Time from hospital admission to CT brain in acute ischaemic stroke.

A retrospective study of all acute ischaemic stroke patients admitted to Midland Regional Hospital Mullingar (MRHM) between January 2004 and September 2009 was undertaken in order to assess the median time from hospital admission to CT brain scan (n = 496). The median time to CT scan ranged from 19-24 hours between 2004-7. In 2008, coinciding with setting up a new Acute Stroke Service (ACSS), the median time to CT scan dropped to 15 hours (n = 130, p =0.03) and decreased further to 3 hours in 2009 (n = 125, p = 0.003). The proportion scanned within 1 hour of admission increased from 7 patients (4.6%) over 2004-7, to 28 patients (21.5%) in 2008 (p = 0) and 44 patients (35%) in 2009 (p = 0.018). This clinically and statistically significant reduction occurred following reorganisation of existing resources on a budget neutral basis at MRHM and was facilitated by the enthusiastic support of a range of disciplines bridging the community and acute hospital interface. Measurement of admission to CT brain scan time is one of several audit parameters which can assess hospitals responsiveness to acute stroke.

Urinary phytoestrogen excretion and prostate cancer risk: a nested case-control study in the Multiethnic Cohort.

BACKGROUND: Phytoestrogens are of special interest in prostate cancer research because populations in Asia with a high consumption of phytoestrogens have a lower incidence of the disease than comparable populations in Western countries. METHODS: This case-control study is nested within a large multiethnic cohort in Hawaii and California. Urine samples were analysed for daidzein, genistein, equol, and enterolactone among 249 incident prostate cancer cases and 404 controls matched on age, race/ethnicity, date/time of specimen collection, and fasting status. RESULTS: The median excretion of daidzein was 0.173 nmol mg(-1) creatinine in cases and 0.291 in controls (P=0.01), and the median excretion of genistein was 0.048 in cases and 0.078 in controls (P=0.05). An inverse association was seen for daidzein overall (odds ratio for the highest vs lowest quintile=0.55, 95% confidence interval=0.31-0.98, P(trend)=0.03) and seemed to apply to localized (P(trend)=0.08) as well as advanced or high-grade cancer (P(trend)=0.09). This association was consistent across the four ethnic groups examined. Although the relationship was weaker for genistein, the odds ratios and trends were similarly inverse. Urinary excretion of equol and enterolactone was not significantly related to prostate cancer risk. CONCLUSION: Our findings suggest that high intake of isoflavones, as reflected by urinary excretion of daidzein and genistein, may be protective against prostate cancer.

Cannabinoid activation of PPAR alpha; a novel neuroprotective mechanism.

BACKGROUND AND PURPOSE: Although CB(1) receptor activation evokes neuroprotection in response to cannabinoids, some cannabinoids have been reported to be peroxisome proliferator activated receptor (PPAR) ligands, offering an alternative protective mechanism. We have, therefore, investigated the ability of a range of cannabinoids to activate PPAR alpha and for N-oleoylethanolamine (OEA), an endogenous cannabinoid-like compound (ECL), to evoke neuroprotection. EXPERIMENTAL APPROACH: Assays of PPAR alpha occupancy and gene transactivation potential were conducted in cell-free and transfected HeLa cell preparations, respectively. In vivo estimates of PPAR alpha activation through fat mobilization and gene transcription were conducted in mice. Neuroprotection in vivo was investigated in wild-type and PPAR alpha gene-disrupted mice. KEY RESULTS: The ECLs OEA, anandamide, noladin ether and virodhamine were found to bind to the purified PPAR alpha ligand binding domain and to increase PPAR alpha-driven transcriptional activity. The high affinity synthetic CB(1/2) cannabinoid agonist WIN 55212-2 bound to PPAR alpha equipotently with the PPARalpha agonist fenofibrate, and stimulated PPARalpha-mediated gene transcription. The phytocannabinoid delta 9 tetrahydrocannabinol was without effect. OEA and WIN 55212-2 induced lipolysis in vivo, while OEA pre-treatment reduced infarct volume from middle cerebral artery occlusion in wild-type, but not in PPAR alpha-null mice. OEA treatment also led to increased expression of the NFkappa B-inhibitory protein, Ikappa B, in mouse cerebral cortex, while expression of the NFkappa B-regulated protein COX-2 was inhibited. CONCLUSIONS AND IMPLICATIONS: These data demonstrate the potential for a range of cannabinoid compounds, of diverse structures, to activate PPAR alpha and suggest that at least some of the neuroprotective properties of these agents could be mediated by nuclear receptor activation.

