Energy intake and dietary macronutrient content in women with anorexia nervosa and volunteers

This study was designed to compare the dietary intakes of patients with anorexia nervosa and normal controls. Twenty-four patients hospitalized for treatment of anorexia nervosa were compared with 10 normal controls. Patients ate a self-selected diet and maintained their admission weight to within 1.0 kg during this period (19 +/- 3 days). Food chosen by each subject was weighed before and after meals, and intake was determined to be the difference. Intakes of food energy, protein, fat, and carbohydrate were calculated. Patients were closely monitored to ensure that no disposal of food occurred. Patients with anorexia nervosa had a mean daily energy intake of 1,017 +/- 54 kcal (mean +/- SEM), significantly lower than the mean energy intake for controls (1,651 +/- 108 kcal). Similarly, mean intakes of macronutrients (41 +/- 4 gm protein, 34 +/- 2 gm fat, and 136 +/- 9 gm carbohydrate) were significantly lower for patients than for controls (68.5 +/- gm protein, 65 +/- 6 gm fat, and 204 +/- 13 gm carbohydrate). However, when protein, fat, and carbohydrate were assessed as a percent of total calories, there were no significant differences between patients and controls. There were also no significant differences in calories consumed per kilogram body weight. Underweight patients with anorexia nervosa who maintain their weight on an unrestricted hospital diet have energy intake per kilogram body weight and dietary macronutrient content indistinguishable from those of normal women.     

Day-to-day consistency in amount and source of carbohydrate intake associated with improved blood glucose control in type 1 diabetes.

OBJECTIVE: To determine if a relationship exists between blood glucose control and variability in nutrient intake from day-to-day in subjects with type 1 diabetes. METHODS: Two three-day diet records and one measurement of glycated hemoglobin (HbA1c) were obtained from 272 subjects with type 1 diabetes treated with a mixture of regular and NPH insulins before breakfast and supper and using a standardized algorithm to adjust insulin dose according to the results of self-monitoring of blood glucose two to four times daily. Day-to-day variation in nutrient intake was expressed as the coefficient of variation (CV = SDx100/mean). RESULTS: Nutrient intakes in the study population (mean +/- SD) were energy 8.35+/-2.43 MJ, fat 81+/-30 g, protein 94+/-28 g, carbohydrate 227+/-68 g, starch 126+/-38 g and dietary fiber 20+/-6 g with diet glycemic index being 84.2+/-7.4. Neither energy, nutrient intakes nor insulin dose was significantly related to HbA1c. Day-to-day variation of carbohydrate (p = 0.0097) and starch (p = 0.0016) intakes and diet glycemic index (p = 0.033) was positively related to HbA1c, and the associations remained significant when adjusted for age, sex, duration of diabetes and BMI. Day-to-day variation in energy, protein or fat intakes was not related to HbA1c. CONCLUSIONS: Consistency in the amount and source of carbohydrate intake from day-to-day is associated with improved blood glucose control in people with type 1 diabetes, a result which supports continued educational efforts to achieve adherence to a diabetes diet plan. This conclusion may not apply to people on intensified insulin therapy who adjust their insulin dose based on their actual carbohydrate intake at each meal.     

Effect of low-glycemic-index dietary advice on dietary quality and food choice in children with type 1 diabetes

BACKGROUND: The practicality of diets with a low glycemic index (GI) is controversial. Theoretically, low-GI diets may limit food choice and increase dietary fat intake, but there is little objective evidence to support such a theory. OBJECTIVE: The objective was to determine the effect of low-GI dietary advice on dietary quality and food choice in children with diabetes. DESIGN: Children aged 8-13 y with type 1 diabetes (n = 104) were recruited to a prospective, randomized study comparing the effects of traditional carbohydrate-exchange dietary advice (CHOx) with those of more flexible low-GI dietary advice (LowGI). We determined the effect on long-term macronutrient intake and food choice with the use of 3-d food diaries. RESULTS: There were no differences in reported macronutrient intakes during any of the recording periods. After 12 mo, intakes of dietary fat (33.5 +/- 5.6% and 34.2 +/- 6.7% of energy, P = 0.65), carbohydrate (48.8 +/- 5.4% and 48.6 +/- 6.5% of energy, P = 0.86), protein (17.6 +/- 2.5% and 17.3 +/- 3.7% of energy, P = 0.61), total sugars, and fiber did not differ significantly between the CHOx and LowGI groups, respectively. The average number of different carbohydrate food choices per day also did not differ significantly. Subjects in the lowest-GI quartile consumed less carbohydrate as potato and white bread, but more carbohydrate as dairy-based foods and whole-grain breads than did subjects in the highest-GI quartile. CONCLUSION: Children with diabetes who receive low-GI dietary advice do not report more limited food choices or a diet with worse macronutrient composition than do children who consume a traditional carbohydrate-exchange diet.     

