Diet and alcohol in liver cirrhosis: a case-control study

A retrospective case-control study on alcohol and dietary habits was conducted over 3 years in a Gastroenterology Department on 152 male patients with liver cirrhosis. The study also included 304 hospital controls, selected within the same age range (32-83 years). Alcohol consumption and dietary habits were assessed from a standardized questionnaire by a highly trained dietician. The variations of the relative risk (RR) of liver cirrhosis as a function of the estimated mean daily intakes of alcohol, fats, carbohydrates and proteins were studied using stratified conditional logistic regression models. Obviously the relative risk of liver cirrhosis was found to be strongly and positively correlated with alcohol consumption but, in addition, this study has been able to show a significant and positive association with the mean daily fat intake and negative associations with the mean daily carbohydrate and protein intakes. Whereas in the control group, the calorie percentage from fats was 33.8 (87.11 g/d), it was 39.6 in the cirrhotic group (102.1 g/d). These findings indicate that in addition to alcohol consumption, dietary habits and in particular, high mean daily fat intake, should be considered.     

Changes in dietary habits during the first year at university

Leaving home is a time when changes in dietary intake are likely. The purpose of this study was to measure changes in students’ dietary habits from leaving home in September to start their university course, to May the following year. Three cohorts (97, 123, 157) of first‐year students were surveyed over three consecutive years using food frequency questionnaires completed by students in September, late January and May of the following year (the same academic year). Reported intakes of energy, protein, fat and carbohydrate declined significantly (P < 0.05) from the period September–January for both the male and female groups and although there was a small decrease in energy intake for the male group for the period January–May and a small increase for the female group for the same period, none of these were significant. Reported intakes of alcohol in males increased in each of the three periods but none of these increases were significant. Reported intakes of most food items and the frequency with which they were consumed declined during the period September–January, but the reference nutrient intake was still met for many nutrients. Nonetheless, we consider it important to monitor food consumption, particularly when first leaving home, to ensure adequacy; and alcohol to ensure that total consumption does not take place in single binge sessions.     

Implications for cancer epidemiology of differences in dietary intake associated with alcohol consumption

Several dietary factors are thought to modify risk for cancers that are known to be associated with alcohol intake. In this study, we sought to identify and describe alcohol-related differences in dietary and nutritional factors that are potential independent predictors of cancer risk or effect modifiers or confounders of alcohol-cancer relationships. Data were obtained from a large hospital-based case-control study that was designed to estimate the cancer risk from various tobacco products. Study subjects consisted of 465 male and 300 female incident lung cancer cases and 870 male and 556 female hospitalized patient controls matched on age (+/- 5 yrs). Nutritional data were analyzed as log-transformed frequencies of 30 food items, 9 factor scores generated to describe overall patterns of dietary intake, and nutrient scores estimating daily intake of fat, vitamin A, fiber, and cholesterol. We observed many more significant differences in nutritional exposures by alcoholic beverage intake than would be expected merely by chance. For males, the most striking relationships included increased meat and egg consumption with increasing alcohol consumption and higher intake of cantaloupe and cold cereal among lighter drinkers. For females, we observed strong inverse relationships between alcohol consumption and reported intake of fruit, cold cereal, and ice cream. We also observed a direct association between alcohol and meat consumption, though it was weaker than that found among men. Findings based on factors and nutrients followed the pattern observed for the individual food items, with highest fat scores and lowest fruit scores among the heaviest drinkers. Implications for nutrient-alcohol interactions and statistical considerations are discussed.     

The effects of varying dietary fat on the nutrient intake in male and female runners

OBJECTIVE: The present study examined the effects of varying dietary fat levels on nutrients in female and male endurance runners. METHODS: Three diets (low, medium and high fat) were designed for each subject using their food preferences and three-day food records. Each diet was eaten for 28 to 31 days. The diets were self-selected from seven-day sample menus. Twelve male and 13 female runners between 18 and 55 years of age who averaged 42 miles/week participated in the study. Daily food intakes, activity records and weekly palatability/hunger scales were completed. RESULTS: Dietary fat intakes, as a percent of total energy intake (%E), averaged 17%E, 31%E, and 44%E on the low, medium and high fat diets, respectively. Energy consumption was less than their estimated energy expenditure (EEE) on all diets. On the low fat diet, the female runners were consuming approximately 60% of their EEE. As dietary fat increased, the difference between calorie intake and estimated energy expenditure became less and the subjects were less hungry on the two higher fat diets. For all subjects, as energy intakes increased, so did carbohydrate intake. Therefore, carbohydrate intake was not different on the two lower fat diets. Irrespective of gender, calcium and zinc intakes, which were below 1989 RDAs, increased with increasing fat intakes, between the low and medium fat diets. Zinc intake was also higher on the highest fat diet. Essential fatty acid intakes for females on the low fat diet were less than 2.5%E. Half of the female runners ate less than the RDA of calcium and zinc on the low fat diet and Fe on the medium fat diet. CONCLUSION: This study suggests that endurance runners may not be consuming enough calories on a low fat diet and that increasing dietary fat increased energy consumption. On the low fat diet, essential fatty acids and some minerals (especially zinc) may be too low. A low fat diet could compromise health and performance.     

