Use of a three-day estimated food record, a 72-hour recall and a food-frequency questionnaire for dietary assessment in a Mediterranean Spanish population

AIM: To assess the validity and the short-term reproducibility of a semi-quantitative, self-administrated food frequency questionnaire and a structured 72-hour recall in a Mediterranean Spanish population. METHODS: 44 free-living volunteers participated in the study. Macronutrient, vitamin and mineral intake, recorded on the food frequency questionnaire and the structured 72-h recall were compared with intakes derived from a three-day food record (reference method). Validity of the dietary assessment methods was further assessed by comparing urinary nitrogen, plasma vitamin C, plasma beta-carotene and whole blood glutathione peroxidase activity levels with the corresponding nutrient intakes from the questionnaires. The food frequency questionnaire and the 72-h recall were administered twice to assess the short term reproducibility. RESULTS: Pearson's correlation coefficients between urinary nitrogen, plasma vitamin C, plasma beta-carotene and whole blood glutathione peroxidase activity levels and the reported nitrogen, vitamin C, beta-carotene and selenium intakes were 0.26, 0.53, 0.17, 0.26 for the food frequency questionnaire; 0.41, 0.09, 0.34, 0.42 for the structured 72-h recall and 0.50, 0.54, 0.44, 0.38 for the three-day food record, respectively. The short term reproducibility of analysed nutrient intake showed average intra-class correlation coefficients of 0.91 and 0.69 for the food frequency questionnaire and the structured 72-h recall irrespectively. CONCLUSION: The food frequency questionnaire and the structured 72-h recall provide valid estimates of nutrient intake and could be used for dietary assessments.     

The relation of diet, cigarette smoking, and alcohol consumption to plasma beta-carotene and alpha-tocopherol levels

The relation of diet and nutritional supplements, cigarette use, alcohol consumption, and blood lipids to plasma levels of beta-carotene and alpha-tocopherol was studied among 330 men and women aged 18-79 years. Dietary carotene, preformed vitamin A, and vitamin E intake were estimated by a self-administered semiquantitative food frequency questionnaire. The correlation of dietary carotene with plasma beta-carotene was reduced in smokers compared with nonsmokers (r = 0.02 vs. 0.44 among men; r = 0.19 vs. 0.45 among women). Smokers had much lower plasma levels of beta-carotene than did nonsmokers (geometric mean 8.5 vs. 15.3 micrograms/dl for men; 17.3 vs. 26.3 micrograms/dl for women) despite only slightly lower intakes of carotenoids. In multiple regression analyses, men who smoked one pack per day had 72% (95% confidence interval (CI) 58-89) of the plasma beta-carotene levels of nonsmokers after accounting for dietary carotene and other variables; for women, the corresponding percentage was 79% (CI 64-99). In similar models, men drinking 20 g of alcohol per day had 76% (CI 65-88) of the beta-carotene levels of nondrinkers; women had 89% (CI 73-108) of the levels of nondrinkers. An interaction term for carotene intake and smoking was statistically significant in a model combining both sexes. These results suggest that plasma levels of beta-carotene among smokers and, perhaps, heavy consumers of alcohol may be reduced substantially below levels due to differences in diet. The correlation of calorie-adjusted intake of vitamin E with lipid-adjusted plasma levels of vitamin alpha-tocopherol was 0.53 for men (n = 137) and 0.51 for women (n = 193) and did not differ by alcohol consumption and cigarette use; these correlations were largely accounted for by use of vitamin supplements. In linear regression models, vitamin E intake and plasma lipids were significant predictors of plasma alpha-tocopherol levels.     

Relationship between smoking, dietary intakes and plasma levels of vitamin E and beta-carotene in matched maternal-cord pairs.

