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Pinto E, Viegas C, Martins PV, Nascimento T, Schurgers L, Simes D. New Food Frequency Questionnaire to Estimate Vitamin K Intake in a Mediterranean Population. Nutrients 2023; 15:3012. [PMID: 37447338 DOI: 10.3390/nu15133012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Vitamin K is a multifunctional micronutrient essential for human health, and deficiency has been linked to multiple pathological conditions. In this study, we aimed to develop and validate a new food frequency questionnaire (FFQ) to estimate total vitamin K intake, over the course of a 30-day interval, in a Portuguese, Mediterranean-based, population. We conducted a prospective study in a non-random sample of 38 healthy adult volunteers. The FFQ was designed based on a validated Portuguese FFQ used in nationally representative studies and on literature reviews, to include foods containing ≥5 μg of vitamin K/100 g and foods with a lower vitamin K content, yet commonly included in a Mediterranean diet. Vitamin K intake was estimated from 24 h recalls and six days of food records. The final FFQ included 54 food items which, according to regression analyses, explains 90% of vitamin K intake. Mean differences in vitamin K intake based on food records (80 ± 47.7 μg/day) and on FFQ (96.5 ± 64.3 μg/day) were statistically non-significant. Further, we found a strong correlation between both methods (r = 0.7; p = 0.003). Our results suggest that our new FFQ is a valid instrument to assess the last 30 days of vitamin K intake in the Portuguese Mediterranean population.
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Affiliation(s)
- Ezequiel Pinto
- Centro de Estudos e Desenvolvimento em Saúde, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
| | - Carla Viegas
- Centre of Marine Sciences (CCMAR), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
| | - Paula Ventura Martins
- Research Centre for Tourism, Sustainability and Well-Being, CinTurs, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
| | - Tânia Nascimento
- Centro de Estudos e Desenvolvimento em Saúde, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
| | - Leon Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200 MD Maastricht, The Netherlands
| | - Dina Simes
- Centre of Marine Sciences (CCMAR), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal
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Vernia F, Burrelli Scotti G, Bertetti NS, Donato G, Necozione S, Vernia P, Pallotta N. Low Vitamin K and Vitamin D Dietary Intake in Patients with Inflammatory Bowel Diseases. Nutrients 2023; 15:nu15071678. [PMID: 37049518 PMCID: PMC10096607 DOI: 10.3390/nu15071678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The inadequate dietary intake of Vitamin D and Vitamin K is an easily reversible factor favoring IBD-associated bone loss, but data on Vitamin K are lacking. A 28-item quantitative food frequency questionnaire was administered to 193 IBD patients (89 Crohn’s disease and 104 ulcerative colitis), and 199 controls. Patients’ demographics, clinical and laboratory findings were analyzed in relation to recommended daily allowances. VitD intake was inadequate both in the IBD and control patients (8.3 ± 4.5 µg/day in IBD, 53.1% RDA, and 9.7 ± 5.9 µg/day, 63.2% RDA, respectively). Conversely, the mean ViK intake was less than adequate in IBD, at 116.7 ± 116.3 µg/day (78.7% RDA), and high in controls, at 203.1 ± 166.9 µg/day (138.8% RDA). Nonetheless, due to marked inter-individual differences, diets were severely lacking VitK in 40% of UC and 49% of CD patients, more so in females and those with active disease. The intake of Vit D was non-significantly lower in colitis than that in Crohn’s disease (7.9 vs. 8.7 µg/day). The opposite was observed for VitK (123.5 vs. 107.0 µg/day). Thus, the diet lacks the micronutrients involved in bone wellbeing in a large proportion of IBD patients. While VitD supplementation is the rule, VitK shortages need proactive nutritional intervention.
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Affiliation(s)
- Filippo Vernia
- Division of Gastroenterology, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: ; Tel.: +39-0862-368760
| | - Giorgia Burrelli Scotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Noemi Sara Bertetti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Donato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Necozione
- Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Piero Vernia
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Nadia Pallotta
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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Varsamis N, Christou GA, Derdemezis C, Tselepis A, Kiortsis D. The Associations of Dietary Vitamin K Intake and Circulating Vitamin 25(OH)D with Serum Lipoprotein Levels: The Vitamin Deficiency Matters. Horm Metab Res 2023; 55:196-204. [PMID: 36848929 DOI: 10.1055/a-2020-2080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A synergistic interplay between vitamins K and D appears to exist. We aimed to investigate for the first time whether the associations of dietary vitamin K intake and circulating 25(OH)D with serum lipoprotein levels are influenced by the existence of deficiency of either or both vitamins K and D. Sixty individuals [24 males, 36(18-79) years old] were examined. Vitamin deficiency of K1 and D were defined as vitamin K1 intake/body weight (BW)<1.00 μg/kg/day and circulating 25(OH)D<20 ng/ml, respectively. In individuals with vitamin K1 deficiency, the vitamin K1 intake/BW correlated positively with high density lipoprotein-cholesterol (HDL-C) (r=0.509, p=0.008) and negatively with serum triglycerides (TG) (r=-0.638, p=0.001), whereas circulating 25(OH)D correlated negatively with TG (r=-0.609, p=0.001). In individuals with vitamin D deficiency, the vitamin K1 intake/BW correlated positively with HDL-C (r=0.533, p=0.001) and negatively with TG (r=-0.421, p=0.009), while circulating 25(OH)D correlated negatively with TG (r=-0.458, p=0.004). The above-mentioned associations of vitamin K1 intake/BW and circulating 25(OH)D with serum lipoproteins were not detected in individuals without vitamin K1 deficiency or the ones without vitamin D deficiency. The vitamin K2 intake/BW correlated negatively with low density lipoprotein-cholesterol (LDL-C) (r=-0.404, p=0.001). In conclusion, the associations of vitamin K1 intake with TG and HDL-C and of circulating 25(OH)D with TG were more pronounced in individuals with deficiency of either or both vitamins K1 and D. Increased dietary vitamin K2 intake was associated with decreased LDL-C.
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Affiliation(s)
- Nikolaos Varsamis
- Atherothrombosis Research Centre, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Georgios A Christou
- Atherothrombosis Research Centre, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Christos Derdemezis
- Atherothrombosis Research Centre, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Alexandros Tselepis
- Atherothrombosis Research Centre/Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece
| | - Dimitrios Kiortsis
- Atherothrombosis Research Centre, University of Ioannina Faculty of Medicine, Ioannina, Greece
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Zouine N, Lhilali I, Menouni A, Godderis L, El Midaoui A, El Jaafari S, Zegzouti Filali Y. Development and Validation of Vitamin D- Food Frequency Questionnaire for Moroccan Women of Reproductive Age: Use of the Sun Exposure Score and the Method of Triad's Model. Nutrients 2023; 15:nu15040796. [PMID: 36839154 PMCID: PMC9967684 DOI: 10.3390/nu15040796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/08/2023] Open
Abstract
This cross-sectional study aimed to develop and validate a vitamin D food frequency questionnaire (VitD-FFQ) to assess vitamin D intake in Moroccan women of reproductive age. Using the method of triads, the VitD-FFQ was validated against seven-day dietary records (7d-FR) and 25-hydroxyvitamin D (25(OH)D) as a biomarker of vitamin D status in 152 women (aged 18-45 years). Participants' sun exposure scores (SES) were assessed using a specific questionnaire (SEQ). Predictors of vitamin D status were identified via linear regression models. Several statistical tests were applied to evaluate the criterion validity of the FFQ against two references methods (7d-FR and the biomarker-serum 25(OH)D). Median (Interquartile range) intakes were 7.10 ± 6.95 µg /day and 6.33 ± 5.02 µg/ day, respectively, for VitD-FFQ and 7d-FR. Vitamin D status was mainly determined by SES (R = 0.47) and vitamin D absolute food intakes derived by the VitD-FFQ (R = 0.56), which demonstrated a more significant prediction ability compared to 7d-FR (R = 0.36). An agreement was observed between the VitD-FFQ and 7d-FR (BA index of 3.29%) with no proportional bias (R2 = 0.002, p = 0.54). <10% of participants were incorrectly classified, and weighted kappa statistics showed that VitD-FFQ had an acceptable ranking ability compared to the 7d-FR and the biomarker. The validity coefficient for the VitD-FFQ was high: ρQR = 0.90 (95%CI: 0.89-0.92), and a range from 0.46 to 0.90. Adjustment for the participants' SES and BMI (body mass index) improved the biomarker's validity coefficient (ρRB 0.63 (95% CI 0.39-0.82). Our results indicate that the VitD-FFQ is valid for estimating absolute vitamin D intake in Moroccan women of reproductive age.
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Affiliation(s)
- Noura Zouine
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Higher Institute of Nursing and Health Professions of Fes-Meknes Annex, Meknes 50000, Morocco
| | - Ilham Lhilali
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Higher Institute of Nursing and Health Professions of Fes-Meknes Annex, Meknes 50000, Morocco
| | - Aziza Menouni
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Health and Environment Unit, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Lode Godderis
- Health and Environment Unit, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
| | - Adil El Midaoui
- Faculty of Sciences and Techniques, Errachidia, Moulay Ismail University of Meknes, Errachidia 52000, Morocco
- Department of Pharmacology and Physiology, Faculty of Medicine, University of Montreal, Montreal, QC H3C 3J7, Canada
- Correspondence:
| | - Samir El Jaafari
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
| | - Younes Zegzouti Filali
- Cluster of Competency “Environment and Health”, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- BASE Laboratory, FSM-FSTE, Moulay Ismail University of Meknes, Meknes 50000, Morocco
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Development of a Semi-Quantitative Food Frequency Questionnaire to Estimate Macronutrient Intake among Type 2 Diabetes Mellitus Patients in Malaysia. Nutrients 2023; 15:nu15030506. [PMID: 36771212 PMCID: PMC9921655 DOI: 10.3390/nu15030506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
The Food Frequency Questionnaire (FFQ) is one of the most frequently used instruments in epidemiological studies for evaluating dietary intake. Because of the variety of dietary habits within different populations, an FFQ must be tailored to the specific group. To date, no specific FFQ has been developed for type 2 diabetes mellitus (T2DM) patients in Malaysia. In this study, we developed a semi-quantitative FFQ to estimate macronutrient intake among T2DM patients. The development of the FFQ was based on the data acquired from 150 respondents with T2DM from the southern part of Peninsular Malaysia who completed the three-day 24-h dietary recalls. The respondents were selected by convenience sampling. The mean intake from each food item and the proportions of macronutrients were calculated. The approach from a previous study was used to compile a list of foods items with a cumulative 90% macronutrient contribution that is significant for the nutrient of interest. In conclusion, we have successfully developed a new semi-quantitative FFQ with a total of 79 food items and nine food groups. The frequencies of the FFQ were divided into nine categories and this FFQ represents the usual food intake of T2DM patients in Malaysia. However, this tool has yet to be validated in patients with T2DM in Malaysia.
