Dietary intake among elderly Chinese in Hong Kong

Evaluation and improvement of nutritional status should be among the research priorities aimed towards a better life for the elderly. In a cohort study of about 1 ,000 elderly subjects in Hong Kong, a 24-hour dietary recall and dietary consumption pattern were obtained in the first phase cross-sectional study. This paper reports on the 695 men and women living outside institutions. All subjects were aged 70 and above. They were either living with their spouse, with children or grandchildren, or with relatives or friends. Based on Recommended Dietary Allowances for East Asia, the dietary intakes in general were adequate in terms of energy and nutrients except for calcium, vitamin A, riboflavin and niacin. The general low intake of these nutrients, especially calcium, were supported by the dietary consumption pattern and deserves attention from health care providers. Practical dietary recommendations can be given to improve the nutritional intake of the ageing Chinese population in Hong Kong.     

Comparison of estimated nutrient intake by two methods: validation of a food frequency questionnaire

The validity of a quantitative self-administered food frequency questionnaire (FFQ) was tested by comparison with 7-d weighed food records (7DWR). Subjects for the study were 24 females between 20 and 43 years of age (mean = 24 years). The main aim of the FFQ was to classify subjects according to their total fat intake.
The mean nutrient intakes estimated by the FFQ were consistently and significantly higher than the estimates by the 7DWR. Rank correlations showed that the FFQ was able to rank subjects similarly for total energy intake, fat, alcohol and fibre intake as well as for the percentage contribution of macronutrients to energy intake. Intra-class correlations showed that the two methods did not agree at the individual level for energy and macronutrient intake except alcohol. These results suggest that the FFQ was suitable for ranking the subjects according to their total fat intake but was not suitable for estimating the individual nutrient intake or average nutrient intake of this relatively small group.     

农村老年人膳食微量元素摄入水平调查

目的了解四川省农村≥65岁老年人膳食微量元素摄入情况和食物来源。方法采集当地粮食、蔬菜等食物样品,测定其中8种微量元素的含量,结合膳食问卷调查结果计算个体日常膳食微量元素摄入情况。结果114份样品中各种微量元素的检出率均80%;人群膳食Se、Ca、Cu、Fe、Zn每天平均摄入量分别为(14.325±8.914)μg,(333.407±269.785),(3.109±4.890),(18.179±27.515),(6.902±3.493)mg,其中Se、Ca、Cu、Fe和Zn的摄入量均有50%的老年人低于日推荐摄入量或日适宜摄入量;对人体有毒性作用的Cd和Pb周摄入量超过WHO推荐的周允许摄入量的老年人分别有439和154人;除男性膳食Cu日摄入量明显高于女性(P0.001)外,其他膳食微量元素摄入情况性别差异无统计学意义。结论四川省农村老年人膳食必需微量元素摄入量普遍不足,对人体有毒性作用的Cd和Pb摄入量严重超标。     

湖北省老年住院患者营养状况调查及评价

目的 评估湖北省老年住院患者营养状况及其影响因素,为老年住院患者合理营养支持提供依据。方法 采取分层随机抽样方法,对2014年5—12月湖北省黄冈市等5个地区住院治疗的4 946例老年患者进行营养状况评估。结果 城市和农村居民肥胖率分别34.16%和15.44%,差异有统计学意义(χ²=30.47,P<0.05);营养风险筛查(NRS)评分中,老年住院患者营养风险发生率、贫血发生率、血清总蛋白(TP)异常发生率、血清白蛋白(ALB)异常发生率、总淋巴细胞计数(TLC)和红细胞计数(RBC)异常发生率分别为53.62%、44.54%、53.98%、59.12%、43.17%和39.39%,其中,城市和农村老年住院患者贫血发生率、TP异常发生率、ALB异常发生率、RBC异常发生率差异均有统计学意义(χ²=21.72、32.85、38.23、21.07,均P<0.05)。结论 随着年龄的增长,农村地区老年住院患者的营养风险和营养不良发生率高于城市地区,需要社会和家庭更加关注农村老年患者的营养状况,及时调整膳食结构和食物品种搭配,合理补充各类营养素。     

