Dietary patterns in adolescence are related to adiposity in young adulthood in black and white females

Few studies have systematically used a total diet approach to classify adolescent dietary patterns. We examined dietary patterns in relation to nutrient intakes and adiposity in the National Heart, Lung, and Blood Institute Growth and Health Study cohort of 2371 black and white girls recruited at 9-10 y of age and followed for 10 y. Serial measurements were obtained for indices of anthropometry, dietary intake, physical activity, and sociodemographic variables. Dietary patterns for the 2 racial subgroups were separately identified by cluster analysis of 40 food groupings derived from 3-d food records. Nutrient intakes and measures of adiposity (BMI, percent body fat, and waist circumference) were compared by dietary pattern. We identified 4 discrete dietary patterns for black and for white adolescents. A Healthy pattern, followed by 12% of white girls and characterized by a high intake of fruits, vegetables, dairy, grains without added fats, mixed dishes and soups, and a low intake of sweetened drinks, other sweets, fried foods, burgers, and pizza, was related to more favorable nutrient intakes and a smaller increase in waist circumference. Among black girls, none of the dietary patterns appeared distinctly advantageous in terms of mitigating increases in adiposity. In conclusion, a cumulative pattern of food intake consistent with recommendations for general health appears to help prevent overweight, but this pattern was followed by only a minority of adolescent girls.     

Physical status, nutrient intake and dietary pattern of adolescent female factory workers in urban Bangladesh

This cross-sectional study examined the physical status, nutrient intake and dietary pattern of adolescent female factory workers in urban Bangladesh. A total of 1211 postmenarchial girls aged 14-19 y from seventeen readymade garment industries spread over the Dhaka City participated in the study. Body weight, height and skin fold thickness were measured for all subjects. The nutrient intake was assessed by 24-h recall method and 7-day food frequency questionnaire was used to investigate their dietary pattern on a sub-sample of 509 girls. Sixty five percent of the girls were short (height-for-age, <3rd percentile of NCHS reference values). Pre-valence of short stature was higher in the older girls. Mean body weight was 38k g for the 14 year old girls, which gradually increased across the age groups to about 42 kg for the 18 and 19 year olds. About 17% of the girls were thin (BMI-for-age <5th percentile of NCHS reference values). Over all, about 23% were lean (TSFT-for-age <5th percentile of NCHS reference values). Food intake data revealed a deficit of 1.62 MJ/day in energy. Mean intake of protein, calcium, iron, vitamin A, thiamin, riboflavin, niacin and vitamin C were below the recommended dietary allowance. Most of the energy and nutrients came from cereal grains. Habitual pattern of food intake revealed poor intake of eggs, milk, meat, and green leafy vegetables. In conclusion, the data show a poor physical status of the adolescent female factory workers in Bangladesh. Simultaneous substantial deficits in energy and several nutrients in their diet stress the need for an appropriate intervention to improve their overall nutritional and physical status of these young females.     

Crohn's disease affects diet and growth in children

Background: Thirteen (eight girls, five boys) patients, aged 9.8–15.4 years, and 13 controls matched for age and sex were studied to identify foods that might aggravate the symptoms of children with Crohn's disease, to examine the adequacy of nutrient intake and to assess nutritional status.
Methods: The link between symptoms and food intake was determined by 48-h dietary recall on two separate occasions and by a dietary questionnaire. Nutritional status was assessed using growth charts and biochemical values.
Results: Patients with Crohn's disease identified several foods that aggravate symptoms. The intakes of bread, cereals and fat were greater in patients than in controls. The mean relative (% energy) intake of protein was lower, but the mean absolute intake of carbohydrates was higher in patients than in controls. The intakes of vitamin D, calcium, iron and zinc by the patients were below the respective recommended dietary allowances (RDAs). Nutritional status was good in the majority of the patients. However, the mean height-for-age was lower in the patients than in the controls, and 38% of the patients had serum albumin concentrations below the reference value.
Conclusions: Symptoms and foods that aggravate symptoms may restrict diet and thus decrease nutrient intake. The diet of children with Crohn's disease may contain insufficient amounts of nutrients. In some children, Crohn's disease markedly retards growth. These results substantiate the need for coordinated dietetic follow-up.     

