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1.  Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study 
BMC Public Health  2012;12:1050.
Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake.
In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV), wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall.
Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively) (p<0.05). The average 24-hour nutrient intakes between wasted and non-wasted tuberculosis patients were comparable. Nutrient intake among men was higher when compared to women regardless of wasting and severity of tuberculosis. Among those with wasting, men had higher average energy intake than women (8.87 vs. 5.81 MJ, respectively) (p<0.05). Among patients with mild disease, men had higher average energy intake than women with mild disease (12.83 vs. 7.49 kcal, respectively) (p<0.001).
Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.
PMCID: PMC3537524  PMID: 23217171
Tuberculosis disease severity; Gender; Dietary intake; Body wasting; HIV
2.  Dietary quality and adequacy among Aboriginal alcohol consumers in the Northwest Territories, Canada 
International Journal of Circumpolar Health  2012;71:10.3402/ijch.v71i0.17341.
The present study aimed to assess dietary adequacy and quality among Inuvialuit alcohol consumers and non-consumers in the Northwest Territories (NWT), Canada.
Study design
Cross-sectional study.
A validated quantitative food frequency questionnaire was administered to individuals (n =216) of randomly selected households in 3 NWT communities to capture dietary intake and alcohol consumption over a 30-day recall period. The daily energy and nutrient intake, dietary adequacy and the top food sources of energy and selected nutrients were determined by alcohol consumption status.
Energy intake was higher among all alcohol consumers regardless of gender. Male alcohol consumers had lower nutrient intake density (per 4,184 kJ) of protein, cholesterol and several micronutrients (p≤0.05), and female alcohol consumers had lower intake density of saturated fat (p≤0.01), thiamine, folate and sodium (p≤0.05). Among all men and women, 70–100% had inadequate intakes of dietary fibre, vitamin E and potassium. Non-nutrient-dense foods contributed similar amounts and traditional foods (TF) contributed 3% less to energy comparing alcohol consumers to non-consumers.
Nutrient inadequacies are prevalent among Aboriginal populations in the Canadian Arctic and may be exacerbated by alcohol consumption due to alcohol's effects on dietary intake, nutrient transport and metabolism. Adult Inuvialuit who consumed alcohol had increased caloric intake and consumed similar amounts of non-nutrient-dense foods and less nutrient-dense TF. Fewer dietary inadequacies were observed among alcohol consumers than non-consumers, which might be due to the increase in overall food intake among alcohol consumers; however, further exploration of volume and pattern of drinking might help explain this result.
PMCID: PMC3417643  PMID: 22456041
NWT; Aboriginal; dietary adequacy; alcohol; chronic disease
3.  Dietary Intake Among Native Hawaiian, Filipino, and White Children and Caregivers in Hawai‘i 
Little is published about dietary intake of children of ethnic populations found in Hawai‘i, due to an absence of national statistics collected on Hawai‘i's population. This information is needed to focus planning of food, agriculture and health programs aimed to prevent obesity and related chronic disease and to improve health. Dietary patterns of 156 Native Hawaiian (n=110), Filipino (n=28) and White (n=18) children and their caregivers were compared using socio-demographic, annual “food season,” and 24 hour dietary recall data from a baseline survey of four lower income communities selected for an intervention program in rural Hawai‘i. Ethnic differences were found in the Healthy Eating Index (HEI) dairy component, and in calcium and vitamin C nutrient intakes among caregivers only (adjusting for food season). Whites always had higher intakes of these foods and nutrients than Filipinos or Native Hawaiians. Vitamin C intake remained significantly different among ethnic groups after further adjusting for dairy food group intake. Dietary patterns showed low intake of fruits and vegetables, fiber and dairy foods among these understudied populations.
PMCID: PMC3525334  PMID: 23251873
4.  Nutrient intakes of rural Tibetan mothers: a cross-sectional survey 
BMC Public Health  2010;10:801.
Tibetan food intake is influenced by the region's high altitude and unique culture. Few published studies of nutrient intakes among Tibetan women are available. The present study of Tibetan mothers with young children explores dietary patterns, nutrient intakes, and differences between socio-demographic groups.
A cross-sectional survey of 386 women with a child aged less than 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were recruited using simple random sampling and were interviewed face-to-face by trained investigators. Dietary information was collected via a food frequency questionnaire. Nutrient intakes were calculated using food composition tables. Non-parametric tests were used to compare nutrient intakes according to socio-demographic variables, and to compare results with the 2002 Chinese National Nutrition and Health Survey (2002 NNHS) and dietary reference intakes (DRIs).
