Pre-coded Food Diary Research Articles

Normal and unusual days for dietary intake during the 12 months after a breast cancer diagnosis in women

PurposeThere are several reasons to report days as being unusual with regard to dietary intake, including special occasions and celebrations. For breast cancer patients during the 12 month post-surgery period, unusual days may also include days that are affected by being a cancer patient. The aim of this study was to study dietary intake on “normal” and “unusual” days, and to study what is reported in “free text fields” of a food diary.MethodsWomen (n = 456), mean age 55.5 years newly diagnosed with invasive breast cancer (stage I/II) were included in this clinical study. “Normal” and “unusual” days in general, over time and during the week and weekends were studied using repeated administration of a 7-day pre-coded food diary.ResultsThe breast cancer patients reported 26% of all days as unusual. The intake of energy, most nutrients, especially alcohol and sugar, red and processed meat, and sweets, cakes, and snacks was 5–126% higher, whereas intake of fiber, fruit and berries, vegetables, and dairy products was 7–17% lower on unusual than on normal days (P < 0.001). The same pattern was seen for normal/unusual days during the weekdays, weekends and over time. Finally, 99% of the breast cancer patients used the free text fields to report additional intake with a mean energy of 1.1 MJ/day.ConclusionFor breast cancer patients during the 12-month post-surgery period, unusual days are important drivers of total intake, especially for alcohol. The free text fields in the pre-coded food diary contributed substantially to the total intake.

Dietary changes in early-stage breast cancer patients from pre-surgery and over the 12 months post-surgery

The time after a breast cancer diagnosis is a potential period for making positive dietary changes, but previous results are conflicting. The main aim of the present study was to study breast cancer patients' dietary changes during the 12 months post-surgery and from 12 months pre-surgery to 12 months post-surgery with repeated administration of a 7-d pre-coded food diary and an FFQ, respectively. Women (n 506), mean age 55·3 years diagnosed with invasive breast cancer (stages I and II), were included. The dietary intake was quite stable over time, but the intake was lower for energy (0·3 and 0·4 MJ/d), alcohol (1·9 and 1·5 g/d) and vegetables (17 and 22 g/d) at 6 months than 3 weeks post-surgery (food diary) and at 12 months post-surgery than pre-surgery (FFQ), respectively. Furthermore, energy percentage (E%) from carbohydrates increased between 0·8 and 1·2 E% and E% from fat decreased between 0·6 and 0·8 E% over time, measured by both dietary assessment methods. We observed a higher intake of dairy products (11 g/d) at 6 months post-surgery (food diary), and a lower intake of dairy products (34 g/d) and red and processed meat (7·2 g/d) at 12 months post-surgery (FFQ). Moreover, 24 % of the patients claimed they made dietary changes, but mostly they did not change their diet differently compared with those patients who claimed no changes. In conclusion, breast cancer patients reported only minor dietary changes from 12 months pre-surgery and during the 12 months post-surgery.

