Sampling design, response rates, and analysis weights for the National Human Exposure Assessment Survey (NHEXAS) in EPA region 5.

For the Phase I field test of the National Human Exposure Assessment Survey (NHEXAS) in U.S. Environmental Protection Agency (EPA) Region 5, this paper presents the survey sampling design, the response rates achieved, and the sample weighting procedure implemented to compensate for unit nonresponse. To enable statistically defensible inferences to the entire region, a sample of about 250 members of the household population in EPA Region 5 was selected using a stratified multistage probability-based survey sampling design. Sample selection proceeded in four nested stages: (1) sample counties; (2) area segments based on Census blocks within sample counties; (3) housing units (HUs) within sample segments; and (4) individual participants within sample households. Each fourth-stage sample member was asked to participate in 6 days of exposure monitoring. A subsample of participants was asked to participate in two rounds of longitudinal follow-up data collection. Approximately 70% of all sample households participated in household screening interviews in which rosters of household members were developed. Over 70% of the sample subjects selected from these households completed the Baseline Questionnaire regarding their demographic characteristics and potential for exposures. And, over 75% of these sample members went on to complete at least the core environmental monitoring, including personal exposures to volatile organic compounds (VOCs) and tap water concentrations of metals. The sample weighting procedures used the data collected in the screening interviews for all household members to fit logistic models for nonresponse in the later phases of the study. Moreover, the statistical analysis weights were poststratified to 1994 State population projections obtained from the Bureau of the Census to ensure consistency with other statistics for the Region.     

National Human Exposure Assessment Survey (NHEXAS): distributions and associations of lead, arsenic and volatile organic compounds in EPA region 5.

The National Human Exposure Assessment Survey (NHEXAS) Phase I field study conducted in EPA Region 5 provides extensive exposure data on approximately 250 study participants selected via probability sampling. Associated environmental media and biomarker (blood, urine) concentration data were also obtained to aid in the understanding of relationships of the exposures to both contaminant sources and doses. Distributional parameters for arsenic (As), lead (Pb), and four volatile organic compounds (VOCs)--benzene, chloroform, tetrachloroethylene, and trichloroethylene--were estimated for each of the relevant media using weighted data analysis techniques. Inter-media associations were investigated through correlation analysis, and longitudinal correlations and models were used to investigate longitudinal patterns. Solid food appeared to be a major contributor to urine As levels, while Pb levels in household (HH) dust, personal air, and beverages all were significantly associated with blood Pb levels. Relatively high (>0.50) longitudinal correlations were observed for tap water Pb and As, as compared to only moderate longitudinal correlations for the personal air VOCs.     

Responses to the region 5 NHEXAS time/activity diary. National Human Exposure Assessment Survey.

The time/activity diary developed for use in the National Human Exposure Assessment Survey (NHEXAS) was completed by 249 participants in the Research Triangle Institute/Environmental and Occupational Health Sciences Institute (RTI/EOHSI) NHEXAS population-based pilot project conducted in the upper Midwest (EPA Region 5). The majority of participants successfully completed the diary during the 6-day study period. Participant responses showed internal consistency between related questions within the diary and between instruments used within the study. Comparison of response rates with the National Human Activity Pattern Survey, a nationwide population-based study, found consistent results when the same questions were used in both studies. Several questions identified age-specific activities. The value of the 6-day diary over 1-day surveys was apparent in discriminating between episodic and regularly conducted activities and in identifying subpopulations whose behavior may contribute to exposure to environmental pollutants.     

The National Human Exposure Assessment Survey (NHEXAS) study in Arizona--introduction and preliminary results.

