Longitudinal associations of blood pressure with aortic stiffness and pulsatility: the Atherosclerosis Risk in Communities Study.

OBJECTIVE: To characterize the longitudinal relationships between blood pressure measured over 24 years and arterial stiffness in late life measured as pulse wave velocity (PWV). METHODS: Carotid--femoral (cf) and femoral--ankle (fa) PWV were measured in 4166 adults at the visit 5 Atherosclerosis Risk in Communities study cohort examination (2011-2013). Participants were categorized into tertiles of PWV measurements. Blood pressure measurements were made at baseline (1987-1989), three subsequent triennial examinations, and visit 5. RESULTS: Partial correlation coefficients between visit 5 cfPWV and SBP ranged from 0.13 for visit 1 SBP to 0.32 for visit 5 SBP. For visit 5 faPWV, correlations were ∼0 for visits 1 to 4 SBP, but was 0.20 for visit 5 SBP. Over 24 years of follow-up, those with higher average SBP were more likely to fall in the middle and upper tertiles of visit 5 cfPWV. Average pulse pressure and mean arterial pressure over 24 years had similar but weaker associations with cfPWV tertiles. DBP had no clear association with cfPWV. Blood pressure measurements were positively associated with faPWV tertiles only cross-sectionally at visit 5. CONCLUSION: Adult life-course measures of SBP, more so than mean arterial and pulse pressure, were associated with later life central arterial stiffness. By contrast, only contemporaneous measures of blood pressure were associated with peripheral arterial stiffness. Although arterial stiffness was only measured at later life, these results are consistent with the notion that elevated blood pressure over time is involved in the pathogenesis of arterial stiffening.

Light to moderate alcohol consumption is protective for type 2 diabetes mellitus in normal weight and overweight individuals but not the obese.

OBJECTIVE: To examine the association between alcohol consumption and risk of type 2 diabetes mellitus (T2DM) overall and by body mass index. METHODS: Cross-sectional study of employed individuals. Daily alcohol intakes were calculated from a self-administered food frequency questionnaire by 5,512 Maori, Pacific Island, and European workers (3,992 men, 1520 women) aged 40 years and above. RESULTS: There were 170 new cases of T2DM. Compared to the group with no alcohol consumption and adjusting for age, sex, and ethnicity, the group consuming alcohol had relative risks of T2DM of 0.23 (95% CI: 0.08, 0.65) in normal weight individuals, 0.38 (0.18, 0.81) in overweight individuals, and 0.99 (0.59, 1.67) in obese individuals. After further adjusting for total cholesterol, HDL-cholesterol, triglycerides, smoking habit, physical activity, socioeconomic status, body mass index, and hypertension, the relative risks of T2DM were 0.16 (0.05, 0.50) in normal weight individuals, 0.43 (0.19, 0.97) in overweight individuals, and 0.92 (0.52, 1.60) in overweight individuals. Across the categories of alcohol consumption, there was an approximate U-shaped relationship for new cases of T2DM. There was no significant association between alcohol consumption and IGT. CONCLUSIONS: Alcohol consumption was protective against diagnosis of T2DM in normal and overweight individuals but not in the obese.

Redistribution of heart failure as the cause of death: the Atherosclerosis Risk in Communities Study.

BACKGROUND: Heart failure is sometimes incorrectly listed as the underlying cause of death (UCD) on death certificates, thus compromising the accuracy and comparability of mortality statistics. Statistical redistribution of the UCD has been used to examine the effect of misclassification of the UCD attributed to heart failure, but sex- and race-specific redistribution of deaths on coronary heart disease (CHD) mortality in the United States has not been examined. METHODS: We used coarsened exact matching to infer the UCD of vital records with heart failure as the UCD from 1999 to 2010 for decedents 55 years old and older from states encompassing regions under surveillance by the Atherosclerosis Risk in Communities (ARIC) Study (Maryland, Minnesota, Mississippi, and North Carolina). Records with heart failure as the UCD were matched on decedent characteristics (five-year age groups, sex, race, education, year of death, and state) to records with heart failure listed among the multiple causes of death. Each heart failure death was then redistributed to plausible UCDs proportional to the frequency among matched records. RESULTS: After redistribution the proportion of deaths increased for CHD, chronic obstructive pulmonary disease, diabetes, hypertensive heart disease, and cardiomyopathy, P < 0.001. The percent increase in CHD mortality after redistribution was the highest in Mississippi (12%) and lowest in Maryland (1.6%), with variations by year, race, and sex. Redistribution proportions for CHD were similar to CHD death classification by a panel of expert reviewers in the ARIC study. CONCLUSIONS: Redistribution of ill-defined UCD would improve the accuracy and comparability of mortality statistics used to allocate public health resources and monitor mortality trends.

