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Biomedical subjects

Helen Smiciklas-Wright

Publications and source records attributed to Helen Smiciklas-Wright.

At least 19 recordsLinked to original sources
PubMed2007

Assessing the effect of underreporting energy intake on dietary patterns and weight status.

OBJECTIVES: To identify misreporting among older rural adults using a prediction algorithm and to compare dietary patterns of underreporters and plausible reporters. DESIGN: In this cross-sectional study, diet information was assessed by five 24-hour recalls collected over 10 months. All foods were classified into 24 food subgroups. Demographic, health, and anthropometric data were collected via home visit. SETTING: Rural Pennsylvania. SUBJECTS: One hundred seventy-nine community-dwelling adults, aged 66 to 87 years. STATISTICAL ANALYSIS: Cluster analysis. RESULTS: Underreporters (n=43) were more likely than plausible reporters (n=133) to be overweight and less educated but did not differ by sex. Underreporters consumed fewer servings across the majority of food groups. Two dietary patterns were determined for all and plausible reporters, in both cases one of higher and one of lower nutrient density. Using only plausible reporters to determine dietary patterns was very similar to using all reporters. The correlation between energy intake and weight status was improved for plausible-reporting women, but not men. CONCLUSIONS: Dietary patterns of plausible reporters were generally similar to that of all reporters; however, correlations with energy intake and weight status improved for women using only plausible reporters. Individuals may not accurately report dietary intake. Those obtaining diet reports should be aware of reporting errors before making decisions about dietary adequacy.

Aged↗
PubMed2006

Dairy and dairy-related nutrient intake during middle childhood.

OBJECTIVE: To characterize patterns of dairy intake among girls in middle childhood. DESIGN: Longitudinal data were used to characterize girls' patterns of dairy intake at age 5, 7, 9, and 11 years. SUBJECTS: Participants were 151 girls from predominately middle-class and exclusively non-Hispanic white families living in central Pennsylvania. STATISTICAL ANALYSES: Intakes of dairy, energy, macronutrients, vitamin D, calcium, and phosphorus were assessed using three 24-hour dietary recalls in 151 non-Hispanic white girls at age 5, 7, 9, and 11 years. Analyses of changes over time were conducted using repeated measures analysis of variance. McNemar's chi(2) test was used to analyze change in percentage of dairy consumers over time. RESULTS: From age 5 to 11 years, girls' total dairy intake remained stable. Total milk consumption declined, due to a decline in intake of milk as a beverage, while intakes of cheese and dairy desserts increased. Much of the decline in milk intake from age 5 to 11 years, especially for milk as a beverage, was due to a reduction in the percentage of girls consuming milk as a beverage, not simply due to a decline in the servings of milk as a beverage consumed by consumers. On average, girls met vitamin D recommendations over time; however, by age 9 and 11 years girls failed to meet calcium and phosphorus recommendations. CONCLUSIONS: Although girls' dairy intake was stable over time, at age 7, 9, and 11 years girls did not meet the recommended three servings per day, leading to suboptimal intakes of calcium and phosphorus at age 9 and 11 years. Increasing milk intake among all children should continue to be a major focus of interventions.

Analysis of Variance↗
PubMed2006

Comparative strategies for using cluster analysis to assess dietary patterns.

OBJECTIVES: To characterize dietary patterns using two different cluster analysis strategies. DESIGN: In this cross-sectional study, diet information was assessed by five 24-hour recalls collected over 10 months. All foods were classified into 24 food subgroups. Demographic, health, and anthropometric data were collected via home visit. SUBJECTS: One hundred seventy-nine community-dwelling adults, aged 66 to 87 years, in rural Pennsylvania. STATISTICAL ANALYSIS: Cluster analysis was performed. RESULTS: The methods differed in the food subgroups that clustered together. Both methods produced clusters that had significant differences in overall diet quality as assessed by Healthy Eating Index (HEI) scores. The clusters with higher HEI scores contained significantly higher amounts of most micronutrients. Both methods consistently clustered subgroups with high energy contribution (eg, fats and oils and dairy desserts) with a lower HEI score. Clusters resulting from the percent energy method were less likely to differentiate fruit and vegetable subgroups. The higher diet quality dietary pattern derived from the number of servings method resulted in more favorable weight status. CONCLUSIONS: Cluster analysis of food subgroups using two different methods on the same data yielded similarities and dissimilarities in dietary patterns. Dietary patterns characterized by the number of servings method of analysis provided stronger association with weight status and was more sensitive to fruit and vegetable intake with regard to a more healthful dietary pattern within this sample. Public health recommendations should evaluate the methodology used to derive dietary patterns.