The objective of the National Human Exposure Assessment Survey (NHEXAS) in Arizona is to determine the multimedia distribution of total human exposure to environmental pollutants in the classes of metals, pesticides, and volatile organic compounds (VOCs) for the population of Arizona. This was accomplished by studying a probability-based sample of the total population in Arizona with a nested design for the different stages of sampling (954 Stage I, 505 Stage II, and 179 Stage III participants). This report compares the study population demographics with those from the U.S. Census and provides preliminary data on the distributions of the example pollutant for each class, lead for metals, chlorpyrifos for pesticides, and benzene for metals. The probability-based sample age and gender demographics compare reasonably well with the Census data (1990 Census and 1996 Census Estimate). The race/ethnicity compared less well with 21% Hispanics in the 1996 Census Estimate and 42% Hispanics in the entire NHEXAS-Arizona sample and 30% Hispanics as Stage III participants for this study. The chemical analyses of the various media (yard soil, foundation soil, house dust, indoor air, outdoor air, drinking water, food, and beverage) show generally low levels of the representative pollutants. The 50th percentiles of the distributions are generally near or below the analytical detection limits, and applicable Federal action limits were rarely exceeded.     

Assessing the measurement precision of various arsenic forms and arsenic exposure in the National Human Exposure Assessment Survey (NHEXAS)

Archived samples collected from 1995 to 1997 in the National Human Exposure Assessment Survey (NHEXAS) in U.S. Environmental Protection Agency Region 5 (R5) and the Children's Study (CS) in Minnesota were analyzed for total arsenic, arsenate [As(V)], arsenite, dimethyl arsenic acid (DMA), monomethyl arsenic acid (MMA), arsenobetaine (AsB), and arsenocholine. Samples for the CS included drinking water, urine, hair, and dust; both studies included food (duplicate plate, composited 4-day food samples from participants). Except for AsB and As(V), the levels for As species measured in the food and drinking water samples were very low or nonexistent. The analytical methods used for measuring As species were sensitive to < 1 ppb. During the analysis of food and drinking water samples, chromatographic peaks appeared that contained As, but they did not correspond to those being quantified. Thus, in some samples, the sum of the individual As species levels was less than the total As level measured because the unknown forms of As were not quantified. On the other hand, total As was detectable in almost all samples (> 90%) except for hair (47%), indicating that the analytical method was sufficiently sensitive. Population distributions of As concentrations measured in drinking water, food (duplicate plate), dust, urine, and hair were estimated. Exposures to total As in food for children in the CS were about twice as high as in the general R5 population (medians of 17.5 ppb and 7.72 ppb, respectively). In addition, AsB was the most frequently detected form of As in food eaten by the participants, while As(V) was only rarely detected. Thus, the predominant dietary exposure was from an organic form of As. The major form of As in drinking water was As(V). Spearman (rank) correlations and Pearson (log-concentration scale) correlations between the biomarkers (urine, hair) and the other measures (food, drinking water, dust) and urine versus hair were performed. In the NHEXAS CS, total As and AsB in the food eaten were significantly correlated with their levels in urine. Also, levels of As(V) in drinking water correlated with DMA and MMA in urine. Arsenic levels in dust did not show a relationship with urine or hair levels, and no relationship was observed for food, drinking water, and dust with hair. Urine samples were collected on days 3, 5, and 7 of participants' monitoring periods. Total As levels in urine were significantly associated across the three pairwise combinations--i.e., day 3 versus day 5, day 3 versus day 7, and day 5 versus day 7. Because the half-life of As in the body is approximately 3 days, this suggests that some exposure occurred continually from day to day. This trend was also observed for AsB, suggesting that food is primarily responsible for the continual exposure. DMA and MMA in urine were also significantly correlated but not in all combinations.     

Spatial distributions of arsenic exposure and mining communities from NHEXAS Arizona. National Human Exposure Assessment Survey.