The concentrations of tocopherols and carotenoids are lowered in umbilical cord blood plasma, which may have a negative effect on antioxidant protection in neonates. Smoking may adversely affect dietary intakes and plasma concentrations of carotenoids. The dietary intakes of vitamin E and beta-carotene were assessed in 66 pregnant women (31 smokers and 35 non-smokers) between 10 and 20 weeks gestation using a food frequency questionnaire. The concentrations of alpha-tocopherol and beta-carotene were measured in maternal plasma at the time of the dietary assessment, and in the matched umbilical cords of their newborn after delivery. In smoking and non-smoking mothers, the mean intakes of vitamin E (9.3 [SD 5] and 8.2 [SD 5] mgd-1) and beta-carotene (3464 [SD 1885] and 2977 [SD 1503] micrograms d-1) were not significantly different. The plasma concentrations of alpha-tocopherol (20.8 [SD 4] and 20.5 [SD 4] mumol L-1), the alpha-tocopherol to lipid ratios (3.2 [SD 0.8] and 3.5 [SD 0.8]) and the plasma concentrations of beta-carotene (0.22 [SD 0.1] and 0.22 [SD 0.1] mumol L-1) were not significantly different in smoking and non-smoking mothers. There were no significant differences in plasma alpha-tocopherol (7.4 [SD 2] and 7.3 [SD 2] mumol L-1), in alpha-tocopherol to lipid ratios (3.2 [SD 0.6] and 2.8 [SD 0.6]) or in beta-carotene concentrations (0.05 [SD 0.04] and 0.03 [SD 0.02] mumol L-1) in cords from newborns of smoking and non-smoking mothers. There was a significant correlation (r = 0.41, P = 0.015) between dietary intakes and plasma concentrations of beta-carotene in non-smoking mothers. However, this relationship was not significant in smoking mothers (r = 0.28, P = 0.12). There were no relationships between dietary intakes and plasma concentrations of tocopherol. These results indicate that smoking during pregnancy does not appear to affect the dietary intakes or plasma concentrations of alpha-tocopherol and beta-carotene in pregnant women or their babies. However, smoking does influence the relationship between dietary intakes and plasma levels of beta-carotene.     

Inadequate antioxidant nutrient intake and altered plasma antioxidant status of rheumatoid arthritis patients

OBJECTIVE: Elevated free radical generation in inflamed joints and impaired antioxidant system have been implicated in rheumatoid arthritis (RA). The present study was performed to evaluate dietary nutrient intake and plasma oxidant/antioxidant status in RA patients. METHODS: RA patients (n = 97) and their age, gender-matched controls (n = 97) participated in this cross-sectional case-control study. Nutrient intake was estimated using a semi-quantitative food frequency questionnaire. Twenty subjects from each group provided blood samples, and plasma concentrations of alpha-tocopherol and malondiadehyde (MDA) were measured. Also, plasma activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) were measured. RESULTS: The mean calorie intake of RA patients was lower than that of the healthy controls. Energy-adjusted intake of fat, vitamin A and beta-carotene were significantly lower in patients than those of the control subjects. RA patients had a decreased mean plasma alpha-tocopherol level. The activity of plasma SOD and GPx in patients was significantly lower than that in control subjects. CONCLUSION: These results suggest proper antioxidant nutrient intake management may reduce free radical generation and improve antioxidant status in RA patients.     

Nutritional status of vitamin A, E, C, B1, B2, B6, nicotinic acid, B12, folate, and beta-carotene in young women

