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PubMed2004

Prudent diet and the risk of insulin resistance.

BACKGROUND AND AIM: Diet is a potentially modifiable risk factor for diabetes. Dietary patterns may exert greater effects on health than individual foods, nutrients or food groups. Data on associations between dietary patterns and the risk of insulin resistance and type 2 diabetes are sparse. The aim of the study was to examine associations between dietary patterns and the risk of insulin resistance. METHODS AND RESULTS: We performed a cross sectional study involving a group of 1018 men and women, sampled from 17 general practice lists in the South of Ireland, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and provided fasting blood samples for analysis of glucose, insulin and lipids. Dietary intake was assessed using a food frequency questionnaire. The food frequency questionnaire was a modification of the UK arm of the European Prospective Investigation into cancer, EPIC study, which was based on that used in the US Nurses' Health Study. Dietary patterns were assessed by K cluster analysis. Insulin resistance was estimated on the basis of fasting glucose and insulin, using the glucose homeostasis model (HOMA scores). Insulin resistance was defined as the upper quartile of the HOMA scores. Three dietary patterns were identified by cluster analysis (traditional Irish diet, a prudent diet and an alcohol and convenience foods diet). Participants in clusters 1 (traditional Irish diet) and 3 (high alcohol and convenience foods) had a lower intake of more 'healthy' food groups (such as fruit, vegetables, low fat dairy products, poultry, fish and whole grain products) and higher intake of foods richer in total and SFA content (such as high fat dairy products, butter, meat and meat products). Cluster 2 (prudent dietary pattern) was characterized by a higher intake of food groups that are typically recommended in health promotion programs and a lower intake of meat (read meat), meat products, sweets, high fat dairy and white bread (white bread and unrefined cereal). The prudent diet had the lowest HOMA scores in analysis of covariance. The prevalence of insulin resistance in the prudent diet was lower than that in the traditional diet (OR=0.53; 95%CI, 0.33-0.85 in fully adjusted analysis). CONCLUSION: A prudent diet may be associated with enhanced insulin sensitivity and a lower risk of type 2 diabetes.

Aged↗
PubMed1992

[Dietary intake patterns in the school health program].

AIM: To investigate dietary intake patterns among school-students. DESIGN: An observational prospective study. A dietary survey was used to establish how many times habitual foods were eaten each week. SITE. The population of the northern half of the city of Soria. (North Soria Health Centre). PARTICIPANTS: All the school-children aged 6 and 7 (74 boys and 57 girls in both the private and public sectors) took part in the programme. MEASUREMENTS AND MAIN FINDINGS: The intake of foodstuffs was stratified as greatest in quartiles. The consumers of sweet "junk" foods also ate significantly more savory "junk" food (p = 0.00009). We found and inverse consumption relationship between savory "junk" foods and an intake of greens and root-crops (p = 0.03) and of pasta and rice (p = 0.008). The lower consumption of greens and fruits was linked to a lower consumption of fish (p = 0.023), to a lower consumption of meat (p = 0.037) and of meat products (p = 0.008). Lower consumption of eggs was linked to a greater consumption of meat (p = 0.016) and fish (p = 0.029). CONCLUSIONS: The consumption of savory "junk" foods and meat products can replace nutrients of a high biological value which are found in greens and root-crops. New studies to deepen the taxonomical analysis of the school diet are required. These should identify eating patterns which could endanger health in adult life.

Chi-Square Distribution↗
PubMed2006

Pattern of dietary fiber intake among the Japanese general population.

OBJECTIVES: To evaluate the dietary fiber (DF) intake pattern among the Japanese general population. DESIGN: We performed a dietary survey among the general population in northern Japan to evaluate the intake patterns. DF intake was calculated by substituting the DF content of each food in the Dietary Fiber Table for the intake of each food from this dietary survey. SUBJECTS: Five hundred and seventy-seven subjects participated in the study, 198 men and 379 women. RESULTS: In subjects with higher DF intakes the origins of the DF that were from all food groups, but with the notable exception of rice. The contribution of the seaweed group was of particular interest. From multiple regression analysis, as for food group, seaweeds showed the highest positive correlation with DF intake in both genders, followed by vegetables, pulses, fruits. On the other hand, rice showed the negative correlation with DF intake in both genders. As for life factor, body mass index showed the negative correlation with DF intake in women. CONCLUSION: Seaweed, a typical Japanese food, was most related to the increase in DF intake for the Japanese general population, whereas rice, the Japanese staple, had a small influence on decreased DF intake.