Median intakes of energy (p < 0.001), protein (p < 0.001), fat (p < 0.001), vitamin A (p < 0.001), vitamin B1 (p < 0.001), vitamin B2 (p < 0.001), vitamin C (p < 0.001), and vitamin E (p < 0.001) were lower than the average levels reported in 2002 NNHS. The median intakes of calcium (517 mg/d, p < 0.001), iron (35 mg/d, p < 0.001), and zinc (17.3 mg/d, p < 0.001) were higher than the average levels in 2002 NNHS. The highest education subgroup had significantly higher intakes of vitamins A and C than the lowest education subgroup.
Although the diet of Tibetan mothers with young children has been partially influenced by other factors, their dietary patterns are still mostly composed of Tibetan traditional foods. Compared with the 2002 NNHS, Tibetan women with young children appear to have insufficient intakes of many nutrients, which will affect their nutritional status.
PMCID: PMC3022869  PMID: 21194479
5.  Food intake and food consumption patterns of hospital workers in the dominican republic 
Coronary heart disease (CHD) is the leading cause of death according to official mortality statistics in the Dominican Republic. The purpose of this study was to assess food intake and food consumption patterns of Dominicans and to discuss CHD risks related to nutrient intake. The subjects were 22 men and 81 women voluntarily recruited among 230 hospital workers in Santo Domingo. The mean nutrient intake and food consumption were estimated from a single 24-hour recall method administered by trained persons who elicited each subject’s previous day’s intake from midnight to midnight. The mean energy intake was 2030 kcal. The mean intake of total protein, total fat and carbohydrates were 66.3g, 89.1 g and 248g, respectively. Percentage of energy from total fat was 39.5%, which was higher than WHO recommendations. But, the percentage of animal fat per total fat was 46.8%. Especially, the value in the low income group was 31.7%. Moreover, we analyzed the food consumption structure in order to understand the Dominican dietary pattern, and three factors were found to explain the characteristics on the basis of factor analysis.
The low percentage of animal fat was due to the diets rich in vegetable oil. Our results suggested that it was difficult to assume that CHD risks increased as a result of the Dominican dietary pattern. This was consistent with our previous findings that the average serum cholesterol level of Dominicans was generally low.
PMCID: PMC2723269  PMID: 21432505
The Dominican Republic; Nutrition; Coronary heart disease; 24-hour recall method; Percentage of energy from total fat
6.  Food intakes and preferences of hospitalised geriatric patients 
BMC Geriatrics  2002;2:3.
A cross sectional survey was carried out on 120 hospitalised geriatric patients aged 60 and above in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur to investigate their nutrient intakes and food preferences.
Food intakes were recorded using a one day weighed method and diet recall. Food preferences were determined using a five point hedonic score. Food wastages and factors affecting dietary adequacy were also investigated.
The findings indicated that the mean intakes of energy and all nutrients investigated except for vitamin C and fluid were below the individual requirement for energy, protein and fluid, and the Malaysian Recommendation of Dietary Allowances (RDA) for calcium, iron, vitamin A, thiamin, riboflavin, niacin and acid ascorbic. In general, subjects preferred vegetables, fruits and beans to red meat, milk and dairy products. There was a trend of women to have a higher percentage for food wastage. Females, diabetic patients, subjects who did not take snacks and subjects who were taking hospital food only, were more likely to consume an inadequate diet (p < 0.05 for all values).
Food service system in hospital should consider the food preferences among geriatric patients in order to improve the nutrient intake. In addition, the preparation of food most likely to be rejected such as meat, milk and dairy products need some improvements to increase the acceptance of these foods among geriatric patients. This is important because these foods are good sources of energy, protein and micronutrients that can promote recovery from disease or illness.
PMCID: PMC122060  PMID: 12165100
7.  Inadequacy of nutrients intake among pregnant women in the Deep South of Thailand 
BMC Public Health  2010;10:572.
The deep south of Thailand is an area which has been affected by violence since 2004, yet the concurrent coverage of antenatal care has remained at over 90%. Our study aimed to describe the prevalence of nutrient inadequacy among pregnant women who attended antenatal care clinics in hospitals in the study area and assess factors associated with nutrient inadequacy.
Pregnant women from four participating hospitals located in lower southern Thailand were surveyed during January-December 2008. Nutrient intake was estimated based on information provided by the women on the amount, type and frequency of various foods eaten. Logistic regression was used to assess individual and community factors associated with inadequate nutrient intake, defined as less than two thirds of the recommended dietary allowance (RDA).
The prevalence of carbohydrate, protein, fat, calories, calcium, phosphorus, iron, thiamine, riboflavin, retinol, niacin, vitamin C, folic acid and iodine inadequacy was 86.8%, 59.2%, 78.0%, 83.5%, 55.0%, 29.5%, 45.2%, 85.0%, 19.2%, 3.8%, 43.2%, 0.8%, 0.0% and 0.8%, respectively. Maternal age, education level, gestational age at enrolment and pre-pregnancy body mass index and level of violence in the district were significantly associated with inadequacy of carbohydrate, protein, phosphorus, iron, thiamine and niacin intake.