Dietary intakes of Pacific, Māori, Asian and European adolescents: the Auckland High School Heart Survey

Objective: To compare dietary intakes of European, Māri, Pacific Island and Asian adolescents living in Auckland.
Methods: A self-administered food frequency questionnaire was used to assess daily nutrient intakes of 2,549 14- to 21-year-old high-school students in Auckland (1,422 male and 1,127 female) in a cross-sectional survey carried out between 1997 and 1998.
Results: Compared with Europeans, Māri and Pacific Islanders consumed more energy per day. Carbohydrate, protein and fat intakes were higher in Māri and Pacific Islanders than in Europeans. Cholesterol intakes were lowest in Europeans and alcohol intakes were highest in Europeans and Māri. When nutrient intakes were expressed as their percentage contribution to total energy, many ethnic differences in nutrient intakes between Europeans and Māri or Pacific Islanders were eliminated. After adjustment for energy intake and age, Europeans ate the fewest eggs, and Pacific Islanders and Asians ate more servings of chicken and fish, and fewer servings of milk and cereal than Europeans. Compared to Europeans, Pacific Islanders consumed larger portion sizes for nearly every food item.
Conclusion: There were marked differences in nutrient intakes between Pacific, Māri, Asian and European adolescents. Ethnic differences in food selections, frequency of food servings and portion sizes contribute to the differences in nutrient intakes between these ethnic groups. These differences generally matched those of other studies in children and adults from these ethnic groups.
Implications: Interventions that reduce frequency of food consumption and serving sizes and promote less-fatty food choices in Māri and Pacific adolescents are needed.     

Dietary Patterns,Eating Behavior,and Nutrient Intakes of Spanish Preschool Children with Autism Spectrum Disorders

Eating behavior problems are characteristic of children with autism spectrum disorders (ASD) with a highly restricted range of food choices, which may pose an associated risk of nutritional problems. Hence, detailed knowledge of the dietary patterns (DPs) and nutrient intakes of ASD patients is necessary to carry out intervention strategies if required. The present study aimed to determine the DPs and macro-and micronutrient intakes in a sample of Spanish preschool children with ASD compared to typically developing control children. Fifty-four children with ASD (two to six years of age) diagnosed with ASD according to the Diagnostic Manual-5 criteria), and a control group of 57 typically developing children of similar ages were recruited. A validated food frequency questionnaire was used, and the intake of energy and nutrients was estimated through three non-consecutive 24-h dietary registrations. DPs were assessed using principal component analysis and hierarchical clustering analysis. Children with ASD exhibited a DP characterized by high energy and fat intakes and a low intake of vegetables and fruits. Likewise, meat intake of any type, both lean and fatty, was associated with higher consumption of fish and dietary fat. Furthermore, the increased consumption of dairy products was associated with increased consumption of cereals and pasta. In addition, they had frequent consumption of manufactured products with poor nutritional quality, e.g., beverages, sweets, snacks and bakery products. The percentages of children with ASD complying with the adequacy of nutrient intakes were higher for energy, saturated fat, calcium, and vitamin C, and lower for iron, iodine, and vitamins of group B when compared with control children. In conclusion, this study emphasizes the need to assess the DPs and nutrient intakes of children with ASD to correct their alterations and discard some potential nutritional diseases.     

The role of diet in the management of gout: a comparison of knowledge and attitudes to current evidence