Nutritional Status, Dietary Intake, and Relevant Knowledge of Adolescent Girls in Rural Bangladesh

This study estimated the levels and differentials in nutritional status and dietary intake and relevant knowledge of adolescent girls in rural Bangladesh using data from the Baseline Survey 2004 of the National Nutrition Programme. A stratified two-stage random cluster-sampling was used for selecting 4,993 unmarried adolescent girls aged 13–18 years in 708 rural clusters. Female interviewers visited girls at home to record their education, occupation, dietary knowledge, seven-day food-frequency, intake of iron and folic acid, morbidity, weight, and height. They inquired mothers about age of their daughters and possessions of durable assets to divide households into asset quintiles. Results revealed that 26% of the girls were thin, with body mass index (BMI)-for-age <15^th percentile), 0.3% obese (BMI-for-age >95^th percentile), and 32% stunted (height-for-age ≤2SD). Risks of being thin and stunted were higher if girls had general morbidity in the last fortnight and foul-smelling vaginal discharge than their peers. Consumptions of non-staple good-quality food items in the last week were less frequent and correlated well positively with the household asset quintile. Girls of the highest asset quintile ate fish/meat 2.1 (55%) days more and egg/milk two (91%) days more than the girls in the lowest asset quintile. The overall dietary knowledge was low. More than half could not name the main food sources of energy and protein, and 36% were not aware of the importance of taking extra nutrients during adolescence for growth spurt. The use of iron supplement was 21% in nutrition-intervention areas compared to 8% in non-intervention areas. Factors associated with the increased use of iron supplements were related to awareness of the girls about extra nutrients and their access to mass media and education. Community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents.Key words: Adolescents, Dietary knowledge, Food frequency, Girls, Nutrition, Bangladesh     

A new reference method for the validation of the nutrient profiling schemes using dietary surveys

Nutrient profiles of foods are increasingly used as the scientific basis of nutritional labeling, health claims, or nutritional education. Nutrient profiling schemes are based on sets of rules, scores, or thresholds applied to the nutritional composition of foods. However, there is a lack of scientific validation of nutritional profiling schemes. To develop a reference method using existing dietary surveys, to define a set of indicator foods that are positively or negatively associated with a "healthy diet." Such indicator foods can be used both for establishing relevant nutrient profiles and for the validation of existing or future nutrient profiling schemes. The proposed validation method is based on food and nutrient intakes of adults participating in national dietary surveys in five EU countries: Belgium (n = 2,507), Denmark (n = 3,151), France (n = 1,474), Ireland (n = 1,379), and Italy (n = 1,513). The characterization of indicator foods is divided in two steps. First, "healthy diets" of individuals are identified in the five national dietary surveys by comparison to the Eurodiet reference intakes. Second, indicator foods associated positively or negatively to the "healthy diets" are determined. With a P-value of 10(-3) for the test of comparison of food intakes between the "most healthy eaters" and the "less healthy eaters," it was possible to identify 294 indicator foods out of 1,669 foods tested in the five countries. In all the countries except Italy, there were more indicator foods positively associated than indicator foods negatively associated with the "healthy diet." The food categories of these indicator foods were in good agreement with Food Based Dietary Guidelines like the USDA dietary guideline for Americans. A new reference method for the validation of profiling schemes was developed based on dietary intake data from using dietary surveys in five European countries. Only a minority of foods consumed in these dietary surveys could be used as indicator foods of healthy or unhealthy diets in order to subsequently test nutritional profiling schemes. Further work is needed to build a list of indicator foods that could be considered as a "gold standard."     

Nutrient Intake Amongst Rural Adolescent Girls of Wardha

Objective:

To assess the nutrient intake of rural adolescent girls.

Materials and Methods:

The cross-sectional study was carried in four adopted villages of the Department of Community Medicine, M.G.I.M.S., Sewagram. A household survey was carried out in the villages. A list of all the adolescent girls in the age group of 10-19 years was prepared by enumeration through house-to-house visit. All adolescent girls were included in the study. A pre-designed and pre-tested questionnaire was used to collect data on socio-demographic variables and anthropometric variables. A 24 h recall method was used to assess nutrient intake. Data generated was entered and analyzed using epi_info 2000. Nutrient intake was compared with ICMR Recommended Dietary Allowances. Nutritional status was assessed by BMI for age.