Adult↗
PubMed1991

Can dietary intake patterns account for the familial aggregation of disease? Evidence from adult siblings living apart.

The familial aggregation of certain chronic diseases is well documented [Perkins, 1986; King et al., 1984; Anderson, 1982]. Dietary data on adult brothers living apart were used to examine whether familial clustering of disease could be explained by nature or nutriture. Intakes of nutrients were strikingly more similar among siblings than expected: when correlations were adjusted for country of residence, 21 of 25 (84%) were statistically significant. Thus, dietary patterns among adult siblings are more alike than could be predicted by their sharing a common culture, as alike as has been described for monozygotic twins, and as alike as described for familial correlations of serum cholesterol. Incorporation of dietary measures in co-twin studies or studies of siblings can improve the estimates of the true genetic effect on disease pathogenesis.

Adult↗
PubMed2003

Why do some overweight children remain overweight, whereas others do not?

OBJECTIVE: To study the dynamics of childhood overweight and the influence of dietary intake on tracking of overweight. DESIGN AND SETTING: A follow-up study conducted in China. SUBJECTS: Ninety-five overweight children, 6-13 years old, identified from 1455 children at baseline, were followed over a 2-year period. METHODS: Data on anthropometry and 3-day dietary intake were collected at baseline and during follow-up. Overweight was defined using the International Obesity Task Force reference of body mass index (BMI)-for-age. Differences between groups were tested using analysis of variance and Cochran-Mantel-Haenszel tests. RESULTS: Of the 95 overweight children, 36.8% remained overweight 2 years later ('tracking group'). Urban boys were three times more likely than rural boys to remain overweight (63.2% vs. 21.9%). At baseline, the tracking group had higher BMI, body weight and fat intake (% of energy), and lower carbohydrate intake (% of energy), than the non-tracking group (who shifted from overweight to not overweight); they were more likely to have a high-fat or high-meat diet, but less likely to have a diet high in carbohydrate or vegetables and fruit. During the follow-up, the tracking group increased fat intake and reduced carbohydrate intake while the non-tracking group did not; and they also grew slower in height but faster in weight. Tracking of overweight seemed to be related to tracking of high-meat (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0-5.6, P < 0.05) and high-fat (RR 1.5, 95% CI 0.9-2.5, P < 0.1) diets. CONCLUSION: Considerable changes in children's overweight status during childhood and adolescence were observed in China, a transitional society. Dietary patterns, particularly dietary composition, seemed to influence the tracking patterns of overweight.

Adolescent↗
PubMed2001

Use of multiple correspondence analysis and cluster analysis to study dietary behaviour: food consumption questionnaire in the SU.VI.MAX. cohort.

Although the effects of individual foods or nutrients on the development of diseases and their risk factors have been investigated in many studies, little attention has been given to the effect of overall dietary patterns. The main objectives of this study were to identify dietary patterns and groups of subjects with similar food consumption habits, i.e. 'dietary profiles', using multiple correspondence analysis and cluster analysis. A food frequency questionnaire was sent to a large population-based sample (2923 women and 2,180 men), recruited among the 'SUpplementation en VItamines et Minéraux AntioXydants' (SU.VI.MAX.) cohort participants in France. The food items were dichotomised in order to focus the study on the highest levels of consumption. Multiple correspondence analysis allows the construction of principal components, which optimally summarise the data, and enables the construction of graphical displays. An interesting property of these graphical displays is that associations between food items can be observed on various projection planes, each category of each food item being located at the centre of gravity of the subjects corresponding to this category. An ascending hierarchical classification was unsuccessfully tried in order to determine clusters from these principal components. Therefore, a 'dissection' of the cloud of points was performed according to the orientation of the axes, providing a readily interpretable eight-dietary profiles typology for each sex. This statistical approach allows identification of particular dietary patterns and dietary profiles, which might be more appropriate in studies of diet-disease associations than the single food or nutrient approach that has dominated past epidemiological research.

