US and France adult fruit and vegetable consumption patterns: an international comparison.

BACKGROUND/OBJECTIVES: To observe fruit and vegetable consumption as it relates to body mass index (BMI) and other variables, by analyzing the health surveys of two countries -- the United States and France -- with traditionally distinct diets, and identifying factors that may explain the differences. SUBJECTS/METHODS: Two nationally representative surveys that assess food intake via 24-h diet recalls. Respondents include 2126 women and 1911 men from the US National Health and Nutrition Examination Survey, and 1572 women and 1141 men from the French Nutrition Barometer Survey. Standard linear regression models and t-tests of both simple and predictive marginal means were run employing the software package SUDAAN. RESULTS: Americans appear to consume fruits and vegetables less often than their French counterparts (1.04 vs 1.33 times per day fruits; 1.98 vs 2.29 times per day vegetables). American men consume fruits and vegetables least often (0.98 times per day fruits; 1.88 times per day vegetables) than do American women or French men (1.10 vs 1.25 times per day fruits; 2.07 vs 2.18 times per day vegetables). French women consume fruits and vegetables most often (1.41 times per day fruits; 2.41 times per day vegetables). The French have lower mean BMI than Americans (23.34 vs 28.22 women; 25.20 vs 28.02 men). Regression analyses showed that age, BMI and educational attainment are strongly associated with frequency of consumption. CONCLUSIONS: These results support our hypothesis that the French tend to eat fruits and vegetables more often than Americans. This study proves to be an important first step in determining some of the influential factors that may affect various populations' consumption of fruits and vegetables.

Insulin-like growth factor-1 and breast cancer risk in postmenopausal African-American women.

We explored the relationship between insulin-like growth factor-1 (IGF-1) concentrations and breast cancer risk. Also, we examined whether obesity, sex hormone-binding globulin (SHBG), and estradiol influenced IGF-1 concentrations. A pilot study of 60 postmenopausal African-American women (30 cases and 30 controls) was used. Plasma concentrations of IGF-1 were higher among the cases, as compared to the controls. A negative trend was seen for plasma concentrations of IGF-1 and TNM (tumor-node-metastasis) stage and IGF-1 and body mass index. IGF-1 was found to be associated negatively with SHBG. After adjustment, plasma concentrations of IGF-1 remained significantly and positively associated with breast cancer risk (odds ratio, 1.183; 95% confidence interval, 1.167-1.201). No significant associations for breast cancer risk were observed for estradiol, SHBG, and body mass index. Further research with a larger sample is needed to clarify the relationships between obesity and IGF-1 concentrations to breast cancer risk in this population.

Correlates of serum lycopene in older women.

Experimental and epidemiological evidence suggests that lycopene, a predominant carotenoid found in human serum, may reduce the risk of certain cancers. We examined the association of dietary, physiological, and other factors with serum lycopene concentrations in a subsample of 946 postmenopausal women participating in the Women's Health Initiative. Pearson partial correlation coefficients and linear regression coefficients were calculated after adjustment for age, ethnicity, and serum low-density-lipoprotein (LDL) cholesterol. Serum lycopene was correlated with serum LDL cholesterol (r = 0.23) and dietary lycopene (r = 0.17, both p < 0.001). Individual food items found to be correlated with serum lycopene after adjustment included fresh tomatoes or tomato juice (r = 0.11), cooked tomatoes, tomato sauce, or salsa (r = 0.17), and spaghetti with meat sauce (r = 0.19, all p < 0.01). Age and body mass index were negatively associated with serum lycopene levels (both p < 0.001). Serum lycopene levels were highest in the summer and highest for those living in the northeastern United States. If we postulate that high serum lycopene levels reduce cancer risk, it becomes apparent that we have limited ability to detect this association from studies of lycopene intake. An understanding of factors associated with serum lycopene levels can be useful for the interpretation of studies of dietary lycopene and disease risk.

Measurement characteristics of the Women's Health Initiative food frequency questionnaire.

