Surveys of the Nutrition of Populations. Description of the Population, General Methods and Procedures, and the Findings in Respect to the Energy Principle (Calories) in a Rural Population in Middle Tennessee (Part 1)

Researching the impact of oral health on diet and nutritional status: methodological issues

OBJECTIVES

Assessment of the impact of dental function on diet and nutritional status requires robust methodologies and a standardised approach to increase accuracy of results and to facilitate cross study comparisons. The objectives of this paper are: to report the outcomes of a consensus workshop that critically reviewed publications reporting on dietary methodologies in relation to the impact of oral health on nutrition; to highlight future directions for research and; to make recommendations for appropriate use of methodologies for future research.

DATA

Data relevant to nutrition and dental status published from 1980 to 2005 in English were presented at the consensus workshop for discussion and appraisal.

SOURCES

Relevant papers were retrieved through PubMed. Relevant texts were obtained from the library at Newcastle University, UK.

STUDY SELECTION

A purposive sample of original articles that illustrated the application of a range of nutritional methodologies to the study of oral health impacts was identified. Original flagship texts on nutritional methodologies were reviewed.

CONCLUSIONS

Numerous studies have shown an association between loss of teeth and inferior diet. Further research is required to elucidate the impact of novel approaches to prosthetic rehabilitation and the impact of contemporaneous dietary and dental intervention on diet, nutritional status, disease progression and quality of life. The recommendation of the consensus workshop was that future studies should adopt a comprehensive approach to the assessment of nutrition that encompasses measurement of diet, body composition, biochemical indices of intake and levels of nutrients, and functional biomarkers of disease.

Do highly physically active females have a lowered basal metabolic rate?

In several studies estimated energy intake has been found to be low compared with estimated energy expenditure in female athletes. It has therefore been suggested that female athletes may have a depressed basal energy expenditure (BMR). The main purpose of the present study was to explore this possibility by measuring BMR in physically extremely active females. Eight female dancers and 7 controls with low physical activity, all musicians, were studied; the variables measured included body weight, height, skinfold thickness and total body potassium. BMR was measured by indirect calorimetry. In conclusion, the present study lends no support to the idea of a lowered basal metabolic rate in female athletes as an explanation of the general finding of a lower estimated energy intake than energy expenditure in this type of subjects.

Limitations in the assessment of dietary energy intake by self-report

Development of the doubly-labeled water method has made it possible to test the validity of dietary intake instruments for the measurement of energy intake. Comparisons of measured energy expenditure with energy intake from either weighed or estimated dietary records against energy expenditure have indicated that obese subjects, female endurance athletes, and adolescents underestimate habitual and actual energy intake. Individual underestimates of 50% are not uncommon. Even in non-obese adults, where bias is minimal, the standard deviation for individual errors in energy intake approaches 20%. Two investigations of the validity of self-reported dietary records for measuring change in dietary intake also indicate large underestimates of the actual change. Because of bias and imprecision, self-reported energy intakes should be interpreted with caution unless independent methods of assessing their validity are included in the experimental design.

Appraisal of Nutritional Status: Including Some Recent Observations on Iron and Lactobacillus casei Factor (Vitamin M, Folic Acid)

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