Higher Total Fat Intake Research Articles

Relationship between body mass index, serum cholesterol, leisure-time physical activity, and diet in a Mediterranean Southern-Europe population.

The aim of the present study was to determine the relationship of BMI with other cardiovascular risk factors, leisure-time physical activity and diet. Participants were recruited in a cross-sectional population-based survey in a southern-Europe Mediterranean population (Spain); cardiovascular risk factors were measured, and leisure-time physical activity and diet intake were evaluated. Linear regression analysis adjusted for several confounders showed a significant, direct association of BMI and total cholesterol (P<0.005) and LDL-cholesterol (P<0.006), in men. HDL-cholesterol was inversely related to BMI in both sexes (P<0.0001). Higher BMI was more frequent in less-active men (P<0.04) but not in women. BMI increased significantly (P<0.0001) by 1.92 kg/m(2) with each 4.18 MJ consumed in men but not in women. Dietary intakes of carbohydrate (P<0.03), total fat (P<0.03) and saturated fatty acids (P<0.02) were directly associated with BMI in men but not in women, in whom protein intake was correlated (P<0.001) with BMI. Linear regression models including dietary components explained up to 10.6 and 21.1 % of BMI variability in men and women, respectively. Sex differences in the association of BMI with total cholesterol, and LDL-cholesterol, may account for the lower risk for CHD in women compared with men of similar BMI reported in the literature for the southern-Europe Mediterranean region. An increases of BMI may be more deleterious in populations in which it is accompanied by other risk factors such as a higher intake of total fat and, particularly, of saturated fatty acids, or lower leisure-time physical activity.

Relationship between dietary intake in children with diabetes mellitus type I, their management at diagnosis, social factors, anthropometry and glycaemic control

Background: In diabetes mellitus, dietary intake is important for metabolic control and contributes to the risk of developing microvascular and macrovascular complications. Little is known about factors influencing dietary intake. Objectives: To ascertain the long-term influence of two initial programmes of treatment of diabetes mellitus type I in children and adolescents on dietary intake and to compare with dietary recommendations. To examine for correlations with social factors, anthropometry and glycaemic control. Design: Children, 3-15 years of age, were chosen at random to be treated either in a paediatric ward (the control group) or, partly, in an apartment where their families were provided with extra psychological support and practical education (the study group). A prospective dietary assessment of 34 children with diabetes mellitus was performed, using 4 day food diaries at 6, 12 and 24 months after diagnosis. Results: Both management groups complied we ll with the dietary recommendations, showed stable nutritional habits during the first 2 years after diagnosis and had favourable intake concerning fat and carbohydrates compared with healthy children. The study group demonstrated less day-to-day variation in their consumption of polyunsaturated fat. Few dietary correlations to social factors were shown. There were no significant correlations between dietary intake and age or gender. High long-term HbA1c (8.3%, 5 years) was significantly associated with a higher intake of total fat, and more pronounced day-to-day variation in energy, carbohydrates and polyunsaturated fat. Conclusions: Both treatment programmes appear well suited for establishing and maintaining recommended dietary intake. The home-like environment of the training apartment made it possible to illustrate the dietary customs of the child and family, and permitted an individual nutritional education with behaviour modification. The importance of the quantity an d quality of fat consumed must be emphasized strongly. Keywords: children; diet; glycaemic control; insulin-dependent diabetes mellitus (type I); management regimen; social factors

Intake of dietary fat and vitamin in relation to breast cancer risk in Korean women: a case-control study.

To investigate association between breast cancer risk and nutrients intake in Korean women, a case-control study was carried out, at Seoul, Korea. Incident cases (n=224) were identified through the cancer biopsy between February 1999 and December 2000 at two University hospitals in Seoul. Hospital-based controls (n=250) were selected from patients in the same hospitals, during the same periods. Food intake was investigated semiquantitative frequency questionnaire (98 items) by trained dietitian. Subjects were asked to indicate the average food intake and vitamin supplement for a 12 months period of 3-yr prior to the baseline phase. In investigation of vitamin supplement use, subjects were asked the average frequency of use, duration, dose and the brand name of vitamin supplement (multivitamins, vitamin A, vitamin C and vitamin E). And nutrients were calorie adjusted by the residuals method. In this study, higher breast cancer risk incidence was not observed with higher intake of total fat and saturated fatty acids, however statistically significant trends with breast cancer incidence for total saturated fatty acids were found (ptrend=0.0458). In analyses of vitamins, beta-carotene and vitamin C were significantly associated with decreasing risk of breast cancer. In analyses, results from dietary plus supplement of vitamin was not associated with breast cancer risk in this study. In conclusion, our findings suggest that antioxidant vitamins such as beta-carotene and vitamin C intake could lower the breast cancer risk in Korean women.

