Longitudinal change in food habits between adolescence (11-12 years) and adulthood (32-33 years): the ASH30 Study

BACKGROUND: Links between diet in childhood and the prevention of disease in adulthood have been established. This longitudinal dietary survey provided quantitative evidence of dietary change from adolescence to adulthood, in Northumberland, England. OBJECTIVE: To report longitudinal dietary change in 198 respondents between the ages of 12 and 33 years, to explore dietary 'tracking' between the same time points and to describe the effects of gender, socio-economic status and location on dietary change. METHODS: A longitudinal study recorded dietary change from adolescence to adulthood. Two 3-day food diaries were collected in 1980 and 2000 from the same 198 respondents. Foods consumed were assigned to the five categories in the Balance of Good Health (BGH). Demographic and socio-economic information were obtained in 1980 and 2000. RESULTS: Intakes of foods containing fat and/ or sugar and milk and dairy foods decreased (p < 0.01 and p < 0.031, respectively), while intakes of fruits and vegetables increased (p < 0.01). Intakes of bread, other cereals and potatoes (p = 0.002, r = +0.219); fruits and vegetables (p < 0.01, r = +0.256) and meat, fish and alternatives (p = 0.026, r = +0.158) 'tracked' from adolescence to adulthood. Men had increased intake from meat, fish and alternatives and decreased milk and dairy foods more than female respondents (p = 0.003 and p = 0.019). Respondents who had moved away from Northumberland had a greater increase in intake of fruits and vegetables compared with those who remained in the local (p = 0.010). Individuals who had moved to a lower socio-economic group had increased their intake of bread, other cereals and potatoes (p = 0.040). CONCLUSION: Food intake changed considerably in a direction more in the line with current dietary recommendations. Food intake in adolescence was a significant, but not strong, predictor of intake in adulthood. Dietary change is influenced by variables including gender, location and socio-economic status.     

Nutritional adequacy of four dietary patterns defined by cluster analysis in Japanese women aged 18-20 years

Information on nutritional adequacy and inadequacy of dietary patterns is useful when making practical dietary recommendations. We examined nutritional inadequacy of dietary patterns among 3756 Japanese female dietetic students aged 18-20 years. Diet was assessed with a validated self-administered diet history questionnaire (DHQ). Dietary patterns were determined from intakes of 33 food groups summarized from 147 foods assessed with DHQ, by cluster analysis. Nutritional inadequacy for the selected 21 nutrients in each dietary pattern was examined using the reference values given in the Dietary Reference Intakes for the Japanese (DRIs) as the gold standard. Four dietary patterns identified were labeled 'fish and vegetables' (n=697), 'meat and eggs' (n=1008), 'rice' (n=1041), and 'bread and confectionaries' (n=1010) patterns. The 'fish and vegetables' pattern, characterized by high intakes of vegetables, potatoes, pulses, fruits, fish, and dairy products, showed significantly the lowest percentage of subjects with inadequate intakes for 15 nutrients, except for the highest prevalence in sodium. In contrast, 'bread and confectionaries' pattern, characterized by high intakes of bread, confectionaries, and soft drinks, showed the highest prevalence of inadequate intakes for nine nutrients. The median number of nutrients not meeting the DRIs as a marker of overall nutritional inadequacy was five in 'fish and vegetables' pattern. It was significantly lower than nine both in 'meat and eggs' and 'rice', and 10 in 'bread and confectionaries' patterns (p<0.001). A dietary pattern high in vegetables, fruits, fish, and some others showed better profile of nutritional adequacy except for sodium in young Japanese women.     

Contribution of various food groups to dietary vitamin B-6 intake in free-living, low-income elderly persons