Adult↗
PubMed1983

Evaluation of FAO/WHO pesticide standards in relation to Polish and Honduran diets.

The FAO/WHO Codex Alimentarius Commission publishes a Guide to Codex Maximum Limits for Pesticide Residues (1978) which gives both acceptable daily intake (ADI) values and maximum residue limit (MRL) values for many pesticides in raw agricultural commodities (rac's) from crops on which their use is approved. ADI values are determined from animal toxicology data which given a no-observable-effect level (NOEL) and use of a safety factor. Specific MRL values are calculated from the ADI and a food factor (F), which is the decimal fraction of that rac in the assumed typical diet. One of the difficulties with this procedure is that dietary patterns differ substantially between countries. Whatever dietary pattern is assumed in calculation of the MRLs may be inappropriate for that country. Theoretical maximum residue intakes (TMRIs) were calculated from the Codex ADIs and MRLs using F values calculated from the national dietary patterns published separately in Poland and Honduras. The equation is TMRI = sigma MRLi X Fi X D, where D is the daily individual diet weight of rac's in kilograms for the particular country. The TMRI should be lower than the maximum permitted intake (MPI) calculated as MPI = ADI X 60, where the 60 is an arbitrary human body weight in kilograms. The TMRI exceeded the MPI for 16 of 33 pesticides used in Poland and for 10 of 20 used in Honduras. At the extreme, the Polish TMRI/MPI ratio for aldrin--dieldrin is 19.5 and 18.1 for fenithion; nine pesticides had ratios of 4.0 or higher.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

alpha-Tocopherol intake and plasma concentration of Hispanic and non-Hispanic white elders is associated with dietary intake pattern.

alpha-Tocopherol from foods has been associated with protection against several chronic diseases and maintenance of immune function. However, most people do not meet current recommendations for intake. We examined alpha-tocopherol intake and plasma concentration in a representative sample of Puerto Rican and Dominican older adults (n = 447) and in neighborhood-matched non-Hispanic whites (n = 155). A validated food frequency questionnaire was used to assess dietary intake. Mean dietary intakes of alpha-tocopherol were 6 mg in both ethnicities. Only 4.7% of women and 7.9% of men met the estimated average requirement (12 mg/d) for vitamin E from food alone. Top sources of alpha-tocopherol for Hispanics included oils and milk, and for non-Hispanic whites they were ready-to-eat breakfast cereal and sweet baked products. Mean plasma alpha-tocopherol concentrations were 24.5 micromol/L for Hispanics and 25.8 micromol/L for non-Hispanic whites (P > 0.05). Plasma alpha-tocopherol was positively associated with alpha-tocopherol intake (P = 0.003), and significance remained after adjusting covariates and after exclusion of supplement users (P for trend = 0.008). We identified the following 5 dietary patterns by cluster analysis: 1) fruit and breakfast cereal, 2) starchy vegetables, 3) rice, 4) milk and milk products, and 5) sweets. Those following the sweets pattern had the lowest plasma alpha-tocopherol relative to those following the fruit and breakfast cereal or milk patterns (P < 0.05 for all), although they had similar intakes. A large proportion of these elders (>90%) have inadequate intake of alpha-tocopherol, and plasma concentrations were associated with intake patterns.

Aged↗
PubMed2001

Analysis of patterns of food intake in nutritional epidemiology: food classification in principal components analysis and the subsequent impact on estimates for endometrial cancer.

