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1.
OBJECTIVES: To identify dietary transition stages based on dietary patterns of adult Haitians having lived in Montreal for various lengths of time, and to assess associated dietary quality. SUBJECTS: One hundred and eighty-one Haitians aged 25-60 years were recruited by the modified random digit dialling method. DESIGN: Socio-economic, diet and lifestyle variables were documented by questionnaire. Three non-consecutive 24-hour dietary recalls were conducted over a 3-month period. Dietary patterns were studied using cluster analysis, and their association with proportion of lifetime in Canada and with socio-economic status (SES) was examined. Diet quality criteria were micronutrient adequacy and healthfulness based on dietary recommendations of the World Health Organization. RESULTS: Four dietary phenotypes were identified which could roughly represent stages of dietary transition or acculturation (Traditional, Pre-Western, Western and Modern). Subjects in the 'Traditional' cluster were older and had lived for a significantly lower proportion of their lifetime in Canada; they also tended to be of lower SES. Diet quality was significantly higher in the 'Traditional' than the 'Western' type, particularly with respect to healthfulness. A significantly lower proportion of subjects complying with limited intake of total fat ( < 30%) and cholesterol ( < 45%) was observed in the 'Western' compared with other diet phenotypes. Less than 15% of all subjects consumed enough dietary fibre, irrespective of diet type. CONCLUSION: Dietary transition stages could be identified on the basis of food patterns of Haitians according to the proportion of their lifetime in Canada. Encouraging the youth to retain the traditional food culture in its positive aspects would appear relevant  相似文献   

2.
OBJECTIVE: The Mediterranean diet is rich in fat and starch, and hence may be related to overweight. We therefore investigated the relationship between adherence to a Mediterranean diet and body mass index (BMI) and waist-to-hip ratio (WHR). DESIGN AND SETTING: Data were obtained from the control group of a network of case-control studies on cancer conducted in major teaching and general hospitals in four Italian areas between 1991 and 2002. An interviewer-administered validated 78-item food-frequency questionnaire was used to obtain information on the subjects' habitual diet. Information on socio-economic factors, lifestyle habits and anthropometric measures was also collected. A Mediterranean diet score (MDS) was derived on the basis of eight characteristics of the Mediterranean diet. SUBJECTS: Subjects were 6619 patients (3090 men, 3529 women) admitted to hospital for a wide spectrum of acute, non-neoplastic conditions, unrelated to known risk factors for cancer and long-term modifications of diet. RESULTS: In multiple linear regression models adjusted for age, study centre, education, tobacco smoking, occupational physical activity and total energy intake, the MDS was not related to BMI (beta = 0.05 for men and -0.04 for women) or WHR (beta = 0.000 and 0.001, respectively) in both sexes. CONCLUSIONS: Adherence to the major characteristics of the Mediterranean diet is unrelated to BMI and WHR, confirming previous data from Greece and Spain.  相似文献   

3.
OBJECTIVES: To identify and characterise dietary patterns in a middle-aged Irish population sample and study associations between these patterns, sociodemographic and anthropometric variables and major risk factors for cardiovascular disease. DESIGN: A cross-sectional study. SUBJECTS AND METHODS: A group of 1473 men and women were sampled from 17 general practice lists in the South of Ireland. A total of 1018 attended for screening, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and provided a fasting blood sample for glucose, lipids and homocysteine. Dietary intake was assessed using a standard food-frequency questionnaire adapted for use in the Irish population. The food-frequency questionnaire was a modification of that used in the UK arm of the European Prospective Investigation into Cancer study, which was based on that used in the US Nurses' Health Study. Dietary patterns were assessed primarily by K-means cluster analysis, following initial principal components analysis to identify the seeds. RESULTS: Three dietary patterns were identified. These clusters corresponded to a traditional Irish diet, a prudent diet and a diet characterised by high consumption of alcoholic drinks and convenience foods. Cluster 1 (Traditional Diet) had the highest intakes of saturated fat (SFA), monounsaturated fat (MUFA) and percentage of total energy from fat, and the lowest polyunsaturated fat (PUFA) intake and ratio of polyunsaturated to saturated fat (P:S). Cluster 2 (Prudent Diet) was characterised by significantly higher intakes of fibre, PUFA, P:S ratio and antioxidant vitamins (vitamins C and E), and lower intakes of total fat, MUFA, SFA and cholesterol. Cluster 3 (Alcohol & Convenience Foods) had the highest intakes of alcohol, protein, cholesterol, vitamin B(12), vitamin B(6), folate, iron, phosphorus, selenium and zinc, and the lowest intakes of PUFA, vitamin A and antioxidant vitamins (vitamins C and E). There were significant differences between clusters in gender distribution, smoking status, physical activity, body mass index, waist circumference and serum homocysteine concentrations. CONCLUSION: In this general population sample, cluster analysis methods yielded two major dietary patterns: prudent and traditional. The prudent dietary pattern is associated with other health-seeking behaviours. Study of dietary patterns will help elucidate links between diet and disease and contribute to the development of healthy eating guidelines for health promotion.  相似文献   