Within the context of the National Human Exposure Assessment Survey (NHEXAS), metals were evaluated in the air, soil, dust, water, food, beverages, and urine of a single respondent. Potential doses were calculated for five metals including arsenic. In this paper, we seek to validate the potential dose calculations through spatial analysis of the data. Others report elevated arsenic concentrations in biological and environmental samples from residents of mining towns, particularly Ajo, Arizona. These reports led us to expect potential arsenic doses above the 90th percentile of the NHEXAS exposure distribution to be from residents of mining communities. Arsenic dose was calculated using media concentrations, time activity patterns, and published exposure factors. Of the 179 homes evaluated, 54 were in mining communities; 11 of these were considered separately for reasons of population bias. Of the 17 homes with the greatest potential arsenic doses, almost half (47%) were in mining communities. We evaluated the potential doses by media from nonmining and mining areas using the nonparametric Mann-Whitney U test. Statistically significant (p = 0.05) differences were found between mining (n = 43) and nonmining sites (n = 122) for total exposure and for each of the following media: house dust, yard soil, outdoor air, beverage consumed, and water consumed. No differences were found in either food or indoor air of mining and nonmining areas. We eliminated outliers and repeated the test for all media; significance increased. Dietary, organic arsenic from fish consumption contributed to elevated arsenic exposure among people from nonmining communities and acted as an initial confounder. When controlling for fish consumption, we were able to validate our potential dose model using arsenic, particularly in Ajo. Further, we identified three mining communities lacking elevated arsenic exposure. Additional work is needed speciating the arsenic and evaluating health risks. The utilization of Geographic Information System facilitated spatial this project and paves the way for more sophisticated future spatial analyses.     

Evaluations of primary metals from NHEXAS Arizona: distributions and preliminary exposures. National Human Exposure Assessment Survey.

NHEXAS AZ is a multimedia, multipathway exposure assessment survey designed to evaluate metals and other analytes. This paper reports the analyte-specific concentration distributions in each of the media examined (air, soil, house dust, food, beverage, and water), for various methodologies used (inductively coupled plasma-atomic emission spectroscopy and hydride generation-atomic absorption spectroscopy). Results are reported for the five primary metals (Pb, As, Cd, Cr, and Ni). Ingestion was the most important pathway of exposure. Metal concentrations in air were very low (ng/m3) and found only above the 90th percentile. Metals were commonly found in house dust and soil. Exposure transfer coefficients minimize the importance of this component for those over the age of 6 years. When ranked by exposure, food, beverage, and water appeared to be the primary contributors of metal exposure in NHEXAS AZ. For instance, at the 90th percentile, Pb was undetected in air, found at 131 and 118 microg/m3 in floor dust and soil, respectively, and measured at 16 microg/kg in food, 7.1 microg/kg in beverage, and 2.0 and 1.3 microg/l in drinking and tap water, respectively. We calculated preliminary estimates of total exposure (microg/day) for each participant and examined them independently by age, gender, and ethnicity as reported by the subjects in the NHEXAS questionnaire. At the 90th percentile for Pb, total exposures were 64 microg/day across all subjects (n=176); adult men (n=55) had the greatest exposure (73 microg/day) and children (n=35) the least (37 microg/day). Hispanics (n=54) had greater exposure to Pb (68 microg/day) than non-Hispanics (n=119; 50 microg/day), whereas non-Hispanics had greater exposure for all other metals reported. These results have implications related to environmental justice. The NHEXAS project provides information to make informed decisions for protecting and promoting appropriate public health policy.     

Mass data massage: an automated data processing system used for NHEXAS, Arizona. National Human Exposure Assessment Survey.

Data entry and management are critical components of all large survey projects; data quality objectives must be met and data must be quickly and readily accessible. We developed a comprehensive system for data entry and management utilizing scannable forms with bubble fields and handwriting recognition. This 'Mass Data Massage' (MDM) system had three components: (1) form creation and database definition; (2) programming of data dictionaries for documentation and preliminary logic and range checks; and (3) data entry, management and documentation using the 'Mass Data Cleaning Program' (MDCP). Scannable forms were written in Teleform, where the data field definition, variable names and ranges were defined as the form was created. Completed forms were returned from the field, subjected to final field quality control (QC) checks, and transferred to the data management section. They were batched and coded as necessary. Once a batch of data was scanned and visually verified, the operator called up the menu for the MDCP. The MDCP had 31 program modules with 500-1200 lines of code each. The operator could select and run the appropriate dictionary on each data batch 'correcting' apparent errors in responses. This process was iterative until the data batch passed all dictionary checks. Proposed 'changes' were forwarded to the data coordinator (DC) for acceptance or rejection. After all errors had been resolved, each data batch was subjected to a 10% quality assurance (QA) check. The original data batch and associated file of applied changes were archived. Time expenditure using the scanning approach varied with the number of questions and the types of responses (handwritten or bubble fields). One-page forms took 42-60% of the time needed for hand entry; forms longer than 10 pages took 35-38% of the time. Use of faster machines will further speed the process. The main advantage of the system was the reduction of systematic errors. Scanning alone reduced errors found on 995 NHEXAS Baseline Questionnaires. Overall, the dictionary identified 0.55% errors on the scanned forms. Ten percent QC checks, performed on corrected batches ready for appendage to the master database, revealed an overall error rate of 0.02%. Similar checks on a laboratory form scanned from numeric handwriting detected 0.3% errors following dictionary application and 0.2% errors during the 10% QA check. This system was faster, more accurate, and more cost-effective than hand entry of data. A batch of data that took >1 week to process using the hand entry method was processed within 1 day using MDM. Human coding of specific answers and the final verification were the most time-consuming processes.     

