Dietary reference intakes: a comparison with the Nova Scotia Nutrition Survey

Dietary nutrients and anthropometry of Dene/Métis and Yukon children

OBJECTIVE

To describe nutrient intakes and anthropometry of 10-12-year-old Dene/Métis and Yukon children in the Canadian Arctic.

STUDY DESIGN

24 h-recall interviews (n = 222 interviews) were conducted on Canadian Dene/Métis and Yukon children in five communities during two seasons in 2000-2001; the children were measured for height and weight (n = 216).

METHODS

Assessment of nutrient adequacy used Dietary Reference Intakes (DRIs) including cut-point procedures. Anthropometric measurements (height and weight) were assessed and body mass index (BMI) was compared to the 2000 CDC Growth Charts.

RESULTS

Thirty-two percent of the children were above the 85th percentile of BMI-for-age. More than 50 percent of children were below the Estimated Average Requirement (EAR) for vitamins A and E, phosphorus and magnesium; mean intakes were below the Adequate Intake (AI) for vitamin D, calcium, dietary fiber, omega-6 fatty acids, and omega-3 fatty acids. Nutrients that were probably adequate for some gender/season groups were protein, carbohydrate, iron, copper, selenium, zinc, manganese, riboflavin and vitamins B6 and C.

CONCLUSIONS

Excessive prevalence of overweight and inadequacy of some nutrients were observed among Dene/Métis and Yukon children, suggesting a necessity for dietary improvement. However, many nutrients were adequate, in some cases probably due to continued traditional food use.

Smoking, Adolescents and Health: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, ages11-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR=3.34, 95%CI: 2.33, 4.77, p<0.001). The mean values of total-and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33± 33.83, 90.73± 31 and 46.7± 12.24 vs.156± 29.53, 85±26.5 and 49.4±13.7 mg/dl, respectively, p<0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7± 14.5, 67.6± 11.55 vs. 104.9± 14.3, 63.2± 10.8 mmHg, respectively, p<0.05). The smokers had higher BMI than non-smokers (20.34 ±3.84 vs.19.55 ± 3.66, p<0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions. Asia Pac JPublic Health 2004; 16(1): 15-22.

Fast food and deprivation in Nova Scotia

OBJECTIVE

To examine the relationship between density of fast food restaurants and measures of social and material deprivation at the community level in Nova Scotia, Canada.

METHODS

Census information on population and key variables required for the calculation of deprivation indices were obtained for 266 communities in Nova Scotia. The density of fast food restaurants per 1000 individuals for each community was calculated and communities were divided into quintiles of material and psychosocial deprivation. One-way analysis of variance was used to investigate associations between fast food outlet densities and deprivation scores at the community level.

RESULTS

A statistically significant inverse association was found between community-level material deprivation and the mean number of fast food restaurants per 1000 people for Nova Scotia (p < 0.000). Significant positive relationships were found between density of fast food restaurants and psychosocial deprivation (p < 0.000). Both associations were principally linear with greater fast food outlet density occurring as material deprivation decreased and as psychosocial deprivation increased.

INTERPRETATION

Community-level deprivation in Nova Scotia is associated with fast food outlet density and lends support for environmental explanations for variations in the prevalence of obesity. Such findings are valuable to population health intervention initiatives targeting the modification of environmental determinants of obesity.

Dietary intakes of Canadians in the 1990s using population-weighted data derived from the provincial nutrition surveys

Provincial nutrition surveys of adults were conducted between 1990 and 1999 in Canada. Eight reports have been issued, and one is forthcoming. The purpose of this study was to estimate the national dietary intake of adult Canadians, using the publicly available data. Group mean-nutrient-intake data from 16 915 adults, aged 18 to 84 years, from published provincial reports were collated by age and sex for each of 9 provinces (Manitoba data were unavailable). Using Canadian census data appropriate to the year of collection, intake data were weighted to provide 1 national intake value for each nutrient, by 8 age and sex categories. In general, the energy and nutrient intake of adults decreased with age. For every age group, with the exception of vitamin C, intake of nutrients by men was greater than that by women. On the basis of a comparison of recently recommended intakes (Dietary Reference Intakes), the nutrients that are of concern because of inadequate intake include dietary fibre, calcium, magnesium, and folate. The data demonstrate the impact of folate fortification on folate intake; the mean intake became twice that of prefortification levels. This study used group mean-intake data; therefore, we cannot make definitive conclusions about the prevalence of inadequacy for the nutrients. Because of limitations with some provincial response rates, our data should not be construed as representative of the Canadian population. However, because these surveys were completed between the 19701972 Nutrition Canada Survey and the 2004 Canadian Community Health Survey, these population-weighted data might be a useful point of comparison for monitoring trends in nutrient intake from food.

