An epidemiologic review of dietary intake studies among American Indians and Alaska Natives: implications for heart disease and cancer risk

PURPOSE: Dietary factors play an important role in the occurrence of heart disease and cancer. While American Indians and Alaska Natives (AIANs) have unique heart disease and cancer mortality profiles, little is known about the effect of diet on heart disease and cancer risk in these populations. This paper reviews existing nutritional intake data from adult AIANs, and considers the potential impact of diet on heart disease and cancer in these communities. METHODS: A review of the literature was conducted using the Medline database system and other reference materials. Studies documenting nutrient intakes only were included in this review. Studies were limited to those among healthy, non-pregnant adults. RESULTS: A total of twelve reports from 1959 to 1996 were found. Sample sizes for the studies ranged from 20 to 575 subjects. Most studies were done among women, and a variety of nutritional assessment techniques (24 hour recall, food frequency questionnaire, multiple-day food record) were used. Most studies also had limited nutrient intake data, especially for dietary fiber and vitamin E. The majority of studies reported moderately high intakes of fat and saturated fat, and low intakes of polyunsaturated fat and fiber. CONCLUSIONS: Based on the limited data, diet may play an important role in the heterogeneity of heart disease and cancer mortality in AIAN communities. More research is needed to assess the impact of diet on heart disease and cancer risk, including more longitudinal data, and data to assess the validity and reliability of traditional methods of dietary assessment.     

Fibre and nutrient intakes of chronic care elderly patients

It has been previously suggested that chronic care elderly patients are at increased nutritional risk. However dietary intake studies have not completely supported this statement. To determine usual dietary intakes, 32 elderly patients, mean (+/- SEM) age 84 +/- 1 years, from two hospitals, had 3-day dietary intakes estimated or weighed and analyzed for nutrient composition. The group as a whole had low intakes of dietary fibre but intakes of other nutrients were equal to or greater than the Canadian recommendations. The distribution of macronutrients also met recommended guidelines. In general, this group of elderly patients appeared to be eating well, however, some individuals results suggest nutritional risk.     

Estimation of the use of dietary supplements in the National Diet and Nutrition Survey: people aged 65 years and Over. An observed paradox and a recommendation

OBJECTIVE: To compare the evidence derived from blood biochemical status indices with the evidence from a questionnaire and from a 4-day weighed dietary record of micronutrient supplement use in the British National Diet and Nutrition Survey (NDNS) of People Aged 65 Years and Over; to resolve some apparent incompatibility between nutrient intake and status estimates, and to recommend an approach towards supplement recording that should improve accuracy. DESIGN: The survey procedures described in the National Diet and Nutrition Survey Report (1998) included a health-and-lifestyle questionnaire, a 4-day weighed diet record, and fasting blood and urine sample for biochemical indices, including a wide range of micronutrients. SETTING: Eighty randomly selected postcode sectors from mainland Britain during 1994-1995. SUBJECTS: Of 2060 people interviewed, 1467 provided a blood sample and 1217 provided both a blood sample, and a complete 4-day diet record. About 20% were living in institutions such as nursing homes, and the remainder were living in private households. RESULTS: After assigning the subjects to four categories by the use of dietary supplements (A, those not taking supplements (by questionnaire or by the 4-day record); B, those taking supplements (excluding prescribed ones) by questionnaire only; C, those taking supplements by 4-day record only; and D, those taking supplements by both questionnaire and 4-day record), these categories were then compared with respect to estimated total nutrient intakes and blood biochemical indices. Those in category B had estimated (4-day) nutrient intakes (from foods and supplements) that were indistinguishable from those in category A, but had biochemical indices that indicated significantly higher dietary intakes of several vitamins. CONCLUSIONS AND RECOMMENDATION: The 4-day weighed intake record may not have identified all of the subjects who were regularly taking micronutrient supplements in amounts sufficient to improve their biochemical status. Because survey respondents may use supplements irregularly or change their usual patterns of supplement use during a period of intensive diet-recording, it is important to design a dietary instrument that will minimise this potential source of inaccuracy. We therefore recommend that population surveys in which an accurate estimate of micronutrient intakes is required, from supplements as well as from food, should record supplement use for a period longer than 4-days. It is likely that a better estimate of long-term intakes can be achieved by combining a 4-day weighed diet record with a structured recall or several weeks of diary records, which focus specifically on the use of supplements.     