Validation of a questionnaire assessing food frequency and nutritional intake in Greek adolescents

The aim of the study was to develop and validate a specific semi-quantitative food frequency questionnaire to assess nutritional intake of Greek adolescents. The sample of the study consisted of 250 pupils (15.3±0.7 years), who completed the Youth Adolescent Food Frequency Questionnaire enriched with 22 Greek foods and recipes to include ethnic and racial diversity. A 3-day weighed food recall was used as the criterion to test the validity of the questionnaire. The analysis of correlation revealed significant correlations between the two methods for almost all variables. The Pearson's coefficients ranged from 0.83 for energy intake to 0.34 for folate intake. Non-significant correlations were found for selenium and vitamin D intakes. The findings of the study provide evidence for the validity of the scale and its utility in assessing nutritional intake of Greek adolescents.     

Nutritional and Hydration Status and Adherence to Dietary Recommendations in Dalmatian Dialysis Patients

Protein-energy wasting (PEW) is considered one of the major complications of chronic kidney disease (CKD), particularly in dialysis patients. Insufficient energy and protein intake, together with clinical complications, may contribute to the onset and severity of PEW. Therefore, the aim of the study was to analyze the differences in nutritional and hydration status and dietary intake among Dalmatian dialysis patients. Fifty-five hemodialysis (HD) and twenty peritoneal dialysis (PD) participants were included. For each study participant, data about body composition, anthropometric, laboratory, and clinical parameters were obtained. The Malnutrition Inflammation Score (MIS) and two separate 24-h dietary recalls were used to assess nutritional status and dietary intake. The Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) were calculated to compare actual dietary intake with recommended intake. Additionally, the estimated 10-year survival was calculated using the Charlson Comorbidity Index. The prevalence of malnutrition according to MIS was 47.3% in HD and 45% in PD participants. Significant differences in fat tissue parameters were found between HD and PD participants, whereas significant differences in hydration status and muscle mass parameters were not found. A significant difference in NAR between HD and PD participants was noticed for potassium and phosphorus intake, but not for MAR. MIS correlated negatively with anthropometric parameters, fat mass, visceral fat level and trunk fat mass, and iron and uric acid in HD participants, whereas no significant correlations were found in PD participants. The estimated 10-year survival correlated with several parameters of nutritional status in HD and PD participants, as well as nutrient intake in HD participants. These results indicate a high prevalence of malnutrition and inadequate dietary intake in the Dalmatian dialysis population which, furthermore, highlights the urgent need for individualized and structural nutritional support.     

Dietary variety and its effect on food intake of elderly adults

BACKGROUND: Older people frequently have poor food intake. This present study investigated the effect of dietary variety on food intake in younger and older people. METHODS: Eighteen young adults (mean age = 26 years) and 18 older adults (mean age = 70 years) consumed four consecutive courses of sandwiches on two occasions. In the plain treatment, each course of sandwiches was of the same type, while in the variety treatment four courses, each of a different type of sandwich, were served. Each time the participants were presented with a serving of sandwiches and asked to eat as much as they liked. RESULTS: In the plain condition, the older adult group consumed more than their young counterparts. This situation was reversed for the variety condition when the young group ate more than the older adults. Interestingly, the older adult group ate more when a variety of sandwiches was presented. This may be contrary to what is predicted by the sensory-specific satiety model of eating behaviour. CONCLUSIONS: This study suggests that presenting the older people with a varied meal may be a valid strategy to improve food intake in this group.     

Validation of a food frequency questionnaire for women with osteoporosis

The importance of nutrient intakes in osteoporosis prevention in treatment is widely recognized. The objective of the present study was to develop and validate a FFQ for women with osteoporosis. The questionnaire was composed of 60 items, separated into 10 groups. The relative validation was accomplished through comparison of the 3-Day Food Record (3DR) with the FFQ. The 3DR was applied to 30 elderly women with confirmed osteoporosis, and after 45 days the FFQ was administrated. Statistical analysis comprised the Kolmogorov-Smirnov, Student T test and Pearson correlation coefficient. The agreement between two methods was evaluated by the frequency of similar classification into quartiles, and by the Bland-Altman method. No significant differences between methods were observed for the mean evaluated nutrients, except for carbohydrate and magnesium. Pearson correlation coefficients were positive and statistically significant for all nutrients. The overall proportion of subjects classified in the same quartile by the two methods was on average 50.01% and in the opposite quartile 0.47%. For calcium intake, only 3% of subjects were classified in opposite extreme quartiles by the two methods. The Bland-Altman analysis demonstrated that the differences obtained by the two methods in each subject were well distributed around the mean of the difference, and the disagreement increases as the mean intake increases. These results indicates that the FFQ for elderly women with osteoporosis presented here is highly acceptable and is an accurate method that can be used in large-scale or clinical studies for evaluation of nutrient intakes in a similar population.     

