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Eat for health: a nutrition and cancer control supermarket intervention.

The growing evidence linking dietary patterns to the incidence and prevention of chronic disease has prompted a number of prominent health and scientific agencies to publish dietary guidelines for the public. Some dietary guidelines address specific diseases, such as cancer or heart disease; others focus on overall health promotion. This situation has created a demand for nutrition education and information programs for the public. Increasingly, supermarkets are seen as potential sites for effective consumer education. Eat for Health is a joint research study by the National Cancer Institute (NCI) and Giant Food Inc., a regional supermarket chain in the Washington-Baltimore area. The study's goal was to test the feasibility of supermarkets as a site for consumer nutrition education. Eat for Health's educational focus was diet and cancer control issues in the context of dietary patterns that promote health. Particular attention was paid to reduction of fat intake and increases in consumption of dietary fiber from grains, vegetables, and fruits. Analysis of program results is currently underway; data should be available in early 1990.

Advertising↗

Genetic and dietary adaptation to malaria in human populations.

Plasmodial invasion places a severe oxidant stress on parasitized erythrocytes which can result in red cell damage and removal within the reticuloendothelial system or lysis, thus interrupting the parasitic cycle. The basis of a number of genetic adaptations to malaria--including the hemoglobin variants, the thalassemias, and glucose-6-phosphate dehydrogenase deficiency--is an increased sensitivity of the variant erythrocytes to the oxidant stress of plasmodial parasitization. It is suggested that dietary adaptations of traditional cusines in human populations living in areas where malaria is endemic augment this oxidant stress. It appears that there are three components of this adaptive dietary pattern in most tropical populations: the consumption of 'oxidant fuels', moderate to high iron intake, and limitation of dietary antioxidant intake or storage. It is argued that this dietary pattern maximizes iron-mediated free radical production in parasitized erythrocytes and thus provides a form of diet-mediated antimalarial prophylaxis. African pastoral populations that are heavy consumers of milk appear to manifest a different adaptive pattern involving low intakes of para-aminobenzoic acid, vitamin E, and iron. Periodic food restriction may also contribute to this antimalarial effect.

Adaptation, Physiological↗

Recent developments concerning diet and hypertension.

1. Recent data from randomized controlled dietary trials have shown blood pressure-lowering effects of foodstuffs and dietary patterns to be of practical importance for both individual and population blood pressure control. 2. The salient studies include Dietary Approaches to Stop Hypertension (DASH) trials, on complex dietary patterns and of additive effects of salt restriction, Trial of Nonpharmacologic Interventions in the Elderly (TONE), on weight control and sodium restriction as substitutes for drug therapy, and two Australian trials showing additive effects of dietary fish and weight control and of dietary protein and fibre in treated hypertensives. 3. Regular coffee drinking raised blood pressure in older hypertensives, whereas potential antihypertensive effects of dietary anti-oxidants require further scrutiny.

Animals↗

Dietary behaviours and sociocultural demographics in Northern Ireland.

Subjects aged 16-64 years (592; 258 men and 334 women), randomly selected from the population of Northern Ireland, kept a 7 d weighed record of all food and drink consumed. Social, personal and anthropometric data were also collected. From the weighed records food consumption was described in terms of forty-one food groups. Using principal components analysis, four distinct dietary patterns were generated which were identified as a traditional diet, a cosmopolitan diet, a convenience diet and a 'meat and two veg' diet. These dietary patterns were then correlated with sociocultural, lifestyle and anthropometric variables. It is clear that dietary behaviour is influenced by a number of inter-related sociocultural demographics and that identifiable population groups in Northern Ireland have different dietary behaviours.

Adolescent↗

Patterns of dietary supplement usage in demographically diverse older people.

