bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary exposures and oral precancerous lesions in Srikakulam District, Andhra Pradesh, India
Authors: Hebert James R , Gupta Prakash C , Bhonsle Ramesh B , Mehta Hemali , Zheng Wei , Sanderson Maureen , Teas Jane
Published: February 2003

Objective:

To test the effect of dietary nutrients on oral precancerous lesions in a reverse-smoking (i.e. smoking with the glowing end inside the mouth) population in South India.

Design:

Case–control. Cases with precancerous lesions were matched to an equal number of lesion-free controls matched on age (±5 years), sex and village. All subjects used tobacco in some form. Dietary data were obtained using an interviewer-administered food-frequency questionnaire, designed for use in this population. All interviews were conducted blinded to the disease status of the subject. Data were analysed using logistic regression.

Setting:

Nineteen rural villages in Srikakulam District, Andhra Pradesh.

Subjects:

From a survey of 6007 tobacco users, 485 (79% women) were found to have precancerous, mostly palatal, lesions (cases), and 487 lesion-free subjects were selected as controls.

Results:

All eligible subjects consented to participate and nearly all (>99%) had complete data for analyses. Reverse smoking was the most common form of tobacco use among cases (81.9%) and controls (73.5%), and reverse smokers were 5.19 times more likely than chewers to have these lesions (95% confidence interval = 1.35, 19.9). After controlling for relevant covariates, including the type of tobacco use, protective linear effects were observed for zinc (70% reduction across the interquartile range, P<<0.002 ), calcium (34% reduction, P<0.002 ), fibre (30% reduction, P<0.009 ), riboflavin (22% reduction, P<0.03 ) and iron (17% reduction, P<0.05 ).

Conclusions:

Several dietary nutrients appear to protect against oral precancerous lesions that are strongly associated with reverse smoking. The results of this study indicate scope for targeting dietary factors in preventing oral cancer, which should be coupled with aggressive anti-tobacco use efforts.
Dietary intakes of 6–24-month-old urban South Island New Zealand children in relation to biochemical iron status
Authors: Soh Patsy , Ferguson Elaine L , McKenzie Joanne E , Skeaff Sheila , Parnell Winsome , Gibson Rosalind S
Published: February 2003

Objective:

To investigate food sources and intakes of iron, and dietary factors associated with serum ferritin levels in 6–24-month-old children.

Design:

A cross-sectional survey employing proportionate cluster sampling was conducted in 1998/1999. Dietary intakes were assessed using a non-consecutive 3-day weighed food record. Serum ferritin and C-reactive protein were analysed from non-fasting venepuncture blood samples and general sociodemographic data were collected.

Setting:

Cities of Christchurch, Dunedin and Invercargill, New Zealand.

Subjects:

Randomly selected healthy 6–24-month-old non-breast-feeding children (n=226).

Results:

Total iron intakes (±standard deviation (SD)) among non-breast-feeding infants (<12 months old;n=42) and toddlers (≥12 months old;n=184) were 8.4±2.9 mg day−1and 5.0±2.5 mg day−1, respectively. Fifteen per cent of infants and 66% of toddlers were at risk of inadequate iron intakes. Main sources of dietary iron were infant formula (60%) for infants and cereals (31%) for toddlers. Meat contributed on average 2% and 10% of dietary iron in the infant and toddler diets, respectively. Dietary factors positively associated with serum ferritin were intakes of iron and vitamin C, whereas intakes of calcium and dietary fibre were negatively associated. For each 1% increase in percentage of energy from iron-fortified formula concomitant with a 1% decrease from dairy products, there was a 4.2% increased odds of replete iron stores (ferritin ≥20 μg l−1).

Conclusions:

Toddlers were at higher risk of sub-optimal iron intakes than infants. Results suggest that a diet high in bioavailable iron is important for optimising the iron stores of young children in New Zealand.
The intake of carotenoids in an older Australian population: The Blue Mountains Eye Study
Authors: Manzi Fiona , Flood Victoria , Webb Karen , Mitchell Paul
Published: February 2003

Objective:

To describe the distribution of carotenoid intakes and important food sources of carotenoids in the diet of a representative population of older Australians.

Design:

Population-based cohort study.

Setting:

Two post-code areas in the Blue Mountains, west of Sydney, Australia.

Subjects:

We studied 2012 (86%) of the 2334 participants aged 55 + years attending the 5-year follow-up of the cross-sectional Blue Mountains Eye Study (BMES), who completed a detailed semi-quantitative food-frequency questionnaire. The intakes for five carotenoids were studied: α-carotene, β-carotene, β-cryptoxanthin, lutein and zeaxanthin combined, and lycopene.

Results:

The mean intake per day for each carotenoid was: α-carotene, 2675 μg; β-carotene equivalents, 7301 μg; β-cryptoxanthin, 299 μg; lutein and zeaxanthin, 914 μg; lycopene, 3741 μg; retinol, 653 μg; total vitamin A, 1872 μg retinol equivalents. β-Carotene equivalents contribute a substantial proportion of total vitamin A intake (65%) in this population. Women had slightly higher intakes than men for α-carotene, β-carotene equivalents, and lutein and zeaxanthin (P<0.05) . Carrots and pumpkin were the main contributors to α-carotene and β-carotene equivalent intakes. Orange juice, oranges and papaw were the main contributors to β-cryptoxanthin intake. Broccoli, green beans and oranges contributed substantially to lutein and zeaxanthin intake. The main contributors to lycopene intake were tomatoes and bolognaise sauce.