To investigate the vitamin status of young Japanese women, dietary intakes of vitamin A, E, C, B1, B2, B6, B12, niacin, folate, and beta-carotene were assessed by a 3-d weighed food record in 150 female students aged 21-22. Whole blood levels of vitamin B1, B2, and nicotinic acid, and serum levels of retinol, alpha-tocopherol, vitamin B6, and beta-carotene were determined by HPLC. Vitamin B12 and folate in serum were measured by chemiluminescence immunoassay, and serum vitamin C was done by dinitrophenylhydrazine method. When the 6th revision RDAs for the Japanese (physical activity level 1) were applied, 46.7% of the females showed sufficient intake for vitamin A, 28.7% for E, 80.7%, for B1, 92.7% for B2, 54.7% for B6, 99.3% for niacin, 76.0% for B12, 34.0% for folate, and 54.0% for C. Fifty-nine percent of total vitamin A (microgRE) intakes were derived from beta-carotene. The mean+/- SD of energy intakes was low, 1.572+/-315 kcal. Significant correlations among intakes of energy and all these vitamins were found. Serum folate and ascorbic acid levels in the females with corresponding vitamin intakes above the RDA were significantly higher than in those with intakes below the RDA. There were significant correlations between blood vitamin levels and vitamin intakes in vitamin B12 (r=0.185), folate (r=0.255), vitamin C (r=0.272), and beta-carotene (r=0.319). Mean blood levels of folate, ascorbic acid, vitamin B2, B12, and beta-carotene were higher in the highest quartile of intake than in the lowest. The 95% confidence intervals of blood vitamin levels obtained from the females with sufficient vitamin intakes were nearly equal to those obtained from all subjects. Only a few females (0.7-4.7%) had their blood vitamin levels below the lower limits. Serum alpha-tocopherol levels were significantly correlated with serum levels of retinol, beta-carotene, and vitamin C. This data suggested that young women should increase suitable dietary food intakes in order to maintain good status of vitamin. Moreover, sufficient amount of physical activity would be expected for prevention of excessive energy intake.     

Nutritional and plasmatic antioxidant vitamins status of ultra endurance athletes

OBJECTIVE: The "Marathon des Sables" (MDS) is a competition known to induce oxidative stress. Antioxidant vitamins prevent exercise-induced oxidative damages. The purpose of this study was to evaluate daily intake and plasma level of the main antioxidant vitamins (alpha-tocopherol, vitamin C, beta-carotene and retinol) in 19 male athletes who participated in this competition. METHODS: Data collected before the beginning of the competition included daily dietary intake using a 7-day food record and plasma biochemical measurements (alpha-tocopherol, vitamin C, beta-carotene and retinol). RESULTS: First, total energy intake was obviously lower than the energetic intake usually observed in well-trained endurance athletes. Second, antioxidant vitamins intake was also insufficient. Indeed, the intake was lower than the French Dietary Reference Intakes (DRI) for this population in 18 subjects for vitamin E and 6 subjects for vitamin C, beta-carotene and Retinol Equivalent. As a significant relationship was found between total energy intake and the intake of vitamin E (r = 0.73; p < 0.001) and vitamin C (r = 0.78; p < 0.001), the low total energy intake contributed partially to the insufficient antioxidant vitamins intake. The dietary questionnaire analysis also revealed a low intake of vegetable oils, fruits and vegetables. However, plasma concentrations of these antioxidant vitamins were similar to the literature data observed in athletes. CONCLUSION: This study evidenced obvious insufficient energy intake in ultra endurance athletes associated with a low antioxidant vitamin intake.     

Validity and reliability of a new food frequency questionnaire compared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer

BACKGROUND: A pilot study was carried out to evaluate validity and reproducibility of a food frequency questionnaire (FFQ), which was designed to be used in a prospective cohort study in a population at high risk for esophageal cancer in northern Iran. METHODS: The FFQ was administered four times to 131 subjects, aged 35-65 years, of both sexes. Twelve 24-h dietary recalls for two consecutive days were administered monthly during 1 year and used as a reference method. The excretion of nitrogen was measured on four 24-h urine samples, and plasma levels of beta-carotene, retinol, vitamin C and alpha-tocopherol was measured from two time points. Relative validity of FFQ and 24-h diet recall was assessed by comparing nutrient intake derived from both methods with the urinary nitrogen and plasma levels of beta-carotene, retinol, vitamin C and alpha-tocopherol. RESULTS: Correlation coefficients comparing energy and nutrients intake based on the mean of the four FFQ and the mean of twelve 24-h diet recalls were 0.75 for total energy, 0.75 for carbohydrates, 0.76 for proteins and 0.65 for fat. Correlation coefficients between the FFQ-based intake and serum levels of beta-carotene, retinol, vitamin C and vitamin E/alpha-tocopherol were 0.37, 0.32, 0.35 and 0.06, respectively. Correlation coefficients between urinary nitrogen and FFQ-based protein intake ranged from 0.23 to 0.35. Intraclass correlation coefficients used to measure reproducibility of FFQ ranged from 0.66 to 0.89. CONCLUSION: We found that the FFQ provides valid and reliable measurements of habitual intake for energy and most of the nutrients studied.     

