Data analysts consider standard regression models (e.g., generalized linear model) or nonparametric smoothing techniques (e.g., loess or splines) when examining the association between two variables. Before this step, a quantile-based summarization is typically used for exploring the exposure-response relationship. Unfortunately, these exploratory approaches may not be optimal or efficient for guiding the formal analysis in many biological and nutritional data settings. We suggest a recently developed method for selection of cutpoints as a tool of data summary and segmented regression as a modeling approach in the analysis of plasma total homocysteine and related vitamins. These methods are often complementary in discovering the underlying complex pattern of association.
Fortification with calcium to increase dietary intakes of this mineral is currently under evaluation in Canada. To model the potential dietary consequences of food fortification, data from a large national survey of Canadians (n = 1543) were used. Food fortification scenarios were based on reference amounts for labeling requirements. Consumption of milk, cheese and other dairy products was associated with high calcium intakes, and there was a low prevalence of inadequacy in men
Despite its health implications, the fibre intake of Irish children is unknown. The North/South Ireland Food Consumption Survey indicated that 77% of Irish adults do not consume adequate fibre and surveys of children and adolescents in Canada and Sweden have confirmed suboptimal fibre intake in these groups. This study undertook to assess fibre intake and the incidence of constipation in Irish children aged 5-8 years. Children admitted to hospital with an acute self-limiting medical illness were included in the study. Three day food diaries were recorded on discharge from hospital. The presence of constipation was ascertained Seventy six per cent of 135 children s diets did not contain adequate fibre. The incidence of constipation was 13.6% in those with inadequate fibre intake as opposed to 6% in those with adequate fibre intake. Poor dietary fibre needs to be addressed in the context of health promotion and disease prevention involving parents, health care professionals and government public policy.
OBJECTIVES: This article compares rates of overweight/obesity and obesity and food consumption patterns of off-reserve Aboriginal and non-Aboriginal people aged 19 to 50 in Ontario and the western provinces. DATA SOURCES; The data are from the 2004 Canadian Community Health Survey: Nutrition (cycle 2.2). ANALYTICAL TECHNIQUES: Cross-sectional analyses were used to estimate the percentages of individuals who were overweight/obese or obese and average nutrient consumption, based on Aboriginal identity and other selected characteristics. Logistic regression was used to determine the independent influence of Aboriginal identity on overweight/obesity and obesity. MAIN RESULTS: In 2004, the overweight/obesity and obesity rates of off-reserve Aboriginal people aged 19 to 50 were higher than those of the non-Aboriginal population. These overall differences primarily reflected higher rates of overweight/obesity and obesity among Aboriginal women. At ages 19 to 30, these differences can partly be explained by higher calorie intake by Aboriginal women, despite identical energy needs, based on height, weight, age and physical activity. Most of the excess calories are eaten as snacks and come from "other foods".
AIMS AND OBJECTIVITIES: The aims were to test internal consistency and interrater reliability of Mini Nutritional Assessment during implementation of Mini Nutritional Assessment in community residential homes and to test sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment. BACKGROUND: There is a need in clinical practice to assess nutritional status in older people and to identify those who could benefit from early intervention. METHODS: The two-step Mini Nutritional Assessment procedure (Mini Nutritional Assessment-short form and Mini Nutritional Assessment) was used in 127 older people admitted to eight residential homes. In three of those homes (A, B and C), registered nurses simultaneously performed the assessment procedure, after receiving education and training. The intention was to offer the registered nurses a tool for independent practice use. RESULTS: Internal consistency was 0.68 (Cronbach's alpha) (n = 127). In residential home A, B and C, the registered nurses carried out Mini Nutritional Assessment in 45 residents out of 68. The agreement level between the author's and the registered nurses' assessments was 62% (kappa 0.41). In residential home A, B and C, the agreement level was 89%, 89% and 44%, respectively. Sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment were 89%, 82% and 92%, respectively. CONCLUSIONS: The two-step Mini Nutritional Assessment procedure seems to be a useful tool to identify residents in need of nutritional interventions, despite the registered nurses not carrying out Mini Nutritional Assessment in all residents and the low agreement in residential home C. It indicates that to implement and use Mini Nutritional Assessment in nursing care demands the creating necessary staff resources, such as adequate staffing, sufficient education and continual supervision. RELEVANCE TO CLINICAL PRACTICE: Because of the high sensitivity of Mini Nutritional Assessment-short form and Mini Nutritional Assessment, Mini Nutritional Assessment-short form alone might be sufficient for practice use, as its simplicity might increase its usefulness.
To estimate folate intake and knowledge in women of childbearing age, in relation to risk of neural tube defects.
One hundred forty-eight women (aged 18 to 45 years) in the Vancouver area of British Columbia, Canada.
Using an interviewer-administered survey, we examined women for folate knowledge and the relation of folate knowledge to intake in a random sample. Contribution of folate from food, fortified grain products, and supplements was assessed by validated semiquantitative food frequency questionnaire.
Descriptive statistics, t tests, Chi;(2), Pearson correlation analysis.
