Fruit and vegetable intake among Jordanians: results from a case-control study of colorectal cancer.

BACKGROUND: Diets that include fruits and vegetables have been suggested as one way to reduce the risk of developing colorectal cancer (CRC); however, the association between consuming fruits and vegetables and CRC risk is not clear. The objective of the present study is to compare fruit and vegetable intake between 2 groups of Jordanians and further investigate this possible relationship. METHODS: A history of fruit and vegetable consumption was obtained from 220 people with CRC and 281 healthy controls, all of whom were from Jordan. Both groups were matched for age, sex, occupation, and marital status. Fruit and vegetable consumption was quantified for the previous 12 months in both groups. RESULTS: Total vegetable intake was associated with the risk of developing CRC. Consuming 5 servings of vegetables a day decreased the risk of developing CRC when compared with no more than 1 serving a day (odds ratio [OR] = 0.23; 95% confidence interval [CI]: 0.55-0.97). A significant direct relationship between CRC risk and consuming cauliflower and cabbage was found; however, no association was found for raw or cooked leafy vegetable and other vegetable types. Consuming several types of fruits also revealed no association with risk of CRC, although an increased intake of dates and figs was associated with a reduced risk of developing CRC. The ORs for the highest intake of servings compared with the lowest intake were 0.48 (95% CI: 0.27-0.87; P = .004) for dates and 0.604 (95% CI: 0.35-1.06; P = .003) for figs. CONCLUSIONS: Consuming fruits and vegetables did not significantly correlate with a lowered incidence of CRC. However, a trend of protection was detected for several types of fruits and vegetables.

Nutrient intake and lifestyle factors by diabetes status of Circassians and Chechans in Jordan.

OBJECTIVES: Diabetes is one of the most prevalent diseases in Jordan. However, little is known about nutrient intakes of minority groups in Jordan with and without diabetes. Our study aimed to examine if the intake of energy, macronutrients and some micronutrients differed between normal and diabetic adults among Circassians and Chechans in Jordan. DESIGN, SETTING, PARTICIPANTS: This cross-sectional study was conducted among 437 Circassians (160 males and 277 females) and 355 Chechans (119 males and 236 females) aged > or = 18 years. They were recruited from the Chechan and Circassian communities living in Jordan. MAIN OUTCOME MEASURES: A participant was defined as affected by type 2 diabetes mellitus if diagnosis was known to patient or if his or her condition complied with the American Diabetes Association definition. One 24-hour dietary recall for each participant was collected by face-to-face interview. RESULTS: Most of the measured anthropometric and biochemical parameters showed a significant difference between normal individuals and those with impaired fasting glucose or diabetes. Intakes of nutrients involved in the pathogenesis of diabetes including protein, fat and fiber did not differ between stratified participants according to blood glucose status for both Circassians and Chechans. CONCLUSIONS: Intake of nutrients did not differ in participants with normal blood glucose from those who had impaired fasting glucose or diabetes in the two studied populations. These two populations may need genetic studies to identify the risk factors other than dietary and lifestyle factors for type 2 diabetes.

The relationship between kidney stones and dietary habits.

BACKGROUND: Kidney stones are considered a serious disease, due to the great discomfort that they can cause and may even lead to renal failure. Dietary habits could be the reason behind stone formation in kidneys. METHODS: Twelve kidney stone samples were collected and analyzed together with typical foodstuffs frequently consumed in the Koya area using the x-ray fluorescent technique. RESULTS: All the analyzed stones were found to be calcium-based. The results show that elements such as Ca, Zr, S and Cl can be regarded as the core elements for the formation of kidney stones in Koya city in north Iraq. CONCLUSION: Many dietary foods and drink frequently consumed by the people in Koya city were observed to contain the core elements. However, more studies are needed to demonstrate if dietary intake may be the main source for kidney stone formation.

Macro- and micronutrients consumption and the risk for colorectal cancer among Jordanians.

