OBJECTIVE: To assess manifest bias in ageing effects, i.e. longitudinal changes due to unintended time effects or to selection. DESIGN: Mixed-longitudinal study in birth cohorts 1913-1918, with baseline measurements taken in 1988/1989 and repeated in 1993, including a short questionnaire in non-responders. SETTING: Full baseline and follow-up data were collected in nine towns in eight European countries including Belgium, Denmark, France, Italy, The Netherlands, Portugal, Spain and Switzerland. Incomplete data were available from towns in Portugal, Poland, Northern Ireland and Connecticut, USA. SUBJECTS: Using standardized methodologies data were collected from a random age-stratified sample of elderly men and women, including a total of 1221 re-invited subjects from nine towns and 210 newly-invited subjects from three towns in 1993. RESULTS: An overall retrieval of 50-74% of the former participants could be reached in towns that had previously participated (apart from one exception of 41%), where estimates of mortality varied from 10% to 18%. There was a tendency for healthy and active persons to have a higher participation rate than others, as was the case for high educated newly-invited subjects compared to lower educational classes. For most of the variables used in the analysis of period effects, no evidence of any undesirable period effect was found. In those instances that period effects showed up to be statistically significant, coinciding implausible cohort effects gave the impression that these were due to instability of the estimation procedure. CONCLUSIONS: Non-participants may be less healthy and active than the participants. Only very limited unconvincing evidence to suggest unintended time effects was observed. This confirms the high standards of the methodology and of measurements.
This study evaluated the relationship between meeting the Nutrition Recommendations and mortality from all causes in a cohort of 1,623 men from the Quebec City area followed from 1985 to 1991. The usual dietary intake was assessed by a self-administered semi-quantitative food frequency questionnaire. Most participants did not meet the Nutrition Recommendations. During the follow-up 69 men died. The mortality was significantly lower among those who did not meet the recommendations for total fat (RR = 0.45, CI: 0.25-0.81) or for carbohydrates (RR = 0.49, CI: 0.26-0.92). This unexpected result could be attributable to an excessive alcohol intake or to dietary changes in the direction of the Nutrition Recommendations, made prior to the dietary assessment often because of illness. It would be interesting to continue the follow-up of this cohort to evaluate the long-term effect of a diet meeting the Nutrition Recommendations on mortality from all causes.
The aim of the investigation was to study cohort differences at age 70 in probands born in 1901/02 and 1911/12 and to study longitudinal changes of dietary habits and intake of energy and nutrients between ages 70 and 76. The study is part of the gerontological and geriatric population studies in Gothenburg, Sweden. The intake of both energy and nutrients was higher in the later cohort. One explanation for this lay in the choice of food items in that cohort. Intake of energy and almost all nutrients decreased in both men and women between ages 70 and 76. Energy intake reduced by 23% in men and 20% in women. The proportion of probands with nutrient intakes below RDA increased significantly at age 76. The study revealed both cohort and longitudinal age changes in dietary habits. There is no reason to believe that elderly people are more conservative regarding their food choices than the rest of the population--at least not at the relatively young ages studied.
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.
We evaluated which equations best predicted the lung function of a cohort of nonagenarians based on which best accounted for subsequent survival. In 1998, we measured lung function, grip strength and dementia score (Mini Mental State Examination (MMSE)) in a population-based sample of 2262 Danes born in 1905. Mortality was registered to 2011 when only five (0.2%) subjects were alive. In half the cohort, we recorded forced expiratory volume in 1 s (FEV1). Complete data were available in 592 subjects with results expressed as standardised residuals (SR) using various prediction equations. Cox proportional hazard regression found lower FEV1SR was a predictor of mortality having controlled for MMSE, grip strength and sex. The US National Health and Nutrition Examination Survey (NHANES) III (1999) equations gave a better spread of median survival by FEV1SR quartile: 3.94, 3.65, 3.51 and 2.61 years with a hazard ratio for death of 1, 1.16, 1.32 and 1.60 respectively, compared with equations derived with the inclusion of elderly subjects. We conclude that extrapolating from NHANES III equations to predict lung function in nonagenarians gave better survival predictions from spirometry than when employing equations derived using very elderly subjects with possible selection bias. These findings can help inform how future lung function equations for the elderly are derived.