4.
OBJECTIVE: To describe geographical differences and time trends in the supply of the most important food components of the traditional Mediterranean diet. DESIGN: Food supply data collected from national food balance sheets for the period 1961-2001. SETTING: Selected Mediterranean countries: Spain, Italy, France, Greece, Algeria, Morocco, Tunisia and Turkey. RESULTS: Differences of almost 30-fold and five-fold were found in the supply of olive oil and fruits and vegetables, respectively, among the Mediterranean countries studied during the 1960s. A favourable increasing trend for the supply of fruit and vegetables was observed in most Mediterranean countries. However, an increase in the supply of meats and dairy products and a decrease in the supply of cereals and wine were observed in European Mediterranean countries from 1961 until 2001. Only in African and Asiatic Mediterranean countries were cereals the base of food supply. During the 1990s, Greece's food supply pattern was closest to the traditional Mediterranean diet, while Italy and Spain maintained a high availability of fruits, vegetables and olive oil, but were losing the other typical components. Among African and Asiatic Mediterranean countries, only Turkey presented a traditional Mediterranean dietary pattern except with respect to olive oil, the supply of which was very low. France showed a Western dietary pattern, with a high supply of animal products and a low supply of olive oil. CONCLUSIONS: Dietary supplies in the Mediterranean area were quite heterogeneous in the 1960s and have experienced a process of Westernization, especially in European Mediterranean countries.  相似文献   

5.
OBJECTIVE: To report the rationale, recruitment, design, dietary intervention and baseline characteristics of participants in the Medi-RIVAGE study (Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms). DESIGN: A randomised, parallel trial comparing a new nutritional programme with a conventional programme. SETTING: Centre for Detection and Prevention of Arteriosclerosis, Timone University Hospital, Marseille, France, and collaborating teams. SUBJECTS: Two hundred and twelve male and female volunteers with at least one cardiovascular risk factor. INTERVENTION: A Mediterranean-type diet characterised mainly by the quality of fatty acids, amount of fish, vegetable foodstuffs and fibre was proposed and compared with a usually prescribed, low-fat/cholesterol diet. Body mass index, fasting lipids and lipoproteins, apolipoproteins, glucose, insulin and homocysteine were the main outcome measures. Gene polymorphisms of interest were determined. RESULTS: Characteristics of men in the two arms were comparable with regard to sociodemographic variables, and clinical and biological cardiovascular risk factors. There were few differences between the groups of women (cholesterol-related parameters, P<0.05). There was no difference between arms in allelic distribution of the gene polymorphisms studied. Saturated fat and protein intakes were high while carbohydrate and fibre intakes were low, but with no difference between arms. Overall, the nutritional markers were comparable in both arms with few exceptions. Correlations between nutritional intakes and plasma nutrient levels ranged from 0.19 (beta-carotene) to 0.47 (folate). CONCLUSIONS: The comparability of the two arms is notable and warrants a low risk of biases. Current diet departs from the traditional Mediterranean one. The assessment of nutritional intake is validated by correlations obtained between dietary intake and relevant biomarkers. This will be important to estimate participant compliance and to analyse intervention data.  相似文献   

