Analysis of risk and protective factors for psychosocial distress among in-school adolescents in Tanzania

Introduction

Psychosocial distress has emerged as one of the world’s major public health problems, especially among adolescents in both low- and middle-income countries. This study used data from the 2015 version of the Global School-Based Health Survey to determine the risk and protective factors for psychosocial distress among in-school adolescents in Tanzania.

Materials and methods

Chi-square and logistic regression analyses were used to estimate the magnitude of associations. A total of 2936 students participated in the study, of which 52.3% were female.

Results

Psychosocial distress was found in 16.9% of the students at similar rates for both males and females. The risk factors associated with psychosocial distress were hunger (OR?=?1.57, p?<?0.001), being bullied (OR?=?1.92, p?<?0.001), being attacked (OR?=?1.31, p?<?0.05), engaging in physical activity (OR?=?1.33, p?<?0.05), truancy (OR?=?1.28, p?<?0.05) and tobacco use (OR?=?2.40, p?<?0.01). However, the protective factors were grade (OR?=?0.55, p?<?0.01) and having one or two (OR?=?0.56, p?<?0.01) and three or more close friends (OR?=?0.57, p?<?0.01).

Conclusions

The prevalence of psychosocial distress among adolescents in Tanzania is relatively high and appears to be common among both sexes. To reduce psychosocial distress among in-school adolescents, more attention needs to be paid to the risk factors whiles encouraging healthy relationships among adolescents and their close friends.

     

Adherence to the Mediterranean diet and weight status in children: the role of parental feeding practices

Abstract

The study examines Parental Feeding Practices (PFP) in relation to adherence to the Mediterranean Diet (MD) and children’s weight status. It’s a cross-sectional study of 402 parents (68.4% mothers), with children aged 2–12 years. Parents completed the Comprehensive Parental Feeding Questionnaire and the Mediterranean Diet Quality Index for children and adolescents (KIDMED), evaluating children’s adherence to the MD. Logistic regression showed that in children aged 2–<6 years, “emotion regulation/food as reward” and “pressure” decrease MD adherence (OR?=?0.186, p?<?0.0001 and OR?=?0.496, p?=?0.004), and “monitoring” decrease excess body weight (OR?=?0.284, p?=?0.009). In older children (6–12 years), “healthy eating guidance” and “monitoring” increase MD adherence (OR?=?3.262, p?=?0.001 and OR?=?3.147, p?<?0.0001), “child control” decreases MD adherence (OR?=?0.587, p?=?0.049), “pressure” decrease excess body weight (OR?=?0.495, p?<?0.0001) and “restriction” increase excess body weight (OR?=?1.784, p?=?0.015). “Healthy eating guidance” and “monitoring” seem to be the best PFP employed, in terms of children’s MD adherence and weight status.     

Characteristics of Eating Habits and Physical Activity in Relation to Body Mass Index Among Adolescents

Objective: To assess eating habits and the level of physical activity in adolescents and develop a predictive model for the body mass index (BMI) based on these variables.

Design: In this cross-sectional study, eating habits and the level of physical activity were assessed using a questionnaire validated in adolescents. Body mass and height collected during the last annual checkup were extracted from personal medical records.

Subjects: The sample included 330 boys and 377 girls (mean age 15.8 ± 0.2 years) who were first-year high school students in the city of Belgrade, Serbia.

Measures: Responses to each of the 14 questions about eating habits and 6 questions about physical activity were scored from the least (0) to the most (3) desired behaviors. These ratings were then averaged to arrive to an aggregate score for each domain. The BMI was calculated according to the standard method. A series of regression analyses was performed to derive the best model for predicting BMI in boys and girls based on individual eating habits and physical activity items, first separately and then combined.

Results: In the sample, 24.5% of boys and 9.5% of girls were overweight or obese. Girls’ eating habits were better than boys (mean aggregate score 2.3 ± 0.3 and 2.1 ± 0.3, respectively, p < 0.001), whereas the level of physical activity was greater in boys than girls (2.1 ± 0.6 vs 1.9 ± 0.6, p < 0.001). The differences between boys and girls in the BMI, eating habits, and physical activity remained significant after controlling for their knowledge about healthy eating and education level of their parents. Eating habits were a better predictor of BMI than physical activity, particularly in boys (R ² = 0.13 vs R ² = 0.02) compared to girls (R ² = 0.04 vs R ² = 0.01). Combining eating habits and physical activity in the multivariate model of BMI resulted in a better predictive accuracy in boys (R ² = 0.17) but not girls (R ² = 0.04).