Nutrient intake inadequacy among pregnant women was common in this area. Increasing levels of violence was associated with nutrient inadequacy in addition to individual factors.
PMCID: PMC2958163  PMID: 20863408
8.  Energy and nutrients in self-reported diet before and at week 18–22 of pregnancy 
A satisfactory nutritional status, as a result of optimal food intake, before conception and during pregnancy, is important for a successful pregnancy.
To evaluate the energy and nutrient intake before conception and at mid-gestation in a group of pregnant women (n=50) in relation to the Nordic Nutrition Recommendations (NNR).
Pre-pregnant diet was studied by an 84-item food-frequency questionnaire and mid-gestational diet by repeated 24 h dietary recalls.
Average requirements (AR) were met for all nutrients except for selenium intake before pregnancy. Absolute intakes were below recommended intake (RI) according to NNR for folate, vitamin D, selenium, vitamin E and iron both before and at mid-gestation. However, intakes were still above the lower intake levels (LI) defined by NNR for almost all women. Twenty-three women were below LI for selenium before pregnancy and five for each of vitamin D and selenium at mid-gestation. When expressed as nutrient densities (amount of nutrient per energy unit), intakes were below NNR for folate, vitamin D and selenium before pregnancy, and for folate, vitamin D and iron at mid-gestation. Intakes were adjusted for underreporting, estimated to 20% as revealed after comparing energy intake/basal metabolic rate with grouped physical activity level values.
The reported food intake satisfied the recommended level of intake according to AR, but when using RI for planning a diet as a reference, folate, vitamin D, selenium and iron intake were insufficient. Most striking were the low levels of folate and vitamin D intake both before pregnancy and at mid-gestation.
PMCID: PMC2606998
conception; dietary intake; 24 h dietary recall; folate; food-frequency questionnaire; vitamin D
9.  Regional comparison of dietary intakes and health related behaviors among residents in Asan 
Nutrition Research and Practice  2007;1(2):143-149.
Inadequate dietary intakes and poor health behaviors are of concern among rural residents in Korea. This study is conducted to compare dietary intakes, dietary diversity score (DDS), mean nutrient adequacy ratio (MAR) and health related behaviors by rural, factory and urban areas in Asan. A total of 930 adults (351 men and 579 women) were interviewed to assess social economic status (SES), health related behaviors and food intakes by a 24-hour recall method. Mean age was 61.5 years with men being older (64.8 years) than women (59.3 years, p<0.001). Men in the factory area were older than rural or urban men while urban women were the youngest. Education and income of urban residents were higher than other area residents. There were more current drinkers in urban area while smoking status was not different by regions. Physical activity was significantly higher in rural or factory areas, whilst urban residents exercised more often (p<0.05). Rural or factory area residents considered themselves less healthy than others while perceived stress was lower than urban residents. Energy intakes were higher in urban residents or in men, however, after SES was controlled, energy intake did not show any differences. Energy-adjusted nutrient intakes were significantly higher in the urban area (p<0.05) for most nutrients except for carbohydrate, niacin, folic acid, vitamin B6, iron and fiber. Sodium intake was higher in factory area than in other areas after SES was controlled. DDS of rural men and MAR of both men and women in the rural area were significantly lower when SES was controlled. In conclusion, dietary intakes, diversity, adequacy and perceived health were poor in the rural area, although other health behaviors such as drinking and perceived stress were better than in the urban area. In order to improve perceived health of rural residents, good nutrition and exercise education programs are recommended.
PMCID: PMC2882589  PMID: 20535400
Dietary intake; health behavior; regional comparison; rural area
10.  Fast Food Consumption, Quality of Diet, and Obesity among Isfahanian Adolescent Girls 
Journal of Obesity  2012;2012:597924.
Background and Objective. Few data are available linking fast food intake to diet quality in developing countries. This study was conducted to determine the association between fast food consumption and diet quality as well as obesity among Isfahani girls. Methods. This cross-sectional study was done among 140 Iranian adolescents selected by the use of systematic cluster random sampling. Dietary intakes were assessed using a validated food frequency questionnaire. Diet quality was defined based on energy density and nutrient adequacy ratios (NARs). Results. Individuals in the highest quartile of fast food intake had significantly lower NARs for vitamin B1 (P = 0.008), phosphorus (P = 0.0250), selenium (P < 0.001) and vitamin B2 (P = 0.012) compared with those in the lowest quartile. Those in top quartile of fast food intake consumed more energy-dense diets than those in the bottom quartile (P = 0.022). High intakes of fast foods were significantly associated with overweight (top quartile: 40% versus bottom quartile: 0%, P = 0.0001) and obesity (11.4% versus 2.9%, P = 0.0001). Conclusion. Fast food consumption is associated with poor diet quality and high prevalence of overweight and obesity among Isfahani adolescents. Prospective data are required to confirm these findings.