Results:

The mean height of the adolescent girls was 142.9 cm. Overall, 57% of the adolescents were thin (BMI for age <5^th percentile for CDC 2000 reference) and 43% of the adolescents were normal (BMI for age between 5^th – 85^th percentile for CDC 2000 reference). The average energy intake, which was 1239.6±176.4 kcal/day, was deficient of RDA by 39%. The average protein intake was 39.5±7 gm/day. It was deficient by 36% and the average iron intake, which was 13.2±2.5 mg/day, was deficient by 48%.

Conclusions:

The findings reiterate the dietary deficiency among adolescent girls which adversely affects the nutritional status. If the poor nutritional status is not corrected promptly before they become pregnant, it adversely affects the reproductive outcome. If we have to meet out the goals of Reproductive and Child Health Program, intervention strategies to improve the dietary intake of adolescent girls are needed so that their requirements of energy, protein, vitamins and minerals are met.     

Nutritional and health consequences are associated with food insecurity among U.S. elderly persons

The purpose of this study was to examine the consequences associated with food insecurity for the nutritional and health status of the elderly in the United STATES: The data analyzed were from the Third National Health and Nutrition Examination Survey (1988-1994) and the Nutrition Survey of the Elderly in New York State (1994). Multiple logistic and linear regression analyses were used to assess the extent to which food-insecure elderly were likely to have lower nutrient intake, skinfold thickness, self-reported health status and higher nutritional risk. Regardless of food insecurity status, older people consumed less than the recommended dietary allowance for eight nutrients. Food-insecure elderly persons had significantly lower intakes of energy, protein, carbohydrate, saturated fat, niacin, riboflavin, vitamins B-6 and B-12, magnesium, iron and zinc, as well as lower skinfold thickness. In addition, food-insecure elderly persons were 2.33 (95% confidence interval: 1.73-3.14) times more likely to report fair/poor health status and had higher nutritional risk. These results indicate that food-insecure elderly persons have poorer dietary intake, nutritional status and health status than do food-secure elderly persons. It is necessary to ensure the nutritional well-being of all elderly persons who are at nutritional and health risk, including those who are food insecure and have even poorer nutritional and health status than those who are food secure.     

Development of a Diet Quality Index with Special Reference to Micronutrient Adequacy for Adolescent Girls Consuming a Lacto-Vegetarian Diet

Recent dietary guidelines emphasize micronutrient sufficiency by giving importance to consumption of whole grains and a variety of fruits and vegetables. The objective of this study was to identify a measure of micronutrient quality of diets in adolescent girls consuming a lacto-vegetarian diet. Data were collected on the nutritional status of 630 schoolgirls (ages 10 to 16 years) from Pune city, India, in a cross-sectional survey during 2006-2007. Dietary intakes were assessed by 24-hour recall on 3 nonconsecutive days. Nutrient intakes were calculated from the Indian nutritive value databases. Micronutrient adequacy was expressed as a ratio of observed intake to reference intake. An Adolescent Micronutrient Quality Index (AMQI) was formulated using the Indian and the recent US dietary guidelines. Fasting blood samples were analyzed for plasma levels of vitamin C, beta carotene, and zinc. The average energy intake of the majority of the girls was below the Indian recommended dietary intakes, whereas micronutrient intakes were 50% to 70% lower than recommended dietary intakes. The mean AMQI score was 41.5±9.4. The age of subjects as well as mother's education and occupation were significantly associated with the AMQI. The AMQI was correlated with nutrient intakes and the ratio of observed intake to reference intake (P<0.01) after controlling for energy intake and sociodemographic factors. Higher AMQI scores were associated with higher concentrations of plasma vitamin C (r=0.26), beta carotene (r=0.34), and zinc (r=0.12). The AMQI is a useful measure of the dietary adequacy and micronutrient quality of the diets of adolescent girls consuming lacto-vegetarian diets.     

School lunch menus and 11 to 12 year old children's food choice in three secondary schools in England-are the nutritional standards being met?

