Dietary trajectories over 21 years and frailty in Norwegian older adults: the Tromsø Study 1994-2016.

PURPOSE: To investigate the association between five dietary trajectories over 21 years and frailty in Norwegian older adults. METHODS: This study used data from three surveys of the Tromsø Study. Diet was measured using food frequency questionnaires at baseline (Tromsø4, 1994-95), after 7 years (Tromsø5, 2001) and at the end of follow-up (Tromsø7, 2015-16). Survey-specific diet scores were constructed based on the Nordic Nutrition Recommendations 2023 and group-based trajectory modelling was used to derive dietary trajectories. At follow-up, frailty was assessed with a 41-item frailty index. Linear regression analysis was performed to assess the associations between dietary trajectories and frailty, adjusted for baseline variables. RESULTS: Among the 715 participants, 55% were women, with an average age of 54 years at baseline and 74 years at follow-up. The dietary trajectories 'moderately healthy' and 'healthy increase' were associated with a lower frailty index score at follow-up (ß = -0.02, 95% confidence interval (CI) = -0.04, -0.002, ß = -0.03, 95% CI = -0.06, -0.007), compared with the 'unhealthy' trajectory. CONCLUSION: Our findings suggest that maintaining a moderately healthy to very healthy diet from mid-life into older age is associated with a lower risk of frailty and supports the promotion of a healthy diet from adulthood to facilitate healthy ageing.

Potato Consumption and All-Cause and Cardiovascular Disease Mortality - A Long-Term Follow-Up of a Norwegian Cohort.

BACKGROUND: Potatoes are a staple food in many traditional cuisines, yet their impact on long-term risk of cardiovascular disease (CVD) and mortality is unclear, hampering evidence-based dietary guidelines. OBJECTIVES: This study aimed to examine the association between potato consumption and all-cause and CVD-specific death over a substantial follow-up period within a cohort predominantly consuming boiled potatoes. METHODS: Adults from 3 Norwegian counties were invited to 3 health screenings in 1974-1988 (>80% attendance). Dietary data were collected using semiquantitative food frequency questionnaires at each screening to categorize weekly potato consumption (≤6, 7-13, or ≥14 potatoes/wk) and calculate daily cumulative mean intakes (grams/day). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression to estimate HRs and 95% CIs for the association between potato consumption and risk of death from all causes, CVD, ischemic heart disease (IHD), and acute myocardial infarction (AMI). RESULTS: Among 77,297 participants with a mean baseline age of 41.1 y (range: 18.0-63.9 y), we observed 27,848 deaths, including 9072 deaths due to CVD, over a median follow-up of 33.5 y. Participants who consumed ≥14 potatoes/wk had a lower risk of all-cause death compared with those consuming ≤6 potatoes/wk (HR: 0.88; 95% CI: 0.84, 0.93). Potato consumption was associated with a minor, inverse risk of death due to CVD, IHD, and AMI. In continuous analyses of cumulative intakes, each 100 g/d increment was associated with 4% lower risk of death from all causes (HR: 0.96; 95% CI: 0.94, 0.98), CVD (HR: 0.96; 95% CI: 0.93, 0.99), IHD (HR: 0.96; 95% CI: 0.91, 1.00), and AMI (HR: 0.96, 95% CI: 0.91, 1.01). CONCLUSIONS: In this cohort with a generally high consumption of predominantly boiled potatoes, we find modest, inverse associations between potato consumption and death from all causes, CVD, and IHD.

Evaluation of a digital FFQ using 24 h recalls as reference method, for assessment of habitual diet in women with South Asian origin in Norway.

