Trends in dietary habits and food consumption in Catalonia, Spain (1992–2003)

Edible Offal as a Valuable Source of Nutrients in the Diet-A Review

The global increase in demand for meat leads to substantial quantities of by-products, including edible offal from both wild and domesticated animals raised for diversified consumption products within an agricultural framework. Information on the nutritional value of offal is scattered and limited. This review aims to synthesize scientific publications on the potential of offal as a source of nutrients and bioactive substances in human diets. The literature review included publications available in ISI Web of Science and Google Scholar published between 2014 and 2024. Findings indicate that edible offal is characterized by a nutrient concentration often surpassing that found in skeletal muscle. This review discusses the yield of edible offal and explores factors influencing human consumption. Selected factors affecting the nutritional value of offal of various animals and the importance of individual nutrients in ensuring the proper functioning of the human body were analyzed. The optimal use of offal in processing and catering can significantly benefit aspects of human life, including diet quality, food security, and conservation of natural resources.

Dietary Zn deficiency, the current situation and potential solutions

Zinc (Zn) deficiency is a worldwide problem, and this review presents an overview of the magnitude of Zn deficiency with a particular emphasis on present global challenges, current recommendations for Zn intake, and factors that affect dietary requirements. The challenges of monitoring Zn status are clarified together with the discussion of relevant Zn bioaccessibility and bioavailability issues. Modern lifestyle factors that may exacerbate Zn deficiency and new strategies of reducing its effects are presented. Biofortification, as a potentially useful strategy for improving Zn status in sensitive populations, is discussed. The review proposes potential actions that could deliver promising results both in terms of monitoring dietary and physiological Zn status as well as in alleviating dietary Zn deficiency in affected populations.

Recent Insights on the Role of Various Food Processing Operations Towards the Development of Sustainable Food Systems

Chronic hunger and malnutrition will eventually result from the population's rapid growth. It is unlikely to succeed in tackling the rising challenges of delivering sustainable food for all people unless high attention is paid on the function of food processing to ensure the supply of stable food. It is impossible to overstate the importance of developing food processing and preservation technologies that can reduce food losses and wastage during surplus seasons. Therefore, sustainable food systems must be developed to provide healthy diets without damaging our world and its resources. The goal is to use various perspectives to confirm why food processing is crucial to future food supply. It is important to show the appropriate utilization of sustainability factors and effect assessments to construct for feeding the globe while staying within planetary limits. There has never been a better time to assure a plentiful food supply to feed the people than right now, when the population is expanding at a worrying rate. The sustainable food project seeks to move the food systems in a long-term, more equitable direction. Food processing, or the conversion of raw materials into functional, edible, and consumer acceptable food, is a critical link in the food value chain between consumption and production. This review looked at various existing and emerging food processing followed by preservation techniques. Food systems must also attempt to reduce food waste and losses, as well as the current and future impacts on the environment and society, to be sustainable.

Effectiveness of Fit and Trimmed Staffs (FATS) program on weight management among the healthcare providers at Simpang Health Clinic, Perak: A pre-post interventional study

INTRODUCTION

Obesity is associated with an increased risk for non-communicable diseases. Local studies have shown that 33.1% of healthcare providers (HCPs) are overweight, while 21.1% are obese. Interventions that consist of diet, physical exercise and cognitive behavioural training have been shown to be successful in reducing weight.

METHOD

We designed a weight loss programme for our HCPs named the 'Fit and Trimmed Staff programme, which consisted of 3 months of group education on obesity-related health problems led by a doctor, a pharmacist, a nutritionist and an occupational therapist among HCPs. Monthly individual dietary counselling by a nutritionist was also provided for 6 months. We measured the body weight, body mass index, percentage of body fat, visceral fat and percentage of skeletal muscle of the HCPs before and after the intervention.

RESULTS

Forty-five (56.25%) HCPs at Simpang Health Clinic were either overweight or obese; the majority of them were drivers and administrative clerks (100%), followed by health attendants (69.2%) and medical assistants (63.6%). At 6 months post-intervention, there was a trend towards a non-significant reduction in the fat percentage (median=-0.8%, P=0.423). Approximately 42% (n=19) of the HCPs lost weight, while 58% gained weight. Weight loss was observed more commonly in the male HCPs (>50%) than in the female HCPs.

CONCLUSION

A weight loss programme solely consisting of health discussion and nutritional advice is inadequate to induce weight reductions. A multimodal approach may be considered in managing weight among HCPs.

Gender Differences in Eating Habits of Polish Young Adults Aged 20-26

The aim of the study was to examine the nutritional behaviour of young adults depending on gender. A survey was conducted among 467 young adults using the "Questionnaire for the study of nutritional behaviour and opinions on food and nutrition". Questions concerned the frequency of consumption of selected groups of food products. The questionnaire was supplemented by questions regarding the number of portions of fruits and vegetables consumed, putting sugar in drinks, putting salt in dishes and the number of glasses of water drunk. Differences in nutritional behaviours were determined using the χ² test, at p < 0.05. The dietary choices of women more often than those of men corresponded to the principles of healthy nutrition, related to a greater number of meals consumed during the day, more frequent consumption of fruits and vegetables and the selection of products with lower energy value or preferring healthier methods of culinary processing. Health education programs should prevent the emergence of unfavourable dietary habits such as skipping breakfast or other meals or limiting the consumption of fruits and vegetables and frequently replacing them with high-energy snacks.

Comorbidities and Outcomes among Females with Non-Alcoholic Fatty Liver Disease Compared to Males

Sex-based medicine is an important emerging discipline within medicine. We investigated the clinical characteristics, complications, and outcomes of Nonalcoholic Fatty Liver Disease (NAFLD) in females compared to males. Demographics, comorbidities, malignancy, complications, outcomes, and all-cause mortality of NAFLD patients older than 18 years were analyzed. The data were extracted using the MDClone platform from “Clalit” in Israel. A total of 111,993 (52.8%) of the study subjects were females with an average age of 44.4 ± 14.7 years compared to 39.62 ± 14.9 years in males, p < 0.001. Significantly higher rates of hypertension, diabetes mellitus, obesity, dementia, and thyroid cancer and lower rates of ischemic heart disease (22.3% vs. 27.3%, p < 0.001) were found among females. Females had a higher rate of cirrhosis, 2.3% vs. 1.9%, p < 0.001, and a lower rate of hepatocellular carcinoma, 0.4% vs. 0.5%, p < 0.001. In the multivariate analysis, a relationship between age, diabetes mellitus, and cirrhosis development were found among males and females. A lower age-adjusted mortality rate was found among females, 94.5/1000 vs. 116/1000 among males. In conclusion, older age at diagnosis, higher rates of hypertension, diabetes mellitus, obesity, cirrhosis, and a lower age-adjusted all-cause mortality rate were found among females with NAFLD.

