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PubMed2000

Dietary patterns in six european populations: results from EURALIM, a collaborative European data harmonization and information campaign.

OBJECTIVE: To determine and describe the extent to which European dietary data collected in disparate surveys can be meaningfully compared. DESIGN: Seven independent population-based surveys from six European countries were initially included. Differences in study designs and methodological approaches were examined. Risk factor data for 31,289 adults aged 40-59 y were harmonized and pooled in a common, centralized database. RESULTS: Direct comparisons of dietary measures across studies were not deemed appropriate due to methodological heterogeneity. Nonetheless, comparisons of intra-population contrasts by gender across sites were considered valid. Women consumed fruit and vegetables more often than men. Age-standardized gender differences in the prevalence of low fruit and vegetable consumption ranged from 7 to 18% and 5 to 15%, respectively. Data on energy intake showed good agreement across study populations. The proportion of total energy from macronutrients was similar for women and men. Gender differences for relative intakes of saturated fatty acids (percentage energy) were small and only in France were they significant. Dietary fibre density was significantly higher in women than in men. Overall, the participating Southern European populations from Italy and Spain exhibited more healthful food composition patterns. CONCLUSIONS: Contrasts in dietary patterns by gender across populations may provide the basis for health promotion campaigns. The most favourable patterns observed may serve as attainable goals for other populations. An international risk factor surveillance programme based upon locally run, good quality studies has the potential to provide the needed data. SPONSORSHIP: European Community (DG V), project 96CVVF3-446-0; Swiss Federal Office for Education and Science, OFES 96.0089.

Adult↗
PubMed2001

[Transition of dietary pattern in China].

The implications of dietary transition in China during the past 50 years were investigated. Data were collected from the representative national surveys, China Health and Nutrition Survey (1989-1997), China National Nutrition Survey (1982 and 1992), the Annual Household Consumption Surveys of the State Statistic Bureau and the Annual Death Report of China. In the early part of the major economic transformation, cereal intake increased before 1985 and decreased thereafter. There was also a long-term reduction of vegetable consumption, which has stabilized now. Intakes of animal foods increased slowly before 1979 and more quickly after the economic reforms occurred. The total energy intake has reduced, as energy expenditure has, large changes in the composition of energy have occurred. The proportion of energy from fat increased quickly and reached 27.3% in average and 32.8% in urban residents in 1997. More than one third of all Chinese adults and 58.4% of adults in urban areas consuming over 30% of their energy from fat. These changes resulted in rapid increases the prevalence of overweight and obesity and dietary-related chronic non-communicable diseases in urban residents. The traditional Chinese diet is shifting towards a diet with high fat, high energy density and low dietary fiber. The Chinese diets have entered into a new stage of transition.

China↗
PubMed2006

Dietary patterns in patients with advanced cancer: implications for anorexia-cachexia therapy.

BACKGROUND: Severe malnutrition and wasting are considered hallmarks of advanced malignant disease, and clinical research into anorexia-cachexia therapy and nutritional support for cancer patients is ongoing. However, information on typical dietary intakes and food choices for this population is notably lacking; proposed therapies for anorexia and wasting are not framed within the context of current intake. OBJECTIVE: The objective of the study was to characterize the food intake patterns of patients with advanced cancer. DESIGN: Patients with advanced cancer (n = 151) recruited from a regional cancer center and palliative-care program completed a 3-d dietary record a mean (+/-SD) 8 +/- 7 mo before death. Food items were categorized according to macronutrient content and dietary use and subsequently entered into cluster analysis. RESULTS: Wide variations in intakes of energy (range: 4-53 kcal . kg body wt(-1) . d(-1); x +/- SD: 25.1 +/- 10.0 kcal . kg body wt(-1) . d(-1)) and protein (range: 0.2-2.7 g . kg body wt(-1) . d(-1); x +/- SD: 1.0 +/- 0.4 g . kg body wt(-1) . d(-1)) were observed. Even the subjects with the highest intakes had a recent history of weight loss, which suggests that the diets of those persons were consistently inadequate for weight maintenance. Cluster analysis found 3 dietary patterns that differed in food choice and caloric intake. Low intakes and a high risk of weight loss were associated with decreased frequency of eating and dietary profiles with little variety and unusually high proportions of liquids. CONCLUSION: These data provide a glimpse into dietary habits toward the end of life. Unique dietary patterns were found in this nutritionally vulnerable patient population.

