically relevant sites, the lumbar spine and femoral neck, can respond dramatically to mechanical loading characteristic of gymnastics training in college-aged women. This occurred despite high initial BMD values and was independent of reproductive hormone status. The results provide evidence to support the view that high impact loading, rather than selection bias, underlies high BMD values characteristic of women gymnasts. Because all athletes underwent resistance training throughout the year of study, muscle strengthening activity did not appear to be a significant factor in the skeletal response observed in gymnasts. We conclude that activities resulting in high skeletal impacts may be particularly osteotropic for young women.
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Affiliation(s)
- D R Taaffe
- Musculoskeletal Research Laboratory, Veterans Affairs Medical Center, Palo Alto, California, USA
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833
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Baranowski T, Smith M, Baranowski J, Wang DT, Doyle C, Lin LS, Hearn MD, Resnicow K. Low validity of a seven-item fruit and vegetable food frequency questionnaire among third-grade students. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1997; 97:66-8. [PMID: 8990421 DOI: 10.1016/s0002-8223(97)00022-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- T Baranowski
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Ga., USA
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834
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Van Liere MJ, Lucas F, Clavel F, Slimani N, Villeminot S. Relative validity and reproducibility of a French dietary history questionnaire. Int J Epidemiol 1997; 26 Suppl 1:S128-36. [PMID: 9126541 PMCID: PMC2072997 DOI: 10.1093/ije/26.suppl_1.s128] [Citation(s) in RCA: 153] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND A self-administered dietary history questionnaire, especially developed for use in a large French prospective cohort study, was tested for accuracy of food intake measurement by comparing it to the average of 9-12 24-hour recalls. This questionnaire was structured according to the French meal pattern. An important feature of the questionnaire was the separation into a quantification part and qualification part. The first part quantifies consumption by frequency and portion sizes per food group or food item. The second part provides more detailed qualitative information on separate items within one food group. The total number of food items in the questionnaire was 238. METHODS The questionnaire was administered twice to 119 study subjects, with an interval of approximately one year (1990-1991). During that year, 24-hour recalls were carried out monthly. Reproducibility and relative validity of the questionnaire were assessed. RESULTS The correlation coefficients for reproducibility ranged from 0.40 to 0.74 for foods and from 0.54 to 0.75 for nutrients. The correlation coefficients for relative validity ranged from 0.10 to 0.71 for foods and from 0.29 to 0.81 for nutrients (adjustment for total energy and attenuation for nutrients). Percentage of subjects classified in the same or adjacent quintile by questionnaire as well as by 24-hour recall was on average 76% for foods and 72% for nutrients. CONCLUSIONS These data indicate that this questionnaire can be used to classify study subjects according to their food or nutrient intake over a one-year period, within a known degree of precision.
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Affiliation(s)
- Marti J. Van Liere
- Epidémiologie des cancers
INSERM : U351Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif,FR
| | - François Lucas
- Epidémiologie des cancers
INSERM : U351Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif,FR
- Department of Psychology
Brooklyn College of CUNYBrooklyn, NY 11120,US
| | - Françoise Clavel
- Epidémiologie des cancers
INSERM : U351Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif,FR
- * Correspondence should be adressed to: Françoise Clavel
| | - Nadia Slimani
- IARC
International Agency for Research on Cancer150 Cours Albert-Thomas
69372 Lyon,FR
| | - Sylvie Villeminot
- Epidémiologie des cancers
INSERM : U351Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif,FR
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835
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Breslow RA, Subar AF, Patterson BH, Block G. Trends in food intake: the 1987 and 1992 National Health Interview Surveys. Nutr Cancer 1997; 28:86-92. [PMID: 9200155 DOI: 10.1080/01635589709514557] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To examine food intake trends in the US population, cross-sectional nationally representative food intake data were obtained from the 1987 and 1992 National Health Interview Survey Cancer Control Supplements. In each of these years, approximately 10,000 respondents completed methodologically consistent food frequency questionnaires containing the same 57 food items. Between 1987 and 1992, the proportion of Americans consuming high-fat foods, including fried fish, fried chicken, bacon, eggs, whole milk, and butter, decreased. The proportion of Americans drinking alcoholic beverages also decreased: fewer drank wine and hard liquor in 1992. The proportion of fruit and vegetable consumers remained stable over time. These results are similar to those obtained from more detailed national surveys. National guidelines urge Americans to avoid intake of high-fat foods, increase consumption of fruits and vegetables, and practice moderation when drinking alcoholic beverages to prevent cancer and other chronic diseases. The direction of Americans' apparent changes in food usage between 1987 and 1992, evaluated using limited data from food frequency questionnaires, suggests greater behavioral changes in the direction of guidelines recommending avoidance of foods that may increase the risk of cancer than in the direction of guidelines recommending increased consumption of foods that may confer protection.
