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1.
Public Health Nutr ; 22(15): 2777-2792, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31190677

RESUMO

OBJECTIVE: The present study evaluated the association of two measures of diet quality with BMI and waist circumference (WC), overall and by education level, among Mexican men and women. DESIGN: We constructed two a priori indices of diet quality, the Mexican Diet Quality Index (MxDQI) and the Mexican Alternate Healthy Eating Index (MxAHEI), which we examined relative to BMI and WC. We computed sex-specific multivariable linear regression models for the total sample and by education level. SETTING: Mexico. PARTICIPANTS: Mexican men (n 954) and women (n 1356) participating in the Mexican National Health and Nutrition Survey 2012. RESULTS: Total dietary scores were not associated with BMI in men and women, but total MxDQI was inversely associated with WC in men (-0·10, 95 % CI -0·20, -0·004 cm). We also found that some results differed by education level in men. For men with the lowest education level, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean reduction in BMI of 0·11 (95 % CI -0·18, 0·04) and 0·18 (95 % CI -0·25, -0·10) kg/m2, respectively. Likewise, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean change in WC of -0·30 (95 % CI -0·49, -0·11) and -0·53 (95 % CI -0·75, -0·30) cm, respectively, in men with the lowest level of education. In women, the association of diet quality scores with BMI and WC was not different by education level. CONCLUSIONS: Our findings suggest that a higher diet quality in men with low but not high education is associated with lower BMI and WC.


Assuntos
Índice de Massa Corporal , Dieta Saudável/estatística & dados numéricos , Escolaridade , Circunferência da Cintura , Adulto , Feminino , Humanos , Modelos Lineares , Masculino , México , Pessoa de Meia-Idade , Inquéritos Nutricionais
2.
Eur J Nutr ; 57(2): 643-653, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27885555

RESUMO

PURPOSE: Although there is convincing evidence that red and processed meat intake increases the risk of colorectal cancer (CRC), the potential role of meat cooking practices has not been established yet and could partly explain the current heterogeneity of results among studies. Therefore, we aimed to investigate the association between meat consumption and cooking practices and the risk of CRC in a population-based case-control study. METHODS: A total of 1671 CRC cases and 3095 controls recruited in Spain between September 2008 and December 2013 completing a food frequency questionnaire with a meat-specific module were included in the analyses. Odds ratios (OR) and confidence intervals (CI) were estimated by logistic regression models adjusted for known confounders. RESULTS: Total meat intake was associated with increased risk of CRC (OR T3-T1 1.41; 95% CI 1.19-1.67; p trend < 0.001), and similar associations were found for white, red and processed/cured/organ meat. Rare-cooked meat preference was associated with low risk of CRC in red meat (ORrare vs. medium 0.66; 95% CI 0.51-0.85) and total meat (ORrare vs. medium 0.56; 95% CI 0.37-0.86) consumers, these associations being stronger in women than in men. Griddle-grilled/barbecued meat was associated with an increased CRC risk (total meat: OR 1.45; 95% CI 1.13-1.87). Stewing (OR 1.25; 95% CI 1.04-1.51) and oven-baking (OR 1.18; 95% CI 1.00-1.40) were associated with increased CRC risk of white, but not red, meat. CONCLUSIONS: Our study supports an association of white, red, processed/cured/organ and total meat intake with an increased risk of CRC. Moreover, our study showed that cooking practices can modulate such risk.


Assuntos
Neoplasias Colorretais/etiologia , Culinária , Dieta/efeitos adversos , Preferências Alimentares , Alimentos em Conserva/efeitos adversos , Produtos da Carne/efeitos adversos , Carne/efeitos adversos , Idoso , Animais , Estudos de Casos e Controles , Estudos de Coortes , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etnologia , Dieta/etnologia , Feminino , Preferências Alimentares/etnologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Risco , Autorrelato , Fatores Sexuais , Espanha
3.
Public Health Nutr ; 21(7): 1307-1318, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29306339

