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PubMed1999

Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group.

In the Seven Countries Study, associations between the intake of food-groups and 25-year mortality from coronary heart disease (CHD, defined as sudden coronary death or fatal myocardial infarction) were investigated. Baseline surveys were carried out between 1958 and 1964. A number of individual characteristics were measured in 12,763 middle-aged men belonging to 16 cohorts in seven countries (USA, Finland, The Netherlands, Italy, former Yugoslavia, Greece and Japan). Dietary information was collected in sub-samples using the weighed record method. Vital status of all participants was verified at regular intervals during 25 years of follow-up and the underlying cause of death was adjudicated. Eighteen different food-groups and combinations were considered for comparison among cohorts. Large differences in food-group consumption were seen, with high consumption of dairy products in Northern Europe, meat in the USA, vegetables, legumes, fish, and wine in Southern Europe, and cereals, soy products, and fish in Japan. Population death rates from CHD showed large differences, ranging from 268 per 1000 in East Finland to 25 per 1000 in Crete, Greece. Animal food-groups were directly correlated, and vegetable food-groups (except potatoes) as well as fish and alcohol were inversely correlated with CHD mortality. Univariate analysis showed significant positive correlation coefficients for butter (R = 0.887), meat (R = 0.645), pastries (R = 0.752), and milk (R = 0.600) consumption, and significant negative correlation coefficients for legumes (R = -0.822), oils (R = -0.571), and alcohol (R = -0.609) consumption. Combined vegetable foods (excluding alcohol) were inversely correlated (R = -0.519), whereas combined animal foods (excluding fish) were directly correlated (R = 0.798) with CHD death rates. Multivariate stepwise analysis selected butter, lard + margarine and meat as significant predictors and produced an R2 of 0.922. These findings were confirmed by factor analysis. These cross-cultural analyses are consistent with the hypothesis that dietary patterns are important determinants of differences in population CHD death rates, and confirm the opposite effects on apparent risk of animal and vegetable foods.

Coronary Disease↗
PubMed2004

Nutrition and the endothelium.

Growing evidence suggests that dietary factors play an important role in modulating endothelial function. Epidemiologic and clinical studies have related intake of alpha-linolenic acid and long-chain n-3 fatty acids to lower plasma concentrations of inflammatory cytokines and endothelial adhesion molecules, both of which are considered markers of endothelial dysfunction. In contrast, trans fatty acid intake and a higher dietary glycemic load have been associated with increased plasma concentrations of these biomarkers. Recently, several epidemiologic and intervention studies have examined the relationship between overall dietary patterns and endothelial dysfunction. In general, a "prudent diet," characterized by higher intake of fruits, vegetables, legumes, fish, poultry, and whole grains, is associated with a beneficial effect on the endothelium. Conversely, a "Western diet," characterized by higher intake of red and processed meats, sweets, desserts, French fries, and refined grains, is associated with an impairment of the endothelial function. These findings provide additional biological mechanisms through which dietary factors influence the risk of cardiovascular diseases.

Cardiovascular Diseases↗
PubMedDate not supplied

Predictors of dietary change in Mexican American families participating in a health behavior change program.

Previous research indicates that Mexican Americans have dietary patterns related to cardiovascular disease risk factors. Research on health beliefs in this ethnic group suggests that Mexican Americans may be less amenable to interventions based on cognitive-behavioral change models. Our study derives from the experience in a community trial, the San Diego Family Health Project, in which Mexican American families were recruited for a structured heart health intervention program. We examined correlations between one-year dietary change scores (three-day sodium, three-day fat, 24-hour sodium, 24-hour fat) and a set of predictor variables derived from social learning theory. Both adults and children had lower intake scores after the intervention, except for children's 24-hour sodium scores. Our correlational analysis found only weak and somewhat inconsistent relationships between theoretically based predictor and outcome variables for adults. The children's results showed statistically significant correlations between two theoretical variables (self-efficacy and supporting others' dietary change) and three-day fat and 24-hour sodium intake. We discuss the implications for cardiovascular disease risk reduction interventions with Mexican Americans.

