Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate

Dietary patterns are important in the prevention of chronic disease; however, there are few studies that include repeat measures of dietary patterns. The objective of this study was to assess the relations between dietary patterns during adult life (at ages 36, 43, and 53 y) and risk factors for chronic disease at age 53 y. Participants of a longitudinal study of health completed a 5-d food diary at 3 occasions during adult life (n = 1265). Factor analysis was used to identify dietary patterns and a pattern score was calculated from the consumption of the food items in each dietary pattern. Means and 95% CI for dietary pattern scores were calculated for each risk factor category using random effects models adjusted for socio-demographic and health-related behaviors. In women, the fruit, vegetables, and dairy pattern was inversely associated with BMI (P < 0.004), waist circumference (P = 0.0007), blood pressure (P = 0.02), and was positively associated with red cell folate (P < 0.03). The ethnic foods and alcohol pattern was also inversely associated with blood pressure (P = 0.008), whereas the meat, potatoes and sweet foods pattern was positively associated with glycated hemoglobin (P = 0.01). In men, a mixed pattern was inversely associated with waist circumference (P = 0.02) and blood pressure (P = 0.01), whereas there were no significant associations with the ethnic foods and alcohol pattern. Specific dietary patterns throughout adult life were associated with chronic disease risk factors.     

The effect of age, sex, and education on food consumption of a middle-aged English cohort-EPIC in East Anglia

BACKGROUND: Different dietary patterns are associated with differing risks of chronic disease. Yet independent relationships between diet and demographic variables, such as age, sex, and education, are poorly described. METHODS: The first 1968 subjects enrolled to the European Prospective Investigation of Cancer (EPIC) cohort from general practices in East Anglia, UK, provided food frequency and demographic data. RESULTS: Men ate meat, eggs, milk, and sugary foods more frequently, but fruit and vegetables less frequently than women. Older subjects ate red meats and saturated bread spreads more frequently but consumed less poultry and drank less coffee than younger subjects. Better educated subjects ate less meat, more salads, and fewer cakes and sweet foods than those less educated. Five clusters representing different dietary patterns were readily identified. These were (a) younger well-educated, probably containing many vegetarians; (b) "low calorie," two-thirds female; (c) high alcohol, nuts, meat, largely male; (d) preferring fruits, vegetables, unsaturated fats, poultry, and fish, 71% female; (e) preferring meat, potatoes, sweet foods, saturated fats, less well-educated older men. CONCLUSIONS: The reported consumption of many foods varies by age, gender, and education. A pattern of eating that is generally considered less healthful was particularly seen in older men, placing them at increased risk of chronic disease.     

Dietary patterns and survival in older Dutch women

BACKGROUND: The need to gain insight into prevailing eating patterns and their health effects is evident. OBJECTIVE: This study aimed to identify dietary patterns and their relation to total mortality in older Dutch women. DESIGN: A principal component analysis of 22 food groups was used to identify dietary patterns in 5427 women aged 60-69 y who were included in the Dutch European Prospective Investigation into Cancer and Nutrition-Elderly cohort (follow-up: approximately 8.2 y). Mortality ratios for 3 major principal components were assessed by using Cox proportional hazard analysis. RESULTS: The most relevant principal components were a Mediterranean-like dietary pattern (high intakes of vegetable oils, pasta and rice, sauces, fish, and wine), a Traditional Dutch dinner dietary pattern (high intakes of meat, potatoes, vegetables, and alcoholic beverages), and a Healthy Traditional Dutch dietary pattern (healthy variant of the Traditional Dutch dinner dietary pattern; high intakes of vegetables, fruit, nonalcoholic drinks, dairy products, and potatoes). Differences in mean intakes between the highest and lowest tertiles of the 3 patterns were greatest for fruit, dairy products, potatoes, and alcoholic beverages. Consumption of Mediterranean foods, such as fish and oils, was relatively low overall. Two hundred seventy-seven deaths occurred in 44,667 person-years. Independent of age, education, and other lifestyle factors, only the Healthy Traditional dietary pattern score was associated with a lower mortality rate. Women in the highest tertile of this pattern experienced a 30% reduction in mortality risk. CONCLUSION: A Healthy Traditional Dutch diet, rather than a Mediterranean diet, appears beneficial for longevity and feasible for health promotion in older Dutch women. This diet is comparable with other reported healthy or prudent diets that have been shown to be protective against morbidity or mortality.     

Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study

BACKGROUND: Several nutrients are known to affect bone mineral density (BMD). However, these nutrients occur together in foods and dietary patterns, and the overall effects of dietary choices are not well understood. OBJECTIVE: We evaluated associations between dietary patterns and BMD in older adults. DESIGN: Of the original Framingham Heart Study subjects, 907 aged 69-93 y completed food-frequency questionnaires as part of an osteoporosis study. We defined dietary patterns by cluster analysis. BMD was measured at the proximal right femur (femoral neck, trochanter, Ward's area) with a dual-photon absorptiometer and at the 33% radial shaft with a single-photon absorptiometer. We regressed BMD measures onto the cluster variable, adjusting for potential confounders. RESULTS: Six dietary patterns were identified, with relatively greater proportions of intake from meat, dairy, and bread; meat and sweet baked products; sweet baked products; alcohol; candy; and fruit, vegetables, and cereal. After adjustment for multiple comparisons, men in the last group had significantly (P = 0.05) greater BMD than did 2-4 other groups at the hip sites and the candy group at the radius. Men in the candy group had significantly (P < 0.05) lower BMD than did those in the fruit, vegetables, and cereal group for 3 of the 4 sites. Women in the candy group had significantly (P < 0.01) lower BMD than did all but one other group at the radius. CONCLUSIONS: Dietary pattern is associated with BMD. High fruit and vegetable intake appears to be protective in men. High candy consumption was associated with low BMD in both men and women.     

Dietary patterns and changes in body mass index and waist circumference in adults

BACKGROUND: Obesity has increased > 20% in the past decade in the United States, and more than one-half of US adults are overweight or obese. OBJECTIVE: Our objective was to further elucidate the nutritional etiology of changes in body mass index (BMI; in kg/m(2)) and waist circumference by dietary intake pattern. We hypothesized that a healthy dietary pattern would lead to smaller changes in BMI and waist circumference than would other dietary patterns. DESIGN: Subjects were 459 healthy men and women participating in the ongoing Baltimore Longitudinal Study of Aging. Diet was assessed with the use of 7-d dietary records, from which 41 food groups were created and entered into a cluster analysis. RESULTS: Five dietary patterns were derived (healthy, white bread, alcohol, sweets, and meat and potatoes). The mean annual change in BMI was 0.30 +/- 0.06 for subjects in the meat-and-potatoes cluster and 0.05 +/- 0.06 for those in the healthy cluster (P < 0.01). The mean annual change in waist circumference was more than 3 times as great for subjects in the white-bread cluster (1.32 +/- 0.29 cm) as for those in the healthy cluster (0.43 +/- 0.27 cm) (P < 0.05). CONCLUSIONS: Consuming a diet high in fruit, vegetables, reduced-fat dairy, and whole grains and low in red and processed meat, fast food, and soda was associated with smaller gains in BMI and waist circumference. Because foods are not consumed in isolation, dietary pattern research based on natural eating behavior may be useful in understanding dietary causes of obesity and in helping individuals trying to control their weight.     

Dietary patterns as identified by factor analysis and colorectal cancer among middle-aged Americans

BACKGROUND: Although diet has long been suspected as an etiological factor for colorectal cancer, studies of single foods and nutrients have provided inconsistent results. OBJECTIVE: We used factor analysis methods to study associations between dietary patterns and colorectal cancer in middle-aged Americans. DESIGN: Diet was assessed among 293,615 men and 198,767 women in the National Institutes of Health-AARP Diet and Health Study. Principal components factor analysis identified 3 primary dietary patterns: a fruit and vegetables, a diet foods, and a red meat and potatoes pattern. State cancer registries identified 2151 incident cases of colorectal cancer in men and 959 in women between 1995 and 2000. RESULTS: Men with high scores on the fruit and vegetable pattern were at decreased risk [relative risk (RR) for quintile (Q) 5 versus Q1: 0.81; 95% CI: 0.70, 0.93; P for trend = 0.004]. Both men and women had a similar risk reduction with high scores on the diet food factor: men (RR: 0.82; 95% CI: 0.72, 0.94; P for trend = 0.001) and women (RR: 0.87; 95% CI: 0.71, 1.07; P for trend = 0.06). High scores on the red meat factor were associated with increased risk: men (RR: 1.17; 95% CI: 1.02, 1.35; P for trend = 0.14) and women (RR: 1.48; 95% CI: 1.20, 1.83; P for trend = 0.0002). CONCLUSIONS: These results suggest that dietary patterns characterized by a low frequency of meat and potato consumption and frequent consumption of fruit and vegetables and fat-reduced foods are consistent with a decreased risk of colorectal cancer.     

Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality

BACKGROUND: Few studies have examined the long-term effect of habitual diet on risks of incident diabetes, coronary heart disease, and mortality. OBJECTIVE: We analyzed the prospective relation of dietary patterns with incident chronic disease and mortality during 15 y of follow-up in the Whitehall II study. DESIGN: We conducted a prospective analysis (106,633 person-years at risk) among men and women (n = 7731) with a mean age of 50 y at the time of dietary assessment (127-item food-frequency questionnaire). Coronary death or nonfatal myocardial infarction and incident diabetes were verified by record tracing and oral-glucose-tolerance tests. RESULTS: Cluster analysis identified 4 dietary patterns at baseline. The patterns were termed unhealthy (white bread, processed meat, fries, and full-cream milk; n = 2665), sweet (white bread, biscuits, cakes, processed meat, and high-fat dairy products; n = 1042), Mediterranean-like (fruit, vegetables, rice, pasta, and wine; n = 1361), and healthy (fruit, vegetables, whole-meal bread, low-fat dairy, and little alcohol; n = 2663). Compared with the unhealthy pattern, the healthy pattern reduced the risk of coronary death or nonfatal myocardial infarction and diabetes; hazard ratios (95% CI) were 0.71 (0.51, 0.98) and 0.74 (0.58, 0.94), respectively, after adjustment for age, sex, ethnicity, dietary energy misreporting, social position, smoking status, and leisure-time physical activity. Dietary pattern was not associated with all-cause mortality. Residual confounding by socioeconomic factors was unlikely to account for the observed dietary effects. CONCLUSIONS: The healthy eating pattern reduced risks of diabetes and major coronary events. Such dietary patterns offer considerable health benefits to individuals and contribute to public health.     

Dietary patterns are associated with body mass index in multiethnic women

This cross-sectional study investigated the relationship between dietary patterns and body mass index among 514 women with different ethnic backgrounds who completed a validated food-frequency questionnaire. An exploratory factor analysis with orthogonal rotation started with 23 food items and resulted in four factors that accounted for 93% of the total variance. Confirmatory factor analysis with the 16 items that had factor loadings of at least 0.60 validated the four dietary patterns. The most significant dietary pattern, "meat," was characterized by high intake of processed and red meats, fish, poultry, eggs, fats and oils, and condiments. The "vegetable" pattern loaded high on different vegetables, whereas the third pattern named "bean" was high in legumes, tofu and soy protein. The major components of the "cold foods" pattern were fruit, fruit juice and cold breakfast cereals. Although the "meat" pattern was predominant among Hawaiians and the "bean" pattern very common among Chinese and Japanese women, factors two and four were not related to ethnicity. After adjustment for daily energy intake, the "meat" pattern was positively associated with body mass index (r = 0.17, P: = 0.0001), whereas the other three patterns showed negative relationships to body mass index (r = -0.076, P: = 0.084, r = -0.13, P: = 0.003, and r = -0.13, P: = 0.003) for vegetables, beans and cold foods, respectively. The associations were similar in direction and magnitude for all ethnic groups. The study results support the ideas that choosing the right foods may be important in weight control and that food-based dietary patterns may be useful in dietary counseling.     