RESUMO

OBJECTIVE: Eating away from home is associated with poor diet quality, in part due to less healthy food choices and larger portions. However, few studies account for the potential additional contribution of differences in food composition between restaurant- and home-prepared dishes. The present study aimed to investigate differences in nutrients of dishes prepared in restaurants v. at home. DESIGN: Eight commonly consumed dishes were collected in twenty of each of the following types of locations: small and large restaurants, and urban and rural households. In addition, two fast-food items were collected from ten KFC, McDonald's and food stalls. Five samples per dish were randomly pooled from every location. Nutrients were analysed and energy was calculated in composite samples. Differences in nutrients of dishes by preparation location were determined. SETTING: Hunan Province, China. SUBJECTS: Na, K, protein, total fat, fatty acids, carbohydrate and energy in dishes. RESULTS: On average, both the absolute and relative fat contents, SFA and Na:K ratio were higher in dishes prepared in restaurants than households (P < 0·05). Protein was 15 % higher in animal food-based dishes prepared in households than restaurants (P<0·05). Quantile regression models found that, at the 90th quantile, restaurant preparation was consistently negatively associated with protein and positively associated with the percentage of energy from fat in all dishes. Moreover, restaurant preparation also positively influenced the SFA content in dishes, except at the highest quantiles. CONCLUSIONS: These findings suggest that compared with home preparation, dishes prepared in restaurants in China may differ in concentrations of total fat, SFA, protein and Na:K ratio, which may further contribute, beyond food choices, to less healthy nutrient intakes linked to eating away from home.


Assuntos
Dieta/estatística & dados numéricos , Fast Foods/análise , Fast Foods/estatística & dados numéricos , Valor Nutritivo , Restaurantes , China , Culinária/estatística & dados numéricos , Gorduras na Dieta/análise , Proteínas Alimentares/análise , Análise de Alimentos , Humanos , Potássio/análise , Sódio/análise
4.
Int J Cancer ; 141(1): 83-93, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28380695

RESUMO

Prostate, breast and colorectal cancer are the most common tumours in Spain. The aim of the present study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and prostate, breast and colorectal cancer, in the MCC-Spain case-control study. A total of 1,718 colorectal, 1,343 breast and 864 prostate cancer cases and 3,431 population-based controls recruited between 2007 and 2012, were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on six recommendations for cancer prevention (on body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods and alcoholic drinks; score range 0-6) was constructed. We used unconditional logistic regression analysis adjusting for potential confounders. One-point increment in the WCRF/AICR score was associated with 25% (95% CI 19-30%) lower risk of colorectal, and 15% (95% CI 7-22%) lower risk of breast cancer; no association with prostate cancer was detected, except for cases with a Gleason score ≥7 (poorly differentiated/undifferentiated tumours) (OR 0.87, 95% CI 0.76-0.99). These results add to the wealth of evidence indicating that a great proportion of common cancer cases could be avoided by adopting healthy lifestyle habits.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias Colorretais/epidemiologia , Terapia Nutricional , Neoplasias da Próstata/epidemiologia , Neoplasias da Mama/dietoterapia , Neoplasias da Mama/patologia , Neoplasias Colorretais/dietoterapia , Neoplasias Colorretais/patologia , Feminino , Humanos , Estilo de Vida , Masculino , Neoplasias da Próstata/dietoterapia , Neoplasias da Próstata/patologia , Fatores de Risco , Espanha/epidemiologia
5.
Br J Nutr ; 117(5): 750-758, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28347359

RESUMO

No study has analysed how protein intake from early childhood to young adulthood relate to adult BMI in a single cohort. To estimate the association of protein intake at 2, 11, 15, 19 and 22 years with age- and sex-standardised BMI at 22 years (early adulthood), we used linear regression models with dietary and anthropometric data from a Filipino birth cohort (1985-2005, n 2586). We used latent growth curve analysis to identify trajectories of protein intake relative to age-specific recommended daily allowance (intake in g/kg body weight) from 2 to 22 years, then related trajectory membership to early adulthood BMI using linear regression models. Lean mass and fat mass were secondary outcomes. Regression models included socioeconomic, dietary and anthropometric confounders from early life and adulthood. Protein intake relative to needs at age 2 years was positively associated with BMI and lean mass at age 22 years, but intakes at ages 11, 15 and 22 years were inversely associated with early adulthood BMI. Individuals were classified into four mutually exclusive trajectories: (i) normal consumers (referent trajectory, 58 % of cohort), (ii) high protein consumers in infancy (20 %), (iii) usually high consumers (18 %) and (iv) always high consumers (5 %). Compared with the normal consumers, 'usually high' consumption was inversely associated with BMI, lean mass and fat mass at age 22 years whereas 'always high' consumption was inversely associated with male lean mass in males. Proximal protein intakes were more important contributors to early adult BMI relative to early-childhood protein intake; protein intake history was differentially associated with adulthood body size.


Assuntos
Envelhecimento , Índice de Massa Corporal , Proteínas Alimentares/administração & dosagem , Adolescente , Adulto , Antropometria , Composição Corporal , Criança , Pré-Escolar , Dieta , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Inquéritos Nutricionais , Filipinas , Fatores Socioeconômicos , Adulto Jovem
6.
Environ Health ; 16(1): 130, 2017 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-29212512

RESUMO

CORRECTION: After publication of the article [1], it has been brought to our attention that the thirteenth author of this article has had their name spelt incorrectly. In the original article the spelling "Laura Rizzir" was used. In fact the correct spelling should be "Laura Rizzi".