Aged↗
PubMed2006

Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial.

CONTEXT: Obesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets. OBJECTIVES: To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components. DESIGN, SETTING, AND PARTICIPANTS: Randomized intervention trial of 48,835 postmenopausal women in the United States who were of diverse backgrounds and ethnicities and participated in the Women's Health Initiative Dietary Modification Trial; 40% (19,541) were randomized to the intervention and 60% (29,294) to a control group. Study enrollment was between 1993 and 1998, and this analysis includes a mean follow-up of 7.5 years (through August 31, 2004). INTERVENTIONS: The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable, fruit, and grain consumption and did not include weight loss or caloric restriction goals. The control group received diet-related education materials. MAIN OUTCOME MEASURE: Change in body weight from baseline to follow-up. RESULTS: Women in the intervention group lost weight in the first year (mean of 2.2 kg, P<.001) and maintained lower weight than control women during an average 7.5 years of follow-up (difference, 1.9 kg, P<.001 at 1 year and 0.4 kg, P = .01 at 7.5 years). No tendency toward weight gain was observed in intervention group women overall or when stratified by age, ethnicity, or body mass index. Weight loss was greatest among women in either group who decreased their percentage of energy from fat. A similar but lesser trend was observed with increases in vegetable and fruit servings, and a nonsignificant trend toward weight loss occurred with increasing intake of fiber. CONCLUSION: A low-fat eating pattern does not result in weight gain in postmenopausal women. Clinical Trial Registration ClinicalTrials.gov, NCT00000611.

Aged↗
PubMed1991

Dietary patterns and cancer.

The possible role of dietary habits in the aetiology of cancers, and in the differences observed in the prevalence of this group of diseases between populations, should be considered in the context of the competing theories of cancer causation. This paper briefly reviews the historical context in which the contemporary emphasis on nutritional influences in cancer causation is placed and outlines the scope of the evidence currently available.

Animals↗
PubMed2006

Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial.

CONTEXT: Multiple epidemiologic studies and some trials have linked diet with cardiovascular disease (CVD) prevention, but long-term intervention data are needed. OBJECTIVE: To test the hypothesis that a dietary intervention, intended to be low in fat and high in vegetables, fruits, and grains to reduce cancer, would reduce CVD risk. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of 48,835 postmenopausal women aged 50 to 79 years, of diverse backgrounds and ethnicities, who participated in the Women's Health Initiative Dietary Modification Trial. Women were randomly assigned to an intervention (19,541 [40%]) or comparison group (29,294 [60%]) in a free-living setting. Study enrollment occurred between 1993 and 1998 in 40 US clinical centers; mean follow-up in this analysis was 8.1 years. INTERVENTION: Intensive behavior modification in group and individual sessions designed to reduce total fat intake to 20% of calories and increase intakes of vegetables/fruits to 5 servings/d and grains to at least 6 servings/d. The comparison group received diet-related education materials. MAIN OUTCOME MEASURES: Fatal and nonfatal coronary heart disease (CHD), fatal and nonfatal stroke, and CVD (composite of CHD and stroke). RESULTS: By year 6, mean fat intake decreased by 8.2% of energy intake in the intervention vs the comparison group, with small decreases in saturated (2.9%), monounsaturated (3.3%), and polyunsaturated (1.5%) fat; increases occurred in intakes of vegetables/fruits (1.1 servings/d) and grains (0.5 serving/d). Low-density lipoprotein cholesterol levels, diastolic blood pressure, and factor VIIc levels were significantly reduced by 3.55 mg/dL, 0.31 mm Hg, and 4.29%, respectively; levels of high-density lipoprotein cholesterol, triglycerides, glucose, and insulin did not significantly differ in the intervention vs comparison groups. The numbers who developed CHD, stroke, and CVD (annualized incidence rates) were 1000 (0.63%), 434 (0.28%), and 1357 (0.86%) in the intervention and 1549 (0.65%), 642 (0.27%), and 2088 (0.88%) in the comparison group. The diet had no significant effects on incidence of CHD (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.90-1.06), stroke (HR, 1.02; 95% CI, 0.90-1.15), or CVD (HR, 0.98; 95% CI, 0.92-1.05). Excluding participants with baseline CVD (3.4%), the HRs (95% CIs) for CHD and stroke were 0.94 (0.86-1.02) and 1.02 (0.90-1.17), respectively. Trends toward greater reductions in CHD risk were observed in those with lower intakes of saturated fat or trans fat or higher intakes of vegetables/fruits. CONCLUSIONS: Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors, suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT00000611.

