Dietary patterns of Spanish-speaking people living in the Boston area.
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Adult↗
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Toward more healthful dietary patterns--a matter of policy.
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Evaluation of dietary quality in relationship to nutritional and lifestyle factors in elderly people of the US Framingham Heart Study and the European SENECA study.
OBJECTIVE: To evaluate dietary quality of European and American elderly subjects using different derivatives of dietary patterns (dietary scores and clusters) and to investigate the relationship of these approaches to nutritional and lifestyle factors. DESIGN: Data from the cross-sectional SENECA baseline study and Framingham Heart Study (original cohort and offspring) were used for data analysis. Food intake data were summarised into dietary clusters and into dietary scores (Healthy Diet Indicator and Mediterranean Diet Score). These measures of dietary quality were then tested for associations with lifestyle factors and measures of nutritional status. SUBJECTS/SETTING: The study population, aged 70-77 y, consisted of 828 subjects from Framingham, MA (USA) and 1282 subjects from the following European centres: Hamme, Belgium; Roskilde, Denmark; Padua, Italy; Culemborg, The Netherlands; Vila Franca de Xira, Portugal; Betanzos, Spain; and Yverdon, Burgdorf and Bellinzona, Switzerland. RESULTS: Dietary intake varied widely across the European and American research centres. In general, Southern European centres and Framingham had higher mean diet scores, indicating a higher dietary quality, than Northern European centres (MD-scores: 4.2-4.4 vs 2.7-3.5). Cluster analysis identified the following five dietary patterns characterised by: (1) sugar and sugar products; (2) fish and grain; (3) meat, eggs and fat; (4) milk and fruit; and (5) alcohol intake. The meat, eggs and fat pattern had significantly lower average dietary quality, as measured with all three diet scores than all other groups except the alcohol group. The fish and grain group had significantly better Mediterranean diet scores than all other groups. CONCLUSIONS: Dietary scores and dietary clusters are complementary measures to classify dietary quality. The associations with nutritional and lifestyle factors indicate the adequate categorisation into dietary quality groups. SPONSORSHIP: European Union, US Department of Agriculture, Agriculture Research Service, under agreement (58-1950-9-001), Haak Bastiaanse-Kuneman Foundation.
Aged↗
Comparison of children's dietary intake patterns with US dietary guidelines.
Monitoring dietary intake patterns among children is important in order to explore and prevent the onset of adult health problems. The aim of the present study was to compare children's dietary intakes with national recommendations and to determine whether sex or ethnic differences were evident. This was done using a methodology that allows assessment of intake from the major components of the Food Guide Pyramid developed by the United States Department of Agriculture (USDA: US Department of Agriculture and US Department of Health and Human Services (1992)). The sample studied included 110 African-American and Caucasian males and females (mean age 9.9 years, BMI 20.1 kg/m2) from Birmingham, AL, USA, who were participating in a study investigating the development of obesity. Dietary data were based on three 24 h recalls and food group intake was determined using the USDA Pyramid Servicing Database. The results indicated that a high percentage of subjects failed to meet the recommended number of servings from each of the food groups. For example, only 5 % and 9 % met fruit and dietary group recommendations respectively. Consumption of foods from the Pyramid 'tip' (including discretionary fat and added sugar) contributed almost 50 % of the diet. African-Americans were more likely to meet requirements for the meat group, with a higher proportion of Caucasians meeting dietary recommendations. Males were more likely to meet the vegetable group guidelines although females consumed more energy per day from discretionary fat. In conclusion, these results suggest that implementation of nutrition education programmes may be important for promoting healthy nutrition among American children.
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Physiological small bowel malabsorption of carbohydrates protects against large bowel diseases in Africans.
In African black people there is a paucity of 'developed society' large bowel diseases such as diverticular disease, colorectal adenomas and carcinomas, ulcerative colitis and Crohn's disease. Appendicitis has an incidence of about 5-10% of the number likely to be observed in a white population. The conundrum is that the disparity exists despite many Africans having adopted an urbanized lifestyle with major changes in their dietary pattern. Dietary fiber intake, which was previously 30-35 g, has decreased to 12-14 g daily. Studies on small bowel function in black people have shown that physiological malabsorption of lactose, fructose, sucrose and maize (the staple food) occurs. It is hypothesized that the increased concentration of substrate available for fermentation in the colon compensates for the low dietary fiber intake, is protective to the large bowel and is a factor in the prevention of 'developed society' large bowel diseases in the African population.
Asian People↗
Diet and cancer: where are we and where are we going?
