Comparison of nutrient intake in adolescents and adults with and without food allergies

Background

Exclusion diets for the management of food allergy pose a risk of nutritional deficiencies and inadequate growth in children, yet less is known about their effect in adolescents and adults. The present study aimed to compare the dietary intake of adolescents and adults with food allergies with that of a control group.

Methods

A food allergic and a control group were recruited from Portsmouth and the Isle of Wight in the UK. Participants were recruited from a food allergy charity, allergy clinics, a local school and university, and previous research studies. Macro and micronutrient intake data were obtained using a 4‐day estimated food diary. Sociodemographic and anthropometric data was collected via a constructed questionnaire.

Results

This cross‐sectional study included 81 adolescents (48 food allergic and 33 controls) aged 11–18 years and 70 adults aged 19–65 years (23 food allergic and 47 controls). Overall, 19 (22.8%) adolescents and 19 (27.1%) adults took dietary supplements, with no difference according to food allergic status. Adolescents with food allergy had higher intakes of niacin and selenium than adolescents without (P < 0.05). This difference persisted when dietary supplements were removed from the analysis. Adults with food allergies had higher intakes of folate and zinc than those without (P < 0.05); however, this difference did not persist when dietary supplements were removed from the analysis. Across all participants, the intake of several micronutrients was suboptimal. There was no difference in protein or energy intake, or body mass index, according to food allergic status.

Conclusions

The dietary intake of food allergic participants was broadly similar and, in some cases, better than that of control participants. However, suboptimal intakes of several micronutrients were observed across all participants, suggesting poor food choices.

     

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.     

Recent national French food and nutrient intake data

In France, the first national dietary survey, called ASPCC, was done in 1993-1994. According to this survey, the mean fat intake in France is rather high, both for men (37.7%) and women (40%). Saturated fat intake is above 15% of energy. The intake of fruit and vegetables is particularly low for younger people and manual workers. Fruit intake is also lower for people from the north of the country. These data show the necessity of a targeted nutritional policy in France. Therefore, public health authorities are determining new dietary guidelines. The fact that people with unsatisfactory nutritional status are often not concerned with nutrition proves the importance of simple understandable food-based dietary guidelines.     

Comparison of a food frequency questionnaire using reported vs standard portion sizes for classifying individuals according to nutrient intake

Individual intakes of retinol, carotene, vitamin C, and folacin calculated from a food frequency questionnaire using reported portion size were compared with intakes calculated using standard portion size information. Data from a case-control study to determine the association of nutrient intake and risk of cervical dysplasia were supplemented by standard portion size information from the US Department of Agriculture and reanalyzed. Significant mean differences were found between intake calculated from reported portion size data and that calculated from standard portion size data for all nutrients. Correlation of nutrient intakes obtained by the two methods of data collection ranged from .73 to .92. Calculation of the rho statistic, measuring the consistency of classification of participants into groups of high, medium, and low nutrient intake, led to values ranging from .55 to .71, indicating some misclassification of study participants. To determine the effect misclassification had on the study outcome, odds ratios were calculated using nutrient amounts obtained from both methods of collecting portion size data. Results indicate that replacing reported portion size data with standard portion size data may lead to conflicting outcomes for specific nutrients in research concerning the relationship between diet and disease.     

Comparison of nutrient intake determined by four dietary intake instruments

We compared nutrient intake estimates among four commonly used food intake instruments: 24-hour recall, a 2-day diet diary, a modified diet history, and a quantitative food-frequency questionnaire. The four instruments were administered to each of fifty people selected by systematic sampling from Washington County, Maryland. Using an analysis of variance for a complete block design, we analyzed data by mean differences across all instruments, and by simple correlations and Kappa statistics between instrument pairs. The food-frequency questionnaire gave the highest mean estimates, and the modified diet history estimate means fell between the food-frequency questionnaire and the other two instruments. However, when adjusted for calories (nutrients/1000 kcal), the food-frequency questionnaire estimates for nutrients were no longer consistently higher than those of the other instruments. Total fat, oleic acid, cholesterol, protein, sodium, iron, thiamin, and niacin were most consistently estimated by two or more instruments as measured by correlation coefficients. Crude fiber, calcium, and vitamins A and C gave the least consistent estimates among all four instruments. The correlation coefficients and Kappa scores were modest for all instrument pair comparisons, but the majority were statistically significant at p ≤ 0.005. All data showed greater consistency between instruments that measured either long-term intake (modified diet history and food-frequency questionnaire) or short-term intake (diet diary and twenty-four hour recall). In addition, demographic variables (age, sex, and marital status), as well as differences in caloric intake, affected instrument estimates of some nutrients.     

