Obesity Prevalence and Dietary Intake of Antioxidants in Native American Adolescents

Antioxidants are well known for possessing anti-inflammatory properties, which can reduce the risk of chronic disease and obesity. However, very little research has been done to examine antioxidant intake among adolescent minority populations such as Native American adolescents. Our study examined the significance of antioxidant intake among Native American adolescents at an urban residential high school in Southern California. Our study population consisted of 183 male and female Native American adolescents, 14-18 years of age, representing 43 tribes from across the United States. Students' primary source of meals was provided by the school food service. Based on the BMI calculations, the rate of obesity within our population was 38% for males and 40% for females, more than two-fold the national rate indicated by NHANESIII data. We used the Harvard School of Public Health Youth/Adolescent Questionnaire (HSPH YAQ), a semi-quantitative food frequency questionnaire, to examine antioxidant nutrient intake and evaluate the differences in the intake between normal and obese weight students. Statistical analysis of the results showed that intakes of vitamins C, E, and lycopene were the antioxidant nutrients found to be significantly different between normal and obese weight students and intakes of these nutrients were found to be higher among normal weight students (p-values = 0.02451, 0.00847, and 0.04928, respectively). These results suggest that dietary intake of antioxidants could be increased among Native American adolescents. Further research is needed to confirm our findings and identify effective ways for school food service to incorporate antioxidant rich foods into school menus

Dietary factors associated with obesity indicators and level of sports participation in Flemish adults : a cross-sectional study

BACKGROUND: Obesity develops when energy intake continuously exceeds energy expenditure, causing a fundamental chronic energy imbalance. Societal and behavioural changes over the last decades are held responsible for the considerable increase in sedentary lifestyles and inappropriate dietary patterns. The role of dietary fat and other dietary factors in the aetiology and maintenance of excess weight is controversial. The purposes of the present study were to investigate the dietary factors associated with body mass index (BMI) and waist circumference (WC), and to analyse whether dietary intake varies between subjects with different levels of sports participation. METHODS: Data for this cross-sectional study, including anthropometric measurements, 3-day diet diary and physical activity questionnaire, were collected by the Flemish Policy Research Centre Sport, Physical Activity and Health (SPAH) between October 2002 and April 2004. Results of 485 adult men and 362 women with plausible dietary records were analysed. Analyses of covariance were performed to determine the differences in dietary intake between normal weight, overweight and obese subjects, and between subjects with different levels of sports participation. RESULTS: Total energy intake, protein and fat intake (kcal/day) were significantly higher in obese subjects compared to their lean counterparts in both genders. Percentage of energy intake from fat was significantly higher in obese men compared to men with normal weight or WC. Energy percentages from carbohydrates and fibres were negatively related to BMI and WC in men, whereas in women a higher carbohydrate and fibre intake was positively associated with obesity. Alcohol intake was positively associated with WC in men. Subjects participating in health related sports reported higher intake of carbohydrates, but lower intake of fat compared to subjects not participating in sports. CONCLUSION: This study supports the evidence that carbohydrate, fat, protein and fibre intake are closely related to BMI and WC. The sex differences for dietary intake between obese men and women might reflect the generally higher health consciousness of women. Alcohol intake was only associated with WC, emphasizing the importance of WC as an additional indicator in epidemiological studies. Besides enhancing sports and physical activity, it is necessary to improve the knowledge about nutrition and to promote the well-balanced consumption of wholesome food

Intakes, adequacy, food sources and biomarker status of iron, folate, and vitamin B₁₂ in Māori and non-Māori octogenarians : life and living in advanced age : a cohort study in New Zealand (LiLACS NZ) : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand

Background: Iron, folate and vitamin B12 are the three key nutrients associated with the development of anaemia and have also been associated with the dietary patterns linked to higher malnutrition risk in older adults. Octogenarians may be at increased risk for iron, folate and vitamin B12 deficiency due to reduced food intake. Dietary factors, cooking methods, medications, presence of inflammation, and impaired gastrointestinal absorption may affect the availability and bioavailability of these nutrients. There are currently no specific nutrient reference values (NRVs) or biomarker cut-offs for adults in advanced age and little is known about the relationship between dietary intake and biomarkers for older adults. Aim: To investigate the intake, adequacy, food sources and biomarker status of iron, folate and vitamin B12 and the relationship between dietary intake and biomarkers. Methods: In the follow up assessment of LiLACS NZ, 216 Māori and 362 non-Māori participants completed a detailed dietary assessment using 2x 24-hr multiple pass recalls. Adequacy of iron, folate and vitamin B12 were determined by comparison to the Estimated Average Requirement (EAR) for adults aged 71+ years. Serum ferritin, serum iron, total iron binding capacity, transferrin saturation, red blood cell (RBC) folate, serum folate, serum vitamin B12 and haemoglobin were compared to recognised cut-offs for adults. Generalised linear models and binary regression estimated the association between dietary intake and biomarkers. Results: Most participants had adequate dietary iron intakes (88% Māori; 95% non-Māori above EAR) and biomarkers for iron (>94% above cut-offs). The EAR for vitamin B12 was met by 74% Māori; 78% non-Māori and folate met by 42% Māori; 49% non-Māori. Māori versus non-Māori had higher intakes of vitamin B12 (p=0.038) and serum vitamin B12 (p=0.026). Increased dietary folate intake was associated with increased RBC folate for Māori (p=0.001) and non-Māori (p=0.014) and with increased serum folate for Māori (p215μg/day was associated with reduced risk of deficiency in RBC folate for Māori (p=0.001). Conclusions: Dietary intake and stores of iron are largely adequate in this population. Strategies to optimise the intake and bioavailability of foods rich in folate and vitamin B12 may be beneficial

Spatial variation of salt intake in Britain and association with socioeconomic status

Objectives: To evaluate spatial effects of variation and social determinants of salt intake in Britain. Design: Cross-sectional survey. Setting: Great Britain. Participants: 2105 white male and female participants, aged 19–64 years, from the British National Diet and Nutrition Survey 2000–2001. Primary outcomes: Participants’ sodium intake measured both with a 7-day dietary record and a 24-h urine collection. By accounting for important linear and non-linear risk factors and spatial effects, the geographical difference and spatial patterns of both dietary sodium intake and 24-h urinary sodium were investigated using Bayesian geo-additive models via Markov Chain Monte Carlo simulations. Results: A significant north–south pattern of sodium intake was found from posterior probability maps after controlling for important sociodemographic factors. Participants living in Scotland had a significantly higher dietary sodium intake and 24-h urinary sodium levels. Significantly higher sodium intake was also found in people with the lowest educational attainment (dietary sodium: coeff. 0.157 (90% credible intervals 0.003, 0.319), urinary sodium: 0.149 (0.024, 0.281)) and in manual occupations (urinary sodium: 0.083 (0.004, 0.160)). These coefficients indicate approximately a 5%, 9% and 4% difference in average sodium intake between socioeconomic groups. Conclusions: People living in Scotland had higher salt intake than those in England and Wales. Measures of low socioeconomic position were associated with higher levels of sodium intake, after allowing for geographic location

Exploring the relationship between dietary patterns, eating behaviour and fat taste detection thresholds : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