Adult↗
PubMedDate not supplied

[Nutritional regimen of students].

Data derived from study into the dietary pattern of 354 students at the Mogilev Technological Institute are presented. From pertinent questioning it follows that not a small number of students fail to observe the standard nutritional regimen, this being the case more often among students living in hotels or hiring private flats than among those who live with their families. The results of these investigations helped introduce a number of proposals on rationalization of the students dietary.

Diet↗
PubMed2002

Nutrition transition in India.

OBJECTIVE: The primary objective of this review is to examine the demographic and nutrition transition in India in relation to its contribution to the emerging epidemic of chronic non-communicable diseases in this country. SETTING: India, the country as a whole and its different states with a population exceeding 1 billion in 2001. SUBJECTS: The review examines demographic changes in the population with consequent effects on the population pyramid, the rapidity and rates of urbanisation with striking variations in chronic disease patterns and the trends in obesity between rural and urban communities, attempting to relate their prevalence with the diet and lifestyle changes accompanying them. DESIGN: The review is based largely on representative large-scale surveys in the country and other reliable documented data on population characteristics. It also includes a review of the published literature. RESULTS: The results indicate that the demographic changes, rates of urbanisation and changes in dietary patterns are contributing to the changing trends in chronic disease in India. CONCLUSIONS: There is clear evidence of a demographic, epidemiological and nutrition transition in India that is fuelling the epidemic of chronic diseases and obesity, particularly in the urban areas.

Adolescent↗
PubMed2004

Diet and cancer prevention: evidence-based medicine to genomic medicine.

The practice of medicine, including health promotion and disease prevention, is on the verge of being revolutionized once again as the scientific and medical community transitions from evidence-based medicine to genomic medicine. Evidence-based medicine entails the systematic approach of formulating a question, developing literature search strategies, and evaluating and applying evidence to establish clinical practice guidelines. In 1982, when the National Research Council published the first comprehensive review of diet and cancer, the literature was primarily based on epidemiological studies, comparing dietary patterns between countries of low and high incidence for particular cancers. The American Institute for Cancer Research conducted an evidence-based review of the world literature and issued its first report in 1997, and the National Cancer Institute followed with evidence-based overviews of cancer prevention. The World Health Organization International Agency for Research on Cancer recently published a series of handbooks on cancer prevention in relation to dietary factors. The expert recommendations stemming from this extensive evidence subsequently influenced the clinical practice of medicine. In 2001, the complete sequencing of the human genome signified the beginning of the postgenomic era, in which new approaches and technologies are causing a shift in biomedical research. A widening understanding of the complex interactions among genotype, diet, lifestyle, and environment has evoked a change in clinical medical practice, where the evidence- and population-based protocol is evolving into a more personalized system that includes the analysis of individual genotype and phenotype. The implications of this evolution are considerable, because genomic medicine has the potential to give rise to personalized nutrition recommendations and specialized medical treatment.

Alcohol Drinking↗
PubMed2002

Dietary factors associated with the risk of high iron stores in the elderly Framingham Heart Study cohort.