6.
BACKGROUND: This paper describes the development of the UK Women's Cohort Study and presents cohort baseline characteristics. METHODS: In total, 35,372 women, aged 35-69 years at recruitment, were selected to ensure a wide range of dietary intakes. Diet was assessed by a 217-item food-frequency questionnaire (FFQ). Detailed lifestyle information was collected by postal questionnaire. Vegetarians, fish-eaters and meat-eaters were compared. RESULTS: The cohort women are mainly white, well-educated, middle-class and married with children. They are health-conscious with only 11% current smokers and 58% taking dietary supplements. Twenty-eight per cent of subjects self-report as being vegetarian and 1% as vegan. However, only 18% are defined as 'vegetarian' from the FFQ. Fat provides 32% of energy; vitamin and mineral intakes are high, with a broad range of intakes. Meat-eaters are older, with a higher body mass index (BMI) and the lowest intakes of carbohydrate, fibre, vitamin C, folate, iron and calcium. Other fish-eaters are similar to vegetarians. Vegetarians have the lowest intakes of protein, fat and saturated fat. Oily fish-eaters have the lowest BMI; are the least likely to smoke or use full-fat milk; and are the most likely to use dietary supplements and consume the most fruit and vegetables. Oily fish-eaters have the highest total energy intake and vegetarians the lowest. Semi-skimmed milk, bread, potatoes, wine, bananas and muesli are important contributors to energy for all groups. CONCLUSION: A large cohort of middle-aged women has been created encompassing a wide range of different eating patterns, including diets currently of interest to research into protection against cancer and coronary heart disease. Participants will be followed up to study the effects of different food and nutrient intakes on long-term health outcomes.  相似文献   

7.
OBJECTIVES: To describe the selection and modification of an appropriate diet score to assess diet quality in early old age. DESIGN AND SETTING: Cross-sectional analyses of the Boyd Orr cohort - a long-term follow-up of men and women whose families took part in a survey of diet and health in pre-war Britain. Dietary data were obtained from a 113-item food-frequency questionnaire. A nine-item Healthy Diet Indicator (HDI) developed by Huijbregts and colleagues was identified from the literature and modified because some dietary variables were unavailable and to accord more closely with recommendations of the UK Committee on Medical Aspects of Food Policy. SUBJECTS: In total, 1475 traced, surviving cohort members aged 60 years and over. RESULTS: Modification resulted in a 12-item Healthy Diet Score (HDS). We found that about half the variation in the HDS was explained by variation in the HDI (r=0.71). There was, however, little misclassification of subjects (<10%) into extreme thirds of the distribution by the HDS compared with the HDI. Items of the score most strongly correlated with overall score were saturated fat (r=-0.57), red meat (r=-0.46), dietary fibre (r=0.58), fruit and vegetables (r=0.54) and percentage energy from carbohydrates (r=0.51). Modifying existing items had greater impact on agreement between HDI and HDS than the addition of new items. CONCLUSIONS: The selection and modification of diet scores is more complicated than often assumed. Furthermore, modest changes to an existing score can produce a score that is different from the original, and although it was not possible to test this issue, it may no longer predict subsequent health experience.  相似文献   

8.
OBJECTIVE: To assess, particularly in longitudinal studies, how close or far the food intakes of population groups are from a reference dietary pattern. DESIGN: Computation of an index, called the Mediterranean Adequacy Index (MAI), by dividing the sum of the percentage of total energy from typical Mediterranean food groups by the sum of the percentage of total energy from non-typical Mediterranean food groups. The reference Italian-Mediterranean diet utilised was that of subjects from Nicotera in 1960. SETTING: Different areas in Italy. SUBJECTS: Men aged 45-65 years at the start of the study from rural areas of Italy in the Seven Countries Study followed for 26 years (Crevalcore and Montegiorgio), elderly men and women from Perugia followed for 11 years, men and women from Pollica (Salerno) followed for 32 years, and families from Rofrano (Salerno) followed for 41 years. RESULTS: The median value of MAI among 40-59-year-old men from Nicotera in 1960 was 7.2; in Crevalcore it was 2.9 in 1965 and 2.2 in 1991; and in Montegiorgio, 5.6 in 1965 and 3.9 in 1991. In Pollica, the values in men ranged from 5.6 to 6.3 in 1967 and from 2.4 to 4.5 in 1999; for women, the corresponding ranges were 4.2-7.2 and 2.7-4.1. In elderly men of Perugia, median MAI value was 4.9 in 1976 and 3.2 in 1987; for women, the corresponding values were 3.1 and 2.6. CONCLUSIONS: The diet of these Italian population groups has changed over the last four decades, progressively abandoning the nutritional characteristics of the reference Italian-Mediterranean diet. The MAI proposed is simple to compute; it has satisfactory discriminating power particularly for longitudinal dietary data with only a few limitations.  相似文献   

