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1.
Nutrients ; 13(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34444849

RESUMO

A balanced diet and weight loss are the first lines of treatment for the prevention of metabolic syndrome (MS). Dietary strategies may include changing the composition of macronutrients, adopting a particular dietary pattern as a Mediterranean diet. However, the role of micronutrients, particularly potassium, in the propensity for or treatment of the syndrome is unclear. The study aimed to examine the relationship between the presence of the MS and its risk factors and the 24-h potassium excretion as the most valid proxy for dietary intake. The analyses were performed as part of the national survey estimating sodium and other electrolytes excretion conducted between 2014-2016 in Israel. The survey included urine collection, anthropometric and blood pressure measurements, and a comprehensive medical questionnaire that included details on the intake of medications that may affect electrolyte secretion. A model was constructed to evaluate the probability for the MS. MS score and its probability were examined in relation to potassium excretion at different levels and in stratification to sex. A total of 581 participants were included in the analysis. The mean potassium excretion was 2818 ± 1417 mg. The prevalence of the MS was 18.5% among participants with above-average potassium excretion and about 10.4% among participants with lower-than-average excretion (p = 0.007). A dose-response relationship was observed between MS score and potassium: the higher the score, the lower was the excretion of potassium. Potassium excretion, rather than sodium excretion, correlated with all components of the MS and even predicted MS independently from other variables. This is the first study based on a national survey showing that potassium consumption, as represented by daily excretion in urine, is inversely related to the presence of MS components after adjustment for several leading variables and careful exclusion of participants taking drugs which may interfere in potassium excretion.


Assuntos
Dieta/efeitos adversos , Síndrome Metabólica/epidemiologia , Potássio/urina , Medição de Risco/métodos , Adulto , Antropometria , Pressão Sanguínea , Fatores de Risco Cardiometabólico , Eletrólitos/urina , Feminino , Humanos , Israel , Masculino , Síndrome Metabólica/etiologia , Avaliação Nutricional , Prevalência , Sódio/urina , Coleta de Urina
2.
Sci Rep ; 11(1): 15803, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34349181

RESUMO

Since current recommendations call for a substantial reduction in overall sodium consumption, we tested whether or not these recommendations are implemented in common large subpopulations such as those with abnormal weight or hypertension in the current high sodium, high-calorie nutritional environment. In a national representative cross-sectional survey of the community-dwelling subjects aged 25-65 years conducted in Israel between 2015 and 2017, 582 randomly selected subjects completed health and dietary questionnaires, underwent blood pressure and anthropometric measurements and collected 24-h urine specimens, to assess dietary sodium intake. Overall mean 24-h sodium excretion was 3834 mg, more than double the recommended upper intake for adults < 1500 mg/day. Sodium excretion was directly related to caloric intake and blood pressure and linked to the presence of hypertension and overweight/obesity. The highest sodium excretion was seen in overweight/obese hypertensive subjects. This recent national survey shows a high consumption of sodium in the Israeli population and a dose-response association between caloric intake and urinary sodium excretion, independent of BMI and hypertension. Nevertheless, overweight/obese subjects with hypertension consume (excrete) more sodium than other BMI/ blood pressure-related phenotypes and may thus comprise a target subpopulation for future efforts to reduce sodium intake.

3.
Nutrients ; 13(8)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34444813

RESUMO

The intestinal microbiome continues to shift and develop throughout youth and could play a pivotal role in health and wellbeing throughout adulthood. Environmental and interpersonal determinants are strong mediators of the intestinal microbiome during the rapid growth period of preadolescence. We aim to delineate associations between the gut microbiome composition, body mass index (BMI), dietary intake and socioeconomic status (SES) in a cohort of ethnically homogenous preadolescents. This cohort included 139 Arab children aged 10-12 years, from varying socioeconomic strata. Dietary intake was assessed using the 24-h recall method. The intestinal microbiome was analyzed using 16S rRNA gene amplicon sequencing. Microbial composition was associated with SES, showing an overrepresentation of Prevotella and Eubacterium in children with lower SES. Higher BMI was associated with lower microbial diversity and altered taxonomic composition, including higher levels of Collinsella, especially among participants from lower SES. Intake of polyunsaturated fatty acids was the strongest predictor of bacterial alterations, including an independent association with Lachnobacterium and Lactobacillus. This study demonstrates that the intestinal microbiome in preadolescents is associated with socioeconomic determinants, BMI and dietary intake, specifically with higher consumption of polyunsaturated fatty acids. Thus, tailored interventions during these crucial years have the potential to improve health disparities throughout the lifespan.