Conclusions:

Vitamin A intake in this population is high relative to the Australian Recommended Dietary Intake. Carotenoid intakes, particularly β-carotene, make a substantial contribution, particularly from fruit and vegetables. This study provides important information as a basis for examining associations between dietary carotenoid intake and eye disease in the BMES.
Disparities in economic development in Eastern China: impact on nutritional status of adolescents
Authors: Hesketh Therese , Ding Qu Jian , Tomkins Andrew M
Published: February 2003

Objective:

To compare the effects of disparities in economic development in urban and rural Eastern China on the nutritional status of adolescents.

Design:

A cross-sectional survey consisting of self-completion questionnaires, anthropometry and haemoglobin measurement.

Setting:

Twelve middle schools in an urban and a rural area of Zhejiang Province: Hangzhou, the capital, and Chunan, a poor mountainous area.

Subjects:

Some 4835 young adolescents (predominant age range 13–16 years).

Results:

The mean body mass index (BMI) was significantly higher in urban Hangzhou (P=0.01) Overweight affected 3.6% overall; adjusted odds ratios (ORs) showed male sex (OR 2.1, 95% confidence interval (CI) 1.1–3.4) and urban residence (OR 9.1, 95% CI 3.7–22) to be the most important risk factors. The prevalence of underweight was 18%, with no significant urban–rural difference. Predictors of underweight were male sex (OR 1.5, 95% CI 1.1–2.0) and low household income (OR, 1.3, 95% CI 1.1–1.5). Mean haemoglobin was significantly lower in the rural area. Anaemia was more common in girls, 51% compared with 21% of the boys, but rural residence was not an independent risk factor. Rural students exercised more and had a less varied diet than their urban counterparts. Around one-third of the respondents consumed dietary supplements on a regular basis.

Conclusions:

These results suggest that in urban areas of Eastern China a dual picture is emerging with the problems of excess (overweight and obesity) coexisting with underweight and anaemia. In rural areas the problems of relative nutritional deprivation predominate, but the long-term consequences of such marginal underweight and anaemia are not clear.
A cohort study of dietary fibre intake and menarche
Authors: Koo Malcolm M , Rohan Thomas E , Jain Meera , McLaughlin John R , Corey Paul N
Published: February 2003

Objective:

To evaluate the influence of dietary fibre on menarche in a cohort of pre-menarcheal girls.

Design:

Prospective cohort study.

Setting:

Ontario, Canada.

Subjects:

Free-living pre-menarcheal girls (n= 637), 6 to 14 years of age.

Methodology:

Information on dietary intake, physical activity and date of menarche was collected at baseline and was updated annually by self-administered questionnaires for three years. Cox proportional hazards models were used to evaluate the association between dietary fibre and menarche, adjusting for age at entry to the study and potential confounders.

Results:

A higher intake of energy-adjusted dietary fibre was associated with a lower risk of (i.e. a later age at) menarche (relative hazard 0.54, 95% confidence interval (CI) 0.31–0.94 for highest vs. lowest quartile,Pfor trend = 0.027). At the fibre component level, a higher intake of energy-adjusted cellulose was associated with a lower risk of menarche (relative hazard 0.45, 95% CI 0.26–0.76,Pfor trend = 0.009).

Conclusions:

The findings are consistent with the hypothesis that pre-menarcheal dietary intake can influence menarche.
Nutritional status of 11–12-year-old Jamaican children: coexistence of under- and overnutrition in early adolescence
Authors: Jackson Maria , Samms-Vaughan Maureen , Ashley Deanna
Published: February 2003

Objective:

To determine the nutritional status of a cohort of 11–12 year olds and ascertain social and demographic factors associated with under- and overweight in early adolescence.

Design:

Cross-sectional.

Subjects:

Subgroup (n=1698) of the birth cohort (September–October 1986) of the Jamaican Perinatal Survey enrolled in schools in the Kingston Metropolitan area. One thousand and sixty-three parents or caregivers provided social and demographic information.

Results:

Undernutrition and overnutrition are of public health significance among adolescent Jamaican children. Ten per cent of 11–12 year olds had body mass index (BMI) values below the 5th percentile (boys, 10.6%; girls, 7.1%) but this prevalence is relatively low compared with other developing countries. The prevalence of stunting was low (3%). The prevalence of overweight (BMI≥85th percentile) (19.3%) was approaching prevalence rates found in the USA. Similar social and demographic variables were associated with thinness and fatness in males. Birth weight predicted overweight in girls.

Conclusions:

Under- and overnutrition in early adolescence are important problems in Jamaica. There is a need to address both under- and overnutrition in adolescence in preventive and rehabilitative intervention programmes.
Relative bias in diet history measurements: a quality control technique for dietary intervention trials
Authors: Martin Gina S , Tapsell Linda C , Batterham Marijka J , Russell Kenneth G
Published: February 2003

Objective:

Investigation of relative bias in diet history measurement during dietary intervention trials.

