Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake

Objectives: The energy density (ED) of the diet is considered an important determinant of total energy intake and thus energy balance and weight change. We aimed to compare relationships between ED and macronutrient content in individual food and beverage items as well as population diet in a typical Western country. Design: Nutrient data for 3673 food items and 247 beverage items came from the Australian Food and Nutrient database (AusNut). Food and beverage intake data came from the 1995 Australian National Nutrition Survey (a 24-h dietary recall survey in 13 858 people over the age of 2). Relationships between ED and macronutrient and water content were analysed by linear regression with 95% prediction bands. Results: For both individual food items and population food intake, there was a positive relationship between ED and percent energy as fat and negative relationships between ED and percent energy as carbohydrate and percent water by weight. In all cases, there was close agreement between the slopes of the regression lines between food items and dietary intake. There were no clear relationships between ED and macronutrient content for beverage items. Carbohydrate (mostly sucrose) contributed 91, 47, and 25% of total energy for sugar-based, fat-based, and alcohol-based beverages respectively. Conclusions: The relationship between ED and fat content of foods holds true across both population diets and individual food items available in the food supply in a typical Western country such as Australia. As high-fat diets are associated with a high BMI, population measures with an overall aim of reducing the ED of diets may be effective in mediating the growing problem of overweight and obesity

Use of vitamin supplements and risk of total cancer and cardiovascular disease among the Japanese general population: A population-based survey

<p>Abstract</p> <p>Background</p> <p>Despite the popular use of vitamin supplements and several prospective cohort studies investigating their effect on cancer incidence and cardiovascular disease (CVD), scientific data supporting their benefits remain controversial. Inconsistent results may be partly explained by the fact that use of supplements is an inconsistent behavior in individuals. We examined whether vitamin supplement use patterns affect cancer and CVD risk in a population-based cohort study in Japan.</p> <p>Methods</p> <p>A total of 28,903 men and 33,726 women in the Japan Public Health Center-based Prospective Study cohort, who answered questions about vitamin supplement use in the first survey from 1990-1994 and the second survey from 1995-1998, were categorized into four groups (never use, past use, recent use, and consistent use) and followed to the end of 2006 for cancer and 2005 for CVD. Sex-specific hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to describe the relative risks of cancer and CVD associated with vitamin supplement use.</p> <p>Results</p> <p>During follow-up, 4501 cancer and 1858 CVD cases were identified. Multivariate adjusted analysis revealed no association of any pattern of vitamin supplement use with the risk of cancer and CVD in men. In women, consistent use was associated with lower risk of CVD (HR 0.60, 95% CI 0.41-0.89), whereas past (HR 1.17, 95% CI 1.02-1.33) and recent use (HR 1.24, 95% CI 1.01-1.52) were associated with higher risk of cancer.</p> <p>Conclusions</p> <p>To our knowledge, this is the first prospective cohort study to examine simultaneously the associations between vitamin supplement use patterns and risk of cancer and CVD. This prospective cohort study demonstrated that vitamin supplement use has little effect on the risk of cancer or CVD in men. In women, however, consistent vitamin supplement use might reduce the risk of CVD. Elevated risk of cancer associated with past and recent use of vitamin supplements in women may be partly explained by preexisting diseases or unhealthy background, but we could not totally control for this in our study.</p

An economic evaluation of adaptive e-learning devices to promote weight loss via dietary change for people with obesity.

