Relative Validity of a Food Frequency Questionnaire Used to Assess Food Intake During a Dietary Intervention Study

To develop a cost-effective alternative for evaluating dietary intake in large-scale intervention trials of cancer and cardiovascular disease outcomes, we designed and validated a semiquantitative food frequency questionnaire (FFQ). We collected 6 to 8 of the 24-hr dietary recalls from 87 adults (ages 30–72 yr) who were randomly assigned to a walnut-supplemented diet or a control diet in a 6-mo dietary intervention trial. Relative validity of a 171-item FFQ in assessing intake of selected foods and the prescribed intervention (intake ≥25 g/day or intake < 2 g of walnuts) was determined using 24-h dietary recalls as the reference. De-attenuated correlations between FFQ and dietary recalls were .82 for walnuts, .80 for fruits, .79 for grains, .77 for vegetables, .63 for water, .44 for sweets, and .36 for dairy/eggs. High within-person variation did not allow de-attenuation for the remaining foods, but uncorrected correlations were high (> .7) for the beverage variables. The FFQ correctly classified 86 out of 87 subjects in the 2 prescribed intervention groups. The FFQ can provide an accurate measure of a food-based intervention (i.e., walnut supplementation) in a trial setting and can also accurately estimate a number of other food groups consumed during the trial.     

Dietary risk factors for ovarian cancer: the Adventist Health Study (United States)

Few prospective studies have reported dietary risk factors for ovarian cancer. A total of 71 histologically confirmed epithelial ovarian cancers occurred among 13,281 non-Hispanic white California Seventh-day Adventist women during follow-up. Participants were part of the Adventist Health Study (AHS) and had no history of cancer or hysterectomy at baseline in 1976 when they completed a detailed lifestyle questionnaire including a dietary assessment. The association of dietary variables with either all ovarian cancer cases or postmenopausal cases was tested using proportional hazards regression with adjustment for age and other covariates. The strongest hazardous risk factor associations among the food variables were found for meat intake with a risk ratio (RR) of 2.42 for intake ≥1 time/week versus no meat (p for trend = 0.006), and cheese intake with a RR of 2.02 for intake of >2 time/week versus <1 per week (p for trend = 0.10), both of these being in postmenopausal cases. We found significantly reduced risk of all ovarian cancer with higher tomato consumption (RR = 0.32) comparing intakes ≥ five times/week versus never to <1 time/week (p for trend = 0.002), and also with higher fruit consumption (p < 0.01). A weak protective association was found with low fat, but not whole milk. Little confounding was observed between these foods.     

Non-ideality in vinyl polymerisation, 1. Free-radical polymerisation of styrene with benzoyl peroxide

Styrene was polymerised in benzene with benzoyl peroxide at 60°C covering a wide range of concentrations of both monomer and initiator. It is known that benzoyloxyl radicals obtained from spontaneous decomposition of benzoyl peroxide are susceptible to secondary dissociation because of high average life-time of the former radicals (≈10^?9 s). Mathematical formulation is presented regarding the effect of secondary dissociation and monomer concentration on the characteristic constant of primary radical termination. The graphical procedure presented here without recourse to induced decomposition of the initiator is found to be a simple but reasonably accurate method for determining the ratio of rate constants of secondary dissociation to initiation. Polymerisation data obtained also at 40, 50, 70, and 80°C for 6 mol/l of monomer in benzene has been utilised to estimate the approximate value of the energy of activation for initiation. The value so obtained (≈74kJ/mol) is substantially higher than that for propagation. This is apparently due to the structural difference of the radicals reacting with the monomer.     

Prevalence and Assessment of Factors Contributing to Adverse Drug Reactions in Wards of a Tertiary Care Hospital,India

Background

Adverse drug reactions account for the highest proportion among the causes of morbidity and mortality in clinical wards and are posing a considerable challenge. Hence, the objective of this study was to find out the prevalence of adverse drug reactions and the factors which contribute to their prevalence.