Usability of a smartphone food picture app for assisting 24-hour dietary recall: a pilot study

BACKGROUND/OBJECTIVES

The Recaller app was developed to help individuals record their food intakes. This pilot study evaluated the usability of this new food picture application (app), which operates on a smartphone with an embedded camera and Internet capability.

SUBJECTS/METHODS

Adults aged 19 to 28 years (23 males and 22 females) were assigned to use the Recaller app on six designated, nonconsecutive days in order to capture an image of each meal and snack before and after eating. The images were automatically time-stamped and uploaded by the app to the Recaller website. A trained nutritionist administered a 24-hour dietary recall interview 1 day after food images were taken. Participants'' opinions of the Recaller app and its usability were determined by a follow-up survey. As an evaluation indicator of usability, the number of images taken was analyzed and multivariate Poisson regression used to model the factors determining the number of images sent.

RESULTS

A total of 3,315 food images were uploaded throughout the study period. The median number of images taken per day was nine for males and 13 for females. The survey showed that the Recaller app was easy to use, and 50% of the participants would consider using the app daily. Predictors of a higher number of images were as follows: greater interval (hours) between the first and last food images sent, weekend, and female.

CONCLUSIONS

The results of this pilot study provide valuable information for understanding the usability of the Recaller smartphone food picture app as well as other similarly designed apps. This study provides a model for assisting nutrition educators in their collection of food intake information by using tools available on smartphones. This innovative approach has the potential to improve recall of foods eaten and monitoring of dietary intake in nutritional studies.     

Comparison between Self-Completed and Interviewer-Administered 24-Hour Dietary Recalls in Cancer Survivors: Sampling Bias and Differential Reporting

Self-completed 24 h dietary recalls (24-HRs) are increasingly used for research and national dietary surveillance. It is unclear how difficulties with self-completion affect response rates and sample characteristics. This study identified factors associated with being unable to self-complete an online 24-HR but willing to do so with an interviewer. Baseline 24-HRs from the ASCOT Trial were analysed (n = 1224). Adults who had been diagnosed with cancer in the past seven years and completed treatment, were invited to self-complete 24-HRs online using myfood24^®. Non-completers were offered an interviewer-administered 24-HR. One third of participants willing to provide dietary data, were unable to self-complete a 24-HR. This was associated with being older, non-white and not educated to degree level. Compared to interviewer-administered 24-HRs, self-completed 24-HRs included 25% fewer items and reported lower intakes of energy, fat, saturated fat and sugar. This study highlights how collection of dietary data via online self-completed 24-HRs, without the provision of an alternative method, contributes to sampling bias. As dietary surveys are used for service and policy planning it is essential to widen inclusion. Optimisation of 24-HR tools might increase usability but interviewer-administered 24-HRs may be the only suitable option for some individuals.     

Reproducibility and relative validity of a food frequency questionnaire to assess intake of dietary flavonol and flavone in Chinese university campus population

