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Biomedical subjects

G C Frank

Publications and source records attributed to G C Frank.

At least 19 recordsLinked to original sources

Methodological issues regarding eating behavior of high-risk adolescents.

Teens exist in multiple environments that offer a variety of foods and a range in nutrient intakes. Currently used dietary data-collection methods may not be contemporary and encompass the real world of today's youth. If we consider respondent capability when we design our dietary assessment methods, then we can increase accuracy and reduce errors in our data. Our methodological challenge is to improve collection methods and to: Focus on the teen and his or her respective environments, Develop environment-specific probes within food records, recalls, checklists, and frequencies, Inbed safeguards to assure impartial reporting when surrogate respondents-for example, parents or school food service staff-are queried, Differentiate between foods "as offered or available at the home or school" versus foods as actually selected and eaten, Tease out the influence of peers and older siblings on food choices versus selections based on personal choice or cost, Employ cooperative education in the classroom so teens will feel comfortable with spontaneous interviews by unfamiliar people, Train students in dietary recordkeeping procedures by incorporating assessment activities into the classroom instruction. In conclusion, the teen lives in multiple environments that influence his or her food and nutrient intake. To increase validity, reliability, and our confidence in the dietary data about teens, we must acknowledge these microenvironments and evolve our methods. The process must be evolutionary not revolutionary like the lives of many teens. The result will be an increased accuracy in both defining actual nutrient intakes and exploring the role foods and nutrients have in the overall health or nutrient deficit teens face.

Adolescent↗

Effects of debittering on grapefruit juice acceptance.

This study was conducted to assess the acceptance of grapefruit juice which has undergone a debittering process. The sensory effect of debittering and the sensory attributes of sourness, sweetness, bitterness, and aftertaste were appraised, and the correlation between chemical and sensory analyses of the debittered juice were identified. The effect of added grapefruit flavor on perception of sweetness and sourness was statistically significant. Both the level of bitterness and storage duration of grapefruit were shown to influence the way judges perceived bitterness and sweetness. Storage study showed no difference in aftertaste, which may increase consumers buying interest in debittered juice with a high level of bitterness (450 ppm).

Beverages↗

Environmental influences on methods used to collect dietary data from children.

When collecting dietary data on children, confidence about responses is required. Children exist in multienvironments in their everyday lives, eg, the personal, school, home, peer, medical care, media, food industry, and fast-food facility environments. These macroenvironments influence the format and type of data-collection methods used to interview today's youth. Researchers should identify the influence of each environment on the child's eating pattern and nutrient intake, explore the pros and cons of various data-collection methods amid these environments, and determine unresolved methodological issues to stimulate future research. Standardized protocols for interviewing children, exclusion criteria for surrogate responses, and currency of nutrient data for new food products available to children are needed. Redefining our methods by understanding the macroenvironments of youth can create a dietary methodology for the 21st century--an evolutionary method that builds on past research and incorporates current technology and societal changes.

Aging↗

A food frequency questionnaire for adolescents: defining eating patterns.

A self-administered food frequency questionnaire (FFQ) was developed to indicate weekly consumption of 64 foods. Reliability, validity, and usefulness of the tool to define a protein eating pattern were determined. Adolescents (N = 1,108) completed the FFQ during the Bogalusa Heart Study. Two-hour and 2-week reliability measures demonstrated consistency of intake of specific foods. Frequency of foods obtained from seven consecutive 24-hour recalls was compared with frequency obtained from the FFQ. A mean 50% agreement for both frequency and quantity of food intake was observed. Geometric means showed differences in mean number of protein foods by age of adolescent but the only significant difference was for beef intake of 15-year-olds. White children reported more servings of beef, cheese, and vegetables with meat than did black children. Black children reported more servings of eggs, luncheon meat, pork, poultry, and total protein than did white children. Boys reported a greater frequency of total protein foods, specifically, eggs, milk, and poultry, than did girls. Significant correlations were noted between low-density-lipoprotein cholesterol and intake of eggs and luncheon meat. We were able to quantitate the reliability and validity of the FFQ and to use it to explore the association of specific eating patterns with cardiovascular disease risk.

Adolescent↗

Fat and cholesterol avoidance among Mexican-American and Anglo preschool children and parents.