A cross-sectional study comparing the nutritional status of peritoneal dialysis and hemodialysis patients in Korea.

OBJECTIVE: This study was performed to compare the nutritional status of peritoneal dialysis (PD) and hemodialysis (HD) patients in Korea and to validate the nutritional assessment method. DESIGN: For nutritional assessment, we used five nutrition-related indicators, including percentage unplanned weight loss, percentage ideal body weight (IBW), serum albumin, appetite and intake, and any gastrointestinal symptoms affecting intake. A 1-month food frequency interview was conducted by clinical dietitians using food models to estimate energy and protein intake. The validity of the nutritional assessment method was tested by objective measures. PATIENTS/SETTING: A cross-sectional study was conducted in our center for 51 PD patients and 169 HD patients who met the study criteria. In the study, HD patients typically underwent dialysis three times per week, and most PD patients performed four 2-L dialysis exchanges every day. RESULTS: Our data showed a higher incidence of malnutrition in PD patients than in HD patients (33% v 18%) and in diabetics than in nondiabetics. Age, height, and dietary energy intake of the two groups were comparable. In PD patients, however, duration of dialysis treatment (23.9 +/- 19.1 months v 41.8 +/- 31.7 months, P < 0.001) and serum albumin (35.2 +/- 5.0 g/L v 39. 7 +/- 3.4 g/L, P < 0.0001) were significantly lower, whereas percentage IBW (108.1% +/- 12.4% v 96.2% +/- 11.6%, P < 0.0001) and dietary protein intake (1.12 +/- 0.34 g/kg IBW v 0.98 +/- 0.31 g/kg IBW, P < 0.05) were significantly higher than in HD patients. In malnourished PD and HD patients, percentage IBW, serum albumin, dietary energy, and protein intake were significantly lower than in well-nourished counterparts. CONCLUSION: A higher incidence of malnutrition was observed in PD patients than in HD patients. Nutritional profile of PD patients was different from that of HD patients. Higher body weight and lower serum albumin in PD patients did not seem to be related to dietary energy and protein intake. The five nutritional indicators can be used as a simple inexpensive and reliable method for the early detection of malnutrition in dialysis patients.     

A dietary survey in Indian hemodialysis patients

Malnutrition is a common problem in maintenance hemodialysis (MHD) patients, and compromised intake is an important cause. There is no information available about the nutrient intakes of MHD patients in India. The nutrient intakes of 106 MHD patients were studied cross-sectionally and on follow-up. A 24-hour recall was used on 4 consecutive days. After 2 months on dialysis, the mean energy intake was 29±6.6 kcal/kg ideal body weight (IBW) and the mean protein intake was .93±.39 g/kg IBW (high biological value [HBV] protein 49%±8.5%). Dietary deficiency of both protein and calories was present in 64.9%. Intake was better on nondialysis days compared with dialysis days, and in women and older patients. On follow-up there was no significant increase in food intake up to 6 months. After that, the total calorie intake increased significantly with a disproportionate drop in high biological value protein consumed and appeared to be derived predominantly from carbohydrate food (mean kcal/kg, 37±6.9; mean protein g/kg, 0.96±0.19; ratio of HBV protein to total protein consumed, .42±.09). In summary this study showed suboptimal energy and protein intake in an MHD population. Intakes were further compromised on dialysis days, and with increasing time spent on dialysis, the quality of nutrient intake became poorer.     

Influence of dietary protein on glomerular filtration and urinary albumin excretion in insulin-dependent diabetes.

