Mean Daily Energy Intake Research Articles

Changes to dietary intake during a 12-week commercial web-based weight loss program: a randomized controlled trial

The primary aim of this secondary analysis was to compare changes in dietary intake among participants randomized to two versions of a 12-week commercial web-based weight loss program (basic or enhanced) with a waiting-list control. An additional investigation compared changes in dietary intake of successful participants (weight loss ≥5%) with those not successful. Dietary intake was assessed at baseline and 12 weeks using a validated 120-item semiquantitative food frequency questionnaire. Adults (n=268, 60% female participants, body mass index 32.1 ± 3.9) classified as plausible reporters of energy intake were included in the analyses. Analysis of covariance with baseline observations carried forward for drop-outs (n=38) was used. The basic and enhanced groups significantly increased their percentage of energy contribution from fruits and reduced energy-dense, nutrient-poor foods compared with controls (P<0.001). Successful participants (n=49) reported superior improvements in dietary intake including greater reductions in the mean daily energy intake (P<0.001), the percentage of energy from energy-dense, nutrient-poor foods (-12.0% E vs -4.3% E, P<0.001) and greater increases in the energy contribution from fruits (P<0.001), vegetables (P=0.003) and breads/cereals (P=0.02). Use of a commercial web-based weight loss program facilitated some improvements in the dietary intake. The enhanced web-based tools appeared not to have generated greater improvements in reported dietary intake, compared with the basic or control groups. Those who achieved a weight loss of ≥5% improved their dietary intake in line with the program recommendations and dietary guidelines. Further research to determine web-based components that may improve success and the reasons why programs are successful for some participants is required.

A Simulation Study of the Potential Effects of Whole Grain Food Substitutions on Diet Quality in Lower Mississippi Delta Adults

The majority of adult diets in the United States do not meet recommendations for consumption of whole grains (3), putting these individuals at increased risk for diet-related chronic diseases (10). Poor diet quality, inadequate consumption of whole grains, and chronic diseases are particularly prevalent in the impoverished rural South (1,7,9,12). Hence, dietary interventions designed to address nutrition inadequacies and thereby improve diet quality could lower chronic disease prevalence in this region of the country. Assessing a population’s diet quality is a necessary step for determining nutrition inadequacies and subsequently designing effective dietary interventions that address these problems. The Healthy Eating Index–2005 (HEI-2005) is a tool that assesses diet quality in terms of adherence to the 2005 Dietary Guidelines for Americans (DGA). Whole grains are among the 2005 and 2010 DGA key recommendations for food groups to encourage (10,11). However, little research has been conducted to determine the potential impact of whole grain for refined grain substitutions on diet quality. Hence, the objective of this study was to use simulation modeling to determine the effects of substituting familiar, more healthful whole grain foods for less healthy, refined grain foods on diet quality and total energy intake in lower Mississippi Delta (LMD) adults. Analyses were performed using data from the Foods of Our Delta Study (FOODS), a cross-sectional telephone survey of residents in a 36-county LMD region that was conducted from January to June 2000 (2). Dietary intake data were collected using the U.S. Department of Agriculture’s (USDA) 24-hour dietary recall multiple pass methodology with the assistance of a foods measurement guide that had been mailed to study participants. Dietary intake data were collected for 1,751 adults (18 years of age and older) using a single 24-hour recall. However, only plausible (500 ≤ intake kcal ≤ 6,000) 24-hour recalls were used for this study (13). The HEI-2005, a scoring method designed to measure adherence to the 2005 DGA (5), was used to measure diet quality. Briefly, the HEI-2005 is composed of 12 components corresponding to total fruit, whole fruit, total vegetables, dark green and orange vegetables and legumes, total grains, whole grains, milk, meat and beans, oils, saturated fat, sodium, and kcal from solid fats, alcoholic beverages, and added sugars (SoFAAS). The total score, calculated as the sum of the component scores, has a maximum value of 100. For each component, higher scores reflect better adherence to DGA recommendations corresponding to that component. All foods selected as substitutions were deemed familiar foods based on their inclusion in the FOODS data set. White breads, rolls, biscuits, and spaghetti were replaced with their whole wheat counterparts, and white rice was replaced with brown rice. To simulate the effects of substituting 25, 50, and 100% of targeted foods with their replacements on HEI-2005 total and component scores, the targeted items’ nutrient profiles were reduced by the respective amounts for the analyses and the replacement items’ nutrient profiles were inserted at the corresponding level. The nutrient profiles for the replacement foods were extracted from the FOODS data set. All statistical analyses were performed using SAS software (version 9.2, SAS Institute) and SUDAAN software (version 10.0.1, Research Triangle Institute). SAS survey and SUDAAN procedures were used to compute frequencies, means, and their associated 95% confidence intervals. These procedures are tailored to account for the complex sampling design used in FOODS. Hence, the results are weighted and should be considered representative of the LMD adult population. The population ratio method was used to compute mean HEI-2005 scores and corresponding 95% confidence intervals using jackknife variances for the overall population. It is the least biased way to estimate a mean HEI-2005 score for a population (4). Sixty-two of the 1,751 LMD respondents were excluded due to implausible dietary records, resulting in a total sample size of 1,689 adults. The sample was composed of 48% males, 43% African Americans, 21% < 30 years of age, and 23% ≥ 60 years of age. Approximately one-fourth (23%) of the sample’s household income was under $15,000 per year and 23% of the sample had less than a high school education. Almost one-fourth (24%) of the respondents were current smokers and 18% were former smokers. Based on self-reported heights and weights, 67% of the sample was either overweight (25.0 ≤ BMI ≤ 29.9) or obese (BMI ≥ 40.0). The mean daily energy intake for the LMD adult respondents was 2,010 kcal. 1 Corresponding author. USDA Agricultural Research Service. E-mail: jessica.thomson@ars.usda.gov. 2 Department of Medicine, University of Illinois at Chicago. Affiliated with USDA Agricultural Research Service at the time this work was completed.

