Dental health of Spanish children: an investigation in primary care

The oral hygiene of patients between seven and 14 years old from a health centre in Toledo was studied through case-finding from March to December 1987. A total of 304 interviews were held; bad dental care (frequency of teeth brushing with fluoride toothpaste less than once per day and/or daily consumption of chocolate and sweets) was found in 83%, and caries were diagnosed through inspection in 92% of the patients. Seventy three per cent reported washing their teeth only occasionally or never; 40% consumed sweets daily; 53% had never visited the dentist; and 50% had not received preventive care for dental disease. These results contrast with those from the United Kingdom and other developed countries, indicating a precarious state of dental health in Spain, a fact which should be taken into account by the Spanish health organization when comparing the health levels between different countries.     

Acculturation and dietary habits of Korean Americans

This is the first study to investigate how food and nutrient intakes vary with the levels of acculturation of Korean Americans using a dietary assessment tool tested for validity and reliability. The respondents were Korean Americans (n 486) resident in the Greater New York metropolitan area, USA. They were divided into two groups according to the total score of acculturation: low- and high-acculturated groups. Using a food-frequency questionnaire and a modified Suinn-Lew Asian self-identity acculturation scale, differences in the frequencies of food items, food groups and nutrient intakes consumed were analysed by level of acculturation. The low-acculturated group tended to consume significantly more rice, mixed rice, soyabean paste chigae (pot stew), saengsun (fish) chigae, kimchi chigae, other fish broiled or baked, eggs, kimchi, spinach, persimmons, and white or brown sugar in coffee or tea. The high-acculturated group demonstrated a statistically greater tendency to consume bread, cereal, spaghetti, ham, green salad, sweetcorn, chocolate, candies and diet soft drinks. The more acculturated an individual, the more significant was the tendency to consume sweets. The more acculturated group had significantly (P<0.05) higher intakes of % energy from total fat, thiamin, vitamin E and folate, while the low-acculturated group consumed greater amounts of Na, niacin and dietary fibre. The information from the present study can be used to describe dietary habits according to various aspects of acculturation, and allows a better understanding of the dynamics of acculturation and dietary habits.     

Coronary heart disease incidence in diabetic patients,and its relationship to general risk factors

The five-year incidence of coronary heart disease (CHD) was examined in middle-aged diabetics (54 insulin-dependent — IDDM, 152 non-insulin-dependent — NIDDM) and 105 controls. In comparison to the controls, CHD incidence was higher only in IDDM patients (11.5 vs 4.0%), but the difference was not a significant one. CHD incidence cases in both IDDM and NIDDM groups were significantly related with longer duration of the disease and, when IDDM patients are concerned, with higher diastolic blood pressure.     

The use of sweets as rewards in schools

Personal interviews with headteachers and survey questionnaires from school staff were used to determine the extent of the use of sweets as rewards in six mainstream infant and junior and two special schools (for children with physical and behavioural difficulties) in Calderdale. The 96 questionnaires returned indicated that 41% of teachers used sweets as rewards occasionally and 3% used them often, with use markedly higher in special schools. Nine per cent of special school staff ranked sweets the most effective reward. Sweets were more likely to be given to children aged 5–7 years. Other uses of sweets included use to calm upset children by 7% of staff, and on special occasions such as birthdays and Christmas (83%). Policies on the consumption of sweets from home varied from an outright ban to no policy. The use of sweets as rewards is established as common practice in these Calderdale schools. This needs to be questioned in view of the risks to psychological health from the promotion of the association of sweets with achievement and comfort, and the risks to dental health from encouraging the eating of sweets.     