0411 Association Between Healthy Dietary Patterns and Self-Reported Sleep Disturbances in Older Men

Abstract Introduction Ageing is often accompanied by an increased prevalence of sleep problems. Healthy lifestyle choices, including diet, are especially important to mitigate such impairments. To date, little is known about how dietary patterns may link to measures of sleep quality in older subjects. Therefore, we investigated in a Swedish older male population, whether adherence to the Mediterranean Diet (MD) or the Healthy Diet Indicator (HDI; based on recommendations from the World Health Organization) is linked to a decrease in sleep disturbances. Methods We studied 970 men (age: 71 ± 1yr) from the ULSAM dataset. Sleep initiation or maintenance problems were evaluated by self-reporting questionnaires. Dietary intake was recorded with a pre-coded seven-day food diary. To calculate the adherence scores, intake of dietary components was assessed. Traditional MD components included fat quality, vegetables, fruits, cereals, fish, meat, dairy, and alcohol. The HDI components included saturated-, polyunsaturated fatty acids, proteins, carbohydrates, sucrose, fiber, fruits and vegetables, cholesterol, and fish. Reasonable dietary reporting was calculated to identify possible under- or over-reporters. Results When adjusted for potential confounders, no associations between dietary scores and sleep parameters were found. In contrast, low consumption of dairy products —one of the dietary features of the MD —was associated with better subjective sleep initiation. This association was, however, not found in men with adequate reports of daily energy intake (~54% of the cohort). Conclusion Our findings do not suggest that older men can mitigate perceived sleep problems by adhering to the MD or HDI. Whether low consumption of dairy products can facilitate sleep initiation must be confirmed in future studies by utilizing objective measures of sleep, such as polysomnography. Finally, when investigating associations between dietary patterns and sleep, particular attention should be paid to the potential confounder of inadequate reporting of energy intake. Support This research was funded by Novo Nordisk Foundation (NNF14OC0009349), Swedish Brain Foundation, Swedish Research Council (2015-03100), Åke Wiberg Foundation (M17-0088), Fredrik and Ingrid Thuring Foundation (2017-00313) and the Swedish Medical Research Society.

Weekly variation in diet and physical activity among 4-75-year-old Danes.

To compare dietary intake and physical activity (PA) between days of the week in a large sample of the Danish population; furthermore, to investigate the influence of gender and age as determinants for weekly variation. Analysis was based on cross-sectional data from the Danish National Survey of Diet and Physical Activity 2011-2013. Dietary intake and PA were assessed by 7 d of pre-coded food diaries and pedometer-determined step counts. Dietary intake and PA on weekdays (Monday-Thursday), Friday, and weekend days (Saturday and Sunday) were compared using linear mixed models. Survey with national representation, conducted in Denmark between 2011 and 2013. A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively. Energy intake during Friday and weekend days was 7-20 % higher compared with weekdays, while step counts were 10 and 17 % lower on Saturday and Sunday, respectively (all P < 0·001). Energy density of liquids and solids, consumption of added sugar, alcohol, discretionary foods, beer, wine and sugar-sweetened beverages were substantially higher, and consumption of dietary fibre, vegetables, fruit and wholegrain products were lower, during Friday and weekend days compared with weekdays (all P < 0·001). The observed patterns were present across gender and age, although weekly variation was most pronounced among children and relatively modest among the elderly. Weekend health behaviours of Danes display less favourable eating and PA behaviour compared with weekdays, making the weekend an important target for public health interventions aiming to improve dietary intake and PA behaviour.

Validation of repeated self-reported n-3 PUFA intake using serum phospholipid fatty acids as a biomarker in breast cancer patients during treatment

BackgroundThe role of n-3 polyunsaturated fatty acids (PUFAs) in breast cancer is not clear and under debate. To explore this relationship it is important to have proper validated dietary assessment methods for measuring the intake of n-3 PUFAs. The aim of the current study is to validate two different methods used to assess the intake of selected n-3 PUFAs as well as food sources of long-chained n-3 PUFAs. Also, we aim to study how stable the intake of fatty acids is during breast cancer treatment.MethodsThe study-population was patients with breast cancer (Stages I-II) or ductal carcinoma in situ (DCIS-grade III) undergoing treatment (n = 49) in Norway. Dietary intake was assessed by two self-administered methods, a 256 food item food frequency questionnaire (FFQ) and a 7-day pre-coded food diary (PFD). The FFQ was administered presurgery and twelve months postsurgery, and the PFD was administered shortly after surgery (10 +/− 2 days), six and twelve months postsurgery. Fasting blood samples (presurgery, six and twelve months postsurgery) were analysed for serum phospholipid fatty acids, a biomarker for intake of n-3 PUFAs.ResultsMean (SD) age was 54.2 (7.8) years at diagnosis, and the mean (SD) body mass index (BMI) was 24.8 (3.4) kg/m2. Correlation coefficients between dietary intakes of n-3 PUFAs measured with the FFQ and the PFD ranged from 0.35 to 0.66. The correlation coefficients between the PFD and the biomarker (serum phospholipid n-3 PUFAs) as well as between the FFQ and the biomarker demonstrated stronger correlations twelve months after surgery (ρ 0.40–0.56 and 0.36–0.53, respectively) compared to around surgery (ρ 0.08–0.20 and 0.28–0.38, respectively). The same pattern was observed for intake of fatty fish. The intake of n-3 PUFAs did not change during treatment assessed by the FFQ, PFD or biomarker.ConclusionThese results indicate that the FFQ and the PFD can be used to assess dietary intake of fish and n-3 PUFAs in breast cancer patients during breast cancer treatment. Still, the PFD shortly after surgery should be used with caution. The diet of patients undergoing breast cancer treatment was quite stable, and the intake of n-3 PUFAs did not change.