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Hribar M, Žlavs K, Pravst I, Žmitek K. Validation of the food frequency questionnaire for the assessment of dietary vitamin D intake. Front Nutr 2022; 9:950874. [PMID: 36211494 PMCID: PMC9537601 DOI: 10.3389/fnut.2022.950874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/26/2022] [Indexed: 11/14/2022] Open
Abstract
Vitamin D and its adequate status are related to many aspects of human health; therefore, an appropriate tool is needed for the valid assessment of vitamin D status. The main contributor to vitamin D status is endogenous synthesis after cutaneous exposure to ultraviolet B light (UVB), but in the absence of UVB radiation, vitamin D intake becomes an important source of vitamin D. Various tools are available for vitamin D intake assessments, with the Food Frequency Questionnaire (FFQ) being among the fastest, cheapest, and most convenient; however, until now, these tools have not been adapted for the Slovenia (SI). To enable valid vitamin D intake estimation, we developed a simple one-page semi-quantitative FFQ (sqFFQ/SI) and tested its validity using a 5-day dietary record (DR) as a reference method. The reproducibility was tested with the second sqFFQ/SI (sqFFQ/SI2) 6 weeks after the first (sqFFQ/SI1). The validity and reproducibility of this method were tested on 54 participants using Bland–Altman plots, Spearman’s correlation, and Kappa analyses of tertiles. The mean daily vitamin D intake was 3.50 ± 1.91 μg according to the 5-day DR, and 2.99 ± 1.35 and 3.31 ± 1.67 μg according to the sqFFQ/SI1 and repeated sqFFQ/SI (sqFFQ/SI2), respectively. When analyzing for validity, the sqFFQ/SI1 was found to be significantly correlated (p < 0.05) with the 5-day DR, with an acceptable correlation coefficient of 0.268 and a Bland–Altman index of 3.7%. For reproducibility, the correlation between the sqFFQ/SI1 and sqFFQ/SI2 was highly significant (p < 0.001), with a good correlation coefficient of 0.689 and a Bland–Altman index of 3.7%. Kappa analyses of tertiles showed a poor validity and acceptable reproducibility. Overall, we observed a higher reproducibility than validity. Validation and reproducibility analyses demonstrated that the proposed sqFFQ/SI is acceptable and is, therefore, an appropriate tool for the effective assessment of habitual vitamin D intake on an individual level. With this consideration, this tool will be used in further population studies to assess vitamin D intake and for the development of a screening tool for the assessment of the risk for vitamin D deficiency, which will be used as a foundation for evidence-based policy-making decisions.
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Affiliation(s)
- Maša Hribar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Žlavs
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
- *Correspondence: Igor Pravst,
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
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Andrade JM, Grandoff PG, Schneider ST. Vitamin D Intake and Factors Associated With Self-Reported Vitamin D Deficiency Among US Adults: A 2021 Cross-Sectional Study. Front Nutr 2022; 9:899300. [PMID: 35634404 PMCID: PMC9131078 DOI: 10.3389/fnut.2022.899300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Vitamin D deficiency is a global issue that may be attributed to various factors such as dietary habits, sun exposure, age, race and chronic conditions. The purpose of this study was to determine the relationship between vitamin D intake from food/supplements and factors that may be associated with self-reported vitamin D deficiency among US adults. A cross-sectional online study was conducted among 1,637 adults using a 38-item questionnaire. Frequency counts and percentages were tabulated and a multiple linear regression was performed. Statistical significance was determined at p < 0.05. Participants (n = 554, 33.8%) were considered vitamin D deficient and consumed an average of 347.05 ± 307.8 IUs of vitamin D through foods/beverages. The multivariate linear regression showed no statistically significant difference with vitamin D intake from foods/beverages on vitamin D deficiency status. Significant positive correlations were seen with vitamin D deficiency status and certain chronic conditions such as chronic kidney disease (p = 0.04), depression (p < 0.001), diabetes (p = 0.02), and vitamin D supplement use (p < 0.001). Significant negative correlations were observed with vitamin D deficiency status and age (p = 0.01) and sun exposure (p < 0.001). Future focus should be on educating individuals about factors associated with vitamin D to reduce the prevalence of vitamin D deficiency.
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Abidi SHR, Almas A, Ghani A, Sabir S, Iqbal R. Assessment of macronutrients consumption in the diet of adolescent school children in four seasons: a longitudinal study from an urban city in Pakistan. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:43. [PMID: 34656183 PMCID: PMC8520200 DOI: 10.1186/s41043-021-00268-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND A healthy diet in the adolescence period is essential for physical, mental, and immunological development. We aimed to assess macronutrient consumption in the diet of adolescent school children using 24 h recalls in four seasons of the year. METHOD This was a longitudinal study conducted from February 2014 to June 2015. The study population included 155 school children aged 7-14 years from an urban school in Karachi. 24HR recall was conducted on 4 random days of the 4 main seasons. A food composition table was developed where the weight, calories, carbohydrate, fat, and protein content of the food items were listed. Macronutrients quantification was calculated by using proportional weight from the food composition table. Food groups were also assigned to each food item including vegetables, fruits, grains, protein foods, dairy products, and oils. RESULTS A total of 155 adolescent children aged between 7 and 14 years were approached. Out of the 155 preadolescents and adolescents, 150 (96.7%) agreed to participate. The mean (SD) age of the children was 11.31 (1.6) years, and 59% of all the children were males. Overall mean (SD) daily intake for all seasons was 195.31 (86.87) grams of carbohydrates, 94.77 (71.87) grams of proteins, and 55.87 (30.79) grams of fats. Carbohydrates formed 48.16%, protein 21.92%, and fat 29.93% of the total caloric intake. The mean (SD) daily caloric intake was 1517 (644) grams. Overall, the highest source of calories was from carbohydrate 781 (347) Kilocalories (Kcal), followed by fat 502 (277) Kcal and protein 379 (287). The Carbohydrate intake in 24 h was highest in the autumn; 212.81 (85.37), and there was a significant difference in carbohydrate intake in all seasons (p value 0.003). Consumption of discretionary food group was high (31.3%), and consumption of fruits and vegetables was low (29%). CONCLUSION The study reports a suboptimal caloric intake of fewer than 2000 cal/day among the adolescents from school. The highest source of calories was from carbohydrates.The highest consumption of food was in autumn and the least in summer. Fruits and vegetable intake was low, and discretionary food intake was high.
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Affiliation(s)
| | - Aysha Almas
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Abdul Ghani
- Health Department, Government of Baluchistan, Chaghi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Romania Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Ganji V, Abu-Dbaa R, Othman H, Zewein M, Al-Abdi T, Shi Z. Validation of Vitamin D-Specific Food Frequency Questionnaire against Food Records for Qatari Women. Foods 2020; 9:foods9020195. [PMID: 32075164 PMCID: PMC7074537 DOI: 10.3390/foods9020195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
The measurement of vitamin D nutritional status through dietary assessment is cost effective. Food frequency questionnaire (FFQ) is usually validated against food records (FR). There is no vitamin D-specific FFQ for Qatar population. The objective of this study was to develop a vitamin D-centric FFQ and validate FFQ against three-day FR for Qatar population. A quantitative FFQ based on vitamin D containing foods consumed in Qatar was developed. Vitamin D contents of foods were gathered from food labels and food composition tables from the United States Department of Agriculture. A vitamin D content database was developed for this study purpose. Dietary intakes while using FFQ and three-day FR were collected from 62 women. Vitamin D intakes from FFQ and three-day FR were validated with quartile comparison and Bland-Altman (BA) tests. BA plot showed an agreement between FFQ and three-day FR vitamin D intakes. The BA index was 3.23%, which is <5%, a commonly used standard for validation. Quartile correlation showed that ≈73% of subjects were within the same or adjacent quartile. In conclusion, an agreement was found between vitamin D intakes from FFQ and three-day FR in Qatari women. More studies are needed to validate the vitamin D-specific FFQ in Qatari population at large.
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Głąbska D, Wojtas M, Guzek D. Development and validation of the semi-quantitative brief food frequency questionnaire to assess the magnesium intake in young women. Nutr Diet 2019; 77:274-282. [PMID: 31793188 DOI: 10.1111/1747-0080.12594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/19/2019] [Accepted: 10/23/2019] [Indexed: 12/31/2022]
Abstract
AIM The aim of the study was to develop and validate the semi-quantitative brief food frequency questionnaire to assess the magnesium intake (Mg-FFQ). METHODS The developed questionnaire consists of 39 questions and it was validated in a group of 75 women aged 20-30. The validity was assessed with reference to the 3-day dietary record and the reproducibility was assessed for a period of 6 weeks. RESULTS The Bland-Altman index for the assessment of validity was 6.7% and for reproducibility-8.0%, while the kappa statistic indicated a slight and substantial agreement, respectively. The high reproducibility was confirmed by a high share of respondents correctly classified into tertiles (73.3%) and correctly classified into categories of adequate/inadequate intake (85.3%). CONCLUSION For the developed and validated Mg-FFQ, a high reproducibility, accompanied by a satisfactory validity, was confirmed, so it may be used to assess the magnesium intake in the epidemiological studies in young Polish women aged 20-30.
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Affiliation(s)
- Dominika Głąbska
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Małgorzata Wojtas
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Dominika Guzek
- Chair of Consumption Research, Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
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Larson-Meyer DE, Douglas CS, Thomas JJ, Johnson EC, Barcal JN, Heller JE, Hollis BW, Halliday TM. Validation of a Vitamin D Specific Questionnaire to Determine Vitamin D Status in Athletes. Nutrients 2019; 11:nu11112732. [PMID: 31717985 PMCID: PMC6893639 DOI: 10.3390/nu11112732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022] Open
Abstract
The study objective was to validate a food frequency and lifestyle questionnaire (FFLQ) to assess vitamin D intake and lifestyle factors affecting status. Methods: Data collected previously during the fall (n = 86), winter (n = 49), and spring (n = 67) in collegiate-athletes (Study 1) and in active adults (n = 123) (Study 2) were utilized. Study 1: Vitamin D intake and ultraviolet B exposure were estimated using the FFLQ and compared to serum 25(OH)D concentrations via simple correlation and linear regression modeling. Study 2: Vitamin D intake from food was estimated using FFLQ and compared to vitamin D intake reported in 7-Day food diaries via paired t-test and Bland–Altman analysis. Results: Study 1: Serum 25(OH)D was not associated with vitamin D intake from food, food plus supplements, or sun exposure, but was associated with tanning bed use (r = 0.39) in spring, supplement use in fall (r = 0.28), and BMI (body mass index) (r = −0.32 to −0.47) across all seasons. Serum 25(OH)D concentrations were explained by BMI, tanning bed use, and sun exposure in fall, (R = 0.42), BMI in winter (R = 0.32), and BMI and tanning bed use in spring (R = 0.52). Study 2: Estimated Vitamin D intake from food was 186.4 ± 125.7 via FFLQ and 148.5 ± 228.2 IU/day via food diary. There was no association between intake estimated by the two methodologies (r = 0.12, p < 0.05). Conclusions: FFLQ-estimated vitamin D intake was not associated with serum 25(OH)D concentration or food-record-estimated vitamin D intake. Results highlight the difficulty of designing/utilizing intake methodologies for vitamin D, as its status is influenced by body size and both endogenous and exogenous (dietary) sources.