Elderly persons are reported to have low dietary intakes of vitamin B-6. Knowing which foods are the primary contributors of dietary vitamin B-6 may be useful to health professionals working to improve the nutritional status of the elderly. Therefore, we examined the contribution of five food groups--flesh foods (including all meat/fish/poultry), grains/cereals, legumes/nuts, fruits/vegetables, and dairy products/eggs--to dietary vitamin B-6 intake in 198 free-living elderly persons aged 60 years or older. Subjects were primarily Caucasian, low-income non-smokers; their mean age was 72 years. Mean dietary vitamin B-6 intake, determined from 3-day diet records, was 1.6 +/- 0.6 mg/day. The fruit/vegetable group was the largest dietary contributor of vitamin B-6 (0.69 mg/day). Flesh foods and cereals/grains contributed equally to the vitamin B-6 intake (0.35 and 0.34 mg/day, respectively). The lowest contributors were dairy products/eggs and legumes/nuts. Approximately 96% of the vitamin B-6 intake could be accounted for by the five food groups. Twenty percent of the population (no. = 39) consumed less than 66% of the Recommended Dietary Allowance (RDA) for vitamin B-6; their vitamin B-6 intake from fruits/vegetables and grains/cereals was 0.36 and 0.10 mg/day, respectively. Individuals with vitamin B-6 intakes greater than or equal to 100% of the RDA (no. = 69) consumed greater amounts of fruits/vegetables (primarily bananas) and grains/cereals (primarily breakfast cereal) than did persons who consumed less than 66% of the RDA for vitamin B-6; their vitamin B-6 intake from fruits/vegetables and grains/cereals was 0.98 and 0.55 mg/day, respectively. In the elderly population studied, plant foods were the major dietary contributors of vitamin B-6.     

Dietary Intakes of Children Enrolled in US Early Child-Care Programs During Child-Care and Non-Child-Care Days

BackgroundEarly-child-care (ECE) programs may substantially influence child diet quality.ObjectiveThe Study of Nutrition and Activity in Child Care Settings describes the usual food group intake of preschool-aged children attending ECE programs relative to Dietary Guidelines for Americans (DGA) recommendations, comparing intakes during child-care and non-child-care days.DesignMeal observations and parent-completed food diaries in a cross-sectional nationally representative multistage cluster sample of Child and Adult Care Food Program-participating ECE programs.Participants/settingOne thousand four hundred sixty-eight children aged 3 to 5 years attending 217 Child and Adult Care Food Program-participating ECE programs (eg, child-care centers and Head Start) during 2017.Main outcome measuresDaily energy intake, daily US Department of Agriculture Food Pattern Food Group intakes, and percentage of daily intakes meeting 2015-2020 DGA Food Pattern recommendations.Statistical analyses performedRegression-adjusted usual intakes and percentage of children meeting recommendations were estimated using the National Cancer Institute method. Single-day mean intakes were used to test for statistical differences between child-care and non-child-care days.ResultsMean usual energy intake was 1,524 ± 19.3 kcal during child-care days and exceeded the recommended range at 1,702 ± 30.2 kcal during non-child-care days; single-day means indicated significantly lower energy intake on child-care days (P < 0.001). The percent of children meeting DGA recommendations on a child-care day varied by DGA food group: fruits (51.4%), grains (50.1%), dairy (42.5%), vegetables (6.5%), whole grains (4.6%), and protein foods (0.1%). Recommended limits on calories from added sugar and solid fats were met by 28.2% and 14.6% of children, respectively. Compared with mean food group intakes during a single child-care day, non-child-care day intakes were similar for fruits and vegetables, lower for dairy and whole grains, and higher for total grains, protein foods, and calories from added sugars and solid fats.ConclusionsAlthough there is room to increase nutrient density inside and outside of child care, intakes on child-care days more closely align to DGAs.     

上海市社区中老年妇女膳食模式研究

目的了解上海社区中老年妇女的膳食模式和营养现况。方法采用分层整群随机抽样的方法对上海城区两个街道596名45～65岁中老年妇女进行膳食调查。用因子分析方法分析食物频率问卷收集的膳食信息,得出主要膳食模式,并进一步分析各膳食模式的营养素摄入及与人口学特征的关系。结果 (1)4种膳食模式较有意义,分别是蛋类、豆类及制品膳食模式,糖、油及调味品膳食模式,蔬菜、奶类和大米膳食模式,水果、牛羊肉和水产品膳食模式。(2)糖、油及调味品膳食模式与总能量、蛋白质和脂肪供能比的关系有统计学意义(P0.001),高五分位数组低学历、低家庭年收入比例较高(P值分别为0.009和0.008)。(3)蔬菜、奶类和大米模式则能量低,脂肪低,钙、蛋白质和碳水化合物供能比高,高五分位数组的体质指数均值明显低于低五分位数组(P=0.019)。水果、畜肉和水产品模式蛋白质供能比、维生素B2、维生素B6和维生素C都较高。(5)未发现蛋类、豆类及制品膳食模式与营养素及人口学特征变量间有统计学意义的关联。结论蔬菜、奶类和大米的膳食模式可能降低超重肥胖的发生。     

A comparison of three dietary pattern indexes for predicting biomarkers of diet and disease

OBJECTIVE: Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes-Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)-for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes. METHODS: We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged > or =20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates. RESULTS: All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p < or = 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p < or = 0.03). CONCLUSIONS: The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.     