Aged↗
PubMed2006

Girls' dairy intake, energy intake, and weight status.

We explored the relationships among girls' weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. Participants included 172 11-year-old non-Hispanic white girls, assessed cross-sectionally. Intakes of dairy, calcium, and energy were measured using three 24-hour recalls. Body mass index and body fat measures from dual-energy x-ray absorptiometry were obtained. Because preliminary analyses suggested systematic underreporting of energy intake, the relationships among dairy servings and measures of weight status were examined for the total sample and for subsamples of under-, plausible, and overreporters. Data for the total sample provided support for the hypothesized relationship among weight status, dairy servings, and energy intake. Thirty-nine percent of girls reported consuming the recommended >/=3 servings of dairy per day; these girls also reported higher energy intake but had lower body mass index z scores and body fat than the girls who consumed fewer than three dairy servings each day. Among plausible reporters, no relationship between dairy intake and weight status was noted. This discrepancy may be attributable to a high percentage (45%) of overweight underreporters in the total sample. Our findings reveal that reporting bias, resulting from the presence of a substantial proportion of underreporters of higher weight status, can contribute to obtaining spurious associations between dairy intake and weight status. These findings underscore the need for randomly controlled trials to assess the role of dairy in weight management.

Absorptiometry, Photon↗
PubMed2006

Understanding reporting bias in the dietary recall data of 11-year-old girls.

OBJECTIVE: This study describes patterns of bias in self-reported dietary recall data of girls by examining differences among girls classified as under-reporters, plausible reporters, and over-reporters on weight, dietary patterns, and psychosocial characteristics. RESEARCH METHODS AND PROCEDURES: Participants included 176 girls at age 11 and their parents. Girls' weight and height were measured. Three 24-hour dietary recalls and responses to psychosocial measures were collected. Plausibility cut-offs for reported energy intake as a percentage of predicted energy requirements were used to divide the sample into under-reporters, plausible reporters, and over-reporters. Differences among these three groups on dietary and psychosocial variables were assessed to examine possible sources of bias in reporting. RESULTS: Using a +/-1 standard deviation cut-off for energy intake plausibility, 50% of the sample was categorized as plausible reporters, 34% as under-reporters, and 16% as over-reporters. Weight status of under-reporters was significantly higher than that of plausible reporters and over-reporters. With respect to reported dietary intake, under-reporters were no different from plausible reporters on intakes of foods with higher nutrient densities and lower energy densities and were significantly lower than plausible reporters on intakes of foods with lower nutrient densities and higher energy densities. Over-reporters reported significantly higher intakes of all food groups and the majority of subgroups, relative to plausible reporters. Under-reporters had significantly higher levels of weight concern and dietary restraint than both plausible reporters and over-reporters. DISCUSSION: Techniques to categorize plausible and implausible reporters can and should be used to provide an improved understanding of the nature of error in children's dietary intake data and account for this error in analysis and interpretation.

Adiposity↗
PubMed2006

Girls' calcium intake is associated with bone mineral content during middle childhood.

We examined longitudinally the association between calcium intake and total body bone mineral content (TBBMC) in 151 non-Hispanic white girls. Intakes of dairy, energy, and calcium were assessed using three 24-h dietary recalls in girls at ages 5, 7, 9, and 11 y. We assessed their total-body bone mineral content with dual-energy X-ray absorptiometry at ages 9 and 11 y. Dairy foods comprised the major contributor (70%) to calcium intake over the 6-y period; 28% of calcium came from other foods, and 2% from supplements. By age 9 and 11 y, the majority of girls did not meet calcium recommendations. Higher calcium intake at ages 7 and 9 y was associated with higher TBBMC at age 11 y. Calcium intake at age 9 y was also positively associated with TBBMC gained from age 9 to 11 y. Calcium intake at age 11 y was not correlated with TBBMC at the same age. Relations between calcium intake and TBBMC did not differ for total calcium and for calcium from dairy sources, likely reflecting the fact that dairy products were the major source of calcium in this sample. Results from the present study provide new longitudinal evidence that calcium intake, especially calcium from dairy foods, can have a favorable effect on girls' TBBMC during middle childhood.

Adolescent↗
PubMed2005

Dietary fiber intake by American preschoolers is associated with more nutrient-dense diets.

