Effects of meat consumption and vegetarian diet on risk of wrist fracture over 25 years in a cohort of peri- and postmenopausal women

BACKGROUND: Evidence suggesting that a diet high in fruits and vegetables may be beneficial to bone health has sparked interest in the potential benefit of a vegetarian diet. However, other studies have raised a question regarding the adequacy of protein in such a diet. OBJECTIVE: The aim of the present study was to take a whole foods approach in examining the effects of foods high in protein on the risk of wrist fracture (WF) in a cohort with a significant proportion consuming a meat-free diet. DESIGN: A cohort study of women who completed two lifestyle surveys 25 years apart. SUBJECTS: One thousand eight hundred and sixty-five peri- and postmenopausal women at the time of the first survey. RESULTS: There was a significant interaction between meat consumption and foods high in vegetable protein. Among vegetarians, those who consumed the least vegetable protein intake were at highest risk for fracture. However, increasing levels of plant-based high-protein foods decreased WF risk, with a 68% reduction in risk (hazard ratio (HR) = 0.32, 95% confidence interval (CI) 0.13-0.79) in the highest intake group. Among those with lowest vegetable protein consumption, increasing meat intake decreased the risk of WF, with the highest consumption decreasing risk by 80% (HR = 0.20, 95% CI 0.06-0.66). CONCLUSIONS: The finding that higher consumption frequencies of foods rich in protein were associated with reduced WF supports the importance of adequate protein for bone health. The similarity in risk reduction by vegetable protein foods compared with meat intake suggests that adequate protein intake is attainable in a vegetarian diet.     

Changes in food supply in Mediterranean countries from 1961 to 2001

OBJECTIVE: To describe geographical differences and time trends in the supply of the most important food components of the traditional Mediterranean diet. DESIGN: Food supply data collected from national food balance sheets for the period 1961-2001. SETTING: Selected Mediterranean countries: Spain, Italy, France, Greece, Algeria, Morocco, Tunisia and Turkey. RESULTS: Differences of almost 30-fold and five-fold were found in the supply of olive oil and fruits and vegetables, respectively, among the Mediterranean countries studied during the 1960s. A favourable increasing trend for the supply of fruit and vegetables was observed in most Mediterranean countries. However, an increase in the supply of meats and dairy products and a decrease in the supply of cereals and wine were observed in European Mediterranean countries from 1961 until 2001. Only in African and Asiatic Mediterranean countries were cereals the base of food supply. During the 1990s, Greece's food supply pattern was closest to the traditional Mediterranean diet, while Italy and Spain maintained a high availability of fruits, vegetables and olive oil, but were losing the other typical components. Among African and Asiatic Mediterranean countries, only Turkey presented a traditional Mediterranean dietary pattern except with respect to olive oil, the supply of which was very low. France showed a Western dietary pattern, with a high supply of animal products and a low supply of olive oil. CONCLUSIONS: Dietary supplies in the Mediterranean area were quite heterogeneous in the 1960s and have experienced a process of Westernization, especially in European Mediterranean countries.     

Fruit and vegetable consumption and risk of colorectal cancer in Japan: The Miyagi Cohort Study

OBJECTIVE: Adequate fruit and vegetable intake has been suggested to protect against colorectal cancer. However, several recent prospective studies have reported no association. We therefore examined the association between fruit and vegetable intakes and the risk of colorectal cancer in a prospective cohort study in Japan. DESIGN: Between June and August 1990, 47 605 Japanese men and women completed a self-administered questionnaire, including a food-frequency questionnaire. We divided the subjects into quartiles based on their self-reported fruit and vegetable consumption. There were 165 colon cancer and 110 rectal cancer incidences identified during 7 years of follow-up, to the end of December 1997. We used Cox proportional hazards models to estimate the relative risk (RR) of developing colorectal cancer according to the level of fruit and vegetable consumption, applying adjustments for potential confounders. RESULTS: No statistically significant association was observed between fruit and vegetable consumption and the risk of colorectal cancer. The multivariate RR of colon cancer in the highest quartile of fruit and vegetable intake compared with the lowest was 1.13 (95% confidence interval (CI) 0.73-1.75), the RR for vegetables alone was 1.24 (95% CI 0.79-1.95) and that for fruit alone was 1.45 (95% CI 0.85-2.47). The corresponding multivariate RRs for rectal cancer were 1.12 (95% CI 0.67-1.89), 1.14 (95% CI 0.67-1.93) and 1.41 (95% CI 0.73-2.73). CONCLUSIONS: We found no association between the consumption of fruit and vegetables and the risk of colorectal cancer among the Japanese population.     

