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PubMed1991

Food patterns in the British isles.

Food supply statistics can show the general dietary pattern in European countries. However, their energy content is 50% or more above physiological needs, and because the wastage of each food will be different within a country as well as between countries, comparisons between their nutrient content and a country's mortality may be unreliable. The types and amounts of food brought into the home are closer to what people eat, and this paper describes the main dietary changes which have occurred in Britain at this level since 1970. During a time when life expectancy increased and mortality from coronary heart disease fell, the main characteristics of the diet remained British, but it became more pre-packaged. Many recent changes were in the direction advocated by nutritionists, but, because of a decline in sugars and starches as well as in fat, the proportion of energy derived from fat remained at about 42%. Intakes of several other nutrients also declined, but the ratio of polyunsaturated to saturated fatty acids doubled to 0.37.

Diet Surveys↗
PubMed1999

Dietary guidelines and patterns of food and nutrient intake in Sweden.

The Nordic and Swedish Nutrition Recommendations emphasize the balance between macronutrients in the diet. The amount of saturated and total fat should be limited to c. 10 %energy and 30 %energy, respectively, and the amount of total carbohydrates should be 55-60 %energy. Data from the first Swedish national dietary survey in 1989 show that the average diet is too high in fat, especially saturated fat (36-37 %energy and 16 %energy, respectively) while the content of total carbohydrates and dietary fibre is too low. However, parts of the population consume a diet that meets the recommendation for a particular macronutrient. A comparison of subjects with a low or high intake of total fat and saturated fat, dietary fibre or fruit and vegetables show some common trends with respect to the characteristics of a dietary pattern equal or close to the recommendations, e.g. more frequent consumption of fruit and vegetables and a lower consumption of some fat-rich foods, such as spreads, cheese and sausages.

Adolescent↗
PubMed2002

Position of the American Dietetic Association: health implications of dietary fiber.

Dietary fiber consists of the structural and storage polysaccharides and lignin in plants that are not digested in the human stomach and small intestine. A wealth of information supports the American Dietetic Association position that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Recommended intakes, 20-35 g/day for healthy adults and age plus 5 g/day for children, are not being met, because intakes of good sources of dietary fiber, fruits, vegetables, whole and high-fiber grain products, and legumes are low. Consumption of dietary fibers that are viscous lowers blood cholesterol levels and helps to normalize blood glucose and insulin levels, making these kinds of fibers part of the dietary plans to treat cardiovascular disease and type 2 diabetes. Fibers that are incompletely or slowly fermented by microflora in the large intestine promote normal laxation and are integral components of diet plans to treat constipation and prevent the development of diverticulosis and diverticulitis. A diet adequate in fiber-containing foods is also usually rich in micronutrients and nonnutritive ingredients that have additional health benefits. It is unclear why several recently published clinical trials with dietary fiber intervention failed to show a reduction in colon polyps. Nonetheless, a fiber-rich diet is associated with a lower risk of colon cancer. A fiber-rich meal is processed more slowly, which promotes earlier satiety, and is frequently less calorically dense and lower in fat and added sugars. All of these characteristics are features of a dietary pattern to treat and prevent obesity. Appropriate kinds and amounts of dietary fiber for the critically ill and the very old have not been clearly delineated; both may need nonfood sources of fiber. Many factors confound observations of gastrointestinal function in the critically ill, and the kinds of fiber that would promote normal small and large intestinal function are usually not in a form suitable for the critically ill. Maintenance of body weight in the inactive older adult is accomplished in part by decreasing food intake. Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into a range adequate to prevent constipation. By increasing variety in the daily food pattern, the dietetics professional can help most healthy children and adults achieve adequate dietary fiber intakes.

Cardiovascular Diseases↗
PubMed1993

The impact of diet on coronary heart disease.

