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[Gender and age-related differences in life style characteristics, health condition, and unidentified complaints in healthy old-aged people].

PURPOSE: The purpose of this study was to examine gender and age-related differences in life style such as exercise and dietary habits etc., health conditions and unidentified complaints in healthy older-aged people. METHOD: A questionnaire consisting of 40 items on life style and 16 items on unidentified complaints was administered to 890 people aged 60 to 89 in the community (304 males and 586 females). The proportions of gender and age-range for each item were computed, and a two-way analysis of variance based on the Lancaster method was applied. RESULTS: Most of the aged spend their time living regularly and have leisure activities. The smoking and drinking rates for males are higher than those for females in all age-ranges. The aged exercise more than one or two days a week for both sexes. Many aged males have exercised more than three days a week and/or for more than seven years. Most of the aged have regular dietary habits and there are many males who are careful to eat appropriate portion sizes. Females have more interest in food in the higher age-ranges, but tend to control meal-portions voluntarily. The rate of seeing a doctor regularly and having fractures increases in the higher age-ranges. The rates of arthritis and neuralgia are higher for females than for males. More females complain of 'eyes have grown blurred' and 'pain and swelling in a joint' and males complain more of 'cough and phlegm' and 'feel very thirsty'. CONCLUSION: Gender and age-related differences exist in most life style items for healthy old-aged people, and there is little in the way of age-related differences in the content of unidentified complaints.

Age Factors↗

Science-based solutions to obesity: what are the roles of academia, government, industry, and health care?

The complexity of the obesity epidemic requires the cooperation of key stakeholders in this effort. No one sector, academia, government, industry, or health care, has been successful in combating this disease to date. On March 10-11, 2004, The Harvard Medical School Division of Nutrition hosted the symposium "Science-Based Solutions to Obesity: What is the Role of Academia, Government, Industry, and Health care?" as a platform to address the role of these stakeholders, both individually and collectively, in combating the nation's epidemic of obesity. The proceedings from the symposium, included in this supplement, discuss the following: the science of obesity-related topics such as genetics, protein and weight loss, portion size, energy density, and behavior; the need for more aggressive government policies; industry's role in using research and development capabilities to promote healthier, portion-controlled products; and how to translate nutrition information from medical doctors to patients.

Academic Medical Centers↗

Diet and gallstones in Italy: the cross-sectional MICOL results.

Fifteen thousand nine hundred ten men and 13,674 women (age, 30-69 years) were enrolled in an epidemiological survey of the general population, between December 1984 and April 1987. Each participant was submitted to ultrasonography (US) of the gallbladder and completed a food-frequency questionnaire, covering 38 food items. A common portion size was identified and subjects were asked how often each item was consumed. Nutrient intake was computed by multiplying the intake frequency and nutrient content per portion for each item, and then by summing the product over all foods. Each nutrient intake was adjusted for energy intake. Alcohol intake was calculated by summing the consumption of wine, beer, and liquor. Having excluded subjects aware of having gallstones (GS) or previously submitted to cholecystectomy (to avoid prothopatic bias), 787 males and 1,014 females with GS and 14,272 males and 10,836 females without GS were available for analysis. Relative risks (RR) of GS were computed by quintiles of nutrient intake. The overnight fasting period was calculated as the difference between the specified time of dinner and the time of the next meal (breakfast or lunch). A significant negative association was found between RR of GS and total energy intake for males (chi2 for trend = 8.37; P = .004), fiber intake for females (chi2 = 5.45; P = .02), and daily alcohol consumption for males (chi2 = 10.86; P = .001). A positive association was observed between RR of GS and carbohydrate (chi2 = 5.95; P = .01 for males; chi2 = 9.39; P = .002 for females) and protein intake only for males (chi2 = 10.92; P = .01). Prevalence of GS was higher among subjects who had an overnight fasting period of over 12 hours than subjects with that of less than 12 hours. (RR: 1.35; 95% CI: 1.01-1.80 for males; RR: 1.28; 95% CI: 1.03-1.60 for females). These data do not confirm that high energy intake is associated with an increased risk of GS. Factors protecting against GS comprise: low carbohydrate (males and females) and protein (males) intakes, high fiber (females) and moderate alcohol intake (males) consumption, and a shorter overnight fasting period for both sexes.

Cholelithiasis↗

Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods.

