Evolution of food intake estimates in Brazil: the 2008-2009 and 2017-2018 National Dietary Surveys / Evolução das estimativas da quantidade dos alimentos consumidos no Brasil: Inquérito Nacional de Alimentação 2008-2009 e 2017-2018

ABSTRACT Objective To present changes in the estimated amount of food intake in Brazil between the 2008-2009 and 2017-2018 National Dietary Surveys. Methods Food intake data from the 2008-2009 and 2017-2018 surveys were used to highlight the differences in the frequencies of foods mentioned, the number of the measurement units mentioned, and the frequency of measurements that were incompatible with the reported food and were exchanged by the most mentioned measurement (standard measurement), as well as to describe the updates performed in the database between edits. Results The elaboration of the 2017-2018 referenced measurement table was based on the 2008-2009 table, which was revised and updated. In the 2008-2009 survey, 9980 household measurements were mentioned for 1970 types of food and preparations, while in 2017-2018 there were 11050 and 2534, respectively. While in 2008-2009, 2.8% of citations were replaced by the standard measurement, in 2017-2018, only 0.7% of food items needed to be replaced. Conclusion The procedures used to estimate the amount of food intake between the surveys allowed updating the table of household measurements and minimizing errors in the estimate of this amount, with a reduction in measurement units that were inconsistent or incompatible with the aforementioned foods.

RESUMO Objetivo Apresentar a evolução na estimativa da quantidade dos alimentos consumidos no Brasil entre os Inquéritos Nacionais de Alimentação de 2008-2009 e de 2017-2018. Métodos Foram utilizados dados de consumo alimentar de 2008-2009 e de 2017-2018 para evidenciar as diferenças nas frequências de citações, nos números de unidades de medidas citadas e na frequência de medidas incompatíveis com o alimento que foram substituídas pela medida citada com maior frequência (medida padrão), bem como descrever as atualizações realizadas no banco de dados entre as edições. Resultados A construção da tabela de medidas referidas de 2017-2018 foi baseada na tabela de 2008-2009, a qual foi revisada e atualizada. No inquérito de 2008-2009 foram citadas 9980 medidas caseiras para 1970 alimentos e preparações, enquanto em 2017-2018 foram 11050 para 2534, respectivamente. Enquanto em 2008-2009 2,8% das citaçoes foram substituídas pela medida padrao, em 2017-2018, somente 0,7% dos alimentos precisaram ser substituídos. Conclusão Os procedimentos utilizados na estimativa de quantidade de alimentos consumidos entre os inquéritos permitiram atualizar a tabela de medidas caseiras e minimizar erros na estimativa dessa quantidade, com redução de unidades de medidas incoerentes ou incompatíveis com os alimentos citados.

Variedad en la calidad de la dieta en adultos españoles y mexicanos / Diet quality variety in Spanish and Mexican adults

La pérdida de patrones de alimentación tradicionales a favor de otros más occidentales redunda en un descenso de calidad de la dieta alrededor del mundo. Muchos aspectos determinan la calidad dietética, aunque en general pueden resumirse en una dieta moderada, variada, equilibrada y adecuada para cada individuo. Estos aspectos son evaluados por el Diet Quality Index-International (DQI-I). Objetivo: Comparar la calidad de la dieta de población mexicana y española mediante un índice de calidad internacional de la dieta, determinando que factores son en mayor medida responsables de la pérdida de calidad. Material y métodos: Estudio observacional transversal sobre una muestra representativa de sujetos adultos residentes en Querétaro (México) y de sujetos de la misma franja de edad procedentes de la Región de Murcia, en la cuenca mediterránea española. Se recogieron datos sociodemográficos, antropométricos, de frecuencia de consumo de alimentos y de ingesta con 3 recuerdos de 24 horas y se valoró el DQI-I en la población. Resultados: Se encontraron diferencias para el gasto energético y el DQI-I en todos sus aspectos con valores de calidad superiores para la población mexicana. La variedad fue la dimensión más castigada para todos los sujetos, presentando los mexicanos mejores cifras de consumo de vegetales pero peores para las fuentes proteicas. Conclusiones: La muestra mexicana mejoró las cifras de calidad de la española, tal vez por una mayor influencia de conocimientos en nutrición. El 86% de la población podría mejorar sus puntajes de calidad en el DQI-I ajustando sus frecuencias de consumo de alimentos(AU)

The loss of traditional eating patterns in favour of more Western ones results in a decline in dietary quality around the world. Many aspects determine dietary quality, but in general they can be summarised as a moderate, varied, balanced diet suitable for each individual. These aspects are assessed by the Diet Quality Index-International (DQI-I). Objective: To compare the quality of the diet of the Mexican and Spanish populations using an international diet quality index, determining which factors are most responsible for the loss of quality. Material and methods: Cross-sectional observational study on a representative sample of adult subjects living in Querétaro (Mexico) and subjects of the same age group from the Region of Murcia, in the Spanish Mediterranean basin. Sociodemographic, anthropometric, food frequency consumption and intake data were collected with 3 24-hour recall and the DQI-I was assessed in the population. Results: Differences were found for energy expenditure and DQI-I in all aspects with higher quality values for the Mexican population. Variety was the most punished dimension for all subjects, with Mexicans presenting better figures for vegetable intake but worse for protein sources. Conclusions: The Mexican sample improved the quality figures of the Spanish sample, perhaps due to a greater influence of nutritional knowledge. Eighty-six percent of the population could improve their DQI-I quality scores by adjusting their food consumption frequencies(AU)