We investigated the effects of dietary constituents on glomerular filtration (GFR) and albumin excretion rates (AERs) in a cross-sectional study in 39 young subjects with insulin-dependent diabetes. Dietary protein intake correlated significantly in patients with GFRs less than 150 mL/min per 1.73 m2 (r = 0.53, n = 23, P = 0.009), but not with AER. GFR also correlated with mean blood glucose at a concentration less than 12.0 mmol/L (r = 0.61, P = 0.0035). Protein and fat intakes were similar in patients with and without microalbuminuria (AER greater than 20 mg/L) but long-term glycemic control was worse in the former [HbA1 12.4 +/- 2.9% (mean +/- SD) and 10.6 +/- 2.1%, respectively, P = 0.043]. In seven patients, short-term reduction of dietary protein from 2.0 to 1.0 to 0.5 g.kg-1.d-1 produced a progressive fall in GFR by 11.6 +/- 6.0 and 9.6 +/- 5.9 mL/min, respectively (P less than 0.05), but did not consistently affect AER. We conclude that both dietary protein and glycemic control influence GFR but neither alone appears to explain glomerular hyperfiltration. Microalbuminuria was associated with poor glycemic control but not with dietary fat or protein consumption.     

Accuracy of dietary recall using the USDA five-step multiple-pass method in men: an observational validation study

OBJECTIVE: This observational validation study was conducted under controlled conditions to test the accuracy of dietary recall in normal weight, overweight, and obese men using the USDA five-step multiple-pass method for dietary recall. DESIGN: Cross-sectional analysis of actual and recalled intake of food during 1 day. SUBJECTS/SETTING: Forty-two men ranging in age from 21 to 65 years and in body mass index from 21 to 39 kg/m(2) who lived in the metropolitan Washington DC area were studied. INTERVENTION: The subjects selected and consumed all meals and snacks, for 1 day, from a wide variety of foods provided at a human study facility. MAIN OUTCOME MEASURES: Actual and recalled energy, protein, carbohydrate, and fat intakes were determined by direct observation and by a 24-hour dietary recall, respectively. Dietary recall was determined via telephone administration of the USDA five-step multiple-pass method the following day. STATISTICAL ANALYSES PERFORMED: Analysis of variance and covariance tested the overall accuracy of recall and the effect of body mass index on dietary recall. Bland-Altman plots were used to assess bias in recall of food intake. RESULTS: In this population of men, there were no significant differences between actual and recalled intakes of energy (3,294+/-111 and 3,541+/-124 kcal/day), protein (117+/-5 and 126+/-5 g/day), carbohydrate (414+/-16 and 449+/-16 g/day), or fat (136+/-7 and 146+/-8 g/day), respectively. Accuracy of recall was not related to body mass index in that the obese men recalled food intake as accurately as the nonobese men. The energy intake of these men was significantly correlated (r=0.57, P<.05) with their estimated energy requirements. Significant interindividual variation in accuracy of recall was found. CONCLUSIONS: Under controlled conditions, the USDA five-step multiple-pass method can accurately assess intakes of energy, protein, carbohydrate, and fat in a population of men regardless of their body mass index. Researchers and clinical dietitians need to continue to examine factors that influence underreporting and overreporting of food intake by the multiple-pass 24-hour recall method.     

Anthropometric characteristics, dietary patterns and risk of type 2 diabetes mellitus in Vietnam

OBJECTIVE: To determine the impact of anthropometric characteristics and dietary patterns on Type 2 diabetes mellitus in Vietnam. METHODS: Data from 144 subjects (9m/39f newly diagnosed diabetics; 18m/78f control subjects) were analyzed in this case-control study. Height, weight, waist and hip circumferences and percent body fat were measured. Dietary intakes were assessed by 24-hour recall on three non-consecutive weekdays. Fasting blood samples were collected for the analysis of plasma glucose, fructosamine, protein and lipid concentrations. RESULTS: Although the body mass index (BMI, kg/m(2)) was similar between diabetic and control subjects, diabetic subjects had significantly greater percent body fat (31.1 +/- 5.8% vs. 27.7 +/- 6.2%) and waist-hip ratios (WHR, 0.91 +/- 0.07 vs. 0.86 +/- 0.08). Diabetic subjects had higher intakes of protein (p < 0.01), especially animal protein (p < 0.001), and consumed more meat (p < 0.01) than control subjects. Percent body fat and WHR were positively associated with diabetes (odds ratios [OR] 1.53 [95%CI 1.29-1.79] and 1.09 [95% CI 0.89-1.58], respectively) as were protein intake (OR 1.21 [95% CI 1.12-1.31]) and animal protein intake (OR 1.18 [95% CI 1.10-1.26]). CONCLUSIONS: This study indicates that percent body fat and WHR are risk factors associated with diabetes even when the BMI is normal. Evolving dietary patterns with increasingly more protein and meat consumption may also contribute to the deterioration of glucose metabolism among Vietnamese people.     

