Several healthy dietary patterns have been linked to longevity. Recently, a Nordic dietary pattern was associated with a lower overall mortality. No study has, however, investigated this dietary pattern in relation to cause-specific mortality. The aim of the present study was to examine the association between adherence to a healthy Nordic food index (consisting of wholegrain bread, oatmeal, apples/pears, root vegetables, cabbages and fish/shellfish) and overall mortality, and death by cardiovascular disease, cancer, injuries/suicide and other causes. We conducted a prospective analysis in the Swedish Women's Lifestyle and Health cohort, including 44,961 women, aged 29-49 years, who completed a food frequency questionnaire between 1991-1992, and have been followed up for mortality ever since, through Swedish registries. The median follow-up time is 21.3 years, and mortality rate ratios (MRR) were calculated using Cox Proportional Hazards Models. Compared to women with the lowest index score (0-1 points), those with the highest score (4-6 points) had an 18% lower overall mortality (MRR 0.82; 0.71-0.93, p
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
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Cites: J Gerontol A Biol Sci Med Sci. 2001 Oct;56 Spec No 2:54-6411730238
The association between vegetable and fruit consumption and risk of cancer and cardiovascular disease (CVD) has been investigated by several studies, whereas fewer studies have examined consumption of vegetables and fruits in relation to all-cause mortality. Studies on berries, a rich source of antioxidants, are rare. The purpose of the current study was to examine the association between intake of vegetables, fruits and berries (together and separately) and the risk of all-cause mortality and cause-specific mortality due to cancer and CVD and subtypes of these, in a cohort with very long follow-up.
We used data from a population-based prospective Norwegian cohort study of 10,000 men followed from 1968 through 2008. Information on vegetable, fruit and berry consumption was available from a food frequency questionnaire. Association between these and all-cause mortality, cause-specific mortality due to cancers and CVDs were investigated using Cox proportional hazard regression models.
Men who in total consumed vegetables, fruit and berries more than 27 times per month had an 8-10% reduced risk of all-cause mortality compared with men with a lower consumption. They also had a 20% reduced risk of stroke mortality. Consumption of fruit was inversely related to overall cancer mortality, with hazard rate ratios of 0.94, 0.84 and 0.79 in the second, third and firth quartile, respectively, compared with the first quartile.
Increased consumption of vegetables, fruits and berries was associated with a delayed risk of all-cause mortality and of mortality due to cancer and stroke.
Foods rich in antioxidants have been associated with a reduced risk of myocardial infarction. However, findings from randomized clinical trials on the role of antioxidant supplementation remain controversial. It has been suggested that antioxidants interact with each other to promote cardiovascular health. We therefore investigated the association between dietary Non Enzymatic Antioxidant Capacity (NEAC), measuring the total antioxidant potential of the whole diet, and the risk of myocardial infarction. We followed 45,882 women aged 30-49 years and free from cardiovascular diseases through record linkages from 1991 until 2012. Dietary NEAC was assessed by a validated food frequency questionnaire collected at baseline. Total dietary NEAC was categorized into quintiles and multivariable Cox proportional hazard regression models were fitted to estimate hazard ratios (HR) with 95% confidence intervals (CI). During a mean follow-up time of 20.3 years we detected 657 incident cases of myocardial infarction. After adjusting for potential confounders, we found a significant 28% lower risk of myocardial infarction among women in the fourth (HR: 0.72; 95% CI 0.55-0.95) and a 40% lower risk among women in the fifth quintile (HR: 0.60, 95% CI 0.45-0.81) of dietary NEAC compared to women in the first quintile, with a significant trend (p-value
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.
A Mediterranean diet has a recognized beneficial effect on health and longevity, with a protective influence on several cancers. However, its association with breast cancer risk remains unclear.
We aimed to investigate whether adherence to a Mediterranean dietary pattern influences breast cancer risk.
The Swedish Women's Lifestyle and Health cohort study includes 49,258 women aged 30 to 49 years at recruitment in 1991-1992. Consumption of foods and beverages was measured at enrollment using a food frequency questionnaire. A Mediterranean diet score was constructed based on the consumption of alcohol, vegetables, fruits, legumes, cereals, fish, the ratio of unsaturated to saturated fat, and dairy and meat products. Relative risks (RR) for breast cancer and specific tumor characteristics (invasiveness, histological type, estrogen/progesterone receptor status, malignancy grade and stage) associated with this score were estimated using Cox regression controlling for potential confounders.
1,278 incident breast cancers were diagnosed. Adherence to a Mediterranean dietary pattern was not statistically significantly associated with reduced risk of breast cancer overall, or with specific breast tumor characteristics. A RR (95% confidence interval) for breast cancer associated with a two-point increment in the Mediterranean diet score was 1.08 (1.00-1.15) in all women, and 1.10 (1.01-1.21) and 1.02 (0.91-1.15) in premenopausal and postmenopausal women, respectively. When alcohol was excluded from the Mediterranean diet score, results became not statistically significant.
Adherence to a Mediterranean dietary pattern did not decrease breast cancer risk in this cohort of relatively young women.
Cites: J Natl Cancer Inst. 2007 Aug 1;99(15):1152-6117652280
Little is known about the mediating effects of the determinants of fruit and vegetable (FV) intake in school-based interventions that promote FV intake, and few studies have examined the impact of the degree of implementation on the effects of an intervention. The present study examined whether the degree of implementation of an intervention had an effect on children's fruit or vegetable intake and determined possible mediators of this effect. The study is part of the European PRO GREENS intervention study which aimed to develop effective strategies to promote consumption of fruit and vegetables in schoolchildren across Europe. Data from 727 Finnish children aged 11 years were used. The baseline study was conducted in spring 2009 and the follow-up study 12 months later. The intervention was conducted during the school year 2009-2010. The effects were examined using multilevel mediation analyses. A high degree of implementation of the intervention had an effect on children's fruit intake. Knowledge of recommendations for FV intake and liking mediated the association between a high degree of implementation of the intervention and an increase in the frequency of fruit intake. Knowledge of recommendations for FV intake and bringing fruits to school as a snack mediated the association between a low degree of implementation of the intervention and an increase in the frequency of fruit intake. Overall, the model accounted for 34 % of the variance in the change in fruit intake frequency. Knowledge of recommendations acted as a mediator between the degree of implementation of the intervention and the change in vegetable intake frequency. In conclusion, the degree of implementation had an effect on fruit intake, and thus in future intervention studies the actual degree of implementation of interventions should be assessed when considering the effects of interventions.