Dietary adequacy and alcohol consumption of Inuvialuit women of child‐bearing age in the Northwest Territories, Canada

Previous studies highlight a possible association between alcohol-drinking patterns and dietary inadequacies, which may have negative implications, particularly for women of child-bearing age. The present study aimed to compare dietary adequacy among alcohol drinkers versus nondrinkers in Inuvialuit women of child-bearing age. A cross-sectional survey of 92 randomly selected women of childbearing age (19-44 years) was conducted in three communities in the Northwest Territories of Arctic Canada, using a validated quantitative food frequency questionnaire. Data were analysed to compare mean daily energy and nutrient intakes, dietary adequacy and nutrient densities (per 4184 kJ) between alcohol drinkers and nondrinkers, as well as heavy drinkers and nonheavy drinkers, using the nonparametric Wilcoxen rank sum test. The response rate was between 65% and 85% depending on the community sampled. Of the study participants, 54% (n = 49) were drinkers and 46% (n = 42) were nondrinkers. Of the drinkers, 45% (n = 22) were heavy drinkers. Mean energy intakes were high among all women, although they were significantly higher among drinkers [17,179 kJ (4106 kcal)] compared to nondrinkers [13,317 kJ (3183 kcal)]. There were no significant differences in nutrient intake between the two groups; however, drinkers had a lower nutrient density for most nutrients. Heavy drinkers had a significantly lower nutrient density for all nutrients, except protein, iron, and vitamins B6 , C and D, compared to nonheavy drinkers. The findings of the present study provide evidence of inadequate dietary intake among Inuvialuit of child-bearing age, regardless of alcohol-drinking behaviour.

Nutrient intakes, major food sources and dietary inadequacies of Inuit adults living in three remote communities in Nunavut, Canada

Inuit in Nunavut, Canada, are currently undergoing a nutritional transition that may contribute to an increased prevalence of chronic disease. Information is lacking about the extent to which contemporary Inuit diets are meeting current dietary recommendations. A culturally appropriate quantitative food frequency questionnaire (QFFQ) developed and validated for Inuit in Nunavut, Canada, was used to assess food and nutrient intake in a cross-sectional sample of adults. Participants included 175 women and 36 men with mean (SD) ages of 42.4 (13.2) and 42.1 (15.0) years, respectively. The response rate for those who completed the study was 79% with 208 QFFQs included for analysis. Reported mean daily energy intakes were: men 15,171 kJ (3626 kcal); women 11,593 kJ (2771 kcal). Dietary inadequacy was expressed as the percentage of participants reporting intakes below the sex- and age-specific estimated average requirements (EARs). For nutrients without EARs, adequate intakes were used. Energy and sodium intakes exceeded the recommendations. Less than 10% of participants met recommendations for dietary fibre intake. Vitamin E intakes were below EARs for ≥97% of participants, whereas >20% reported inadequate vitamin A, folate and magnesium intakes. Among women, >50% reported inadequate calcium and vitamin D intakes. Non-nutrient-dense foods contributed 30% of energy, 73% of sugars and 22% of fat. Traditional foods contributed 56% of protein and 49% of iron. The present study demonstrates a relatively high prevalence of inadequate nutrient intakes among Inuit. The results may be used to monitor the nutrition transition among Inuit, evaluate nutritional interventions, and inform public health policy decision-making.

