Dietary intake and nutritional indicators are transiently compromised during radiotherapy for rectal cancer.

OBJECTIVE: Patients with rectal cancer receive curative radiotherapy towards the pelvis for 5 weeks. Little is known about the impact of radiotherapy on dietary intake and nutritional status. The objective was to examine whether curative radiotherapy for rectal cancer promoted altered intake of energy and nutrients, and change in nutritional indicators. DESIGN: Prospective study. SETTING: Department of Oncology in a tertiary care hospital. SUBJECTS: A total of 31 consecutive patients receiving radiotherapy for rectal cancer (50 Gray). INTERVENTIONS: A 7-day food intake registration, body weight, upper arm circumference, and analyses of blood samples were performed at the start and the end of radiotherapy, and at follow-up 4-6 weeks and 1 year after the end of radiotherapy. RESULTS: At the end of 5 weeks of radiotherapy, the mean daily energy intake was reduced by 15% from 8.9 to 7.6 MJ as compared with baseline (P = 0.002), and the intake of several nutrients was reduced (P < 0.01). The percentages of energy derived from fat, protein, and carbohydrates did not change, nor did the nutrient density. A transient body weight reduction of < 1 kg was observed (P = 0.009). Serum concentrations of vitamin A and 25-OH vitamin D did not change during radiotherapy. The daily intake of energy and nutrients, and body weight, had increased towards pretreatment values 4-6 weeks after radiotherapy. CONCLUSIONS: Radiotherapy for rectal cancer caused a transient reduction in energy intake and nutritional indicators. The nutritional quality of the diet was unchanged during radiotherapy.

Dietary patterns and their socio-demographic determinants in 10 European countries: data from the DAFNE databank.

OBJECTIVE: To describe the dietary patterns of 10 European countries and their socio-demographic determinants, using the comparable between-countries DAFNE data. DESIGN: Analysis of standardized and postharmonized data collected through the national household budget surveys. SETTING: Nationally representative surveys undertaken in 10 European countries, generally in the second half of the 1990s. RESULTS: The differences in the fruit and vegetable consumption previously identified between Mediterranean and Northern European countries seem to be leveling out, particularly in relation to fruit consumption. Pulses, however, still characterize the diet of the Mediterraneans. Straying from their traditional food choices, Mediterraneans recorded high availability of unprocessed red meat, while Central and Northern Europeans preferably consumed meat products. The household availability of beverages (alcoholic and non-alcoholic) is generally higher among Central and Northern European populations. Principal component (PC) analysis led to the identification of two dietary patterns in each of the 10 countries. The first was similar in all countries and indicated 'wide-range' food buyers. The second was slightly more varied and described 'beverage and convenience' food buyers. PC1 was common among households of retired and elderly members, while PC2 was common among households located in urban or semi-urban areas and among adult Scandinavians living alone. CONCLUSIONS: The dietary patterns identified point towards a progressive narrowing of dietary differences between North and South European countries. The comparable between-countries DAFNE data could prove useful in ecological studies, in the formulation of dietary guidelines and public health initiatives addressing specific population groups. SPONSORSHIP: European Commission.

Relations between high ponderal index at birth, feeding practices and body mass index in infancy.

OBJECTIVE: We compared feeding practices between infants of high ponderal index (PI) at birth (PI above the 90th percentile) and normal PI at birth (PI between 10th and 90th percentiles), and examined how birth size and infant feeding practices were related to body mass index (BMI) at 12 months. DESIGN: In a cohort of 3000 infants invited to participate in a national Norwegian dietary survey, 1825 participated both at 6 and 12 months of age, and the present study included those born full term and with a PI (weight/length3) at birth > or =10th percentile (n=1441). Data on feeding practices were collected by food-frequency questionnaires, and anthropometrical data were measured by health-care personnel. RESULTS: A lower proportion of infants born with high PI were exclusively breastfed for at least 4 months compared with infants born with normal PI (37 and 47%, respectively; P=0.03). Earlier introduction of solid foods and higher consumption of some foods were also observed among infants of high PI. In a multivariate analysis, adjusted mean BMI (kg/m2) at 12 months was higher for infants of high PI at birth than for infants of normal PI (17.6 and 17.0, respectively; P<0.001) and higher for infants exclusively breastfed <3 months than for infants exclusively breastfed > or =3 months (17.5 and 17.2, respectively; P=0.001). CONCLUSIONS: High PI at birth was associated with a shorter duration of exclusive breastfeeding. Furthermore, high PI at birth and short-term exclusive breastfeeding were both associated with higher BMI at 12 months.