BACKGROUND: The Food Frequency Questionnaire (FFQ) is one of the most commonly used tools in epidemiologic studies to assess long-term nutritional exposure. The purpose of this study is to describe the development of a culture specific FFQ for Arab populations in the United Arab Emirates (UAE) and Kuwait. METHODS: We interviewed samples of Arab populations over 18 years old in UAE and Kuwait assessing their dietary intakes using 24-hour dietary recall. Based on the most commonly reported foods and portion sizes, we constructed a food list with the units of measurement. The food list was converted to a Semi-Quantitative Food Frequency Questionnaire (SFFQ) format following the basic pattern of SFFQ using usual reported portions. The long SFFQ was field-tested, shortened and developed into the final SFFQ. To estimate nutrients from mixed dishes we collected recipes of those mixed dishes that were commonly eaten, and estimated their nutritional content by using nutrient values of the ingredients that took into account method of preparation from the US Department of Agriculture's Food Composition Database. RESULTS: The SFFQs consist of 153 and 152 items for UAE and Kuwait, respectively. The participants reported average intakes over the past year. On average the participants reported eating 3.4 servings/d of fruits and 3.1 servings/d of vegetables in UAE versus 2.8 servings/d of fruits and 3.2 servings/d of vegetables in Kuwait. Participants reported eating cereals 4.8 times/d in UAE and 5.3 times/d in Kuwait. The mean intake of dairy products was 2.2/d in UAE and 3.4 among Kuwaiti. CONCLUSION: We have developed SFFQs to measure diet in UAE and Kuwait that will serve the needs of public health researchers and clinicians and are currently validating those instruments.

Adult↗

Pesticide residues in food--acute dietary exposure.

Consumer risk assessment is a crucial step in the regulatory approval of pesticide use on food crops. Recently, an additional hurdle has been added to the formal consumer risk assessment process with the introduction of short-term intake or exposure assessment and a comparable short-term toxicity reference, the acute reference dose. Exposure to residues during one meal or over one day is important for short-term or acute intake. Exposure in the short term can be substantially higher than average because the consumption of a food on a single occasion can be very large compared with typical long-term or mean consumption and the food may have a much larger residue than average. Furthermore, the residue level in a single unit of a fruit or vegetable may be higher by a factor (defined as the variability factor, which we have shown to be typically x3 for the 97.5th percentile unit) than the average residue in the lot. Available marketplace data and supervised residue trial data are examined in an investigation of the variability of residues in units of fruit and vegetables. A method is described for estimating the 97.5th percentile value from sets of unit residue data. Variability appears to be generally independent of the pesticide, the crop, crop unit size and the residue level. The deposition of pesticide on the individual unit during application is probably the most significant factor. The diets used in the calculations ideally come from individual and household surveys with enough consumers of each specific food to determine large portion sizes. The diets should distinguish the different forms of a food consumed, eg canned, frozen or fresh, because the residue levels associated with the different forms may be quite different. Dietary intakes may be calculated by a deterministic method or a probabilistic method. In the deterministic method the intake is estimated with the assumptions of large portion consumption of a 'high residue' food (high residue in the sense that the pesticide was used at the highest recommended label rate, the crop was harvested at the smallest interval after treatment and the residue in the edible portion was the highest found in any of the supervised trials in line with these use conditions). The deterministic calculation also includes a variability factor for those foods consumed as units (eg apples, carrots) to allow for the elevated residue in some single units which may not be seen in composited samples. In the probabilistic method the distribution of dietary consumption and the distribution of possible residues are combined in repeated probabilistic calculations to yield a distribution of possible residue intakes. Additional information such as percentage commodity treated and combination of residues from multiple commodities may be incorporated into probabilistic calculations. The IUPAC Advisory Committee on Crop Protection Chemistry has made 11 recommendations relating to acute dietary exposure.

Animals↗

Perspectives of using the EPIC-SOFT programme in the context of pan-European nutritional monitoring surveys: methodological and practical implications.