9.
OBJECTIVE: To review the evidence that the traditional Mediterranean diet is associated with longevity. SETTING: Elderly persons of both genders in Greece, Spain, Denmark and Australia studied by different groups of investigators. METHODS: Adherence to the principles of the Mediterranean diet was operationalised through a score devised a priori, and study participants were followed up until death or the end of the study. Proportional hazard models were used. RESULTS: Closer adherence to the Mediterranean diet was associated with a significant decrease in general mortality among the elderly persons studied. CONCLUSION: The Mediterranean diet is positively associated with longevity among the elderly. If the assumption holds that there is no interaction between age and diet with respect to general mortality, it can be inferred that the traditional Mediterranean diet represents a healthy nutritional pattern.  相似文献   

10.
OBJECTIVE: Throughout the world, the proportion of the male population aged 65 years and older is increasing. Yet, we have limited information regarding diet quality and predictors of diet quality in this segment of the population. The objectives of the current analyses are to describe the diet quality of a cohort of men >65 years of age, and identify lifestyle factors associated with poor diet quality. METHODS: We present a cross-sectional analysis of the diet quality of 5928 men, aged 65-100 years, who are participants in the Osteoporotic Fractures in Men (MrOS) cohort study. Dietary intake was determined using a modified Block 98 food-frequency questionnaire. Diet quality was calculated using the previously validated Diet Quality Index-Revised (DQI-R). Univariate and multivariate modelling was used to estimate the variance in diet quality predicted by a number of sociodemographic factors, including age, race/ethnicity, body mass index (BMI), marital status, education, smoking status, physical activity, self-perceived health and nutritional supplement use. RESULTS: Overall, we found that in this geographically diverse group of older men, diet quality was low, with a mean modified DQI-R for the entire study population of 62.5 (standard deviation 13.1) out of an ideal of 100. Further, younger age, very low total calorie intake (< or = 1187 kcal day- 1), higher BMI, residence in a North or Southeast community, being of African-American or Hispanic race, being less educated, not using dietary supplements and smoking were each significant independent predictors of a poorer diet. CONCLUSION: These data may prove useful in both understanding the dietary intake of older US men as it relates to published dietary guidelines, and for targeting future dietary intervention programmes.  相似文献   

11.
OBJECTIVE: To investigate the possible role of diet in age-related cognitive decline (ARCD) and cognitive impairment of both degenerative (Alzheimer's disease, AD) and vascular (vascular dementia, VaD) origin. DESIGN: Literature review. RESULTS: In an elderly population of southern Italy with a typical Mediterranean diet, high energy intake of monounsaturated fatty acids (MUFA) appeared to be associated with a high level of protection against ARCD. In addition, dietary fat and energy in the elderly seem to be risk factors, while fish consumption and cereals are found to reduce the prevalence of AD in European and North American countries. Finally, the relative risk of dementia (AD and VaD) was lower in the subjects of a French cohort who drank three or four glasses of red wine each day compared with total abstainers. CONCLUSION: Essential components of the Mediterranean diet--MUFA, cereals and wine--seem to be protective against cognitive decline. As such, dietary antioxidants and supplements, specific macronutrients of the Mediterranean diet, oestrogens and anti-inflammatory drugs may act synergistically with other protective factors, opening up new therapeutic interventions for cognitive decline.  相似文献   

