Consumption of energy-dense, nutrient-poor foods by the US population: effect on nutrient profiles

Custodio MR. Food Sources and Nutrient Intakes of Filipino Working Adults

Nutrition is an integral part of economic development, since it influences workers' healthand productivity. This study evaluated the usual nutrient intakes and food sources of workingadults. We conducted a cross-sectional survey that involved 1264 selected working adults aged 19to 59 years old from randomly selected job sectors. Quantitative dietary data was collected by a 2-day, non-consecutive 24 h recall, while a dietary diversity questionnaire was used to assess the typesand frequency of foods consumed. Physical activity was measured using the World HealthOrganization global physical assessment questionnaire. The prevalence of inadequate intakes,defined as the percentage of adults with intakes less than the estimated average requirements (EAR)or acceptable macronutrient distribution ranges (AMDR) were estimated using the PC-Softwarefor Intake Distribution Estimation (PC-SIDE) program. The mean daily energy intake of workingadults was 1768 kcal/day or 74% of the Estimated Energy Requirements (EER) for this age group.The percentage contribution to the total energy of fats (58%) and proteins (34%) were excessivelyhigh. Consumption of fruits and vegetables was only 30% and 40% of the recommended nutrientintake, respectively. Salt intake was 52% above the adequate intake. Nutrient inadequacy was highin almost all nutrients, including iron (99%), folate (97.9%), riboflavin (95.8%), calcium (94.7%),vitamin C (87.3%), and thiamin (76.6%). The top five food sources of energy included rice (35.6%),pork (15.1%), fats and oils (4.7%), chicken (4.4%), and bread (3.8%). Energy and nutrient intakes ofworking adults is extremely sub-optimal due to the consumption of few nutrient-dense foods. Thismay pose a triple burden of malnutrition if left unsolved.

Absence of MyD88 from Skeletal Muscle Protects Female Mice from Inactivity-Induced Adiposity and Insulin Resistance

OBJECTIVE

Inactivity and inflammation are linked to obesity and insulin resistance. It was hypothesized that MyD88 (mediates inflammation) knockout from muscle (MusMyD88-/- ) would prevent, whereas miR146a-/- (MyD88 inhibitor) would exacerbate, inactivity-induced metabolic disturbances.

METHODS

Cre-control, MusMyD88-/- , and miR146a-/- mice were given running wheels for 5 weeks to model an active phenotype. Afterward, half were placed into a small mouse cage (SMC) to restrict movement for 8 days. Body composition, muscle (3 H)2-deoxyglucose uptake, visceral fat histology, and tissue weight (hind limb muscles, visceral fat, and liver) were assessed. In skeletal muscle and visceral fat, RNA sequencing and mitochondrial function were performed on female MusMyD88-/- and Cre-control SMC mice.

RESULTS

The SMC induced adiposity, hyperinsulinemia, and muscle insulin-stimulated glucose uptake, which was worsened in miR146a-/- mice. In females, MusMyD88-/- mice were protected. Female MusMyD88-/- mice during the SMC period (vs. Cre-control) exhibited higher Igf1 and decreased Ip6k3 and Trim63 muscle expression. Visceral fat transcript changes corresponded to improved lipid metabolism, decreased adipose expansion (Gulp1↑, Anxa2↓, Ehd1↓) and meta-inflammation (Hmox1↓), and increased beiging (Fgf10↑). Ralgapa2, negative regulator of GLUT4 translocation, and inflammation-related gene 993011J21Rik2 were decreased in both muscle and fat.

CONCLUSIONS

Whole-body miR146a-/- exacerbated inactivity-induced fat gain and muscle insulin resistance, whereas MusMyD88-/- prevented insulin resistance in female mice.