OBJECTIVE: To illustrate and discuss implications of the new Diet Reference Intakes for fiber, relative to a nationally representative sample of American preschoolers. DESIGN: Cross-sectional study using the Continuing Survey of Food Intake by Individuals 1994-1996, 1998. SUBJECTS: Children 2 through 5 years of age who provided 2 days of dietary intake data (N=5,437) were grouped and 2- and 3-year-olds (n=2,805) were compared with 4- and 5-year-olds. STATISTICAL ANALYSIS: Descriptive analysis (mean+/-standard error) was used to describe the sample and to rank children into quartiles of dietary fiber intake. Nonparametric test for trend was employed to examine significance level of observed changes in nutrient and food group consumption by increasing fiber intake quartiles. RESULTS: Main contributors to dietary fiber intakes were low-fiber fruits and legumes. Children in the high-fiber quartile consumed diets with higher nutrient and fiber density and increased number of servings of Food Guide Pyramid food groups. Many children in this population did not meet intake recommendations of "age plus five," and most lacked the 14 g/1,000 kcal of energy consumed, even after considering a hypothetical estimated average of 5 g/day functional fiber. CONCLUSIONS: Children would benefit from diets higher in fiber. Newly recommended intake levels are only met by a few and further studies need to be conducted to provide evidence for a recommended intake level of fiber in children. Average consumption of functional fiber in children has to be examined.

Age Distribution↗
PubMed2005

Tanita foot-to-foot bioelectrical impedance analysis system validated in older adults.

Simple, accurate, and noninvasive methods for assessing body composition are needed in many clinical, community, and research settings. The foot-to-foot bioelectrical impedance analysis (BIA) system may be one method of addressing those needs. The objective of this study was to determine the validity of a foot-to-foot BIA system for body-composition assessment of older adults. Subjects 55 years of age or older without functional limitations or cognitive impairments (N=50) were measured using both the Tanita foot-to-foot system (Tanita Corporation of America, Inc, Arlington Heights, IL) and traditional hand-to-foot BIA. The correlation for percent body fat measurements between the Tanita and traditional BIA was r=0.84 (P<.001). Percent body fat estimates from both BIA measures were significantly correlated with waist circumference, body mass index, and age (all P<.01). The Tanita BIA system provides a valid measure of percent body fat in older adults, and could be a convenient and practical approach for assessment in public health settings.

Adipose Tissue↗
PubMed2005

Adverse effect of high added sugar consumption on dietary intake in American preschoolers.

OBJECTIVES: To assess the effect of Dietary Reference Intakes (DRI)-recommended added sugar intake levels on nutrient and food group consumption by preschoolers. STUDY DESIGN: This was a cross-sectional study of 2- to 5-year-olds in the United States Department of Agriculture Continuing Survey of Food Intake by Individuals (CSFII), 1994 to 1996, and 1998 (n = 5437). Main food sources of added sugar were established. For five categories (< or =10% energy from added sugar, 11% to 15%, 16% to 20%, 21% to 25%, and >25%), mean nutrient and food group consumption and proportion of children not meeting the DRI were ascertained. The nonparametric test for trend indicated significance of changes. Analysis was stratified by age (2- to 3-year-olds versus 4- to 5-year-olds), and survey design corrected to maintain the nationally representative character of the data. RESULTS: The majority of children consumed less than 25% of energy from added sugar; the main sources were fruit and or soft drinks and desserts. Increasing added sugar consumption was paralleled by decreasing nutrient and food group intakes and increasing proportions of children with intakes below the DRI. Calcium intake was insufficient in large proportions of children consuming 16% or more from added sugar. CONCLUSIONS: In preschoolers, the new DRI for added sugar are reason for concern. Further research is needed to investigate the effects of the DRI on diet quality, body weight, and health status in young children.

Child Nutritional Physiological Phenomena↗
PubMed2005

Nutritional status predicts primary subclasses of T cells and the lymphocyte proliferation response in healthy older women.

Aging is often associated with a dysregulation in immune function, particularly in T-cell responses, even in the healthy elderly. Adequate nutrition is important for optimal immune function. The literature on the relation of nutritional status with immune function in the elderly offers mixed findings. Because several nutrients can influence immune response, and there are interactions among nutrients, examining the association of various nutrients measured simultaneously with tests of immune function is important. We examined the association of protein, iron, zinc, vitamin B-12, and folic acid with tests of acquired immunity in healthy older women (76.7 +/- 7.0 y; n = 130). Discriminant analysis was used to identify the predictive subset of nutrients that could correctly classify subjects into the lowest or highest quartiles (< or =25th or >75th percentile) on various immune function tests (T cells and subsets and lymphocyte proliferation in response to culture with mitogens). Protein and iron status variables were identified in the predictive subset for all immune tests; in addition, zinc emerged in the predictive model for T cells and their subsets as well as for the proliferation response to concanavalin A. The probability of correctly classifying women into the lowest or highest quartiles of immune tests by the predictive subset of nutrition variables was high, i.e., 62.8-83.5% for T cells and their subsets, and 79.3-89.7% for the proliferation response to mitogens. In conclusion, protein, iron, and zinc were significant predictors of immune function in older women. Adequate status of these nutrients may help maintain immunity in older adults.

