Modified Block Food Frequency Questionnaire Research Articles

Dietary choline and betaine intake minimally impacts rate of annualized cognitive performance throughout the menopause transition: data from the Study of Women's Health Across the Nation.

Dietary choline is associated with lower risk of dementia in older adults, yet this association during mid-life remains unknown. Given that menopause reflects a nutrition-sensitive time point where prevention strategies may mitigate cognitive deficits, we examined the relationship of choline, betaine, and egg intakes (ie, dietary exposures) with cognitive performance in the Study of Women's Health Across the Nation (SWAN) cohort (N = 1,006). SWAN is a longitudinal study of women across the menopause transition. Diet was assessed via modified Block food frequency questionnaire, and cognitive function was examined using the Symbol Digit Modalities Test, Digits Backward Test, and East Boston Memory Test (EBMT). Annualized rate of cognitive scores and quartiles of diet were computed using linear mixed models overall (all diet exposures) and by baseline menopausal status (choline, betaine only). Among all women, higher choline (P-for-trend = 0.006) and betaine (P-for-trend = 0.005) intakes, independently and combined (ie, choline + betaine; P-for-trend = 0.001), were significantly associated with reduced rate of change on the EBMT-Delayed Recall (DR), but egg intake did not consistently impact cognitive function. By menopausal status, higher betaine, but not choline, was associated with a lower annualized rate of change in cognitive performance on the EBMT-DR (mean difference [95% confidence interval]; Q1: referent vs Q4: -0.071 [-0.17, 0.03]; P-for-trend = 0.006) for early perimenopausal women; nevertheless, choline and betaine were not associated with cognitive function among premenopausal women. Higher dietary betaine intake among early perimenopausal women and higher dietary intakes of betaine and choline, independently and combined, among all women, were minimally associated with the trajectory of verbal episodic memory, yet no associations between diet and cognition were observed among premenopausal women. Future research should address the relationship between dietary intake and cognition during menopause in other research settings and cohorts.

Prenatal Iodine Intake and Maternal Pregnancy and Postpartum Depressive and Anhedonia Symptoms: Findings from a Multiethnic US Cohort.

Objective: Emerging evidence suggests that essential trace elements, including iodine, play a vital role in depressive disorders. This study investigated whether prenatal dietary iodine intake alone and in combination with supplemental iodine intake during pregnancy were associated with antepartum and postpartum depressive and anhedonia symptoms. Methods: The study population included 837 mothers in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study. The modified BLOCK food frequency questionnaire was used to estimate prenatal dietary and supplemental iodine intake, while the 10-item Edinburg Postpartum Depression Scale (EPDS) ascertained depressive symptoms. Analyses considered the global EPDS score and the anhedonia and depressive symptom subscale scores using dichotomized cutoffs. Logistic regression estimating odds ratios and 95% confidence intervals (CIs) assessed associations of iodine intake in the second trimester of pregnancy and 6-month postpartum depressive and anhedonia symptoms considering dietary intake alone and combined dietary and supplementary intake in separate models. Results: Most women were Black/Hispanic Black (43%) and non-Black Hispanics (35%), with 39% reporting a high school education or less. The median (interquartile range, IQR) dietary and supplemental iodine intake among Black/Hispanic Black (198 (115, 337) µg/day) and non-Black Hispanic women (195 (126, 323) µg/day) was higher than the overall median intake level of 187 (116, 315) µg/day. Relative to the Institute of Medicine recommended iodine intake level of 160-220 µg/day, women with intake levels < 100 µg/day, 100-<160 µg/day, >220-<400 µg/day and ≥400 µg/day had increased adjusted odds of 6-month postpartum anhedonia symptoms (aOR = 1.74 (95% CI: 1.08, 2.79), 1.25 (95% CI: 0.80, 1.99), 1.31 (95% CI: 0.82, 2.10), and 1.47 (95% CI: 0.86, 2.51), respectively). The corresponding estimates for postpartum global depressive symptoms were similar but of smaller magnitude. Conclusions: Prenatal iodine intake, whether below or above the recommended levels for pregnant women, was most strongly associated with greater anhedonia symptoms, particularly in the 6-month postpartum period. Further studies are warranted to corroborate these findings, as dietary and supplemental iodine intake are amenable to intervention.