Methods

A prospective patient record review was carried out at a tertiary care hospital in North India from August 2010–May 2011. A total of 1033 subjects admitted to hospital for any kind of treatment were included while patients admitted in the ward because of adverse drug reactions were excluded. The ward where we collected the data includes multispecialty and cardiovascular wards. The causality, severity, and preventability of adverse drug reactions were assessed using Naranjo, modified Hartwig, and Schumock and Thornton criteria, respectively. Kolmogorov-Smyrnov, chi -square and multiple logistic regression tests were used to determine adverse drug reactions ascribed to drugs.

Results

Out of 1033 patients whose records were assessed, 167(16.2%) experienced one or more adverse drug reactions. The metabolic systems, which accounted for 49(24.6%) were most frequently affected by adverse drug reactions, followed by gastrointestinal, 45(22.6%); hematological, 28(14.1%) and cutaneous, 21(10.6%) systems. The drug classes most frequently associated with the reactions were antibiotics 40(20.1%), diuretics 35(17.6%) and anticoagulants 30(15.1%). According to the selected preventability scale, 72(36.2%) adverse drug reactions were classified as probably or definitely preventable. About 165(83%) of the reactions were type A, which represents augmentation of the pharmacological action of a drug. Number of drugs, length of hospitalization and number of diagnosis were identified as significant predisposing factors for ADRs.

Conclusion

The result of this study suggested that adverse drug reactions were significant causes of superimposed health problems that occur following hospitalization. The major risk factors associated with ADR include number of drugs, length of hospitalization and number of diagnosis. Based on the findings a rigorous study is recommended to determine the burden and identify the risk factors of adverse drug reactions to target interventions.     

Exposure to environmental tobacco smoke in the nonsmoking population of Cambodia

OBJECTIVE: To estimate the extent of environmental tobacco smoke (ETS) exposure among nonsmokers in the adult population of Cambodia. METHODS: A cross-sectional survey was conducted on a nationally representative sample of 13,988 Cambodian adults in 2005. Information on smoking and exposure to ETS was obtained by trained interviewers using a standard questionnaire. RESULTS: Overall, 37.4% of the 10,263 nonsmoking responders, or an estimated 1,629,700 nonsmoking Cambodians, were exposed to ETS. One third of pregnant women (31.4%) were exposed to ETS at home. In both unadjusted and adjusted models, men were less likely to be exposed to ETS at home (OR=0.34; 95% CI=0.29-0.41) and more likely to be exposed to ETS at work and in public places (OR=3.08; 95% CI=2.14-4.43 and OR=2.17; 95% CI=1.82-2.59, respectively). Education was inversely related to ETS exposure at home (OR=0.51; 95% CI=0.27-0.96 for 10 years of education vs 5 years or less). Legislators, senior officials, and managers were less likely to be exposed to ETS at home than professionals (OR=0.13; 95% CI=0.04-0.46), but more likely to be exposed at work or in public places. Rural residence was associated with higher ETS exposure in the home (OR=2.52; 95% CI=1.71-3.71) and lower ETS exposure at work (OR=0.42; 95% CI=0.24-0.76) compared to urban residence. CONCLUSIONS: The high prevalence of ETS exposure among adult Cambodians indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations to protect nonsmokers in Cambodia.     

Relative validity of a food frequency questionnaire used to assess food intake during a dietary intervention study

To develop a cost-effective alternative for evaluating dietary intake in large-scale intervention trials of cancer and cardiovascular disease outcomes, we designed and validated a semiquantitative food frequency questionnaire (FFQ). We collected 6 to 8 of the 24-hr dietary recalls from 87 adults (ages 30-72 yr) who were randomly assigned to a walnut-supplemented diet or a control diet in a 6-mo dietary intervention trial. Relative validity of a 171-item FFQ in assessing intake of selected foods and the prescribed intervention (intake > or =25 g/day or intake < 2 g of walnuts) was determined using 24-h dietary recalls as the reference. De-attenuated correlations between FFQ and dietary recalls were .82 for walnuts, .80 for fruits, .79 for grains, .77 for vegetables, .63 for water, .44 for sweets, and .36 for dairy/eggs. High within-person variation did not allow de-attenuation for the remaining foods, but uncorrected correlations were high (> .7) for the beverage variables. The FFQ correctly classified 86 out of 87 subjects in the 2 prescribed intervention groups. The FFQ can provide an accurate measure of a food-based intervention (i.e., walnut supplementation) in a trial setting and can also accurately estimate a number of other food groups consumed during the trial.     

