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Giskes K, Avendano M, Brug J, Kunst AE. A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obes Rev 2010; 11:413-29. [PMID: 19889178 DOI: 10.1111/j.1467-789x.2009.00658.x] [Citation(s) in RCA: 259] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This Review examined socioeconomic inequalities in intakes of dietary factors associated with weight gain, overweight/obesity among adults in Europe. Literature searches of studies published between 1990 and 2007 examining socioeconomic position (SEP) and the consumption of energy, fat, fibre, fruit, vegetables, energy-rich drinks and meal patterns were conducted. Forty-seven articles met the inclusion criteria. The direction of associations between SEP and energy intakes were inconsistent. Approximately half the associations examined between SEP and fat intakes showed higher total fat intakes among socioeconomically disadvantaged groups. There was some evidence that these groups consume a diet lower in fibre. The most consistent evidence of dietary inequalities was for fruit and vegetable consumption; lower socioeconomic groups were less likely to consume fruit and vegetables. Differences in energy, fat and fibre intakes (when found) were small-to-moderate in magnitude; however, differences were moderate-to-large for fruit and vegetable intakes. Socioeconomic inequalities in the consumption of energy-rich drinks and meal patterns were relatively under-studied compared with other dietary factors. There were no regional or gender differences in the direction and magnitude of the inequalities in the dietary factors examined. The findings suggest that dietary behaviours may contribute to socioeconomic inequalities in overweight/obesity in Europe. However, there is only consistent evidence that fruit and vegetables may make an important contribution to inequalities in weight status across European regions.
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Affiliation(s)
- K Giskes
- Department of Public Health, Erasmus Medical Center, Rotterdam, the
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Abu-Rmeileh NME, Hart CL, McConnachie A, Upton MN, Lean MEJ, Watt GCM. Contribution of Midparental BMI and other determinants of obesity in adult offspring. Obesity (Silver Spring) 2008; 16:1388-93. [PMID: 18421278 DOI: 10.1038/oby.2008.211] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to evaluate midparental BMI among intergenerational factors associated with obesity in adult offspring. The data was from an unusual two-generational observational design of 1,477 married couples from Renfrew and Paisley in Scotland who were aged 45-64 years when screened in 1972-1976, and 1,040 sons and 1,298 daughters aged 30-59 years when screened in 1996. BMI was categorized as normal (< 25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (> or = 30 kg/m(2)) in offspring and parents. Midparental BMI was defined as the mean of the mother's and father's BMI. Low physical activity, nonsmoking status, higher cholesterol level, and manual social class were all associated with increased BMI in offspring. The effect of reported dietary intake was less clear. Offspring of obese parents (defined by midparental BMI) were over four times more likely to be obese than offspring of normal weight parents. Midparental BMI had a strong effect on offspring BMI, independent of social class, smoking habit, physical activity, and reported dietary intake. Adding midparental BMI to the regression model more than doubled the explained variation of offspring BMI from 7.7 to 17%. Every 1 kg/m(2) increment in midparental BMI was associated with a BMI greater by 0.51 kg/m(2) in offspring. We conclude that midparental BMI is a useful simple tool to predict offspring BMI. Whether it represents genetic or environmental family effects, it is easily ascertained by the individual and could be used in health promotion and clinical settings to target individuals who are at increased risk of becoming obese.