OBJECTIVE: To assess the effect of different methods of classifying food use on principal components analysis (PCA)-derived dietary patterns, and the subsequent impact on estimation of cancer risk associated with the different patterns. METHODS: Dietary data were obtained from 232 endometrial cancer cases and 639 controls (Western New York Diet Study) using a 190-item semi-quantitative food-frequency questionnaire. Dietary patterns were generated using PCA and three methods of classifying food use: 168 single foods and beverages; 56 detailed food groups, foods and beverages; and 36 less-detailed groups and single food items. RESULTS: Classification method affected neither the number nor character of the patterns identified. However, total variance explained in food use increased as the detail included in the PCA decreased (approximately 8%, 168 items to approximately 17%, 36 items). Conversely, reduced detail in PCA tended to attenuate the odds ratio (OR) associated with the healthy patterns (OR 0.55, 95% confidence interval (CI) 0.35-0.84 and OR 0.77, 95% CI 0.49-1.20, 168 and 36 items, respectively) but not the high-fat patterns (OR 0.95, 95% CI 0.57-1.58 and OR 0.85, 0.51-1.40, 168 and 36 items, respectively). CONCLUSIONS: Greater detail in food-use information may be desirable in determination of dietary patterns for more precise estimates of disease risk.

Adult↗
PubMed1997

Worldwide patterns of dietary lipids intake and health implications.

The purpose of this paper was to identify broad patterns of dietary lipids intake in the world and to assess their health implications. Household budget surveys are a valuable source of information that have been long overlooked, even though they allow assessment of within-region variability according to sociodemographic variables. With respect to per capita dietary lipids intake at a national level, four different patterns can be identified: high total dietary lipids, high intake of mostly saturated animal lipids; high total dietary lipids, low animal lipids; moderate total dietary lipids, low to moderate animals lipids; and low total dietary lipids, low animal lipids. Over time, animal lipids intake tends to decrease in countries with the first intake pattern and consumption of saturated animal lipids and polyunsaturated plant lipids-the latter frequently partly hydrogenated-tends to increase in most of the other populations. Of the visible dietary lipids, vegetable oils have been gradually assuming greater importance, with North America showing the largest absolute increase in availability per capita over the past 30 y. Studies have shown that olive oil, which is essentially a monounsaturated oil, increases high-density-lipoprotein cholesterol and reduces low-density-lipoprotein cholesterol, promoting in a balanced way a desirable blood lipid profile. Although concerns have been raised about the long-term safety of some trans fatty acids and polyunsaturated fatty acids, epidemiologic studies suggest that olive oil may have beneficial effects not only on cardiovascular health but also on the development of several malignancies including breast cancer.

Animals↗
PubMed2002

Obesigenic families: parents' physical activity and dietary intake patterns predict girls' risk of overweight.

OBJECTIVE: To determine whether obesigenic families can be identified based on mothers' and fathers' dietary and activity patterns. METHODS: A total of 197 girls and their parents were assessed when girls were 5 y old; 192 families were reassessed when girls were 7 y old. Measures of parents' physical activity and dietary intake were obtained and entered into a cluster analysis to assess whether distinct family clusters could be identified. Girls' skinfold thickness and body mass index (BMI) were also assessed and were used to examine the predictive validity of the clusters. RESULTS: Obesigenic and a non-obesigenic family clusters were identified. Mothers and fathers in the obesigenic cluster reported high levels of dietary intake and low levels of physical activity, while mothers and fathers in the non-obesigenic cluster reported low levels of dietary intake and high levels of activity. Girls from families in the obesigenic cluster had significantly higher BMI and skinfold thickness values at age 7 and showed significantly greater increases in BMI and skinfold thickness from ages 5 to 7 y than girls from non-obesigenic families; differences were reduced but not eliminated after controlling for parents' BMI. CONCLUSIONS: Obesigenic families, defined in terms of parents' activity and dietary patterns, can be used predict children's risk of obesity.

Adult↗
PubMed1974

Growth pattern and dietary intake of children with chronic renal insufficiency.

The growth pattern and dietary intake of 33 children with varying degrees of renal insufficiency has been investigated. The development of impaired renal function in infancy has a more deleterious effect on linear growth than has its onset in later years. A reduction in growth velocity may occur once the glomerular filtration rate falls below 25 ml/min/1.73m(2). There was a significant reduction of the energy, protein, and vitamin D intakes of children with renal insufficiency compared with those recommended for their age, and of energy intake compared with that of normal children of their own height. Reduced growth velocity occurred when energy intake fell below 80% of that recommended. The reduction in the intake of energy and nutrients in these children may in part be responsible for their growth retardation.

