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[Disparities in food consumption and nutrient intake among in relation to smoking].

BACKGROUND: Nutritional habits and smoking are well known to be two of the most important risk factors for the development of cardiovascular diseases and cancer. The aim of this study was to assess disparities in food consumption and nutrient intake in relation to smoking in the population of Pamplona, Spain. METHODS: A cross study by postal survey was carried out on a representative sample (n=875; 29.3% of the theoretical sample) of Pamplona's population aged between 18 and 65 years. Food consumption was evaluated by a food consumption frequency questionnaire. The survey also contained questionnaires about consumption of tobacco and alcohol, physical activity, as well as a sociodemographic record. A bivariant analysis was carried out (p<0.05) by Kruskal Wallis and chi2 Pearson tests. RESULTS: Male smokers consume less fruit, vegetables and chicken than other groups, while male ex-smokers seem to have healthier food consumption patterns. Female smokers have a less healthy diet as well, although differences are less marked. In both genders, smokers consume more alcohol. With respect to nutrients, smokers consume less folate, niacin and antioxidants (vitamin C). Female non-smokers consume more fibre than other groups. CONCLUSIONS: This study highlights the prevalence of a healthier diet among non-smokers and ex-smokers, who share similar diet patterns that are healthier than those of smokers. It would also be desirable for smokers to have healthier food consumption habits in order to reduce the effects of tobacco and to meet the additional demand for some nutrients required by this group.

Adolescent↗
PubMed1998

Cancer-related behavior of vitamin supplement users.

Epidemiological studies suggest that certain vitamin supplements may reduce the risk of some cancers. However, observational studies can be compromised by confounding, because supplement use is related to other factors that affect cancer risk. The purpose of this paper is to identify cancer-related behaviors that could confound studies of the associations between vitamin supplement use and cancer risk. Data are from a random digit dial survey to monitor cancer risk behavior in adults in Washington State (n = 1449). Unconditional logistic regression was used to examine whether regular supplement users were more likely to practice other cancer-related behaviors than nonusers, after adjustment for age, education, and smoking. Among women, supplement users were more likely to have had a sigmoidoscopy [odds ratio (OR), 2.3; 95% confidence interval (CI), 1.2-4.5], hemoccult (OR, 2.3; CI, 1.5-3.5), or mammogram (OR, 1.5; CI, 1.0-2.1) in the past 2 years. Among men, supplement users were twice as likely to have had a prostate-specific antigen test (OR, 2.2; CI, 1.3-3.7) and to regularly take aspirin (OR, 1.7; CI, 1.1-2.6). Supplement users were statistically significantly more likely to exercise regularly, eat four or more servings of fruits and vegetables per day, follow a low-fat diet pattern, and believe in a connection between diet and cancer. The association was especially strong for fruits and vegetables (women, OR, 1.9; and CI, 1.3-2.6; men, OR, 2.4; CI, 1.6-3.8). Those investigating the benefits and risks of vitamin and mineral supplements need to be aware of the lifestyle characteristics of supplement users to assess the potential for bias in their studies.

Adult↗
PubMed2002

The underweight/overweight household: an exploration of household sociodemographic and dietary factors in China.

OBJECTIVE: The goal of this paper is to explore the hypothesis that the nutrition transition is related to households having an underweight and an overweight member simultaneously (under/over households and under/over pairs). DESIGN: The 1993 China Health and Nutrition Survey (CHNS) was used to test the association between being an under/over household and household characteristics related to the nutrition transition. Sociodemographic and diet patterns were tested for the main age combinations of the under/over pairs. SETTING: In China, 8.1% of all households were found to have underweight and overweight members within the same household. SUBJECTS: Results are from the 1993 China Health and Nutrition Survey and are based on a sample of 13814 persons from 3340 households. RESULTS: The under/over household was more urban, had a higher income and was more likely to have assets such as a television, a motor vehicle and a washing machine, even after controlling for sociodemographic confounders. The under/over household had a diet that was higher in fat and protein compared with the underweight and normal weight households. There were no significant differences between the under/over and overweight households, with many of the associations near unity. Comparisons of the under/over subgroups by age of the under/over pairs showed some differences by income and occupation, but not for diet. CONCLUSIONS: It is imperative, as more individuals become exposed to the diet and lifestyle patterns of the nutrition transition, to find effective public health programmes that can simultaneously promote a healthy lifestyle, improve diet quality and address both undernutrition and chronic disease.