Association of food frequency questionnaire estimates of vitamin A intake with serum vitamin A levels

To assess the validity of nutrient intake estimates from a food frequency questionnaire, the authors compared estimates of intake of preformed retinol (dietary plus supplements), beta-carotene, other active carotenoids, and total vitamin A computed from questionnaire responses with serum retinoid and carotenoid concentrations. Data were obtained from 302 male and female current or former smokers, participants in a lung cancer chemoprevention trial at the Fred Hutchinson Cancer Research Center in Seattle, Washington, during 1985-1986. Both serum beta-carotene and serum alpha-carotene were associated, although weakly, with food frequency estimates of total vitamin A intake, dietary vitamin A, beta-carotene, other carotenoids, and total carotenoids (0.18 less than or equal to r less than or equal to 0.26). Serum retinol was associated with supplementary vitamin A intake (r = 0.16). Nondietary factors were also associated with serum nutrient concentrations--in particular, cigarette smoking, alcohol intake, and body mass index. Cigarette smoking emerged as an important modifying factor of the relation between serum beta-carotene and dietary beta-carotene (r = 0.14 for current smokers, r = 0.30 for former smokers).     

Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers

The aim of the present cross-sectional study was to examine the agreement and disagreement between a 7 d diet diary (7DD) and a self-administered machine-readable food-frequency questionnaire (FFQ) asking about diet in the previous year, and to validate both methods with biomarkers of nutrient intake. The subjects were an age- and employment-grade-stratified random subsample of London-based civil servants (457 men and 403 women), aged 39-61 years, who completed both a 7DD and a FFQ at phase 3 follow-up (1991-1993) of the Whitehall II study. Mean daily intakes of dietary energy, total fat, saturated, monounsaturated and polyunsaturated fatty acids, linoleic acid, total carbohydrate excluding fibre, sugars, starch, dietary fibre, protein, vitamin C, vitamin E (as alpha-tocopherol equivalents), folate, carotenes (as total beta-carotene activity), Fe, Ca, Mg, K and alcohol were measured. Serum cholesteryl ester fatty acids (CEFA), plasma alpha-tocopherol and beta-carotene were also measured as biomarkers. Estimates of mean energy intake from the two methods were similar in men, and some 10 % higher according to the FFQ in women. Compared with the 7DD, the FFQ tended to overestimate plant-derived micronutrient intakes (carotenes from FFQ v. 7DD men 2713 (SD 1455) v. 2180 (SD 1188) microg/d, women 3100 (SD 1656) v. 2221 (SD 1180) microg/d, both differences P<0.0001) and to underestimate fat intake. Against plasma beta-carotene/cholesterol, carotene intake was as well estimated by the FFQ as the 7DD (Spearman rank correlations, men 0.32 v. 0.30, women 0.27 v. 0.22, all P< or =0.0001, energy-adjusted data). Ranking of participants by other nutrient intakes tended to be of the same order according to the two dietary methods, e.g. rank correlations for CEFA linoleic acid against FFQ and 7DD estimates respectively, men 0.38 v. 0.41, women 0.53 v. 0.62, all P< or =0.0001, energy-adjusted % fat). For alpha-tocopherol there were no correlations between plasma level and estimated intakes by either dietary method. Quartile agreement for energy-adjusted nutrient intakes between the two self-report methods was in the range 37-50 % for men and 32-44 % for women, and for alcohol, 57 % in both sexes. Disagreement (misclassification into extreme quartiles of intake) was in the range 0-6 % for both sexes. The dietary methods yielded similar prevalences (about 34 %) of low energy reporters. The two methods show satisfactory agreement, together with an expected level of systematic differences, in their estimates of nutrient intake. Against the available biomarkers, the machine-readable FFQ performed well in comparison with the manually coded 7DD in this study population. For both methods, regression-based adjustment of nutrient intake to mean dietary energy intake by gender appears on balance to be the optimal approach to data presentation and analysis, in view of the complex problem of low energy reporting.     

