4-Nonylphenol (NP) and bisphenol A (BPA) are phenolic substances used in high volumes by the industry. Studies on cells and in experimental animals have shown that both these compounds can be classified as estrogenic hormone disrupters. Information about the exposure of humans to NP and BPA is still scarce, especially regarding levels in human blood. The first aim of this study was to investigate possible sources of NP and BPA exposure from food, by analyzing the levels of NP and BPA from a Swedish food market basket, based on the Swedish per capita food consumption. A second aim was to investigate blood serum levels of NP and BPA, as well as NP-ethoxylates, among young women in Sweden (n=100). Moreover, associations between food consumption and blood NP and BPA levels were studied. In food, NP was to some extent found at levels above limit of quantification (LOQ 20 ng/g fresh weight) in fruits, cereal products, vegetables, and potatoes. BPA levels above LOQ (2 ng/g fresh weight) were found in fish, meats, potatoes, and dairy products. The estimated mean intakes per capita were (medium bound) 27 µg NP/day and 3.9 µg BPA/day, showing that food is a source of BPA and NP in the general Swedish population. In blood serum, free NP above limit of detection (LOD 0.5 ng/g) was detected in 46% of the study participants while detectable levels of total NP (LOD 0.8 ng/g) were observed in 43%. The corresponding percentages for BPA were 25% and 22%, respectively. The results indicate that there is a continuous source of exposure to NP and BPA that is high enough for free NP and BPA to be detected in some consumers. Among the participants with quantifiable levels of free and total NP (n=38), 85% (median, range: 38-112%) of the NP was present as free NP. For BPA 76% (49-109%) was detected as free BPA (n=15). All women had levels of ethoxylates of NP below LOD (0.1-0.7 ng/g). A significantly higher total consumption of fruits and vegetables was reported in questionnaires by participants with NP levels at or above LOD than among women with levels below LOD. This result is supporting the market basket results of relatively high NP levels in these types of food.
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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According to results from the 2004 Canadian Community Health Survey-Nutrition, total beverage consumption among adults declined steadily with age. This reflects drops in the percentage of adults consuming most beverages and in the amounts consumed. While water was the beverage consumed most frequently and in the greatest quantity by adults, for many of them, coffee ranked second. Largely as a result of drinking coffee, more than 20% of men and 15% of women aged 31 to 70 exceeded the recommended maximum of 400 milligrams of caffeine per day. About 20% of men aged 19 to 70 consumed more than two alcoholic drinks a day. Owing to declines in the consumption of soft drinks and alcohol, the contribution of beverages to adults' total calorie intake falls at older ages. Regardless of age, men were generally more likely than women to report drinking most beverages, and those who did, drank more. There were, however, a few exceptions, with higher percentages of women than men reporting that they drank water and tea.
According to results from the 2004 Canadian Community Health Survey--Nutrition, children and teens get about one-fifth of their daily calories from beverages. As they get older, boys and girls drink less milk and fruit juice, and more soft drinks and fruit drinks. By ages 14 to 18, boys' average daily consumption of soft drinks matches their consumption of milk, and exceeds their consumption of fruit juice and fruit drinks. Beverage consumption by children and teens varies little by province, except in Newfoundland and Labrador where it tends to be comparatively high, and in British Columbia where it tends to be low.
To comprehensively examine the cardiovascular health of Canadians, we developed the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) health index. We analyzed trends in health behaviours and factors to monitor the cardiovascular health of the Canadian population.
We used data from the Canadian Community Health Survey (2003-2011 [excluding 2005]; response rates 70%-81%) to examine trends in the prevalence of 6 cardiovascular health factors and behaviours (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes and hypertension) among Canadian adults aged 20 or older. We defined ideal criteria for each of the 6 health metrics. The number of ideal metrics was summed to create the CANHEART health index; values range from 0 (worst) to 6 (best or ideal). A separate CANHEART index was developed for youth age 12-19 years; this index included 4 health factors and behaviours (smoking, physical activity, fruit and vegetable consumption and overweight/obesity). We determined the prevalence of ideal cardiovascular health and the mean CANHEART health index score, stratified by age, sex and province.
During the study period, physical activity and fruit and vegetable consumption increased and smoking decreased among Canadian adults. The prevalence of overweight/obesity, hypertension and diabetes increased. In 2009-2010, 9.4% of Canadian adults were in ideal cardiovascular health, 53.3% were in intermediate health (4-5 healthy factors or behaviours), and 37.3% were in poor cardiovascular health (0-3 healthy factors or behaviours). Twice as many women as men were in ideal cardiovascular health (12.8% vs. 6.1%). Among youth, the prevalence of smoking decreased and the prevalence of overweight/obesity increased. In 2009-2010, 16.6% of Canadian youth were in ideal cardiovascular health, 33.7% were in intermediate health (3 healthy factors or behaviours), and 49.7% were in poor cardiovascular health (0-2 healthy factors or behaviours).
Fewer than 1 in 10 Canadian adults and 1 in 5 Canadian youth were in ideal cardiovascular health from 2003 to 2011. Intensive health promotion activities are needed to meet the Heart and Stroke Foundation of Canada's goal of improving the cardiovascular health of Canadians by 10% by 2020 as measured by the CANHEART health index.
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To examine absolute socio-economic differences in food habits and their changes over time.
A longitudinal study using the cohort baseline mail surveys conducted in 2000-2002 (n 8960, response rate 67 %) and the follow-up in 2007 (n 7332, response rate 83 %), including data on seven food habits recommended in the national dietary guidelines, as well as socio-economic and sociodemographic variables.