Epidemiologic studies have shown that populations that consume more fruits and vegetables have lower incidences of some diseases. These health effects have largely been attributed to flavonoid intake and bioavailability. However, no published data on the estimated flavonol and flavone intake of Chinese adults are currently available. Considering reports that food frequency questionnaires (FFQs) have been shown to provide good measurements of energy, macronutrient, and micronutrient intakes, we hypothesized that FFQ may be used to estimate intake of dietary flavonol and flavone. The two 7-day 24-hour dietary recalls (24-HDRs) and plasma levels were used as reference criteria. A total of 128 subjects each completed two 7-day 24-HDR and 2 FFQs, and 92 subjects donated 2 plasma samples. Pearson correlation coefficients and the agreement of quartile categorization between the FFQ and each reference instrument were conducted. Pearson correlation coefficients between 2 FFQs were 0.62 for flavonol and 0.65 for flavone and ranged from 0.48 (quercetin) to 0.63 (luteolin) (all P < .05). Pearson correlation coefficients between FFQ and 24-HDR were 0.62 for flavonol and 0.68 for flavone and ranged from 0.36 (quercetin) to 0.63 (luteolin) (all P < .05). Between the FFQ and plasma samples, Pearson correlation coefficients were 0.52 for flavonol and 0.41 for flavone and ranged from 0.32 (quercetin) to 0.44 (kaempferol) (all P < .05). The complete and partial agreement by quartiles ranged from 70% to 89%. The findings indicate that administering FFQ is a reliable and accurate method of assessing dietary intake of flavonol and flavone.     

Dietary assessment instruments for preschool children: reliability of parental responses to the 24-hour recall and a food frequency questionnaire

Nutrient intakes of preschool-age children were assessed with a 24-hour dietary recall and a 3-month food frequency questionnaire (FFQ). Parents of 55 preschoolers (mean age = 4.25 +/- 0.59 years) completed the recall and FFQ on two occasions 1 week apart. The recalls and FFQs were analyzed for energy, cholesterol, protein, total carbohydrate, calcium, sodium, potassium, and saturated, polyunsaturated, and monounsaturated fats; each nutrient was expressed as raw value, value per kg body weight, and value per 1,000 kcal. Test-retest reliability estimates for the 24-hour recall indicated significant variability in reported total energy intake, but stable reports of intake were observed for one or all units of expression for polyunsaturated fats, cholesterol, protein, total carbohydrate, calcium, and potassium. The FFQ showed significant positive test-retest reliability estimates for all nutrients for all units of expression. Comparison of the recall and FFQ data showed similar percentages of intakes of energy from fat, carbohydrate, and protein and significant correlations for reported intakes of cholesterol, protein, calcium, and potassium. Comparison of the recall and FFQ data with recall data from a comparable cohort showed lower reported intakes for our sample, with the exception of protein, carbohydrate, calcium, and potassium. If validation studies are successful, the FFQ may be useful in epidemiological studies of preschoolers' intakes over extended periods. The recall may prove to be a useful tool in the assessment of day-to-day variations in macronutrient intakes.     

Relative validation of a short food frequency questionnaire to assess calcium intake in older adults

OBJECTIVE: To develop and validate a food frequency questionnaire (FFQ) for estimating calcium intake in community-dwelling older adults using a food record as the reference method. METHOD: A validation study involving 102 subjects (67 females) aged > or =65 years and residing independently in Adelaide, Australia, between 2002-06 was performed. Estimates of calcium intake over the last year were calculated from two versions (35 and 15 items) of the FFQ and compared with average intake from four days of non-consecutive food records (4DFR). RESULTS: Mean calcium intake from the 4DFR was 987 mg/day (95% CI 922-1051). The 35 and 15-item questionnaires gave mean intakes of 992 mg/day (95% CI 913-1,071) and 1017 mg/day (95% CI 927-1,106) respectively. Mean difference (95% limits of agreement) between the food record and the 35 and 15-item questionnaires was 5 mg (-739-729) and 28 mg (-936-879) respectively. The 15-item questionnaire demonstrated 82% sensitivity for classifying subjects with calcium intake below the estimated average requirement (EAR, 840 mg for males 51-70 years; 1,100 mg for females >51 years and males >70 years of age) and 46% specificity for classifying subjects with intake above the EAR. CONCLUSION: The FFQ evaluated as part of this study is one of very few that has been tested across both genders and in older adults specifically. The 15-item version has demonstrated a level of sensitivity and specificity comparable with other FFQs for evaluating calcium intake. Implications: The 15-item FFQ can be confidently used for measuring group mean calcium intake in older Australians or as a screening tool to allow health professionals to identify those who are most at risk of inadequate dietary calcium intake.     

Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews.

The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.