OBJECTIVE: To evaluate the usefulness of a computerized 24 h diet recall programme (EPIC-SOFT) for pan-European dietary surveys. METHODS: The perspectives of using EPIC-SOFT in study contexts other than EPIC were evaluated. In order to estimate the usefulness of existing EPIC-SOFT material for developing new versions for non-EPIC countries, a comparison of food and recipe lists and portion pictures between a country participating in EPIC (Sweden, n=2311 foods, 140 photo series) and a non-EPIC country (Finland, FINDIET 1997 Study, n=1373 foods, 126 photo series) was performed. RESULTS: Despite certain limitations, the EPIC-SOFT programme is a promising tool for pan-European Dietary Surveys. About 12-17 man-months would be needed to develop a new version for a non-EPIC country, depending on the extra work required. A 95% coverage of food and mixed recipes was found between the EPIC-Sweden and FINDIET 1997 databases. Of the pictures in the Finnish portion size book, 62% had an equivalent in the EPIC-SOFT picture book, but the range and size of photo series was larger in the latter than in the former, especially for vegetables. A tendency was observed that, if the central serving in a given picture book was larger, the consumers in that country also reported a larger mean portion. CONCLUSIONS: This report shows that the EPIC-SOFT programme is already available for use in 11 European countries and could be extended easily to other countries if resources are made available. However, further developments are required to obtain standardized nutrient estimates and make the maintenance of the EPIC-SOFT databases independent from the EPIC logistics. The available EPIC-SOFT material would be useful for developing new versions for countries of similar food culture.

Databases, Factual↗

Changes in beverage intake between 1977 and 2001.

OBJECTIVE: To examine American beverage consumption trends and causes. METHODS: Nationally representative data from the 1977-1978 Nationwide Food Consumption Survey, the 1989-1991 and 1994-1996 (also for children aged 2 to 9 years in 1998) Continuing Surveys of Food Intake by Individuals (CSFII), and 1999-2001 National Health and Nutrition Examination Survey were used in this study. The sample consisted of 73,345 individuals, aged >or=2 years. For each survey year, the percentage of total energy intake from meals and snacks was calculated separately for respondents aged 2 to 18 years, 19 to 39, 40 to 59, and >or=60. The percentage of energy intake by location (at home consumption or preparation, vending, store eaten out, restaurant/fast food, and school), as well as for specific beverages was computed separately for all age groups. The proportion consumed, mean portion size, and number of servings were calculated. RESULTS: For all age groups, sweetened beverage consumption increased and milk consumption decreased. Overall, energy intake from sweetened beverages increased 135% and was reduced by 38% from milk, with a 278 total calorie increase. These trends were associated with increased proportions of Americans consuming larger portions, more servings per day of sweetened beverage, and reductions in these same measures for milk. CONCLUSIONS: There is little research that has focused on the beneficial impacts of reduced soft drink and fruit drink intake. This would seem to be one of the simpler ways to reduce obesity in the United States.

Adolescent↗

Fruits and vegetables, 5+ a day: are we getting the message across?

Fruit and vegetables have important health promoting properties. The 5+ a day programme aims to promote awareness of the need to eat more of these foods. This paper presents and discusses the results of two surveys designed to determine the success of the 5+ a day programme across New Zealand. Household surveys were carried out by a marketing research company in 1999 and 2000. The 1999 questionnaire focused on awareness and understanding of the 5+ a day campaign. The 2000 questionnaire focused on attitudes to health and on intakes of fruits and vegetables. Data were collected from households nationwide (1999 survey N = 200, 2000 survey N = 520). Spontaneous consumer awareness of messages promoting the need to eat more fruit and vegetables was high. Seventy-one percent of all respondents identified the 5 servings a day message from the 5+ a day logo regardless of whether they had seen it before. The meaning of the hand in the logo was less clear with only 2.5% identifying the 'serving size' element of the logo. Fruit and vegetable intakes of respondents were influenced by demographic factors: gender, ethnicity, education and occupation (all P < or = 0.05). Positive attitude towards the relationship between fruit, vegetables and health was influenced by similar factors and in turn affected fruit and vegetable intakes. The 5+ a day message is well recognised and understood. Portion size is less well understood. The 5+ a day message promotes positive attitudes towards healthy eating which are associated with healthier eating habits, but some groups within society may need further attention.

Adolescent↗

Readability and content analysis of print cholesterol education materials.

This article reports the results of an analysis of the readability levels and content of 38 print cholesterol education materials available from government, health agency, professional association, university and industry sources. Each item was characterized according to the primary intended audience (general public, public and screening participants, or those identified with elevated cholesterol and patients in treatment), size, length and appearance. Readability analysis was done using the SMOG and Fog Grading formulas and content analysis examined the presence of messages in each of nine key areas. The readability assessment revealed that the average reading grade level was close to Grade 11, which is too difficult for many adults. Content analysis suggested a need to better address other heart disease risk factors, portion size and the use of brand name food recommendations. Further practice and research needs are identified.