World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review

OBJECTIVE

To provide a systematic overview of world dietary sugar and sugar-sweetened beverage (SSB) intake trends in children and adolescents.

DATA SOURCES

Medline, Embase, and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched through January 2019 to identify longitudinal follow-up studies with time-trend data and repeated cross-sectional studies.

DATA EXTRACTION

Data from studies reporting ≥ 2 measurements (sugars, SSB, or sweets/candy) over ≥ 2 years and included ≥ 20 healthy, normal- or overweight children or adolescents aged 1-19 years.

DATA ANALYSIS

Data from 43 articles (n = 4 prospective cohort studies; n = 39 repeated cross-sectional studies) from 15 countries (n = 8 European countries plus Australia, Canada, China, South Korea, Mexico, Russia, and the United States) are presented narratively. According to the risk of bias in nonrandomized studies of interventions tool, 34 studies were judged to have a moderate risk of bias, and 5 to have a serious risk of bias.

CONCLUSIONS

Consumption among US children and adolescents increased substantially in the decades preceding 2000, followed by a faster and continued decline. As a whole, other international intake trends did not reveal drastic increases and decreases in SSB and dietary sugars; they tended to change only slightly across 3 decades.

Indications and Findings of Upper Endoscopies in Males and Females, Are They the Same or Different?

Sex and gender can affect the prevalence and prognosis of diseases. Our aim was to assess similarities and differences for males and females who underwent an upper endoscopy, with regards to indications and results. We reviewed all upper endoscopy reports from 2012 to 2016. Data regarding demographics, indications, and procedure findings were collected. The upper endoscopy findings were compared regarding the most common indications: gastroesophageal reflux, abdominal pain, gastrointestinal bleeding, and anemia. We investigated 12,213 gastroscopies among males (age, 56.7 ± 17.4) and 15,817 among females (age, 56.0 ± 17.3, p = 0.002). Males who underwent an upper endoscopy for gastroesophageal reflux had higher rates of esophagitis (7.7% vs. 3.4%, p < 0.001) and Barret's esophagus (4.4% vs. 1.5%, p < 0.001). Females who underwent an upper endoscopy for abdominal pain had a higher rate of hiatal hernia, whereas males had higher rates of esophagitis, helicobacter pylori infection, gastritis, gastric ulcer, duodenitis, and duodenal ulcer (p < 0.001). Gastrointestinal bleeding as an indication for upper endoscopy showed that helicobacter, duodenitis, and duodenal ulcers are more common among males compared to females (p < 0.001). Males with anemia who underwent an upper endoscopy had higher rates of esophagitis (p = 0.021) gastritis (p = 0.002), duodenitis (p < 0.001), and duodenal ulcer (p < 0.001). We found significant differences regarding the pathological gastroscopy findings between males and females in relation to the different indications.

A 47-Year Comparison of Lower Body Muscular Power in Spanish Boys: A Short Report

Much of the evidence examining temporal trends in fitness among youth has found a decrease in measures of muscular strength and muscular power over recent decades. The aim of this study was to examine trends in lower body muscular power in Spanish boys over 47 years. In 1969 140 boys (10-11 years; body mass index = 19.24, SD = 2.91 kg/m²) and in 2016, 113 boys (10-11 years; body mass index = 19.20, SD = 3.15 kg/m²) were recruited. Lower body power was assessed using the vertical jump (VJ) and standing long jump (SLJ) tests. Significant differences and a large effect size were shown between groups in the SLJ (p = 0.001; d = 0.94) and the VJ (p = 0.001; d = 0.66). SLJ data in 1969 were higher (1.52 m, SD = 0.19) when compared to the 2016 data (1.34 m, SD = 0.18). The VJ performance of the 1969 sample was also higher (25.95 cm; SD = 6.58) than the 2016 sample (21.56 cm; SD = 4.72). SLJ and VJ performance of the 2016 group decreased 11.8% and 16.9%, respectively. There were no significant differences between groups in body mass index. The results indicate a secular decline in lower body muscular power in 10-11-year-old Spanish boys with no significant changes in body mass index over the 47-year study period.

Erosion of the Mediterranean diet among adolescents: evidence from an Eastern Mediterranean Country

At a time when the health benefits of the Mediterranean diet (MD) are pervasively recognised, a paradoxical observation is the decreasing adherence to this dietary pattern in its native countries. This study aims to investigate temporal trends in adherence to the MD among adolescents (10–19 years old) in Lebanon. Data were drawn from three national cross-sectional surveys conducted at three points in time: 1997 (n2004), 2009 (n3656) and 2015 (n1204). Dietary intake was assessed using 24-h dietary recalls, and adherence to the MD was assessed using two country-specific indexes: the composite Mediterranean diet (c-MED) index and Lebanese Mediterranean diet (LMD) index. Significant decreases in c-MED and LMD scores and in the proportion of adolescents adhering to the MD were observed between 1997 and 2015, with more consistent results among females (P< 0·05). Projections for the year 2030 showed further decreases, with less than a quarter of adolescents remaining adherent to the MD. Based on linear regression analyses, belonging to the year 2009 was associated with significantly lower MD scores compared with 1997, even after adjustment for potential covariates (c-MEDβ= –0·16, 95 % CI –0·30, –0·01; LMDβ= –0·42, 95 % CI –0·67, –0·17). Similar results were obtained when comparing survey year 2015 with 1997 (c-MED scoreβ= –0·20, 95 % CI –0·33, –0·06; LMD scoreβ= –0·60, 95 % CI –0·82, –0·37). Findings highlight the erosion of the MD among Lebanese adolescents and underline the need for a comprehensive food system approach that fosters the promotion of the MD as a nutritionally balanced and sustainable dietary pattern.