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Affiliation(s)
- D. Enette Larson-Meyer
- Department of Family and Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA;
- Division of Kinesiology & Health, University of Wyoming, Laramie, WY 82017, USA;
- Correspondence: ; Tel.: +1-307-766-4378; Fax: +1-307-766-5686
| | - Corey S. Douglas
- Department of Family and Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA;
- Lake Erie College of Osteopathic Medicine, Erie, PA 16509, USA
| | - Joi J. Thomas
- University of Minnesota Athletics, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Evan C. Johnson
- Division of Kinesiology & Health, University of Wyoming, Laramie, WY 82017, USA;
| | | | - Jenna E. Heller
- Wellness Department, Arizona State University, Tempe, AZ 85287, USA;
| | - Bruce W. Hollis
- Dr Bruce Hollis’ Laboratory, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Tanya M. Halliday
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA;
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Ducharme FM, Jensen M, Mailhot G, Alos N, White J, Rousseau E, Tse SM, Khamessan A, Vinet B. Impact of two oral doses of 100,000 IU of vitamin D 3 in preschoolers with viral-induced asthma: a pilot randomised controlled trial. Trials 2019; 20:138. [PMID: 30777118 PMCID: PMC6379931 DOI: 10.1186/s13063-019-3184-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/07/2019] [Indexed: 02/08/2023] Open
Abstract
Background New evidence supports the use of supplemental vitamin D in the prevention of exacerbation of asthma; however, the optimal posology to sufficiently raise serum levels while maximising adherence is unclear. The objective was to ascertain the efficacy of high-dose vitamin D3 in increasing serum vitamin D in preschoolers with asthma and provide preliminary data on safety and efficacy outcomes. Methods We conducted a 7-month, triple-blind, randomised, placebo-controlled, pilot trial of children aged 1–5 years with viral-induced asthma. Participants were allocated to receive two oral doses of 100,000 IU vitamin D3 (intervention) or identical placebo (control) 3.5 months apart, once in the fall and once in the winter. Serum 25-hydroxyvitamin D (25OHD) was measured by tandem mass spectrometry at baseline, 10 days, 3.5 months, 3.5 months + 10 days, and 7 months. The main outcome was the change in serum 25OHD from baseline (Δ25OHD) over time and at 3.5 and 7 months; other outcomes included the proportion of children with 25OHD ≥ 75 nmol/L, safety, and adverse event rates. Results Children (N = 47) were randomised (intervention, 23; control, 24) in the fall. There was a significant adjusted group difference in the Δ25OHD (95% confidence interval) of 57.8 (47.3, 68.4) nmol/L, p < 0.0001), with a time (p < 0.0001) and group*time interaction effect (p < 0.0001), in favour of the intervention. A significant group difference in the Δ25OHD was observed 10 days after the first (119.3 [105.8, 132.9] nmol/L) and second (100.1 [85.7, 114.6] nmol/L) bolus; it did not reach statistical significance at 3.5 and 7 months. At 3.5 and 7 months, respectively, 63% and 56% of the intervention group were vitamin D sufficient (≥ 75 nmol/L) compared to 39% and 36% of the control group. Hypercalciuria, all without hypercalcaemia, was observed in 8.7% of intervention and 10.3% of control samples at any time point. Exacerbations requiring rescue oral corticosteroids, which appear as a promising primary outcome, occurred at a rate of 0.87/child. Conclusion Two oral boluses of 100,000 IU vitamin D3,once in the fall and once in the winter, rapidly, safely, and significantly raises overall serum vitamin D metabolites. However, it is sufficient to maintain 25OHD ≥ 75 nmol/L throughout 7 months in only slightly more than half of participants. Trial registration ClinicalTrials.gov, NCT02197702 (23 072014). Registered on 23 July 2014. Electronic supplementary material The online version of this article (10.1186/s13063-019-3184-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francine Monique Ducharme
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, Sainte-Justine University Health Centre, Montreal, Quebec, Canada. .,Department of Pediatrics, University of Montreal, Sainte-Justine University Health Centre, 3175 Côte Ste-Catherine, Montreal, Quebec, H3T 1C5, Canada. .,Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada.
| | - Megan Jensen
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, Sainte-Justine University Health Centre, Montreal, Quebec, Canada
| | - Geneviève Mailhot
- Department of Nutrition, University of Montreal, Montreal, Quebec, Canada
| | - Nathalie Alos
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - John White
- Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Elizabeth Rousseau
- Department of Pediatrics, University of Montreal, Sainte-Justine University Health Centre, 3175 Côte Ste-Catherine, Montreal, Quebec, H3T 1C5, Canada
| | - Sze Man Tse
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, Sainte-Justine University Health Centre, Montreal, Quebec, Canada.,Department of Pediatrics, University of Montreal, Sainte-Justine University Health Centre, 3175 Côte Ste-Catherine, Montreal, Quebec, H3T 1C5, Canada
| | - Ali Khamessan
- Euro-Pharm International Canada, Montreal, Quebec, Canada
| | - Benjamin Vinet
- Clinical Research and Knowledge Transfer Unit on Childhood Asthma, Research Centre, Sainte-Justine University Health Centre, Montreal, Quebec, Canada
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Abstract
Sickle cell disease (SCD) and vitamin D deficiency share manifestations such as bone complications and bony pains. Canadian SCD children are characterized by compromised sun exposure all year long and potential dietary deficiency, which combined to SCD-causing high nutritional demands, may lead to impaired vitamin D status. The objectives of this study were to document vitamin D status and intake and assess the relationship between vitamin D status and SCD-related outcomes in Canadian children with SCD followed in a tertiary pediatric center. Our study population included 119 children (47% males, median age [interquartile range]: 11.1 [9.2-14.8]) mainly of Haitian and Sub-Saharan African origin who had at least one measure of serum 25-hydroxyvitamin D (25OHD) performed between June 2015 and February 2017. Predominant genotypes were homozygous hemoglobin S (60%) and sickle hemoglobin-C (32%). Vitamin D deficiency (25OHD<30 nmol/L) and insufficiency (30 to 49 nmol/L) were present in 31% and 37% of children, respectively. Vitamin D-sufficient children (25OHD>50 nmol/L) had higher hemoglobin levels, lower leukocyte, reticulocyte, and neutrophil counts, compared with vitamin D-deficient and insufficient children. Vitamin D intake was low and modestly correlated to serum 25OHD levels. Acute SCD complications in the preceding 2 years were not associated with vitamin D status in these children.
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Głąbska D, Uroić V, Guzek D, Pavić E, Bival S, Jaworska K, Giljević Z, Lange E. The Possibility of Applying the Vitamin D Brief Food Frequency Questionnaire as a Tool for a Country with No Vitamin D Data in Food Composition Tables. Nutrients 2018; 10:E1278. [PMID: 30201901 PMCID: PMC6164093 DOI: 10.3390/nu10091278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 11/17/2022] Open
Abstract
Although the role of vitamin D is well known, the possibility of assessing its intake may be constricted in countries with no vitamin D data in food composition tables, as in the case of Croatia. The aim of the presented study was to adjust the VIDEO-FFQ (Vitamin D Estimation Only-Food Frequency Questionnaire), previously validated in Poland, to the Croatian population and to assess the validity and reproducibility of the adjusted Cro-VIDEO-FFQ (Croatian-VIDEO-FFQ). The study involved a group of Croatian women aged 20⁻30 and the Polish questionnaire was adjusted for a population due to similarities of the nutritional habits between countries. 106 individuals were recruited and 63 completed all the stages of the study. Participants conducted a 3-day dietary record and filled out the Cro-VIDEO-FFQ1 (first stage), as well as the same questionnaire (Cro-VIDEO-FFQ2) 6 weeks after (second stage). The following vitamin D intakes were observed in the studied group: 1.9 µg (0.2⁻8.0 µg) for 3-day dietary record, 3.3 µg (1.1⁻10.6 µg) for Cro-VIDEO-FFQ1, 3.6 µg (1.4⁻7.8 µg) for Cro-VIDEO-FFQ2. The Bland-Altman indexes in assessment of validity and reproducibility were 4.8% and 6.3%, respectively, with mean differences of 0.55 µg and 0.12 µg, as well as limits of agreement -0.91⁻2.01 µg and -0.44⁻0.69 µg. The kappa coefficient indicated a fair agreement for validity (0.21) and substantial for reproducibility (0.62), while correlations were significant (p = 0.0027, r = 0.37 for validity; p < 0.0001, r = 0.80 for reproducibility). It was observed that VIDEO-FFQ may be adjusted as a simple tool to assess vitamin D intake in a population with no vitamin D data in food composition tables, while Cro-VIDEO-FFQ may be a valid tool for nutritional assessment in Croatia.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159c Nowoursynowska Str., 02-787 Warsaw, Poland.
| | - Valentina Uroić
- Department of Nutrition and Dietetics, University Hospital Centre Zagreb, 12 Kišpatićeva Str., 10-000 Zagreb, Croatia.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Str., 02-787 Warsaw, Poland.
| | - Eva Pavić
- Department of Nutrition and Dietetics, University Hospital Centre Zagreb, 12 Kišpatićeva Str., 10-000 Zagreb, Croatia.
| | - Sandra Bival
- Department of Nutrition and Dietetics, University Hospital Centre Zagreb, 12 Kišpatićeva Str., 10-000 Zagreb, Croatia.
| | - Kamila Jaworska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159c Nowoursynowska Str., 02-787 Warsaw, Poland.
| | - Zlatko Giljević
- Division of Endocrinology, Department of Internal Medicine, University Hospital Centre, 12 Kišpatićeva Str., 10-000 Zagreb, Croatia.
- Department of Internal Medicine, School of Medicine, University of Zagreb, 3 Šalata Str., 10-000 Zagreb, Croatia.
| | - Ewa Lange
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159c Nowoursynowska Str., 02-787 Warsaw, Poland.
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Markers of Bone Health, Bone-Specific Physical Activities, Nutritional Intake, and Quality of Life of Professional Jockeys in Hong Kong. Int J Sport Nutr Exerc Metab 2018; 28:440-446. [PMID: 28556673 DOI: 10.1123/ijsnem.2016-0176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Weight-making practices, regularly engaged in by horse racing jockeys, have been suggested to impair both physiological and mental health. This study aimed to assess bone health markers, nutritional intake, bone-specific physical activity (PA) habits, and quality of life of professional jockeys in Hong Kong (n = 14), with gender-, age-, and body mass index-matched controls (n = 14). Anthropometric measurements, serum hormonal biomarkers, bone mineral density, bone-specific PA habits, nutritional intake, and quality of life were assessed in all participants. The jockey group displayed significantly lower bone mineral density at both calcanei than the control group (left: 0.50 ± 0.06 vs. 0.63 ± 0.07 g/cm2; right: 0.51 ± 0.07 vs. 0.64 ± 0.10 g/cm2, both ps < .01). Thirteen of the 14 jockeys (93%) showed either osteopenia or osteoporosis in at least one of their calcanei. No significant difference in bone mineral density was detected for either forearm between the groups. The current bone-specific PA questionnaire score was lower in the jockey group than the control group (5.61 ± 1.82 vs. 8.27 ± 2.91, p < .05). Daily energy intake was lower in the jockeys than the controls (1,360 ± 515 vs. 1,985 ± 1,046 kcal/day, p < .01). No significant group difference was found for micronutrient intake assessed by the bone-specific food frequency questionnaire, blood hormonal markers, and quality of life scores. Our results revealed suboptimal bone conditions at calcanei and insufficient energy intake and bone-loading PAs among professional jockeys in Hong Kong compared with healthy age-, gender-, and body mass index-matched controls. Further research is warranted to examine the effect of improved bone-loading PAs and nutritional habits on the musculoskeletal health of professional jockeys.