Dietary intake and development of a quantitative food-frequency questionnaire for the Barbados National Cancer Study

OBJECTIVE: To develop a quantitative food-frequency questionnaire (QFFQ) for the Barbados National Cancer Study (BNCS) that will permit examination of associations of diet with breast and prostate cancer. DESIGN: Population intake data from the year 2000 Barbados Food Consumption and Anthropometric Surveys (BFCAS 2000) were used to derive a list of foods consumed by the population. A 192-item draft QFFQ was developed from this list. SETTING: Barbados, West Indies provides an ideal environment to understand cancer risk in African-origin populations, with high relevance to African-Americans. The BNCS is a population-based case-control study examining risk factors for breast and prostate cancer in such populations. SUBJECTS: A total of 1600 persons, 18 years and older, completed a 24-hour recall in the BFCAS 2000. Fifty of 63 randomly selected residents (79% response rate) gave additional updated information on foods consumed. RESULTS: The 50 participants provided a one-time 24-hour recall and completed the draft QFFQ. The final instrument contains 148 items: breads, cakes, cereals = 17; rice, pastas, noodles = 8; dairy = 10; meat, fish, poultry = 42; fruit = 16; vegetables = 26; soft drinks = 14; alcoholic beverages = 5; others = 10. Additional questions include supplement use and food preparation methods such as grilling. CONCLUSION: The final instrument is concise, complete and the most up-to-date for assessing the food and nutrient intake of African-origin Barbadians and the associations with breast and prostate cancer.     

The influence of fruit and vegetable intake on the nutritional status and plasma homocysteine levels of institutionalised elderly people

OBJECTIVE: To determine the difference in the nutritional status of elderly people depending on their consumption of fruits and vegetables, and to study the possible association between the consumption of these foods and different cardiovascular risk factors, especially total plasma homocysteine (t-Hcys) levels. DESIGN, SETTING AND SUBJECTS: A cross-sectional study in 152 institutionalised older people from Madrid aged > or = 65 years. Food and nutrient intakes were recorded over 7 days using the 'precise individual weighing' method. The weight, height, and waist and hip circumferences of all subjects were recorded, as were their alpha-erythrocyte glutathione reductase, serum B6, B12 and folate levels, erythrocyte folate levels, t-Hcys levels, serum lipids and blood pressure. The experimental population was then divided into tertiles depending on the serving intake of fruit and vegetables (T1, < 2.29 servings day(-1); T2, 2.29-2.79 servings day(-1); and T3, >2.79 servings day(-1)). RESULTS: Compared with T1 subjects, T3 subjects showed consumptions of cereals, pulses, meat, fish and eggs closer to those recommended (P < 0.05). In addition, the contribution of their diet towards covering the recommended daily intake of vitamin B1, niacin, vitamin B6, folic acid, vitamin C, B12, vitamin A, and P, Mg, Zn and Fe was higher. The intake of fibre increased with consumption of fruit and vegetables (r = 0.6839, P < 0.001). T3 subjects also had better serum and erythrocyte folate levels than T1 and T2 subjects (P < 0.05). A positive correlation was found between the consumption of fruit and vegetables and serum folate (r = 0.2665, P < 0.01) and with erythrocyte folate levels (r = 0.2034, P < 0.05), and a negative correlation with t-Hcys (r = -0.2493, P < 0.01). CONCLUSIONS: Greater consumption of fruit and vegetables is associated with better food habits, increased vitamin and mineral intakes and lower t-Hcys levels. Considering that the fruit and vegetable intake in Spanish elderly people is very low, it is recommended that the consumption of fruits and vegetables by elderly people be increased.     