Adolescent↗
PubMed2001

The relationship between parental modeling, eating patterns, and dietary intake among African-American parents.

OBJECTIVE: This article examines the relationship between the frequency with which African-American parents report modeling healthful dietary behaviors for their children and parental dietary intake. DESIGN: Cross-sectional, baseline data from a community-based dietary change study to reduce fat intake and increase fruit and vegetable consumption among African-American parents was analyzed to identify role-modeling behaviors. SUBJECTS/SETTING: Subjects were 456 African-American parents who participated in a dietary change study as part of a national parent education group. Participants completed the Parental Dietary Modeling Scale, an eating patterns questionnaire and a food frequency questionnaire. STATISTICAL ANALYSES PERFORMED: Descriptive statistics and stepwise multiple linear regression analyses were conducted. RESULTS: Parental modeling of healthful dietary behavior was associated with the performance low-fat eating patterns (r = 0.48; P < .001), lower dietary fat intake (r = -0.30; P < .001), and higher consumption of fruits and vegetables (r = 0.18; P < .001). APPLICATIONS: The frequency with which parents model healthful dietary behaviors may be associated with parental dietary intake and may have long-term implications for the development of childhood eating patterns. Dietetics professionals need to carefully assess parents' current dietary modeling behaviors and inform parents about how performance of these general behaviors may affect their child's ultimate nutrition health.

Adult↗
PubMed2004

Mediterranean diet, antioxidants and cancer: the need for randomized trials.

In nutritional epidemiology the traditional approach has been to assess single nutrients or food items. Now, a growing interest exists in dietary patterns. The study of dietary patterns with a whole-diet approach represents a needed and complementary methodology. Among a priori defined patterns, the highly palatable traditional Mediterranean diet has many options to be the first choice in the dietary prevention of cancer. However, sound epidemiologic evidence about its ability to prevent the most frequent cancers is scarce. In conjunction with large and well-designed cohort studies, randomized trials using a whole-diet approach and not a simple antioxidant supplement are needed in Mediterranean countries.

Antioxidants↗
PubMed2000

Correlates of the "western" and "prudent" diet patterns in the us.

PURPOSE: Underlying the diversity and changeability of US eating habits are fundamental dietary patterns shaped by common sociohistorical experiences. Currently, little is known of what patterns exist or their associations with sociodemographic/lifestyle factors. We examined these issues in third National Health and Nutrition Examination Survey data.METHODS: Analyses were based on 5,794 US-born, white participants. Interviews included a 60-item food frequency questionnaire (FFQ) and questions on sociodemographics and health behaviors. Dietary patterns were identified by principal components analysis on FFQ responses. Component scores representing intake level of each pattern were dichotomized at the median. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI).RESULTS: We identified two primary dietary patterns-a "western" pattern characterized by processed and red meats, eggs, potatoes, and refined grains, and a "prudent" pattern characterized by cruciferous vegetables, greens, carrots, salads, and fresh fruits. The two patterns occurred across geographic regions and in both women and men. After age- and sex-adjustment, the "western" diet was associated with rural residence (OR = 1.9, 95% CI 1.7-2.2), working class status (OR = 1.4, 95% CI 1.2-1.6), and lack of high school completion (OR = 1.6, 95% CI 1.4-1.8). The "prudent" diet was associated with high school completion (OR = 2.8, 95% CI 2.5-3.3) and behaviors reflecting greater health awareness, such as daily physical activity (OR = 2.0, 95% CI 1.8-2.2), non-smoking (OR = 2.1, 95% CI 1.8-2.4), and supplement use (OR = 1.8, 95% CI 1.6-2.0).CONCLUSIONS: The two dietary patterns resemble those found in previous US studies. Findings regarding correlates agree with social histories describing the emergence of those patterns. Principal components analysis is potentially useful for identifying fundamental dietary patterns for future investigations of diet-disease associations.

Journal Article↗
PubMed1994

Dietary intake patterns and sociodemographic factors in the atherosclerosis risk in communities study. ARIC Study Investigators.