National Human Exposure Assessment Survey: analysis of exposure pathways and routes for arsenic and lead in EPA Region 5

The National Human Exposure Assessment Survey (NHEXAS) Phase I field study conducted in EPA Region 5 (Great Lakes Area) provides extensive exposure data on a representative sample of approximately 250 residents of the region. Associated environmental media and biomarker (blood, urine) concentration data were also obtained for the study participants to aid in understanding of the relationships of exposures to both contaminant pathways and doses. Besides fulfilling the primary NHEXAS objectives, the NHEXAS data provided an opportunity to explore secondary usages, such as examining pathway to route of exposure relationships. A generic type of structural equation model was used to define the anticipated relationships among the various data types for both arsenic (As) and lead (Pb). Since, by design, only a few participants provided data for all sample types, implementing this model required that some media concentrations (outdoor air and soil) be imputed for subjects with missing information by using measurements collected in the same geographic area and time period. The model, and associated pairwise correlations, generally revealed significant but weak associations among the concentrations, exposures, and doses; the strongest associations occurred for the various air measurements (indoor versus outdoor and personal). The generally weak associations were thought to be partly due to the absence of complete coverage of nonresidential environmental media and to nonsynchronization of relevant measurement times and integration periods of collection across the various sample types. In general, relationships between the NHEXAS questionnaire data and the various concentration, exposure, and body-burden measures were also weak. The model results and the modeling exercise suggest several ways for optimizing the design of future exposure assessment studies that are aimed at supporting structural modeling activities.     

National human exposure assessment survey (NHEXAS): exploratory survey of exposure among population subgroups in EPA Region V

The National Human Exposure Assessment Survey (NHEXAS) provides a rich database of exposure and environmental measurements for persons living in EPA Region V (Great Lakes). Demographics (e.g., gender, minority status, age, income, and year home built) between U.S. Census data and the overall Region V sample were compared and showed good agreement. This representative sample was used to conduct an exploratory investigation of selected subpopulations that might exhibit higher exposures, on average, to volatile organic chemicals (VOCs) such as benzene, chloroform, etc.; inspirable particles; and metals (e.g., lead, arsenic, etc.) than the general population in Region V. Means and medians were the metrics of comparison. Personal air exposures for p-dichlorobenzene were significantly higher in adults (> 21 years old) than in children (1-14 years old) (median: below detection limit vs. 0.87 microgram/m3, p = 0.0005), while a trend toward higher levels of arsenic exposure in children than adults was observed (median: 1.13 vs. 0.8 ng/m3, p = 0.083). A trend towards higher personal air exposure to lead for minorities vs. nonminorities was evident (median: 26 vs. 12 ng/m3, p = 0.066), but personal exposure to 1,1,1-trichloroethane tended to be higher in nonminorities (mean: 22 vs. 3.7 micrograms/m3, p = 0.081). Dietary exposure to arsenic from solid foods was significantly higher in adults than children (mean: 21 vs. 7.1 micrograms/kg, p = 0.0001; median: 10 vs. 5.6 micrograms/kg, p = < 0.001), and for cadmium it was higher for nonminorities than minorities (median: 18 vs. 15 micrograms/kg, p = 0.023). In contrast, the dietary intake for arsenic, which is based on body weight, was significantly higher in children than adults (mean: 1.72 vs 1.38 micrograms/kg-1 day-1, p = < 0.0001; median 1.02 vs. 0.83, p = < 0.0001). Dietary exposure to chromium in beverages tended to be higher in minorities than nonminorities (median: 16 vs. 13 micrograms/kg, p = 0.017). Lead levels in surface dust wipes tended to increase with the age of the home (mean: 128 micrograms/g in homes built since 1980 to 1075 micrograms/g in homes built before 1940; median: 93 to 236 micrograms/g, respectively). These findings were consistent with the observation that for persons living in older homes personal air exposures to lead are elevated compared to persons living in recently built homes (median: 12 ng/m3 in homes built since 1980, vs. 24 ng/m3 in homes built before 1940, p = 0.043).     