Nutritional Behaviors,Vitamin Supplementation and Physical Activity among Polish Adults during the COVID-19 Pandemic

The COVID-19 pandemic and its consequences, including social isolation, movement restrictions and work instability have altered many people’s nutritional behaviors and daily lifestyle. The aim of the study was to evaluate the influence of the COVID-19 pandemic on selected eating habits, physical activity and daily lifestyle changes of Polish adults (n = 145). The self-designed and anonymous questionnaire was available online from the 1 May 2021 to the 15 May 2021. In general, 60% of respondents declared that the COVID-19 pandemic did not affect their dietary habits, whereas 26% of surveyed individuals answered in the affirmative. The effect of the COVID-19 pandemic on changing dietary habits was differentiated by age (Pearson’s χ² = 12.604; p = 0.0134). The number of meals consumed by respondents per day differed across gender groups (Pearson’s χ² = 9.653; df = 4; p = 0.0466). An increase in body weight during the COVID-19 pandemic was reported by 43% of women and 7.6% of surveyed men. Additionally, hybrid working women declared most often an increase in body mass independent of age, education level and living place. Moreover, the majority of respondents who reported the effect of the pandemic on changing dietary habits also declared more frequent sweets consumption. The study revealed that respondents who stated more frequent sweets consumption during the COVID-19 pandemic were more likely associated with an increase in body mass (OR = 6.75, 95% CI, 6.75–91.25). No increase in the consumption of vitamin D, C and Mg supplements and pickled products was found.     

Cravings and aversions of pregnant adolescents.

Adolescents from 31 eastern Tennessee counties were interviewed during the third trimester of pregnancy (n = 97) and at 1-year postpartum (n = 64) to assess cravings and aversions, beliefs about dietary cravings, and how these factors influence dietary intake. Characteristics of cravings and aversions were assessed using a semistructured interview. Beliefs about cravings during pregnancy were measured with a 13-item Likert-type scale (alpha = 0.79). Two 24-hour recalls and 2 days' food records provided dietary data. Most adolescents (86%) reported cravings during pregnancy. They most frequently reported cravings for sweets, especially chocolate; fruits and fruit juices; fast foods; pickles; ice cream; and pizza. Many participants (66%) experienced aversions during pregnancy toward previously liked foods. The most common aversions were to meats, eggs, and pizza. Fewer cravings and aversions were noted during the first year postpartum. No significant relationship existed between craving and aversions and belief scores. Adolescents craving sweets during pregnancy consumed more sugar and energy than those who did not crave sweets. Cravings generally resulted in increased intake, and aversions led to decreased food consumption. On the basis of these results, we suggest that nutritional assessment of pregnant adolescents include questions about cravings and aversions.     

"Chocolate Addiction": a Preliminary Study of its Description and its Relationship to Problem Eating

Definitions of chocolate addiction and its potential relationship to dieting and problem eating were investigated in 50 individuals who identified themselves as "chocoholics". Respondent were interviewed and completed a battery of questionnaires on food cravings, eating, weight, dieting and depression. On average this sample consumed about 12 (60-g) bars of chocolate per week and craved chocolate about six times per week. Cravings and amount consumed were not significantly related but amount consumed was significantly correlated with disinhibition (r=0·3). Most (76%) respondents had definition of chocolate addiction that centred on a lack of control around chocolate and regarded the "addictive" factor in chocolate as orosensory (i.e. taste, smell, texture). Unlike most others, dieters and secret eaters experienced negative affect following consumption of chocolate. Consumers who preferred to eat in secret reported a higher degree of aberrant eating. The extent to which the behaviour of "chocolate addicts" resembles that of eating disordered individuals and other addictions remains to be clarified.     