Dietary Composition, Angiographic Coronary Disease, and Cardiovascular Outcomes in the WISE Study (Women's Ischemia Syndrome Evaluation).

Studies relating diet to angiographic coronary artery disease (CAD) and subsequent major adverse cardiac events (MACE) in women are limited. Information on diet was collected in the Women's Ischemia Syndrome Evaluation (WISE), a prospective cohort study of symptomatic women referred for coronary angiography to evaluate suspected ischemic heart disease. A consecutive subgroup (n = 201 of 936) of enrolled women completed the modified Block food frequency questionnaire (FFQ). Data on outcomes were collected and adjudicated after 8-year follow-up. A set of logistic regression models were fitted for non-obstructive versus obstructive coronary stenosis (<50% versus ≥50%). Cox proportional hazard regression models were fitted for outcomes, with each dietary composition variable adjusted for the degree of coronary stenosis. At baseline, the subgroup cohort was 58 ± 12 years old with a body mass index (BMI) of 30 ± 7 kg/m2. An increased proportion of calories consumed from protein was associated with higher levels of baseline obstructive coronary stenosis. Those individuals who ate a higher amount of protein, carotene, and servings of vegetables and meat, however, were each associated with lower subsequent adverse outcomes, respectively. Among women undergoing coronary angiography for suspected CAD, a higher percentage of protein intake was associated with higher baseline stenosis severity; however, the amount of protein intake, vegetable, meat, and carotene intake, was conversely associated with subsequent lower adverse cardiovascular outcome risk.

Dietary Outcomes of a Multilevel, Multicomponent, Cluster Randomized Obesity Intervention in 6 Native American Communities in the Upper Midwest and Southwest United States

BackgroundImpacts of colonization on dietary intake have led to high rates of obesity and noncommunicable diseases among Native American adults. Multilevel, multicomponent (MLMC) interventions may improve dietary intake. ObjectivesTo assess the impact of a MLMC obesity intervention, OPREVENT2 (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans 2; clinicaltrials.gov NCT02803853), on dietary intake in Native American adults in Intervention versus Comparison communities. MethodsA cluster-randomized controlled trial was performed among participants in 6 communities randomized to Intervention (n = 3 and Comparison (n = 3). Adults aged 18 to 75 were recruited from tribal communities in the Southwest and upper Midwest United States from September 2016 to May 2017 (n = 601). This analysis included participants who completed baseline and follow-up surveys (82% retention), reported dietary intake between 500 and 7000 kcal/d, and had no missing data for outcomes of interest (n = 446). The intervention was implemented from May 2017, to November 2018. OPREVENT2 integrated individual, environmental, social, and structural factors and was implemented in food stores, worksites, schools, and community media outlets in Intervention communities. Activities included taste tests, cooking demonstrations, and stocking healthier items in food stores and were reinforced by a social m)edia campaign, posters, brochures, and booklets focused on nutrition. Individual-level dietary intake among participating Native American adults was assessed via modified Block food-frequency questionnaire at preintervention and postintervention. Multilevel mixed-effects linear regression, with clustering at the community level, was performed. ResultsBetween-group effects were significant (P < 0.05) for intake of carbohydrates (-23 g/d), total fat (-9 g/d), saturated fats (-3 g/d), and monounsaturated fats (-4 g/d), with greater decreases in Intervention communities. Between-group effect for total sugar (-12 g/d in Intervention communities) was not statistically significant. ConclusionsThis MLMC intervention was associated with significantly improved carbohydrate, total fat, and saturated fat intake among Native American adults. These changes are important for improving health within this population.