Relation of body energetic status to dietary self-selection in Sprague-Dawley rats

Self-selection from carbohydrate, protein and fat sources including essential micronutrients was studied in male Sprague-Dawley rats that were 4 weeks of age at the beginning of the experiment. During the experimental period of 14 days, the intake of carbohydrate and fat was quite constant, whereas that of protein increased gradually. The mean intake of carbohydrate, protein, and fat was 31.1 +/- 3.5%, 56.1 +/- 4.6%, and 12.8 +/- 2.8% of the total energy intake, respectively. Animals fed on a mixed diet consisting of high sucrose, consumed 65.1% of their daily energy as carbohydrate, 17.6% as protein, and 17.3% as fat. Total energy intake and body weight gain were not significantly different between the rats on self-selection and those fed on the mixed diet. These results indicate that young rats on dietary self-selection were able to gain body weight comparable to that of rats fed on the mixed diet. Body energetic status affected self-selection patterns. In rats fasted for 5 days or fed on a protein-free diet for 21 days, fat intake increased, but protein intake decreased. On the other hand, fat intake decreased in animals given a sucrose diet higher in energy content than the stock diet; these animals exhibited increased accumulation of body energy. These results indicate that dietary self-selection is closely related to nutritional and physiological body requirements.     

Dietary fat:carbohydrate ratio and obesity in middle-aged men

Nutrient intakes from 7-d diet records were compared with hydrostatically determined body composition in 155 sedentary obese men aged 30-59 y. Percent body fats ranged from 18.6 to 40.3. The men ate (mean +/- SD) 2570 +/- 514 kcal/d: 15.6 +/- 2.6% from protein, 40.7 +/- 5.7% from fat, 37.5 +/- 6.9% from carbohydrate, and 6.2 +/- 6.0% from alcohol. Percent body fat correlated positively (p less than 0.05) with g/1000 kcal intake of total, saturated, and monounsaturated fatty acids and negatively with carbohydrates and plant protein. Total calories, number of meals, and distribution of calories were unrelated to percent body fat, total weight, or fat-free mass. The higher proportion of fat and carbohydrate in the diet may contribute to obesity in men. The modest caloric intake of these men and the lack of correlation between percent body fat and total calories suggest that calorie differences are not the major cause of the variations in obesity in these men.     

Anthropometric characteristics and competition dietary intakes of professional rugby league players

This study aimed to describe the physique characteristics and competition nutrient intake of professional Rugby League players and to assess use of a statistical technique for evaluating validity of dietary reporting. Players (n = 74) were endomorphic mesomorphs and had a mean weight, height, and BMI of 93.4 +/- 10.9 kg, 179.9 +/- 7.3 cm, and 28.5 +/- 2.1 kg/m2 respectively. Mean sum of eight skinfolds was 78.9 +/- 2.2 mm (12.4 +/- 2.9% fat). Players (n = 34) reported a mean daily energy intake of 17,708 +/- 3,688 kJ (carbohydrate 51%, protein 18%, fat 25%, alcohol 4%) with 6 and 2.0 g x kg(-1) x d(-1) from carbohydrate and protein respectively. Micronutrient intake was adequate but alcohol consumption was high relative to health standards. The dietary records provided a plausible estimate of energy intake however further research is required to evaluate statistical techniques for assessing dietary validity in athlete groups.     

Body composition and dietary intakes in adult celiac disease patients consuming a strict gluten-free diet

BACKGROUND: Celiac disease responds to dietary gluten withdrawal, but data on the long-term effects of gluten-free diets are discordant. OBJECTIVE: Our aim was to evaluate the nutritional status and body composition of adult celiac disease patients consuming a gluten-free diet who were in clinical, biochemical, and histologic remission. DESIGN: We studied 71 patients (51 women and 20 men; mean age: 27 y; range: 17-58 y) and 142 healthy control subjects matched by sex and age. The subjects' height, weight, body mass index, fat and lean mass, and bone mineral content (evaluated by dual-energy X-ray absorptiometry) were measured; a 3-d dietary questionnaire was administered; and total daily energy, fat, carbohydrate, and protein intakes were calculated. RESULTS: The weight, height, and body mass index of male celiac disease patients and the weight and body mass index of female celiac disease patients were significantly lower than the corresponding measurements in control subjects. The fat and lean mass of both male and female patients was significantly different from that of control subjects; however, bone mineral content was significantly lower only in females in whom celiac disease was diagnosed in adulthood. Total energy intake was lower in the patients than in the control subjects (9686 +/- 1569 and 11297 +/- 1318 kJ/d in males and 6736 +/- 1318 and 7740 +/- 1715 kJ/d in females), and the diet of the patients was unbalanced, with a higher percentage of energy as fat and a lower percentage of energy as carbohydrates. CONCLUSIONS: Although strictly compliant with their gluten-free diet and in complete remission, patients with celiac disease showed differences in body composition and dietary intakes compared with control subjects. Strict follow-up and dietary advice in terms of the choice and composition of foods seem necessary to prevent malnutrition.     