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Affiliation(s)
- R A Breslow
- Applied Research Branch, National Cancer Institute, Bethesda, MD 20892, USA.
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836
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Bell IR, Schwartz GE, Bootzin RR, Wyatt JK. Time-dependent sensitization of heart rate and blood pressure over multiple laboratory sessions in elderly individuals with chemical odor intolerance. ARCHIVES OF ENVIRONMENTAL HEALTH 1997; 52:6-17. [PMID: 9039852 DOI: 10.1080/00039899709603794] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this study, we tested the hypothesis that low-level chemical odor intolerance (i.e., "cacosmia") is a manifestation of heightened sensitizability to environmental stimuli. We examined supine heart rate and blood pressure of elderly individuals, who were classified as either having a higher degree of chemical odor intolerance (n = 12) or a lower degree of chemical odor intolerance (n = 13), upon awakening in a sleep research laboratory on 6 different days during an 8-wk protocol. During the 2 initial wk, they consumed a customary baseline diet (including ad lib milk and other dairy products), followed by 3 wk each of nondairy-containing and dairy-containing diets in randomly assigned, counterbalanced order. Measurements were made on 3 pairs of successive days, distributed over a 6-wk period, and on which different diets were consumed. The high-intolerance group had significantly higher mean supine systolic and diastolic blood pressures than did the low-intolerance group. Although subjects consumed milk products during both the initial baseline and subsequent dairy diet periods, the high-intolerance group had significantly higher heart rates and diastolic blood pressures later in the study than at baseline, especially when they were on the dairy diet. In contrast, the cardiovascular measures of the low-intolerance group lowered on average with time. The high-intolerance subjects had an increased mean diastolic blood pressure on the second days versus the first days in the laboratory (averaged across all diets). Collectively, the data suggest that elderly individuals with a high degree of chemical odor intolerance evidence (a) increased sympathetic tone in the cardiovascular system at rest over multiple measurements; and (b) greater sensitizability and/or lesser habituation of heart rate and diastolic blood pressure over time as a function, in part, of repeated environmental stressor exposures (i.e., a novel laboratory contextual setting and/or specific dietary constituents). Consistent with a sensitization model, the findings emphasize the need for two or more identical sessions at least 24 h apart in physiological studies of individuals with a high degree of intolerance for chemical odors versus normal individuals. The results of the blood pressure observations suggest that the possibility of abnormally labile autonomic function and cognitive sequelae in individuals with a high degree of intolerance for chemical odor increases with age.
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Affiliation(s)
- I R Bell
- Department of Psychiatry and Psychology, University of Arizona, Tucson 85723, USA
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837
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Nebeling LC, Forman MR, Graubard BI, Snyder RA. Specific and total carotenoid intakes among oral contraceptive and estrogen hormone users in the United States. J Am Coll Nutr 1996; 15:608-13. [PMID: 8951739 DOI: 10.1080/07315724.1996.10718637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare carotenoid intakes between hormone users and nonusers in a nationally representative sample of US women by demographic and lifestyle characteristics and to identify those with potentially greater risk for disease. DESIGN Data from the 1987 National Health Interview Survey's-Epidemiology Supplement food frequency questionnaire were linked to the USDA-NCI Carotenoid database to estimate mean total and specific carotenoid intakes. SUBJECTS Women (n = 8,962) were grouped by menopausal status and classified by hormone use into premenopausal oral contraceptive users/nonusers (n = 5,918) and postmenopausal estrogen replacement hormone users/nonusers (n = 3,044). STATISTICAL ANALYSES PERFORMED Mean carotenoid intakes and standard errors were weighted using SUDAAN and adjusted for potential confounding factors using multiple linear regression analysis. Statistically significant differences were at p values < 0.01. RESULTS Compared to nonusers, oral contraceptive users had lower specific carotenoid intakes. Demographic and lifestyle characteristics differed between oral contraceptive users/nonusers and were examined in relation to carotenoid intakes. More oral contraceptive users than nonusers were married, highly educated, drank alcoholic beverages, and smoked. After adjustment for these factors in a multiple linear regression model, the associations between oral contraceptive use and carotenoid intake remained statistically significant. Mean carotenoid intakes were not significantly different among estrogen hormone replacement users versus nonusers. CONCLUSIONS Oral contraceptive users have lower dietary carotenoid intakes than nonusers. Since oral contraceptive users smoke and drink more than nonusers, and both factors are associated with lower carotenoid intakes, oral contraceptive users form a potential high risk group for disease.