Survey of the diet of Pima Indians using quantitative food frequency assessment and 24-hour recall. Diabetic Renal Disease Study

OBJECTIVE: A dietary survey was conducted in the Gila River Indian Community in Arizona using two methods of dietary assessment--24-hour recall and quantitative food frequency (QFF) assessment--to determine the usual intake of the population. DESIGN: Interviews were conducted by Pima women who were trained and monitored by a research dietitian. Energy and nutrient intake were calculated using a computerized dietary database that included specific Pima foods. SUBJECTS: An age- and sex-stratified sample of 575 Pima Indians (273 men, 302 women) aged 18 to 74 years participated in the study. STATISTICAL ANALYSES: Spearman correlations were used to compare the results of the two survey methods for energy and each nutrient. Intraclass correlations were used to measure reproducibility. RESULTS: According to the 24-hour recall, mean reported energy intakes within decades of age were 95% to 112% of those in the US population for Pima women, and 76% to 94% of those in the US population for Pima men. Total energy intake assessed using QFF was 30% higher in men and 33% higher in women than the intake assessed using the 24-hour recall method. CONCLUSIONS: A large dietary survey conducted using lay interviewers in a Native-American community was as reproducible as studies conducted in the general US population. The Pima diet was distributed among the major nutrients in a proportion similar to the US diet.     

Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis

The aim of this investigation was to assess the relationship between smoking status and nutrient intakes using a meta-analysis. Publications in English were sought through a Medline search using the following key words: food habits, eating, feeding behavior, diet, food, nutrition, nutritional status or assessment, tobacco use disorder, tobacco, nicotine and smoking. Scanning relevant reference lists of articles and hand searching completed the data collection. No attempt was made to search for unpublished results. Paper selection was based on nutritional surveys including comparisons of smokers with nonsmokers. Fifty-one published nutritional surveys from 15 different countries with 47,250 nonsmokers and 35,870 smokers were used in the analysis. The estimates of size effects were calculated with the mean and variance values of each nutrient intake and the size of the sample. Smokers declared significantly (all P < 10(-5)) higher intakes of energy (+4.9%), total fat (+3.5%), saturated fat (+8.9%), cholesterol (+10.8%) and alcohol (+77.5%) and lower intakes of polyunsaturated fat (-6.5%), fiber (-12.4%), vitamin C (-16.5%), vitamin E (-10.8%) and beta-carotene (-11.8%) than nonsmokers. Protein and carbohydrate intakes did not differ between smokers and nonsmokers. There was no evidence of heterogeneity among studies. In conclusion, the nutrient intakes of smokers differ substantially from those of nonsmokers. Some of these differences may exacerbate the deleterious effects of smoke components on cancer and coronary heart disease risk.     

Fat intake: implications of changes in distribution for setting dietary goals in the UK

STUDY OBJECTIVE: To examine (a) changes in the shape of the distribution of dietary fat intake as the mean dietary fat intake of the population shifts and (b) implications for setting national dietary goals. DESIGN: Data on the percentage of energy from total fat, saturates, monounsaturates, polyunsaturates, and the P:S ratio were analysed for two dietary intervention trials and six cross sectional dietary surveys. The nutrient distributions from each study were described in terms of the mean, standard deviation (SD), coefficient of variation (CV), and skewness statistic. For the intervention trials statistical parameters were compared for groups who received and did not receive dietary advice. For the cross sectional studies, statistical parameters were compared across groups with different levels of mean fat intake. The implications of the results for setting dietary goals were considered using statistical models. MAIN RESULTS: For most fat fractions there was a positive association between the mean and the SD, and an inverse association between the mean and the CV, indicating that as the mean shifts upwards the SD increases but not in proportion to the mean. This is intermediate between a constant SD and a constant CV model. For a population nutrient goal of a maximum of 15% saturates, the estimated population mean for British women would be 8.4% using the constant SD model and 10.8% using the constant CV model. For saturates and the P:S ratio, a lower mean intake was associated with a greater positive skew in the distribution of reported intakes. For saturates, this is consistent with a group of high fat consumers who fail to reduce their intake as the population mean shifts downwards: a "rearguard effect". Findings for the P:S ratio are consistent with a group of consumers who produced a strong positive skew at low mean intakes, which reduced in size as the mean population intake increases: a "vanguard effect". CONCLUSIONS: These findings provide evidence that the distribution of fat intake may change with the mean to a degree that the setting and monitoring of nutritional goals may need to take account of changes in variance and shape of the intake distribution.     

Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire

OBJECTIVE: The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency questionnaire (SFFQ) adapted for use in the elderly. DESIGN AND SUBJECTS: The study was carried out in a sample of 80 men and women aged 55-75 y participating in a community based prospective cohort study in Rotterdam, The Netherlands. The two-step dietary assessment comprised a simple self-administered questionnaire (20 min) followed by a structured interview with trained dietitians (20 min) based on the completed questionnaire. Multiple food records (FR) collected over a one year period served as reference method. 24 h urine urea was used as indirect marker for protein intake. RESULTS: Compared with FR, the SFFQ generally overestimated nutrient intake as reflected by difference in means and the ratio of SFFQ to FR. Energy adjustment reduced the observed overestimation. Pearson's correlation coefficients varied from close to 0.5 to about 0.9 for crude data, and after adjustment for age, sex, total energy intake, and for within-person variability in daily intake for 0.4-0.8. Cross-classification into quintiles resulted in correct classification into the same or adjacent quintile of 75.8% for crude and 76.8% for energy-adjusted data. Validation of protein intake estimated by SFFQ with protein excretion from 24h urine urea indicated overestimation of protein intake by SFFQ. Spearman correlation coefficient between protein intake estimated from urea excretion and SFFQ was 0.67. CONCLUSIONS: Adaptation of a SFFQ for use in the elderly resulted in a valid and time-efficient dietary assessment instrument. Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly.     

Comparison of food frequency questionnaires: the reduced Block and Willett questionnaires differ in ranking on nutrient intakes

Food frequency questionnaires, major tools in epidemiologic studies, are often criticized for biased and imprecise intake estimates. The aim of this study was to compare the performance of two widely used food frequency questionnaires, a reduced 60-item Block questionnaire and a 153-item Willett food frequency questionnaire, relative to three 24-hour recalls administered by telephone. The dietary data were collected in 1991 from a group of healthy women age 25-49 years (n=101) during the baseline period of a weight-loss intervention study in Minneapolis, Minnesota. Total energy and macro- and micronutrient intakes were compared across methods by using four analytic approaches: comparison of means and correlation coefficients, regression analysis, and estimation of percent agreement between each questionnaire and recalls. The Block instrument showed an overall underestimation bias, but was more successful in categorizing individuals on percent energy from fat and carbohydrate intakes than was the Willett instrument. The Willett instrument showed no overall underestimation bias and was more successful in classifying individuals on vitamin A and calcium intakes. Diverging performance characteristics of diet assessment methods have an implication for the design of studies, interpretation of results, and comparison of findings across studies.     

Dietary practices and lipid intake in relation to plasma lipid profile in Hong Kong Chinese

OBJECTIVE: To study dietary lipid intake and plasma lipid profile of the Hong Kong Chinese population as part of a territory wide survey on cardiovascular risk factors. DESIGN: Randomised age and sex stratified survey. SUBJECTS: 1010 subjects aged 25-74 y (500 men, 510 women). MEASUREMENTS: A food frequency method with food tables compiled for Hong Kong was used for nutrient quantitation, while a separate questionnaire was used to examine dietary practices. Plasma lipid profile was estimated using standard laboratory methods. RESULTS: Total calorie, fat, saturated fatty acid (SFA), poly- and mono-unsaturated fatty acid (PUFA and MUFA), and cholesterol intake were higher in men; however when adjusted for caloric intake no difference was observed. Men had lower intake of PUFA as percentage of total energy had a higher Hegsted Score compared with women. Subjects consuming beans twice or more per week had lower total cholesterol and LDL-cholesterol concentrations. Overall, the population dietary intake was close to the ideal for cardiovascular health: percentage fat not greater than 30% of the total calorie intake, saturated fat intake not greater than 10% of calories, and cholesterol less than 180 mg/1000 Kcal. CONCLUSION: The dietary pattern for Hong Kong Chinese appear to be satisfactory with respect to cardiovascular health.     