Increased prevalence of albuminuria among non-European peoples with type 2 diabetes.

BACKGROUND: A high incidence of albuminuria, varying by ethnicity, has been found in a number of populations worldwide. There have been few opportunities to explore the prevalence of albuminuria as a marker of chronic kidney disease while adjusting for other risk factors in the different ethnic groups in New Zealand. METHODS: We examined the association between albuminuria and ethnicity using cross-sectional data from a large cohort study of type 2 diabetes conducted in New Zealand. RESULTS: The study population was 65 171 adults in primary care with type 2 diabetes, not on renal replacement therapy; median age was 64.7 years, median diabetes duration 5.1 years and 48.5% were non-European. Microalbuminuria or greater was present in 50% of Maori, 49% of Pacific people, 31% of Indo- and East-Asians and 28% of Europeans. Regression analyses were used to examine the association between ethnicity and albuminuria-measured as albumin:creatinine ratio-after controlling for study site and other known risk variables: age, sex, duration of diabetes, smoking status, socioeconomic status, body mass index, systolic and diastolic blood pressure, triglyceride levels, HbA(1C) and being on an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. After controlling for these risk factors and compared with Europeans, odds ratios for 'advanced' albuminuria (≥100 mg/mmol) were 3.9 (95% confidence interval: 3.2-4.6) in Maori, 4.7 (3.6-6.3) in Pacific people, 2.0 (1.5-2.7) in Indo-Asians and 4.1 (3.2-5.1) in East-Asians. CONCLUSION: Non-European ethnicities appear to carry significantly higher risks of albuminuria in type 2 diabetes.

Dietary intakes of Pacific, Maori, Asian and European adolescents: the Auckland High School Heart Survey.

OBJECTIVE: To compare dietary intakes of European, Maori, Pacific Island and Asian adolescents living in Auckland. METHODS: A self-administered food frequency questionnaire was used to assess daily nutrient intakes of 2,549 14- to 21-year-old high-school students in Auckland (1,422 male and 1,127 female) in a cross-sectional survey carried out between 1997 and 1998. RESULTS: Compared with Europeans, Maori and Pacific Islanders consumed more energy per day. Carbohydrate, protein and fat intakes were higher in Maori and Pacific Islanders than in Europeans. Cholesterol intakes were lowest in Europeans and alcohol intakes were highest in Europeans and Maori. When nutrient intakes were expressed as their percentage contribution to total energy, many ethnic differences in nutrient intakes between Europeans and Maori or Pacific Islanders were eliminated. After adjustment for energy intake and age, Europeans ate the fewest eggs, and Pacific Islanders and Asians ate more servings of chicken and fish, and fewer servings of milk and cereal than Europeans. Compared to Europeans, Pacific Islanders consumed larger portion sizes for nearly every food item. CONCLUSION: There were marked differences in nutrient intakes between Pacific, Maori, Asian and European adolescents. Ethnic differences in food selections, frequency of food servings and portion sizes contribute to the differences in nutrient intakes between these ethnic groups. These differences generally matched those of other studies in children and adults from these ethnic groups. IMPLICATIONS: Interventions that reduce frequency of food consumption and serving sizes and promote less-fatty food choices in Maori and Pacific adolescents are needed.

Overweight and obesity prevalence among adult Pacific peoples and Europeans in the Diabetes Heart and Health Study (DHAHS) 2002-2003, Auckland New Zealand.