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis

ImportanceThere is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS).ObjectiveTo evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis.Design, Setting, and ParticipantsA cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. ExposuresNutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ).Main Outcomes and MeasuresAmyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale–Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). ResultsBaseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of “good” micronutrients and “good” food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses.Conclusions and RelevanceAntioxidants, carotenes, fruits, and vegetables were associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis. We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes.

Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk.

In preclinical studies, the combination of chronic stress and a high sugar/fat diet is a more potent driver of visceral adiposity than diet alone, a process mediated by peripheral neuropeptide Y (NPY). In a human model of chronic stress, we investigated whether the synergistic combination of highly palatable foods (HPF; high sugar/fat) and stress was associated with elevated metabolic risk. Using a case-control design, we compared 33 post-menopausal caregivers (the chronic stress group) to 28 age-matched low-stress control women on reported HPF consumption (modified Block Food Frequency Questionnaire), waistline circumference, truncal fat ultrasound, and insulin sensitivity using a 3-h oral glucose tolerance test. A fasting blood draw was assayed for plasma NPY and oxidative stress markers (8-hydroxyguanosine and F2-Isoprostanes). Among chronically stressed women only, greater HPF consumption was associated with greater abdominal adiposity, oxidative stress, and insulin resistance at baseline (all p's≤.01). Furthermore, plasma NPY was significantly elevated in chronically stressed women (p<.01), and the association of HPF with abdominal adiposity was stronger among women with high versus low NPY. There were no significant predictions of change over 1-year, likely due to high stability (little change) in the primary outcomes over this period. Chronic stress is associated with enhanced vulnerability to diet-related metabolic risk (abdominal adiposity, insulin resistance, and oxidative stress). Stress-induced peripheral NPY may play a mechanistic role.

Dietary Intake of Adults with Type 2 Diabetes Measured Using the Modified Block Food Frequency Questionnaire

Diet is fundamental in the overall management of type 2 diabetes (T2D). Few studies have described the dietary intake of Canadians with T2D. This study examined the baseline dietary intake of participants of the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study using a modified 55-item Block Food Frequency Questionnaire (FFQ). A total of 196 individuals (51% women), mean age 59.6 years and BMI 33.6 kg/m2 were included. Overall, mean caloric intake was estimated to be 1286 kcals (95% CI, 1220, 1351) and was higher in men (1363 kcals) compared with women (1211 kcals; p=0.02). Mean carbohydrate and protein intakes were 594 kcals (95% CI, 562, 627) and 241 kcals (95% CI 229, 254), respectively. Mean fat intake was 498 kcals (95% CI 455, 540) for men and 442 kcals (95% CI 408, 476) for women (p=0.04). Mean daily consumption of fruits and vegetables were 1.6 (95% CI, 1.5, 1.8) and 1.8 (95% CI 1.7, 1.9) cup equivalents/person/day, respectively. Overall, mean fibre intake was 13.0 g/day (95% CI 12.3, 13.8); there were no differences between men and women. Adults with T2D reported consuming a diet low in fruits and vegetables and dietary fibre. Men reported higher intakes of dietary fat and total energy. Overall, the Block FFQ may have underestimated energy intake however, these results suggest targeted dietary counselling for men living with T2D should be considered.

Abstract PR04: Prostate cancer risk and dietary folate in a multiethnic population: Higher intake increases risk in the California Collaborative Prostate Cancer Study.