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Morel S, Portolese O, Chertouk Y, Leahy J, Bertout L, Laverdière C, Krajinovic M, Sinnett D, Levy E, Marcil V. Development and relative validation of a food frequency questionnaire for French-Canadian adolescent and young adult survivors of acute lymphoblastic leukemia. Nutr J 2018; 17:45. [PMID: 29679986 PMCID: PMC5911374 DOI: 10.1186/s12937-018-0355-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/10/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Survivors of childhood acute lymphoblastic leukemia (cALL) experience cardiometabolic and bone complications after treatments. This study aimed at developing and validating an interview-administrated food frequency questionnaire (FFQ) that will serve to estimate the impact of nutrition in the development of long-term sequalea of French-Canadian cALL survivors. METHODS The FFQ was developed to assess habitual diet, Mediterranean diet score, nutrients promoting bone health and antioxidants. It was validated using a 3-day food record (3-DFR) in 80 cALL survivors (50% male) aged between 11.4 and 40.1 years (median of 18.0 years). Reproducibility was evaluated by comparing FFQs from visit 1 and 2 in 29 cALL survivors. RESULTS When compared to 3-DFR, the mean values for macro- and micronutrient intake were overestimated by our FFQ with the exception of lipid-related nutrients. Correlations between nutrient intakes derived from the FFQs and the 3-DFRs showed moderate to very good correlations (0.46-0.74). Intraclass correlation coefficients assessing FFQ reproducibility ranged from 0.62 to 0.92, indicating moderate to good reliability. Furthermore, classification into quartiles showed more than 75% of macro- and micronutrients derived from FFQs 1 and 2 classified into the same or adjacent quartile. CONCLUSIONS Overall, our results support the reproducibility and accuracy of the developed FFQ to appropriately classify individuals according to their dietary intake. This validated tool will be valuable for future studies analyzing the impact of nutrition on cardiometabolic and bone complications in French-speaking populations.
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Affiliation(s)
- Sophia Morel
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6 Canada
| | - Olivia Portolese
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Yasmine Chertouk
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Jade Leahy
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Laurence Bertout
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Caroline Laverdière
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Maja Krajinovic
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Daniel Sinnett
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5 Canada
| | - Emile Levy
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6 Canada
| | - Valérie Marcil
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5 Canada
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6 Canada
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17
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Assessment of dietary calcium intake of university students: a pilot study in Turkey. Arch Osteoporos 2018; 13:36. [PMID: 29600439 DOI: 10.1007/s11657-018-0447-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 03/19/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of this study was to adapt the rapid assessment method (RAM) and International Osteoporosis Foundation Food Frequency Questionnaire (IOF FFQ) tools, used for the assessment of daily calcium intake in university students, and to compare the data obtained using 24-h recall (24-HR) data. There was a moderate positive correlation between the RAM and IOF. PURPOSE/INTRODUCTION Calcium is an essential mineral that plays vital roles in metabolism and it is very important to accurately assess the amount of calcium intake on the diet. It was aimed to assess the daily calcium intake of university students by two different food frequency questionnaires (FFQs) developed specifically for evaluating calcium intake, and 24-h recall method. METHOD The study was conducted with a total of 183 female university students aged 18-31. In the study, a questionnaire including sociodemographic information, a calcium calculator, IOF FFQ, prepared in seven different languages, and RAM was applied. In addition, 1-day food consumption records were obtained using 24-HR method. RESULTS The daily average calcium intakes of individuals according to two different food frequency questionnaires (RAM FFQ and IOF FFQ) and 24-h food consumption records are respectively 1594.2 ± 810.9, 897.9 ± 368.4, and 605.6 ± 278.3 mg. When the daily average calcium intake was compared with the other two methods, RAM was found to be statistically higher (p < 0.001). There was a moderate positive correlation between the RAM and IOF FFQ methods (Pearson r = 0.528, p < 0.01) and the intra-class correlation coefficient between these two methods was found to be significant and moderate (ICC r = 0.452, p < 0.01). CONCLUSION In terms of protecting and improving health, it is important to make suggestions using fast and short tools to ensure adequate calcium intake from young age. It is thought that FFQs are the most appropriate methods in assessing daily calcium intake for this study group because it is observed that the list of foods and the amount of portions in FFQs reduce the problem of remembering at 24-h method to a great extent.
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Nematollahi M, Eslami AA. Development and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT) for Iranian women. Health Promot Perspect 2018; 8:54-62. [PMID: 29423363 PMCID: PMC5797309 DOI: 10.15171/hpp.2018.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 08/22/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Osteoporosis is common among women which may be mostly due to the low intake of calcium. This article reports the development, cultural adaptation and psychometric properties of a Calcium Intake Questionnaire based on the social cognitive theory (CIQ-SCT)among Iranian women. Methods: In 2016, this cross-sectional study was carried out among 400 younger than 50 years old women in Isfahan, Iran. After literature review, a preliminary 35-item questionnaire was developed. Then, forward-backward translation and cultural adaptation of the tool was conducted. Content Validity Index confirmed by an expert panel and Face Validity was evaluated in a pilot study. Exploratory and confirmatory factor analyses (EFA &CFA) were conducted on the calibration and validation sample, respectively. Reliability was also assessed using internal consistency test. Results: After determining content and face validity, 20 items with 5 factors (self-efficacy,outcome expectations, social support and self-regulation) were obtained. Cronbach alpha for the instrument was found to be 0.901. In EFA, we identified a 4-factor model with a total variance of 72.3%. The results related to CFA (CMIN/DF=1.850, CFI =0.946, TLI=0.938, RMSEA=0.069[90% CI: 0.057-0.081]) indicated that the model was fit to the social cognitive theory. Self regulation was detected as the best predictor for calcium intake. Conclusion: The CIQ-SCT showed acceptable levels of reliability and validity in explaining the calcium intake based on the constructs of social cognitive theory. Further psychometric testing is recommended in different population to approve the external validity of the instrument.
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Affiliation(s)
- Mahin Nematollahi
- Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Ali Eslami
- Department of Health Education, Isfahan University of Medical Sciences, Isfahan, Iran
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Pehowich DJ, Pehowich ED. Evidence of dietary calcium and vitamin D inadequacies in a population of dental patients. J Evid Based Dent Pract 2016; 16:213-219. [PMID: 27938693 DOI: 10.1016/j.jebdp.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To determine the dietary calcium and vitamin D intake of a cohort of dental patients identified as being at risk of inadequacy based on a 24-hour food recall. METHODS A retrospective chart analysis was carried out on 5-day food record and nutrient analyses of 670 dental patients aged 18 to 82 years obtained over a 10-year period. All patients had scored poorly on a 24-hour food recall survey during their initial examination. RESULTS The overall mean and median calcium and vitamin D intakes of the patients were significantly lower than the current estimated needs for the general population. Although calcium intake did not change over the 10-year period, vitamin D consumption decreased. The greatest dietary intake inadequacies for both calcium and vitamin D were seen in both male and female patients over age 50 years. CONCLUSIONS A 24-Hour Food Recall Questionnaire may be an effective means for the oral health professional to screen patients for calcium and vitamin D and other nutrient inadequacies. CLINICAL SIGNIFICANCE Screening for potential dietary inadequacies of calcium and vitamin D may identify patients potentially at risk for poor bone health. Our results indicate that the dental health professional can obtain evidence necessary to change patient dietary behavior and thus contribute to successful treatment outcomes.
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Affiliation(s)
- Daniel J Pehowich
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Enid D Pehowich
- Department of Cellular Biology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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20
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Hoffmann MR, Senior PA, Jackson ST, Ferland G, Presse N, Jindal K, Li P, Alzaben AS, Mager DR. Vitamin D Status and Bone Mineral Density is Influenced by Vitamin D Supplementation and Vitamin K1 Intake in Adults with Diabetes and Chronic Kidney Disease. CAN J DIET PRACT RES 2016; 78:11-19. [PMID: 27779902 DOI: 10.3148/cjdpr-2016-023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Patients with diabetes (DM) and chronic kidney disease (CKD) are at increased risk for suboptimal bone health. The study objective was to investigate the relationships between vitamin D (vitD), vitamin K1 (vitK1), and calcium intake with bone mineral density (BMD) and vitamin D status in an ambulatory population with DM and CKD. METHODS Adults (age 18-80 years; n = 62) with DM and CKD (stages 1-4) were recruited from the Northern Alberta Renal Program. Primary outcome variables included vitD, vitK1, and calcium intake; serum 25(OH)D, 1,25(OH)2D; and BMD as measured by dual X-ray absorptiometry. Statistical significance was determined at P < 0.05. RESULTS Participants met the estimated average requirement or adequate intake for vitD, vitK1, and calcium intake in 73% (n = 45), 66% (n = 39), and 52% (n = 31), respectively, with a combined intake of micronutrient supplementation and diet. Participants had serum 25(OH)D concentrations ≥75 nmol/L (n = 41), normal BMDs (n = 48), and 66% (n = 41/62) were taking vitD supplements (>1000 IU/D). BMD was positively influenced by serum 25(OH)D. However, serum 25(OH) ≥100 nmol/L was associated with lower BMD (absolute and T-scores) for whole-body and spine (P ≤ 0.05). VitK1 intake (≥200 μg/day) was associated with higher whole-body and femoral-neck BMDs (absoluteand T-scores; P ≤ 0.05). CONCLUSION VitD status and BMD in adults with DM and CKD was influenced by vitD supplementation and vitK1 intake.
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Affiliation(s)
- Michelle R Hoffmann
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Peter A Senior
- b Divsion of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, AB.,c Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, AB
| | - Stephanie T Jackson
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Guylaine Ferland
- d Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC.,e Département de Nutrition, Université de Montréal, Montreal, QC
| | - Nancy Presse
- d Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC.,e Département de Nutrition, Université de Montréal, Montreal, QC
| | - Kailash Jindal
- f Northern Alberta Renal Program, Edmonton, AB.,g Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, AB
| | - Ping Li
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Abeer S Alzaben
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Diana R Mager
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB.,h Department of Pediatrics, University of Alberta, Edmonton, AB
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Khalesi S, Doshi D, Buys N, Sun J. Validation of a short food frequency questionnaire in Australian adults. Int J Food Sci Nutr 2016; 68:349-357. [PMID: 27744752 DOI: 10.1080/09637486.2016.1240763] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of this article is to report on the validity and internal consistency of a short food frequency questionnaire (FFQ) to measure dietary intake in Australian adults. A total of 407 individuals completed the short FFQ. The Cronbach's alpha of 0.66 indicated acceptable internal consistency for the FFQ. Content validity was measured using factor analysis showed that 35% of total variance was explained by factor analysis. The FFQ was also validated against 31 3-day food records (FR). No significant difference between average intake of energy, most macronutrients, and some micronutrients between two instruments was identified. An acceptable levels of correlation (0.39-0.69) was observed between the two instruments. Bland and Altman's plots showed relative agreement in both instruments with potential bias in measuring iron and iodine. The current FFQ can be an acceptable tool to quickly measuring dietary intake in Australian adults.
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Affiliation(s)
- Saman Khalesi
- a Menzies Health Institute Queensland and School of Medicine , Griffith University , Gold Coast, Australia.,b School of Medical and Applied Sciences , Central Queensland University , Rockhampton , Australia
| | - Deepak Doshi
- c Director Medical Services, Roma Hospital , Southwest Hospital and Health Service, Roma, Bond University , Gold Coast , Australia
| | - Nicholas Buys
- d Menzies Health Institute Queensland, Griffith University , Gold Coast, Australia
| | - Jing Sun
- a Menzies Health Institute Queensland and School of Medicine , Griffith University , Gold Coast, Australia
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Kim E, Kim M, Sohn C. Validity and Reliability of a Self-administered Food Frequency Questionnaire to Assess Vitamin K Intake in Korean Adults. Clin Nutr Res 2016; 5:153-60. [PMID: 27482519 PMCID: PMC4967718 DOI: 10.7762/cnr.2016.5.3.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 07/13/2016] [Accepted: 07/16/2016] [Indexed: 11/24/2022] Open
Abstract
This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings.