OBJECTIVE: To analyze dietary supplement usage data from 494 older adults, aged 65 to 101 years. SETTING: Community dwellers living independently of institutionalized care. DESIGN: All dietary supplements, including botanicals, were recorded to aid in assessing the health status of older adults. PARTICIPANTS: 1) 224 individuals enrolled in a study that follows the health of persons 85 years and older (oldest-old) in Klamath County, a non-metropolitan area in southern Oregon; 2) 134 participants of oldest-old age living in the metropolitan Portland area, enrolled in a randomized clinical trial of GBE biloba extract (GBE) for dementia prevention; and 3) 136 participants, ages 65-85 years (young-old), also of the Portland area, enrolled in a study of the effects of yoga and exercise on cognition. MEASUREMENTS: Data verified from labels, not from self-report. RESULTS: Of the participants, 70.6% used dietary supplements. Women took supplements more often than men, and usage decreased with age. A greater percentage, 67.4%, of the non-metropolitan oldest-old took supplements, compared to 56.7% of the metropolitan oldest-old. The greatest usage, 89.7%, was in the metropolitan young-olds. All of these percentages exceed those for comparable age groups in national representative surveys. CONCLUSIONS: Dietary supplement usage by older adults in these studies in Oregon exceeded that in other reports and may reflect high interest in complementary and alternative medicine. This report confirms the results of other studies showing that elderly adults, particularly women, use dietary supplements more than other segments of the US population. Researchers and clinicians should be aware of this pattern and potential conflicts with research design or treatment regimen intended for older people.

Aged↗

Changing patterns of hypertension, diabetes, obesity and diet among Melanesians and Micronesians in the Solomon Islands.

A cross-sectional survey of diabetes, hypertension, obesity and dietary patterns has been conducted in the Western Province of the Solomon Islands. Three groups--traditional and more urbanized Melanesians and semitraditional Micronesians--were compared. Abnormal glucose tolerance was rare (less than 1% over all) in Melanesians regardless of acculturation, but was present in 9.7% of adult Micronesians in whom it was associated with age; obesity; female sex; and a diet that was high in energy and refined carbohydrates. Hypertension, which was associated with advancing age and obesity, was recorded in 6.0% and 8.3% of traditional and partly urbanized Melanesians, respectively, and in 4.8% of Micronesians. Systolic and diastolic blood pressures correlated significantly with age for all except traditional Melanesian women among whom the association was limited to the systolic blood pressure only. Significant correlation coefficients were recorded between diastolic blood pressure and body mass index for both sexes and all groups, and between systolic blood pressure and body mass index for all women but only for Micronesian men. Dramatic differences in life-style and dietary patterns are described for rural and more urbanized Melanesians among whom the mean daily urinary sodium outputs were 67 and 119 mmol/L, respectively.

Acculturation↗

Tooth wear patterns in the deciduous dentition.

Tooth wear is common in the deciduous dentition. A recent study suggests that tooth wear in the deciduous dentition is related to subsequent tooth wear in adults, so that early identification of factors related to tooth wear could be of long-term benefit. The purposes of this study were to describe patterns of tooth wear in the deciduous dentition and to relate tooth wear to occlusal characteristics and longitudinal dietary patterns. Data were collected as part of a longitudinal study of a cohort of children recruited at birth from Iowa hospitals. Stone casts were obtained in the deciduous dentition stage, and 355 children, 4 to 5 years old, met the selection criteria. Tooth wear was categorized for each tooth as none, mild, moderate, or severe, and related to occlusal characteristics and longitudinal data on fruit juice and soft drink consumption. All children exhibited some tooth wear on at least 1 tooth, and nearly 16% of them had at least 1 tooth with severe wear. Tooth wear was generally more severe in the maxillary arch and the anterior teeth. Severe tooth wear on the molars was significantly related to posterior crossbites, but severe tooth wear on the incisors was related to Class III canine relationships. There were no statistically significant relationships between tooth wear and soft drink or fruit juice consumption. Based on our results, we concluded that mild tooth wear is universal in the deciduous dentition, but only a few occlusal factors are related to severe tooth wear. Tooth wear was not related to any dietary patterns we investigated.