12.
OBJECTIVE: To assess whether the Mediterranean diet contributes to overall mortality differences and trends between Mediterranean and non-Mediterranean European Union (EU) countries.Design: Routinely recorded adjusted overall mortality and food availability data in Mediterranean and non-Mediterranean EU countries. A Mediterranean diet score designed a priori was used as instrument. SETTING: Fifteen EU countries in the 1960s and the 1990s. SUBJECTS: The general population in the 15 EU countries. RESULTS: The difference between Mediterranean and non-Mediterranean EU countries in a 7-point Mediterranean diet score was reduced from 2.9 in the 1960s to 1.6 in the 1990s. This reduction may underlie the reduction in the difference in general mortality between these countries, from about 100 deaths per 100,000 person-years in the early 1970s to about 50 deaths per 100,000 person-years in the 1990s. CONCLUSIONS: The decline in overall mortality in the 15 EU countries over the last 25 years is probably unrelated to diet. However, the gradual loss of the survival advantage of Mediterranean EU citizens, compared with other EU citizens, may be linked to the gradual abandonment by the former of their dietary traditions.  相似文献   

13.
OBJECTIVE: To examine global food demand patterns and how changing diets may stimulate demand for and trade of Mediterranean diet products. DESIGN: Literature review. Trends in global and US food consumption patterns are examined and trade data are reviewed to evaluate the impact of changing diets on trade of Mediterranean diet products. Market access issues are also addressed briefly to highlight the role of policy in the trade of Mediterranean diet products. RESULTS: Diets are shifting towards higher-value products such as meats, fruits and vegetables, and a wider array of packaged food products. Trade in these products has also grown in the past two decades, with several non-traditional importers and exporters becoming increasingly active in the global market. CONCLUSIONS: Income-driven demands for quality and variety are likely to increase the demand for Mediterranean diet products globally. While the middle-income countries appear to be the best growth prospects, the USA remains a potential growth market if these products can meet the growing consumer demand for variety, quality and convenience. Although consumer trends globally indicate growth in demand for Mediterranean diet products, the additional demand may not be reflected by a corresponding growth in trade. Trade in Mediterranean diet products continues to be hampered by higher than average trade barriers and high transportation costs for perishables.  相似文献   

14.
OBJECTIVE: To investigate the association between pregravid weight status and diet quality. DESIGN: Institute of Medicine body mass index (BMI) cut-off points of 26.0-29.0 kg m- 2 for overweight and >29 kg m- 2 for obese were used to categorise women's weight status. Dietary information was obtained by self-report at 26-28 weeks' gestation using a modified Block food-frequency questionnaire. The Diet Quality Index for Pregnancy (DQI-P) included: servings of grains, vegetables and fruits, folate, iron and calcium intake, percentage calories from fat, and meal pattern score. Multinomial logistic regression models were used to estimate the association between weight status and tertiles of DQI-P controlling for potential individual confounders. SETTING: A clinical-based population recruited through four prenatal clinics in central North Carolina. SUBJECTS: A total of 2394 women from the Pregnancy, Infection and Nutrition study were included in this analysis. RESULTS: Evidence of a dose-response relationship was found between BMI and inadequate servings of grains and vegetables, and iron and folate intake. Pregravid obesity was associated with 76% increased odds of falling into the lowest diet quality tertile compared with underweight women after controlling for potential confounders. CONCLUSION: A modest association was found between pregravid weight status and diet quality. If corroborated, these findings suggest that overweight pregnant women should be targeted for nutrition counselling interventions aimed to improve diet quality.  相似文献   

15.
OBJECTIVE: Little is known about the relationship of monetary diet costs to dietary intake and obesity, particularly in non-Western populations. This study examined monetary cost of dietary energy in relation to diet quality and body mass index (BMI) among young Japanese women. DESIGN: Dietary intake was assessed by a validated, self-administered, diet history questionnaire. Diet costs were estimated using retail food prices. Monetary cost of dietary energy (Japanese yen 1000 kcal-1) was then calculated. BMI was computed from self-reported body weight and height. SUBJECTS: A total of 3931 female Japanese dietetic students aged 18-20 years. RESULTS: Monetary cost of dietary energy was positively associated with intakes of fruits, vegetables, fish and shellfish, and pulses; however, higher monetary cost of dietary energy was also associated with higher consumption of fat and oil, meat and energy-containing beverages, and lower consumption of cereals (rice, bread and noodles) (all P for trend <0.01). At the nutrient level, monetary cost of dietary energy was positively associated with intakes of dietary fibre and key vitamins and minerals, but also associated positively with intakes of fat, saturated fatty acids, cholesterol and sodium, and negatively with carbohydrate intake (all P for trend <0.0001). After adjustment for possible confounders, monetary cost of dietary energy was quite weakly but significantly negatively associated with BMI (P for trend = 0.0197). CONCLUSIONS: Increasing monetary cost of dietary energy was associated with both favourable and unfavourable dietary intake patterns and a quite small decrease in BMI in young Japanese women.  相似文献   