Optimistic and pessimistic self-assessment of own diets is associated with age, self-rated health and weight status in Danish adults

The aim of this study was to analyse concordance between Danish adults’ recorded diet quality and their own assessment of the healthiness and to examine socio-demographic, health and behavioural characteristics associated with an optimistic or pessimistic self-assessment.Data were derived from The Danish National Survey of Diet and Physical Activity 2011–2013 and included a random sample of 3014 adults (18–75 y). Diet quality was evaluated on the basis of seven-day pre-coded food diaries and categorised ‘unhealthy’, ‘somewhat healthy’ and ‘healthy’. Self-assessment of the healthiness of own diets was registered via personal interviews and categorised healthy enough ‘to a high degree’, ‘to some degree’ or ‘not at all/only partly’. Highly and somewhat optimistic self-assessment, respectively, were defined as assessing own diets as healthy enough to a high degree or to some degree while having unhealthy diets. Highly and somewhat pessimistic self-assessment, respectively, were defined as assessing own diets as not healthy enough or healthy enough to some degree while having healthy diets. Multiple logistic regression models were used to examine characteristics associated with optimistic and pessimistic self-assessments, respectively.Among individuals with unhealthy diets, 13% were highly optimistic and 42% somewhat optimistic about the healthiness of their diets. Among individuals with healthy diets, 14% were highly pessimistic and 51% somewhat pessimistic about the healthiness of their diets. Highly optimistic self-assessment was associated with increasing age, excellent self-rated health, normal weight and a moderate activity level. Highly pessimistic self-assessment was associated with decreasing age, good self-rated health and being obese. The findings indicate that people seem to use personal health characteristics as important references when assessing the healthiness of their diets.

Relative validity of a web-based food frequency questionnaire for patients with type 1 and type 2 diabetes in Denmark.

Background:Diet has an important role in the management of diabetes. However, little is known about dietary intake in Danish diabetes patients. A food frequency questionnaire (FFQ) focusing on most relevant nutrients in diabetes including carbohydrates, dietary fibres and simple sugars was developed and validated.Objectives:To examine the relative validity of nutrients calculated by a web-based food frequency questionnaire for patients with diabetes.Design:The FFQ was validated against a 4-day pre-coded food diary (FD). Intakes of nutrients were calculated. Means of intake were compared and cross-classifications of individuals according to intake were performed. To assess the agreement between the two methods, Pearson and Spearman's correlation coefficients and weighted kappa coefficients were calculated.Subjects:Ninety patients (64 with type 1 diabetes and 26 with type 2 diabetes) accepted to participate in the study. Twenty-six were excluded from the final study population.Setting:64 volunteer diabetes patients at the Steno Diabetes Center.Results:Intakes of carbohydrates, simple sugars, dietary fibres and total energy were higher according to the FFQ compared with the FD. However, intakes of nutrients were grossly classified in the same or adjacent quartiles with an average of 82% of the selected nutrients when comparing the two methods. In general, moderate agreement between the two methods was found.Conclusion:The FFQ was validated for assessment of a range of nutrients. Comparing the intakes of selected nutrients (carbohydrates, dietary fibres and simple sugars), patients were classified correctly according to low and high intakes. The FFQ is a reliable dietary assessment tool to use in research and evaluation of patient education for patients with diabetes.