Daily Intakes of Iron, Zinc and Manganese in Korean Children Aged 6 to 11 Years

The essential trace elements such as Fe, Zn, and Mn play an important role in human growth and development. The purpose of this study was to estimate the daily intakes of Fe, Zn, and Mn in Korean elementary school students. A total 1,320 elementary school students aged 6 to 11 years participated in this study. A 24‐hr recall method for 3 days was conducted and daily intakes of Fe, Zn, and Mn were calculated. The mean daily intakes of energy, Fe, Zn, and Mn were 1852.4 kcal, 13.4 mg, 9.1 mg, and 4.5 mg for boys aged 6 to 8 years and 1764.3 kcal, 13.0 mg, 8.6 mg, and 4.2 mg for girls aged 6 to 8 years and 1830.1 kcal, 13.0 mg, 9.2 mg, and 4.4 mg boys aged 9 to 11 years and 1783.1 kcal, 12.5 mg, 9.0 mg, and 4.2 mg girls aged 9 to 11 years, respectively. The major food groups consumed Fe and Mn were cereals, vegetables, and pulses and Zn were cereals, meats, and vegetables. The median intakes of Fe, Zn, and Mn in total subjects were 12.7 mg, 8.8 mg, and 4.2 mg and were more than their recommended intakes (RIs of Fe and Zn) and adequate intake (AI of Mn). Daily intakes of Fe, Zn, and Mn of elementary school students participated in this study were sufficient compared with the dietary reference intakes. However, in order to assess accurately trace elements in elementary school students, systematic balance study examining their intakes and excretions is needed in future.

Beverage intake in low-income parent–child dyads

Beverage consumption adds to daily energy intake and often exceeds the recommended amount for discretionary energy. Previous research has shown that children are consuming sugar-sweetened beverages (SSB) in greater frequency and the relationship between parent–child dyads in beverage consumption is meaningful due to the parental influence on the development of beverage consumption behaviors. In particular, low-income families are at greater risk for obesity and higher levels of SSB consumption. The current investigation assessed habitual beverage intake among low-income parent–child dyads (N = 95) with children between the ages of 9–17 years. The sample (46% African American; 45% Caucasian) had a mean body mass index (BMI) for the parents of 31.8 ± 8.9 kg/m 2, while the mean BMI percentile for age and gender for the children was 70.3 ± 31.3. Both parents and children consumed fewer nutrient-dense beverages and more energy-dense beverages than the recommended amount. The mean daily energy intake from beverages was 451 ± 236 kcal for the parents and 457 ± 237 kcal for the children. Correlations between parent–child dyad intake was also evident, identifying parents as potential role models and gatekeepers of the home food environment. Future interventions to prevent childhood obesity in low-income populations should address beverage intake, particularly SSB consumption, and determine the degree to which this behavior is learned behavior in the home.

Cochrane Review: Nutritional support in children and young people with cancer undergoing chemotherapy

AbstractBackgroundMalnutrition can often be a consequence of cancer itself or a result of chemotherapy. Nutritional support aims to reverse malnutrition seen at diagnosis, prevent malnutrition associated with treatment and promote weight gain and growth. The most effective and safe forms of nutritional support in children and young people with cancer are unclear.ObjectivesTo determine the effects of any form of parenteral (PN) or enteral (EN) nutritional support in children and young people with cancer undergoing chemotherapy.Search strategyWe searched the following databases: CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to 2006), EMBASE (1974 to 2006), CINAHL (1982 to 2006), the National Research Register (2007) and Dissertations &amp; Theses (2007). We scrutinised reference lists of articles to identify additional trials. We also contacted experts in the field for information on relevant trials.Selection criteriaRandomised or quasi‐randomised controlled trials comparing any form of nutritional support with another, or control, in children or young people with cancer undergoing chemotherapy.Data collection and analysisTwo authors independently selected trials. Three authors independently assessed quality and extracted data. We contacted trialists for missing information.Main resultsWe included eight trials which randomised 159 participants (&lt; 21 years) with leukaemias or solid tumours undergoing chemotherapy. The trials were all of low quality. One small trial found that compared to EN, PN significantly increased weight (mean difference (MD) 4.12; 95% CI 1.91 to 6.33), serum albumin levels (MD 0.70; 95% CI 0.14 to 1.26), calorie intake (MD 22.00; 95% CI 5.12 to 38.88) and protein intake (MD 0.80; 95% CI 0.45 to 1.15). One trial comparing peripheral PN and EN with central PN found that mean daily weight gain (MD ‐27.00; 95% CI ‐43.32 to ‐10.68) and energy intakes (MD ‐15.00; 95% CI ‐26.81 to ‐3.19) were significantly less for the peripheral PN and EN group, whereas mean change in serum albumin was significantly greater for that group(MD 0.47; 95% CI 0.13 to 0.81, P = 0.008). Authors' conclusionsThere is limited evidence from individual trials to suggest that parenteral nutrition is more effective than enteral nutrition in well‐nourished children and young people with cancer undergoing chemotherapy. The evidence for other methods of nutritional support remains unclear. No studies were identified comparing the nutritional content in the PN or EN groups of studies. Further research, incorporating larger sample sizes and rigorous methodology utilising valid and reliable outcome measures, is essential.Plain Language SummaryNutritional support in children and young people with cancer undergoing chemotherapyNutritional support is of great importance in managing children and young people with cancer. It may help to reverse malnutrition seen at diagnosis, prevent malnutrition associated with the cancer treatment and promote weight gain and growth. Nutritional support may be provided by one of two methods: nutritional liquids delivered through a central or peripheral vein which bypass the gut (parenteral nutrition); or nutritional liquids or solids that pass through any part of the gut, regardless of method of delivery (e.g. orally or via a tube) (enteral nutrition).We found some evidence from one small trial to suggest that parenteral nutrition may result in an increase in weight, serum albumin levels, and calorie and protein intake when compared to enteral nutrition (usual food intake). However, the evidence for other methods of delivery of nutritional support remains unclear. No studies were identified that compared the nutritional content in either the PN or EN groups of studies. The trials were all of low quality and very different in terms of outcome measures used. In future much larger, rigorously conducted trials with better defined outcome measures are needed in order to address this important question.