Assuntos
Dieta , Microbioma Gastrointestinal , Fatores Socioeconômicos , Bactérias/classificação , Bactérias/genética , Índice de Massa Corporal , Criança , Estudos de Coortes , Ingestão de Alimentos , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Humanos , Masculino , Obesidade/microbiologia
4.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205416

RESUMO

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10-12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10-12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10-12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.


Assuntos
Dieta , Ingestão de Alimentos/fisiologia , Obesidade Pediátrica/epidemiologia , Árabes , Aleitamento Materno/estatística & dados numéricos , Criança , Cultura , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Comportamento Alimentar , Métodos de Alimentação , Feminino , Seguimentos , Idade Gestacional , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Israel/epidemiologia , Masculino , Fatores Socioeconômicos
5.
Eur J Nutr ; 60(7): 3625-3638, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33683418

RESUMO

PURPOSE: To compare the adherence to the Mediterranean diet (MD) in Israeli adolescents in 2003-4 and in 2015-6, and associated factors. METHODS: Adolescents (aged 11-19 years) from two cross-sectional, school-based, nationally representative surveys, Mabat Youth I (2003-4, n 5005) and II (2015-6, n 3906), completed self-administered questionnaires on food frequency, eating behaviors and lifestyle. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED index), derived from these questionnaires, was used; higher scores indicate better diet quality. The samples comprised eight subgroups, according to population group (Jews/Arabs), school level (middle/high) and sex. RESULTS: The percentages with poor, average and good KIDMED scores were 11.6, 45.3 and 43.1% in 2015-6, compared to 25.5, 55.2 and 19.3%, respectively, in 2003-4. Significant improvement was seen in all subgroups (all p < 0.001), and was attributed to increased consumption of fruits, vegetables, cereals, dairy products, and decreased negative eating behaviors. In Mabat Youth II, physical activity at least 1 h/day was positively associated with good KIDMED scores among Jewish adolescents; dieting and sleeping at least 7 h/day were associated with good MD adherence in Jewish boys; always/often reading food labels predicted good MD adherence among Jewish boys and Arab girls. Overweight and obesity were negatively associated with better KIDMED scores in Jewish boys. CONCLUSION: MD adherence in Israeli adolescents has improved overall. The changes in MD components and the associated behavioral factors indicate the initiatives, relevant to the different subgroups, that are necessary to promote healthier nutrition and lifestyles.


Assuntos
Dieta Mediterrânea , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Obesidade , Sobrepeso , Inquéritos e Questionários
6.
J Nutr ; 151(5): 1249-1255, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33693862

RESUMO

BACKGROUND: Handgrip strength (HGS) is used to assess muscle strength, which is an important indicator of health status in older adults. OBJECTIVE: We evaluated associations of demographic, anthropometric, clinical, and nutritional factors with muscle strength in community-dwelling elderly adults. METHODS: This population-based cross-sectional study employed the 2014-2015 Israeli Health and Nutrition Survey in the Elderly (n = 1039, age ≥65 y, 46.7% males, 9.9% Arabs). Trained personnel performed face-to-face interviews that focused on health and nutrition status, as well as anthropometric measurements and examinations. HGS was measured in the dominant hand 3 times using a digital grip strength dynamometer; the highest result was reported. Dietary intake data were collected using single-day 24-h recall. Multivariable logistic regressions were used to explore factors associated with low HGS (<27 kg for men and <16 kg for women). RESULTS: HGS measurements were completed by 704 participants. Following adjustment for several factors, higher prevalence of low HGS was significantly associated with age (OR: 1.14; 95% CI: 1.11, 1.18), whereas decreased prevalence was associated with higher levels of education (OR: 0.55; 95% CI: 0.32, 0.94) and meeting physical activity recommendations (OR: 0.53; 95% CI: 0.31, 0.88); P < 0.05 for all. Incremental increases of 100 kcal/d in energy intake and of 1 cm in midarm circumference were associated with decreased prevalence of low HGS (OR: 0.95; 95% CI: 0.91, 0.99 and OR: 0.91; 95% CI: 0.85, 0.97, respectively; P < 0.01 for both). Associations were not found of low HGS with ethnicity, comorbidity, BMI, smoking, or alcohol consumption or with protein, carbohydrate, or fat intakes. CONCLUSION: Energy intake, physical activity, midarm circumference, and education are associated with HGS in elderly Israeli adults. Further cohort studies are necessary to assess possible causal relations between these factors and HGS. Modifiable factors should be targeted in planning public health strategies for promoting a healthy aging population.