Quality of Diets Consumed by Older Rural Adults

Older adults residing in rural communities are at risk for low dietary quality because of a variety of social, physical and environmental circumstances. Minority elders are at additional risk because of poorer health status and lower socioeconomic status. This study evaluated the food group intake of 130 older (>70 years) African American (34%), European American (36%), and Native American (30%) residents of two rural communities in central North Carolina. An interviewer-administered food frequency questionnaire was used to measure dietary intake. Food items were classified into food groups similar to the United States Department of Agriculture (USDA) Food Guide Pyramid and the National Cancer Institutes 5 A Day for Better Health program. None of the survey participants met minimum intake recommendations and most over-consumed fats, oils, sweets and snacks. African Americans and Native Americans consumed fewer servings of meats,fruits and vegetables, and fats, oils, sweets and snacks than European Americans. African American men consumed the fewest servings of fruits and vegetables of all gender/ethnic groups. Consumption of fats, oils and sweets was greatest among those 85 years and older and was more common among denture users. National strategies to educate the public about the importance of consuming a varied diet based on the recommendations presented in national nutrition education campaigns may not be reaching older adults in rural communities, particularly minority group members.     

Management of diabetic patients requiring nutritional support.

A retrospective analysis was performed on 70 patients with diabetes mellitus who required nutritional support over the 10-yr period 1979-1989. Information was available for 65 patients, of whom 55 had non-insulin-dependent diabetes mellitus (NIDDM). Enteral nutrition (EN, 750-2200 kcal/day) was given to 40 NIDDM patients (group A) and 6 insulin-dependent diabetic (IDDM) patients (group B), and parenteral nutrition (PN, 1600-2400 kcal/day) was given to 18 NIDDM patients (group C) and 4 IDDM patients (group D). Three NIDDM patients required both types of feeding. Preadmission diabetes treatment remained the same during feeding for 31% of the total group (38% of group A, 33% of group B, 23% of group C, and 0% of group D). The NIDDM patients in group C who received insulin during PN required a high daily dose of approximately 100 U. The IDDM patients on PN required an increase of 225% from their preadmission daily dose. The likelihood of a patient requiring a major change from preadmission diabetes therapy depended mainly on the severity of the underlying illness and on the type of feeding (greater with PN) but not on preadmission therapy, age of patient, or type of EN (cyclic vs. continuous). Hypoglycemic episodes were uncommon in all groups. There were no significant differences between the prefeeding and feeding blood glucose levels and HbA1c results.     

Low glycemic response to traditionally processed wheat and rye products: bulgur and pumpernickel bread

To look at the effect of processing wheat and rye on blood glucose responses with special reference to bulgur and pumpernickel bread, groups of 9-12 Noninsulin-dependent (NIDDM) and 5-6 Insulin-dependent diabetic volunteers (IDDM) were fed test meals containing 50 g carbohydrate portions of four wheat and three rye products. Glycemic indices for IDDM and NIDDM combined, calculated as the incremental area under the blood glucose response curve, where white bread = 100, demonstrated values of 96 +/- 5 for wholemeal wheat bread, 89 +/- 6 for wholemeal rye bread, 78 +/- 3 for pumpernickel bread, 65 +/- 4 for bulgur, 63 +/- 6 for whole wheat kernels and 48 +/- 5 for whole rye kernels. Results for IDDM and NIDDM were similar (r = 0.96, p less than 0.01). It is concluded that traditional processing of cereals, such as parboiling (bulgur) or the use of wholegrains in bread (pumpernickel) may result in the low GI value associated with the unmilled cereal. Cereal foods processed in these ways may form a useful part of the diet where a reduction in postprandial glycemia is required.     

Kiwis, food and cholesterol: New Zealand consumers' food concerns and awareness of nutritional guidelines.

New Zealand food shoppers' nutrition and food concerns and attitudes to cholesterol screening were assessed during four consecutive surveys. Over 1000 shoppers were interviewed during each survey, as part of the evaluation of the Heart Food Festival in 1988-89. Over two thirds of the respondents reported that they usually read the ingredients label on food products. Over a third were concerned about the presence of additives in foods (36 per cent), along with fat (27 per cent), salt (18 per cent), sugar (14 per cent) and fibre (5 per cent). Over half indicated that reductions in fat intake would make their diets healthier. One in five reported they were aware of the New Zealand nutrition guidelines. Only one third of respondents could correctly identify the bottom row of the healthy food pyramid. Almost one in eight respondents knew their cholesterol levels and a further two thirds wished to know them. Few differences were observed between the responses of early and late school leavers. In contrast, pronounced differences were associated with gender and the respondents' age groups. The results suggest that awareness of links between nutrition and heart disease is widespread. Educational and empowerment strategies are required to translate such awareness into dietary change.     