The epidemiologic relationship between dietary intake and coronary heart disease (CHD) is reviewed by presenting the findings of the major large national and international cohort studies. There is considerable heterogeneity in the results from these studies because of the many differences in design, sample population, and analysis. Dietary intervention studies, which have numerous limitations, likewise have reported discrepant results, although short-term dietary changes do appear to reduce the likelihood of CHD progression. Although proof is lacking that the currently recommended prudent dietary patterns reduce the incidence or severity of CHD, healthy dietary choices are both inexpensive and safe and are supported by a foundation of sound biological principles.

Clinical Trials as Topic↗
PubMed2000

Continuity and change in women's weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events.

The life course perspective offers a framework for understanding continuity and change in health and health practices. Body weight, and the diet and physical activity strategies used to manage weight in pregnancy and the postpartum period, are a focus of much study because of an association between parity and body weight. The motherhood transition offers an opportunity to study weight concerns and weight management strategies during a period of weight fluctuation that is part of a life transition for many women. Our aim was to develop an in-depth understanding of women's experiences of pregnancy and postpartum weight changes, the strategies that women used to deal with weight changes, and patterns in their attitudes and strategies across pregnancy and the postpartum period. A longitudinal design, using multiple, in-depth, qualitative interviews with 36 women from pregnancy through the postpartum period, was chosen for data collection. Prepregnancy orientations towards body weight emerged as the primary influence on women's pregnancy and postpartum attitudes towards weight, on patterns of physical activity and diet, and on postpartum weight outcomes among most study participants. Four different trajectories ("relaxed maintenance", "exercise", "determined", and "unhurried"), characterized by differences in women's orientations towards their body weight and their diet and physical activity patterns across pregnancy and the postpartum period, emerged from the data. Only a few women diverged from prepregnancy trajectories in weight orientation and diet and physical activity patterns postpartum. Delayed resumption of prepregnancy physical activity and dietary patterns contributed to postpartum weight retention for a subset of "exercisers". Stress and age- or role-related changes in perspective interrupted the continuity of weight orientations and behavioral patterns for three other women. These findings highlight the direction and momentum provided by trajectories in health attitudes and strategies as processes shaping responses to a life transition.

Adult↗
PubMed1999

Fatty acid composition of human milk in Kuwaiti mothers.

Kuwaiti diet is exceptionally rich in fat, carbohydrates and proteins. In addition, subjects in Kuwait are exposed to extreme heat and sun light. Fatty acid profiles of human milk obtained from 19 full breast feeding Kuwaiti mothers were analyzed. Dietary patterns for individual mothers were determined by 24 h dietary recall and food frequency questionnaire. The fatty acid content of human milk was affected by the diet consumed by the lactating mother. The content of long chain polyunsaturated fatty acids (LCP) in human milk lipids did not correlate with their parent fatty acids like linoleic and alpha-linolenic acids. However the human milk LCP were related to the of content of LCP in the maternal diet. Mothers reporting a high fish consumption showed significant amounts of C22:6, omega 3 and C20:5, omega 3 fatty acids. As a general conclusion, breast milk produced by a well nourished mother is better suited to meet the lipid requirements of infants.

Adult↗
PubMed2006

Comparison of three different dietary scores in relation to 10-year mortality in elderly European subjects: the HALE project.

OBJECTIVE: To investigate and compare the associations between dietary patterns and mortality using different European indexes of overall dietary quality. DESIGN, SETTING AND PARTICIPANTS: The HALE (Healthy Ageing: a Longitudinal study in Europe) population includes 2,068 men and 1,049 women, aged between 70 and 90 years of 10 European countries. Subjects were followed for 10 years. This cohort study was conducted between 1988 and 2000. RESULTS: During the follow-up period, 1,382 people died. The Mediterranean Diet Score (MDS) (HR: 0.82 with 95% CI: 0.75-0.91), the Mediterranean Adequacy Index (MDI) (HR: 0.83 with 95% CI: 0.75-0.92) and the Healthy Diet Indicator (HDI)(HR: 0.89 with 95% CI: 0.81-0.98) were inversely associated with all-causes mortality. Adjustments were made for age, gender, alcohol consumption, physical activity, smoking, number of years of education, body mass index, chronic diseases at baseline and study centre. CONCLUSIONS: The MDS, the MDI and the HDI were significantly inversely related with mortality. SPONSORSHIP: This study is based on data of the HALE project and supported by a grant from the European Union (QLK6-CT-2000-00211) to D Kromhout.