Background:  Evidence supports dietary modifications in the management of gout. Despite this, the degree of implementation of this evidence by nutrition professionals and rheumatologists and those affected by gout is unknown. The present study aimed to compare usual dietary practices of patients with gout to evidence for dietary management of gout and to investigate whether the knowledge and attitudes of nutrition professionals and rheumatologists reflects current evidence.
Methods:  A food frequency questionnaire was used to determine usual dietary intake of patients with gout, a separate questionnaire examined gout-related dietary modifications ( n  = 29). Online questionnaires to examine attitudes towards dietary management of gout were completed by nutrition professionals and rheumatologists.
Results:  Proportions of participants whose reported intakes were inconsistent with current evidence for the dietary management of gout were: alcohol, n  = 14 (48%); beer, n  = 18 (62%); seafood, n  = 29 (100%); meat, n  = 7 (24%); beef/pork/lamb, n  = 24 (83%); dairy products, n  = 12 (41%); vitamin C supplementation, n  = 29 (100%). Of the 61 rheumatologists and 231 nutrition professionals who completed the online survey, the majority considered that weight loss and decreased alcohol intake were important or very important outcomes. Proportions were lower for decreased purine intake. Thirty-four (56%) rheumatologists do not refer patients with gout to dietetic services and, of those who do, the majority refer less than half.
Conclusions:  Overall, patients with gout in the present study were not implementing evidence for dietary management of their condition and complex dietary issues were evident.     

Nutrition knowledge, attitudes and fat intake: application of the theory of reasoned action

Validated questionnaires eliciting information on nutrition knowledge and attitudes, related to fat intake from meat, meat products, dairy products and fried foods, were completed by 538 subjects. There were high correlations (ranging from 0.40 to 0.77) between the sums of belief-evaluations, attitudes, intention and self-reported behaviour, with similar correlations for a subgroup of males aged 35-54 years. Nutrition knowledge, showed some statistically significant (but small) negative correlations with components of attitudes. Females had higher nutrition knowledge scores and more negative views of the foods than did males. Fat intake, measured using 3 day weighed intakes, correlated with self-reported behaviour (r = 0.55, p<0.01) in a subsample of 30 males, aged 35-54 years. Thus, nutrition knowledge seems less clearly related to consumption of these foods than are more specific beliefs and attitudes.     

Nutrition knowledge, attitudes and fat intake: application of the theory of reasoned action

Validated questionnaires eliciting information on nutrition knowledge and attitudes, related to fat intake from meat, meat products, dairy products and fried foods, were completed by 538 subjects. There were high correlations (ranging from 0.40 to 0.77) between the sums of belief-evaluations, attitudes, intention and self-reported behaviour, with similar correlations for a subgroup of males aged 35–54 years. Nutrition knowledge, showed some statistically significant (but small) negative correlations with components of attitudes. Females had higher nutrition knowledge scores and more negative views of the foods than did males. Fat intake, measured using %day weighed intakes, correlated with self-reported behaviour (r = 0.55, P <0.01) in a subsample of 30 males, aged 35–54 years. Thus, nutrition knowledge seems less clearly related to consumption of these foods than are more specific beliefs and attitudes.     

Choose a diet that is low in saturated fat and cholesterol and moderate in total fat: subtle changes to a familiar message

"Choose a diet that is low in saturated fat and cholesterol and moderate in total fat," issued in Nutrition and Your Health: Dietary Guidelines for Americans in the year 2000, has an interesting and lengthy history. The first guideline, for which there was extensive scientific data to show that dietary excess increased chronic disease risk, prompted much scientific discussion and debate when implemented as dietary guidance. Three major changes in the guideline are noted since it was issued in 1980, i.e., numerical goals for dietary fats; the applicability of recommended fat intakes for all individuals > or =2 y old; and rewording to emphasize reducing saturated fat and cholesterol intakes. The shift in emphasis includes the terminology moderate fat, which replaces the phrasing low fat. National data about the food supply, the population's dietary intake, knowledge, attitudes and behaviors, and nutritional status indicators (e.g., serum cholesterol levels) related to dietary fats help to monitor nutrition and health in the population. Experts consider that national data, although not without limitations, are sufficient to conclude that U.S. intakes of fats, as a proportion of energy, have decreased. The lower intakes of saturated fat and cholesterol are consistent with decreases in blood cholesterol levels and lower rates of coronary mortality over the past 30 years. Strategies are needed and some are suggested, to further encourage the population to achieve a dietary pattern that is low in saturated fat and cholesterol and moderate in total fat. Other suggestions are offered to improve national nutrition monitoring and surveillance related to the guideline.     

Longitudinal changes in nutritional habits of teenagers: differences in intake between schooldays and weekend days

Longitudinal changes in nutritional habits were studied in Dutch adolescents from 12 to 17 years of age (131 girls and 102 boys). The dietary differences on schooldays and weekend days are reported. In girls only small changes in nutritional habits were seen as they grew older. In boys there was a gradual increase in food intake with age. Overall, higher nutrient intakes could be seen on weekend days. The energy intake on weekend days was consistently higher for girls and boys in all age-groups. The proportional intakes of fat and sugar were rather high, especially on weekend days. The alcohol consumption increased with age for girls as well as boys, and was for some individuals extremely high (boys) on weekend days. The observed levels of intake compared with the recommendations showed a rather low intake of polyunsaturated fatty acids, polysaccharides and iron.     

