Few studies exist on the validity of food frequency questionnaires (FFQs) administered to elderly people. The aim of this study was to assess the validity of a short FFQ on present dietary intake, developed specially for the AGES-Reykjavik Study, which includes 5,764 elderly individuals. Assessing the validity of FFQs is essential before they are used in studies on diet-related disease risk and health outcomes.
128 healthy elderly participants (74 y ± 5.7; 58.6% female) answered the AGES-FFQ, and subsequently filled out a 3-day weighed food record. Validity of the AGES-FFQ was assessed by comparing its answers to the dietary data obtained from the weighed food records, using Spearman's rank correlation, Chi-Square/Kendall's tau, and a Jonckheere-Terpstra test for trend.
For men a correlation = 0.4 was found for potatoes, fresh fruits, oatmeal/muesli, cakes/cookies, candy, dairy products, milk, pure fruit juice, cod liver oil, coffee, tea and sugar in coffee/tea (r = 0.40-0.71). A lower, but acceptable, correlation was also found for raw vegetables (r = 0.33). The highest correlation for women was found for consumption of rye bread, oatmeal/muesli, raw vegetables, candy, dairy products, milk, pure fruit juice, cod liver oil, coffee and tea (r = 0.40-0.61). An acceptable correlation was also found for fish topping/salad, fresh fruit, blood/liver sausage, whole-wheat bread, and sugar in coffee/tea (r = 0.28-0.37). Questions on meat/fish meals, cooked vegetables and soft drinks did not show a significant correlation to the reference method. Pearson Chi-Square and Kendall's tau showed similar results, as did the Jonckheere-Terpstra trend test.
A majority of the questions in the AGES-FFQ had an acceptable correlation and may be used to rank individuals according to their level of intake of several important foods/food groups. The AGES-FFQ on present diet may therefore be used to study the relationship between consumption of several specific foods/food groups and various health-related endpoints gathered in the AGES-Reykjavik Study.
Cites: Public Health Nutr. 2001 Apr;4(2):249-5411299098
Cites: Epidemiology. 2000 Jul;11(4):440-510874552
Cites: J Gerontol A Biol Sci Med Sci. 2001 Oct;56 Spec No 2:54-6411730238
Given the importance of prevention of complications in type 2 diabetes (T2D), we aimed to examine changes over time in consumption of fruits, vegetables and juice among men who were diagnosed with T2D in comparison with men without diabetes. The prospective Cohort of Swedish Men, aged 45-79 years in 1997, was used to examine changes in diet after diagnosis of T2D. Dietary intake was assessed using FFQ in 1997 and 2009. In all, 23 953 men who were diabetes free at baseline (1997) and completed both FFQ were eligible to participate in the study. Diagnosis of T2D was reported by subjects and ascertained through registers. Multivariable linear mixed models were used to examine changes in mean servings/week over time. In total, 1741 men developed T2D during the study period. Increased consumption of vegetables and fruits was observed among those who developed T2D (equivalent to 1·6 servings/week, 95 % CI 1·08, 2·03) and men who remained diabetes free (0·7 servings/week, 95 % CI 0·54, 0·84). Consumption of juice decreased by 0·6 servings/week (95 % CI -0·71, -0·39) among those who developed T2D and increased by 0·1 servings/week (95 % CI 0·05, 0·15) in those who were diabetes free. Changes over time and between groups were statistically significant. Although improvements in diet were observed, only 36 % of those with T2D and 35 % of those without diabetes consumed =5 servings of fruits and vegetables/d in 2009.
Prospective studies of dietary fiber intake in relation to stroke risk have reported inconsistent results.
This study assessed the association between intake of total fiber and fiber sources and stroke incidence in healthy Swedish adults.
The analysis was based on 69,677 participants (aged 45-83 y) from the Swedish Mammography Cohort and the Cohort of Swedish Men who were free from cancer, cardiovascular disease, and diabetes at baseline (1 January 1998). Diet was assessed with a food-frequency questionnaire. Cases of stroke were ascertained through linkage to the Swedish Inpatient Register and the Swedish Cause of Death Register. Cox proportional hazards regression model was used to calculate RRs, adjusted for potential confounders.