Is a fat-avoidance scale a useful tool for monitoring and tracking dietary fat selections of adults and children? Using a seven-point scale, we addressed this question with 341 preschool children and 421 of their parents participating in a longitudinal study of childhood behaviors in San Diego County, California. Milk type and cooking fat reported in the fat-avoidance scale was compared with data reported in a 24-hour food intake record. An overall 86% agreement for milk type and a 78% agreement for cooking fat were noted. Anglo preschoolers (n = 143) had significantly greater mean scores for fat and cholesterol avoidance than did Mexican-American preschoolers (n = 198). Anglo, but not Mexican-American, women avoided fat and cholesterol more often than did their male counterparts. A significantly higher sum score was noted for Anglo men and women and Mexican-American men as education increased. These findings indicate that the fat-avoidance scale has a relative validity compared with a 1-day food record, that fat avoidance can be measured, that differences can be noted in a biethnic sample of children and adults, and that the scale has potential for monitoring success in achieving a lower fat and cholesterol intake.

Adult↗

Nutritional therapy for hyperlipidemia and obesity: office treatment integrating the roles of the physician and the registered dietitian.

Clinical therapy for hyperlipidemia and obesity mandates dietary changes. The rationale for modification of specific dietary components becomes more impressive with each decade, as research and epidemiologic studies continue. Treatment modalities should be based on lipid patterns and lipid aberrations. Intervention methods should become practical and behaviorally motivating for patients. The environment must be receptive, with sophisticated interaction between the physician and registered dietitian. Third party reimbursement trends should be considered, but should not deter nutrition care services essential for medical management of the individual with heart disease.

Body Weight↗

Heart Smart: a school health program meeting the 1990 Objectives for the Nation.

The importance of health promotion is recognized throughout the nation. The Surgeon General's report of 1980, Promoting Health/Preventing Disease, delineates objectives for intervention in 15 health priority areas. Approximately one-third of the objectives relate directly to the health of children, and many are addressed by a comprehensive cardiovascular (CV) health promotion program for elementary school children--Heart Smart. Priority areas addressed by this program are high blood pressure control, nutrition, fluoridation and dental health, smoking, misuse of alcohol and drugs, physical fitness and exercise, and control of stress and violence. Heart Smart is a cognitive behavioral intervention designed to address health enabling and reinforcing factors within the school environment. It is based on data from the Bogalusa Heart Study which clearly document the need for CV health intervention beginning early in life. Heart Smart includes a longitudinal classroom curriculum, an aerobic fitness program taught within physical education classes, a school lunch program offering CV healthy foods, and a teacher staff development program. The goal is to reduce CV risk factors in children. With health-enhancing behavior change of the students, family, and elementary school staff, objectives for CV risk reduction in our nation can be achieved.

Adolescent↗

Trends in fatty acid intakes of 10-year-old children, 1973 to 1982.

Diets of four groups of 10-year-old children (no. = 871, 30% black, 70% white) were examined over 10 years with 24-hour dietary recalls to study temporal trends in cholesterol, fat, and fatty acid intakes in a community. Boys had higher intakes per day and per kilogram body weight than girls for all nutrients (p less than .0001), but there were no sex differences in nutrients per 1,000 kcal. The only racial difference detected was a higher myristic acid intake in whites (p less than .02). There was a 16% decline in dietary cholesterol intake between 1978 and 1982. Three shifts in fatty acid intake increased the P:S ratio from 0.29 in 1973 to 0.45 in 1978: (a) a 5% decline in oleic acid, coupled with a 5% rise in linoleic acid; (b) a quadrupling of linolenic acid; and (c) less stearic and more myristic acid, with palmitic acid unchanged. Total fat intake provided 38% of the calories in each survey, but the changes in proportions of fatty acids paralleled trends in food consumption patterns and nutrient sources. Despite the changes, few children met prudent diet recommendations, and serum total cholesterol and very-low-density-lipoprotein cholesterol levels did not change over time.

Body Constitution↗

Caffeine intakes of children from a biracial population: the Bogalusa Heart Study.

To investigate caffeine intake patterns in children, dietary intakes were examined for a biracial sample of 1,284 infants and children. Twenty-four-hour dietary recalls were completed by parents of children aged 6 months and repeated at ages 1, 2, 3, and 4 years; children 10 years old served as their own respondents and were surveyed at ages 13, 15, and 17 years. The sample was 60% white and 40% black. Additional cohorts of 10-year-olds (no. = 686) were studied for temporal trend. Whites consumed significantly more caffeine than blacks as early as 1 year and persisted at a higher intake level from 2 to 17 years. This trend continued whether intake was measured in total milligrams, milligrams per 1,000 kcal, or milligrams per kilogram body weight. Significant sex differences in caffeine intakes per 1,000 kcal occurred among 15- and 17-year-olds (girls greater than boys). Peak periods of consumption occurred at ages 2, 3, 13, and 17. Snacks contributed large quantities of caffeine, particularly for 10-year-olds. Most frequent sources of caffeine were regular carbonated beverages, chocolate-containing foods, and tea. Mean intakes of caffeine for 10-year-olds were consistent from 1973 to 1982. Those observations document caffeine intakes beginning early in life.

