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PubMed1998

Eating patterns and risk of colon cancer.

Colon cancer has been associated with several nutrients and foods. The authors used data from a population-based study conducted in Northern California, Utah, and Minnesota to examine associations between dietary eating patterns and risk of developing colon cancer. Through factor analysis, detailed dietary intake data obtained from 1,993 cases (diagnosed in 1991-1994) and 2,410 controls were grouped into factors that were evaluated for relations with lifestyle characteristics and colon cancer risk. Several dietary patterns emerged. The dietary patterns with the most variation were labeled "Western," "prudent," "high fat/sugar dairy," "substituters," and "drinkers." The "Western" dietary pattern was associated with a higher body mass index and a greater intake of total energy and dietary cholesterol. The "prudent" pattern was associated with higher levels of vigorous leisure time physical activity, smaller body size, and higher intakes of dietary fiber and folate. Persons who had high scores on the "drinker" pattern were also more likely to smoke cigarettes. The "Western" dietary pattern was associated with an increased risk of colon cancer in both men and women. The association was strongest among people diagnosed prior to age 67 years (for men, odds ratio (OR)=1.96, 95% confidence interval (CI) 1.22-3.15; for women, OR=2.02, 95% CI 1.21-3.36) and among men with distal tumors (OR=2.25, 95% CI 1.47-3.46). The "prudent" diet was protective, with the strongest associations being observed among people diagnosed prior to age 67 years (men: OR=0.63, 95% CI 0.43-0.92; women: OR=0.58, 95% CI 0.38-0.87); associations with this dietary pattern were also strong among persons with proximal tumors (men: OR=0.55, 95% CI 0.38-0.80; women: OR=0.64, 95% CI 0.45-0.92). Although "substituters" (people who substituted low fat dairy products for high fat dairy products, margarine for butter, poultry for red meat, and whole grains for refined grains) were at reduced risk of colon cancer, the reduction in risk was not statistically significant. These data support the hypothesis that overall dietary intake pattern is associated with colon cancer, and that the dietary pattern associated with the greatest increase in risk is the one which typifies a Western-style diet.

Adult↗
PubMed1998

Emerging relationships of vitamins and cancer risks.

Evidence is emerging that at least some vitamins may play a role in reducing cancer risks. Over the past year, the best evidence for such effects has been presented for vitamins A, D and E; less consistent evidence has been presented for vitamin C. Although there are still many inconsistencies in our understanding of the anti-cancer roles and mechanisms of these vitamins, it is possible that they may account for at least some of the apparently cancer-protective effects associated with certain dietary patterns.

Animals↗
PubMed2000

Longitudinal nutrient intake patterns of US adolescent women: the Penn State Young Women's Health Study.

PURPOSE: To use longitudinal nutrient intake data to determine whether dietary patterns remain consistent (or "track") as U.S. females progress from age 12 to 18 years. METHODS: Three-day diet records were collected at regular intervals over 6 years from participants in the Penn State Young Women's Health Study. Eighty-one subjects remained in the cohort during the study period. Tracking in body weight, in dietary intake of fat, sugar, iron, vitamin C, and in a total dietary score (TDS) was assessed using quartile-ranking analysis, year-to-year Pearson correlation analysis, and longitudinal linear analysis. RESULTS: Rank analysis revealed that subjects maintained their relative quartile positions for body weight throughout the study period, and year-to-year correlation coefficients for this variable were .93-.94. In contrast, rank and correlation analyses showed that the subjects did not track strongly with respect to any nutrient variable. Age 12 to 18 years correlation coefficients ranged from r = .04 for fat intake to r = .15 for the TDS. In longitudinal linear models, slopes differed in direction and significance across the original quartiles for nutrient intake, indicating varying dietary trends over time within the study population. CONCLUSIONS: Nutrient intake patterns do not track strongly throughout adolescence among U.S. females.

Adolescent↗
PubMed1977

The nutritional epidemiology of cardiovascular disease.