Design:

Retrospective analysis of human dietary data from two randomised controlled trials examining modified fat diets in the prevention and treatment of type II diabetes mellitus.

Setting:

Wollongong, Australia.

Subjects:

Thirty-five overweight, otherwise healthy subjects in trial 1 and 56 subjects with diabetes in trial 2.

Interventions:

Diet history interviews and three-day weighed food records administered at one-month intervals in trial 1 and three-month intervals in trial 2.

Results:

In a cross-sectional bias analysis, graphs of the association between bias and mean dietary intake showed that bias decreased in higher carbohydrate consumers in trial 1 (r= −0.344,P<0.05 ). No other significant associations were found. In a longitudinal analysis, bias did not change over time in either trial. There were no significant differences in bias magnitudes between the trials, with the exception of monounsaturated fat measurement where bias was significantly greater and more positive in trial 2, indicating overestimation of monounsaturated fat intake with the diet history. Subjects in control and intervention groups underestimated energy, fat, saturated fat and alcohol intakes with the diet history in both trials. Overweight and obese individuals appeared to make the greatest contribution to the overall underestimation of saturated fat intake by the diet history regardless of whether they were in the control or intervention group and whether they were healthy or had diabetes.

Conclusion:

Bias in diet history measurement appears to be macronutrient-specific, with energy, fat and saturated fat consistently underreported in the interview by subjects with and without diabetes and in both intervention and control groups in a dietary intervention trial. Relative bias analysis appears to be an informative tool in quality control for dietary intervention trials when biochemical markers are unavailable.
Free school meals and children's social and nutritional status in Trinidad and Tobago
Authors: Gulliford MC , Mahabir D , Rocke B , Chinn S , Rona RJ
Published: February 2003

Objective:

To evaluate the provision of free school meals in Trinidad and Tobago in relation to children's social and nutritional status.

Design and methods: Cross-sectional survey of a nationally representative sample of 66 government schools, including children in the admissions classes (aged 4 to 7 years) and classes for ‘rising nines’ (aged 7–10 years). Data included questionnaire details of free school meals and children's social background, and measurements of children's heights, weights and skinfold thicknesses.

Results:

Of 6731 eligible children, data were analysed for 5688 (85%). There were 2386 (42%) children receiving free meals provided at school. At different schools the proportion of all children receiving free meals ranged from 20% to 100%, P < 0.001. Receipt of free meals was associated with larger family size (one child, 32% received free meals; ≥6 children, 63%), lower paternal educational attainment (primary, 52% free; university, 30%), father's employment (employed, 39% free meals; unemployed <12 months, 59%) as well as maternal education and employment and household amenities. After adjusting for age, sex and ethnic group, children who received free meals were shorter (mean difference in height standard deviation score (SDS) –0.12, 95% confidence interval (CI) –0.17 to –0.06), lighter (body mass index SDS –0.21, –0.28 to –0.14) and thinner (subscapular skinfold SDS –0.13, –0.18 to –0.09).

Conclusions:

Free school meals were widely available, with some targeting of provision to children with less favourable social and nutritional status. Greater universality would reduce inequity, but more stringent targeting and reduction of school-level variation would increase efficiency.
Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC–Oxford
Authors: Appleby Paul N , Davey Gwyneth K , Key Timothy J
Published: February 2003

Objective:

To compare the prevalence of self-reported hypertension and mean systolic and diastolic blood pressures in four diet groups (meat eaters, fish eaters, vegetarians and vegans) and to investigate dietary and other lifestyle factors that might account for any differences observed between the groups.

Design:

Analysis of cross-sectional data from participants in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC–Oxford).

Setting:

United Kingdom.

Subjects:

Eleven thousand and four British men and women aged 20–78 years at blood pressure measurement.

Results:

The age-adjusted prevalence of self-reported hypertension was significantly different between the four diet groups, ranging from 15.0% in male meat eaters to 5.8% in male vegans, and from 12.1% in female meat eaters to 7.7% in female vegans, with fish eaters and vegetarians having similar and intermediate prevalences. Mean systolic and diastolic blood pressures were significantly different between the four diet groups, with meat eaters having the highest values and vegans the lowest values. The differences in age-adjusted mean blood pressure between meat eaters and vegans among participants with no self-reported hypertension were 4.2 and 2.6 mmHg systolic and 2.8 and 1.7 mmHg diastolic for men and women, respectively. Much of the variation was attributable to differences in body mass index between the diet groups.

Conclusions:

Non-meat eaters, especially vegans, have a lower prevalence of hypertension and lower systolic and diastolic blood pressures than meat eaters, largely because of differences in body mass index.
Validation of a semi-quantitative food-frequency questionnaire for use among adults in Guatemala
Authors: Rodríguez Monica M , Méndez Humberto , Torún Benjamín , Schroeder Dirk , Stein Aryeh D
Published: February 2003

Objective:

The purpose of the study was to assess the validity of a 52-item semiquantitative food-frequency questionnaire (FFQ) by comparing it with multiple 24-hour dietary recalls.

Design:

Three non-consecutive 24-hour dietary recalls and one FFQ were administered over a one-month period.