Dietary counseling is associated with an improved lipid profile in children with familial hypercholesterolemia

Background and aimsFamilial hypercholesterolemia (FH) is a genetic disorder characterized by elevated levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Guidelines recommend cholesterol-lowering medication from 8 to 10 years of age and dietary recommendations. Little is known about the diet of FH children and the effect of dietary counseling. The aim of the study was to describe the diet of FH children with respect to fat quality, and to investigate if dietary counseling improved lipid profile. MethodsFifty-four FH children (5–18 years) were included in the study and dietary intake was recorded with a pre-coded food diary for four days. Information about plasma lipid levels was obtained. ResultsMedian intake of total fat, monounsaturated fat, polyunsaturated fat (PUFA) and saturated fat (SFA) was 30.8, 10.4, 5.9 and 12.0 E %, respectively. Among non-statin treated FH children, SFA intake was significantly correlated with TC, LDL-C and apolipoprotein (apo) B (rsp = 0.55; p = 0.004, rsp = 0.46; p = 0.02, and rsp = 0.45; p = 0.02, respectively), and PUFA/SFA ratio significantly inversely correlated with TC (rsp = −0.42; p = 0.03). Compared to the first visit, non-statin and non-plant sterol treated FH children (n = 10) had significantly reduced levels of TC (p < 0.01), LDL-C (p = 0.01), high-density lipoprotein cholesterol (p = 0.02), apo B (p = 0.05) and apo A-1 (p = 0.02) levels at a later visit. ConclusionsFH children had a higher intake of SFA than recommended and the SFA intake was positively correlated with plasma TC, LDL-C and apo B levels in FH children not using statins. Importantly, the plasma lipid profile was improved in FH children after dietary counseling where focus was on reducing intake of SFA and dietary cholesterol.

The reliability and validity of a short food frequency questionnaire among 9-11-year olds: a multinational study on three middle-income and high-income countries.

The main aim of this study was to assess the reliability and validity of a food frequency questionnaire with 23 food groups (I-FFQ) among a sample of 9-11-year-old children from three different countries that differ on economical development and income distribution, and to assess differences between country sites. Furthermore, we assessed factors associated with I-FFQ's performance. This was an ancillary study of the International Study of Childhood Obesity, Lifestyle and the Environment. Reliability (n=321) and validity (n=282) components of this study had the same participants. Participation rates were 95% and 70%, respectively. Participants completed two I-FFQs with a mean interval of 4.9 weeks to assess reliability. A 3-day pre-coded food diary (PFD) was used as the reference method in the validity analyses. Wilcoxon signed-rank tests, intraclass correlation coefficients and cross-classifications were used to assess the reliability of I-FFQ. Spearman correlation coefficients, percentage difference and cross-classifications were used to assess the validity of I-FFQ. A logistic regression model was used to assess the relation of selected variables with the estimate of validity. Analyses based on information in the PFDs were performed to assess how participants interpreted food groups. Reliability correlation coefficients ranged from 0.37 to 0.78 and gross misclassification for all food groups was <5%. Validity correlation coefficients were below 0.5 for 22/23 food groups, and they differed among country sites. For validity, gross misclassification was <5% for 22/23 food groups. Over- or underestimation did not appear for 19/23 food groups. Logistic regression showed that country of participation and parental education were associated (P⩽0.05) with the validity of I-FFQ. Analyses of children's interpretation of food groups suggested that the meaning of most food groups was understood by the children. I-FFQ is a moderately reliable method and its validity ranged from low to moderate, depending on food group and country site.

Intake and sources of gluten in 20- to 75-year-old Danish adults: a national dietary survey.