Longitudinal study of nutrient and food intakes of infants aged 2 to 24 months

OBJECTIVE: To determine the nutrient and food intakes of healthy, white infants from families of middle and upper socioeconomic status and to compare intakes to current recommendations. DESIGN: Using an incomplete random block design, we interviewed 98 mother-infant pairs longitudinally when infants were 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 months old. Data obtained included 24-hour dietary recalls, usual food intake, and food likes and dislikes. SETTING: Interviews were conducted in the mother's home by registered dietitians. Subjects resided in two urban areas of Tennessee. SUBJECTS: Of the original 98 subjects, 94 completed the 2-year study. RESULTS: Mean energy and nutrient intakes generally met or exceeded the Recommended Dietary Allowance (RDA). Exceptions were zinc and vitamin D, which were each below 100% of the RDA at 9 of the 10 data points, and vitamin E, which was below the RDA in the infants' second year. Fat intake decreased from more than 40% of energy in the first 6 months to 30% to 32% from 10 to 24 months. One third of the infants drank reduced-fat milks at 12 months and more than half drank them at 24 months. Although infants ate a variety of foods, vegetables often were the least favorite foods. A variety of dairy products provided calcium for the infant but lacked vitamin D. CONCLUSIONS: Several nutritional issues about infant feeding before 2 years of age arose. Low intakes of zinc, vitamin D, and vitamin E were observed. In the second year, low fat intake, use of reduced-fat milks, and dislike of vegetables were areas of concern.     

Folate, vitamin D, and iron intakes are low among pregnant Finnish women

OBJECTIVE: To evaluate dietary habits and nutrient intake of Finnish pregnant women, to relate these to the use of dietary supplements, and to explore possible dietary variations according to age and education. DESIGN: A random dietary survey using two five day estimated food records. SETTING: Pregnant women from 13 maternity clinics in the city of Oulu, Finland. SUBJECTS: One hundred and eighteen pregnant women in their third trimester. MAIN RESULTS: The main sources of energy were cereal products and milk products. The consumption of fish and poultry was low. Women with a higher educational level consumed more vegetables, fruit, fruit juices, and tea and less sausages, inner organs and coffee than women with a lower educational level. Younger women (< 25 y) consumed more sugar and pork and less berries, butter and inner organs than older women. On average 15% of the total energy was supplied by protein, 33% by fats, 52% by carbohydrates, and 12% by sucrose. Compared to the Nordic nutrition recommendations, the proportion of polyunsaturated fatty acids and the intake of dietary fibre were low and the intake of sugar high. The intakes of vitamins and minerals met or exceeded the recommended allowances, except for vitamin D, folate, and iron. Of the subjects 70% used dietary supplements. With the exception of vitamin D, folate, and iron, both the supplement users and non-users had an adequate nutrient intake from their diet. CONCLUSIONS: A balanced diet covers the increased nutrient requirements during pregnancy, with the exception for vitamin D, folate, and iron. The use of dietary supplements during pregnancy is excessive and partly focused on the wrong nutrients. Young and less educated, and smoking pregnant women need more nutritional guidance.     

A case-control study of element levels and cancer of the upper aerodigestive tract

A population-based case-control study was conducted in western Washington state to investigate possible dietary risk factors for laryngeal, esophageal, and oral cancers. Using results from a food frequency questionnaire, past dietary intakes of iron, zinc, and calcium were estimated for 661 cases and 466 controls. Clippings were also taken from the nails of both halluces to determine concentrations of iron, zinc, calcium, chromium, and cobalt in 507 of the cases and 434 of the controls. After adjustment for smoking, alcohol, and dietary beta-carotene and vitamin C intake, individuals who reported dietary intakes of iron and zinc in the upper quartile were less likely to develop cancers of the larynx and esophagus than were individuals with intakes in the lowest quartile [odds ratios (OR), 0.5 for iron and 0.1 for zinc]. However, there were no significant differences in zinc concentrations in nail tissue between subjects with these types of cancer and controls. Esophageal cancer cases had higher nail concentrations of iron and calcium than did controls (OR, 2.9 for high versus low quartiles of iron; OR, 2.6 for high versus low quartiles of calcium). Individuals who developed esophageal or oral cancer were more likely to have elevated cobalt concentrations in their nail tissue than were individuals without cancer (OR, 9.0 and 1.9 respectively, for high versus low quartiles). The results of this study suggest that there may be differences in mineral intake or metabolism between individuals who develop some carcinomas of the upper aerodigestive tract and those who do not.     

Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents

Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified.     