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Affiliation(s)
- L C Nebeling
- Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, MD 20892-7326, USA
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838
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Neumark-Sztainer D, French SA, Jeffery RW. Dieting for weight loss: associations with nutrient intake among women. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1996; 96:1172-5. [PMID: 8906143 DOI: 10.1016/s0002-8223(96)00300-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- D Neumark-Sztainer
- Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis 55454, USA
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839
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Cavan KR, Gibson BL, Cole DC, Riedel D. Fish consumption by Vietnamese women immigrants: a comparison of methods. ARCHIVES OF ENVIRONMENTAL HEALTH 1996; 51:452-7. [PMID: 9012324 DOI: 10.1080/00039896.1996.9936045] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this study, the measurement properties of an interview-administered fish consumption frequency questionnaire, used with a pilot study of 20 Vietnamese immigrant women, were described. Reproducibility across two summer interviews and one winter interview for estimates of seasonal and yearly intake of Great Lakes fish was moderate (intraclass correlation coefficients: .51-.61). Detailed questioning, by species, resulted in higher estimates of mean overall consumption (44.6-57.8 meals/y) than did asking about any fresh-water fish consumed (33.5-46.1; differences 5.1-15.7). Estimates based on the fish consumption frequency questionnaire (i.e., 6.2+/-2.0 meals per winter season) were comparable with those based on extrapolation from a 1-mo calendar (5.8+/-5.6); however, both estimates of consumption were far less than a weighed record (29.1+/-22.2). The results of this study suggest that measurement variation in fish consumption estimates should be detailed in research reports and should be discussed with respect to risk assessments.
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840
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Eck LH, Klesges LM, Klesges RC. Precision and estimated accuracy of two short-term food frequency questionnaires compared with recalls and records. J Clin Epidemiol 1996; 49:1195-200. [PMID: 8827001 DOI: 10.1016/0895-4356(96)00219-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Two widely used food frequency questionnaires (Block FFQ, Willett FFQ) were modified to reflect intake over the past 7 days and compared to intake information gathered from diet records and 24-hr recalls covering the same 7-day period. The Block FFQ and the Willett FFQ were also gathered at the beginning of the assessment period to reflect the 7-day period of time before records and recalls were gathered. Fifty-six subjects were assigned to either recording diet for 3 days, recording diet for 6 days, or providing three 24-hr recalls. Results indicate similar levels of within-method test-retest reliabilities for 3-day RECORDS and 6-day RECORDS, and within the two Block FFQs and within the two Willett FFQs from each subject, while lower reliabilities were seen in 24-hr RECALLS. When the FFQs were compared to the 6-day RECORDS with between-method agreement coefficients, there was a moderate level of agreement, with most values between 0.5 and 0.8 for both FFQs. Significant differences between mean levels of nutrients estimated by the three methods indicated differences only in the estimates of carbohydrate and vitamin A. The use of FFQs to gather short-term intake information is discussed.
