Family food behaviours and adolescents' overweight status: a mother-offspring link study

BACKGROUND

The role of family food behaviours on weight status of family members is not well understood. The objective of this study was to examine the influence of some aspects of family food behaviours on adolescents overweight.

METHOD

In a cross-sectional mother-child-linked study design, participants were a subsample of 3862 adolescents (51.9% boys) from the Mater hospital-University of Queensland Study of Pregnancy (MUSP), a longitudinal study of a birth cohort of 7,223 women and their offspring. Information on aspects of family food behaviours (family meal patterns and influences, frequency of family food consumption, and influences on family food selection) was collected by self reported questionnaires from mothers in a 14 years follow up (in 1994-1997) and other covariates at different stages of follow-ups. Body Mass Index of the adolescents was calculated using measured height and weight.

RESULTS

Being overweight at 14 years had significant negative associations with mothers' report on the importance of family meals (OR=1.28), frequency of eating cake/biscuits (OR=1.71), and significant positive association with mothers' report on frequency of consumption of cooked vegetables (OR=1.32), soft drinks (OR=1.60) and importance of fattening of foods (OR=1.27).

CONCLUSION

The study confirmed the importance of the family and some family food behaviours in shaping risk of being overweight amongst adolescents. Because of the cross-sectional nature of this study, we could not conclude that they had casual correlations. Comparison with the literature suggests that some of these effects may be specific to particular contexts, potentially affected by cultural and socio-economic differences.

Randomised comparison of the effects of Sprinkles and Foodlets with the currently recommended supplement (Drops) on micronutrient status and growth in Iranian children

BACKGROUND/OBJECTIVES

Multiple micronutrient supplementation with Sprinkles powder and crushable Foodlets tablets may be effective means of controlling micronutrient deficiencies in infants. Their efficacy has not been tested in countries like Iran where wheat as the staple food may affect nutrient bioavailability. This study aimed to compare the efficacy of Sprinkles, Foodlets and the current supplement (Drops) for improving micronutrient status and growth among Iranian infants.

SUBJECTS/METHODS

Infants of 6-18 months of age, living in an urban district of Iran were randomised to receive daily Sprinkles (n=120), Foodlets (n=121) or Drops (n=121) for 4 months. Haemoglobin (Hb), serum ferritin, serum retinol, serum zinc, 25(OH) D concentration and anthropometry were assessed at baseline and at 4 months.

RESULTS

Iron status improved with all treatments. Drops showed significantly greater changes in Hb and serum ferritin, though changes in anaemia prevalence were not different across groups. Infants having Foodlets and Sprinkles had significantly greater reductions in proportion of children with zinc deficiency compared with Drops. No significant differences in treatment effects were observed for mean serum 25(OH) D and retinol, or for growth of infants across groups.

CONCLUSION

The study was the first efficacy trial with Sprinkles and Foodlets in the Middle East where wheat or rice is the principal complementary foods. Differences across treatment groups were largely consistent with supplement micronutrient composition for iron and zinc, with no benefit in this population for serum retinol, 25(OH) D, growth or anthropometric status. The trial identified trade-offs in combining multiple micronutrients in a single delivery mechanism.

Validation of a FFQ to estimate the intake of PUFA using plasma phospholipid fatty acids and weighed foods records

Due to the growing knowledge about the role of specific fatty acids in health and disease, dietary intake measurements of individual fatty acids or classes of fatty acids are becoming increasingly important. The objective of this study was to evaluate the ability of the Nambour FFQ to estimate intakes of specific fatty acids, particularly PUFA. The study population was a sub-sample of adult participants in a randomised controlled trial of beta-carotene and sunscreen in the prevention of skin cancer (n 43). Dietary intake was assessed by a self-administered FFQ and a weighed food record (WFR). Non-fasting blood samples were collected and analysed for plasma phospholipid fatty acids. Median intakes on the FFQ were generally higher than the WFR except for the n-3 PUFA groups, where the FFQ estimated higher intakes. Correlations between the FFQ and WFR were moderate (r 0 x 32-0 x 59) except for trans fatty acids (r 0 x 03). Correlations between each of the dietary assessment methods and the plasma phospholipids were poor for all fatty acids other than the PUFA. Using the methods of triads approach, the FFQ validity coefficients for total n-3 fatty acids, total long chain n-3 fatty acids, EPA, arachidonic acid, docosapentaenoic acid and DHA were 0 x 50, 0 x 63, 0 x 45 and 0 x 62 and 0 x 62, respectively. For most fatty acids, the FFQ adequately estimates group mean fatty acid intakes and can adequately rank individuals; however, the ability of this FFQ to estimate trans fatty acids was poor.