Many studies have shown that overall dietary patterns, dietary components consumed, or mode of food preparation are all possibly relevant in either reducing or increasing the risk of cancer in animals or man. Yet, dietary intervention studies, stemming from laboratory and epidemiological observational studies have often failed to demonstrate the anticipated protection against cancer. One possible explanation for the discrepancy between the results of various observational and experimental chemo-prevention studies is the lack of control for biological diversity of the participants of these studies. It is suggested that future epidemiological studies provide evidence stratified by status of major metabolic polymorphisms pertinent to the study subject, and that future intervention studies take these differences into account in the design and analysis phases.
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[The Chinese total diet study in 1992--chemical contaminants. (II) Different age-sex groups].
The total diet study on various age-sex groups and the comparison of two seasons (spring and autumn) in adult male were conducted in the second Chinese Total Diet Study in 1992-1993. The dietary pattern, dietary intake of heavy metals and other harmful elements and radionuclides were studied in 4 age-sex groups in 4 provinces and cities, i.e. Hebei, Shanxi, Hubei and Shanghai. The contamination of lead in diet was the most outstanding finding. The intake of lead in 2-7 years old exceeded 18.9% of the ADI. The contamination of cadmium and mercury in diet were low, and the dietary intake were 24% and 35% of the ADI respectively. The dietary intakes of aluminium in the two young groups exceeded about 8% of the ADI. The intake of dietary fluoride in the two young groups were a little too low, and it was adequate in the adult groups. The overall dietary intake of radionuclides in the 4 age-sex groups was only 36% of ALI. The intakes of man-made radionuclides, 90Sr and 137Cs were all below 1% of ALI. The comparisons of two seasons (spring and autumn) showed that the overall intakes of radionuclides were higher in autumn than in spring. The intake of 210Pb was 3-4 times in autumn than in spring.
Adolescent↗
Nutrition for toddlers: the foundation for good health--2. Current problems and ways to overcome them.
Part 2 of a two-part review of toddler nutrition considers some current concerns, including the influence of changing lifestyles on dietary patterns; dietary imbalances; obesity; and iron deficiency anaemia. The review includes some practical steps to prevent obesity and iron deficiency anaemia.
Anemia, Iron-Deficiency↗
Use of qualitative and quantitative methods to define behavioral fat-reduction strategies and their relationship to dietary fat reduction in the Patterns of Dietary Change Study.
OBJECTIVE: The purposes of this study were to identify specific food choice behaviors used to decrease dietary fat intake in a community-dwelling population; assess how people categorize changes to diet; determine whether logical grouping of food intake changes revealed one or more common patterns or strategies used by these participants to decrease fat; and determine which strategies were responsible for the greatest decrease in dietary fat intake in the study population. DESIGN: Survey analysis and in-depth interviews were used to quantitatively and qualitatively define dietary change patterns retrospectively in a population who, according to self-report, had decreased their fat intake. Specific food changes made to decrease fat intake, interview statements, and participants' reduction of percentage energy from fat were examined. SETTING: Interviews were conducted from June 1993 through April 1994. SUBJECTS: Included in the study were 145 persons aged 30 to 55 years who reported that they had been decreasing their dietary fat intake for 5 years or more, maintained a healthful diet for at least 5 months, and resided in the United States while changing their diets. STATISTICAL ANALYSES PERFORMED: Confirmatory factor analysis, reliability analysis, and linear regression analysis were performed. RESULTS: Nine fat-reduction strategies were identified. Decrease fat flavorings, decrease "recreational foods," decrease cooking fat, replace meat, change breakfast, and use fat-modified foods accounted for significant reduction in fat intake. CONCLUSIONS: People use a variety of dietary changes to reduce their fat intake. These changes can be categorized into strategies according to the way people change their diets. Knowledge of these strategies and their importance in dietary fat reduction can improve and help nutritionists prioritize the messages they convey.
Adult↗
The impact of inter-generational social and regional circumstances on dietary intake patterns of British adults: results from the 1946 British Birth Cohort.