Evaluation Studies as Topic↗

In vitro accessibility and intake of beta-carotene from cooked green leafy vegetables and their estimated contribution to vitamin A requirements.

Provitamin A carotenoids from green leafy vegetables constitute a major dietary source of vitamin A in Tanzania. The efficiency of different vegetable preparations in contributing to the daily safe intake level of vitamin A for children was evaluated in the present study. The amount of bioaccessible (available for absorption) all-trans-beta-carotene from green leafy vegetable dishes prepared either traditionally in households or with an improved method was estimated by an in vitro digestion method that simulates human digestion. The median vegetable portion size consumed by 34 children (2-12 years old) in the surveyed households was determined by weighing. The amount of all-trans-beta-carotene available for absorption from the same type of vegetables cooked without oil by traditional or a modified method ranged from 5 to 12% and 4 to 15%, respectively. Vegetables cooked with modified method with oil had 2-5 times higher amount of in vitro accessible all-trans-beta-carotene than vegetables cooked without oil. A median portion (84 g) of such a relish then provided 88-477% of the daily safe intake level of vitamin A, while portions cooked without oil only provided between 23 and 46%. In this study, a wide variation in all-trans-beta-carotene content and bioaccessibility among studied green leaves was obtained. Still, to supply daily safe intake level of vitamin A for children from a median vegetable relish portion it is necessary to add oil in the preparation.

Antioxidants↗

Weight of foods and number of portions consumed are not proxies for expressing nutrient intakes in field studies.

In order to determine whether simplified indicators for usual consumption of selected food groups, specifically those derived from either the percentage of the number of daily portions, the percentage of total daily weight consumed, or both, could serve as proxies for the conventional expression of daily energy intake, these indicators were computed and compared from food-frequency data in a data set. Food consumption was reported in frequency categories and portion sizes per month, per week, or per day, and the cumulative sum was divided by 365 to provide a daily average. The survey was done in the township of Santa Cruz and three hamlets of a rural county seat in Guatemala. Data from food-frequency questionnaires from 269 individuals (55 men and 214 women aged 16 to 86 years) were analyzed. For foods of plant origin, the percentage of total energy, percentage of total food weight, and percentage of total number of portions consumed showed low correlations (r < .45). When subdivided into specific foods and food groups (fruits and vegetables, red meat, etc.), marked differences were revealed across sites and among different indicators of consumption. Despite the simplicity of calculation, neither the percentage of weight of food in a group nor the percentage of portions consumed could serve reliably as proxies for their contributions to the percentage of total energy in this rural population in Guatemala.

Adolescent↗

Evening meals selected by college students: impact of the foodservice system.

We studied college students to determine the effect of variations in the foodservice system on their food choices. We measured time students spent waiting to enter the dining facility and selecting foods in the servery and analyzed photographs of food selections. Data were collected for the same menu four times. Time spent both waiting for access and in the servery decreased during the academic year. Female students selected significantly higher levels of energy and several nutrients (protein, vitamin A, iron, and cholesterol) when they spent more time in the servery. Food appearance influenced food choices for men and women. Escalloped potatoes and stuffed shells were selected by fewer students when they appeared dry. Limiting portion sizes had no impact on food choices of women but markedly changed choices for men. When protein-containing foods were limited, men increased their selection of higher-fat items so that energy intake was unchanged. The location of milk machines did not directly influence the number of students who selected milk, but there is some suggestion that improved access resulted in some increase in choice of calcium-containing foods by women. Dietitians can influence food choices by assuring speed of service, product consistency, portion control, and ease of access to foods containing nutrients that may be deficient in the population being served.

Adult↗

Elevated and sustained desire for sweet taste in african-americans: a potential factor in the development of obesity.

