The purpose of the present study was to evaluate the capacity of the 'Determine Your Nutritional Health' Checklist (NSI Checklist) and the 'Mini Nutritional Assessment' (MNA) methods to predict nutrition-related health problems. Data were from the Danish part of the 'Survey in Europe of Nutrition in the Elderly, a Concerted Action' (SENECA) baseline survey from 1988, and the follow-up study from 1993. Based on the baseline survey thirty-nine (19.3%) of the subjects were classified at high nutritional risk, 103 (51%) were considered at moderate nutritional risk and sixty (29.7%) were within the 'good' range according to the criteria in the NSI Checklist. With the MNA, 171 subjects were classified according to their nutritional risk into a well-nourished group, comprising 78.4%, and a group who were at risk of undernutrition, comprising 21.6% at baseline. A total of 115 subjects participated in the follow-up study. The mortality rate and the prevalence of various morbidity indicators were compared between the different risk groups. The analysis showed that subjects with a high MNA score (> or = 24) had significantly lower mortality (rate ratio estimate: 0.35; 95% Cl 0.18, 0.66) compared with subjects with a low MNA score (
In November 1988 a random sample of 435 men and women aged 70-75 years from the general population in Roskilde, a provincial town in Denmark, were invited to participate in a study of nutrition and health. Forty-six per cent of the total sample agreed to participate. The total sample could be characterized by socio-economic variables and data on previous hospitalizations obtained from public registers. A subgroup of the non-participants could be further characterized by some of the topics under study using information obtained by telephone interviews. It was found that the non-participants differed from participants by selected health variables. More non-participants than participants had been hospitalized one year before contact. Telephone interviews with non-participants revealed generally poorer self-judged health and less-frequent eating of cooked meals compared with participants. The degree of bias introduced by this selectivity is estimated by weighting and by a minimum/maximum calculation. Review of participation in previous studies of nutrition and health in the elderly shows that problems with non-participation have been treated in various ways. It is concluded that consideration of factors discriminating between participants and non-participants is important for proper estimation of population parameters.
In 1989, 674 schoolchildren aged 12-14 years in nine elementary schools in a municipality in Copenhagen, Denmark, answered a questionnaire about their dietary habits and knowledge. The majority of the pupils had fruit (87%), vegetables (72%), rye bread (81%), and drank fat-reduced milk (73%) every day. A diet score (reliability = 0.58) was calculated on the basis of the intake of 8 food items relevant to current dietary recommendations. There were no age and sex differences as to dietary habits, but immigrant children had a lower diet score than native children. Dietary knowledge was measured by the ability to state correctly whether 11 different food items had a high content or not of fat, sugar or dietary fibres. Dietary knowledge was highest for questions about fat and sugar. A knowledge score measured the number of correct answers to all 33 questions (reliability = 0.90). Knowledge was highest among older children, native children, and children with the most healthy dietary habits. In the multivariate regression analysis, knowledge, health attitudes and ethnicity were the only significant predictors of dietary behaviour. It is concluded that both social and personal factors are important for dietary behaviour, and health promotion in children should include other methods than educational programmes.
BACKGROUND: In studies of health behaviour exploring factors associated with differences and changes in eating patterns of populations, diet is often measured with short food frequency questionnaires (FFQ). This study examines the validity of a short FFQ by comparing frequencies of food intake from the FFQ to information on food intake obtained by a diet history interview. METHODS: Food intake was measured at two separate occasions in the same 329 individuals, first in 1987-1988 and 6 years later in 1993-1994. RESULTS: In 1987-1988 the Spearman correlation coefficients were around r = 0.50 for most foods, with white and dark ryebread and light bread as extremes on the one hand (r = 0.10, r = 0.23 and r = 0.27, respectively) and coarse bread, fruit and cakes as extremes on the other (r = 0.61, r = 0.60, r = 0.60, respectively). In general, the correlations were higher at the second data collection in 1993-1994. At both data collections, the mean food intake from the diet history interview increased with increasing frequency category, indicating that the questionnaire was able to identify levels of food intake correctly. In general, when individual changes in food intake were assessed during the study period, those who reported a less frequent intake by the FFQ in 1993-1994 compared with 1987-1988 also had a lower mean daily intake according to the diet history information. CONCLUSION: The short FFQ can quantify food intakes and, is also responsive to changes in food intake over time. Thus the short FFQ can be used to monitor changes in food patterns at a group level.
OBJECTIVE: To describe 10 year trends and individual changes in food habits of Danish men and women in relation to dietary recommendations using data from both a cohort and a repeated cross-sectional study, and to examine whether the two sampling methods give similar results. DESIGN: Baseline data were collected in 1982-1984 and respectively repeated measurements for cohort and cross-sectional changes in food habits. SETTING: The County of Copenhagen, Denmark. SUBJECTS: Men and women aged 30-70y in 1982-1984, 1986-1988 and 1992-1994. The trend analyses included 3785 subjects for cohort and 7316 for cross-sectional study, respectively. Longitudinal changes were studied among 2430 individuals with food data from all three examinations. METHODS: Food intakes were estimated using a short food frequency questionnaire. RESULTS: During the study period both men and women reported a decreased intake frequency of animal and vegetable fats, milk, eggs, meat products, white bread and potatoes, while they had increased intakes of low-fat margarine, fruit, raw vegetables, coarse breads, oatmeal, pasta, rice, cakes and candy. In both men and women the decrease in the consumption frequency of, white bread and potatoes, and the increase in pasta, and candy, were higher in the younger than in the older age group. In contrast, the increased consumption frequency of coarse breads, and oatmeal were most pronounced in the older age groups. For most foods the cohort and the repeated cross-sectional surveys gave similar results. CONCLUSIONS: From 1982 through 1994 the food habits of middle-aged Danish men and women changed in the direction of a more healthy diet as recommended by health authorities. With the limitation of a possible reporting bias both the cohort and repeated cross-sectional study designs may be used for monitoring changes in food intake.
BACKGROUND: In studies from Italy and Greece a Mediterranean dietary pattern predicts overall survival. Despite an increase in the movement of food around the world, there is still a wide spectrum of dietary patterns and the aim of the present study was to examine the association between a Mediterranean dietary pattern and mortality in a cohort of elderly people living in a North European Community. METHODS: Diet and nutritional status was studied among 202 men and women born 1914-1918 and living in a Danish Municipality (Roskilde) in 1988. They were followed for 6 years. RESULTS: A diet score, with seven dietary characteristics of the Mediterranean diet, was associated with a significant reduction in overall mortality. A one unit increase in the diet score predicted a 21% (95% confidence interval 2-36%) reduction in mortality. Subjects with high diet scores (> or = 4) had significantly higher plasma carotene levels than those with a low score and plasma carotene was negatively associated with mortality. CONCLUSION: A Mediterranean diet score predicts survival in a North European population. Plasma carotene may serve as an intermediate factor in this association.