A basic review of the extensive literature focusing on the major risk factors of atherosclerotic coronary heart disease and stroke, i.e., elevation of blood lipids related to diet, blood pressure elevation, and genetic factors using the traditional epidemiological model of interaction between host, agent, and environment, has strongly supported the concept that diet and particularly saturated fat and/or cholesterol are significant contributors to the elevation of blood lipids, especially cholesterol, and contribute importantly to the premature development and mortality of atherosclerotic coronary heart disease. Certainly genetics exert an important impact on this process. To date it remains unclear whether or not major changes in the dietary pattern of huge population groups can be practically effected. The minor dietary modifications so far studied in the average atherosclerosis-prone population cannot be anticipated to make a major dent in the epidemic proportions of atherosclerotic coronary heart disease. It is quite clear that prospective preventive medicine must be implemented at a very early age in the pediatric age group, in which atherosclerosis is now recognized by many as the number one pediatric problem. Tremendous biochemical advances have provided new insights in knowledge regarding the transport of blood lipids, particularly cholesterol, and the regulatory mechanisms at the cellular level for cholesterol under normal circumstances and in the genetic influenced hyperlipidemias (TABLE 4). A bright future lies ahead for the reduction of the epidemic of atherosclerosis which could be greatly enhanced by a greater personal responsibility for health care and a much more careful and prudent diet selection and exercise managment.

Adult↗
PubMedDate not supplied

Utilizing a 24-hour dietary recall and culturally specific diabetes education in Mexican Americans with diabetes.

Two objectives were established for this study: 1) to assess the impact of a culturally specific, intensive diabetes education program on dietary patterns, and 2) to assess nutrient consumption relative to the Recommended Dietary Allowances. The study population consisted of elderly Mexican Americans with diabetes living in Harlingen and Brownsville, Texas. The experimental group (n = 78) participated in an intense, 2-hour nutrition education session, while the control group (n = 74) did not. The education session was conducted for groups of eight subjects via videotapes and interactive discussion. All groups experienced significant weight loss except the women in the experimental group. After the education program, however, the experimental women had increased the percentage of calories consumed daily from carbohydrate. Mean calcium consumption was substantially less than the RDA in all groups, and inadequate amounts of ascorbic acid and vitamin A often were consumed. Intensive, frequent, long-term follow-up appears essential for more sustained results.

Cultural Characteristics↗
PubMed2000

Relative risk of dietary components and colorectal cancer.

OBJECTIVES: To investigate the relative risk factor of dietary components for colorectal cancer in a Chinese rural area through a hospital-based study. DESIGN AND SETTING: Colorectal cancer patients diagnosed at a county cancer center, Hebei Province, China, and out-patients with similar age, sex and resident place were selected for cases and controls, respectively. All subjects were given to interview about their food intake using a foods frequency questionnaire. The intake of different dietary components and life style were compared between cases and controls. MAIN RESULTS: There were 45 colorectal cancer patients and 45 outpatients being the cases and controls in the hospital-based study. In comparison of dietary components between cases and controls, milks, vegetables, fruits and teas had protective effect, and odds ratios were 0.21 (95% CI 0.07-0.60), 0.13 (95% CI 0.03-0.49), 0.27 (95% CI 0.11-0.68) and 0.39 (95% CI 0.16-0.98), respectively. Meats and saturated fats had an increased risk for colorectal cancer, and odds ratios were 5. 13 (95% CI 1.54-17.00) and 3.61 (95% CI 1.17-11.11), respectively. CONCLUSIONS: These findings indicate that there is a similar trend of dietary factors and risk of colorectal cancer in rural areas in comparison with westem dietary pattern, and suggest that the special attention should be paid to dietary habit for prevention and control of colorectal cancer in Chinese rural area.

Adult↗
PubMed2003

Health assessment of U.S. Army Rangers.