Oral habituation is a relatively long-lasting decrease in oral responsiveness that results from the repeated presentation of a single stimulus. The purpose of this study was to evaluate the degree of habituation to sweet-tasting foods and to determine whether there are differences in the rate of habituation between African Americans and European Americans. These two groups were compared because the prevalence of obesity and obesity-related disorders such as diabetes and hypertension is significantly higher among African Americans than among European Americans. Nine different commercial foods and beverages that differed in sweetness intensity and caloric density served as stimuli. Subjects tasted and rated each food once per minute for a 30-min period on scales related to desire for another taste of the same sample and desire for a different taste. The stimuli and portion size for each of the 30 samples were two candy bars (Ultra Slim-Fast Cocoa Almond Crunch Bar, 1/16 of a bar; Natural Nectar Peanut Butter Granola Bar, 1/16 of a bar), three beverages (Nestea Lemon Flavored Instant Tea with NutraSweet, 5 mL; Welch's Grape Juice, 5 mL; Pink Swimmingo Kool-Aid, 5 mL), two gelatin desserts (Cherry Flavored Jell-O Gelatin, 5 g; Cherry Flavored Jell-O Gelatin with NutraSweet, 5 g), one enteral nutrition drink (Vanilla Ensure Plus, 5 mL), and one pudding (Ultra Slim-Fast Chocolate Pudding, 5 g). Subjects consumed the entire portion of each sample. Habituation occurred for seven of the nine foods as judged by a decrease in the desire for another taste of the same food. The degree of habituation for European Americans and African Americans was similar except for the sweetest food (Cherry Flavored Jell-O Gelatin with NutraSweet), for which African Americans showed no habituation. The degree of habituation in both groups was unrelated to caloric density. Overall, young African Americans had a significantly greater desire for another taste of the same food than did young European Americans for seven of the nine foods, and this desire was strongly correlated with the sweetness intensity for young African Americans but not for young European Americans. Furthermore, young African Americans had a greater desire than young European Americans for a different taste for seven of nine foods. The greater desire for intense sweet tastes may be a factor in the elevated incidence of obesity and diabetes in African Americans. In addition, young African Americans had greater perceived stress in this study than did young European Americans. If African Americans use sweet taste to compensate for feelings of stress, this compensation may also contribute to weight gain.

Adult↗

[Development of a quantitative questionnaire of food intake in japanese immigrants and their descendants residents in Sao Paulo, Brazil].

The present study describes the development of a questionnaire to assess usual frequency and quantity of food and nutrient intake by people of Japanese descent living in São Paulo, Brazil. Both the food list and appropriate serving sizes for food items from the Food Frequency Questionnaire (FFQ) were selected from a cross-sectional assessment of diet in a random sample of Japanese immigrants living in the city of São Paulo (first- and second-generations, n = 166), aged 45-70 years, using self-administered three-day food records. We used the food records to select food items on the basis of their contribution to total population intake of relevant foods and nutrients. Criteria for grouping separate foods included similarity in nutrient content per usual serving and the importance of a particular food (e.g., typical Japanese foods). Four portion sizes were presented: small, medium, large, and extra-large. We examined the frequency distribution of equivalent-gram weights of each selected food and identified the four serving sizes in the distribution. The quantitative FFQ was designed with 129 food groups and exact frequencies of intake. Instructions for self-reporting and applications of the method for epidemiological use are discussed.

Aged↗

A recipe for improving food intakes in elderly hospitalized patients.

BACKGROUND & AIMS: The aim of this study was to compare food wastage and intake between the normal hospital menu and one where more energy dense but smaller portions were provided. METHODS: This study was carried out on an Elderly Rehabilitation ward in a University hospital. Patients were randomly allocated to receive either a normal or a reduced portion size fortified menu for a 14 day cycle and then swapped-over at the end of each cycle for the 56 day study. One group received a cooked breakfast and normal menus throughout the study. RESULTS: All the menu combinations could meet the patients recommended intake. The fortified menu provided 14% more energy than the normal menu. Food wastage was highest in the cooked breakfast group (32%) and lowest in the Fortified group (27%). The total weight of wasted food was less than in the previous study. Nutritional intakes were 25% higher on the fortified menu compared with the normal menu. The mean protein intakes were still below that recommended. All patients had higher energy intakes on the Fortified menu compared with their intake on the normal menu despite being served a lower weight of food. CONCLUSIONS: We conclude from our own data and that of others that it is possible for elderly patients to achieve their nutritional targets using a combination of smaller portions of increased energy and protein density and between-meal snacks. The needs of other groups of patients also needs to be assessed in a similar way to make hospital food appropriate to the needs of the sick.

Aged↗

Living on the edge: dietary strategies of economically impoverished women in Cali, Colombia.