No difference in lifestyle changes by adding individual counselling to group-based rehabilitation RCT among coronary heart disease patients

AIMS: First, to examine whether autonomy-supportive and self-efficacy-enhancing individual lifestyle counselling was associated with improved maintenance of heart-protective diets and smoking cessation compared with group-based counselling. Second, to investigate to what extent reported motivation was associated with maintenance of dietary changes. METHODS: A randomized controlled trial and longitudinal study of predictor variables in a four-week heart rehabilitation setting with two years follow-up. A total of 176 (38 female) patients were included, mainly with coronary heart disease. The main outcome measures were dietary changes and smoking cessation. Motivational factors were tested for predictive power in the three dietary outcomes: daily intake of fruit and vegetables, a low saturated fat diet, and weekly intake of fish dinners. RESULTS: No clinically significant difference in improvement of dietary maintenance was found between the two groups. The between-group difference in smoking status change was statistically insignificant (p = 0.12). Both groups showed an improvement in their dietary measures. Self-efficacy predicted an increased frequency of eating fish dinners (p = 0.001) and more daily units of fruit and vegetables (p < 0.001). Autonomous motivation had a marginal association with increased intake of fruits and vegetables (p = 0.08) and was significantly associated with a lower saturated fat diet (p = 0.001). CONCLUSIONS: Among this highly motivated group of rehabilitation patients, no effect was found of adding autonomy-supportive, individual counselling to group-based interventions. Based on longitudinal documentation, this cardiac rehabilitation programme improves long-term maintenance of dietary changes, and this maintenance is related to autonomous motivation and self-efficacy.     

Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis

BACKGROUND: The balance between the intake of animal and the intake of plant foods may influence renal vascular integrity as reflected by urinary albumin excretion. OBJECTIVE: We assessed cross-sectional associations between urinary albumin excretion and dietary patterns and intake of plant and animal foods. DESIGN: At baseline, diet (food-frequency questionnaire) and the urinary albumin-to-creatinine ratio (ACR; spot urine collection) were measured in 5042 participants in the Multi-Ethnic Study of Atherosclerosis who were aged 45-84 y and were without clinical cardiovascular disease, diabetes, or macroalbuminuria (sex-adjusted ACR >or= 250). We derived dietary patterns by principal components analysis. We also summed food groups to characterize plant food intake (fruit, fruit juice, vegetables, nuts, legumes, whole grains, and refined grains), animal food intake (red meat, processed meat, poultry, fish, high-fat dairy, and low-fat dairy), and nondairy animal food intake. RESULTS: After adjustment for multiple demographic and lifestyle confounders, a dietary pattern characterized by high consumption of whole grains, fruit, vegetables, and low-fat dairy foods was associated with 20% lower ACR across quintiles (P for trend = 0.004). Neither total animal nor total plant food intake was associated with ACR. However, greater low-fat dairy consumption was associated with 13% lower ACR across quartiles (P for trend = 0.03). Total nondairy animal food consumption was associated with 11% higher ACR across quintiles (P for trend = 0.03). CONCLUSIONS: A high intake of low-fat dairy foods and a dietary pattern rich in whole grains, fruit, and low-fat dairy foods were both associated with lower ACR. In contrast, collectively, nondairy animal food intake was positively associated with ACR.     

A Comparison of Three Dietary Pattern Indexes for Predicting Biomarkers of Diet and Disease

Objective: Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes—Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)—for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes.

Methods: We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged ≥20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates.

Results: All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p ≤ 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p ≤ 0.03).

Conclusions: The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.     

Association of fruit and vegetable intake with dietary fat intake

We examined the relation of fruit and vegetable intake with dietary fat intake under conditions in which individuals consume recommended number of portions of dairy, meat and grain foods, using 24-hour dietary recall data from the NHANES II of 1976–80. Only recalls that included at least 2 servings each of dairy foods and meat and 4 servings of grains, but variable servings of fruits and vegetables (ranging from 0 to 2 or more) were examined, yielding a total of 9 food group patterns (possible combinations of food group servings) as reported by 1,490 respondents. In patterns ranging from 0 to 2 servings each of fruits and vegetables, the mean percent of energy as fat varied from 39% to 36%. We observed a slight trend for decreasing energy from fat with increasing number of fruit-but not vegetable-servings. Consumption of fruits and vegetables was not associated with selection of lower-fat foods in the meat, dairy or grain groups. The percent of daily fat contributed by the miscellaneous food group (containing visible fats, sweeteners, and baked products with a high fat or sugar content) increased with increasing vegetable-but not fruit-servings. These results suggest that without conscious effort to reduce fat intake, an increase in fruit and vegetable intake may have a relatively minor impact on reduction of dietary fat.     