Alcohol intake and risk of skin cancer: a prospective study

OBJECTIVE

To investigate the association between total alcohol intake and intake of different types of alcoholic beverages in relation to the risk of basal cell (BCC) and squamous cell (SCC) carcinoma of the skin.

DESIGN

Prospective cohort study.

SETTING

Follow-up data from a community-based skin cancer study in Australia.

SUBJECTS

Randomly selected sample of 1360 adult residents of the township of Nambour who completed a food frequency questionnaire in 1992 and were monitored for BCC and SCC until 31 December 2002.

RESULTS

No significant association was found between overall BCC or SCC risk and total alcohol intake, or intake of beer, white wine, red wine or sherry and port. However, among those with a prior skin cancer history, there was a significant doubling of risk of SCC for above-median consumption of sherry and port (multivariable adjusted relative risk 2.46, 95% confidence interval 1.06-5.72) compared with abstainers.

CONCLUSIONS

There are no associations between first occurrence of skin cancers and alcoholic beverage consumption. People with a history of skin cancer who consume above-average quantities of sherry or port may be at a raised risk of SCC, although replication of these findings in different study populations is needed to confirm this possible role of specific alcoholic beverages in secondary keratinocytic skin cancer risk.

Factors to consider in Micronesian food-based interventions: a case study of preventing vitamin A deficiency

Background:

Many factors need to be considered in a food-based intervention. Vitamin A deficiency and chronic diseases, such as diabetes, heart disease and cancer, have become serious problems in the Federated States of Micronesia (FSM) following the decreased production and consumption of locally grown foods. However, agricultural and social conditions are still favourable for local food production.

Aim:

To identify key factors to consider in a Micronesian food-based intervention focusing on increased production and consumption of four major Micronesian staple foods: banana, breadfruit, giant swamp taro and pandanus.

Methods:

Ethnographic methods including key informant interviews and a literature review.

Results:

Pacific and Micronesian values, concepts of food and disease, and food classifications differ sharply from Western concepts. There are few FSM professionals with nutrition expertise. Traditional foods and food cultivars vary in nutrient content, consumption level, cost, availability, status, convenience in growing, storing and cooking, and organoleptic factors.

Conclusions:

A systematic consideration of the factors that relate to a food-based intervention is critical to its success. The evaluation of which food and cultivar of that food that might be most effectively promoted is also critical. Regional differences, for example FSM inter-island differences between the staple foods and cultivars, must be considered carefully. The evaluation framework presented here may be relevant to Pacific Island and other countries with similar foods where food-based interventions are being planned. An ethnographic approach was found to be essential in understanding the cultural context and in data collection and analysis.

Identifying competencies for Australian health professionals working in international health

A profile of the roles performed by Australian health professionals working in international health was constructed to identify the core competencies they require, and the implications for education and training of international health practitioners. The methods used included: literature review and document analysis of available training and education; an analysis of competencies required in job descriptions for international health positions; and consultations with key informants. The international health roles identified were classified in four main groups: Program Directors, Program Managers, Team Leaders and Health Specialists. Thirteen 'core' competencies were identified from the job analysis and key informant/group interviews. Contributing to international health development in resource poor countries requires high level cultural, interpersonal and teamwork competencies. Technical expertise in health disciplines is required, with flexibility to adapt to new situations. International health professionals need to combine public health competencies with high level personal maturity to respond to emerging challenges.

Validation of a food-frequency questionnaire assessment of carotenoid and vitamin E intake using weighed food records and plasma biomarkers: The method of triads model

BACKGROUND

Reliability or validity studies are important for the evaluation of measurement error in dietary assessment methods. An approach to validation known as the method of triads uses triangulation techniques to calculate the validity coefficient of a food-frequency questionnaire (FFQ).

OBJECTIVE

To assess the validity of an FFQ estimates of carotenoid and vitamin E intake against serum biomarker measurements and weighed food records (WFRs), by applying the method of triads.

DESIGN

The study population was a sub-sample of adult participants in a randomised controlled trial of beta-carotene and sunscreen in the prevention of skin cancer. Dietary intake was assessed by a self-administered FFQ and a WFR. Nonfasting blood samples were collected and plasma analysed for five carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, lycopene) and vitamin E. Correlation coefficients were calculated between each of the dietary methods and the validity coefficient was calculated using the method of triads. The 95% confidence intervals for the validity coefficients were estimated using bootstrap sampling.