Dietary intake in patients with acquired immunodeficiency syndrome (AIDS), patients with AIDS-related complex, and serologically positive human immunodeficiency virus patients: correlations with nutritional status

One of the major clinical manifestations of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) is the development of cachexia. This most likely results from a multifactorial interplay of poor diet, malabsorption, and altered metabolism. To assess the potential role of nutrient intake in the development or persistence of malnutrition, a detailed analysis was performed of a 72-hr diet record in clinically stable patients with AIDS (N = 18), ARC (N = 12) and in human immunodeficiency virus (HIV) seropositive controls without significant manifestations of disease (N = 13). Total calorie intake was 39.1 +/- 13.2 kcal/kg/day in AIDS patients vs 34.6 +/- 7.8 kcal/kg/day in ARC patients or 31.9 +/- 17.7 kcal/kg/day in HIV seropositive cases (all p = NS). Likewise, mean protein intakes were similar among the groups and exceeded recommended daily dietary allowance (RDA) guidelines. The mean body weight changes from the inception of illness were -11 +/- 1% in AIDS, -6 +/- 7% in ARC, vs +3 +/- 2% in HIV-seropositive-only cases (p less than 0.05 vs AIDS and ARC). Dietary vitamin and mineral analysis revealed that 88% of AIDS, 88% of HIV seropositive, and 89% of ARC patients were ingesting less than 50% RDA for at least one nutrient. The mean number of deficiencies per patient was 1.8 +/- 1.3 in AIDS, 3.8 +/- 3.5 in ARC, and 2.9 +/- 2.5 in HIV-seropositive-only cases (p less than 0.05 AIDS vs ARC). There were no significant correlations between specific anthropometric measurements and dietary intakes of protein or fat.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dietary intakes of police department employees in a wellness program

A 12-month nutrition program was developed and implemented as a project of the Wellness Department of the Austin Police Department (APD). Forty APD employees began the program; 24 completed the dietary portion of the study. A comparison of 7-day dietary intakes recorded before and after the program indicated a decrease in energy intake from a mean of 2,273 +/- 694 kcal/day to 1,379 +/- 364 kcal/day (p less than .001). Percentage of energy from protein increased from 16% to 21% (p less than .001), and energy from fat decreased from 42% to 36% (p less than .05). Percentages of energy from carbohydrate and alcohol were not significantly different from the beginning to the end of the study. Daily intakes of cholesterol decreased from 405 +/- 188 mg/day to 295 +/- 132 mg/day (p less than .05). Phosphorus and iron intakes decreased significantly (p less than .01 and p less than .001, respectively), while intakes of calcium remained constant. Mean consumption of thiamin, riboflavin, and niacin decreased significantly (p less than .01, p less than .05, and p less than .01, respectively). The changes in vitamin A and ascorbic acid intakes were not significant. Results indicated that a nutrition education program can effect positive changes toward better food choices. However, dietitians working with similar populations should stress eating patterns that include foods dense in micronutrients.     

Dietary intake and body composition of prepubescent female aesthetic athletes

The purpose of this study was to assess dietary intake and body composition of prepubescent girls competing in 3 aesthetic sports (artistic and rhythmic gymnastics and ballet). Because physiological demands of ballet training are similar to those in other aesthetic sports, ballet dancers were, for the purpose of this study, regarded as athletes. The sample consisted of 39 athletes (median age, 11 years, range 9-13) and 15 controls (median age, 11 years, range 10-12). Dietary intake was assessed using a quantitative food frequency questionnaire, and body composition, by means of anthropometry. There was no significant difference in total energy intake between groups, but there was a significant difference in energy substrate distribution. Artistic gymnasts reported significantly higher carbohydrate and lower fat contribution to total energy (57% +/- 6% and 29% +/- 5%, respectively) than rhythmic gymnasts (48% +/- 6% and 36% +/- 5%), ballet dancers (51% +/- 4% and 34% +/- 3%), or controls (51% +/- 5% and 34% +/- 4%). Relative to body weight, artistic gymnasts reported higher intake of carbohydrates (9.1 +/- 4.2 g/kg) than rhythmic gymnasts (5.6 +/- 3.1 g/kg), ballet dancers (6.6 +/- 2.5 g/kg), or controls (5.4 +/- 1.9 g/kg). Artistic gymnasts also had the lowest body-fat percentage among the groups. In all the groups mean reported daily intakes of most nutrients were higher than the current daily recommended intakes. The exceptions were dietary fiber and calcium. The proportion of athletes with an inadequate reported intake was highest for phosphorus (33%), followed by vitamin A and niacin (18%) and zinc (13%).     

