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PubMed1994

Reproductive and hormonal factors in male and female colon cancer.

We analysed data from a case-control study in the Netherlands in order to investigate whether reproductive events and hormonal factors are similarly related to colon cancer risk in men and women after adjustment for dietary factors. In total, 232 colon cancer cases (102 women, 130 men) and 259 controls (123 women, 136 men) were interviewed about life style, medical conditions and usual dietary patterns, using a structured dietary history technique. In women, age at first childbirth was positively associated with colon cancer risk (odds ratio (OR) age > or = 26 vs < 26 years, 1.7; 95% confidence interval (CI), 0.9-3.3). Women with three or more children were at reduced risk compared with women with one or two children (OR, 0.6; 95% CI, 0.3-1.1). When women had had their first child after the age of 26 years, parity was observed to be important (for one or two children vs > or = three children: OR, 2.8; 95% CI, 1.1-7.0). For men, opposite but non-significant associations were found. Adjustment for dietary patterns and other risk factors did not change the estimates markedly. Of the hormonal factors, late age at menarche decreased risk (OR, 0.5; 95% CI, 0.3-0.9) while late age at natural menopause slightly increased risk. Our study provides additional support for the role of reproductive status in the aetiology of colon cancer in women, independently of dietary factors.

Adult↗
PubMed1987

[Nutritional behavior of non-insulin-dependent type II diabetes patients using the KALI 2.1.2 computer program].

Forty patients with non-insulin-dependent diabetes mellitus (NIDDM) were investigated regarding their individual diet history, including dietary pattern and dietary habits. The energy intake in men was 2,180 +/- 460 kcal/day. The carbohydrate content was 192 +/- 57 g/day (38 +/- 7%), protein 93 +/- 20 g/day (19 +/- 3%) and fat 96 +/- 26 g/day (43 +/- 7%). Nutritional intake of saturated fatty acids was 37 +/- 11 g/day, whereas the intake of polyenic acid was 14 +/- 5 g/day. Thus the p/s-quotient was 0.4 +/- 0.1. The cholesterol intake amounted to 396 +/- 165 mg/day. The dietary fibre content was 33 +/- 21 g/day. The caloric intake of women was 1,800 kcal/day. The daily amount of carbohydrate was 154 +/- 46 g/day (37 +/- 6%), of protein 82 +/- 21 g/day (20 +/- 4%), of fat 82 +/- 32 g/day (43 +/- 6%). Saturated fatty acids were 33 +/- 14 g/day, polyenic acid 11 +/- 5 g/day, the p/s-quotient 0.4 +/- 0.2. The cholesterol intake was calculated to be 341 +/- 118 mg/day. The supply of electrolytes, trace elements and vitamins was often marginal. We found that usually practiced diabetes diet is too fatty, rich in cholesterol and poor in carbohydrate and fibre. As a result of the high amount of fat, which comprises 43% of the total calories and the low p/s-quotient of 0.4, the diet must be considered atherogenic.

Blood Pressure↗
PubMed1985

Dietary determinants of gastric cancer in south Louisiana inhabitants.

In south Louisiana, 391 recently diagnosed gastric cancer patients and an equal number of controls were interviewed. Questions asked covered residential and occupational histories, environmental exposures, tobacco use, diet, alcohol consumption, and pertinent demographic characteristics. Elevated relative risks were found for use of tobacco and alcohol products. Diet was found to be the main determinant of gastric cancer risk in south Louisiana. Both dietary patterns and dietary risk factors differed for blacks and whites, although fruits as a group and dietary vitamin C were found to exert strong protective effects for both blacks and whites. Consumption of smoked foods and homemade or home-cured meats increased risk of gastric cancer for blacks but not for whites. The findings are discussed in the light of the prevailing etiologic hypotheses.

Adult↗
PubMed2005

Multivariate analysis of diet in children at four and seven years of age and associations with socio-demographic characteristics.