Validation of a semi-quantitative food-frequency questionnaire used among 2-year-old Norwegian children.

OBJECTIVES: An adequate diet is of profound importance in infancy and early childhood. To ensure an optimal diet, knowledge about actual intake must be obtained. The aims of this study were to assess the validity of a semi-quantitative food-frequency questionnaire (SFFQ) applied in a large nation-wide survey among 2-year-old children and to examine the validity of the SFFQ in relation to different background parameters. DESIGN: The SFFQ was administered to the parents close to the child's second birthday, and one to two weeks later they started to weigh and record the child's diet for 7 days. SUBJECTS: One-hundred and eighty-seven families with a 2-year-old child completed both methods. RESULTS: There were no differences between the intakes of protein, saturated fatty acids, total carbohydrates and calcium estimated from the two methods. The average intake of all micronutrients, except for calcium, was overestimated by the SFFQ. Bland-Altman plots showed a systematic increase in difference between the two methods with increasing intake for most nutrients. Spearman correlation coefficients between methods for nutrient intakes ranged from 0.26 to 0.50, the median correlation was 0.38. The correlations increased when estimates were adjusted for energy intake, the median correlation being 0.52. Differences in observed validity were found according to the number of siblings. CONCLUSIONS: This study indicates that the SFFQ may be a valuable tool for measuring average intakes of energy, macronutrients and several food items among a 2-year-old population in Norway. The ability of the questionnaire to rank children according to intakes of nutrients and food items was rather low.

Six carotenoids in plasma used to assess recommended intake of fruits and vegetables in a controlled feeding study.

BACKGROUND: There is a need for objective and universally applicable biomarkers for the intake of foods believed to affect human health. OBJECTIVE: The purpose of this feeding study was to test whether plasma concentrations of carotenoids could be used to distinguish recommended consumption of mixed fruits and vegetables (five a day) from the current national intake of fruits and vegetables (two a day). DESIGN: A strict crossover design was chosen to correct for observed interindividual variations in carotenoid response. A total of 40 healthy subjects were included in the study. After 1 week run-in period with no fruits and vegetables in the diet, one group was given two portions (300 g) of fruits and vegetables daily, while another group was given five portions (750 g) for 14 days. Following a 2 week wash-out period and 1 week run-in, the regimens were switched between the groups. Fruits and vegetables were combined to match a typical Norwegian diet. RESULTS: Enhanced intake from two to five portions of mixed fruits and vegetables increased plasma concentrations of alpha-carotene (P=0.033) and lutein (P=0.051) in a crossover analysis. Analysis of data in the parallel part of the study revealed differences between the high and low intake for plasma concentrations of alpha-carotene (P=0.013) and beta-carotene (P=0.016). A trend was also evident for plasma concentrations of lycopene (P=0.057) and lutein (P=0.076) in the parallel analysis. No effect of high vs low intake of fruits and vegetables was observed for plasma concentrations of beta-cryptoxanthin, zeaxanthin, cholesterol and triacylglycerols. CONCLUSION: The study indicates that plasma concentration of alpha-carotene, beta-carotene and lutein may be used to assess changes of fruit and vegetable intake corresponding to an increase from the present national intake in Norway to the recommended amount of five portions of fruits and vegetables daily. SPONSORSHIP: Norwegian Research Council, National Nutrition Council, Throne Holst Foundation for Nutrition Research and Freia Chokoladefabriks Medisinske Fond.

Validation of a semi-quantitative food-frequency questionnaire used among 12-month-old Norwegian infants.