Mean daily folate intake from food, fortified foods, and supplementation was 812+/-710 Dietary Folate Equivalents (DFE)/day. Fortification of bread and grain products contributed 104+/-68 microg synthetic folic acid (SFA)/day (equal to 174+/-114 DFE), and supplements contributed 205+/-388 microg SFA/day. Although 86% of women met the Estimated Average Requirement (320 DFE/day) for folate, only 26% met the recommendation (400 microg SFA/day) for women capable of becoming pregnant. Most (95%) of the women had heard of folate, but only 25% knew that it could prevent birth defects. One-fourth of the women had good or very good knowledge of folate-rich foods. However, folate knowledge was not related to its intake. The most common sources of folate information were magazines/newspapers, doctors, and television/radio. Lack of awareness of the importance of folate was the most common reason given for choosing not to use folic acid supplements before pregnancy. However, 78% of the women indicated that, with knowledge of the benefits of folate, they would use supplemental folic acid daily to reduce the risk of birth defects.
Educational strategies are required to increase folate awareness among women and to promote the benefits of periconceptional folic acid supplementation. Targeting physicians to educate women on the importance of folate could be a potentially successful route. J
Cancer rates in the province of Nova Scotia, Canada, are among the highest in the country and coincide with elevated rates of risk factors such as smoking, poor diet, and obesity. To investigate the importance of diet on cancer, using data from the 1990 Nova Scotia Nutrition Survey, we developed a diet quality score reflecting compliance with 17 nutrient recommendations. The survey data were subsequently linked with the provincial cancer registry, and the relationship between diet quality and cancer was quantified using logistic regression. Our results support an inverse relationship between diet quality and cancer, although limited statistical power resulting from our small study sample did not reveal any statistically significant relationships. We estimated that cancer incidence could potentially be reduced by approximately 35% through improved diet quality. On the basis of poor diet, nutrition-related factors (high body mass index), our estimates of the preventable fraction of cancer, and the high provincial cancer rates, we recommend health promotion strategies aimed at improving diet quality in Nova Scotia.
Day-to-day variability in dietary intake makes it difficult to measure accurately the "usual" intake of foods and nutrients. The objectives of the present study were to estimate within- and between-subject variability for foods and nutrients by adjusted and unadjusted models and to assess the number of days required to assess nutrient and food group intakes accurately by two different methods. Adult men and women aged 18-65 y (n = 1543) in the Food Habits of Canadians Study provided a 24-h recall. A repeat interview was conducted in a subsample to estimate components of variability. Within- and between-subject variability were determined by mixed model procedure (crude and adjusted for age, gender, education, smoking, family size and season). The number of days required to obtain various degrees of accuracy was ascertained by two methods, one that uses the variance ratio for groups and one that considers within-subject variability alone for individuals. Variance ratios were higher using the adjusted compared with the unadjusted method (e.g., for men, energy 1.07 vs. 0.49). More days were required to reflect usual intake with accuracy using the adjusted model (energy 5 vs. 2 d), indicating the need to control for confounders to obtain reliable estimates of intakes.
This article examines recent trends in the incidence of and mortality from colorectal cancer among Canadian men and women, then further analyzes trends by three subsites.
Incidence data for colorectal cancer were obtained from the National Cancer Incidence Reporting System and from the Canadian Cancer Registry. Mortality data were extracted from the Canadian Vital Statistics Database. Supplementary data on nutrition are from the National Population Health Survey.
Age-standardized incidence and mortality rates were calculated for men and women. Age-specific incidence and mortality rates were calculated by 10-year age groups. Joinpoint analysis was applied to detect statistically significant changes in linear trends.
Since the mid-1980s, colorectal cancer incidence has been declining, with steeper rates of decrease among women. Decreasing rates of colorectal cancer are limited to tumours located in the distal colon and rectum; the incidence of cancers of the proximal colon has not changed over time.
The objective of this study was to compare the nutrient content of foods and diets based on data from two food composition databases used in the Baltic Nutrition Surveys (conducted in Estonia, Latvia and Lithuania in 1997): an adapted version of the Finnish Micro-Nutrica Nutritional Analysis program (used in Estonia) and the Russian Institute of Nutrition Food Composition Database (used in Latvia and Lithuania).
The adapted Micro-Nutrica and Russian databases were used to estimate the energy and nutrient (protein, fat, carbohydrate, vitamin C, calcium and iron) content of 15 common foodstuffs in the region and the nutrient intakes of 32 Latvian respondents (based on 24-h recalls). Differences between databases were estimated.
There were discrepancies in the energy and nutrient content of the 15 selected foods using the two databases. The adapted Micro-Nutrica database generally gave a lower energy content than the Russian database (median: -6%), and a lower fat content for typically fat-rich foods. Intakes of energy, fat, carbohydrate and calcium by the 32 selected respondents were significantly lower when the Micro-Nutrica database was used. Differences were particularly high for fat (difference=-23.5%, 95% confidence interval=-31.1 to -15.8%, P