Activation of heat shock gene transcription by heat shock factor 1 involves oligomerization, acquisition of DNA-binding activity, and nuclear localization and can occur in the absence of stress.

The existence of multiple heat shock factor (HSF) genes in higher eukaryotes has promoted questions regarding the functions of these HSF family members, especially with respect to the stress response. To address these questions, we have used polyclonal antisera raised against mouse HSF1 and HSF2 to examine the biochemical, physical, and functional properties of these two factors in unstressed and heat-shocked mouse and human cells. We have identified HSF1 as the mediator of stress-induced heat shock gene transcription. HSF1 displays stress-induced DNA-binding activity, oligomerization, and nuclear localization, while HSF2 does not. Also, HSF1 undergoes phosphorylation in cells exposed to heat or cadmium sulfate but not in cells treated with the amino acid analog L-azetidine-2-carboxylic acid, indicating that phosphorylation of HSF1 is not essential for its activation. Interestingly, HSF1 and HSF2 overexpressed in transfected 3T3 cells both display constitutive DNA-binding activity, oligomerization, and transcriptional activity. These results demonstrate that HSF1 can be activated in the absence of physiological stress and also provide support for a model of regulation of HSF1 and HSF2 activity by a titratable negative regulatory factor.

Characterization of constitutive HSF2 DNA-binding activity in mouse embryonal carcinoma cells.

Two distinct murine heat shock transcription factors, HSF1 and HSF2, have been identified. HSF1 mediates the transcriptional activation of heat shock genes in response to environmental stress, while the function of HSF2 is not understood. Both factors can bind to heat shock elements (HSEs) but are maintained in a non-DNA-binding state under normal growth conditions. Mouse embryonal carcinoma (EC) cells are the only mammalian cells known to exhibit HSE-binding activity, as determined by gel shift assays, even when maintained at normal physiological temperatures. We demonstrate here that the constitutive HSE-binding activity present in F9 and PCC4.aza.R1 EC cells, as well as a similar activity found to be present in mouse embryonic stem cells, is composed predominantly of HSF2. HSF2 in F9 EC cells is trimerized and is present at higher levels than in a variety of nonembryonal cell lines, suggesting a correlation of these properties with constitutive HSE-binding activity. Surprisingly, transcription run-on assays suggest that HSF2 in unstressed EC cells does not stimulate transcription of two putative target genes, hsp70 and hsp86. Genomic footprinting analysis indicates that HSF2 is not bound in vivo to the HSE of the hsp70 promoter in unstressed F9 EC cells, although HSF2 is present in the nucleus and the promoter is accessible to other transcription factors and to HSF1 following heat shock. Thus trimerization and nuclear localization of HSF2 do not appear to be sufficient for in vivo binding of HSF2 to the HSE of the hsp70 promoter in unstressed F9 EC cells.

Intake of flavonoids and lung cancer.

BACKGROUND: To investigate the possible relationship between intake of flavonoids-powerful dietary antioxidants that may also inhibit P450 enzymes-and lung cancer risk, we conducted a population-based, case-control study in Hawaii. METHODS: An in-person interview assessed smoking history and usual intake of 242 food items for 582 patients with incident lung cancer and 582 age-, sex-, and ethnicity-matched control subjects. Subjects who donated a blood sample were genotyped for the P450 enzyme variant allele CYP1A1*2 by use of a polymerase chain reaction-based method. Logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). All P values are two-sided. RESULTS: After adjusting for smoking and intakes of saturated fat and beta-carotene, we found statistically significant inverse associations between lung cancer risk and the main food sources of the flavonoids quercetin (onions and apples) and naringin (white grapefruit). The lung cancer OR for the highest compared with the lowest quartile of intake was 0.5 (95% CI = 0.3-0.9) for onions (P for trend =.001) and 0.6 (95% CI = 0.4-1.0) for apples (P for trend =.03). The OR for the highest compared with the lowest tertile of intake for white grapefruit was 0.5 (95% CI = 0.2-0.9) (P for trend =.02). No association was found for important food sources of other flavonoids. Using published food-composition data for flavonoids, we found an inverse association between intake of quercetin and risk of lung cancer (P for trend =.07) that appears consistent with associations for its food sources. The effect of onions was particularly strong against squamous cell carcinoma (a cell type specifically associated with CYP1A1*2 in our study) and was modified by the CYP1A1 genotype, suggesting that CYP1A1 may play a role in this association. CONCLUSION: If replicated, particularly in prospective studies, these findings would suggest that foods rich in certain flavonoids may protect against certain forms of lung cancer and that decreased bioactivation of carcinogens by inhibition of CYP1A1 should be explored as underlying mechanisms.