AIM: This paper describes and compares proportions of overweight, obese, and average BMI and their relationship with physical activity for Pacific ethnic groups (Samoan, Tongan, Niue, Cook Islands) and European New Zealanders by gender who participated in the 2002-03 Diabetes Heart and Health Study (DHAHS). METHODS: The DHAHS was a cross-sectional population based study of people age 35-74 years carried out in Auckland between 2002-03. A total of 1011 Pacific people comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders and 47 'Other Pacific' (mainly Fijian) and 1745 European participants took part in the survey. Participants answered a self-administered questionnaire to assess their participation in physical activity, perceived weight, and their perception of their current weight. Following this participant's height and weight was measured for calculation of BMI. Ethnic-specific cut offs were used for classification of overweight (Pacific > or = 26.0-<32.0, European > or = 25.0-<30.0) and obesity (Pacific > or = 26.0, European > or = 32.0). RESULTS: Approximately 95% of Pacific men and 100% Pacific women were 'overweight or obese'. Proportions of obesity were for men: all Pacific 53%, Samoan 58%, Cook Island 23%, Tongan 60%, and Niuean 49%; and for women: all Pacific 74%, Samoan 75%, Cook Island 69%, Tongan 78%, and Niuean 76%. Pacific people were as accurate at estimating their body weight as Europeans, and included similar proportions who under-estimated their weight. The Cook Islands group were most likely to accurately report their weight and were significantly less likely to underestimate their weight. A significantly higher proportion of Pacific people reported that they were heavier than a year ago (22.7%) compared to Europeans (17.2%), but significantly fewer Pacific people (55.6%) reported thinking that they were overweight compared to Europeans (64.9%). After adjustment for possible confounding variables, older Pacific adults were over 11 times more likely to be obese than their Europeans counterparts. CONCLUSION: The continued rise in overweight and obesity in older Pacific adults means that almost all are now overweight or obese. This raises concerns about interventions focussed on overweight and obesity, and will require the adoption of a total Pacific population 'environmental change' approach rather than dietary or physical activity interventions targeted to overweight individuals.

Seasonal variation in the acute presentation of urinary calculi over 8 years in Auckland, New Zealand.

STUDY TYPE: Symptom prevalence (retrospective cohort) Level of Evidence 2b. OBJECTIVE: To determine the incidence of acute presentation of urinary calculi (UC) in Auckland, New Zealand, during the period 1999-2007, and whether there was any significant seasonal variation. PATIENTS AND METHODS: The details of all UC within the population presenting acutely to public hospitals in Auckland between 1999 and 2007 were collected using clinical coding searches International Classification of Disease 10th revision (Australian Modification) N132 and N20. Climatic variables for the Auckland region were obtained from the National Institute of Water and Atmospheric Research, New Zealand. The mean atmospheric temperature, hours of sunshine and humidity data were calculated monthly for this period. RESULTS: During the study there were 7668 acute presentations of UC in the Auckland region. A Poisson regression model showed that the number of presentations was significantly related to temperature (P < 0.001) and hours of sunshine (P = 0.004) but not humidity (P = 0.14). For each degree increase in temperature the number of presentations increased by 2.8% (95% confidence interval 1.3-4.3%). For each 1-h increase in sunshine, the number of presentations increased by 0.2% (0.06-0.33)%. CONCLUSION: The acute presentation of UC in Auckland, New Zealand, varies significantly with temperature and hours of sunshine. Humidity was not a significant factor.

'From Kava to Lager'--alcohol consumption and drinking patterns for older adults of Pacific ethnic groups, and Europeans in the Diabetes Heart and Health Study (DHAHS) 2002-2003, Auckland New Zealand.

AIM: This paper describes and compares alcohol consumption and drinking patterns for Pacific ethnic groups (Samoan, Tongan, Niue, Cook Islands) and European New Zealanders by gender participating in the 2002-03 Diabetes Heart and Health Study (DHAHS). METHODS: The DHAHS was a cross-sectional population based study of people age 35-74 years carried out in Auckland between 2002-03. A total of 1011 Pacific people comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders and 47 'Other Pacific' (mainly Fijian) and 1745 European participants took part in the survey Participants answered a self-administered questionnaire to assess whether they consumed alcohol, their drinking patterns and consumption levels and reasons for stopping drinking. RESULTS: Approximately half (51.3%) of all Pacific people did not currently drink compared to 6.2% of the European population. Of 'non-drinkers'--never Drinking'was significantly more common in Pacific (40%) compared to Europeans (13%) p < 0.0001. Ex-drinkers comprised 6.3% of the 'ever-drank' population for European compared to 27.6% for Pacific. The majority of Pacific men and women drinkers (>60%) consumed alcohol 'weekly' or 'less than weekly'. In contrast the majority of European men and women drinkers (>60%) consumed alcohol '2-3 days per week' or 'daily'. European men were significantly more likely to drink wine and spirits, and European women were significantly more likely to drink wine than their Pacific counterparts. Pacific drinkers consumed an average of 6.9 drinks on a typical occasion and 82 mls of pure alcohol per week, compared to 3.6 drinks and 126 mls per week for Europeans. CONCLUSION: Middle-aged and older Pacific adults are less likely to consume alcohol than Europeans however those who drink consume more on a typical occasion but drink less regularly resulting in lower weekly consumption of pure alcohol. Drinking patterns in these Pacific adults tend to show substantial diversity by age (older are less likely to drink), sex (women less likely to drink), and financial deprivation (middle groups consume more than least and most financially deprived). For Europeans a more homogenous drinking style prevailed by age, sex, and deprivation. Pacific drinkers were also approximately five times more likely to stop drinking compared to Europeans, citing family and social reasons as their main motivation for stopping drinking.