OBJECTIVES: (1) To determine the extent to which an individual's childhood social circumstances and region of residence influence their dietary pattern at age 43 years and (2) to establish the extent to which an individual adopts the dietary pattern of their social and regional circumstances at age 43 years. DESIGN: Longitudinal study of a social class stratified, random sample of all legitimate, singleton births in the week of 3-9 March 1946. SETTINGS: England, Scotland and Wales. SUBJECTS: The 3187 survey members who provided sociodemographic information at age 4 years in 1950 and sociodemographic and dietary data (48-hour dietary recall) at 43 years in 1989. RESULTS: People who remained in the non-manual social class consumed significantly higher amounts of food items correlated with the factor health aware (items include high-fibre breakfast cereals, wholemeal breads, apples and bananas) than those who remained in the manual social class. Those who made the transition from manual social class in childhood to non-manual social class at age 43 years partly adopted the distinctive dietary patterns of the non-manual social classes. Consumption of items in the factors refined (items include whole-fat milk, white bread, sugar and butter) and sandwich (items include tomatoes, lettuce, onions, bacon and ham) did not differ by social class or regional mobility. CONCLUSIONS: This work suggests that although adult dietary patterns are developed as a result of childhood influences, these patterns can be modified as a result of social and regional transitions. Such changes in dietary patterns may influence susceptibility to disease.
Adult↗
Effect of amino acid imbalance and deficiency on dietary choice patterns of rats.
Detailed dietary choice patterns were determined with a computerized feeding monitoring system in groups of Sprague Dawley rats kept on a 12:12 hr light-dark cycle and offered in sequence a series of dietary choice regimens involving amino acid-imbalanced or deficient diets with threonine as the most limiting amino acid. Animals established their preference for a threonine-basal diet over a threonine-imbalanced or a threonine-devoid (devoid of threonine) diet shortly (within 2-3 hr) after the consumption of small quantities of either diet in the beginning of the first dark-cycle. An intensive sampling process characterized by frequent small bouts was evident throughout the light period. Both the meal size and the meal frequency of the imbalanced or devoid diet were curtailed after prolonged choices. Animals preferred the threonine-corrected (imbalance corrected by threonine supplementation) over the threonine-basal diet initially with an increase in meal frequency. But no clear choice for either diet was observed thereafter. Animals did not establish their preference for the threonine-corrected diet when paired with the threonine-devoid diet until after 5 days with a steady decrease in the meal size of the devoid diet but not the meal frequency. When the protein-free diet was introduced as an alternative for the threonine-imbalanced diet, animals selected the protein-free diet during the first dark-cycle after consuming a small amount of the imbalanced diet. Initially there was a drastic reduction in meal size of the imbalanced diet and subsequently a decrease in meal frequency as well. Nevertheless, animals immediately rejected the protein-free diet and chose the threonine-basal diet when it replaced the imbalanced diet as an alternative. The almost exclusive preference for the basal diet occurred in the beginning of the first dark-cycle with an increase in meal size but no change in meal frequency. The sampling bouts of small quantities, which followed the first introduction of the diets in the choice regimens, may be an inherent investigative behavior whereby the physical or oropharyngeal properties of the diets are recognized. The establishment of the choices for the alternative diets in the present experiments provides additional information about the rapid time course of the food intake control mechanisms in rats fed amino acid-imbalanced or deficient diets.
Animals↗
Angiotensinogen genotype and blood pressure response in the Dietary Approaches to Stop Hypertension (DASH) study.
OBJECTIVE: To determine the relationship between angiotensinogen (ANG) genotype and blood pressure response to the dietary patterns of the Dietary Approaches to Stop Hypertension (DASH) trial. The angiotensin converting enzyme (ACE) gene was also tested. DESIGN: The DASH trial was a randomized outpatient feeding study comparing the effects on blood pressure (BP) of three dietary patterns: a control diet, similar to typical American intake; a 'fruits and vegetables' diet (F/V) that is rich in fruits and vegetables but otherwise resembles the control diet; and the DASH diet that is reduced in fats and that emphasizes fruits, vegetables and low-fat dairy products. Participants' genotype was also determined. SETTING: Four clinical sites. PARTICIPANTS: Adults with above-optimal BP or stage 1 hypertension. INTERVENTION: Participants ate one of the three dietary patterns for 8 weeks. Sodium intake and weight were held constant. In 355 of 459 DASH participants, DNA was extracted from leukocytes and genotyped for the G-6A ANG polymorphism and the D/I ACE polymorphism, by the polymerase chain reaction. MAIN OUTCOMES: Genotype at ANG and ACE loci; BP after 8 weeks of intervention diet. RESULTS: There was no association between ACE genotype and BP response. Associations with ANG polymorphism were significant: net systolic and diastolic BP response to the DASH diet was greatest in individuals with the AA genotype (-6.93/-3.68 mmHg) and least in those with the GG genotype (-2.80/0.20 mmHg). A similar relationship existed for the F/V diet. CONCLUSIONS: ANG genotype is associated with BP response to the DASH diet. The AA genotype confers excess risk of hypertension and is associated with increased responsiveness to diet.