Background: Dietary pattern analysis provides a unique opportunity to explore combinations of food intake in conjunction with factors known to affect dietary intake. Fat taste sensitivity is an emerging correlate of dietary intake and, when impaired, has a proposed role in the dysregulation of dietary intake and eating behaviours. Aim: To investigate dietary patterns, eating behaviours and fat taste detection thresholds in a group of New Zealand European women aged 19-45 years and identify associations between these factors. Methods: Fifty post-menarche, pre-menopausal New Zealand European (NZE) women, (18-40 years) completed a partially validated, semi-quantiative 220-item food frequency questionnaire and a validated Three-factor eating questionnaire. Height and weight were measured to calculate body mass index (BMI) (kg/m2) and a bioeletrical impedence analysis (BIA) was completed to measure body fat percentage (BF%). During sensory testing protocol participants were exposed to increasing concentrations of ultra-heat treatment (UHT) milk/oleic acid (OA) solutions using the three alternative forced choice method (3-AFC). A naïve OA detection threshold was determined at the point where the participant identified the OA solution correctly three times at the same concentration. Dietary patterns were determined using principal component factor analysis. Associations between dietary pattern scores, taste sensitivity, eating behaviour and baseline characteristics were investigated. Results: Three dietary patterns were identified: ‘unhealthy’, ‘healthy’ and ‘snacking’. Most women had low eating behaviour scores for cognitive restraint (90%) and disinhibition (74%). Hunger scores were comparatively higher, only 40% had low scores. Twenty-three participants (46%) were classified as hypersensitive and 54% were hyposensitive to OA taste. ‘Unhealthy’ pattern scores were inversely associated with cognitive restraint (r=.391, P=.005) and positively associated with age (r=.297, P=.036). ‘Healthy’ pattern scores were positively associated with cognitive restraint (r=.418, P=.003), OA taste detection thresholds (r=0.446, P=.001) and BMI (r=.325, P=.021). Women with low ‘snacking’ pattern scores were significantly older (31.7 years (24.7, 40.4)) than those with moderate scores (24.0 years (22.0, 28.1)) (P=.037). No relationship was found between OA taste detection thresholds and eating behaviour. Conclusion: Participants in this study showed a significant link between habitual dietary intake and measures for eating behaviour and fat taste sensitivity. Both ‘healthy’ and ‘unhealthy’ dietary patterns were associated with one, or both, of these factors. An unexpected positive association between the ‘healthy’ dietary pattern and fat taste sensitivity indicates a need for further investigation to better understand this relationship. Findings from the current study support the use of dietary patterns to better represent habitual intake in future research investigating fat taste sensitivity or eating behaviour. Key words: Habitual intake, dietary intake, fat taste sensitivity, cognitive restraint, disinhibition, hunge

The role of dietary sodium intake on the modulation of T helper 17 cells and regulatory T cells in patients with rheumatoid arthritis and systemic lupus erythematosus

We aimed at investigating whether the frequency and function of T helper 17 (Th17) and regulatory T cells (Treg) are affected by a restriction of dietary sodium intake in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We enrolled RA and SLE patients not receiving drugs known to increase urinary sodium excretion. Patients underwent a dietary regimen starting with a restricted daily sodium intake followed by a normal-sodium daily intake. The timepoints were identified at baseline (T0), after 3 weeks of low-sodium dietary regimen (T3), after 2 weeks of normal-sodium dietary regimen (T5). On these visits, we measured the 24-hour urinary sodium excretion, the frequency and function of Th17 and Treg cells in the peripheral blood, the serum levels of cytokines. Analysis of urinary sodium excretion confirmed adherence to the dietary regimen. In RA patients, a trend toward a reduction in the frequencies of Th17 cells over the low-sodium dietary regimen followed by an increase at T5 was observed, while Treg cells exhibited the opposite trend. SLE patients showed a progressive reduction in the percentage of Th17 cells that reached a significance at T5 compared to T0 (p = 0.01) and an increase in the percentage of Treg cells following the low-sodium dietary regimen at both T1 and T3 compared to T0 (p = 0.04 and p = 0.02, respectively). No significant apoptosis or proliferation modulation was found. In RA patients, we found a reduction at T5 compared to T0 in serum levels of both TGFβ (p = 0.0016) and IL-9 (p = 0.0007); serum IL-9 levels were also reduced in SLE patients at T5 with respect to T0 (p = 0.03). This is the first study investigating the effects of dietary sodium intake on adaptive immunity. Based on the results, we hypothesize that a restricted sodium dietary intake may dampen the inflammatory response in RA and SLE patients

The confusion about dietary fatty acids recommendations for CHD prevention

A recent meta-analysis of prospective cohort studies has not found an association between dietary saturated fat intake and CHD incidence. This funnelled the discussion about the importance of the recommendation to lower the intake of saturated fat for the prevention of CHD. At the same time a document of the European Food Safety Authority has suggested that specific quantitative recommendations are not needed for individual fatty acids but that more general statements can suffice. In this review, we discuss methodological aspects of the absence of association between SFA intake and CHD incidence in prospective cohort studies. We also summarise the results of the controlled dietary experiments on blood lipids and on CHD incidence in which saturated fat was replaced by either cis-unsaturated fat or carbohydrates. Finally, we propose a nutritionally adequate diet with an optimal fatty acid composition for the prevention of CHD in the context of dietary patterns. Such diets are characterised by a low intake of saturated fat, and as low as possible intake of trans-fat and fulfil the requirements for the intake of n-6 and n-3 fatty acids. No recommendation is needed for the intake of cis-MUF