Dietary intakes of European, Maori, Pacific and Asian adults living in Auckland: the Diabetes, Heart and Health Study.

OBJECTIVE: To compare dietary intakes of European, Maori, Pacific, and Asian men and women living in Auckland. METHODS: Daily nutrient intakes were calculated from a self-administered food frequency questionnaire from participants in a cross-sectional health screening study carried out between 2002 and 2003. Participants were 4,007 Maori, Pacific, Asian and European people (1,915 men, 2,092 women) aged 35 to 74 years. RESULTS: Compared with Europeans, Maori and Pacific men had higher total energy intakes per day, while Asians had lower intakes. A similar pattern was observed for carbohydrate and fat consumption. While protein and cholesterol consumption tended to be lower in Europeans than the other three ethnic groups, alcohol consumption and calcium intakes were highest among Europeans. Many of the differences between ethnic groups were attenuated when nutrient consumption was expressed as their percentage contribution to total energy intake suggesting that total food consumption was the major determinant of ethnic differences in nutrient intakes. CONCLUSIONS: There were substantial differences in dietary habits, food selections and cooking practices between European, Maori, Pacific and Asian participants. However, the observed differences were in the area of serving sizes and frequency of consumption of certain foods than to major differences in the range of foods and nutrients consumed or the percentage contribution of carbohydrate, fat or protein to total energy intake. IMPLICATIONS: The development of strategies to reduce serving sizes and the frequency of consumption of certain foods will be required to help address the major nutrition-related health problems in New Zealand.

Ethnic differences in cardiovascular disease risk factors and diabetes status for Pacific ethnic groups and Europeans in the Diabetes Heart and Health Survey (DHAH) 2002-2003, Auckland New Zealand.

AIM: The aim of this paper is to provide levels of cardiovascular disease (CVD) risk factors and diabetes status for Pacific ethnic groups and make comparisons amongst these groups (Samoan, Tongan, Niuean, Cook Islanders) with European New Zealanders by gender from the 2002-03 DHAH Survey. METHODS: The DHAH was a cross-sectional population-based survey and was carried out in Auckland between 2002-03. A total of 1011 Pacific comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders, and 47 Other Pacific (mainly Fijian) and 1745 European participants took part in the survey. Participants answered a self-administered questionnaire to assess whether they had previously diagnosed CVD risk factors (blood pressure, cholesterol, diabetes) and lifestyle risk factors (smoking, physical inactivity). All participants provided an early morning mid-stream urine sample, an initial blood test and full glucose tolerance test (GTT) for those not previously diagnosed with diabetes. RESULTS: In both men and women, CVD risk among the Pacific groups were all significantly higher than Europeans. Niueans had the lowest Pacific CVD risk and Samoans had the highest estimated risk. Individual risk factors differed between the groups, however; the most observable differences were the more adverse lipid profile in Tongan men and the lower total cholesterol and micro-albumin in Niuean women when compared to their Samoan counterparts. Diabetes prevalence was highest in Samoan men (26.2%) and Tongan women (35.8%). Tongan women had a diabetes prevalence over double that of their men (17.8%), whereas in the other Pacific groups, male and female prevalence was very similar. Niueans had the lowest diabetes prevalence of both sexes (men 14.9%, women 10.8%). Undiagnosed diabetes as a proportion of total diabetes was similar in Samoan, Niuean and Cook Islands groups (1/4-5) suggesting efficient screening. Cook Islanders had a ratio of one undetected diabetes case for every two known cases. CONCLUSION: CVD risk factors, diabetes prevalence, and levels of undetected diabetes differed between the Pacific ethnic groups with Niueans having the healthiest profile. More rigorous screening of diabetes in Cook Islanders is needed if they are to experience similar detection rates as other Pacific Island communities in New Zealand. Greater attention is required to identify and manage CVD risk among all Pacific peoples to reduce the gap in CVD risk factors, morbidity and mortality when compared to European New Zealanders.