Assuntos
Ingestão de Energia , Força da Mão , Vida Independente , Estado Nutricional , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
7.
Environ Int ; 143: 105951, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32683210

RESUMO

Treated wastewater (TWW) is increasingly used for agricultural irrigation, especially in arid and semi-arid regions. Carbamazepine is among the most frequently detected pharmaceuticals in TWW. Moreover, its uptake and accumulation have been demonstrated in crops irrigated with TWW. A previous controlled trial found that urine concentrations of carbamazepine were higher in healthy volunteers consuming TWW-irrigated produce as compared to freshwater-irrigated produce. The aim of the current study was to assess whether carbamazepine is quantifiable in urine of Israelis consuming their usual diets and whether concentrations vary according to age, personal characteristics and diet. In this cross-sectional study, we recruited 245 volunteers, including a reference group of omnivorous healthy adults aged 18-66; pregnant women; children aged 3-6 years; adults aged >75 years; and vegetarians/vegans. Participants provided spot urine samples and reported 24-hour and "usual" dietary consumption. Urinary carbamazepine levels were compared according to group, personal characteristics, health behaviors, and reported diet. Carbamazepine was detectable (≥1.66 ng/L) in urine of 84%, 76%, 75.5%, 66%, and 19.6% of the reference group, vegetarians, older adults, pregnant women, and children, respectively. Quantifiable concentrations (≥5.0 ng/L) of carbamazepine were found in 58%, 46%, 36.7%, 14%, and 0% of these groups, respectively (p = 0.001 for comparison of proportions across groups). In adults, higher carbamazepine concentrations were significantly associated (p < 0.05) with self-defined vegetarianism, usual consumption of dairy products and at least five vegetables/day, and no meat or fish consumption in the past 24-hours. This study demonstrates that people living in a water-scarce region with widespread TWW irrigation, are unknowingly exposed to carbamazepine. Individuals adhering to recommended guidelines for daily fresh produce consumption may be at higher risk of exposure to TWW-derived contaminants of emerging concern.


Assuntos
Irrigação Agrícola , Longevidade , Idoso , Carbamazepina , Criança , Pré-Escolar , Estudos Transversais , Dieta , Feminino , Humanos , Gravidez , Águas Residuárias
8.
Nutrients ; 12(6)2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32585990

RESUMO

Efforts to shape the food environment are aimed at reducing diet-related co-morbidities. Front-of-package labeling (FOPL) may support the consumers to make an informed decision at the point of purchase and encourage industry to reformulate food products. The Israeli Ministry of Health (MOH) implemented a unique FOPL system, using two colors: A mandatory warning (red) label alongside a voluntary positive (green) label. An independent Scientific Committee, from academia, the healthcare system, and MOH was appointed to determine the core principles for the positive FOPL. The criteria were based on the Mediterranean diet principles, with adjustments to the Israeli dietary habits, focusing on the health advantages of the food and considering its processing level. The food products eligible for positive FOPL are foods in their natural form or with added spices or herbs, or those that underwent minimal processing, with no food additives. Based on population consumption data, 19.8% of food products were eligible for positive FOPL; of them, 54% were fruits and vegetables, 20% dairy, and 14% grains. An evaluation plan is needed to assess the degree of acceptance of the positive FOPL by the industry, retailers, and the public, and its impact on food consumption and on public health.


Assuntos
Rotulagem de Alimentos/normas , Promoção da Saúde/métodos , Política Nutricional , Humanos , Israel , Saúde Pública
9.
Isr J Health Policy Res ; 9(1): 5, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32014056