Adolescent↗
PubMed1984

Dietary patterns in anorexia nervosa.

This study characterized the dietary patterns of 96 patients with anorexia nervosa who were seen for diet history. The mean age of the patients was 16.6 yr, and mean loss from preillness weight was 28%. Twenty-five patients ate high-quality meals regularly but simply restricted calories. Eleven maintained a high-quality diet but ate at irregular intervals; of these, six had episodes of binge-eating and vomiting or fasting. Among patients whose diets were qualitatively poor, 19 consumed regular meals and 41 ate irregularly; 31 of the latter had episodes of binge-eating and vomiting or fasting. No typical profile of dietary manipulations by these patients was found. Beyond the generalization that there was caloric restriction that resulted in weight loss, there was great variability in the diet patterns.

Adolescent↗
PubMed1990

The effects of variations in carbohydrate, protein, and fat content of the diet upon weight loss, blood values, and nutrient intake of adult obese women.

The effects on weight reduction of three different 1,200-kcal diets followed for a 10-week period were examined in adult, sedentary, overweight women. Diet patterns contained 25%, 45%, or 75% carbohydrate, with variations in fat and protein. Parameters evaluated and compared for each diet were body composition, cholesterol, triglycerides, blood urea nitrogen (BUN), uric acid, percent body fat, and nutrient intake. Each diet group contained at least 11 women. Behavioral approaches were used to ensure that subjects complied with the caloric intake and the dietary pattern. No significant differences were found in the parameters except for BUN, which was significantly greater in the 25% carbohydrate group. Each 1,200-kcal diet contributed to weight loss. Selection of a weight reduction diet can be designed around preferred food patterns and nutrition needs of individuals rather than a proportion of the energy provided by carbohydrate in healthy adult women. Practitioners may use this research to demonstrate to clients that body weight can be lost while following a variety of nutritious diets.

Adult↗
PubMed2002

Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population.

Tobacco and alcohol consumption are strongly related to other cardiovascular and cancer risk factors. The aim of the present study was to analyse the association of nutrient intake, blood lipid variables and leisure-time physical activity with tobacco and alcohol consumption status. Participants were recruited in a cross-sectional population-based survey, including cardiovascular risk factor measurements and evaluation of physical activity and diet intake in a Mediterranean population (n 1748). Multiple linear regression analysis, adjusted for several confounders, showed a direct association of saturated fatty acids (g and % total energy intake), dietary cholesterol intakes and serum triacylglycerol with smoking. An inverse association was observed for smoking and unsaturated fatty acids (% energy intake), vitamin C, alpha-tocopherol and beta-carotene intakes, leisure-time physical activity and HDL-cholesterol. These associations were not observed for alcohol drinking. After adjusting for the confounders earlier mentioned, low dietary intakes of vitamin C and dietary fibre were more likely in heavy-smokers as compared with non-smokers (odds ratio 1.74 (95 % CI 1.07, 2.73) and 1.94 (95 % CI 1.29, 2.92) of low vitamin C (<60 mg/d) and dietary fibre intakes (<10 g/d) respectively). Alcohol consumption was directly associated with HDL-cholesterol and triacylglycerol, and attenuated the effects of smoking on HDL-cholesterol. These results suggest that the dietary intake of fibre and several antioxidant components of the Mediterranean diet is reduced in smokers, who also show an adverse lipid profile. However, the worst triacylglycerol levels are associated with the combination of heavy smoking and heavy alcohol drinking. Moderate alcohol consumption was not associated with an unhealthy diet pattern or adverse lipid profile. The health benefits of the Mediterranean diet appear to be strongly counteracted by smoking.