OBJECTIVE: To describe the meal patterns and food use on weekdays among 10- to 11-year-old Finnish children and to analyse these in relation to family's socio-economic status and the child's behaviour. DESIGN: Cross-sectional study on a cohort of 404 children aged 10-11 years in the rural town of Ylivieska, mid-western Finland. METHODS: A food-frequency questionnaire including questions on meal patterns and food use and the Child Behaviour Checklist (CBCL) completed by the parents and the child together. RESULTS: Practically all children (99%) ate breakfast regularly, 94% had a daily school lunch and 80% had dinner at home daily. Vegetables were consumed daily at home by 26% and fruits or berries by 21%, while 46% of the children had salad daily at school. Twenty-four per cent ate sweets daily or nearly so on weekdays. The children from families of high socio-economic status ate vegetables more often, and fewer of them used butter or high-fat milk. The children with no regular family dinner ate sweets and fast foods more often, and had higher total CBCL problem scores than those with a regular family dinner. CONCLUSION: Skipping meals appears not to be common among Finnish children aged 10-11 years, but a considerable proportion consume sweets frequently and vegetables infrequently. High family socio-economic status and a tendency to eat together are associated with healthy food choices among schoolchildren.
Epidemiologic studies of fish consumption in relation to risk of stroke have yielded inconsistent results.
In this study, we examined the association between fish consumption and stroke incidence in women.
We analyzed data from a population-based prospective cohort of 34,670 women in the Swedish Mammography Cohort who were free of cardiovascular disease and cancer at baseline. Information on fish consumption was obtained by a self-administered questionnaire in 1997. Incident cases of stroke were ascertained from the Swedish Hospital Discharge Registry. We used Cox proportional hazards regression to estimate relative risks (RRs) and 95% CIs.
Over a mean follow-up of 10.4 y, we ascertained 1680 incident cases of stroke, including 1310 cerebral infarctions, 233 hemorrhagic strokes, and 137 unspecified strokes. Fish consumption was significantly inversely associated with risk of total stroke but not with cerebral infarction or hemorrhagic stroke. Compared with women in the lowest quintile of fish consumption (3.0 servings of fish/wk) was 0.84 (95% CI: 0.71, 0.98; P for trend = 0.049). Consumption of lean fish but not of other fish types was inversely associated with risk of stroke. The multivariable RR of total stroke was 0.67 (95% CI: 0.49, 0.93; P for trend = 0.07) for =3 servings of lean fish/wk compared with that for no consumption.
These results suggest that the consumption of fish, especially of lean fish, may reduce risk of stroke in women. This trial was registered at clinicaltrials.gov as NCT01127698.
Comment In: Womens Health (Lond Engl). 2011 May;7(3):279-8121612349
AIM: As part of a longitudinal nutrition study of adolescents, changes in serum ferritin (s-Ft), serum transferrin receptors (s-TfR) and the TfR/Ft ratio from 15 to 21 y of age were studied in randomly selected Swedish adolescents. METHODS: Blood samples from 60 males and 66 females were drawn at 15, 17 and 21 y of age. RESULTS: In males, median s-Ft increased significantly from 33 microg l(-1) at 15 y to 96 microg l(-1) at 21 y, and in females, after a non-significant decrease at 17 y, from 27 at 15 y to 34 microg l(-1) at 21 y. Between 15 and 17 y, s-TfR increased significantly, in males from 5.9 to 7.7 microg l(-1), and in females from 5.2 to 7.6 microg l(-1), whereas s-TfR decreased significantly in both genders between 17 and 21 y. The log (TfR/Ft) ratio did not change in males between 15 and 17 y, but decreased significantly from 2.2 +/- 0.3 to 1.8 +/- 0.3 by the age of 21 y. In females, the TfR/Ft ratio increased significantly between 15 and 17 y, whereas a significant decrease was found by the age of 21 y. S-Ft
The aim of this paper is to analyse the relationships between eating behaviours (picky eating, irregular eating and overeating), and dietary adequacy in accordance with nutrition recommendations and body weight during the preschool years.
Our analyses were performed using data from the Longitudinal Study of Child Development in Québec (1998-2002), a population-based birth cohort.
The study followed a representative sample (n=2103) of children born in 1998 in the Canadian province of Québec.
Eating behaviours were derived from self-administered questionnaires when children were 2.5, 3.5 and 4.5 years. Nutrition data were collected from one 24-hour recall interview conducted at home by trained nutritionists at 4.5 years. Children's weight and height were measured at 4.5 years. Statistical analyses were carried out with SAS (version 8.2). Weighted data adjusted for within-variability were used in the analysis, and the significance level was set at 5%.
Picky eaters consume fewer total fats, less energy and less protein than children never reporting picky eating behaviours. Picky eaters were more likely to consume less than dietary recommendations for fruit and vegetables, and meat and alternatives. Overeaters consumed more total energy and more of each macronutrient than children who were never reported as overeaters during the preschool years. These children consumed more servings of grain products and meats and alternatives per day than children not classified as overeaters. Even when the number of servings of grain products consumed was similar for overeaters and children who were never overeaters, overeaters had higher body mass index.
Given that children as young as 4.5 years are displaying some form of problematic eating behaviour which is shown to be related to dietary adequacy and body weight, public health professionals should be targeting parents of young children to provide messages about strategies for coping with problematic eating behaviours in early childhood.