Setting:

Four communities of El Progreso, Guatemala.

Subjects:

Seventy-three individuals aged 22–55 years.

Results:

Intakes of energy and other nutrients as measured by the FFQ were higher than intakes measured by 24-hour recalls. Energy was overestimated by 361 kcal, and nutrient overestimates were particularly great for vitamin C and iron. Pearson correlation coefficients for crude energy and nutrients intakes ranged from 0.64 for energy to 0.12 for vitamin C. Exact agreement for both methods (measured by the concordance correlation coefficient) ranged from 0.59 (fat) to 0.06 (vitamin C). Pearson correlation coefficients for energy-adjusted nutrients ranged from 0.59 (carbohydrates) to 0.11 (thiamin). Pearson correlation coefficients for the proportion of total energy derived from specific foods ranged from 0.59 (tortillas) to 0.01 (sugared beverages). Cross-classification of quartiles of crude nutrient intakes for both methods indicated that <11% were grossly misclassified; after adjusting for energy intake, <13% were grossly misclassified.

Conclusions:

This FFQ provides good measures of energy and macronutrient intakes and a reasonably reliable measure of micronutrient intake, indicating its suitability for comparing exposures within a study population in reference to heath-related endpoints. Our results highlight the need to adapt any FFQ to specific cultural needs – in this case, the Guatemalan ‘core foods’ (tortilla, bread and beans), for which inter-individual variability in intake is high.
Exploring predictors of eating behaviour among adolescents by gender and socio-economic status
Authors: Lien Nanna , Jacobs David R , Klepp Knut-Inge
Published: February 2003

Objective:

Guided by theory, this study explored cross-sectional differences in factors influencing adolescent eating behaviour including gender and socio-economic status (SES), and subsequently tested the longitudinal predictive power of the models.

Design/setting/subjects: Data were collected by questionnaires in a longitudinal study of adolescents (age 13 years at baseline) and their parents from Hordaland County, Norway. Association of personal and environmental variables (family, friends, school/society) with the consumption of fruit and vegetables (FV) and selected sources of fat and of sugar were assessed at age 15 (n = 613). The final cross-sectional models were subsequently employed in groups stratified by gender/SES and to predict consumption at age 21 (n = 380).

Results:

The model explained more of the variation in the sugar score (21%) and the FV score (13.5%) than in the fat score (5%). SES was associated with both the sugar and FV scores. The strongest associations with the sugar score and FV were for antisocial behaviour and evaluation of own diet, respectively. The former association was significant in all gender/SES groups, whereas the latter association was only significant in the low SES groups. For all three types of food, the strongest significant predictors in the longitudinal models were frequency of consumption at age 15.

Conclusion:

The model's ability to explain variation in eating behaviours differed by food type, and possibly by gender/SES, but previous eating behaviour was an important predictor for all three foods. Prospective studies should carefully operationalise theoretical constructs when further investigating the influences of and interrelationships between these factors and gender/SES on the development of eating behaviours.
Livelihoods, nutrition and health in Dhaka slums
Authors: Pryer Jane A , Rogers Stephen , Normand Charles , Rahman Ataur
Published: February 2003

Objectives:

To identify groups within Dhaka slums that report similar patterns of livelihood, and to explore nutritional and health status.

Design:

A random sample of households participated in a longitudinal study in 1995–1997. Socio-economic and morbidity data were collected monthly by questionnaire and nutritional status was assessed. Cluster analysis was used to aggregate households into livelihood groups.

Setting:

Dhaka slums, Bangladesh.

Subjects:

Five-hundred and fifty-nine households.

Main outcome measures: Socio-economic and demographic variables, nutritional status, morbidity.

Results:

Four livelihood groups were identified. Cluster 1 (n = 178) was the richest cluster with land, animals, business assets and savings. Loans as well as income were higher, which shows that this group was credit-worthy. The group was mainly selfemployed and worked more days per month than the other clusters. The cluster had the second highest body mass index (BMI) score, and the highest children's nutrition status. Cluster 2 (n = 190) was a poor cluster and was mainly dependent selfemployed. Savings and loans were lower. Cluster 3 (n = 124) was the most vulnerable cluster. Members of this group were mainly casual unskilled, and 40% were femaleheaded households. Total income and expenditure were lowest amongst the clusters. BMI and children's nutritional status were lowest in the slum. Cluster 4 (n = 67) was the second richest cluster. This group comprised skilled workers. BMI was the highest in this cluster and children's nutritional status was second highest.

Conclusions:

Cluster analysis has identified four groups that differed in terms of socioeconomic, demographic and nutritional status and morbidity. The technique could be a practically useful tool of relevance to the development, monitoring and targeting of vulnerable households by public policy in Bangladesh.
Anthropometric indices predict physical function and mobility in older Australians: the Australian Longitudinal Study of Ageing
Authors: Bannerman Elaine , Miller Michelle D , Daniels Lynne A , Cobiac Lynne , Giles Lynne C , Whitehead Craig , Andrews Gary R , Crotty Maria
Published: February 2003

Objective:

To evaluate, in terms of function and mobility, the predictive value of commonly adopted anthropometric ‘definitions’ used in the nutritional assessment of older adults, in a cohort of older Australians.