Adult↗
PubMed2006

Disentangling women's responses on complex dietary intake patterns from an Indian cross-sectional survey: a latent class analysis.

OBJECTIVE: To investigate the degree of individual heterogeneity related to complex dietary behaviour and to further examine the associations of different dietary compositions with selected characteristics. DESIGN: Latent class analysis was applied to data from the recent cross-sectional National Family Health Survey that collected information on the intake frequency of selected foods. Different responses regarding intake frequency were condensed into a set of five meaningful latent clusters representing different dietary patterns and these clusters were then labelled based on the reported degree of diet mixing. SETTING: Indian states. Subjects In total, 90,180 women aged 15-49 years. RESULTS: Three clusters were predominantly non-vegetarian and two were vegetarian. A very high or high mixed-diet pattern was observed particularly in the southern and a few north-eastern states. Many women in the very high mixed-diet cluster consumed mostly non-green/leafy vegetables on a daily basis, and fruits and other non-vegetarian diet on a weekly basis. In contrast, those in the low mixed-diet cluster consumed more than three-fifths of the major vegetarian diet ingredients alone on a daily basis. The affluent group that represented the low mixed-diet cluster were primarily vegetarians and those who represented the very high mixed-diet cluster were mostly non-vegetarians. The significant interrelationships of different characteristics highlight not only socio-economic, spatial and cultural disparities related to dietary practices, but also the substantial heterogeneity in diet mixing behaviour. CONCLUSIONS: The results of this study confirmed our hypothesis of heterogeneous dietary behaviour of Indian women and yielded useful policy-oriented results which might be difficult to establish otherwise.

Adolescent↗
PubMed2004

Dietary patterns, insulin sensitivity and adiposity in the multi-ethnic Insulin Resistance Atherosclerosis Study population.

Epidemiological investigations increasingly employ dietary-pattern techniques to fully integrate dietary data. The present study evaluated the relationship of dietary patterns identified by cluster analysis with measures of insulin sensitivity (SI) and adiposity in the multi-ethnic, multi-centre Insulin Resistance Atherosclerosis Study (IRAS, 1992-94). Cross-sectional data from 980 middle-aged adults, of whom 67 % had normal and 33 % had impaired glucose tolerance, were analysed. Usual dietary intake was obtained by an interviewer-administered, validated food-frequency questionnaire. Outcomes included SI, fasting insulin (FI), BMI and waist circumference. The relationship of dietary patterns to log(SI+1), log(FI), BMI and waist circumference was modelled with multivariable linear regressions. Cluster analysis identified six distinct diet patterns--'dark bread', 'wine', 'fruits', 'low-frequency eaters', 'fries' and 'white bread'. The 'white bread' and the 'fries' patterns over-represented the Hispanic IRAS population predominantly from two centres, while the 'wine' and 'dark bread' groups were dominated by non-Hispanic whites. The dietary patterns were associated significantly with each of the outcomes first at the crude, clinical level (P<0.001). Furthermore, they were significantly associated with FI, BMI and waist circumference independent of age, sex, race or ethnicity, clinic, family history of diabetes, smoking and activity (P<0.004), whereas significance was lost for SI. Studying the total dietary behaviour via a pattern approach allowed us to focus both on the qualitative and quantitative dimensions of diet. The present study identified highly consistent associations of distinct dietary patterns with measures of insulin resistance and adiposity, which are risk factors for diabetes and heart disease.

Adipose Tissue↗
PubMed1997

[Stomach cancer: risk factors]

For the last fifty years, stomach cancer has become less important in terms of morbidity and mortality in developed countries, but the same pattern has not occurred in Brazil. The main risk factors for this neoplasm are certain diet patterns that became evident through epidemiological studies in various population groups. After the carcinogenic effects of nitrosamines and the anti-oxidant activity of vitamin C were discovered, some of the associations between stomach cancer and diet were partially understood. After the description of Helicobacter pylori in 1983 and the evidence of the relationship between this bacteria and certain stomach diseases, new elements were added to the knowledge about the development of this neoplasm. Current knowledge, albeit incomplete, provides interesting prospects for the prevention and early diagnosis of stomach cancer.