OBJECTIVE: Dietary assessment tools should be designed for the target population. We developed an FFQ designed to assess diet in South Asian women in Norway. The study objective was to evaluate this FFQ using 24-h dietary recalls as reference method. DESIGN: Approximately 3 weeks after the participants (n 40) had filled in the FFQ, the first of three non-consecutive 24-h dietary recalls was completed. The recalls were telephone-based, unannounced and performed by a trained dietitian, with 2-3 weeks between each interview. SETTING: The DIASA 1 study, in Oslo, Norway. PARTICIPANTS: Women of South Asian ethnic origin participating in the DIASA 1 study were invited to participate in the evaluation study. RESULTS: The WebFFQasia significantly overestimated the absolute intake of energy, protein, fat and carbohydrates compared with the 24-h dietary recalls. Absolute intakes of sugar, starch and fibre did not differ significantly between the methods. For energy percentages (E%), there were no significant differences, except for monounsaturated fat. Correlations were strong for E% from sugar and saturated fat and moderate for E% from fibre, carbohydrate, total fat and protein. Fourteen food groups out of twenty three were not significantly different compared with the reference method, and sixteen groups showed strong to moderate correlations. CONCLUSION: The WebFFQasia may be used to assess E% from habitual diet and can adequately estimate intakes and rank participants according to nutrient intake and main food categories at group level.

Associations and predictive power of dietary patterns on metabolic syndrome and its components.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance. METHODS AND RESULTS: The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables. CONCLUSIONS: The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.

Nutritional assessment of women with celiac disease compared to the general population.

BACKGROUND & AIMS: The nutritional quality of a gluten-free diet is debated because of the elimination of grains that are important sources of nutrients. The aim of this cross-sectional study was to perform a nutritional assessment in treated women with celiac disease and ongoing symptoms, and compare dietary intake with a healthy reference group (Norkost 3). METHODS: Celiac disease patients with biopsy confirmed mucosal healing, but persistent gastrointestinal symptoms, were included from an ongoing clinical trial. Nutritional assessment included anthropometrics, blood samples and dietary intake obtained by two 24 h recalls. Dietary intake in celiac women was compared with dietary intake in healthy women (Norkost 3). Two sample t-test was used for comparison of CeD and Norkost 3 women. Adjustment for age, BMI, education and smoking, by use of multiple linear regression analysis, did not change the results. RESULTS: In total, 59 women with celiac disease and 925 women that participated in Norkost 3 were included, with a mean age of 45 years in both groups. Women with celiac disease had a higher proportion of energy (E%) from fat (39 vs 34%, P < 0.001) and saturated fat (15 vs 13%, P = 0.01), a lower E% from protein (16 vs 18%, P = 0.01) and a lower intake of dietary fiber (19 vs 22 g, P = 0.002) compared to Norkost 3 women. Women with celiac disease had a lower intake of bread, fruit and milk, and a higher intake of cereals and cheese compared to Norkost 3 women. The average requirement was not met for several micronutrients, but blood analysis revealed few nutritional deficiencies: two women with insufficient vitamin D status and one with insufficient folic acid status. CONCLUSION: The women with celiac disease had an unbalanced diet with a higher intake of total- and saturated fatty acids and a lower intake of fiber compared to the general population. These findings emphasizes the need for nutritional follow-up of celiac patients and development of nutrient dense gluten-free products.

Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016.

BACKGROUND: A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population. METHODS: We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged [Formula: see text] years, of which [Formula: see text] completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey's method. RESULTS: The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet. CONCLUSIONS: Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL.

Bilberry/red grape juice decreases plasma biomarkers of inflammation and tissue damage in aged men with subjective memory impairment -a randomized clinical trial.