Barriers to calcium intake in African–American women

Objectives: The objectives of this study were to determine dietary intake of calcium, intake of food components known to inhibit calcium bioavailability, demographic factors related to calcium intake, and the knowledge needs and barriers related to calcium consumption among low-income African–American women in Baton Rouge, Louisiana. Methods: Ninety subjects were interviewed at local grocery stores. Calcium intake was determined using a 24-h recall. In addition, a survey was administered to the subjects to determine knowledge needs and barriers towards calcium consumption. Results: Subjects’ mean dietary calcium intake was below the recommended dietary allowance (RDA), with 80% of the subjects having a calcium intake below 75% of the RDA. In addition, intakes of protein and sodium were above the recommended amounts. The general knowledge of the subjects concerning the role of calcium in osteoporosis was high, but this did not have an effect on the consumption of products containing calcium. The most important barriers to dairy product intake were perceived negative taste, perceived association with digestion problems and the perception that they already had adequate intake. Conclusion: Inadequate calcium intake in African–American women is affected by many factors including their lack of awareness of actual consumption. Nutrition education programmes need to address these factors.     

Food-based dietary guidelines--the Austrian perspective

Presently, no national dietary guidelines--neither food- nor nutrient-based--exist for Austria. Usually, the recommendations of the German Society of Nutrition are used instead. The determination of national characteristics of nutritional behaviour and food consumption can reveal starting-points for the improvement of nutritional status in Austria. Seven-day weighed records (children and adolescents, n = 2.173) and 24-h-recalls (adults, n = 2.488) were used for the evaluation of nutrient intake and food consumption. For a sub-sample of children and adolescents, results from laboratory assessment of biomarkers were also available (n = 1.400). Based on fat intake, the age groups were divided into low fat intake (less than 25th percentile = 28-34% fat energy) and high-fat eaters (greater than 75th percentile = 38-45% fat energy). Approximately 75% of the Austrian population have fat intakes above 30% of energy intake, older age groups having a higher prevalence of high fat intakes. Intakes of saturated fatty acids reach 40-46% of total fat. The usual intake of dietary fibre in the Austrian population is between 17-21 g/d; some individuals are able to achieve the recommended intakes for dietary fibre, but do not represent a significant majority of the population. The mean intakes of fruits are clearly higher in children and adolescents (10% of total food intake) than in adults (2-6%). Differences in the intake of selected nutrients in foods between low and high fat consumers, unexpectedly, did not result in different plasma concentrations of cholesterol, nor did it result in differences in fat soluble vitamins. Therefore, one of the primary dietary guidelines for Austria should be the reduction of fat consumption, which is also associated with increasing intakes of fruits and vegetables, increasing intakes of dietary fibre and decreasing intakes of cholesterol.     

Nutrient intake and food consumption among medical students in Greece assessed during a Clinical Nutrition course

The objective of this study was to determine nutrient intake and food consumption patterns among medical students at the University of Crete, Greece. As part of the Clinical Nutrition course from 1989 to 2001, a total of 951 third-year medical students (500 male, 451 female) aged 22+/-2 years underwent dietary interview, during which individual 24-h dietary recalls were taken. The students also completed a questionnaire on smoking habits, and anthropometric measurements were performed. The Mann-Whitney test was applied to assess differences in nutrient and food group intake between lower and higher fat eaters. Analysis of covariance was used to study relationships between nutrient intakes and tobacco use, adjusting for gender, age, and body mass index. The mean daily energy intake was 2493 kcal (10437 kJ) for males and 1675 kcal (7012 kJ) for females. The contribution of total fat to energy intake was 40% in each gender. Lower fat eaters (/=46.0% of total energy). Smokers had higher intakes of energy (P<0.05) and saturated fatty acids (P<0.01), and lower intakes of fiber (P<0.001), folate (P<0.05) and vitamin C (P<0.001) than non-smokers/ex-smokers. Our results indicate a need for Greek medical students to improve their dietary and health habits. Dietary assessment could be used to enhance nutrition education in medical schools.     