Journal Article↗
PubMed2005

Antecedent intake of traditional Asian-style diets exacerbates pancreatic beta-cell function, growth and survival after Western-style diet feeding in weaning male rats.

The prevalence of type 2 diabetes has been rapidly increasing in conjunction with the westernization of diet patterns in Asia. We determined whether the antecedent consumption of traditional Asian-style diets (ADs) deteriorates insulin action, insulin secretion and pancreatic beta-cell mass after subsequent imposition of the diabetogenic challenge of Western-style diets (WDs) in weaning male Sprague-Dawley rats. Rats were provided AD (a low-fat and plant protein diet), WD (a high-fat and animal protein diet) or a control diet (CD) (a low-fat and animal protein diet) for 12 weeks. After 12 weeks, the groups were divided into two subsets; one set of the groups continued to consume their previous diets of WD, AD and CD for another 12 weeks, and the second set was divided into three groups represented by a switch in their designated diets from WD to AD, AD to WD and CD to WD. Whole-body glucose disposal rates and GLUT4 contents in soleus muscles were lower in WD regardless of the antecedent protein sources. The first-phase insulin secretion was higher in the CD group than in the other groups, whereas the second phase was lowered with AD consumption as antecedent and/or present diets. Asian-style diet and AD-WD intake did not compensate for insulin resistance due to the failure of beta-cell expansion via decreased proliferation. These findings suggest that the antecedent consumption of AD possibly accelerates and augments the development of glucose dysregulation via decreased insulin secretion capacity and pancreatic beta-cell mass when the diets switch to WD.

Animals↗
PubMed1994

Achieving dietary recommendations: whole-grain foods in the Food Guide Pyramid.

The Food Guide Pyramid illustrates USDA's food guide developed to help people follow the Dietary Guidelines for Americans. Unlike earlier food guides, the new food guide specifies foods for a total diet; that is, it addresses both concerns about adequacy and moderation. The food guide recommends increased intakes of the vegetable, fruit, and grain groups with special emphasis on dark-green leafy vegetables, legumes, and whole-grain products. These foods are important sources of several vitamins and minerals, complex carbohydrates, and dietary fiber, and they are generally low in fat. Analyses of expected nutrient levels provided by the food guide diet patterns indicate that the nutrient contribution of whole-grain products is particularly important for diets at lower calorie levels. In these diets, it is recommended that at least half the number of servings in the grain group be whole-grain products. In all diets, it is recommended that several servings of whole-grain products be included each day. Average intakes of vegetables, fruits, and grain products are less than recommended. The pyramid graphic has been especially helpful in emphasizing to the public the importance of increased consumption of vegetables, fruits, and grain products for a healthful diet.

Diet↗
PubMed2002

Chemical contaminants in breast milk: time trends and regional variability.

Research on environmentally related chemical contaminants in breast milk spans several decades and dozens of countries. The ability to use this research as an environmental indicator is limited because of a lack of consistent protocols. Data on xenobiotics in breast milk are influenced by choices in sample selection, sample pooling, analysis, and reporting. In addition, most studies have focused only on a small panel of persistent organic pollutants, despite indications that a wide range of additional chemical contaminants may also enter breast milk. Despite these limitations, however, it is possible to draw some generalizations. In this paper we review available data on levels of organochlorine pesticides, polychlorinated biphenyls (PCBs), polychlorinated dibenzodioxins (PCDDs), polybrominated diphenyl ethers (PBDEs), metals, and solvents in breast milk. Examples drawn from around the world illustrate the available data and the patterns that have appeared in various areas over time. Over the past few decades, levels of the organochlorine pesticides, PCBs, and dioxins have declined in breast milk in countries where these chemicals have been banned or otherwise regulated. In contrast, the levels of PBDEs are rising. Regional differences in levels of xenobiotics in breast milk are related to historical and current local use patterns. Diet is a major factor that influences breast milk levels of persistent organic pollutants, with patterns in fish consumption playing a particularly significant role. Improved global breast milk monitoring programs would allow for more consistent data on trends over time, detection of new xenobiotics in breast milk, and identification of disproportionately exposed populations.