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Affiliation(s)
- L H Eck
- Department of Psychology, University of Memphis, Tennessee 38152, USA
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841
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842
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Bell IR, Bootzin RR, Davis TP, Hau V, Ritenbaugh C, Johnson KA, Schwartz GE. Time-dependent sensitization of plasma beta-endorphin in community elderly with self-reported environmental chemical odor intolerance. Biol Psychiatry 1996; 40:134-43. [PMID: 8793045 DOI: 10.1016/0006-3223(95)00331-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This study examined plasma beta-endorphin as a marker of the physiological stress response in community elderly who were either high (n = 15) or low (n = 15) in self-rated frequency of illness from environmental chemical odors. Individuals who report nonatopic multiple sensitivities to or intolerances for low levels of environmental chemicals also claim high rates of comorbid food sensitivities or intolerances. Subjects gave 9 AM blood samples for plasma beta-endorphin 90 min after ingesting either 1% fat cow's milk or a soy-based nondairy drink, on six different mornings in the laboratory after all-night sleep recordings. The six sessions-were divided into three sets of two successive days each, with each set [involving baseline (ad lib milk), nondairy (soy-based), and dairy diets] separated from the next by 3 weeks. In the chemically tolerant subjects, stably lower beta-endorphin levels suggested that milk may have been a physiologically less stressful beverage than was the soy drink. In contrast, the chemical odor intolerant group exhibited a) increased levels of plasma beta-endorphin averaged over the 6 days (p = .02); and b) marked fluctuations in endorphin from one laboratory day to the next (Group x Diet x Day interaction, p = .005). The findings were consistent with time-dependent, context-dependent sensitization of beta-endorphin in the chemical odor intolerant individuals.
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Affiliation(s)
- I R Bell
- Department of Psychiatry, University of Arizona Health Sciences Center, Tucson, USA
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843
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Sorensen G, Thompson B, Glanz K, Feng Z, Kinne S, DiClemente C, Emmons K, Heimendinger J, Probart C, Lichtenstein E. Work site-based cancer prevention: primary results from the Working Well Trial. Am J Public Health 1996; 86:939-47. [PMID: 8669517 PMCID: PMC1380434 DOI: 10.2105/ajph.86.7.939] [Citation(s) in RCA: 165] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This paper presents the behavioral results of the Working Well Trial, the largest US work site cancer prevention and control trial to date. METHODS The Working Well Trial used a randomized, matched-pair evaluation design, with the work site as the unit of assignment and analysis. The study was conducted in 111 work sites (n = 28,000 workers). The effects of the intervention were evaluated by comparing changes in intervention and control work sites, as measured in cross-sectional surveys at baseline and follow-up. The 2-year intervention targeted both individuals and the work-site environment. RESULTS There occurred a net reduction in the percentage of energy obtained from fat consumption of 0.37 percentage points (P = .033), a net increase in fiber densities of 0.13 g/1000 kcal (P = .056), and an average increase in fruit and vegetable intake of 0.18 servings per day (P = .0001). Changes in tobacco use were in the desired direction but were not significant. CONCLUSIONS Significant but small differences were observed for nutrition. Positive trends, but no significant results, were observed in trial-wide smoking outcomes. The observed net differences were small owing to the substantial secular changes in target behaviors.
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Affiliation(s)
- G Sorensen
- Division of Cancer Epidemiology and Control, Boston, MA 02115, USA
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844
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Patterson RE, Kristal AR, Coates RJ, Tylavsky FA, Ritenbaugh C, Van Horn L, Caggiula AW, Snetselaar L. Low-fat diet practices of older women: prevalence and implications for dietary assessment. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1996; 96:670-9. [PMID: 8675910 DOI: 10.1016/s0002-8223(96)00186-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the importance of information on low-fat diet practices and consumption of reduced-fat foods for accurate assessment of energy and fat intakes using a semiquantitative food frequency questionnaire (FFQ). SUBJECTS Subjects were 7,419 women, aged 50 to 79 years, who filled out an FFQ as part of eligibility screening for a diet modification component and/or a hormone replacement trial in a multicenter study of chronic disease prevention in postmenopausal women (Women's Health Initiative). STATISTICAL ANALYSIS For 26 FFQ questions, we recoded the low-fat diet choices of participants to a high-fat counterpart and recalculated energy and fat intakes. We then determined the decrease in energy and nutrient estimates attributable to adding low-fat options to the FFQ. RESULTS Low-fat diet practices were widespread in this population. For example, 69% of respondents rarely or never ate skin on chicken, 76% rarely or never ate fat on meat, 36% usually drank nonfat milk, 52% usually ate low-fat or fat-free mayonnaise, 59% ate low-fat chips/snacks, and 42% ate nonfat cheese. These low-fat choices had substantial effects on energy and nutrient estimates. Absolute decreases (and mean percentage decreases) for energy and nutrient measures attributable to adding low-fat diet options to the FFQ were 196 kcal (11.4%) energy, 9 percentage points in percentage energy from fat (22.3%), 23.2 g fat (29.0%), and 9.6 g saturated fat (32.5%). Black and Hispanic women and women of lower socioeconomic status reported significantly fewer low-fat diet practices than white women and women of higher socioeconomic status. CONCLUSION Failure to collect information on low-fat diet practices with an FFQ will result in an upward bias in estimates of energy and fat intake, and the amount of error will vary by the personal characteristics of respondents.