BACKGROUND: Few randomized clinical trials have explored the health effects of bilberries in humans. The aim was to test the effect of bilberry and red grape-juice consumption on visual memory, motor speed and dexterity as well as inflammatory and tissue damage biomarkers of plasma in aged men with subjective memory impairment. METHODS: Nine-week double-blind, placebo-controlled, dietary intervention study of aged men (n = 60, age ≥ 67 years) with subjective memory impairment randomized to consume a 50/50 mix of bilberry/red grape-juice or an iso-caloric placebo juice. A selection of Cambridge Cognition Test Battery (CANTAB), Grooved Pegboard tests and blood-sampling for biomarker analysis were performed before and after the intervention. RESULTS: Compared to placebo the selected memory and motor test scores were un-affected by the bilberry/red grape intervention. However, the plasma levels of tissue damage biomarkers decreased significantly more in the bilberry/red grape group. In particular lactate dehydrogenase (LDH) decreased from 362 U/L (median, baseline) to 346 U/L (median, post intervention) in the bilberry/red grape group. Also, several biomarkers of inflammation (EGF, IL6, IL9, IL10 and TNFα) decreased significantly more in the bilberry/red grape group. Furthermore, several plasma polyphenols; p-coumaric acid, hippuric acid, protocatechuic acid, 3HPAA and vanillic acid, increased significantly more in the bilberry/red grape group compared to placebo with the largest increase in p-coumaric acid with 116%; from 2.2 [1.0,5.5] to 4.7 [2.8,8.1] µM/L (median [95% CL]). CONCLUSIONS: The results indicate that a nine-week bilberry/red grape juice intervention has no measurable effects on the selected memory scores in aged men experiencing memory problems but decreases the level of biomarkers of inflammation and tissue damage. Whether the dampening effects on inflammation and tissue damage biomarkers have relevance for neuroinflammatory brain pathology remains to be established. TRIAL REGISTRATION: Registration number ( ClinicalTrials.gov : NCT00972972 ), September 9, 2009.

Butyrate Levels in the Transition from an Infant- to an Adult-Like Gut Microbiota Correlate with Bacterial Networks Associated with Eubacterium Rectale and Ruminococcus Gnavus.

Relatively little is known about the ecological forces shaping the gut microbiota composition during infancy. Therefore, the objective of the present study was to identify the nutrient utilization- and short-chain fatty acid (SCFA) production potential of gut microbes in infants during the first year of life. Stool samples were obtained from mothers at 18 weeks of pregnancy and from infants at birth (first stool) at 3, 6, and 12-months of age from the general population-based PreventADALL cohort. We identified the taxonomic and SCFA composition in 100 mother-child pairs. The SCFA production and substrate utilization potential of gut microbes were observed by multiomics (shotgun sequencing and proteomics) on six infants. We found a four-fold increase in relative butyrate levels from 6 to 12 months of infant age. The increase was correlated to Eubacterium rectale and its bacterial network, and Faecalibacterium prausnitzii relative abundance, while low butyrate at 12 months was correlated to Ruminococcus gnavus and its associated network of bacteria. Both E. rectale and F. prausnitzii expressed enzymes needed for butyrate production and enzymes related to dietary fiber degradation, while R. gnavus expressed mucus-, fucose, and human milk oligosaccharides (HMO)-related degradation enzymes. Therefore, we believe that the presence of E. rectale, its network, and F. prausnitzii are key bacteria in the transition from an infant- to an adult-like gut microbiota with respect to butyrate production. Our results indicate that the transition from an infant- to an adult-like gut microbiota with respect to butyrate producing bacteria, occurs between 6 and 12 months of infant age. The bacteria associated with the increased butyrate ratio/levels were E. rectale and F. prausnitzii, which potentially utilize a variety of dietary fibers based on the glycoside hydrolases (GHs) expressed. R. gnavus with a negative association to butyrate potentially utilizes mucin, fucose, and HMO components. This knowledge could have future importance in understanding how microbial metabolites can impact infant health and development.

Iodine Intake in Norwegian Women and Men: The Population-Based Tromsø Study 2015-2016.