Health awareness and life-style practices of employees in extended-care facilities

From six extended-care facilities, 306 employees responded to a questionnaire on perceived life-style. Most respondents were female, married, and under age 35. The majority had had recent blood pressure checks, seldom missed work because of infections, made time for leisure activities, and felt secure in their jobs. Overall, the percentage of smokers was slightly below the national average, but 45% of the technical employees smoked. Perception of overweight and skipped meals increased with level of education. Consumption of fried foods and sweets decreased with the level of education while fiber intake increased. More skilled and technical employees than professional employees consumed milk products. Less than half of any employee group consumed excessive amounts of coffee or colas. Few study participants consumed alcohol. Very few members of any group consumed meals away from home five or more times per week. Less than half of all employees believed that they received enough exercise; one-third or less exercised regularly. A greater percentage of technical employees than of the other two employee groups expressed interest in improving health through physical fitness and class sessions.     

Lebensmittelverzehr bei Kindern und Jugendlichen in Deutschland

Since dietary behaviour has an essential impact on health, information on food consumption was obtained in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The average food frequency and portion size "in recent weeks" was assessed with a food frequency questionnaire. Two versions of the questionnaire, identical in content, exist: one aimed at parents of 1-10-year-olds and the other directly at 11-17-year-olds. The results include data on 7,186 boys and 6,919 girls, aged 3-17. About half of the participants each consume bread, milk and fresh fruits every day. The majority (about three quarter) eat fast food only once a month or less. However, 16 % of the participants eat chocolate, and almost 20 % other sweets every day. More boys than girls individually consume soft drinks, milk, dairy products, meat, sausage, cereals and white bread every day. More girls consume fresh fruits and raw vegetables each day. With increasing age the proportion of daily consumers of soft drinks, cheese (and among boys also meat and sausage) increases, but the proportion of daily consumers of juices, tap water, milk, dairy products, fresh fruits, raw vegetables, cookies, chocolate, sweets (and among girls also breakfast cereals) falls. As expected the consumption of sweets and soft drinks is relatively high. Whereas more than half of the children each consume fruits and vegetables on a daily base, this consumption declines with increasing age.     

Kiwis,food and cholesterol: New Zealand consumers' food concerns and awareness of nutritional guidelines

Abstract: New Zealand food shoppers' nutrition and food concerns and attitudes to cholesterol screening were assessed during four consecutive surveys. Over 1000 shoppers were interviewed during each survey, as part of the evaluation of the Heart Food Festival in 1988-89. Over two thirds of the respondents reported that they usually read the ingredients label on food products. Over a third were concerned about the presence of additives in foods (36 per cent), along with fat (27 per cent), salt (18 per cent), sugar (14 per cent) and fibre (5 per cent). Over half indicated that reductions in fat intake would make their diets healthier. One in five reported they were aware of the New Zealand nutrition guidelines. Only one third of respondents could correctly identify the bottom row of the healthy food pyramid. Almost one in eight respondents knew their cholesterol levels and a further two thirds wished to know them. Few differences were observed between the responses of early and late school leavers. In contrast, pronounced differences were associated with gender and the respondents' age groups. The results suggest that awareness of links between nutrition and heart disease is widespread. Educational and empowerment strategies are required to translate such awareness into dietary change.     