Dietary Analysis of Young Professional Soccer Players for 1 Week During the Competitive Season

Limited data exist concerning the dietary practices of young professional soccer players that compete within the United Kingdom. Therefore, the purpose of this study was to investigate the nutritional and activity habits of professional male soccer players (n = 10; age: 17 ± 1 years, height: 1.72 ± 0.01 m, mass: 67.5 ± 1.8 kg, estimated maximal aerobic capacity: 57.8 ± 0.9 ml·kg·min) who played for the youth team of a UK-based Championship club. All players recorded their 7-day dietary intake and activity habits during a competitive week that included a match day, 4- training days, and 2 rest days in the first half of the 2009/2010 playing season. The intake of carbohydrates (5.9 ± 0.4 g·kg·d), proteins (1.7 ± 0.1 g·kg·d), and fats (1.5 ± 0.1 g·kg·d) represented 56 ± 1, 16 ± 1, and 31 ± 1% of the mean daily energy intake respectively. The intake of fiber was found to be significantly lower than Recommended Nutrient Intake (RNI) values (67% of RNI, p < 0.001), whereas all other analyzed micronutrients met or exceeded recommended values. A mean daily energy deficit of 788 ± 174 kcal existed because daily energy expenditures exceeded that of intake (3,618 ± 61 vs. 2831 ± 164 kcal, p = 0.001). The mean daily fluid intake was 3.2 ± 0.3 L. Consequently, the nutritional practices of the sampled group of professional youth soccer players were inadequate to sustain optimized performance throughout training and match play. Youth soccer players should therefore seek to ensure that their diets contain adequate energy through increased total caloric intake, while also optimizing the proportion of energy derived from carbohydrates and ensuring that enough fiber-rich foods are consumed.

Health aspects, nutrition and physical characteristics in matched samples of institutionalized vegetarian and non-vegetarian elderly (&gt; 65yrs)

BackgroundEpidemiological studies indicate that a well balanced vegetarian diet offers several health benefits including a lower prevalence of prosperity diseases in vegetarians compared to omnivores. It was the purpose of the present study to compare nutritional and physical characteristics in matched samples of institutionalized vegetarian (V) and non-vegetarian (NV) elderly.MethodsTwenty-two female and 7 male V (females: 84.1 ± 5.1yrs, males: 80.5 ± 7.5yrs) and 23 female and 7 male NV (females: 84.3 ± 5.0yrs, males: 80.6 ± 7.3yrs) participated. All subjects were over 65 years of age, and free of major disease or physical handicap. Dietary intake, blood profile, anthropometrics, and handgrip strength were determined.ResultsMean daily energy intake was 6.8 ± 2.0MJ in V females, and 8.0 ± 1.4MJ in the NV females, only the V did not reach the recommended value of 7.8 MJ. Male V and NV had a mean daily energy intake of 8.7 ± 1.6MJ and 8.7 ± 1.2MJ respectively (RDI: 8.8 MJ). Mean carbohydrate intake was significantly below the RDI in NV only (female V: 47.8 ± 7.5E%, female NV: 43.3 ± 4.6E%, male V: 48.1 ± 6.4E%, male NV: 42.3 ± 3.6E%), while protein (female V: 17.3 ± 3.4E%, female NV: 19.5 ± 3.5E%, male V: 17.8 ± 3.4E%, male NV: 21.0 ± 2.0E%), and saturated fat intake (female V: 25.4 ± 8.2 g/day, female NV: 32.2 ± 6.9 g/day, male V: 31.4 ± 12.9 g/day, male NV: 33.4 ± 4.7 g/day) were too high in both V and NV. Mean micronutrient intakes met the RDI's in all 4 groups. Mean blood concentrations for vitamin B12, folic acid, iron, and calcium were normal in all 4 groups. Mean zinc blood serum was below the reference value in all groups, whereas estimated zinc intake was in agreement with the RDI. The mean blood cholesterol concentration was above the 200 mg/dl upper limit in the V group (213 ± 40 mg/dl) and below that limit in the NV (188 ± 33 mg/dl) group. Mean BMI was 26.1 ± 4.7 kg/m2 in the female V, 26.8 ± 3.7 kg/m2 in the female NV, 23.5 ± 3.7 kg/m2 in the male V, and 25.2 ± 4.2 kg/m2 in the male NV. V and NV scored below the reference values for the handgrip strength test.ConclusionsGenerally, our results show a similar profile for V and NV concerning dietary intake, blood values, and physical characteristics. Attention should be paid to the intake of mono- and disaccharides and saturated fats in the diet of both V and NV. This study indicates that a vegetarian lifestyle has no negative impact on the health status at older age.