RESULTS

The validity coefficients of the FFQ were highest for alpha-carotene (0.85) and lycopene (0.62), followed by beta-carotene (0.55) and total carotenoids (0.55), while the lowest validity coefficient was for lutein (0.19). The method of triads could not be used for beta-cryptoxanthin and vitamin E, as one of the three underlying correlations was negative.

CONCLUSIONS

Results were similar to other studies of validity using biomarkers and the method of triads. For many dietary factors, the upper limit of the validity coefficients was less than 0.5 and therefore only strong relationships between dietary exposure and disease will be detected.

Development of a food composition database for the estimation of dietary intakes of glucosinolates, the biologically active constituents of cruciferous vegetables

Evidence indicates that cruciferous vegetables are protective against a range of cancers with glucosinolates and their breakdown products considered the biologically active constituents. To date, epidemiological studies have not investigated the intakes of these constituents due to a lack of food composition databases. The aim of the present study was to develop a database for the glucosinolate content of cruciferous vegetables that can be used to quantify dietary exposure for use in epidemiological studies of diet-disease relationships. Published food composition data sources for the glucosinolate content of cruciferous vegetables were identified and assessed for data quality using established criteria. Adequate data for the total glucosinolate content were available from eighteen published studies providing 140 estimates for forty-two items. The highest glucosinolate values were for cress (389 mg/100 g) while the lowest values were for Pe-tsai chinese cabbage (20 mg/100 g). There is considerable variation in the values reported for the same vegetable by different studies, with a median difference between the minimum and maximum values of 5.8-fold. Limited analysis of cooked cruciferous vegetables has been conducted; however, the available data show that average losses during cooking are approximately 36 %. This is the first attempt to collate the available literature on the glucosinolate content of cruciferous vegetables. These data will allow quantification of intakes of the glucosinolates, which can be used in epidemiological studies to investigate the role of cruciferous vegetables in cancer aetiology and prevention.

Association between clinical type of diarrhoea and growth of children under 5 years in rural Bangladesh

BACKGROUND

The role of diarrhoea in the aetiology of growth retardation in young children remains controversial. To evaluate this, a population-based, longitudinal study of young children aged 6-48 months was conducted in Matlab, a rural area of Bangladesh, between May 1988 and April 1989.

METHODS

Data obtained from 584 children were examined by one-year (n = 412) and 3-month (n = 1220) growth periods. Each growth period was analysed based on clinical types of diarrhoea, namely, non-diarrhoea, non-dysentery diarrhoea (diarrhoea without blood), and dysentery (diarrhoea with blood). Weight and height gains were compared among the study groups initially by one-way analysis of variance followed by multivariate analysis adjusting for potential confounding variables.

RESULTS

Compared to non-diarrhoea and non-dysentery diarrhoea, dysentery was associated with significantly lower annual weight gain (1866 g [P < 0.01] and 1550 g [P < 0.05] versus 1350 g, respectively) and height gain (6.51 cm and 5.87 cm versus 5.27 cm [P < 0.01], respectively). Both 3-month dysentery and non-dysentery intervals were significantly associated with less weight gain compared to non-diarrhoea intervals (490 g and 522 g versus 637 g [P: < 0.05], respectively). Dysentery intervals were also associated with significantly poorer height gain compared to other intervals (2.19 cm versus 2.42 cm [P < 0.05] and 2.46 cm [P < 0.01], respectively).

CONCLUSIONS

The growth of young children is strongly influenced by the clinical type of diarrhoea and the impact is dependent on the proportion of dysentery episodes in the total diarrhoeal burden.

Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial

BACKGROUND

The use of sunscreens on the skin can prevent sunburn but whether long-term use can prevent skin cancer is not known. Also, there is evidence that oral betacarotene supplementation lowers skin-cancer rates in animals, but there is limited evidence of its effect in human beings.

METHODS

In a community-based randomised trial with a 2 by 2 factorial design, individuals were assigned to four treatment groups: daily application of a sun protection factor 15-plus sunscreen to the head, neck, arms, and hands, and betacarotene supplementation (30 mg per day); sunscreen plus placebo tablets; betacarotene only; or placebo only. Participants were 1621 residents of Nambour in southeast Queensland, Australia. The endpoints after 4.5 years of follow-up were the incidence of basal-cell and squamous-cell carcinomas both in terms of people treated for newly diagnosed disease and in terms of the numbers of tumours that occurred. Analysis of the effect of sunscreen was based only on skin cancers that developed on sites of daily application. All analyses were by intention to treat.