Is there a relationship between diet quality and bone health in elderly women? A cross-sectional study

ABSTRACT Objective: To evaluate whether there is a relationship between diet quality and bone health in a group of elderly Brazilian women. Subjects and methods: A cross-sectional study was performed with 105 elderly women. Participants were evaluated regarding diet quality (good, needing improvement, and poor) and its relationship with bone mineral density (BMD), bone-specific alkaline phosphatase (BSAP), and C-telopeptide (CTX). Results: Fifty eight participants (55.2%) presented a poor-quality diet and 47 (44.8%) required dietary improvements, while no subjects presented a good quality diet. The group requiring dietary improvements had lower CTX [0.35 (0.05;1.09) vs. 0.52 (0.10;1.45); p = 0.03)] and BSAP (38.7 ± 12.9 U/L vs. 46.10 ± 15.2 U/L; p < 0.01) levels than the poor-quality diet group. Groups did not differ in terms of BMD. Conclusion: In this group of elderly Brazilian women, there was a relationship between diet quality and bone health, where worse diet quality was associated with higher levels of bone remodelling markers.

Are there differences in nutrient intake of Brazilian adults according to weight status? / Há diferenças na ingestão de nutrientes de adultos brasileiros segundo a condição de peso?

Abstract It was assessed the intake and prevalence of inadequate nutrient intake according to weight status among Brazilian adults from urban areas (n=16,198) evaluated in the Brazilian National Dietary Survey (NDS - 2008-2009), that obtained food records from two non-consecutive days. The prevalence of inadequate nutrient intake according to weight status was estimated based on Brazilian and international recommendations, in which usual intake was estimated applying the National Cancer Institute method. From 14 nutrients evaluated, six differed according to weight status in men, and only two among women. For men, the mean proportion of energy derived from lipids and saturated fat and mean intake of cholesterol, zinc, and vitamin B12 were greater among those with excess weight compared to those with normal weight; the inverse was observed for dietary fiber. Mean sodium intake was greater and proportion of energy from added sugar intake was lower among obese women compared to overweight ones. Strategies to encourage food consumption with high micronutrient density should be targeted to adult population regardless of their weight status.

Resumo Avaliou-se a ingestão e a prevalência de ingestão inadequada de nutrientes segundo a condição de peso em adultos brasileiros de áreas urbanas (n = 16.198) investigados no Inquérito Nacional de Alimentação (INA 2008-2009), que obteve o registro alimentar de dois dias não consecutivos. A prevalência de inadequação da ingestão de nutrientes foi estimada segundo a condição de peso e com base em recomendações brasileiras e internacionais, sendo a ingestão usual estimada pelo método do National Cancer Institute. Dos 14 nutrientes avaliados, seis diferiram segundo a condição de peso em homens e apenas dois entre as mulheres. Para os homens, a proporção média de energia proveniente dos lipídios e da gordura saturada e a ingestão média de colesterol, zinco e vitamina B12 eram mais elevadas para aqueles com excesso de peso do que entre os que tinham peso normal; o inverso foi observado para fibra dietética. A ingestão média de sódio foi maior e a proporção de ingestão de energia proveniente do açúcar de adição foi menor entre as mulheres obesas comparadas àquelas com sobrepeso. Estratégias para incentivar o consumo de alimentos com alta densidade de micronutrientes devem ser dirigidas à população adulta independentemente da sua condição de peso.

Development and relative validity of semi-quantitative food frequency questionnaire for Korean adults / 한국영양학회지

PURPOSE: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. METHODS: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. RESULTS: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. CONCLUSION: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.

Avaliação da ingestão nutricional de pacientes com doença renal crônica em tratamento hemodialítico / Nutritional intake assessment in patients with chronic kidney disease in hemodialitic treatment