OBJECTIVE: To assess the validity of a semi-quantitative food-frequency questionnaire (SFFQ) used in a large nation-wide dietary survey among 12-month-old Norwegian infants. METHODS: The SFFQ was administered to the parents about 1 week before the infants turned 12-month-old. The participants filled in the SFFQ and 1-2 weeks later they kept weighed food records for a total of 7 days. Both methods were completed for 64 infants. RESULTS: The SFFQ overestimated energy intake with 25% and gave significantly higher estimates of all nutrients compared with the records, except for calcium. Much of the difference between the methods disappeared when nutrient density was compared. Spearman correlation coefficients between pairwise measurements of nutrient intakes from the food records and the SFFQ ranged from 0.18 for vitamin D to 0.72 for polyunsaturated fatty acid intake (median r=0.50). On average 38% of the infants were classified in the same quartile with the two methods, and 3% in the opposite quartile. The correlations for food items varied from 0.28 for sweetened drinks to 0.83 for commercial porridge (median r=0.62). CONCLUSION: This study indicated that the SFFQ overestimates average absolute nutrient intakes. However, the questionnaire gave better estimates for average nutrient densities than for absolute nutrient intakes. The capability of the questionnaire to rank infants according to intake of nutrients and food items was moderate, but at the same level as others have observed with food-frequency questionnaires.

Infant feeding practices and associated factors in the first six months of life: the Norwegian infant nutrition survey.

AIM: To describe and evaluate infant feeding practices during the first 6 mo of life in relation to recommendations, and to study infant feeding practices in relation to maternal and infant characteristics. METHODS: Data from 2383 Norwegian infants aged 6 mo were collected by a self-administered semi-quantitative food-frequency questionnaire measuring feeding practices at 6 mo and feeding practices retrospectively at < or = 5.5 mo of age. RESULTS: Only 1% of the infants had never been breastfed. The proportion of breastfed infants was 96% at 1 mo, 85% at 4 mo and 80% at 6 mo. The proportion of exclusively breastfed infants was 90% at 1 mo, 44% at 4 mo and 7% at 6 mo. Twenty-one percent of the infants were introduced to solid foods before the age of 4 mo. For exclusive breastfeeding at 4 mo, breastfeeding at 6 mo and timely introduction of solid foods (not before 4 mo) significant positive trends were found for maternal age, education and degree of urbanization. Negative associations were found for maternal smoking. Furthermore, exclusive breastfeeding at 4 mo was associated with infant gender and marital status, and the odds of breastfeeding at 6 mo significantly decreased with decreasing infant birthweight. Finally, both the odds of exclusive breastfeeding at 4 mo and of breastfeeding at 6 mo increased with increasing numbers of children. CONCLUSION: These results indicate that a majority of Norwegian infants are fed in accordance with infant feeding recommendations during their first 6mo of life. However, the duration of exclusive breastfeeding is shorter than recommended. Infant feeding practices are significantly associated with maternal and infant characteristics.

Levels of ochratoxin A in blood from Norwegian and Swedish blood donors and their possible correlation with food consumption.

Blood levels of ochratoxin A were determined in 406 Scandinavian blood donors (206 from Oslo, Norway, and 200 from Visby on the island of Gotland, Sweden), using an HPLC method. In connection with the blood collection, the subjects were asked to fill in a food questionnaire to obtain individual dietary information relevant to ochratoxin A exposure. The mean plasma level of ochratoxin A was 0.18 ng/ml in Oslo and slightly higher, 0.21 ng/ml (P=0.046) in Visby. There was no correlation between plasma levels of ochratoxin A and the estimated total dietary intake of ochratoxin A based on consumption data and levels in food (retrieved from the literature), neither was the plasma level of ochratoxin A correlated with the total amount of food consumed. However, consumption of several foods, including cereal products, wine, beer and pork, were to some minor degree related to high plasma levels of ochratoxin A. The strongest correlations (correlation coefficient r>0.4; P<0.001) were observed for women in relation to the consumption of beer or medium brown bread. Correlation analysis of combinations of two or more food categories did not result in any statistically significant correlation.