Analysis of Variance↗

The dietary adequacy of edentulous older adults.

This study tested the null hypothesis that there are no differences in dietary patterns or adequacy between edentulous patients and individuals with nearly complete dentitions. The research design involved comparing the dietary patterns and adequacies of 34 edentulous subjects who regularly wear dentures with 38 subjects who had nearly complete dentitions. The subjects were between the ages of 51 and 83 years and were sampled from patients attending Case Western Reserve University Dental Clinic. Although edentulous subjects were more likely to claim that they had trouble chewing their food, they were not more likely to select easy-to-chew foods. On the other hand, the diet of dentate subjects tended to be superior to that of edentulous subjects, as indicated by a lower fat and cholesterol consumption and a higher consumption of protein and all of the vitamins and minerals (significantly or nearly significantly for vitamin A, ascorbic acid, calcium, and riboflavin).

Aged↗

Chronic low intakes of vitamin A-rich foods in households with xerophthalmic children: a case-control study in Nepal.

Dietary patterns in 81 rural Nepali households with a 1-6-y-old child with a history of xerophthalmia were compared with dietary patterns of 81 households with an age-matched nonxerophthalmic control subject. Weekly food-frequency questionnaires were collected from case and control "focus" children, a younger sibling (if present), and the household 1-2 y after recruitment and treatment of cases. Control households and children were more likely than case households and children to consume vitamin A-rich foods during the monsoon (July-September) and major rice harvesting (October-December) seasons. Cases were less likely to consume preformed vitamin A-rich foods throughout the year [odds ratio (OR) = 1.2-4.5] with the strongest differences observed from October to December (OR = 2.0-4.2). Dietary risks were generally shared by younger siblings of cases, suggesting that infrequent intake of beta-carotene and preformed vitamin-A rich foods begins early in life and clusters among siblings within households, a pattern that is consistent with their higher risk of xerophthalmia and mortality. In developing countries where vitamin A deficiency is endemic, dietary counseling for children with xerophthalmia should be extended to their younger siblings. Moreover, dietary intake of preformed vitamin A may be as, or more, important as carotenoid-containing food consumption in protecting children and other members of households from vitamin A deficiency.

Carotenoids↗

[Development and testing of a semi-quantitative food frequency questionnaire for Bolivian adolescents].

INTRODUCTION: Since previous studies suggest that the dietary patterns and lifestyle in adolescence have an impact in health later in life, it is pertinent to monitor and document their dietary patterns. OBJECTIVE: To develop and test the reliability and validity of a semi-quantitative food frequency questionnaire for Bolivian adolescents. SETTING: La Paz, September - October 2004. METHODOLOGY: A convenience sample of 82 students from a secondary participated in the study. A semi quantitative food frequency questionnaire was applied twice with one month interval (Q1 and Q2). A 3 days dietary record (3R) was obtained from 32 of the Students as standard. RESULTS: Most of the questions (87%) reporting intake of each individual food item agreed moderately to substantially while only 2 individual food items fell into the category of slight agreement and 11 into the category of fair agreement using the kappa statistic. Quantities obtained from both applications of the questionnaire yielded similar results (P > 0.05). Nutrient estimates obtained from the Q1 and Q2 and the 3R were not statistically different (P > 0.05). CONCLUSION: The semi-quantitative food frequency questionnaire is apparently reliable and valid for the measurement of absolute food intake in Bolivian adolescents. Care will be taken in the future to prevent overestimation of intake measured by this particular questionnaire.

Adolescent↗

Evolution of the response patterns to dietary carbohydrates and the developmental differentiation of gene expression of alpha-amylase in Drosophila.