OBJECTIVE: Diet and lifestyle have been reported to be important risk factors for the development of colorectal cancer (CRC). However, the association between total energy and nutrient intake and the risk of developing CRC has not been clearly explained. The aim of our study is to examine the relationship between total energy intake and other nutrients and the development of CRC in the Jordanian population. RESEARCH METHODS AND PROCEDURES: Dietary data was collected from 169 subjects who were previously diagnosed with CRC, and 248 control subjects (matched by age, gender, occupation and marital status). These control subjects were healthy and disease free. Data was collected between January 2010 and December 2012, using interview-based questionnaires. Logistic regression was used to evaluate the association between quartiles of total energy, macro- and micronutrient intakes with the risk of developing CRC in our study population. RESULTS: Total energy intake was associated with a higher risk of developing CRC (OR = 2.60 for the highest versus lowest quartile of intake; 95% CI: 1.21-5.56, p-trend = 0.03). Intakes of protein (OR = 3.62, 95% CI: 1.63-8.05, p-trend = 0.002), carbohydrates (OR = 1.41, 95% CI: 0.67-2.99, p-trend = 0.043), and percentage of energy from fat (OR = 2.10, 95% CI: 0.38-11.70, p-trend = 0.009) significantly increased the risk for the development of CRC. Saturated fat, dietary cholesterol and sodium intake showed a significant association with the risk of developing CRC (OR = 5.23, 95% CI: 2.33-11.76; OR = 2.48, 95% CI: 1.18-5.21; and OR = 3.42, 95% CI: 1.59-7.38, respectively), while vitamin E and caffeine intake were indicative of a protective effect against the development of CRC, OR = 0.002 (95% CI: 0.0003-0.011) and 0.023 (95%CI: 0.008-0.067), respectively. CONCLUSION: Our results suggest an increased risk for the development of CRC in subjects with high dietary intake of energy, protein, saturated fat, cholesterol, and sodium, and diets high in vitamin E and caffeine were suggestive of a protective effect against the risk of developing CRC. IMPACT: This is the first study in Jordan to suggest that it may be possible to reduce CRC risk by adjusting the intake of some macro-and micronutrients.

Food groups and the risk of colorectal cancer: results from a Jordanian case-control study.

The role of diet in colorectal cancer (CRC) in Jordan has not been studied previously. This study aimed at examining the association between food groups (including grains, fruits, vegetables, milk, and meat and legumes) and CRC risk in Jordan. We compared intakes of the different food groups among CRC patients (n=167) and matched controls (n=240) by age, sex, occupation, and marital status. A validated food frequency questionnaire was used to collect dietary data. Logistic regression was used to evaluate the association of quartiles of intakes of the different food groups with CRC risk. In addition, the association of selected food items with CRC risk was examined. Odds ratios (ORs) for the fourth versus the first quartile of intake were 2.92 [95% confidence interval (CI): 1.40-6.08] for grains, 1.66 (95% CI: 0.81-3.40) for vegetables, 0.55 (95% CI: 0.26-1.16) for fruits, 0.96 (95% CI: 0.46-1.97) for milk, and 1.43 (95% CI: 0.68-2.98) for meat and legumes. In a comparison of the highest with the lowest weekly frequency of consumption, there was a direct association between the risk of CRC and the frequency of consumption of chicken (OR=2.52, 95% CI: 1.33-4.77). An increase in risk was observed with increased consumption of white bread (OR=3.13, 95% CI: 1.18-9.25), whereas consumption of whole bread was associated with a decreased risk for CRC (OR=0.32, 95% CI: 0.12-0.84). Our results support a role of diet in CRC. Direct associations were found for grains, white bread, and chicken, whereas an inverse relation was reported for whole bread.

Validation of a food frequency questionnaire to assess macronutrient and micronutrient intake among Jordanians.

The aim of this study was to examine the validity and reliability of a food frequency questionnaire (FFQ) among a convenience sample of healthy adults in Jordan. A modified version of the questionnaire known as Diet History Questionnaire I, which measures dietary intakes over a 1-year period, was administrated to 101 apparently healthy men and women recruited from three large medical centers in Jordan. Fifty-five participants completed the modified FFQ and three 24-hour recalls. Participants (N=101) completed the FFQ two times separated by a 1-month period. Reliability of the FFQ was assessed using test-retest method. Mean age of participants was 33.4±18.5 years. Energy, carbohydrate, fiber, fat, saturated fat, calcium, and iron had deattenuated correlations of .732, .563, .544, .487, .484, .451, and .459, respectively. The FFQ and 24-hour recalls produced similar agreement percentages ranging between 25.5% and 43.6%. Mean energy-adjusted reliability coefficients ranged from .695 to .943. A Cronbach's α for the total FFQ items of .857 was found. The modified FFQ has reasonable relative validity and reliability for energy, carbohydrate, fiber, fat, saturated fat, calcium, and iron intakes in Jordanian adults over a 1-year period. However, its application may require additional modifications and validation efforts. Future research is warranted to further modify and test the FFQ in a larger and more diverse sample of Jordanians as well as to develop FFQ for the use among other age groups.