Nutrient and food intake in obese women on a low-fat or low-calorie diet

The low-fat group consumed significantly fewer calories from fat and more calories from carbohydrate at both 6 and 12 months than the low-calorie group, but their fat intake was still about twice their goal at both 6 months (39 gm per day) and 12 months (46 gm per day). The low-calorie group achieved their fat goal of 30% of calorie intake, but they consumed from 300 to 700 kcal more than their calorie goal. Caloric intake, physical activity, palatability, satiety, quality of life, and weight loss were not significantly different by treatment. Two studies, which gave patients hypocaloric diets of varying fat and carbohydrate content (fat calories 10% to 45%) for from 10 to 12 weeks, found no effect of diet composition on weight loss. In addition, one study, which gave patients a low-fat, energy-unrestricted diet (fat calories 19%), reported a weight loss of 10.1 lb at 16 to 20 weeks and 5.7 lb at 9 to 12 months, which is similar to that seen in the low-fat group in the this study. Most of the decrease in fat intake (90%) in the low-fat group resulted from a reduction in intake of fat from fat and oils; meat, fish, and poultry; dairy products; and sweets. The dietary changes in the low-fat group are consistent with those found in one study, which prescribed a 15% fat calorie diet to women with breast cancer. Intake of vitamin C increased in the low-fat group and decreased in the low-calorie group. This difference was significant and was caused by an increased intake of fruits and vegetables in the low-fat group and a decreased consumption of fruits in the low-calorie group. Calcium intake decreased significantly more in the low-calorie group because of a decreased intake of dairy foods.     

The glycemic index: similarity of values derived in insulin-dependent and non-insulin-dependent diabetic patients

To see whether relative differences in the glycemic responses to different foods were similar in insulin-dependent (IDDM) and non-insulin-dependent diabetic patients (NIDDM) we determined the glycemic index (GI) of a total of 20 foods and mixed test meals in groups of IDDM and NIDDM volunteers. The mean GI values ranged from 32 in NIDDM and 41 in IDDM (pearled barley) to 105 in NIDDM and 111 in IDDM (bread with cheese and tomato). The correlation between the mean GI values in IDDM and NIDDM was highly significant (r = 0.927, p less than 0.001). The mean GI values for 15 of the 20 test meals was greater in IDDM than in NIDDM (mean of GI for all 20 foods, 76 in IDDM compared with 68 in NIDDM, p less than 0.005). However, the difference in GI between IDDM and NIDDM was t statistically significant for 19 of the 20 individual test meals. Greater within-individual variability of glycemic responses in IDDM probably accounts for the slightly greater mean GI value seen in IDDM compared with NIDDM. The addition of 32 g cheddar cheese to four foods which were also fed without cheese had no significant effect on the GI in NIDDM (mean GI of 68 without cheese compared with 72 for the meals with cheese), but had a small effect in IDDM where the mean GI was increased from 72 to 87 (p less than 0.05). However, despite small increases in glycemic response to foods with added cheese, the relative differences between foods were unaffected by the addition of cheese in both IDDM and NIDDM. It is concluded that mean GI values for foods are very similar in IDDM and NIDDM patients.     

The glycemic index: similarity of values derived in insulin-dependent and non-insulin-dependent diabetic patients.

To see whether relative differences in the glycemic responses to different foods were similar in insulin-dependent (IDDM) and non-insulin-dependent diabetic patients (NIDDM) we determined the glycemic index (GI) of a total of 20 foods and mixed test meals in groups of IDDM and NIDDM volunteers. The mean GI values ranged from 32 in NIDDM and 41 in IDDM (pearled barley) to 105 in NIDDM and 111 in IDDM (bread with cheese and tomato). The correlation between the mean GI values in IDDM and NIDDM was highly significant (r = 0.927, p less than 0.001). The mean GI values for 15 of the 20 test meals was greater in IDDM than in NIDDM (mean of GI for all 20 foods, 76 in IDDM compared with 68 in NIDDM, p less than 0.005). However, the difference in GI between IDDM and NIDDM was t statistically significant for 19 of the 20 individual test meals. Greater within-individual variability of glycemic responses in IDDM probably accounts for the slightly greater mean GI value seen in IDDM compared with NIDDM. The addition of 32 g cheddar cheese to four foods which were also fed without cheese had no significant effect on the GI in NIDDM (mean GI of 68 without cheese compared with 72 for the meals with cheese), but had a small effect in IDDM where the mean GI was increased from 72 to 87 (p less than 0.05). However, despite small increases in glycemic response to foods with added cheese, the relative differences between foods were unaffected by the addition of cheese in both IDDM and NIDDM. It is concluded that mean GI values for foods are very similar in IDDM and NIDDM patients.     