BACKGROUND: Comprehensive and up-to-date data on differences in dietary intake according to various sociodemographic factors are needed to understand the potential impact of dietary factors on disease risks in the United States. METHODS: Usual dietary intake assessed by a food frequency questionnaire was examined in relation to race, sex, and educational attainment using baseline data obtained from randomly selected samples of 15,800 middle-aged black and white men and women who participated in the Atherosclerosis Risk in Communities Study. RESULTS: In almost all comparisons, higher educational attainment was associated with recommended dietary intake patterns--lower per energy intakes of meats, eggs, chicken with skin, and whole milk and higher intakes of fruits, vegetables, fish, chicken without skin, and low-fat milk. As expected from these food intake patterns, higher educational attainment was associated with lower intakes of saturated fatty acid and cholesterol and with higher intakes of dietary fiber and various micronutrients. Compared with women's diets, men's diets were slightly more atherogenic (in whites only) based upon Keys score and had lower micronutrient levels. Although there were large differences in the food intakes between blacks and whites, the differences in nutrient intakes were generally smaller. However, intakes of cholesterol and vitamin A were somewhat higher and intakes of saturated fatty acid, calcium, and potassium were lower among blacks than in whites. CONCLUSIONS: This community-based study clearly demonstrated that regardless of race and sex, high educational attainment is associated with recommended dietary intake patterns. Continuing efforts to improve general educational level and to promote healthy dietary habits among those with low socioeconomic status are warranted.

Black or African American↗
PubMed2001

[A dietary intervention study on the hypertensive high risk population in a northern rural area of Beijing].

To investigate the relationship between optimal living mode, healthy dietary pattern and the incidence of primary hypertension, a dietary intervention study on hte hypertensive high risk population was carried out in Fangshan district of Beijing during 1997-1999. The subjects were divided into two groups: control group and intervention group. A 3-day-dietary-recall combined with weighing method and a healthy diet education program were used in the study. The results indicated that the dietary pattern was not reasonable in the hypertensive high risk population. After two-year-intervention, the dietary pattern of people in the intervention group has changed distinctively. Compared with the results in 1997, the dietary risk factors decreased obviously in the intervention group, but increased in control group, such as high energy, fat, oil and cholesterol which can promote hypertension. Furthermore, in the past two years, the number of over weight + obese people increased by 24.6% in control group, but was no change in the intervention group. The intervention group subjects experienced an average decline of 3.7 and 5.1 mmHg of systolic blood pressure(SBP) and diastolic blood pressure(DBP) respectively, and new cases of hypertension observed in the intervention group were significantly lower than in control group. Thus it can be considered that the dietary intervention may be effective for the high risk population and play a very important role in the prevention of hypertension.

Adult↗
PubMed1998

Patterns of dietary fluoride supplement use during infancy.

OBJECTIVES: This paper reports on patterns of dietary fluoride supplement use during infancy. METHODS: Data were collected by mail for a birth cohort (n = 1,072) studied at 6 weeks and 3, 6, 9, and 12 months of age. RESULTS: Percentages using supplements were 13.7 at 6 weeks, 13.4 at 3 months, 16.5 at 6 months, 13.0 at 9 months, and 12.1 at 12 months. Among those receiving supplements, mean proportions of weeks that supplements were received during the different time periods varied from 0.59 to 0.80. Number of days per week receiving supplements averaged 4.8 to 5.0. Mean fluoride dosages when supplements were received were 0.22 mg to 0.24 mg. Estimated average daily fluoride ingestion per day (among those receiving supplements during that time period and factoring in those days and weeks that supplements were not received) was 0.11 mg at 6 weeks, 0.15 mg at 3 months, 0.12 mg at 6 months, 0.11 mg at 9 months, and 0.14 mg at 12 months. Among the subset of 129 children with complete data at all time points who used supplements sometime during their first year of life, mean annual daily supplement dosage was 0.07 mg fluoride, with 75 percent having less than or equal to 0.10 mg. Those infants with mothers and fathers with more education were more likely to receive supplements. CONCLUSIONS: Group average use of fluoride supplements was fairly consistent over the 12 months; however, individual patterns varied substantially. Estimated actual mean daily fluoride intake when including days that supplements were not received was substantially less than the recommended 0.25 mg per day.

Adult↗