Ensuring sufficient iodine intake is a public health priority, but we lack knowledge about the status of iodine in a nationally representative population in Norway. We aimed to assess the current iodine status and intake in a Norwegian adult population. In the population-based Tromsø Study 2015-2016, 493 women and men aged 40-69 years collected 24-h urine samples and 450 participants also completed a food frequency questionnaire (FFQ). The 24-h urinary iodine concentration (UIC) was analyzed using the Sandell-Kolthoff reaction on microplates followed by colorimetric measurement. Iodine intake was estimated from the FFQ using a food and nutrient calculation system at the University of Oslo. The mean urine volume in 24 h was 1.74 L. The median daily iodine intake estimated (UIE) from 24-h UIC was 159 µg/day (133 and 174 µg/day in women and men). The median daily iodine intake estimated from FFQ was 281 µg/day (263 and 318 µg/day in women and men, respectively). Iodine intake estimated from 24-h UIC and FFQ were moderately correlated (Spearman rank correlation coefficient r = 0.39, p < 0.01). The consumption of milk and milk products, fish and fish products, and eggs were positively associated with estimated iodine intake from FFQ. In conclusion, this shows that iodine intake estimated from 24-h UIC describes a mildly iodine deficient female population, while the male population is iodine sufficient. Concurrent use of an extensive FFQ describes both sexes as iodine sufficient. Further studies, applying a dietary assessment method validated for estimating iodine intake and repeated individual urine collections, are required to determine the habitual iodine intake in this population.

Iodine intake among children and adolescents in Norway: Estimates from the national dietary survey Ungkost 3 (2015-2016).

BACKGROUND: Iodine is crucial for normal growth and neurodevelopment. Before 1950, goitre caused by iodine deficiency was widespread in Norway, but decreased significantly after mandatory fortification of animal fodder. Recent dietary changes in milk consumption and fish intake may again have increased the risk of inadequate intakes in some population groups in Norway. The situation for children and adolescents is unclear, and data from nationally representative studies are highly needed. We aimed to describe the iodine intake in Norwegian children and adolescents and estimate the proportion of individuals with an increased risk of suboptimal, adequate and excessive usual iodine intake. In addition, we aimed to investigate whether individuals' characteristics were associated with iodine intake, and to identify the major iodine contributing foods in the diet of this population. METHODS: Data from 1722 individuals (4-, 9- and 13-year-olds) from a national dietary survey in Norway from 2015-2016 was used. Both descriptive and inferential statistics were conducted. Usual iodine intakes were estimated, stratified by age group and sex and compared to dietary reference intake cut-offs. Linear regression models were used to assess the association between iodine intake and participants' characteristics. The contribution of iodine from different foods was described for all and across different participant groups. RESULTS: We estimated that the proportion of participants with an increased risk of a suboptimal usual intake of iodine varied from 3-36%. A significant increased risk was observed for older children and girls compared to younger children and boys. Excessive usual intakes were not observed in any age group. Iodine intake was associated with sex, maternal educational level and area of residence. A lower intake was observed for girls and those with a mother with a low educational level. Moreover, those living in the western part and Mid-Norway had statistically significantly higher intakes compared to those living in the capital city and surroundings. Milk, milk products, cheese, fish and shellfish were the main contributors to iodine intake. Supplements contributed with very little of the total iodine intake. CONCLUSIONS: We have shown that the estimated risk of suboptimal usual iodine intakes among children and adolescents in Norway varies according to age, sex, maternal educational level and area of residence. Those with a limited intake of the main dietary contributors to iodine intake may be at risk, and adolescent girls seem to be especially vulnerable.

Dietary Intake, Body Composition, and Oral Health Parameters among Female Patients with Primary Sjögren's Syndrome.

There is limited knowledge about dietary intake and body composition among patients with primary Sjögren's syndrome. We assessed dietary intakes with 24-h recalls and body composition with anthropometry and bioelectrical impedance in 20 female patients. Various scoring tools were used to assess oral health. The patients had a lower energy percentage (E%) from carbohydrates (p = 0.02) and a higher E% from fat (p = 0.01) compared to a reference group. The lower intake of carbohydrates was due to a lower bread intake (p = 0.04), while the higher intake of fat was due to a higher intake of butter, margarine, and oil (p = 0.01). The patients ate more than twice (p = 0.02) as much fish as the reference group. The compliance to recommended intakes of macro- and micronutrients was good. Forty-percent of the patients were overweight/obese. Increased intake of beverages was observed in patients with severe xerostomia and/or low oral health-related quality of life, whereas reduced fat intake was found in hyposmic patients. In conclusion, the dietary intake among the patients was not much different from the reference group and complied with recommendations. Most oral health parameters were not associated with nutrient intakes. Specific dietary guidelines are probably not needed to ensure adequate nutrition among such patients.