Does Excess Body Fat Maintained After the Seventh Decade Decrease Life Expectancy?

OBJECTIVES: To determine whether the attenuation in risk of death due to excess body fat seen in most studies of older adults may be due to confounding, the relationship between adiposity and mortality was examined in adults who never smoked, were free of major chronic diseases, and maintained stable weight over long periods. DESIGN: Prospective cohort study. SETTING: The Adventist Health Study and Adventist Mortality Study in California. PARTICIPANTS: Six thousand thirty adults aged 25 to 82 who had never smoked and had no history of coronary heart disease, cancer, or stroke. MEASUREMENTS: During 29 years of follow‐up, anthropometric data were collected at baseline and 17 years later, and mortality surveillance continued for 12 years thereafter. Data were analyzed using survival analysis with attained age as the time variable. RESULTS: Instantaneous hazard plots indicated that men with a body mass index (BMI) greater than 22.3 kg/m² and women with a BMI greater than 27.4 kg/m² had a greater mortality risk through the ninth decade than those with lower BMI. For men aged 75 to 99 who maintained stable body weight, a BMI greater than 22.3 kg/m² was associated with a 3.7‐year (95% confidence interval (CI)=1.1–6.3) shorter life expectancy and significantly greater mortality (hazard ratio (HR)=1.88, 95% CI=1.16–3.04, for BMI=22.3–27.3 kg/m²; HR=2.00, 95% CI=1.01–3.97 for BMI>27.3 kg/m²; reference, BMI≤22.3 kg/m²). For women aged 75 to 99 who maintained stable body weight, a BMI greater than 27.4 kg/m² was associated with a 2.1‐year (95% CI=0.5–3.8) shorter life expectancy and significantly greater mortality (HR=1.12, 95% CI=0.80–1.58 for BMI<20.6 kg/m²; HR=1.41, 95% CI=1.05–1.89 for BMI>27.4 kg/m²; reference, BMI 20.6–27.4 kg/m²). CONCLUSION: Excess body fat maintained after the seventh decade decreases life expectancy but appears to be less lethal in women.     

Reliability of Meat,Fish, Dairy,and Egg Intake Over a 33-Year Interval in Adventist Health Study 2

We studied Adventist Health Study 2 (AHS-2) cohort members to determine the reliability of long-term recall of adult dietary intake that occurred 33 years ago. Establishing the reliability of these measures supports studies of how dietary exposure across the life course affects risk of cancer and other noncommunicable disease outcomes. Among 1816 AHS-2 cohort members, we conducted a statistical comparison of long-term recall of meat, fish, dairy, and eggs at AHS-2 baseline with their report of current diet 33 years before AHS-2 baseline at an age of 30–60 years. Major findings are as follows: 1) a high correlation for frequency of red meat (R = 0.71), poultry (R = 0.67), and fish (R = 0.60); lower correlations for dairy (R = 0.19) and eggs (R = 0.28); 2) good concordance for dichotomous measures of red meat [sensitivity: 0.70; specificity: 0.92; positive predictive value (PPV): 0.91], poultry (sensitivity: 0.76; specificity: 0.87; PPV: 0.83), fish (sensitivity: 0.61; specificity: 0.93; PPV: 0.89), dairy (sensitivity: 0.95; specificity: 0.57; PPV: 0.99), and eggs (sensitivity: 0.95; specificity: 0.41; PPV: 0.96); negative predictive value for dairy and eggs was poor. Among older AHS-2 cohort members, we found good reliability of recall of red meat, poultry, and fish intake that occurred 33 years earlier.