Habitual food intake and polyunsaturated fatty acid deficiency in liver cirrhosis

OBJECTIVE: We compared the habitual food intake and plasma fatty acid composition in cirrhotic patients living in two different regions in Japan, Okayama and Toyama, and evaluated the effects of dietary polyunsaturated fatty acid and alpha-tocopherol intake on serum alanine aminotransferase (ALT) activity. METHOD: A quantitative food-frequency questionnaire method was used. RESULTS: The significantly higher intake of fish in the patients living in Toyama resulted in higher plasma levels of docosahexaenoic acid and lower levels of arachidonic acid. Serum ALT activity correlated negatively with plasma arachidonic acid (r = -0.456, P < 0.05) and alpha-tocopherol (r = -0.505, P < 0.05) levels. Dietary intakes of vitamin E and polyunsaturated fatty acids (mg/g) correlated negatively with serum ALT (r = -0.377, P < 0.05). Dietary intake of linoleic acid and the ratio of polyunsaturated to saturated fatty acid in dietary fat correlated significantly with serum ALT (r = 0.604, P < 0.01, and r = 0.622, P < 0.01, respectively). The amount of vegetable intake correlated with intake of vitamin E and polyunsaturated fatty acid (r = 0.527, P < 0.02). CONCLUSIONS: These findings suggest that habitual food intake affects the plasma fatty acid profile and that elevated serum ALT may be related to arachidonic acid deficiency and vulnerability to lipid peroxidation in cirrhotic patients with hepatitis B and C viruses.     

Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals.

The authors assessed the reproducibility and validity of an expanded 131-item semiquantitative food frequency questionnaire used in a prospective study among 51,529 men. The form was administered by mail twice to a sample of 127 participants at a one-year interval. During this interval, men completed two one-week diet records spaced approximately 6 months apart. Mean values for intake of most nutrients assessed by the two methods were similar. Intraclass correlation coefficients for nutrient intakes assessed by questionnaires one year apart ranged from 0.47 for vitamin E without supplements to 0.80 for vitamin C with supplements. Correlation coefficients between the energy-adjusted nutrient intakes measured by diet records and the second questionnaire (which asked about diet during the year encompassing the diet records) ranged from 0.28 for iron without supplements to 0.86 for vitamin C with supplements (mean r = 0.59). These correlations were higher after adjusting for week-to-week variation in diet record intakes (mean r = 0.65). These data indicate that the expanded semiquantitative food frequency questionnaire is reproducible and provides a useful measure of intake for many nutrients over a one-year period.     

Serum concentrations of beta-carotene and alpha-tocopherol are associated with diet, smoking, and general and central adiposity