Celiac disease, an immunological response triggered by gluten, affects ~1% of the Western population. Information concerning gluten intake in the general population is scarce. We determined intake of gluten from wheat, barley, rye and oat in the Danish National Survey of Diet and Physical Activity 2005-2008. The study population comprised a random cross-sectional sample of 1494 adults 20-75years, selected from the Danish Civil Registration System. Protein content in wheat, rye, barley and oat was determined from the National Danish Food Composition Table and multiplied with the amount of cereal used in recipes. Amount of gluten was calculated as amount of cereal protein ×0.80 for wheat and oat, ×0.65 for rye and ×0.50 for barley. Dietary intake was recorded daily during seven consecutive days in pre-coded food diaries with open-answer possibilities. Mean total gluten intake was 10.4±4.4g/day (10th-90th percentiles; 5.4-16.2g/day), in men 12.0±4.6g/day and 9.0±3.4g/day in women. It was higher among men than among women in all age groups (20-75years; P<0.0001); however, this difference was eliminated when adjusting for energy intake. Intake of different gluten sources tended to be higher in men than in women with the exception of gluten from barley. Total gluten intake decreased with increasing age (P<0.0001) as did gluten intake from wheat (P<0.0001), whereas intake of gluten from rye (P<0.0001) and barley (P=0.001) increased with increasing age, also when adjusted for energy intake or body weight. This study presents representative population-based data on gluten intake in Danish adults. Total gluten intake decreased with increasing age.

Disparities in dietary habits and physical activity in Denmark and trends from 1995 to 2008.

To examine social disparities in dietary-, alcohol- and leisure-time physical activity habits in Danish adults from 1995 to 2008 and to test the hypothesis of widening disparities. Four cross-sectional surveys of representative samples of the Danish population aged 20-75 years were analysed, a total of 7900 respondents. Dietary and alcohol habits were measured by a 7-day pre-coded food diary and physical activity and education by a face-to-face interview. Multivariate analyses were used to test associations between explanatory variables and response variables and the hypothesis of widening disparities. In all analyses, both diet quality and physical inactivity differed systematically with educational group and with healthier habits for the group with long education. Only for alcohol habits was an opposite social gradient seen. Disparities persisted over all time periods. The analyses using "The Concentration Index" did not change any of the conclusions. Gender also influenced diet quality. Men had dietary and alcohol habits furthest away from the guidelines. A trend of healthier habits was also found over the time period. Social disparities in diet quality and leisure-time physical activity were seen for all examined time periods and with no significant change therefore, there is no support to the hypothesis of widening social disparities in all educational groups some improvement of dietary habits was found, especially for those foods where comprehensive initiatives had taken place however, social disparities still exist there is an ongoing need to address these disparities in order to reduce social inequality in health.

Identifying dietary patterns and associated health-related lifestyle factors in the adult Danish population

To identify and describe dietary patterns in Danish adults and to examine which demographic and health-related lifestyle factors are associated with dietary patterns. Data derived from the Danish national survey of diet and physical activity collected in 2003-2008 and included 1569 men and 1785 women. Diet was assessed by a 7-day pre-coded food diary. Information on age, gender, weight, height, physical activity, smoking habits, educational level and attitudes towards healthy eating habits was derived from face-to-face interviews. Principal component analysis was applied to explore dietary patterns. Associations with lifestyle factors were examined by means of multiple regression analyses. Three major dietary patterns were identified: a 'traditional' pattern correlated with intake of rye bread, white bread, fat on bread, cheese, jam, cold meat, minced meat, potatoes and gravy, and cake and biscuits; a 'health-conscious' pattern correlated with coarse bread, fruit, vegetables, low-fat dairy, nuts, water and tea; and a 'fast food' pattern correlated with pizza, hamburger/spring rolls, crisps, rice and pasta, sugar-sweetened soft drinks and sweets. The 'traditional' pattern was positively associated with male gender and age, whereas the 'health-conscious' pattern was positively associated with being female, increasing age and educational level. The 'fast food' pattern was inversely associated with age and smoking. Three distinct dietary patterns were identified, and associated lifestyle and demographic factors were characterised. The findings are valuable in targeting future nutrition education and will enable more focused strategies in communicating food-based dietary guidelines.