Intraspecific variation of alpha-amylase activity in D. melanogaster and D. immigrans, which is distantly related to D. melanogaster, and interspecific variation of alpha-amylase activity in 18 Drosophila species were examined. The amount of intraspecific variation of alpha-amylase activities measured in terms of coefficient of variation in D. melanogaster and D. immigrans was one-half and one-tenth or less, respectively, of the interspecific variation in 18 Drosophila species. We also surveyed the response patterns of alpha-amylase activity to dietary carbohydrates at the larval and adult stages. The levels of alpha-amylase activity depended on both repression by dietary glucose (glucose repression) and induction by dietary starch (starch induction). In general, our data suggest that glucose repression was conserved among species at both stages while starch induction was mainly observed in larvae, although the degree of the response depended on species. In D. lebanonensis lebanonensis and D. serrata, larvae expressed electrophoretically different alpha-amylase variants (isozymes) from those of adult flies. These results may suggest that the regulatory systems responsible both for the response to environment and developmental expression are different among species in Drosophila.

Animals↗

Geographical variation in urinary mercury concentrations among populations living in highland and lowland Bolivia.

Mercury (Hg) concentrations were determined in spot urine samples of populations living in the highland and lowland areas of Bolivia. The mean levels of the Hg (U-Hg) were 0.43 and 0.34 micrograms Hg/g creatinine in lowlanders and in highlanders, respectively, which did not suggest existence of high-level exposure to Hg in these populations. In both highlanders and lowlanders, there was a marked difference in levels of U-Hg among different populations. Several lines of evidence suggested that local dietary patterns resulted in the observed difference in U-Hg among different populations. Several lines of evidence suggested that local dietary patterns resulted in the observed difference in U-Hg levels, although the responsible food items could not be specified. In most of the populations examined, females showed higher U-Hg levels than males. Other factors possibly related to the observed geographical differences are discussed.

Altitude↗

Walk a mile in my shoes: culturally sensitive food-habit research.

Issues of cultural meaning loom large in efforts to gather dietary data accurate enough to support nutritional analyses, identify marginal diets, or relate risk to dietary pattern. When scientifically trained researchers work in nonscientific settings--which are common in both the Western and non-Western worlds--many important problems of design, collection, and interpretation arise. Assumptions about the appropriateness of dietary patterns vary markedly from setting to setting, including assumptions about who makes dietary decisions. The definition of risk that is meaningful to food specialists may not be so to target populations. Even attitudes toward asking questions vary from society to society. Researchers can resolve many cultural communication issues by awareness, attention, and judicious combination of culturally sensitive qualitative and quantitative research techniques.

Cross-Cultural Comparison↗

Modifications in food-group consumption are related to long-term body-weight changes.

BACKGROUND: Dietary patterns play an important role in the control of body weight. OBJECTIVE: The aim of this study was to verify whether changes in some dietary patterns over a 6-y follow-up period would be associated with weight changes. DESIGN: A sample of 248 volunteers of the Québec Family Study were measured twice (visit 1: 1989-1994; visit 2: 1995-2000). Body weight, percentage body fat, subcutaneous skinfold thicknesses, and waist circumference measurements as well as 3-d dietary and physical activity records were obtained at each visit. At visit 2, all participants filled out a food-based questionnaire examining changes in the consumption of 10 food categories. To further investigate the relation between changes in food-group consumption and body-weight changes, a total of 51 food subcategories were identified from dietary records. RESULTS: A self-reported decrease in the consumption of food in the fat group or an increase in consumption in the fruit group from the food-based questionnaire predicted a lower increase in body weight and adiposity indicators over time. A more detailed examination of the change in food groups between diet records revealed that increases in the consumption of whole fruit as well as skimmed milk and partly skimmed milk were the 2 food patterns that negatively correlated with the changes of each body weight-related indicator. CONCLUSIONS: These results show that changes in the consumption of some specific food groups are associated with body-weight changes. Such specific eating patterns could help to improve obesity treatment and prevention.

Adolescent↗

Diet and survival of elderly Greeks: a link to the past.