Conclusions: Eating habits and physical activity differ between adolescent boys and girls and can predict BMI, particularly in boys. The results suggest the need to develop gender-specific programs for promoting healthy lifestyle among adolescents in our country.     

Do physicians discuss needed diet and nutrition health topics with adolescents?

PurposePreventive services guidelines recommend screening all adolescents for diet habits, physical activity and growth, counseling underweight teens about body image and dieting patterns, and counseling overweight or obese teens about dietary habits and exercise. In this study, we assess whether adolescents at risk for overweight or for eating disorders have discussed recommended diet and nutrition topics with their physicians.MethodsWe surveyed 14–18-year-old adolescents who had been seen for well care in primary care pediatric and family medicine practices. Adolescents self-reported their weight, height, body image, dieting habits, and issues they had discussed with their clinicians. Body mass index (BMI) was used to define those “at risk for an eating disorder” (< 5% BMI), “at risk of becoming overweight” (85%–95% BMI), and “overweight” (> 95% BMI).ResultsA total of 8384 adolescents completed surveys (72% completion rate). Nearly one-third of adolescents were “at risk” or overweight. Females were less likely to be overweight than males (9.4% vs. 15.7%; p < .001). Although 26.4% were attempting to lose weight, only 12.2% of all teens were actually overweight. Exercise and restricting intake were the preferred methods of weight loss. Physicians routinely discussed adolescents’ weight during visits, and were more likely to discuss it with those “at risk” (p < .001). Body image was more often discussed with girls than with boys (52% vs. 44.6%, p < .001) and with those at risk (51.6% vs. 45.5%; p < .001). Discussion of healthy eating and weight loss occurred more often with adolescents “at risk” for becoming overweight (p < .001).ConclusionsMany adolescents are at risk for being overweight or are currently overweight, confirming the importance of clinicians discussing diet and nutrition health topics with all teens. Many adolescents also misclassify their body image, and hence perceive their body image to be different from their actual BMI; clinicians should discuss body image with all adolescents, not just those at risk for eating disorders. Better interventions are needed to promote healthy nutrition and physical activity to all adolescents.     

Socioecological Path Analytic Model of Diet Quality among Residents in Two Urban Food Deserts

BackgroundDiet is critical to chronic disease prevention, yet there are persistent disparities in diet quality among Americans. The socioecological model suggests multiple factors, operating at multiple levels, influence diet quality.ObjectiveThe goal was to model direct and indirect relationships among healthy eating identity, perceived control of healthy eating, social support for healthy eating, food retail choice block scores, perceptions of healthy food availability, and food shopping behaviors and diet quality measured using Healthy Eating Index-2010 scores (HEI-2010) for residents living in two urban communities defined as food deserts.DesignA cross-sectional design was used including data collected via self-reported surveys, 24-dietary recalls, and through objective observations of food retail environments.Participants/settingData collection occurred in 2015-2016 in two low-income communities in Cleveland (n=243) and Columbus (n=244), OH.Main outcome measureHEI-2010 scores were calculated based on the average of three 24-hour dietary recalls using the Nutrition Data System for Research.AnalysisSeparate path models, controlled for income, were run for each community. Analysis was guided by a conceptual model with 15 hypothesized direct and indirect effects on HEI-2010 scores. Associations were considered statistically significant at P<0.05 and P<0.10 because of modest sample sizes in each community.ResultsAcross both models, significant direct effects on HEI-2010 scores included healthy eating identity (β=.295, Cleveland; β=.297, Columbus, P<0.05) and distance traveled to primary food store (β=.111, Cleveland, P<0.10; β=.175, Columbus, P<0.05). Perceptions of healthy food availability had a significant, inverse effect in the Columbus model (β=−.125, P<0.05). The models explained greater variance in HEI-2010 scores for the Columbus community compared with Cleveland (R²=.282 and R²=.152, respectively).ConclusionsFindings highlight the need for tailored dietary intervention approaches even within demographically comparable communities. Interventions aimed at improving diet quality among residents living in food deserts may need to focus on enhancing healthy eating identity using culturally relevant approaches while at the same time addressing the need for transportation supports to access healthy food retailers located farther away.     