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Affiliation(s)
- Eunsu Kim
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
| | - Misung Kim
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
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Yanagisawa A, Sudo N, Amitani Y, Caballero Y, Sekiyama M, Mukamugema C, Matsuoka T, Imanishi H, Sasaki T, Matsuda H. Development and Validation of a Data-Based Food Frequency Questionnaire for Adults in Eastern Rural Area of Rwanda. Nutr Metab Insights 2016; 9:31-42. [PMID: 27429558 PMCID: PMC4936789 DOI: 10.4137/nmi.s38374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 12/31/2022] Open
Abstract
This study aimed to develop and evaluate the validity of a food frequency questionnaire (FFQ) for rural Rwandans. Since our FFQ was developed to assess malnutrition, it measured energy, protein, vitamin A, and iron intakes only. We collected 260 weighed food records (WFRs) from a total of 162 Rwandans. Based on the WFR data, we developed a tentative FFQ and examined the food list by percent contribution to energy and nutrient intakes. To assess the validity, nutrient intakes estimated from the FFQ were compared with those calculated from three-day WFRs by correlation coefficient and cross-classification for 17 adults. Cumulative contributions of the 18-item FFQ to the total intakes of energy and nutrients reached nearly 100%. Crude and energy-adjusted correlation coefficients ranged from -0.09 (vitamin A) to 0.58 (protein) and from -0.19 (vitamin A) to 0.68 (iron), respectively. About 50%-60% of the participants were classified into the same tertile. Our FFQ provided acceptable validity for energy and iron intakes and could rank Rwandan adults in eastern rural area correctly according to their energy and iron intakes.
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Affiliation(s)
- Ayumi Yanagisawa
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Noriko Sudo
- Natural Science Division, Faculty of Core Research, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Yukiko Amitani
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Yuko Caballero
- The Graduate School of Humanities and Sciences, Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Makiko Sekiyama
- Graduate Program in Sustainability Science-Global Leadership Initiative (GPSS-GLI), Graduate School of Frontier Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | | | | | - Hirotaka Matsuda
- Graduate Program in Sustainability Science-Global Leadership Initiative (GPSS-GLI), Graduate School of Frontier Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Perreault M, Xu VYY, Hamilton S, Wright D, Foster W, Atkinson SA. Validation of a Food Frequency Questionnaire for Bone Nutrients in Pregnant Women. CAN J DIET PRACT RES 2016; 77:133-9. [PMID: 27182607 DOI: 10.3148/cjdpr-2016-002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE The aim was to validate a food frequency questionnaire (FFQ) against a 3-day food record (3DFR) for pregnant women with a focus on nutrients important for bone health from food and supplements. METHODS The FFQ and 3DFR were administered to pregnant women (n = 42) aged 18-45 years in their third trimester of pregnancy in Hamilton, Ontario. Nutrient analysis of intakes was conducted using an FFQ calculator and Nutritionist-Pro software. The average daily serving consumption of Milk and alternatives group and Vegetable subgroup from Canada's Food Guide were also compared. RESULTS There was a high positive correlation between methods for total dietary vitamin D (r = 0.83). Low positive associations were observed for total protein (r = 0.37), calcium (r = 0.36), vitamin K (r = 0.41), and servings of Milk and alternatives (r = 0.36). A cross-classification analysis using participants' intake quartiles revealed no major misclassifications. Bland-Altman analysis showed that the FFQ mildly underestimated the intake for protein, whereas it grossly overestimated the intake of vitamin K, and daily servings of Milk and alternatives and Vegetable. CONCLUSIONS This FFQ can serve as a useful tool in clinical and research settings to assess key bone nutrients from foods and supplement sources in pregnant women.
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Affiliation(s)
- Maude Perreault
- a Department of Pediatrics, McMaster University, Hamilton, ON
| | - Victoria Y Y Xu
- a Department of Pediatrics, McMaster University, Hamilton, ON.,b School of Medicine, Queen's University, Kingston, ON
| | - Suzanne Hamilton
- c Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | - Deslyn Wright
- c Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | - Warren Foster
- c Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
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25
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Mailhot G, Perrone V, Alos N, Dubois J, Delvin E, Paradis L, Des Roches A. Cow's Milk Allergy and Bone Mineral Density in Prepubertal Children. Pediatrics 2016; 137:peds.2015-1742. [PMID: 27244780 DOI: 10.1542/peds.2015-1742] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent data suggest that cow's milk allergy (CMA) has become more persistent, prolonging treatment via strict elimination of cow's milk products into a period of skeletal growth. The objectives of this study were to compare bone mineral density (BMD), vitamin D status, and dietary intakes of calcium and vitamin D between prepubertal children with persistent CMA and those with non-cow's milk food allergies (NCMA) as control subjects and to assess the use of and compliance to calcium and vitamin D supplementation among children with persistent CMA. METHODS Fifty-two children with persistent CMA and 29 with NCMA were recruited. BMD was measured by using dual energy radiograph absorptiometry, and vitamin D status was assessed by using plasma 25-hydroxyvitamin D concentrations. Calcium and vitamin D intakes, as well as compliance to calcium and vitamin D supplementation, were recorded. RESULTS Lumbar spine BMD z scores were significantly lower in children with CMA. Low bone mass was detected in 6% of the CMA group compared with none in the NCMA group. Children with CMA displayed significantly lower calcium intakes than control subjects. Vitamin D status was not reduced in children with CMA compared with control subjects. Fewer than one-half of children with CMA reported the use of calcium and vitamin D supplements. However, adherence was high among supplement users, with a mean compliance rate of 5.5 days per week. CONCLUSIONS These prepubertal children with persistent CMA had lower lumbar spine BMD z scores than children with NCMA, which likely resulted from lower calcium intake.
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Affiliation(s)
- Genevieve Mailhot
- Department of Nutrition and Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal, Quebec, Canada; and
| | | | - Nathalie Alos
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal, Quebec, Canada; and Divisions of Endocrinology and
| | - Josée Dubois
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal, Quebec, Canada; and Departments of Radiology, and
| | - Edgard Delvin
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal, Quebec, Canada; and Clinical Biochemistry, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | | | - Anne Des Roches
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal, Quebec, Canada; and Allergy, Department of Pediatrics,
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26
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Development and validation of an interview-administered FFQ for assessment of vitamin D and calcium intakes in Finnish women. Br J Nutr 2016; 115:1100-7. [PMID: 26856375 DOI: 10.1017/s0007114515005474] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Increased vitamin D fortification of dairy products has increased the supply of vitamin D-containing products with different vitamin D contents on the market in Finland. The authors developed a ninety-eight-item FFQ with eight food groups and with a question on supplementation to assess dietary and supplemental vitamin D and Ca intakes in Finnish women (60ºN). The FFQ was validated in subgroups with different habitual vitamin D supplement use (0-57·5 µg/d) against the biomarker serum 25-hydroxyvitamin D (S-25(OH)D) and against 3-d food records (FR) (n 29-67). Median total vitamin D intake among participants was 9·4 (range 1·6-30·5) µg/d. Spearman's correlations for vitamin D and Ca ranged from 0·28 (P 0·146, FFQ v. S-25(OH)D, persons not using supplements) to 0·75 (P<0·001, FFQ v. FR, supplement use included). The correlations between the FFQ and S-25(OH)D concentrations improved within increasing supplement intake. The Bland-Altman analysis showed wide limits of agreement between FFQ and FR: for vitamin D between -7·8 and 8·8 µg/d and for Ca between -938 and 934 mg/d, with mean differences being 0·5 µg/d and 2 mg/d, respectively. The triads method was used to calculate the validity coefficients of the FFQ for vitamin D, resulting in a mean of 1·00 (95 % CI 0·59, 1·00) and a range from 0·33 to 1·00. The perceived variation in the estimates could have been avoided with a longer FR period and larger number of participants. The results are comparable with earlier studies, and the FFQ provides a reasonable estimation of vitamin D and Ca intakes.
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27
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Głąbska D, Guzek D, Sidor P, Włodarek D. Vitamin D Dietary Intake Questionnaire Validation Conducted among Young Polish Women. Nutrients 2016; 8:E36. [PMID: 26742070 PMCID: PMC4728650 DOI: 10.3390/nu8010036] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/07/2015] [Accepted: 12/13/2015] [Indexed: 01/28/2023] Open
Abstract
Due to inadequate intake of Vitamin D, identification of individuals characterised by the highest risk of deficiencies is one of the more crucial tasks for public health. The aim of the presented study was to assess the validity and reproducibility of the designed Vitamin D dietary intake questionnaire based on food frequency assessment--VIDEO-FFQ (VItamin D Estimation Only--Food Frequency Questionnaire) in a group of Polish women aged 20-30 years. Seventy-five participants kept a three-day dietary record and filled out the VIDEO-FFQ twice (immediately after the three-day dietary record and after six weeks). The assessment of validity and reproducibility was conducted by verifying standard errors of estimation, median differences, and percentages of individuals classified into tertiles, correlations and Bland-Altman plots. The Vitamin D intake for the majority of the surveyed women was inadequate as over 85% of them were characterised by values of intake lower than 5.0 μg per day. The results allowed concluding that a high accuracy of the VIDEO-FFQ was achieved. The required Bland-Altman index values lower than 5.0% were obtained, confirming satisfactory validity and reproducibility. The VIDEO-FFQ may be deemed a convenient practical tool for the estimation of Vitamin D intake in young women.
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Affiliation(s)
- Dominika Głąbska
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, Warsaw, Poland-159c Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Dominika Guzek
- Laboratory of Food Chemistry, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, Warsaw, Poland-159c Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Patrycja Sidor
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, Warsaw, Poland-159c Nowoursynowska Str, 02-776 Warsaw, Poland.
| | - Dariusz Włodarek
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, Warsaw, Poland-159c Nowoursynowska Str, 02-776 Warsaw, Poland.
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LeBlanc CMA, Ma J, Taljaard M, Roth J, Scuccimarri R, Miettunen P, Lang B, Huber AM, Houghton K, Jaremko JL, Ho J, Shenouda N, Matzinger MA, Lentle B, Stein R, Sbrocchi AM, Oen K, Rodd C, Jurencak R, Cummings EA, Couch R, Cabral DA, Atkinson S, Alos N, Rauch F, Siminoski K, Ward LM. Incident Vertebral Fractures and Risk Factors in the First Three Years Following Glucocorticoid Initiation Among Pediatric Patients With Rheumatic Disorders. J Bone Miner Res 2015; 30:1667-75. [PMID: 25801315 PMCID: PMC4556451 DOI: 10.1002/jbmr.2511] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/10/2015] [Accepted: 03/13/2015] [Indexed: 12/21/2022]
Abstract
Vertebral fractures are an important yet underrecognized manifestation of osteoporosis in children with chronic, glucocorticoid-treated illnesses. Our goal was to determine the incidence and clinical predictors of vertebral fractures in the 3 years following glucocorticoid initiation among pediatric patients with rheumatic disorders. Incident vertebral fractures were evaluated according to the Genant semiquantitative method on lateral radiographs at baseline and then annually in the 3 years following glucocorticoid initiation. Extended Cox models were used to assess the association between vertebral fractures and clinical risk predictors. A total of 134 children with rheumatic disorders were enrolled in the study (mean ± standard deviation (SD) age 9.9 ± 4.4 years; 65% girls). The unadjusted vertebral fracture incidence rate was 4.4 per 100 person-years, with a 3-year incidence proportion of 12.4%. The highest annual incidence occurred in the first year (6.0%; 95% confidence interval (CI) 2.9% to 11.7%). Almost one-half of the patients with fractures were asymptomatic. Every 0.5 mg/kg increase in average daily glucocorticoid (prednisone equivalents) dose was associated with a twofold increased fracture risk (hazard ratio (HR) 2.0; 95% CI 1.1 to 3.5). Other predictors of increased vertebral fracture risk included: (1) increases in disease severity scores between baseline and 12 months; (2) increases in body mass index Z-scores in the first 6 months of each 12-month period preceding the annual fracture assessment; and (3) decreases in lumbar spine bone mineral density Z-scores in the first 6 months of glucocorticoid therapy. As such, we observed that a clinically significant number of children with rheumatic disorders developed incident vertebral fractures in the 3 years following glucocorticoid initiation. Almost one-half of the children were asymptomatic and thereby would have been undiagnosed in the absence of radiographic monitoring. In addition, discrete clinical predictors of incident vertebral fractures were evident early in the course of glucocorticoid therapy.