PURPOSE: Assess the health behaviors of U.S. Army Rangers, including their diet and physical activity patterns, and their use of alcohol, tobacco, and nutritional supplements. METHODS: Army Rangers (N=38) completed selected self-report and food frequency questionnaires, and anthropometric measures (height, weight, circumferences) were taken. RESULTS: Dietary patterns were collected from questionnaires that asked respondents to report the frequency of usual consumption from a list of foods over a period of 1 year. The data collected indicated a diet high in fat (38.0% of energy) and low in carbohydrates (41.9%). Protein intake (17.9% of energy) was consistent with recommendations for endurance and strength training athletes. Hours engaged in physical activity averaged 12 per week. Overall, 76% of the volunteers reported using alcohol on a regular basis, and 52.6% used some form of tobacco: 50% reported using either snuff or chewing tobacco. The use of supplements was high with 13% taking creatine and ephedrine products on a regular basis. CONCLUSION: Although physical activity patterns indicated a high level of activity, dietary and other health behaviors, such as smoking, alcohol use, and patterns of supplement use, suggest that health education programs may be important in this select Army population.

Adolescent↗
PubMed2002

Dietary acculturation: applications to nutrition research and dietetics.

The US immigrant population is growing dramatically, making the health status of racial/ethnic minorities an increasingly important public health issue. Immigration to the United States is usually accompanied by environmental and lifestyle changes that can markedly increase chronic disease risk. In particular, adoption of US dietary patterns that tend to be high in fat and low in fruits and vegetables is of concern. The process by which immigrants adopt the dietary practices of the host country--called "dietary acculturation"--is multidimensional, dynamic, and complex; in addition, it varies considerably, depending on a variety of personal, cultural, and environmental attributes. Therefore, to intervene successfully on the negative aspects of dietary acculturation, it is important to understand the process and identify factors that predispose and enable it to occur. In this report, we give an overview of acculturation, define dietary acculturation and present a model for how it occurs, discuss measurement issues related to dietary acculturation, review the literature relating acculturation to eating patterns, and provide a case study illustrating how information on acculturation can be used to design dietary interventions in 2 markedly different immigrant groups. Finally, we give applications for nutrition researchers and dietetic practitioners. Studies investigating associations of acculturation with disease risk should identify and intervene on those steps in the acculturation process that are most strongly associated with unhealthful dietary changes. Practitioners working with immigrants should determine the degree to which dietary counseling should be focused on maintaining traditional eating habits, adopting the healthful aspects of eating in Western countries, or both.

Acculturation↗
PubMed1996

Nutritional management of eating disorders.

Abnormal nutritional status and dietary patterns are central features of the eating disorders. Normalization of these features are key components of treatment and recovery because they are powerful perpetuating factors. Restrictive diets, fat avoidance, and abnormal cognitive and perceptual patterns are typically present, in addition to altered nutritional parameters because of hormonal and metabolic factors. The primary goal of nutrition intervention in the patient with anorexia nervosa is to promote weight gain through increased energy intake, expansion of the diet, and knowledgeable and empathetic dietary counseling. A regular pattern of nutritionally balanced, planned meals and snacks, and the avoidance of restrictive dieting, are essential elements of treatment for the patient with bulimia nervosa. As a member of the multidisciplinary treatment team, the dietitian or nutrition professional with knowledge of nutritional science, counseling skills, and a nonjudgmental attitude can provide expertise in this area.

Anorexia Nervosa↗
PubMed2004

Meal and snack patterns of infants and toddlers.

OBJECTIVE: To describe meal and snack patterns of infants and toddlers. DESIGN: A cross-sectional telephone survey in which mothers reported their infants' and toddlers' food and beverage intakes for a 24-hour period. SUBJECTS: Subjects included 3,022 infants and toddlers, ages 4 to 24 months, in the Feeding Infants and Toddlers Study. STATISTICAL ANALYSES PERFORMED: Means+/-standard deviations, frequencies, percentages, energy and nutrient analyses, nutrient densities. RESULTS: On average, infants and toddlers were fed seven times per day. The breakfast, lunch, and dinner pattern, plus snacks, emerged at 7 to 8 months and was well established by 9 to 11 months. Breakfasts were higher in nutrient density for iron, folate, and calcium than other meals. The percentage of children reported to be eating snacks increased with age. The afternoon snack was consumed by over 80% of toddlers (12 to 24 months), and snacks provided about 25% of toddlers' daily energy intakes. Typical snack foods for toddlers were milk, water, cookies, crackers, chips, and fruit drinks. APPLICATIONS/CONCLUSIONS: Results of this study provide parents and professionals with specific information about meal and snack patterns, thereby allowing development of targeted messages and/or strategies to improve the dietary patterns of infants and toddlers. Although most foods provided to the Feeding Infants and Toddlers Study infants and toddlers were nutritionally and developmentally appropriate, snack choices could be improved by delaying introduction of and limiting exposures to foods low in nutrients and high in calories.