Effects of orthodox religious fasting versus combined energy and time restricted eating on body weight,lipid concentrations and glycaemic profile

Abstract

For seven weeks, 37 overweight adults followed a hypocaloric diet based on Orthodox Fasting (OF). A hypocaloric, time restricted eating (TRE) plan (eating between 08:00 to 16:00?h, water fasting from 16:00 to 08:00?h) was followed by 23 Body Mass Index (BMI)-matched participants. Anthropometric, glycaemic and inflammation markers and serum lipids were assessed before and after the diets. Both OF and TRE groups demonstrated reductions in BMI (28.54?±?5.45 vs 27.20?±?5.10?kg/m², p?<?0.001 and 26.40?±?4.11 vs 25.81?±?3.78?kg/m² p?=?0.001, respectively). Following the intervention, the OF group presented lower concentrations of total and low-density lipoprotein-cholesterol, compared with the pre-fasting values (178.40?±?34.14 vs 197.17?±?34.30?mg/dl, p?<?0.001 and 105.89?±?28.08 vs 122.37?±?29.70?mg/dl, p?<?0.001, respectively). Neither group manifested significant differences in glycaemic and inflammatory parameters. Our findings suggest that OF has superior lipid lowering effects than the TRE pattern.     

Influence of polyphenols from lingonberry,cranberry, and red grape on in vitro digestibility of rice

Abstract

Dietary polyphenols are abundant antioxidants in the human diet and are associated with lower rates of diabetes and cardiovascular disease. This study aims to determine the effects of cooking white rice (WR) added with lingonberry (WRLB), cranberry (WRCB), and red grape (WRRG) on in vitro digestibility. There was significantly lower level of glucose release for WRRG compared with WR (p?<?0.05). WRLB and WRCB showed no effect on glucose release compared with WR (p?>?0.05). Increasing concentrations of red grape polyphenol decreased digestibility of white rice (p?<?0.05). A positive correlation between the red grape phenolic content and the resistant starch was observed (R?=?0.9854). Red grape polyphenol had the greatest impact on reducing in vitro digestibility of white rice. The addition of polyphenols in carbohydrate-rich foods may be a practical means to reduce the high glycemic response of rice eaten around the world.     

Friends and Family: How African-American Adolescents’ Perceptions of Dietary Beliefs and Behaviors of Others Relate to Diet Quality

Background

Adolescents’ dietary intake often fails to meet national dietary guidelines, especially among low-income African-American youth. The dietary habits established in adolescence are likely to continue into adulthood, and a poor-quality diet increases the risk of developing obesity and chronic disease. Based on principles from ecological and social-cognitive behavior change health theories, perceptions of parental beliefs about healthy eating, perceptions of peer eating behaviors, and parental monitoring of what adolescents eat may positively influence adolescent diet quality.

Eating Habits and Food Additive Intakes Are Associated with Emotional States Based on EEG and HRV in Healthy Korean Children and Adolescents

Purpose: Recent study suggests that psychological issues and eating habits are closely related. In this study, we aimed to find the association between eating habits and intakes of artificial sweeteners with emotional states of schoolchildren using quantitatively analyzing objective biosignals.

Methods: The study was conducted at the National Standard Reference Data Center for Korean EEG as a cross-sectional study. Three hundred eighteen healthy children who have not been diagnosed with neurologic or psychiatric disorders were evaluated (168 girls and 150 boys; mean age of 11.8 ± 3.6 years). Analysis indicators were a dietary intake checklist for children's nutrition-related behavior score (NBS), consisting of 19 items; food frequency questionnaires (FFQs), consisting of 76 items; the Child Depression Inventory (CDI); State–Trait Anxiety Inventory–State (STAI-S); State–Trait Anxiety Inventory–Trait (STAI-T); electroencephalograph (EEG); and heart rate variability (HRV).

