Dietary intake among adults in Trinidad and Tobago and development of a quantitative food frequency questionnaire to highlight nutritional needs for lifestyle interventions

Associations of Fecal Microbiota with Ectopic Fat in African Caribbean Men

OBJECTIVE

The gut microbiome has been associated with visceral fat (VAT) in European and Asian populations; however, associations with VAT and with ectopic fats among African-ancestry individuals are not known. Our objective was to investigate cross-sectional associations of fecal microbiota diversity and composition with VAT and ectopic fat, as well as body mass index (BMI), among middle-aged and older African Caribbean men.

METHODS

We included in our analysis n = 193 men (mean age = 62.2 ± 7.6 years; mean BMI = 28.3 ± 4.9 kg/m2) from the Tobago Health Study. We assessed fecal microbiota using V4 16s rRNA gene sequencing. We evaluated multivariable-adjusted associations of microbiota features (alpha diversity, beta diversity, microbiota differential abundance) with BMI and with computed tomography-measured VAT and ectopic fats (pericardial and intermuscular fat; muscle and liver attenuation).

RESULTS

Lower alpha diversity was associated with higher VAT and BMI, and somewhat with higher pericardial and liver fat. VAT, BMI, and pericardial fat each explained similar levels of variance in beta diversity. Gram-negative Prevotellaceae and Negativicutes microbiota showed positive associations, while gram-positive Ruminococcaceae microbiota showed inverse associations, with ectopic fats.

CONCLUSIONS

Fecal microbiota features associated with measures of general adiposity also extend to metabolically pernicious VAT and ectopic fat accumulation in older African-ancestry men.

Validity and Reproducibility of a Culture-Specific Electronic Food Frequency Questionnaire: A Trinidad and Tobago Diet Assessment Study

Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate (r = .44, P ≤ .0001) for sweetened beverages to high (r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from (r = .08) for water to (r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.

A systematic review of measurement methods used to estimate fluid and beverage intake in free-living, working-age adults

BACKGROUND

Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduced work performance. This systematic review aimed to (1) characterise existing fluid intake measurement tools used in the workplace setting or among free-living, healthy adults of working age and (2) report the current validation status of available assessment tools for use in a UK setting.

METHODS

Three electronic databases were searched for publications measuring beverage intake using a defined tool or method. Additional studies were identified by hand from trial registers, grey literature and reference lists. Eligibility was determined using predefined inclusion/exclusion criteria. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology framework. Narrative synthesis was performed.

RESULTS

The review identified 105 studies. The most frequently reported beverage assessment methods were total diet diaries/records (n = 22), fluid specific diaries/records (n = 18), food and fluid frequency questionnaires (n = 17), beverage-specific frequency questionnaires (n = 23) and diet recalls (n = 11). General dietary measurement tools (measuring beverages as part of total diet) were used in 60 studies, and 45 studies used a beverage-specific tool. This review identified 18 distinct dietary assessment tools, of which 6 were fluid/beverage specific. Twelve tools published relative validity for a beverage-related variable and seven tools for total daily fluid intake (from whole diet or from beverages only).

CONCLUSIONS

Several fluid intake assessment tools were identified; however, few have been fully evaluated for total beverage intake, and none in a UK working population.

A Review of Current Research and Knowledge Gaps in the Epidemiology of Shiga Toxin-Producing Escherichia coli and Salmonella spp. in Trinidad and Tobago

Salmonella and Shiga toxin-producing Escherichia coli are two of the main causes of foodborne disease globally, and while they have been implicated as possible causes of foodborne disease within the Caribbean region, the actual incidence is unknown. Trinidad and Tobago, one of the larger countries in the Caribbean, has an estimated annual foodborne disease burden of over 100,000 cases and, similar to other countries, the etiology of most of these cases is unknown. Both pathogens can reside as part of the normal gastrointestinal microflora of many wild and domestic animals, with animals acting as reservoirs, spillover hosts, or dead-end hosts. Carriage in animal species can be asymptomatic or, in the case of Salmonella in particular, there may be clinical manifestation in animals, which resemble the disease seen in humans. In this review, we will focus on the epidemiology of these two foodborne pathogens in Trinidad and Tobago and identify any knowledge gaps in the published literature. The filling of this critical knowledge void is essential for the development and implementation of appropriate mechanisms to reduce the dissemination and transmission of these pathogens, not only in Trinidad and Tobago, but also in the wider Caribbean.

Trends in energy and nutrient supply in Trinidad and Tobago from 1961 to 2007 using FAO food balance sheets

OBJECTIVE

Trinidad and Tobago has experienced an epidemiological transition over recent decades characterised by reduced rates of communicable diseases but rapidly increasing rates of obesity and non-communicable chronic diseases. The objective of the present study was to investigate the changes in energy and nutrient supply that have taken place in Trinidad and Tobago between 1961 and 2007.

DESIGN

Food balance sheets for each year between 1961 and 2007 were downloaded from the FAOSTAT database and daily per capita supply for seventeen food commodity groupings was calculated. After appropriate coding, energy and nutrient supply were determined using dietary analysis software.

SETTING

FAO food balance sheets for Trinidad and Tobago from 1961 to 2007.

SUBJECTS

None.

RESULTS

The food supply in 2007 provided an extra 1561 kJ (373 kcal)/capita per d than it did in 1961. Energy from carbohydrate as a percentage of total energy fell from 62% in 1961 to 57% in 2007, whereas energy from fat as a percentage of total energy increased from 26% to over 30% and now lies at the upper end of WHO recommendations. Sugars increased from 20% to over 26% of total energy and are well above WHO recommendations. When expressed on a nutrient density basis, supplies of vitamin A, folate and Ca are lower than WHO recommendations.

CONCLUSIONS

Nutritional imbalances in the Trinidadian food supply need to be addressed to combat the rise in nutrition-related chronic disease that is projected to cause increased disability and premature death in the country in the coming years.