Diet and risk of dementia: Does fat matter?: The Rotterdam Study.

To examine whether high intake of total fat, saturated fatty acids (saturated fat), trans fatty acids (trans fat), and cholesterol and low intake of monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), n-6 PUFA, and n-3 PUFA are associated with increased risk of dementia and its subtypes. Data from the Rotterdam Study, a prospective cohort study among elderly, were used. At baseline (1990 to 1993), 5,395 subjects had normal cognition, were noninstitutionalized, and underwent complete dietary assessment by a semiquantitative food-frequency questionnaire. The cohort was continuously monitored for incident dementia, and re-examinations were performed in 1993 to 1994 and 1997 to 1999. The association between fat intake and incident dementia was examined by Cox's proportional hazards models. After a mean follow-up of 6.0 years, 197 subjects developed dementia (146 AD, 29 vascular dementia). High intake of total, saturated, trans fat, and cholesterol and low intake of MUFA, PUFA, n-6 PUFA, and n-3 PUFA were not associated with increased risk of dementia or its subtypes. Rate ratios of dementia per standard deviation increase in intake were for total fat 0.93 (95% CI 0.81 to 1.07), for saturated fat 0.91 (95% CI 0.79 to 1.05), for trans fat 0.90 (95% CI 0.77 to 1.06), for cholesterol 0.93 (95% CI 0.80 to 1.08), for MUFA 0.96 (95% CI 0.84 to 1.10), for PUFA 1.05 (95% CI 0.80 to 1.38), for n-6 PUFA 1.03 (95% CI 0.77 to 1.36), and for n-3 PUFA 1.07 (95% CI 0.94 to 1.22). High intake of total, saturated, and trans fat and cholesterol and low intake of MUFA, PUFA, n-6 PUFA, and n-3 PUFA were not associated with increased risk of dementia or its subtypes.

Non-diabetic relatives of Type 2 diabetic families: dietary intake contributes to the increased risk of diabetes.

Non-diabetic first degree relatives of Type 2 diabetic patients are at increased risk of developing diabetes and cardiovascular disease. This is assumed to reflect a shared genetic predisposition. The aim of this study was to test the hypothesis that lifestyle factors, specifically dietary factors, are also important to the increased risk in non-diabetic relatives. Dietary intake was assessed using a validated food frequency questionnaire in 149 non-diabetic first degree relatives (age 20-65 years) from families of North European extraction with two or more living Type 2 diabetic family members, and 143 age- and sex-matched control subjects from the background population with no family history of diabetes. Relatives reported higher absolute intakes of total fat (mean (95% confidence intervals) 83 (76-91) vs. 71 (66-76) g/day, P = 0.01), saturated fat (SFA; 39 (36-43) vs. 33 (30-36) g/day, P < 0.01) and cholesterol (391 (354-427) vs. 318 (287-349) mg/day, P < 0.01), and a lower intake of non-starch polysaccharide (P < 0.05). Considered as percentage of total daily energy intake, relatives had higher intakes of total fat (P < 0.01) and SFA (P < 0.02), and a lower intake of carbohydrate (P < 0.02). These differences remained after exclusion of suspected under- and over-reporters of dietary intake. Non-diabetic relatives of Type 2 diabetic patients were found to consume diets that will promote rather than prevent the development of diabetes and cardiovascular disease. This suggests that the increased risk to non-diabetic relatives is therefore not entirely genetic, and there is scope for decreasing the risk through lifestyle modification.

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.

Dietary Fat Intake and Risk of Epithelial Ovarian Cancer: A Meta-Analysis of 6,689 Subjects From 8 Observational Studies