Selecting a healthy diet score: lessons from a study of diet and health in early old age (the Boyd Orr cohort)

OBJECTIVES

To describe the selection and modification of an appropriate diet score to assess diet quality in early old age.

DESIGN AND SETTING

Cross-sectional analyses of the Boyd Orr cohort - a long-term follow-up of men and women whose families took part in a survey of diet and health in pre-war Britain. Dietary data were obtained from a 113-item food-frequency questionnaire. A nine-item Healthy Diet Indicator (HDI) developed by Huijbregts and colleagues was identified from the literature and modified because some dietary variables were unavailable and to accord more closely with recommendations of the UK Committee on Medical Aspects of Food Policy.

SUBJECTS

In total, 1475 traced, surviving cohort members aged 60 years and over.

RESULTS

Modification resulted in a 12-item Healthy Diet Score (HDS). We found that about half the variation in the HDS was explained by variation in the HDI (r=0.71). There was, however, little misclassification of subjects (<10%) into extreme thirds of the distribution by the HDS compared with the HDI. Items of the score most strongly correlated with overall score were saturated fat (r=-0.57), red meat (r=-0.46), dietary fibre (r=0.58), fruit and vegetables (r=0.54) and percentage energy from carbohydrates (r=0.51). Modifying existing items had greater impact on agreement between HDI and HDS than the addition of new items.

CONCLUSIONS

The selection and modification of diet scores is more complicated than often assumed. Furthermore, modest changes to an existing score can produce a score that is different from the original, and although it was not possible to test this issue, it may no longer predict subsequent health experience.

Individual and neighbourhood determinants of health care utilization. Implications for health policy and resource allocation

OBJECTIVES

To investigate the importance of both individual and neighbourhood socioeconomic characteristics for health care utilization.

METHODS

Various linkage procedures generated a longitudinal dataset with information on 2,116 Nova Scotians, their residential neighbourhoods, 8 years of health care utilization and vital status. Unilevel and multilevel regression analyses were employed to examine the effects of both individual and neighbourhood characteristics on health care use.

RESULTS

Individual income and education determined physician and hospital use. Also, neighbourhood characteristics, specifically average income and percentage of single mother families, were found to determine health care use. When considering individual and neighbourhood characteristics simultaneously, individual income and education determined physician and hospital use independently, while neighbourhood income determined physician use independently.

CONCLUSIONS

Both individual and neighbourhood socioeconomic characteristics determine health care use. Acknowledging this allows better targeting of health policy and planning, and enables more accurate needs-based resource allocation.

Dietary iron as a risk factor for myocardial infarction. Public health considerations for Nova Scotia

BACKGROUND

Epidemiological and experimental studies have suggested that high levels of dietary iron and hemeiron can lead to myocardial injury. Lean meat, a primary source of iron and hemeiron, is promoted because it is lower in fat and cholesterol. Does lean meat put us at risk for myocardial infarction, and should we reconsider its promotion?

METHODS

We analyzed the importance of dietary iron and hemeiron as a risk for myocardial infarction among 2,198 Nova Scotians who participated in a nutrition survey and who were followed for eight years, using logistic regression.

RESULTS

Acute myocardial infarction incidents occurred in 94 (4.3%) participants. We found no increased risk for myocardial infarction associated with high intake of iron and hemeiron.

CONCLUSIONS

Based on Nova Scotian data showing no increased risk for myocardial infarction with high intake of iron and hemeiron, there is no need for immediate reconsideration of promotion of lean meat.