Fatty Acid Composition of Meat and Edible Offal from Free-Living Red Deer (Cervus elaphus)

The objective of the study was to characterize tissue-associated differences in the fatty acid composition of fat in skeletal muscles M. longissimus dorsi (loin), M. biceps femoris (hind quarter), and M. triceps brachii (shoulder), and internal organs (i.e., liver, heart, and kidney) from free-living red deer (Cervus elaphus) females (n = 11) hunted in Lithuania. Skeletal muscles were characterized by lower content of free fat compared with the offal. The highest percentage of saturated fatty acids was found in the liver fat, whereas the lowest percentage was in the heart. Red deer offal showed significantly lower and higher proportions of monounsaturated and polyunsaturated fatty acids compared to meat, respectively. Higher proportions of oleic fatty acid in the shoulder and hind quarter compared to the loin were the only significant differences between skeletal muscles. The lowest and the highest n-6 polyunsaturated/n-3 polyunsaturated fatty acids (n-6/n-3PUFA) ratio were found in the liver and heart, respectively. More favorable lower atherogenic index and higher hypocholesterolemic/hypercholesterolemic ratio found in the offal showed their high nutritional value, however, higher peroxidizability index indicated higher susceptibility to lipid peroxidation compared to skeletal muscles.

Drinking water consumption patterns among adults-SMS as a novel tool for collection of repeated self-reported water consumption

Studies have shown that the average drinking water consumption ranges between 0.075 and 3 L/day for adults with both national and regional differences. For exposure assessment of drinking water hazards, country-specific drinking water consumption data including sources of the consumed water may therefore be warranted. To estimate the amount and source of drinking water consumed among adults in Sweden, we collected self-reported estimates using both traditional methods (telephone interviews, web questionnaire) and a novel method (Short Message Service, SMS questionnaires) in a population from an average sized Swedish municipality. Monthly SMS questionnaires were sent out during one year to obtain longitudinal information as well. SMS showed to be a promising tool for collecting self-reported consumption, as most citizens could participate and the method showed high response rate. Data collected via the SMS questionnaire shows an average consumption of cold tap water of 4.9 glasses/24 h (one glass=200 ml), while the average estimates of cold tap water collected by the traditional methods range from 4.5 to 7.0 glasses/24 h. For statistical distributions, the mean daily consumption of cold tap water for the population was best fitted to a gamma distribution. About 70% of the cold tap water is consumed at home. Based on the results from the SMS study, we suggest using 1 l/day for the average adult population and 2.5 l/day for high consumers for risk assessment of cold tap water consumption. As 46% of the tap water consumed is heated, we suggest using 1.85 l/day for total tap water consumption.

Weekday snacking prevalence, frequency, and energy contribution have increased while foods consumed during snacking have shifted among Australian children and adolescents: 1995, 2007 and 2011-12 National Nutrition Surveys

Background

There are limited data on the evolution of eating habits, including snacking, in Australia. This study aimed to understand snacking trends among Australian children over three previous National Nutrition Surveys.

Methods

Data were analysed from a single weekday 24-h recall in the National Nutrition Surveys 1995, 2007, 2011–12 among children 2-16y (n = 8258). A snacking occasion was defined as an eating occasion that occurred between meals based on time of day.

Results

The percentage of children snacking increased over time (92.5 ± 0.5(SE) % in 1995, 98.1 ± 0.3% in 2007, and 95.8 ± 0.4% in 2011–12) (P < 0.001), particularly among those having four or more snacking occasions (7.1 ± 0.5% in 1995, 17.9 ± 0.6% in 2007, and 18.5 ± 0.8% in 2011–2) (P < 0.001). The mean number of snacking occasions increased from 2.0 ± 0.0 in 1995, to 2.5 ± 0.0 in 2007 and 2011–12 (P < 0.001). The energy contribution from snacking increased from 24.1 ± 0.3% in 1995 to 27.7 ± 0.3% in 2007 and 30.5 ± 0.4% in 2011–12 (P < 0.001), while the energy from discretionary food during snacking decreased from 56.5 ± 0.7% in 1995 to 47.3 ± 0.5% in 2007 and 47.9 ± 0.7% in 2011–12 (P < 0.001). There were differences in the top foods consumed during snacking: non-alcoholic beverages were prominent contributors in 1995 but not in 2007 or 2011, and pome fruit was the second top energy contributor during snacking in 2007 and 2011 but only fourth in 1995.

Conclusions

Snacking is a prominent dietary pattern that has increased over time in frequency and energy contribution. Foods and beverages consumed during snacking occasions include a mix of core foods and discretionary foods, and while the contribution of discretionary foods has decreased, there is still an opportunity to encourage consumption of more nutrient dense foods during snacking.

Electronic supplementary material

The online version of this article (10.1186/s12937-017-0288-8) contains supplementary material, which is available to authorized users.

Consumption of seafood and its estimated heavy metals are associated with lipid profile and oxidative lipid damage on healthy adults from a Spanish Mediterranean area: A cross-sectional study

The association between the consumption of seafood and its benefits on cardiovascular (CVD) risk can be challenged by its heavy metal (HM) content. This study aimed to explore the association of seafood consumption and its estimated HM contents with the lipid profile and lipid oxidation biomarkers in adults from a Spanish Mediterranean area who do not present risk factors for CVD. In this cross-sectional study, the clinical history, three-day dietary record, lipid profile (LDLc, HDLc, APOB/A, and triglyceride levels), plasma oxidised LDL (oxLDL) and 8-isoprostane levels of 81 adults without risk factors for CVD [43% men, with a mean age of 43.6 years (95%CI: 40.1-47.1)] were assessed. The HM [arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb)] contents of seafood were estimated according to data from analyses of marine species in the same Mediterranean area. Moderate adherence to the Mediterranean diet (score: 4.6 of 9) with a mean seafood consumption of 74.9g/day (95%CI: 59.9-89.9), including 22.7g of shellfish per day (95%CI: 13.5-31.9), was observed. The estimated HM contents were lower than the provisional tolerable weekly intakes (PTWIs): 21.12µg/kg/week As, 0.57µg/kg/week InAs, 0.15µg/kg/week Cd, 1.11µg/kg/week Hg and 0.28µg/kg/week Pb. After adjusting by confounder variables, an increase in shellfish consumption was associated with increases in the levels of LDLc (P=0.013), non-HDLc (P=0.015), APOB/A (P=0.02) and plasma oxLDL (P=0.002). Moreover, an increase in the estimated As and Hg levels in shellfish was associated with an increase in LDLc (P=0.015 and P=0.018, respectively), non-HDLc (P<0.008 and P<0.008, respectively), APOB/A ratio (P=0.008 and P=0.009, respectively), and oxLDL (P≤0.001 and P≤0.001, respectively) levels. In conclusion, in adults without risk factors for CVD, increasing shellfish consumption, even by a moderate amount, could favour a pro-atherogenic lipid profile and a higher level of oxidised LDL. These associations are likely influenced by the estimated exposure to As and Hg from shellfish despite these values are lower than the PTWIs.