Age Factors↗
PubMed2003

Total-diet study: dietary intakes of macro elements and trace elements in Italy.

The present study provides the dietary intakes of macro elements (Ca, Mg, Na, K, P) and trace elements (Fe, Zn, Cu, Se) from the Italian total diet. The contribution of the most representative food groups of the total diet (cereals and cereal products, vegetables, fruit, milk and dairy products, meat and meat products, fish) to the daily intakes of these nutrients was also evaluated. The Italian total diet was formulated following the 'market-basket' approach. Cereals represented the primary sources of Cu (35 %), Fe (30 %) and Mg (27 %). About 89 % of the total daily intake of Fe was derived from plant foods. The vegetables food group was the main source of dietary K (27 %). Most of the Ca (59 %) and P (27 %) was derived from the milk-and-dairy food group. Of the dietary Zn, 41 % was provided by meat, which, together with the fish food group, was the primary source of Se (20 %). The adequacy of the Italian total diet with respect to nutritional elements was assessed by comparing the daily intakes with the average requirement values of the Italian recommended dietary allowances. The present findings indicated that the dietary patterns of the Italian total diet were generally consistent with current Italian dietary recommendations for both macro and trace elements. The major concern was for Ca, for which daily intake was 76 % of the average recommendation for the Italian population. It should not be ruled out that there could be a potential risk of inadequate Fe intake in some segments of the population.

Adolescent↗
PubMed2006

Dietary composition and weight loss: can we individualize dietary prescriptions according to insulin sensitivity or secretion status?

There is considerable uncertainty over whether any one dietary pattern broadly facilitates weight loss or maintenance of weight loss, and current dietary guidelines recommend a spectrum of dietary composition for the general population. However, emerging evidence suggests that specific dietary compositions may work better for identifiable groups of overweight/obese individuals based on their individual metabolic status. In particular, characteristics of insulin dynamics, such as insulin sensitivity or insulin secretion status, may interact with diets that vary in macronutrient composition to influence the weight loss achieved with a hypocaloric diet.

Diet, Reducing↗
PubMed1989

Sports nutrition. Approaching the nineties.

A sophisticated appreciation of the role of nutrition in athletic performance has been made possible by increasing knowledge of the physiology of exercise. The nutritional issues of training are of primary importance, since this occupies most of the athlete's effort. The nutritional support of an intense daily training programme includes an appropriately high energy intake, predominantly in the form of carbohydrate in order to continually replenish muscle glycogen stores. Recent review of the protein needs of athletes indicates that requirements may be substantially above those of sedentary subjects, to account for the oxidation of amino acids during exercise as well as the retention of nitrogen during periods of muscle building. However, these increased requirements are likely to be met by the generous protein intakes anticipated in a high energy diet. The same would seem to hold true for micronutrient considerations, although there is no evidence that vitamin requirements are considerably increased by exercise. Nevertheless, a high energy diet chosen from a sufficiently varied range of foods should allow micronutrient intakes well in excess of population recommended dietary intake levels. Current interest is focused on the mineral status of athletes, particularly that of iron and calcium. In the case of iron, there is a possibility that the increased level of loss by some endurance athletes will not be met by their usual dietary patterns. Screening for early signs of iron deficiency, and appropriate supplementation and dietary counselling seem warranted in high risk groups. Competition poses the challenge of identifying possible factors limiting performance, and taking steps to delay or reduce these. Of paramount importance is body temperature regulation through the maintenance of hydration levels. This issue has long been recognised, but recent studies of gastric emptying and the benefits of carbohydrate supplementation during exercise have caused an update of the advice to athletes regarding fluid intake during exercise. It now seems possible to simultaneously achieve fluid and carbohydrate requirements for endurance exercise within a wide range of choice of beverages containing up to 10% carbohydrate. Concern about the adequacy of carbohydrate fuel stores in endurance exercise situations is also well known. The recognition that training achieves various physiological adaptations to enhance the lifespan of fuel stores has taken away some of the attention previously focussed on carbohydrate-loading techniques.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed2003