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Affiliation(s)
- R E Patterson
- Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Wash 98104, USA
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845
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Lynne Brown J. Effect of Delivery Method on Impact of Learn-at-home Lessons at Worksites. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s0022-3182(96)70049-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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846
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Männistö S, Virtanen M, Mikkonen T, Pietinen P. Reproducibility and validity of a food frequency questionnaire in a case-control study on breast cancer. J Clin Epidemiol 1996; 49:401-9. [PMID: 8621990 DOI: 10.1016/0895-4356(95)00551-x] [Citation(s) in RCA: 136] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A 110-item food frequency questionnaire was tested among 152 community controls of the Kuopio Breast Cancer Study. They completed the questionnaire twice and kept two 7-day diet records at 3-month intervals. The intraclass correlations for nutrients varied from 0.49 (thiamine with supplements) to 0.81 (lactose), and for foods from 0.52 (poultry) to 0.84 (alcoholic drinks). The Pearson correlations between the first food frequency questionnaire and the 14-day diet records, after adjustment for energy, varied for nutrients from 0.18 (thiamine without supplements) to 0.80 (alcohol), and for foods from 0.30 (inner organs) to 0.90 (coffee). Comparison of quintile classification between the two methods is reasonably accurate when observed restrictions concerning some nutrients and foods are taken into account. A low association (r = 0.12) was observed between toenail selenium and dietary selenium intake, indicating the difficulty of estimating selenium intake in the Finnish diet.
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Affiliation(s)
- S Männistö
- Department of Nutrition, National Public Health Institute, Helsinki, Finland
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847
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Abstract
Our research team is involved in ongoing research in both worksites and medical office settings. These settings offer great potential for reaching individuals who would not otherwise participate in health promotion, but they also place considerable constraints on assessment time and efforts, especially if one's goal is to attract a high and representative proportion of employees or patients. This paper reports on our experience with measures of dietary behavior in these two settings. We found it problematic to collect detailed assessments such as 4-day food records or comprehensive food frequency/history checklists in worksites or medical office settings using population-based samples. Instead, we recommend and provide data on the utility of a dietary-fat screening instrument, and on the Food Habits Questionnaire (FHQ-Kristal, Shattuck, & Henry, 1990), a brief measure of dietary behaviors associated with high-fat eating patterns. The FHQ, in particular, was found to correlate well with other more costly and time-consuming methods of assessment, to be reliable and responsive to intervention effects, and to provide behavioral targets for intervention. The strengths and limitations of these measures for tailoring intervention and assessing outcomes are discussed.
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Affiliation(s)
- R E Glasgow
- Oregon Research Institute, Eugene 97403, USA
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848
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Godfrey K, Robinson S, Barker DJ, Osmond C, Cox V. Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ (CLINICAL RESEARCH ED.) 1996; 312:410-4. [PMID: 8601112 PMCID: PMC2350090 DOI: 10.1136/bmj.312.7028.410] [Citation(s) in RCA: 379] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To assess how nutrient intakes of mothers in early and late pregnancy influence placental and fetal growth. DESIGN Prospective observational study. SETTING Princess Anne Maternity Hospital, Southampton. SUBJECTS 538 mothers who delivered at term. MAIN OUTCOME MEASURES Placental and birth weights adjusted for the infant's sex and duration of gestation. RESULTS Mothers who had high carbohydrate intakes in early pregnancy had babies with lower placental and birth weights. Low maternal intakes of dairy and meat protein in late pregnancy were also associated with lower placental and birth weights. Placental weight fell by 49 g(95% confidence interval 16 g to 81 g; P=0.002) for each log g increase in intake of carbohydrate in early pregnancy and by 1.4 g (0.4 g to 2.4 g; P=0.005) for each g decrease in intake of dairy protein in late pregnancy. Birth weight fell by 165 g (49 g to 282 g; P=0.005) for each log g increase in carbohydrate intake in early pregnancy and by 3.1 g (0.3 g to 6.0 g; P=0.03) for each g decrease in meat protein intake in late pregnancy. These associations were independent of the mother's height and body mass index and of strong relations between the mother's birth weight and the placental and birth weights of her offspring. CONCLUSION These findings suggest that a high carbohydrate intake in early pregnancy suppresses placental growth, especially if combined with a low dairy protein intake in late pregnancy. Such an effect could have long term consequences for the offspring's risk of cardiovascular disease.