PMCID: PMC3352603  PMID: 22619703
11.  Improvement of the Vietnamese Diet for Women of Reproductive Age by Micronutrient Fortification of Staples Foods and Condiments 
PLoS ONE  2012;7(11):e50538.
A micronutrient survey carried out in 2010 among randomly selected Vietnamese women in reproductive age indicated that anemia and micronutrient deficiencies are still prevalent. The objective of this study was thus to analyze the dietary micronutrient intakes of these women, to select the food vehicles to be fortified and to calculate their contributions to meet the recommended nutrient intake (RNI) for iron, zinc, vitamin A and folic acid.
Main Findings
Consumption data showed that the median intake was 38.4% of the RNI for iron, 61.1% for vitamin A and 91.8% for zinc. However, more than 50% of the women had daily zinc consumption below the RNI. Rice and vegetable oil were consumed daily in significant amounts (median: 320.4 g/capita/day and 8.6 g/capita/day respectively) by over 90% of the women, making them suitable vehicles for fortification. Based on consumption data, fortified vegetable oil could contribute to an additional vitamin A intake of 27.1% of the RNI and fortified rice could increase the intake of iron by 41.4% of the RNI, zinc by 15.5% and folate by 34.1%. Other food vehicles, such as fish and soy sauces and flavoring powders, consumed respectively by 63% and 90% of the population could contribute to increase micronutrient intakes if they are properly fortified and promoted. Wheat flower was consumed by 39% of the women and by less than 20% women from the lowest socioeconomic strata.
The fortification of edible vegetable oils with vitamin A and of rice with iron, zinc and folic acid are the most promising fortification strategies to increase micronutrient intakes of women in reproductive age in Vietnam. While rice fortification will be implemented, fortification of fish and soy sauces with iron, that has been proven to be effective, has to be supported and fortification of flavouring powders with micronutrients investigated.
PMCID: PMC3511532  PMID: 23226308
12.  Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study 
Objective To investigate the association between tea drinking habits in Golestan province, northern Iran, and risk of oesophageal squamous cell carcinoma.
Design Population based case-control study. In addition, patterns of tea drinking and temperature at which tea was drunk were measured among healthy participants in a cohort study.
Setting Golestan province, northern Iran, an area with a high incidence of oesophageal squamous cell carcinoma.
Participants 300 histologically proved cases of oesophageal squamous cell carcinoma and 571 matched neighbourhood controls in the case-control study and 48 582 participants in the cohort study.
Main outcome measure Odds ratio of oesophageal squamous cell carcinoma associated with drinking hot tea.
Results Nearly all (98%) of the cohort participants drank black tea regularly, with a mean volume consumed of over one litre a day. 39.0% of participants drank their tea at temperatures less than 60°C, 38.9% at 60-64°C, and 22.0% at 65°C or higher. A moderate agreement was found between reported tea drinking temperature and actual temperature measurements (weighted κ 0.49). The results of the case-control study showed that compared with drinking lukewarm or warm tea, drinking hot tea (odds ratio 2.07, 95% confidence interval 1.28 to 3.35) or very hot tea (8.16, 3.93 to 16.9) was associated with an increased risk of oesophageal cancer. Likewise, compared with drinking tea four or more minutes after being poured, drinking tea 2-3 minutes after pouring (2.49, 1.62 to 3.83) or less than two minutes after pouring (5.41, 2.63 to 11.1) was associated with a significantly increased risk. A strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk (weighted κ 0.68).
Conclusion Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer.
PMCID: PMC3269898  PMID: 19325180
13.  Macro and Micro-Nutrients Intake, Food Groups Consumption and Dietary Habits among Female Students in Isfahan University of Medical Sciences 
Improving the dietary intake among different groups and population is important for improving the health status. This study determines the nutrients and food group intake as well as dietary habits among female students in Isfahan University of Medical Sciences.
Two hundreds and eighty nine healthy female youths who were randomly selected among students of Isfahan University of Medical Sciences in Isfahan, Iran were enrolled. A validated semi quantitative food frequency questionnaire was used.
Folate, iron, calcium and fiber intake were lower than the recommended dietary allowances (RDA) amounts (70, 76, 90, 56% of RDA, respectively). Forty five percent of the population consumed fast foods 2 times a week and 35% used the frying oils for cooking most of the time.
Female youths had lower amount of some micronutrients. Consuming frying oils, hydrogenated vegetable oils, and fast food intake should be limited among this group.
