ABSTRACT. Objective. Dental caries is a common, chronic disease of childhood. The impact of contemporary changes in beverage patterns, specifically decreased milk intakes and increased 100% juice and soda pop intakes, on dental caries in young children is unknown. We describe associations among caries experience and intakes of dairy foods, sugared beverages, and nutrients and overall diet quality in young children.Methods. Subjects (n ؍ 642) are members of the Iowa Fluoride Study, a cohort followed from birth. Food and nutrient intakes were obtained from 3-day diet records analyzed at 1 (n ؍ 636), 2 (n ؍ 525), 3 (n ؍ 441), 4 (n ؍ 410), and 5 (n ؍ 417) years and cumulatively for 1 through 5 (n ؍ 396) years of age. Diet quality was defined by nutrient adequacy ratios (NARs) and calculated as the ratio of nutrient intake to Recommended Dietary Allowance/Adequate Intake. Caries were identified during dental examinations by 2 trained and calibrated dentists at 4 to 7 years of age. Examinations were visual, but a dental explorer was used to confirm questionable findings. Caries experience was assessed at both the tooth and the surface levels. Data were analyzed using SAS. The Wilcoxon rank sum test was used to compare food intakes, nutrient intakes, and NARs of subjects with and without caries experience. Logistic and Tobit regression analyses were used to identify associations among diet variables and caries experience and to develop models to predict caries experience. Not all relationships between food intakes and NARs and caries experience were linear; therefore, categorical variables were used to develop models to predict caries experience. Food and beverage intakes were categorized as none, low, and high intakes, and NARs were categorized as inadequate, low adequate, and high adequate.Results. Subjects with caries had lower median intakes of milk at 2 and 3 years of age than subjects without caries. Subjects with caries had higher median intakes of regular (sugared) soda pop at 2, 3, 4, and 5 years and for 1 through 5 years; regular beverages from powder at 1, 4, and 5 years and for 1 through 5 years; and total sugared beverages at 4 and 5 years than subjects without caries.Logistic regression models were developed for exposure variables at 1, 2, 3, 4, and 5 years and for 1 through 5 years to predict any caries experience at 4 to 7 years of age. Age at dental examination was retained in models at all ages. Children with 0 intake (vs low and high intakes) of regular beverages from powder at 1 year, regular soda pop at 2 and 3 years, and sugar-free beverages from powder at 5 years had a decreased risk of caries experience. High intakes of regular beverages from powder at 4 and 5 years and for 1 through 5 years and regular soda pop at 5 years and for 1 through 5 years were associated with significantly increased odds of caries experience relative to subjects with none or low intakes. Low (vs none or high) intakes of 100% juice at 5 years were associated with decreased caries experience. In general, in...
Computer-administered food frequency questionnaires (FFQs) can address limitations inherent in paper questionnaires, by allowing very complex skip patterns, portion size estimation based on food pictures and real-time error checking. This manuscript evaluates a web-based FFQ, the Graphical Food Frequency System (GraFFS). Participants completed the GraFFS, six, telephone-administered 24-hr dietary recalls over the next 12 weeks, followed by a second GraFFS. Participants were 40 men and 34 women, ages 18–69, living in the Columbus, OH area. Intakes of energy, macronutrients and 17 micronutrients/food components were estimated from the GraFFS and the mean of all recalls. Bias (recalls minus the second GraFFS) was −9%, −5%, +4% and −4% for energy and percentages of energy from fat, carbohydrate and protein. De-attenuated, energy-adjusted correlations (inter-method reliability) between the recalls and the second GraFFS for fat, carbohydrate, protein and alcohol were 0.82, 0.79, 0.67 and 0.90; for micronutrients/food components the median was 0.61 and ranged from 0.40 for zinc to 0.92 for β-carotene. The correlations between the two administrations of the GraFFS (test-retest reliability) for fat, carbohydrate, protein and alcohol were 0.60, 0.63, 0.73 and 0.87; among micronutrients/food components the median was 0.67 and ranged from 0.49 for vitamin B12 to 0.82 for fiber. The measurement characteristics of the GraFFS were at least as good as those reported for most paper FFQs, and its high inter-method reliability suggests that further development of computer-administered FFQs is warranted.