AIM: We have previously reported on distinct dietary patterns obtained from principal components analysis (PCA) of food frequency questionnaires from 3-y-old children. In this study, we repeat these analyses at 4 and 7 y of age. DESIGN: As part of regular self-completion questionnaires, the primary source of data collection in the Avon Longitudinal Study of Parents and Children, parents were asked to record the frequency of consumption of 57 different food types for their children. A total of 9550 subjects (68% of original cohort) were available from the 4-y data sweep and 8286 (59%) from the 7-y. METHODS: Distinct dietary patterns were identified at each age using PCA. These were then related to social and demographic characteristics of the parent and child. RESULTS: Three dietary patterns were established cross-sectionally at both 4 and 7 y of age to best describe the types of diet being consumed. One component at both time points described a diet based on 'junk'-type foods with high-fat and sugar content, processed and convenience foods. A second described the 'traditional' British diet based on meat, potatoes and vegetables. The final, a 'health-conscious' pattern was associated with vegetarian style foods, rice, pasta, salad and fruit. At both time points, the 'junk' pattern was significantly more likely in white children, where maternal education level was low and where the child had more siblings. The 'traditional' pattern was more likely in girls, where the mother had a partner and in nonvegetarians (both mother and child). The 'health-conscious' pattern was more likely with increasing levels of education and increasing maternal age. CONCLUSION: We have demonstrated consistent dietary patterns in cross-sectional analyses at two ages in these children with similar socio-demographic associations evident at each age. Future analyses will track these dietary patterns over time and form a basis for the study of a variety of childhood outcomes.

Adult↗
PubMed2006

Estimating dietary consumption patterns among children: a comparison between cross-sectional and longitudinal study designs.

Estimating dietary intake for children is an essential component of conducting pesticide exposure assessments given the fact that children are predominantly exposed to certain pesticides, such as organophosphorus pesticide, through dietary intake. Different study designs and their respective sampling methodology utilized to estimate food consumption patterns can significantly alter the parameter estimates and the variability in the values obtained. This study investigated the impacts of study design on overall estimates of dietary intake by applying the temporal sampling characteristics used in cross-sectional approaches, as in The Continuing Survey of Food for Intakes by Individuals (CSFII), to food consumption data collected in a longitudinal manner via a bootstrap sampling technique. We examined the precision of time-averaged dietary intake estimates under various sampling schemes and explored the contribution of seasonality toward the dietary patterns. A comparison between the estimates of food consumption obtained from the bootstrap replicates and the longitudinal study estimates indicate that variability is significantly decreased when employing a longitudinal study design. Moreover, both between and within-subject variability decreases when individuals are followed over an increasing number of days. Finally, within the longitudinal study cohort, we observed a seasonal component to dietary intake for fruits and grains. Our findings suggest that longitudinal dietary surveys offer substantial improvements for exposure assessment compared to a standard cross-sectional design.

Child↗
PubMed2004

Diet and obesity.

PURPOSE OF REVIEW: Obesity continues to increase in the United States and worldwide. There is controversy surrounding different dietary patterns used to promote weight loss, and none has emerged as clearly more effective. This paper briefly reviews the factors that influence energy intake and dietary treatments used to promote weight loss. RECENT FINDINGS: Increasing portion size, eating away from home, and consuming a variety of high-energy dense foods appear to increase energy intake. Hormonal influences on diet continue to be explored. Very-low-calorie diets and low-carbohydrate diets lead to greater initial weight loss, but long-term results are no better than more moderate calorie-restricted diets. A program using meal replacements appears to lead to weight loss slightly greater than calorie-restricted diets and offers one option to treat obesity. Dietary patterns low in energy density and glycemic index have potential in treating obesity and should be studied further. SUMMARY: Clearly, a dietary pattern that prescribes a lower total energy intake is necessary for weight loss, and this pattern should be sustainable to maintain weight loss. Although many dietary programs can achieve short-term loss of weight, dietary treatment should be recommended that emphasizes lifestyle changes and is consistent with other dietary guidelines to promote long-term health. Features consistent with this are a dietary pattern low in total calories, saturated fat, and refined carbohydrate; moderate in whole grains; and high in low-energy dense vegetables and fruits. Future studies should explore dietary strategies and combination therapies that contribute to weight loss, long-term weight maintenance, and improved health.