Aged↗
PubMed1994

Dietary patterns among adolescents in the west of Scotland.

Dietary data from 15-year-old adolescents participating in the West of Scotland Twenty-07 study were examined in order to describe current eating patterns and food habits. Comparison of the data with a 'healthy eating' index showed that less than one-third of the sample were eating a diet similar to that promoted by local health education campaigns. Multivariate analysis showed that adolescents from non-manual and wealthier families, non-smokers, and females were more likely to be classified as 'healthy eaters'. Comparison of the data with that collected from a 35-year-old cohort in the same study showed that significantly fewer 15-year-olds were likely to consume diets associated with long-term health.

Adolescent↗
PubMed2001

Dietary patterns among a national random sample of British adults.

STUDY OBJECTIVES: To identify groups within the UK male and female population who report similar patterns of diet. DESIGN: National representative dietary survey, using seven day weighed dietary records, of men and women aged 16-64 years living in private households in Great Britain in 1986-7. Cluster analysis was used to aggregate participants into diet groups. SETTING: Great Britain. PARTICIPANTS: 1087 men and 1110 women. RESULTS: 93% of men and 86% of women fell into one of four distinct diet groups. Among men the most prevalent diet group was "beer and convenience food" (34% of the male population); second was "traditional British diet" (18%); third was "healthier but sweet diet" (17.5%) and fourth was "healthier diet " (17%). Among women, the most prevalent diet group was " traditional British diet" (32%); second, was "healthy cosmopolitan diet" (25%); third was a "convenience food diet" (21%); and fourth was "healthier but sweet diet" (15%). There were important differences in nutrient profile, sociodemographic and behavioural characteristics between diet groups. CONCLUSIONS: Cluster analysis identified four diet groups among men and four among women, which differed not only in terms of reported dietary intakes, but also with respect to nutrient, social and behavioural profiles. The groups identified could provide a useful basis for development, monitoring and targeting of public health nutrition policy in the UK.

Adolescent↗
PubMed1975

Dietary patterns among men of Japanese ancestry in Hawaii.

The dietary patters of 6663 men of Japanese ancestry, living in Hawaii and participating in the Honolulu Heart and Japan-Hawaii Cancer Studies, were analyzed according to country of birth and boyhood education. Approximately 80% of the men were born and educated in Hawaii (Nisei); the others were either born in Japan (Issei) or traveled to Japan for 5 or more years of boyhood education (Kibei). Twenty-four-hr diet recalls, obtained at the first cycle of examinations (1965 to 1968), revealed that the Nisei consumed significantly greater intakes of total and animal protein, total and saturated fat, and cholesterol than the Issei and Kibei. Values for weight, height, skinfold thickness, and serum cholesterol were in the same direction, and the differences were statistically significant. Food frequency questionnaires at the 1st and 3rd examinations covered a 6-year interval. At both time periods, the Issei and Kibei ate Japanese foods more frequently and in greater quantities than the Nisei. In general, the Nisei consumed more Western foods. Both food frequency questionnaires included 6 identical items; coffee, milk, green tea, rice, tofu (soybean curd), and tsukudani (preserved seaweed paste). The frequent and infrequent consumers were similarly characterized over the 6-year period. The findings suggest that the country of birth and education has lasting effects on adult eating patterns. The observed heterogeneity for specific food items and nutrients between the Nisei and Issei-Kibei men augers well for attempts to relate such items to chronic diseases such as cancer.

Body Height↗
PubMed2003

How reproducible is self-reported information on exposure to smoking, drinking, and dietary patterns? Evidence among Brazilian adults in the Pró-Saúde Study.

CONTEXT: Epidemiological studies of the validity and reliability of self-reported information on important risk factors for non-communicable chronic diseases are scarce in Brazil. OBJECTIVE: We evaluated the test-retest reliability of information--overall and stratified by gender, age and education--on active and passive smoking, alcohol intake and aspects of dietary habits. TYPE OF STUDY: Test-retest reliability. SETTING: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. PARTICIPANTS: 192 University employees. PROCEDURES: Self-administered questionnaires were completed on two occasions, two weeks apart. MAIN MEASUREMENTS: Kappa Statistics; Intraclass Correlation Coefficient. RESULTS: Information on smoking status and pack-years smoked had almost perfect levels of agreement, respectively, kappa = 0.97 (95% CI, 0.92-1.00), and intraclass correlation coefficient = 0.93 (CI 95%, 0.89-0.96). Characteristics of alcohol intake yielded substantial levels of agreement (kappa ranging from 0.62 to 0.69). The reproducibility of the information on dietary habits varied from 0.67 to 0.79 (kappa). No clear-cut patterns could be identified comparing information by age or gender. There was a slight tendency towards greater reliability among people with higher levels of education. CONCLUSION: The reproducibility of information on smoking, drinking, and dietary patterns ranged from substantial to excellent, as investigated in the Pró-Saúde Study, a longitudinal investigation recently launched in Rio de Janeiro.