Dietary guidelines and patterns of food and nutrient intake in Sweden

The Nordic and Swedish Nutrition Recommendations emphasize the balance between macronutrients in the diet. The amount of saturated and total fat should be limited to c. 10 %energy and 30 %energy, respectively, and the amount of total carbohydrates should be 55-60 %energy. Data from the first Swedish national dietary survey in 1989 show that the average diet is too high in fat, especially saturated fat (36-37 %energy and 16 %energy, respectively) while the content of total carbohydrates and dietary fibre is too low. However, parts of the population consume a diet that meets the recommendation for a particular macronutrient. A comparison of subjects with a low or high intake of total fat and saturated fat, dietary fibre or fruit and vegetables show some common trends with respect to the characteristics of a dietary pattern equal or close to the recommendations, e.g. more frequent consumption of fruit and vegetables and a lower consumption of some fat-rich foods, such as spreads, cheese and sausages.     

A comparison of food frequency and diet recall methods in studies of nutrient intake of low-income pregnant women

The aim of this study was to develop a self-administered food frequency questionnaire for use with low-income pregnant women and to evaluate its performance in classifying women according to nutrient intake. Index nutrients used were energy, protein, calcium, iron, zinc, and vitamins A, B-6, and C. Two hundred ninety-five Massachusetts women, aged 14 to 43 years, participated in the field test of the questionnaire. A subset of 95 women provided three 24-hour diet recalls for use in comparative studies. Correlation coefficients between questionnaire and diet recall scores were adjusted for measurement error resulting from the limited number of 24-hour recalls per subject, and their confidence intervals were computed. When subjects with implausibly high energy scores (greater than 4,500/day) were removed from the sample, reducing sample size by about 15%, correlation coefficients increased substantially (25% to 64%) for all nutrients except vitamin A. Adjusted correlation coefficients exceeded 0.5, excluding vitamin A (r approximately 0.15), and quintile comparisons indicated that the questionnaire would correctly identify a high proportion of the women having low intake of selected nutrients. We conclude that a self-administered questionnaire can provide useful data about individual recent intake of selected nutrients in a majority of English-speaking, low-income pregnant women, but that overestimation of food use may occur among up to 20% of this population.     

Differences in intake of food and nutrients between manual and desk workers]

AIM: To compare intake of food and nutrients between manual and desk workers. SUBJECTS AND METHODS: Subjects were 28,603 residents (13,432 were male and 15,171 were female) in a city. Using a questionnaire, information on frequencies of consumption of different foodstuffs for one year and the type of employment was collected. Intake of nutrients was calculated from the frequencies and compared between manual and desk workers. The comparison was carried out with stratification by gender and adjustment for age and smoking habits. RESULTS: Desk workers took larger amounts of protein and lipids, and smaller amounts of carbohydrates than manual workers. Predominant foodstuffs in the latter was rice wheat products, potatoes and soybean products, while desk workers consumed more meat, processed meat, milk products, fish, vegetables and fruits. CONCLUSIONS: Differences in intake of nutrients and food depending on occupation should be considered, when the relationship between health status and employment is evaluated.     

Validation of a food frequency questionnaire for assessment of calcium and bone-related nutrient intake in rural populations

OBJECTIVE: To assess the ability of a semiquantitative food frequency questionnaire (FFQ) to measure calcium and bone-related nutrient intakes in a rural South Dakota population. DESIGN: Intake estimates from FFQ were compared with four 24-hour recalls obtained quarterly during the preceding year. SUBJECTS: Convenience sample of 100 participants of the South Dakota Rural Bone Health Study were recruited, with 81 completing the FFQ. MAIN OUTCOME MEASURES: Calcium and bone-related nutrient intakes were expressed as milligrams per day, milligrams per 1,000 kcal, or quartiles. STATISTICAL ANALYSES PERFORMED: Intakes by FFQ and 24-hour recalls were compared using paired t test and quartiles were formed to examine cross-classification. RESULTS: Calcium intakes from FFQ and recalls were 1,287 and 1,141 mg/day (P=0.01), but calcium per 1,000 kcal did not differ. Calcium intake by FFQ correlated with intake by recall when expressed as milligrams per day (r=0.49, P<0.001) or milligrams per 1,000 kcal (r=0.59, P<0.001). Bland-Altman graphs indicated fairly good agreement between methods. Seventy-eight percent of subjects fell into the same or within one quartile category when calcium intake was expressed as milligrams per day and 83% when expressed as milligrams per 1,000 kcal. Gross misclassification occurred in 0% to 4% of the nutrients. CONCLUSIONS: Although FFQ may not be a valid indicator of an individual's intake, it does adequately classify rural populations into quartiles of calcium and bone-related nutrient intakes, making it a useful tool for assessing dietary calcium and bone related intake in rural populations.     

Number of food items as an indicator of nutrient intake

Total food duplicates for 24 hours were collected from farmers in Japan, once in 1977–1981 (109 subjects) and then in 1991–1992 (72 subjects). Nutrients (including energy, protein, fat, some minerals, and several vitamins) in each food item in the food duplicate were estimated taking advantage of the values given in the Standard Tables of Food Compositions in Japan. The number of the food items in each food duplicate was counted excluding duplication. Analyses demonstrated that the daily nutrient intake (especially that of energy, protein and vitamin B₁) has a significant association with the number of items of food taken a day, that the daily intake of most nutrients is sufficient when 30 food items were taken a day, but that the sufficient supply of calcium and iron needs an intake of more than 30 food items.     

