Reproducibility and accuracy of a food frequency questionnaire used for diet intervention studies

The purpose of the present investigation was to determine whether altering the format of a food frequency questionnaire affected its accuracy and reproducibility. Three questionnaires were tested at one-month intervals. Questionnaire I contained 39 food items listed according to food categories. Questionnaire II contained 55 food items, presented according to the meal in which they were consumed. Questionnaire III contained 31 food items presented in a similar order to that in Questionnaire II. To determine the accuracy of the food frequency questionnaire, results were compared to those obtained from a simultaneously administered seven-day diet diary. Results from this study showed that food frequency questionnaires containing broad categories of food items presented in order of the meals in which they are consumed are the most reproducible. Highly reproducible results also can be obtained from seven-day diet diary, if data are calculated in terms of nutrients (i.e. carbohydrates, fats, proteins, etc.) and not specific food items. Finally, this study suggests that individuals more closely maintain their intake of nutrients, rather than specific food items.     

What do nurses and physicians think about the need for specific dietary restrictions in patients with epilepsy?

PURPOSE: It is the responsibility of physicians and nurses to provide patients and their families with appropriate information. In the study described here, we attempted to identify nurses' and physicians' beliefs about and experience with the need for specific dietary restrictions in patients with epilepsy. METHODS: A cross-sectional study was carried out using a questionnaire in Shiraz, Iran, in 2004. All nurses from the pediatric and internal medicine wards of Nemazee and Dastghaib hospitals and also a random sample of general practitioners, pediatricians, and internists from around the city were included in the study. RESULTS: The total number of participants was 250. Among the participants, 58.4% believed there existed a relationship between consumption of specific foods and occurrence of seizures. Personal experience with the occurrence of a seizure in a patient who consumed a specific food was reported by 28% of the participants. Dairy products, sour foods, food additives, meats and fish, and fruits and vegetables were the most common foods reported. CONCLUSIONS: It is clear that health care professionals want to know if their epileptic patients require dietary restrictions and, hence, collect information from different and sometimes unreliable sources. It will be invaluable, in future studies, to take into consideration the experience of health care workers caring for epileptic patients in the evaluation of the relationship between consumption of specific foods and seizures.     

Dietary supplementation with blueberries, spinach, or spirulina reduces ischemic brain damage

Free radicals are involved in neurodegenerative disorders, such as ischemia and aging. We have previously demonstrated that treatment with diets enriched with blueberry, spinach, or spirulina have been shown to reduce neurodegenerative changes in aged animals. The purpose of this study was to determine if these diets have neuroprotective effects in focal ischemic brain. Adult male Sprague-Dawley rats were fed with equal amounts of diets (blueberry, spinach, and spirulina) or with control diet. After 4 weeks of feeding, all animals were anesthetized with chloral hydrate. The right middle cerebral artery was ligated with a 10-O suture for 60 min. The ligature was later removed to allow reperfusional injury. Animals were sacrificed and brains were removed for caspase-3 enzymatic assays and triphenyltetrazolium chloride staining at 8 and 48 h after the onset of reperfusion. A subgroup of animals was used for locomotor behavior and biochemical assays. We found that animals which received blueberry, spinach, or spirulina enriched diets had a significant reduction in the volume of infarction in the cerebral cortex and an increase in post-stroke locomotor activity. There was no difference in blood biochemistry, blood CO2, and electrolyte levels among all groups, suggesting that the protection was not indirectly mediated through the changes in physiological functions. Animals treated with blueberry, spinach, or spirulina had significantly lower caspase-3 activity in the ischemic hemisphere. In conclusion, our data suggest that chronic treatment with blueberry, spinach, or spirulina reduces ischemia/reperfusion-induced apoptosis and cerebral infarction.     

The relationship of diet and exercise for weight control and the quality of life gap associated with diabetes

OBJECTIVE: The demanding behavioral changes for weight control to manage diabetes might contribute to lower quality of life (QOL). This research examines whether the demands of diet and exercise contribute to lower QOL among persons with diabetes. METHODS: Data were from the Behavioral Risk Factor Surveillance System (BRFSS), which measures days in the last month for poor physical health, poor mental health, limited activity, pain, depression, stress, poor sleep, and high energy, as well as weight control efforts. RESULTS: Respondents with diabetes averaged more impaired days on every measure of QOL. Neither efforts to control weight nor dieting were related to any measure. Exercise was associated with reductions in impaired days on all measures. CONCLUSIONS: Exercising to control weight had a powerful effect on reducing QOL differences while attempting to maintain or reduce weight, and dieting to do so had no effect.     

The association between smoking,beverage consumption,diet and bladder cancer: a systematic literature review

In this paper the association between smoking history, beverage consumption, diet and bladder cancer incidence is systematically reviewed. A rating system has been used to summarise the level of scientific evidence (i.e. convincing, probable, possible, and no evidence) and the level of association (i.e. substantially increased, (RR2.5), moderately increased (1.5RR<2.5), slightly increased (1.2RR<1.5), no association (0.8RR<1.2), slightly decreased (0.7RR<0.8), moderately decreased (0.4RR<0.7), and substantially decreased (RR<0.4)). There is convincing evidence that cigarette smoking status, frequency and duration substantially increase the risk of bladder cancer. However, the evidence is not clear for other forms of smoking. A small increased risk for cigar, pipe, and environmental smoking is only possible. There is possible evidence that total fluid intake is not associated with bladder cancer. Although there is convincing evidence for a positive association between alcohol consumption and bladder cancer risk in men, the risk is small and not clinically relevant. Coffee and tea consumption are probably not associated with bladder cancer. The authors conclude that total fruit consumption is probably associated with a small decrease in risk. There is probably no association between total vegetable intake, vitamin A intake, vitamin C intake and bladder cancer and a possibly moderate inverse association with vitamin E intake. Folate is possibly not associated with bladder cancer. There probably is a moderate inverse association between selenium intake and bladder cancer risk.     