Whole mount immunofluorescence analysis of placentas from normotensive versus preeclamptic pregnancies.

INTRODUCTION: Defects in placental angiogenesis and spiral artery remodeling have been proposed to play essential roles in the development of preeclampsia. However, the specific molecular mechanism(s) responsible for aberrant placental angiogenesis in preeclampsia are incompletely understood. The vascular endothelial growth factor receptors (VEGFR1, R2, R3) and STAT3 have critical functions in normal blood vessel development, but their potential roles in preeclampsia are currently unclear. In this study, we utilized a novel whole mount immunofluorescence (WMIF) method to compare expression of VEGFR1, R2, R3 and activated, phosphorylated STAT3 (pSTAT3) in placentas of preeclamptic (PE) versus normotensive (NT) pregnancies. METHODS: Placental biopsies collected from NT and PE pregnant women were fixed and stained with fluorochrome-conjugated antibodies to identify specific cell populations as follows: CD31 for blood vessel endothelial cells, cytokeratin-7 for trophoblast cells, and CD45 for immune cells. Expression of the VEGFRs and pSTAT3 were subsequently characterized by WMIF in conjunction with confocal microscopy. RESULTS: A total of 18 PE and 18 NT placentas were evaluated. No significant differences in the cell type-specific expression patterns or expression levels of VEGFR1, VEGFR2 or VEGFR3 were detected between NT and PE placentas. In contrast, statistically significant increases in pSTAT3 staining were detected in endothelial cells of PE placentas versus NT controls. DISCUSSION: Our study demonstrates that increased pSTAT3 expression in placental endothelial cells is associated with PE. We speculate that elevated pSTAT3 expression in the blood vessels of PE placentas may be due to aberrant angiogenesis, increased pro-inflammatory cytokine expression, and/or placental stress.

Small subclass of rat olfactory neurons with specific bulbar projections is reactive with monoclonal antibodies to the HSP70 heat shock protein.

As part of a study of turnover of rat olfactory receptor neurons we have been examining immunohistochemical expression of members of the 70 kD heat shock protein (HSP70) family in the olfactory epithelium. Expression of HSP70 family members is up-regulated in many cells following exposure to physiologically stressing conditions. Because dying neurons are likely to undergo some sort of physiological stress before the onset of frank degeneration, we hoped that anti-HSP70 monoclonal antibodies would prove to be useful markers for early stages of olfactory neuron cell death. Two anti-human HSP70 monoclonal antibodies were used, Mabs 2A4 and 3a3. Two-dimensional gel electrophoresis/western blot analysis indicates that these Mabs are reactive with the HSC70 and HSP70 members of the rat HSP70 family. Immunohistological observations show that both Mabs are strongly reactive with a widely dispersed subpopulation of olfactory receptor neurons. Morphological, immunohistological, and autoradiographic birthdating analyses demonstrate that reactive cells are fully mature receptor neurons. Their reactivity, however, does not appear to be stress-related. More significantly, axons of reactive neurons show intense anti-2A4 reactivity. This has allowed us to trace these axons to their target glomeruli in the olfactory bulb, demonstrating that the reactive neurons project to just one to two glomeruli on either side of each bulb via consistent and predictable pathways. This is the first subpopulation of olfactory receptor neurons to be traced to such a small number of glomeruli. Given this extremely small number, it seems likely that the reactive receptor cell subpopulation serves some specific olfactory function. In addition, axonal 2A4 reactivity should also prove useful in defining the relative roles of receptor neurons and glomeruli in the establishment of epithelial-glomerular connections.

Vitamin E intakes and sources in the United States.

Twenty-four-hour-recall data from 11,658 adults interviewed in the Second National Health and Nutrition Examination Survey (NHANES II) were used to estimate intakes of vitamin E and polyunsaturated fatty acids (PUFAs) in the United States. Although mean intakes of vitamin E were close to the recommended dietary allowance for both men and women (9.6 and 7.0 mg/d, respectively), median intakes were considerably lower (7.3 and 5.4 mg/d). If a ratio of vitamin E to PUFAs of greater than or equal to 0.4 is considered desirable, 23% of men and 15% of women had diets with low ratios. Ratios tended to decrease as PUFAs in the diet increased. The fruits-and-vegetables group and the fats-and-oils group each provided 20% of the vitamin E in the US diet. Increasing food choices from the fruits-and-vegetables group would provide low-fat sources of vitamin E for individuals whose intakes are likely to be inadequate.