Abstract Background: High intake of dietary folate has been associated with both increased and decreased risk of prostate cancer in some previous epidemiologic studies which included mostly non-Hispanic white men. Timing of high folate intake may determine its impact on lesion development. In studies of colon cancer, for instance, high dietary folate appears protective in prelesion men, whereas high folate consumption in postlesion men accelerates cancer cell proliferation. We investigated the association between dietary folate intake and risk of advanced and localized prostate cancer among African American and White men from the California Collaborative Prostate Cancer Study. Methods: We examined 737 African American cases (233 advanced stage at diagnosis; 264 localized) and controls (N=240); and 1357 White cases (905 advanced stage; 452 localized) and controls (N=855). Folate intake during the reference year (1 year prior to diagnosis for cases or study selection for controls) was assessed by modified Block Food Frequency Questionnaire and categorized by quartiles. Risk was estimated by fitting conditional logistic regression models adjusted for race/ethnicity, age, and family history of prostate cancer. Results: Dietary folate intake was linearly related to risk of prostate cancer (p&amp;lt;0.001). Risk increased by 16% for each increase of one quartile. Men in the upper quartile of intake (&amp;gt;632 mg/day) were at 45% increased risk compared to men in the lowest quartile (OR=1.45, 95% CI 1.16-1.81). The associations for advanced (OR=1.41, 95% CI 1.11, 1.81) and localized (OR=1.57, 95% CI 1.17, 2.11) disease were similar. The results were similar for African Americans and Whites. Conclusions: Recent high folate intake appears to be a risk factor. Men who consume high levels of dietary folate in the postlesion period may be at substantially greater risk for both advanced stage and localized prostate cancer in this multi-ethnic study. This abstract is also presented as Poster B43. Citation Format: Glovioell W. Rowland, Esther M. John, Sue A. Ingles. Prostate cancer risk and dietary folate in a multiethnic population: Higher intake increases risk in the California Collaborative Prostate Cancer Study. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr PR04.

Micronutrients intake is associated with improved sperm DNA quality in older men

To investigate whether lifestyle factors such as increased dietary intake of micronutrients reduce the risks of sperm DNA damage, and whether older men benefit more than younger men. Cross-sectional study design with equalized assignments into age groups. National laboratory and university. Nonclinical group of 22-80-year-old nonsmoking men (n = 80) who reported no fertility problems. Sperm DNA damage measured by alkaline and neutral DNA electrophoresis (i.e., sperm Comet assay). Sociodemographics, occupational exposures, medical and reproductive histories, and lifestyle habits were determined by questionnaire. The average daily dietary and supplement intake of micronutrients (vitamin C, vitamin E, b-carotene, zinc, and folate) was determined using the 100-item Modified Block Food Frequency Questionnaire (FFQ). Men with the highest intake of vitamin C had approximately 16% less sperm DNA damage (alkaline sperm Comet) than men with the lowest intake, with similar findings for vitamin E, folate, and zinc (but not β-carotene). Older men (>44 years) with the highest vitamin C intake had approximately 20% less sperm DNA damage compared with older men with the lowest intake, with similar findings for vitamin E and zinc. The older men with the highest intake of these micronutrients showed levels of sperm damage that were similar to those of the younger men. However, younger men (<44 years) did not benefit from higher intakes of the micronutrients surveyed. Men with higher dietary and supplement intake of certain micronutrients may produce sperm with less DNA damage, especially among older men. This raises the broader question of how lifestyle factors, including higher intakes of antioxidants and micronutrients, might protect somatic as well as germ cells against age-associated genomic damage.

Development of an Updated Phytoestrogen Database for Use With the SWAN Food Frequency Questionnaire: Intakes and Food Sources in a Community-Based, Multiethnic Cohort Study

Phytoestrogens, heterocyclic phenols found in plants, may benefit several health outcomes. However, epidemiologic studies of the health effects of dietary phytoestrogens have yielded mixed results, in part due to challenges inherent in estimating dietary intakes. The goal of this study was to improve the estimates of dietary phytoestrogen consumption using a modified Block Food Frequency Questionnaire (FFQ), a 137-item FFQ created for the Study of Women's Health Across the Nation (SWAN) in 1994. To expand the database of sources from which phytonutrient intakes were computed, we conducted a comprehensive PubMed/Medline search covering January 1994 through September 2008. The expanded database included 4 isoflavones, coumestrol, and 4 lignans. The new database estimated isoflavone content of 105 food items (76.6%) vs. 14 (10.2%) in the 1994 version and computed coumestrol content of 52 food items (38.0%), compared to 1 (0.7%) in the original version. Newly added were lignans; values for 104 FFQ food items (75.9%) were calculated. In addition, we report here the phytonutrient intakes for each racial and language group in the SWAN sample and present major food sources from which the phytonutrients came. This enhanced ascertainment of phytoestrogens will permit improved studies of their health effects.