Diet quality and its relationship with central obesity among Mexican Americans: findings from National Health and Nutrition Examination Survey (NHANES) 1999-2012

OBJECTIVE

Using the Healthy Eating Index-2010 (HEI-2010), the present study aimed to examine diet quality and the impact of overall diet quality and its components on central obesity among Mexican-American men and women.

DESIGN

Cross-sectional data from NHANES 1999-2012 were used. The HEI-2010 data, including twelve components for a total score of 100, were collected with a 24 h recall interview. Central obesity was defined as a waist circumference of ≥88 cm for women and ≥102 cm for men. Weighted logistic regressions were performed to assess associations between HEI-2010 scores and central obesity.

SETTING

National Health and Nutrition Examination Survey (NHANES) 1999-2012.

SUBJECTS

A total of 6847 Mexican Americans aged ≥20 years with reliable dietary recall status and non-pregnancy status.

RESULTS

Higher HEI-2010 total score was associated with lower odds of central obesity in Mexican-American men (OR; 95 % CI=0·98; 0·98, 1·00). Among all Mexican Americans, one-unit higher score of total fruit and sodium (i.e. lower level of intake) was associated with 4 % (0·96; 0·93, 0·99) and 2 % (0·98; 0·96, 0·99) lower odds of central obesity, respectively. However, a higher total proteins score was associated with higher odds of central obesity (1·08; 1·00, 1·16). In gender-specific analyses, a higher whole fruit or sodium score was inversely associated with central obesity in men but not in women.

CONCLUSIONS

HEI-2010 scores of total fruit and sodium were inversely associated with central obesity among all Mexican Americans. However, total proteins score and central obesity was positively associated. In Mexican-American men, HEI-2010 total and whole fruit scores were inversely associated with central obesity.

Intake Trends of Red Meat, Alcohol, and Fruits and Vegetables as Cancer-Related Dietary Factors from 1998 to 2009

Objectives

Cancer is the leading cause of death worldwide, and cancer incidence and mortality have been increasing steadily in South Korea. This study aimed to examine the change in consumption of three cancer-related dietary factors—red meat, alcohol, and fruits/vegetables, and to evaluate consumption of these dietary factors among Koreans according to the criteria from the recommendations of the World Cancer Research Fund/American Institute of Cancer Research.

Methods

Consumption of red meat, alcoholic beverages, and fruits and vegetables was calculated from the 24-hour recall data of 36,486 individuals older than 20 years who were selected from the Korea National Health and Nutrition Examination Survey 1998–2009. The intake adequacy of these three factors was evaluated by the recommended criteria of the World Cancer Research Fund/American Institute of Cancer Research report.

Results

The mean red meat intake in the men in their 20s increased sharply (from 91.6 g to 111.3 g, p < 0.05). The mean alcohol intake increased continuously in men (from 10.3 g to 20.0 g, p < 0.05) and women (from 1.5 g to 3.5 g, p < 0.05). The mean fruit/vegetable intake decreased in the 21–29–year age group (from 349.4 g to 306.7 g in men; from 393.3 g to 292.5 g in women; p < 0.05). The percentage of individuals who did not meet the intake criteria for the three cancer-related dietary factors was especially high, and the percentage increased over 10 years in those in their 20s (p < 0.05).

Conclusion

We confirmed that intakes of red meat, alcoholic drink, and fruits and vegetables have moved toward a negative direction in both men and women in their 20s.

Beneficial changes in food consumption and nutrient intake after 10 years of follow-up in a Mediterranean cohort: the SUN project

Background

The assessment of changes in dietary habits provides interesting information on whether or not the observed trends are in line with accepted nutritional guidelines. The objective was to evaluate within-subject longitudinal changes in food consumption and nutrient intake and in a 10-year follow-up study.

Methods

The SUN (Seguimiento Universidad de Navarra) project is a prospective Spanish cohort study. Diet was assessed using a 136-item food-frequency questionnaire (FFQ), previously validated in Spain. The participants were 3036 university graduates (55.8 % women) of Spain and the main outcome measures the changes in dietary quality and in food consumption and nutrient intake. Paired t-tests and conditional logistic regression models were used to evaluate within-subject longitudinal dietary changes and the risk of inadequacy respectively, after 10 years of follow-up.

Results

During follow-up, participants showed a relevant and significant increase (p < 0.001) in the consumption of fruits (7.4 %), vegetables (8.6 %), low-fat dairy products (35.2 %), lean meat (12.4 %), fish (2.9 %), whole grains (53.2 %), nuts (52.4 %) and a significant decrease in legumes (−7.4 %), whole-fat dairy products (−44.2 %), red meat (−17.6 %), sugar-sweetened beverages (−58.7 %) and wine (−11.9 %). With respect to nutrients, we found a higher proportion of carbohydrates (3.6 %) and fiber (7.4 %) and a decrease in total energy intake (2.7 %), total fat (−4.5 %), SFA (−9.4 %), MUFA (−4.9 %), PUFA (−12.7 %), w-3 and w-6 fatty acids (−9.1 and −20.5 % respectively) and cholesterol (−9.6 %).

Conclusions

In this Mediterranean cohort study, mainly beneficial changes in the consumption of most foods and macronutrients were observed after 10 years of follow-up.