Diet and lung cancer risk: findings from the Western New York Diet Study

This study compares the diets of 450 lung cancer cases (296 males, 154 females) with those of 902 controls (587 males, 315 females). Cases were lung cancer patients diagnosed between August 1980 and July 1984 in three western New York counties, while controls were selected from the general population of these same counties. Usual diet was estimated by detailed interviews using a modified food frequency method. Case-control comparisons were made for dietary fat, protein, fiber, calories, cholesterol, and vitamins A, C, and E according to quartiles of intake, adjusting for age and pack-years of cigarettes by multiple logistic regression. Risk was lower for males in the lowest quartile of total dietary fat intake compared with those in the highest quartile (relative risk = 0.5), although the overall trend in the association with dietary fat was not statistically significant (p = 0.12). Likewise, there was a weak, but not statistically significant, direct association between dietary cholesterol and lung cancer in men (p = 0.17). The intake of vitamin A from fruits and vegetables (carotene) was much more strongly associated with reduced cancer risk. For males, the relative risks by quartiles (lowest intake to highest intake) were 1.8, 1.8, 1.0, 1.0 (p for trend = 0.001). For females, this relation was considerably weaker, and was not statistically significant. These findings are generally in agreement with those of several previous studies. The risk reduction associated with vitamin A from fruits and vegetables (carotene) was most evident for males, for those with squamous cell cancers, for light or ex-smokers, and for those over 60 years of age.     

The relationship between child and parent food hedonics and parent and child food group intake in children with overweight/obesity

Many factors influence children's dietary intake, including children's and parents' food hedonics (liking), and parent intake. This secondary data analysis studied the relationship between child and parent liking, and parent intake and child intake of fruits, vegetables, low-fat dairy, snack foods, and sweetened beverages in 4- to 9-year-old overweight/obese (body mass index ≥85th percentile) children presenting for obesity treatment (September 2005 to September 2007) in Providence, RI. One hundred thirty-five parent-child pairs, with complete baseline dietary (3-day food record) and food group hedonic data were included. Hedonic ratings were mean ratings using a 5-point Likert scale (lower scores represented greater liking of a food group). Children were aged 7.2±1.6 years, 63.0% girls, 12.6% African American, and 17.8% Hispanic, with a mean body mass index z score of 2.3±0.6. Total servings consumed by children over 3 days were: fruits 2.7±3.2, vegetables 3.4±2.5, low-fat dairy 2.4±2.1, snack foods 5.9±4.2, and sweetened beverages 2.7±3.1. After demographic and anthropometric variables were controlled, parent intake was positively related (P<0.05) to child intake of all food groups except sweetened beverages. Child liking was only significantly (P<0.05) related to child intake of vegetables. In young children with obesity/overweight, parent intake was consistently related to child intake. Changing parent intake may be important in helping to change the dietary intake of young children with overweight/obesity.     

Association of self-perceived body weight status with dietary reporting by U.S. teens

OBJECTIVE: Children's self perception of body weight and the medical definition of obesity show poor correlation. This study examined the independent associations of body mass index (BMI) and self-perceived weight status (considered self over-, under-, or right weight) with food reporting, nutrient intake estimates, and biomarkers of dietary exposure. RESEARCH METHODS AND PROCEDURES: Dietary (one 24-hour recall), anthropometric, and biochemical data were from the third National Health and Nutrition Examination Survey (1269 boys and 1385 girls, ages 12 to 18 years). Sex-specific multiple regression analyses were used to determine the association of BMI and self-perceived body weight status with reported intakes of energy, macronutrients, low-nutrient-dense foods, micronutrients, and serum concentrations of selected vitamins and carotenoids. RESULTS: Reported intakes of energy, macronutrients, number of eating occasions, percentage of energy from low-nutrient-dense foods, likelihood of meeting the standard of intake of micronutrients, and biomarkers were not different among boys and girls who perceived themselves as overweight relative to those who perceived themselves at the right weight (p > 0.05). In boys, BMI was a negative predictor of percentage of energy from low-nutrient-dense foods (p = 0.004) and intake of ascorbic acid (p = 0.04). BMI was inversely related to serum concentrations of most carotenoids (p < or = 0.002). DISCUSSION: Perceiving oneself as overweight was not associated with reporting of low-nutrient-dense foods, macronutrients, micronutrients, and biomarker status; BMI, however, was a significant predictor of several outcomes.     