Dietary patterns, insulin sensitivity and inflammation in older adults

Background/ObjectivesSeveral studies have linked dietary patterns to insulin sensitivity and systemic inflammation, which affect risk of multiple chronic diseases. The purpose of this study was to investigate the dietary patterns of a cohort of older adults, and examine relationships of dietary patterns with markers of insulin sensitivity and systemic inflammation.Subjects/MethodsThe Health, Aging and Body Composition (Health ABC) Study is a prospective cohort study of 3075 older adults. In Health ABC, multiple indicators of glucose metabolism and systemic inflammation were assessed. Food intake was estimated with a modified Block food frequency questionnaire (FFQ). In this study, dietary patterns of 1751 participants with complete data were derived by cluster analysis.ResultsSix clusters were identified, including a ‘Healthy foods’ cluster, characterized by higher intake of lowfat dairy products, fruit, whole grains, poultry, fish and vegetables. In the main analysis, the ‘Healthy foods’ cluster had significantly lower fasting insulin and HOMA-IR than the ‘Breakfast cereal’ and ‘High-fat dairy products’ clusters, and lower fasting glucose than the ‘High-fat dairy products’ cluster (P ≤ 0.05). No differences were found in 2-hour glucose. With respect to inflammation, the ‘Healthy foods’ cluster had lower IL-6 than the ‘Sweets and desserts’ and ‘High-fat dairy products’ clusters, and no differences were seen in CRP or TNF-α.ConclusionsA dietary pattern high in lowfat dairy products, fruit, whole grains, poultry, fish and vegetables may be associated with greater insulin sensitivity and lower systemic inflammation in older adults.

Abstract 2776: Prostate cancer and dietary calcium: Effect modification by the vitamin D receptor Cdx-2 polymorphism in the California Collaborative Prostate Cancer Study

Abstract Background: Calcium is classified as a probable cause of prostate cancer by the World Cancer Research Fund. We previously showed that the relationship between dietary calcium intake and prostate cancer risk was modified by a the vitamin D receptor, Cdx-2 polymorphism among African Americans. The high absorption A allele increases calcium absorption and is common among African Americans. The A alleles is less common among Caucasians, who have a lower incidence of prostate cancer compared to African Americans. Methods: We examined Caucasian and African American prostate cancer cases and controls from the California Collaborative Prostate Cancer Study. Of 1854 cases, 1140 were advanced stage at diagnosis and 714 were localized; 500 were African American and 1354 were Caucasian. Dietary calcium was assessed from a 74-item modified Block food frequency questionnaire. The VDR Cdx-2 genotype was measured by TaqMan assay. Main effects of genotype and of dietary calcium, and diet-gene interactions were estimated using conditional logistic regression, adjusting for study site (Northern/Southern California), Hispanic ancestry, socio-economic status, age, and family history of prostate cancer. Results: Analysis of race-specific quartiles of calcium intake showed that intake of more than 680 mg/day (above the median for African Americans or above the first quartile for whites) was associated with increased prostate cancer risk (odds ratio 1.48, 95% confidence interval 1.25 – 1.77). The effect of calcium intake on risk of advanced (but not localized) prostate cancer was modified by the VDR Cdx-2 genotype for both African Americans and whites. High calcium intake (&amp;gt;680 mg/day) was significantly associated with increased risk only among those with the VDR Cdx-2 GG low calcium absorption genotype (OR=1.90, 95% CI 1.40 – 2.57). High absorption genotypes (GA and AA) were associated with increased risk only among those consuming less than 680 mg/day of calcium. Odds ratios were 1.24 (95% CI: 0.82 – 1.87) for genotype GA and 1.69 (95% CI: 1.05 – 2.74) for genotype AA compared to genotype GG. Conclusions: Our findings suggest that genetically-determined high calcium absorption among African Americans could contribute to racial ethnic disparities in prostate cancer incidence. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2776. doi:10.1158/1538-7445.AM2011-2776