Estimated vitamin intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Vitamin intakes of 255 toddlers (aged 18-30 mo) were estimated from food consumption recorded during 1 y at sites in Egypt, Kenya, and Mexico. Mean intakes were compared with requirements standards by using a probability approach to estimate the prevalence of inadequate intakes. There were predicted inadequacies for vitamin A (32%) and riboflavin (20%) in Egypt, vitamins A (68%) and C (63%) and riboflavin (52%) in Mexico, and vitamin B-12 (44%) in Kenya. Vitamin E was inadequate in all diets, but in relation to polyunsaturated fatty acids only the intake in Mexico was low. No diet provided the recommended amount of vitamin D, but its dietary requirement is uncertain. Correlations among nutrient intakes suggest factors that may contribute to reported associations of consumption of animal products with improved growth or development among these children: provision of vitamin B-12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density.

PIP: Data on 255 children, 18-30 months old, in Kalama village on the Nile delta in Egypt, the Embu district in Kenya, and the Solis Valley in Mexico were analyzed over a 1-year period to study the relationships of energy and animal protein intakes with vitamins, minerals, and two factors that affect bioavailability, dietary fiber and phytate. The researchers used the probability approach to determine the prevalence of inadequate intakes. Estimated intake inadequacies were 32% for vitamin A and 20% for riboflavin in Egypt; 68% for vitamin A, 63% for vitamin C, and 52% for riboflavin in Mexico, and 44% for vitamin B12 in Kenya. All the diets were deficient in vitamin E. Yet, when researchers compared vitamin E in relation to polyunsaturated fatty acids, the vitamin E intake was low only in Mexico. None of the diets had the recommended amount of vitamin D, but actual dietary requirements were unknown. Further, the researchers had no information on solar exposure. Provision of vitamin B12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density were associated with improved growth or development among children ingesting animal products (p 0.05). Intakes of folacin, niacin, and thiamin were negatively related to animal protein intake (p 0.05).

Estimated protein intakes of toddlers: predicted prevalence of inadequate intakes in village populations in Egypt, Kenya, and Mexico.

This paper presents a probability assessment of the adequacy of protein intakes of toddlers (aged 18-30 mo) in study communities in Egypt, Kenya, and Mexico judged in relation to FAO/WHO/UNU estimates of requirements. Effects of supplementing amino acid intakes, or of assuming lower bioavailability for lysine are also considered. In Egypt and Mexico existing protein intakes of toddlers were adequate. In Kenya existing intakes were marginal. Total protein intake was low and often lysine or tryptophan concentration was low. If Kenyan intakes met estimated energy requirements, protein intakes would be adequate. We conclude that protein intake is unlikely to be a primary limiting factor for toddler growth and development, and the benefit to be expected from increasing the intake of limiting amino acids is marginal. Reported associations of animal-source protein and energy with growth, size, and psychologic function of these toddlers are unlikely to be causally attributable to inadequacy of protein intakes.

Estimated mineral intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Intakes of minerals and factors that might affect their bioavailability were estimated for 255 toddlers aged 18-30 mo living in villages in Egypt, Kenya, and Mexico. Mean intakes over 1 y were compared with international-requirement estimates by using a probability approach. The prevalence of iron intakes likely to be inadequate to prevent anemia was estimated as 35% in Egypt, 13% in Kenya, and 43% in Mexico. The prevalence of zinc intakes likely to be inadequate to meet basal requirements was estimated as 57% and 25% in Kenya and Mexico, respectively, but only 10% in Egypt, where the use of yeast-leavened breads was judged to have improved zinc availability. There was no suggestion that estimated copper or magnesium intakes were inadequate, but calcium intakes in Kenya and Egypt were well below recommended amounts. Studies of factors affecting mineral bioavailability in the diets of these countries' populations could suggest dietary changes that might improve effective mineral intake with minimal cost.

Nitric oxide synthase type II expression by different cell types in MHV-JHM encephalitis suggests distinct roles for nitric oxide in acute versus persistent virus infection.

