RESUMEN
Background. Everything known about the roles, relationships, and repercussions of comorbidity in cardiovascular disease is shaped by how comorbidity is currently measured. Objectives. To critically examine how comorbidity is measured in randomized controlled trials or clinical trials and prospective observational studies in acute myocardial infarction (AMI), heart failure (HF), or stroke. Design. Systematic review of studies of hospitalized adults from MEDLINE CINAHL, PsychINFO, and ISI Web of Science Social Science databases. At least two reviewers screened and extracted all data. Results. From 1432 reviewed abstracts, 26 studies were included (AMI n = 8, HF n = 11, stroke n = 7). Five studies used an instrument to measure comorbidity while the remaining used the presence or absence of an unsubstantiated list of individual diseases. Comorbidity data were obtained from 1-4 different sources with 35% of studies not reporting the source. A year-by-year analysis showed no changes in measurement. Conclusions. The measurement of comorbidity remains limited to a list of conditions without stated rationale or standards increasing the likelihood that the true impact is underestimated.
RESUMEN
OBJECTIVE: To evaluate the dietary contribution of culturally preferred foods in a population of Black Seventh-Day Adventists from the eastern and southern United States in order to improve the standard food frequency questionnaire. DESIGN: Intake of such foods was assessed using a specially designed self-administered food frequency questionnaire consisting of a list of 60 items. A demographic questionnaire was administered by later telephone interview. SETTING: Southern and northeastern United States. SUBJECTS: One hundred and sixty-one Black Seventh-Day Adventists were selected from 60 congregations. Approximately half had Caribbean roots. RESULTS: Among the special foods included, red beans stood out and were among the top five contributors to eight of nine selected nutrients. Various legumes, cruciferous vegetables, and okra-corn-tomatoes were the most frequently consumed special foods. Macaroni and cheese was an important contributor to total energy, fat, saturated fat, and protein. At least weekly consumption of red beans, rice and beans, pinto beans, black-eyed peas, plantains and poke salad was reported by 47%, 40%, 31%, 28%, 26% and 25% of subjects, respectively. These foods (largely the legumes) contributed 77% and 104% of the dietary reference intakes for folate and total fiber, respectively. On average, all these foods contributed an estimated 726 calories per day. CONCLUSIONS: These findings show that, in total, these foods make a major contribution to the diets of these subjects and that the most commonly eaten at least should be included in dietary questionnaires designed for this minority population.