Knowledge of dietary and behaviour-related determinants of non-communicable disease in urban Senegalese women

OBJECTIVE: To assess knowledge of dietary and behaviour-related determinants of non-communicable disease (NCD) of urban Senegalese women. DESIGN: A cross-sectional, population study using an interviewer-administered knowledge questionnaire, developed and validated for this study. The questionnaire consisted of 24 items with six scores measuring knowledge of: (1) diet- and behaviour-related causes of NCD; (2) diet quality-NCD relationship; (3) fruit and vegetable link with NCD; (4) health consequences of obesity; (5) causes of cardiovascular disease (CVD); and (6) causes of certain cancers. SUBJECTS: A random sample of 301 women aged 20-50 years. RESULTS: The knowledge scores developed suggest that the health consequences of obesity (mean score of 65.4%) were best understood followed by causes of CVD (mean score of 60.6%), because obesity, smoking, high blood cholesterol and dietary fat were well recognised as risk factors for CVD. Subjects scored least for their knowledge of the protective effect of fruit and vegetables (mean score of 19.9%). Knowledge of causes of certain cancers (mean score of 36.1%) was also low. Women who worked outside the home had better knowledge for two scores but otherwise no relationship was found between knowledge and literacy, formal education or body mass index. CONCLUSIONS: Findings suggest reasonable overall knowledge concerning diet and behaviour with NCD, especially given the relatively new context of the obesity epidemic in Senegal. However, there was poor knowledge of the benefit of eating fruit and vegetables and other preventable causes of certain cancers. Education targeting the benefits of vegetables and fruit may have the greatest impact on NCD prevention.     

Dietary intake and development of a quantitative food-frequency questionnaire for a lifestyle intervention to reduce the risk of chronic diseases in Canadian First Nations in north-western Ontario

OBJECTIVES: To characterise the diet of First Nations in north-western Ontario, highlight foods for a lifestyle intervention and develop a quantitative food-frequency questionnaire (QFFQ). DESIGN: Cross-sectional survey using single 24 h dietary recalls. SETTING: Eight remote and semi-remote First Nations reserves in north-western Ontario. SUBJECTS: 129 First Nations (Oji-Cree and Ojibway) men and women aged between 18 and 80 years. RESULTS: The greatest contributors to energy were breads, pasta dishes and chips (contributing over 20 % to total energy intake). 'Added fats' such as butter and margarine added to breads and vegetables made up the single largest source of total fat intake (8.4 %). The largest contributors to sugar were sugar itself, soda and other sweetened beverages (contributing over 45 % combined). The mean number of servings consumed of fruits, vegetables and dairy products were much lower than recommended. The mean daily meat intake was more than twice that recommended. A 119-item QFFQ was developed including seven bread items, five soups or stews, 24 meat- or fish-based dishes, eight rice or pasta dishes, nine fruits and 14 vegetables. Frequency of consumption was assessed by eight categories ranging from 'Never or less than one time in one month' to 'two or more times a day'. CONCLUSION:We were able to highlight foods for intervention to improve dietary intake based on the major sources of energy, fat and sugar and the low consumption of fruit and vegetable items. The QFFQ is being used to evaluate a diet and lifestyle intervention in First Nations in north-western Ontario.     

Changes in carotenoid intake from fruit and vegetables in the Spanish population over the period 1964-2004

OBJECTIVE: To assess changes in carotenoid intake based on the variations in the consumption of fresh fruit and vegetables in the Spanish population over the period 1964-2004. DESIGN: Consumption data of fresh fruit and vegetables from Family Budget Surveys carried out in 1964, 1980, 1990 and 2004. Consumption data (g per person per day) accounted for >90% of fruit and vegetable consumption at each time point. Quality controlled high-performance liquid chromatography analysis of the carotenoid composition of Spanish fruit and vegetable was used. SUBJECTS: Randomly selected, private households throughout Spain (20,800 households in 1964, 30,311 households in 1980, 21,155 households in 1990 and 6000 households in 2004). Twelve vegetables and 16 fruits representing 89-96% of the total consumption of fresh fruit and vegetables were used. RESULTS: Individual consumption of fruit and vegetables has changed over this period, altering the total and individual intake of carotenoids. Total carotenoid intake increased from 2.5 mg per person per day in 1964 to 4.1 mg per person per day in 1990, with a decrease to 3.3 mg per person per day in 2004. These increments are due to an increase in lycopene, alpha- and beta-carotene, while a decrease in lutein and zeaxanthin is observed during the last decade. A continuous and consistent decrease in the relative contribution of lutein in the diet is observed over the period studied. CONCLUSION: Although the consumption of fruit and vegetables is still consistent with a Mediterranean-type pattern, modifications in the consumption of individual fruits and vegetables have provoked changes in total and specific carotenoid intake with potential relevance in human health.     