16.
OBJECTIVE: To assess knowledge of dietary and behaviour-related determinants of non-communicable disease (NCD) of urban Senegalese women. DESIGN: A cross-sectional, population study using an interviewer-administered knowledge questionnaire, developed and validated for this study. The questionnaire consisted of 24 items with six scores measuring knowledge of: (1) diet- and behaviour-related causes of NCD; (2) diet quality-NCD relationship; (3) fruit and vegetable link with NCD; (4) health consequences of obesity; (5) causes of cardiovascular disease (CVD); and (6) causes of certain cancers. SUBJECTS: A random sample of 301 women aged 20-50 years. RESULTS: The knowledge scores developed suggest that the health consequences of obesity (mean score of 65.4%) were best understood followed by causes of CVD (mean score of 60.6%), because obesity, smoking, high blood cholesterol and dietary fat were well recognised as risk factors for CVD. Subjects scored least for their knowledge of the protective effect of fruit and vegetables (mean score of 19.9%). Knowledge of causes of certain cancers (mean score of 36.1%) was also low. Women who worked outside the home had better knowledge for two scores but otherwise no relationship was found between knowledge and literacy, formal education or body mass index. CONCLUSIONS: Findings suggest reasonable overall knowledge concerning diet and behaviour with NCD, especially given the relatively new context of the obesity epidemic in Senegal. However, there was poor knowledge of the benefit of eating fruit and vegetables and other preventable causes of certain cancers. Education targeting the benefits of vegetables and fruit may have the greatest impact on NCD prevention.  相似文献   

17.
OBJECTIVES: To examine the association between education level and food purchasing behaviour and the contribution of dietary knowledge to this relationship; and the association between household income and purchasing behaviour and the contribution made by subjective perceptions about the cost of healthy food.DESIGN AND SETTING: The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Data were collected by face-to-face interview from residents of private dwellings (n=1003), and the response rate was 66.4%. Dietary knowledge was measured using a 20-item index that assessed general knowledge about food, nutrition, health and their interrelationships. Food-cost concern was measured using a three-item scale derived from principal components analysis (alpha=0.647). Food purchasing was measured using a 16-item index that reflected a household's purchase of grocery items that were consistent (or otherwise) with dietary guideline recommendations. Associations among the variables were analysed using linear regression with adjustment for age and sex.RESULTS: Significant associations were found between education, household income and food purchasing behaviour. Food shoppers with low levels of education, and those residing in low-income households, were least likely to purchase foods that were comparatively high in fibre and low in fat, salt and sugar. Socio-economic differences in dietary knowledge represented part of the pathway through which educational attainment exerts an influence on diet; and food purchasing differences by household income were related to diet in part via food-cost concern.CONCLUSIONS: Our findings suggest that socio-economic differences in food purchasing behaviour may contribute to the relationship between socio-economic position and food and nutrient intakes, and, by extension, to socio-economic health inequalities for diet-related disease. Further, socio-economic differences in dietary knowledge and concerns about the cost of healthy food play an important role in these relationships and hence should form the focus of future health promotion efforts directed at reducing health inequalities and encouraging the general population to improve their diets.  相似文献   