BACKGROUND: High body iron stores may increase the risk of several chronic diseases. Whether dietary factors contribute to the risk of high iron stores is unknown. OBJECTIVE: We assessed the relation between dietary factors and the risk of high iron stores in the elderly Framingham Heart Study cohort. DESIGN: We examined the relation between the usual intake of dietary factors (food-frequency questionnaire) and the risk of high iron stores (serum ferritin >300 and 200 micro g/L in men and women, respectively) in 614 subjects aged 68-93 y. RESULTS: The risk of high iron stores was significantly higher 1) in subjects who took > or =30 mg supplemental Fe/d than in nonusers [odds ratio (OR): 4.32; 95% CI: 1.63, 11.47], 2) in subjects who consumed >21 servings of fruit/wk than in those who consumed < or =14 servings/wk (OR: 2.88; 95% CI: 1.26, 6.61), and 3) in subjects who consumed >4 but <7 or > or=7 servings of red meat/wk than in those who consumed < or =4 servings/wk (ORs: 2.94 and 3.61, respectively; 95% CIs: 1.33, 6.47 and 1.57, 8.27, respectively). Whole-grain intake (>7 servings/wk) was inversely associated (OR: 0.23; 95% CI: 0.07, 0.75). CONCLUSIONS: Among elders, intakes of highly bioavailable forms of iron (supplemental iron and red meat) and of fruit, a dietary source of an enhancer of nonheme-iron absorption (vitamin C), promote high iron stores, whereas foods containing phytate (whole grains) decrease these stores. Individual dietary patterns may be important modulators of high iron stores.

Aged↗
PubMed2002

Nutritional and lifestyle determinants of DNA oxidative damage: a study in a Mediterranean population.

In order to evaluate dietary and lifestyle determinants of oxidative DNA damage we used a modification of the 'comet assay' (single cell alkaline gel electrophoresis), with the fpg enzyme (formamidopyrimidine DNA glycosilase), to measure the basal level of DNA oxidation in peripheral lymphocytes donated by 71 healthy adults living in Florence, Italy. Detailed information about dietary and lifestyle habits was collected by two validated and standardized questionnaires; we also measured plasma concentrations of selected micro-nutrients (six carotenoids, retinol, alpha- and gamma-tocopherol). DNA damage, measured as percent DNA migrated in the comet tail (mean 4.67%, interquartile range 2.36-6.62%), was not associated with gender, age, weight, body mass index, physical activity or smoking history. A positive correlation with height and period of blood sampling emerged: DNA damage tended to be higher among taller subjects (P = 0.02) and in samples obtained in summer months (P = 0.02). Multivariate analyses showed a positive association with coffee (P = 0.01) and tomato consumption (P = 0.05). Instead, the consumption of cruciferous vegetables tended to be negatively associated with oxidative damage (P = 0.09). Furthermore, a positive non-significant association between the consumption of total vegetables and fresh fruit and DNA damage emerged (P = 0.08 and P = 0.10, respectively). The estimated intake of simple sugars showed a strong positive association with oxidative DNA damage (P = 0.01), while vitamin E showed a borderline positive association (P = 0.06). The plasma levels of several micro-nutrients did not appear to influence DNA damage. Our results, although based on a relatively small group of subjects, indicate that individual dietary and lifestyle habits only modestly affect the levels of lymphocyte DNA oxidation and suggest that specific dietary patterns, rich in fresh fruit and vegetables, are not clearly related to decreased oxidative damage in peripheral lymphocytes in a Mediterranean population.

Adult↗
PubMed1991

[Diet as a risk factor for cardiovascular disease in residents of the metropolitan area, San Jose, Costa Rica].

The purpose of this study was to define the dietary pattern of fatty acids, cholesterol, fiber and sucrose in a random sample of 51 families of San José, Costa Rica. Food intake was estimated by using the one-day food weighing method. For food composition values, a single table was created using data taken from others. The results indicated that the level of macronutrient diet composition was in accordance with the United States National Cholesterol Education Program Recommendations. Nevertheless, total dietary fiber (20.3 g/d) intake was below the level suggested by the guidelines, and the percentage of calories from sucrose (12.6%) was above those recommendations. In conclusion, the low P/S ratio, low dietary fiber and high percentage of calories from sucrose in the diet of this urban population group of San José, has several atherogenic features representing one of the important risk factors associated with cardiovascular disease.

Adolescent↗
PubMed2002

A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders.