Caribou consumption in northern Canadian communities

Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) found in both farmed and wild deer, elk, and moose in the United States and Canada. Surveillance efforts in North America identified the geographical distribution of the disease and mechanisms underlying distribution, although the possibility of transmission to other cervids, including caribou, and noncervids, including humans, is not well understood. Because of the documented importance of caribou (Rangifer tarandus) to human populations in the northern regions of Canada, a risk-management strategy for CWD requires an understanding of the extent of potential dietary exposure to CWD. Secondary 24-h dietary recalls conducted among Inuvialuit and Inuit in 4 communities in the Northwest Territories and Nunavut were employed in this study. Econometric demand systems were estimated to model the impacts of individual- and community-level socioeconomic characteristics on expenditures on caribou and other foods, in order to examine the households' ability to consume other foods in response to changing levels of caribou consumption. Thirty-five percent of respondents reported consuming caribou in the survey period, and caribou comprised, on average, 26% of daily dietary intake by weight, or approximately 65 g/d, across individuals in the 4 communities. Consuming caribou was also shown to exert positive impacts on dietary quality, as measured by calorie intake and dietary diversity. Communities with less access to employment, income and food stores are predicted to be constrained in their ability to obtain an adequate diet in the event of scarcity of caribou meat.

DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma

This pilot study aims to provide effect size confidence intervals, clinical trial and intervention feasibility data, and procedural materials for a full-scale randomized controlled trial that will determine the efficacy of Dietary Approaches to Stop Hypertension (DASH) as adjunct therapy to standard care for adults with uncontrolled asthma. The DASH diet encompasses foods (e.g., fresh fruit, vegetables, and nuts) and antioxidant nutrients (e.g., vitamins A, C, E, and zinc) with potential benefits for persons with asthma, but it is unknown whether the whole diet is beneficial. Participants (n = 90) will be randomized to receive usual care alone or combined with a DASH intervention consisting of 8 group and 3 individual sessions during the first 3 months, followed by at least monthly phone consultations for another 3 months. Follow-up assessments will occur at 3 and 6 months. The primary outcome measure is the 7-item Juniper Asthma Control Questionnaire, a validated composite measure of daytime and nocturnal symptoms, activity limitations, rescue medication use, and percentage predicted forced expiratory volume in 1 second. We will explore changes in inflammatory markers important to asthma pathophysiology (e.g., fractional exhaled nitric oxide) and their potential to mediate the intervention effect on disease control. We will also conduct pre-specified subgroup analyses by genotype (e.g., polymorphisms on the glutathione S transferase gene) and phenotype (e.g., atopy, obesity). By evaluating a dietary pattern approach to improving asthma control, this study could advance the evidence base for refining clinical guidelines and public health recommendations regarding the role of dietary modifications in asthma management.

Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999-2004

BACKGROUND

Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet.

OBJECTIVE

This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12-18 y of age (n = 5811).

DESIGN

We conducted secondary analyses of 24-h diet recalls and anthropometric data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. We classified adolescents by frequency of snack consumption (0, 1, 2, 3, and > or =4 snacks/d) and by the percentage of energy intake from snacks (0%, <10%, 10-19%, 20-29%, 30-39%, and > or =40%). We classified adolescents who had a body mass index (BMI) > or =85th percentile of BMI-for-age as overweight or obese. We defined abdominal obesity as a waist circumference > or =90th percentile. We determined covariate-adjusted prevalences of overweight or obesity and abdominal obesity and odds ratios with SUDAAN software (release 9.0.1; Research Triangle Institute, Research Triangle Park, NC).

RESULTS

Mean values of all obesity indicators studied were inversely associated with snacking frequency and percentage of energy from snacks. The prevalence of overweight or obesity and of abdominal obesity decreased with increased snacking frequency and with increased percentage of energy from snacks. Odds ratios (95% CIs) for overweight or obesity and for abdominal obesity ranged from 0.63 (0.48, 0.85) to 0.40 (0.29, 0.57) and from 0.61 (0.43, 0.86) to 0.36 (0.21, 0.63) for 2 to > or =4 snacks/d, respectively. Reduced risks of overweight or obesity and abdominal obesity were associated with snacking.

CONCLUSION

Snackers, compared with nonsnackers, were less likely to be overweight or obese and less likely to have abdominal obesity.

Are energy dense diets also nutrient dense?

OBJECTIVE

Some beverages are nutrient dense, but they are often excluded from nutrient density calculations. The purpose of this study was to assess whether the energy-nutrient association changed when beverages were included in these calculations.

DESIGN

Applying a cross-sectional design, a 24-hour dietary recall was collected on each participant. Subjects/

SETTING

440 young adults (ages 19-28 years) in Bogalusa, Louisiana participated in this study.

