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PubMed1990

Dietary and physical determinants of menarche.

Age at menarche shows a downward secular trend and differs according to socioeconomic conditions, presumably the result of dietary variations. We report two studies conducted in Quebec City in which the relation between diet and menarche was evaluated. In 1978-1980, baseline information for these studies was obtained on girls aged 9 through 15 and included body weight, height, fatfold thickness at six sites, percent of body fat (derived from underwater weighing), and a 3-day dietary record. In a cross-sectional study of 207 girls aged 11 through 15, we compared dietary patterns between premenarcheal and menarcheal girls using logistic regression. In a 6-year follow-up study of 109 girls who had not experienced menarche at the baseline data collection, the relation between time of occurrence of menarche and dietary patterns was assessed using proportional hazards models. The results confirm the association between body weight and age at menarche. Body fat, however, was not strongly related to the onset of menstruation. In both studies, a higher dietary energy intake was associated with an earlier age at menarche. Dietary composition, and dietary fat in particular, was not related to menarche.

Adolescent↗
PubMed2004

Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington State.

OBJECTIVE: To examine associations of diet with acculturation among Hispanic immigrants from Mexico to Washington state and to compare dietary patterns of Hispanic with non-Hispanic white residents. DESIGN: Data are part of the baseline assessment for a community-randomized cancer prevention trial. The Fat-Related Diet Habits questionnaire and the National 5-A-Day for Better Health program dietary assessment instruments were used to collect data on fat and fruit and vegetable intake, respectively. Data were also collected on demographic characteristics and acculturation status. SUBJECTS/SETTING: A total of 1,689 adult Hispanic and non-Hispanic white residents of 20 communities in the Yakima Valley, WA, completed in-person interviews. STATISTICAL ANALYSES PERFORMED: Mixed model regression analyses tested associations of acculturation with diet. These models compared the fat and the fruit and vegetable intake of Hispanics vs non-Hispanic white residents. Additional analyses compared the diets of highly acculturated Hispanics with low-acculturated Hispanics. All models included age, sex, income, and education and were also adjusted for the random effect of community. RESULTS: Dietary patterns varied by ethnicity and acculturation status. On average, compared with non-Hispanic white residents, Hispanics consumed one more serving of fruits and vegetables per day (P<.001). Dietary habits changed as Hispanics acculturated to the United States. Highly acculturated Hispanics ate fewer servings of fruits and vegetables per day compared with those not highly acculturated (P<.05). Highly acculturated Hispanics had slightly higher, but not statistically significant, scores on the Fat-Related Diet Habits questionnaire, which corresponds to a higher fat intake, compared with low-acculturated Hispanics. The early dietary changes made on acculturation included adding fat at the table to breads and potatoes. APPLICATIONS/CONCLUSIONS: Nutrition professionals should encourage their Hispanic clients to maintain their traditional dietary practices, such as a high intake of fruits and vegetables and eating bread and potatoes without added fat.

Acculturation↗
PubMedDate not supplied

Relative weight, weight loss efforts and nutrient intakes among health-conscious vegetarian, past vegetarian and nonvegetarian women ages 18 to 50.

OBJECTIVE: To compare relative weight, weight loss efforts and nutrient intakes among similarly health-conscious vegetarian, past vegetarian and nonvegetarian premenopausal women. METHODS: Demographic data, lifestyle practices and weight loss efforts (by questionnaire), body mass index (BMI;kg/m2) and dietary intake (via multiple-pass 24-hour diet recall) were compared in a convenience sample of 90 current vegetarians, 35 past vegetarians and 68 nonvegetarians. RESULTS: Age (31.9 +/- 8.8), educational attainment, smoking status, alcohol use, physical activity and perceived health status were similar among the three groups of women. BMI did not differ by dietary pattern and averaged 23.7 +/- 4.7 for all women combined. Participants had intentionally lost > or = 10 pounds a mean of 2.1 times, and 39% of women perceived themselves to be overweight; again, no differences were observed among dietary groups. Dietary intakes of vegetarians and current nonvegetarians were consistent with current recommendations for macronutrient composition (< 30% fat, < 10% saturates). Compared to current nonvegetarians, current vegetarians had lower intakes of protein, saturated fat, cholesterol, niacin, vitamins B12 and D, and higher fiber and magnesium intakes. Vegetarians' mean vitamin B12 and D intakes were well below recommendations. CONCLUSIONS: Relative weight and weight loss efforts do not differ by dietary pattern among similarly health-conscious vegetarian and nonvegetarian women. The only differences in nutrient intake with potential health implications were vitamins D and B12.