OBJECTIVES: To determine if the lunchtime food provided to schoolchildren adheres to nutritional standards and to examine the influence of children's food choice on nutrient intake at lunchtime. SUBJECTS/SETTING: Seventy-four children aged 11-12 years were recruited from three secondary schools. The school populations spanned a spectrum of socio-economic deprivation. Lunchtime food and nutrient intake was assessed over a 5 day period. DESIGN: Cross-sectional study of menu composition and children's food choice in relation to nutrient intake. METHODS: Dietary recording was by an indirect weighing method of menu composition and nutrient intake over a 5 day period. Statistical analysis was carried out using general linear modelling techniques including: t-test, one-way ANOVA and ANCOVA. RESULTS: One school met the standards on food group provision. Intakes of total fat, saturated fatty acids and monounsaturated fatty acids were greater in boys. Intake of folate was greater in girls. There were between-school differences (independent of gender) for intake of fatty acids, starch, calcium and folate, with socio-economic deprivation associated with a lesser nutrient intake. Children could have chosen meals higher in calcium, iron, folate and zinc and lower in starch and fat, from the extensive cafeteria menu of between 26 and 42 food. For some nutrients, providing 'healthier' food influences intake of those nutrients whilst for other nutrients, children's food choice predominates. The majority of children did not meet the recommended targets for lunchtime nutrient intake, especially for micronutrients. CONCLUSIONS: Food provision in two out of three schools did not meet government guidelines and socio-economic deprivation was associated with worse food provision. Children from deprived areas were more likely to choose those foods of limited nutritional value than those from more privileged backgrounds. The statutory nutritional standards on their own, without a pricing policy to encourage healthier food choice or restrictions in food choice towards less healthy food are unlikely to catalyse the dietary changes that are so needed to ensure improved nutrient intakes amongst schoolchildren in England.     

Nutritional status and dietary habits of adolescent girls in Oman

Weight, height, and dietary patterns were obtained from 683 adolescent girls aged 11 to 18 years in five geographical regions of the Sultanate of Oman. Using body mass index (Wt/Ht²) of NHANESI as a reference for adolescence, the prevalence of under‐weight among these girls was relatively high (24%). However the nutritional status improved with age. Twelve percent of these girls were overweight or obese. Breakfast was frequently skipped (21%) by adolescent girls compared to lunch (6%) and supper (9.5%). Older (15–18 years) as well as overweight girls were more likely to skip breakfast than younger (11–14 years), normal and underweight girls. Nutritional status and age of girls were significantly associated with some foods consumed at main meals and snacking time. The pattern of skipping breakfast and the snacking habits of Omani adolescents was similar to that of their counterparts in Western communities. This suggests a change in dietary habits toward those practiced in Western communities, a change that may explain in part the steady rise in diet‐related chronic diseases in this country. It is imperative that nutrition intervention programmes should therefore consider such alteration in food habits.     

Consumption of 'extra' foods by Australian children: types, quantities and contribution to energy and nutrient intakes

OBJECTIVE: To measure the types and quantities of energy-dense, nutrient-poor 'extra' foods consumed by Australian children and adolescents and their contribution to total energy and nutrient intakes. DESIGN, SETTING AND SUBJECTS: We used data from 3007 children, aged 2-18 years, who participated in the nationally representative 1995 National Nutrition Survey. Intake was determined by 24-h recall and 'extra' foods were defined using principles outlined in the Australian Guide to Healthy Eating (AGHE) and by applying cut points for maximum amounts of fat and sugar within each food category. RESULTS: All children (99.8%) consumed at least one 'extra' food and the most commonly consumed were margarine, sugar-sweetened soft drinks, cordials and sugar. 'Extra' foods contributed 41% of daily energy intake. Those foods contributing most to energy intake were fried potatoes (4.2%), sugar-sweetened soft drinks (3.3%), ice cream/ice confection (3.1%) and cordials (2.7%). Age and sex were important determinants of 'extra' food intake, with males and older children generally consuming more and different types of, 'extra' foods than females and younger children. 'Extra' foods contributed 19% protein, 47% total fat, 47% saturated fat, 54% sugar, and approximately 20-25% of selected micronutrients to the diet. Calcium and zinc intakes from core foods were below 70% of the recommended dietary intakes for adolescent girls. CONCLUSIONS: 'Extra' foods are over-consumed at two to four times the recommended limits and contribute excessively to the energy, fat and sugar intakes of Australian children, while providing relatively few micronutrients. This is of concern in terms of children's weight and nutrient status.     