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Affiliation(s)
- Niveen M E Abu-Rmeileh
- General Practice and Primary Care, Division of Community Based Sciences, University of Glasgow, Glasgow, UK
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Ball K, Mishra GD, Thane CW, Hodge A. How well do Australian women comply with dietary guidelines? Public Health Nutr 2007; 7:443-52. [PMID: 15153275 DOI: 10.1079/phn2003538] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjective:To investigate the proportion of middle-aged Australian women meeting national dietary recommendations and its variation according to selected sociodemographic and behavioural characteristics.Design:This cross-sectional population-based study used a food-frequency questionnaire to investigate dietary patterns and compliance with 13 commonly promoted dietary guidelines among a cohort of middle-aged women participating in the Australian Longitudinal Study on Women's Health.Setting:Nation-wide community-based survey.Subjects:A total of 10 561 women aged 50–55 years at the time of the survey in 2001.Results:Only about one-third of women complied with more than half of the guidelines, and only two women in the entire sample met all 13 guidelines examined. While guidelines for meat/fish/poultry/eggs/nuts/legumes and ‘extra’ foods (e.g. ice cream, chocolate, cakes, potatoes, pizza, hamburgers and wine) were met well, large percentages of women (68–88%) did not meet guidelines relating to the consumption of breads, cereal-based foods and dairy products, and intakes of total and saturated fat and iron. Women working in lower socio-economic status occupations, and women living alone or with people other than a partner and/or children, were at significantly increased risk of not meeting guidelines.Conclusions:The present results indicate that a large proportion of middle-aged Australian women are not meeting dietary guidelines. Without substantial changes in their diets, and help in making these changes, current national guidelines appear unachievable for many women.
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Affiliation(s)
- Kylie Ball
- School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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Welch AA, Luben R, Khaw KT, Bingham SA. The CAFE computer program for nutritional analysis of the EPIC-Norfolk food frequency questionnaire and identification of extreme nutrient values. J Hum Nutr Diet 2005; 18:99-116. [PMID: 15788019 DOI: 10.1111/j.1365-277x.2005.00593.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food frequency questionnaires (FFQs) are widely used in nutritional epidemiology but no papers detail the development of the supporting programs and nutritional databases. The principles involved in data collection, processing and treatment of the European Prospective Investigation into Cancer Study (EPIC)-Norfolk Study FFQ and development of the structure and content of the Compositional Analyses from Frequency Estimates (CAFE) program for calculating nutrient intakes are described. Extreme nutrient values and derivation of cut-points for data exclusion are also discussed. METHODS The FFQ was sent to 25,637 participants. To exclude extreme (nonphysiological) outliers of nutrient intakes, the extreme top and bottom 0.5% of the ratio of energy intake to estimated basal metabolic rate was used. RESULTS The CAFE computer program modifies nutrient intake according to specific fats used in food preparation and the amount of visible fat on meat. It incorporates different breakfast cereals and distinguishes between text for brands and types. After exclusion of outliers of nutrient intake some extreme values remained for energy, carbohydrate, protein, fat and alcohol, because of high reported frequencies of certain foods. CONCLUSIONS The features of CAFE include flexible, updateable, databases and a novel method for matching text. The effect of extreme nutrient values on the accuracy of the FFQ in estimating diet in nutritional epidemiology should be investigated further.
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Affiliation(s)
- A A Welch
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Site, Wort's Causeway, Cambridge, UK.
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Wrieden WL, Connaghan J, Morrison C, Tunstall-Pedoe H. Secular and socio-economic trends in compliance with dietary targets in the north Glasgow MONICA population surveys 1986-1995: did social gradients widen? Public Health Nutr 2005; 7:835-42. [PMID: 15482607 DOI: 10.1079/phn2004636] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare trends in the consumption of key foods over 10 years in the most deprived and least deprived quarters in north Glasgow, Scotland as defined by the Carstairs deprivation index for their postcode of domicile. DESIGN Four random, cross-sectional, age- and gender-stratified population surveys carried out in 1986, 1989, 1992 and 1995. After assigning a deprivation score, food-frequency questionnaires from 2883 men and 3127 women were examined for compliance with dietary targets, examining trends by gender and within the most and least deprived quarters of the population. SETTING North Glasgow, Scotland. SUBJECTS Over 600 men and 600 women (aged 25-64 years) in each of the four survey years who completed a lifestyle questionnaire including a food frequency section. RESULTS Increasing trends in the reported consumption of fruit and vegetables and oil-rich fish were observed over the 10-year period. However, the trend to increased fruit and vegetable consumption in the most deprived groups was not significant, and in 1995 only 8% of men and 12% of women in this group claimed consumption of these foods 4 or more times a day. In general, a higher percentage of those in the least deprived group met the targets for the key foods. CONCLUSIONS Trends to increasing consumption of fruit and vegetables and fish were in the right direction, but the targets for consumption of certain key foods were met by a minority of the population. The progress towards the target for fruit and vegetables showed widening social gradients with time.