BACKGROUND: Previous studies of associations between diet, obesity, and blood concentrations of alpha-tocopherol and beta-carotene have been equivocal. Furthermore, most studies used only body mass index (BMI) as an obesity measure. OBJECTIVES: Our objectives were to examine the associations between energy and nutrient intakes, alcohol consumption, tobacco use, and serum cholesterol and serum concentrations of alpha-tocopherol and beta-carotene, and to examine the associations between different measures of general and central adiposity and serum concentrations of alpha-tocopherol and beta-carotene. DESIGN: This was a cross-sectional, population-based study of 253 men and 276 women aged 46-67 y. Nutrient data were collected by a modified diet history method. Measures of obesity included BMI, percentage of body fat (impedance analysis), waist-to-hip ratio, and waist circumference. The associations between serum nutrient concentrations and the other factors were examined by multiple linear regression. RESULTS: Twenty-one percent of men and 34% of women used antioxidant supplements. The mean BMI was 26.1 in men and 25.4 in women. Serum beta-carotene concentration was positively associated with serum cholesterol concentration, fiber intake, and beta-carotene intake, and negatively associated with smoking and all measures of obesity. In men, serum beta-carotene concentration was not significantly associated with central adiposity after adjustment for body fat. Serum alpha-tocopherol concentration was positively correlated with serum cholesterol, obesity, and vitamin E intake. In women, serum alpha-tocopherol concentration was also positively associated with intakes of ascorbic acid and selenium. Serum alpha-tocopherol concentration was associated with central adiposity after adjustment for body fat. CONCLUSION: Serum beta-carotene and alpha-tocopherol concentrations have different associations with diet, smoking, general adiposity, and central adiposity.     

Dietary intake, neutrophil fatty acid profile, serum antioxidant vitamins and oxygen radical absorbance capacity in patients with ulcerative colitis

Nutrition may play an important role in the pathogenesis and treatment of ulcerative colitis. Several studies suggest an association between dietary factors and the onset of ulcerative colitis; however, only few studies have examined the relationship between dietary intake and relapse of ulcerative colitis. The aim of this study was to assess the dietary intake and antioxidative capacity of ulcerative colitis patients and to elucidate the efficacy of dietary therapy for ulcerative colitis. Dietary intake, fatty acid composition of phospholipids in plasma and neutrophils, serum fat-soluble vitamin levels, and oxygen radical absorbance capacity were analyzed in 29 ulcerative colitis patients (7 males and 22 females), who were treated at the Department of Gastroenterology, Okayama University Hospital. Total fat intake, fat energy ratio and linoleic acid intake were significantly lower, while protein and carbohydrate intakes were significantly higher, in the patients than age- and sex-matched controls. In the neutrophil phospholipids of ulcerative colitis patients, significantly higher levels of linoleic aicd and arachidonic acid and a lower level of eicosapentaenoic acid were observed. The concentrations of serum retinol and beta-carotene but not alpha-tocopherol were significantly lower and serum oxygen radical absorbance capacity was also lower than in the controls. Significant correlations between serum oxygen radical absorbance capacity and retinol (r = 0.567, p = 0.0031), alpha-tocopherol (r = 0.560, p = 0.0036) and beta-carotene (r = 0.440, p = 0.0279) concentrations were observed in the ulcerative colitis patients. A diet restricting the intake of linoleic acid and supplemented with eicosapentaenoic acid and antioxidative vitamins may be recommendable for the nutritional management of ulcerative colitis patients.     

Socioeconomic Indicators Are Independently Associated with Nutrient Intake in French Adults: A DEDIPAC Study

Studies have suggested differential associations of specific indicators of socioeconomic position (SEP) with nutrient intake and a cumulative effect of these indicators on diet. We investigated the independent association of SEP indicators (education, income, occupation) with nutrient intake and their effect modification. This cross-sectional analysis included 91,900 French adults from the NutriNet-Santé cohort. Nutrient intake was estimated using three 24-h records. We investigated associations between the three SEP factors and nutrient intake using sex-stratified analysis of covariance, adjusted for age and energy intake, and associations between income and nutrient intake stratified by education and occupation. Low educated participants had higher protein and cholesterol intakes and lower fibre, vitamin C and beta-carotene intakes. Low income individuals had higher complex carbohydrate intakes, and lower magnesium, potassium, folate and vitamin C intakes. Intakes of vitamin D and alcohol were lower in low occupation individuals. Higher income was associated with higher intakes of fibre, protein, magnesium, potassium, beta-carotene, and folate among low educated persons only, highlighting effect modification. Lower SEP, particularly low education, was associated with lower intakes of nutrients required for a healthy diet. Each SEP indicator was associated with specific differences in nutrient intake suggesting that they underpin different social processes.     