Aged↗
PubMed2004

Diet, nutrition and the prevention of hypertension and cardiovascular diseases.

Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases like coronary heart disease (CHD) and stroke and are also linked to other cardiovascular risk factors like diabetes, high blood pressure and obesity. The interpretation of evidence needs to involve a critical appraisal of methodological issues related to measurement of exposures, nature of outcome variables, types of research design and careful separation of cause, consequence and confounding as the basis for observed associations. Adequate evidence is available, from studies conducted within and across populations, to link several nutrients, minerals, food groups and dietary patterns with an increased or decreased risk of CVD. Dietary fats associated with an increased risk of CHD include trans-fats and saturated fats, while polyunsaturated fats are known to be protective. Dietary sodium is associated with elevation of blood pressure, while dietary potassium lowers the risk of hypertension and stroke. Regular frequent intake of fruits and vegetables is protective against hypertension, CHD and stroke. Composite diets (such as DASH diets, Mediterranean diet, 'prudent' diet) have been demonstrated to reduce the risk of hypertension and CHD. Sufficient knowledge exists to recommend nutritional interventions, at both population and individual levels, to reduce cardiovascular risk. That knowledge should now be translated into policies which promote healthy diets and discourage unhealthy diets. This requires coordinated action at the level of governments, international organizations, civil society and responsible sections of the food industry.

Cardiovascular Diseases↗
PubMed1975

Diet, growth and cultural food habits in Chinese-American infants.

This study was composed of one hundred Chinese-American mothers and infants in the Chinatown district of San Francisco. The mothers were interviewed with regard to infants' dietary intakes and past dietary patterns, infant health, maternal pre-natal history and diet, cultural habits, and socio-economic status. Infants' growth patterns were recorded and compared to those of American and Chinese babies. Their growth patterns were noted to be dissimilar to both American and Chinese growth patterns, but to be very similar to infant growth patterns in underdeveloped countries. The cultural influences on the dietary intakes were commented upon.

California↗
PubMed1998

Diet, nutrition, and prostate cancer.

Cancer of the prostate gland is one of the most common malignancies in affluent nations, in part due to the application of new screening and diagnostic tools. The development of life-threatening prostate cancer is the culmination of a complex series of initiation and promotional events over a period of decades and under the influence of many interacting genetic and environmental factors. A rapidly accumulating scientific literature provides compelling evidence for the hypothesis that diet and nutrition are important factors modifying risk of prostate cancer. Additional resources devoted to interactive research efforts by laboratory scientists and epidemiologists will provide further enlightenment and continued refinement of our assessment of risks and benefits for specific nutrients and dietary patterns. These studies provide hope that evidence-based dietary interventions will significantly impact the risk of prostate cancer and enhance the efficacy of therapeutic interventions.

Animals↗
PubMed1982

Nutrition education in supermarkets: an unsuccessful attempt to influence knowledge and product sales.

Although much evidence links dietary patterns with coronary heart disease, effective and economical methods for inducing dietary change in nonclinical populations are needed to influence public health. This study was designed as a preliminary investigation of the feasibility of conducting effective nutrition education campaigns in supermarket settings. Eight supermarkets from a supermarket chain in the Twin Cities area participated. Four were assigned to an experimental condition in which educational materials consisting of posters, recipes, and brochures were placed in the dairy section during a 6-month period. Four other stores were assigned to a control condition and received no educational materials. Shoppers in experimental and control stores completed a nutrition survey pre- and post-intervention. In addition, sales data for 25 dairy products were collected during a 10-month period. A significant increase in knowledge on the nutrition survey between pre- and posttests occurred among shoppers in all stores. There was no significant knowledge or product sales effect due to the education campaign. Study results suggest that, overall, shopper knowledge of food selections for cardiovascular disease risk reduction is high and improving. Unfortunately, knowledge is often not reflected in food purchase patterns.