New Iodine Food Composition Database and Updated Calculations of Iodine Intake among Norwegians.

Iodine food composition data of Norwegian foods have been sparse and knowledge about different dietary iodine sources limited. We compiled a comprehensive iodine food composition database and estimated dietary iodine intake among adults in the latest Norwegian national dietary survey (Norkost 3). The iodine content of food and beverages were compiled using international guidelines and standards. Iodine content of 3259 food items were compiled, including analytical values, values from other food composition databases, estimated values, and values that were based on recipes. Estimated iodine intake in the Norkost 3 population ranged from 15 to 1462 µg/day. Men had significantly higher intake of iodine than women (p < 0.001). The proportion of men and women with estimated iodine intake below average requirement was 19% and 33%, respectively. In young women, 46% had estimated iodine intakes below average requirement and a high probability of inadequate iodine intake. Several dietary sources contributed to iodine intake and differences in the consumption pattern may put subgroups at risk of insufficient iodine intake. In the coming years, the determination of iodine in foods and national dietary surveys should be regularly performed to monitor the iodine intake in the Norwegian population.

Evaluation of a short Food Frequency Questionnaire to assess cardiovascular disease-related diet and lifestyle factors.

BACKGROUND: The Vascular lifestyle-Intervention and Screening in phArmacies (VISA) study investigates diet and lifestyle factors associated with risk of cardiovascular disease (CVD). As part of the study methodology, a short Food Frequency Questionnaire (FFQ), the VISA-FFQ, was adapted from the Norwegian NORDIET-FFQ. OBJECTIVE: The aim of this study was to evaluate the VISA-FFQ and its ability to estimate intakes of foods and lifestyle factors in screening for elevated risk of CVD. The evaluation included assessment of relative validity of intake of milk fat and assessment of reproducibility of several foods and lifestyle factors. DESIGN: Relative validity of milk fat estimated from the VISA-FFQ was assessed in 307 participants by comparing estimated dietary intake of the fatty acids pentadecanoic acid (15:0) and heptadecanoic acid (17:0), from milk fat with whole blood biomarkers 15:0 and 17:0. Reproducibility was evaluated in 122 participants by comparing consistency in intakes of different foods and lifestyle factors reported by the VISA-FFQ and administered twice with a 4-week interval. RESULTS: Dietary 15:0 milk fat estimated from the VISA-FFQ correlated positively with whole blood 15:0 (r = 0.32, P < 0.05). Men presented higher correlations than women did. Acceptable and consistent reproducibility (r = 0.44-0.94 and no large difference between test and retest) was observed for most beverages, milk products, spreads on bread and meat (all of which included food items categorised into at least two fat categories) and also for eggs, fruits and vegetables, nuts, pasta and rice, dessert/sweets, smoking and physical activity. Reproducibility did not consistently meet a satisfactory standard (r ≤ 0.41 or large difference between test and retest) for unsweetened cereals, fatty fish, cakes, oils, white-, bread, crispbread and rice. CONCLUSION: The validity of the VISA-FFQ was acceptable for intake of milk fat, and there was an overall satisfactory, though variable, reproducibility for intake of several foods and lifestyle factors in the VISA-FFQ.

The validity of a web-based FFQ assessed by doubly labelled water and multiple 24-h recalls.