Adolescent↗

Sodium, potassium, calcium, magnesium, and phosphorus intakes of infants and children: Bogalusa Heart Study.

Electrolyte and mineral intakes assessed by 24-hour dietary recall were examined for race and sex differences in cohorts of infants and school-age children at 6 months and at 1, 2, 3, 4, 10, 13, 15, and 17 years. A fourfold increase in sodium intake occurred from 6 months to 4 years, and potassium intake doubled. Sodium increased from 0.88 gm at 6 months to 3.21 gm at 4 years and 3.67 gm by 17 years; a slight increase for potassium was noted from 4 to 17 years for boys. Calcium intake was relatively constant from 6 months to 17 years. Boys had higher intakes of sodium and sodium per kilogram body weight than did girls. Black children at 2, 3, and 4 years had significantly higher sodium, potassium, calcium, phosphorus, and magnesium expressed as total intake and per kilogram body weight than white children did. At 6 months, 66% of the infants exceeded the National Research Council's recommended range for sodium. At 1 to 10 years, 90% to 100% and at 13 to 17 years, 60% to 65% exceeded the recommended range. In contrast, 58% to 77% of preschool children and only 5% to 20% of school-age children surpassed the recommended potassium range. Fifty percent to 70% of children more than 10 years old achieved the recommended range for potassium. Approximately half of the children 6 months through 4 years of age met the Recommended Dietary Allowance (RDA) for calcium. Sixty percent to 80% of adolescents ingested less than two-thirds the RDA. Girls had lower intakes than did boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

School health promotion: child nutrition programs.

Since 1946, with the enactment of the National School Lunch Act, an important and integral part of the comprehensive school health program has been ensuring the nutritional needs of students are met. This article describes the history of the school nutrition program and how it has adapted to meet the needs of today's students. The modern menu is more healthful, foods are prepared with less salt, sugar, and fat, and nutrition education complements food choices. Through collaboration, nutrition education has been integrated into health education and the other elements of the total school health program to better meet students needs.

Child↗

Implementation of "Heart Smart:" a cardiovascular school health promotion program.

The Bogalusa Heart Study, an investigation of 8,000 children, has compiled a large data bank on cardiovascular (CV) risk factors in children during the past 12 years. Precursors of heart disease begin at a young age, with many children already possessing one or more known clinical risk factors--hypertension, obesity, and adverse lipoprotein changes. Having obtained data examining the determinants, distributions, interrelationships and trends over time for CV risk factors, a foundation was provided to address additional questions directed toward intervention strategies. "Heart Smart" is a comprehensive, research-based CV health promotion program testing differential effects of a population (public health) strategy versus a high-risk approach within four elementary schools. The major goal of "Heart Smart" is to reduce CV risk factors in children with an intervention to facilitate the adoption of healthful lifestyles. Objectives, intervention modalities, and design and evaluation procedures for children and adults in a total school environment (K-6) are described.

Cardiovascular Diseases↗

Racial contrasts in hemoglobin levels and dietary patterns related to hematopoiesis in children: the Bogalusa Heart Study.

Racial differences in hemoglobin (Hgb) levels were explored in two groups of children at different maturational stages, the pre-adolescent (10-year-olds: Whites n = 160, Blacks n = 56,) and the adolescent (15-year-olds; Whites n = 60, Blacks n = 44). Mean Hgb levels were higher for Whites than Blacks in both age groups. When all the dietary components (i.e., iron, zinc, copper, folacin, ascorbic acid and vitamins B12, E and B6) were considered as a group, they accounted for 8.4 per cent of the Hgb variance in 10-year-olds and 10.1 per cent of variance in 15-year-olds. However, even after controlling for the variations in dietary patterns of the adolescents and pre-adolescents, race still accounted for a notable proportion of Hgb variance in both age groups (9.1 per cent in 10-year-olds and 7.0 per cent in 15-year-olds). Within each race, gender accounted for a greater percentage of the Hgb variance in the adolescents than in the pre-adolescents. Our results indicate that in all likelihood racial differences in Hgb levels during childhood exist independent of racial differences in intake of specific "blood building" nutrients and maturational changes.