Frequency of food consumption and lipoprotein serum levels in the population of an urban area, Brazil

OBJECTIVE: To identify the association between food group consumption frequency and serum lipoprotein levels among adults. METHODS: The observations were made during a cross-sectional survey of a representative sample of men and women over 20 years old living in Cotia county, S. Paulo, Brazil. Data on food frequency consumption, serum lipids, and other covariates were available for 1, 045 adults. Multivariate analyses adjusted by age, gender, body mass index, waist-to-hip ratio, educational level, family income, physical activity, smoking, and alcohol consumption were performed. RESULTS: Consumption of processed meat, chicken, red meat, eggs and dairy foods were each positively and significantly correlated with LDL-C, whereas the intake of vegetables and fruits showed an inverse correlation. Daily consumption of processed meat, chicken, red meat, eggs, and dairy foods were associated with 16.6 mg/dl, 14.5 mg/dl, 11.1 mg/dl, 5.8 mg/dl, and 4.6 mg/dl increase in blood LDL-C, respectively. Increases of daily consumption of fruit and vegetables were associated with 5.2 mg/dl and 5.5 mg/dl decreases in LDL-C, respectively. Alcohol beverage consumption showed a significant positive correlation with HDL-C. CONCLUSIONS: Dietary habits in the study population seem to contribute substantially to the variation in blood LDL and HDL concentrations. Substantially CHD risk reduction could be achieved with dietary changes.     

Iron deficiency in older people: interactions between food and nutrient intakes with biochemical measures of iron; further analysis of the National Diet and Nutrition Survey of people aged 65 years and over.

OBJECTIVE: To quantitatively investigate relationships between food consumption, nutrient intake and biochemical markers of iron status in a population of older people. DESIGN: National Diet and Nutrition Survey: cross-sectional survey of a nationally representative population of men and women aged 65 y and over. SETTING: Mainland Great Britain SUBJECTS: 1268 participants (651 men and 617 women) who provided both dietary intake and blood biochemistry. 986 were living in private households and 282 were living in residential or nursing homes. RESULTS: Intakes of alcohol, vitamin C, protein, haem and non-haem iron and fibre were positively associated with iron status. Consumption of meat, poultry and fish were positively associated with six measures of iron status, and vegetables and potatoes with four measures. Calcium, dairy foods and tea generally had a negative association with most measures of iron status. CONCLUSIONS: A varied diet containing meat, poultry and fish, vegetables and fruit, with a moderate intake of alcohol will make a positive contribution to the iron status of elderly people.     

Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis

BACKGROUND: The balance between the intake of animal and the intake of plant foods may influence renal vascular integrity as reflected by urinary albumin excretion. OBJECTIVE: We assessed cross-sectional associations between urinary albumin excretion and dietary patterns and intake of plant and animal foods. DESIGN: At baseline, diet (food-frequency questionnaire) and the urinary albumin-to-creatinine ratio (ACR; spot urine collection) were measured in 5042 participants in the Multi-Ethnic Study of Atherosclerosis who were aged 45-84 y and were without clinical cardiovascular disease, diabetes, or macroalbuminuria (sex-adjusted ACR >or= 250). We derived dietary patterns by principal components analysis. We also summed food groups to characterize plant food intake (fruit, fruit juice, vegetables, nuts, legumes, whole grains, and refined grains), animal food intake (red meat, processed meat, poultry, fish, high-fat dairy, and low-fat dairy), and nondairy animal food intake. RESULTS: After adjustment for multiple demographic and lifestyle confounders, a dietary pattern characterized by high consumption of whole grains, fruit, vegetables, and low-fat dairy foods was associated with 20% lower ACR across quintiles (P for trend = 0.004). Neither total animal nor total plant food intake was associated with ACR. However, greater low-fat dairy consumption was associated with 13% lower ACR across quartiles (P for trend = 0.03). Total nondairy animal food consumption was associated with 11% higher ACR across quintiles (P for trend = 0.03). CONCLUSIONS: A high intake of low-fat dairy foods and a dietary pattern rich in whole grains, fruit, and low-fat dairy foods were both associated with lower ACR. In contrast, collectively, nondairy animal food intake was positively associated with ACR.     

Dietary Predictors of 5-Year Changes in Waist Circumference

Background

Previous studies on the association between macronutrient intake and the development of abdominal obesity, which carries an increased health risk, have not shown a consistent pattern, possibly due to mixed effects of other aspects of the food intake.

Objective

This study investigated the association between intake from 21 food and beverage groups and the subsequent 5-year difference in waist circumference.

