Food Recall Research Articles

A Nontrivial Analysis of Patient Safety Risk from Parenteral Drug- and Medical Device-Borne Endotoxin.

A thorough and systematic analysis of potential endotoxin-related safety issues from parenteral drugs and devices is important to ensure appropriate current Good Manufacturing Practices, compendial requirements, standards and regulatory guidance. Lately, the US Food and Drug Administration has been expecting pharmaceutical firms to apply an arbitrary safety factor to compendial compliant drug specifications for endotoxin, potentially causing manufacturing challenges, supply issues and additional unwarranted costs. The aim of this study was to evaluate data from three disparate sources over an extended period of time, from 2008 to 2021, to determine if there exists an industry-wide risk to patients from parenteral drugs and devices, thereby evaluating if changes to current Good Manufacturing Practices or compendial requirements are indeed warranted. Food and Drug Administration data from current Good Manufacturing Practices non-compliance observations, product recalls and the FDA Adverse Event Reporting System were used as the three sources of data. Parenteral products were separated into drugs and devices, potential endotoxin-related patient safety issues were characterised in terms of the available non-compliance information, the type and number of product recalls, and the type and number of potential adverse events. Descriptive statistics in Microsoft Excel 2019 and Pivot tables were used for the analysis and presentation of the data. From 2011 to 2021, a total of 188 endotoxin-related current Good Manufacturing Practices compliance observations were recorded, 70% and 30% were associated with laboratory and manufacturing origins, respectively. Finished drug product testing accounted for 56% of these. In contrast, 95% of all endotoxin-related product recalls were associated solely with medical devices. Over the years 2008-2021, approximately 1.4% of all adverse events (23,663,780) were recorded with some reference to pyrexia (fever); however, there are sparse data categorically attributing this to the administration of parenteral drugs or devices or combinations of these possessing high levels of endotoxin. Analysis of data concerning drug- and device-borne endotoxin obtained from FDA data from current Good Manufacturing Practices non-compliance observations, product recalls and the FDA Adverse Event Reporting System demonstrated the absence of industry-wide issues with endotoxin contamination. Based upon these data, changes to current Good Manufacturing Practices and the compendial methodology of setting endotoxin specifications (and hence the compendial methodology of testing for endotoxins) are unwarranted.

Quality shareholders versus transient investors: The alarming case of product recalls

In this installment of Organizational Performance, we draw attention to two types of shareholders that tend to push executive decision-making in different directions. Quality shareholders (QSs) invest in a small number of companies and hold their shares over time. QSs offer patient capital that allows executives to focus on building and sustaining competitive advantages. Transient institutional investors (TIIs) hold dispersed shareholdings across a wide array of companies and frequently trade in and out of any given stock. TIIs impose pressure on quarterly earnings reports that induce managerial myopia and inhibit strategic thinking. We consider the influence of these investors on how many consumers are harmed before a defective product is pulled from the market. The good news is that for every 1% increase in QS shareholding, prerecall consumer harm decreases by 2%. Unfortunately, for the same amount of increase in TII shareholding, prerecall consumer harm increases by 6%—a frightening prospect. The case of product recalls draws the difference between QSs and TIIs into stark contrast. In response, we offer practical recommendations to assist managers in navigating these two types of powerful institutional investors.

Exploring the Sociodemographic Characteristics and Staple Food Consumption Patterns of Low-Income People in Kendari City, Indonesia