Dietary fiber in conservative management of chronic renal failure

Conservative management of chronic renal failure has included a variety of dietary manipulations. Supplementation of dietary fiber to reduce adverse symptoms is a novel approach, but whether it can make an effective clinical impact is yet undetermined. This commentary accompanies a brief report of improved well-being during fiber supplementation. It explains some of the background thinking and early trials of fiber supplementation in chronic renal failure patients.     

Hypertension-related dietary patterns of rural older adults

Background. Prevalence of hypertension is greater in older adults, and increased intake of fruits, vegetables, and dairy—good sources of potassium, calcium, and magnesium—can reduce blood pressure. This study examined the hypertension-related dietary patterns of older adults.Methods. A cohort of 180 Pennsylvania adults (aged ≥65), 90 with hypertension, were randomly selected from the Geisinger Rural Aging Study (GRAS). Data were collected by trained interviewers at a home visit. Dietary assessment used five 24-h recalls. We compared the characteristics and dietary intake of people with hypertension to those without hypertension and compared their intakes to current recommendations.Results. Mean intakes of all participants were less than two thirds of the DRI for calcium and magnesium and fell far short of the 3,500 mg of potassium recommended for prevention and treatment of hypertension. Participants with hypertension consumed less sodium than controls. Both groups ate fewer fruits and vegetables than recommended but reached the dairy recommendation. Calcium intake was mainly from high-fat dairy products, beans were the top source of potassium and magnesium.Conclusions. Older adults with hypertension should be guided to choose more low-fat dairy products and other low-fat calcium sources and to increase intakes of beans, dark green leafy vegetables, and other potassium and magnesium sources.     

Patterns of eating and movement that best maintain reduction in overweight

Two studies of the influences of specific patterns of eating and exercising behaviour on body weight in English Midlands women were re-analysed using correlations as the measure of effect size. As predicted from computational modelling of hunger-sating mechanisms, avoiding energy-containing drinks and foods at the ends of and between meals was the behaviour most influencing year-long weight loss. However, although eating between meals is often called snacking, the term 'snack' appeared to be too ambiguous in this culture for its use in helping efforts to control weight. Avoidance of particular sorts of fat-rich foods was also associated with longer-term weight loss. Attempts at severe restriction of intake at mealtimes were associated with weight loss during a period of intensive dieting, but did not contribute to maintenance of that weight reduction. Using diet formulae to attain rapid weight loss was associated with significant weight gain over a year. These results support the suggestion that the first line of defence against weight gain is avoiding all sources of energy during drink breaks, with personally relevant advice on lower fat versions of particular foods also being important. Continued neglect of the behaviour-specific correlational approach to gaining evidence for less fattening habits does nothing to slow the rise in obesity.     

Nutrient Intakes, Nutritional Patterns and the Risk of Liver Cirrhosis: An Explorative Case-Control Study

Several experimental studies have suggested that specific nutrients might play a role on the risk of liver damage. Nevertheless, few epidemiological studies have evaluated the role of diet on the risk of symptomatic liver cirrhosis, giving contradictory results. To evaluate the role of the intake of nutritional factors and dietary patterns on the risk of symptomatic liver cirrhosis and to examine their combined action with alcohol consumption we used data from the Italian Study on Liver Cirrhosis Determinants project. From 1994 to 1998 all the consecutive cirrhotic inpatients admitted to 19 Italian collaborative hospitals for signs of liver decompensation in whom the diagnosis of liver cirrhosis was made for the first time (259 cases) and one or two gender, age and area of residence matched individuals (416 controls) were recruited. Data on lifetime alcohol intake, usual consumption of 191 food items and on markers of hepatitis B and C viral infection were collected. The analysis of principal components identified a nutritional pattern positively correlated with vegetable and fruit intakes and negatively with animal and no-fruit sugar products. With respect to abstainers, relative risks in consumers of use < or = 25 and > or = 51 g/day of alcohol increased from 0.4 [95% confidence interval 0.0, 5.9] to 9.3 [1.3, 69.0] and from 2.1 [1.1, 4.2] to 18.1 [2.8, 118.3] for the lowest and the highest value of this nutritional pattern, respectively. Diet might therefore modulate the damaging effect of alcohol on the liver.     

Diet and risk of seromucinous benign ovarian cysts

Objective: To analyze the relation between selected dietary indicators and the risk of seromucinous benign ovarian cysts. Study design: We used data from a case–control study on risk factors for benign ovarian cysts conducted in Italy between 1984 and 1994. Cases included 225 women with a histologically confirmed diagnosis of benign seromucinous ovarian neoplasm dating back no more than 2 years. Controls were 450 women below the age of 65 years admitted for acute non-gynecological, non-hormonal, non-neoplastic conditions. Results: Women with seromucinous cysts reported more frequent consumption of beef and other red meat and cheese and less frequent consumption of green vegetables. The multivariate odds ratios (ORs) in highest versus less frequent consumption levels were 2.7 (95% confidence interval (CI) 1.8–4.3) for beef and other red meat, 0.6 (95% CI 0.3–0.9) for green vegetables and 1.4 (95% CI 1.0–2.2) for cheese. Conclusion: Seromucinous benign ovarian cysts are associated with beef and cheese consumption, whereas high intake of green vegetables seems to have a protective effect.