Noninvasive evaluation of hand circulation before radial artery harvest for coronary artery bypass grafting

BACKGROUND: Epidemiologic studies have shown dietary antioxidants to be inversely correlated with ischemic heart disease. OBJECTIVE: We investigated whether dietary beta-carotene, vitamin C, and vitamin E were related to the risk of myocardial infarction (MI) in an elderly population. DESIGN: The study sample consisted of 4802 participants of the Rotterdam Study aged 55-95 y who were free of MI at baseline and for whom dietary data assessed by a semiquantitative food frequency questionnaire were available. During a 4-y follow-up period, 124 subjects had an MI. The association between energy-adjusted beta-carotene, vitamin C, and vitamin E intakes and risk of MI was examined by multivariate logistic regression. RESULTS: Risk of MI for the highest compared with the lowest tertile of beta-carotene intake was 0.55 (95% CI: 0.34, 0.83; P for trend = 0.013), adjusted for age, sex, body mass index, pack-years, income, education, alcohol intake, energy-adjusted intakes of vitamin C and E, and use of antioxidative vitamin supplements. When beta-carotene intakes from supplements were considered, the inverse relation with risk of MI was slightly more pronounced. Stratification by smoking status indicated that the association was most evident in current and former smokers. No association with risk of MI was observed for dietary vitamin C and vitamin E. CONCLUSION: The results of this observational study in the elderly population of the Rotterdam Study support the hypothesis that high dietary beta-carotene intakes may protect against cardiovascular disease. We did not observe an association between vitamin C or vitamin E and MI.     

Consumption of calcium-rich food in the adult population of French-speaking Switzerland and of Tessin

Food intake high in calcium content is important in the development of skeleton and the prevention of osteoporosis. From a public health perspective, it is therefore important to know the dietary calcium intake of a population. Two population surveys in the French and Italian parts of Switzerland (MONICA, 1988-1989, and Geneva, 1991), were combined to study nutritional habits related to calcium intake. A random population sample, aged 35 et 65 years, answered to a 24 hour recall questionnaire, either self-administered (MONICA, cantons of Vaud, Fribourg and Tessin, N = 2734) or by phone (canton of Geneva, N = 475). In the 4 cantons, for the previous day, 60% of participants ate dairy products, particularly whole milk and cheese. They drunk 3-4 dl/day of milk. A significant proportion (10%) of french and italian speaking Swiss did not consume any food high in calcium content. In Geneva, the mean daily calcium intake was 656 mg in men and 489 mg in women. In conclusion 1) eating habits related to calcium intake are similar across cantons; 2) women consume dairy products more frequently than men, but in smaller quantities; 3) about 60% of men and 80% of women do not get the daily amount of calcium recommended for the prevention of osteoporosis.     

Diet and Parkinson's disease. II: A possible role for the past intake of specific nutrients. Results from a self-administered food-frequency questionnaire in a case-control study

In a case-control study, we compared the past dietary habits of 342 Parkinson's disease (PD) patients recruited from nine German clinics with those of 342 controls from the same neighborhood or region. Data were gathered with a structured interview and a self-administered food-frequency questionnaire. Nutrient intakes were calculated from the reported food intakes through linkage with the German Federal Food Code and analyzed using multivariate conditional logistic regression to control for total energy intake, educational status, and cigarette smoking. At the macronutrient level, patients reported higher carbohydrate intake than controls after adjustment for total energy intake, smoking, and educational status (OR = 2.74, 95% confidence interval [CI]: 1.30-6.07, for the highest versus lowest quartile, p trend = 0.02). This was reflected in higher monosaccharide and disaccharide intakes at the nutrient level. There was no difference between patients and controls in protein and fat intake after adjustment for energy intake. We found an inverse association between the intakes of beta-carotene (OR = 0.67, 95% CI: 0.37-1.19, p trend = 0.06) and ascorbic acid (OR = 0.60, 95% CI: 0.33-1.09, p trend = 0.04) by patients, although only the trend for ascorbic acid intake reached statistical significance. There was no difference between groups for alpha-tocopherol intake after adjustment for energy intake. We also found that patients reported a significantly lower intake of niacin than controls (OR = 0.15, 95% CI: 0.07-0.33, p trend < 0.00005). Our results suggest that if antioxidants play a protective role in this disease, the amounts provided by diet alone are insufficient. Although the interpretation of the inverse association between niacin intake and PD is complicated by the high niacin content in coffee and alcoholic beverages, which were also inversely associated with PD in this study, the strength of this association and its biologic plausibility warrant further investigation.     