Which plasma antioxidants are most related to fruit and vegetable consumption?

Substantial evidence suggests that fruit and vegetable intake reduces the risk of some cancers and other chronic diseases. While a varied diet containing fruits and vegetables may confer benefits greater than those of any single nutrient, it would be useful to have data on the plasma nutrients most influenced by fruit and vegetable intake. The authors examined the correlation between fruit and vegetable intake as measured by the abbreviated CLUE II food frequency questionnaire and several plasma antioxidants. This study includes 116 male subjects aged 35-72 years who were nonsmokers and nonusers of vitamin supplements and who provided blood samples in the CLUE II Study in Washington County, Maryland. Plasma was assayed for ascorbic acid, beta-carotene, beta-cryptoxanthin, and alpha- and gamma-tocopherol. Lipid- and energy-adjusted partial correlation for the relation with fruit and vegetable intake was r = 0.64 for ascorbic acid, r = 0.44 for beta-carotene, and r = 0.50 for beta-cryptoxanthin. While this study does not address efficacy, the stronger association of ascorbic acid with fruit and vegetable intake seen here may imply that ascorbic acid is an important component of the protective effect seen for fruits and vegetables in numerous epidemiologic studies.     

Plasma levels of retinol, carotenoids, and tocopherols in relation to dietary pattern among pregnant Tanzanian women

In Tanzania, as in other developing countries, dietary intake of nutrients in pregnant women is marginal or lower than the recommended intakes and therefore these women are at high risk for deficiencies. Our aim was to evaluate the relationship between diet and plasma levels of retinol, carotenoids, and alpha-tocopherol in the third trimester of pregnancy. Ninety pregnant women aged between 18 and 45 years were equally recruited from three villages. Seven-day food frequency data was collected by questionnaire. Plasma levels of retinol, carotenoids, and tocopherols were assessed by high-performance liquid chromatography (HPLC). Results indicated that cooked green leafy vegetables constituted the major source of provitamin A carotenoids, with low intake of yellow/orange fruits and preformed vitamin A. Lutein, lycopene, and beta-carotene were the predominant carotenoids in the plasma with mean values of 1.61, 0.84, and 0.63 mumol/L, respectively. There was no significant correlation between frequencies of vegetable consumption and either plasma retinol or carotenoids. However, increased consumption of green leafy vegetables with oil, which increases bioavailability, was correlated with high plasma retinol levels (p = 0.03). Low retinol levels (< or = 0.70 mumol/L) were present in 26% of women. The mean plasma retinol concentration was 0.89 mumol/L and 63% of the women had values below 1.05 mumol/L. The mean plasma alpha-tocopherol concentration was 15.4 mumol/L and women with plasma retinol concentration > 1.05 mumol/L had significantly higher mean alpha-tocopherol than women with plasma retinol concentration < or = 0.70 mumol/L (p < or = 0.01). Twenty-four percent of the women were anemic (hemoglobin: Hb < 110 g/L) and the mean Hb value was 116.3 g/L.     

Effect of a blueberry nutritional supplement on macronutrients, food group intake, and plasma vitamin E and vitamin C in US athletes

Antioxidants from a blueberry beverage may impact plasma vitamins. We examined vitamins/food selection in 12 college athletes during 30 days compared with placebo. Blood was collected before and after exercise at the beginning of the study (day 1) and then after a 30-day period of taking a daily supplemental beverage (day 30). The six trials involved blood that was drawn pre-beverage ingestion/pre-exercise (trials 1 and 4), post-beverage ingestion/pre-exercise (trials 2 and 5), and post-beverage ingestion/1 h post-exercise (trials 3 and 6), on day 1 (trials 1, 2, and 3) and day 30 (trials 4, 5, and 6). Analysis of variance revealed non-significant differences for macronutrient or gamma-tocopherol and vitamin C intakes by food frequency questionnaire or plasma vitamins by liquid chromatography. There was a trend (P = 0.083) in the group x time interaction for alpha-tocopherol intake by repeated-measures analysis of variance. Blueberry alpha-tocopherol (23.91 +/- 9.31 mg) was significantly (P < 0.05) higher than placebo alpha-tocopherol intake (7.59 +/- 0.95 mg) on day 1, but not on day 30 (blueberry, alpha-tocopherol = 9.04 +/- 2.35 mg, placebo, alpha-tocopherol = 11.46 +/- 3.65 mg) by pairwise comparisons. Blueberry supplementation did not affect plasma vitamin concentrations or gamma-tocopherol and vitamin C intakes, and may reduce alpha-tocopherol intake in those starting with a higher alpha-tocopherol intake, yet not altering athletes' eating habits.     