During 10.3 y of follow-up, 3680 incident stroke cases, including 2722 cerebral infarctions, 363 intracerebral hemorrhages, 160 subarachnoid hemorrhages, and 435 unspecified strokes, were ascertained. High intakes of total fiber and fiber from fruits and vegetables but not from cereals were inversely associated with risk of stroke. After adjustment for other risk factors for stroke, the multivariable RRs of total stroke for the highest vs. lowest quintile of intake were 0.90 (95% CI: 0.81, 0.99) for total fiber, 0.85 (95% CI: 0.77, 0.95) for fruit fiber, 0.90 (95% CI: 0.82, 1.00) for vegetable fiber, and 0.94 (95% CI: 0.84, 1.04) for cereal fiber.
These findings indicate that intake of dietary fiber, especially fruit and vegetable fibers, is inversely associated with risk of stroke.
Knowledge of dietary habits makes the basis for public nutrition policy. The aim of this study was to assess dietary intake of Icelandic six-year-olds.
Subjects were randomly selected six-year-old children (n=162). Dietary intake was assessed by three-day-weighed food records. Food and nutrient intake was compared with the Icelandic food based dietary guidelines (FBDG) and recommended intake of vitamins and minerals.
Fruit and vegetable intake was on average 275Â±164 g/d, and less than 20% of the subjects consumed =400 g/day. Fish and cod liver oil intake was in line with the FBDG among approximately 25% of subjects. Most subjects (87%) consumed at least two portions of dairy products daily. Food with relatively low nutrient density (cakes, cookies, sugar sweetened drinks, sweets and ice-cream) provided up to 25% of total energy intake. The contribution of saturated fatty acids to total energy intake was 14.1%. Less than 20% of the children consumed dietary fibers in line with recommendations, and for saturated fat and salt only 5% consumed less than the recommended upper limits. Average intake of most vitamins and minerals, apart from vitamin-D, was higher than the recommended intake.
Although the vitamin and mineral density of the diet seems adequate, with the exception of vitamin-D, the contribution of low energy density food to total energy intake is high. Intake of vegetables, fruits, fish and cod liver oil is not in line with public recommendations. Strategies aiming at improving diet of young children are needed.
We examined whether there are sex differences in children's fruit and vegetable (FV) intake and in descriptive norms (i.e. perceived FV intake) related to parents and friends. We also studied whether friends' impact is as important as that of parents on children's FV intake. Data from the PRO GREENS project in Finland were obtained from 424 children at the age 11 years at baseline. At baseline, 2009 children filled in a questionnaire about descriptive norms conceptualised as perceived FV intake of their parents and friends. They also filled in a validated FFQ that assessed their FV intake both at baseline and in the follow-up in 2010. The associations were examined with multi-level regression analyses with multi-group comparisons. Girls reported higher perceived FV intake of friends and higher own fruit intake at baseline, compared with boys, and higher vegetable intake both at baseline and in the follow-up. Perceived FV intake of parents and friends was positively associated with both girls' and boys' FV intake in both study years. The impact of perceived fruit intake of the mother was stronger among boys. The change in children's FV intake was affected only by perceived FV intake of father and friends. No large sex differences in descriptive norms were found, but the impact of friends on children's FV intake can generally be considered as important as that of parents. Future interventions could benefit from taking into account friends' impact as role models on children's FV intake.
BACKGROUND: Epidemiologic evidence supports an association between high folate intake and reduced risk of some cancers, in particular colorectal cancer. However, epidemiologic data concerning the relationship between folate and pancreatic cancer risk are sparse. We examined the association between folate intake and risk of pancreatic cancer in a population-based prospective study of Swedish women and men. METHODS: We prospectively followed 81,922 women and men in the Swedish Mammography Cohort and the Cohort of Swedish Men who were cancer-free and completed a 96-item food-frequency questionnaire in 1997. Cox proportional hazards models were used to estimate multivariable rate ratios (RRs) with 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS: A total of 135 incident pancreatic cancer cases were diagnosed during a mean follow-up of 6.8 years. In multivariable analyses controlling for age, smoking, fruit and vegetable consumption, and other potential confounders, dietary and total folate intakes were statistically significantly inversely associated with risk of pancreatic cancer. The multivariable rate ratios of pancreatic cancer for those in the highest category of folate intake (> or = 350 microg/day) compared with the lowest category of intake ( or = 300 microg/day compared with 0 microg/day of supplemental folic acid, multivariable RR = 1.02; 95% CI = 0.56 to 1.88). The sex- and age-standardized incidence rates of pancreatic cancer per 100,000 person-years were 41 for the lowest and 18 for the highest category of dietary folate intake. CONCLUSION: Our results suggest that increased intake of folate from food sources, but not from supplements, may be associated with a reduced risk of pancreatic cancer.