Design:

Prospective cohort study – Australian Longitudinal Study of Ageing (ALSA).

Setting:

Adelaide, South Australia (1992–1994).

Subjects:

Data were analysed from 1272 non-institutionalised (685 males, 587 females) older adults ≥70 years old in South Australia. Seven ‘definitions’ commonly used in the anthropometric assessment of both under- and overnutrition (including four using body mass index (BMI), waist-to-hip ratio, waist circumference and percentage weight change) were evaluated at baseline, for their ability to predict functional and mobility limitation assessed (by self-report questionnaire) at two years follow-up. All questionnaires were administered and anthropometry performed by trained investigators. The associations between the definitions and decline in mobility and physical function were evaluated over two years using multiple logistic regression.

Results:

A BMI >85th percentile or >30 kgm−2 or a waist circumference of >102 cm in males and >88 cm in females increased risk of functional and mobility limitations. Over two years, a loss of 10% body weight significantly increased the risk of functional and mobility limitations.

Conclusion:

Maintaining weight within older adults, irrespective of initial body weight, may be important in preventing functional and mobility limitations. Excessive weight is associated with an increased risk of limitation in function and mobility, both key components of health-related quality of life.
Severe underreporting of energy intake in normal weight subjects: use of an appropriate standard and relation to restrained eating
Authors: Asbeck I , Mast M , Bierwag A , Westenhöfer J , Acheson KJ , Müller MJ
Published: February 2003

Objective:

To assess the influence of different standards and restrained eating on underreporting in healthy, non-obese, weight-stable young subjects.

Design and subjects:

Eighty-three young adults (20–38 years, 55 women, 28 men) were assessed under weight-stable conditions with a 7-day dietary record and the three-factor eating questionnaire by Stunkard and Messick. Resting energy expenditure (REE; indirect calorimetry) plus data derived from physical activity records (PA) (Standard 1) or REE times an activity factor (AF) (Standard 2) was used as standard for total energy expenditure (TEE). For comparison, doubly labelled water (DLW) was used to measure TEE in a subgroup of subjects.

Results:

There was an association between self-reported energy intake and Standard 2 (r = 0.72) but not with Standard 1. When compared with DLW both calculated standards were inaccurate, but Standard 2 avoided high levels of overreporting. Using Standard 2 to identify ‘severe’ underreporting (SU; as defined by a deviation of energy intake (EI) and TEE of >20%), SU was seen in 37% of all subjects. It was more frequently found in women than in men (49% of women, 14.3% of men, P < 0.05). Underreporting subjects had a reduced EI (P < 0.01) but there were no significant differences in nutritional status (body weight and height, body mass index, fat mass and fat-free mass), energy expenditure and the proportion of energy from macronutrients between normal and underreporting subjects. However, high restraint was associated with a higher degree of underreporting in the total group, whereas disinhibition had an influence only in men.

Conclusions:

A high prevalence of SU is seen in non-obese subjects. Characteristics of eating behaviour (restraint and disinhibition) were associated with underreporting but seemed to have a different influence in men and women.
Long-term effects of breast-feeding in a national birth cohort: educational attainment and midlife cognitive function
Authors: Richards Marcus , Hardy Rebecca , Wadsworth Michael EJ
Published: February 2003

Objective:

A recent meta-analysis showed that breast-feeding confers a 3.2 point increment in cognitive function through adolescence. Little is known, however, about possible longer-term effects of breast-feeding. We investigated the effect of breast-feeding on educational attainment, and on a range of cognitive skills in midlife, in the British 1946 birth cohort.

Objective:

Design: Regression analyses were used to test the association between breast-feeding, likelihood of obtaining advanced educational qualifications by age 26 years, and three cognitive test scores at age 53 years: i.e. reading ability (NART), timed visual search and verbal memory. These associations were then adjusted for social confounding variables and for cognitive ability at age 15 years.

Setting and subjects:

One thousand seven hundred and thirty-nine male and female participants in the MRC National Survey of Health and Development, also known as the British 1946 birth cohort, distributed throughout England, Wales and Scotland.

Results:

Breast-feeding was significantly and positively associated with educational attainment, an effect that was independent of early social background, but largely accounted for by cognitive ability at age 15 years. Breast-feeding was significantly and positively associated with the NART at 53 years, an effect that was independent of early social background, educational attainment and adult social class, but, again, largely accounted for by cognitive ability at 15 years. There was no independent effect of breast-feeding on timed visual search or verbal memory at 53 years.

Conclusion:

The benefit of breast-feeding has long-term potential impact across the life course through its influence on childhood cognition and educational attainment.
Socio-economic differences in fruit and vegetable consumption among Australian adolescents and adults
Authors: Giskes Katrina , Turrell Gavin , Patterson Carla , Newman Beth
Published: February 2003

Objectives:

To determine whether socio-economic groups differ in their fruit and vegetable consumption, and the variety eaten, and whether socio-economic differences are similar for adolescents and adults. The study also examined whether socio-economic groups vary in their reported desire to increase the amount of fruit and vegetables consumed, and the perceived barriers to achieving this.