OBJECTIVE: To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. DESIGN: Six-month, home-based nutrition intervention study. SUBJECTS: Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). INTERVENTION: Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. MAIN OUTCOME MEASURES: Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. RESULTS: Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P < or = .02; r = 0.33 and r = 0.33, respectively). CONCLUSION: The results of this study suggest that it is possible to improve the dietary intake of community dwelling elders to include more fruits, vegetables, and calcium-rich foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.

Aged↗
PubMed2003

Effects of dietary intervention on hyperlipidemia in eight communities of Beijing, China.

OBJECTIVE: To examine the effect of community-based dietary intervention on hyperlipidemia. METHODS: A total of 180 hyperlipidemia individuals with TG>2.26 mmol x L(-1) (200 mg x dL(-1)) and/or TC>5.72 mmol x L(-1) (220 mg x dL(-1)) were selected from 428 eligible subjects in eight communities of Beijing. They were randomly divided into intervention group (n=108) and control group (n=72). Dietary intervention was provided for the intervention group for 6 months. Information on dietary intakes, physical examinations and blood samples was collected. Serum lipids were assayed at baseline and endpoint of the study period. RESULTS: Respective decrease in dietary intake of total calories, fat, cholesterol and cooking oil by 13.62%, 24.75%, 24.40%, and 22.43%, in the intervention group was observed. The percentages of total calories from fat, carbohydrate and protein appeared to be desirable after study. Reduced body weight and BMI were also observed. There was a respective 5.61% and 7.06% decrease in total serum cholesterol and low-density lipoprotein cholesterol in the intervention group, while no significant changes were found in the control group. CONCLUSIONS: Community-based dietary intervention can effectively improve dietary patterns, control body weight, and decrease the levels of total serum cholesterol and low-density lipoprotein cholesterol.

Adult↗
PubMed2002

Genetics of eating and its relation to obesity.

Humans show remarkable variability in their eating styles. Reasons for this variability are poorly understood, but carry important implications for the onset of obesity and its comorbidities. Although it is well established that genes influence obesity, genetic influences on human eating patterns have received less attention. Dramatic increases in the prevalence of obesity justify additional research into the genetics of eating style. This review highlights what is known about the genetics of food preferences and selection in humans. Data from family and twin studies suggest a moderate genetic contribution to eating style, with clear environmental effects emerging as well. Select studies show support for gene-environment interactions and common genetic bases for certain dietary patterns, obesity, and/or metabolic complications. Genetically informative designs that infuse innovative behavioral measures may help explain individual differences in eating styles and hopefully promote more effective obesity treatments.

Eating↗
PubMed1995

Mediterranean diet, Italian-style: prototype of a healthy diet.

Since Keys' first observations in the 1960s, the Mediterranean diet has been under scrutiny by researchers and public health specialists for its health-promoting qualities. Detailed analyses of food surveys carried out in Italy at that time permitted a definition of an Italian-style Mediterranean diet, characterized by low total fat (< 30% of energy), low saturated fat (< 10% of energy), high complex carbohydrates, and high dietary fiber. The importance of the plant components of this dietary pattern became increasingly recognized as a result of advances in the understanding of the pathophysiology of chronic and degenerative diseases. Thus, the Mediterranean diet was found not only to produce favorable effects on blood lipid profiles, but also to protect against oxidative stress and carcinogenesis. However, possible unwanted effects, such as those on micronutrient bioavailability, also must be taken into account. In recent years, despite an increase in consumption of animal foods, the dietary profile of southern Italy has maintained its basic features, and vital statistics still demonstrate a comparative advantage of eating behaviors in Mediterranean countries.

Antioxidants↗
PubMed1992

Calcium intake and 28-year cardiovascular and coronary heart disease mortality in Dutch civil servants.