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Affiliation(s)
| | - Jinhui Ma
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Monica Taljaard
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Johannes Roth
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | | | - Paivi Miettunen
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Bianca Lang
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Adam M Huber
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Kristin Houghton
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Josephine Ho
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Nazih Shenouda
- Department of Medical Imaging, University of Ottawa, Ottawa, ON, Canada
| | | | - Brian Lentle
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Robert Stein
- Department of Pediatrics, University of Western Ontario, London, ON, Canada
| | | | - Kiem Oen
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada
| | - Celia Rodd
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada
| | - Roman Jurencak
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | | | - Robert Couch
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - David A Cabral
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - Nathalie Alos
- Department of Pediatrics, Université de Montréal, Montréal, QC, Canada
| | - Frank Rauch
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Kerry Siminoski
- Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Leanne M Ward
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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29
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Cummings EA, Ma J, Fernandez CV, Halton J, Alos N, Miettunen PM, Jaremko JL, Ho J, Shenouda N, Matzinger MA, Lentle B, Stephure D, Stein R, Sbrocchi AM, Rodd C, Lang B, Israels S, Grant RM, Couch R, Barr R, Hay J, Rauch F, Siminoski K, Ward LM. Incident Vertebral Fractures in Children With Leukemia During the Four Years Following Diagnosis. J Clin Endocrinol Metab 2015; 100:3408-17. [PMID: 26171800 PMCID: PMC4909472 DOI: 10.1210/jc.2015-2176] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The purpose of this article was to determine the incidence and predictors of vertebral fractures (VF) during the 4 years after diagnosis in pediatric acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS Children were enrolled within 30 days of chemotherapy initiation, with incident VF assessed annually on lateral spine radiographs according to the Genant method. Extended Cox models were used to assess the association between incident VF and clinical predictors. RESULTS A total of 186 children with ALL completed the baseline evaluation (median age, 5.3 years; interquartile range, 3.4-9.7 years; 58% boys). The VF incidence rate was 8.7 per 100 person-years, with a 4-year cumulative incidence of 26.4%. The highest annual incidence occurred at 12 months (16.1%; 95% confidence interval [CI], 11.2-22.7), falling to 2.9% at 4 years (95% CI, 1.1-7.3). Half of the children with incident VF had a moderate or severe VF, and 39% of those with incident VF were asymptomatic. Every 10 mg/m(2) increase in average daily glucocorticoid dose (prednisone equivalents) was associated with a 5.9-fold increased VF risk (95% CI, 3.0-11.8; P < .01). Other predictors of increased VF risk included VF at diagnosis, younger age, and lower spine bone mineral density Z-scores at baseline and each annual assessment. CONCLUSIONS One quarter of children with ALL developed incident VF in the 4 years after diagnosis; most of the VF burden was in the first year. Over one third of children with incident VF were asymptomatic. Discrete clinical predictors of a VF were evident early in the patient's clinical course, including a VF at diagnosis.
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Affiliation(s)
- Elizabeth A Cummings
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Jinhui Ma
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Conrad V Fernandez
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Jacqueline Halton
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Nathalie Alos
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Paivi M Miettunen
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Jacob L Jaremko
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Josephine Ho
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Nazih Shenouda
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Mary Ann Matzinger
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Brian Lentle
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - David Stephure
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Robert Stein
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Ann Marie Sbrocchi
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Celia Rodd
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Bianca Lang
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Sara Israels
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Ronald M Grant
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Robert Couch
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Ronald Barr
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - John Hay
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Frank Rauch
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Kerry Siminoski
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
| | - Leanne M Ward
- Dalhousie University (E.A.C., C.V.F., B.La.), Halifax, Nova Scotia B3H 4R2, Canada; University of Ottawa (H.M., J.Ha., N.S., M.A.M., L.M.W.), Ottawa, Ontario K1N 6N5, Canada; Université de Montréal (N.A.), Montreal, Quebec H3T 1J4, Canada; University of Calgary (P.M.M., J.Ho., D.S.), Calgary, Alberta T2N 1N4, Canada; University of Alberta (J.L.J., R.C., K.S.), Edmonton, Alberta T6G 2R3, Canada; University of British Columbia (B.Le.), Vancouver, British Columbia V6T 1Z4, Canada; University of Western Ontario (R.S.), London, Ontario N6A 3K7, Canada; McGill University (A.M.S., F.R.), Montréal, Quebec H3A 0G4, Canada; University of Manitoba (C.R., S.I.), Winnipeg, Manitoba R3T 2N2, Canada; University of Toronto (R.M.G.), Toronto, Ontario M5S 2J7, Canada; McMaster University (R.B.), Hamilton, Ontario L8S 4L8, Canada; and Brock University (J.H.), St. Catharines, Ontario L2S 3A1, Canada
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Doubelt I, de Zepetnek JT, MacDonald MJ, Atkinson SA. Influences of nutrition and adiposity on bone mineral density in individuals with chronic spinal cord injury: A cross-sectional, observational study. Bone Rep 2015; 2:26-31. [PMID: 28377950 PMCID: PMC5365169 DOI: 10.1016/j.bonr.2015.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Dietary inadequacy and adiposity, both prevalent in the chronic spinal cord injury (SCI) population, are known to influence bone turnover and may be potential modifiable risk factors for the development of sublesional osteoporosis following SCI. This pilot study in an SCI cohort aimed to assess measures of nutrition and obesity, to determine if these measures were associated with bone mineral density (BMD), and to compare these measures to a non-SCI control cohort. METHODS In a cross-sectional observational study, volunteers with chronic SCI (> 1 year post-injury, lesions from C1 to T12 and severity category A-D by the American Spinal Injury Association Impairment Scale) were assessed, and 8 non-SCI individuals were recruited as a comparison group. BMD at the femoral neck (FN) and lumbar spine (LS), and an estimate of visceral adipose tissue (VAT) from lumbar vertebrae 1 through 4 were measured using dual energy X-ray absorptiometry (DXA); nutrient intake of calcium, vitamins D & K, and protein were estimated using a food frequency questionnaire; plasma 25-hydroxyvitamin D (25(OH)D) was analyzed using ultra-high performance liquid chromatography/tandem mass spectroscopy; and serum leptin, adiponectin and insulin were analyzed using a multiplex assay. RESULTS A total of 34 individuals with SCI (n = 22 tetraplegic; n = 12 paraplegic; 94% male) who averaged 12.7 (9.0) years post-injury, age 40.0 (10.9) years and % body fat of 28.4 (7.3) were assessed. Multiple linear regression analyses in the SCI cohort showed significant associations between BMD at the FN and LS with leptin (FN: r = 0.529, p = 0.005; LS: r = 0.392, p = 0.05), insulin (FN: r = 0.544, p = 0.003; LS: r = 0.388, p = 0.05), and VAT percent (FN: r = 0.444, p = 0.02; LS: r = 0.381, p = 0.05). Adiponectin was only correlated with LS BMD (r = 0.429, p = 0.03). No significant relationships were found between BMD and serum 25(OH)D, or intakes of calcium, vitamins D & K, and protein. Intake of vitamin D was adequate in 69% of participants with SCI, where 91% of those persons consumed either vitamin D and/or multivitamin supplements. Vitamin D status was similar between SCI and non-SCI groups as was sub-optimal status (25(OH)D < 75 nmol/L) (60% of SCI compared to 50% of non-SCI). Participants with SCI had significantly lower FN BMD in comparison to non-SCI controls (p = 0.001). CONCLUSIONS Compromised BMD among individuals with SCI was not associated with a deficiency of vitamin D or other bone nutrients. The observed positive associations between BMD and leptin, insulin, adiponectin and VAT provide a framework to evaluate links between adiposity and bone health in a larger SCI cohort.
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Key Words
- AIS, American Spinal Injury Association Impairment Scale
- Adiposity
- Bone mineral density
- DRI, dietary reference intakes
- EAR, estimated average requirement
- FFQ, food frequency questionnaire
- IOM, Institute of Medicine
- Nutritional status
- SCI, spinal cord injury
- SLOP, sublesional osteoporosis
- Spinal cord injury
- Sublesional osteoporosis
- UPLC/MS–MS, ultra high performance liquid chromatography tandem mass spectrometry
- VAT, visceral adipose tissue
- WC, waist circumference.
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Affiliation(s)
- Irena Doubelt
- Department of Pediatrics, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada
| | - Julia Totosy de Zepetnek
- Department of Kinesiology, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada
| | - Maureen J. MacDonald
- Department of Kinesiology, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada
| | - Stephanie A. Atkinson
- Department of Pediatrics, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada
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Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model. Public Health Nutr 2015; 19:437-45. [PMID: 25959015 DOI: 10.1017/s136898001500138x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied. DESIGN In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated 'true' exposure, were calculated using the method of triads. Bland-Altman plots were also constructed. SETTING Three major universities in Serbia. SUBJECTS Healthy young women (n 422) aged 18-35 years. RESULTS The WRH-FFQ estimate of vitamin D intake for all participants was 4.0 (sd 3.3) µg/d and 3.1 (sd 2.3) µg/d for the subgroup. Bland-Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were ρ QI=0.847 (95% CI 0.564, 0.928), ρ RI=0.810 (95% CI 0.537, 0.997) and ρ BI=0.499 (95% CI 0.190, 0.840), while the correlation coefficients were 0.686, 0.422 and 0.404. CONCLUSIONS The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification.
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Beckett EL, Martin C, Duesing K, Jones P, Furst J, Yates Z, Veysey M, Lucock M. Vitamin D Receptor Genotype Modulates the Correlation between Vitamin D and Circulating Levels of let-7a/b and Vitamin D Intake in an Elderly Cohort. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2015; 7:264-73. [DOI: 10.1159/000381676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/14/2015] [Indexed: 11/19/2022]
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The Relationship between Intramuscular Adipose Tissue, Functional Mobility, and Strength in Postmenopausal Women with and without Type 2 Diabetes. J Aging Res 2015; 2015:872726. [PMID: 25692042 PMCID: PMC4322662 DOI: 10.1155/2015/872726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/02/2015] [Accepted: 01/03/2015] [Indexed: 12/25/2022] Open
Abstract
Objectives. To determine (1) whether intramuscular adipose tissue (IntraMAT) differs between women with and without type 2 diabetes and (2) the association between IntraMAT and mobility and strength. Methods. 59 women ≥ 65 years with and without type 2 diabetes were included. A 1-Tesla MRI was used to acquire images of the leg. Timed-up-and-go (TUG) and grip strength were measured. Regression was used to determine associations between the following: (1) type 2 diabetes and IntraMAT (covariates: age, ethnicity, BMI, waist : hip ratio, and energy expenditure), (2) IntraMAT and TUG (covariates: diabetes, age, BMI, and energy expenditure), and (3) IntraMAT and grip strength (covariates: diabetes, age, height, and lean mass). Results. Women with diabetes had more IntraMAT. After adjustment, IntraMAT was similar between groups (diabetes mean [SD] = 13.2 [1.4]%, controls 11.8 [1.3]%, P = 0.515). IntraMAT was related to TUG and grip strength, but the relationships became nonsignificant after adjustment for covariates (difference/percent IntraMAT [95% CI]: TUG = 0.041 seconds [-0.079-0.161], P = 0.498, grip strength = -0.144 kg [-0.335-0.066], P = 0.175). Conclusions. IntraMAT alone may not be a clinically important predictor of functional mobility and strength; however, whether losses in functional mobility and strength are promoted by IntraMAT accumulation should be explored.