FADS genotype and diet are important determinants of DHA status: a cross-sectional study in Danish infants

Infant docosahexaenoic acid (DHA) status is supported by the DHA content of breast milk and thus can decrease once complementary feeding begins. Furthermore, it is unclear to what extent endogenous DHA synthesis contributes to status. We investigated several determinants, including FADS genotypes on DHA status at 9 mo and 3 y. This was a cross-sectional study with Danish infants from 2 prospective studies [Essentielle Fedtsyrer i OvergangskosteN (EFiON) and the Småbørns Kost Og Trivsel (SKOT) cohort] in which we measured red blood cell (RBC) DHA status at 9 mo (n = 409) and 3 y (n = 176) and genotyped 4 FADS tag single nucleotide polymorphisms (SNPs): rs3834458, rs1535, rs174575, and rs174448 (n = 401). Information about breastfeeding was obtained by using questionnaires, and fish intake was assessed by using 7-d precoded food diaries. FADS genotype, breastfeeding, and fish intake explained 25% of the variation in infant RBC DHA status [mean ± SD: 6.6 ± 1.9% of fatty acids (FA%)]. Breastfeeding explained most of the variation (∼20%), and still being breastfed at 9 mo was associated with a 0.7 FA% higher DHA compared with no longer being breastfed (P < 0.001). The FADS SNPs rs1535 and rs3834458 were highly correlated (r = 0.98). Homozygous carriers of the minor allele of rs1535 had a DHA increase of 1.8 FA% (P = 0.001) relative to those with the wild-type allele, whereas minor allele carriers of rs174448 and rs174575 had a decrease of 1.1 FA% (P = 0.005) and 2.0 FA% (P = 0.001), respectively. Each 10-g increment in fish intake was associated with an increased DHA status of 0.3 FA%. At 3 y, fish intake was the only significant determinant of DHA status (0.2 FA%/10 g). Breastfeeding, FADS genotype, and fish intake are important determinants of DHA status in late infancy. The EFiON study was registered at clinicaltrials.gov as NCT 00631046.

Duration of Lactation, Maternal Metabolic Profile, and Body Composition in the Norwegian EBBA I-Study

There is conflicting evidence as to whether duration of lactation may decrease the risk of subsequent development of an unfavorable maternal metabolic profile, including overweight and obesity. We hypothesized that duration of lactation is associated with a more favorable metabolic profile and healthier anthropometric measurements. Ninety-eight parous women were studied from the Norwegian EBBAI-study (Energy Balance and Breast cancer Aspects-study), a cross-sectional study of healthy premenopausal women 25-35 years old. Historical lactation data were collected, anthropometric measurements were taken, fasting blood samples (for serum glucose, triglycerides, total cholesterol, and high-density lipoprotein cholesterol) were drawn, and women were asked to fill in a precoded food diary. Mean time since last birth was 4.7 years, mean number of children was 1.9, mean total duration of lactation was 19 months, and average length of lactation per child was 10.3 months. Women who on average lactated for less than 10 months per child had higher mean levels of fasting serum glucose (5.2 mmol/L vs. 5.0 mmol/L, p=0.04), serum triglyceride (0.91 mmol/L vs. 0.66 mmol/L, p=0.001), and serum cholesterol (4.78 mmol/L vs. 4.32 mmol/L, p=0.004) and a higher waist-to-hip ratio (0.81 vs. 0.77, p=0.001) than women who lactated for 10 months or more per child. The inverse association between average length of lactation per child and waist-to-hip ratio persisted after adjustment for potential confounders. These results support the hypothesis that duration of lactation may be associated with a healthier metabolic profile and healthier anthropometric measurements, especially lipid levels and waist-to-hip ratio, even years after weaning.