7.
BMC Nephrol ; 18(1): 160, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28506221

RESUMO

BACKGROUND: While chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries. METHODS: We investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m2 measured using serum creatinine concentration (mg/dL). RESULTS: After adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11-1.73 for men; OR = 1.35, 95% CI = 1.11-1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98-1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01-1.52). CONCLUSION: Our findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization.


Assuntos
Taxa de Filtração Glomerular , Inquéritos Epidemiológicos/estatística & dados numéricos , Testes de Função Renal/estatística & dados numéricos , Inquéritos Nutricionais/estatística & dados numéricos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Urbanização , Distribuição por Idade , Idoso , China/epidemiologia , Escolaridade , Feminino , Nível de Saúde , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/diagnóstico por imagem , Fatores de Risco , Distribuição por Sexo , Classe Social , Estatística como Assunto
8.
BMC Public Health ; 17(1): 354, 2017 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-28438148

RESUMO

BACKGROUND: Cadmium (Cd), lead (Pb) and arsenic (As) are common environmental contaminants that have been associated with lower birthweight. Although some essential metals may mitigate exposure, data are inconsistent. This study sought to evaluate the relationship between toxic metals, nutrient combinations and birthweight among 275 mother-child pairs. METHODS: Non-essential metals, Cd, Pb, As, and essential metals, iron (Fe), zinc (Zn), selenium (Se), copper (Cu), calcium (Ca), magnesium (Mg), and manganese (Mn) were measured in maternal whole blood obtained during the first trimester using inductively coupled plasma mass spectrometry. Folate concentrations were measured by microbial assay. Birthweight was obtained from medical records. We used quantile regression to evaluate the association between toxic metals and nutrients due to their underlying wedge-shaped relationship. Ordinary linear regression was used to evaluate associations between birth weight and toxic metals. RESULTS: After multivariate adjustment, the negative association between Pb or Cd and a combination of Fe, Se, Ca and folate was robust, persistent and dose-dependent (p < 0.05). However, a combination of Zn, Cu, Mn and Mg was positively associated with Pb and Cd levels. While prenatal blood Cd and Pb were also associated with lower birthweight. Fe, Se, Ca and folate did not modify these associations. CONCLUSION: Small sample size and cross-sectional design notwithstanding, the robust and persistent negative associations between some, but not all, nutrient combinations with these ubiquitous environmental contaminants suggest that only some recommended nutrient combinations may mitigate toxic metal exposure in chronically exposed populations. Larger longitudinal studies are required to confirm these findings.


Assuntos
Peso ao Nascer , Exposição Materna/efeitos adversos , Metais Pesados/sangue , Adulto , Arsênio , Cádmio/sangue , Cobre/sangue , Estudos Transversais , Feminino , Ácido Fólico , Intoxicação por Metais Pesados , Humanos , Ferro/sangue , Chumbo/sangue , Manganês/sangue , Intoxicação , Selênio/sangue , Fatores Socioeconômicos , Zinco/sangue
9.
Matern Child Nutr ; 13(2)2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27062326

RESUMO

Undernutrition and diarrhoeal disease are major causes of infant mortality. We investigated the combined roles of breastfeeding and diarrhoea on infant size in 2940 infants from the Cebu Longitudinal Health and Nutrition Survey. The study aimed to assess whether breastfeeding status modified the deficits associated with diarrhoeal disease. The primary exposures were combinations of current breastfeeding status (yes/no), the presence of diarrhoeal disease in previous week (yes/no) and a categorical survey variable (six surveys taken at bimonthly intervals when infants were 2-12 months of age). Relative weight (weight-for-length z-scores), calculated using the WHO growth standards, was estimated using sex-stratified, fixed-effects longitudinal models that also adjusted for energy from complementary foods. Post-estimation Wald tests were conducted to identify subgroup differences in relative weight. Diarrhoea was associated with reduced relative weight in both breastfed and non-breastfed infants of 6-12 months. Diarrhoea-related deficits in relative weight were significantly exacerbated in non-breastfed girls of 6 and 8 months. Importantly, in infants <6 months, being breastfed and having diarrhoea was still associated with greater relative weight compared with being non-breastfed and diarrhoea-free. Breastfeeding emerged as a strong contributor to relative weight in younger infants (<6 months) while diarrhoeal disease strongly contributed to deficits in relative weight in older infants (6-12 months). These findings underscore the importance of breastfeeding for promoting infant nutritional status in infants with or without diarrhoea from birth to 12 months.