Adolescent↗

Validation of the 24-hour dietary recall in preschool children.

The results of the current study indicate that data obtained by the dietary recall correlate highly with the children's weighed food intake if a parent or the primary caretaker providing the child's food responds to the interview. Meredith et al. found parents to be poor reporters of children's consumption outside the home. It is encouraging to note that parents can be reliable reporters of their children's food intake in the home environment. When errors did occur, they were errors in portion size, as 96% of foods eaten by the children were correctly identified by the parents. Parents under-reported only 4% of the time. This slight tendency to under-report is consistent with other reports of the validity of the 24-hour dietary recall. In younger children, parents appear to be reliable reporters of their children's in-home dietary intake. As children become older, they appear to be able to recall their own intake both within and outside the home. There are several possible explanations for these findings. First, several factors could have influenced the accuracy of parental reports of the child's intake during the day that we weighed foods. Because food was weighed in the homes, the parents undoubtedly attended more closely to their child's diet. Additionally, the dietary recalls were collected at the end of the day of observation. This was closer in time than most 24-hour recalls and may have reflected less memory decay than usual. Also, since our sample was primarily middle-class families who were well educated, the correspondence between actual vs. reported dietary intake may have been artificially enhanced.(ABSTRACT TRUNCATED AT 250 WORDS)

Child Nutritional Physiological Phenomena↗

Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Design and participation.

Cardiovascular risk factor variables were examined in a cohort of 440 infants from birth through 7 years of age. Anthropometric measures, BP, serum lipid and lipoprotein values, and dietary intake data were obtained according to detailed protocols. Various quality controls to ensure the collection of valid and reliable data were instituted. Participation remained high throughout the study with 80% of the children examined at 6 months and 60% at 7 years of age. Rates were slightly higher for black than for white children. Children born in the private hospital were more likely to continue in the study than children born in the charity hospital. Children of parents examined when the child was 2 years of age were more likely to be examined during the preschool phases, but parental examination was not related to child examination when the child was 7 years of age. As in studies of school-aged children, measurement errors were lowest for height, weight, and serum total cholesterol. Measurement errors for BP were highest at the younger ages, particularly for diastolic BP. Examination of a newborn cohort throughout time affords the opportunity to study early development of relationships and tracking of cardiovascular risk factors.

Absenteeism↗

Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Dietary intakes.

Dietary patterns and racial differences in nutrient intake were observed in children 6 months to 4 years of age in the Bogalusa Heart Study. Even in this sample of young children, the composition of the intakes of the majority of children was not compatible with prudent recommendations of less than 35% and 10% of energy from total and saturated fat, respectively. Mean cholesterol intake of the 4-year-old children (390 mg) was approximately one half of the average daily adult levels. The polyunsaturated to saturated fatty acid ratio ranged from 0.41 to 0.53 and sucrose to starch ratio from 1.32 to 1.57, reflecting a high saturated fat and sucrose intake. White children had greater intakes of sucrose than black children; however, total fat and cholesterol intakes were greater in black children. Gender differences were noted among the 2, 3, and 4-year-old children: energy, sugar, and starch intakes were greater in boys, and cholesterol intake per 1,000 kcal was greater in girls. Mean intakes per 1,000 kcal in Bogalusa were higher for fat and carbohydrate and lower for protein than reported in the Second Health and Nutrition Examination Survey. However, when the National Research Council recommended dietary allowances for protein and energy are used for comparison, a more than adequate intake was noted in these children. The data found in this newborn-infant cohort contribute information regarding the early development of dietary habits that likely influence eating behavior in later childhood and adolescence.

Age Factors↗

Macronutrient intakes of 10-year-old children, 1973 to 1982.

Diets of four groups of 10-year-old children (no. = 871) from a biracial community were examined to document eating patterns and to note temporal trends in energy, protein, fat, and carbohydrate intakes. A 24-hour dietary recall method, incorporating numerous quality controls, was adapted for interviewing children. Protein provided 13%, fat 38%, and carbohydrate 49% of calories. Few racial differences in eating patterns were detected. Boys had higher energy intakes than girls, but after diets were adjusted per 1,000 kcal, no other sex differences in intake were found. Snacks yielded roughly one-third of daily energy intake, one-fifth of the day's protein, one-third of the fat, and two-fifths of the total carbohydrate intake. Density of macronutrients within the children's diets was consistent over time. Diets of children in the Bogalusa study typify the American eating pattern and are comparable with those found in major national surveys.

Anthropometry↗