Low energy density and high nutritional quality are each associated with higher diet costs in French adults

BACKGROUND: Low-energy-density diets are associated with higher diet costs per 10 MJ. Are diets of higher nutritional quality also associated with higher costs per 10 MJ? OBJECTIVE: The objective was to determine the relations between energy-adjusted diet costs, dietary energy density, and nutritional quality of diets. DESIGN: This was a cross-sectional study of a nationally representative sample of 1332 French adults in the 1999 Enquête Individuelle et Nationale sur les Consommations Alimentaires (INCA) data set. Analyses were based on data from 7-d food records. The monetary cost of each diet was estimated by using mean retail prices for 620 foods. Nutritional quality was estimated by calculating the mean adequacy ratio (MAR), based on 23 nutrients. Energy density was based on solid foods only. RESULTS: In a bivariate analysis, low-energy-density diets were of higher nutritional quality but also cost more. Participants in the highest tertile of MARs had the lowest dietary energy density and the highest diet costs, calculated both per day and per 10 MJ. In a multivariate model, dietary energy density was negatively linked to diet costs (euro/10 MJ), whereas MAR values were positively linked to diet costs after adjustment for age and energy intake. For a given energy intake and energy density, each 10% increase in MAR led to a 13% increase in estimated diet costs per 10 MJ. CONCLUSIONS: In this study of self-selected diets of French adults, lower energy density and higher nutritional quality were associated with higher energy-adjusted diet costs. Higher-quality diets cost more not only because they have a low energy density but also because they are nutrient rich.     

Pulse consumption in Canadian adults influences nutrient intakes

Pulses (dry beans, peas, lentils) are nutrient-dense foods that are recommended as good choices in either the vegetable or meat and alternative food groups in Canada's Food Guide. To examine the prevalence and the effect of pulse consumption on nutrient intake in Canadian adults (?≥?19 years), we analysed cross-sectional data (n 20?156) from the 2004 Canadian Community Health Survey, Cycle 2·2. Participants were divided into non-consumers and quartiles of pulse intake. Sample weights were applied and logistic regression analysis was used to explore the association of nutrient intakes and pulse consumption, with cultural background, sex, age and economic status included as covariates. On any given day, 13?% of Canadians consume pulses, with the highest consumption in the Asian population. The pulse intake of consumers in the highest quartile was 294 (se 40)?g/d and, compared with non-consumers, these individuals had higher intakes of carbohydrate, fibre and protein. As well, the micronutrient intake of pulse consumers was enhanced, resulting in fewer individuals who were below the estimated average requirement for thiamin, vitamin B6, folate, Fe, Mg, P and Zn, compared with non-consumers. Although pulses are generally low in Na, its intake also was higher in pulse consumers. Among the higher quartiles of pulse consumers, fruit and vegetable intake was one serving higher. These data indicate that pulse consumption supports dietary advice that pulses be included in healthful diets. Further studies elucidating the sources of increased Na in pulse consumers will be necessary so that dietary advice to increase consumption of pulses will maximise their nutritional benefits.     

Low folic acid status and its association with anaemia in urban adolescent girls and women of childbearing age in Sri Lanka

Folic acid deficiency is implicated in the aetiology of nutritional anaemia and adverse pregnancy outcomes for the fetus. Data on folic acid status among adolescent girls and non-pregnant, non-lactating young women are limited. We assessed folic acid status in a random sample of 552 subjects (277 adolescent girls aged 15-18.9 years and 275 women aged 19-30 years) living in Colombo, Sri Lanka. The association of low folic acid status with anaemia was evaluated. Socio-economic, food intake and anthropometric data were obtained. Hb, serum folic acid, vitamin B12 and ferritin and plasma homocysteine concentrations were measured. Forty-three per cent of subjects studied had low serum folic acid concentrations (<3 ng/ml) and 47 % had low Fe stores (serum ferritin <20 microg/l). Overall prevalence of anaemia was 12.9 %, and 43.9 % of anaemic subjects had both low folic acid status and depleted Fe stores (serum ferritin <12 microg/l). Both low folate status and depleted Fe stores were significantly associated with anaemia (odds ratio = 2.32; 95 % CI 1.34, 4.01 and odds ratio = 5.98; 95 % CI 3.36, 10.63, respectively). Serum folic acid concentration was associated (r = 0.108, P = 0.015) with folate intake as indicated by a computed folate index. Folate index was associated inversely with household size and positively with economic status and education level. In this study population low folic acid status, besides depleted Fe stores, was associated with anaemia. The high prevalence of low folic acid status observed highlights the need for nutrition education to improve intakes of folate, Fe and other micronutrients among adolescent girls and young women.     