Journal Article↗
PubMed2001

Treatment approaches: food first for weight management and health.

Many genetic, environmental, behavioral, and cultural factors affect health. Diet is as vital as any of them for preventing disease and promoting well-being. We know that what we eat can lead to premature disability and mortality: to obesity, coronary heart disease, type 2 diabetes, degenerative arthritis, sleep apnea, and other illnesses. Now scientific evidence points to links between dietary patterns and illness. The study of these links is a new approach to understanding the role that diet plays in chronic disease. Initial studies include those on eating patterns and risk of colon cancer. More recently, researchers have investigated all-cause mortality and leading causes of chronic disease. Novel epidemiological approaches include factorial analysis to evaluate dietary patterns and cluster analysis to examine nutrient intake, gender, and weight status across food-pattern clusters. These methods work best within groups to identify major dietary patterns, but not necessarily ideal diets. They may also differ across population groups. The success of the Dietary Approaches to Stop Hypertension and Lyon Diet Heart studies supports the value of dietary pattern analysis. At the same time, the relative failure of single-nutrient studies underscores the need for new methodologies and directions in research.

Body Weight↗
PubMed2005

Frequency of food intake and estimated nutrient intake among men and women: the JACC Study.

BACKGROUND: The aim of this study was to determine the frequency of food intake and estimated nutrient intake in the JACC study cohort. METHODS: The subjects were 46,465 men and 64,327 women aged 40-79 years who responded to the self-administered food frequency questionnaire. We calculated the dietary intake of major nutrients by multiplying the frequency of consumption of each food with each portion size, estimated from a validation study. RESULTS: Women reported to more likely consume vegetables, seaweed, fruits, sweets, oolong-tea, western-style-breakfast, and less likely to consume rice and miso-soup than men. Women reported less preference of salty foods and fatty foods than men. Compared with men, women had higher mean intakes of carotene and vitamin C, and lower intake of total energy, carbohydrate and sodium. The frequency of consumption of beef, chicken, dairy products, fresh fish, fish products, rice, and miso-soup increased with age in men, and that of vegetables, seaweed, beans, tofu, fruits, sweets, and green-tea increased with age in both sexes. Men aged 40-49 years had the lowest mean intake levels of crude fiber, calcium, iron, retinol, carotene, and vitamins A, C, and E. Women aged 40-49 years had the lowest mean intake levels of crude fiber, iron, and vitamins C. Women aged 70-79 years had the lowest mean intake levels of calcium, retinol, and vitamins A. CONCLUSIONS: Women had a more westernized dietary pattern than men. Elderly men had a mixture of unhealthy and healthy dietary patterns while elderly women generally had a healthier dietary pattern compared with younger persons.

Adult↗
PubMed2003

Correlates of serum high-density lipoprotein cholesterol: a community-based study of middle-aged and older men and women in Japan.

The authors examined the relationships of high-density lipoprotein (HDL) cholesterol with sex, age, body composition, and lifestyle related factor including dietary patterns, alcohol consumption, smoking, and physical activity in a community-based sample from Mie prefecture, Japan. The study population comprised of 463 men (65.7+/-8.6 years) and 845 women (61.9+/-10.1 years) who participated in an annual healthy examination and a lifestyle related survey in 2001. Using factor analysis based on data from the lifestyle-related questionnaires, three dietary patterns were identified: prudent, Western, and high-salt dietary patterns. Univariate and multivariate analyses indicated that important predictors of higher HDL cholesterol levels were being female and a higher frequency of alcohol consumption. Less strongly related were age and a prudent dietary pattern. Smoking and body mass index (BMI) were strongly negatively related to HDL cholesterol levels. We suggested that efforts to reduce coronary heart disease risks focus on weight control and good daily lifestyles in middle-aged and older Japanese population.