Aged↗
PubMed2004

The quality of girls' diets declines and tracks across middle childhood.

BACKGROUND: Food group intakes by US children are below recommendations and micronutrient inadequacies have been reported. There are few longitudinal data that focus on developmental changes in food and nutrient intake from early to middle childhood. We examined changes in nutrient and food group intakes over time and the tracking of intakes across middle childhood in a longitudinal sample of girls. METHODS: Three multiple-pass 24-hour diet recalls were conducted in a sample of 181 non-Hispanic White girls at ages 5, 7, and 9 years. Food and nutrient data were averaged across 3 days. Analyses of time effects were conducted using repeated measures analysis of variance and tracking of intakes was assessed via rank analysis. RESULTS: We found significant decreases in nutrient densities (intakes per 1000 kcal) of vitamins C and D, calcium, phosphorus, magnesium and zinc at age 9. Girls maintained their relative quartile positions for these micronutrients from ages 5-9. Analysis of food group data showed similar trends. At age 9, significantly fewer girls were meeting the recommendations for dairy, fruit and vegetable servings than at age 5 and girls also tended to remain in their respective quartiles over time, especially for fruit and dairy intakes. CONCLUSIONS: These results highlight the importance of developing healthy eating practices during early childhood when caretakers have considerable control over children's food intake.

Journal Article↗
PubMed2004

Dietary patterns in women treated for breast cancer who successfully reduce fat intake: the Women's Intervention Nutrition Study (WINS).

OBJECTIVE: The objectives of this study were to assess the types of dietary changes made by women who successfully reduced their fat intake in response to low-fat diet instruction and to evaluate the effects of these changes on nutrient intake. DESIGN: Two hundred women enrolled in the low-fat intervention arm of the Women's Intervention Nutrition Study (WINS) were randomly selected. Woman whose baseline fat intake was less than 20% energy from fat were excluded from the study, resulting in a total population of 163. These women were categorized into either the strictly adherent (SA) (those who met their fat gram goal and reported less than 20 % calories from fat, n=50) or the not strictly adherent (NSA) (those who exceeded their fat gram goal and reported 20% or greater calories from fat, n=113) group. The food choices made by SA and NSA subjects were analyzed to identify those that promoted greater adherence. SUBJECTS/SETTING: The participants were free-living women who had been instructed to follow a diet that would meet a specific fat gram goal calculated to provide 15% of calories from fat. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to describe food groups and subgroups. t tests were used to determine statistical significance between and within groups. chi(2) analysis was used to assess differences in demographic variables. RESULTS: There were no marked differences in food patterns of the SA and NSA subjects when compared with the Food Guide Pyramid (FGP) recommendations. Both met FGP serving recommendations at baseline. At 12 months, both showed reductions in the number of servings from fats and oils; SA subjects showed a greater reduction (from 4.18+/-3.6 to 3.0+/-2.4) as well as a reduction in servings from the bread group intake (5.7+/-2.2 to 4.8+/-2.1). Evaluation of food subgroups from within FGP groups showed strategies that promoted fat reduction, such as reducing portion sizes of high-fat foods. The use of these strategies was greater in the SA subjects. The reduction in fat intake had little impact on nutrient adequacy. SA and NSA subjects reduced energy intake from baseline to follow-up, with SA subjects reporting lower intakes. There were few differences in nutrient intakes between the SA and NSA subjects at either time period. CONCLUSIONS: The results from this study suggest specific strategies that promote successful reduction in fat intake without compromising nutrient intake. This information can be used to guide others in making dietary changes.

Adult↗
PubMed2004

Portion size of common foods predicts energy intake among preschool-aged children.

This study evaluated the relationship of food intake behaviors to total energy intake among children aged 2 to 5 years old (N=5447) who participated in the Continuing Survey of Food Intakes by Individuals, 1994-1996, 1998 (CSFII 94-96, 98). Food intake behaviors examined were portion size for 10 commonly eaten foods, number of eating occasions per day, and number of foods consumed per day. Using regression models, we examined these eating behaviors as predictors of energy intakes with adjustment for body weight. Eating behaviors and body weight were positively related to energy intake, together explaining 38% to 39% of the variability. Portion size alone accounted for 17% to 19% of the variance in energy intake, whereas body weight predicted only 4%. Feeding recommendations should highlight the importance of age-appropriate portion sizes and provide guidance on the frequency of eating and number of foods consumed.