FINDINGS

1383 participants underwent full skin examination by a dermatologist in the follow-up period. 250 of them developed 758 new skin cancers during the follow-up period. There were no significant differences in the incidence of first new skin cancers between groups randomly assigned daily sunscreen and no daily sunscreen (basal-cell carcinoma 2588 vs 2509 per 100,000; rate ratio 1.03 [95% CI 0.73-1.46]; squamous-cell carcinoma 876 vs 996 per 100,000; rate ratio 0.88 [0.50-1.56]). Similarly, there was no significant difference between the betacarotene and placebo groups in incidence of either cancer (basal-cell carcinoma 3954 vs 3806 per 100,000; 1.04 [0.73-1.27]; squamous-cell carcinoma 1508 vs 1146 per 100,000; 1.35 [0.84-2.19]). In terms of the number of tumours, there was no effect on incidence of basal-cell carcinoma by sunscreen use or by betacarotene but the incidence of squamous-cell carcinoma was significantly lower in the sunscreen group than in the no daily sunscreen group (1115 vs 1832 per 100,000; 0.61 [0.46-0.81]).

INTERPRETATION

There was no harmful effect of daily use of sunscreen in this medium-term study. Cutaneous squamous-cell carcinoma, but not basal-cell carcinoma seems to be amenable to prevention through the routine use of sunscreen by adults for 4.5 years. There was no beneficial or harmful effect on the rates of either type of skin cancer, as a result of betacarotene supplementation.

The dietary intake of chemical residues in Brisbane adults

The purpose of this work was to integrate existing chemical residue and food consumption data for individuals to improve estimates of the dietary intake of chemical residues in the population of Brisbane. Previous estimates of intakes from the Australian Market Basket Survey (AMBS) have been based on energy-adjusted 'hypothetical national diets' and so allow no assessment of variation in intakes between individuals or groups. Data on concentration of fenitrothion, chlorpyrifos-methyl, pirimiphos-methyl, heptachlor and dieldrin in selected foods were taken from reports of the AMBS. Food consumption data were based upon the National Dietary Survey of Adults (NDSA) 1983; the same data from which the hypothetical diets are derived. The distribution of estimated 24-hour intakes was adjusted to represent usual intakes. Mean intakes of all residues were about one third those reported previously. None of the observed diets contained levels of residues that were greater than the Acceptable Daily Intakes. These findings support reassurances to the public that residues of agricultural chemicals monitored in the AMBS do not pose a health risk.

Development of a dietary supplement database

Data describing the composition of dietary supplements are not readily available to the public health community. As a result, intake from dietary supplements is generally not considered in most dietary surveys and, hence, little is known about the significance of supplement intake in relation to total diet or disease risk. To enable a more comprehensive analysis of dietary data, a database of the composition of various dietary supplements has been compiled. Active ingredients of all dietary supplements sold in Australia are included in the Australian Register of Therapeutic Goods (ARTG), maintained by the Therapeutic Goods Administration. Products included in the database were restricted to those vitamin, mineral and other supplements identified in dietary data collected from studies conducted in southeast Queensland and New South Wales (850 supplements). Conversion factors from ingredients compounds to active elements were compiled from standard sources. No account has been made for bioavailability, consistent with current practice for food composition databases. The database can be queried by ARTG identification number, brand, product title, or a variety of other fields. Expected future developments include development of standard formulations for use when supplements are incompletely specified, and expansion of products included for more widespread use.

Nutrition and health in South-East Asia

Poor nutrition remains a significant contributor to morbidity and mortality in South-East Asia. Manifestations of this include protein-energy malnutrition, iodine deficiency diseases, vitamin A deficiency, iron deficiency and some non-communicable diseases of adults. The extent of these diseases, and their interactions with infection, make nutrition the single most important modifiable host factor underlying health status in the region. It is vital that long-term sustainable programs for the control of nutrition problems are accorded a high priority within the health sector.

Metalaxyl and phosphonate as prophylactic and curative agents against stem infection of Leucadendron caused by Phytophthora cinnamomi

Neither metalaxyl (100 mL of a solution of 2.0 g a.i./L, applied as a root drench to 10-L pots) nor phosphonate (foliar spray at 1.0 g a.i./L, applied to runoff) controlled Phytophthora cinnamomi stem infection of Leucadendron laureolum x L. salignum hybrid when applied 10 days after inoculation. Both fungicides were most effective when applied prior to inoculation. Neither fungicide was able to kill P. cinnamomi within established infections. The fungus survived within the vascular tissues of treated plants. Infection was confined to cortical tissue by wound periderm when the rate of tissue invasion by P. cinnamomi was slowed by the fungicides. The results confirm observations made in protea growers' fields that with highly susceptible species, systemic fungicides can have poor curative properties and should be used as a prophylactic, in conjunction with other disease control methods.