Adolescent↗
PubMed2006

Nutrition and inflammatory load.

Chronic inflammation has been suggested to play an important role in metabolic diseases, such as atherothrombosis and type 2 diabetes. A lot of research has focused on the immunomodulatory effects of several nutrients, such as fatty acids, antioxidants, carbohydrates, specific amino acids, micronutrients, and alcohol, which play a crucial role in the maintenance of an "optimal" immune response. In addition, specific dietary patterns, such as the Mediterranean diet, are evolving as protective against cardiovascular disease, because of their anti-inflammatory properties. In this article, the existing data concerning the nutrients' pro- and anti-inflammatory properties are presented, as well as dietary patterns that could protect from chronic inflammation and its metabolic and atherothrombotic complications.

Antioxidants↗
PubMed1999

Convergence of plant-rich and plant-only diets.

Discussants at the Third International Congress on Vegetarian Nutrition considered the nutritional adequacy, benefits, and health outcomes of plant-only (e.g., vegan and fruitarian), plant-based (e.g., macrobiotic, lactovegetarian, semivegetarian, and meatless), and omnivorous dietary patterns. The increased availability of a variety of plant foods, the advent of nutrient-fortified plant foods, the use of vitamin and mineral supplements, and the widespread dissemination of sound information on dietary patterns mean that convergence between the essential nutrient profiles of plant-only and plant-rich, plant-based diets is possible. Special attention should be paid to nutrition among vulnerable groups by age or physiologic status if they consume diets based solely on plants. Research has shown that both plant-only and plant-based eating patterns have health benefits, most notably in reducing the risk of chronic, degenerative diseases. The panel concluded that evidence for a convergence of scientific opinion on the safety and healthfulness of plant-only diets that are appropriately planned to meet all nutrient requirements compared with plant-based diets is considerable.

Diet, Macrobiotic↗
PubMed1978

Variation in energy intake of aldolescent schoolgirls.

Twenty-four 16 to 17 year-old grammar school girls completed daily dietary histories (for eight weeks), and recorded details of mood, appetite and menstrual cycle. Marked daily variation in energy intakes was noted: on average an individual's highest daily intake was nearly four times her lowest intake, one subject having a nearly tenfold difference. Fluctuations were not related to mood, suggesting that this has less influence on dietary patterns than is generally supposed. While sitting examinations, energy intake was reduced by an average of 11.85%. It was not significantly changed during a field trip or by menstruation. This study suggests that dietary patterns previously considered to be abnormal or unusual are exhibited by and firmly entrenched in normal school girls.

Adolescent↗
PubMed2001

Are low intakes of calcium and potassium important causes of cardiovascular disease?