Adult↗
PubMed1980

Breast cancer in Japan and United States: epidemiology, hormone receptors, pathology, and survival.

Breast cancer is the most common cancer among American women, whereas in Japan it ranks third behind gastric and uterine cancers. In spite of the relatively low incidence of breast cancer in Japan, a sharp increase in the frequency has been noted since 1966, which is decidedly related to change in dietary patterns in Japanese women. An increase of over 250% in dietary intake of fat has been noted during the past 15 years. Cancer is detected at an earlier stage in Japan as compared with the United States, and consequently the end result is significantly better. But the improved results could not be totally explained on the basis of early detection, since stage-for-stage the Japanese series appears to be consistently better than the US series by 10% in their ten-year survival rates.

Adult↗
PubMed1996

Tobacco and diet as determinants of survival in male laryngeal cancer patients.

In a series of 213 incident cases of laryngeal cancer, interviewed 10 years ago in the framework of a population-based case-control study, survival has been evaluated in relation to tobacco, alcohol consumption and dietary habits. The occurrence of other primaries and stage at diagnosis were taken into account as possible confounding factors. Heavy tobacco smoking appeared to worsen the prognosis in a dose-dependent manner. No effect was apparent for alcohol. The consumption of vegetables, citrus fruit, olive oil and orange juice was associated with a better prognosis; an opposite association was found for butter and milk. A tentative differentiation between dietary patterns showed a 36% advantage in survival for those whose dietary habits corresponded to the "Mediterranean diet". Our results support the hypothesis that diet may interfere with the mechanisms of cancer progression, and suggest that dietary intervention could be a means of improving survival in laryngeal cancer patients.

Case-Control Studies↗
PubMed2004

Advice that includes food sources of unsaturated fat supports future risk management of gestational diabetes mellitus.

Abstract Women with gestational diabetes mellitus (GDM) have a greater risk of developing type 2 diabetes mellitus (DM) and heart disease than pregnant women without GDM. Advice given during the GDM pregnancy provides an opportunity to develop protective dietary patterns for the long-term management of this risk. Dietary guidelines for the prevention and management of type 2 DM support the inclusion of unsaturated fats, but food advice needs to target this outcome. The aim of this study was to compare the dietary intakes of women with GDM given general low-fat advice (control group) to women with GDM given the same advice with additional targets for food sources of unsaturated fats (intervention group). After approximately 6 weeks, the intervention group reported more ideal dietary fatty acid intakes than the control group, with polyunsaturated:saturated fat ratios of 1:1 and 0.4:1, respectively ( P < .001), assessed using repeated measures analysis of variance. These results confirm the need to include food sources of unsaturated fats in advice strategies to assure optimal protective eating habits in this at-risk group.

Adult↗
PubMed2000

A qualitative study of participants' experiences with dietary assessment.

OBJECTIVE: This article reports on the use of focus groups and an experimental participatory activity to investigate factors influencing participants' decisions about what to eat and what to report on food records and food frequency questionnaires. DESIGN: Four focus groups examined participants' experience with diet records and 3 focus groups explored the topic of food portions using a group consensus activity. Twenty-two women participated in the diet record focus groups, and 15 participated in portion estimation groups. SUBJECTS: Focus group participants were equally distributed by age and body mass index values. Each woman completed a 10-day doubly labeled water protocol to measure total energy expenditure, 7 days of diet records (before and during total energy expenditure), and a food frequency questionnaire after the total energy expenditure. ANALYSIS: Transcripts of the focus groups were coded to index categories of responses and to identify themes within and across those responses. Themes discussed in this article are those that were discussed most often and at greatest length by all groups. RESULTS: The diet record focus groups revealed that 2 major factors influenced reporting on diet records: honesty vs social acceptability, and simplifying food intake. The portion estimation focus groups revealed 5 factors that influenced perceptions of portion size: the role of food in the meal, the type of food, personal preferences, product serving sizes, and comparison of personal servings with those of others. APPLICATIONS: The validity and reliability of self-reported food consumption is greatly influenced by the ways people interpret and respond to dietary assessment instruments. These findings indicate that dietetics professionals need to take extra steps to address issues of accurately recording "bad" foods when training patients to complete diet records. Extra probing is needed when dietary records do not include snacks and include simple meals and a large amount of prepared and packaged food because this may indicate that changes in normal dietary patterns were made in order to more easily complete a dietary record.