The aim of this study was to validate the estimated habitual dietary intake from a newly developed web-based FFQ (WebFFQ), for use in an adult population in Norway. In total, ninety-two individuals were recruited. Total energy expenditure (TEE) measured by doubly labelled water was used as the reference method for energy intake (EI) in a subsample of twenty-nine women, and multiple 24-h recalls (24HR) were used as the reference method for the relative validation of macronutrients and food groups in the entire sample. Absolute differences, ratios, crude and deattenuated correlations, cross-classifications, Bland-Altman plot and plots between misreporting of EI (EI-TEE) and the relative misreporting of food groups (WebFFQ-24HR) were used to assess the validity. Results showed that EI on group level was not significantly different from TEE measured by doubly labelled water (0·7 MJ/d), but ranking abilities were poor (r -0·18). The relative validation showed an overestimation for the majority of the variables using absolute intakes, especially for the food groups 'vegetables' and 'fish and shellfish', but an improved agreement between the test and reference tool was observed for energy adjusted intakes. Deattenuated correlation coefficients were between 0·22 and 0·89, and low levels of grossly misclassified individuals (0-3 %) were observed for the majority of the energy adjusted variables for macronutrients and food groups. In conclusion, energy estimates from the WebFFQ should be used with caution, but the estimated absolute intakes on group level and ranking abilities seem acceptable for macronutrients and most food groups.

Tomato-based randomized controlled trial in prostate cancer patients: Effect on PSA.

BACKGROUND & AIMS: The effect of lycopene-containing foods in prostate cancer development remains undetermined. We tested whether a lycopene-rich tomato intervention could reduce the levels of prostate specific antigen (PSA) in prostate cancer patients. METHODS: Prior to their curative treatment, 79 patients with prostate cancer were randomized to a nutritional intervention with either 1) tomato products containing 30 mg lycopene per day; 2) tomato products plus selenium, omega-3 fatty acids, soy isoflavones, grape/pomegranate juice, and green/black tea (tomato-plus); or 3) control diet for 3 weeks. RESULTS: The main analysis, which included patients in all risk categories, did not reveal differences in changes of PSA-values between the intervention and control groups. Post-hoc, exploratory analyses within intermediate risk (n = 41) patients based on tumor classification and Gleason score post-surgery, revealed that median PSA decreased significantly in the tomato group as compared to controls (-2.9% and +6.5% respectively, p = 0.016). In separate post-hoc analyses, we observed that median PSA-values decreased by 1% in patients with the highest increases in plasma lycopene, selenium and C20:5 n-3 fatty acid, compared to an 8.5% increase in the patients with the lowest increase in lycopene, selenium and C20:5 n-3 fatty acid (p = 0.003). Also, PSA decreased in patients with the highest increase in lycopene alone (p = 0.009). CONCLUSIONS: Three week nutritional interventions with tomato-products alone or in combination with selenium and n-3 fatty acids lower PSA in patients with non-metastatic prostate cancer. Our observation suggests that the effect may depend on both aggressiveness of the disease and the blood levels of lycopene, selenium and omega-3 fatty acids.

Concentrations of phthalates and bisphenol A in Norwegian foods and beverages and estimated dietary exposure in adults.