Men participating in a weight-loss intervention are able to implement key dietary messages, but not those relating to vegetables or alcohol: the Self-Help, Exercise and Diet using Internet Technology (SHED-IT) study

To describe dietary changes in men participating in an obesity intervention as part of the Self-Help, Exercise and Diet using Information Technology (SHED-IT) study. An assessor-blinded randomized controlled trial comparing Internet (n 34) v. information-only groups (n 31) with 6-month follow-up. Dietary intake assessed by FFQ, reporting usual consumption of seventy-four foods and six alcoholic beverages using a 10-point frequency scale. A single portion size (PSF) factor was calculated based on photographs to indicate usual serving sizes. The campus community of the University of Newcastle, New South Wales, Australia. Sixty-five overweight/obese men (43 % students, 42 % non-academic general staff, 15 % academic staff; mean age 35.9 (sd 11.1) years, mean BMI 30.6 (sd 2.8) kg/m2). The average PSF decreased significantly over time (χ2 = 20.9, df = 5, P < 0.001) with no differences between groups. While both groups reduced mean daily energy intake (GLM χ2 = 34.5, df = 3, P < 0.001), there was a trend towards a greater reduction in the Internet group (GLM χ2 = 3.3, P = 0.07). Both groups reduced percentage of energy from fat (P < 0.05), saturated fat (P < 0.001) and energy-dense/nutrient-poor items (P < 0.05), with no change in dietary fibre or alcohol (P > 0.05). Although men reported some positive dietary changes during weight loss, they did not increase vegetable intakes nor decrease alcohol consumption, while saturated fat, fibre and Na intakes still exceeded national targets. Future interventions for men should promote specific food-based guidelines to target improvements in their diet-related risk factor profile for chronic diseases.

Food consumption and nutrient intake in Finnish 1–6-year-old children

To study food consumption and nutrient intake in Finnish children aged 1-6 years and to assess the effect of age and sex on food consumption and nutrient intake. Cross-sectional samples of children participating in the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort study in Finland. The study population comprised healthy children recruited in the nutrition study within the DIPP study in 1998-2003. Three-day food records (2535 in total) from 1-, 2-, 3-, 4- and 6-year-old children were kept between the years 2003 and 2005. The energy-adjusted consumption of fruits and berries, cereal products, infant formulas and meat dishes was higher and the consumption of vegetables, salads, breads, dairy products, fat spreads, drinks, sweets and sugar was lower among 1-year-old children than older age groups (P for all <0.05). The mean daily energy intake increased with age and was higher among boys than girls in all age groups, except among the 2-year-olds (P for all <0.05). The diet of the 2-6-year-old children contained too much saturated fat and sucrose, and too little PUFA compared with the current Nordic Nutrition Recommendations. The intakes of most vitamins and minerals met the recommendations. However, the intakes of vitamin D, E and iron fell below the recommended levels. The nutrient density of the diet decreased after the age of 1 year at the time that the children adapted to the regular family diet. In order to improve the diet of young children, it is essential to evaluate the diet of the whole family.

Energy Expenditure in the Race Across America (RAAM)

Energy Expenditure was measured with doubly labelled water technique during heavy sustained exercise with an official finishing team in the Race Across America. Energy Intake was also calculated to produce an energy balance for the race. A team of 4 cyclists (Mean +/-SD age: 37+4 yr; body height: 182+8 cm; body mass: 80.8+6.6 kg) completed the race in a relay fashion. The team completed the race in 6 days 10 h and 51 min. Total mean energy expenditure was found to be 43,401 kcals (181,711 kJ) with a mean daily energy expenditure of 6,420 kcals (26,879 kJ). Total mean energy intake from all food and drink consumed was calculated at 29,506 kcals (123,536 kJ) with a mean daily energy intake of 4 918 kcals (20,591 kJ). This resulted in a total mean energy deficit of 13,878 kcals (58,104 kJ) with a mean daily energy deficit of 1,503 kcals (6,293 kJ). The high energy expenditure highlights the need for correct and practical dietary strategies and challenges nutritionists to devise high energy diets that not only contain the correct macronutrient balance, but are also palatable to the cyclists, thus encouraging a high energy intake.