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Affiliation(s)
- Wendy Louise Wrieden
- Centre for Public Health Nurition Research, The Institute for Cardiovascular Research, University of Dundee, Ninewells Hospital and Medical School, UK.
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Giskes K, Turrell G, Patterson C, Newman B. Socio-economic differences in fruit and vegetable consumption among Australian adolescents and adults. Public Health Nutr 2002; 5:663-9. [PMID: 12372160 DOI: 10.1079/phn2002339] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine whether socio-economic groups differ in their fruit and vegetable consumption, and the variety eaten, and whether socio-economic differences are similar for adolescents and adults. The study also examined whether socio-economic groups vary in their reported desire to increase the amount of fruit and vegetables consumed, and the perceived barriers to achieving this. DESIGN, SETTING AND SUBJECTS The 1995 Australian National Nutrition Survey collected fruit and vegetable intake data from adolescents aged 13-17 years and adults 18-64 years using a 24-hour dietary recall. Gross annual household income was used to measure socio-economic position. RESULTS Approximately 44% of males and 34% of females did not consume fruit in the 24 hours preceding the survey, and 20% of males and 17% of females did not consume vegetables. Among adolescents and adults, fruit and vegetable consumption was positively related to income. The only exception was vegetable consumption among adolescent males, which did not vary by income. Lower-income adults consumed a smaller variety of fruits and vegetables than their higher-income counterparts. Fruit and vegetable variety did not vary by income among adolescents. Lower-income adults expressed less desire to increase their fruit and vegetable consumption, and were more likely to report that price and storage were barriers to doing so. Socio-economic differences in consumption and variety were more apparent for adults than for adolescents. CONCLUSIONS In addition to increasing the consumption of fruits and vegetables among the general population, nutrition interventions, programmes and policy aiming to improve diet should target adolescents and adults from low socio-economic groups. Strategies should address price and storage barriers.
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Affiliation(s)
- Katrina Giskes
- Centre for Public Health Research, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Hart CL, Hole DJ, Gillis CR, Smith GD, Watt GC, Hawthorne VM. Social class differences in lung cancer mortality: risk factor explanations using two Scottish cohort studies. Int J Epidemiol 2001; 30:268-74. [PMID: 11369726 DOI: 10.1093/ije/30.2.268] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The study investigated differences in lung cancer mortality risk between social classes. METHODS Twenty years of mortality follow-up were analysed in 7052 men and 8354 women from the Renfrew/Paisley general population study and 4021 working men from the Collaborative study. RESULTS More manual than non-manual men and women smoked, reported morning phlegm, had worse lung function and lived in more deprived areas. Lung cancer mortality rates were higher in manual than non-manual men and women. Significantly higher lung cancer mortality risks were seen for manual compared to non-manual workers when adjusting for age only and adjustment for smoking reduced these risks to 1.41 (95% CI : 1.12-1.77) for men in the Renfrew/Paisley study, 1.28 (95% CI : 0.94-1.75) for women in the Renfrew/Paisley study and 1.43 (95% CI : 1.02-2.01) for men in the Collaborative study. Adjustment for lung function, phlegm and deprivation category attenuated the risks which were of borderline significance for men in the Renfrew/Paisley study and non significant for women in the Renfrew/Paisley study and men in the Collaborative study. Adding extra socioeconomic variables, available in the Collaborative study only, reduced the difference between the manual and non-manual social classes completely. CONCLUSIONS There is a difference in lung cancer risk between social classes, in addition to the effect of smoking. This can be explained by poor lung health, deprivation and poor socioeconomic conditions throughout life. As well as anti-smoking measures, reducing socioeconomic inequalities and targeting individuals with poor lung function for help with smoking cessation could help reduce future lung cancer incidence and mortality.