Phthalates and bisphenol A (BPA) are ubiquitous in our environment. These chemicals have been characterized as endocrine disruptors that can cause functional impairment of development and reproduction. Processed and packaged foods are among the major sources of human exposure to these chemicals. No previous report showing the levels of these chemicals in food items purchased in Norway is available. The aim of the present study was to determine the concentration of ten different phthalates and BPA in foods and beverages purchased on the Norwegian market and estimate the daily dietary exposure in the Norwegian adult population. Commonly consumed foods and beverages in Norway were purchased in a grocery store and analysed using gas- and liquid chromatography coupled with mass spectrometry. Daily dietary exposures to these chemicals in the Norwegian adult population were estimated using the latest National dietary survey, Norkost 3 (2010-2011). This study showed that phthalates and BPA are found in all foods and beverages that are common to consume in Norway. The detection frequency of phthalates in the food items varied from 11% for dicyclohexyl phthalate (DCHP) to 84% for di-iso-nonyl phthalate (DiNP), one of the substitutes for bis(2-ethylhexyl) phthalate (DEHP). BPA was found in 54% of the food items analysed. Among the different phthalates, the highest concentrations were found for DEHP and DiNP in the food items. Estimated dietary exposures were also equally high and dominated by DEHP and DiNP (400-500 ng/kg body weight (bw)/day), followed by di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di-n-octyl phthalate (DnOP) and di-iso-decyl phthalate (DiDP) (30-40 ng/kg bw/day). Dimethyl phthalate (DMP), diethylphthalate (DEP) and DCHP had the lowest concentrations and the exposures were around 10-20 ng/kg bw/day. Estimated dietary exposure to BPA was 5 ng/kg bw/day. In general, levels of phthalates and BPA in foods and beverages from the Norwegian market are comparable to other countries worldwide. Grain and meat products were the major contributors of exposure to these chemicals in the Norwegian adult population. The estimated dietary exposures to these chemicals were considerably lower than their respective tolerable daily intake (TDI) values established by the European Food Safety Authority (EFSA).

Both genetic and dietary factors underlie individual differences in DNA damage levels and DNA repair capacity.

The interplay between dietary habits and individual genetic make-up is assumed to influence risk of cancer, via modulation of DNA integrity. Our aim was to characterize internal and external factors that underlie inter-individual variability in DNA damage and repair and to identify dietary habits beneficial for maintaining DNA integrity. Habitual diet was estimated in 340 healthy individuals using a food frequency questionnaire and biomarkers of antioxidant status were quantified in fasting blood samples. Markers of DNA integrity were represented by DNA strand breaks, oxidized purines, oxidized pyrimidines and a sum of all three as total DNA damage. DNA repair was characterized by genetic variants and functional activities of base and nucleotide excision repair pathways. Sex, fruit-based food consumption and XPG genotype were factors significantly associated with the level of DNA damage. DNA damage was higher in women (p=0.035). Fruit consumption was negatively associated with the number of all measured DNA lesions, and this effect was mediated mostly by ß-cryptoxanthin and ß-tocopherol (p<0.05). XPG 1104His homozygotes appeared more vulnerable to DNA damage accumulation (p=0.001). Sex and individual antioxidants were also associated with DNA repair capacity; both the base and nucleotide excision repairs were lower in women and the latter increased with higher plasma levels of ascorbic acid and α-carotene (p<0.05). We have determined genetic and dietary factors that modulate DNA integrity. We propose that the positive health effect of fruit intake is partially mediated via DNA damage suppression and a simultaneous increase in DNA repair capacity.

Intake of trans fatty acids from partially hydrogenated vegetable and fish oils and ruminant fat in relation to cancer risk.

Intake of trans fatty acids (TFA) may influence systemic inflammation, insulin resistance and adiposity, but whether TFA intake influences cancer risk is insufficiently studied. We examined the association between TFA intake from partially hydrogenated vegetable oils (PHVO-TFA), partially hydrogenated fish oils (PHFO-TFA), and ruminant fat (rTFA) and cancer risk in the Norwegian counties study, a large cohort study with a participation rate >80%. TFA intake was assessed three times in 1974-1988 by questionnaire. A total of 77,568 men and women were followed up through 2007, during which time 12,004 cancer cases occurred. Hazard ratios (HRs) and confidence intervals (CIs) were estimated with Cox regression for cancer sites with ≥150 cases during follow-up. Significantly increased or decreased risks were found when comparing the highest and lowest intake categories (HRs, 95% CIs) for PHVO-TFA and pancreatic cancer in men (0.52, 0.31-0.87) and non-Hodgkin lymphoma (NHL) in both genders (0.70, 0.50-0.98); PHFO-TFA and rectal cancer (1.43, 1.09-1.88), prostate cancer (0.82, 0.69-0.96), and multiple myeloma (2.02, 1.24-3.28); and rTFA and all cancers (1.09, 1.02-1.16), cancer of the mouth/pharynx (1.59, 1.08-2.35), NHL (1.47, 1.06-2.04) and multiple myeloma (0.45, 0.24-0.84). Furthermore, positive trends were found for PHFO-TFA and stomach cancer (p(trend) = 0.01) and rTFA and postmenopausal breast cancer (p(trend) = 0.03). Inverse trends were found for PHVO-TFA and all cancers (p(trend) = 0.006) and cancer of the central nervous system in women (p(trend) = 0.005). PHFO-TFA, but not PHVO-TFA, seemed to increase cancer risk. The increased risks observed for rTFA may be linked to saturated fat.