Dietary arginine and linear growth: the Copenhagen School Child Intervention Study

The amino acid arginine is a well-known growth hormone (GH) stimulator and GH is an important modulator of linear growth. The aim of the present study was to investigate the effect of dietary arginine on growth velocity in children between 7 and 13 years of age. Data from the Copenhagen School Child Intervention Study during 2001-2 (baseline), and at 3-year and 7-year follow-up, were used. Arginine intake was estimated via a 7 d precoded food diary at baseline and 3-year follow-up. Data were analysed in a multilevel structure in which children were embedded within schools. Random intercept and slopes were defined to estimate the association between arginine intake and growth velocity, including the following covariates: sex; age; baseline height; energy intake; puberty stage at 7-year follow-up and intervention/control group. The association between arginine intake and growth velocity was significant for the third and fourth quintile of arginine intake (2.5-2.8 and 2.8-3.2 g/d, respectively) compared with the first quintile ( < 2.2 g/d) (P for trend = 0.04). Protein intake (excluding arginine) was significantly associated with growth velocity; however, the association was weaker than the association between arginine intake and growth velocity (P for trend = 0.14). The results of the present study suggest a dose-dependent physiological role of habitual protein intake, and specifically arginine intake, on linear growth in normally growing children. However, since the study was designed in healthy children, we cannot firmly conclude whether arginine supplementation represents a relevant clinical strategy. Further research is needed to investigate whether dietary arginine may represent a nutritional strategy potentially advantageous for the prevention and treatment of short stature.

Evaluation of a short food frequency questionnaire used among Norwegian children

ObjectiveThe aim of this study was to evaluate a short food frequency questionnaire (FFQ) against a four-day precoded food diary (PFD) with regard to frequency of food intake among Norwegian 9- and 13-year-olds.Subjects and designA total of 733 9-year-olds and 904 13-year-olds completed first a short FFQ and one to two weeks later a four-day PFD. The short FFQ included questions about 23 food items, including different drinks, fruits, vegetables, bread, fish, pizza, sweets, chocolate and savoury snacks. The PFD covered the whole diet.ResultsWhen comparing mean intake from the PFD with comparable food items in the FFQ, all food items showed that increasing intake measured with the PFD corresponded with increasing intake with the short FFQ. However, participants reported a significantly higher frequency of intake for most foods with the short FFQ compared with PFD, except for soft drinks with sugar and sweets. The median Spearman correlation coefficient between the two methods was 0.36 among the 9-year-olds and 0.32 among the 13-year-olds. Often eaten foods such as fruits and vegetables had higher correlations than seldom eaten foods such as pizza and potato chips. The median correlation coefficients for drinks alone were higher (r=0.47) for both age groups.ConclusionsResults indicate that the short FFQ was able to identify high and low consumers of food intake and had a moderate capability to rank individuals according to food intake. Drinks, fruits and vegetables had better correlations with the PFD than infrequently eaten food items.

Relative validity of the pre-coded food diary used in the Danish National Survey of Diet and Physical Activity

To determine the relative validity of the pre-coded food diary applied in the Danish National Survey of Dietary Habits and Physical Activity. A cross-over study among seventy-two adults (aged 20 to 69 years) recording diet by means of a pre-coded food diary over 4 d and a 4 d weighed food record. Intakes of foods and drinks were estimated, and nutrient intakes were calculated. Means and medians of intake were compared, and cross-classification of individuals according to intake was performed. To assess agreement between the two methods, Pearson and Spearman's correlation coefficients and weighted kappa coefficients were calculated. Validation study of the pre-coded food diary against a 4 d weighed food record. Seventy-two volunteer, healthy free-living adults (thirty-five males, thirty-seven females). Intakes of cereals and vegetables were higher, and intakes of fruit, coffee and tea were lower, in the weighed food record compared with the food diary. Intakes of nutrients were grossly the same in the two methods, except for protein, where a higher intake was recorded in the weighed record. In general, moderate agreement between the two methods was found. Participants were classified moderately correct according to food and nutrient intakes assessed in the pre-coded food diary; however values of absolute food intakes should be used and interpreted with caution. Improvement of the methods to estimate portion size may increase the accuracy of the dietary intake estimates.