Inadequate levels of calcium and potassium intake have long been associated with higher blood pressures. Epidemiologic data have suggested these associations and many clinical trials have indicated causal relationships. However, the intervention data are plagued with inconsistent study designs, populations, and results, and there remain many questions regarding dietary recommendations of these nutrients for cardiovascular health. Until recently, nutrition research focused on single-nutrient interventions, generally with disparate results. Recognizing that nutrients are not consumed individually but as combined constituents of a varied diet, efforts in this area have shifted to the role of the overall diet, or dietary patterns, in blood pressure and cardiovascular disease. The suggestions of epidemiologic surveys nearly two decades ago that the total diet has a greater influence on cardiovascular health than do specific components, are now being borne out by randomized controlled trials demonstrating this effect. From these dietary pattern studies, it has become increasingly clear that it is not merely excesses of single nutrients but also deficiencies of multiple nutrients in combination, such as calcium and potassium, that have the greatest dietary effects on cardiovascular health. Several risk factors for cardiovascular disease have now been shown to be reduced with diets that meet the current recommended dietary guidelines, ie, that provide appropriate levels of vitamins, minerals, fiber, and macronutrients. In addition, new data indicate that regular consumption of these diets is associated with decreased mortality. Adequate intake of minerals such as calcium and potassium-specifically derived from foods, where they coexist with other essential nutrients-contributes to cardiovascular as well as overall health.

Blood Pressure↗
PubMed2001

Analytical approaches to food-based dietary guidelines in the European setting.

OBJECTIVE: To show the effects of statistical approaches of data analysis to be used in the development of Food-Based Dietary Guidelines (FBDG). SETTING: Databases from dietary surveys in 6 European countries. RESULTS: Quantile analysis based on iron intake among adult women resulted in differences among European countries regarding (macro) nutrient intake and consumption of food groups. However, in all countries women in the highest quartile had a higher intake of energy and dietary fibre and a higher intake of most food groups. In developing FBDG adjustment of energy intake is recommended. Discriminant analyses showed that among Dutch women potatoes, red meat, sausages, offal, savoury snacks, eggs and total vegetables were found to be the most predictive for differences in iron intake. Relatively high correlations were observed for iron and dietary fibre and iron and (some) B-vitamins. Examples from cluster and factor analysis showed that this type of analysis considers the complexity of the dietary pattern and could also be a helpful instrument in the development of FBDG. CONCLUSIONS: The use of a nutrient distribution can be used as a minimum approach in developing FBDG. More advanced methods can also be used in addition to set priorities for FBDG and to analyse complete dietary patterns.

Cluster Analysis↗
PubMedDate not supplied

Recent dietary guidelines to prevent and treat cardiovascular disease, diabetes, and obesity.

Nutrition guidelines are emphasizing dietary patterns as primary and secondary prevention trials provide increasing evidence of the importance of lifestyle changes to prevent/control cardiovascular disease (CVD) risk factors such as diabetes and hypertension. Despite the increasing evidence that weight loss and modified dietary patterns are effective, there is considerable debate about the level of carbohydrate that will be most beneficial. Epidemiologic studies indicate that certain ethnic and racial minority groups have increased CVD risk with higher rates of obesity, hypertension, diabetes, and stroke. Immigrant and Native American populations have had a dramatic rise in obesity, diabetes, and ultimately CVD with acculturation, accompanied by a higher fat intake and decreased physical activity. Culturally tailored intervention approaches are being used to reduce risk. The lack of third-party payment still limits the availability of nutrition services. However, medical nutrition therapy is covered by Medicare for diabetes and pending legislation will extend coverage to CVD. Medical education researchers have developed tools such as the WAVE (Weight, Activity, Variety and Excess) pocket guide as a quick method to facilitate addressing referral for medical nutrition therapy that can be readily incorporated into practice settings.

Cardiovascular Diseases↗
PubMed1998

Dietary fat patterns in urban African American women.