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Affiliation(s)
- C L Hart
- Department of Public Health, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
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Wrieden WL, Hannah MK, Bolton-Smith C, Tavendale R, Morrison C, Tunstall-Pedoe H. Plasma vitamin C and food choice in the third Glasgow MONICA population survey. J Epidemiol Community Health 2000; 54:355-60. [PMID: 10814656 PMCID: PMC1731679 DOI: 10.1136/jech.54.5.355] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVE To determine the contribution of different foods to the estimated intakes of vitamin C among those differing in plasma vitamin C levels, and thereby inform dietary strategies for correcting possible deficiency. DESIGN Cross sectional random population survey. SETTING North Glasgow, Scotland, 1992. PARTICIPANTS 632 men and 635 women, aged 25 to 74 years, not taking vitamin supplements, who participated in the third MONICA study (population survey monitoring trends and determinants of cardiovascular disease). MEASUREMENTS AND MAIN RESULTS Dietary and sociodemographic information was collected using a food frequency and lifestyle questionnaire. Plasma vitamin C was measured in non-fasted venous blood samples and subjects categorised by cut points of 11.4 and 22.7 micromol/l as being of low, marginal or optimal vitamin C status. Food sources of dietary vitamin C were identified for subjects in these categories. Plasma vitamin C concentrations were compared among groups classified according to intake of key foods. More men (26%) than women (14%) were in the low category for vitamin C status; as were a higher percentage of smokers and of those in the older age groups. Intake of vitamin C from potatoes and chips (fried potatoes) was uniform across categories; while the determinants of optimal versus low status were the intakes of citrus fruit, non-citrus fruit and fruit juice. Optimal status was achieved by a combined frequency of fruit, vegetables and/or fruit juice of three times a day or more except in older male smokers where a frequency greater than this was required even to reach a marginal plasma vitamin C level. CONCLUSION Fruit, vegetables and/or fruit juice three or more times a day increases plasma vitamin C concentrations above the threshold for risk of deficiency.
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Affiliation(s)
- W L Wrieden
- Centre for Applied Nutrition Research, Matthew Building, University of Dundee, DD1 4HT
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Radimer KL, Allsopp R, Harvey PW, Firman DW, Watson EK. Food insufficiency in Queensland. Aust N Z J Public Health 1997; 21:303-10. [PMID: 9270158 DOI: 10.1111/j.1467-842x.1997.tb01704.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To investigate the prevalence of food insufficiency and factors associated with it, two questions assessing household and individual food insufficiency were included in 13 regional health surveys conducted in Queensland in 1993. The surveys used computer-assisted telephone interviewing methodology. Of the 10,451 people interviewed, 9.7 per cent and 6.4 per cent reported household and individual food insufficiency, respectively, and 11.3 per cent reported at least one type. Prevalence was significantly higher in women than men and in urban than rural residents, and decreased monotonically with increasing age from 16.6 per cent in 18- to 30-year-olds to 1.7 per cent in over-70-year-olds. Higher prevalence also was associated with lower income, unemployment, single or separated, divorced or widowed status versus married (or de facto), one-adult households, and shared accommodation. Lower prevalence was associated with more education in those aged 50 and under but not in those over 50 years. Using logistic regression to control simultaneously for important sociodemographic factors, we found that risk of food insufficiency was most highly associated with age and income (threefold risk), unemployment and shared accommodation (twofold risk) and one-adult households, and being single versus separated, widowed or divorced (one-and-a-half-fold risk). Some differences in risks existed between men and women and between rural and urban residents, although none excluded the role of chance. Association of the items with lower reported fruit, vegetable and meat intake, poorer health status, and greater underweight supports their validity.