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Cheng TYD, Goodman GE, Thornquist MD, Barnett MJ, Beresford SAA, LaCroix AZ, Zheng Y, Neuhouser ML. Estimated intake of vitamin D and its interaction with vitamin A on lung cancer risk among smokers. Int J Cancer 2014; 135:2135-45. [PMID: 24622914 PMCID: PMC4293152 DOI: 10.1002/ijc.28846] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/17/2014] [Indexed: 11/11/2022]
Abstract
Data are very limited on vitamin D and lung cancer prevention in high-risk populations. The authors investigated whether estimated vitamin D intake was associated with lung cancer risk and whether effect modification by vitamin A existed among current/former heavy smokers and workers with occupational exposure to asbestos. A case-cohort study selected 749 incident lung cancers and 679 noncases from the Carotene and Retinol Efficacy Trial (CARET), 1988-2005. The active intervention was supplementation of 30 mg β-carotene + 25,000 IU retinyl palmitate/day. Baseline total intake including both diet (from food frequency questionnaire) and personal supplements (from brand names linked to the labeled potencies) was assessed. Hazard ratios (HRs) were estimated by Cox proportional hazard models. No significant association of total vitamin D intake with lung cancer was observed overall. However, total vitamin D intake ≥600 versus <200 IU/day was associated with a lower risk of non-small cell lung cancer among former smokers [HR = 0.36, 95% confidence interval (CI) = 0.13-0.96]. Total vitamin D intake ≥400 versus <400 IU/day was associated with a lower risk of total lung cancer among participants who received the CARET active intervention (HR = 0.56, 95% CI = 0.32-0.99) and among those who had total vitamin A intake ≥1,500 µg/day retinol activity equivalent (RAE; HR = 0.46, 95% CI = 0.23-0.91). The beneficial associations were attenuated among those who did not receive the CARET active intervention or who had total vitamin A intake <1,500 µg/day RAE (p-interaction = 0.02 for current smokers). Our observation suggests that vitamin A may assist vitamin D in preventing lung cancer among smokers.
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Affiliation(s)
- Ting-Yuan David Cheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Gary E. Goodman
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Mark D. Thornquist
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Matt J. Barnett
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Shirley A. A. Beresford
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Andrea Z. LaCroix
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Yingye Zheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
| | - Marian L. Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (T-YDC, GEG, MDT, MJB, SAAB, AZL, YZ, MLN) Department of Epidemiology, University of Washington, Seattle, WA (T-YDC, SAAB, AZL, MLN) Department of Biostatistics, University of Washington, Seattle, WA (MDT, YZ)
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Abstract
OBJECTIVE To identify and critique tools for the assessment of Ca and/or dairy intake in adults, in order to ascertain the most accurate and reliable tools available. DESIGN A systematic review of the literature was conducted using defined inclusion and exclusion criteria. Articles reporting on originally developed tools or testing the reliability or validity of existing tools that measure Ca and/or dairy intake in adults were included. Author-defined criteria for reporting reliability and validity properties were applied. SETTING Studies conducted in Western countries. SUBJECTS Adults. RESULTS Thirty papers, utilising thirty-six tools assessing intake of dairy, Ca or both, were identified. Reliability testing was conducted on only two dairy and five Ca tools, with results indicating that only one dairy and two Ca tools were reliable. Validity testing was conducted for all but four Ca-only tools. There was high reliance in validity testing on lower-order tests such as correlation and failure to differentiate between statistical and clinically meaningful differences. Results of the validity testing suggest one dairy and five Ca tools are valid. Thus one tool was considered both reliable and valid for the assessment of dairy intake and only two tools proved reliable and valid for the assessment of Ca intake. CONCLUSIONS While several tools are reliable and valid, their application across adult populations is limited by the populations in which they were tested. These results indicate a need for tools that assess Ca and/or dairy intake in adults to be rigorously tested for reliability and validity.
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Cook LS, Moon BL, Dong Y, Neilson HK. Reliability of self-reported sun exposure in Canadian women and estimation of lifetime exposure to vitamin D from sun and diet. Public Health Nutr 2014; 17:747-55. [PMID: 23885709 PMCID: PMC10282289 DOI: 10.1017/s136898001300178x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 03/25/2013] [Accepted: 06/04/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess the inter-method reliability of the Ovarian Cancer in Alberta (OVAL) survey developed to estimate adult vitamin D exposure from sun and diet for every tenth year, against the longer Geraldton Skin Cancer Prevention Survey (the assumed 'gold standard'). We also estimated total vitamin D exposure using the OVAL survey. DESIGN A randomized crossover design to assess the inter-method reliability of sun exposure (OVAL v. Geraldton survey), using intra-class correlation and estimated total vitamin D exposure from sun and diet. SETTING Calgary, Alberta, Canada. SUBJECTS Randomly selected women (n 90) aged 40-79 years. RESULTS The average lifetime sun exposure of 13,913 h (average 411 h/year) from the Geraldton survey was not significantly different from the 13,034 h (average 385 h/year) from the OVAL survey for periods with sufficient UV radiation to stimulate vitamin D production. The intra-class correlation coefficient for average lifetime sun exposure was 0.77 (95% CI 0.69, 0.86); the annual average was 0.60 (95% CI 0.47, 0.74). Estimated vitamin D from diet and supplements increased with age. CONCLUSIONS Our OVAL survey reliably estimated adult sun exposure relative to the Geraldton survey, suggesting that assessing sun exposure every tenth year is a reliable and efficient method for estimating sun contributions to lifetime vitamin D exposure.
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Affiliation(s)
- Linda S Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
- Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Bevin L Moon
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Yan Dong
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
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Kowalkowska J, Slowinska MA, Slowinski D, Dlugosz A, Niedzwiedzka E, Wadolowska L. Comparison of a full food-frequency questionnaire with the three-day unweighted food records in young Polish adult women: implications for dietary assessment. Nutrients 2013; 5:2747-76. [PMID: 23877089 PMCID: PMC3738998 DOI: 10.3390/nu5072747] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/13/2013] [Accepted: 06/26/2013] [Indexed: 11/20/2022] Open
Abstract
The food frequency questionnaire (FFQ) and the food record (FR) are among the most common methods used in dietary research. It is important to know that is it possible to use both methods simultaneously in dietary assessment and prepare a single, comprehensive interpretation. The aim of this study was to compare the energy and nutritional value of diets, determined by the FFQ and by the three-day food records of young women. The study involved 84 female students aged 21-26 years (mean of 22.2 ± 0.8 years). Completing the FFQ was preceded by obtaining unweighted food records covering three consecutive days. Energy and nutritional value of diets was assessed for both methods (FFQ-crude, FR-crude). Data obtained for FFQ-crude were adjusted with beta-coefficient equaling 0.5915 (FFQ-adjusted) and regression analysis (FFQ-regressive). The FFQ-adjusted was calculated as FR-crude/FFQ-crude ratio of mean daily energy intake. FFQ-regressive was calculated for energy and each nutrient separately using regression equation, including FFQ-crude and FR-crude as covariates. For FR-crude and FFQ-crude the energy value of diets was standardized to 2000 kcal (FR-standardized, FFQ-standardized). Methods of statistical comparison included a dependent samples t-test, a chi-square test, and the Bland-Altman method. The mean energy intake in FFQ-crude was significantly higher than FR-crude (2740.5 kcal vs. 1621.0 kcal, respectively). For FR-standardized and FFQ-standardized, significance differences were found in the mean intake of 18 out of 31 nutrients, for FR-crude and FFQ-adjusted in 13 out of 31 nutrients and FR-crude and FFQ-regressive in 11 out of 31 nutrients. The Bland-Altman method showed an overestimation of energy and nutrient intake by FFQ-crude in comparison to FR-crude, e.g., total protein was overestimated by 34.7 g/day (95% Confidence Interval, CI: -29.6, 99.0 g/day) and fat by 48.6 g/day (95% CI: -36.4, 133.6 g/day). After regressive transformation of FFQ, the absolute difference between FFQ-regressive and FR-crude equaled 0.0 g/day and 95% CI were much better (e.g., for total protein 95% CI: -32.7, 32.7 g/day, for fat 95% CI: -49.6, 49.6 g/day). In conclusion, differences in nutritional value of diets resulted from overestimating energy intake by the FFQ in comparison to the three-day unweighted food records. Adjustment of energy and nutrient intake applied for the FFQ using various methods, particularly regression equations, significantly improved the agreement between results obtained by both methods and dietary assessment. To obtain the most accurate results in future studies using this FFQ, energy and nutrient intake should be adjusted by the regression equations presented in this paper.
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Affiliation(s)
- Joanna Kowalkowska
- Department of Human Nutrition, University of Warmia and Mazury, Słoneczna 44a, Olsztyn 10-718, Poland; E-Mails: (M.A.S.); (E.N.); (L.W.)
| | - Malgorzata A. Slowinska
- Department of Human Nutrition, University of Warmia and Mazury, Słoneczna 44a, Olsztyn 10-718, Poland; E-Mails: (M.A.S.); (E.N.); (L.W.)
| | - Dariusz Slowinski
- Chair of Geotechnics and Road Engineering, University of Warmia and Mazury, Prawocheńskiego 19, Olsztyn 10-720, Poland; E-Mail:
| | - Anna Dlugosz
- Chair and Department of Nutrition and Dietetics, Nicolaus Copernicus University, Collegium Medicum, Dębowa 3, Bydgoszcz 85-626, Poland; E-Mail:
| | - Ewa Niedzwiedzka
- Department of Human Nutrition, University of Warmia and Mazury, Słoneczna 44a, Olsztyn 10-718, Poland; E-Mails: (M.A.S.); (E.N.); (L.W.)
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury, Słoneczna 44a, Olsztyn 10-718, Poland; E-Mails: (M.A.S.); (E.N.); (L.W.)