Dietary Patterns and Survival of Older Adults

Background Recent research has linked overall dietary patterns to survival in older adults. Objectives The objective of this study was to determine the dietary patterns of a cohort of older adults, and to explore associations of these dietary patterns with survival over a 10-year period. A secondary goal was to evaluate participants' quality of life and nutritional status according to their dietary patterns. Design The Health, Aging, and Body Composition Study is a prospective cohort study of 3,075 older adults. In this study, all-cause mortality was assessed from baseline through Year 10. Food intake was estimated with a modified Block food frequency questionnaire, and dietary patterns of 2,582 participants with complete data were derived by cluster analysis. Results Six dietary pattern clusters were identified, including a Healthy Foods cluster, characterized by higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables. Both the High-Fat Dairy Products and Sweets and Desserts clusters had a 1.4-fold higher risk of mortality than the Healthy Foods cluster after adjusting for potential confounders. The Healthy Foods cluster also had significantly more years of healthy life and more favorable levels of selected nutritional biomarkers than the other clusters. Conclusions A dietary pattern consistent with current guidelines to consume relatively high amounts of vegetables, fruit, whole grains, poultry, fish, and low-fat dairy products may be associated with superior nutritional status, quality of life and survival in older adults.

Abstract PR-3: CDX-2 polymorphism, calcium intake, and prostate cancer risk for African Americans in a population-based study

Abstract Background: Prostate cancer incidence and mortality rates are highest among American men of African descent. The World Cancer Research Fund has classified calcium as a probable cause of prostate cancer. The CDX-2 polymorphism (A to G) in the Vitamin D Receptor (VDR) alters calcium absorption in the small intestines. It functionally limits transcriptional activity of the VDR promoter. VDR impacts cell differentiation, metastasis, and apoptosis in the prostate. The CDX-2 polymorphism is potentially useful for determining whether prostate cancer risk is causally related to calcium absorbing activity. Methods: To study the impact of calcium intake and absorption among our most at-risk ethnic group, we examined 447 African American cases (233 advanced stage at diagnosis; 214 localized) and controls (N=223) from the California Collaborative Study of Aggressive Prostate Cancer. Using DNA extracted from buffy coat, the VDR CDX-2 genotype was measured by TaqMan assay. Dietary calcium was assessed from a 74-item modified Block food frequency questionnaire. Main effects of genotype and of dietary calcium, and diet-gene interactions were estimated using conditional logistic regression, adjusting for SES, age, family history, and total caloric intake. Results: Men who were least able to absorb calcium (GG genotype) were at 59% decreased risk of advanced prostate cancer; the adjusted relative risk was OR=0.41 (95% confidence interval =0.19, 0.90). Men with high total calcium intake (in the upper quartile) had an approximate two-fold increased risk of advanced prostate cancer compared to those in the lowest quartile; all cases OR= 1.91 (95% CI=1.20,3.03); OR=2.16 (95% CI= 1.26,3.71) for advanced stage. The dose-response relationship was significant (P-value for trend &amp;lt; 0.01). Gene by Nutrition interactions were not significant. Conclusions: Our findings provide evidence that African American carriers of the ancestral CDX-2 ‘AA’ allele for enhanced biological absorption of calcium, are at high risk for aggressive prostate cancer; and that high intake of dietary or total calcium poses formidable risks for both advanced and localized prostate cancer. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):PR-3.