The association between fruit and vegetable (FV) consumption and overall mortality has seldom been investigated in large cohort studies. Findings from the few available studies are inconsistent.
The objective was to examine the dose-response relation between FV consumption and mortality, in terms of both time and rate, in a large prospective cohort of Swedish men and women.
FV consumption was assessed through a self-administrated questionnaire in a population-based cohort of 71,706 participants (38,221 men and 33,485 women) aged 45-83 y. We performed a dose-response analysis to evaluate 10th survival percentile differences (PDs) by using Laplace regression and estimated HRs by using Cox regression.
During 13 y of follow-up, 11,439 deaths (6803 men and 4636 women) occurred in the cohort. In comparison with 5 servings FV/d, a lower consumption was progressively associated with shorter survival and higher mortality rates. Those who never consumed FV lived 3 y shorter (PD: -37 mo; 95% CI: -58, -16 mo) and had a 53% higher mortality rate (HR: 1.53; 95% CI: 1.19, 1.99) than did those who consumed 5 servings FV/d. Consideration of fruit and vegetables separately showed that those who never consumed fruit lived 19 mo shorter (PD: -19 mo; 95% CI: -29, -10 mo) than did those who ate 1 fruit/d. Participants who consumed 3 vegetables/d lived 32 mo longer than did those who never consumed vegetables (PD: 32 mo; 96% CI: 13, 51 mo).
Antioxidants present in fruits and vegetables may protect the lung from oxidative damage and prevent COPD.
To determine the association between fruit and vegetable consumption and risk of COPD by smoking status in men.
The population-based prospective Cohort of Swedish Men included 44 335 men, aged 45-79 years, with no history of COPD at baseline. Fruit and vegetable consumption was assessed with a self-administered questionnaire.
During a mean follow-up of 13.2 years, 1918 incident cases of COPD were ascertained. A strong inverse association between total fruit and vegetable consumption and COPD was observed in smokers but not in never-smokers (p-interaction=0.02). The age-standardised incidence rate per 100 000 person-years in the lowest quintile (
Previous largely cross-sectional studies suggest that fruit and vegetable consumption reduces the risk of allergic disease in children, but results are conflicting.
To investigate the association between current fruit or vegetable intake and allergic disease in 8-year-old Swedish children, and to evaluate the potential effect of disease-related modification of consumption.
Cross-sectional data were obtained from a Swedish birth cohort study. Information on fruit and vegetable consumption as well as symptoms and diagnoses of allergic diseases was obtained by parental questionnaires at the 8-year follow-up. Allergen-specific IgE levels against food and inhalant allergens were obtained from blood samples collected at age 8 years. In total, 2447 children were included. Data were analyzed with logistic regression.
An inverse relation was observed between total fruit consumption and rhinitis (odds ratio, highest vs lowest quartile, 0.62; 95% CI, 0.45-0.86; P for trend, .002), whereas no association was observed for total vegetable intake. In analyses of individual foods, intake of apples/pears and carrots was inversely associated with rhinitis, asthma, and atopic sensitization. Fifty percent of the children with rhinitis were sensitized against birch pollen, which may cross-react with apples and carrots. After exclusion of children who reported food-related allergic symptoms, most of the observed inverse associations moved toward the null and became nonsignificant.
We confirm the inverse associations between fruit intake and allergic disease in children observed in earlier studies. However, our data also indicate that disease-related modification of consumption contributed to this association.
Dietary factors affecting the risk of developing abdominal aortic aneurysm (AAA) are scarcely investigated. The aim of this study was to investigate the associations of fruit and vegetable consumption with the risk to develop AAA.
The prospective Cohort of Swedish Men and the Swedish Mammography Cohort, consisting of 44,317 men and 36,109 women, 46 to 84 years of age at the start of the 13-year follow-up (1998-2010), were used. Fruit and vegetable consumption was assessed at baseline with a 96-item food-frequency questionnaire. By linkage to the Swedish Inpatient Register and the Swedish Vascular Registry (Swedvasc), 1086 primary cases of AAA (222 ruptured) were identified. Cox proportional hazards models were used to estimate hazard ratios with 95% confidence intervals (CIs). Those in the highest quartile of fruit consumption (>2.0 servings/d), in comparison with those in the lowest quartile (