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.
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Daily sitting time may be a risk factor for incident cardiovascular disease (CVD); however, this has not yet been extensively studied. Our aim was to study the association of total sitting time with the risk of CVD.
Participants (n = 4516, free of CVD at baseline) from the National FINRISK 2002 Study were followed for fatal and nonfatal CVD using national registers. Participants underwent a health examination and completed questionnaires, including total daily sitting time.
During a mean follow-up of 8.6 years, 183 incident CVD cases occurred. Sitting on a typical weekday, at baseline, was statistically significantly associated with fatal and nonfatal incident CVD. The hazard ratios (with 95% confidence intervals, CI) for the total amount of sitting were 1.05 (95% CI, 1.00-1.10) in the age and gender adjusted model and 1.06 (95% CI, 1.01-1.11) in the fully adjusted model, including age, gender, employment status, education, BMI, smoking status, leisure time physical activity, use of vegetables and fruit, alcohol use, blood pressure or its medication, and cholesterol or its medication.
Our findings suggest that total amount of daily sitting is a risk factor for incident CVD. More research is needed to understand the etiology of sedentary behavior and CVD.
To decrease the intake of sucrose, increase the intake of fibre and the consumption of fruit and vegetables among secondary-school pupils.
Intervention study among eighth grade pupils during one school year. Data were collected by questionnaires and from a subgroup of pupils by 48 h dietary recall at baseline in spring 2007 and after the intervention in 2008.
Twelve secondary schools were randomly allocated to intervention (IS) and control schools (CS) within three cities. Intervention included nutrition education and improvement of the food environment focusing particularly on the quality of snacks at school.
A total of 659 pupils completed the questionnaires and the dietary recall was obtained from 287 pupils both at baseline and follow-up.
The frequency of consumption of rye bread increased (P = 0.03) and that of sweets decreased (P = 0.006) among girls in the IS. The intake of sucrose fell among IS pupils, from 12.8 % to 10.5 % of the total energy intake (P = 0.01). Intake of fruit (g/MJ) remained the same in IS, whereas it decreased in CS (P = 0.04).
Sugar intake can be lowered by improving the quality of snacks, but it is more difficult to increase fibre intake and fruit and vegetable consumption unless the content of school lunches can be modified. It is the responsibility of the adults working in schools to create a healthy environment and to make healthy choices easy for pupils.
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 simplified model not requiring a clinic visit is important for cardiovascular prevention. We compared such a model, with one requiring clinical measurements for prediction of ischemic stroke.
Five population-based Finnish cohorts comprising 14?296 men and 16?065 women aged 25-64 years were randomly recruited from 1982, and followed up using the national registers until the end of the 2007. The final Cox model included age, prior history of diabetes and hypertension, happy marriage, capability to walk 500 m (self-estimate), regular exercise, vegetable/fruit intake, smoking, body mass index, and systolic blood pressure; the layperson-oriented model was developed by taking blood pressure away from the final model.
Four hundred sixty-nine men and 371 women developed ischemic stroke events. The area under the receiver operating characteristic curve (95% confidence interval) for 10 years incidence of ischemic stroke was 0·817 (0·791-0·843) and 0·813 (0·787-0·839) for the model with and without systolic blood pressure in men and 0·815 (0·782-0·848) and 0·812 (0·779-0·844), respectively, in women (P?>?0·10). The predicted 10-year events rate matched well with the observed one across deciles of the predicted risk in men (?(2) ?=?11·57, 9df, P?=?0·239) and in women (?(2) ?=?11·18, P?=?0·263). The overall net reclassification improvement after adding blood pressure was 8·8% (P?=?0·016) in men and 3·2% (P?=?0·234) in women. The predicted 10-year risk of the ischemic stroke based on global vascular event models that includes coronary heart diseases did not match well with the observed stroke risk.
The layperson model performed as well as the clinical-based one.
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.
Food habits and their socio-economic differences in Russia have rarely been compared to those in western countries. Our aim was to determine socio-economic differences and their changes in the consumption of vegetables, fruit and berries in two neighbouring areas: the district of Pitkäranta in the Republic of Karelia, Russia, and North Karelia, Finland.
Cross-sectional risk factor surveys in Pitkäranta, in 1992, 1997, 2002 and 2007 (1144 men, 1528 women) and in North Karelia, in 1992, 1997 and 2002 (2049 men, 2316 women), were carried out. Data collected with a self-administered questionnaire were analysed with logistic regression.
The consumption of fruit and vegetables was more common in North Karelia than in Pitkäranta, but increased markedly in Pitkäranta from 1992 to 2007. In Pitkäranta, women, and in North Karelia both men and women with higher education ate fresh vegetables more often than those with a lower education. In both areas, daily consumption of fruit tended to be more common among subjects with a higher education. In Pitkäranta, there were virtually no differences by employment status. In North Karelia, vegetable consumption was less common among the unemployed than the employed subjects. Only minor socio-economic differences in berry consumption were observed. The educational differences in vegetable consumption seemed to widen in Pitkäranta and narrow in North Karelia.
A converging trend was observed, with the Russian consumption levels and socio-economic differences starting to approach those observed in Finland. This may be partly explained by the improvements in availability and affordability of fruit and vegetables in Pitkäranta.
To examine (i) whether the consumption of fresh vegetables, fruit and berries is associated with plasma vitamin C concentration and (ii) educational differences in plasma vitamin C concentration in two neighbouring areas in Russia and Finland.
Cross-sectional risk factor surveys in 1992, 1997 and 2002. Logistic regression analysis was applied to examine the associations of consumption of selected foods and education with plasma vitamin C concentration.
District of Pitkäranta in the Republic of Karelia, Russia and North Karelia, Finland.
Adults aged 25-64 years: 579 men and 612 women in Pitkäranta; 974 men and 642 women in North Karelia.
The plasma vitamin C concentration was strikingly low in Pitkäranta, Russia across the study years. During the 10 years of monitoring, the mean plasma vitamin C concentration among men ranged from 2·5 to 8·0 µmol/l in Pitkäranta, Russia and from 27·1 to 53·9 µmol/l in North Karelia, Finland. In both areas, daily consumption of fruit was most strongly associated with plasma vitamin C, while the association of fresh vegetable consumption with plasma vitamin C was less consistent. Consumption of berries was less important in explaining plasma vitamin C. In Pitkäranta, the plasma vitamin C concentration was lower among respondents in the lowest education group.
Differences in the consumption of fresh vegetables and fruit resulted in notable differences in vitamin C status between Pitkäranta and North Karelia in spring. In comparative settings, knowledge of local food culture and validation pilots are important before conducting large population surveys.