Intranasal inoculation with mouse hepatitis virus strain JHM (MHV-JHM) results in acute meningoencephalitis. We found NOS II mRNA expression in brains of acutely infected animals on days 5 through 7 after infection. In situ hybridization and immunohistochemistry demonstrated NOS II message and protein in infiltrating macrophages. Persistent infection with MHV-JHM results in chronic demyelinating encephalomyelitis. NOS II mRNA was detected in persistently infected spinal cords. In situ hybridization and immunohistochemistry showed expression of NOS II in astrocytes in and around demyelinated lesions. These results suggest the role of NO release in acute versus persistent infection with this virus, and its contribution to the resulting pathology, may be different.

FDG-PET appearance of pelvic Castleman's disease.

We report a case of Castleman's disease demonstrating 18F-fluorodeoxyglucose (FDG) localization by whole-body PET imaging in a pelvic soft-tissue mass shown on abdominopelvic CT. In this case, there is mild FDG localization within pelvic Castleman's disease with standard uptake values lower than in many cases of low-grade and intermediate-grade lymphomas previously reported. FDG-PET may be of value as an imaging modality for differentiating Castleman's disease from lymphoma.

Cefquinome (HR 111V). In vitro evaluation of a broad-spectrum cephalosporin indicated for infections in animals.

Cefquinome (formerly HR 111V), an aminothiazolyl cephalosporin, was compared with cefepime, cefpirome, cefotaxime, and ceftazidime against 681 clinical cultures and a challenge set of bacteria with well-characterized resistance mechanisms. Cefquinome minimum inhibitory concentrations (MIC90) for the enterobacteriaceae ranged from < or = 0.12-2 micrograms/ml with the highest MIC (4 micrograms/ml) obtained among Citrobacter freundii, Enterobacter cloacae, and Providencia stuartii strains. A total of 90% of the Pseudomonas aeruginosa were inhibited by cefquinome at < or = 8 micrograms/ml. Cefquinome activity of particular note for Gram-positive isolates included Corynebacterium jeikeium (MIC90, 8 micrograms/ml) and enterococci (MIC50, 4-8 micrograms/ml). Oxacillin-resistant Staphylococcus aureus was 32-fold less susceptible (MIC90, 16 micrograms/ml) to cefquinome than oxacillin-susceptible (MIC90, 0.5 micrograms/ml) strains. Cefquinome was very potent against fastidious isolates such as Moraxella catarrhalis (MIC90, 0.25-2 micrograms/ml); Haemophilus influenzae (MIC90, 0.06-1 micrograms/ml), Neisseria gonorrhoeae (MIC90, 0.06-0.5 micrograms/ml), and Streptococcus species (MIC90, < or = 0.03-006 micrograms/ml). When tested against organisms possessing Bush group 2 enzymes (including extended spectrum beta-lactamases), cefquinome remained active (MIC, < or = 8 micrograms/ml) against the majority of strains. This compound should be very active against pathogens generally found in animal infections and possesses a potency and spectrum comparable to the "fourth-generation" cephalosporins (cefepime and cefpirome) being investigated for human infectious diseases.

Nutrient intakes of women in NHANES II, emphasizing trace minerals, fiber, and phytate.

Nutrient intakes of 1,066 young women 18 to 24 years of age were estimated using a shortened nutrient data base (the University of California, Berkeley Minilist) containing 235 food items. The dietary data consisted of 24-hour recalls collected during the Second National Health and Nutrition Examination Survey (NHANES II). A cross-reference index, recipe file, and concentration factors were developed to substitute foods on the data base for the 1,267 foods reported by the young women. Estimates of energy, protein, fat, carbohydrate, and iron intakes using the NHANES II nutrient data base and the UCB Minilist were within 3% of one another, and had correlation coefficients above 0.97. Mean +/- S.E. daily intakes of copper, zinc, dietary fiber, and phytate, which are not included in the NHANES II data base, were estimated to be 1.16 +/- 0.02 mg, 8.11 +/- 0.14 mg, 13.2 +/- 0.3 gm, 395 +/- 14 mg, respectively. The values agree closely with other published values for young women's intakes. A shortened nutrient data base can be a valid tool for estimating intakes of populations.

An evaluation of food group intakes by Mexican-American children.