The purpose of this study was to describe the scope of fatty food preferences of urban African American women and to examine factors associated with the selection of high fat foods. A volunteer sample of urban African American women church-goers were invited for dietary and risk factor screening at health fairs held following Sunday services. A standardized instrument, the Fat Intake Scale (FIS), was administered primarily by dietitians to estimate dietary fat intake and usual food choices. A sum score of 25 or more is thought to be associated with higher fat and cholesterol intake. As a validation of the FIS, a 24-hour recall was administered to a subsample. Sociodemographics, smoking status and comorbidity were assessed by self-report. Body weight, height, and total blood serum cholesterol were assessed using standardized measurement techniques. In the 521 participating women, 61% were classified as obese based on national reference norms for body mass index (BMI). More than 81% had an FIS of 25 or greater. On multiple logistic regression analysis, significant predictors of a higher fat diet (FIS > or = 25) included age greater than 45 years, obesity, and the absence of comorbidity. These findings suggest that there are independent predictors of selection of a diet high in fat. This has implications for planning and targeting community-based nutrition interventions for African American women who exhibit among the highest rates of obesity in the U.S. and who suffer an excess burden of obesity-related diseases.

Adolescent↗
PubMed2004

Associated nutritional risk of breast and colon cancers: a population-based case-control study in Montreal, Canada.

To investigate whether particular patterns of food consumption are related to the occurrence of breast and colon cancer, two simultaneous case-control studies of French-Canadians with 616 cases (414 breast cancer, 202 colon cancer) and 429 population-based controls were carried out. Food consumption data were obtained via a validated food frequency questionnaire. Three dietary patterns were identified. The 'chocolate-cereal' pattern was typified by a high intake of chocolate-based products, breakfast cereals, water, and fruits. The 'pork and processed meat' pattern was characterized by a high intake of pork, white bread and processed meat products, with the 'drinker' pattern depicted by elevated consumption of wine, liquor, and beer. After adjustment for determinants of breast and colon cancers, no significant association was apparent between the three dietary patterns and breast or colon cancer. These results suggest that the observed breast and colon cancer relationship may not be a result of food patterns in French-Canadian women.

Adult↗
PubMed2005

Influences of maternal dietary intake and suckling on breast milk lipid and fatty acid composition in low-income women from Brasilia, Brazil.

Diet has a strong effect, while suckling stimulus is believed not to influence breast milk fatty acids. The effect of dietary pattern and suckling on the fatty acid composition of Brazilian women's breast milk was studied. A cross-sectional study was conducted with low-income women living in the central region of Brazil, where dietary DHA is not readily available. Fore and hind milk fatty acids were collected from 77 women on day 15+/-1 postpartum, and information on maternal characteristics and dietary habit was taken. The effect of suckling stimulus was measured by the changes between fore and hind milk. The mean body mass index (BMI) of volunteers was 23.7+/-3.2 kg/m(2), and the milk lipid concentration was 4.8+/-1.2 g/dl. A mixture of traditional and western type of dietary habit, high in fat and sugar was observed. The fatty acids of the subject's milk were 41.93+/-1.42% saturated, 33.31+/-1.67% monounsaturated and 25.03+/-5.23% polyunsaturated (wt/wt). The DHA level in the milk was 0.34+/-0.19%, similar to the values found in milk of many western societies. DHA and 18:3n-3 levels increased from fore to hind milk (p<0.05). Correlation existed mostly between dietary components and milk 16:0 and oleic acid (18:0). An analysis of classes of fatty acids in milk showed oleic acid (18:0) to present a negative correlation with all milk fatty acid classes. The results suggest that breast milk fatty acids of Brazilian women reflect a western maternal dietary pattern and are influenced by the suckling.

Brazil↗
PubMed1997

Feasibility of a randomized trial of a high-vegetable diet to prevent breast cancer recurrence.