Methods

The study population consisted of 22,570 women and 20,126 men, aged 50 to 64 years at baseline, with complete data on baseline and follow-up waist circumference, baseline diet (192 items food frequency questionnaire), body mass index, and selected potential confounders (eg, smoking status, sport activities, and intake of alcoholic beverages). Multiple linear regression analyses were performed.

Results

For women, 5-year difference in waist circumference was inversely related to intake from red meat, vegetables, fruit, butter, and high-fat dairy products, whereas intake from potatoes, processed meat, poultry, and snack foods was positively associated. For men, red meat and fruit intakes were inversely associated with 5-year difference in waist circumference, whereas snack foods intake was positively associated. Sex differences occurred for vegetables, high-fat dairy products, and processed meat.

Conclusions

The results suggest that a diet low in fruits and red meat and high in snack foods was associated with larger waist circumference gains in both sexes. Furthermore, in women a diet low in vegetables, butter, and high-fat dairy products, and high in poultry, potatoes, and processed meat were likely determinants of subsequent gain at the waist.     

Longitudinal change in food habits between adolescence (11-12 years) and adulthood (32-33 years): the ASH30 Study

BACKGROUND: Links between diet in childhood and the prevention of disease in adulthood have been established. This longitudinal dietary survey provided quantitative evidence of dietary change from adolescence to adulthood, in Northumberland, England. OBJECTIVE: To report longitudinal dietary change in 198 respondents between the ages of 12 and 33 years, to explore dietary 'tracking' between the same time points and to describe the effects of gender, socio-economic status and location on dietary change. METHODS: A longitudinal study recorded dietary change from adolescence to adulthood. Two 3-day food diaries were collected in 1980 and 2000 from the same 198 respondents. Foods consumed were assigned to the five categories in the Balance of Good Health (BGH). Demographic and socio-economic information were obtained in 1980 and 2000. RESULTS: Intakes of foods containing fat and/ or sugar and milk and dairy foods decreased (p < 0.01 and p < 0.031, respectively), while intakes of fruits and vegetables increased (p < 0.01). Intakes of bread, other cereals and potatoes (p = 0.002, r = +0.219); fruits and vegetables (p < 0.01, r = +0.256) and meat, fish and alternatives (p = 0.026, r = +0.158) 'tracked' from adolescence to adulthood. Men had increased intake from meat, fish and alternatives and decreased milk and dairy foods more than female respondents (p = 0.003 and p = 0.019). Respondents who had moved away from Northumberland had a greater increase in intake of fruits and vegetables compared with those who remained in the local (p = 0.010). Individuals who had moved to a lower socio-economic group had increased their intake of bread, other cereals and potatoes (p = 0.040). CONCLUSION: Food intake changed considerably in a direction more in the line with current dietary recommendations. Food intake in adolescence was a significant, but not strong, predictor of intake in adulthood. Dietary change is influenced by variables including gender, location and socio-economic status.     

Dietary patterns in pregnancy and associations with socio-demographic and lifestyle factors

OBJECTIVE: To obtain distinct dietary patterns in the third trimester of pregnancy using principal components analysis (PCA); to determine associations with socio-demographic and lifestyle factors. DESIGN AND METHODS: A total of 12 053 pregnant women partaking in a population-based cohort study recorded current frequency of food consumption via questionnaire in 1991-1992. Dietary patterns identified using PCA were related to social and demographic characteristics and lifestyle factors. RESULTS: Five dietary patterns were established and labelled to best describe the types of diet being consumed in pregnancy. The 'health conscious' component described a diet based on salad, fruit, rice, pasta, breakfast cereals, fish, eggs, pulses, fruit juices, white meat and non-white bread. The 'traditional' component loaded highly on all types of vegetables, red meat and poultry. The 'processed' component was associated with high-fat processed foods. The 'confectionery' component was characterized by snack foods with high sugar content and the final 'vegetarian' component loaded highly on meat substitutes, pulses, nuts and herbal tea and high negative loadings were seen with red meat and poultry. There were strong associations between various socio-demographic variables and all dietary components; in particular, a 'health conscious' diet was positively associated with increasing education and age and non-white women. There was a negative association with increased parity, single, non-working women, those who smoked and who were overweight pre-pregnancy. Opposite associations were seen with the 'processed' component. CONCLUSIONS: Distinct dietary patterns in pregnancy have been identified. There is clear evidence of social patterning associated with the dietary patterns, these social factors need to be accounted for in future studies using dietary patterns. This study will form the basis for further work investigating pregnancy outcome.     