STATISTICAL ANALYSIS

Mean nutrient intakes and food group consumption were examined across the energy density (ED) tertiles using two calculation methods: one with food and all beverages (excluding water) (ED1) and one including food and only energy containing beverages (ED2). Regression models were used and multiple comparisons were performed using the Tukey-Kramer procedure. A p-value < 0.05 was considered to be significant.

RESULTS

With increasing ED, there was a significant increase in the consumption of total meats (ED1 p < 0.05; ED2 p < 0.01). In contrast, there was a significant decrease in consumption of fruits/juices (ED1 p < 0.01; ED2 p < 0.0001), vegetables (ED1 p < 0.01; ED2 p < 0.05), beverages (both p < 0.0001) and total sweets with increasing ED (both p < 0.0001). There was a significantly higher mean intake of total protein (grams) (ED2 p < 0.0001), amino acids (ED1 histidine/leucine p < 0.05; ED2 p < 0.0001), and total fat (grams) (ED1 p < 0.0001; ED2 p < 0.0001) with higher ED compared to lower ED. The percent energy from protein (ED1 p < 0.05; ED2 p < 0.0001), total fat (both p < 0.001) and saturated fatty acids (both p < 0.0001) significantly increased and the percent energy from carbohydrate (both p < 0.0001) and sucrose (both p < 0.0001) significantly decreased with increasing ED.

CONCLUSION

This study suggests that ED may influence the ND of the diet depending on whether energy containing beverages are included or excluded in the analysis.

Dietary sugars intake and micronutrient adequacy: a systematic review of the evidence

Guidelines for sugars intake range from a population mean of less than 10 % energy from free sugars, to a maximum for individuals of 25 % energy from added sugars. The aim of the present review was to examine the evidence for micronutrient dilution by sugars and evaluate its nutritional significance. From a web-based search of MEDLINE and hand search of linked papers, forty-eight relevant publications were identified on sugars (total sugars, non-milk extrinsic sugars, or added sugars) or sugar-containing drinks. These included five reports from expert committees, six reviews, thirty-three observational studies and four small-scale interventions. There was inconsistency between studies as to the relationship between sugars intake (however expressed) and micronutrients. The statistical patterns varied between nutrients and population groups. Curvilinear associations were found in some analyses, with lower nutrient intakes at both extremes of sugar intake; however, factors such as dieting and under-reporting may confound the associations observed. Some studies found statistically significant inverse associations but these were weak, with sugars explaining less than 5 % of the variance. Mean intakes of most micronutrients were above the RDA or reference nutrient intake except among very high consumers of sugars. The available evidence does not allow for firm conclusions on an optimal level of added sugars intake for micronutrient adequacy and the trends that exist may have little biological significance except for a few nutrients (for example, Fe). It is established that energy intake is the prime predictor of micronutrient adequacy. A better understanding of valid approaches to energy adjustment, misreporting and the assessment of micronutrient adequacy is crucial to further progress in this area.

Perioperative nutrition and the use of nutritional supplements

The poor dietary habits and aging of the US population have caused a steady increase in the incidence of chronic disease. The prevalence of these diseases, such as obesity, diabetes, and heart disease, may have a significant effect on perioperative management, surgical outcome, and complication rates in these patients. Nutritional intervention and supplementation may help curb some of these potential adverse affects of poor nutrition by promoting wound healing; enhancing immunity; reducing swelling, bruising, and inflammation; and reducing oxidation caused by anesthetic agents and surgery. Although a perioperative regimen of dietary supplements may enhance surgical outcomes, it is equally important to know the popular herbal products that are contraindicated in the perioperative period.

Nutrition risk in the child and adolescent population of the Basque country: the enKid Study