Exposure science and the U.S. EPA National Center for Computational Toxicology

The emerging field of computational toxicology applies mathematical and computer models and molecular biological and chemical approaches to explore both qualitative and quantitative relationships between sources of environmental pollutant exposure and adverse health outcomes. The integration of modern computing with molecular biology and chemistry will allow scientists to better prioritize data, inform decision makers on chemical risk assessments and understand a chemical's progression from the environment to the target tissue within an organism and ultimately to the key steps that trigger an adverse health effect. In this paper, several of the major research activities being sponsored by Environmental Protection Agency's National Center for Computational Toxicology are highlighted. Potential links between research in computational toxicology and human exposure science are identified. As with the traditional approaches for toxicity testing and hazard assessment, exposure science is required to inform design and interpretation of high-throughput assays. In addition, common themes inherent throughout National Center for Computational Toxicology research activities are highlighted for emphasis as exposure science advances into the 21st century.     

Variability in concentrations of selected trace elements in water and sediment of six acidic lakes

Concentrations of the trace elements aluminum, cadmium, lead, manganese, and zinc were determined in water and sediments of six acidic clear-water lakes (pH 3.6–6.2) in northwestern New Jersey. Levels of aluminum, lead, and zinc in the water column were sharply elevated in the most acidic lakes, with values similar to acidified systems elsewhere. Seasonal fluctuations occurred, with lead displaying peak concentrations in all lakes during the fall sampling period. Analyses of core samples of lake sediment indicated that while lead concentrations exhibited a typical sharp increase in most recent sediments, cadmium and zinc levels in the upper layers were substantially lower than values reported for similar systems elsewhere. As expected, manganese concentrations generally decreased in the upper sediment layers in the acidic lakes, while aluminum varied dramatically between systems.     

吉布提市自来水部分元素检测与分析

目的为了保障亚丁湾护航补给饮用水的安全性,我们对亚丁湾护航补给点之一的吉布提市生活饮用水水质进行了元素检测。方法采集管网末梢水,利用电感耦合等离子体质谱仪(ICP-MS)检测水中Be、Na、Mg、Al、K、Ca、V、Cr、Fe、Mn、Co、Ni、Cu、Zn、As、Se、Mo、Ag、Cd、Sb、Ba、Tl、Pb、Th和U,共25种元素含量。结果除钠、铁和铊超标外,其余各项检测指标均合格。结论吉布提市市供自来水部分检测指标超过我国标准要求,该饮用水若未经处理暂不宜作为舰艇补给用水。     

Dietary intakes of selected elements from longitudinal 6-day duplicate diets for pregnant and nonpregnant subjects and elemental concentrations of breast milk and infant formula.