Effect of television viewing on food and nutrient intake among adolescents

ObjectiveAmong the behaviors associated with food intake, exposure to television is particularly important given the number of adolescents exposed. Also, increased time spent watching television has been associated with physical inactivity and with less desirable dietary intake among adolescents. The aim of this study was to examine the association between television viewing and dietary intake among 13-y-old adolescents.MethodsA cross-sectional evaluation was carried out in the 2003–2004 school year, including adolescents born in 1990 and enrolled in the schools of Porto, Portugal. Time spent watching TV was collected by self-administered questionnaires and dietary intake was evaluated using a food frequency questionnaire. Included in the analysis were 1436 adolescents.ResultsSpending more than 120 min per day watching TV was significantly associated with higher intake of total fat and polyunsaturated fat and with lower intake of magnesium, in both sexes. Additionally, in girls, spending more than 120 min per day watching TV was associated with lower intake of complex carbohydrates, fiber, total vitamin A, folate, vitamin C, calcium, iron, phosphorus, and potassium. In boys, higher intake of saturated fat and cholesterol was found among those spending more time watching TV.ConclusionsWe found that television viewing is associated with higher consumption of foods containing more fats and sugars and a lower consumption of fruits and vegetables. Consequently, adolescents who watched more television had a higher intake of total fat and polyunsaturated fat and a lower intake of minerals and vitamins. This dietary behavior among adolescents may have long-term health implications, not only limited to obesity.     

Energy and nutrient intake and food patterns among Turkish university students

The goal of this study was to determine the nutritional value and nutrients provided by each meal and snack of consumed by university students. Subjects were randomly selected from volunteer students at five universities in Ankara. A sample of 400 students (167 female and 233 male) aged between 19 and 24 years participated in this study. A questionnaire designed to assess general characteristics, anthropometric measurements, and 24 hours dietary records was administered using face to face interviews. According to body mass index classifications, 69.5% of male students, and 77.7% of female students were found to be in the normal weight categories. Overweight categories were found to be 25.1% and 5.6% for males and females, respectively. Breakfast and lunch were the most frequently skipped meals, with a total of 47.7% of students skipping breakfast and 25.2% skipping lunch. The percentages of energy deficiency were found to be 78.4% in males, and 81.1% in females. Dinner was the main meal for consumption of energy and the other nutrients, except saturated fatty acids, for both genders. Also, dinner was the largest contributor of energy in both genders. Students ate more bread, cereals, and meat at dinner than during the other meals and snacks. Fruit was consumed more during snacks than at the other meals by all students. It was concluded that students need more nutritional information about healthy nutritional habits, adequate intake of nutrients, and ideal body weights.     

Recording the nutrient intake of nursing home residents by food weighing method and measuring the physical activity

The nutrient intake of 47 female nursing home residents, able to eat without help, and of 20 eating-dependent seniors was measured by weighing method. Hand grip strength was examined by a dynamometer. Furthermore the level of physical activity of the seniors able to eat without help was determined by means of a questionnaire. The results showed that the median energy intake of self-feeding elderly women was 1620 kcal (850-4450 kcal). More than one third of the seniors consumed less than 1700 kcal / d. The intake of vitamins and minerals remained below 40-90% of the recommended level. One important cause for the inadequate micronutrient intake was that 30% of the total energy intake is met by foods of a low nutrient density (cakes, cookies, spreadable fats, soups). The eating-dependent seniors were at high risk for protein-calorie malnutrition, consuming an average of 1130 kcal / d and 34 g protein / d. The level of physical activity was very low. Only 34% of the seniors were active for more than 2 hours per week (walking, gymnastics). 30% of the residents were largely inactive although they were able to walk. It is often ignored that immobility is a major risk factor for the development of malnutrition. Firstly inactivity accelerates the loss of muscle mass. This loss of metabolically active tissue decreases the energy requirements thus leading to a loss of appetite and reduced food intake.     

Development of a semiquantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark.

Foods to be included in a Danish self-administered semiquantitative food frequency questionnaire were identified from food tables developed, together with data collected, for the survey 'Dietary habits in Denmark, 1985'. The questionnaire was to be used in a prospective study on diet, cancer and health, and the aim was to rank individuals with regard to intake of 19 different nutrients considered of prime importance in human carcinogenesis. The questionnaire for the dietary survey included 247 foods and recipes. From stepwise multiple regression analyses with the intake of each of the 19 nutrients as the dependent variable and the intake of the 247 foods and recipes as independent variables, the foods in the models explaining 90% of the between-person variability were considered for the final questionnaire. All relevant analyses were performed for the study group as a whole, for men and women separately, and in each gender for subgroups of energy intake. Taken together, the models explaining 90% of the between-person variability identified a total of 74 foods or recipes, which were important predictors of the intake of one or more of the nutrients considered. A few foods were excluded and a few foods were added to the final questionnaire based on common biological background information, and on information on foods providing important amounts of given nutrients, but which failed to contribute to regression analyses. The 92 foods and recipes, which were included in the final questionnaire provided altogether 81% of the average total supply of the nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)