Energy intakes and losses in cystic fibrosis

Energy intakes in cystic fibrosis (CF) are affected by malabsorption, despite the use of enteric-coated pancreatic enzymes. Relaxation of fat restrictions was introduced to aid consumption of a diet sufficient to compensate for malabsorption and help prevent malnutrition. We examined the energy intakes and losses of 50 CF patients on a normal fat intake (mean age 9.6 [s.d.=6.67] years, M:F ratio 33:17). Mean standard deviation scores for height and weight were –1.03 and –0.80, respectively. Nutrient balances were made by means of 7-day weighed dietary inventories and 3-day faecal collections. Mean metabolizable energy intake was 97.3 [s.d. 23.1)% RDA. Mean digestibility coefficient for energy was 0.89 (s.d. 0.07), reducing mean energy intakes to 91.9 (s.d. 24.0)% RDA. The results indicate that despite relaxation of dietary restrictions and the use of enteric-coated pancreatic enzymes, energy intakes of CF patients are still inadequate. Closer monitoring of energy losses as well as intakes is required, to optimize growth and nutritional status in CF patients.     

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.     

青海高等职业技术学院学生膳食营养状况

目的了解高等职业技术学院学生膳食营养状况,为开展营养指导工作提供依据。方法对青海高等职业技术学院385名学生采用24 h膳食回顾法连续3 d跟踪调查,计算学生每人每日营养素摄入量,并与推荐摄入量比较。结果与《中国居民膳食营养素参考摄入量》比较,学生的能量、蛋白质、脂肪、维生素、矿物盐摄入量均有不同程度的不足;钙摄入量明显不足,仅占推荐摄入量的33.3%;维生素C摄入量不足,占推荐量的64.0%;蛋白质主要来源于粮谷类食物,占蛋白总量的52.1%;脂肪供能比例偏低,占总能量15.8%。结论该学院学生膳食结构不合理。应全面增加各种营养素摄入量,加强营养知识教育,提高学生的营养水平。     

Energy intake and physical fitness in children and adults of both sexes

Submaximal power output and body fatness have been measured in 1307 subjects recruited from 375 families coming from an area of 80 km around Quebec city. Total energy, carbohydrate, sugar, fat, saturated fat and alcohol intakes were calculated from a 3-day dietary record. The association between dietary intakes and the indicators of physical fitness was studied in adults (n=727) and children (n=580) of both sexes. Correlation analyses with residuals of age performed in each generation and sex subsample showed that body fatness is significantly but negatively associated with all intakes (?0.16≤r≤?0.50), with the exception of alcohol intake. On the other hand, multiple correlations of all intakes on submaximal power output range from 0.26 to 0.30 in adults, and from 0.20 to 0.24 in children. These observations suggest that submaximal power output is less related to energy intakes and that the association tends to be slightly more important in adults than in children. These data support the contention that physical fitness is determined by the genotype and the habitual energy expenditure and to a lesser degree by the nutritional habits.     

某市中小学生膳食营养状况分析

目的分析某市中小学生膳食营养状况,为膳食营养指导提供科学依据。方法采用5 d称重法和发放膳食调查表的方法对某市寄宿和非寄宿生171人进行膳食调查。结果中、小学寄宿和非寄宿生钙、视黄醇和核黄素摄入量低于RNI标准,尤其是钙摄入量偏低,均低于RNI的50%以下。蛋白质、脂肪、碳水化合物的供能比,中学寄宿生脂肪产能比达30.8%,略高于推荐标准范围,而中学非寄宿生和小学生供能比均较适宜。中学寄宿与非寄宿生血清钙缺乏检出率分别为6.52%和21.95%,差异有统计学意义(P<0.05);肥胖检出率分别为3.39%和14.29%,差异有统计学意义(P<0.05)。小学寄宿与非寄宿生血清钙缺乏检出率分别为73.91%和78.95%。结论中小学生营养素的摄入不均衡,钙、视黄醇、核黄素缺乏,应调整膳食结构,增加动物性食物、乳及乳制品、有色蔬菜及含钙丰富食物的摄入量。     

Moderate alcohol intake and nutritional status in nonalcoholic elderly subjects

Three hundred and seventy-three female and 213 male nonalcoholic subjects, aged 60-100 y, who had participated in a nutritional status survey of elderly people in the Boston area were grouped according to usual alcohol intake: 0-4, 5-14, or 15+ g/d. The age- and sex-adjusted mean intake of calories, fat, protein, carbohydrate, and 10 micronutrients and the mean levels of 14 nutrient and 22 nonnutrient biochemical indices were compared for the three categories of alcohol intake. The mean micronutrient intakes were also adjusted for total caloric intake and the mean nutrient biochemical concentrations were also adjusted for the corresponding nutrient intakes. The results suggest that caloric intake and blood concentrations of retinol, iron, ferritin, HDL cholesterol, AST, and ALT increased with increasing alcohol intake whereas folate and phosphorus intakes and blood measures of riboflavin, copper, zinc, urea nitrogen, and creatinine decreased with increasing alcohol intake.