Current diet and colorectal adenomas: a case-control study including different sets of traditionally chosen control groups.

High intake of fat and a low intake of foods rich in antioxidants and fibre are suggested to be associated with risk of colorectal adenomas. Inconsistency may, however, be due to dietary assessment problems or differences in the identification of cases and controls. We have compared 87 adenoma cases aged 50-76 years with 35 healthy controls and 35 'hospital' controls. All the controls were matched for sex and age (+/-5 years) and proven to be free of polyps. Current habitual diet was measured by a 5-day dietary record by weighing. Regarding the intakes of vegetable fat, protein, cholesterol, vitamin A, total vitamin D, edible fats, coffee and fish and fish products, the outcomes of the analysis depended upon the source of controls. However, an increased adenoma risk compared with either set of controls related to a low consumption of vegetables, cereals, iron, vitamin C and fibre and a high intake of total fat was found. This is suggestive of substantial differences, since bias due to abdominal symptoms, the dietary records or an inappropriate choice of controls, would have affected the estimations. The findings give further strength to the role of these dietary factors in the formation of precancerous lesions in the large intestine.

Results from two repeated 5 day dietary records with a 1 y interval among patients with colorectal polyps.

BACKGROUND: Dietary factors are known to be associated with initiation and development of colorectal cancer (CRC), and also with CRC's major precursor, the colorectal polyp. In long-term intervention studies on colorectal polyps, dietary changes may therefore affect potential effects of the study intervention. OBJECTIVE: To examine potential dietary changes among polyp-patients randomly selected from a 3 y intervention study after 1 y. DESIGN AND SUBJECTS: Of 116 polyp-bearing out-patients (50% men), aged 50-76 y, who participated in the double-blind 3 y placebo-controlled endoscopic follow-up and intervention study against growth and recurrence of polyps, 30 patients were randomised (strata: sex, age and polyp size) to perform a repeated 5 day dietary record by weighing after 1 y. The patients received a daily mixture of vitamin C (150 mg), alpha-tocopherol (75 mg), beta-carotene (15 mg), selenium (101 microg) and calcium (1.6 g) or placebo (lactose) for a period of 3 y with annual colonoscopic examinations and polyps size measurements to test if the mixture was able to reduce polyp growth and recurrence. Polyps of >9 mm were removed, whereas the remainders and new discoveries of polyps <9 mm were left in situ until the end of the study. RESULTS: Twenty-nine patients agreed to perform the repeated 5 day dietary record, and 86% performed the second record within 48-58 weeks after the first record. The results showed that, with the exception of vitamin D, milk and milk products, no significant differences were found between the two records. The median value of the Spearman's correlation coefficient for energy and energy-yielding nutrients was 0.66, for vitamins and minerals 0.58, and for foods 0.58. Individual differences between the records were found for most variables, but most of these were negligible. CONCLUSION: After 1 y, no major dietary changes were found which could be associated with a changed susceptibly for malignancy, and thereby affect potential effects of the study intervention. We may thus suggest that a potential changed susceptibility towards growth and recurrence of polyps, is due to the specific intervention, and not due to other major dietary changes.

Methodology for rendering household budget and individual nutrition surveys comparable, at the level of the dietary information collected.

OBJECTIVE: To describe the methodology applied in order to render comparable, at the level of the dietary information collected, the household budget survey (HBS) and individual nutrition survey (INS) data from four European countries (Belgium, Greece, Norway and the United Kingdom). SETTING: In Belgium, data from the HBS of 1987-88 were compared with data from the Belgian Interuniversity Research on Nutrition and Health collected from 1980 to 1985. In Greece, data from the HBS undertaken in 1993-94 in the greater Athens area were compared with data collected around 1994 in the same region, in the context of the Greek segment of the European Prospective Investigation on Cancer and Nutrition study. In Norway, data from the HBS carried out in 1992, 1993 and 1994 were compared with the NORKOST study conducted in 1993-94. In the United Kingdom, data from four HBSs carried out in 1985, 1986, 1987 and 1988 were compared with the National Dietary and Nutritional Survey of British adults conducted in 1987-88. DESIGN: INS-generated data were converted into 'HBS-like' estimates with the application of yield factors for weight changes during cooking, recipe-based calculations and edible proportion coefficients taking into account weight changes during the food preparation. The 'HBS-like' estimates thus obtained were compared with the original HBS values, after applying an adjustment factor for food spoiled or given to pets. CONCLUSION: The methodological considerations overviewed in the present paper indicate that a number of issues need to be taken into account before a proper comparison of the dietary data collected through surveys implemented with varied methodologies is carried out.