Results: Higher scores on the CDI, STAI-S, and STAI-T indicate negative emotions, and these scores were significantly decreased from the first to the fourth quartiles. The HRV results showed that the standard deviation of all normal-to-normal (SDNN) intervals was significantly higher in the first quartile than in the fourth quartile (p < 0.05). The intakes of artificial sweeteners and processed foods such as hamburgers correlate with higher theta/beta ratios, and intakes of natural foods such as legumes and fruits correlate with lower theta/beta ratios (p < 0.05).

Conclusions and Implications: From this result we confirmed a link between overall nutritional behavior, food additive intakes, and emotion in apparently healthy children and adolescents.     

Diet and Exercise Habits of Patients with Diabetes,Dyslipidemia, Cardiovascular Disease or Hypertension

Objective: The objective of this study was to determine whether free-living individuals diagnosed with diabetes, dyslipidemia, cardiovascular disease or hypertension follow standard dietary recommendations for treatment of these diet-modifiable disorders.

Methods: Data are from 1,782 adult men and women who completed an annual clinic visit as part of a large study of diet and health. Usual dietary intake over the previous month was assessed with a self-administered food frequency questionnaire. Trained staff obtained a detailed medical history and information on health and exercise habits, measured height and weight, and collected a fasting blood specimen to measure total serum cholesterol, triglycerides and carotenoids. Multivariate linear regression was used to test associations of diet-modifiable chronic diseases with diet and exercise habits.

Results: 42% of the study sample reported at least one diet-modifiable disease or risk factor for disease. These individuals had higher total serum cholesterol (p < 0.001) and triglycerides (p < 0.001) compared to those without these conditions. Diabetics consumed a greater percent of energy from fat (p < 0.01), and men with hypertension consumed a greater percent energy from saturated fat (p < 0.05) compared to those without these conditions. There were few other differences in dietary intake between diseased and healthy individuals, and on average, all participants had diets that were not consistent with recommended guidelines for prevention or treatment of these diet-modifiable disorders. Forty-six percent of all participants were overweight or obese, and BMI was significantly higher among participants with at least one diet-modifiable disorder (p < 0.001). Healthy and diseased participants exercised about 17 minutes per day, and compared to non-diabetics, persons with diabetes exercised with 25% less intensity (p < 0.05).

Conclusion: Participants in this sample with diet-modifiable disorders reported that they are motivated to eat less fat, but most are still overweight or obese, consume a diet high in fat and low in fruits and vegetables and engage in very little physical exercise. New strategies are needed to help patients adopt and maintain healthful dietary practices that will reduce their risk.     

Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur,Malaysia

BACKGROUND/OBJECTIVES

This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia.

SUBJECTS/METHODS

This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively.

RESULTS

The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 ± 8.2%) had poorer diet quality than females (mean = 39.9 ± 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 ± 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 ± 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents.

CONCLUSIONS

In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.     

The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters,Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized,Double-Blind,Placebo-Controlled Trial

Abstract

Objective: To our knowledge, no study has investigated the effects of choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM). The aim of this study was investigation of the effects of the choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with T2DM.

Methods: A randomized double-blind placebo-controlled parallel clinical trial was carried out among 96 diabetic patients. Ninety-six patients were randomly assigned to either choline, magnesium, choline-magnesium, or placebo for 2 months. Anthropometric measurement; metabolic, inflammatory, and endothelial markers; dietary intake; and physical activity were assessed at baseline and after treatment.

Results: There was a significant change in serum magnesium in both magnesium and choline-magnesium groups (p?<?0.05). Also, significant changes were observed in interleukin (IL)-6 levels in magnesium and choline-magnesium groups (p?<?0.05). Moreover, vascular cell adhesion molecule-1 (VCAM-1) levels decreased in choline and choline-magnesium groups (p?<?0.05). When adjusted for potential confounders, inflammation and endothelial factors (IL-6 and VCAM-1) decreased significantly in the choline-magnesium group as compared to other groups (p?<?0.05). Compared to baseline values there were no significant differences in all anthropometric measurements and metabolic factors among four groups (p?>?0.05).

Conclusions: Choline and magnesium co-supplementation was more effective in improving inflammation and endothelial dysfunction than supplementation with choline or magnesium alone.     