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Affiliation(s)
- K Godfrey
- Medical Research Council Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital, UK
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849
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Dolecek TA, Bradham KH, Espeland MA, Margitic SE, Byington RP, Hoen H, Kappelle LJ. Maximizing recruitment efforts in a drug lipid-lowering trial with dietary intervention to lower LDL cholesterol. CONTROLLED CLINICAL TRIALS 1996; 17:33-45. [PMID: 8721800 DOI: 10.1016/0197-2456(95)00099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A select group of screened applicants initially disqualified from a four-center, primary prevention drug lipid-lowering trial because of borderline elevated serum low-density lipoprotein cholesterol (LDL-C) levels, as defined in National Cholesterol Education Program-Adult Treatment Panel I (NCEP-ATP I) guidelines, participated in a dietary intervention protocol that was incorporated into the screening phase of the trial. Seventy-seven screened applicants for the Asymptomatic Carotid Artery Progression Study entered the dietary program, which was overseen by an experienced registered dietitian at the central operations sites who collaborated with local staff at clinical sites during program implementation. NCEP-ATP I fat-modified step I diet specifications served as the basis for the intervention. The program, consisting of five sessions conducted over an 8-week period, primarily used written and audiovisual educational materials in combination with behavioral approaches. Of the original 77 participants, 36 responded to the intervention by achieving their LDL-C goal. Twenty-nine were nonresponders and 12 were dropouts. Responders achieved an average 11.7% drop in total cholesterol at the end of the 8-week program. Mean LDL-C decline paralleled total cholesterol change. High-density lipoprotein cholesterol also decreased significantly. These results were sustained for 24 of the responders attending the final screening visit approximately a month later, when another fasting blood lipid measurement was made. Participants who dropped out were more likely to be smokers. Pre- and postintervention nutrition data assessed by semiquantitative food frequency questionnaire for 20 screenees randomized into the study indicated significant reductions in total fat, saturated fat, polyunsaturated fat, and dietary cholesterol, all known to influence blood lipid levels. Similar programs may prove useful to other drug lipid-lowering trials to maximize recruitment efforts.
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Affiliation(s)
- T A Dolecek
- Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina 27157-1063, USA
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850
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Mitchell DT, Korslund MK, Brewer BK, Novascone MA. Development and validation of the Cholesterol-Saturated Fat Index (CSI) Scorecard: a dietary self-monitoring tool. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1996; 96:132-6. [PMID: 8557938 DOI: 10.1016/s0002-8223(96)00041-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The Cholesterol-Saturated Fat Index (CSI) Scorecard was developed and tested as a self-monitoring tool for patients consuming a cholesterol-lowering diet. SUBJECTS/DESIGN Twelve nutritionists used the CSI Scorecard to estimate the CSI score of the same five food records. Subsequently, using a revised tool, 12 subjects with hypercholesterolemia estimated the CSI score of their 4-day food records and 11 participated in evaluation meetings. STATISTICAL ANALYSES Two-tailed, one-sample t tests and the Spearman rho correlation test were used, respectively, to compare CSI Scorecard estimates of nutritionists and participants to CSI scores obtained from computer calculations. RESULTS The CSI scores estimated by the nutritionists were close to the computed scores at the 25th and 75th food record percentiles. The correlation of the estimated CSI scores of participants to the computed scores was rs = .8 (P < .05). APPLICATION The CSI Scorecard is a new, simple, quick, and accurate dietary self-monitoring tool patients can use in research centers and primary care settings. By numerically illustrating the saturated fat and cholesterol content of foods, the CSI Scorecard facilitates dietary self-monitoring and, thus, self-efficacy in the adoption and maintenance of a cholesterol-lowering dietary pattern.
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Affiliation(s)
- D T Mitchell
- George Washington University Lipid Research Clinic, Washington, DC, USA
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