Introdução: A hemodiálise é um tratamento comumente realizado em pacientes que apresentam perda da função renal, com o intuito de liberar resíduos prejudiciais à saúde do corpo. Esta terapêutica ocasiona perdas de nutrientes do sangue, sendo, dessa forma, contribuinte para a desnutrição, o que reforça o papel da nutrição como tratamento coadjuvante.A análise da ingestão alimentar é capaz de fornecer informações para nortear as condutas dietéticas,portanto, este estudo objetivou verificar a adequabilidade da ingestão nutricional com as recomendações nutricionais específicas e sua relação com o estado nutricional de pacientes submetidos a tratamento hemodialítico em uma clínica do município de Vitória da Conquista, BA. Método: A avaliação da ingestão nutricional foi procedida determinando a ingestão proteica por quilo de peso, de quilocalorias por quilo de peso, cálcio, ferro, potássio e fósforo,comparando-as com as recomendações específicas. O estado nutricional foi determinado por meio da Avaliação Subjetiva Global modificada. Resultados: Um total de 122 pacientes foram incluídos no estudo, estando a maioria em risco nutricional e nenhum com desnutrição gravíssima. A maioria também apresentou inadequação quanto à ingestão de calorias e dos nutrientes avaliados. Não foram encontradas correlações entre a ingestão calórica vs. estado nutricional e ingestão proteica vs. estado nutricional, mas analisando a ingestão calórica e proteica foi observada forte correlação (r=0,799). Conclusão: As ingestões de proteínas, quilocalorias, cálcio, ferro, potássio e fósforo apresentaram-se inadequadas na população estudada, o que pode influenciar o estado clínico e nutricional destes pacientes.(AU)

Introduction: Hemodialysis is a treatment commonly performed in patients who had loss of kidney function, in order to release harmful waste to body's health. This therapy causes loss of nutrients from the blood, and thus contributes to malnutrition, which reinforces the role of nutrition as adjuvant treatment. Analysis of food intake is able to provide information to guide dietetic conducts, so this study aimed to verify the nutritional intake adequacy with specific nutritional recommendations and their relation with the nutritional status of patients undergoing hemodialysis treatment at a clinic in the city of Vitória da Conquista, BA. Method: The assessment of nutritional intake was done determining the protein intake per kilogram of weight, kilocalories per kilogram of weight, calcium, iron, potassium and phosphorus comparing it to the specific recommendations. Nutritional status was determined using the Subjective Global Assessment modified. Results: A total of 122 patients were included in the study, with the majority in nutritional risk and none had very serious malnutrition. Similarly, most also had impairments as to intake of calories and nutrients evaluated. No correlations were found between calorie intake vs. nutritional status and protein intake vs. nutritional status, but in the analyse caloric and protein intake was found strong correlation (r=0.799). Conclusion: The intake of protein, kilocalories, calcium, iron, potassium and phosphorus showed to be inadequate in the study population, which may influence the clinical and nutritional status of these patients.(AU)

Evaluation on the methods of dietary survey associated with childhood obesity in China and abroad / 中华健康管理学杂志

Dietary surveyis a method to evaluate whether dietary intake meets body requirements by recording food consumed during a certain period.Widely-used dietary survey methods include:24 h dietary recall,dietary record,food frequency questionnaire and dietary history questionnaire.Since each method has its own advantages and limitations,researchers need to choose appropriate methods according to research purposes,accuracy requirements,availability of resources,etc.Obese children who are the focus and the major difficulty in dietary survey,it is important to choose an appropriate survey method.This article reviews widely-used dietary survey methods and evaluates them in the study of obese children related dietary surveys.

Qualidade da dieta de estudantes de uma universidade pública brasileira / Diet quality of students at a brazilian public university

O objetivo deste estudo transversal foi avaliar as dietas de acadêmicos de uma universidade pública brasileira quanto à adequação energética, ao consumo de macro e micronutrientes e de fibras alimentares. A pesquisa foi realizada de março/2010 a dezembro/2011, utilizando-se o Registro Alimentar de três dias e o software Dietpro5i para a coleta e a determinação da composição das dietas, respectivamente. O estudo envolveu 278 indivíduos distribuídos em quatro grupos: Educação Física/feminino (n=66), Educação Física/masculino (n=69), Farmácia/feminino (n=79) e Farmácia/masculino (n=64). Realizou-se estatística descritiva e ANOVA/post hoc de Tukey (SPSS vs.14.0). Em todos os grupos, observou-se uma dieta hiperenergética, hiperproteica, hiperglicídica, adequada quanto à contribuição calórica dos macronutrientes e em ferro e deficiente em cálcio e fibras alimentares. Observou-se que 39,3% de todos os indivíduos apresentaram consumo insuficiente de zinco. Comparando estatisticamente os grupos, destaca-se que o maior consumo energético médio pertence ao grupo Educação Física/masculino (3.760,3±686,6 kcal/dia; p<0,002 para todos os grupos), sendo que 53,1% deles realizavam uma dieta hipercalórica. Esse grupo também apresentou o maior consumo médio de proteínas (1,7±0,7 g/kg/dia), carboidratos (358,8±91,4 g/dia), ferro (13,9±4,5 mg/dia) (p<0,05 para esses componentes de todos os grupos) e zinco (12,1±5,3 mg/dia; p=0,004 para Farmácia/masculino). Do grupo Farmácia/feminino, observou-se o menor consumo médio de cálcio (601,1±227,0 mg/dia; p<0,022 para homens de ambos os cursos), enquanto o grupo Farmácia/masculino apresentou o maior percentual de indivíduos com dieta deficiente em fibras alimentares (85,8%; p=0,022 para Farmácia/feminino). Essas constatações sinalizam algumas inadequações alimentares, as quais podem constituir um fator de risco, a longo prazo, para a saúde dessa população.