Epidemiologic evidence supports the concept that diet influences risk for breast cancer and suggests that prognosis after the diagnosis of breast cancer may also be related to modifiable nutritional factors. The purpose of this study was to investigate the feasibility of a randomized trial of a high-vegetable, reduced-fat, and increased-fiber diet intervention to reduce risk for recurrence among breast cancer survivors. This major change in dietary pattern was promoted through intensive telephone counseling. Participants were 93 women who had been diagnosed with breast cancer (stages I, II, and IIIA) within the previous four years and who had completed their initial treatment. We assessed adherence to the study diet using repeated 24-hour dietary recalls at 6 and 12 months and measurement of circulating carotenoid concentrations. Six months after randomization, the intervention group had significantly increased their mean intake of vegetables (+4.6 servings/day), fruit (+0.7 servings/day), and fiber (+6.4 g/1,000 kcal) and significantly reduced their intake of dietary fat (-9.9% of energy) compared with the control group. Circulating concentrations of carotenoids also increased in the intervention group. These changes persisted at the 12-month visit. Results of this study demonstrate that telephone counseling can be a useful approach in diet intervention and that breast cancer survivors can adopt and maintain a high-vegetable, reduced-fat dietary pattern.

Biomarkers↗
PubMed2004

Adherence to the traditional mediterranean diet is inversely associated with body mass index and obesity in a spanish population.

The Mediterranean diet is a healthy eating pattern with protective effects on chronic diseases. The purpose of this study was to assess the relation between BMI and obesity and the level of adherence to the traditional Mediterranean diet. The subjects were Spanish men (n = 1547) and women (n = 1615) aged 25-74 y who were examined in 1999-2000, in a population-based, cross-sectional survey in the northeast of Spain (Girona). Dietary intake was assessed using a FFQ. A Mediterranean diet score, including foods considered to be characteristic components of the traditional Mediterranean diet (vegetables, fruits, pulses, nuts, fish, meat, cereals, olive oil, and wine) was created. An increase of 5 U in the dietary score was associated with a change in the BMI of 0.43 (P = 0.030) and 0.68 (P = 0.007), after controlling for potential confounders, in men and women, respectively. The obesity risk decreased in men (P = 0.010) and women (P = 0.013) with increasing adherence to the traditional Mediterranean dietary pattern. The population in the top tertile of this score were less likely to be obese in both genders [odds ratio (OR) and (95% CI): 0.61 (0.40-0.92) in men; 0.61 (0.40-0.93) in women] after adjusting for potential confounders. These data suggest that the traditional Mediterranean dietary pattern is inversely associated with BMI and obesity. This finding may be useful in the development of dietary approaches for dietary counseling and the prevention of obesity.

Adult↗
PubMed2003

Medically administered antibiotics, dietary habits, fluoride intake and dental caries experience in the primary dentition.

OBJECTIVES: Dental caries continues to be a major public health problem in the US and other nations, particularly among younger children. Unfortunately, understanding of factors contributing to caries in this age group is incomplete and further studies are necessary. The purpose of this study was to assess factors related to extensive caries experience among children aged 4-7 years, including antibiotic use, dietary patterns, fluoride intakes, and tooth brushing habits. METHODS: The case-control study was nested within a longitudinal cohort study of children's oral health. The larger cohort study collected data on fluoride intakes and behavioral factors, including antibiotic use and dietary patterns of children periodically from birth. A single dental examination was completed for each child at a time between the ages of 4-7 years. A case-control design was used to compare children with severe caries experience (6 or greater dmfs) to those with no caries experience. Cases (n = 39) included all who met the criteria and had sufficient longitudinal data (n = 39) while a control group was selected to have comparable mean age, exam dates, and an equal number of boys and girls. RESULTS: Backward elimination logistic regression controlling for demographic variables showed severe caries experience to be related to greater regular pop/other sugared beverage intake, greater frequency of starch foods, and greater frequency of eating occasions. Mother's education and fluoride intake from water were inversely related to severe caries experience. Antibiotic use was generally higher in the control group, but was not significantly different than in the severe caries group. CONCLUSIONS: Although we cannot rule out the possibility that antibiotics may be associated with increased or decreased caries risk, our data suggest that they play only a minor role in caries prevention compared to fluoride. Dietary sugar continues to be a significant risk factor for caries in the primary dentition.

Anti-Bacterial Agents↗
PubMed2005

Competing dietary claims for weight loss: finding the forest through truculent trees.