RESUMO

BACKGROUND: A recurring problem in medical institutions is patients not always receiving food meeting their nutritional and medical needs. A proposed contributing factor is non- inclusion of dietitians in food service staff. Recently, positions for food service dietitians in hospitals were created. For the newly defined role of "Food Service Dietitian", comprehensive training courses were developed (70 dietitians participated). OBJECTIVE: To examine the impact of the addition of the role of a "Food Service Dietitian" in medical institutions on suitability of foods served, food costs and food waste. METHODS: A three years (2014-2017) national case study to examine the new role's impact was carried out, in 18 hospitals, nine of which employ a food service dietitian (intervention), and 9 without (control). The number of nutritional analyses of menus was checked, as was the extent of kitchen staff training, and how often night meals were served for all patients. Data were gathered regarding food costs and waste with respect to food distributed to staff and patients. Food costs savings and waste reduction were calculated, based on reduction in provision of unnecessary meals, at a cost of 18 NIS per day per meal. RESULTS: Kitchen staff training was carried out in all intervention institutions, and not in the controls. In most controls, nutritional analyses were not performed, whereas in the intervention hospitals, full analyses were performed and tailoring of menus to specific department requirements improved significantly. In most intervention hospitals, late night snacks were provided, this not being so in the controls. Total food cost savings of $229,569 per annum was seen in the six intervention hospitals, attributable to 4 factors: 1.Meals not delivered to fasting patients, or those receiving parenteral/enteral nutrition- cost savings of 328,500 NIS ($93,857)2.Better tailoring and monitoring of food delivered to the wards and staff (bread, cheese, milk etc)- annual cost savings of 235,000 NIS ($67,142) in the hospitals with a food service dietitian.3.Checking expiry dates of medical foods, and improved communication between the wards, the kitchen and the food distribution centers, has lessened food waste with savings of 5% from the medical food budget per annum of 40,000 NIS ($11,428).4.As a result of dietitian-performed nutritional analyses, tailoring of food provided according to the patient's medical and nutrition needs was improved. In one hospital, after re-evaluation of serve sizes in high protein diets, sizes were reduced while retaining adequacy, with immediate cost savings of 200,000 NIS ($57,142) per annum. CONCLUSIONS: Implementation of the new role of Food Service Dietitian led to cost savings and significant improvements in adherence to the nutritional care plan.


Assuntos
Serviço Hospitalar de Nutrição/normas , Nutricionistas/normas , Valor Nutritivo , Adulto , Feminino , Serviço Hospitalar de Nutrição/estatística & dados numéricos , Hospitais/normas , Hospitais/estatística & dados numéricos , Humanos , Israel , Masculino , Nutricionistas/estatística & dados numéricos , Estudos de Casos Organizacionais , Satisfação do Paciente , Eliminação de Resíduos/estatística & dados numéricos
10.
Environ Res ; 182: 108739, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32069760

RESUMO

BACKGROUND: Human biomonitoring (HBM) data is increasingly being compared to risk-based screening values to assess human health risk. However, as screening values have not been established for assessing biomarker concentrations of organophosphate (OP) pesticide metabolites, there are few studies using HBM data on urinary OP concentrations to assess human health risk. The purpose of the current study was to measure OP exposure in a sample of children in Israel; to explore associations between dietary patterns and OP exposure; and to assess risk of OP pesticides using urinary metabolite concentrations. METHODS: We recruited 103 children in Israel and collected demographic and dietary data and urinary samples, and measured creatinine and dialkyl phosphate (DAP) concentrations. We compared urinary DAP concentrations to international populations and analysed associations between fruit and vegetable consumption and urinary DAP concentrations. Using urinary DAP concentrations, we calculated estimated daily intakes (EDI) of OP pesticides in each child and compared those to the acceptable daily intake (ADI). RESULTS: Concentrations of several dialkyl phosphate metabolites (dimethylphosphate (DMP) and dimethylthiophosphate (DMTP)) were higher in our study population of Israeli children (geometric mean concentrations of DMP and DMTP were 6.6 µg/L and 7.6 µg/L, respectively) compared to children in the US, Canada, Spain, and Denmark. We found positive correlations between total fruit consumption and creatinine adjusted log transformed urinary DMP, DMTP, diethylthiophopshate (DETP), total dimethyl (DM) and total DAP concentrations (p < 0.05), positive correlations between cucumber consumption and diethylphosphate (DEP), DETP and diethyl (DE) concentrations (p < 0.05), and positive correlations between apple consumption and DETP concentrations (p = 0.02). Based on urinary DAP concentrations, we found that a portion of the children in our study had EDIs above the ADI, ranging from 2.9% to 79.4% of the children, depending on the active OP ingredient. CONCLUSIONS: We found that Israeli children in our study are widely exposed to OP pesticides; that levels of dimethyl metabolites were high compared to other international populations; and that fruit consumption was associated with higher urinary DAP levels. Using urinary DAP concentration data, we found that a portion of the children in our study may be exposed to OP pesticides at levels above those considered safe.


Assuntos
Dieta , Exposição Ambiental , Compostos Organofosforados , Praguicidas , Canadá , Criança , Humanos , Israel , Organofosfatos , Medição de Risco , Espanha
11.
Aging Clin Exp Res ; 32(8): 1459-1467, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31522392