The effect of dietary carbohydrate:fat ratio on energy intake by adult women

The effect of the dietary carbohydrate:fat (C:F) ratio on the spontaneous energy intake by healthy adults was investigated by comparing a high-carbohydrate diet (fat 24%, carbohydrate 58%, protein 18% of energy) and a high-fat diet (fat 47%, carbohydrate 35%, protein 18% of energy) in a 2 X 2 week cross-over design. Subjects were 22 healthy nuns in a Trappist convent with very regular activities. The diets consisted of combinations of liquid formula (75%) and standardized snacks (25%). The difference in C:F ratio was concealed: energy density, taste and appearance were similar. Energy consumption was recorded continuously. The mean daily energy intakes remained constant: 8276 kJ (1978 kcal). The difference in mean daily energy intake between diets was 73 kJ +/- 180 (SEM). Small changes in body weight were observed, but these are argued not to indicate definitive effects. It is concluded that changing the C:F ratio within commonly occurring ranges does not influence the spontaneous energy intake of healthy adults. The composition of the dietary fat was kept constant. Under practical conditions a change in the C:F ratio will also induce a change in the fatty acid composition of the diet, which might affect the energy intake regulation. Other experiments are required to see whether the C:F ratio can affect body composition or other physiological parameters in the long run.     

Nutritional survey of the US Navy SEAL trainees

The nutritional status of 267 male US Navy Sea, Air, and Land (SEAL) trainees was assessed to determine dietary patterns. Diet records, blood samples, 24-h urine collections, and physical characteristics were analyzed. Energy intake was 3886 +/- 73 kcal/d (SEM) with 15.7 +/- 0.2, 42.9 +/- 0.6, and 41.2 +/- 0.5% of the energy derived from protein, carbohydrate (CHO), and fat, respectively. Mean cholesterol intake (1008 +/- 35.7 mg/d [SEM]) exceeded the US Dietary Goal (less than or equal to 300 mg/d) and serum cholesterol concentration was 5.25 +/- 0.41 mmol/L (SEM). Over 38% of the trainees had cholesterol concentrations greater than 5.3 mmol/L, an indicator of high risk for cardiovascular disease. Mean sodium intake was 250 +/- 22 mmol/d. Over 86% of the trainees consumed greater than 144 mmol/d. Urinary Na excretion was high (146.7 +/- 6.7 mmol/d [SEM]) and correlated with Na intake (r = 0.365; p = 0.001). Potassium and selected vitamin intakes approximated the Military Recommended Dietary Allowances. Fat, cholesterol, and Na intakes were high relative to the dietary goals. Whether more dietary CHO would improve performance in endurance training remains to be determined.     

Social and dietary determinants of body mass index of adult Jamaicans of African origin

OBJECTIVES: To determine the relationships between body mass index (BMI) and diet, social and behavioural factors among adult Jamaicans of African origin. DESIGN: Cross-sectional. SETTING: Urban communities in Jamaica, West Indies. SUBJECTS: Three-hundred and sixty-three males and 561 females of African origin, aged 25-74 y. RESULTS: Women had higher mean BMIs (27.5+/-6.4 kg/m(2)) than men (23.4+/-4.3 kg/m(2)); 30.7% of women compared with 6.7% of men were obese. There was a tendency for obese men to have higher percentage of intakes from fat and less from carbohydrate, and women reported diets in which the percentage contribution of protein increased significantly with increasing BMI. In multivariate analyses, BMI was not explained by energy but was associated with protein intakes in females only. Predictors of relative weight were inversely related. Social (marital status) and behavioural (cigarette smoking) factors predicted BMI in both genders; older age in men and increased fibre intakes in women were associated with lower BMI. CONCLUSIONS: Social and behavioural factors are important determinants of body weight. Further investigations are needed which consider factors such as physical activity, genetic and other environmental variables as predictors of relative weight.