Association of fruit and vegetable intake with dietary fat intake

We examined the relation of fruit and vegetable intake with dietary fat intake under conditions in which individuals consume recommended number of portions of dairy, meat and grain foods, using 24-hour dietary recall data from the NHANES II of 1976–80. Only recalls that included at least 2 servings each of dairy foods and meat and 4 servings of grains, but variable servings of fruits and vegetables (ranging from 0 to 2 or more) were examined, yielding a total of 9 food group patterns (possible combinations of food group servings) as reported by 1,490 respondents. In patterns ranging from 0 to 2 servings each of fruits and vegetables, the mean percent of energy as fat varied from 39% to 36%. We observed a slight trend for decreasing energy from fat with increasing number of fruit-but not vegetable-servings. Consumption of fruits and vegetables was not associated with selection of lower-fat foods in the meat, dairy or grain groups. The percent of daily fat contributed by the miscellaneous food group (containing visible fats, sweeteners, and baked products with a high fat or sugar content) increased with increasing vegetable-but not fruit-servings. These results suggest that without conscious effort to reduce fat intake, an increase in fruit and vegetable intake may have a relatively minor impact on reduction of dietary fat.     

Food Preferences of Older Adults in Senior Nutrition Programs

The Elderly Nutrition Program (ENP) is being challenged to improve the quality of meal programs. The purpose of this study was to explore how food preferences varied depending on gender and ethnic groups. A total of 2,024 participants in the ENP aged 60 years or older were interviewed. A majority of the participants were female (74.7%), served by congregate meal programs (71.7%), with the mean ± SD age of 76.9 ± 9.2 years. A general impression of the meals and preferences for 13 food groups (fresh fruit, chicken, soup, salad, vegetables, potatoes, meat, sandwiches, pasta, canned fruit, legumes, deli meats, and ethnic foods) were assessed. After adjusting other variables, older males were significantly more likely to prefer deli meats, meat, legumes, canned fruit, and ethnic foods compared to females. In addition, compared with African Americans, Caucasians demonstrated higher percentages of preference for 9 of 13 food groups including pasta, meat, and fresh fruit. To improve the quality of the ENP, and to increase dietary compliance of the older adults to the programs, the nutritional services require a strategic meal plan that solicits and incorporates older adults’ food preferences.     

Transitions in living arrangements are associated with changes in dietary patterns in young women

Household composition influences people's diet, so typical transitions in young women's lives, including cohabitation, marriage, and motherhood, might be expected to influence their subsequent dietary behavior. The objective was to examine associations between transitions in living arrangements and changes in energy intake and dietary patterns for women in their 20s and 30s using longitudinal data collected in 2003 and 2009. FFQ were collected twice from 6534 women born in 1973-1978 participating in the Australian Longitudinal Study on Women's Health. Transition groups were defined from changes in their living arrangements. Factor analysis was used to identify dietary patterns. Associations between transitions in living arrangements and changes in energy intake and dietary pattern scores were analyzed using multiple linear regression. Women living with children had greater energy intake than other women initially and those who started a family had the greatest increases over time. Five similar dietary patterns were derived from both surveys. Women living in a family at both times had higher scores on the high-fat and sugar, meat, and cooked vegetables patterns and lower scores on the Mediterranean-style and fruit patterns than other women. Women starting a family increased their consumption of the high-fat and sugar, fruit, and cooked vegetables patterns. Women not living with children at both times had increased scores on the Mediterranean-style pattern and decreased scores on the high-fat and sugar and cooked vegetables patterns compared with other women. In conclusion, starting a family is associated with changes in women's diet that are mainly unhealthy.     