RESUMO

BACKGROUND: Obesity has been traditionally viewed as a protective factor for fractures. Recent studies have challenged this concept, particularly regarding abdominal obesity. We aimed to investigate the association between abdominal obesity, body mass index (BMI) and fragility fractures prevalence in a sample of community-dwelling elderly Israeli women. METHODS: The data in this cross-sectional study were based on 'Mabat Zahav'-a survey of a nationally representative sample of elderly Israelis. The study population included 669 women. Data on fragility fractures site and circumstances were self-reported, and height, weight, waist and calf circumferences were measured. Waist circumference (WC) variable was divided into tertiles: < 88 cm, 88-99 cm and > 99 cm. RESULTS: Sixty-five women reported fragility fractures (14 hip fractures, 18 vertebral fractures and 39 wrist fractures). Mean age was 73.9 ± 5.9 years, mean BMI was 29.9 ± 5 kg/m2 and mean WC was 93.9 ± 12 cm. While BMI was not associated with osteoporotic fractures, abdominal obesity (WC > 88 cm) was positively associated with fragility fractures, independently of age, smoking, physical activity [middle and high WC tertiles {3.15 (95% CI 1.41-7.02), 2.78 (95% CI 1.05-7.31), respectively}]. CONCLUSIONS: Among this sample of elderly women, abdominal obesity was positively associated with fragility fractures, independently of age, smoking, physical activity and BMI. Waist circumference, an easily measured anthropometric indicator, may be useful for assessing the risk of fragility fractures in elderly women, particularly among those with normal or high BMI-a vast population which has been traditionally considered as having lower fracture risk.


Assuntos
Fraturas Ósseas , Fragilidade , Obesidade Abdominal , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/epidemiologia , Fragilidade/complicações , Fragilidade/epidemiologia , Humanos , Israel/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Fatores de Risco , Circunferência da Cintura
12.
Clin Nutr ; 38(6): 2928-2935, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30642736

RESUMO

BACKGROUND & AIMS: There is a substantial body of evidence supporting the health benefits of the Mediterranean diet, which has differing variations across the Mediterranean region. Abbreviated dietary screeners can be adapted and used to assess adherence to the local Mediterranean diet variant. We aimed to describe the process of adapting the Spanish Mediterranean Diet Adherence Screener (MEDAS) for use in Israel, and to test the predictive utility of the adapted score for mortality. METHODS: A professional committee of nutritional policy makers, dieticians and researchers adapted MEDAS to create an Israeli Mediterranean diet screener (I-MEDAS) that reflected the local Mediterranean diet and national dietary recommendations. The Hadera District Study (HDS) was a population-based, prospective cohort study of adults in Israel. Food frequency questionnaire (FFQ) data from the HDS was used to calculate Mediterranean diet adherence according to the I-MEDAS score criteria and evaluate the score's predictive utility. Mortality status was obtained from the national population registry. Cox proportional hazards regression models were used to test the predictive utility of the I-MEDAS score for all-cause mortality. RESULTS: The 14-item MEDAS was adapted to create a 17-item I-MEDAS. According to FFQ data from the HDS cohort (n = 1092 adults; median [IQR] follow-up time = 14 [12-15] years, 179 deaths), the median (IQR) I-MEDAS score was 8 (7-9). In multivariable analysis, every 1-point increase in the I-MEDAS score reduced the hazard of death by 12% (adjusted HR: 0.88; 95% CI: 0.80-0.97). The original MEDAS score was less strongly associated with mortality, and lost significance after adjustment for potential confounders. CONCLUSIONS: I-MEDAS reflects the local Mediterranean diet and national dietary recommendations in Israel. The I-MEDAS score, calculated from FFQ data, demonstrated predictive utility for mortality in a population-based cohort of adults.


Assuntos
Dieta Mediterrânea/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
13.
Environ Int ; 121(Pt 1): 643-648, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30316179

RESUMO

BACKGROUND: Environmental tobacco smoke (ETS) exposure in infants and children causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. The aim of this study was to measure ETS exposure in children in Israel (ages 4-11 years) using urinary cotinine measurements, in order to compare exposure levels to other international populations, and to assess predictors of ETS exposure in children in Israel. METHODS: A subset of children who participated in the National Health and Nutrition Survey (RAV- MABAT) in 2015-2016 were invited to participate in the Second Israel Biomonitoring Survey. We analyzed urinary cotinine and creatinine concentrations in 103 children. Parents of study participants were interviewed in person on children's exposure to ETS at home and in other environments and on sociodemographic variables. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means in children and analyzed associations in univariable and multivariable analyses, between sociodemographic variables and parental - reported exposure, and urinary cotinine concentrations. RESULTS: Based on urinary creatinine measurement, over 60% of children are exposed to ETS (compared to <40% based on parental report). Linear regression showed a positive association between urinary cotinine concentration and reported ETS exposure (p = 0.001). Mean cotinine concentration among children whose parents reported that they are exposed to ETS at home (5.1 µg/l) was significantly higher than the concentration among children whose parents reported they are not exposed to ETS at home (1.6 µg/l, p < 0.001). There was an inverse relationship between total family income and urinary cotinine concentration (p < 0.05). In a multivariable model adjusted for ethnicity and other factors, family income was a significant predictor of urinary cotinine level (p = 0.04, slope = -0.49). Geometric mean creatinine adjusted concentrations in children in the current study were higher than in children in Canada and selected European countries. CONCLUSIONS: We found evidence of widespread exposure to ETS in children in the study. There is an urgent need to protect children in Israel from exposure to ETS.