The etiology of epithelial ovarian cancer is unknown. Prior work suggests that high dietary fat intake is associated with an increased risk of this tumor, although this association remains speculative. A meta-analysis was performed to evaluate this suspected relationship. Using previously described methods, a protocol was developed for a meta-analysis examining the association between high vs. low dietary fat intake and the risk of epithelial ovarian cancer. Literature search techniques, study inclusion criteria, and statistical procedures were prospectively defined. Data from observational studies were pooled using a general variance-based meta-analytic method employing confidence intervals (CI) previously described by Greenland. The outcome of interest was a summary relative risk (RRs) reflecting the risk of ovarian cancer associated with high vs. low dietary fat intake. Sensitivity analyses were performed when necessary to evaluate any observed statistical heterogeneity. The literature search yielded 8 observational studies enrolling 6,689 subjects. Data were stratified into three dietary fat intake categories: total fat, animal fat, and saturated fat. Initial tests for statistical homogeneity demonstrated that hospital-based studies accounted for observed heterogeneity possibly because of selection bias. Accounting for this, an RRs was calculated for high vs. low total fat intake, yielding a value of 1.24 (95% CI = 1.07-1.43), a statistically significant result. That is, high total fat intake is associated with a 24% increased risk of ovarian cancer development. The RRs for high saturated fat intake was 1.20 (95% CI = 1.04-1.39), suggesting a 20% increased risk of ovarian cancer among subjects with these dietary habits. High vs. low animal fat diet gave an RRs of 1.70 (95% CI = 1.43-2.03), consistent with a statistically significant 70% increased ovarian cancer risk. High dietary fat intake appears to represent a significant risk factor for the development of ovarian cancer. The magnitude of this risk associated with total fat and saturated fat is rather modest. Ovarian cancer risk associated with high animal fat intake appears significantly greater than that associated with the other types of fat intake studied, although this requires confirmation via larger analyses. Further work is needed to clarify factors that may modify the effects of dietary fat in vivo.

Maternal diet rich in saturated fat during breastfeeding is associated with atopic sensitization of the infant.

To investigate the impact of maternal diet during breastfeeding on atopic sensitization of infants at risk. Prospective cohort study. Turku University Central Hospital, Finland. Altogether 114 infants with a family history of atopic disease were followed during their first year of life. The mothers completed a 4 day food record during breastfeeding just before the infants were 3 months old. Atopic sensitization of the infants was determined by a positive skin prick test result at 12 months. Positive skin prick test reactivity to at least one antigen was detected in 27/114 (24%) infants at 12 months. The energy intake of the mothers was low, mean 8.0 MJ/day (95% CI 7.7-8. 3), and the proportion of energy derived from fat was high, mean 36. 6 E% (95% CI 35.6-37.6). Atopic mothers had a higher intake of total fat and saturated fat and a lower intake of carbohydrate as a percentage of total energy intake than non-atopic mothers; P=0.017, P=0.050, P=0.004 respectively. Maternal intake of saturated fat during breastfeeding was associated with atopic sensitization of the infant, OR=1.16 (95% CI 1.001-1.36); P=0.048 irrespective of the maternal atopic status. Our results show that an unbalanced maternal diet during breastfeeding may be a risk factor underlying the later development of atopic sensitization of the infant regardless of maternal atopic disease. The observation thus extends findings implying that early nutrition programmes the subsequent health of the child to the risk of developing atopic disease. Academy of Finland and National Technology Agency.

Adult nutrient intake as a risk factor for Parkinson's disease.

This population-based case-control study evaluated nutrient intake as a risk factor for Parkinson's disease (PD) among people aged > or =50 years in metropolitan Detroit. Cases (n = 126) were diagnosed between 1991 and 1995 and neurologist-confirmed. Controls (n = 432) were frequency-matched for sex, age (+/-5 years) and race. Using a standardized food frequency questionnaire, subjects reported the foods they ate within the past year. Estimating the association between PD and risk of being in the highest versus the lowest intake quartile, there were elevated odds ratios for total fat (OR 1.94, 95% confidence interval [CI] : 1.05-3.58), cholesterol (OR 2.11, 95% CI: 1.14-3.90), lutein (OR 2.52, 95% CI: 1.32-4.84) and iron (OR 1.88, 95% CI: 1.05-3.38). These results suggest an association of PD with high intake of total fat, saturated fats, cholesterol, lutein and iron.

Dietary guidelines and food nutrient intakes in Portugal.

The average intakes of nutrients by a group of 489 adult Portuguese (> or = 40 years) living in a metropolitan area of Northern Portugal were studied using a food frequency questionnaire, and used to compare with the most recent recommendations for the same population by the National Council of Food and Nutrition. The data suggested a relative concordance between consumption levels and nutritional goals, however we found differences between subgroups of the population. Higher intakes of total fat and saturated fat, and lower intakes of fibre/energy and carbohydrates were shared by younger people (40-55 years), and higher intakes of total fat, saturated fat, fibre/energy, protein and carbohydrates and lower intakes of alcohol by women. Nutrients have been analysed in terms of the percentage contribution to total energy intake, but as alcohol is energy dense, its consumption can decrease the proportion of the energy intake from nutrients other than alcohol, and some caution must be taken in interpreting these results.

