U.S.S.R. and U.S. nutrient intake, plasma lipids, and lipoproteins in men ages 40-59 sampled from Lipid Research Clinics populations

Dietary habits in three Central and Eastern European countries: the HAPIEE study

BACKGROUND

The high cardiovascular mortality in Eastern Europe has often been attributed to poor diet, but individual-level data on nutrition in the region are generally not available. This paper describes the methods of dietary assessment and presents preliminary findings on food and nutrient intakes in large general population samples in Russia, Poland and the Czech Republic.

METHODS

The HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study examined random samples of men and women aged 45-69 years at baseline in Novosibirsk (Russia), Krakow (Poland) and six Czech urban centres in 2002-2005. Diet was assessed using a food frequency questionnaire (at least 136 items); complete dietary information was available for 26,870 persons.

RESULTS

Total energy intakes among men ranged between 8.7 MJ in the Czech sample and 11.7 MJ in the Russian sample, while among women, energy intakes ranged between 8.2 MJ in the Czech sample and 9.8 MJ in the Russian sample. A Healthy Diet Indicator (HDI), ranging from a score of 0 (lowest) to 7 (highest), was developed using the World Health Organisation's (WHO) guidelines for the prevention of chronic diseases. The mean HDI scores were low, ranging from 1.0 (SD = 0.7) among the Polish subjects to 1.7 (SD = 0.8) among the Czech females. Very few subjects met the WHO recommended intakes for complex carbohydrates, pulses or nuts; intakes of saturated fatty acids, sugar and protein were too high. Only 16% of Polish subjects met the WHO recommendation for polyunsaturated fat intake. Consumption of fruits and vegetables was lower than recommended, especially among those Russian subjects who were assessed during the low intake season. Fewer than 65% of subjects consumed adequate amounts of calcium, magnesium and potassium, when compared with the United Kingdom's Reference Nutrient Intake.

CONCLUSION

This first large scale study of individual-based dietary intakes in the general population in Eastern Europe implies that intakes of saturated fat, sugar and complex carbohydrates are a cause for concern. The development of country-specific nutritional tools must be encouraged and nutritional campaigns must undergo continuing development.

Obesity, diet, and poverty: trends in the Russian transition to market economy

OBJECTIVE

To examine trends in macronutrient intake, overweight, and obesity.

DESIGN

Cross-sectional samples-collected nine times between 1992 and 2000-from the Russian Longitudinal Monitoring Survey provide interviewer-administered 24-h diet recalls and measured height and weight, together with detailed information regarding income and expenditures.

SETTING

The Russian Federation.

SUBJECTS

Women and men, aged 19-55 y.

INTERVENTIONS

None.

METHODS

A nationally representative sample of working-age Russian adults was stratified by gender and income (per cent of regional poverty level). Secular trends in mean energy and macronutrient intake, as well as prevalence of overweight and obesity in the population are described over the first 8 y of the Russian Federation.

RESULTS

Overall, energy intake increased slightly. Fat, as a percentage of energy (E%), decreased from 39.6 to 31.6% and protein, as a per cent of energy, decreased from 14.3 to 12.5%. Overweight (determined by body mass index (BMI) >/=25 kg/m(2)) prevalence remained relatively stable at about 50% and obesity (BMI >/=30 kg/m(2)) prevalence increased from 13.3 to 16.0% of the adult population. Women consumed less energy than men and displayed higher prevalences of overweight and obesity in all time periods. There was an income effect among men in all time periods, with higher-income men consuming more calories, fat, and protein than lower-income men; this effect was not apparent in women except in the proportion of fat and protein intake.

CONCLUSIONS

The adult Russian population appears to have escaped macronutrient privation during economic reform and has experienced increasing rates of obesity.

Frequency of consumption of selected indicator foods and serum cholesterol. GISSI-EFRIM investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto--Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico

The relationship between frequency of consumption of eleven indicator foods (milk, meat, liver, carrots, green vegetables, fruit, eggs, ham, fish, cheese and alcohol) and serum cholesterol was investigated in the comparison group of a case-control study of acute myocardial infarction conducted in Italy. Data were collected on 792 subjects from various Italian regions, admitted to hospital for acute conditions unrelated to any known or potential risk factor for myocardial infarction or to long-term modifications in diet. No statistically or epidemiologically meaningful relationship emerged between serum cholesterol level and frequency of consumption of any of these foods. Cholesterol levels rose according to increasing consumption tertiles for most of the indicator foods considered. Higher values for the higher tertile of consumption were observed for meat, ham and eggs, but also for fruit, carrots and green vegetables. However, correlation coefficients between frequency of consumption of various food items and serum cholesterol level were uniformly low for all food items considered, ranging between -0.09 (for milk) and 0.19 (for ham). Although a more comprehensive diet history may lead to different indications, the present data are not suggestive of any major influence of long-term frequency of consumption of a few selected indicator foods on serum cholesterol levels.