Adult↗
Dietary Westernisation: conceptualisation and measurement in Mauritius.
OBJECTIVES: The aims of the study were to provide information that will contribute to conceptualising what is called "dietary Westernisation", and to provide an example of measuring it on an individual level. DESIGN: Food consumption frequency and demographic data on adults in Mauritius were examined in 1988, 1992 and 1998. In 1992, a 24-hour recall was also included. The cross-sectional samples consisted of 1115 (age 25-74 years) Mauritians in 1987/88, 1917 (age 30-74 years) in 1992 and 2239 (age 20-74 years) in 1998. Principal components analysis was carried out on daily consumption frequencies of 10 indicator foods (white rice, white bakery bread, pulses, processed meat, poultry, fresh/frozen fish, butter, margarine, whole milk and skimmed/low-fat milk). Correlations between dietary patterns and selected food consumption frequencies were examined in each survey year. RESULTS: Four dietary patterns were identified as being related to dietary Westernisation. The Traditional dietary pattern was characterised by higher consumption frequencies of Indian breads, salted/smoked fish and sugar-sweetened tea. The Western dietary pattern was characterised by higher consumption frequencies of cakes/pastries, meat and many Western fast foods like burgers, but, surprisingly, also by brown bread, breakfast cereals and salad. The Bread/butter dietary pattern predominantly described more frequent consumption of bread compared with rice. The Margarine/milk dietary pattern was inconsistently related with staple foods. Younger, educated and wealthier Mauritians appeared to adopt Western dietary patterns earlier. CONCLUSIONS: This study suggests that relatively few indicator foods are needed for measuring dietary Westernisation. Dietary Westernisation in a non-Western country may also include shifts towards voluntary consumption of healthier foods.
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[A study of dietary intakes and dietary preferences by questionnaire at a health facility in an urban area].
Dietary preferences and intakes of 2504 patients in a human dock in Tokyo were studied by questionnaire and analyzed according to: 1. Comparison of dietary patterns for breakfast to that for lunch and dinner. 2. Consistency between dietary patterns according to Category Score Table for Breakfast and that from Hayashi's Quantification Theory Type III (QIII). Dietary patterns for breakfast were shown to fall into four Types based on dietary intakes and dietary preferences: Balanced Diet-Japanese Style (Type 1); Balanced Diet-Western Style (Type 2); Unbalanced Diet-Western Style (Type 3); and Unbalanced Diet-with drinks (Type 4). Based on the responses to the questionnaire, there was no correlation between the dietary pattern for lunch to that for breakfast. On the other hand, the dietary pattern for dinner tended to correlate with breakfast. The sample population was divided into two random groups A and B. Group A was analyzed by QIII, and B by the four types of breakfast dietary patterns. Comparison of scores for categorized values for Group A with those of the Group B indicated 91.8% consistent rate. These results, demonstrate that this questionnaire can be used effectively to sort intakes into four dietary patterns, and may be useful in preventive health care studies.
Diet Surveys↗
Water and food consumption patterns of U.S. adults from 1999 to 2001.
OBJECTIVE: High water consumption has been proposed as an aid to weight control and as a means of reducing the energy density of the diet. This study examines the relationship between water consumption and other drinking and eating patterns. RESEARCH METHODS AND PROCEDURES: The National Health and Nutrition Examination Survey 1999 to 2001, with responses from 4755 individuals > or =18 years of age, provides the data for this cross-sectional analysis. A cluster analysis was performed using z-scores of specific food and beverage consumption to examine patterns. A multinomial logit analysis was used to examine sociodemographic characteristics of each dietary pattern and to examine the effects of water consumption on the likelihood of consuming a non-dairy caloric beverage. All results were weighted to be nationally representative and controlled for design effects. RESULTS: Within the sample, 87% consumed water, with an average daily consumption of 51.9 oz (1.53 liters) per consumer. Water consumers drank fewer soft/fruit drinks and consumed 194 fewer calories per day. Water consumers (potentially a self-selected sample) consumed more fruits, vegetables, and low- and medium-fat dairy products. Four distinct unhealthy dietary patterns were found that included little or no water consumption. Older and more educated persons used healthier food patterns. Mexican dietary patterns were much healthier than dietary patterns of blacks. DISCUSSION: Water consumption potentially is a dietary component to be promoted, but much more must be understood about its role in a healthy diet. Because high water consumption is linked with healthier eating patterns-patterns more likely to be followed by higher-educated, older adults-the target of water promotion and healthy diet options should focus on younger and less educated adults.