Diet and nutritional status of adolescent tribal population in nine states of India

Tribal population constitutes about 8% of the total population in India. They are particularly vulnerable to undernutrition, because of their geographical isolation, socio-economic disadvantage and inadequate health facilities. Recognizing the problem, Government of India launched different programmes for their welfare. Adolescence is a significant period of growth and maturation. The nutritional status of adolescent girls, the future mothers, contributes significantly to the nutritional status of the community. Therefore an attempt was made to assess the diet and nutritional status of adolescent population from the different tribal areas of India. The available database collected by National Nutrition Monitoring Bureau (1998-99) was utilized for this purpose. Data on a total of 12,789 adolescents (10-17 yrs) was included for the analysis. Four percent of the adolescent girls were married and less than 1% were either pregnant (0.4%) or lactating (0.7%) at the time of the survey. The mean intake of all the foodstuffs, especially the income elastic foods such as Pulses, Milk & Milk products, Oils & fats and Sugar & Jaggery were lower than the recommended levels of ICMR. The intake of all the foodstuffs except green leafy vegetables was lower than that of their rural counterparts. The intake of all the nutrients were below the recommended level, while that of micronutrients such as iron, vitamin A and riboflavin were grossly inadequate in all the age and sex groups. About 63% of adolescent boys and 42% of girls were undernourished (< 5th BMI age percentiles of NHANES). A significant association between undernutrition and socio-economic parameters like type of family, size of land holding and occupation of head of household was observed. Therefore, there is a need to evolve comprehensive programmes for the overall development of tribal population with special focus on adolescents.     

Dietary sources of iron in English adolescents

Adolescents have been identified as a group in which iron intake may be inadequate. Previous studies have reported values for total iron intake but few have reported iron intake from different dietary sources. Information on the proportion of dietary iron provided by different food groups provides a clearer insight into the adequacy of the diet and assists health education.
This paper reports the contribution of different food groups to total iron intake in 379, 11 to 12-year-old, adolescents. Each child completed two 3-day dietary records between January and July 1990, and was interviewed by one dietitian to clarify information recorded. Food tables were used to calculate nutrient intake.
Total iron intake was 11.7 mg/day in boys and 11.2 mg/day in girls. The four most important sources of iron were meat and meat products (18.7%), breakfast cereals (14.8%), bread (11.9%) and potatoes (11.1%). Vegetables contributed only 3.4%. An appreciable amount of iron was derived from chocolate (4.1%). Less 'desirable' foods i.e. crisps, chips and chocolate together accounted for 13% of the total iron intake. The contribution to total iron intake by each source was similar for boys and girls.     