Assuntos
Exposição Ambiental , Poluição por Fumaça de Tabaco/análise , Asma/etiologia , Criança , Pré-Escolar , Cotinina/urina , Creatinina/urina , Monitoramento Ambiental , Feminino , Humanos , Renda , Israel , Modelos Lineares , Masculino , Inquéritos Nutricionais , Pais , Infecções Respiratórias/etiologia , Fatores Socioeconômicos , Inquéritos e Questionários
14.
Thyroid ; 28(8): 1042-1051, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29855255

RESUMO

BACKGROUND: Milk is a major source of iodine in human nutrition. Because both iodine content and the consumption of milk and dairy vary widely over time and populations, their contribution to iodine intake must be evaluated regularly. A recent national iodine survey found Israel's population to be mildly iodine deficient, possibly due to unmonitored changes in the food content of dietary iodine. Accounting for dairy iodine content can help guide efforts to prevent iodine deficiency. OBJECTIVES: This study aimed to determine the iodine concentration of dairy products typically consumed in the Israeli diet, and to estimate iodine intake from dairy products among Israeli adults. METHODS: Iodine was analyzed in 33 selected dairy products that account for 89% of the total population's dairy intake according to the "MABAT" Israeli National Health and Nutrition survey. Based on these data, the distribution of iodine intake from milk, dairy, and dairy-based foods in the adult population was calculated. RESULTS: Israeli milk is rich in iodine, with a mean concentration of 22 µg/100 g. However, due to low dairy consumption, the mean iodine intake from milk and dairy was only 34 µg/day (median 23 µg/day; range: 0-337 µg/day) or 22% of the recommended daily allowance. Self-reported intake among poor, male, and Arab subgroups was even lower. CONCLUSIONS: Because Israeli milk and dairy products are iodine rich, their contribution to the population's iodine intake would increase if they were consumed in greater amounts, particularly by high-risk groups. Dairy's potential contribution to iodine nutrition should be considered in recommendations for dairy consumption and iodine prophylaxis.


Assuntos
Laticínios/análise , Dieta , Iodo/análise , Leite/química , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Israel , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Gravidez , Adulto Jovem
15.
Isr J Health Policy Res ; 7(1): 33, 2018 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-29936912

RESUMO

BACKGROUND: Exposure to environmental tobacco smoke (ETS) increases the risk of heart and respiratory disease, cancer, and premature mortality in non-smoking individuals. Results from the first Israel Biomonitoring Study in 2011 showed that over 60% of non-smoking adults are exposed to ETS. The purpose of the current study was to assess whether policies to restrict smoking in public places have been associated with reductions in exposure to ETS, and to examine predictors of exposure. METHODS: We analyzed urinary cotinine and creatinine concentrations in 194 adult participants in the National Health and Nutrition (RAV MABAT) Survey in 2015-2016. Study participants were interviewed in person on smoking status and exposure to ETS. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means and medians among smokers and non-smokers. We analyzed associations in univariable analyses, between socio-demographic variables and self - reported exposure, and urinary cotinine concentrations. RESULTS: There was no reduction in geometric mean urinary cotinine levels in non-smokers in the current study (1.7 µg/g) compared to that in 2011 (1.6 µg/g). Median cotinine levels among the non - smoking Arab participants were higher in comparison to the Jewish and other participants (2.97 versus 1.56 µg/l, p = 0.035). Participants who reported that they were exposed to ETS at home had significantly higher median levels of creatinine adjusted urinary cotinine than those reporting they were not exposed at home (4.19 µg/g versus 2.9 µg/g, p = 0.0039). CONCLUSIONS: Despite additional restrictions on smoking in public places in 2012-2016, over 60% of non-smoking adults in Israel continue to be exposed to ETS. Urinary cotinine levels in non-smokers have not decreased compared to 2011. Results indicate higher exposure to ETS in Arab study participants and those reporting ETS exposure at home. There is an urgent need: (1) to increase enforcement on the ban on smoking in work and public places; (2) for public health educational programs and campaigns about the adverse health effects of ETS; and (3) to develop and disseminate effective interventions to promote smoke free homes. Periodic surveys using objective measures of ETS exposure (cotinine) are an important tool for monitoring progress, or lack thereof, of policies to reduce exposure to tobacco smoke in non-smokers.