Comparison of three different methods of assessing cardiovascular disease risk in New Zealanders with Type 2 diabetes mellitus.

AIM: To compare three methods of assessing 5-year absolute risk of cardiovascular disease (CVD) in adults with type 2 diabetes; the Framingham CVD equation, the UK Prospective Diabetes Study (UKPDS) coronary heart disease plus stroke equations and the New Zealand Guidelines Group (NZGG)-modified Framingham CVD equation. METHODS: Participants were 423 people with newly (n=118) or previously diagnosed (n=305) Type 2 diabetes mellitus aged 35 to 74 years with no past history of cardiovascular disease or nephropathy from an interviewed study population of 4049 adults. Absolute 5-year CVD risks were calculated in 5-year age bands by gender; Maori, Pacific, and European ethnicity; and newly and previously diagnosed diabetes. RESULTS: The mean 5-year CVD risk score was 2.9% (95%CI: 2.40-3.42; p<0.0001) lower for the UKPDS risk engine compared to the original Framingham equation in absolute terms, and 7.6% (95%CI: 7.05-8.08; p<0.0001) lower than the NZGG-modified Framingham equation. In general, 5-year CVD risks were highest using the NZGG-modified equation, intermediate using the original Framingham equation and lowest using the combined UKPDS coronary heart disease plus stroke equations, in all age groups by gender, ethnicity, and time of diagnosis of Type 2 diabetes. However, the 5-year CVD risks are themselves potentially low as they include treated blood pressure and lipid values. Compared to the UKPDS 15% level of risk, the NZ Guidelines modified 15% level of risk results in people with diabetes being recommended for CVD drug management 10 to 17 years earlier. CONCLUSIONS: In general, among people with Type 2 diabetes, the Framingham equations showed higher 5-year CVD risk estimates compared to combined UKPDS coronary heart disease plus stroke equations and the NZGG-modified Framingham equation showed the highest 5-year CVD risks. In practice, people with type 2 diabetes will be managed earlier and more intensively based on their risk estimated by the current NZGG guidelines than if the UKPDS or original Framingham equations were used.

Comparison of different markers of socioeconomic status with cardiovascular disease and diabetes risk factors in the Diabetes, Heart and Health Survey.

AIM: To compare different markers of socioeconomic status (SES) with cardiovascular disease (CVD) and diabetes risk factors. METHODS: Data were from 4020 participants aged 35-74 years from the Diabetes, Heart and Health Survey that was carried out in 2002 and 2003. Measures of SES were the occupation-based NZ Socioeconomic Index (NZSEI), combined household income, education, and the area-based deprivation measure NZDep2001. RESULTS: After adjusting for all other SES measures, there were relatively few independent risk factor associations with NZSEI or education. Both low income and being more deprived as measured by NZDep2001 were independently associated with higher 2-hour glucose tolerance concentrations, HbA1c levels, waist-to-hip ratio, urinary albumin concentrations, 5-year CVD risk, current cigarette smoking, lower HDL-cholesterol, and less time spent exercising compared to the highest SES strata. Low income was independently associated with a higher prevalence of total and previously diagnosed diabetes mellitus, and lower stature. More deprivation was independently associated with higher diastolic blood pressure levels, fasting glucose concentrations and BMI. Associations with height, and 2-hour glucose levels, and prevalence of total and previously diagnosed diabetes were greater with income, whereas NZDep2001 showed stronger associations with diastolic blood pressure, raised blood pressure, HDL-cholesterol, fasting glucose, BMI, waist-to-hip ratio, exercise levels, urinary albumin concentrations, 5-year risk of CVD and prevalence of smoking compared to the highest SES groups. Associations of income and NZDep2001 with HbA1c were similar. CONCLUSIONS: Cardiovascular disease and diabetes risk factors were more strongly associated with the area-based NZDep2001 and household income than with the individual's occupation-based NZSEI or education. In general, the strongest associations were observed for NZDep. These findings provide support for the application of NZDep in health policy development in New Zealand, when other measures of SES are not available, and we recommend that this very accessible indicator of socioeconomic and health status continue to be updated.

The effects of social networks on disability in older Australians.