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Affiliation(s)
- K L Radimer
- Department of Social and Preventive Medicine, University of Queensland, Brisbane
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Shepherd R, Paisley CM, Sparks P, Anderson AS, Eley S, Lean ME. Constraints on dietary choice: the role of income. ACTA ACUST UNITED AC 1996. [DOI: 10.1108/00346659610129198] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bolton-Smith C, Woodward M, Fenton S, McCluskey MK, Brown CA. Trans fatty acids in the Scottish diet. An assessment using a semi-quantitative food-frequency questionnaire. Br J Nutr 1995; 74:661-70. [PMID: 8541272 DOI: 10.1079/bjn19950169] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Trans fatty acids produced during hardening of oils have been associated with higher cholesterol levels and increased risk of heart disease. The potential risk from trans fatty acids may be greater in populations with relatively low intakes of essential fatty acids such as the Scots, who also have a high prevalence of heart disease. Means and ranges of trans fatty acid intakes are reported here for a Scottish population. A semi-quantitative food-frequency questionnaire was used to survey the diet of 10,359 Scottish men and women aged 40-59 years in 1984-6 as part of the baseline Scottish Heart Health Study. Trans fatty acid levels were calculated for each food item on the questionnaire and the total subdivided into that which is derived naturally (primarily by bacterial fermentation in ruminants) and that which is produced during industrial hydrogenation (hardening) of vegetable and fish oils. Means and ranges of intakes of each trans fatty acid variable were calculated by sex, age, smoking and social class groups. Mean total trans fatty acid intakes for men were 7.1 (SD 3.1) g/d, 2.7 (SD 2.9)% energy and for women were 6.4 (SD 2.9) g/d, 3.3 (SD 3.0)% energy. Industrially hydrogenated trans fatty acids made up nearly 58% of the total intake for men and 61% for women, with about 60% coming from cakes, biscuits and sweets, and 20% coming from the cheaper hard margarines. The main sources of the naturally derived trans fatty acids were red meat (27%), milk (20%), butter (18-19%) and cheese (13-16%). Differences between age, smoking and social class groups were apparent. However, apart from the social class differences of up to 1 g/d, these were so small that they are unlikely to be of any biological significance unless compounded by other factors such as marginal essential fatty acid adequacy. The possibility of trans fatty acid intakes up to 48 g/d and 12% total energy (compared with the Department of Health (1991) recommendations of 5 g/d or 2% energy) highlights the need for careful monitoring of the health risks at these high levels of intake.
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Affiliation(s)
- C Bolton-Smith
- Cardiovascular Epidemiology Unit, University of Dundee, Ninewells Hospital and Medical School
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Bolton-Smith C, Woodward M. Intrinsic, non-milk extrinsic and milk sugar consumption by Scottish adults. J Hum Nutr Diet 1995. [DOI: 10.1111/j.1365-277x.1995.tb00294.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mackeown J, Cleaton‐Jones P, Hargreaves J. Variety of individual food items consumed by 11‐year old children in Kwazulu and Namibia. Ecol Food Nutr 1994. [DOI: 10.1080/03670244.1994.9991414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wrieden WL, Bolton-Smith C, Brown CA, Tunstall-Pedoe H. Nutrient intakes in North Glasgow: results from the Scottish MONICA studies of 1986 and 1989. J Hum Nutr Diet 1994. [DOI: 10.1111/j.1365-277x.1994.tb00431.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Emmett PM, Symes CL, Heaton KW. The contribution of breakfast cereals to non-starch polysaccharide intakes in English men and women. J Hum Nutr Diet 1993. [DOI: 10.1111/j.1365-277x.1993.tb00365.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Emmett P, Symes C, Braddon F, Heaton K. Validation of a new questionnaire for assessing habitual intake of starch, non-starch polysaccharides, sugars and alcohol. J Hum Nutr Diet 1992. [DOI: 10.1111/j.1365-277x.1992.tb00159.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Radimer KL, Allsopp R, Harvey PWJ, Firman DW, Watson EK. Food insufficiency in Queensland. Aust N Z J Public Health 1977. [DOI: 10.1111/j.1467-842x.1977.tb00992.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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