Dietary intake of heterocyclic amines in relation to socio-economic, lifestyle and other dietary factors: estimates in a Swedish population

OBJECTIVES: To estimate the dietary intakes of heterocyclic amines (HCAs), to examine the intakes in relation to socio-economics, lifestyle and other dietary factors and to compare the classification of subjects by intake of HCA versus intake of meat and fish. DESIGN: Cross-sectional analysis within the Malm? Diet and Cancer (MDC) cohort. Data were obtained from a modified diet history, a structured questionnaire on socio-economics and lifestyle, anthropometric measurements and chemical analysis of HCAs. HCA intake was cross-classified against meat and fish intake. The likelihood of being a high consumer of HCAs was estimated by logistic regression analysis. Dietary intakes were examined across quintiles of HCA intake using analysis of variance. SETTING: Baseline examinations conducted in 1991-1994 in Malm?, Sweden. SUBJECTS: A sub-sample of 8599 women and 6575 men of the MDC cohort. RESULTS: The mean daily HCA intake was 583 ng for women and 821 ng for men. Subjects were ranked differently with respect to HCA intake compared with intake of fried and baked meat and fish (kappa = 0.13). High HCA intake was significantly associated with lower age, overweight, sedentary lifestyle and smoking. Intakes of dietary fibre, fruits and fermented milk products were negatively associated with HCA intake, while intakes of selenium, vegetables, potatoes, alcohol (among men) and non-milk-based margarines (among women) were positively associated with HCA intake. CONCLUSIONS: The estimated daily HCA intake of 690 ng is similar to values obtained elsewhere. The present study suggests that lifestyle factors (e.g. smoking, physical activity, fruit and vegetable intakes, and types of milk products and margarines) may confound associations between HCA intake and disease. The poor correlation between HCA intake and intakes of fried meat and fish facilitates an isolation of the health effects of HCAs.     

Evaluation of brief dietary questions to estimate vegetable and fruit consumption - using serum carotenoids and red-cell folate

OBJECTIVE: To evaluate responses to self-administered brief questions regarding consumption of vegetables and fruit by comparison with blood levels of serum carotenoids and red-cell folate. DESIGN: A cross-sectional study in which participants reported their usual intake of fruit and vegetables in servings per day, and serum levels of five carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin and lycopene) and red-cell folate were measured. Serum carotenoid levels were determined by high-performance liquid chromatography, and red-cell folate by an automated immunoassay system. SETTINGS AND SUBJECTS: Between October and December 2000, a sample of 1598 adults aged 25 years and over, from six randomly selected urban centres in Queensland, Australia, were examined as part of a national study conducted to determine the prevalence of diabetes and associated cardiovascular risk factors. RESULTS: Statistically significant (P<0.01) associations with vegetable and fruit intake (categorised into groups: /=4 servings per day) were observed for alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin and red-cell folate. The mean level of these carotenoids and of red-cell folate increased with increasing frequency of reported servings of vegetables and fruit, both before and after adjusting for potential confounding factors. A significant association with lycopene was observed only for vegetable intake before adjusting for confounders. CONCLUSIONS: These data indicate that brief questions may be a simple and valuable tool for monitoring vegetable and fruit intake in this population.     

