Estimating Usual Intake in the 2nd Bavarian Food Consumption Survey: Comparison of the Results Derived by the National Cancer Institute Method and a Basic Individual Means Approach.

BACKGROUND: The valid estimation of the usual dietary intake remains a challenge till date. We applied the method suggested by the National Cancer Institute (NCI) to data from the 2nd Bavarian Food Consumption Survey (BVS II) and compared it to an individual means approach. METHODS: Within the cross-sectional BVS II, 1,050 Bavarian residents aged 13-80 years participated in a personal interview and completed three 24-h dietary recalls by telephone interview. For the 13 main food groups and 23 subgroups the usual intake was calculated by (1) an individual means approach and (2) by the NCI method. RESULTS: The distributions derived by the individual means approach are wider than those derived from the NCI approach. For a majority of food groups and subgroups, the proportion of participants who meet the dietary recommendations published by the German Nutrition Society is higher when the NCI approach is applied. The proportions of participants above or below recommended amounts differ greatly for "meat and meat products" and "cheese." CONCLUSION: The mean intake at the groups level can easily be derived from the individual means approach. Since only the NCI method accounts for intra-personal variation, this method provides more valid intake estimates at the individual level and should be applied when, for example, individual intakes are compared with dietary recommendations.

Plasma levels of tumor necrosis factor alpha and soluble tumor necrosis factor receptors in patients with narcolepsy.

BACKGROUND: Narcolepsy is a disabling sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. Recent studies suggest that the immune system might play a pathogenic role pointing to a possible involvement of inflammatory cytokines. METHODS: We investigated a sample of 30 patients with narcolepsy in comparison with 120 sex- and age-matched and 101 sex-, body mass index (BMI)-, and age-matched randomly selected normal controls. In these groups, plasma concentrations of tumor necrosis factor alpha (TNF-alpha) and its soluble receptors p55 and p75 (soluble TNF receptor [sTNF-R] p55 and sTNF-R p75) were measured using commercial enzyme-linked immunosorbent assays. RESULTS: The narcoleptic patients showed a significantly higher BMI compared with controls of the same age. Soluble TNF-R p75 levels were consistently elevated in the narcoleptic patients compared with their sex- and age-matched (P = .001) as well as sex-, BMI-, and age-matched counterparts (P = .003). Female narcoleptic patients exhibited higher sTNF-R p55 levels compared with their sex- and age-matched controls (P = .01), but this difference disappeared when comparing patients with sex-, BMI-, and age-matched normal controls. Tumor necrosis factor alpha levels did not differ significantly between groups. CONCLUSION: Narcoleptic patients show increased plasma levels of sTNF-R p75, suggesting a functional alteration of the TNF-alpha cytokine system, further corroborating a possible pathogenic role of the immune system in this sleep disorder.

TNF-alpha, soluble TNF receptor and interleukin-6 plasma levels in the general population.

The cytokines tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptors p55 and p75, and interleukin 6 (IL-6) are involved in host defense against several microbiological agents, in the process of inflammation and also in body weight regulation. In the present study, we sought to assess the influence of age, gender, smoking, and body mass index on plasma levels of TNF-alpha, TNF receptors, and IL-6 in more than 550 adult subjects randomly selected from the Bavarian population. None of the cytokine parameters had a normal distribution and all distributions were significantly skewed. The cytokine plasma levels investigated increased significantly with age, while gender had a relatively weaker influence on the plasma levels. Plasma levels of TNF-alpha, TNF receptors, and IL-6 correlated significantly with the BMI. The study provides insights into factors influencing the cytokine levels investigated in a randomly chosen study sample.

Estimated physical activity in Bavaria, Germany, and its implications for obesity risk: results from the BVS-II Study.

BACKGROUND: Adequate physical activity (PA) is considered as a key factor in the fight against the obesity epidemic. Therefore, detailed description of the actual PA and its components in the population is necessary. Additionally, this study aims to investigate the association between PA and obesity risk in a representative population sample in Bavaria, Germany. METHODS: Data from 893 participants (age 13-80 years) of the Bavarian Food Consumption Survey II (BVS II) were used. In each participant, three computer-based 24-hour recalls were conducted by telephone assessing type and duration of PA in the domains occupation, sports, other strenuous leisure time activities (of mostly moderate intensity) as well as TV/PC use in leisure time and duration of sleeping. After assigning metabolic equivalents (METs) to each activity, estimates of energy expenditure (MET*h) and total daily PA level (PALest.) were calculated. In a subgroup of adults (n = 568) with anthropometric measurements logistic regression models were used to quantify the impact of PA on obesity risk. RESULTS: Estimated average PA in women and men was 38.5 +/- 5.0 and 40.6 +/- 9.3 MET*h/d, respectively, corresponding to PALest. values of 1.66 +/- 0.22 and 1.75 +/- 0.40. Obese subjects showed lower energy expenditure in the categories sports, occupation, and sleeping, while the time spent with TV/PC during leisure time was highest. This is confirmed in logistic regression analyses revealing a statistically significant association between obesity and TV/PC use during leisure time, while sports activity was inversely related to obesity risk. Overall, less than 1/3 of the study participants reached the recommended PAL of >or= 1.75. Subjects within the recommended range of PA had an about 60 % (odds ratio = 0.43; 95% CI: 0.21-0.85) reduced risk of obesity as compared to inactive subjects with a PALest. <1.5. CONCLUSION: Based on the results of short-term PA patterns, a major part of the Bavarian adult population does not reach the recommendations (PAL>1.75; moderate PA of > 30 min/d). Despite the limitations of the study design, the existing associations between sports activity, TV/PC use and obesity risk in this population give further support to the recommendation of increasing sports activity and reducing sedentary behaviour in order to prevent rising rates of obesity.

Leptin plasma levels in the general population: influence of age, gender, body weight and medical history.

The polypeptide leptin exerts a multitude of regulatory functions. It has been implicated in the pathophysiology of inflammatory, metabolic and psychiatric disorders and has been found to be differentially expressed in men and women. Although a clear increase of leptin levels with age has been repeatedly observed in men, the association of leptin levels and age in women is an issue of scientific discussion. To investigate the association of age, gender, body mass index (BMI) and selected diseases with plasma levels of leptin in 551 adults randomly chosen from the Bavarian population, we assessed subjects' characteristics, lifestyle, and medical history including life time history of frequent diseases and performed blood sampling and standardized anthropometric measurements. Leptin plasma levels were measured using a Radioimmunoassay. Leptin levels were significantly higher in women as compared to men and this difference persisted even after controlling for differences in age or BMI. Leptin levels increased across the age groups in both men and women. Controlling for differences in BMI substantially attenuated the influence of age on leptin levels. In women, age was no longer significantly associated with leptin levels after controlling for BMI. With regard to medical history, hyperuricemia and gout were significantly associated with higher leptin levels, even after controlling for BMI, whereas subjects with high blood pressure or dyslipoproteinemia showed higher leptin levels only if the BMI was not considered as control variable. The BMI and its influence on the interrelations of gender, age and leptin should be considered when interpreting leptin levels.