Dietary guidelines and patterns of food and nutrient intake in Sweden.

The Nordic and Swedish Nutrition Recommendations emphasize the balance between macronutrients in the diet. The amount of saturated and total fat should be limited to c. 10 %energy and 30 %energy, respectively, and the amount of total carbohydrates should be 55-60 %energy. Data from the first Swedish national dietary survey in 1989 show that the average diet is too high in fat, especially saturated fat (36-37 %energy and 16 %energy, respectively) while the content of total carbohydrates and dietary fibre is too low. However, parts of the population consume a diet that meets the recommendation for a particular macronutrient. A comparison of subjects with a low or high intake of total fat and saturated fat, dietary fibre or fruit and vegetables show some common trends with respect to the characteristics of a dietary pattern equal or close to the recommendations, e.g. more frequent consumption of fruit and vegetables and a lower consumption of some fat-rich foods, such as spreads, cheese and sausages.

Saturated Fat Intake and the Risk of Severe Hyperemesis Gravidarum

We conducted a case-control study to investigate the effect of prepregnancy diet, particularly dietary fats, on the risk of severe hyperemesis gravidarum. Cases were 44 women previously hospitalized at Brigham and Women's Hospital, Boston, MA, for severe hyperemesis gravidarum who delivered a singleton liveborn between January 1, 1993, and December 31, 1995. Controls were 87 women who delivered a singleton liveborn at Brigham and Women's Hospital during the same period and who experienced less than 20 hours of nausea and fewer than three episodes of vomiting over the duration of their pregnancies. Odds ratios were derived from unconditional logistic regression models using data collected via self-administered food frequency questionnaires. Our results indicate that prepregnancy, high daily intake of total fat increases the risk of severe hyperemesis gravidarum (odds ratio = 2.9 for each 25 gm per day increase; 95% confidence interval = 1.4-6.0). This association is driven primarily by saturated fat intake [odds ratio = 5.4 for each 15 gm per day increase (equivalent to one quarter-pound cheeseburger); 95% confidence interval = 2.0-14.8]. We observed no independent effect of total energy intake.

Dietary guidelines and patterns of intake in Denmark.

Food-based dietary guidelines in Denmark have usually been expressed in simple terms only and need to be elaborated. Quantitative recommendations on fruit and vegetable intake were issued in 1998, recommending 600 g/d (potatoes not included). This paper is based on a national dietary survey in 1995 (n = 3098, age range 1-80 years) supplemented with data from a simple frequency survey in 1995 (n = 1007, age range 15-80 years) and from the first national survey in 1985 (n = 2242, age range 15-80 years). Only data on adults are included in this paper. Fat intake, saturated fat in particular, is too high (median intake 37 %energy and 16 %energy, respectively). Main fat sources are separated fats (butter, margarine, oil, etc.: 40%), meat (18%), and dairy products (21%). Total fat intake decreased from 1985 to 1995 but fatty acid composition did not improve. Dietary fibre intake is from 18 to 22 g/d (women and men, respectively) with 62% from cereals, 24% from vegetables and 12% from fruit. Mean intake of vegetables and potatoes was from 200 to 250 g/d (women and men, respectively). Mean intake of fruit and vegetables (potatoes not included) was 277 g/d, or less than half of the new recommendation (600 g/d). Only 15% of participants in the frequency survey reported consuming both fruit and vegetables every day, and only 28% reported to do so almost every day. In conclusion, dietary intake in Denmark is characterized by a high intake of saturated fat and total fat, and by a relatively low intake of fruit and vegetables.

Risk factors for atherosclerosis in students of a private university in São Paulo-Brazil.

To characterize the risk profile for atherosclerosis (AS) in adolescents and young adults of a private university in São Paulo. Clinical, nutritional, and laboratory parameters were evaluated in 209 students of both genders aged 17 to 25 years. In addition to determination of the lipid profile, the association of its abnormal values with other risk factors for AS was also investigated. Increased levels of total cholesterol, LDL-C and triglycerides (TG) were observed in 9.1%, 7.6% and 16.3% of the students, respectively, and decreased levels of HDL-C in 8.6% of them. Prevalence of the remaining risk factors analyzed was elevated: sedentary life style (78.9%); high intake of total fat (77.5%); high cholesterol intake (35.9%); smoking, hypertension (15.8%) and obesity (7.2%). There was an association between elevated LDL-C and TG levels and sedentary life style and body mass index. The high prevalence of risk factors for AS in young individuals draws attention to the need for adopting preventive plans.