The aim of this study was to evaluate students' diets at a Brazilian public university with regard to energetic adequacy and the consumption of macronutrients, micronutrients, and dietary fiber. This research was conducted from March/2010 to December/2011, using the Three-day Diet Record and Dietpro5i software, to collect and analyze the diet composition information. It was composed of 278 subjects, divided into four groups: Physical Education/ female (n=66), Physical Education/male (n=69), Pharmacy/female (n=79), and Pharmacy/male (n=64). Descriptive statistics and ANOVA/post hoc Tukey were performed (SPSS vs.14.0). All groups presented diets with high contents in energy, carbohydrates, and protein; adequate for macronutrient caloric contribution and iron; and low in calcium and dietary fiber. It was observed that 39.3% of all individuals presented low zinc consumption. Statistically comparing the groups, what stands out is that the highest mean energy consumption was found in the Physical Education/male group (3.760.3±686.6 kcal/ day; p<0.002 among all groups), and 53.1% of them were under a high-energy diet. This group also presented the highest mean consumption for protein (1.7±0.7 g/kg/ day), carbohydrates (358.8±91.4 g/day), iron (13.9±4.5 mg/day) (p<0.05 for this component among all groups), and zinc (12.1±5.3 mg/day; p=0.004 for Pharmacy/male). Pharmacy/female presented the lowest mean calcium consumption (601.1±227.0 mg/day; p<0.022 for both male groups), while the Pharmacy/male group presented the highest percentage of individuals with deficient dietary fiber intake (85.8%; p=0.022 for Pharmacy/ female). Some results indicate dietary inadequacy, which can become a risk factor for this population's health in the long term.

Comparison of Nutrient Intake and Diet Quality Between Hyperuricemia Subjects and Controls in Korea

Hyperuricemia is associated with metabolic syndrome as well as gout, and the prevalence of hyperuricemia is increasing in Korea. This study aimed to compare the nutrient intake and diet quality between hyperuricemia subjects and controls. Of the 28,589 people who participated in a health examination between 2008 and 2011, 9,010 subjects were selected whose 3-day food records were available. Clinical and laboratory data were collected from electronic medical records. Diet quality was evaluated using the food habit score (FHS), nutrient adequacy ratio (NAR), and mean adequacy ratio (MAR). The prevalence of hyperuricemia was 13.8% (27.1%, men; 5.2%, women). Body mass index, waist circumference, triglycerides, total cholesterol, and low-density lipoprotein cholesterol were significantly higher (p < 0.0001), while high-density cholesterol (p < 0.001) was significantly lower in the hyperuricemia subjects than in the controls. The hyperuricemia subjects had a lower intake of vitamin A (p < 0.004), vitamin C, folate, fiber, and calcium than the controls (p < 0.0001). Intake of vegetables and dairy products was significantly lower, whereas alcohol intake was significantly higher in the hyperuricemia subjects than in the controls ( p < 0.0001). The FHS (p < 0.0001), MAR (p < 0.0001), and NARs for vitamin A (p = 0.01), vitamin B2, vitamin C, folate, and calcium (p < 0.0001) were significantly lower in the hyperuricemia subjects than in the controls. In conclusion, the hyperuricemia subjects reported poorer diet quality than the controls, including higher alcohol intake and lower vegetable and dairy product intake.

Demographic Differences of Preference, Intake Frequency and Craving Hedonic Ratings of Sweet Foods Among Malaysian Subjects in Kuala Lumpur

As the sugar intake of Malaysians is one of the highest in the Asia Pacific region, we wanted to investigate how this high prevalence of ‘sweet tooth’ is influenced by biological determinants like age, gender, ethnicity and Body Mass Index (BMI). Therefore, this study was to determine the demographic and BMI differences of preference, intake frequency and craving of a list of sweet beverages and food among Malaysian subjects. Convenience sampling was performed around Kuala Lumpur, with informed consents, involving 367 multi-ethnic subjects (163 males, 204 females; 83 Malays, 201 Chinese, 83 Indians; 209 lean, 158 overweight). Demographics and anthropometric measurements were taken and questionnaire on the preference/frequency/craving of a list of 22 sweet food and beverages with a 7 point hedonic scale (from 1= very unpleasant/never/never crave to 7 = very pleasant/at least once a day/ always crave) was performed. Females significantly preferred more, took less frequently but had equal craving of sweet foods compared to males. Lean subjects and those <25 years showed significantly higher preference, intake frequency and craving of sweet foods. The ethnic differences in rating the preference, intake frequency and cravings seemed to be food-specific and culturally-related, where overall, ethnic Chinese had significantly higher intake frequency but lesser craving of sweet foods compared to Malays and Indians. Understanding the demographic and anthropometric factors that may affect the preference, intake frequency and craving of certain sweet foods can help to plan for strategies to prevent the detrimental health burden of high sugar intake among Malaysians.