Economically impoverished women in Cali, Colombia, have restricted access to food in a city where food is abundant. Ethnographic observations, interviews and 2 day food records were used to better understand the coping strategies used by a group of these women (n = 85) to maintain adequate levels of energy intake. Anthropometric indicators of nutritional status were normal for the group. Interview data revealed that the ability to purchase food was a concern for 58% of the women. When faced with a restricted ability to purchase food, the women indicated they made compromises in meal composition, reduced portion sizes, and/or reduced the number of meals. They also relied on relatives, friends, neighbors, store credit, or local government programs for access to food. Changes in meal composition were identified in 17.1% of all diet records (n = 509). Low energy intake (defined as energy intake < or = 1.27 x BMR) was identified in 17.1% of all diet records. Carbohydrate consumption was significantly greater on low-energy intake days. The adequate nutritional status of this group of women suggests that their coping strategies are usually adequate to maintain energy intake, but the presence of uncertainty, the frequency of compromises in diet composition, and the frequency of low-energy intake days suggest that these women are at risk for undernutrition.

Adaptation, Psychological↗

Olive oil, other seasoning fats, and the risk of colorectal carcinoma.

BACKGROUND: An association between fats and colorectal carcinoma has been suggested, but the epidemiologic evidence by type of dietary fat is far less clear. Colorectal carcinoma rates have been relatively low in Mediterranean countries compared with most other Western countries, but the components of the Mediterranean diet responsible for this favorable pattern are unclear. METHODS: The relationship between various added (seasoning) fats and colorectal carcinoma risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in six Italian areas. Cases were 1953 patients with incident, histologically confirmed colorectal carcinoma (1225 of the colon and 728 of the rectum) admitted to the major teaching and general hospitals in the study areas. Controls were 4154 subjects with no history of cancer who were admitted to hospitals in the same catchment areas for acute, nonneoplastic diseases unrelated to the the digestive tract and requiring no long term modifications of diet. Dietary habits were investigated using a validated food frequency questionnaire including 78 items. Lipid intake was estimated by taking into account the content of seasoning lipids in different dishes, the frequency of consumption and portion size of each dish, and individual fat intake patterns. RESULTS: The odds ratios (OR) for successive tertiles of olive oil intake, compared with the lowest one, were 0.87 (95% confidence interval [CI], 0.75-1.01) and 0.83 (95% CI, 0.70-0.99) (chi2trend = 4.49, P = 0.03) when colorectal carcinoma was analyzed as a whole, 0.82 (95% CI, 0.68-0.98) and 0.81 (95% CI, 0.66-0.99) (chi2trend = 4.05, P = 0.04) for colon carcinoma, and 0.96 (95% CI, 0.77-1.19) and 0.88 (95% CI, 0.66-1.12) for rectal carcinoma. For specific seed oils (including sunflower, maize, peanut, and soya), the OR for colorectal carcinoma was 0.91 in the highest tertile of intake, and the corresponding values were 1.01 for mixed seed oils and 0.93 for butter. None of these estimates was significantly different from the unity. Allowance for vegetable intake attenuated the apparent protection from olive oil consumption (OR, 0.94 for colon and 0.97 for rectum for the highest tertile), which still was apparent in younger subjects (OR, 0.82 for colon and 0.69 for rectum). CONCLUSIONS: In this study, seasoning fats did not appear to increase the risk of colorectal carcinoma, and there was little evidence for a differential effect by fat type. If such a differential effect exists, it is minor and could favor olive oil.

Adult↗

Diet and risk of esophageal cancer by histologic type in a low-risk population.

In a hospital-based case-control study of esophageal cancer undertaken in Athens (1989-1991), 43 patients with incident esophageal squamous-cell carcinoma and 56 patients with incident esophageal adenocarcinoma were compared to 200 injury patients. Personal interviews were conducted in the hospital setting, and dietary intake was assessed using a validated semi-quantitative food-frequency questionnaire. Nutrient intakes for individuals were calculated by multiplying the nutrient content of a typical portion size for each specified food item by the frequency with which the food was consumed per month and summing these estimates for all food items. Data were modeled through logistic regression, controlling for socio-demographic factors, tobacco smoking, consumption of alcoholic beverages and total energy intake. Consumption of vegetables and fruits as well as intake of vitamin A, vitamin C and crude fiber were inversely associated with esophageal cancer in general, but the respective associations were stronger for adenocarcinoma. There was evidence that added oils and fats and intake of polyunsaturated fat were positively associated with adenocarcinoma but inversely associated with squamous-cell carcinoma.

Adenocarcinoma↗