Diet and glucose tolerance in a Chinese population.

BACKGROUND: Associations between dietary factors and glucose tolerance observed in Caucasian populations may not be applicable to Chinese populations, since the traditional Chinese diet contains plentiful vegetables and is rice-based (which has a lower glycemic index than potatoes). To address this question, the dietary patterns in 988 Hong Kong Chinese subjects with normal and impaired glucose tolerance, and diabetes, were examined in a cross sectional survey to determine if there is any association between diet and glucose tolerance. METHOD: A stratified random population sample of 988 subjects (488 male, 500 female) was recruited. A food frequency questionnaire was used to determine dietary intake, and glucose tolerance was examined using the glucose tolerance test and the WHO criteria used to classify subjects into the three glucose tolerance categories. RESULTS: Using the standardized world population of Segi, the prevalence rate for DM was 6.6% for men and 5.7% for women; and for IGT 10.3% for men and 15.4% for women aged 30-64 y. Abnormal glucose tolerance is associated with female gender, older age, lower educational attainment and higher body mass index (BMI). No clear pattern of association with dietary factors was observed after adjusting for confounding factors. However, if subjects with BMI>or=25 kg/m(2) were excluded, an increase in mean consumption of rice/noodles/pasta per week was observed in the DM group, after adjusting for total energy intake and other confounding factors. No association between dietary variety, which has been linked with body fatness, and glucose tolerance, was observed. CONCLUSION: Dietary habit may not be a strong risk factor for the development of glucose intolerance in Chinese populations, given the favorable features of the Chinese diet. The high consumption of rice in the DM subjects who are of normal BMI suggests that further studies examining glycemic indices of Chinese food items may be beneficial. Obesity still remains the most important predisposing factor.

Adult↗
PubMed1984

Ornithine decarboxylase induction in rat colon: synergistic effects of intrarectal instillation of sodium deoxycholate and starvation-refeeding.

Starvation-refeeding, intrarectal instillation of the suspected colon tumor promoter sodium deoxycholate (NaDOC), and a combination of the treatments were compared for their effects on ornithine decarboxylase (ODC) activity in the colon of male Sprague-Dawley rats. Starvation (48 hours) and refeeding (12 hours) led to a fivefold increase in ODC levels compared to ad libitum-fed controls, while NaDOC instillation led to a threefold rise. The combination of the two treatments gave a synergistic 16-fold increase over controls. The synergism observed in colon may indicate that the two treatments used act via different mechanisms to induce ODC, possibly by an increase in general macromolecular synthesis after starvation-refeeding and a specific increase in ODC synthesis after NaDOC treatment. Since this starvation-refeeding regimen is quite similar to the "starve and gorge" feeding pattern exhibited by pair-fed control animals, the use of pair-fed controls may not be appropriate for examining either ODC levels or processes, such as tumor promotion, which may be linked to ODC levels. The synergistic enhancement of tumor promoter-related ODC induction by a dietary pattern (rather than a dietary component) suggests a new area for investigation of potential nutrition-cancer interactions.

Animals↗
PubMedDate not supplied

Youth WAVE Screener: addressing weight-related behaviors with school-age children.