Fruit and vegetable availability among ten European countries: how does it compare with the 'five-a-day' recommendation? DAFNE I and II projects of the European Commission.

Recasting the role of fruit and vegetables (F&V) in the diet, and planning national and international campaigns to enhance their consumption are major public health service objectives. The present study seeks to describe F&V availability patterns in ten European countries and examine compliance with current recommendations. The mean and median F&V availability (g/person per d) was estimated based on household budget survey data retrieved from the Data Food Networking (DAFNE) databank. Low F&V consumers were identified based on WHO international recommendations (minimum combined F&V intake of about 400 g/person per d) and current conservative guidelines of a minimum daily intake of three portions of vegetables and two portions of fruit. Considerable disparities in F&V availability were found among the surveyed European populations. Only in Mediterranean countries did the mean daily population intake clearly exceed combined F&V recommendations. Dietary patterns were positively skewed in all populations studied, on account of the presence of exceptionally high values among segments of the populations. Moreover, the correlation was unexpectedly weak between the proportion of low fruit and low vegetable consumers (Spearman's correlation coefficient +0.18). More than 50% of the households in the surveyed populations are likely to consume less than the recommended daily vegetable intake of three portions, and this applies even to the two Mediterranean populations. The efficiency of F&V promoting strategies may be enhanced if F&V are addressed separately; furthermore, interventions that would specifically focus on vegetables are probably needed.

Smoking and colorectal adenomas: a case-control study.

A positive association between tobacco and colorectal adenomas has been suggested. Smoking is, however, also associated with 'poor' dietary habits, which in turn may be related to risk of adenomas. It is therefore of interest to study the relationship between smoking, diet and risk of colorectal adenomas in follow-up studies. We compared 87 adenoma cases to 35 'hospital' and 35 healthy controls (all controls were age- and sex-matched and proven to be free of adenomas). Smoking data were collected by an interview and a self-administrated questionnaire with a time interval of at least one month. After 3 years of follow-up, all polyps were removed. Our data indicate that smoking is associated with adenoma prevalence, but not necessarily with size, multiplicity, growth or recurrence of adenomas. Compared to both sets of controls, cases reported to have smoked more than 15 pack-years, or who are current smokers, had a fourfold increased frequency of adenomas (odds ratios 3.6-5.9). Smokers with adenomas had dietary habits that may also be associated with adenomas. The smoking estimates remained largely unchanged even after adjustments for dietary variables in multivariate analysis. This study lends support to the theory of an initiating role of tobacco smoke in neoplasia formation.

Household budget survey nutritional data in relation to mortality from coronary heart disease, colorectal cancer and female breast cancer in European countries. DAFNE I and II projects of the European Commission. Data Food Networking.

OBJECTIVE: We have undertaken a study to examine whether Household Budget Survey (HBS)-derived nutritional patterns are related to mortality from diseases with strong nutritional components, namely coronary heart disease, colorectal cancer and cancer of the female breast. DESIGN: Ecological correlation study. In the context of the Data Food Networking projects of the European Union, raw data from the national HBS of 10 European countries were provided. For each of the 10 participating countries, daily food availability per capita around 1990 was calculated. Individual foods were aggregated into 12 major food groups that were linked with the diseases under consideration. Mortality data were available from a World Health Organisation database. We have used a composite score to summarise the postulated influence of diet. SETTING: Ten European countries circa 1990. RESULTS: The correlation coefficients between the composite score and the age-adjusted mortality from each of the studied diseases were: + 0.51 (P approximately 0.14) for colorectal cancer; +0.72 (P approximately 0.02) for female breast cancer; and +0.60 (P approximately 0.07) for coronary heart disease, after adjustment for tobacco smoking. CONCLUSIONS: We conclude that dietary information from HBS is sufficiently reliable to reveal correlations with mortality rates from chronic diseases with fairly strong nutritional roots. HBS data could be used, with little cost, for monitoring secular trends in dietary patterns with a view to their health implications.