Iron intake, body iron stores and colorectal cancer risk in women: a nested case-control study.

Accumulated evidence suggests that increased body iron stores may increase the risk of colorectal cancer, possibly via catalyzing oxidation reactions. We examined the relationship between iron status and colorectal cancer in a case-control study nested within the New York University Women's Health Study cohort. For 105 incident cases of colorectal cancer with an average follow-up of 4.7 years and 523 individually matched controls, baseline levels of serum iron, ferritin, total iron binding capacity (TIBC) and transferrin saturation were determined as indicators of body iron stores, and total iron intake was assessed based on their diet and supplement intake. Overall, there were no associations between the risk of colorectal cancer and any of these indices except for serum ferritin, which showed a significant inverse association. When analyzed by subsite, there was an increasing trend in risk of cancer of the proximal colon with increasing total iron intake (p-value for trend = 0.04). In addition, a significantly increased risk of colorectal cancer associated with higher total iron intake [odds ratio (OR) = 2.50; 95% confidence interval (CI): 1.06-5.87] was observed among subjects with higher intake of total fat. Our results do not support a role of increased body iron stores in the development of colorectal cancer, but suggest that luminal exposure to excessive iron may possibly increase the risk in combination with a high fat diet.

Atherogenic diet and blood lipid profile in children and adolescents from Galicia, NW Spain. The Galinut Study.

We studied serum levels of total cholesterol, lipoproteins and triglycerides in venous blood samples and the intake of nutrients using the subject's daily record of food eaten during a period of 7 d. The material comprised 7367 children and adolescents. The overall average lipid levels (4.55 +/- 0.91 mmol/L for TC, 1.42 +/- 0.47 mmol/L for HDL-C, 2.74 +/- 0.96 mmol/L for LDL-C) are high and similar to those found in other regions of Spain in the 1990s. The proportion of children with TC > or = 5.17 mmol/L (200 mg/dl) was 19%; that of children with HDL-C < or = 0.91 mmol/L (35 mg/dL) 6.5%. There is a striking and statistically significant difference between the proportions of boys and girls aged 15-20 y who have HDL-C levels in this range (15.8% for boys and only 4.2% for girls). We also demonstrate a high total fat (44% of TCV), saturated fat (16% TCV) and cholesterol (387 mg) intake. Because of the elevated fat and saturated fat intake and the increment of a more atherogenic lipid profile in our children, preventive nutritional measures are necessary, and life habits such as physical exercise and actively reducing fat and saturated fat intake have to be applied and inculcated in children from an early age.

Atherogenic diet and blood lipid profile in children and adolescents from Galicia, NW Spain. The Galinut Study

We studied serum levels of total cholesterol, lipoproteins and triglycerides in venous blood samples and the intake of nutrients using the subject's daily record of food eaten during a period of 7 d. The material comprised 7367 children and adolescents. The overall average lipid levels (4.55 ± 0.91 mmol/L for TC, 1.42 ± 0.47 mmol/L for HDL‐C, 2.74 ± 0.96 mmol/L for LDL‐C) are high and similar to those found in other regions of Spain in the 1990s. The proportion of children with TC ≥5.17 mmol/L (200mg/dl) was 19%; that of children with HDL‐C ≤0.91 mmol/L (35 mg/dL) 6.5%. There is a striking and statistically significant difference between the proportions of boys and girls aged 15‐20 y who have HDL‐C levels in this range (15.8% for boys and only 4.2% for girls). We also demonstrate a high total fat (44% of TCV), saturated fat (16% TCV) and cholesterol (387 mg) intake. Because of the elevated fat and saturated fat intake and the increment of a more atherogenic lipid profile in our children, preventive nutritional measures are necessary, and life habits such as physical exercise and actively reducing fat and saturated fat intake have to be applied and inculcated in children from an early age.