Maternal nutritional status and the risk for orofacial cleft offspring in humans

Periconceptional folate and folic acid intake prevents orofacial clefts (OFC) in the offspring. It has been suggested that other nutrients also play a role. We investigated the preconceptional intake of macronutrients (protein, fat, carbohydrate, fiber, and cholesterol), vitamins (vitamin A, retinol, beta-carotene, ascorbic acid, and alpha-tocopherol), minerals (calcium, phosphorus, iron, magnesium, and zinc) and food groups in mothers of OFC children and controls. At approximately 14 mo after the index pregnancy, 206 mothers of a child with a nonsyndromic OFC and 203 control mothers completed a FFQ on current food intake and a general questionnaire. After exclusion of pregnant and lactating mothers, mothers who reported a change in diet compared with the preconceptional period, and those for whom periconceptional folic acid supplement use was unclear, 182 OFC mothers and 173 control mothers were evaluated. Macronutrient, vitamin, mineral, and food group intakes were compared. After adjustment for energy, quintiles of dietary nutrient intake and odds ratios with 95% CI were calculated. The preconceptional intake of all macronutrients, vitamins, minerals, and food groups with the exception of milk (products), potatoes, pies/cookies were lower in OFC mothers than in controls. The energy-adjusted intakes of vegetable protein, fiber, beta-carotene, ascorbic acid, alpha-tocopherol, iron, and magnesium were significantly lower in cases compared with controls. Increasing intakes of vegetable protein, fiber, ascorbic acid, iron, and magnesium decreased OFC risk. In conclusion, a higher preconceptional intake of nutrients predominantly present in fruits and vegetables reduces the risk of offspring affected by OFC.     

Diet, plasma levels of beta-carotene and alpha-tocopherol, and risk of malignant melanoma

Dietary intake and the plasma levels of retinol, alpha-tocopherol, lycopene, alpha-carotene, and beta-carotene for 204 cases with malignant melanoma were compared with those of 248 controls. Cases and controls were patients 18 years of age or older making their first visit to a dermatology subspecialty clinic for pigmented lesions from July 1, 1982 to September 1, 1985. Intakes of nutrients were estimated using a semiquantitative food frequency questionnaire. No significant associations with malignant melanoma were observed for higher plasma levels of lycopene, retinol, or alpha-carotene in logistic regression analyses after controlling for age, sex, plasma lipids, and known constitutional risk factors (hair color and ability to tan). In similar models, the odds ratio comparing the highest with the lowest quintile was 0.9 (95% confidence interval (CI) 0.5-1.5) for plasma beta-carotene, 0.7 (95% CI 0.5-1.3) for plasma alpha-tocopherol, 0.7 (95% CI 0.4-1.2) for carotene intake, and 0.7 (95% CI 0.4-1.3) for total vitamin E intake. A trend toward reduced risk of melanoma was observed for increasing intake of iron (not including supplements); this was related to the more frequent consumption of baked goods, such as cake, among controls. Alcohol consumption was positively associated with risk of melanoma (chi for trend = 2.1, p = 0.03); the odds ratio for consumption of over 10 g/day compared with persons with no alcohol intake was 1.8 (95% CI 1.0-3.3).