Dietary trends inteh United States [1] (multiple letters)

The authors reply: To the Editor: Nusbaum and Eshleman suggest that dietary trends may reflect respondents’ adherence to the dietary guidelines of the time. From 1916 to 1976, nutritional recommendations relative to the basic food groups were fairly stable. The basic five food groups of 1916 were reduced to the basic four (two daily servings of milk and of meat, poultry, or eggs and four daily servings of fruits and vegetables and of breads and grains) in the 1960s. Not until the introduction of the U.S. Dietary Goals in 1977 did dietary guidelines explicitly recommend nutrient limitations for fats, sugars, and cholesterol. Neither our group nor others have attempted to quantify the dietary guidelines of the 1960s or to ascertain who followed the guidelines most closely

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18–24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61–0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05–1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85–2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08–1.36), and marriage (aOR 1.55; 95% CI 1.37–1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18–24 vs. 25–32 years)