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Liu L, Wang PP, Roebothan B, Ryan A, Tucker CS, Colbourne J, Baker N, Cotterchio M, Yi Y, Sun G. Assessing the validity of a self-administered food-frequency questionnaire (FFQ) in the adult population of Newfoundland and Labrador, Canada. Nutr J 2013; 12:49. [PMID: 23590645 PMCID: PMC3637508 DOI: 10.1186/1475-2891-12-49] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 03/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Food- Frequency Questionnaire (FFQ) is a dietary assessment tool frequently used in large-scale nutritional epidemiology studies. The goal of the present study is to validate a self-administered version of the Hawaii FFQ modified for use in the general adult population of Newfoundland and Labrador (NL). METHODS Over a one year period, 195 randomly selected adults completed four 24-hour dietary recalls (24-HDRs) by telephone and one subsequent self-administered FFQ. Estimates of energy and nutrients derived from the 24-HDRs and FFQs were compared (protein, carbohydrate, fibre, fat, vitamin A, carotene, vitamin D, and calcium). Data were analyzed using the Pearson's correlation coefficients, cross-classification method, and Bland-Altman plots. RESULTS The mean nutrient intake values of the 24-HDRs were lower than those of the FFQs, except for protein in men. Sex and energy-adjusted de-attenuated Pearson correlation coefficients for each nutrient varied from 0.13 to 0.61. Except for protein in men, all correlations were statistically significant with p < 0.05. Cross-classification analysis revealed that on average, 74% women and 78% men were classified in the same or adjacent quartile of nutrient intake when comparing data from the FFQ and 24-HDRs. Bland-Altman plots showed no serious systematic bias between the administration of the two instruments over the range of mean intakes. CONCLUSION This 169-item FFQ developed specifically for the adult NL population had moderate relative validity and therefore can be used in studies to assess food consumption in the general adult population of NL. This tool can be used to classify individual energy and nutrient intakes into quartiles, which is useful in examining relationships between diet and chronic disease.
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Affiliation(s)
- Lin Liu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL A1B 3V6, Canada
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Pritchard JM, Giangregorio LM, Atkinson SA, Beattie KA, Inglis D, Ioannidis G, Gerstein H, Punthakee Z, Adachi JD, Papaioannou A. Changes in trabecular bone microarchitecture in postmenopausal women with and without type 2 diabetes: a two year longitudinal study. BMC Musculoskelet Disord 2013; 14:114. [PMID: 23530948 PMCID: PMC3618189 DOI: 10.1186/1471-2474-14-114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 03/19/2013] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The risk of experiencing an osteoporotic fracture is greater for adults with type 2 diabetes despite higher than normal bone mineral density (BMD). In addition to BMD, trabecular bone microarchitecture contributes to bone strength, but is not assessed using conventional BMD measurement by dual x-ray absorptiometry (DXA). The aim of this study was to compare two year changes in trabecular bone microarchitecture in women with and without type 2 diabetes. METHODS We used a 1 Tesla magnetic resonance imaging (MRI) scanner to acquire axial images (resolution 195 μm × 195 μm × 1000 μm) of the distal radius. We report the change in the number and size of trabecular bone holes, bone volume fraction (BVTV), trabecular thickness (Tb.Th), number (Tb.N) and separation (Tb.Sp), endosteal area, nodal and branch density for each group. Lumbar spine and proximal femur BMD were measured with DXA (Hologic, Discovery QDR4500A) at baseline and follow-up. Using a multivariable linear regression model, we evaluated whether the percent change in the trabecular bone microarchitecture variables differed between women with and without type 2 diabetes. RESULTS Of the 54 participants at baseline with valid MRI image sets, 37 participants (baseline mean [SD] age, 70.8 [4.4] years) returned for follow-up assessment after 25.4 [1.9] months. Lumbar spine BMD was greater for women with diabetes compared to without diabetes at both baseline and follow-up. After adjustment for ethnicity, women with diabetes had a higher percent increase in number of trabecular bone holes compared to controls (10[1] % versus -7 [2]%, p=0.010), however results were no longer significant after adjustment for multiple comparisons (p=0.090). There were no differences in the change in other trabecular bone microarchitecture variables between groups. CONCLUSION There were no differences in percent change in trabecular bone microarchitecture variables over two years in women with type 2 diabetes compared to women without diabetes. This study provides feasibility data, which will inform future trials assessing change in trabecular bone microarchitecture in women with type 2 diabetes. Larger studies using higher resolution imaging modalities that can assess change in trabecular and cortical bone compartments in women with type 2 diabetes are needed.
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Affiliation(s)
- Janet M Pritchard
- Faculty of Health Sciences, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
| | - Lora M Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Stephanie A Atkinson
- Department of Pediatrics, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
| | - Karen A Beattie
- Department of Medicine, McMaster University, Charlton Medical Centre, 501-25 Charlton Ave E, Hamilton, ON L8N 1Y2, Canada
| | - Dean Inglis
- Department of Civil Engineering, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
| | - George Ioannidis
- Department of Medicine, McMaster University, Charlton Medical Centre, 501-25 Charlton Ave E, Hamilton, ON L8N 1Y2, Canada
| | - Hertzel Gerstein
- Department of Medicine, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
| | - Zubin Punthakee
- Department of Medicine, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Charlton Medical Centre, 501-25 Charlton Ave E, Hamilton, ON L8N 1Y2, Canada
| | - Alexandra Papaioannou
- Department of Medicine, McMaster University, 1280 Main St West, Hamilton, ON L8S 4K1, Canada
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El Hayek J, Pham TT, Finch S, Hazell TJ, Jean-Philippe S, Vanstone CA, Agellon S, Rodd C, Rauch F, Weiler HA. Vitamin D status in Montréal preschoolers is satisfactory despite low vitamin D intake. J Nutr 2013; 143:154-60. [PMID: 23256141 DOI: 10.3945/jn.112.169144] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The 2007 to 2009 Canadian Health Measures Survey reported vitamin D status in a representative sample of Canadians (6-79 y); however, children <6 y were not assessed. Our objective was to measure vitamin D intake from food and supplements, sun exposure, and biological vitamin D status of children ages 2 through 5 y in Montréal (latitude 45°N). Preschoolers (n = 508) were recruited between June 2010 and 2011 in a random sample of licensed daycares in the regions of greater Montréal, Canada in a cross-sectional study. The total plasma 25-hydroxyvitamin D [25(OH)D] concentration was measured using a chemiluminescence assay (Liaison, Diasorin). Dietary intake was assessed during one 24-h period plus a 30-d FFQ. Socioeconomic, demographic, anthropometry, and sun exposure data were collected. Plasma 25(OH)D was ≥50 nmol/L in 88% of children, whereas 49.4% had concentrations ≥75 nmol/L during the 1-y study. Almost 95% of preschoolers had vitamin D intakes less than the Estimated Average Requirement (EAR), and 4.8% of preschoolers ≤3.9 y and 25.9% of preschoolers ≥4 y had calcium intakes less than the EAR. Plasma 25(OH)D was different across age, income, sun index, milk intake, and dietary and supplemental vitamin D intake tertiles. Despite vitamin D intakes less than the EAR, the vitamin D status of Montréal preschoolers attending daycare is mostly satisfactory even in winter, suggesting that the EAR value is too high in the context of typical exogenous intakes of vitamin D in North America.
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Affiliation(s)
- Jessy El Hayek
- School of Dietetics and Human Nutrition, McGill University, Montréal, QC, Canada
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Rodd C, Lang B, Ramsay T, Alos N, Huber AM, Cabral DA, Scuccimarri R, Miettunen PM, Roth J, Atkinson SA, Couch R, Cummings EA, Dent PB, Ellsworth J, Hay J, Houghton K, Jurencak R, Larché M, LeBlanc C, Oen K, Saint-Cyr C, Stein R, Stephure D, Taback S, Lentle B, Matzinger M, Shenouda N, Moher D, Rauch F, Siminoski K, Ward LM. Incident vertebral fractures among children with rheumatic disorders 12 months after glucocorticoid initiation: a national observational study. Arthritis Care Res (Hoboken) 2012; 64:122-31. [PMID: 22213727 DOI: 10.1002/acr.20589] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the frequency of incident vertebral fractures (IVF) 12 months after glucocorticoid (GC) initiation in children with rheumatic diseases and to identify children at higher risk. METHODS Children with rheumatic diseases initiating GC were enrolled in a prospective observational study. Annual spine radiographs were evaluated using the Genant semiquantitative method. Spine areal bone mineral density (aBMD) was measured every 6 months. Clinical features, including cumulative GC dose, back pain, disease and physical activity, calcium and vitamin D intake, and spine aBMD Z scores, were analyzed for association with IVF. RESULTS Seven (6%) of 118 children (95% confidence interval 2.9-11.7%) had IVF. Their diagnoses were: juvenile dermatomyositis (n = 2), systemic lupus erythematosus (n = 3), systemic vasculitis (n = 1), and mixed connective tissue disease (n = 1). One child was omitted from the analyses after 4 months because of osteoporosis treatment for symptomatic IVF. Children with IVF received on average 50% more GC than those without (P = 0.030), had a greater increase in body mass index (BMI) at 6 months (P = 0.010), and had greater decrements in spine aBMD Z scores in the first 6 months (P = 0.048). Four (67%) of 6 children with IVF and data to 12 months had spine aBMD Z scores less than -2.0 at 12 months compared to 16% of children without IVF (P = 0.011). CONCLUSION The incidence of VF 12 months following GC initiation was 6%; most children were asymptomatic. Children with IVF received more GC, had greater increases in BMI, and had greater declines in spine aBMD Z scores in the first 6 months.
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Affiliation(s)
- Celia Rodd
- McGill University, Montreal, Quebec, Canada
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Pritchard JM, Giangregorio LM, Atkinson SA, Beattie KA, Inglis D, Ioannidis G, Punthakee Z, Adachi JD, Papaioannou A. Association of larger holes in the trabecular bone at the distal radius in postmenopausal women with type 2 diabetes mellitus compared to controls. Arthritis Care Res (Hoboken) 2012; 64:83-91. [PMID: 22213724 PMCID: PMC5096917 DOI: 10.1002/acr.20602] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Adults with type 2 diabetes mellitus (DM) have an elevated fracture risk despite normal areal bone mineral density (aBMD). The study objective was to compare trabecular bone microarchitecture of postmenopausal women with type 2 DM and women without type 2 DM. METHODS An extremity 1T magnetic resonance imaging system was used to acquire axial images (195 × 195 × 1,000 μm(3) voxel size) of the distal radius of women recruited from outpatient clinics or by community advertisement. Image segmentation yielded geometric, topologic, and stereologic outcomes, i.e., number and size of trabecular bone network holes (marrow spaces), endosteal area, trabecular bone volume fraction, nodal and branch density, and apparent trabecular thickness, separation, and number. Lumbar spine (LS) and proximal femur BMD were measured with dual x-ray absorptiometry. Microarchitectural differences were assessed using linear regression and adjusted for percent body fat, ethnicity, timed up-and-go test, Charlson Index, and calcium and vitamin D intake; aBMD differences were adjusted for body mass index (BMI). RESULTS Women with type 2 DM (n = 30, mean ± SD age 71.0 ± 4.8 years) had larger holes (+13.3%; P = 0.001) within the trabecular bone network than women without type 2 DM (n = 30, mean ± SD age 70.7 ± 4.9 years). LS aBMD was greater in women with type 2 DM; however, after adjustment for BMI, LS aBMD did not differ between groups. CONCLUSION In women with type 2 DM, the average hole size within the trabecular bone network at the distal radius is greater compared to controls. This may explain the elevated fracture risk in this population.
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Abstract
Interest in calcium has continued since the 1980s when its role in promoting bone growth and retention was established in clinical trials of children and postmenopausal women. The human nutrition functions now attributed to calcium have expanded beyond bone health to include other conditions such as body weight maintenance. While most efforts have been focused on the findings that dietary intakes are low, there are emerging data on safety concerns of excess amounts. This Special Issue on calcium nutrition, spanning the lifecycle from critically ill neonates through to older adults, has been written by some of the leading researchers in this field.
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