Adult↗
PubMed2004

The effect of the PREMIER interventions on insulin sensitivity.

OBJECTIVE: This ancillary study of PREMIER sought to determine the effects on insulin sensitivity of a comprehensive behavioral intervention for hypertension with and without the Dietary Approaches to Stop Hypertension (DASH) dietary pattern. RESEARCH DESIGN AND METHODS: Participants were assigned to one of three nonpharmacologic interventions for blood pressure (group A, advice only; group B, established; and group C, established plus DASH). The established intervention included weight loss, reduced sodium intake, increased physical activity, and moderate alcohol intake; the DASH dietary pattern was added to the established intervention for those in group C. The DASH dietary pattern is high in fruits, vegetables, and low-fat dairy products while being lower in total fat, saturated fat, and cholesterol. It is abundant in nutrients such as magnesium, calcium, and protein, which have been associated with improved insulin sensitivity. Insulin sensitivity was measured at baseline and at 6 months using the frequently sampled intravenous glucose tolerance test with minimal model analysis. RESULTS: Both intervention groups decreased total calories, percentage of calories from fat, and sodium intake to similar levels, with similar amounts of energy expenditure and weight loss. Covariate differences seen only in group C included increased intake of protein, potassium, calcium, and magnesium. Compared with control subjects, insulin sensitivity improved significantly only in group C, from 1.96 to 2.95 (P = 0.047). Group B did have a significant decrease in fasting insulin and glucose, but the changes in insulin sensitivity did not reach statistical significance when compared with control subjects. CONCLUSIONS: These results suggest that including the DASH dietary pattern as part of a comprehensive intervention for blood pressure control enhances insulin action beyond the effects of a comprehensive intervention that does not include DASH.

Adult↗
PubMed2000

Western diet, family history of colorectal cancer, NAT2, GSTM-1 and risk of colon cancer.

OBJECTIVE: In this study we examine the combined effects of Western diet, age at diagnosis, and genetic susceptibility. METHODS: We use data collected as part of an incident case-control study of colon cancer. Family history of colorectal cancer, N-acetyltransferase (NAT2), and glutathione-S-transferase (GSTM-1) are studied with Western diet and age at diagnosis. RESULTS: A significant interaction between age at time of diagnosis, Western dietary pattern, and family history of colorectal cancer (p for interaction = 0.03) was detected. Those with a family history of colorectal cancer who ate a predominantly Western diet were at increased risk of colon cancer (OR 14.0, 95% CI 3.9-50.1 for < or = 55 years; OR 7.7, 95% CI 2.0-29.1 for 56-66 years; OR 1.6, 95% CI 0.8-3.2 for > or = 67 years) compared to those without a family history of colorectal cancer and low levels of a Western diet. Associations with the Western diet were stronger than individual components of the dietary pattern. Neither NAT2 nor GSTM-1 showed significant interaction with Western diet. CONCLUSION: The extent to which diet comprising a Western dietary pattern influences risk of colon cancer is dependent on age. This dietary pattern also appears to modulate the colon cancer risk associated with a family history of colon cancer.

Age of Onset↗
PubMed2006

Eating patterns and dietary composition in relation to BMI in younger and older adults.