PMCID: PMC3385798  PMID: 22754682
Dietary intake; Dietary habit; Macronutrient; Micronutrient; Student; Female
14.  Folate, vitamin B6, vitamin B12, methionine and alcohol intake in relation to ovarian cancer risk 
Folate, methionine, vitamin B6, and vitamin B12 may influence carcinogenesis due to their roles in the one-carbon metabolism pathway which is critical for DNA synthesis, methylation, and repair. Low intake of these nutrients has been associated with an increased risk of breast, colon, and endometrial cancers. Previous studies that have examined the relation between these nutrients and ovarian cancer risk have been inconsistent and have had limited power to examine the relation by histologic subtype. We investigated the association between folate, methionine, vitamin B6, vitamin B12, and alcohol among 1910 women with ovarian cancer and 1989 controls from a case-control study conducted in eastern Massachusetts and New Hampshire from 1992 to 2008. Diet was assessed via food frequency questionnaire. Participants were asked to recall diet one-year before diagnosis or interview. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (95% CIs). We also examined whether the associations varied by ovarian cancer histologies using polytomous logistic regression. We observed an inverse association between dietary vitamin B6 (covariate-adjusted OR=0.76, 95% CI 0.64–0.92; ptrend=0.002) and methionine intake (covariate-adjusted OR=0.72, 95% CI=0.60–0.87; ptrend<0.001) and ovarian cancer risk comparing the highest to lowest quartile. The association with dietary vitamin B6 was strongest for serous borderline (covariate-adjusted OR=0.49, 95% CI=0.32–0.77; ptrend=0.001) and serous invasive (covariate-adjusted OR=0.74, 95% CI=0.58–0.94; ptrend=0.012) subtypes. Overall, we observed no significant association between folate and ovarian cancer risk. One-carbon metabolism related nutrients, especially vitamin B6 and methionine, may lower ovarian cancer risk.
PMCID: PMC3288483  PMID: 21953625
ovarian cancer; folate; alcohol; methionine; B-vitamins
15.  Vitamin A status of 20- to 59-year-old adults living in Seoul and the metropolitan area, Korea 
Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of Korean adults living in Seoul and the metropolitan area. Three consecutive 24-h food recalls were collected from 106 healthy subjects (33 males and 73 females) aged 20-59 years. Fasting blood samples of the subjects were obtained and plasma retinol and carotenoids were analyzed. The daily vitamin A intakes (mean ± SD) were 887.77 ± 401.35 µg retinol equivalents or 531.84 ± 226.42 µg retinol activity equivalents. There were no significant differences in vitamin A intakes among age groups. The retinol intake of subjects was 175.92 ± 129.87 µg/day. The retinol intake of the subjects in their 50's was significantly lower than those in their 20's and 30's (P < 0.05). Provitamin A carotenoid intakes were 3,828.37 ± 2,196.29 µg/day β-carotene, 472.57 ± 316.68 µg/day α-carotene, and 412.83 ± 306.46 µg/day β-cryptoxanthin. Approximately 17% of the subjects consumed vitamin A less than the Korean Estimated Average Requirements for vitamin A. The plasma retinol concentration was 1.22 ± 0.34 µmol/L. There was no significant difference in plasma retinol concentrations among age groups. However, the concentrations of β-carotene, lycopene, and lutein of subjects in their 50's were significantly higher than those of in their 20's. Only one subject had a plasma retinol concentration < 0.70 µmol/L indicating marginal vitamin A status. Plasma retinol concentration in 30% of the subjects was 0.70- < 1.05 µmol/L, which is interpreted as the concentration possibly responsive to greater intake of vitamin A. In conclusion, dietary intakes and status of vitamin A were generally adequate in Korean adults examined in this study.
PMCID: PMC3296922  PMID: 22413040
Vitamin A status; retinol; provitamin A carotenoids; carotenoids
16.  Nutrient intake and meal patterns of Micmac indian and Caucasian women in Shubenacadie, NS. 
Canadian Medical Association Journal  1977;116(12):1356-1359.
North American Indians have a higher morbidity from gallbladder disease, diabetes mellitus and obesity than other North Americans; this may result from their food intake. Nutrient intake and meal patterns were compared in 120 Micmac Indian and 115 Caucasian women in Shubenacadie, NS. Findings were compared with the Canadian Dietary Standard (CDS) and the Nutrition Canada national and Indian survey reports. The diet of Indian women had higher carbohydrate, lower protein and lower fibre content than that of Caucasian women, who derived a higher percentage of energy from protein and had a higher intake of vitamin A, niacin and ascorbic acid. Overnight fast was longer among Indian women. A high percentage of all women studied reported diets that did not reach the CDS for total energy intake in kilocalories or for calcium, iron, vitamin A, thiamin or riboflavin.
PMCID: PMC1879315  PMID: 861896
17.  Dietary intake of polyunsaturated fatty acids (PUFA) among breastfeeding and non-breastfeeding 24–48 month old children in Bangladesh1,2,3 
To assess the adequacy of polyunsaturated fatty acid intake by rural Bangladeshi children 24–48 months of age in relation to their breastfeeding status.