Intakes of culinary herbs and spices from a food frequency questionnaire evaluated against 28-days estimated records.

BACKGROUND: Worldwide, herbs and spices are much used food flavourings. However, little data exist regarding actual dietary intake of culinary herbs and spices. We developed a food frequency questionnaire (FFQ) for the assessment of habitual diet the preceding year, with focus on phytochemical rich food, including herbs and spices. The aim of the present study was to evaluate the intakes of herbs and spices from the FFQ with estimates of intake from another dietary assessment method. Thus we compared the intake estimates from the FFQ with 28 days of estimated records of herb and spice consumption as a reference method. METHODS: The evaluation study was conducted among 146 free living adults, who filled in the FFQ and 2-4 weeks later carried out 28 days recording of herb and spice consumption. The FFQ included a section with questions about 27 individual culinary herbs and spices, while the records were open ended records for recording of herbs and spice consumption exclusively. RESULTS: Our study showed that the FFQ obtained slightly higher estimates of total intake of herbs and spices than the total intake assessed by the Herbs and Spice Records (HSR). The correlation between the two assessment methods with regard to total intake was good (r = 0.5), and the cross-classification suggests that the FFQ may be used to classify subjects according to total herb and spice intake. For the 8 most frequently consumed individual herbs and spices, the FFQ obtained good estimates of median frequency of intake for 2 herbs/spices, while good estimates of portion sizes were obtained for 4 out of 8 herbs/spices. CONCLUSIONS: Our results suggested that the FFQ was able to give good estimates of frequency of intake and portion sizes on group level for several of the most frequently used herbs and spices. The FFQ was only able to fairly rank subjects according to frequency of intake of the 8 most frequently consumed herbs and spices. Other studies are warranted to further explore the intakes of culinary spices and herbs.

Relative validity of fruit and vegetable intake estimated from an FFQ, using carotenoid and flavonoid biomarkers and the method of triads.

The aim of the present study was to validate the intakes of fruit, juice and vegetables from an FFQ. In sub-study I (n 147), intakes from the FFQ were evaluated against 7 d weighed food records (WR) and plasma carotenoid concentrations, whereas in sub-study II (n 85), the intakes were evaluated against plasma carotenoid concentrations and amounts of flavonoids in 24 h urine samples. Relative validity was evaluated by comparing median intakes, estimating correlation coefficients and validity coefficients using the method of triads. In sub-study I, we observed no significant difference in daily median fruit intake between the FFQ and the WR, whereas the intake of vegetables was higher from the FFQ than from the WR. The correlations between intakes from the FFQ and the WR ranged from 0·31 to 0·58. In sub-study II, the intakes of fruit and vegetables correlated significantly with plasma carotenoid concentrations and urinary flavonoids. The validity coefficients for the intakes of fruit and vegetables from the FFQ ranged from 0·61 to 0·88 in sub-study I and from 0·60 to 0·94 in sub-study II. In summary, based on the associations observed between intakes from the FFQ and the biomarkers and the FFQ validity coefficients, the FFQ was found valid and suitable for ranking individuals according to their usual intake of fruit, juice and vegetables.