Design, setting and subjects: The 1995 Australian National Nutrition Survey collected fruit and vegetable intake data from adolescents aged 13–17 years (n = 654) and adults 18–64 years (n = 7695) using a 24-hour dietary recall. Gross annual household income was used to measure socio-economic position.

Results:

Approximately 44% of males and 34% of females did not consume fruit in the 24 hours preceding the survey, and 20% of males and 17% of females did not consume vegetables. Among adolescents and adults, fruit and vegetable consumption was positively related to income. The only exception was vegetable consumption among adolescent males, which did not vary by income Lower-income adults consumed a smaller variety of fruits and vegetables than their higher-income counterparts. Fruit and vegetable variety did not vary by income among adolescents. Lower-income adults expressed less desire to increase their fruit and vegetable consumption, and were more likely to report that price and storage were barriers to doing so. Socio-economic differences in consumption and variety were more apparent for adults than for adolescents.

Conclusions:

In addition to increasing the consumption of fruits and vegetables among the general population, nutrition interventions, programmes and policy aiming to improve diet should target adolescents and adults from low socio-economic groups. Strategies should address price and storage barriers.
Food insecurity among refugee families in East London: results of a pilot assessment
Authors: Sellen Daniel W , Tedstone Alison E , Frize Jacqueline
Published: February 2003

Objective:

To identify child hunger and examine its association with family factors, receipt of benefits, housing conditions and social support among recently arrived refugee families with young children.

Design:

Structured and semi-structured questionnaire administered to a service-based, purposive sample of caregivers.

Setting:

East London, United Kingdom.

Subjects:

Thirty households with children <5 years old, resident in the UK for <2 years.

Results:

All households sampled were food-insecure, and 60% of index children were experiencing hunger as defined on the Radimer/Cornell scale. Child hunger was significantly associated with recent arrival, marginally significantly associated with receipt of fewer benefits and younger parenthood, and not associated with maternal education or self-efficacy score, household size or composition, or measures of social support.

Conclusions:

A community-based, participatory approach for rapid assessment of the prevalence, extent and causes of child hunger among newly arrived asylum seekers recently arrived in Britain is feasible, and preliminary results suggest a programmatic need for a broader, population-based assessment of food insecurity in this rapidly growing population group.
Acceptability of the use of iron cooking pots to reduce anaemia in developing countries
Authors: Geerligs Paul Prinsen , Brabin Bernard , Mkumbwa Albert , Broadhead Robin , Cuevas Luis E
Published: February 2003

Objective:

To evaluate acceptability, compliance and attitude towards the use of iron pots compared with aluminium pots, for cooking in a community that traditionaly did not use iron pots.

Design:

Randomised trial.

Setting:

Two rural Malawian villages.

Subjects:

Fifty-two households received iron pots and 61 aluminium pots.

Results:

Pot characteristics were assessed by a questionnaire after 3, 6, 11 and 20 weeks of use. Within households using iron pots there was a significant decrease in acceptability score with usage, from an initial value of 13.7 to 11.4 (range 1–20) (P = 0.01). Answers to questions concerning cooking characteristics showed that after 3 weeks' use the aluminium pot scored better, whereas after 20 weeks fewer answers differed between the iron and aluminium pot groups. Almost a third of the households planned to continue using iron pots daily after 20 weeks, although they had ready access to their former aluminium pot. The presence of a group of consistent pot users suggests that if households were convinced about daily use, then they were likely to maintain consistent use. Some householders considered that iron pots required less firewood for cooking than aluminium pots. The main problems related to lower acceptability were rusting and pot weight. About 25% of problems with iron pots were unrelated to their cast iron characteristics. Overall 23.4% of the households indicated they would buy an iron pot.

Conclusions:

The low acceptability of iron pots for cooking could limit their value as an intervention to control iron-deficiency anaemia. Design modifications and better instructions on pot use should improve acceptability. The study highlights the need to assess the acceptability of interventions in order to facilitate their adoption in traditional communities.
Sociodemographic inequalities in the diet of young children in the 1946 British birth cohort
Authors: Prynne CJ , Paul AA , Mishra GD , Hardy RJ , Bolton-Smith C , Wadsworth MEJ
Published: February 2003

Abtsract

Objective:

To evaluate whether there was food and nutrient equality across occupational social classes and geographical region for members of the 1946 British birth cohort at age 4 years.

Design:

Cross-sectional analysis of selected food groups, energy and nutrients from one-day recall diet records.

Setting:

England, Scotland and Wales in 1950.

Subjects:

Nationally representative sample of 4419 children aged 4 years in 1950 from the MRC National Survey of Health and Development (NSHD) (1946 Birth Cohort).

Results:

Significant food and nutrient inequalities occurred by region and occupational social class of the father. Disparity in fruit and vegetable consumption primarily led to the nutrient differences, especially with respect to lower vitamin C and carotene intakes in children from Scotland and from a manual social class background. Lower energy intake in Scottish children was attributable to inequality in the consumption of foods providing fat, and also to the retention of the traditional Scottish diet that included porridge and soups. Consumption of some rationed foods – bacon, orange juice and tea – was inequitably distributed by father's social class, but others, in particular meat and spreading fats, were consumed more uniformly. In contrast to fruits and vegetables, which showed marked sociodemographic disparities, other non-rationed foods such as bread and potatoes were consumed universally.