Fat intake, diet variety and health promotion

Different epidemiological studies indicated that the optimization of diet and nutrition combined with healthy life style can decrease the risk and even lead to amelioration of various noncommunicable diseases. Promising food-based dietary guidelines have been recommended in order to improve the nutritional and health status. One of the most popular recommendations is related to the amount (less fat and fat-rich foods) and type of the dietary fat component (less saturated, more polyunsaturated fatty acids, lower n-6:n-3 ratio). An overview on the nutrient intake among different age groups in Austria shows that the general consumption of some food groups--especially those rich in carbohydrates--is too low and that the intake of fat is far beyond the recommended amount of 30% of total energy (E%). The results of the 24-hour recall made among Austrian adults (n = 2,585) showed that about 18% of this population group had a fat intake of 30-35 E%, whereas 60% had an intake higher than 35 E%. Only 24% of the female and male adults had a fat intake lower than 30 E%. A result of this high proportion of fat--in the form of foods rich in fat--in the average total energy consumption is a too low intake of carbohydrates, and foods rich in carbohydrates, respectively. An increasing fat intake is associated with an increasing intake of some nutrients such as vitamin A, E, calcium and zinc, but a decreasing intake of other nutrients like vitamin C, folate, carotenoids and others. The diversity of foods consumed during a day increases with decreasing amount of fat in the diet of adults. People with a high amount of fat in their daily diet show a lower intake of vegetables and fruit, cereal products, carotenoids, folates and dietary fibers, but a higher intake of meat and meat products, milk and milk products, sweets and flummeries as well as saturated fatty acids (SFA) and cholesterol. Of course, a higher variety of food items in the daily diet should not be associated with a higher energy intake. Thus, foods with a high nutrient density (vegetables, fruits, low-fat milk products, whole grain cereals, legumes etc.) are recommended. Finally, it has to be annotated that a high diversity in the daily diet with reduced fat and SFA intake allows a sufficient nutrient intake and is an important approach for health promotion.     

Nutrition Screening,Reported Dietary Intake,Hospital Foods,and Malnutrition in Critical Care Patients in Malawi

In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related to malnutrition determined by mid-upper arm circumference (MUAC). Adult in-patients (n = 126) in tuberculosis, burn, oncology, and intensive care units in two public tertiary hospitals in Malawi were screened for nutritional status using MUAC and a question on current dietary intake. The hospital menu was reviewed; portion sizes were weighed. The prevalence of moderate and severe malnutrition was 62%. Patients with organ-related diseases and infectious diseases had the highest rates of reduced reported dietary intake, 71.4% and 57.9%, respectively; however, there was no association between reported dietary intake and MUAC. In those unable to eat, however, the rate of severe malnutrition was 50%. The menu consisted of porridge and thickened corn-based starch with fried cabbage; protein foods were provided twice weekly. There was a nutrient gap of 250 calories and 13 gm protein daily. The findings support the need for increasing dietetic/nutrition services to prevent and treat malnutrition in hospitals using simple screening tools.     

Food intake and circadian rhythms in shift workers with a high workload

Shift work is associated with nutritional and health problems. In the present study, the food intake of garbage collectors of the city of Florianopolis (Brazil) was investigated using a dietary survey method based on meal recording during 24 h and adapted for the Brazilian food context. Three different shifts (morning, afternoon, and night) were compared (n=22 per shift). Age, body weight and body mass index (BMI) were similar for all groups. Daily energy expenditure was high in all three shifts, especially in morning shift workers. No difference in daily energy intake was found, in spite of differences in food choices and circadian ingestion rhythms. Energy intake was high and close to levels previously reported in athletes. Several factors not associated with shifts had significant impact on ingestion: hour of the day, time since the last meal, age, and BMI. Ingested foods were analyzed in groups based on nutrient content. Shifts significantly influenced intake of starches, alcoholic drinks, and sweets. In different periods of the day, food and nutrient intake were considerably affected by shifts. The analysis of circadian distribution of food choices and nutrient intake is important in shift workers, because total daily intake may not reveal shift-associated differences.     

Empirically derived major dietary patterns and their associations with overweight in Korean preschool children

Prevailing dietary patterns and their association with nutritional outcomes are poorly understood, particularly for children in Korea. Our purposes were to identify major dietary patterns and to examine their associations with overweight among young children in Korea. For 1441 preschool children, usual diet was assessed by a FFQ, from which thirty-three food groups were created and entered into a factor analysis. We identified three dietary patterns by relative intake frequency of (1) vegetables, seaweeds, beans, fruits, milk and dairy products (Korean healthy pattern); (2) beef, pork, poultry, fish and fast foods (animal foods pattern); and (3) ice cream, soda, chocolate, cookies and candies (sweets pattern). The Korean healthy pattern was associated with better health status. As compared with the lowest quintile, the multivariate-adjusted OR of the highest quintile for health status inferior or similar to their peers was 0.59 (95 % CI 0.42, 0.84). Likelihood of being overweight was higher among those in the highest quintile (OR 1.77 (95 % CI 1.06, 2.94)) v. the lowest quintile regarding the animal foods pattern. These findings suggest that major dietary patterns are predictors of overweight and health status in Korean preschool children.