Changes in Dietary Intake, Body Weight, Nutritional Status, and Metabolic Rate in a Pancreatic Cancer Patient

Pancreatic cancer patients often have a poor prognosis and suffer from nutritional problems. Malnutrition is characterized by weight loss and decreased dietary intake, and is common among pancreatic cancer patients. The objective of this report was to describe the changes in dietary intake, body weight, nutritional status, and metabolic rate on a continuum from the time of diagnosis until the end of life in a patient with pancreatic cancer. In summary, the patient's nutritional status gradually declined, accompanied by extreme weight loss and decreased dietary intake. Conversely, resting energy expenditure, measured by indirect calorimetry, increased from 24 kcal/kg/day to 35 kcal/kg/day. Nutritional management during cancer treatment is important but may be challenging in pancreatic cancer patients.

Procedimentos empregados na estimativa das medidas de massa e de volume de alimentos selecionados pelo Inquérito Nacional de Alimentação 2008-2009 / Procedures for estimating the weight and volume of selected foods reported in cooking units by the National Dietary Survey of 2008-2009

OBJETIVO: Descrever os procedimentos utilizados para estimar as medidas de massa e de volume dos itens mais consumidos no Brasil e apresentar propostas que possam ser adotadas para o aprimoramento do cálculo das quantidades ingeridas nos inquéritos alimentares no Brasil. MÉTODOS: Foram utilizados os dados do Inquérito Nacional de Alimentação 2008-2009 para descrever as frequências brutas das unidades de medida referidas para os cinco itens mais consumidos no Brasil (arroz, feijão, café, pão e carne bovina frita), exemplificouse a construção da base de dados utilizada no Inquérito Nacional de Alimentação e discutiramse as principais dificuldades encontradas nesse processo. RESULTADOS: Foram citadas aproximadamente 11.800 unidades de medidas associadas a cerca de 2.000 alimentos/preparações. A colher de servir foi a medida mais citada para o arroz (57%); a concha, para o feijão (80%); a xícara de café, para café (36%); unidade, para pão de sal (88%) e bife, para carne bovina frita (54%). Medidas equivocadas ou incompatíveis com os alimentos e unidades de medida que dificilmente podem ser dimensionadas foram citadas e uma unidade de medida padrão foi utilizada para estimar a quantidade consumida nessas situações. CONCLUSÃO: Na estimativa das quantidades relatadas no Inquérito Nacional de Alimentação foram adotados procedimentos no intuito de minimizar os erros de mensuração. Esforços para melhorar a quantificação dos alimentos consumidos em inquéritos nacionais se justificam uma vez que a padronização das medidas referidas em inquéritos nutricionais possibilita comparações nacionais e internacionais e contribui para elaboração de recomendações e guias de alimentação e nutrição.

OBJECTIVE: The present study described the methods used for estimating the weight and volume of the most consumed foods in Brazil reported in cooking units and presented suggestions that improve the assessment of food consumption reported in dietary surveys in Brazil. METHODS: Data from the National Dietary Survey of 2008-2009 were used for describing the rates of measurements reported for the five most commonly consumed items in Brazil (rice, beans, coffee, bread and beef steak), illustrating the construction of the database used in National Dietary Survey and discussing the main difficulties found in the process. RESULTS: Around 11,800 units of measurement associated with approximately 2,000 foods/preparations were cited. The serving spoon was the most cited measure for rice (57%); ladle for beans (80%); coffee cup for coffee (36%); unit for bread (88%), and unit for beef steak (54%). Misleading and incompatible measurements and those that can hardly be estimated were cited and a standard unit of measurement was used for estimating the amount consumed in these situations. CONCLUSION: Procedures were used for minimizing measurement errors when estimating quantities of foods consumed reported by the National Dietary Survey. Efforts to improve the quantification of food intake in national surveys are justified since the standardization of the measures reported in dietary surveys enables national and international comparisons and helps to develop recommendations and guidelines on food and nutrition.

Lack of Association between Self-reported Saltiness of Eating and Actual Salt Intake / 가정의학회지

BACKGROUND: Reducing salt intake is known to be an important factor for lowering blood pressure and preventing cardiovascular disease. Estimating amount of salt intake is a necessary step towards salt intake reduction. Self-reported saltiness of diet is a method most easily used to measure a patient's salt intake. The purpose of this study was to examine the value of self-reported saltiness of diet in measuring salt intake. METHODS: We used data from 681 participants who visited a health center at a university hospital between August 2003 and November 2005. A self-administered questionnaire was used to collect information on self-reported saltiness of diet, other dietary habits and lifestyle factors. Salt intake was estimated on the basis of 24-hour dietary recall with a computer-aided nutritional analysis program (CAN-Pro 2.0, Korean Nutrition Society). RESULTS: There was no statistically significant difference between the mean salt intake of the self-reported salty diet group (13.7 +/- 4.8 g/d) and the self-reported unsalty diet group (13.3 +/- 4.4 g/d). If we assume calculated salt intake as the gold standard, the sensitivity and specificity of self-reported saltiness were 39.5% and 63.6%, respectively. Salt intake was increased with higher calorie intake, frequency of eating breakfast (> or =5 times/wk) and being satiated with usual diet in men, but it was increased only with higher calorie intake in women. Regardless of actual salt intake, the group satiated with a usual diet tended to be in the group of self-reported salty diet. CONCLUSION: Self-reported saltiness of diet was not associated with actual salt intake. Further studies will be needed on the simpler and more objective tools to estimate salt intake.