Adult↗
Gender differences in familial aggregation of obesity-related phenotypes and dietary intake patterns in Korean families.
PURPOSE: To investigate familial influences on obesity-related phenotypes and dietary intake patterns, and to examine gender differences in Korean families with adolescent children. METHODS: A cross-sectional observational study was conducted on 134 biologically related families composed of 260 parents and 231 adolescent children aged 11 to 19 years. Anthropometric measurements, including total fatness and fat distribution, were measured. Dietary intake was assessed by the semi-quantitative food frequency questionnaire (FFQ). RESULTS: The odds ratio and 95% confidence intervals for overweight were 6.6 (range, 1.5-29.7) in the sons and 13.7 (range, 2.5-76.4) in the daughters of overweight parents. Obesity and fat distribution in the adolescents were more significantly correlated with mothers than fathers. Daughters had more significant familial aggregations with their parents than did sons. The dietary intake patterns of both sons and daughters correlated more strongly with their mothers than their fathers. We observed significant correlations in anthropometric variables and dietary intake patterns between spouses and between siblings. CONCLUSIONS: In the contemporary Korean nuclear family, maternal anthropometry and dietary behavior have a greater impact on children than do paternal contributions, and daughters resemble their parents more than sons. Genetics and environmental factors within the family infrastructure may provide strategies for the prevention and treatment of adolescent obesity.
Adolescent↗
Tracking of dietary intake patterns of Chinese from childhood to adolescence over a six-year follow-up period.
Limited literature has explored whether dietary intake patterns are maintained or changed between childhood and adolescence. More research is required to understand the predictors of these patterns. Using longitudinal data collected in China for 984 children initially aged 6--13 y, we examined children's dietary intake patterns over a 6-y period and the predictors. Detailed data on children's diets (three 24-h recalls in each survey), anthropometry, sociodemographic characteristics and parental education and occupation were collected. To study the predictors of tracking and changes, we conducted ordinary and multinomial logistic regression analyses. Significant correlations (r = 0.28-0.51, P < 0.05) between individuals' 1991 and 1997 dietary intakes were observed for macronutrients and major food groups (vegetable and fruit, meat and edible oil), which were also supported by kappa (a statistic measuring agreement beyond chance). About half of those who initially consumed high fat, high carbohydrate, high vegetable and fruit, and high meat diets continued such diets 6 y later. Family income, urban-rural residence, mother's education and baseline dietary intakes were important predictors of children's dietary intake patterns. In conclusion, even under conditions of rapid socioeconomic change, children are likely to maintain their dietary intake patterns from childhood into adolescence. Efforts to promote healthy eating behaviors may be more effective if focused on younger children, and parents should be involved in these efforts.
Adolescent↗
Disentangling women's responses on complex dietary intake patterns from an Indian cross-sectional survey: a latent class analysis.
OBJECTIVE: To investigate the degree of individual heterogeneity related to complex dietary behaviour and to further examine the associations of different dietary compositions with selected characteristics. DESIGN: Latent class analysis was applied to data from the recent cross-sectional National Family Health Survey that collected information on the intake frequency of selected foods. Different responses regarding intake frequency were condensed into a set of five meaningful latent clusters representing different dietary patterns and these clusters were then labelled based on the reported degree of diet mixing. SETTING: Indian states. Subjects In total, 90,180 women aged 15-49 years. RESULTS: Three clusters were predominantly non-vegetarian and two were vegetarian. A very high or high mixed-diet pattern was observed particularly in the southern and a few north-eastern states. Many women in the very high mixed-diet cluster consumed mostly non-green/leafy vegetables on a daily basis, and fruits and other non-vegetarian diet on a weekly basis. In contrast, those in the low mixed-diet cluster consumed more than three-fifths of the major vegetarian diet ingredients alone on a daily basis. The affluent group that represented the low mixed-diet cluster were primarily vegetarians and those who represented the very high mixed-diet cluster were mostly non-vegetarians. The significant interrelationships of different characteristics highlight not only socio-economic, spatial and cultural disparities related to dietary practices, but also the substantial heterogeneity in diet mixing behaviour. CONCLUSIONS: The results of this study confirmed our hypothesis of heterogeneous dietary behaviour of Indian women and yielded useful policy-oriented results which might be difficult to establish otherwise.
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