Assuntos
Peso Corporal , Aleitamento Materno , Diarreia/epidemiologia , Adulto , Dieta , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Inquéritos Nutricionais , Filipinas/epidemiologia , Prevalência , Adulto Jovem
10.
Am J Epidemiol ; 183(3): 169-82, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-26740026

RESUMO

Seafood consumption during pregnancy is thought to be beneficial for child neuropsychological development, but to our knowledge no large cohort studies with high fatty fish consumption have analyzed the association by seafood subtype. We evaluated 1,892 and 1,589 mother-child pairs at the ages of 14 months and 5 years, respectively, in a population-based Spanish birth cohort established during 2004-2008. Bayley and McCarthy scales and the Childhood Asperger Syndrome Test were used to assess neuropsychological development. Results from multivariate linear regression models were adjusted for sociodemographic characteristics and further adjusted for umbilical cord blood mercury or long-chain polyunsaturated fatty acid concentrations. Overall, consumption of seafood above the recommended limit of 340 g/week was associated with 10-g/week increments in neuropsychological scores. By subtype, in addition to lean fish, consumption of large fatty fish showed a positive association; offspring of persons within the highest quantile (>238 g/week) had an adjusted increase of 2.29 points in McCarthy general cognitive score (95% confidence interval: 0.42, 4.16). Similar findings were observed for the Childhood Asperger Syndrome Test. Beta coefficients diminished 15%-30% after adjustment for mercury or long-chain polyunsaturated fatty acid concentrations. Consumption of large fatty fish during pregnancy presents moderate child neuropsychological benefits, including improvements in cognitive functioning and some protection from autism-spectrum traits.


Assuntos
Cognição , Transtornos do Neurodesenvolvimento/epidemiologia , Efeitos Tardios da Exposição Pré-Natal , Fenômenos Fisiológicos da Nutrição Pré-Natal , Alimentos Marinhos/estatística & dados numéricos , Adulto , Desenvolvimento Infantil , Pré-Escolar , Ácidos Graxos Insaturados/sangue , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Mercúrio/sangue , Transtornos do Neurodesenvolvimento/prevenção & controle , Testes Neuropsicológicos , Gravidez , Espanha/epidemiologia
11.
Epidemiology ; 27(3): 449-58, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26745610

RESUMO

BACKGROUND: Phthalates are hypothesized to cause obesity, but few studies have assessed whether prenatal phthalate exposures are related to childhood body mass index (BMI). METHODS: We included 707 children from three prospective cohort studies enrolled in the US between 1998 and 2006 who had maternal urinary phthalate metabolite concentrations measured during pregnancy, and measures of weight and height at ages 4 to 7 years. We calculated age- and sex-standardized BMI z scores and classified children with BMI percentiles ≥85 as overweight/obese. We used mixed effects regression models to estimate associations between a 1 standard deviation increase in natural log phthalate metabolite concentrations and BMI z scores and overweight/obesity. We estimated associations in multiple metabolite models adjusted for confounders, and evaluated heterogeneity of associations by child's sex, race/ethnicity, and cohort. RESULTS: Mono-3-carboxypropyl phthalate concentrations were positively associated with overweight/obese status in children (odds ratio [95% credible interval] = 2.1 [1.2, 4.0]) but not with BMI z scores (ß = -0.02 [-0.15, 0.11]). We did not observe evidence of obesogenic effects for other metabolites. However, monoethyl phthalate and summed di-(2-ethylhexyl) phthalate metabolites (∑DEHP) concentrations were inversely associated with BMI z scores among girls (monoethyl phthalate beta = -0.14 [-0.28, 0.00]; ∑DEHP beta = -0.12 [-0.27, 0.02]). CONCLUSIONS: Maternal urinary mono-3-carboxypropyl phthalate, a nonspecific metabolite of several phthalates, was positively associated with childhood overweight/obesity. Metabolites of diethyl phthalate and DEHP were associated with lower BMI in girls but not in boys, suggesting that prenatal exposures may have sexually dimorphic effects on physical development.