Impact of parental education and income inequality on children's food intake

OBJECTIVE: To analyse the association between socio-economic indicators and diet among 2-year-old children, by assessing the independent contribution of parental education and equivalent income to food intake. DESIGN: The analysis was based on data from a prospective birth cohort study. Information on diet was obtained using a semi-quantitative food-frequency questionnaire. Low and high intake of food was defined according to the lowest and the highest quintile of food consumption frequency, respectively. SETTING: Four German cities (Munich, Leipzig, Wesel, Bad Honnef), 1999-2001.Subjects Subjects were 2637 children at the age of 2 years, whose parents completed questionnaires gathering information on lifestyle factors, including parental socio-economic status, household consumption frequencies and children's diet. RESULTS: Both low parental education and low equivalent income were associated with a low intake of fresh fruit, cooked vegetables and olive oil, and a high intake of canned vegetables or fruit, margarine, mayonnaise and processed salad dressing in children. Children with a low intake of milk and cream, and a high intake of hardened vegetable fat, more likely had parents with lower education. Low butter intake was associated with low equivalent income only. CONCLUSIONS: These findings may be helpful for future intervention programmes with more targeted policies aiming at an improvement of children's diets.     

Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children

OBJECTIVE: To examine the contribution to fruit and vegetable eating in children of potential predictive variables within the domains of demographics, parental feeding practices and personality traits. DESIGN: Cross-sectional survey. SETTING: Questionnaires were distributed to parents through 22 London nursery schools. SUBJECTS: Questionnaires were completed and returned by 564 parents or principal caregivers of 2-6-year-old children. RESULTS: Significant predictors of children's fruit and vegetable intake emerged from all three domains examined. Demographic variables associated with child's vegetable consumption were mother's education and child's age and gender. Only ethnicity was significantly associated with fruit consumption. Parental consumption, breast-feeding and early introduction to fruit and vegetables were related to intake of both. Family meal times were associated with higher intake of vegetables, but not of fruit. Two characteristics of children themselves (food neophobia and enjoyment of food) were strongly related to the consumption of fruit and vegetables. Subsequent multivariate analyses revealed that parental intake and child food neophobia independently predicted intake of both foods. In the presence of these, fruit consumption was affected by breast-feeding and early introduction to fruit, whereas vegetable consumption was related only to child's gender and enjoyment of food. CONCLUSIONS: These findings may be used to inform future interventions aimed at increasing children's consumption of fruit and vegetables. Parents should be made aware of the possible impact of their own behaviour on the eating habits of their children.     

Mediterranean diet in relation to body mass index and waist-to-hip ratio

OBJECTIVE: The Mediterranean diet is rich in fat and starch, and hence may be related to overweight. We therefore investigated the relationship between adherence to a Mediterranean diet and body mass index (BMI) and waist-to-hip ratio (WHR). DESIGN AND SETTING: Data were obtained from the control group of a network of case-control studies on cancer conducted in major teaching and general hospitals in four Italian areas between 1991 and 2002. An interviewer-administered validated 78-item food-frequency questionnaire was used to obtain information on the subjects' habitual diet. Information on socio-economic factors, lifestyle habits and anthropometric measures was also collected. A Mediterranean diet score (MDS) was derived on the basis of eight characteristics of the Mediterranean diet. SUBJECTS: Subjects were 6619 patients (3090 men, 3529 women) admitted to hospital for a wide spectrum of acute, non-neoplastic conditions, unrelated to known risk factors for cancer and long-term modifications of diet. RESULTS: In multiple linear regression models adjusted for age, study centre, education, tobacco smoking, occupational physical activity and total energy intake, the MDS was not related to BMI (beta = 0.05 for men and -0.04 for women) or WHR (beta = 0.000 and 0.001, respectively) in both sexes. CONCLUSIONS: Adherence to the major characteristics of the Mediterranean diet is unrelated to BMI and WHR, confirming previous data from Greece and Spain.     

Intake and food sources of nitrites and N-nitrosodimethylamine in Spain

OBJECTIVE: To conduct a comprehensive assessment of dietary intakes of nitrites and N-nitrosodimethylamine (NDMA). SUBJECTS AND SETTING: A study was conducted within the Spanish cohort of the European Prospective Investigation in Cancer and Nutrition (EPIC) to assess the intake and food sources of these compounds in Spanish adults. The study included 41,446 health volunteers, aged 29-69 years, from Northern and Southern regions. Usual food intake was estimated by in-person interviews using a computerised dietary questionnaire. RESULTS: The estimated geometric mean was 0.994 mg day(-1) for nitrites and 0.114 microg day(-1) for NDMA. For both compounds a positive trend in consumption with increasing energy intake was observed. Dietary NDMA was related to age and sex after energy adjustment, while nitrite consumption increased with higher intakes of vitamin C (P < 0.001). The food groups that contributed most to intakes were meat products, cereals, vegetables and fruits for nitrites, and processed meat, beer, cheese and broiled fish for NDMA. Current and past smokers, who had high levels of NDMA from tobacco exposure, were also identified as the highest consumers of dietary NDMA. Furthermore, smokers had low intakes of vitamin C (an inhibitor of endogenous nitrosation). CONCLUSIONS: Intake levels of NDMA and nitrites in a Mediterranean cohort are currently relatively lower than those previously reported, although processed meat, beer and cured cheese still are the most important contributors to NDMA intake.     

