Reproducibility and comparative validity of a food frequency questionnaire for Australian children and adolescents

Dietary intake during childhood and adolescence is of increasing interest due to its influence on adult health, particularly obesity, cardiovascular disease and diabetes. There is a need to develop and validate dietary assessment methods suitable for large epidemiologic studies of children and adolescents. Limited large scale dietary studies of youth have been undertaken in Australia, due partly to the lack of a suitable dietary intake tool. A self-administered, semi-quantitative food-frequency questionnaire (FFQ), the 'Australian Child and Adolescent Eating Survey' (ACAES), was developed for youth aged 9-16 years. This study evaluated reproducibility and comparative validity of the ACAES FFQ using assisted food records (FRs) as the reference method. The ACAES FFQ was completed twice (FFQ1 and FFQ2) at an interval of 5 months, along with four one-day assisted FRs. Validity was evaluated by comparing the average of the FRs with FFQ2 (n = 113) as well as with the average of FFQ1 and FFQ2 (n = 101). Reproducibility was evaluated by comparing FFQ1 and FFQ2 (n = 101). The two methods were compared using correlations, Kappa statistics and Bland-Altman plots. Correlation coefficients for comparative validity ranged from 0.03 for retinol to 0.56 for magnesium for transformed, energy-adjusted, deattenuated nutrient data, with correlation coefficients greater than 0.40 for total fat, saturated fat, monounsaturated fat, carbohydrate, sugars, riboflavin, vitamin C, folate, beta-carotene, magnesium, calcium and iron. Correlation coefficients for reproducibility ranged from 0.18 for vitamin A to 0.50 for calcium for transformed, energy-adjusted, deattenuated nutrient data. The ACAES FFQ ranked individuals reasonably accurately, with the comparative validity analysis showing that over 50% of participants were classified within one quintile for all nutrients, with only a small percentage grossly misclassified (0-7%). The ACAES FFQ is the first child and adolescent specific FFQ available for ranking the dietary intakes of Australian children and adolescents for a range of nutrients in epidemiologic research and public health interventions

Energy and macronutrient intakes in preschool children in urban areas of Ho Chi Minh City, Vietnam

Background: An increasing prevalence of overweight and obesity has been documented in preschool children in Ho Chi Minh City (HCMC), Vietnam. However, little is known about what preschool children in HCMC eat or how well their nutrient intake meets nutrient recommendations. This study aims to describe the energy and macronutrient intake and compare these nutrient intakes with the recommendations for Vietnamese children aged four to five years. Methods: The data comes from the baseline measurement of a one year follow-up study on obesity in 670 children attending kindergartens in HCMC. Dietary information for each child at the school and home settings was collected using Food Frequency Questionnaires (FFQs), by interviewing teachers and parents or main caregivers. The average energy and nutrient intake in a day was calculated. The proportion of children with energy intake from macronutrients meeting or exceeding the recommendations was estimated based on the 2006 recommended daily allowance (RDA) for Vietnamese children in this age group. Results: The dietary intake of the participants contained more energy from protein and fat, particularly animal protein and fat, and less energy from carbohydrates, than the RDA. Most children (98.1%) had mean energy intake from protein greater than the recommended level of 15%, and no child obtained energy from animal fat that was in accordance with the recommendation of less than 30% of the total fat intake. Nearly one half of children (46.5%) consumed less than the advised range of mean energy intake from carbohydrate (60%–70%). Conclusion: In this preschool child population in HCMC, in which obesity is emerging as major public health problem, there is an imbalance in dietary intake. Healthy eating programs need to be developed as a part of an obesity prevention program for young children in HCMC

The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: A cross-sectional study

© 2016 Fisher et al. Background: To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. Methods: Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. Results: The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p < 0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p < 0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p < 0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p < 0.05). Conclusions: There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life