Cross-sectional population studies provide valuable information for nutrition surveillance and planning intervention strategies. The enKid Study is the largest nutrition survey on the child and adolescent Spanish population to date. In the present paper, nutrition risks in children and young people of the Basque country based on the enKid Study subsample for the Basque region are presented. Dietary assessment was completed by means of a 24 h recall and a food frequency questionnaire completed in an interview with the mother or caregiver for children under 13 years. A second 24 h recall was completed on 25 % of the sample. Body weight, height and circumference were measured on each individual. Overweight and obesity were defined using Coleet al.cut-offs. Fat intake supplied 40 % of energy intake and saturated fats 13·8 %. Overall, 80 % of the sample had intakes of fat above 35 %. Main food sources of fats were added fats (32 %), meat (20 %) and milk products (20 %). Buns, cakes and pastry supplied 11 % of total fat intake. The nutrients showing the highest proportion of people who did not reach one third (33 %) of the Spanish dietary reference intake levels were vitamin D, vitamin E, vitamin A and folate. Prevailing food pattern showed a high consumption of meat and meat products, milk, dairy products and cereals. Conversely, consumption of fruit, vegetables and fish was low; in fact, 89 % of the sample had a normal consumption of fruit and vegetables below five portions a day. Prevalence of obesity was estimated at 3·94 %, and 17·85 % of the sample was classified as overweight.

The underappreciated role of muscle in health and disease

Muscle plays a central role in whole-body protein metabolism by serving as the principal reservoir for amino acids to maintain protein synthesis in vital tissues and organs in the absence of amino acid absorption from the gut and by providing hepatic gluconeogenic precursors. Furthermore, altered muscle metabolism plays a key role in the genesis, and therefore the prevention, of many common pathologic conditions and chronic diseases. Nonetheless, the maintenance of adequate muscle mass, strength, and metabolic function has rarely, if ever, been targeted as a relevant endpoint of recommendations for dietary intake. It is therefore imperative that factors directly related to muscle mass, strength, and metabolic function be included in future studies designed to demonstrate optimal lifestyle behaviors throughout the life span, including physical activity and diet.

Concept of a nutritious food: toward a nutrient density score

The American diet is said to be increasingly energy-rich but nutrient-poor. To help improve the nutrient-to-energy ratio, the 2005 Dietary Guidelines for Americans recommend that consumers replace some foods in their diets with more nutrient-dense options. Such dietary guidance presupposes the existence of a nutrient density standard. However, a review of the literature shows that the concept of a nutritious food is not based on any consistent standards or criteria. In many cases, healthful foods are defined by the absence of problematic ingredients-fat, sugar, and sodium-rather than by the presence of any beneficial nutrients they might contain. Past attempts to quantify the nutrient density of foods have been based on a variety of calories-to-nutrient scores, nutrients-per-calorie indexes, and nutrient-to-nutrient ratios. The naturally nutrient rich (NNR) score, which is based on mean percentage daily values (DVs) for 14 nutrients in 2000 kcal food, can be used to assign nutrient density values to foods within and across food groups. Use of the NNR score allows consumers to identify and select nutrient-dense foods while permitting some flexibility where the discretionary calories are concerned. This approach has implications for food labeling, nutritional policy making, and consumer education. The Food and Drug Administration has considered approving nutrient claims based on the ratio of a beneficial nutrient to the food's energy content, as opposed to a specified minimum amount of a nutrient per serving size. Given the current dietary trends, the nutrient density approach can be a valuable tool for nutrition education and dietary guidance.

The 2005 Dietary Guidelines Advisory Committee: Developing a Key Message

The 2005 Dietary Guidelines Advisory Committee used an evidence-based approach to evaluate the science base for the relationships of diet and physical activity and health. Nine key messages and corresponding conclusions were included in the 2005 Dietary Guidelines Advisory Committee report. This article describes the development process, scientific basis, and specific recommendations for one of the key messages.

Perioperative nutrition and nutritional supplements

Due to the combination of poor dietary habits and aging in the U.S. population, an increase in the incidence of chronic disease is occurring in this country. The prevalence of poor nutrition, obesity, diabetes, and other chronic diseases can have a significant impact on surgical outcome and complications. The number of patients with pre-existing nutritional deficiencies and health problems who are seeking cosmetic surgical procedures is growing. Nutritional intervention and supplements can have a beneficial effect on such patients who are undergoing surgery. Plastic surgeons performing aesthetic procedures may want to incorporate nutritional guidance and supplementation into their perioperative office regimen to mitigate complications and to optimize surgical outcome.

Changes in food group consumption patterns from childhood to young adulthood: The Bogalusa Heart Study

OBJECTIVE

The objective of this study was to assess changes in food group consumption patterns from childhood to young adulthood.

DESIGN

Twenty-four-hour dietary recalls were collected on a longitudinal sample of young adults.