The city's attractiveness encourages urbanization, namely the movement of people from rural to urban areas. Urbanization accompanied by a transition to diet will significantly impact the food system. This study aims to analyze low-income people's sociodemographic characteristics and consumption patterns. This research was conducted in Kendari City. Data collection was carried out in October-November 2021. Determining the research location began by selecting densely populated residential areas in Kendari City. Based on the Geographic Information System (GIS) results, dense residential blocks were obtained in Mandonga District, namely several Neighborhood Units (RT) in Korumba Village and residential blocks in several RTs in Petoaha Village, Abeli District, which are on the coast of Kendari Bay. The low-income people (LIP) population was obtained from data on Social Assistance recipients in each sample village. The total sample is 20% of the population, covering 194 household respondents and extracting data and information using a combination of the food recall and weighing methods. The variables in this study are sociodemographic characteristics, including age, education, number of family members, and gender; house and Yard, as well as variables related to food sources of carbohydrates consumed by MBR households in the last 3 (three) days, including the type, quantity, price, and expenditure of food. Data analysis was carried out in a qualitative descriptive manner, with cross-tabulations and percentages. The results showed that the respondents were at an average age of 44.91 years, the length of schooling was 8.27 years, the number of family members was 4 (four), and most were women, reaching 150 people. Most respondents have houses made of planks (wood), namely 97 people, with yards that have not been fully utilized for agricultural activities. The staple food consumption pattern of the respondent's family is dominated by rice (0.48 kg), and the amount of consumption of sago and cassava is minimal, only 0.07 kg and 0.05 kg, respectively. The most significant expenditure for food sources of carbohydrates is to buy rice, which is IDR 4,756/day. Therefore, policies are needed to encourage urban agricultural activities and revitalize the utilization of non-rice staple foods. Need to be disseminated. One form is not assisting in the form of rice to LIP when there is a government assistance program.

Development of Phil-HEI and its evaluation of the Filipino diet: 2018 Expanded National Nutrition Survey

ObjectiveTo validate the application of the developed Philippine Healthy Eating Index (Phil-HEI) by exemplifying in a 2-week cycle menu plans and its application on the diet quality of Filipino adults using the 2018 ENNS dietary data. MethodsThe study analyzed data from 31,218 adult Filipinos aged 20 to 59 who participated in the 2018 Expanded National Nutrition Survey (ENNS). Dietary intake was obtained using 24 h food recall, used to calculate the Philippine Healthy Eating Index. To establish the efficiency of the index, the following aspects were evaluated: (1) content validity, (2) construct validity, (3) discriminating validity, (4) sensitivity analysis, and (5) internal consistency reliability. ResultsThe Philippine Healthy Eating Index (Phil-HEI) was developed using local guidelines, Philippine Food Pyramid, Philippine Dietary Reference Intakes, World Health Organization international guidelines, and the adapted AHEI-2010. The study found a significant association between Phil-HEI scores and age, wealth quintile, education, smoking, and BMI. The correlation between the Phil-HEI scores and energy/nutrient intake was significant but weak, with a trend across the Phil-HEI score tertiles. The discrimination validity showed large differences in mean scores based on usual diet versus three cycle menu plans. A sensitivity analysis revealed that higher Phil-HEI scores were associated with lower risk of chronic energy deficiency. The reliability of the Phil-HEI components was low (α = 0.26) due to the complex nature of assessing diet quality. ConclusionsThe Philippine Healthy Eating Index showed itself to be structurally valid when used to evaluate and monitor the diet quality of Filipino adults.

Selected Lifestyle Practices in Urban African American Women—Relationships to Pregnancy Outcome, Dietary Intakes and Anthropometric Measurements

The relationships of selected lifestyle factors (cigarette smoking, consumption of alcoholic beverages, recreational drug use, and exercise during pregnancy), all self-reported, to pregnancy outcomes, dietary intake during pregnancy, and maternal anthropometric measurements, were investigated in a group of urban African American pregnant women. The 234 subjects were aged 16-35 years and were free of diabetes and abnormal hemoglobins. The lifestyle data were collected by trained interviewers during the subjects' prenatal clinic visits, and the dietary data by monthly, quantitative 24-hour food recalls conducted during these same visits. Maternal anthropometric measurements were obtained from the subjects' hospital records, and pregnancy outcome data during physical examinations of the newborn infants. Both cigarette smoking and drug use were associated with significantly lower mean birth weight, length, and head circumference, while exercise was associated with a significantly higher mean birth weight, and head circumference (P < 0.05). Drug use during pregnancy was associated with a significantly higher intake of vitamin C, and a significantly lower intake of iron; while women reporting drug use before pregnancy had significantly higher mean intakes of food energy, protein, total and saturated fat, and zinc. Prepregnancy weight, percent ideal prepregnancy body weight, prepregnancy body mass index, and delivery weight were significantly lower among those reporting drug use before pregnancy. Multiple regression analyses indicated that smoking explained a relatively small proportion of the variance in infant birth weight compared with delivery weight and percent of ideal prepregnancy body weight.