Effects of conventional sucrose-based, fructose-based and isomalt-based chocolates on postprandial metabolism in non-insulin-dependent diabetics.

Milk chocolate is rich in both sucrose and fat, and is therefore considered unsuitable for diabetics. Nevertheless there is little information on the metabolic effects of conventional chocolate or specialized formulations with reduced sucrose content. In the present study six male non-insulin-dependent diabetes mellitus patients (age range 35-60 years; body-mass index less than 28) consumed test meals of chocolate (75 g) on three separate occasions. The control chocolate contained sucrose (45.5% w/w); the test chocolates contained either fructose (45.5% w/w) or isomalt (45.1% w/w). The latter is a sweet disaccharide alcohol which has no glycaemic effect when consumed as a pure compound. Venous blood samples were obtained at 30 min intervals for 5 h, and analysed for glucose, insulin, lactate and triglycerides. All three chocolates provoked a sustained rise in blood glucose, which reached a maximum at 90 min after ingestion and returned to baseline values by 5 h. The highest blood glucose levels occurred after conventional chocolate, and differences were statistically significant at 60 and 90 min (P less than 0.05). The area under the glycaemic curve for isomalt chocolate was 36% smaller than that for conventional chocolate (P less than 0.05), and there were differences in insulin and lactate levels, consistent with the lower glycaemic effect. The glycaemic response to the fructose-based chocolate was also lower than that to control chocolate but the difference was not significant. All three chocolates led to a similar sustained rise in serum triglyceride levels. Isomalt appears to be a palatable alternative sweetener capable of reducing the glycaemic effect of diabetic confectionary.     

Nutritive value of traditional sweets consumed in the Arab Gulf countries

Proximate, mineral, fatty acid and cholesterol composition of eight traditional sweets commonly consumed in the Arab Gulf countries were determined. Four sweets were obtained from Bahrain, whereas the other sweets were obtained from Oman. Protein level ranged from 0.2 to 9.0%, while the fat content ranged from 7.9 to 18.0%. In general, the sweets were found to be high in energy content but poor in most minerals. Iron and zinc contents were low (less than 2 and less than 1 mg/100 g for iron and zinc, respectively). Cholesterol was high in four sweets (range from 10.6 to 20.4 mg/100 g), mainly because of the use of animal fat in preparation of these sweets. The fatty acids profiles showed that palmitic and oleic acids were predominant. One sweet (eggbaith) was found to be very high in linoleic (42%) and low in palmitic (9.6%) acids. The study showed that some traditional sweets are nutritious, while others should be consumed with moderation.     

Nutritive value of traditional sweets consumed in the Arab Gulf countries

Proximate, mineral, fatty acid and cholesterol composition of eight traditional sweets commonly consumed in the Arab Gulf countries were determined. Four sweets were obtained from Bahrain, whereas the other sweets were obtained from Oman. Protein level ranged from 0.2 to 9.0%, while the fat content ranged from 7.9 to 18.0%. In general, the sweets were found to be high in energy content but poor in most minerals. Iron and zinc contents were low (less than 2 and less than 1 mg/100 g for iron and zinc, respectively). Cholesterol was high in four sweets (range from 10.6 to 20.4 mg/100 g), mainly because of the use of animal fat in preparation of these sweets. The fatty acids profiles showed that palmitic and oleic acids were predominant. One sweet (eggbaith) was found to be very high in linoleic (42%) and low in palmitic (9.6%) acids. The study showed that some traditional sweets are nutritious, while others should be consumed with moderation.