Dietary intake in the dependent elderly: evaluation of the risk of nutritional deficit

BACKGROUND

Malnutrition is a frequent problem in elderly dependent patients and their prognosis is adversely affected. Assessment of food consumption and adequacy of energy and nutrient intake of dependent elderly is needed to plan any selected actions for this population.

METHODS

The study comprised a multicentre cross-sectional study of 190 users (≥65 years) of a home care programme provided by primary care centers in Tarragona (Spain), at nutritional risk (Mini Nutritional Assessment: 17-23.5 points). Food consumption was assessed using a semiquantitative validated food frequency questionnaire. Energy intake was compared with the Spanish dietary reference intake (DRI) and nutritional intakes with the DRI of the American Institute of Medicine.

RESULTS

Mean (SD) age was 85.0 (7.2) years (67.5% female). The food items consumed were varied but lower than the recommended portions for cereals, fruits, vegetables and legumes. Energy intake was 7454.2 (1553.9 kJ day(-1)) [1781.6 (371.4) kcal day(-1)] (97.7% of recommended dietary allowance; RDA) and protein intake was 1.0 (0.4) g kg(-1) of weight (121.4% of RDA). Proteins provided 13.3%, carbohydrates provided 39.9% and fats provided 45.8% of energy intake. The intakes of calcium, vitamin D, vitamin E and folates were less than two-thirds of the RDA and their probability of inadequate intake was >85%.

CONCLUSIONS

Dietary intakes of elderly dependent patients at nutritional risk were well balanced. In general, energy and protein intakes meet the recommendations. The diet was high in energy density, low in complex carbohydrates, high in simple carbohydrates and excessive in fats. The dependent elderly had inadequate intake of micronutrients often related to fragility, such as calcium, vitamin D, vitamin E and folates.

Secular changes in intakes of foods among New Zealand adults from 1997 to 2008/09

OBJECTIVE

To examine changes in the food choices of New Zealand (NZ) adults, between the 1997 National Nutrition Survey (NNS97) and the 2008/09 NZ Adult Nutrition Survey (2008/09 NZANS).

DESIGN

The 2008/09 NZANS and the NNS97 were cross-sectional surveys of NZ adults (aged 15 years and over). Dietary intake data were collected using a computer-based 24 h diet recall. Logistic regression models were used to examine changes over time in the percentage reporting each food group, with survey year, sex and age group (19-30 years, 31-50 years, 51-70 years, ≥71 years) as the variables.

SETTING

NZ households.

SUBJECTS

Adults aged 19 years and over (NNS97, n 4339; 2008/09 NZANS, n 3995).

RESULTS

In the 2008/09 NZANS compared with NNS97, males and females were less likely to report consuming bread, potatoes, beef, vegetables, breakfast cereal, milk, cheese, butter, pies, biscuits, cakes and puddings, and sugar/confectionery (all P<0.001). In contrast, there was an increase in the percentage reporting rice and rice dishes (P<0.001), and among females a reported increase in snacks and snack bars (e.g., crisps, extruded snacks, muesli bars; P=0.007) and pasta and pasta dishes (P=0.017). Although food choices were associated with sex and age group, there were few differential changes between the surveys by sex or age group.

CONCLUSIONS

For all age groups there was a shift in the percentage who reported consuming the traditional NZ foods, namely bread, beef, potatoes and vegetables, towards more rice and rice dishes. Declines in the consumption of butter, pies, biscuits, cakes and puddings are congruent with current dietary guidelines.

[Good reproducibility of a 14-item food frequency questionnaire for cardiovascular prevention in students]

Diet is a modifiable risk factor of atherosclerosis. A 14-item food frequency questionnaire (FFQ) has been developed. The reproducibility of this FFQ is unknown in a student population whereas its use could be of interest.

METHODS

This FFQ allows calculating different scores for different food groups involved in cardiovascular disease. The vascular dietary score (VDS) can be calculated. The VSD ranges from -17 to +19. The higher the VSD, the better diet. Reproducibility was assessed in sports faculty students using mean tests comparing measurement 1 and 2 (minimum time interval ≥ 7 days) and intra-class correlation (ICC) tests.

RESULTS

Thirty students (50% men) were included in a French Sports Faculty. Time between two FFQ assessments was 19 ± 9 days. Mean VSD was 0.50 ± 3.70 for the first assessment and 0.30 ± 3.14 for the second one (non significant). Any score for each food group was statistically significant between the first and the second measurement. ICC of VSD was 0.68 [95% confidence interval: 0.43-0.83].

CONCLUSION

This FFQ that assesses a risky vascular diet has good reproducibility. This tool could be useful for large studies involving students.

Fluid intake from beverages across age groups: a systematic review

BACKGROUND

Fluid intake, especially water, is essential for human life and also necessary for physical and mental function. The present study aimed to assess beverage consumption across age groups.

METHODS

A systematic review was conducted. Original research in English language publications and available studies (or abstracts in English) from 2000 to 2013 was searched for by using the medical subheading (MeSH) terms: ('beverage' OR 'fluid' [Major]) AND ('consumption' [Mesh] OR 'drinking' [Mesh] OR 'intake' [Mesh]) AND ('child' [Mesh] OR 'adolescent' [Mesh] OR 'adult' [Mesh]). Article selection was restricted to those papers covering healthy populations of all age groups in a nationwide sample, or from a representative sample of the population of a city or cities, which examined the trends or patterns of beverage intake and the determinants of beverage intake. Sixty-five studies were identified with respect to beverage consumption across age groups. The papers were screened by thoroughly reading titles or abstracts. Full-text articles were assessed by three investigators.

RESULTS

Total beverage intake varied between 0.6 and 3.5 L day(-1) among all age groups (males more than females). Plain water contributed up to 58%, 75% and 80% of the total beverage intake in children, adolescents and adults, respectively. Milk consumption was higher among children; consumption of soft drinks was higher among adolescents; and the consumption of tea, coffee and alcoholic beverages was higher among adults.

CONCLUSIONS

Plain water is the main water source for all age groups and the consumption of other beverages varies according to age.