Nutrition, Physique, Muscular Strength And Health Aspects In Vegetarian And Non-vegetarian Seniors (&gt;65yrs)

Epidemiological studies on vegetarians indicate that a well balanced vegetarian diet offers several health benefits. The prevalence of prosperity diseases is significantly lower in vegetarians compared to omnivores. PURPOSE: It was the purpose of the present study to compare the health and physical fitness status in a group of vegetarian (V) and non-vegetarian (NV) seniors. METHODS: Twenty three female and 7 male NV aged >65 years (female: 84.3±5.0yrs, male: 80.6±7.3yrs) and 22 female and 7 male V aged >65 years (female: 84.1±5.1yrs, male: 80.5±7.5yrs) participated. All subjects were free of major disease or physical handicap. Medical history, dietary analysis (FFQ), blood profile, anthropometrics, and muscular strength were registered. RESULTS: Mean BMI was 26.8±3.7 kg/m2 in the female NV subjects, 26.1±4.7 kg/m2 in the female V subjects, 25.2±4.2 kg/m2 in the male NV subjects and 23.5±3.7 kg/m2 in the male V subjects (p>0.05). The general questionnaire revealed a lower morbidity in the V subjects compared to the NV subjects, with lower use of medication (52%) in the V subjects compared to the NV (77%) (p<0.05). Mean daily energy intake was 8.0±1.4 MJ in the NV females, whereas the 6.8±2.0 MJ in V females did not reach the recommended value of 7.8 MJ (p<0.05). Male V and NV groups had a mean daily energy intake of 8.7±1.6 MJ and 8.7±1.2 MJ respectively (ref: 8.8 MJ). Mean carbohydrate intake was too low (V: 47.9±7.0E%, NV: 42.8±4.1E%), while protein (V: 17.5±3.4E%, NV: 20.3±2.7E%), and fat intake (V: 33.7±7.5E%, NV: 33.9±3.7E%) were too high (p<0.05). Mean vitamin and mineral intakes met the RDA's in both groups. Blood concentrations for vitamin B12, Folic acid, Fe, and Ca were normal in both groups. Zn blood serum was below the reference value in both groups, while estimated Zn intake was sufficient. The mean blood cholesterol concentration was below the 200 mg/dl upper limit in the NV (182±45mg/dl) group and above that limit in the V group (213±40mg/dl). Both groups scored under the reference values for the strength tests. CONCLUSIONS: Comparing V and NV seniors our results show a similar profile for both groups concerning nutritional intake (except for energy intake between the female groups), blood values (except for cholesterol), physical performance capacity and body composition. V had a lower morbidity and use of medication.

Assessing the validity and acceptability of DietPhone as a dietary measurement tool in adolescent girls

Introduction Dietary assessment is essential for investigating the relationship between diet and disease. Previously it has been assumed that dietary measures used in adults were appropriate in younger age groups. However research has highlighted that measuring the diets of adolescents in particular, poses unique challenges (Livingstone et al, 2004). It has been suggested the development of new and innovative techniques for obtaining dietary intakes of adolescents could improve the accuracy of reporting in this age group. This study aims to investigate whether DietPhone is a valid dietary assessment tool and whether it is acceptable to use with adolescents. Methods Eleven third year girls were required to keep a five day dietary record using both diet diaries and DietPhone over separate time periods. Comparisons of the mean daily intakes of energy, protein, carbohydrate, total fat and calcium were made between the two methods. Using the Bland & Altman technique, the level of agreement between the two methods was determined. Additionally focus groups were carried out to establish whether this group found DietPhone to be acceptable to use. Results At the group level, analysis revealed good agreement between the two methods for carbohydrate, with a mean difference of 15.9g being observed. However there appears to be a lack of agreement for intakes of energy, protein, total fat and calcium, with mean differences of 169kcal, 9.3g, 8.3g and 72mg respectively. Furthermore wide limits of agreement were observed for all the nutritional parameters measured, suggesting a lack of agreement at the individual level. Nevertheless DietPhone was established as the preferred method of choice during the focus groups. In addition the group identified several modifications that could ultimately improve DietPhone. Conclusion Due to the lack of agreement observed between the two methods, it is not appropriate to recommend replacing diet diaries with DietPhone as a dietary assessment tool at this time. However it appears that participants enjoyed using DietPhone and it was favoured over using diet diaries, suggesting this technology is acceptable to use with this population. Therefore in the future, DietPhone has the potential to improve the accuracy of dietary assessment in adolescents.