Development and validation of a quantitative food frequency questionnaire to assess nutritional status in Korean adults

This study was performed to evaluate the validity of the food frequency questionnaire (FFQ), which is being used at the Samsung Medical Center. In total, 305 (190 males and 115 females) participants consented and completed the 3-day diet records and FFQ. Age, gender and energy-adjusted and de-attenuated correlations ranged from 0.317 (polyunsaturated fatty acid) to 0.748 (carbohydrate) with a median value of 0.550. The weighted kappa value ranged from 0.18 (vitamin A) to 0.57 (carbohydrate) with a median value of 0.36. More than 75% of the subjects were classified into the same or adjacent quartiles. The FFQ had reasonably good validity compared with that of another study. Therefore, our FFQ is considered a proper method to assess nutrient intake in healthy Korean adults.

Análise da Dieta e Condição de Saúde Bucal em PacientesGestantes / Analysis of the Diet and Oral Health Condition in Pregnant Patients

Objeti vo: Realizar uma análise críti ca do modelo de registrode dieta adotado, avaliar a cariogenicidade da alimentaçãomaterna e a condição de cárie dentária em gestantes atendidasem uma clínica de prevenção em uma escola de graduação emOdontologia.Método: Foi realizada uma pesquisa transversal, com consultasao banco de dados da clínica e análise dos prontuários e diáriosde registro alimentar. Foi realizado o cálculo da amostra eselecionadas aleatoriamente 205 pacientes. Foram realizadostestes estatí sti cos bivariados, ao nível de signifi cância de 5%(α=0,05), uti lizando-se os soft wares estatí sti cos Epi Info versão3.2, GraphPad Instat 3.6 e BioEstat.Resultados: A parti r do diário da dieta, observou-se que68,8% das gestantes apresentavam dieta cariogência, comuma alta frequência de ingestão de carboidratos fermentáveis,principalmente sacarose, de consistência líquida, consumidospreferencialmente entre as principais refeições. Houve umamaior tendência das gestantes em citarem uma frequênciabaixa de ingestão de carboidratos durante a entrevista deanamnese, enquanto ao contrário registrava-se no diário umadieta rica neste componente (p<0,0001). O CPOD médio daspacientes foi 13,9±5,4. Não houve associação estatí sti ca entredieta e variáveis de saúde bucal (p>0,05).Conclusão: O registro do diário da dieta mostrou-se ummétodo efeti vo e válido, desde que corretamente uti lizado. Aprevalência de cárie dentária no grupo de gestantes foi alta e,apesar de apresentarem dieta cariogênica em mais da metadeda amostra, não foi encontrada associação estatí sti ca entredieta e co-fatores...

Objecti ve: To perform a criti cal analysis of the diet record modeladopted, to evaluate the cariogenicity of the maternal diet, andthe incidence of dental caries in pregnant women treated at apreventi on clinic in an undergraduate dental course.Method: A cross-secti onal study was performed withconsultati ons to the database of the clinic and review ofpati ents’ charts and diet records. The sample was calculatedand 205 pati ents were randomly selected. Bivariate stati sti calanalysis was done at a signifi cance level of 5% (α=0.05), usingthe stati sti cal soft wares Epi Info versão 3.2, GraphPad Instat 3.6and BioEstat.Results: The analysis of the diet records showed that 68.8%of the pregnant women presented a cariogenic diet, with highfrequency of ingesti on of fermentable carbon hydrates, mainlysucrose, with liquid consistency, and preferably consumedbetween the main meals. There was higher trend of thepregnant women menti oning a low frequency of carbon hydrateingesti on during the interview, while registering a diet rich ofthese components in their diet records (p<0.0001). The meanDMFT of the pati ents was 13.9 ± 5.4. There was no stati sti callysignifi cant associati on between diet and oral health variables(p>0.05).Conclusion: The diet record was proven an eff ecti ve and validmethod, if correctly employed. The prevalence of dental cariesin the group of pregnant women was high and, although morethan half of the sample presented a cariogenic diet, a signifi cantassociati on between diet and co-factors was not found...

