Objective: The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency questionnaire (SFFQ) adapted for use in the elderly. Design and subjects: The study was carried out in a sample of 80 men and women aged 55±75 y participating in a community based prospective cohort study in Rotterdam, The Netherlands. The two-step dietary assessment comprised a simple self-administered questionnaire (20 min) followed by a structured interview with trained dietitians (20 min) based on the completed questionnaire. Multiple food records (FR) collected over a one year period served as reference method. 24 h urine urea was used as indirect marker for protein intake. Results: Compared with FR, the SFFQ generally overestimated nutrient intake as re¯ected by difference in means and the ratio of SFFQ to FR. Energy adjustment reduced the observed overestimation. Pearson's correlation coef®cients varied from close to 0.5 to about 0.9 for crude data, and after adjustment for age, sex, total energy intake, and for within-person variability in daily intake for 0.4±0.8. Cross-classi®cation into quintiles resulted in correct classi®cation into the same or adjacent quintile of 75.8% for crude and 76.8% for energyadjusted data. Validation of protein intake estimated by SFFQ with protein excretion from 24 h urine urea indicated overestimation of protein intake by SFFQ. Spearman correlation coef®cient between protein intake estimated from urea excretion and SFFQ was 0.67. Conclusions: Adaptation of a SFFQ for use in the elderly resulted in a valid and time-ef®cient dietary assessment instrument. Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly.
Objective-To examine the effect of a reduced sodium and increased potassium and magnesium intake on blood pressure.Design-Randomised double blind placebo controlled trial.Setting-General population of a suburb of Rotterdam.Subjects-100 men and women between 55 and 75 years of age with untreated mild to moderate hypertension.Interventions-During 24 weeks the intervention group received a mineral salt (sodium: potassium: magnesium 8:6:1) and foods prepared with the mineral salt. Controls received common salt and foods.Main outcome measure-Change in blood pressure.Results-Complete follow up was achieved for 97 of the 100 randomised subjects. Systolic blood pressure (mean ofmeasurements at weeks 8, 16, and 24) fell by 7-6 mm Hg (95% confidence interval 4 0 to 11.2) and diastolic blood pressure by 3-3 mm Hg (0.8 to 5.8) in the mineral salt group compared with the controls, with a 28%/ decrease in urinary sodium excretion and a 22% increase in urinary potassium excretion. Twenty five weeks after the study the difference in blood pressure between the groups was no longer detectable.Conclusion-Replacing common sodium salt by a low sodium, high potassium, high magnesium mineral salt could offer a valuable non-pharmacological approach to lowering blood pressure in older people with mild to moderate hypertension.
Purpose The development and validation of algorithms to identify cases of idiopathic acute liver injury (ALI) are essential to facilitate epidemiologic studies on drug-induced liver injury. The aim of this study is to determine the ability of diagnostic codes and laboratory measurements to identify idiopathic ALI cases. Results A total of 707 cases of ALI were identified. After medical review 194 (27%) patients had confirmed idiopathic ALI. The PPV for (I) algorithms with an ICD-9-CM code as well as abnormal tests ranged from 32% (13/41) to 48% (43/90) with the highest PPV found with ALT > 2ULN. The PPV for (II) algorithms with liver test abnormalities was maximally 26% (150/571). Conclusions The algorithm based on ICD-9-CM codes indicative of ALI combined with abnormal liver-related laboratory tests is the most efficient algorithm for identifying idiopathic ALI cases. However, cases were missed using this algorithm, because not all ALI cases had been assigned the relevant diagnostic codes in daily practice.
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