Dietary Intakes, Anthropometric Measurements and Pregnancy Outcomes

The relationships of maternal prenatal dietary intakes and anthropometric measurements to pregnancy outcomes were investigated in a prospective observational study of urban African American women. The 322 subjects, a subset of the 744 women recruited for the study using purposive sampling, were all nulliparous, free of diabetes mellitus and abnormal hemoglobins, and delivered term, singleton infants. Sociodemographic data and monthly quantitative 24-hour food recalls were collected by trained interviewers. Maternal anthropometric measurements were obtained from the subjects' hospital records. Pregnancy outcome data were obtained by physical examinations of the newborn infants by the project pediatrician. With the exception of vitamin C, average maternal dietary intakes were within the ranges of intakes obtained in previous studies. Mean intakes of protein, vitamins A and C, thiamin, riboflavin, and niacin exceeded the 1989 RDA, while those of food energy, vitamin B-6, folate, calcium, iron, magnesium, and zinc were below the RDA. Underweight prior to pregnancy and low pregnancy weight gains were found among 12.9% and 44.4% of the subjects respectively. Dietary intakes were not significantly correlated with pregnancy outcomes. Maternal anthropometric measurements significantly correlated with pregnancy outcomes included delivery weight, pregnancy weight gain, weekly weight gain, prepregnancy weight, net weight gain, height, prepregnancy body mass index, and % ideal prepregnancy body weight (P < 0.05). Using the stepwise selection procedure in multiple regression analysis, delivery weight, % ideal prepregnancy body weight, and prepregnancy body mass index were selected as being predictive of infant birth weight. It was concluded that anthropometric measurements were better nutritional predictors of pregnancy outcome than dietary intake.

Jordan's Population-Based Food Consumption Survey: Protocol for Design and Development.

One of the factors influencing health and well-being is dietary patterns. Data on food consumption are necessary for evaluating and developing community nutrition policies. Few studies on Jordanians' food consumption and dietary habits at various ages have been conducted, despite the increased prevalence of overweight, obesity, and chronic diseases. This will be the first study focusing on Jordanians' food consumption patterns that includes children, adolescents, adults, and older adults. This cross-sectional study aims to describe the design and methodology of the Jordan's Population-based Food Consumption Survey, 2021-2022, which was developed to collect data on food consumption, including energy, nutrients, and food group intake, from a representative sample of Jordanians and to determine the prevalence of overweight and obesity and their relationship to food consumption. Participants were selected by stratified random sampling, using the Estimated Population of the Kingdom by Governorate, Locality, Sex, and Households, 2020 as the sampling frame. The food consumption survey sample was at the population level, representing gender and age classes (8-85 years old). The data collection period was 6 months. Food consumption was assessed using 24-hour dietary recall (2 nonconsecutive days, 1 week apart) interviews representing weekdays and weekends. In addition to data on food consumption, information on the use of food supplements, sociodemographic and socioeconomic status, and health was gathered. Weight, height, and waist circumference were all measured. The survey included 632 households with 2145 participants, of which 243 (11.3%) were children, 374 (17.4%) were adolescents, 1428 (66.6%) were adults, and 99 (4.6%) were older adults. Three food consumption databases were used to stratify the mean 24-hour dietary recall food consumption into energy intake, carbohydrates, proteins, fats, fiber, vitamins and minerals, and food groups. BMI was calculated and classified as normal, overweight, or obese. Central obesity was classified as normal or abnormal based on the waist-to-height ratio. The survey results will be disseminated based on age, energy, nutrient, and food group consumption. The prevalence of overweight and obesity by age group will be presented, as well as a comparison to the situation in Eastern Mediterranean countries. The survey data will be helpful in nutritional studies, assessing changes in dietary patterns, and developing and evaluating nutrition or health policies. It will be a solid base for developing a future national surveillance system on food consumption patterns with comprehensive food consumption, physical activity, biochemical, and blood pressure data. DERR1-10.2196/41636.