SUBJECTS/SETTING

Dietary intake data were collected on 246 young adults (70% European American, 30% African American) aged 19 to 28 years who participated in a previous cross-sectional survey when they were 10-year-olds.

STATISTICAL ANALYSES

Descriptive statistics and linear mixed models adjusting for study time (age), sex, and ethnicity.

RESULTS

In childhood, consumption of fruits/fruit juice and mixed meats ( P </=.05), desserts, candy, and milk ( P </=.0001) were greater than in young adulthood. Young adulthood consumption was greater for sweetened beverages, poultry and seafood ( P </=.001), salty snacks ( P </=.05), and beef ( P </=.01) compared to childhood. Milk consumption decreased, but the decrease was greater among males ( P </=.0001). Sweetened beverage consumption increased, but the increase was greater for European Americans ( P </=.0001). Candy consumption decreased, but the decrease was greater for African Americans ( P </=.05).

CONCLUSIONS

Changes occur in food group consumption patterns from childhood to young adulthood. Overall, there was a decrease in diet quality during this age transition. Understanding eating habits of children early in life is important for planning effective intervention strategies.

Predictors of reported consumption of low-nutrient-density foods in a 24-h recall by 8–16 year old US children and adolescents

The purpose of this study was to develop an explanatory model to predict the number of low-nutrient-density (LND) foods reported in a 24-h recall by US children and adolescents using data from the third National Health and Nutrition Examination Survey. The reported number of LND foods was estimated from 24-h dietary recall data for 8-16 year old respondents (n=4137; 2024 males and 2113 females). The LND foods included--baked and dairy desserts, sweeteners, salty snacks, visible/discretionary fat, and miscellaneous. The predictive ability of socio-demographic, family, weight/dieting related, life-style or food consumption related subject characteristics was determined using multiple linear regression analyses. The strongest independent negative predictor of the reported number of LND foods was the amount of nutrient-dense foods from the five major food groups. In addition, number of eating occasions reported was a significant independent positive predictor, and the weekly frequency of consuming a complete school lunch was a significant independent negative predictor of the reported number of LND foods. These models explained approximately 55% of the variance in LND food reporting in both males and females. Socio-demographic, family, body weight, or lifestyle characteristics contributed little to predicting the number of LND foods reported in a 24-h recall.

Association of self-perceived body weight status with dietary reporting by U.S. teens

OBJECTIVE

Children's self perception of body weight and the medical definition of obesity show poor correlation. This study examined the independent associations of body mass index (BMI) and self-perceived weight status (considered self over-, under-, or right weight) with food reporting, nutrient intake estimates, and biomarkers of dietary exposure.

RESEARCH METHODS AND PROCEDURES

Dietary (one 24-hour recall), anthropometric, and biochemical data were from the third National Health and Nutrition Examination Survey (1269 boys and 1385 girls, ages 12 to 18 years). Sex-specific multiple regression analyses were used to determine the association of BMI and self-perceived body weight status with reported intakes of energy, macronutrients, low-nutrient-dense foods, micronutrients, and serum concentrations of selected vitamins and carotenoids.

RESULTS

Reported intakes of energy, macronutrients, number of eating occasions, percentage of energy from low-nutrient-dense foods, likelihood of meeting the standard of intake of micronutrients, and biomarkers were not different among boys and girls who perceived themselves as overweight relative to those who perceived themselves at the right weight (p > 0.05). In boys, BMI was a negative predictor of percentage of energy from low-nutrient-dense foods (p = 0.004) and intake of ascorbic acid (p = 0.04). BMI was inversely related to serum concentrations of most carotenoids (p < or = 0.002).

DISCUSSION

Perceiving oneself as overweight was not associated with reporting of low-nutrient-dense foods, macronutrients, micronutrients, and biomarker status; BMI, however, was a significant predictor of several outcomes.