PURPOSE: This study evaluated the feasibility of using the youth Weight, Activity, Variety, and Excess (WAVE) screener in a classroom setting for assessing student weight control intentions and the extent to which they used the WAVE strategies to control their weight. METHODS: The Youth WAVE Screener was administered to fifth-grade students in an inner-city school located in the Bronx, New York. The study was conducted in part to increase student awareness of snack foods and sugary beverages in relation to weight. RESULTS: Of the 169 students who completed the survey, 45.5% (n = 77) were trying to lose weight. Students who were trying to lose weight were more likely to have low-fat dairy products, less likely to have sugary beverages, and less likely to eat junk foods than those who were not trying to lose weight. Students who reported exercising 3 times weekly were more likely to report healthier dietary patterns and less sedentary behaviors than were students who exercise less often. Feedback and dialogue with fifth graders addressed the relationship between TV viewing and eating behavior, advertisement, availability, and preferences of fruits and vegetables. CONCLUSIONS: The Youth WAVE Screener can be used to quickly identify children who are concerned about their weight as well as those with dietary and physical activity patterns that may increase the risk of obesity. Diabetes educators can use this screener to start a dialogue with children about their weight-related behaviors.

Adolescent↗
PubMed2000

Diet in residents of East and West Germany in 1991-1992 as ascertained by a retrospective food frequency questionnaire.

In this study, we compared dietary habits of residents in East (N = 76) and West Germany (N = 266) using results obtained in 1992-1993 from a retrospective semi-quantitative food frequency questionnaire referring to 1991-1992. Nutrient intakes were calculated based on the German Federal Food Code. Univariate and multivariate logistic regression was used to determine whether dietary intakes varied according to residence in East and West Germany. At the food level, East German subjects reported a higher consumption of bread, spreadable fat, and sausage, whereas West German participants reported a higher intake of fruit, vegetables, and pasta and rice. At the macronutrient level, energy intake did not differ significantly between groups, nor did the percent contribution of protein, carbohydrate, fat, and alcohol to total energy intake. East German participants had a lower total water and fibre intake, the latter significant only after adjustment for confounders. At the micro-nutrient level, East German participants had a higher intake of cobalamin, retinol and retinol-equivalents (but not of beta-carotene). There were no differences in the intake of vitamins C, D, and E between groups. Less salt and more potassium, calcium, magnesium and zinc were consumed by West than by East German subjects. Overall, both groups showed disadvantageous dietary patterns. The results are discussed in the context of an overview of other dietary surveys performed in the two parts of Germany before and after reunification. In general our results are consistent with other observations showing that dietary habits in East Germany rapidly approached those in West Germany after reunification, although some residual differences seemed to persist.

Adult↗
PubMed2005

Dietary recommendations to meet both endocrine and autocrine needs of Vitamin D.

In the most recent revision of the dietary recommendations for Americans and Canadians in 1997, a recommended intake for Vitamin D was set in the absence of an estimation of mean requirements. There are now new data to estimate average requirements; however, there must be consideration of factors affecting need in populations and of total body tissue needs including the prevention and treatment of cancer. A recent study provides dietary dose-response data in the absence of sun exposure, and a mean requirement of 12.5microg (500IU) was found for Caucasian men. A seasonal build up (summer) and waning (winter) of Vitamin D stores implies that the requirement of Vitamin D in complete absence of yearly summertime sun exposure would approach levels of intake that mimic Vitamin D gained from sun exposure. High prevalence of Vitamin D insufficiency and the re-emergence of rickets have been observed worldwide. For many countries without mandatory staple food fortification, Vitamin D intake is often too low to sustain healthy circulating levels of 25 hydroxyvitamin D. Even in some countries that require (mandatory) or allow fortification (optional), Vitamin D intakes are low in some groups due to their unique dietary patterns, such as low milk consumption, vegetarian diet, limited or no use of dietary supplements, or changes away from traditional food consumption. Supplement use can significantly increase Vitamin D intakes across all age and gender groups but the benefit is primarily gained in persons whose intakes are close to adequate. African American men and women have greater prevalence of Vitamin D insufficiency, which may be a factor in their susceptibility to certain cancers. New recommendations for Vitamin D should be made for the otherwise healthy populations in greatest need of dietary Vitamin D due to lack of adequate sun exposure.

Autocrine Communication↗