Impacts of a Multi-Professional Family versus Isolated Intervention on Food Level Processing in Overweight Adolescents: A Randomized Trial

The food consumption of adolescents has changed nowadays, with an increase in ultra-processed food that in general shows higher calories and lower nutrients. Because of this, the objective of this study was to investigate the impacts of a 12-week multi-professional family versus isolated intervention on the food level processing of overweight adolescents. A randomized clinical trial study was carried out in which adolescents (n = 43; mean aged 13.73 years) who were divided into FG-family group (n = 21; the adolescents performed the activities with their parents) and IG-isolated group (n = 22; the adolescents performed the activities alone). The parameters measured before and after 12 weeks of multi-professional intervention (physical exercise, nutrition and psychoeducation) were: body mass, height and body mass index-BMI. The level of food processing was analyzed using a three-day food recall (24hR), classified according to the Food Guide for the Brazilian Population (fresh, minimally, processed and ultra-processed foods). The main results show that there was only a significant reduction in the consumption of processed foods (FG: 7.93%; IG: 49.73%) and ultra-processed foods (FG: 35.06%; IG: 67.16%) in grams (FG: 22.29%; IG: 65.23%) and calories (p < 0.05; for all comparisons). The consumption of fresh foods in grams (FG:61.97%; IG: 147.13%) and calories (FG: 147.13%; IG: 118.03%) and minimally processed foods (FG: 27.45%; IG: 14.64%) in grams increased significantly (p < 0.05; for all comparisons). However, no significant differences were observed between all variables analyzed for the groups, nor any interaction (p > 0.05). In conclusion, both groups who participated in the activities showed positive changes with increased consumption of fresh foods and reduced consumption of processed foods, without difference between them.

Plasma brain derived neurotrophic factor level as a modifying factor for trans fat intake and hypertension

Long-term consumption of trans-fat has been linked with its incorporation in brain neural membrane that could lead into alteration of signalling pathways, including Brain Derived Neurotrophic Factor (BDNF). As an ubiquitous neurotrophin, BDNF is believed to play a role in the regulation of blood pressure yet prior studies shown conflicting results to its effect. Moreover, direct effect of trans fat intake to hypertension has not yet been elucidated. This study aimed to investigate the role of BDNF and its association between trans-fat intake and hypertension. We conducted a population study in Natuna Regency which once reportedly has the highest prevalence of hypertension from Indonesian National Health Survey. Subjects with hypertension and those without hypertension were recruited for the study. Demographic data, physical examination, and food recall were collected. The level of BDNF from all subjects were obtained through analysis of blood samples. A total of 181 participants were included in this study, comprising 134 (74%) hypertensive subjects and 47 (26%) normotensive subjects. Median of daily trans-fat intake of hypertensive subjects was higher compared to normotensive subjects (0,013 [0,0003-0,07] vs 0,010 [0,0006-0,06] % of total energy/day, p=0,021). Interaction analysis showed significant results for plasma BDNF level in relationship of trans-fat intake and hypertension (p=0,011). Trans-fat intake association to hypertension in overall subjects showed odds ratio (OR) of 1,85 95%CI 1,05-3,26 (p=0,034), while in those with low-middle tercile BDNF level the OR was 3,35 95%CI 1,46-7,68 (p=0,004). Plasma BDNF level has a modifying effect in the association between trans-fat intake and hypertension. Subjects with high trans-fat intake, while having low BDNF level, have the highest probability for hypertension.