Assuntos
Obesidade Infantil/epidemiologia , Ácidos Ftálicos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos de Coortes , Dietilexilftalato/análogos & derivados , Dietilexilftalato/urina , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Ácidos Ftálicos/urina , Gravidez , Estudos Prospectivos , Fatores Sexuais
12.
J Nutr ; 146(10): 2085-2092, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27581582

RESUMO

BACKGROUND: Protein intake (PI) may alter adiposity but few studies have explored the age-specific associations of PI with body mass index (BMI). OBJECTIVE: We analyzed how PI and breastfeeding relate to BMI in the CLHNS (Cebu Longitudinal Health and Nutrition Survey), an observational Filipino birth cohort (1983-2005). METHODS: Random-effects longitudinal regression models estimated the association of daily breastfeeding frequency and energy-adjusted PI residuals with concurrent BMI z scores (zBMI) measured bimonthly from 2 to 24 mo (n = 2899), and the association of breastfeeding history and PI residuals with concurrent BMI using 5 surveys from 2 to 22 y (n = 2435). Models included statistical interactions between PI, breastfeeding, age, and energy intake and adjusted for potential confounders. RESULTS: Breastfeeding was associated with higher predicted zBMI at 6 mo (ß: 0.491 SD; 95% CI: 0.422, 0.560) and at 18 mo (ß: 0.114 SD; 95% CI: 0.032, 0.197). Daily breastfeeding frequency contributed to higher predicted zBMI in younger infants and lower predicted zBMI in later infancy. Those with longer breastfeeding history (19 mo) were significantly smaller at age 11 y (in kg/m2; ß: -0.220; 95% CI: -0.342, -0.097) than those with a shorter (4 mo) breastfeeding duration. Total complementary PI was positively associated with predicted zBMI. Complementary animal PI was positively associated with predicted zBMI in nonbreastfed infants. Plant PI was inversely associated with predicted zBMI of nonbreastfed infants at 6 mo. At 22 y contrasts between high (75th percentile) and low (25th percentile) PIs showed that animal PI was associated with higher predicted BMI (ß: 0.187; 95% CI: 0.045, 0.329), and total PI was inversely related to predicted BMI (ß: -0.008; 95% CI: -0.015, -0.001). CONCLUSION: Breastfeeding frequency, breastfeeding history, and PI contribute to BMI from infancy to young adulthood in the CLHNS.


Assuntos
Índice de Massa Corporal , Aleitamento Materno , Proteínas Alimentares/administração & dosagem , Adiposidade , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Ingestão de Energia , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Estudos Longitudinais , Masculino , Inquéritos Nutricionais , Filipinas , Fatores Socioeconômicos , Adulto Jovem
13.
J Nutr ; 146(9): 1722-30, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27466605

RESUMO

BACKGROUND: Racial/ethnic disparities in dietary quality persist among Americans, but it is unclear whether highly processed foods or convenience foods contribute to these inequalities. OBJECTIVE: We examined the independent associations of race/ethnicity with highly processed and ready-to-eat (RTE) food purchases among US households. We determined whether controlling for between-group differences in purchases of these products attenuated associations between race/ethnicity and the nutritional quality of purchases. METHODS: The 2000-2012 Homescan Panel followed US households (n = 157,142) that scanned their consumer packaged goods (CPG) food and beverage purchases. By using repeated-measures regression models adjusted for sociodemographic characteristics, we examined time-varying associations of race/ethnicity with processed and convenience food purchases, expressed as a percentage of calories purchased. We estimated associations between race/ethnicity and saturated fat, sugar, or energy density of total purchases with and without adjustment for processed and convenience food purchases. RESULTS: Compared with white households, black households had significantly lower purchases of highly processed foods (-4.1% kcal) and RTE convenience foods (-4.9% kcal) and had higher purchases of basic processed foods, particularly cooking oils and sugar (+5.4% kcal), foods requiring cooking/preparation (+4.5% kcal), and highly processed beverages (+7.1% kcal). Hispanics also had lower purchases of highly processed and RTE foods than whites. Blacks had CPG purchases with significantly higher median sugar (+2.2% kcal) and energy density (+72 kcal/1000 g), whereas Hispanics had purchases with lower saturated fat (-0.6% kcal) and energy density (-25 kcal/1000 g) than whites. Racial/ethnic differences remained significant after adjustment for processed and convenience food purchases. CONCLUSIONS: In our study, compared with white households, both black and Hispanic households had lower purchases of highly processed and RTE foods, yet had total CPG purchases with differing nutritional quality. Our findings suggest that highly processed convenience foods are associated with, but cannot fully explain, racial/ethnic disparities in the nutritional quality of CPG purchases.