Associations between bone quality and restrained eating, body weight, diet and physical activity in young adult Caucasian females

This study examined the associations between bone quality estimated from quantitative ultrasound (QUS) and self‐reported diet, eating behaviors, physical activity (PA), and lifestyle factors. Fifty‐eight Caucasian females 19–24 years of age participated. Subjects completed three scans of the right heel using a GE Lunar Achilles InSight QUS machine; a semi‐quantitative modified Block food frequency questionnaire (FFQ) with approximately 105 items; ten questions regarding restrained eating (RE); the International Physical Activity Questionnaire (IPAQ) short form; a health history form; and were measured for height and weight. Factor analysis was used to determine relationships between variables. QUS scores factored with RE and weight; height was related to fiber; and neither total energy (kcal) nor PA were related to QUS or RE. Further research is needed with more sensitive bone markers and a larger sample size to determine the relationship of bone quality with diet, PA, and eating behaviors in young adult females.Funded in part by Federal Hatch Act Funds #LAB93846.

Dietary Glycemic Load, Glycemic Index, and Associated Factors in a Multiethnic Cohort of Midlife Women

Background: Dietary glycemic load (GL) and glycemic index (GI), indicators of the postprandial glucose and insulin response to carbohydrate composition of diet, have been suggested as independent risk factors for cardiovascular disease and diabetes. However, current knowledge about the distribution, correlates, and major contributors of these measures in human populations is limited.Objective: To describe the intakes and correlates of GL and GI in African American, Caucasian, Chinese, and Japanese women in the Study of Women's Health Across the Nation (SWAN).Design: Data are from 2025 women participating in SWAN, a multi-ethnic, community-based cohort study of women transitioning into menopause. GL and GI were estimated from dietary information obtained in the fifth year of the study using a modified Block food frequency questionnaire. The relationship of GL and GI to dietary factors and selected demographic measures, including race/ethnicity and lifestyle factors, was examined using bivariate and multivariate analyses.Results: GI and GL were consistently lower in Caucasian women than in African American, Japanese, or Chinese women. Education was inversely associated with GL and alcohol consumption was inversely associated with GI among all ethnic groups. The association between family income and glycemic measures varied across ethnic groups. GI was positively associated with consumption of grains and potatoes and inversely associated with consumption of fruits, juices, dairy foods, protein sources, and sweets among all ethnic groups.Conclusions: It is important for researchers to consider factors such as ethnicity, family income, and alcohol intake as potential confounders when investigating the associations of GL and GI with disease.

Consumption of sweet foods and breast cancer risk: a case–control study of women on Long Island, New York

Several epidemiologic studies have reported a positive association between breast cancer risk and high intake of sweets, which may be due to an insulin-related mechanism. We investigated this association in a population-based case-control study of 1,434 cases and 1,440 controls from Long Island, NY. Shortly after diagnosis, subjects were interviewed in-person to assess potential breast cancer risk factors, and self-completed a modified Block food frequency questionnaire, which included 11 items pertaining to consumption of sweets (sweet beverages, added sugars, and various desserts) in the previous year. Using unconditional logistic regression models, we estimated the association between consumption of sweets and breast cancer. Consumption of a food grouping that included dessert foods, sweet beverages, and added sugars was positively associated with breast cancer risk [adjusted odds ratio (OR) comparing the highest to the lowest quartile: 1.27, 95% confidence interval (CI): 1.00-1.61]. The OR was slightly higher when only dessert foods were considered (OR: 1.55, 95% CI: 1.23-1.96). The association with desserts was stronger among pre-menopausal women (OR: 2.00, 95% CI: 1.32-3.04) than post-menopausal women (OR: 1.40, 95% CI: 1.07-1.83), although the interaction with menopause was not statistically significant. Our study indicates that frequent consumption of sweets, particularly desserts, may be associated with an increased risk of breast cancer. These results are consistent with other studies that implicate insulin-related factors in breast carcinogenesis.