Mapping low intake of micronutrients across Europe

Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B₁, B₂, B₆, B₁₂, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

Consideration of Age-Related Changes in Behavior Trends in Older Adults in Assessing Risks of Environmental Exposures

Objectives: To explore age-related behavior differences between older and younger adults, and to review how older adult activity patterns are considered in evaluating the potential risk of exposure to environmental pollutants. Methods: Activity pattern data and their use in risk assessments were analyzed using the U.S. EPA Exposure Factors Handbook (EFH), U.S. EPA Consolidated Human Activity Pattern Database (CHAD), and peer-reviewed literature describing human health risk assessments. Results: The characterization by age of some factors likely to impact older adults’ exposures remains limited. We demonstrate that age-related behavior trends vary between younger and older adults, and these differences are rarely explicitly considered in environmental health risk assessment for older adults. Discussion: Incorporating older adult exposure factors into risk assessments may be challenging because of data gaps and difficulty in defining and appropriately binning older adults. Additional data related to older adult exposure factors are warranted for evaluating risk among this susceptible population.

Adherence to the Mediterranean diet pattern has declined in Spanish adults

This work examined the Spanish population's degree of accordance with the Mediterranean diet (MD). This was a cross-sectional study conducted in 2008-2010 among 11,742 individuals representative of the Spanish population aged ≥ 18 y. Habitual food consumption was assessed with a computerized diet history. Accordance of food consumption with the MD was assessed with the MD Adherence Screener (MEDAS) score using the cutoffs ≥ 9 to define strict accordance and ≥ 7 (mid-range value) for modest accordance. Accordance of nutrient intake with the MD was defined as ≥ 4.5 points (mid-range value) on the high-unsaturated fat OmniHeart diet score. The diet of 12% (95% CI: 11.3-12.7%) of the Spanish population reached MEDAS-based strict accordance with the MD and 46% (95% CI: 44.7-47.7) attained modest accordance. Moreover, 39.0% (95%: 37.8-40.1%) of the population achieved OnmiHeart-based MD accordance. Factor analysis identified 2 main dietary patterns. The first one was called "Westernized" and was rich in red and processed meat, French fries, refined cereals, and sweetened beverages and poor in fresh fruit; the second pattern was named "Mediterranean" and was rich in olive oil and plant-based foods. Regardless of how it was defined, MD accordance was less frequent and the Westernized pattern was more frequent among the younger, the less educated, current smokers, and those less physically active and more sedentary. In conclusion, the Spanish population is drifting away from the MD to adopt a less healthy diet, typical of Western countries. The departure from the MD mostly affects the socially disadvantaged and clusters with other unhealthy lifestyles, which may have synergistic undesirable effects on health.

Global gender disparities in obesity: a review

There is a global obesity pandemic. However, the prevalence of overweight and obesity among men and women varies greatly within and between countries, and overall, more women are obese than men. These gender disparities in overweight and obesity are exacerbated among women in developing countries, particularly in the Middle East and North Africa. Yet, in developed countries, more men are overweight than women. Current knowledge suggests that myriad sociocultural dynamics throughout the world exacerbate gender disparities in excess weight gain. Different contextual factors drive gender differences in food consumption, and women often report consuming healthier foods, yet may consume more sugar-laden foods, than men. Acculturation, through complex sociocultural pathways, affects weight gain among both men and women. The nutrition transition taking place in many developing countries has also affected excess weight gain among both genders, but has had an even greater impact on the physical activity levels of women. Furthermore, in some countries, cultural values favor larger body size among women or men as a sign of fertility, healthfulness, or prosperity. As the global obesity pandemic continues, more research on gender disparities in overweight and obesity will improve the understanding of this pandemic.

Time trends in social differences in nutrition habits of a Lithuanian population: 1994-2010

Background

During the post-communist transition period, political, economic, and social changes affected the lifestyles of the Lithuanian population, including their nutritional habits. However, people of lower socio-economic position were more vulnerable to these changes. The aim of the present study was to evaluate the trends in selected food habits of the Lithuanian adult population by their level of education and place of residence from 1994 to 2010.

Methods

The data were obtained from nine biannual cross-sectional postal surveys of Lithuanian health behaviours, beginning in 1994. Each survey used a randomly selected nationally representative sample of 3000 inhabitants aged 20-64 drawn from the population register. In total, 7358 men and 9796 women participated in these surveys. Questions about food consumption were included within all health behaviour questionnaires.

Results

During the transition period, use of vegetable oil in cooking and the frequency of consumption of fresh vegetables increased, use of butter on bread decreased, and the proportion of women drinking high-fat milk declined. Lithuanians with higher education reported more frequent use of vegetable oil in cooking as well as daily consumption of fresh vegetables than those with a lower level of education. Consumption of high-fat milk was inversely associated with educational background. In addition, the proportion of persons spreading butter on bread increased with higher education level. The greatest urban-rural difference was observed in high-fat milk consumption. The increase in the use of vegetable oil in cooking, and the reduction of spreading butter on bread was more evident among less educated and rural inhabitants. Meanwhile, a greater proportion of the rural population, compared to urban, reduced their use of butter on bread. Daily consumption of fresh vegetables increased most among highly educated Lithuanians.

Conclusions

The data from our study indicate beneficial dietary changes among the Lithuanian adult population. In general, those with a higher level of education had healthier food habits than those with low education. The educational gradient in analyzed food habits, except the use of vegetable oil, enlarged. A higher proportion of the rural population, compared to urban, reduced their usage of butter on bread. However, consumption of high-fat milk was greatest in the rural population. Our data highlight the need for future food and nutrition policies, as well as health promotion programmes, targeting the whole population, particularly those with lower education and living in rural areas.

Trend in eating habits among Lithuanian school-aged children in context of social inequality: three cross-sectional surveys 2002, 2006 and 2010

Background

Intermittent monitoring of food intake at the population level is essential for the planning and evaluation of national dietary intervention programs. Social-economic changes in Lithuania have likely affected dietary habits, but only a limited number of temporal studies on food intake trends among young population groups have been published. The aim of this study was to investigate changes in eating habits among Lithuanian school-aged children from 2002 to 2010, and to explore the association of these changes with the respondents' reported socio-economic status (SES).