Assuntos
Dieta , Fast Foods , Manipulação de Alimentos , Embalagem de Alimentos , Valor Nutritivo , Adolescente , Adulto , Bebidas , Criança , Pré-Escolar , Ingestão de Energia , Etnicidade , Características da Família , Ácidos Graxos/administração & dosagem , Feminino , Humanos , Modelos Lineares , Masculino , Análise Multivariada , Adoçantes Calóricos/administração & dosagem , Grupos Raciais , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
14.
J Pediatr Gastroenterol Nutr ; 63(4): e63-8, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27243423

RESUMO

OBJECTIVE: Determine clinical and manometric parameters associated with success of antegrade continence enemas (ACEs) administered via cecostomy in the treatment of constipation and fecal overflow incontinence. METHODS: We performed a retrospective review of clinical symptoms and manometry (colonic and anorectal) before cecostomy in 40 pediatric patients (20 males, 20 females). The mean age at time of follow-up was 9.5 ±â€Š4.4 years with a mean follow-up time of 12.2 ±â€Š10.9 months. Clinical outcomes were defined as good, if subjects had >3 bowel movements per week, <2 episodes of soiling per week, and absence of pain at the time of follow-up after cecostomy. RESULTS: Before cecostomy, the mean duration of constipation and/or fecal incontinence was 7.7 ±â€Š4.4 years, mean number of BMs was 1.5 ±â€Š0.9 per week, and soiling episodes 4.12 ±â€Š3.5 per week; 24 (60%) patients had abdominal pain. At follow-up 30 out of 40 patients had a good outcome, and 10 had a poor outcome; with a difference in the number of weekly BM of 5.7 ±â€Š2.2 versus 1.5 ±â€Š0.9, P < 0.001, and soiling episodes (0.4 ±â€Š1.5 vs 4 ±â€Š3.1, P < 0.001). There was no difference in the duration of symptoms between groups. Obesity was more common in the poor-outcome group, 60% versus 21% (P = 0.01). Abdominal pain was more common in the poor-outcome group, 100% versus 47% (P = 0.003). Normal colonic manometry was associated with good outcome, whereas absence of high-amplitude propagating contraction (HAPC) in any part of the colon was associated with poor outcome. No other differences in colonic manometry were observed between the good- and poor-outcome groups with the exception of a trend toward decreased number of sigmoid HAPCs in the poor-outcome group (P = 0.07). No differences were observed in anorectal manometry measurements between good- and poor-outcome groups with the exception of an observable increased baseline resting pressure in the poor outcome (P = 0.05). CONCLUSIONS: Obesity and abdominal pain tend to be associated with poor outcomes after cecostomy for refractory constipation. Normal colonic and anorectal manometry were associated with good outcome. Absence of HAPC in any part of the colon, and increased baseline resting pressure of the anal canal were more associated with poor outcome. No other specific differences in either colonic or anorectal manometric parameters were observed in patients with good versus poor outcomes with cecostomy. Large prospective studies potentially combining other diagnostic modalities such as colonic transit studies are needed to determine the optimal tests to predict successful outcomes from cecostomy.


Assuntos
Cecostomia , Constipação Intestinal/terapia , Enema/métodos , Incontinência Fecal/terapia , Adolescente , Criança , Pré-Escolar , Constipação Intestinal/diagnóstico , Incontinência Fecal/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Manometria , Estudos Retrospectivos , Resultado do Tratamento
15.
Public Health Nutr ; 19(2): 195-203, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26784586

RESUMO

OBJECTIVE: We examined the association between dietary patterns and diabetes using the strengths of two methods: principal component analysis (PCA) to identify the eating patterns of the population and reduced rank regression (RRR) to derive a pattern that explains the variation in glycated Hb (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting glucose. DESIGN: We measured diet over a 3 d period with 24 h recalls and a household food inventory in 2006 and used it to derive PCA and RRR dietary patterns. The outcomes were measured in 2009. SETTING: Adults (n 4316) from the China Health and Nutrition Survey. RESULTS: The adjusted odds ratio for diabetes prevalence (HbA1c≥6·5 %), comparing the highest dietary pattern score quartile with the lowest, was 1·26 (95 % CI 0·76, 2·08) for a modern high-wheat pattern (PCA; wheat products, fruits, eggs, milk, instant noodles and frozen dumplings), 0·76 (95 % CI 0·49, 1·17) for a traditional southern pattern (PCA; rice, meat, poultry and fish) and 2·37 (95 % CI 1·56, 3·60) for the pattern derived with RRR. By comparing the dietary pattern structures of RRR and PCA, we found that the RRR pattern was also behaviourally meaningful. It combined the deleterious effects of the modern high-wheat pattern (high intakes of wheat buns and breads, deep-fried wheat and soya milk) with the deleterious effects of consuming the opposite of the traditional southern pattern (low intakes of rice, poultry and game, fish and seafood). CONCLUSIONS: Our findings suggest that using both PCA and RRR provided useful insights when studying the association of dietary patterns with diabetes.