Eating Earlier and More Frequently Is Associated With Better Diet Quality in Female Brazilian Breast Cancer Survivors Using Tamoxifen

BackgroundEmerging literature demonstrates that eating time and frequency are associated with quality and quantity of food consumption and anthropometric measurements. Considering that unhealthy dietary choices and obesity are important modifiable risk factors for breast cancer incidence and recurrence, this subject is relevant and has not been studied sufficiently in breast cancer survivors.ObjectiveThis study’s aim was to examine the association of eating time and frequency with diet quality, quantity of food consumption, anthropometric measurements, and body composition parameters in female breast cancer survivors using tamoxifen.DesignThis was a cross-sectional study.Participants/settingThis study was conducted from March 2015 to March 2016 at a Brazilian university hospital (Clinic’s Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil) and included an assessment of 84 female breast cancer survivors using tamoxifen (mean [SD] age was 53.1 [8.7] years).Main outcome measuresQuantitative dietary assessment consisted of three 24-hour dietary recalls. The Brazilian Healthy Eating Index Revised was used for the qualitative diet analysis. Participants were classified by median eating time (early or late eaters of breakfast, lunch, and dinner), as well as by considering the middle time point between the first and last meal of the day (early or late midpoint eaters). Participants were also classified by median eating frequency (<5 or ≥5 eating episodes per day). Anthropometric measurements and body fat percentage by bioelectrical impedance were obtained.Statistical analysisGeneralized linear models and generalized mixed models were used to assess the associations between variables.ResultsEarly breakfast and dinner eating and early midpoint eating were associated with better scores for specific Brazilian Healthy Eating Index Revised components (P < .05). Early breakfast and dinner eating were also associated with better scores for the total index (P = .035 and P = .017, respectively). Early dinner eaters and early midpoint eaters had significantly lower daily energy consumption (P = .007 and P = .002, respectively). Eating ≥5 episodes per day was also associated with better scores of specific Brazilian Healthy Eating Index Revised components and the total index (P < .05). No significant associations between eating time and frequency with anthropometric measurements and body composition parameters were found (P > .05). However, women in the healthy body mass index category vs women in the overweight/obesity category had higher energy consumption at breakfast (P = .046).ConclusionsEarlier food intake time was associated with better diet quality and lower daily energy consumption. Higher frequency of eating was also associated with better diet quality. Future studies, such as randomized controlled trials, are needed to evaluate interventions addressing the timing and frequency of meals and their effect on diet quality and quantity in breast cancer survivors.     

Are eating habits associated with physical fitness in primary school children?

ObjectiveChildren's eating habits have mainly been related to anthropometric characteristics but less is known about their association with physical fitness.Methods278 French school children (131 boys and 147 girls) filled in eating habit questionnaires and completed anthropometric measurement (weight, height, skinfolds) and physical fitness tests. The 20-m Shuttle run test and the Squat Jump test were used to assess aerobic fitness and anaerobic (lower limb muscle power) fitness respectively.ResultsBreakfast consumption was associated with both aerobic fitness (p < 0.05) and lower limb muscle power (p < 0.01) while snacking was negatively related to Squat Jump performances (p < 0.05). There was no association between physical fitness and either the type of the consumed-beverages or TV watching during diner and lunch meals. Cumulated unhealthy eating habits was negatively associated with CRF stages and lower limb muscle power performances (p < 0.05).ConclusionFrench primary school children physical fitness is associated with their eating habits and decreases with the number of unhealthy eating behaviors cumulated.     

Clustering of Multiple Lifestyle Behaviors and Health-related Fitness in European Adolescents

ObjectiveTo explore the clustering of different lifestyle behaviors and whether this clustering differs by gender, age, and health-related fitness.DesignHealthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study.SettingTen European cities.ParticipantsA total of 2,084 adolescents (12.5–17.5 years).Main Outcome MeasuresFour lifestyle behaviors were assessed by self-administered questionnaires: moderate to vigorous physical activity, homework time, screen time, and diet. Health-related fitness components (aerobic capacity, strength, speed-agility, and body composition) were assessed.AnalysisHierarchical method and κ-means cluster analysis. Analysis of variance tests.ResultsFive clusters were identified: Healthy diet and Active, Healthy diet and Academic, Healthy diet and Inactive, Unhealthy diet and Screen user, and Unhealthy diet and Active. Younger adolescents were more active and followed a healthier diet than older adolescents. Older boys devoted more time to screen use, whereas older girls devoted more time to homework. Boys in the Healthy diet and Active cluster presented higher aerobic capacity and speed-agility, whereas girls presented higher aerobic capacity, strength, and speed-agility.Conclusions and ImplicationsClustering of different lifestyle behaviors is observed. Different healthy lifestyles do not always come together and clusters are associated with gender, age, and health-related fitness, but not with body composition. These differences need to be considered when developing intervention strategies for the prevention of unhealthy habits.     