Multi-stage sampling was used to select a representative sample of children 24–48 mo of age from two rural districts in Bangladesh (n=479). Two non-consecutive 24 h periods of dietary data were collected via 12 h daytime in-home observations and recall. Breast milk intake was estimated using test weighing. The National Cancer Institute method for episodically consumed foods was used to estimate distributions of usual food and nutrient intakes.
Based on the estimated intake distributions, more than 95% of the children had usual fat intakes less than 30% of total energy. Among 24–35 mo (younger) and 36–48 mo (older) children, respectively, 4% and 16% of breastfeeding children and 31% and 41% of non-breastfeeding children were estimated to consume less than 10% of total energy from fat. An estimated 80% of all children consumed less than 4% of total energy as linoleic acid, and 99% consumed less than 1% of energy as alpha-linolenic acid. Younger breastfeeding children had higher estimated average docosahexaenoic acid (DHA) intakes (0.04 g DHA/d) than their non-breastfeeding counterparts (0.01 g DHA/d; p = 0.0005). Both breastfeeding and non-breastfeeding older children had estimated mean DHA intakes of 0.02 g/d (p=0.74).
Rural Bangladeshi children 24–48 months of age, and especially those who have discontinued breastfeeding, may benefit from increased fat consumption.
PMCID: PMC3079426  PMID: 21336160
breastfeeding; PUFA; DHA
18.  Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort 
Study objective: To examine associations between food and nutrient intake, measured in childhood, and adult cancer in a cohort with over 60 years follow up.
Design and setting: The study is based on the Boyd Orr cohort. Intake of fruit and vegetables, energy, vitamins C and E, carotene, and retinol was assessed from seven day household food inventories carried out during a study of family diet and health in 16 rural and urban areas of England and Scotland in 1937–39.
Participants: 4999 men and women, from largely working class backgrounds, who had been children in the households participating in the pre-war survey. Analyses are based on 3878 traced subjects with full data on diet and social circumstances.
Main results: Over the follow up period there were 483 incident malignant neoplasms. Increased childhood fruit intake was associated with reduced risk of incident cancer. In fully adjusted logistic regression models, odds ratios (95% confidence intervals) with increasing quartiles of fruit consumption were 1.0 (reference), 0.66 (0.48 to 0.90), 0.70 (0.51 to 0.97), 0.62 (0.43 to 0.90); p value for linear trend=0.02. The association was weaker for cancer mortality. There was no clear pattern of association between the other dietary factors and total cancer risk.
Conclusions: Childhood fruit consumption may have a long term protective effect on cancer risk in adults. Further prospective studies, with individual measures of diet are required to further elucidate these relations.
PMCID: PMC1732406  PMID: 12594199
19.  Seasonal and gender differences of beverage consumption in elementary school students 
Nutrition Research and Practice  2009;3(3):234-241.
The purpose of this study was to compare the beverage consumption by gender and season in elementary school children and to investigate the role of beverage consumption patterns on their daily nutrient intakes and BMIs. Beverage consumption and dietary energy intake in 160 elementary school students in the Gyeongnam area were measured by a beverage frequency and quantity questionnaire and three 24-hour dietary recalls during winter and summer. The number of drinking moments per month, the amounts of beverage per day, and the energy from beverage consumption were not different between winter and summer. In summer, the contribution of energy from sweetened beverage to the daily energy intake in girls accounted for 13.5% which was significantly higher compared to 7.7% in boys. In girls, the consumption of health beverage showed a significant correlation with various nutrient intakes in winter. Meanwhile, the sweetened beverage intake was negatively correlated with energy, protein, vitamin A and niacin intake in summer. Consumption of most of the beverages, including sweetened beverages, were not related with BMI in both sexes and both seasons, except functional drinks which were related with BMI in boys in winter.
PMCID: PMC2808724  PMID: 20090890
Beverage; sweetened drink; children; BMI
20.  High risk mammographic parenchymal patterns and diet: a case–control study 
British Journal of Cancer  2000;83(1):121-126.