Assuntos
Diabetes Mellitus/etiologia , Dieta , Comportamento Alimentar , Projetos de Pesquisa , Adulto , Glicemia/metabolismo , China , Diabetes Mellitus/sangue , Diabetes Mellitus/prevenção & controle , Características da Família , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Análise de Componente Principal
16.
Am J Epidemiol ; 181(4): 234-6, 2015 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-25656531

RESUMO

Error and bias in self-reported intakes make estimating relationships among dietary factors, obesity, and related health outcomes a complex challenge in observational studies. In the absence of measures that can be applied in calibration adjustments of dietary data, simple methods to identify persons who misreport their intakes have been used to assess the impact of screening out reports characterized by energy intakes that are implausible when compared with estimated energy needs. Sensitivity analyses in cross-sectional studies have shown these methods to yield more plausible associations between diet and obesity, but few longitudinal studies have evaluated this approach. In this issue of the Journal, findings reported by Rhee et al. (Am J Epidemiol. 2015;181(4):237) underscore the need for caution in drawing conclusions on how self-reported diet may influence such outcomes based on cross-sectional associations but suggest that this approach might have little impact on the more credible associations derived from prospective analyses. However, other prospective studies have found that diet-disease relationships emerge or are substantially strengthened with the use of calibration adjustments using recovery biomarkers. To better understand the influence of diet on obesity-related health outcomes, efforts to reduce dietary measurement error through improved collection, evaluation, and analysis of consumption data are still urgently needed.


Assuntos
Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Doenças Cardiovasculares/epidemiologia , Carotenoides/sangue , Ingestão de Energia , Exercício Físico , Ácidos Graxos/sangue , Enfermeiras e Enfermeiros/estatística & dados numéricos , Feminino , Humanos
17.
Am J Epidemiol ; 181(9): 661-71, 2015 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25834139

RESUMO

Investigating the association between consumption of sweetened beverages and dietary quality is challenging because issues such as reverse causality and unmeasured confounding might result in biased and inconsistent estimates. Using a dynamic panel model with instrumental variables to address those issues, we examined the independent associations of beverages sweetened with caloric and low-calorie sweeteners with dietary quality and food-purchasing patterns. We analyzed purchase data from the Homescan survey, an ongoing, longitudinal, nationally representative US survey, from 2000 to 2010 (n = 34,294). Our model included lagged measures of dietary quality and beverage purchases (servings/day in the previous year) as exposures to predict the outcomes (macronutrient (kilocalories per capita per day; %), total energy, and food purchases) in the next year after adjustment for other sociodemographic covariates. Despite secular declines in purchases (kilocalories per capita per day) from all sources, each 1-serving/day increase in consumption of either beverage type resulted in higher purchases of total daily kilocalories and kilocalories from food, carbohydrates, total sugar, and total fat. Each 1-serving/day increase in consumption of either beverage was associated with more purchases of caloric-sweetened desserts or sweeteners, which accounted for a substantial proportion of the increase in total kilocalories. We concluded that consumers of both beverages sweetened with low-calorie sweeteners and beverages sweetened with caloric sweeteners had poorer dietary quality, exhibited higher energy from all purchases, sugar, and fat, and purchased more caloric-sweetened desserts/caloric sweeteners compared with nonconsumers.


Assuntos
Bebidas/estatística & dados numéricos , Dieta/estatística & dados numéricos , Alimentos/estatística & dados numéricos , Modelos Teóricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
18.
Epidemiology ; 26(5): 758-68, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26133024

RESUMO

BACKGROUND: Prospective evidence of associations of dietary patterns with cognitive decline is limited and inconsistent. We examined how cognitive changes among Chinese older adults relate to either an adapted Mediterranean diet score or factor analysis-derived dietary patterns. METHODS: This prospective cohort study comprised 1,650 adults ≥55 years of age, who completed a cognitive screening test at two or more waves of the China Health and Nutrition Survey in 1997, 2000, or 2004. Outcomes were repeated measures of global cognitive scores, composite cognitive z scores (standardized units [SU]), and standardized verbal memory scores (SU). Baseline diet was measured by 24-hour recalls over 3 days. We used linear mixed effects models to evaluate how changes in cognitive scores were associated with adapted Mediterranean diet score and two dietary pattern scores derived from factor analysis. RESULTS: Among adults ≥65 years of age, compared with participants in the lowest tertile of adapted Mediterranean diet, those in the highest tertile had a slower rate of cognitive decline (difference in mean SU change/year ß = 0.042; 95% confidence interval [CI]: 0.002, 0.081). A wheat-based diverse diet derived by factor analysis shared features of the adapted Mediterranean diet, with the top tertile associated with slower annual decline in global cognitive function (ß = 0.069 SU/year; 95% CI: 0.023, 0.114). We observed no associations among adults <65 years of age. CONCLUSIONS: Our findings suggest that an adapted Mediterranean diet or a wheat-based, diverse diet with similar components may reduce the rate of cognitive decline in later life in the Chinese population.