Nutritional surveillance in Australia: a case of groping in the dark?

Nutritional surveillance means to watch over nutrition in order to make decisions and take actions to improve nutrition in populations. The information obtained through the surveillance system can be used in at least four areas--policy analysis, planning, program management and research. However, in Australia the information currently available is less than adequate for many key questions in these areas. The present state of infrequent and irregular data collection and analysis handicaps our efforts to understand the nutrition situation and to implement effective strategies to improve the nutritional health of Australians.

Reliability, dependability, and precision of anthropometric measurements. The Second National Health and Nutrition Examination Survey 1976-1980

The components of reliability for eight anthropometric measures were studied in 95 male and 134 female subjects from the Second National Health and Nutrition Examination Survey (NHANES II). The contributions to unreliability variance (Sr2) that occur as a result of measuring errors (Sp2, imprecision variance) and of intrasubject fluctuations in a measurement due to physiologic factors (Sd2, undependability) were estimated (Sr2 = Sp2 + Sd2). Unreliability was then related to the between-subject variance (S2) to estimate the reliability (R = 1 - (Sr2/S2)) of the measurement. Four of the anthropometric measurements (weight, height, sitting height, and arm circumference) had reliabilities in excess of R = 0.97. In the first three of these, measurement imprecision made up two thirds or less of unreliability, and undependability (Sd2) was stable by two weeks. Lesser but still acceptable reliabilities were obtained for triceps and subscapular skinfolds, bitrochanteric breadth, and elbow breadth (R = 0.81-0.95). For these variables imprecision (Sp2) was the major source of error. Furthermore, the unreliability (Sr2) between observers was twice as high or more than the unreliability within observers for these variables, evidence that imprecision (Sp2) is the single most important source of unreliability in these anthropometric measurements. Unreliability standard deviations of skinfolds increased in a linear manner with skinfold thickness corresponding to an unreliability coefficient of variation of 13-19 per cent. None of the other measurements showed such scale effects. Analyses of the kind suggested will help epidemiologists decide whether reliability can be increased by improving precision, and whether there is a need to improve reliability in the first place. Reliability appears to be adequate for all anthropometry in the NHANES II.

Penetration and infection of alfalfa roots by Phytophthora megasperma and the pathological anatomy of infected roots

Penetration of the fine roots of Vernal alfalfa by Phytophthora megasperma was investigated in solution culture. The zoospores encysted on the root tips around the zone of cell division and cell extension and directly penetrated the host by a small infection peg. No appressoria were observed, but the flattened base of the cyst adhered to the host and appeared to serve the same function. Inside the root the hyphae were inter- and intra-cellular. In naturally infested and artificially inoculated field soils most of the fine roots were destroyed and large lesions appeared on the tap root. The latter originated from infection of the spongy-phellem cells formed around the base of the fine lateral roots. Restricted lesion development on the tap root was associated with the formation of wound periderm around the infection court. No wound periderm was formed when the vascular system was infected and only minor damage occurred when invasion was restricted to the cortex. Root damage reduced growth rates in older plants and severe infection produced yellow foliage, premature defoliation, and wilting.

Observations on the Mycorrhizas of Forest Trees. II. The Rhizosphere of Pinus Radiata D. Don

Two common mycorrhiza types of Pinus radiata were examined by light and electron microscopy. Large numbers of bacteria and fungal species other than those forming the mycorrhiza as well as diatoms were observed in the mycorrhizosphere. Different morphological types of bacteria were characteristic of different mycorrhizal types, and in some cases the bacteria were associated with lysed regions of the mantle. The distribution of the bacteria within the rhizosphere is discussed in relation to the clay minerals and the carbohydrate and polyphenol metabolisms of the host.

The Fine Structure of the Mycorrhizas of Pinus Radiata D. Don

The fine structure of one of two common types of mycorrhiza formed by Pinus radiata D. Don is described. The results showed inter alia that the ability of a fungus to form mycorrhiza depended on its tolerance to polyphenolic compounds in the so-called tannin layer of the cortex. Hartig net formation is a process in which the invading fungus lysed the middle lamellae and then separated the cells of the host by mechanical action. Evidence of the transfer of carbohydrate from the cortical cells of the host into the fungus in the Hartig net was obtained. Typical dolipore septae were observed both in the mantle and Hartig net hyphae. A new and hitherto undescribed structure was observed in the fungal partner.