Adolescent↗
PubMed1984

Dietary patterns of elderly people living in inner Sydney.

The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney were collected and analysed. Participants in the study (n = 124) had their midday meal at either an Activity Centre or at home (Meals-on-Wheels Organization). The dietary data was collected over 4 days. Heights and weights and some sociological data were also obtained. The study indicated that a significant proportion of this population may be at nutritional risk, and that this was particularly so for males receiving Meals-on-Wheels.

Aged↗
PubMed2005

Dietary patterns of reservation and non-reservation Native American youths.

OBJECTIVE: A leading cause of morbidity and mortality among Native Americans, cancer is largely preventable through lifestyle habits. Ranked high among those habits is a diet low in fat and high in fiber, fruits, and vegetables. Because Native Americans are not included in national nutritional monitoring systems, limited data exist on the cancer-related dietary habits of this population. To bridge this gap, this study measured the eating patterns of Native American youths in the northeastern United States. DESIGN: Cross-sectional. SETTING: Urban Indian centers and tribal and reservation settings located in New York, Massachusetts, Connecticut, Vermont, and Maine. PARTICIPANTS: 191 self-identified Native American parents of children between 8 and 14 years of age. MAIN OUTCOME MEASURES: Frequency of intake of foods recommended for inclusion in or omission from a diet to reduce cancer risk. RESULTS: Dietary patterns among Native American youths differed from a national US sample and varied between youths in reservation and non-reservation settings. CONCLUSIONS: A need exists for nutrition education and behavior change programs that reflect the culturally specific eating habits of the indigenous peoples of the Northeast. Ideally, developing nutrition curricula for specific communities will be done in cooperation with these communities and acknowledge barriers that may limit Native Americans' access to healthful foods.

Adolescent↗
PubMed1992

Nutrient intakes and dietary patterns of older Americans: a national study.

To assess the dietary status of older Americans, a national household survey of food consumption practices of individuals 65 years of age and older was conducted in May-August, 1990. The design and methodology of the survey were modeled after those of the USDA's Continuing Survey of Food Intakes by Individuals (CSFII). Dietary information for 474 individuals (65 to 98 years of age) in 355 households was collected by interview (24-hour dietary recall). Analyzed indicators of dietary quality were energy (calorie) and nutrient intake, food group intake and frequency, and number of meals skipped. Results indicated that substantial percentages of those surveyed had inadequate intakes of energy and nutrients. Over 40% of men had intakes of vitamins A and E, calcium, and zinc below two-thirds the RDA. For women, over 40% had intakes of vitamin E, calcium, and zinc that were below two-thirds the RDA. Additionally, over 20% of older men and women skipped lunch. These data indicate that a large proportion of noninstitutionalized elderly Americans consume diets that fail to meet dietary standards.

Aged↗
PubMed2004

Dietary patterns and risk of gastric cancer: a case-control study in Uruguay.