Does the diet of the Balearic population, a Mediterranean-type diet, ensure compliance with nutritional objectives for the Spanish population?

OBJECTIVES: To assess the dietary habits of Balearic Islands' consumers who are successful in meeting current nutritional recommendations, to find clues for the development of future food-based dietary guidelines (FBDG) that would be relevant to this population. DESIGN: Cross-sectional nutritional survey carried out in the Balearic Islands between 1999 and 2000. SUBJECTS AND METHODS: Dietary habits were assessed by means of 24-hour recall (two non-consecutive days: warm and cold season) and a food-frequency questionnaire in a random sample (n=1200, aged 16-65 years) living in private households. Differences in percentage of compliers with the intermediate nutritional objectives for the Spanish population and differences in food consumption patterns between genders and between high (above the upper quartile of intake) and low (below the lower quartile of intake) consumers of fat, saturated fatty acids (SFA), fibre, and fruit and vegetables were analysed. RESULTS: Gender differences were observed in nutrient and energy intakes, as well as in attainment of the recommendations. Less than 25% of the population reached the intermediate nutritional recommendations for iodine, fruit, carbohydrates, SFA, fibre and vegetables. Low fat/SFA and high fruit and vegetables/fibre consumers kept a diet in line with the traditional Balearic diet and prevailing dietary pyramids, which ensured better compliance with the nutritional goals. CONCLUSIONS: The intermediate nutritional objectives for the Spanish population could be achieved through maintenance of the traditional Balearic diet, a Mediterranean-type diet in the Balearic population. Therefore, this dietary model could be used to develop FBDG relevant to this population.     

Monetary costs of dietary energy reported by young Japanese women: association with food and nutrient intake and body mass index

OBJECTIVE: Little is known about the relationship of monetary diet costs to dietary intake and obesity, particularly in non-Western populations. This study examined monetary cost of dietary energy in relation to diet quality and body mass index (BMI) among young Japanese women. DESIGN: Dietary intake was assessed by a validated, self-administered, diet history questionnaire. Diet costs were estimated using retail food prices. Monetary cost of dietary energy (Japanese yen 1000 kcal-1) was then calculated. BMI was computed from self-reported body weight and height. SUBJECTS: A total of 3931 female Japanese dietetic students aged 18-20 years. RESULTS: Monetary cost of dietary energy was positively associated with intakes of fruits, vegetables, fish and shellfish, and pulses; however, higher monetary cost of dietary energy was also associated with higher consumption of fat and oil, meat and energy-containing beverages, and lower consumption of cereals (rice, bread and noodles) (all P for trend <0.01). At the nutrient level, monetary cost of dietary energy was positively associated with intakes of dietary fibre and key vitamins and minerals, but also associated positively with intakes of fat, saturated fatty acids, cholesterol and sodium, and negatively with carbohydrate intake (all P for trend <0.0001). After adjustment for possible confounders, monetary cost of dietary energy was quite weakly but significantly negatively associated with BMI (P for trend = 0.0197). CONCLUSIONS: Increasing monetary cost of dietary energy was associated with both favourable and unfavourable dietary intake patterns and a quite small decrease in BMI in young Japanese women.     

Intake of specific flavonoids and risk of acute myocardial infarction in Italy

OBJECTIVE: As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population.DESIGN: Case-control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI.SETTING: Milan, Italy, between 1995 and 2003.SUBJECTS: Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet.RESULTS: A reduced risk of AMI was found for increasing intake of anthocyanidins (OR=0.45, 95% CI 0.26-0.78 for the highest vs. the lowest quintile, Ptrend=0.003) and flavonols (OR=0.65, 95% CI 0.41-1.02, Ptrend=0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR=0.73, 95% CI 0.48-1.10) and total flavonoids (OR=0.74, 95% CI 0.49-1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones.CONCLUSIONS: High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk.     