Methods

We used Lithuanian data from the cross-national Health Behaviour in School-aged Children (HBSC) study collected in 2002, 2006 and 2010. Analyses were conducted on comparable questionnaire-based data from children aged 11, 13 and 15 (total n = 17,189) from a random sample of schools. A food frequency questionnaire was used to investigate frequencies of food consumption. Logistic regression was used to examine the affects of changing social variables on reported diet trends.

Results

In Lithuania, school-aged children have low intakes of fruits and vegetables. Only 21.1% of boys and 27.1% of girls reported daily fruit consumption. Similarly, 24.9% of boys and 29.6% of girls disclosed vegetable intake at least once daily. Comparing 2010 to 2002, the proportion of girls who consumed fruits daily increased from 24.2% to 31.0% (p < 0.001) but the proportion of boys who consumed vegetables daily decreased from 29.3% to 23.1% (p < 0.001). In 2006, for both sexes, there were observed increases in regular (at least five days a week) intake of sweets and chocolates, biscuits and pastries, and soft drinks; however, in the next survey (2010) these figures decreased. In addition, between 2006 and 2010, a substantial decrease in regular consumption of chips and fast food was also detected. Fruit and vegetable consumption as well as intake of sweets and chocolates, biscuits and pastries and soft drinks increased with family social-economic status and family material wealth. Trends in consumption of fruits, and other foods, and their association with changing social variables were demonstrated using the ORs estimated by three logistic models, using 2002 as the reference point. Changes in social variables from 2002 to 2010 affected the likelihood of daily consumption of fruits among boys by 22.5% (the corresponding OR decreased from 1.11 to 0.86) and among girls by 34.0% (the corresponding OR decreased from 1.41 to 1.12). Over the study period, changing social variables had little impact on the daily consumption of vegetables and other foods.

Conclusions

Based on the food consumption trends observed in Lithuania, increases in consumption of fruits and vegetables should be promoted, along with a reduction in the intake of less healthy choices, such as soft drinks and high-fat, high-sugar snack foods, by diminishing social inequalities in food consumption.

Western and Mediterranean dietary patterns among Balearic Islands' adolescents: socio-economic and lifestyle determinants

OBJECTIVE

To assess prevailing food patterns among Balearic Islands' adolescents, and socio-economic and lifestyle determinants.

DESIGN

Cross-sectional nutritional survey carried out (2007-2008) in the Balearic Islands, a Mediterranean region. Dietary assessment was based on a 145-item semi-quantitative FFQ and two non-consecutive 24 h recalls. Anthropometric measurements and questions related to socio-economic, lifestyle, physical activity and body image were assessed.

SETTING

Data obtained from a representative sample of all inhabitants living in the Balearic Islands aged 12-17 years.

SUBJECTS

A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed.

RESULTS

Factor analysis identified two major dietary food patterns: 'Western' and 'Mediterranean'. The 'Western' dietary pattern was higher among boys than girls, associated with spending ≥4 h/d on media screen time, but less prevalent among those adolescents who desired a thinner body and those girls who desired to remain the same weight. The 'Mediterranean' dietary pattern was mainly followed by girls, and also boys who spent < 2 h/d on media screen time and girls with high parental socio-economic status.

CONCLUSIONS

The present study shows the existence of two major dietary patterns among Balearic Islands' adolescents: 'Western' and 'Mediterranean', but girls are more 'Mediterranean' than boys. This evidence supports that the food pattern of Balearic Islands' adolescents is in a transitional state characterised by the loss of the traditional Mediterranean dietary pattern towards a Western dietary pattern. Low parental socio-economic status, much leisure-time on sedentary behaviours such as media screen time and body image are factors associated with the 'Western' dietary pattern.

Increased consumption of fruit and vegetables and future cancer incidence in selected European countries

Cancer is one of the major causes of death in western countries. Fruit and vegetable consumption may reduce the risk of cancers of the oropharynx, oesophagus, lung, stomach and colorectum. We investigated the potential effect of interventions aimed at increasing the intake of fruits and vegetables to the recommended level (500 g/d) on future cancer incidence in Europe. Data on cancer incidence and daily intake of fruit and vegetables were compiled for France, Germany, The Netherlands, Spain and Sweden. We also performed a meta-analysis of European observational studies to arrive at a quantitative estimate on the association between fruit and vegetable intake and cancer risk. Predictions on the future cancer incidence were modelled using PREVENT 3.01. Our study predicted 212,000 fruit- and vegetable-related cancer cases in these countries in 2050, out of which 398 (0.19%) might be prevented if the 500 g/d fruit and vegetable intake were achieved in the aforementioned countries. The largest absolute impact was observed for lung cancer with 257 (out of 136,517) preventable cases if the intervention was successfully implemented. Sweden would benefit the most from intervention to increase fruit and vegetable consumption with a 2% reduction in expected cases. Increasing fruit and vegetable consumption has a small impact on reducing the burden of cancer in Europe. Health impact assessment tools such as PREVENT can provide the basis for decision making in chronic disease prevention.

Dietary pattern, a modifiable risk factor that can be easily assessed for atherosclerosis vascular disease prevention in clinical practice

OBJECTIVES

Nutrition is one of the modifiable risk factors of atherosclerosis vascular diseases (VD). We aimed to (i) evaluate the dietary patterns associated with VD in clinical practice using a validated FFQ; and (ii) determine potential independent sociodemographic and behavioural factors that are involved in such dietary patterns. The FFQ determined the vascular dietary score (VDS; ranges from -17 to 19) for each subject.

DESIGN

Cross-sectional study.

SETTING

A general practitioner's (GP) office in 2009.

SUBJECTS

A total of 250 French subjects (18-84 years old).

RESULTS

A total of 21 % had a favourable vascular diet (VDS ≥ 8), 79 % needed to improve their diet (VDS < 8) and 21 % had a risky vascular diet (VDS ≤ -1). A step-by-step multivariate linear regression analysis with stepwise selection was performed using the VDS as a dependent variable. Significant variables were: age (β = 0·495, P < 0·0001), men (β = -0·282, P < 0·0001), 'sport ≥ 1 h/week' (β = 0·253, P = 0·001), 'walking 20 min/d' (β = 0·161, P = 0·012), 'former smoker' (β = 0·118, P = 0·029), previous nutritional advice (β = 0·105, P = 0·049), 'alcohol ≥ 20 g/d' (β = -0·216, P < 0·0001) and 'primary school' (β = -0·156, P = 0·010). The R2 coefficient of this model was 0·347 (P < 0·0001). In all, 88·7 % of the subjects found the evaluation very interesting and 89·6 % believed that the GP should perform it.