18.
OBJECTIVE: To examine the influence of individual- and area-level socio-economic characteristics on food choice behaviour and dietary intake. SETTING: The city of Eindhoven in the south-east Netherlands. DESIGN: A total of 1339 men and women aged 25-79 years were sampled from 85 areas (mean number of participants per area = 18.4, range 2-49). Information on socio-economic position (SEP) and diet was collected by structured face-to-face interviews (response rate 80.9%). Individual-level SEP was measured by education and household income, and area-level deprivation was measured using a composite index that included residents' education, occupation and employment status. Diet was measured on the basis of (1) a grocery food index that captured compliance with dietary guidelines, (2) breakfast consumption and (3) intakes of fruit, total fat and saturated fat. Multilevel analyses were performed to examine the independent effects of individual- and area-level socio-economic characteristics on the dietary outcome variables. RESULTS: After adjusting for individual-level SEP, few trends or significant effects of area deprivation were found for the dietary outcomes. Significant associations were found between individual-level SEP and food choice, breakfast consumption and fruit intake, with participants from disadvantaged backgrounds being less likely to report food behaviours or nutrient intakes consistent with dietary recommendations. CONCLUSIONS: The findings suggest that an individual's socio-economic characteristics play a more important role in shaping diet than the socio-economic characteristics of the area in which they live. In this Dutch study, no independent influence of area-level socio-economic characteristics on diet was detected, which contrasts with findings from the USA, the UK and Finland.  相似文献   

19.
OBJECTIVE: Valid dietary data are essential when trying to identify whether or not one or more dietary exposures are responsible for disease. We examined diet composition in women who reported dietary change in the past compared with non-changers, and how the associations between dietary factors and postmenopausal breast cancer are influenced by dietary change, obesity status and misreporting of energy. DESIGN: A population-based prospective cohort study. Data were obtained by a diet history method, anthropometrical measurements and an extensive lifestyle questionnaire including items on past food habit change. SETTING: The Malm? Diet and Cancer (MDC) study, conducted in Malm?, Sweden. SUBJECTS: A subsample of 12,781 women from the MDC cohort recruited from 1991 to 1996. A total of 428 postmenopausal women were diagnosed with incident breast cancer, during 9.2 years of follow-up. RESULTS: Past food habit changers reported healthier food habits and lower energy intake compared with non-changers, a finding that raises issues regarding possible reporting biases. When excluding diet changers, the trend of increased breast cancer risk across omega-6 fatty acid quintiles was stronger, and a tendency of decreased risk emerged for 'fruit, berries and vegetables'. When excluding individuals with non-adequate reports of energy intake, risk estimates were similar to that of the whole sample. In women with body mass index < 27 kg m- 2, significant trends of increased breast cancer risk were seen for total fat and omega-6 fatty acids, and of decreased risk for 'fruit, berries and vegetables'. CONCLUSIONS: This study indicates that both obesity and self-reported past food habit change may be important confounders of diet-breast cancer relationships. The study demonstrates that sensitivity analysis, through stratification, may facilitate interpretation of risk relationships and study results.  相似文献   

20.
OBJECTIVE: To analyse the role of various aspects of the Mediterranean diet in several common epithelial cancers, including digestive and selected non-digestive tract neoplasms. DESIGN: Systematic analysis of data from a series of case-control studies. SETTING: Northern Italy, between 1983 and 1998. SUBJECTS: Over 12,000 cases of 20 cancer sites and 10,000 controls. RESULTS: For most epithelial cancers, the risk decreased with increasing vegetable and fruit consumption, with relative risk (RR) between 0.3 and 0.7 for the highest versus the lowest tertile. For digestive tract cancers, population-attributable risks for low intake of vegetables and fruit ranged between 15 and 40%. A protective effect was observed also for breast, female genital tract, urinary tract and a few other epithelial neoplasms. A number of antioxidants and other micronutrients showed an inverse relationship with cancer risk, but the main components responsible for the favourable effect of a diet rich in vegetables and fruit remain undefined. Fish tended to be another favourable diet indicator. In contrast, subjects reporting frequent red meat intake showed RRs above unity for several common neoplasms. Intake of whole-grain foods was related to a reduced risk of several types of cancer, particularly of the upper digestive tract. This may be due to a favourable role of fibre, but the issue is still open to discussion. In contrast, refined grain intake and, consequently, glycaemic load and glycaemic index were associated with increased risk of different types of cancer including, among others, breast and colorectal. CONCLUSIONS: A low-risk diet for cancer in the Mediterranean would imply increasing the consumption of fruit and vegetables, as well as avoiding increasing the intakes of meat and refined carbohydrates. Further, olive oil and other unsaturated fats, which are also typical aspects of the Mediterranean diet, should be preferred to saturated ones.  相似文献   

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