Conclusion:

Local cultural norms may have played as strong a part in sociodemographic differences in the diet of children in the early 1950s as did the strict, post-war food rationing that prevailed. In consequence, nutritional equality was not achieved, and the relatively low intake of antioxidant vitamins during early childhood in certain population groups may have compromised health in the long term.
The contribution of foods to the dietary lipid profile of a Spanish population
Authors: Cucó Gemma , Fernández-Ballart Joan , Martí-Henneberg Carles , Arija Victoria
Published: February 2003

Objective:

To identify the food that has the greatest effect on the variation in the percentage of energy intake derived from fat and saturated fatty acids for the consumption of a Spanish population.

Design:

A cross-sectional study of food consumption, using the 24-hour recall method for three non-consecutive days, one of which was a non-working day. Subjects were interviewed by trained interviewers in the subjects' homes. We used multiple linear regression for statistical analysis.

Setting:

The citizens of Reus.

Subjects:

One thousand and sixty subjects over five years old, randomly selected from the population census of Reus.

Results:

In both sexes, the foods that mainly determine a high consumption of fat are oil and red meat while those that determine a lower consumption of fat are bread, savoury cereals and fruit. The foods that mainly determine a high consumption of saturated fatty acids are red meat and whole-fat dairy products while those that determine a low consumption are bread, savoury cereals and fruit.

Conclusions:

In our population, feasible variations in the intake of some foods – less than one portion – would reduce the estimated percentage of energy intake derived from fat and saturated fatty acids by a quantity considered important for cardiovascular disease prevention. The periodic identification and quantification of the food that most affects the dietary fat profile will help in drawing up dietary guidelines with more reasonable strategies for consuming a healthier diet and decreasing the risk of developing nutritional disorders.
Urinary excretion of dithiocarbamates and self-reported Cruciferous vegetable intake: application of the ‘method of triads’ to a food-specific biomarker
Authors: Fowke Jay H , Hebert James R , Fahey Jed W
Published: February 2003

Objective:

Greater intake of Cruciferous vegetables (e.g. broccoli) may prevent cancer at several sites. Urinary excretion of isothiocyanate conjugates (dithiocarbamates, DTC) provides a specific biomarker of Cruciferous vegetable consumption suitable for epidemiological investigations. However, no gold-standard referent is available for evaluating urinary DTC levels as an estimator of Cruciferous vegetable consumption. We compared urinary DTC levels to intake as measured by two self-reported dietary assessment techniques.

Design:

Cruciferous vegetable consumption was measured before and after a behavioural dietary intervention using multiple 24-hour recalls (24HR), a food-counting questionnaire (VFQ) and urinary DTC excretion levels. Analysis included a structural equation approach (Method of Triads) combining these three assessment techniques to estimate the relationship between DTC level and the study population's ‘true’ Cruciferous vegetable intake.

Setting:

The intervention curriculum assisted participants in consuming about 2 servings per day for a 6-week period. Participants attended four classes emphasising problem-solving skills, dietary counselling and vegetable preparation skills. There were no dietary restrictions.

Subjects:

Thirty-three healthy, free-living, post-menopausal women.

Results:

Although few participants reported Cruciferae consumption prior to the intervention, 30 participants reported Cruciferae consumption after the intervention (Post-intervention). Urinary DTC levels were correlated with estimated intake derived from either the 24HR ( r = 0.57; 95% confidence interval (95% CI) 0.28, 0.76) or VFQ ( r = 0.49; 95% CI 0.17, 0.71). The validity coefficient (Method of Triads) between urinary DTC excretion and an index of true Cruciferous intake was stronger than the Pearson correlation ( rv = 0.65; 95% CI 0.35, 0.90), and comparable to estimates derived from the 24HR ( rv = 0.82; 95% CI 0.65, 1.00) or VFQ ( rv = 0.76; 95% CI 0.47, 0.92) method. These associations were not affected by adjustment for body mass index, energy intake, or social approval or desirability response sets.

Conclusions:

Food-frequency questionnaires (FFQ) suitable for large epidemiological studies may not be designed to measure all Cruciferae, and cannot capture exposure to phytochemicals derived from those vegetables. Urinary DTC measurement was significantly correlated with Cruciferae intake derived from two dietary assessment approaches, and urinary DTC levels could supplement traditional FFQ data by providing an index of recent Cruciferous vegetable intake not susceptible to reporting biases.
Diet patterns and the risk of renal cell carcinoma
Authors: Handa Kiren , Kreiger Nancy
Published: February 2003

Objectives:

Our objective was to identify food intake patterns that might be associated with the risk of renal cell carcinoma.

Design:

A total of 461 cases (210 females, 251 males) were age frequency matched to population controls. Diet factors were created using factor analysis of 69 food items from a food-frequency questionnaire. These factors were modelled using logistic regression to identify those associated with renal cell carcinoma.

Setting:

We investigated the role of diet in the aetiology of renal cell carcinoma using a population-based case–control study conducted in Ontario between 1995 and 1996.

Subjects:

Cases were Ontario residents 20 to 74 years of age identified through review of pathology reports in the Ontario Cancer Registry.