Mammographic parenchymal patterns are related to breast cancer risk and are also thought to be affected by diet. We designed a case–control study comprising 200 cases with high-risk (P2 and DY) mammographic parenchymal pattern and 200 controls with low-risk (N1 and P1) patterns in order to investigate the effect of food and nutrient intake on mammographic patterns. Mammograms were evaluated according to the Wolfe classification system. Dietary data were obtained from 7-day food diaries. Mean daily intake of nutrients was computed from standard UK food tables. The adjusted odds ratio (OR) of having a high-risk pattern in women in the highest tertile of total protein and carbohydrate intake was twice that of women in the lowest tertile (OR = 2.00; 95% confidence interval (CI) 1.06–3.77;P = 0.04 and OR = 1.93; 95% CI 1.03–3.59;P = 0.04 respectively). There was no excess risk for fat intake. In addition, there was no association between intake of vitamins and mammographic parenchymal patterns. Total meat intake was strongly and positively associated with high-risk patterns among post-menopausal women (OR = 2.50, 95% CI 1.09–5.69, P = 0.03). Our study suggests that certain macronutrients and foods such as protein, carbohydrate and meat intake influence the risk of breast cancer through their effects on breast tissue morphology, whereas fat and vitamins do not affect mammographic density. It seems that parenchymal pattern acts as an informative biomarker of the effect of some macronutrient and foodstuffs intake on breast cancer risk. © 2000 Cancer Research Campaign
PMCID: PMC2374534  PMID: 10883679
mammographic parenchymal patterns; diet; tertile
21.  Exposure to Polycyclic Aromatic Hydrocarbons Among Never Smokers in Golestan Province, Iran, an Area of High Incidence of Esophageal Cancer – a Cross-Sectional Study with Repeated Measurement of Urinary 1-OHPG in Two Seasons 
Studies have suggested a possible role of polycyclic aromatic hydrocarbons (PAHs) in the etiology of esophageal cancer in Golestan Province, Iran, where incidence of this cancer is very high. In order to investigate the patterns of non-smoking related exposure to PAHs in Golestan, we conducted a cross-sectional study collecting questionnaire data, genotyping polymorphisms related to PAH metabolism, and measuring levels of 1-hydroxypyrene glucuronide (1-OHPG), a PAH metabolite, in urine samples collected in two seasons from the same group of 111 randomly selected never-smoking women. Beta-coefficients for correlations between 1-OHPG as dependent variable and other variables were calculated using linear regression models. The creatinine-adjusted 1-OHPG levels in both winter and summer samples were approximately 110 μmol/molCr (P for seasonal difference = 0.40). In winter, red meat intake (β = 0.208; P = 0.03), processed meat intake (β = 0.218; P = 0.02), and GSTT1-02 polymorphism (“null” genotype: β = 0.228; P = 0.02) showed associations with 1-OHPG levels, while CYP1B1-07 polymorphism (GG versus AA + GA genotypes: β = –0.256; P = 0.008) showed an inverse association. In summer, making bread at home (> weekly versus never: β = 0.203; P = 0.04), second-hand smoke (exposure to ≥3 cigarettes versus no exposure: β = 0.254; P = 0.01), and GSTM1-02 “null” genotype (β = 0.198; P = 0.04) showed associations with 1-OHPG levels, but GSTP1-02 polymorphism (CT + TT versus CC: β = –0.218; P = 0.03) showed an inverse association. This study confirms high exposure of the general population in Golestan to PAHs and suggests that certain foods, cooking methods, and genetic polymorphisms increase exposure to PAHs.
PMCID: PMC3356003  PMID: 22655262
1-hydroxypyrene glucuronide; esophageal cancer; frying; red meat; polycyclic aromatic hydrocarbon; polymorphism
22.  Validation of digital photographs, as a tool in 24-h recall, for the improvement of dietary assessment among rural populations in developing countries 
Nutrition Journal  2012;11:61.
Improvement of traditional methods for dietary assessment is necessary, especially in rural areas where it is more difficult to succeed with self-reporting methods. This study presents and validates a method for improving accuracy when measuring food and nutrient intake of individuals in rural areas. It is called the “Food photography 24-h recall method” (FP 24-hR) and is a modified 24-h recall with the addition of a digital food photography record and a photo atlas.
The study was carried out in a rural area in the tropical region of Bolivia; 45 women participated. Validation of the method was made by comparing it with a reference method, the Weighed Food Record (WFR). During the FP 24-hR, digital photographs were taken by the subjects of all food consumed during a day and a 24-h recall questionnaire was conducted by an interviewer. An estimate of the amount of food consumed was made using a photo atlas and the photographs taken by the subjects. For validation, comparison was made between the calculations, by both methods, of the levels of food, and nutrient, intake.
The comparison was made in 10 food categories; most of which were somewhat underestimated from −2.3% (cassava) to −6.8% (rice), except for beverages (+1.6%) and leafy vegetables (+8.7%), which were overestimated. Spearman’s correlation coefficients were highly significant (r from 0.75 for eggs to 0.98 for potato and cassava). Nutrient intakes calculated with data from both methods showed small differences from -0.90% (vitamin C) to -5.98% (fat). Although all nutrients were somewhat underestimated, Pearson′s coefficients are high (>0.93 for all) and statistically significant. Bland Altman analysis showed that differences between both methods were random and did not exhibit any systematic bias over levels of food and nutrient intake, with acceptable 95% limits of agreement.
The FP 24-hR exhibits acceptable differences when compared with a WFR, digital photos are useful as a memory aid for the subjects during 24-h recall and as an estimation tool. The method is suitable for assessing dietary intake among rural populations in developing countries.