As part of a longitudinal investigation into mobilization of lead from the maternal skeleton during pregnancy and lactation, we have determined the daily intake of selected elements (hereafter called micronutrients) for various subjects and compared these intakes with recommended and/or published intakes, especially those of the United States, through the U.S. National Health and Nutrition Examination Survey (NHANES). We also sought to ascertain whether there was any seasonal effect in the diets. Six-day duplicate diets were collected from 15 pregnant and 16 nonpregnant migrants to Australia, 6 pregnant Australian control subjects, and 8 children of nonpregnant migrants (6 to 11 years). Samples of breast milk and infant formula were also analyzed. Blended samples were analyzed by inductively coupled plasma mass spectrometry for the elements Ca, Cu, Fe, Mg, P, K, Na, Zn, Ba, Sr, and Pb. Daily intakes of micronutrients were only about half of the daily intake estimated for non-Hispanic white females and infants in the U.S. NHANES III. Estimates of daily intakes from breast milk were also considerably lower for the migrant and Australian infants compared with the values extracted from tables of food composition and dietary recall for non-Hispanic white infants in the U.S. NHANES III. For example, Ca was a factor of approximately 3 times lower, Fe approximately 50, and Zn approximately 4. We consider our estimates a reliable indication of the daily intakes for several reasons, including the collection of up to nine quarterly collections of 6-day duplicate diets and retention of subjects in a longitudinal prospective study. The low intakes of the essential elements such as Ca, Fe, and Zn in all these population groups are of potential concern from a public health viewpoint.     

Mortality and the concentration of elements in tap water in county boroughs in England and Wales.

To explain the associations of water hardness and air temperature with area differences in ischaemic heart disease mortality, samples of tap water were obtained from homes in 61 county boroughs in England and Wales, and the concentration of calcium and 12 other elements was estimated. Multiple regressions were calculated with the death rates from various causes as dependent variables and with the concentration of the elements in the tap water, mean annual temperature, mean annual rainfall, and a socioeconomic index as independent variables. The well known negative association between water hardness and ischaemic heart disease was shown to be due to calcium, and none of 12 other elements examined appeared to contribute significantly to the association. Area differences in other causes of death also showed an association with calcium. There was little association between temperature and ischaemic heart disease.     

Correlations between urinary concentrations and dietary intakes of flavonols in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

In this study, we aimed to study the correlation between acute and habitual intakes of flavonols, their main food sources and their 24-h urinary concentrat     

Associations between fat,sugar and other macronutrient intakes in the National Diet and Nutrition Survey

Observational studies show an inverse relationship between fat and sugar within diets, described as the ‘fat‐sugar seesaw’. It has been suggested however, that this is a consequence of expressing macronutrient intakes as percentages of energy intake rather than by the dietary choices made by individuals. To test this we examined the associations between macronutrient intakes in the diets of adults (n = 1724) participating in the UK National Diet and Nutrition Survey (NDNS) and within the same adults across different days of the week. Pearson's correlations were calculated between the macronutrient intakes from fat, total sugar, intrinsic sugars, non‐milk extrinsic sugars (NMES), non‐sugar carbohydrate, protein and alcohol. Energy intakes relative to estimated basal metabolic rate (BMR) were calculated to partially account for differences in energy requirements. Pearson's correlations also examined associations between the same macronutrients in foods from the Nutrient Databank (ND), used to analyse dietary intakes in the NDNS. Correlations between fat and sugar(s) were calculated in five ways: (i) percentage energy between individuals; (ii) amount (g) between individuals; (iii) amount (g) relative to BMR between individuals; (iv) within individuals over seven days; and (v) between food items in the ND. Negative correlations were obtained between mean daily percentage energy intakes of fat and, total sugars, NMES and intrinsic sugars (all P < 0.001). However, when mean daily macronutrient intakes were expressed in weight (g)/day, these were all positively correlated (all P < 0.001). Mean estimated correlations between macronutrient intakes (g/day) for each individual across the days of the week were also positive, indicating a lack of fat‐sugar seesaw effect. Within the ND, the correlation between fat and total sugar (g/100g of food) was weakly positive (P = 0.006). Only when examining the correlation between fat and sugar(s) between individuals in percentage terms (% energy) was the fat‐sugar seesaw evident; in all other methods the correlations between fat and sugar(s) were positive. Examination of the effects of using percentage energy values to describe the macronutrient composition demonstrated that the fat‐sugar seesaw is only an inevitable mathematical consequence, rather than the result of dietary choice. Comparing diet composition in percentage terms alone can therefore be misleading. It is only when examined as absolute values (weight), as well as percentage contributions to energy, that the interrelationships between macronutrients can be studied fully.     