Saturated Fat Intake and the Risk of Severe Hyperemesis Gravidarum

We conducted a case-control study to investigate the effect of prepregnancy diet, particularly dietary fats, on the risk of severe hyperemesis gravidarum. Cases were 44 women previously hospitalized at Brigham and Women's Hospital, Boston, MA, for severe hyperemesis gravidarum who delivered a singleton liveborn between January 1, 1993, and December 31, 1995. Controls were 87 women who delivered a singleton liveborn at Brigham and Women's Hospital during the same period and who experienced less than 20 hours of nausea and fewer than three episodes of vomiting over the duration of their pregnancies. Odds ratios were derived from unconditional logistic regression models using data collected via self-administered food frequency questionnaires. Our results indicate that prepregnancy, high daily intake of total fat increases the risk of severe hyperemesis gravidarum (odds ratio = 2.9 for each 25 gm per day increase; 95% confidence interval = 1.4-6.0). This association is driven primarily by saturated fat intake [odds ratio = 5.4 for each 15 gm per day increase (equivalent to one quarter-pound cheeseburger); 95% confidence interval = 2.0-14.8]. We observed no independent effect of total energy intake.

A case-control study of diet and prostate cancer

We interviewed 328 men diagnosed with prostate cancer before the age of 75 years and 328 age-matched population controls. The principal hypotheses were that risk would increase with a high intake of total or saturated fat and would decrease with a high intake of carotene (beta-carotene equivalents) or lycopene. We also examined the associations of other nutrients and foods with risk. There was no evidence for an association between fat intake and risk, although the average fat intake was high and the range of fat intakes was narrow (medians of lower and upper thirds of percentage of energy from fat among controls were 34.3% and 42.9% respectively). Risk was lower in subjects with higher carotene intake: odds ratios 0.65 (95% CI 0.45-0.94) and 0.76 (0.53-1.10) in the middle and upper thirds of carotene intake respectively (P for trend = 0.150). Lycopene was not associated with risk. Among 13 other nutrients examined, the odds ratios in the top third of intake were below 0.8 for: potassium, 0.74 (0.51-1.09; P for trend = 0.054); zinc, 0.73 (0.49-1.08; P for trend = 0.126); iodine, 0.75 (0.51-1.11; P for trend = 0.077); vitamin B6 food only, 0.77 (0.53-1.12; P for trend = 0.077); and vitamin B6 including supplements, 0.70 (0.48-1.03; P for trend = 0.029). Among 18 foods examined, statistically significant associations were observed for: garlic as food, > or = 2/week vs never, 0.56 (0.33-0.93); garlic including supplements, > or = 2/week vs never, 0.60 (0.37-0.96); baked beans, > or = 2/week vs < 1/month, 0.57 (0.34-0.95); and garden peas, > or = 5/week vs < or = 3/month, 0.35 (0.13-0.91). This study does not support the hypothesis that fat increases risk and is equivocal in relation to carotene. The possible relationships of vitamin B6, garlic, beans and peas with risk for prostate cancer should be further investigated.

Identifying individuals with high fat levels and low P:S ratios, in their diets, for intensive dietary intervention.

To assess whether simple scores from a dietary questionnaire could identify those with high dietary fat or low P:S ratio intakes, for intensive dietary intervention. Cross-sectional and longitudinal studies. Community setting in the Hunter Region of New South Wales, Australia. Two random samples of adults 35-69 years from the electoral roll. In the cross-sectional study 287/322 (86%) subjects completed the diet questionnaire and a reference standard questionnaire. In the longitudinal study 546/653 (84%) of subjects completed the diet questionnaire, and had blood cholesterol measured on two occasions, 3 months apart. In the cross-sectional study, the simple scores of total fat intake (Fat Intake Score) and P:S ratio (Unsaturated Score) were compared with the daily intakes of total fat and P:S ratio obtained from the standard questionnaire. In the longitudinal study, changes in the scores were compared with changes in blood total cholesterol. A Fat Intake Score of greater than 125 had the best receiver operator characteristics for identifying high total fat intake (> 100 g/day: sensitivity = 67%, specificity = 70%). An Unsaturated Score of less than 0.3 had the best characteristics for identifying a low P:S ratio (< 0.5: sensitivity = 63%, specificity = 60%). Subjects who decreased Fat Intake Score by one category, had a fall in blood cholesterol of 0.14 mmol L-1 (95% confidence interval (CI) = 0.01-0.26 mmol L-1), while those decreasing by two categories decreased their blood cholesterol by 0.56 mmol L-1 (95% CI = 0.30-0.86 mmol L-1). Subjects increasing their Unsaturated Score category had a fall in blood cholesterol of 0.17 mmol L-1 (95% CI = 0.02-0.32 mmol L-1). Simple dietary scores can identify those with high fat intakes, and monitor changes related to changes in blood cholesterol levels.