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information

It is the position of the American Dietetic Association that all foods can fit into a healthful eating style. The ADA strives to communicate healthful eating messages to the public that emphasize the total diet, or overall pattern of food eaten, rather than any one food or meal. If consumed in moderation with appropriate portion size and combined with regular physical activity, all foods can fit into a healthful diet. Public policies that support the total diet approach include Reference Dietary Intakes, Food Guide Pyramid, Dietary Guidelines for Americans, Nutrition Labeling and Healthy People 2010. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthy eating behaviors. Eating practices are influenced by taste and food preferences, concerns about nutrition and weight control, physiology, lifestyle, environment, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, dietetics professionals plan communications and educational programs that utilize theories and models related to human behavior. Communication campaigns/programs should implement an active, behaviorally focused approach within the larger context of food choices. Nutrition confusion can be reduced by emphasizing moderation, appropriate portion size, balance and adequacy of the total diet over time, the importance of obtaining nutrients from foods, and physical activity.

Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988-1994

BACKGROUND

Current dietary guidance recommends limiting the intake of energy-dense, nutrient-poor (EDNP) foods, but little is known about recent consumption patterns of these foods.

OBJECTIVE

The contribution of EDNP foods to the American diet and the associated nutritional and health implications were examined.

DESIGN

Data from the third National Health and Nutrition Examination Survey (n = 15611; age >/=20 y) were used. EDNP categories included visible fats, nutritive sweeteners and sweetened beverages, desserts, and snacks. The potential independent associations of EDNP food intake with intakes of energy, macronutrients, micronutrients, and serum vitamin, lipid, and carotenoid profiles were examined with linear and logistic regression procedures.

RESULTS

EDNP foods supplied approximately 27% of energy intake; alcohol provided an additional 4%. The relative odds of consuming foods from all 5 food groups and of meeting the recommended dietary allowance or daily reference intake for protein and several micronutrients decreased with increasing EDNP food intake (P: < 0.0001). Energy intake and percentage of energy from fat were positively related to EDNP intake. Serum concentrations of vitamins A, E, C, and B-12; folate; several carotenoids; and HDL cholesterol were inversely related (P: </= 0. 0005) whereas serum homocysteine concentration was positively related (P: = 0.02) to EDNP food intake.

CONCLUSIONS

The results suggest that EDNP foods were consumed at the expense of nutrient-dense foods, resulting in 1) increased risk of high energy intake, 2) marginal micronutrient intake, 3) poor compliance with nutrient- and food group-related dietary guidance, and 4) low serum concentrations of vitamins and carotenoids.

[Dietary sources of vitamin A, C, E and beta-carotene in a adult Mediterranean population]

OBJECTIVE

Estimation of vitamin A, C, E and beta-carotene food sources, as well as its nutritional intake and density in adult Catalonian population.

METHODOLOGY

A cross-sectional study was conducted over 2,346 individuals obtained from the sample of Catalonian Survey of Nutritional Status aged 18 to 75 years old to estimate usual dietary intake of vitamins A, C, E and beta-carotene using two 24 hour dietary recalls administered in two periods (june-july and november-december of 1992). Replicated 24 hour Recalls allowed for estimation of usual intake. Calculation of food sources for vitamins encompassed three phases: foods transformation into nutrients, aggregation of foods in categories and sum of nutrients by food categories.

RESULTS

Intake of vitamin A (equivalents of retinol of provitamin A and vitamin A), E, C were closely near or higher than RDA. Nutritional density of vitamin C, E and beta-carotene were higher in female group. Nutritional density was positively associated to age for vitamins C, E and beta-carotene. Addition fat was the first source of vitamin E and it reached 33.8% of total vitamin E intake. Vegetables contributed in 17.3 % to the total vitamin C, whereas fruits accounted for 57.9%. Fruits recached 40.6% of the total beta-carotene intake, whereas vegetables accounted for 34.8%. The major contributors of vitamin A were milk and dairy products.

CONCLUSIONS

Nutritional intake of vitamin A, C and E are over the RDA parameters suggesting an healthy nutritional status that must be confirmed and ratify by biochemical assessment. Nutritional densities were higher in female gender than in males in vitamins C, E, and beta-carotene possibly due to a higher intake of total lipids in male gender than in females. Nutritional density was positively associated to age in the same group of vitamins, suggesting a higher intake of empty calories in younger group. Fruits and Vegetables accounted for more than 70% of vitamin C and beta-carotene and major contributors were citrics, carrots, tomatoes, spinach, and cauliflower, highlighting their importance in elaboration of dietary guide lines.