Association of total calcium and dietary protein intakes with fracture risk in postmenopausal women: The 1999–2002 National Health and Nutrition Examination Survey (NHANES)

ObjectiveWe examined the associations of total calcium intake (TCI) and dietary protein intake (DPI) with risk of fracture.MethodsA total of 2006 postmenopausal women ≥50 y of age who were measured in the 1999–2002 National Health and Nutrition Examination Survey were included in the study. Weighted mean TCI and DPI and percentage of distributions of selected characteristics were estimated by TCI category and fracture status. Multivariate logistic regression models were used to assess the effect of TCI and DPI on risk of fracture.ResultsThirteen percent of participants reported a fracture history, of whom 17.8% consumed a total of ≥1200 mg of calcium per day and 23.8% consumed <400 mg/d. TCI was not associated with fracture risk when controlling for all selected covariates. In women who consumed <46 g/d of dietary protein, those with a TCI ≥1200 mg/d had a significantly higher risk of fracture than those with the lowest TCI (adjusted odds ratio 5.98, 95% confidence interval 1.15–31.13), whereas in women who consumed >70 g/d of dietary protein, those with a TCI ≥1200 mg/d had an insignificant lower risk of fracture (adjusted odds ratio 0.69, 95% confidence interval 0.20–2.39).ConclusionTCI is not associated with risk of fracture among postmenopausal women. Adequate TCI in the presence of inadequate DPI may not be protective against fractures. Optimal proportion of TCI and DPI warrants further investigation among older women.     

Total dietary fiber intakes in the US population are related to whole grain consumption: results from the National Health and Nutrition Examination Survey 2009 to 2010

Whole grain (WG) foods have been shown to reduce chronic disease risk and overweight. Total dietary fiber is associated with WG and its health benefits. The purpose was to determine whether associations exist between WG intake (no-WG intake, 0 ounce equivalent [oz eq]; low, >0-<3 oz eq; high, ≥3 oz eq) and total dietary fiber intake among Americans 2 years and older. One-day food intake data from the US National Health and Nutrition Examination Survey 2009 to 2010 (n = 9042) showed that only 2.9% and 7.7% of children/adolescents (2-18 years) and adults (≥19 years) consumed at least 3 WG oz eq/d, respectively. For children/adolescents and adults, individuals in the high WG intake group were 59 and 76 times more likely to fall in the third fiber tertile, respectively, compared with those with no-WG intake. Total dietary fiber intake from food sources varied by WG intake group for children/adolescents and adults with more total dietary fiber consumed from ready-to-eat (RTE) and hot cereals and yeast breads/rolls in the high WG intake group compared with the no-WG intake group. Major WG sources for children/adolescents and adults included yeast bread/rolls (24% and 27%, respectively), RTE cereals (25% and 20%, respectively), and oatmeal (12% and 21%, respectively). Among those with the highest WG intake, WG RTE cereal with no added bran was the greatest contributor to total dietary fiber compared with other RTE cereal types. Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.     

Deficient dietary iron intakes among women and children in Russia: evidence from the Russian Longitudinal Monitoring Survey.

OBJECTIVES: This study evaluated the iron sufficiency of the Russian diet. METHODS: Data were obtained from 24-hour dietary recalls conducted in 4 rounds (1992 through 1994) of a nationally representative longitudinal survey of 10,548 women and children. Iron bioavailability was estimated via algorithms adjusting for enhancers (heme, vitamin C) and inhibitors (tannins in tea, phytates in grains) consumed at the same meal. RESULTS: Dietary iron intakes were deficient in the most vulnerable groups: young children and women of reproductive age. Poverty status was strongly associated with deficiency. After adjustment for enhancers and inhibitors, estimated bioavailable iron intakes at 3% to 4% of total iron were inadequate in all women and children. CONCLUSIONS: These dietary data suggest that Russian women and children are at high risk of iron deficiency. Grain products rich in phytates, which inhibit absorption, were the major food source of iron in Russia. High intakes of tea and low consumption of vitamin C also inhibited iron bioavailability. Since changes in eating behavior could potentially double iron bioavailability, educational programs should be explored as a strategy for improving iron nutriture.