Adult↗
PubMed2001

A household food inventory for North American Chinese.

OBJECTIVE: To determine whether a short set of questions about foods in the household can provide information about the fat-related dietary behaviour of individual household members in less-acculturated Chinese populations. DESIGN: Cross-sectional survey. PARTICIPANTS: The study population included 244 adult females of Chinese ethnicity in Seattle, WA, and Vancouver, BC, Canada. SETTING: Bilingual interviewers collected information on the presence of 14 high-fat foods and seven reduced-fat foods in the household. Respondents were also asked about the consumption of foods and behaviour reflective of adoption of Western dietary practices, fat-related dietary behaviour, changes in consumption of high-fat foods since immigration, and sociodemographic characteristics. RESULTS: Although this was a less-acculturated sample, many households had Western foods such as butter (58%), lunchmeats (36%), snack chips (43%), and 1% or skim milk (48%). Households with respondents who were younger, married, employed outside the home, and lived with young children had significantly more high-fat foods, while high education and longer percentage of life in North America were significantly associated with having more reduced-fat foods (P , or = 0.05). Participants living in households with more high-fat foods had higher-fat dietary behaviour than those with fewer high-fat foods (fat-related dietary behaviour score, 1.54 versus 1.28; P < 0.001). Women in households with more reduced-fat foods had a significantly decreased consumption of high-fat foods since immigration compared with those in households with fewer reduced-fat foods (P < 0.001). Western dietary acculturation was higher among women in households both with more high-fat foods and more reduced-fat food counterparts (P < or = 0.05). CONCLUSIONS: Our inventory of household foods was strongly associated with current dietary behaviour, changes in food consumption, and westernization of dietary patterns. This simple, practical measure may be a useful alternative dietary assessment tool in less-acculturated Chinese populations.

Acculturation↗
PubMed1990

Dietary evaluation of patients with smell and/or taste disorders.

The impact of smell and taste disorders on dietary habits and nutritional status has received limited research attention. This paper reports findings obtained from questionnaires and diet records completed by 40 healthy subjects and 118 patients with chemosensory dysfunction. Chemosensory disorders were frequently associated with decreases in food acceptability. Although dietary responses to these dysfunctions varied greatly, patients with distorted or phantom smell and/or taste sensations tended to report weight loss whereas those with simple sensory loss were more likely to report weight gain. Indices derived from diet records did not indicate that either group of patients was at substantial nutritional risk, but food frequency responses and estimates of body mass index were consistent with patient reports of changes in dietary patterns and weight. In addition, marked weight change and aberrant dietary practices were noted in individual patients. Thus, there were indications that chemosensory dysfunction may be associated with nutritionally important dietary alterations.

Adult↗
PubMed2002

[Protective effects of physical activity in the occurrence of colon cancer].

The purpose of the study was to assess the role of occupational and leisure physical activity on the risk pattern of colon cancer considering the possible confounding effects of dietary habits. Case-control study has been carried out in 180 incident cases of colon cancer hospitalized in Chair of Surgery CMUJ in Kraków. The equal number of controls individually matched by gender and age were chosen amongst patients with no history of cancer from the university hospital. Food frequency questionnaire combined with quantity of foods eaten was used to assess the usual dietary patterns for 148 food items. The occupational physical activity of the interviewed subjects before the occurrence of the disease was assessed by self-rating. Leisure time activity was measured by the number of hours watching TV. The adjusted risk of colon cancer was reduced by half in those being active in leisure time (OR = 0.56, 95% CI: 0.32-0.98). The effect of occupational physical activity had the same order of magnitude in terms of risk reduction (OR = 0.56; 95% CI: 0.28-1.10). The protective effect of healthy nutrition appeared to be independent from that attributed to physical effort.

Adult↗