Data obtained from a general health examination in 1953-1954 of 2605 middle-aged Dutch civil servants were analysed to investigate the relation between dietary calcium and cardiovascular (CVD) and coronary heart disease (CHD) mortality. Calcium intake was assessed at baseline by a 1-week food frequency recall. Multivariate adjusted odds ratios (OR) were calculated using the highest quintile of calcium intake as the reference. No statistically significant associations were observed for low calcium intake in 15 and 28 years of follow-up in both men and women. For men, multivariate adjusted OR for the lowest quintile of calcium intake were 1.3 (95% confidence interval (CI): 0.8-1.9) and 0.9 (95% CI: 0.6-1.6) for 28-year CVD and CHD mortality, respectively. For women, corresponding OR were 1.1 (95% CI: 0.6-2.0) and 1.1 (95% CI: 0.5-2.5). Although an inverse association between calcium intake and CVD and CHD mortality, possibly mediated by blood pressure, might be hypothesized, no clear association was observed. Because dietary patterns in the 1950s were quite stable, and major calcium sources were addressed, misclassification of calcium intake may not be fully responsible for this finding.

Aged↗
PubMed1995

Fat, cholesterol, fiber and sodium intakes of US population: evaluation of diets reported in 1987-88 Nationwide Food Consumption Survey.

OBJECTIVE: Food intake data from Nationwide Food Consumption Survey (NFCS) was used to evaluate intakes of fat, type of fat, cholesterol, dietary fiber and sodium of Americans classified by age. SURVEY DESIGN & SETTING: Data from the recent USDA's 1987-88 NFCS were used. NFCS was designed to be a self-weighting, multistage, stratified, area probability sample representative of individuals in the 48 conterminous states. 1987-88 NFCS response rate was 35%. Three-day food intake data were used to assess the nutrient intakes. SUBJECTS: Dietary intakes of 9027 individuals (4180 men and 4847 women) were evaluated. Survey sample was divided into 11-14, 15-18, 19-24, 25-50 and > 51 years age groups. RESULTS: On average, Americans consumed more calories from total fat (36.5-38.1% of energy) and saturated fat (13.0-14.1% of energy) than recommended. Mean intakes for polyunsaturated fat (6.1-7.6% of energy) and monounsaturated fat met the recommendations (13.6-14.3% of energy). Total, saturated and monounsaturated fat intakes were significantly lower in the > 51 years age group compared to younger age groups. Mean cholesterol intakes were higher in the 19-24 and 25-50 year age groups than recommended. Fiber intakes were similar across the age groups (12.3-13.4 mg/d). Sodium intakes were higher in the younger population compared to the older population. CONCLUSIONS: Although dietary patterns of Americans in relation to total fat and saturated fat intakes have changed toward a healthier diet, these changes did not meet recommendations. The US population continues to consume lower intakes of fiber and higher intakes of sodium.

Adolescent↗
PubMed2005

A cross-sectional analysis demonstrated the healthy volunteer effect in smokers.

OBJECTIVE: This cross-sectional descriptive analysis sought to determine if a healthy volunteer effect can be demonstrated among smokers selected to participate in a dietary intervention trial. STUDY DESIGN AND SETTING: Body mass index (BMI), body fat, physical activity, dietary intake, and plasma concentration of antioxidant nutrients and carotenoids were assessed cross-sectionally, at the time of enrollment into a dietary intervention trial, among 136 adult smokers. RESULTS: Mean BMI was below national age- and gender-specific averages as was prevalence of overweight and obesity. Physical activity was reported to average 15.4 h/wk. Compared with other sample populations of smokers, our smokers reported lower total fat and cholesterol intakes, higher vitamin C and beta-carotene intakes, and generally equal vitamin E intakes. Plasma ascorbic acid, alpha-tocopherol, alpha- and beta-carotene, and beta-cryptoxanthin concentrations were higher than those of smokers surveyed by NHANES III. CONCLUSION: These findings suggest that a "healthy volunteer effect" can be described among adult smokers. Future dietary intervention trials among smokers should cautiously estimate sample size because smokers electing to participate may report healthier dietary patterns than other smokers. Screening criteria regarding baseline micronutrient status of smokers should be evaluated given that intervention effects may be dependent on overall health status.

Adolescent↗
PubMed2006

Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association.