Elaboração de questionário de frequência alimentar semiquantitativo para adolescentes da região metropolitana do Rio de Janeiro, Brasil / Development of a semiquantitative food frequency questionnaire for adolescents from the Rio de Janeiro metropolitan area, Brazil

OBJETIVO: Descrever a elaboração de um questionário de frequência alimentar para adolescentes do Rio de Janeiro, Brasil. MÉTODOS: Para seleção dos itens alimentares incluídos no questionário de frequência alimentar, utilizaram-se dados de três dias de registro alimentar obtidos em uma amostra de 430 estudantes, na faixa etária de 12 a 19 anos, da rede de ensino estadual de Niterói, Rio de Janeiro. Foram incluídos os itens alimentares mais citados nos registros e que contribuíram com 95 por cento do consumo de energia e nutrientes dos registros alimentares. As porções de referência foram as mais frequentemente referidas nos registros do estudo de base. As opções de frequência foram definidas de forma diferenciada para os diversos itens do questionário. RESULTADOS: Nos registros foram listados 306 alimentos, dos quais 249 itens foram incluídos no questionário, isoladamente ou agrupados, compondo uma lista de 90 itens. Os 14 itens alimentares mais consumidos por adolescentes do Rio de Janeiro, nesse estudo e em estudo anterior, foram associados a oito opções de frequência de consumo; 18 itens alimentares foram acoplados a sete opções de frequência e para 58 itens foram definidas cinco opções de frequência. CONCLUSÃO: O estudo permitiu a elaboração do questionário de frequência alimentar para adolescentes da Região Metropolitana do Rio de Janeiro, o qual será submetido às análises de reprodutibilidade e validade. Este questionário representa um instrumento valioso para pesquisas epidemiológicas que investiguem o consumo alimentar de adolescentes.

OBJECTIVE: The objective of this study was to describe the development of a food frequency questionnaire for adolescents from the Rio de Janeiro metropolitan area, Brazil. METHODS: The selection of food items included in the questionnaire was done by recording the foods consumed during 3 days by 430 students aged 12 to 19 years from the public schools of Niterói (RJ) Brasil. The most cited food items, which contributed to 95 percent of the total energy and nutrient intakes were included in the food frequency questionnaire list. For each item, the most frequent portion size referred to in the records was defined as the reference portion. The food frequency questionnaire presented different frequency options according to the kind of food. RESULTS: In the dietary records, 306 food items were cited. From those, 249 were included in the food frequency questionnaire, grouped or by themselves, forming a list with 90 items. The fourteen most cited items by the adolescents from Rio de Janeiro in this and in a previous study were associated with eight frequency options; 18 and 58 other food items were associated with seven and five frequency options respectively. CONCLUSION: The study enabled the development of a food frequency questionnaire for adolescents from the Rio de Janeiro metropolitan area, which will eventually be submitted to reliability and validity analysis. This food frequency questionnaire represents a valuable tool for epidemiologic investigations of food intake among adolescents.

Development and Validation of a Semi-Quantitative Food Frequency Questionnaire to Assess Diets of Korean Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Our aim was to assess the validity of a semi-quantitative food frequency questionnaire (FFQ) by comparison with the 3-day diet record (DR) in patients with type 2 diabetes. METHODS: Eighty five type 2 diabetic patients (aged 33 to 70 years) from the Korean National Diabetes Program (KNDP) completed 3-day DR and FFQ. The FFQ was designed to reflect the eating pattern of Korean type 2 diabetic patients, and was based on the 2003 Korean National Health and Nutrition Examination Survey. The FFQ consists of 85 food items and 12 food groups. The validity of FFQ was assessed by comparison with the 3-day DR. RESULTS: The mean age was 49 +/- 10 years. Clinical characteristic including body weight, diabetic duration, and HbA1c were not different from the total cohort subjects (n = 1,478). There were no significant differences in the mean intake of protein, fat and calcium estimated by the FFQ and the 3-day DR. Energy and carbohydrate estimated by the FFQ were higher than those estimated by the 3-day DR. The correlation coefficient was highest for energy (r = 0.740; P < 0.00) and lowest for iron (r = 0.269; P < 0.05). The Kappa values for energy, carbohydrate, protein, fat and calcium were 0.54, 0.37, 0.36, 0.46, and 0.19, respectively. CONCLUSION: The FFQ is a reasonable instrument for assessing the intake of most macronutrients in Korean type 2 diabetes, although careful consideration is required for the food groups and nutrients for which the FFQ had low validity.