Assuntos
Cotinina/urina , Monitoramento Ambiental/métodos , Política Antifumo , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adulto , Cotinina/análise , Feminino , Política de Saúde , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Fumar/efeitos adversos , Fumar/etnologia , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/análise
16.
Maturitas ; 114: 46-53, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29907246

RESUMO

OBJECTIVE: To evaluate whether specific obesity phenotypes in community-dwelling elderly: (a) affect differently the relationship between frailty and functional impairment and (b) are related to cognitive impairment. STUDY DESIGN: A post-hoc cross-sectional analysis of the last Israeli national health and nutrition survey of the elderly (≥ 65 yrs.; n = 1619). MAIN OUTCOME MEASURES: We implemented a previously validated frailty model based on frailty-related variables that were obtained in the survey. Mild cognitive impairment was defined using the Mini-Mental State Examination (a score <24 and >17). The Katz's scale of activities of daily living was used for functional assessment. Data were clustered according to different obesity phenotypes using measured body mass index (BMI) and waist circumference (WC). RESULTS: The link between frailty and disability was most prominent in subjects with abdominal obesity who were non-obese by BMI: compared with non-obese subjects as defined by WC and BMI, the odds ratio (OR) for functional limitations in this phenotype was 8.34 (95 % CI, 2.14-32.48) for pre-frail subjects and 69.26 (10.58-453.55) for frail subjects. The rate of cognitive impairment was 3.3 times higher (p = .023) in women who were obese by WC but not by BMI. CONCLUSIONS: In elderly people with a large WC and BMI < 30 kg/m2, disability is more tightly linked to frailty than for any other form of obesity. Cognitive impairment was more prominent in women with central obesity and BMI < 30 kg/m2 than in the other anthropometric phenotypes. WC should be used for early detection of individuals at risk of progression of frailty to functional incapacity.


Assuntos
Atividades Cotidianas/psicologia , Disfunção Cognitiva/complicações , Idoso Fragilizado/psicologia , Obesidade Abdominal/complicações , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Disfunção Cognitiva/psicologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Obesidade Abdominal/psicologia , Circunferência da Cintura
17.
Isr J Health Policy Res ; 7(1): 18, 2018 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-29642949

RESUMO

BACKGROUND: Increasing longevity presents new social and medical challenges in developed countries. The prevalence of frailty is of interest because of its association with health prognosis and outcomes, but so far there is no single best diagnostic tool for this entity. Therefore, estimated prevalence of frailty in countries varies considerably and ranges between 5% and 58%. In Israel, the nation-wide prevalence of frailty in the elderly population is presently unknown. The objective of our study was to assess the rate of the frailty in elderly Israelis. METHODS: A post-hoc analysis based on the results of a national Health and Nutrition Survey in Israeli elderly (MABAT Zahav). A non-direct model to estimate frailty was based on five components that were most similar to the common frailty assessment suggested by Morley et al. The frailty state was then reclassified according to different explanatory variables. RESULTS: Data collected from 1619 subjects (F/M = 52.9/47.1%) with an average age of 74.6 years were analyzed. Estimated frailty prevalence in the elderly population was 4.9%. Frail people were more likely to have a lower income, be unemployed and have a lower education level. Frailty rates were higher in women, in Jews and in subjects more prone to low physical function. CONCLUSIONS: The estimated frailty prevalence in the Israeli elderly population, while relatively low, is comparable to some of the rates suggested in the literature. The factors associated with frailty in the Israeli population are in accordance with the existing literature. The suggested model may be helpful in identifying frailty in Israeli elderly.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Idoso , Analgésicos/administração & dosagem , Árabes , Estudos Transversais , Feminino , Humanos , Hipnóticos e Sedativos/administração & dosagem , Israel/epidemiologia , Judeus , Masculino , Inquéritos Nutricionais , Prevalência
18.
Int J Hyg Environ Health ; 220(2 Pt A): 6-12, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27663636

RESUMO

The use of human biomonitoring (HBM) as a tool for environmental health policy and research is developing rapidly in Israel. Despite challenges in securing political and financial support for HBM, the Ministry of Health has initiated national HBM studies and has utilized HBM data in environmental health policy decision making. Currently, the Ministry of Health is collecting urine samples from children and adults in the framework of the National Health and Nutrition Study (MABAT), with the goal of ongoing surveillance of population exposure to pesticides and environmental tobacco smoke, and of combining HBM data with data on diet and health behavior. In academic research studies in Israel, biomarkers are used increasingly in environmental epidemiology, including in three active birth cohort studies on adverse health effects of phthalates, brominated flame retardants, and organophosphate pesticides. Future Ministry of Health goals include establishing HBM analytical capabilities, developing a long term national HBM plan for Israel and participating in the proposed HBM4EU project in order to improve data harmonization. One of the lessons learned in Israel is that even in the absence of a formal HBM program, it is possible to collect meaningful HBM data and use it in an ad hoc fashion to support environmental health policy.