An assessment of the use of simple methods to predict individual energy intakes for intervention studies.

OBJECTIVE: To investigate to what extent individual energy intakes can be predicted by rapid easily available low-cost estimation methods. DESIGN: Data were obtained from a controlled dietary intervention study period of nine weeks in which the subjects should be weight stable. SUBJECTS: Thirty-one male students in domestic and kitchen management aged 29 +/- 6 y. METHODS: (1) energy intake calculated from a quantitative food frequency questionnaire (FFQEI); (2) energy expenditure derived from estimates of basal metabolic rate (BMR) (FAO/WHO/UNU, 1985) based on weight, gender, age and low (1.55 x BMR), medium (1.78 x BMR) or high (2.10 x BMR) level of activity. Level of activity was determined by questions concerning habitual activities lasting more than 20 min (WHOEE); (3) energy expenditure derived from individual recording in a specially prepared activity diary (ADEE). During the intervention, the subjects were to be fed test diets which should provide them with enough energy to keep them weight stable. The energy levels were established after taking both the FFQEIs, WHOEEs and ADEEs into consideration, and 10 MJ, 13 MJ, 15 MJ and 17 MJ per day were chosen because these levels were estimated to closely match the energy requirements of most of the subjects. The levels of energy were changed during the intervention period if the weight of the subjects fluctuated. The served level of energy at the last day of the intervention was denoted the weight maintenance energy intake (WMEI). WMEI was compared to FFQEI, WHOEE and ADEE in order to evaluate if one estimation method predicted WMEI better than the two others. RESULTS: None of the three methods provided accurate estimates of WMEI of 13.3 +/- 1.8 MJ. However, WHOEE, gave the best estimate as demonstrated by the limits of agreement: -8.7 MJ to +8.9 MJ for FFQEI, -5.4 MJ to +3.9 MJ for WHOEE and -7.2 MJ to +5.2 MJ for ADEE. The coefficients of correlation between the differences and the means of WMEI and FFQEI, WHOEE and ADEE were -0.8 (P < or = 0.001), 0.1 (P = 0.6, NS) and -0.5 (P < or = 0.01), respectively. The coefficients of variation were 34.6% for FFQEI, 11.3% for WHOEE, and 21.0% for ADEE. CONCLUSIONS: Although not precise, WHOEE showed the best agreement with the WMEI. These results demonstrate that a rapid and simple low-cost method predicted WMEI closely enough to avoid major weight fluctuations among these men during the intervention period.

[Do people exercise less than they think?]. / Mosjonerer folk mindre enn de tror?

Physical activity is important for health. Physical inactivity is an independent risk factor for disease and speeds up aging. People say in health surveys that they exercise more than they did before. This does not conform with two important facts: Over the last 20 years people have reduced their calorie intake, but their weight is increasing. The only possible explanation is that they exercise less than before, probably because their daily life requires less and less physical activity. We believe this to be a serious health problem, and support the most recent recommendation: A daily walk for 30 minutes.

[Influence of the diet on cell proliferation in the large bowel and the rectum. Does a strict vegetarian diet reduct the risk of intestinal cancer?]. / Kostholdets innvirkning på celleproliferasjonen i tykk- og endetarm. Reduserer et strengt vegetarisk kosthold risikoen for å utvikle tarmkreft?