In response to an accelerating obesity pandemic, competing weight-loss diets have propagated; those touting carbohydrate restriction are currently most in vogue. Evidence that sustainable weight loss is enhanced by means other than caloric restriction, however, is lacking. Whereas short-term weight loss is consistently achieved by any dietary approach to the restriction of choice and thereby calories, lasting weight control is not. Competing dietary claims imply that fundamental knowledge of dietary pattern and human health is lacking; an extensive literature belies this notion. The same dietary and lifestyle pattern conducive to health promotion is consistently associated with weight control. A bird's eye view of the literature on diet and weight reveals a forest otherwise difficult to discern through the trees. Competing diet claims are diverting attention and resources from what is actually and urgently needed: a dedicated and concerted effort to make the basic dietary pattern known to support both health and weight control more accessible to all.

Body Composition↗
PubMed2005

Diet quality and subsequent cancer incidence and mortality in a prospective cohort of women.

BACKGROUND: We have previously reported on the utility of the Recommended Foods Score (RFS), a measure of overall diet quality, in detecting associations between diet and mortality in a cohort of older women. Using additional follow-up, we have now extended our analysis to detailed studies of associations between RFS and the mortality and incidence from common cancers. METHODS: The RFS, the sum of 23 recommended food items consumed at least weekly, was computed from a 62-item food frequency questionnaire completed at baseline by 42 254 women with a mean age of 61 years. Multivariate adjusted relative risk (RR) of cancer mortality and incidence of the cancers for which we were able to obtain data in relation to quartiles of RFS were examined using proportional hazards regression analyses after a median follow-up period of 9.5 years. RESULTS: We observed that RFS was inversely associated with total mortality (RR = 0.8; P < 0.001) cancer mortality (RR = 0.74; P < 0.001) as well as mortality from cancers of the breast (RR = 0.75; P < 0.06), colon/rectum (RR = 0.49; P < 0.01) and lung (RR = 0.54; P < 0.001). The risk of incident lung cancer (RR = 0.62; P < 0.001) was reduced in women in the highest vs the lowest quartile of RFS; for incident cancers of the breast, colorectum, endometrium, ovaries, and bladder, there was no RFS association. CONCLUSION: A dietary pattern reflecting a higher RFS was associated with decreased overall mortality in women, specifically cancers of the lung, colon/rectum, and to a lesser extent breast. Incidence was only decreased for lung cancers. These observations are consistent with the hypothesis that a high RFS dietary pattern, or associated lifestyle factors, might affect cancer progression and survival.

Coronary Disease↗
PubMed1990

Zinc: consumption patterns and dietary recommendations.

Two important factors that determine zinc nutriture are the amount of zinc provided by the food supply and the zinc content of the foods individuals eat. The amount of zinc provided by the U.S. food supply has varied between 11 and 13 mg/day/person since the beginning of the century. Currently, it is estimated that the U.S. food supply provides 12.3 mg zinc per person per day. Data from the Food and Drug Administration's Total Diet Study and the U.S. Department of Agriculture's Nationwide Food Consumption Survey of Individuals and year-long Beltsville diet study indicate that adult males select diets that contain 90% or more of the 1989 Recommended Dietary Allowance (RDA) for zinc, whereas women select diets that have less than 81% of the RDA for zinc. Zinc densities of the diets for men and women were similar, which suggests that the difference in total zinc intake is attributable to a difference in energy consumption. Consumption patterns that meet the RDA for zinc can be compatible with the recent National Academy of Sciences diet and health recommendations. The dietetic practitioner should encourage consumption patterns that include using zinc-rich foods in the form of poultry and lean meats and low-fat or nonfat dairy products; using grain products and legumes, particularly whole grains, which can make an important contribution to total zinc intake; and increasing physical activity to a moderately active level to increase energy and zinc intake.

Absorption↗