Background-Fructose consumption is rising and its malabsorption causes common gastrointestinal symptoms. Because its absorption capacity is poorly understood, there is no standard method of assessing fructose absorption. We performed a dose response study of fructose absorption in healthy subjects in order to develop a breath test to distinguish normal from abnormal fructose absorption capacity.
Poor dietary habits and inadequate nutrient intakes are of concern in the elderly. The nutritional characteristics of those who survive to become the oldest are not well defined. Our goal was to describe dietary habits, nutrient intakes and nutritional risk of community-dwelling, rural Iowans, 79 y of age and older. Subjects were interviewed (n = 420) using a standardized format on one occasion in their homes and instructed to complete 3-d diet records (n = 261) after the in-home interview. Standardized interviews assessed demographic information, cognitive function and dietary habits (Nutrition Screening Initiative Checklist). Adequate nutrient intake was defined as consumption of the nutrient's estimated average requirement, 67% adequate intake or 67% recommended dietary allowance. Mean age was 85.2 y, 57% lived alone and 58% were widowed. Subjects completing 3-d diet records were younger, more cognitively intact and less likely to be at nutritional risk than subjects not completing diet records. The percentage of subjects with inadequate intakes of selected nutrients was 75% for folate, 83% for vitamin D and 63% for calcium. Eighty percent of subjects reported inadequate intakes of four or more nutrients. Diet variety was positively associated with the number of nutrients consumed at adequate intakes (r = 0.498), total energy (r = 0.522) and dietary fiber (r = 0.421). Our results suggest that rural, community-dwelling old have inadequate intakes of several nutrients. Recommendations to increase diet variety and consume a nutrient supplement may be necessary for elderly people to achieve adequate nutrient intakes.
Even when intake exceeds typical dietary levels, neither dietary sucrose nor aspartame affects children's behavior or cognitive function.
Methods for conducting dietary assessment in the United States date back to the early twentieth century. Methods of assessment encompassed dietary records, written and spoken dietary recalls, FFQ using pencil and paper and more recently computer and internet applications. Emerging innovations involve camera and mobile telephone technology to capture food and meal images. This paper describes six projects sponsored by the United States National Institutes of Health that use digital methods to improve food records and two mobile phone applications using crowdsourcing. The techniques under development show promise for improving accuracy of food records. The first written report of dietary assessment on the western side of the Atlantic appeared in the 1930s. Medlin and Skinner (1) reviewed published reports of dietary assessment between about 1930 and 1985 and found early discussions of daily food intake being recorded by clinic patients and dietitians in both the US and Europe, primarily Great Britain. In the US where kitchen scales were not common portions recorded were estimated, but in England there was a tendency to weigh the food. Soon nutritionists discovered that a different answer might result depending on how the dietary intake data were collected. Even with good records, another challenge was determining the composition of foods recorded. This led to short methods to manually calculate composition of dietary intake records (2) . This manual calculation process was replaced by computerised systems in the 1970s and 1980s as computers became more accessible.Numerous attempts were made to determine the accuracy of food intakes recorded by research participants and how to determine how many days of information were required to accurately reflect usual intake. Basiotis et al. with the US Department of Agriculture created an interesting dataset consisting of intake records kept daily for an entire year by twenty-nine study volunteers in Beltsville, MD. By analysing the composition of these records the authors found that a single day's intake, or even records kept for a week or longer, were not representative of 'usual intake', and it was the usual intake that was most useful for dietary assessment. Intakes of energy and protein were relatively stable from day to day. Thus, an estimate of 3 or 4 d intake was considered to accurately represent the intake for a year for a group of people, but according to their work the individual needed to keep records for a month to accurately reflect usual intake of protein or energy. And if this was not daunting enough, nutrients that are concentrated in a few foods were even more difficult to assess, e.g. records kept for an entire year still did not accurately reflect an individual's usual intake of vitamin A. Fortunately, since that time mathematical models have been developed to estimate usual intake using fewer days of intake (4,5) . For most research goals, long-term (usual) intake is of primary interest but clients are seldom willing to record food intake for long period...
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