The use of complementary and alternative therapies by patients with cancer

The aim of this research was to assess the prevalence and predictors of complementary and alternative therapy (CAT) use among cancer patients in Australia. A total of 1492 cancer patients attending nine major public cancer treatment centers in New South Wales, Australia, were asked to complete the Supportive Care Needs Survey. Of the 1354 consenting patients, 888 (65%) returned a completed survey. This article reports the secondary analyses of the survey data, specifically focusing on CAT use. For all cancers, 17.1% of patients were using at least one CAT. The two main demographic characteristics of CAT users were gender and age, where females were more likely to use CAT than males and that CAT use declined as age increased. Time since diagnosis was identified as the only significant clinical predictor of CAT use, where CAT use increased with time until 5 years since diagnosis. Our research shows that herbal treatments and naturopathy are the most popular CAT used by cancer patients (constituting over 30% of all CAT use recorded). The use of CAT among cancer patients is a significant issue in cancer care, especially considering the potential interactions between CAT and conventional medicines. Given that many cancer patients may not be aware of potential risks associated with these interactions it is important that oncologists and others involved in cancer patient care are informed about CAT and its use amongst their patients

A longitudinal analysis of mid-age women's use of complementary and alternative medicine (CAM) in Australia, 1996-1998

Complementary and Alternative Medicine (CAM) has become increasingly popular amongst healthcare consumers world-wide. As such, CAM is now an important public health issue with taking non-prescription medications. This paper constitutes an exploratory investigation into CAM use over time. As such, there is need for further research to provide in-depth examination of the adoption and relinquishment of CAM use over a longer time period. serious implications for healthcare organization and delivery. While previous studies have provided a profile of CAM users, there remains very limited analysis of CAM consumption over time. The purpose of this paper is to describe the changing use of CAM practitioners over time by 11,454 mid-age women in the Australian Longitudinal Study on Women's Health. Over the study period (1996-1998), 10% of women adopted the use of CAM and 9% relinquished CAM. The predominant factor found to be predictive of CAM adoption was changes in health status. Specifically, those women experiencing more illness over time are more likely to adopt CAM than those experiencing no change or better health. CAM relinquishment was associated with use of non-prescription medications, where women were more likely to relinquish CAM if they never used non-prescription medications or if they stopped

The relationship between psychiatric illnesses and skin disease: a longitudinal analysis of young Australian women

Objective: To examine longitudinally the relationship between skin disease and psychological morbidity in young women, testing the hypothesis that psychological morbidity (depression, anxiety, and stress) is a factor in the causation of skin disease. Design: The Australian Longitudinal Study on Women's Health was designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. Data from 3 surveys (conducted in 2000, 2003, and 2006) were analyzed. Multivariate longitudinal generalized estimating equation models, with and without time lag, were used to determine significant factors associated with skin disease (including anxiety, depressive symptoms, and stress). Setting: An Australian community-based study. Participants: Women, aged 22 to 27 years at the time of the first survey, were randomly selected from the Australian National Medicare database. Participant numbers for the surveys from the years 2000, 2003, and 2006 were 9688, 9081, and 8910, respectively. Main Outcome Measures: Outcome measures were the scores from the Center for Epidemiologic Studies Depression Scale, the Perceived Stress Questionnaire for Young Women, and an item to elicit reporting of anxiety symptoms. Results: Of 6630 women providing data on skin diseases on all 3 surveys, 8.0% (n = 523) reported having skin problems on all 3 occasions; 12.1% (n = 803) on 2 occasions; and 23.9% (n = 1582) on 1 occasion. On the 2000, 2003, and 2006 surveys, prevalence of skin problems was 24.2%, 23.9%, and 24.3%, respectively. In the generalized estimating equation models, depression symptoms and stress (but not anxiety) were significantly associated with skin problems (P < .005). Conclusion: The findings of this relationship of depression and stress to skin disease may have considerable clinical implications, including implications for adjunctive psychological interventions in the management of patients with skin disease