Eating Behaviors and Diet Quality: A National Survey of Australian Young Adults

ObjectiveTo investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults.DesignCross-sectional analysis.ParticipantsYoung adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study.Main outcome measuresFour eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods.AnalysisMultivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders.ResultsGreater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P < 0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P < 0.001).Conclusions and ImplicationsPerceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.     

Misreporting of Energy Intake in Older People: Comparison of Two Dietary Assessment Methods

Abstract

Accurate assessment of dietary intake is essential in clinical practice and research. While energy intake (EI) misreporting has been extensively studied in the general population, relatively little is known about misreporting among older people. This cross-sectional study used clinical data routinely collected in 127 participants, aged 70–96?years, from the Toulouse Frailty Clinic. EI was assessed by diet history interview and three-day food record. Misreporters were identified with the Goldberg cut-off method, using the Harris–Benedict equation to estimate total energy expenditure. The response rate was 66% for three-day food record and 93% for diet history interviews. EI from diet history interviews (1799?±?416?kcal/day) was significantly higher than from food records (1400?±?381?kcal/day; p?<?0.001) and closest to total energy expenditure (1758?±?437?kcal/day; (p?>?0.05). Thirty percent of participants were identified as underreporters with three-day food records vs. 9% with diet history interviews. Overreporters were found with diet history interviews only (11% of participants). In older people, the diet history interview has the advantage of obtaining a higher response rate and a lower underreporting rate, compared to three-day food record. Nevertheless, with this method, overreporting was observed and interpreting results should be done with caution.     

Consumer knowledge and attitudes about genetically modified food products and labelling policy

Abstract

The purpose of this study was to examine the relationship between consumer knowledge, attitudes and behaviours towards foods containing genetically modified organisms (GMOs) and the prevalence of GMO labelling in northern New Jersey supermarkets. This cross-sectional study surveyed 331 adults, New Jersey supermarket customers (mean age 26 years old, 79.8% women). The results show a strong, positive correlation between consumer attitudes towards foods not containing GMOs and purchasing behaviour (Pearson’s r?=?0.701, p?<?0.001) with lesser correlations between knowledge and behaviour (Pearson’s r?=?0.593, p?<?0.001) and knowledge and attitudes (Pearson’s r?=?0.413, p?<?0.001). GMO labelling would assist consumers in making informed purchase decisions.     

Health service utilization among adults aged 50+ across eleven European countries (the SHARE study 2004/5)

Purpose

The current study aims to examine the use of preventive and other health services among adults aged 50+ in eleven European countries.

Methods

The data used were derived from 16,120 adults aged 50+ years participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Preventive Health Services Utilization score (PHSUs) and Health Care Services Utilization score (HCSUs) were assessed as a composite value from answers to 12 and 16 questions respectively, on a scale ranging from 0 to 100. Estimations were based on a complex study design.

Results

Participants from Central European countries were found to have significantly higher mean PHSU and HCSU scores than their counterparts in Northern and Southern regions, (p?<?0.05) and also exhibited a greater gap between the two scores (29.3, 95% CI: 28.6–30.1). Overall mean PHSU score was 39.9 (95% CI: 39.4–40.4) and mean HCSU score 12.4 (95% CI: 12.2–12.7). Women have a higher mean PHSUs and HCSUs (p?<?0.001); as age increases, PHSUs falls and HCSUs rises (p?<?0.001). Better educated participants appear to have higher mean PHSUs and HCSUs (p?<?0.001). In addition, both of the above scores increase in the presence of chronic diseases (p?<?0.001).

Conclusion

Strong correlation is seen between comorbidity, increasing age, educational level, and retirement on the one hand, and increased use of health services on the other hand. The use of health services is a major issue with regard to public health policy formulation.