Calcium, nutrient and food intake of Greek Orthodox Christian monks during a fasting and non-fasting week

OBJECTIVE: To assess the Ca, nutrient and food intake of Greek Orthodox Christian monks during a vegetarian-type fasting week, compared with their normal diet. DESIGN: Dietary data collection (using 7 d weighed food records), anthropometric and blood pressure measurements, as well as serum glucose and lipid analyses, were performed during Palm Sunday week (fasting) and the week following Pentecost Sunday (non-fasting). Mean daily nutrient and food (g/d) intakes were calculated from the food records. SETTING: The study took place in two monasteries in the Municipality of Heraklion, Crete. SUBJECTS: The study involved ten healthy monks aged 254 (sd 10June 2005. RESULTS: Nutrient and food intake profiles were more favourable during the fasting week, when participants had lower intakes of total and saturated fat and trans-fatty acids, and higher intakes of dietary fibre, Fe, folate, legumes and fish/seafood. Ca intake was lower when participants fasted, whereas consumption of dairy products, meat and eggs increased significantly in the non-fasting week. Systolic blood pressure was significantly higher, whereas blood lipid levels were more favourable during the fasting week. CONCLUSIONS: The periodic vegetarianism recommended by the Greek Orthodox Church contributes to the favourable profiles of several biomarkers of health among this sample of monks. The fasting rituals described are an important component of the traditional diet of Crete and should be emphasised in nutrition education programmes promoting this Mediterranean eating pattern.     

Nutrition and the burden of disease in New Zealand: 1997-2011

OBJECTIVE: To estimate the burden of disease due to selected nutrition-related risk factors (high total blood cholesterol, high systolic blood pressure, high body mass index (BMI) and inadequate vegetable and fruit intake) in 1997, as well as the burden that could potentially be avoided in 2011 if small, favourable changes in the current risk factor distribution were to occur. DESIGN: Data on risk factor levels, disease burden and risk associations were combined using comparative risk assessment methodology, a systematic approach to estimating both attributable and avoidable burden of disease. Disease outcomes assessed varied according to risk factor and included ischaemic heart disease, stroke, type 2 diabetes mellitus and selected cancers. SETTING: New Zealand. RESULTS: Approximately 4500 deaths (17% of all deaths) in 1997 were attributable to high cholesterol, 3500 (13%) to high blood pressure, 3000 (11%) to high BMI and 1500 (6%) to inadequate vegetable and fruit intake. Taking prevalence overlap into account, these risk factors were estimated jointly to contribute to approximately 11 000 (40%) deaths annually in New Zealand. Approximately 300 deaths due to each risk factor could potentially be avoided in 2011 if modest changes were made to each risk factor distribution. CONCLUSIONS: High cholesterol, blood pressure and BMI, as well as inadequate vegetable and fruit intake, are major modifiable causes of death in New Zealand. Small changes in the population distribution of these risk factors could have a major impact on population health within a decade.     

Antioxidant characterization of some Sicilian edible wild greens

Epidemiological studies have demonstrated that many antioxidants and the total antioxidant capacity (TAC) of the diet may protect against cancers and cardiovascular disease. Common fruits and vegetables are good sources of antioxidants, although in some Mediterranean areas traditional wild greens are responsible for a significant percentage of total dietary antioxidant intake. In the European Prospective Investigation into Cancer and Nutrition cohort of Ragusa (Sicily), a high number of subjects were found to frequently eat wild greens, including Sinapis incana and Sinapis nigra, Diplotaxis erucoides, Cichorium intybus, Asparagus acutifolius, and Borrago officinalis. On the basis of these observations, detailed characterization of single antioxidant components (i.e., polyphenols, carotenoids, chlorophylls, and ascorbic acid) and the TAC of these edible wild traditional plants was performed. The wild plants examined were found to be very rich in antioxidants, such as flavonoids and carotenoids, with high TAC values, suggesting that the importance of these vegetables, not only in the traditional but even in the contemporary diet, needs to be emphasized.