Assuntos
Monitoramento Ambiental , Humanos , Israel
19.
Public Health Nutr ; 20(5): 883-892, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27829478

RESUMO

OBJECTIVE: To investigate demographic and lifestyle factors associated with adherence to the Mediterranean diet (MD) in Israeli adolescents. DESIGN: Cross-sectional. SETTING: School-based. SUBJECTS: Schoolchildren (n 5268) aged 11-19 years answered self-administered questionnaires on food consumption, eating habits and lifestyle; a subset (n 578) also completed 24 h food recalls. RESULTS: Using a modified KIDMED index, 25·5 % of the students had poor, 55·2 % had average and 19·3 % had good MD adherence. Jewish middle-school children had the highest proportion (28·2 %) of poor MD adherence. Olive oil usage, derived from 24 h food recalls, was 18·1 % in Jewish families v. 71·1 % in Arab homes. In Jewish boys, the odds (OR; 95 % CI) of having poor MD adherence was higher in those who watched television/videos/listened to music for ≥2 h/d (1·25; 0·98, 1·58) and those who sometimes/don't read food labels (1·69; 1·31, 2·18). In Jewish girls, the odds for having poor MD adherence was significantly higher in those whose mother's schooling was <12 years (2·06; 1·41, 3·00) and those who sometimes/don't read food labels (1·35; 1·08, 1·69). In Arab boys, watching television/videos/listening to music for ≥2 h/d was significantly associated with poor MD adherence (1·89; 1·16, 3·07). In Arab girls, no aerobic activity or ball games weekly was associated with poor MD adherence (1·38; 0·91, 2·09). CONCLUSIONS: Israeli adolescents had overall a high rate of poor MD adherence. Jewish middle-school children were at the highest risk. Interventions aimed at increasing physical activity, reducing sedentary time, improving mother's education and promoting reading of food labels are recommended.


Assuntos
Dieta Mediterrânea , Estilo de Vida , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Cooperação do Paciente , Fatores Socioeconômicos , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Israel/epidemiologia , Masculino , Inquéritos Nutricionais , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
20.
Oral Health Prev Dent ; 14(2): 117-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26525123

RESUMO

PURPOSE: To assess the oral health-related quality of life of the Israeli elderly. MATERIALS AND METHODS: Data were collected from a subsample of those interviewed for the cross-sectional Mabat Zahav National Health and Nutrition Survey of the Elderly, carried out in 2005 and 2006 by the Ministry of Health in Israel. In-person interviews were conducted in the interviewees' homes using a structured questionnaire which included 7 questions on subjective dental health status and the 14 questions of the Oral Health Impact Profile 14 (OHIP-14). Statistical significance of continuous variables was assessed with the Student t-test; categorical variables with normal distribution were analysed using the chi-square test and those with non-normal distribution with the Wilcoxon Mann-Whitney two-sample test. RESULTS: 828 Jews and 159 Arabs from the total survey population of 1852 elderly (1536 Jews and 316 Arabs) completed the OHIP-14 questionnaire. An impact of oral health on the quality of life was reported by 16.6% of the respondents, 19.2% of females and 13.9% of males (p<0.05). There were statistically significant differences in impact prevalence by gender, place of birth and economic status. No such differences were found by age group, population group or education. Significant statistical correlation was found between subjective assessment of general and dental health and OHIP impact prevalence, with poorer assessment correlated with increased prevalence of impact. CONCLUSIONS: The quality of life of 17% of Israeli elderly is affected by oral health. The OHIP-14 findings emphasise the importance of including basic dental treatment (treatment of dental pain and infections) in the range of services covered by the National Health Insurance Law.


Assuntos
Saúde Bucal , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Árabes , Estudos Transversais , Pessoas com Deficiência/psicologia , Escolaridade , Feminino , Nível de Saúde , Humanos , Israel , Judeus/etnologia , Masculino , Inquéritos Nutricionais , Dor/psicologia , Características de Residência , Fatores Sexuais , Classe Social , Estresse Psicológico/psicologia
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