Still life with less: North Korean young adult defectors in South Korea show continued poor nutrition and physique

North Korean defectors who settle in South Korea have experienced severe food shortage and transition of food environment which could affect their health status. However, little is known about their anthropometric measurements and dietary intake after settlement in South Korea. The purpose of this study is to compare anthropometric measurements and dietary intake between North Korean young adults who defected to South Korea and those of South Koreans. We hypothesized that North Korean young adults' physiques and dietary intake would be poorer than that of South Koreans. We compared anthropometric measurements and dietary intake from 3-day food records in a cross-sectional study of 103 North Korean young adult defectors, aged 12 to 24 and 309 South Korean subjects. North Korean subjects were significantly shorter (4.9 to 10.8 cm) and lighter (6.0 to 12.5 kg) than the control group. Body mass index were significantly different between North and South Korean groups only in men. North Korean young adult defectors had lower mean daily intakes of energy and most nutrients and food groups compared to the control group, while North Korean subjects had higher nutrient density diet than that of South Koreans. The proportion of subjects who had dietary intakes of nutrients of less than the Estimated Average Requirement was higher in North Korean subjects than in controls except for in the cases of vitamin A and vitamin C. In conclusion, we recommend providing nutrition support programs for North Korean young adult defectors to secure adequate nutrient intake.

Eating out of home in Vietnamese adolescents: socioeconomic factors and dietary associations

BackgroundOut-of-home (OH) eating in developed countries is associated with suboptimal dietary intakes, but evidence is scarce on the situation in developing countries. ObjectiveThe objective of this study was to determine the nutritional contribution of OH eating and related socioeconomic determinants in Vietnamese adolescents. DesignA 24-h recall was used to collect food intake data in a cross-sectional study of 1172 adolescents living in urban and rural areas. Multilevel analysis compared the mean daily intakes of energy, energy density, energy from fat, food groups, vitamin A, iron, and zinc in low, middle, and high consumers of OH food. Socioeconomic associations of OH eating were analyzed in a subsample of 870 adolescents. ResultsOH foods contributed 42% of fruit and vegetables, 23% of sodium, 21% of energy, 21% of vitamin A, 21% of iron, and 21% of zinc consumed per day. OH eating was negatively associated with total energy intake and energy density and positively associated with dietary diversity, energy contribution from fat, and consumption of sugar products. In rural areas, OH eating was positively associated with iron, fruit, meat, poultry, and offal intake. Female sex (P < 0.001), residence in urban areas (P < 0.001), and amount of pocket money (P < 0.001) were positively associated with consumption of OH foods. ConclusionsOH eating added a number of desirable foods and nutrients but was also associated with higher consumption of energy from fat and sugar products. Independent of household wealth and locality, pocket money and sex are important determinants of OH eating.

Energy Availability And Menstrual Regularity In African Black Female Runners

PURPOSE: Endurance female athletes are at risk of having low energy availability which can have detrimental effects on their health and performance. It is also linked with exercise-induced menstrual dysfunction and disordered eating, collectively referred to as the female athlete Triad. Research regarding the prevalence of these components amongst black South African female athletes is limited. Method: Thirty two (n=32) recreational competitive black South African female distance runners, between the ages of 15 and 40 years (mean age: 21.44 ± 6.69), were selected on the basis of availability. Two 24-hour dietary recalls were completed for each athlete to assess mean daily energy intakes, Actical® physical activity monitors measured daily and exercise energy expenditure, the Bod Pod® measured body composition, and menstrual irregularity was assessed with a questionnaire compiled from reviewed literature. Risk for disordered eating was assessed via the EAT-26 questionnaire. RESULTS: Mean energy availability for the group was 124.16 ± 94.93 kJ/kg LBM/day, even though 11 of the athletes were below the recommended daily energy availability to ensure menstrual health. Four of the thirty two athletes (12.5%) reported menstrual irregularities. 40.6% reported risk for disordered eating via the EAT-26 questionnaire. In the total group two athletes presented with low energy availability and irregular menstrual function while five presented with low energy availability and a high risk for disordered eating. CONCLUSION: This group of black female athletes are at risk to develop the Triad since some already present with early stages of one or more components..