Adult↗
PubMed2006

Dietary patterns and metabolic syndrome--a review of epidemiologic evidence.

Metabolic syndrome is associated with increased risk of coronary heart disease and type 2 diabetes, and appears to be widely prevalent in both developed and developing countries. While lifestyle modification is recommended for management of the syndrome, the dietary pattern most beneficial for patients is yet to be ascertained. Original research papers from the Medline database were examined for dietary patterns that may be associated with the syndrome. Three large-scale epidemiological studies were found fitting our criteria. Dietary patterns high in fruit and vegetable content were generally found to be associated with lower prevalence of metabolic syndrome. Diet patterns with high meat intake were frequently associated with components of metabolic syndrome, particularly impaired glucose tolerance. High dairy intake was generally associated with reduced risk for components of metabolic syndrome with some inconsistency in the literature regarding risk of obesity. Minimally processed cereals appeared to be associated with decreased risk of metabolic syndrome, while highly processed cereals with high glycaemic index are associated with higher risk. Fried foods were noticeably absent from any dietary pattern associated with decreased prevalence of metabolic syndrome. The conclusion of this review is that no individual dietary component could be considered wholly responsible for the association of diet with metabolic syndrome. Rather it is the overall quality of the diet that appears to offer protection against lifestyle disease such as metabolic syndrome. Further research is required into conditions, such as overweight and obesity, which may influence the effect of diet on the development of metabolic syndrome.

Blood Glucose↗
PubMed2006

Design of optimal food-based complementary feeding recommendations and identification of key "problem nutrients" using goal programming.

The WHO is urging countries to promote improved complementary feeding practices to ensure optimal health, growth, and development of young children. To help achieve this, a rigorous 4-phase approach for designing optimal population- specific food-based complementary feeding recommendations (CFRs) was developed and is illustrated here. In phase I, an optimized diet is selected, using goal programming (Model #1), which aims to provide a desired nutrient content with respect to habitual diet patterns and cost. Based on its food patterns, a set of draft CFRs is designed. In phase II, their success for ensuring a nutritionally adequate diet is assessed via linear programming (Model type #2) by sequentially minimizing and maximizing the level of each nutrient (i.e., worst and best-case scenarios) while respecting the CFRs. For nutrients that are <70% of desired levels, the best food sources are identified via linear programming in phase III (Model #3). Different combinations of these foods are incorporated into the original draft of the CFRs to produce alternative CFRs, which are then compared on the basis of their cost, flexibility, and "worst-case scenario" nutrient levels (Model type #2) to select, in phase IV, a final set of CFRs. A hypothetical example is used to illustrate this approach. Outcomes include a set of optimal, population-specific CFRs and practical information regarding key "problem nutrients" in the local diet. Such information is valuable for nutrition promotion, as well as nutrition program planning and advocacy, to help achieve global initiatives for improving the complementary feeding practices of young children living in disadvantaged environments.

Breast Feeding↗
PubMed2001

Promotion of lipid oxidation by selenate and selenite and indicators of lipid peroxidation in the rat.

The AIN-93 reformulation of the AIN-76A rodent diet includes a change in selenium supplement from sodium selenite to sodium selenate to reduce dietary lipid peroxidation. A change to selenate as the standard form of Se in rat diets would render results from previous work using selenite less relevant for comparison with studies using the AIN-93 formulation. To critically examine the rationale for the AIN-93 recommendation, we prepared Torula yeast basal diets patterned as closely as possible after the AIN-93 formulation and supplemented with 0, 0.15 (adequate), or 2.0 (high) mg selenium/kg diet as sodium selenite or sodium selenate. Livers isolated from male Sprague-Dawley rats fed these diets for 15 wk showed no differences in thiobarbituric acid-reactive substances or lipid hydroperoxides measured with the ferrous oxidation in xylenol orange method. Lipids isolated from samples of high-selenate and high-selenite diets showed no differences in conjugated dienes. The addition of selenate or selenite to soybean oil did not result in an altered Oil Stability Index. These results demonstrate that selenate is not less likely than selenite to cause oxidation of other dietary components. Benefits of selenate over selenite in the diets of rodents remain to be demonstrated.