Hyperpalatable Foods Consumption in a Representative Sample of the General Population in Brazil: Differences of Binge and Non-Binge Eating Meals

The availability of hyper-palatable foods (HPF) increased over the past three decades worldwide, a period when eating disorders (ED) and obesity have become global public health concerns. The present study aimed to assess HPF consumption during binge and non-binge meals in a representative sample of adults with and without ED from a metropolitan city in Brazil. A total of 2297 individuals were interviewed in their homes by trained lay interviewers to assess the presence of binge eating disorder (BED), bulimia nervosa (BN), and recurrent binge eating (RBE). Information on their food consumption in objective and subjective binge eating episodes (OBE and SBE, respectively), as well as in the 24 h food recall were obtained. Individuals from the general population consumed 56% of their total calories from HPF. In non-binge meals, people with BN consumed substantially fewer calories from HPF than BED (63% vs. 48%) and RBE (63% vs. 48%) groups. During OBE, participants consumed an average of 70% of the calories from HPF, with no between-group differences. During SBE, subjects with BN consumed substantially fewer calories from HPF than those with BED (76% vs. 50%). In conclusion, HPF were highly consumed by the Brazilian population. However, there was a greater impact on BED and RBE subjects and during binge eating episodes.

Profil of omega-3 food intake and its association with socioeconomic status in smoker on online motorcycle drivers

Introduction: Omega-3 fatty acids were found to be effective in reducing inflammation and free radicals caused by air pollution (cigarette smoke), as well as improving lung function. Furthermore, economic conditions can influence a person's food consumption habits. The type of food consumed will certainly affect the amount of omega-3 absorbed by the body, and the quality of food consumed is influenced by socioeconomic status (SES). Therefore, the purpose of this study was to determine omega-3 intake and its relationship with the socioeconomic status of online motorcycle drivers. Design and Methods: This was an observational study with a cross-sectional method of measuring omega-3 consumption using a 24-hour food recall questionnaire and assessing the mean of omega-3 intake after 3 days. The was conducted from May-August 2020, in Kali Rungkut, Surabaya City, and the subjects were online motorcycle drivers. A Chi-square test was used to assess the relationship between omega-3 intake and SES (income and education). Results: There were 49 respondents in this study with most of them having a classification of omega-3 intake at the deficit level (57.14%), and none belonging to the good and more level. There was a significant difference in omega-3 intake on income (p=0.000) and education (p=0.000). Conclusions: Income and education must be prioritized to improve a healthy diet that includes omega-3.

Should a powerful manufacturer collaborate with a risky supplier? Pre-recall vs. post-recall strategies in product harm crisis management

Product recalls occurring due to quality failures can ravage a firm’s reputation. Product quality maintenance is often the responsibility of a manufacturer and its suppliers. Therefore, manufacturer–supplier contracts may lead to efficient quality management. However, numerous recent product recalls showed that a likelihood of a crisis remains despite such supply chain co-operations. Efficient crisis management strategies can mitigate the negative effect of a product recall on firms and consumers. We consider a one-supplier–one-manufacturer supply chain prone to a product recall. Considering a differential game framework, we develop two quality-based cost-sharing contractual models to analyze how, under uncertainty, pre-recall and post-recall strategies of advertising, quality, and pricing vary in the supply chain. Our results indicate that for a high-likelihood/-impact recall, the supplier and manufacturer focus more on their respective post-recall quality effort than on the pre-recall period. Interestingly, by gradual, incremental pre-recall advertising, the manufacturer raises its goodwill before a recall announcement to keep consumers’ higher confidence regarding the product’s quality even after the recall. Our cooperative contractual agreements benefit all the channel members and consumers. The manufacturer is always better off by sharing a greater quality effort with the supplier in the post-recall period than in the pre-recall period.

Diet Quality and Exhaled Breath Condensate Markers in a Sample of School-Aged Children.

Exhaled breath condensate (EBC) analysis is a recently developed, non-invasive method used to identify and quantify biomarkers, mainly those coming from the lower respiratory tract. It seems that diet can influence the airway's inflammation and change the exhaled breath composition. This study aimed to assess the association between diet quality intake and markers in EBC among school-aged children. A cross-sectional analysis included 150 children (48.3% females, aged 7-12 years, mean age: 8.7 ± 0.8 years) from 20 schools across Porto, Portugal. We assessed diet quality through the Healthy Eating Index (HEI)-2015, which was estimated based on a single 24 h food recall questionnaire. EBC samples were collected, and we assessed their ionic content (Na+, K+) and conductivity. The association between diet quality and Na+, K+, Na+/K+ ratio and conductivity was estimated using logistic regression models adjusted for potential confounders. After adjustment, a higher quality diet score increases the odds of higher conductivity values of the EBC (aOR = 1.04, 95%CI 1.00; 1.08). Our findings suggest that a higher diet quality in school-aged children is associated with higher conductivity levels of the EBC.