CONCLUSIONS

Simple dietary assessment for VD prevention can be easily performed in clinical practice to allow physicians to give objective and rapid advice for each patient. Age, educational status, alcohol consumption, gender and physical activity are associated with the VDS. Compliance with such evaluation was found to be very high, which should encourage larger dietary screening in the population in order to reduce the impact of VD.

Vegetable intake in Korea: data from the Korean National Health and Nutrition Examination Survey 1998, 2001 and 2005

The purpose of the present study was to analyse vegetable intake by the Korean population based on different meal formats. Twenty-four-hour dietary recall data from the Korean National Health and Nutrition Examination Survey were used to assess daily vegetable intake and consumption ratio of vegetables for different meal types/dining locations. Analysis was stratified by sex and age group. Daily vegetable intake increased from 293.5 g in 1998 to 305.7 g in 2001 and to 335.9 g in 2005. Findings were similar in men and women, as well as in each age group. Analyses for each meal type revealed that vegetable intake during breakfast did not substantially change, but vegetable intake increased during lunch and dinner. While vegetable consumption ratio during breakfast decreased, it increased during lunch and snack time. Men and women showed similar change in the analysis for meal types and dining locations. There were some differences between the age groups in daily vegetable intake depending on the meal type. Another notable observation was the increasing change of vegetable intake during lunch and during meals eaten at cafeterias and restaurants in all the age groups. Analysis of vegetable consumption ratio showed an increased consumption in cafeterias, restaurants, and other places and decreased vegetable intake at home for those aged 16-64 years with time. Since this change may be related to improvements in socioeconomic status, it will be necessary to further investigate difference in vegetable intake based on socioeconomic levels within the population.

Trends in food and nutritional intakes of French adults from 1999 to 2007: results from the INCA surveys

Two independent cross-sectional dietary surveys (the Individual and National Food Consumption Surveys, INCA), performed in 1998–99 (INCA1) and in 2006–07 (INCA2) on nationally representative samples of French people, were used to analyse trends in the dietary habits and nutritional intake of French adults. Food consumption was recorded through 7-d dietary records, and nutritional intakes were assessed using the French food composition database. After exclusion of under-reporters, analyses were performed on 3267 adults, aged 18–79 years: 1345 from INCA1 and 1922 from INCA2. The trends highlighted over the 8-year period showed a decrease in consumption of dairy products, meat, bread, potatoes, pastries/croissant-like pastries/cakes/biscuits and sugar/confectionery. In contrast, the consumption of fruits and vegetables, rice, ice cream and chocolate increased. Other food groups, like fish and snacking foods, remained stable. Food choices were mostly age specific. These age differences remained consistent over the years and underlined two opposite dietary trends: a ‘traditional’ one mainly followed by the elderly, and a ‘snacking and convenience’ one mainly adopted by young adults. The overall trends in food consumption did not influence the mean energy intake, but did slightly modify the contribution of each macronutrient to energy intake. These repeated surveys highlighted the fact that trends in French food habits have moved towards an average European diet at the crossroads between Mediterranean and Northern diets, and that food consumption changes impacted, to a lesser extent, nutritional intake.

Prospective study of self-reported usual snacking and weight gain in a Mediterranean cohort: the SUN project

BACKGROUND & AIMS

It has been hypothesized that snacking could be a major factor in the development of obesity. However, the relationship between snacking and the increment in body weight remains controversial. Moreover, longitudinal studies about this issue are scarce. Thus, our objective was to prospectively assess the relationship between snacking and weight gain and obesity in a middle-aged free-living population.

METHODS

Longitudinal prospective Spanish dynamic cohort (10,162 university graduates; mean age: 39 years) followed-up for an average of 4.6 years. Dietary habits were ascertained through a validated 136-item food-frequency questionnaire. Usual snackers were defined as those participants who answered affirmatively when asked in the baseline assessment if they usually eat between meals. Validated self-reported weight and body mass index were collected at baseline and during follow-up.

RESULTS

After adjusting for potential confounders, self-reported between-meal snacking was significantly associated with a higher risk of substantial weight gain (> or =3kg/year; p<0.001;> or =5kg/year, p<0.001;> or =10% baseline weight, p<0.001). Among participants with a baseline body mass index lower than 30kg/m(2) (n: 9709) we observed 258 new cases of obesity. Usual snackers presented an adjusted 69% higher risk of becoming obese during follow-up (Hazard Ratio: 1.69; 95% confidence interval: 1.30-2.20).

CONCLUSION

Our results support the hypothesis that self-reported between-meal snacking can be a potential risk factor for obesity.

Eating out of home in Belgium: current situation and policy implications

The aim of the study was to characterise substantial out-of-home (SOH) eaters, describe the nutritional quality of their diet, compare SOH eaters and non-SOH eaters for a set of nutritional indicators and evaluate the quality of meals consumed at home and at different places outside the home. Information on food intake was collected with two 24 h recalls. Habitual food intake was estimated by the Nusser method. Non-dietary variables were obtained using a face-to-face questionnaire. SOH eaters were defined as individuals who consume at least 25% of their daily energy out of home. A representative sample (n 3245) of the Belgian population aged 15 years and older was randomly selected from the National Register using a multi-stage stratified procedure. Of the Belgian population, 35.2% were defined as SOH eaters. Energy intake, energy density of the total diet and daily consumption of most food groups, except for fruits and vegetables, were substantially higher among SOH eaters compared with non-SOH eaters. Out-of-home eating was more common among men than women and decreased with increasing age. There were considerable differences in portion sizes, consumption frequency of different foods and diversity of meals according to different places of consumption. Out-of-home eating is a significant nutritional issue in Belgium and is associated with a more adverse dietary profile. Out-of-home eating, places of consumption, and specific population groups, eating substantially out of home, should consequently be taken into account when designing and evaluating nutrition policies.