Results:

A ‘dessert’ diet factor was positively associated with disease for both sexes (odds ratio estimate (OR) for males = 3.7, 95% confidence interval (CI) 2.0–6.9; OR for females = 1.4, 95% CI 0.8–2.2, for the highest vs. lowest quartile). In males, a ‘beef’ diet factor was identified and was associated with an increased risk of renal cell carcinoma. Furthermore, a ‘juices’ diet factor also showed an association with increased risk in males ( OR = 1.8, 95% CI 1.0–3.1). For females, a positive association was observed between renal cell carcinoma and an ‘unhealthy’ diet factor ( OR = 1.4, 95% CI 0.8–2.4).

Conclusions:

Our findings confirmed that high-fat and high-protein diets might be risk factors for renal cell carcinoma. The data also suggest an increased risk associated with juice intake, a finding not previously reported.
Breast-feeding and the working mother in Nairobi
Authors: Lakati Alice , Binns Colin , Stevenson Mark
Published: February 2003

Objective:

In the fast growing city of Nairobi, women often combine the roles of mother and worker in trying to achieve better standards of living. The objective of this study was to document the effect of returning to work on breast-feeding by mothers in Kenya.

Design:

A cross-sectional survey.

Setting:

Outpatient clinics of two major hospitals in Nairobi, one government hospital in an economically deprived area and one high-fee private hospital.

Subjects:

Four hundred and forty-four working mothers from low and higher socio-economic areas in Nairobi. All working mothers with infants aged 4 to 12 months attending during the survey period were invited to participate.

Results:

The prevalence of breast-feeding at the time of interview was found to be 94.1%. The lower socio-economic group exhibited a higher prevalence of breast-feeding (99%), 10% greater than the higher socio-economic group. The mean number of hours the mothers were away from home due to work was 46.2 hours each week. The majority (54.4%) of the mothers employed a ‘house-girl’ to care for their infant while they were at work, while 28.4% were able to take their infants to work. Most of the breast-feeding mothers (95%) breast-fed their infants at least three times a day and only 23 mothers reported not being able to breast-feed their infants during the day. The lower socio-economic group had a mean of 5.09 breast-feeding times per day while the higher socio-economic group had a mean of 3 times a day. In a logistic regression analysis the mode of work (fixed working hours vs. shift working hours) was associated with exclusive breast-feeding at one month (odds ratio (OR) = 0.45) and two months (OR = 0.39).

Conclusion:

In Western countries ‘return to work’ is often cited as the reason that breast-feeding is discontinued prematurely. In this study we have shown how mothers in Kenya are able to successfully continue breast-feeding after they have returned to work, often for very long hours.
Associates of obesity and weight dissatisfaction among Finnish adolescents
Authors: Mikkilä Vera , Lahti-Koski Marjaana , Pietinen Pirjo , Virtanen Suvi M , Rimpelä Matti
Published: February 2003

Objective:

We investigated behavioural and socio-economic factors associated with obesity and weight dissatisfaction among Finnish adolescents.

Design:

A total of 60252 Finnish adolescents aged 14 to 16 years filled in a questionnaire about their health, health behaviour and socio-economic background. Food choices were obtained by using a short food-frequency questionnaire. Obesity was defined as a weight at least 120% of the sex- and height-specific mean weight for subjects.

Results:

Of girls and boys, 54% and 66%, respectively, were satisfied with their weight. Among dissatisfied normal-weight adolescents, 81% of girls but only 48% of boys thought they were overweight. Of obese boys, 25% were satisfied with their weight. For both genders, obesity and weight dissatisfaction were associated with economic problems in the family. In girls, an association was also found with poor school performance, low educational level of parents and not having evening meals at home; and in boys, with physical inactivity and not eating school lunch. Smoking was more common among girls who were dissatisfied with their weight. Differences in food choices were small between different weight and weight satisfaction categories.

Conclusions:

Having normal weight and being satisfied with that weight are favourable for an adolescent. Obesity and weight dissatisfaction are associated mostly with disadvantageous health behaviours and low socio-economic status. Health behaviour seems to be associated more with weight satisfaction than with actual weight.
New Zealanders' attitudes to milk: implications for public health
Authors: Wham Carol A , Worsley Anthony
Published: February 2003

Objective:

To identify consumer attitudes and beliefs about (liquid) milk that may be barriers to consumption.

Design:

Two random-quota telephone surveys conducted in Auckland one year apart. Respondents were questioned about their usual milk intake and their attitudes to milk. The questionnaire included attitude items that reflected the main themes of consumer interest in milk.

Setting:

New Zealand.

Subjects:

Seven hundred and thirteen respondents in the baseline survey and a separate sample of 719 respondents in the follow-up survey.

Results:

At least one-third of the respondents consumed less than a glass (250ml) of milk a day. Non-consumption was highest in young women (15%). People's concerns about milk related to what was important in their lives; what threatens them physically and emotionally. Women held more positive attitudes but they were concerned about the fat content of milk. Men were less aware of milk's nutritional benefits and as a result were less appreciative of its value.

Conclusions:

There is an opportunity to develop public health initiatives to address the barriers to drinking milk. Industry–health alliances may be an effective means to provide positive nutrition messages about milk and to engage the support of health professionals.