Food group daily servings were examined for 3,436 children who participated in the Mexican-American portion of the 1982-1983 Hispanic Health and Nutrition Examination Survey (HHANES). Mean daily servings of 40 foods and food groups were calculated for four age groups: 1 to 2 years, 3 to 5 years, 6 to 11 years, and 12 to 17 years. The HHANES food servings data were combined into four major groups and compared with recommended servings for children. Mean daily servings of the milk group exceeded the recommended two to three servings for younger children but were low for teenagers. Meat group servings (including eggs and nuts/legumes) exceeded the recommended two daily servings for all age groups, whereas bread group intakes averaged 70% to 80% of a recommendation of four servings but only half of a recommendation of six servings. Intakes of fruits and vegetables were lowest, averaging only 33% to 47% of a recommended four servings, or 26% to 38% of a recommended five servings. Servings of all four groups were lowest for teenagers. A dietary score, based on the number of servings from each of the four groups, was developed for each child. Mean dietary scores ranged from 55% (teenagers) to 70% (toddlers and preschoolers) of the recommended score. According to these analyses, dietary guidance for Mexican-American children should focus on increasing intakes of fruits and vegetables and on encouraging more nutritious food choices by teenagers.

Living arrangements and dietary quality of older U.S. adults.

The association between living arrangement and dietary quality of older U.S. adults was investigated in 4,402 adults aged 55 years or older who participated in the Nationwide Food Consumption Survey, 1977 to 1978. Dietary quality was based on percent of Recommended Dietary Allowances for 3-day intakes of nine nutrients. More men living alone consumed a poor-quality diet than did men living with a spouse, particularly those 75 years or older; for women, this effect was seen only in the 55- to 64-year-old group. In general, more women than men had poor-quality diets. A number of factors (economic, employment, health status, energy intake, body mass index, and nutrient supplement use) were examined for their importance in accounting for differences in dietary quality of older men and women living alone compared with those living with a spouse. Energy intake was the most important variable accounting for the association of living arrangement with dietary quality. Evidence indicated that older adults living alone did not make poorer food choices than those living with a spouse, but rather that they consumed fewer calories.

Demographic and economic factors associated with dietary quality for adults in the 1987-88 Nationwide Food Consumption Survey.

Data for 5,884 adults (19 years of age and older) who participated in the 1987-88 Nationwide Food Consumption Survey (1987-88 NFCS) were used to investigate demographic and economic factors associated with dietary quality. Although the low response rate for the 1987-88 NFCS has raised concerns about possible bias, it is appropriate to use this extensive data set for analyses that do not attempt to generalize the results to the US population as a whole. Two aspects of quality were calculated for the mean of the 3-day reported intakes: number of nutrients below two thirds of the 1989 Recommended Dietary Allowance (RDA) (low-intake nutrients) and percent of energy from fat. Few adults reported mean intakes that met suggested guidelines: 22% of diets were above two thirds of the RDA for all 15 nutrients and 14% were below 30% fat, but only 2% met both criteria. Energy intake was a strong negative predictor of number of low-intake nutrients and a weak positive predictor of percent of energy from fat. Results of multivariate regression analyses identified few demographic or economic predictors of either the number of low-intake nutrients or percent of energy from fat. According to these data, diets of most adults do not conform to current dietary guidelines. Nutrition education efforts should be directed to all adults, and research should be undertaken to determine more effective ways to help adults improve their overall dietary quality.

Evaluation of validity of items for a food behavior checklist.

OBJECTIVES: To evaluate the validity of food behavior items, using a biological measure (serum carotenoids) as the criterion for validity of fruit and vegetable intake, and the results from multiple 24-hour recalls to test convergent validity with nutrient intake. DESIGN: Participants responded to 39 food-behavior questions and later completed three 1-day dietary recalls. Serum carotenoid levels were determined for a 59% randomly selected subsample. SUBJECTS/SETTING: A convenience sample of 100 English-speaking, low-income women participating in a Food Stamp Nutrition Education Program in 8 California counties. Statistical analyses Spearman correlation coefficients were calculated between responses to the food behavior items and (a) serum carotenoid levels and (b) mean nutrient intakes from the 24-hour recalls. Cronbach's coefficient alpha was determined for items within broad food behavior topics. RESULTS: Responses to 10 food behavior items were significantly correlated with serum carotenoid levels (correlations greater than 0.45 were found for choosing low-fat foods and a self-evaluation of overall dietary quality). An additional 12 items showed hypothesized associations with the 24-hour recall data (with a maximum correlation 0.50 for number of eggs per week and dietary cholesterol). Cronbach's coefficient alpha ranged from 0.28 (for 5 fat and cholesterol items) to 0.79 (for 9 fruit and vegetable items). APPLICATIONS/CONCLUSIONS: Nutrition professionals can use these methods to validate items for food behavior checklists for specific populations. The items described here may be useful when designing instruments to administer to low-income women in a community setting.