BACKGROUND: Gastric cancer is a frequent malignancy in the Uruguayan population. In northern counties, incidence rates reach high figures (age-standardized rates [ASR], 37.3 per 100,000 men and 18.3 per 100,000 women). Diet is a major determinant in gastric carcinogenesis. Because foods or food groups have the advantage over nutrients in being most directly related to dietary recommendations, we decided to conduct a case-control study on the relationships between food groups and risk of gastric cancer. For this purpose, we included 240 cases and 960 controls. METHODS: In the present study we employed three analytical approaches: (1) individual food group analysis, (2) factor analysis, and (3) analysis of empirical scores of risk. Individual analysis of food groups was performed by multiple unconditional logistic regression, with food groups being the explanatory variables. Nineteen food groups were created and categorized in tertiles according to the control distribution. Factor analysis aggregated intercorrelated foods in broader eating patterns. In this study we were able to identify three factors or patterns, arbitrarily labeled "starchy," "healthy," and "mixed." Finally, empirical scores of risk were created after examining the risk of each individual food and summing each significant item. This resulted in a risk enhancing score and a protective score. Both scores were categorized in tertiles according to the control distribution. RESULTS: The individual analysis of food groups showed increased risks of gastric cancer for rice, salted meat, stewed meat, white bread, potatoes, and tubers. On the other hand, raw vegetables, total fruits, legumes, and black tea were inversely associated with risk of gastric cancer. All three dietary patterns, generated by factor analysis, were significantly associated with gastric carcinoma risk. Whereas the starchy factor was directly associated with gastric cancer, the healthy and mixed patterns were strongly protective. Finally, the risk enhancing empirical score displayed an increased risk of gastric cancer (odds ratio [OR], 4.1, 95% confidence interval [CI], 2.6-6.6), whereas the protective score showed an important reduction in risk, of 0.38. CONCLUSION: This study displayed consistent results from three different approaches. Concerning different food groups, stewed and processed meat are rich in salt; rice, tubers, and winter squash are sources of starch; and vegetables and fruits are rich in ascorbic acid and carotenoids. All these substances have been strongly related to gastric carcinogenesis. Furthermore, this study suggests that diets rich in vegetables and fruits and with low amounts of salty and starchy foods are recommendable for the prevention of gastric cancer.

Adult↗
PubMed2005

Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns.

The purposes of this systematic review were to present and compare recent estimates of the prevalence of overweight and obesity in school-aged youth from 34 countries and to examine associations between overweight and selected dietary and physical activity patterns. Data consisted of a cross-sectional survey of 137 593 youth (10-16 years) from the 34 (primarily European) participating countries of the 2001-2002 Health Behaviour in School-Aged Children Study. The prevalence of overweight and obesity was determined based on self-reported height and weight and the international child body mass index standards. Logistic regression was employed to examine associations between overweight status with selected dietary and physical activity patterns. The two countries with the highest prevalence of overweight (pre-obese + obese) and obese youth were Malta (25.4% and 7.9%) and the United States (25.1% and 6.8%) while the two countries with the lowest prevalence were Lithuania (5.1% and 0.4%) and Latvia (5.9% and 0.5%). Overweight and obesity prevalence was particularly high in countries located in North America, Great Britain, and south-western Europe. Within most countries physical activity levels were lower and television viewing times were higher in overweight compared to normal weight youth. In 91% of the countries examined, the frequency of sweets intake was lower in overweight than normal weight youth. Overweight status was not associated with the intake of fruits, vegetables, and soft drinks or time spent on the computer. In conclusion, the adolescent obesity epidemic is a global issue. Increasing physical activity participation and decreasing television viewing should be the focus of strategies aimed at preventing and treating overweight and obesity in youth.

Adolescent↗
PubMed1990

Dietary patterns and nutrient intakes of toddlers from low-income families in Denver, Colorado.

Over a 2-year period, dietary and socioeconomic data were collected from 793 food records of 90 toddlers, aged 1 to 2 years, who were predominantly U.S. Hispanics living in low-income households in Denver, CO. This study was part of a larger investigation designed to assess the efficacy of vitamin and mineral supplements in young children. The toddlers were randomly assigned to one of five treatment groups: multivitamin; multivitamin and iron; multivitamin, iron, and zinc; multivitamin and zinc; or placebo. Three-day food records that were collected from the toddlers at the beginning of the study, at 3 months, and at 6 months were used to assess the dietary and nutrient intakes. Meal patterns were devised on the basis of the frequency of food consumption and common food combinations. Nutrient values were calculated using a diet analyzer program. Nutrient analysis of the toddlers' diets indicated that iron and magnesium were consumed least frequently, whereas more than adequate amounts of protein (193% of the Recommended Dietary Allowance) and sodium (207% of minimum requirements for healthy persons) were consumed. No significant differences in nutrient intakes were observed among the treatment groups, suggesting that the vitamin and mineral supplements had no effect. A difference in energy intake was observed over time with the 6-month and 3-month intakes significantly higher than the initial intakes. There was also a high consumption of carbonated beverages. Despite the low income levels of the families, these toddlers were consuming adequate amounts of food; however, an educational component aimed at reducing the toddlers' high intakes of protein, sodium, and carbonated drinks may help improve the present feeding practices of the mothers.

Analysis of Variance↗