Determinants of zinc intake in low-income black and white pregnant women

A prospective study was conducted to evaluate and compare the determinants of dietary zinc intake in black and white low-income pregnant women. The study population consisted of 1298 low-income women (70% Black, 30% White) who received prenatal care at University Hospital at the University of Alabama in Birmingham from 1985 to 1989. Various maternal characteristics were evaluated at the first prenatal visit. Two 24 h recalls were obtained at 18 and 30 wk of gestation to calculate the intakes of dietary zinc and other nutrients. Student's t test, chi2, Pearson correlation coefficients, and multiple regression analyses were used to compare and evaluate the determinants of zinc and other nutrient intakes in Black and White subjects. The mean prepregnancy body mass index and the mean intake of zinc, energy, and all the other nutrients except calcium were significantly higher in Black than in White subjects. There was a significant correlation between zinc and energy intake (r = 0.69, p = 0.001). Age, marital status, parity, socioeconomic status, smoking, and alcohol intake were not significant predictors of zinc or other nutrient intakes. After adjusting for energy intake, race was the only significant predictor of dietary zinc intake. Race and energy intake explained 24% of the variation in zinc intake. Results of this study indicate that after adjusting for other covariates, race and energy intakes are the only predictors of zinc intake in low-income pregnant women.     

The correlation between two dietary assessments of carotenoid intake and plasma carotenoid concentrations: application of a carotenoid food-composition database

A newly available carotenoid food-composition database providing specific carotenoid values for > 2300 foods was linked to dietary data on 57 male nonsmokers to examine the association between dietary carotenoid intake and plasma carotenoid concentrations over 3 wk when free-living. Carotenoid intake was estimated from a food-frequency questionnaire (FFQ) and 7 d of food diaries with concurrent analysis of plasma carotenoid concentrations. After adjustment for energy intake, percentage of energy from alcohol, and plasma lipid concentrations, significant diet-plasma correlations for the FFQ and the food diaries (FD) included alpha-carotene (r = 0.29 and 0.43), beta-carotene (r = 0.36 FFQ only), beta-cryptoxanthin (r = 0.46 and 0.44), lutein (r = 0.44 FD only), and lycopene (r = 0.53 FD only). Dietary carotenoid intakes were associated with plasma carotenoid concentrations for all the carotenoids except for beta-carotene when food diaries were used whereas the diet-plasma correlation for the provitamin A carotenoids were consistently significant when the FFQ was used.     

Variability in the intercomparison of food carotenoid content data: a user's point of view

The availability of reliable information on food composition is essential both for the evaluation of diet and for nutritional research to relate diet to health or disease. In this article, we compare the total and individual carotenoid contents and the retinol equivalents in fruits and vegetables reported in several food composition tables and HPLC studies. The impact of the variability in carotenoid intake was evaluated on the basis of Spanish National Consumption Statistics and on the values for a standard diet. We identify, from a user's point of view, errors concerning identification of the items and the terms used to refer to the compounds. Food composition tables overestimate (by 2 to 48%) the retinol equivalent intake, whereas they underestimate (by 30 to 50%) the total carotenoid intake according to HPLC data. We study the effect of these main sources of error, their impact on dietary assessment and on the classification of relevant contributors, and the possible consequences with respect to proper diet in terms of nutritional assessment and epidemiological studies. Given the different dietary habits among populations and the fact that certain items may be over- or underestimated in databases, the use of a single database may be misleading as to the rate of carotenoid consumption and the "true" nutrient intake in a given population, thus weakening the reliability of the study and resulting in erroneous conclusions.     

Occurrence of Listeria and listeriosis in Hungary

Type A behaviour has been associated with coronary heart disease, but little is known about how Type A behaviour relates to diet. As part of a cross-sectional epidemiological study in Northern Ireland, Type A behaviour was assessed using a validated questionnaire and diet assessed using weighed records. Diet was described in terms of nutrient intake, food intake and dietary pattern. The study population comprised 245 men and 306 women aged 16 to 64 years. The relation between Type A behaviour and diet was examined by calculating partial correlation coefficients between A-type score and dietary variables, controlling for age and household socio-economic group. In men Type A score showed a weak but significant association with fat and protein intake, and intake of beef, cheese, yoghurt and chips. In women, Type A score showed a weak positive association with sugar and alcohol intake. In both men and women, Type A score was positively associated with the "convenience" dietary pattern. These relationships are discussed in the context of the dominant food ideology and coronary risk.