The Role of Omega-3/Omega-6 Ratio on Appetite in Pulmonary Multidrug-Resistant Tuberculosis Patients

Introduction: Tumour necrosis factor-alpha (TNF-α) levels, pro-inflammatory cytokines that suppress appetite, were discovered to be much higher in multidrug-resistant tuberculosis (MDR-TB) than in drug-sensitive TB. Research on the omega-3/omega-6 (ꞷ-3/ꞷ-6) polyunsaturated fatty acids (PUFAs) intake, which can support appetite in patients with MDR-TB, has never been performed. This study aimed to examine the relationship between ꞷ-3/ꞷ-6 PUFAs intake ratio and appetite mediated by TNF-α in pulmonary MDR-TB patients. Methods: This was a cross-sectional study conducted on 46 male and female adults with MDR-TB undergoing intensive phase therapy. Data were collected through questionnaires, 1x24 hours food recall, anthropometric measurements, 100 mm visual analogue appetite scale, and venous blood collection. Results: Correlation analysis used the Pearson and Spearman tests. The findings revealed the ratio of ꞷ-3/ꞷ-6 PUFAs intake of 0.11 ± 0.05, the median value of TNF-α 7.49(1.66-447.62) pg/mL, and an average appetite of 58.72 ± 26.7. There was no relationship between ꞷ-3/ꞷ-6 PUFAs intake ratio and TNF-α (r = 0.016; p = 0.91), likewise between ꞷ-3/ꞷ-6 PUFAs intake ratio with appetite (r = -0.1; p = 0.54), but there was a relationship between TNF-α and appetite (r = 0.031; p = 0.04). Conclusion: There was no relationship between ꞷ-3/ꞷ-6 PUFAs intake ratio and TNF-α and appetite in pulmonary MDR-TB patients. However, there was a relationship between TNF-α and appetite. This study is the first to determine the correlation between ꞷ-3/ꞷ-6 PUFAs intake ratio and appetite in pulmonary MDR-TB patients.

Blockchain-Based Secure Traceable Scheme for Food Supply Chain

The typical food traceability system’s data layer is made up of relational databases managed by core businesses, which cannot ensure data security. It is inefficient and requires a lot of upkeep. The food supply chain has numerous actors, making it difficult for consumers to safeguard their rights when purchasing food with quality issues. Due to the numerous organizations involved in the food supply chain, food safety monitoring and traceability have become challenging. The supply chain’s major organizations have control and administrative authority over the data under the current food traceability system, which is overly centralized for traceability information. The safety and dependability of food may be ensured by using the food traceability system to track food information. We can witness a series of detailed insights into food from the manufacturing source to the consumption terminal. A blockchain-based food tracking system is created as a solution to these issues. On the Ethereum platform, the system was created. It was also employed in the blockchain system, in addition to its features of decentralization, tamper-proof, and traceability. To implement the data update service and the food recall function, introduce the Food and Drug Administration node. Consumers have the option to not only enquire about food traceability throughout the manufacturing process but also to file complaints regarding the traceability system’s rights protection.

Stock market reactions to US Consumer Product Safety Commission enforcement actions

AbstractThis study examines stock market reaction to violations of product safety regulations and firm product responsibilities in the post‐enforcement period. Our event study results show that market reaction was negative to failures by firms to report product defects in a timely way. Our results also show that the stock market reaction varies depending on the type of violations, and whether there are single or multiple violations. Firms spend more on research and development and advertising in the post‐enforcement period, in addition to investing in their compliance programmes which have a significant positive impact on product responsibility stewardship. Our empirical results show that the stock market reacts negatively to recall volume and refund remediation strategy. The stock market reaction is negative to social media communication about product recalls initiated by manufacturers. However, this negative effect appears to be counteracted by the positive corporate social responsibility (CSR) reputation effect of the manufacturers. Our findings imply that US manufacturing firms dealing with product recalls must be sensitive to how consumers and investors interpret the communication.

