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Barbara Dennis

Publications and source records attributed to Barbara Dennis.

4 recordsLinked to original sources

Association between protein intake and blood pressure: the INTERMAP Study.

BACKGROUND: Findings from epidemiological studies suggest an inverse relationship between individuals' protein intake and their blood pressure. METHODS: Cross-sectional epidemiological study of 4680 persons, aged 40 to 59 years, from 4 countries. Systolic and diastolic blood pressure was measured 8 times at 4 visits. Dietary intake based on 24-hour dietary recalls was recorded 4 times. Information on dietary supplements was noted. Two 24-hour urine samples were obtained per person. RESULTS: There was a significant inverse relationship between vegetable protein intake and blood pressure. After adjusting for confounders, blood pressure differences associated with higher vegetable protein intake of 2.8% kilocalories were -2.14 mm Hg systolic and -1.35 mm Hg diastolic (P<.001 for both); after further adjustment for height and weight, these differences were -1.11 mm Hg systolic (P<.01) and -0.71 mm Hg diastolic (P<.05). For animal protein intake, significant positive blood pressure differences did not persist after adjusting for height and weight. For total protein intake (which had a significant interaction with sex), there was no significant association with blood pressure in women, nor in men after adjusting for dietary confounders. There were significant differences in the amino acid content of the diets of persons with high vegetable and low animal protein intake vs the diets of persons with low vegetable and high animal protein intake. CONCLUSIONS: Vegetable protein intake was inversely related to blood pressure. This finding is consistent with recommendations that a diet high in vegetable products be part of healthy lifestyle for prevention of high blood pressure and related diseases.

Adult↗

High rates of obesity and cardiovascular disease risk factors in lower middle class community in Pakistan: the Metroville Health Study.

OBJECTIVES: To describe the distribution of over weight and body mass index, waist circumference and waist/ hip ratio, correlate obesity measures to coronary heart disease risk factors in comparison to Pakistan National Survey (PNS). METHODS: The Metroville Health Study (MHS) was an urban risk factor reduction intervention study in Metroville Karachi. Base line data was used which was not a random sample. Demographic data including serum cholesterol, glucose, haemoglobin, and blood pressure were collected. RESULTS: In MHS high cholesterol was 16% and 24% in men and women respectively, and 25% had hypertension. Self-reported diabetes was 8%, over-weight/obesity 34% and 49% for men and women, compared to 16% and 25% for PNS, while high risk waist-hip ratio (WHR) was present in 41% and 72% of men and women respectively. Under-weight in Metroville men was 12% and 9% in women, compared to 26% and 27% in PNS. The anthropometry variables were significantly correlated with each other while weight was significantly correlated with TC and waist circumference (WC). CONCLUSION: Obesity was alarmingly prevalent in urban Metroville in comparison to PNS. Cardio Vascular Disease (CVD) risk factors were prevalent in Metroville and TC and WC were significantly correlated with obesity measures. For prevention of increasing CVD in urban communities, targeted programs of intervention are required.

Adolescent↗

Attainment of precision in implementation of 24 h dietary recalls: INTERMAP UK.

Collection of complete and accurate dietary intake data is necessary to investigate the association of nutrient intakes with disease outcomes. A standardised multiple-pass 24 h dietary recall method was used in the International Collaborative Study of Macro- and Micronutrients and Blood Pressure (INTERMAP) to obtain maximally objective data. Dietary interviewers were intensively trained and recalls taped, with consent, for randomly selected evaluations by the local site nutritionist (SN) and/or country nutritionists (CN) using a twelve-criterion checklist marked on a four-point scale (1, retrain, to 4, excellent). In the Belfast centre, seven dietary interviewers collected 932 24 h recalls from 40-59-year-old men and women. Total scores from the 134 evaluated recalls ranged from thirty-four to the maximum forty-eight points. All twelve aspects of the interviews were completed satisfactorily on average whether scored by the SN (n 53, range: probing 3.25 to privacy of interview 3.98) or CN (n 19, range: probing 3.26 to pace of interview and general manner of interviewer 3.95); the CN gave significantly lower scores than the SN for recalls evaluated by both nutritionists (n 31, Wilcoxon signed rank test, P=0.001). Five evaluations of three recalls identified areas requiring retraining or work to improve performance. Reporting accuracy was estimated using BMR; energy intake estimates less than 1.2 x BMR identifying under-reporting. Mean ratios in all age, sex and body-mass groups were above this cut-off point; overall, 26.1 % were below. Experiences from the INTERMAP Belfast centre indicate that difficulties in collection of dietary information can be anticipated and contained by the systematic use of methods to prevent, detect and correct errors.

Blood Pressure↗

Standardised coding of diet records: experiences from INTERMAP UK.

Coding diet records is a basic element of most dietary surveys, yet it often receives little attention even though errors in coding can lead to flawed study results. In the INTERnational study of MAcro- and micronutrients and blood Pressure (INTERMAP study), efforts were made to minimise errors in coding the 18, 720 diet records. Staff were centrally trained and certified before being able to process study data and ongoing quality control checks were performed. This involved the senior (site) nutritionist re-coding randomly selected diet records. To facilitate standardisation of coding in the UK, a code book was designed; it included information about coding brand items, density and portion size information, and default codes to be assigned when limited information was available for food items. It was found that trainees, despite previous experience in coding elsewhere, made coding errors that resulted in errors in estimates of daily energy and nutrient intakes. As training proceeded, the number of errors decreased. Compilation of the code book was labour-intensive, as information from food manufacturers and retailers had to be collected. Strategies are required to avoid repetition of this effort by other research groups. While the methods used in INTERMAP to reduce coding errors were time consuming, the experiences suggest that such errors are important and that they can be reduced.

Diet↗