In 1988 and 1989, we investigated in three Greek villages the dietary patterns of 182 men and women aged > 70 y by using a validated semiquantitative food-frequency questionnaire and compared these dietary patterns with the traditional Greek diet as ascertained in the late 1950s by Keys and his colleagues. As in the traditional diet, olive oil dominated fat intake, total fat exceeded 35% of total energy intake, average daily consumption of fruits and vegetables exceeded 500 g, and average ethanol intake for men corresponded to two to three glasses of wine per day. In contrast, consumption of meat and meat products has substantially increased and intake of bread and other cereals has apparently declined. We observed no differences between the two periods with respect to consumption of legumes, eggs and egg products, and sugar confectionery. We have also attempted to assess whether a gradient of adherence to the traditional Greek diet can be identified in the diets of the study subjects, and whether it can subsequently predict total mortality. During a follow-up period of approximately 5 y, 53 deaths were observed. The risk of death was apparently higher among the minority of study subjects whose diet deviated substantially from the traditional Greek pattern, compared with the majority whose diet adhered closely to the traditional pattern.

Aged↗

Dietary habit of smokers in a Chinese population.

The objective of this study is to determine whether smokers have unhealthy dietary habits with respect to cardiovascular diseases and cancer. An age and sex stratified random sample of the Hong Kong Chinese population aged 25 to 74 years (500 men, 510 women) was recruited. A dietary assessment using a food frequency method over a 7 day period, together with a lifestyle questionnaire was administered by a trained interviewer. Approximately half the men were smokers, while only 19/510 women smoked. Smoking was related to lower education level. Male smokers had a lower mean daily consumption of fruits, lower carbohydrate and carbohydrate percentage calorie intake, higher fat and fat percentage calorie intake, and higher vitamin D intake compared with non-smokers. However, the differences were small compared with reported differences in Caucasian populations. No difference in dietary pattern was noted between female smokers and non-smokers. Although there is a tendency for male smokers to have an unhealthy dietary pattern with respect to cardiovascular disease and cancer, the differences between smokers and non-smokers are small, and together with the favourable health features of the Chinese diet, this difference is unlikely to add to the risk of these diseases in smokers or be a confounding factor in examining the aetiology of smoke-related diseases in this population.

Adult↗

[Human ecological and epidemiological studies of Japanese immigrants and their descendants in South America].

Over a million people of Japanese origin reside in South America. However, only a limited number of studies on their health status and lifestyle factors affecting it have been carried out. The author and his co-workers have been conducting a series of field surveys on the health situation and lifestyle factors in Japanese immigrants and their descendants in various areas of South America. The subjects of the first-phase study were residents in four agricultural settlements (colonies) in the suburbs of Brazil, Paraguay and Bolivia. The levels of minerals and heavy metals in the hair were measured, and significant variations were found in several elements. These different levels were found to be regulated by the environmental level of their living place and by the dietary pattern. In the second-phase study, several health-related indicators such as blood pressure, anthropometric features, viral infection markers in sera, and dietary pattern were investigated in two group of immigrants, one from Okinawa and the other from the mainland of Japan, both living in Bolivia. Differences in health situation and lifestyle were identified between them. Traditional habits seen in their original places of residence in Japan still existed in their life in Bolivia, while the introduction of Bolivian lifestyle was prevalent among them. Although the number of Japanese residents in Brazil is largest in the world outside of Japan, little has been known about their health situation. The subjects of the third-phase study were Japanese Brazilians. A descriptive epidemiologic study was carried out, and the mortality and incidence of cancer were determined. Some changes in disease pattern were noted when compared with Japanese in Japan, but these changes were not as marked as in the case of Japanese in the U.S.. A cross-section study on the lifestyle factors of Japanese residents in São Paulo showed some differences in health-related indicators and dietary habits in comparison with Japanese living in five areas of Japan. Such differences were also found among Japanese in São Paulo according to the place of origin in Japan. These series of studies in Japanese immigrants in South America showed the importance of lifestyle factors, especially dietary habits, for the health situation.

Blood Pressure↗