Nutrient intake and food group consumption of 10-year-olds by sugar intake level: the Bogalusa Heart Study

OBJECTIVE

The effect of total sugar intake on nutrient intake and food group consumption was examined in children.

METHODS

Twenty-four hour dietary recalls were collected on a sample of 568 ten-year-olds from two cross-sectional surveys. The population was stratified according to total sugar intake quartiles: < or = 25th (46 g/1000 kcal), 25-50th (67 g/1000 kcal), 50-75th (81 g/1000 kcal) and > or = 75th (106 g/1000 kcal).

RESULTS

No significant difference was shown in energy intakes across the quartiles and no significant race or gender differences were observed in mean total sugar intakes. However, with increasing total sugar intake, there was a significant linear decrease in mean intakes of protein, fat, saturated fat, starch, cholesterol, sodium, vitamins B6 and E, thiamin, niacin, iron, and zinc; and a significant linear increase in mean intakes of carbohydrate, fructose, lactose, sucrose, vitamin D, and calcium. Eating patterns reflected the differing nutrient intakes, with high sugar consumers having significantly higher intakes of total g of candy, beverages and milk and lower intakes of total g of meats, and cheese than lower sugar consumers. The nutritional quality of children's diets high in total sugar appear to be adequate regarding vitamin and mineral intakes and are closer to meeting current dietary fat recommendations.

Diet and nutrition in primary care. From antioxidants to zinc

This article reviews the role of diet in primary prevention based on current epidemiologic and clinical studies. Special consideration is given to circumstances which may require individualizing the dietary prescription. The role of dietary supplements in primary care is discussed. Particular emphasis is given to studies highlighting the clinical importance of specific minerals. Additionally, the practical application of antioxidant vitamins is presented in light of recent research findings.

Indexes of overall diet quality: a review

This article reviews the published indexes of overall diet quality. Approaches used for measuring overall diet quality include those based on examination of the intake of nutrients, food groups, or a combination of both. A majority of the indexes have been examined in relation to nutrient adequacy only; few have been evaluated for assessment of quality according to current dietary guidelines, namely, a diet relatively low in fat that meets energy and nutrient needs. The indexes of overall diet quality were related to the risk of disease more strongly than individual nutrients or foods.

Nutrient patterns, nutritional adequacy, and comparisons with nutrition recommendations among French-Canadian adults in Montreal

OBJECTIVES

A survey was carried out in 1988-89 among French Canadians in Montreal, to provide data on food habits, dietary intakes and sociodemographic factors.

METHODS

Interviewer-administered questionnaires and 7-day food records (7D-FR) were used to gather data.

RESULTS

Some 1,450 individuals (in 845 families) were studied. Complete 7D-FR and sociodemographic data were obtained from 182 children aged 5-18 (44.8% males), and 614 adults aged 19 and over (40.1% males). Most adult respondents greatly surpassed their age-sex specific Canadian Recommended Nutrient Intakes (RNIs), except for low mean energy intakes in women aged 75 years and over (on average, 1477 kcal), and marginally lower than recommended mean calcium consumption, again in the oldest age group (particularly men). Protein furnished 16 to 17% of energy, relative fat intake varied from 34% of energy among the oldest subjects to 38% in 25 to 49 year old women (overall average, 36%). Only 15.3% of respondents consumed < or = 30% relative fat intake; most (66%) were female. Carbohydrate ranged from 45 to 49% (51%) among males and females, respectively. The oldest age group had the highest relative intake of carbohydrates. Saturated fat was 13 to 14% of energy, and the mean P:S ratio was low (.30 to .37). Some respondents had insufficient intakes relative to their RNIs, notably for energy (6.5% of the whole sample; of these, 52.5% were male) and calcium (22.5%; 69.6% females). Contingency table analysis showed this was most evident among participants of low income and education levels, smokers, and female non-smokers.

CONCLUSIONS

French Canadian Montreal adults don't meet the Nutrition Recommendations for Canadians with respect to lowering fat and saturated fat, and increasing complex carbohydrate intakes. Attention should be directed to ensuring adequate consumption of calcium-rich foods, particularly among women in susceptible stages of the lifecycle. Although average alcohol intakes appeared low, some individuals reported high levels of consumption of beer, wine or spirits which suggests the need for further investigation of population alcohol intakes and their effect on dietary choices and nutritional adequacy.