Animals↗
PubMed1989

Long-term (24-year) recall reliability in cancer cases and controls using a 21-item food frequency questionnaire.

The following two questions concerning diet recall were addressed when studying 117 incident cancer cases and 99 controls from the Adventist Mortality Study. Are recalls of past dietary habits reliable? Does recall ability differ between cancer cases and controls? Two sets of dietary data were compared using the American Cancer Society's food frequency questionnaire--as reported in 1960 and recalled in 1984. Ability to recall 21 key food items was evaluated both for individual foods and a combination of all foods by comparing recall scores. The comparison revealed that among food groups, 24-year recall ability varied greatly. There was no significant difference in recall ability between cancer incident cases and controls after controlling for factors that may be related to recall ability (e.g., age, education, and sex). Also, there was no significant difference in recall ability among subjects with or without other chronic diseases likely to affect diet pattern. The results revealed no significant differences in recall ability by sex and body mass index; however, significant differences by vegetarian status and diet stability were found. Significant differences by educational level were found only in univariate analysis.

Aged↗
PubMed2003

The contribution of vegetarian diets to human health.

Our knowledge is far from complete regarding the relationship between vegetarian diets and human health. However, scientific advances in the last decades have considerably changed the role that vegetarian diets may play in human nutrition. Components of a healthy vegetarian diet include a variety of vegetables, fruits, whole grain cereals, legumes and nuts. Numerous studies show important and quantifiable benefits of the different components of vegetarian diets, namely the reduction of risk for many chronic diseases and the increase in longevity. Such evidence is derived from the study of vegetarians as well as other populations. While meat intake has been related to increased risk for a variety of chronic diseases, an abundant consumption of vegetables, fruits, cereals, nuts, and legumes all have been independently related with a lower risk for several chronic degenerative diseases, such as ischemic heart disease, diabetes, obesity, and many cancers. Hence, whole foods of plant origin seem to be beneficial on their own merit for chronic disease prevention. This is possibly more certain than the detrimental effects of meats. Vegetarian diets, as any other diet pattern, have potential health risks, namely marginal intake of essential nutrients. However, from the public health viewpoint the health benefits of a well-planned vegetarian diet far outweigh the potential risks.

Body Weight↗
PubMed2006

[Vegetarian nutrition: preventive potential and possible risks. Part 2: animal foods and recommendations].

INTRODUCTION: As shown in the first part of this article, consuming high amounts of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. However, the relevance of animal foods consumed within a vegetarian diet is less well-known. MATERIALS AND METHODS: We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE-research was performed for all animal food groups relevant with a vegetarian diet (key words: "eggs", "milk", "dietary pattern" "vegetarian diet", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis", "vitamin D", "vitamin B(12)", "iron", "iodine"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. RESULTS: Based on the evidence criteria of the WHO/FAO, colorectal cancer risk reduction by a high intake of milk and milk products is assessed as probable, while a higher risk of prostate and ovarial carcinomas is also probable. The evidence of a risk-increasing effect of eggs relating to cardiovascular disease, colorectal cancer and breast cancer is assessed as probable. As the data of prospective cohort studies suggest, a prudent diet pattern characterized high in fruits, vegetables, whole grains and nuts is associated with a lower risk of coronary heart disease and diabetes mellitus type 2. In contrast, there is no overall association between prudent diet pattern and risk of breast cancer or colorectal cancer. The critical key nutrients for vegetarians are vitamin D and B12, iodine and iron. CONCLUSION: For the first time evidence based dietary recommendations were provided for persons on a vegetarian diet in the D-A-CH-region.

Animals↗