Associations between dietary intake and urinary excretion of sodium, potassium, phosphorus, magnesium, and calcium

OBJECTIVES AND METHODS: The associations between dietary intake and urinary excretion of sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), and phosphorus (P), and the major dietary sources derived from the urinary minerals were studied in a nutritional survey of 219 Japanese females aged 27-84 years, who completed anthropometric measurements, a one-day dietary record, and a 24 hr urine collection. RESULTS: The minerals excreted in the urine were significantly and positively correlated with each other, in which Na excretion was correlated with K and Ca excretion (r = 0.490 and r = 0.482, respectively, p < 0.01) and Ca excretion was correlated with Mg excretion (r = 0.526, p < 0.01). The ratios of urinary exertion to dietary intake of Na, K, Ca, Mg, and P were 81.5%, 62.7%, 24.5%, 21.7%, and 56.1%, respectively. The dietary intake and the urinary excretion of the minerals expressed per body weight (kg) were significantly and positively correlated (Na, r = 0.267; K, r = 0.460; Ca, r = 0.181; Mg, r = 0.245; P, r = 0.351, p < 0.01). Further examinations using chief component analysis for food intake showed several significant positive correlations, including between Na intake and the intake of vegetables, noodles, and seasonings (r = 0.332-0.381, p < 0.01); between K, Mg and P intake and the intake of vegetables, fruits, and potatoes (r = 0.332-0.533, p < 0.01); and between Ca intake and the intake of bread and dairy foods (r = 0.428, p < 0.01). In addition, significant positive associations were found between Na excretion and the intake of confectionaries, nuts, and seeds (r = 0.223, p < 0.01). Weak correlations were also found between K excretion and the intake of vegetables (r = 0.296, p < 0.01); between Ca and P excretion and the intake of meat, oil, and fats (r = 0.135, P < 0.05; r = 0.193, P < 0.01, respectively), and between Mg excretion and the intake of bread and dairy foods (r = 0.137, P < 0.05). CONCLUSIONS: Findings from this study indicate that, while urinary excretion of Ca and Mg is unlikely to be a reliable biochemical marker of dietary intake, the levels of urinary excretion of Na, K, and P can be reflective of the intake of salt, vegetables, and meats, respectively. The urinary excretion of the minerals, particularly Na, K, and Ca, may be highly linked to salt intake in Japanese females.     

Are changes in consumption of "healthy" foods related to changes in consumption of "unhealthy" foods during pediatric obesity treatment?

Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight (≥ 85th to <95th percentile for body mass index [BMI]) and obese (≥ 95th percentile for BMI) children (7.2 ± 1.7 years) with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1) increased growth monitoring with feedback; (2) decrease SFs and sugar sweetened beverages; or (3) increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake.     

Changes in Dietary Guidance: Implications for Food and Nutrient Databases

Two types of dietary guidance for Americans have recently been released, and both have important implications for the way data are organized on food and nutrient databases. New dietary reference intakes (DRIs) have been set for 17 nutrients, and in several cases the units for these recommendations do not match those traditionally carried on nutrient databases. Furthermore, some of the tolerable upper intake levels (ULs) are specified only for supplemental and fortification forms of nutrients, which necessitates calculating separate intake values for nutrients from foods and nutrients that are added to foods or taken as supplements. The year 2000 revision of the Dietary Guidelines for Americans also suggest new ways to evaluate dietary intakes: there is an increased emphasis on obtaining an appropriate number of servings from food groups such as fruits, vegetables, whole grains, and lowfat dairy products. To allow users of nutrient databases to provide relevant evaluations of dietary data, developers will need to consider carrying a much larger array of variables in order to calculate intakes of folate in folate equivalents, vitamin E as alpha-tocopherol (not as alpha-tocopherol equivalents), nutrients occurring in foods versus added or supplemental nutrients, and the number of servings from a variety of food groups.