Age Factors↗
PubMed2004

Persistent oral health problems associated with comorbidity and impaired diet quality in older adults.

Chewing, swallowing, and mouth pain (CSP) are identified as indicators of nutritional risk in older adults. Previous research has shown that oral health problems in community-living older rural adults were associated with increased hospitalization. The purpose of this study was to characterize older adults with self-reported persistent CSP problems at baseline and one-year follow-up. Participants were from the Geisinger Rural Aging Study, either with persistent oral problems (PCSP; n=22) or without problems (NCSP; n=125). Demographic, health, and anthropometric data were collected via home visit; diet information was assessed by five, 24-hour recalls collected over 10 months. PCSP subjects reported almost twice the number of medications (4.2 vs 2.6, respectively, P=.008) and diseases (7.0 vs 4.2, respectively, P=.001), with higher occurrence of type 2 diabetes mellitus, peptic ulcers/gastritis, and angina. PCSP participants had lower Healthy Eating Index scores (66.6 vs 70.6, respectively, P=.04), significantly lower intakes of vitamin A, and higher prevalence of inadequate intakes of vitamins B-6 and A. These results indicate that impaired intake of certain foods and nutrients is associated with persistent oral health problems. Oral status is an important component of overall health and should be monitored for intervention.

Aged↗
PubMed2004

Hypertension-related dietary patterns of rural older adults.

BACKGROUND: Prevalence of hypertension is greater in older adults, and increased intake of fruits, vegetables, and dairy-good sources of potassium, calcium, and magnesium-can reduce blood pressure. This study examined the hypertension-related dietary patterns of older adults. METHODS: A cohort of 180 Pennsylvania adults (aged >/=65), 90 with hypertension, were randomly selected from the Geisinger Rural Aging Study (GRAS). Data were collected by trained interviewers at a home visit. Dietary assessment used five 24-h recalls. We compared the characteristics and dietary intake of people with hypertension to those without hypertension and compared their intakes to current recommendations. RESULTS: Mean intakes of all participants were less than two thirds of the DRI for calcium and magnesium and fell far short of the 3,500 mg of potassium recommended for prevention and treatment of hypertension. Participants with hypertension consumed less sodium than controls. Both groups ate fewer fruits and vegetables than recommended but reached the dairy recommendation. Calcium intake was mainly from high-fat dairy products, beans were the top source of potassium and magnesium. CONCLUSIONS: Older adults with hypertension should be guided to choose more low-fat dairy products and other low-fat calcium sources and to increase intakes of beans, dark green leafy vegetables, and other potassium and magnesium sources.

Aged↗
PubMed2004

Meeting calcium recommendations during middle childhood reflects mother-daughter beverage choices and predicts bone mineral status.

BACKGROUND: Longitudinal data regarding the influence of beverage intakes on calcium adequacy are lacking. OBJECTIVE: This study evaluated calcium intake from ages 5 to 9 y as a function of mother-daughter beverage choices and as a predictor of bone mineral status. DESIGN: Intakes of energy, calcium, milk, sweetened beverages, fruit juices, and non-energy-containing beverages were measured with the use of three 24-h dietary recalls in 192 non-Hispanic white girls aged 5, 7, and 9 y and their mothers. Calcium intakes from ages 5 to 9 y were categorized as either meeting or falling below recommended adequate intakes (AIs). The girls' bone mineral status was assessed with dual-energy X-ray absorptiometry at age 9 y. RESULTS: The mean 5-y calcium intake was related to bone mineral density at age 9 y (beta = 0.27, P < 0.001). The girls who met the AI for calcium were not heavier (P = 0.83) but had higher energy intakes (P < 0.0001) than did the girls who consumed less than the AI. Compared with the girls who consumed less than the AI, the girls who met the AI consumed, on average, almost twice as much milk (P < 0.0001), had smaller decreases in milk intake (P < 0.01), and consumed 18% less sweetened beverages (P < 0.01) from ages 5 to 9 y; the 2 groups did not differ significantly in juice and non-energy-containing beverage intakes. The girls who met the AI were also served milk more frequently than were the girls who consumed less than the AI (P < 0.0001) and had mothers who drank milk more frequently (P < 0.01) than did the mothers of the girls who consumed less than the AI. CONCLUSIONS: These findings provide new longitudinal evidence that calcium intake predicts bone mineral status during middle childhood and reflects mother-daughter beverage choice patterns that are established well before the rapid growth and bone mineralization observed in adolescence.

Animals↗