PURPOSE: The Women's Health Initiative (WHI) is the largest research program ever initiated in the United States with a focus on diet and health. Therefore, it is important to understand and document the measurement characteristics of the key dietary assessment instrument: the WHI food frequency questionnaire (FFQ). METHODS: Data are from 113 women screened for participation in the WHI in 1995. We assessed bias and precision of the FFQ by comparing the intake of 30 nutrients estimated from the FFQ with means from four 24-hour dietary recalls and a 4-day food record. RESULTS: For most nutrients, means estimated by the FFQ were within 10% of the records or recalls. Precision, defined as the correlation between the FFQ and the records and recalls, was similar to other FFQs. Energy adjusted correlation coefficients ranged from 0.2 (vitamin B12) to 0.7 (magnesium) with a mean of 0.5. The correlation for percentage energy from fat (a key measure in WHI) was 0.6. Vitamin supplement use was common. For example, almost half of total vitamin E intake was obtained from supplements. Including supplemental vitamins and minerals increased micronutrient correlation coefficients, which ranged from 0.2 (thiamin) to 0.8 (vitamin E) with a mean of 0.6. CONCLUSIONS: The WHI FFQ produced nutrient estimate, that were similar to those obtained from short-term dietary recall and recording methods. Comparison of WHI FFQ nutrient intake measures to independent and unbiased measures, such as doubly labeled water estimates of energy expenditure, are needed to help address the validity of the FFQ in this population.

Plasma lipid alterations in African-American women with breast cancer.

The purpose of this study was to examine the relationship between plasma lipid and lipoprotein levels, stage of disease and breast cancer risk in African-American women. The study population comprised 163 African-American women: patients (n = 58) and controls (n = 105), with mean ages of 57.2 years and 47.7 years respectively. Approximately 71% and 56% of the women with breast cancer and the control population, respectively, were postmenopausal. Those with cancer had significantly higher education levels, P < or = 0.01, and higher triglyceride levels compared to the controls, P < or = 0.001, but lower body mass index (BMI) levels, P < or = 0.01. There were no statistically significant differences observed in total cholesterol, high-density-lipoprotein-containing cholesterol and low-density-lipoprotein-containing cholesterol between the patients and controls. After adjustments for age, education, BMI, and menopausal status, triglycerides remained significantly and positively associated with breast cancer risk. The significant correlation between the high levels of triglycerides and breast cancer risk (odds ratio = 5.12) may be attributed to differences in lipid metabolism between the women with breast cancer and controls, or to the consequences of breast cancer.

A randomized controlled trial of weight reduction and exercise for diabetes management in older African-American subjects.

OBJECTIVE: To evaluate a weight loss and exercise program designed to improve diabetes management in older African-Americans. RESEARCH DESIGN AND METHODS: Overweight African-Americans (n = 64) ages 55-79 years with NIDDM were randomized to either an intervention (12 weekly group sessions, 1 individual session, and 6 biweekly group sessions) or usual care (1 individual session, and 6 biweekly group sessions) or usual care (1 class and 2 informational mailings). Clinical and behavioral variables were assessed at 0, 3, and 6 months of treatment. RESULTS: Significant net differences in the intervention versus usual care were observed for weight (-2.0 kg, P = 0.006), physical activity, and dietary intake of fat, saturated fat, cholesterol, and nutrition knowledge at 3 months (all P < 0.05) and for weight at 6 months (-2.4 kg; P = 0.006) and mean HbA1c values at 3 and 6 months (respectively, -1.6 and -2.4%, both P < 0.01). After the adjustment for changes in weight and activity, the intervention participants were approximately twice as likely to have a one unit decrease in HbA1c value as those in usual care. Blood pressure increase sin usual care participants resulted in net differences (intervention minus control) at 3 and 6 months of -3.3 (P = 0.09) and -4.0 (P = 0.05) mmHg diastolic, respectively, and -8.4 (P = 0.06) and -5.9 (P > 0.10) mmHg systolic, respectively. Blood lipid profiles improved more in intervention than usual care participants, but not significantly. CONCLUSIONS: The intervention program was effective in improving glycemic and blood pressure control. The decrease in HbA1c values was generally independent of the relatively modest changes in dietary intake, weight, and activity and may reflect indirect program effects on other aspects of self-care.