PMCID: PMC3547686  PMID: 22931128
Weighed record; 24-h recall; Digital photographs; Photo atlas; Developing countries
23.  Nutrient intakes during pregnancy: the influence of smoking status and age 
STUDY OBJECTIVE—To examine the relation of antioxidant and other nutrient intakes in pregnancy to smoking and sociodemographic variables.
DESIGN—Cohort study.
SETTING—St Mary's Maternity Hospital, Portsmouth.
PARTICIPANTS—Pregnant nulliparous women, with no existing complications of pregnancy, were recruited from antenatal booking clinics. A total of 774 women completed seven day food diaries, and supplied detailed data on their use of nutrient supplements.
MAIN RESULTS—Smokers had lower intakes of most micronutrients. After adjustment for the confounding effects of maternal age, height, and education, only vitamin C and carotenoid intakes remained significantly depressed. Age was strongly and significantly associated with the intake of most nutrients, including antioxidants, and this association was independent of other maternal factors. Antioxidant intake was therefore lowest in young women who smoked: for example smokers under 24 years had a mean vitamin C intake of 57 mg (SD 35) compared with 106 mg (SD 52) for non-smokers aged 28 and over (difference 49 mg, 95% CI 39, 59). The corresponding intakes of carotenoid equivalents were 1335 µg (SD 982) and 2093 µg (SD 1283) (difference 758 µg, 95% CI 496, 1020).
CONCLUSIONS—The study has identified, for the first time, young pregnant women as a group at particular risk of low micronutrient intake. The health implications of poor nutrition now need to be evaluated, particularly for those women who smoke.

Keywords: pregnancy; nutrition; age
PMCID: PMC1731547  PMID: 10692957
24.  Validation of a Semi-Quantitative Food Frequency Questionnaire for Argentinean Adults 
PLoS ONE  2012;7(5):e37958.
The Food Frequency Questionnaire (FFQ) is the most commonly used method for ranking individuals based on long term food intake in large epidemiological studies. The validation of an FFQ for specific populations is essential as food consumption is culture dependent. The aim of this study was to develop a Semi-quantitative Food Frequency Questionnaire (SFFQ) and evaluate its validity and reproducibility in estimating nutrient intake in urban and rural areas of Argentina.
Methods/Principal Findings
Overall, 256 participants in the Argentinean arm of the ongoing Prospective Urban and Rural Epidemiological study (PURE) were enrolled for development and validation of the SFFQ. One hundred individuals participated in the SFFQ development. The other 156 individuals completed the SFFQs on two occasions, four 24-hour Dietary Recalls (24DRs) in urban, and three 24DRs in rural areas during a one-year period. Correlation coefficients (r) and de-attenuated correlation coefficients between 24DRs and SFFQ were calculated for macro and micro-nutrients. The level of agreement between the two methods was evaluated using classification into same and extreme quartiles and the Bland-Altman method. The reproducibility of the SFFQ was assessed by Pearson correlation coefficients and Intra-class Correlation Coefficients (ICC). The SFFQ consists of 96 food items. In both urban and rural settings de-attenuated correlations exceeded 0.4 for most of the nutrients. The classification into the same and adjacent quartiles was more than 70% for urban and 60% for rural settings. The Pearson correlation between two SFFQs varied from 0.30–0.56 and 0.32–0.60 in urban and rural settings, respectively.
Our results showed that this SFFQ had moderate relative validity and reproducibility for macro and micronutrients in relation to the comparison method and can be used to rank individuals based on habitual nutrient intake.
PMCID: PMC3360668  PMID: 22662256
25.  Nutrient estimation from an FFQ developed for a black Zimbabwean population 
Nutrition Journal  2005;4:37.
There is little information in the literature on methods of food composition database development to calculate nutrient intake from food frequency questionnaire (FFQ) data. The aim of this study is to describe the development of an FFQ and a food composition table to calculate nutrient intake in a Black Zimbabwean population.
Trained interviewers collected 24-hour dietary recalls (24 hr DR) from high and low income families in urban and rural Zimbabwe. Based on these data and input from local experts we developed an FFQ, containing a list of frequently consumed foods, standard portion sizes, and categories of consumption frequency. We created a food composition table of the foods found in the FFQ so that we could compute nutrient intake. We used the USDA nutrient database as the main resource because it is relatively complete, updated, and easily accessible. To choose the food item in the USDA nutrient database that most closely matched the nutrient content of the local food we referred to a local food composition table.
Almost all the participants ate sadza (maize porridge) at least 5 times a week, and about half had matemba (fish) and caterpillar more than once a month. Nutrient estimates obtained from the FFQ data by using the USDA and Zimbabwean food composition tables were similar for total energy intake intra class correlation (ICC) = 0.99, and carbohydrate (ICC = 0.99), but different for vitamin A (ICC = 0.53), and total folate (ICC = 0.68).
We have described a standardized process of FFQ and food composition database development for a Black Zimbabwean population.
PMCID: PMC1325035  PMID: 16351722

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