Less-energy-dense diets of low-income women in California are associated with higher energy-adjusted diet costs

Background: US-based studies are needed to estimate the relation, if any, between diet quality and estimated diet costs.Objective: We hypothesized that lower cost diets among low-income women in California would be energy dense but nutrient poor.Design: Energy and nutrient intakes for 112 women aged 18–45 y living in California were obtained with a food-frequency instrument. Dietary energy density (in MJ/kg or kcal/g) and energy-adjusted diet costs (in $/10 MJ or $/2000 kcal) were calculated with local food prices. Tertile splits of energy density and energy cost were analyzed with one-factor analysis of variance.Results: Mean daily energy intake excluding all beverages was 7.1 MJ (1699 kcal), and mean dietary energy density was 6.5 kJ/kg (1.54 kcal/g). Lower dietary energy density was associated with significantly higher intakes of dietary fiber (P = 0.004), vitamin A (P < 0.001), and vitamin C (P < 0.001) and with significantly lower intakes of total fat (P = 0.003) and saturated fat (P < 0.001). Higher diet cost was associated with significantly lower dietary energy density (P < 0.001), total fat (P = 0.024), and saturated fat (P = 0.025) and with significantly higher intakes of vitamins A (P = 0.003) and C (P < 0.001). Each additional dollar in estimated diet costs was associated with a drop in energy density of 0.94 MJ/kg (0.225 kcal/g).Conclusions: The finding that higher quality diets were more costly for these low-income women has implications for the food assistance and education programs of the US Department of Agriculture. Policy interventions may be required to allow low-income families in the United States to improve the quality of their diets given their food budget constraints.

Effects of 12 Weeks of Exercise on Hepatic TNF-α and PPARα in an Animal Model of High-Fat Diet-Induced Nonalcoholic Steatohepatitis

Nonalcoholic steatohepatitis (NASH) is hepatic inflammation caused by a buildup of fat in the liver. This study was designed to examine whether the NASH-associated increase in hepatic TNF-α mRNA expression and serum TNF-α, and decrease in hepatic PPARα mRNA expression in rats secondary to 12-week consumption of a high-fat diet would be attenuated with concurrent exercise. A total of 28 male Sprague-Dawley strain rats were randomly assigned into four groups: standard diet without (C, n = 6) and with (E, n = 7) concurrent exercise; and high-fat diet without (H, n = 8) and with (HE, n = 7) concurrent exercise. The mean daily energy intake during the intervention period resulting from the standard and high-fat diets was approximately 82 kcal and 95 kcal, respectively. Swimming exercise was carried out in the E and HE groups for 12 weeks. The initial swimming duration of 30 minutes was progressively increased by 10 min·d −1 to 90 minutes by the end of the fourth week, which then remained unchanged. NASH revealed by histological activity index, which occurred in the H but not the C group, was alleviated in the HE group. Moreover, the upregulation of hepatic TNF-α mRNA expression and serum TNF-α, and downregulation of hepatic PPARα mRNA expression, which were shown in the H group, were attenuated in the HE group. Such findings suggest that long-term exercise carried out concurrently with consumption of a high-fat diet could alleviate high-fat diet-induced NASH. These may be partly attributable to the attenuation of hepatic TNF-α overexpression and the upregulation of hepatic PPARα mRNA expression.

P039 NUTRITIONAL STATUS OF NURSING HOME RESIDENTS

Rationale: Limited information exists on the efficacy of high energy density (>2 kcal/ml) oral nutritional supplements (ONS). This pilot study investigated elderly patients’ compliance with a novel, low volume, energy dense (2.4 kcal/ml) ONS and its effects on food and total energy intakes, appetite and anthropometry. Methods: Thirty one community-based patients identified at risk of malnutrition (using “MUST”, www.bapen.org.uk) were recruited (mean age: 82±12years, mean body mass index (BMI) 20.3±2.4 kg/m2, 52% medium risk, 48% high risk). Patients were offered two 125ml, 2.4 kcal/ml oral nutritional supplements (Fortisip Compact, Nutricia; total provision 600 kcal, 24 g protein in 250ml) daily in addition to the diet for 4 weeks. Compliance, palatability and tolerance of the supplement and its effects on food and total energy intake, hunger (100mm visual analogue scale) and anthropometry (body weight, mid upper arm circumference, MUAC) were assessed. Results are presented as mean±SD. Results: Compliance with supplementation was 97% with mean wastage per bottle of 4ml (3% of bottle volume). There were no significant gastro-intestinal side effects with supplementation and > 80% of patients rated the supplement pleasant and convenient. Patients’ mean total daily energy intake significantly increased (from 1430±599 kcal to 1965±596 kcal, p = 0.0001) with supplementation, with no significant reduction in voluntary food intake and a significant increase in hunger score (from 24±24mm to 36±24mm, p = 0.018). A small but significant increase in body weight (+0.9 kg, p = 0.009) and mid upper arm circumference (+0.3 cm, p = 0.025) were observed. Conclusion: This pilot study in community patients shows that compliance with a high energy density (2.4 kcal/ml), low volume supplement is excellent, leading to significant improvements in total energy intakes and anthropometry. Further controlled study is required to ascertain the clinical benefits of using such an energy dense supplement in the management of patients with malnutrition.