Validity and reproducibility of an adolescent web-based food frequency questionnaire

OBJECTIVE: To assess the validity and reproducibility of a newly developed, cost-effective, and easy to administer, Web-based food frequency questionnaire (FFQ) for the dietary assessment of adolescents. DESIGN: Cross-sectional validation of a Web-based FFQ, which contained 15 food groups (water; soft drinks, including fruit juice and diet soft drinks; alcoholic beverages; soup; milk and milk products; fruit; sweet and savory snacks/fillings; sauces and fat spreads; breakfast cereals; bread; cheese, fish/eggs/meat; pasta/rice; vegetables; and potatoes). Reference data for validation were 3-day estimated food records. Analyses were done for all participants and for consumers only (consumer in both Web-based FFQ and food record). SUBJECTS/SETTING: A selected group of adolescents (12 to 18 years of age, n=104) from participating secondary schools in Ghent, Belgium. RESULTS: For all participants, the measured intakes of water, fruit, breakfast cereals, fish/eggs/meat, pasta/rice, and potatoes were not significantly different between the two methods. The Spearman correlation for all foods was on average 0.38 (ranging from 0.20 for pasta/rice to 0.64 for breakfast cereals). When analyzed for consumers only, the Web-based FFQ showed significantly lower estimates for soft drinks, sweet and savory snacks/fillings, sauces and fat spreads, cheese, pasta/rice, and vegetables. The average Spearman correlation for all foods collectively was 0.30. When reproducibility of the Web-based FFQ was assessed, the average Spearman correlation coefficient for all foods collectively was 0.62. CONCLUSIONS: Most questions on the 15 food groups had acceptable reproducibility, whereas validation only showed reliable intakes for water, fruit, bread, and fish/eggs/meat. This Web-based FFQ could be a start for development of dietary assessment methods in public health nutrition contexts.     

Relationship of Living Conditions With Dietary Patterns Among Survivors of the Great East Japan Earthquake

Background

During the year after the Great East Japan Earthquake on March 11, 2011, the health conditions and lifestyles of survivors were extensively surveyed. We examined the relationship between living conditions and dietary pattern among survivors.

Methods

A total of 10 466 survivors aged 18 years or older (25% of the population of that age in the area) participated in a survey of Iwate Prefecture. The average frequency of daily consumption of 8 food groups was determined by questionnaire. After excluding staple foods, which were consumed 3 times a day by 85% of participants, factor analysis was performed on 7 food groups among 9789 people (3795 men, 5994 women).

Results

Factor analysis identified 2 dietary patterns—prudent and meat. The prudent dietary pattern is characterized by high intakes of fish and shellfish, soybean products, vegetables, fruit, and dairy products and was more evident among older participants and women. The meat dietary pattern is characterized by high intakes of meat and eggs and was more evident among younger participants and men. Age-adjusted multiple logistic regression analyses showed that male and female current smokers and men and women living in difficult conditions were likely to have a lower prudent dietary pattern score; male current smokers and male daily alcohol drinkers were likely to have a higher meat dietary pattern score.

Conclusions

During the year after the earthquake, the prudent dietary pattern was associated with better living conditions among survivors, whereas the meat dietary pattern was not.Key words: Great East Japan Earthquake, living conditions, dietary patterns     

Trends in nutrient and dietary intake among adults and the elderly: from NAHSIT 1993-1996 to 2005-2008

The aim of this study was to investigate trends in nutrients and sources of dietary intake for Taiwanese people from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996 to 2005-2008. Twenty-four hour dietary recall data were obtained from the 2005-2008 NAHSIT. The results showed that intake of cereals and grains, and dietary fiber has decreased, whereas intake of carbohydrate rich convenience foods has increased. As a result, 10-20 g of dietary fat is now obtained from carbohydrate rich foods. A greater proportion of Taiwanese are choosing low-fat meat products, however, excessive intake of meat by men and women aged 19 to 64 years is resulting in excessive intakes of protein, cholesterol and saturated fat. Men and women aged 19 to 30 years had insufficient intakes of fruit and vegetables. Consumption of fruit, dairy/products, and nuts was low in all age groups. We recommend strengthening public nutrition education and changing diet related environment to improve dietary quality and food group distributions. Issues of concern include excessive intakes of energy and the soybean/fish/meat/eggs food group in all subjects, high amount of processed foods and refined-carbohydrate rich foods in men aged 19 to 64 years and women aged 19-30 years, as well as intakes below the DRI for a variety of nutrients in elderly persons.