Fish intake, erythrocyten-3 fatty acid status and metabolic health in Danish adolescent girls and boys

Marine n-3 long-chain PUFA (n-3 LCPUFA) may have a beneficial effect on several aspects of the metabolic syndrome (dyslipidaemia, insulin resistance, hypertension and abdominal obesity). The metabolic syndrome is increasing in prevalence during adolescence, but only few studies have investigated the effects of n-3 LCPUFA in adolescence. The present study examines associations between fish intake (assessed by a 7d pre-coded food diary), erythrocyte (RBC) DHA status (analysed by GC) and metabolic syndrome measures (anthropometry, blood pressure and plasma lipids, insulin and glucose) in 109 17-year-old children from the Copenhagen Birth Cohort Study. Of the children, 8% were overweight or obese and few showed signs of the metabolic syndrome, but all the metabolic syndrome variables were correlated. Median fish intake was 10·7 (interquartile range 3·6-21·2) g/d. Boys tended to have a higher fish intake (P=0·052), but girls had significantly higher RBC levels of DHA (P=0·001). Sex and fish intake explained 37% of the variance in RBC-DHA (P<0·001). After adjusting for confounders, high DHA status was found to be significantly correlated with higher systolic blood pressure (P=0·014) and increased fasting insulin (P=0·018), but no adverse association was observed with the mean metabolic syndrome z-score. Overall, the present study showed the expected association between fish intake and RBC-DHA, which in contrast to our expectations tended to be associated with a poorer metabolic profile. Whether these results reflect the physiological function of n-3 LCPUFA, lifestyle factors associated with fish intake in Denmark, or mere chance remains to be investigated.

Improving the diet of employees at blue-collar worksites: results from the ‘Food at Work’ intervention study

To examine the impact of a 6-month participatory and empowerment-based intervention study on employees' dietary habits and on changes in the canteen nutrition environment. Worksites were stratified by company type and by the presence or absence of an in-house canteen, and randomly allocated to either an intervention group (five worksites) or a minimum intervention control group (three worksites). The study was carried out in partnership with a trade union and guided by an ecological framework targeting both individual and environment levels. Outcome measures included: (i) changes in employees' dietary habits derived from 4 d pre-coded food diaries of a group of employees at the worksites (paired-data structure); and (ii) the canteen nutrition environment as identified by aggregating chemical nutritional analysis of individual canteen lunches (different participants at baseline and at endpoint). Eight blue-collar worksites (five of these with canteens). Employees. In the intervention group (n 102), several significant positive nutritional effects were observed among employees, including a median daily decrease in intake of fat (-2.2 %E, P = 0.002) and cake and sweets (-18 g/10 MJ, P = 0.002) and a median increase in intake of dietary fibre (3 g/10 MJ, P < 0.001) and fruit (55 g/d, P = 0.007 and 74 g/10 MJ, P = 0.009). With regard to the canteen nutrition environment, a significant reduction in the percentage of energy obtained from fat was found in the intervention group (median difference 11 %E, P < 0.001, n 144). The present study shows that moderate positive changes in dietary patterns can be achieved among employees in blue-collar worksites.

Dietary intake in adolescents with asthma – potential for improvement

Associations between an unhealthy diet and overweight and the presence of asthma are reported. The aims of this study were to assess whether the intake of nutrients and food items in adolescents with asthma differs from that of healthy adolescents, whether the intake was in accordance with the Nordic Nutrition Recommendations (NNR) or whether possible relationships were confounded by body composition. A four-day-validated 18-page pre-coded food diary was completed by 169 13- to 14-year-old adolescents, 93 with asthma and 76 healthy control subjects, in addition to clinical assessment, anthropometric measurements, lung function and skin prick tests. Neither intake of added sugar, snacks nor saturated fat was associated with asthma. All groups had an intake of saturated fat and added sugars exceeding the NNR, while the intake of fruits and vegetables, fibre and vitamin D was lower than recommended. The intake of folate, calcium, magnesium and iron was lower than recommended for girls with asthma and healthy girls. The intake of vitamin C was satisfactory for all groups. Body composition did not influence eating habits, and the prevalence of overweight was similar in the two groups. The dietary intake among Norwegian adolescents in general had a potential for improvement. As girls have a lower energy intake than boys, they have a larger demand of quality of the diet. Additional dietary research in adolescents with asthma is recommended.