BACKGROUND: The prevalence of obesity is over 25 % in many developed countries. Obesity is strongly associated with an increased risk of fatal and chronic conditions such as cardiovascular disease and type 2 diabetes. Therefore it has become a major public health concern for many economies. E-learning devices are a relatively novel approach to promoting dietary change. The new generation of devices are 'adaptive' and use interactive electronic media to facilitate teaching and learning. E-Learning has grown out of recent developments in information and communication technology, such as the Internet, interactive computer programmes, interactive television and mobile phones. The aim of this study is to assess the cost-effectiveness of e-learning devices as a method of promoting weight loss via dietary change. METHODS: An economic evaluation was performed using decision modelling techniques. Outcomes were expressed in terms of Quality-Adjusted Life-Years (QALYs) and costs were estimated from a health services perspective. All parameter estimates were derived from the literature. A systematic review was undertaken to derive the estimate of relative treatment effect. RESULTS: The base case results from the e-Learning Economic Evaluation Model (e-LEEM) suggested that the incremental cost-effectiveness ratio was approximately £102,000 per Quality-Adjusted Life-Year (QALY) compared to conventional care. This finding was robust to most alternative assumptions, except a much lower fixed cost of providing e-learning devices. Expected value of perfect information (EVPI) analysis showed that while the individual level EVPI was arguably negligible, the population level value was between £37 M and £170 M at a willingness to pay between £20,000 to £30,000 per additional QALY. CONCLUSION: The current economic evidence base suggests that e-learning devices for managing the weight of obese individuals are unlikely to be cost-effective unless their fixed costs are much lower than estimated or future devices prove to be much more effective

Validação de um questionário de freqüência de consumo alimentar para população adulta Validation of a food frequency questionnaire for the adult population

OBJETIVO: Investigar a validade e a reprodutibilidade de um questionário de freqüência de consumo alimentar desenvolvido para a população adulta. MÉTODOS: Foram entrevistados, em três momentos, 69 indivíduos, de ambos os sexos, freqüentadores de restaurantes industriais em dois órgãos públicos de Brasília, Distrito Federal. Na primeira e terceira entrevistas foram aplicados um recordatório 24 horas e um questionário de freqüência de consumo alimentar, e na segunda entrevista, um recordatório 24 horas. A duração média do estudo foi de 181 dias. Macronutrientes, vitaminas A e C, cálcio, ferro, zinco, colesterol, fibras e energia total foram analisados utilizando-se os coeficientes de correlação intraclasse e de Pearson, este último na forma bruta e deatenuada. RESULTADOS: Quanto à reprodutibilidade, o questionário de freqüência de consumo alimentar obteve desempenho adequado, apresentando resultados acima de 0,7 para lipídeo, colesterol, energia e proteína. Para a validade, os melhores coeficientes deatenuados foram observados para vitamina C (r=0,66), ferro (r=0,58), proteína (r=0,55) e carboidrato (r=0,55) e os piores, para colesterol (r=0,32) e vitamina A (r=0,37). CONCLUSÃO: A obtenção de coeficientes de correlação expressivos para alguns nutrientes indica que este questionário de freqüência de consumo alimentar constitui-se em um bom instrumento de pesquisa para estudos epidemiológicos em população adulta, podendo fornecer informações importantes para a implementação de ações na área de saúde e nutrição.<br>OBJECTIVE: The aim of the present study was to investigate the validity and reproducibility of a food frequency questionnaire developed for the adult population. METHODS: Sixty-nine individuals from both genders who attended industrial restaurants from two government divisions in Brasília, Federal District, Brazil, were interviewed on three different occasions. In the first and third interviews, a 24h recall and a food frequency questionnaire were applied, and in the second interview only a 24h recall was applied. The study lasted 181 days. Macronutrients, vitamins A and C, calcium, iron, zinc, cholesterol, fibers and total energy were analyzed using the intraclass and Pearson's correlation coefficients, this last one in a crude and deattenuated manner. RESULTS: Regarding reproducibility, the food frequency questionnaire provided adequate results, presenting correlation coefficients above 0.7 for lipid, cholesterol, energy and protein. For validity, the best deattenuated coefficients were observed for vitamin C (r=0.66), iron (r=0.58), protein (r=0.55) and carbohydrate (r=0.55) and the worst for cholesterol (r=0.32) and vitamin A (r=0.37). CONCLUSION: The expressive correlation coefficients obtained for some nutrients indicates that this food frequency questionnaire constitutes a good research instrument for epidemiological studies in the adult population, as it can supply important dietary information allowing the implementation of actions in the health and nutrition areas