OBJECTIVE: To investigate the effects of total social networks and specific social networks with children, relatives, friends, and confidants on disability in mobility and Nagi functional tasks. METHODS: Six waves of data from the Australian Longitudinal Study of Ageing were used. Data came from 1,477 participants aged 70 years or older. The effects of total social networks and those with children, relatives, friends, and confidants on transitions in disability status were analyzed using binary and multinomial logistic regression. RESULTS: After controlling for a range of health, environmental, and personal factors, social networks with relatives were protective against developing mobility disability (OR = 0.89; 95% CI = 0.79 to 1.00) and Nagi disability (OR = 0.85; 95% CI = 0.74 to 0.96). Other social subnetworks did not have a consistent effect on the development of disability. DISCUSSION: The effects of social relationships extend beyond disability in activities of daily living. Networks with relatives protect against disability in mobility and Nagi tasks.

Long-term effects of a reduced fat diet intervention on cardiovascular disease risk factors in individuals with glucose intolerance.

The long-term effects on cardiovascular disease risk factors of a reduced fat (RF), ad libitum diet were compared with usual diet (control, CD) in glucose intolerance individuals. Participants were 136 adults aged > or =40 years with 'glucose intolerance' (2h blood glucose 7-11.0 mmol/l) detected at a Diabetes Survey who completed at 1 year intervention study of reduced fat, ad libitum diet versus usual diet. They were re-assessed at 2, 3 and 5 years. Main outcome measures were blood pressure, serum concentrations of total cholesterol, HDL and LDL cholesterol, total cholesterol:HDL ratio, triglycerides and body weight. The reduced fat diet lowered total cholesterol (P<0.01), LDL cholesterol (P< or =0.05), total cholesterol:HDL ratio (P< or =0.05), body weight (P<0.01) and systolic blood pressure (P< or =0.05) initially and diastolic blood pressure (P<0.01) long-term. No significant changes occurred in HDL cholesterol or triglycerides. In the more compliant 50% of the intervention group, systolic and diastolic blood pressure levels and body weight were lower at 1, 2 and 3 years (P<0.05). It was concluded that a reduced fat ad libitum diet has short-term benefits for cholesterol, body weight and systolic blood pressure and long-term benefits for diastolic blood pressure without significantly effecting HDL cholesterol and triglycerides despite participants regaining their lost weight.

Fat content of chips, quality of frying fat and deep-frying practices in New Zealand fast food outlets.

OBJECTIVES: To collect baseline data on the fat content of hot chips, quality (degradation) of cooking fat, deep-frying practices and related attitudes in fast food outlets in New Zealand. To identify the key determinants of the fat content of chips and quality of cooking fat. METHODS: A nationally representative sample of fast food outlets (n=150, response rate 80%) was surveyed between September 1998 and March 1999. Data collected included a questionnaire, observation of cooking practices and analysis of cooked chips and frying fat. RESULTS: Only 8% of independent operators had formal training in deep frying practices compared with 93% of chain operators. There was a wide range of fat content of chips (5%-20%, mean 11.5%). The use of thinner chips, crinkle cut chips and lower fryer fat temperature were associated with higher chip fat content. Eighty-nine per cent of chain outlets used 6-10 mm chips compared with 83% of independent outlets that used chips > or = 12 mm. A wide range of frying temperatures was recorded (136-233 degrees C) with 58% of outlets frying outside the reference range (175-190 degrees C). As indices of fat degradation, fat acid and polar compound values above the recommended levels occurred in 54% and 5% of outlets respectively. Operators seemed willing to learn more about best practice techniques, with lack of knowledge being the main barrier to change. CONCLUSIONS AND IMPLICATIONS: Deep frying practices could be improved through operator training and certification options. Even a small decrease in the mean fat content of chips would reduce the obesogenic impact of this popular food.

Social networks among older Australians: a validation of Glass's model.

BACKGROUND: The purpose of the study was to validate a set of measures of social networks that will be useful in epidemiological studies of the health of older persons. METHODS: Confirmatory factor analysis was used to test a multi-dimensional model of social networks. Data were drawn from The Australian Longitudinal Study of Ageing, conducted in the greater metropolitan area of Adelaide, South Australia. Participants were 1477 persons aged > or = 70 years who lived in the community or an institution and took part in the Australian Longitudinal Study of Ageing. Social networks with children, other relatives, friends and confidants were considered. Demographic indicators of gender, age group, income, education, marital status and place of residence were also measured, and social networks were compared for categories of these variables. RESULTS: Networks with children, relatives, friends and confidants were substantiated in these analyses. Differences in networks between categories of the demographic variables were evident. DISCUSSION: Adoption of the proposed measures will allow greater comparability between studies of older persons. This could lead to a better understanding of the effect of specific social networks upon health.