Assuntos
Transtornos Cognitivos/etiologia , Dieta Mediterrânea , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/prevenção & controle , Inquéritos sobre Dietas , Análise Fatorial , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Estudos Prospectivos , Fatores de Proteção
19.
J Nutr ; 145(8): 1892-9, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26136584

RESUMO

BACKGROUND: There is minimal information on the impact of replacing sugar-sweetened beverage (SSB) consumption with water on diet quality from randomized controlled trials. OBJECTIVE: We evaluated the effect of a water intake intervention on diet quality in overweight Mexican women. METHODS: Women with a body mass index ≥25 and <39, 18-45 y old, and a self-reported high intake of SSBs (≥250 kcal/d) were randomly allocated to either the water and education provision (WEP) group (n = 120) or the education provision (EP) only group (n = 120). Each group received monthly nutrition counseling, and the WEP group received biweekly water deliveries for 9 mo. Three 24-h recalls, anthropometry, and demographic information were collected at baseline, and 3, 6, and 9 mo. Energy, macronutrient, sugar, SSB, fruit and vegetable, salty snack, cake and cookie, and fast food intakes were assessed in study completers (n = 189) classified by intervention assignment and by actual water intake at every time point (low <1200 vs. high ≥1200 mL/d). RESULTS: The WEP group reported greater decreases in SSB intake than the EP group (from 20.9% to 10.3% of energy/d vs. from 20.1% to 17.8%). Thirty-eight percent of the EP group and 84.3% of the WEP group reported attaining a water intake ≥1200 mL/d. Reductions in energy intake and food groups were similar across intervention groups. However, the high actual water intake group reported greater increases vs. the lower intake group in intake of fruits and vegetables (117 vs. 47 g/d), as well as larger reductions in salty snacks (4.6 vs. 0.7 g/d) and cakes and cookies (31.7 vs. 14.7 g/d). CONCLUSIONS: Other than SSBs, improvements in food group intake did not differ by intervention group in overweight Mexican women. However, post hoc analyses suggested that achieving a high actual water intake was associated with additional beneficial changes in food group intake. This trial was registered at clinicaltrials.gov as NCT01245010.


Assuntos
Bebidas , Ingestão de Líquidos , Sobrepeso/terapia , Água , Adulto , Feminino , Humanos , Programas de Redução de Peso , Adulto Jovem
20.
Environ Res ; 136: 280-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25460647

RESUMO

BACKGROUND: Impaired postnatal growth after chloroform exposure in utero has been observed in rodents without an effect on birth weight. We aimed to study the relationship between exposure to trihalomethanes (THMs) during pregnancy and postnatal weight growth during infancy. METHODS: We analysed 2216 mother-child pairs recruited in Gipuzkoa, Sabadell, Valencia (Spain, INMA Project, enrollment: 2003-2008) and Crete (Greece, RHEA Study, enrollment: 2007-2008). Drinking water habits and water-related activities ascertained through personal interviews were combined with THM measurements in drinking water to estimate THM exposure through different exposure routes during pregnancy. Weight measurements during the first year of life were used to fit postnatal weight growth curves from birth to one year and to predict weight at six months. Multiple linear regression was used to evaluate the relationship between six months weight gain and interquartile range (IQR) increase in THM exposure adjusting for confounders. RESULTS: Average weight gain at six months ranged from 4325 g (Gipuzkoa) to 4668 g (Crete). Median residential THM levels ranged from 1 µg/l (Crete) to 117 µg/l (Sabadell). No significant association was observed overall (-24.4 g [95% CI -78.8, 30.0] for an IQR increase in total residential uptake). A negative relationship was observed in Sabadell (-148 g [95% CI -282, -13.7]) for an IQR increase in ingestion THM uptake. CONCLUSIONS: No consistent evidence of an association between THM exposure during pregnancy and postnatal growth was observed. The novelty of the hypothesis and the negative trend observed in the region with the highest levels warrants the replication in future studies.


Assuntos
Crescimento , Exposição Materna , Trialometanos/toxicidade , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez
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