The Asymmetric Effect of Dietary Knowledge on Nutrient Intake In China: Implications for Dietary Education Programs

This paper demonstrates that dietary knowledge can influence nutrient intake differently depending on whether expected food availability is increasing or decreasing. Using data from China, we find that overall dietary knowledge has larger and more statistically significant effects on total calorie intake and the intake of three macro nutrients (carbohydrate, fat, and protein) when expected food availability increases than when it decreases. Without distinguishing the direction of changes in expected food availability, most of the corresponding effects become smaller and statistically insignificant. Thus, the effect of dietary knowledge on nutrient intake might have been underestimated in previous studies. We discuss the implications of these findings for the design and implementation of dietary education programs.Dietary Knowledge, Nutrition, Food, China, Agricultural and Food Policy, Consumer/Household Economics, Food Consumption/Nutrition/Food Safety,

Association between high dietary intake of the n-3 polyunsaturated fatty acid docosahexaenoic acid and reduced risk of Crohn's disease

Background: There are plausible mechanisms for how dietary docosahexaenoic acid (DHA), an n−3 polyunsaturated fatty acid, could prevent Crohn's disease (CD). Aim: To conduct a prospective study to investigate the association between increased intake of DHA and risk of CD. Methods: Overall, 229 702 participants were recruited from nine European centres between 1991 and 1998. At recruitment, dietary intakes of DHA and fatty acids were measured using validated food frequency questionnaires. The cohort was monitored through to June 2004 to identify participants who developed incident CD. In a nested case–control analysis, each case was matched with four controls; odds ratios (ORs) were calculated for quintiles of DHA intake, adjusted for total energy intake, smoking, other dietary fatty acids, dietary vitamin D and body mass index. Results: Seventy-three participants developed incident CD. All higher quintiles of DHA intake were inversely associated with development of CD; the highest quintile had the greatest effect size (OR = 0.07; 95% CI = 0.02–0.81). The OR trend across quintiles of DHA was 0.54 (95% CI = 0.30–0.99, Ptrend = 0.04). Including BMI in the multivariate analysis, due to its correlation with dietary fat showed similar associations. There were no associations with the other dietary fatty acids studied. Conclusion: There were inverse associations, with a biological gradient between increasing dietary docosahexaenoic acid intakes and incident Crohn's disease. Further studies in other populations should measure docosahexaenoic acid to determine if the association is consistent and the hypothesis tested in randomised controlled trials of purely docosahexaenoic acid supplementation

Iodine and pregnancy – a UK cross-sectional survey of dietary intake, knowledge and awareness

Iodine is a key component of the thyroid hormones, which are critical for healthy growth, development and metabolism. The UK population is now classified as mildly iodine-insufficient. Adequate levels of iodine during pregnancy are essential for fetal neurodevelopment, and mild iodine deficiency is linked to developmental impairments. In the absence of prophylaxis in the UK, awareness of nutritional recommendations during pregnancy would empower mothers to make the right dietary choices leading to adequate iodine intake. The present study aimed to: estimate mothers' dietary iodine intake in pregnancy (using a FFQ); assess awareness of the importance of iodine in pregnancy with an understanding of existing pregnancy dietary and lifestyle recommendations with relevance for iodine; examine the level of confidence in meeting adequate iodine intake. A cross-sectional survey was conducted and questionnaires were distributed between August 2011 and February 2012 on local (Glasgow) and national levels (online electronic questionnaire); 1026 women, UK-resident and pregnant or mother to a child aged up to 36 months participated in the study. While self-reported awareness about general nutritional recommendations during pregnancy was high (96 %), awareness of iodine-specific recommendations was very low (12 %), as well as the level of confidence of how to achieve adequate iodine intake (28 %). Median pregnancy iodine intake, without supplements, calculated from the FFQ, was 190 μg/d (interquartile range 144–256μg/d), which was lower than that of the WHO's recommended intake for pregnant women (250 μg/d). Current dietary recommendations in pregnancy, and their dissemination, are found not to equip women to meet the requirements for iodine intake