Dietary patterns and body fat distribution in older adults

To examine whether dietary patterns are related to adipose tissue deposition in older adults, we used data from the Health, Aging, and Body Composition Study of well‐functioning adults aged 70 to 79 in 1998–99. Food intake was assessed with a modified Block food frequency questionnaire, and dietary patterns were derived by cluster analysis in 1,809 participants with complete data. Six dietary pattern clusters were identified: 1) Meat, snacks, fats and alcohol (n=480); 2) Sweets and desserts (n=257); 3) Refined grains (n=247); 4) Breakfast cereal (n=273); 5) Healthy foods (n=306); and 6) High‐fat dairy products (n=246). The ‘Healthy foods’ cluster was characterized by higher intake of lowfat dairy products, fruit, whole grains, poultry, fish and vegetables, and lower intake of red meat, sweets, added fats and high‐calorie drinks. Compared to the ‘Healthy foods’ cluster, the ‘Meat, snacks, fats and alcohol’ cluster had significantly greater abdominal visceral fat, and it and the ‘Breakfast cereal’ cluster had a significantly higher percent body fat, after controlling for age, gender, race, site, education, physical activity, smoking, calorie intake and PPAR‐γ2 Pro12Ala genotype. No differences were found in BMI or total lean body mass between the ‘Healthy foods’ cluster and other clusters. Results suggest a relationship between dietary patterns and body fat distribution in older adults. Supported by NIA/NIH.

Pregravid body mass index is negatively associated with diet quality during pregnancy

To investigate the association between pregravid weight status and diet quality. Institute of Medicine body mass index (BMI) cut-off points of 26.0-29.0 kg m- 2 for overweight and >29 kg m- 2 for obese were used to categorise women's weight status. Dietary information was obtained by self-report at 26-28 weeks' gestation using a modified Block food-frequency questionnaire. The Diet Quality Index for Pregnancy (DQI-P) included: servings of grains, vegetables and fruits, folate, iron and calcium intake, percentage calories from fat, and meal pattern score. Multinomial logistic regression models were used to estimate the association between weight status and tertiles of DQI-P controlling for potential individual confounders. A clinical-based population recruited through four prenatal clinics in central North Carolina. A total of 2394 women from the Pregnancy, Infection and Nutrition study were included in this analysis. Evidence of a dose-response relationship was found between BMI and inadequate servings of grains and vegetables, and iron and folate intake. Pregravid obesity was associated with 76% increased odds of falling into the lowest diet quality tertile compared with underweight women after controlling for potential confounders. A modest association was found between pregravid weight status and diet quality. If corroborated, these findings suggest that overweight pregnant women should be targeted for nutrition counselling interventions aimed to improve diet quality.

Interactions among GSTM1, GSTT1 and GSTP1 polymorphisms, cruciferous vegetable intake and breast cancer risk

Isothiocyanates are anticarcinogenic phytochemicals found in cruciferous vegetables that both induce and are substrates for the gluthatione S-transferases (GSTs). The GSTs are phase II metabolizing enzymes involved in metabolism of various bioactive compounds. Functional polymorphisms in GST genes have been identified and may interact with cruciferous vegetable intake to affect cancer risk. We examined this hypothesis using data from the Long Island Breast Cancer Study Project, a population-based case-control study conducted in Long Island, NY, from 1996 to 1997. Cruciferous vegetable intake in the previous year was assessed via modified Block food frequency questionnaire. DNA was extracted from blood samples (n = 1052 cases and n = 1098 controls) and genotyped for GSTM1 deletion, GSTT1 deletion and GSTP1 Ile105Val using multiplex polymerase chain reaction and Taqman assays. Unconditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI). We found an 86% increase in the OR for breast cancer among carriers of the GSTM1 null, GSTT1 null and GSTP 105Ile/Ile genotypes (OR = 1.86, 95% CI = 1.12, 3.08) and a 36% decrease in the OR among carriers of GSTM1 present, GSTT1 null and GSTP1 105Ile/Val + Val/Val genotypes (OR = 0.64, 95% CI = 0.42, 0.97) compared with GSTM1 present, GSTT1 present and GSTP1 105Ile/Ile carriers. We found no joint effects among GST polymorphisms and cruciferous vegetable intake and breast cancer risk. In conclusion, we found associations between specific combinations of three GST gene polymorphisms and breast cancer risk but these did not modify the association between cruciferous vegetable intake and breast cancer. Additional studies are needed to confirm the associations observed.