Supply chain and operations management on the TMT: A study of recall propensity

AbstractThis study investigates the drivers of product quality failures as manifested through recalls. More specifically, this research develops theory regarding supply chain and operations management (SCOM) representation in organizational top management teams (TMT) and this representation's association with the frequency of recalls, the type of recalls, and the severity of recalls. The moderating effect of both recent and historical organizational recall knowledge is also explored. This study uses unique data sets, collected from multiple sources, containing executives' backgrounds, firm characteristics, and product recalls. The study finds that firms with SCOM representation on their TMTs have fewer recalls overall and fewer severe recalls. We also find that firms with SCOM representation on the TMT are less likely to suffer from subsequent recalls after a history of recalling. Lastly, we discover interesting nuances with respect to the form of SCOM representation present on the TMT (CEO and functional executive).

Spectrum Laboratory Products recalls 3 lots of discoloured epinephrine

Spectrum Laboratory Products recalls 3 lots of discoloured epinephrine

The Use of Digital Images in 24-Hour Recalls May Lead to Less Misestimation of Portion Size Compared with Traditional Interviewer-Administered Recalls

Background: The Automated Self-Administered 24-hour (ASA24) dietary recall system enhances the feasibility of collecting high-quality intake data in population-based studies.Objective: The aim of this study was to assess the accuracy of portion size reporting in the ASA24 compared with interviewer-administered recalls.Methods: True intake for 3 meals was ascertained in 81 adults aged 20–70 y from the Washington, DC area. Participants were randomly assigned to complete an unannounced ASA24 or an interviewer-administered Automated Multiple-Pass Method (AMPM) recall the following day. An adapted Bland-Altman approach was used to assess agreement between true and reported portion sizes. Linear regression was used to assess log-scale differences between true and reported portion sizes by recall mode. The proportions of reported portion sizes within 10% and 25% of truth were estimated. Analyses were conducted for all foods and drinks and predetermined categories.Results: Mean differences between true and reported portion sizes were 3.7 g for the ASA24 and 11.8 g for the AMPM. According to the Bland-Altman-type plots, between 92% and 100% (depending on food or drink category and recall mode) of observations fell within the limits of agreement. After adjustment for multiple testing, the mean ratio of reported to true portion sizes was significantly >1 for the categories of all foods and drinks, all foods excluding liquids, amorphous or soft foods, and small pieces among AMPM respondents. Misestimation in the AMPM was significantly different from that in the ASA24 for all foods and drinks and for all foods excluding liquids. Small proportions of reported portions fell within 10% (16.2% for the ASA24 and 14.9% for the AMPM) and 25% (37.5% for the ASA24 and 33.2% for the AMPM) of truth.Conclusions: The results raise the possibility that digital images tailored to different types and formats of foods may facilitate improved estimation of amounts eaten but highlight the need for continued work in this aspect of dietary assessment. This trial was registered at clinicaltrials.gov as NCT00978406.

The Association between Dietary Patterns and Chemotherapy Side Effects in Patients with Breast Cancer (BrCa)

This study aimed to determine the relationship between food pattern and dietary intake before and during chemotherapy with the severity of gastrointestinal side effects, cancer-related fatigue, and chemotherapy-induced pain. This study was performed on 204 patients with breast cancer who were undergoing chemotherapy. Dietary pattern was collected by food frequency questionnaire and dietary intake during chemotherapy using a 24-hour food recall questionnaire. The severity of chemotherapy side effects including nausea, vomiting, constipation, diarrhea, CRF, and pain was also assessed by valid questionnaires. The relationship between dietary pattern and mean score of chemotherapy side effects was calculated using linear regression analysis. Three dietary patterns were extracted from the participants. After adjusting the effect of all possible confounders, no significant relationship was found between the dietary pattern one year before the start of treatment and the mean of chemotherapy side effects severity. Although the mean of daily energy intake with the severity of nausea and vomiting (r = −0.258, P-value <0.01), constipation, fatigue, and pain have a significant inverse relationship. Nutrition education and following a healthy diet are needed to reduce the severity of chemotherapy side effects during this period.