Data from the Helsinki Health Study survey, followed up for 5-7 years.
Municipal employees of the City of Helsinki, Finland.
Apart from fish and vegetable-based margarine on bread, the proportions of the recommended food items were higher for women than for men. The consumption of the recommended food items either increased or remained stable over the follow-up period. On the basis of the slope index of inequality (SII) it was observed that socio-economic differences widened with regard to the consumption of fresh vegetables and fish and use of vegetable-based margarine or oil in cooking, with the upper classes consuming these foods more often. The largest differences were observed in the consumption of fresh vegetables, for which the SII value among women was 2·38 (95 % CI 1·93, 2·95) at baseline and 2·47 (95 % CI 2·01, 3·03) at follow-up, and 3·36 (95 % CI 1·80, 6·28) and 3·47 (95 % CI 1·95, 6·19) for men, respectively. Socio-economic differences were non-existent for milk, and the reverse was observed for dark bread and vegetable-based margarine on bread.
Consumption of the recommended food items increased in the examined cohort over time. This increase was mostly similar throughout the socio-economic groups and thus the socio-economic differences remained stable. The upper classes followed the guidelines better with regard to the consumption of vegetables and fish and in the use of vegetable-based margarine or oil in cooking.
OBJECTIVES: We assessed changes in cardiovascular disease-related health outcomes and risk factors among American Indians and Alaska Natives by age and gender. METHODS: We used cross-sectional data from the 1995 to 1996 and the 2005 to 2006 Behavioral Risk Factor Surveillance System. The respondents were 2548 American Indian and Alaska Native women and men aged 18 years or older in 1995-1996 and 11 104 women and men in 2005-2006. We analyzed the prevalence of type 2 diabetes, obesity, hypertension, cigarette smoking, sedentary behavior, and low vegetable or fruit intake. RESULTS: From 1995-1996 to 2005-2006, the adjusted prevalence of diabetes among American Indians and Alaska Natives increased by 26.9%, from 6.7% to 8.5%, and obesity increased by 25.3%, from 24.9% to 31.2%. Hypertension increased by 5%, from 28.1% to 29.5%. Multiple logistic models showed no meaningful changes in smoking, sedentary behavior, or intake of fruits or vegetables. In 2005-2006, 79% of the population had 1 or more of the 6 risk factors, and 46% had 2 or more. CONCLUSIONS: Diabetes, obesity, and hypertension and their associated risk factors should be studied further among urban, rural, and reservation American Indian and Alaska Native populations, and effective primary and secondary prevention efforts are critical.
This longitudinal study examined the frequency of consumption of vegetables for dinner by Norwegian adolescents and their parents. Associations of perceived availability, correlations and stability were explored. The longitudinal cohort consist of 1950 adolescents attending 6th/7th (2002) and 9th/10th (2005) grade, and their parents (n=1647). Only 40% of the adolescents and 60% of the adults reported to have eaten vegetables for dinner yesterday, the reported frequency of vegetables for dinner were 3.7 and 4.1 times/week in 2002 and 2005, respectively, and 4.8 times/week for parents. Girls ate more than boys, and high SES adolescents ate more than low SES adolescents. There were significant differences between adolescent and parent report of both frequency of consumption and perceived availability of vegetables for dinner. Adolescent's frequency of consumption of vegetables was related to the parent's consumption, and the adolescent response from 2002 to 2005 showed strong correlations. There were good tracking in the frequency of consumption of vegetables for dinner, and 25% of the adolescents showed a stable high frequency. To conclude, few adolescents and their parents consumed vegetables for dinner. Interventions are needed to meet the recommendations, and parents should be targeted in intervention programs.
Unit of Nutrition, Environment and Cancer, Programme of Epidemilogical Cancer Research, Institut Català d'Oncologia, Av. Gran Via s/n, km 2.7, 08907 L'Hospitalet, Barcelona, Spain. firstname.lastname@example.org
We present the main findings observed to date from the European Prospective Investigation into Cancer and Nutrition (EPIC) on dietary factors associated with the most frequent cancer sites. METHODS: EPIC is a multicentre prospective study carried out in 23 centres in 10 European countries: Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the United Kingdom, including 519,978 participants (366,521 women and 153,457 men), most aged 35-70 years. RESULTS: We observed the following significant associations: gastric cancer risk was inversely associated with high plasma vitamin C, some carotenoids, retinol and a-tocopherol, high intake of cereal fibre and high adhesion to Mediterranean diet, while red and processed meat were associated with increased risk. High intake of dietary fibre, fish, calcium, and plasma vitamin D were associated with a decreased risk of colorectal cancer, while red and processed meat intake, alcohol intake, body mass index (BMI) and abdominal obesity were associated with an increased risk. High intake of fruit and vegetables in current smokers were associated with a decreased risk of lung cancer. An increased risk of breast cancer was associated with high saturated fat intake and alcohol intake. In postmenopausal women, BMI was positively and physical activity negatively associated with breast cancer risk. High intake of dairy protein and calcium from dairy products and high serum concentration of IGF-I were associated with an increased risk of prostate cancer. These results contribute to scientific evidence for appropriate public health strategies and prevention activities aimed at reducing the global cancer burden.
To study the associations between home food availability and dietary patterns among pre-school children.
Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.
The DAGIS study, Finland.
The participants were 864 Finnish 3-6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.
We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named 'sweets-and-treats' (high loadings of e.g. sweet biscuits, chocolate, ice cream), 'health-conscious' (high loadings of e.g. nuts, natural yoghurt, berries) and 'vegetables-and-processed meats' (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (ß=-0·05, P