OBJECTIVE: To compare relative associations of eating patterns and dietary composition with body mass index (BMI) in younger (aged 20-59 years, n=1792) and older (aged 60-90 years, n=893) participants in the Continuing Survey of Food Intakes by Individuals, collected 1994-1996. METHODS: Data from two 24-h dietary recalls from individuals reporting physiologically plausible energy intake (within +/-22% of predicted energy requirements, based on previously published methods) were used. RESULTS: Mean reported energy intake was 96 and 95% of predicted energy requirements in younger and older subjects, respectively. Older subjects were less likely than younger subjects to skip a meal, but snacking was common in both age groups. Fiber density was significantly higher in the older group. A higher BMI in both age groups was associated with a higher total daily energy intake, and higher energy intakes at all eating occasions. In both age groups, eating frequency was positively associated with energy intake, and eating more than three times a day was associated with being overweight or obese. In the younger group but not the older group, a lower fiber density coupled with higher percentage of energy from fat was independently associated with having a higher BMI. CONCLUSIONS: While no one eating occasion contributes more than any other to excess adiposity, eating more often than three times a day may play a role in overweight and obesity in both younger and older persons. A reduced satiety response to dietary fiber in addition to lower energy expenditure may potentially further contribute to weight gain in older persons.

Adult↗
PubMed1978

Duodenal bile acid conjugation patterns and dietary sulphur amino acids in the newborn.

Patterns of glycine and taurine conjugation of bile acids in duodenal juice have been studied in 20 low birth weight babies at 12 and 22 days of age. They were fed from birth on one of three feeds containing different amounts of taurine and its precursors, cysteine and methionone. Taurine conjugation predominated in those fed on human milk throughout the first three weeks of life. In those fed on SMA or S26 infant feeding formulae, both of which contain very little taurine, concentrations of glycine conjugates were found to exceed those of taurine conjugates by the 12th day. The low glycine-taurine conjugate ratios previously described in newborn babies are, therefore, probably related to the taurine content of the milk which they received. Glycine-taurine conjugate ratios less than 1.0 occur in breast fed infants during the first three weeks of life.

Amino Acids, Sulfur↗
PubMed1992

The epidemiology of diet and blood pressure.

Epidemiological studies of diet and blood pressure support the concept that some dietary nutrients are strongly related to blood pressure and are amenable to modifications, with a likely impact on the incidence of hypertension and of related vascular events. For other potential nutrients, the evidence is more difficult to obtain. Further studies are required to establish 1) the practical value of assessment of individual nutrients versus dietary patterns in risk prediction, 2) the effects of changes of these individual nutrients versus dietary patterns on blood pressure, and 3) whether long-term changes in these individual nutrients or dietary patterns reduce the incidence of hypertension and can be implemented at a population level.

Adult↗
PubMed1997

An indirect means of assessing potential nutritional effects of dietary olestra in healthy subgroups of the general population.

The potential for olestra to affect the absorption of dietary components was measured in 18- to 44-y-old humans and the weanling pig. Results from the studies were assessed to determine if they were relevant to subgroups of the population not included in the studies. Hypothetrically, two factors that might cause the study results not to be relevant to certain subgroups are dietary pattern and metabolic need. A dietary pattern resulting in olestra-to-nutrient intake ratios greater than those tested in the studies might produce effects greater than those measured. Metabolic needs (i.e., nutrient requirements) among subgroups greater than those of the study population might mean that any effects on nutrient absorption seen in the studies would be larger among subgroups. If olestra-to-nutrient ratios and nutrient requirements of a subgroup were less than those covered in the studies, then the effects of olestra on the nutritional status of the subgroup should be no different than the effects measured in the studies. Subgroups with high olestra-to-nutrient intake ratios were identified by calculating the ratios for those nutrients assessed in the studies [i.e., macronutrients, vitamins A (including beta-carotene), D, E and K, folate, vitamin B12, calcium, iron and zinc]. Subgroups with the greatest olestra-to-nutrient intake ratios for one or more nutrients included children, teenagers and young adults, women from low income families and vegetarians. Subgroups with the greatest metabolic need for one or more nutrients included children, teenagers, and pregnant and lactating women. The olestra-to-nutrient ratios and nutrient requirements of the subgroups having the greatest ratios and requirements were compared with those of the test population. The olestra-to-nutrient intake ratios fed in the studies were greater than those for any subgroup for all nutrients except calcium, which is not affected by olestra. Metabolic needs of the test population were greater than those of all population subgroups for all nutrients. The effects of olestra on nutritional status should not be different or greater than those measured in the controlled clinical tests for subgroups not directly tested.