• •For more information on the DRIs, see:.
• •For more information on the year 2000 Dietary Guidelines, see:

     

Older adults need guidance to meet nutritional recommendations

OBJECTIVE: The purpose of this study was to compare the diet of healthy, free-living senior volunteers to the dietary reference intakes (DRIs) and Food Guide Pyramid recommendations. METHODS: This study was a cross-sectional assessment of dietary habits, as measured using a standardized food frequency questionnaire, among 1,740 healthy Southwestern U.S. adults, aged 51 to 85 years. Assessment of independently-living volunteers to chemoprevention trials provides an efficient mechanism to profile typical dietary habits among the older adult population. RESULTS: Daily estimated macronutrient intakes exceeded recommended proportions of protein and fat. In contrast, more than 60% of this senior population reported dietary vitamin D, vitamin E, folate and calcium intakes below estimated average requirements (EAR). Based on the Food Guide Pyramid recommendations, fewer than 10% of the older adults consumed the recommended daily dairy and grain servings. More females than males consumed recommended vegetable (49% versus 40%) and fruit (53% versus 48%) servings (p < 0.05). More males consumed recommended grain (11% versus 7%) and protein (78% versus 73%) servings (p < 0.05) than females. CONCLUSIONS: Mean micronutrient intakes compared well with DRIs, although fewer than one-half of these older adults consumed recommended levels for vitamin D, vitamin E, folate, and calcium or daily food servings of dairy, grains, vegetables or fruits. Since the beneficial aspects of foods are not limited to essential nutrients, nutrition recommendations to older adults may be improved by emphasizing daily servings of nutrient-dense choices within the Food Pyramid.     

Factors influencing dairy calcium intake in women.

Most national dietary studies have reported inadequate calcium (Ca) intake by women, indicating that marketing and educational efforts have not effected dietary behavior changes. The purpose of this study was to identify knowledge, attitudes, and behaviors which influence dairy Ca intake.

A questionnaire was developed to accomplish these objectives, and piloted for clarity and content validity. Dietary Ca intake was assessed using a food frequency questionnaire. After revisions, women were sampled from four sources: a health spa, elderhostel classes, through a Cooperative Extension Service program, and from the Illinois Older Women's League. The response rate was 66.5%.

Mean total reported Ca intake (n = 351) was 591 +/? 355 mg/day. Over 40% of the women reported Ca intakes below 60% of the RDA and could therefore be considered to have deficient intake. Unfortunately, 27.1% of these with deficient intake believed they were meeting the Ca RDA. Significant differences (p < or = 0.01) were found in attitudes and beliefs about dairy Ca when comparing women whose intake was below 60% of the RDA with those whose intake was above 60%. The most commonly mentioned beliefs of the entire sample concerned cholesterol (16.5%), high calories (13.7%) and gastrointestinal discomfort (12.8%).

These findings suggest an important discrepancy between perceived and actual Ca intake which could influence receptiveness to education. Non-dairy Ca rich food sources need to be clarified as does the caloric and cholesterol content of dairy foods.     

Dietary calcium intake in lactose maldigesting intolerant and tolerant African-American women

BACKGROUND: The relationship between lactose maldigestion, lactose intolerance, and calcium intake in premenopausal African American women is unknown. OBJECTIVE: To determine how intolerance of lactose and dairy products affects intake of calcium in lactose maldigesting premenopausal African American women. DESIGN: Dietary intake of calcium was assessed in 50 premenopausal lactose maldigesting African American women as determined by the breath hydrogen test. Twenty-six women were lactose intolerant and 24 were lactose tolerant by self-reports. RESULTS: The average intake of calcium in lactose maldigesting and intolerant women was significantly lower than in lactose tolerant women (388 +/- 150 mg/day vs. 763 +/- 333 mg/day, p < 0.0001, t test). Neither group reached the newly established Dietary Reference Intake (DRI) for calcium (1,000 mg/day). Major source of dietary calcium in lactose tolerant women were milk and dairy products (45%), and mixed foods containing calcium from non-dairy sources (30%). In lactose intolerant women, 46% of calcium was from mixed foods and only 12% was from milk and dairy products. Lactose intolerant women had higher body mass index (BMI) than lactose tolerant women (p = 0.008, t test), and calcium intake was negatively associated with BMI (R2 = 0.470). CONCLUSIONS: In African American premenopausal women, lactose tolerance facilitates the dietary intake of calcium when compared with their lactose intolerant counterparts. Low calcium intake is associated with higher BMI.