Colorectal cancers are the most frequent cancer in Norway for men and women combined. Several theories have been suggested as etiological explanations. In this review the influence of dietary factors on the cell proliferation rate has been evaluated. A higher cell proliferation rate is statistically associated with increased risk of colorectal cancer. Foods associated with a lower cell proliferation rate match the staple foods in parts of the world were the incidence of colorectal cancer is low. Vegetarians show a low rate of cell proliferation, and low incidence of colorectal cancer. The low incidence of colorectal cancer among vegetarians may be due not only to the lack of animal foods, but also to several other healthy lifestyle habits. We conclude that a well planned lacto-vegetarian diet or a mixed diet with abundant amounts of vegetables and fruits is beneficial as regards the rate of cell proliferation, and most likely also reduces the risk of developing colorectal cancer.

Do pregnant smokers eat differently from pregnant non-smokers?

This article describes a study of the relationship between diet and smoking in a group of 821 Norwegian pregnant women. The study is part of a multi-centre project, examining risk factors for intrauterine growth retardation. Two 3-day dietary records were collected during the 17th and 33rd week of pregnancy. Information on smoking habits and other relevant parameters were collected through an extensive questionnaire. The results showed that the smokers consumed significantly less than the non-smokers of bread, cakes and cookies, vegetables, fruits and berries, cheese, yoghurt, low fat milk, juice and tea. The smokers also consumed significantly more meat, margarine, whole milk, soft drinks and coffee than the non-smokers on both occasions. The diet of the smokers contained significantly less protein, carbohydrate, dietary fibre, thiamin, riboflavin, vitamin C, calcium and iron as compared with the non-smokers. Fat contributed significantly more to the energy content of the diet of the smokers and it is concluded that their diet was less nutritious than that of the non-smokers throughout pregnancy.

Dietary factors and colorectal polyps: a case-control study.

In the case-control study we compared dietary habits among 108 patients with small (< or = 5 mm, n = 26), medium (5-9 mm, n = 48) or large (> or = 10 mm, n = 34) colorectal polyps with 35 healthy age- and gender-matched controls. A food record by weighing during 5 consecutive days was performed. The intake of fat was significantly higher among the patients, in contrast to a significantly lower intake of carbohydrate, dietary fibre and iron, compared with controls. The intake of vitamin C and calcium was shown to be lower among the patients, but this was significant only for women. There was a tendency among the patients to consume a lower-antioxidant, fibre and cereal fibre diet, and a calcium-rich and more cholesterol-rich diet with increasing size of polyps. The patients with the smallest polyps tended to consume less starch. Our results are too preliminary to draw conclusions with regard to the influence of nutritional factors on the size and growth of polyps. However, our risk factors for the presence of polyps are in agreement with previous studies. Further studies taking into account the size of the polyp are needed to corroborate our findings.

Thyroid hormone responses to military winter exercises in the Arctic region.

The effects of military field exercises in the arctic on thyroid hormone concentrations were examined in Norwegian soldiers (n = 35). Originally the soldiers were divided into 4 groups having low (2 h) or high (6 h) levels of daily sleep, and low or high physical work requirements during the field exercises. The operations were three days of stimulated combat scenarios during winter. Day 1 consisted of 30 h without sleep. Sleep was then provided at approximately 18-22 h intervals thereafter. Blood samples were taken immediately prior to the exercises (BASELINE), during the exercises at 24 h, 48 h, and 72 h, and at 24 h and 48 h of recovery from the exercises (REC1, and REC2). Hormonal analysis consisted of total (T) thyroxine (TT4), free (f) T4, total triidothyronine (TT3), fT3, and thyroid stimulating hormone (TSH). No significant group interactions were observed therefore groups were pooled. However, main effects over time (i.e., days) were observed for all hormones (p < 0.001). TSH declined throughout the exercises, as did fT3. TT4, fT4, and TT3 increased in the first 24 to 48 h of the exercises, then progressively declined thought REC1. By REC2, TT4, fT4, and TSH showed trends towards returning to BASELINE levels, although recovery was not complete. The findings from this study demonstrates that thyroid hormone concentrations become reduced with as little as 72 h of military field operations in an arctic winter environment. However, short-term sleep deprivation and differing levels of physical work seem to have no major impact on the magnitude of the hormonal changes.