Adolescent↗
PubMed1978

Foraging patterns of nonhuman primates and the nature of food preferences in man.

1) There are a variety of foraging and dietary patterns among primates; different species have generally obligate food habits. 2) There are a number of convergent dietary patterns among primates that are not taxonomically dependent; closely related species may have very different food habits, while the diets of unrelated forms may be quite similar. 3) At least at a general level, relationships exist between dietary patterns and alimentary tract adaptations. Further comparative studies of the histology of the gut tract of primates in conjunction with detailed and quantitative studies of the food habits of natural populations are needed to determine if more precise dietary/digestive tract relationships exist. Studies of this type should lead to a better understanding of digestive physiology. However, whether we can ever determine the "natural diet" of man by such comparisons, of course, still remains an unanswered question.

Animals↗
PubMed2006

Cardiovascular disease: optimal approaches to risk factor modification of diet and lifestyle.

Cardiovascular disease (CVD) accounts for almost 50% of all deaths in industrialized nations. As much as 70% of CVD can be prevented or delayed with dietary choices and lifestyle modifications. Western-style diets, sedentary lifestyles, and cigarette smoking are key modifiable CVD risk factors. Although CVD mortality was trending downward for almost 50 years, a resurgence, both nationally and globally, has occurred. A growing epidemic of obesity ("globesity"), decreasing physical activity, and persistent cigarette smoking are major behavioral factors underlying this change. Diet and lifestyle increase CVD risk both directly and indirectly. Direct effects include biological, molecular, and physiologic alterations, including inflammatory stimuli and oxidative stresses. Indirect effects include diabetes, dyslipidemias, and hypertension. However, trials studying links between diet and CVD remain notoriously difficult to execute and interpret. Diet interventions are typically confounded by other aspects of an overall diet as well as by lifestyle. Furthermore, benefits derived from a specific dietary or lifestyle intervention may not be proportional to the degree of risk posed by the unhealthy diet or lifestyle. Nonetheless, therapeutic rationale for diet and lifestyle are supported by basic and clinical research. Key components of a healthy aggregate diet include 1) reduced caloric intake; 2) reduced total fat, saturated fat, trans fat, and cholesterol with proportional increases in monosaturated, n-3 (omega-3), and n-6 fatty acids; 3) increased dietary fiber, fruit, and vegetables; 4) increased micronutrients (eg, folate, B6, B12); 5) increased plant protein in lieu of animal protein; 6) reduced portions of highly processed foods; and 7) adopting a more Mediterranean or "prudent" dietary pattern over the prevailing "western" dietary pattern. Key lifestyle interventions include increased physical activity and smoking cessation. Translation of the benefits of healthy diet and lifestyle to the wider population requires both individual and public health strategies targeting at-risk groups.

Journal Article↗
PubMed2002

[Dietary intake assessments: for who? why?].

The use of dietary intake assessment and questionnaires in clinical practice is largely debated, particularly for obese patients. The time needed to carry out them is very long, and the results are little or not at all workable due to the underreporting which may represent up to 50% of intakes for some patients. The usual methods and tools to evaluate dietary intakes are presented, they should not be used to calculate energy intake, but they permit to initiate a dialogue with the patient on his/her dietary pattern. The analysis of the dietary pattern is the first step in diet prescription and is essential to weight management and follow-up. This analysis must consider 3 important components: type of food usually eaten and preferred, the circumstances and environment of food intakes and meals, possible disorders of eating behaviour. Some results on food consumption in adults and children from the Fleurbaix Laventie Ville Santé Study are presented.

Diet Records↗