A substantial body of evidence strongly supports the concept that multiple dietary factors affect blood pressure (BP). Well-established dietary modifications that lower BP are reduced salt intake, weight loss, and moderation of alcohol consumption (among those who drink). Over the past decade, increased potassium intake and consumption of dietary patterns based on the "DASH diet" have emerged as effective strategies that also lower BP. Of substantial public health relevance are findings related to blacks and older individuals. Specifically, blacks are especially sensitive to the BP-lowering effects of reduced salt intake, increased potassium intake, and the DASH diet. Furthermore, it is well documented that older individuals, a group at high risk for BP-related cardiovascular and renal diseases, can make and sustain dietary changes. The risk of cardiovascular disease increases progressively throughout the range of BP, beginning at 115/75 mm Hg. In view of the continuing epidemic of BP-related diseases and the increasing prevalence of hypertension, efforts to reduce BP in both nonhypertensive and hypertensive individuals are warranted. In nonhypertensive individuals, dietary changes can lower BP and prevent hypertension. In uncomplicated stage I hypertension (systolic BP of 140 to 159 mm Hg or diastolic BP of 90 to 99 mm Hg), dietary changes serve as initial treatment before drug therapy. In those hypertensive patients already on drug therapy, lifestyle modifications, particularly a reduced salt intake, can further lower BP. The current challenge to healthcare providers, researchers, government officials, and the general public is developing and implementing effective clinical and public health strategies that lead to sustained dietary changes among individuals and more broadly among whole populations.

Humans↗
PubMed2000

Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls.

OBJECTIVE: To examine the role of physical activity, inactivity, and dietary patterns on annual weight changes among preadolescents and adolescents, taking growth and development into account. STUDY DESIGN: We studied a cohort of 6149 girls and 4620 boys from all over the United States who were 9 to 14 years old in 1996. All returned questionnaires in the fall of 1996 and a year later in 1997. Each child provided his or her current height and weight and a detailed assessment of typical past-year dietary intakes, physical activities, and recreational inactivities (TV, videos/VCR, and video/computer games). METHODS: Our hypotheses were that physical activity and dietary fiber intake are negatively correlated with annual changes in adiposity and that recreational inactivity (TV/videos/games), caloric intake, and dietary fat intake are positively correlated with annual changes in adiposity. Separately for boys and girls, we performed regression analysis of 1-year change in body mass index (BMI; kg/m(2)). All hypothesized factors were in the model simultaneously with several adjustment factors. RESULTS: Larger increases in BMI from 1996 to 1997 were among girls who reported higher caloric intakes (.0061 +/-.0026 kg/m(2) per 100 kcal/day; beta +/- standard error), less physical activity (-.0284 +/-.0142 kg/m(2)/hour/day) and more time with TV/videos/games (.0372 +/-.0106 kg/m(2)/hour/day) during the year between the 2 BMI assessments. Larger BMI increases were among boys who reported more time with TV/videos/games (.0384 +/-.0101) during the year. For both boys and girls, a larger rise in caloric intake from 1996 to 1997 predicted larger BMI increases (girls:.0059 +/-.0027 kg/m(2) per increase of 100 kcal/day; boys:.0082 +/-.0030). No significant associations were noted for energy-adjusted dietary fat or fiber. CONCLUSIONS: For both boys and girls, a 1-year increase in BMI was larger in those who reported more time with TV/videos/games during the year between the 2 BMI measurements, and in those who reported that their caloric intakes increased more from 1 year to the next. Larger year-to-year increases in BMI were also seen among girls who reported higher caloric intakes and less physical activity during the year between the 2 BMI measurements. Although the magnitudes of these estimated effects were small, their cumulative effects, year after year during adolescence, would produce substantial gains in body weight. Strategies to prevent excessive caloric intakes, to decrease time with TV/videos/games, and to increase physical activity would be promising as a means to prevent obesity.

Adolescent↗