Development and Validation of a Semi-Quantitative Food Frequency Questionnaire to Assess Diets of Korean Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Our aim was to assess the validity of a semi-quantitative food frequency questionnaire (FFQ) by comparison with the 3-day diet record (DR) in patients with type 2 diabetes. METHODS: Eighty five type 2 diabetic patients (aged 33 to 70 years) from the Korean National Diabetes Program (KNDP) completed 3-day DR and FFQ. The FFQ was designed to reflect the eating pattern of Korean type 2 diabetic patients, and was based on the 2003 Korean National Health and Nutrition Examination Survey. The FFQ consists of 85 food items and 12 food groups. The validity of FFQ was assessed by comparison with the 3-day DR. RESULTS: The mean age was 49 +/- 10 years. Clinical characteristic including body weight, diabetic duration, and HbA1c were not different from the total cohort subjects (n = 1,478). There were no significant differences in the mean intake of protein, fat and calcium estimated by the FFQ and the 3-day DR. Energy and carbohydrate estimated by the FFQ were higher than those estimated by the 3-day DR. The correlation coefficient was highest for energy (r = 0.740; P < 0.00) and lowest for iron (r = 0.269; P < 0.05). The Kappa values for energy, carbohydrate, protein, fat and calcium were 0.54, 0.37, 0.36, 0.46, and 0.19, respectively. CONCLUSION: The FFQ is a reasonable instrument for assessing the intake of most macronutrients in Korean type 2 diabetes, although careful consideration is required for the food groups and nutrients for which the FFQ had low validity.

Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística / Association between nutritional status and dietary intake in patients with cystic fibrosis

OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimentos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura ( por centoP/E), percentil do índice de massa corpórea (IMC), escore Z para estatura/idade (E/I) e peso/idade (P/I), e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs). RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7 por cento, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5 por cento estavam acima de 90 por cento do por centoP/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5 por cento da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1 por cento da ingestão calórica em relação à RDA diminui em 2 por cento a chance de ter déficit de estatura (OR = 0,98; IC95 por cento: 0,96-1,00). A escolaridade materna demonstrou uma associação limítrofe (p = 0,054). CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes.

OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was evaluated by the 3-day diet record (weighing the food consumed). The outcome measures were the following nutritional status indicators: weight/height (W/H percent) percentage, body mass index (BMI) percentiles, Z score for weight/age (W/A), Z score for height/age (H/A) and percentage of dietary intake compared with the Recommended Dietary Allowance (RDA). RESULTS: The prevalence of well-nourished patients was 77.7 percent, using BMI above the 25th percentile as the cut-off value, and the W/H percent was above 90 percent in 83.5 percent. The mean dietary intake, evaluated in 82 patients, was 124.5 percent of the RDA. In the univariate logistic regression analyses, we found a significant association between the independent variable calorie intake and the Z score for W/A. The multivariate analysis, based on the Z score for H/A and adjusted for FEV1, methicillin-resistant Staphylococcus aureus colonization and number of hospitalizations, demonstrated that a 1 percent increase in the calorie intake decreases the chance of having short stature by 2 percent (OR: 0.98; 95 percent CI: 0.96-1.00). Maternal level of education showed a borderline association (p = 0.054). CONCLUSIONS: The prevalence of malnutrition was low in this sample of patients. The study model demonstrated an association between dietary intake and nutritional status. Dietary intake was a predictive factor of statural growth in patients with cystic fibrosis.

Adaptação do índice de alimentação saudável ao guia alimentar da população brasileira / Adaptation of the healthy eating index to the food guide of the Brazilian population

OBJETIVO: Adaptar o Índice de Alimentação Saudável norte-americano de acordo com as recomendações do Guia Alimentar da População Brasileira e da Pirâmide Alimentar Adaptada. MÉTODOS: Foi realizada avaliação do consumo alimentar de 502 indivíduos, de ambos os sexos (54, desvio-padrão=10 anos), na cidade de Botucatu (SP) ano de 2006. O método utilizado para estimar a ingestão foi o questionário recordatório de 24 horas e os alimentos relatados foram convertidos em porções, pelo valor energético, de acordo com os grupos alimentares da Pirâmide Alimentar Adaptada. Além disso, foram avaliados os nutrientes (colesterol, gordura total e saturada) e variedade da dieta. Foi realizada análise estatística descritiva e os valores intermediários da pontuação dos componentes foram calculados por razão e proporção. RESULTADOS: Foram alterados os números das porções alimentares conforme as estabelecidas na Pirâmide Alimentar Adaptada, além da inclusão dos grupos das leguminosas, doces e açúcares, óleos e gorduras na pontuação do Índice de Alimentação Saudável adaptado e exclusão do item sódio. Para os nutrientes a variedade da dieta foi estabelecida pontuação intermediária. O Índice de Alimentação Saudável adaptado pontuou 12 componentes no total, classificando as dietas em boa qualidade (boa qualidade: superior a 100 pontos), precisando melhorar (precisando melhorar: 71-100 pontos) e má qualidade (má qualidade: inferior a 71 pontos). A proporção de indivíduos classificados com dieta de boa qualidade 15%, precisando melhorar 71% e de má qualidade 14 por cento. CONCLUSÃO: O Índice de Alimentação Saudável adaptado é um instrumento que pode ser utilizado para avaliar os hábitos alimentares populacionais, porém específico para a população brasileira adulta. Contudo, se faz necessário que estes índices sejam constantemente revisados e adequados às novas recomendações nutricionais.

OBJECTIVE: The objective of this study was to adapt the North American Healthy Eating Index according to the Dietary Guide of the Brazilian Population recommendations and the Adapted Food Pyramid. METHODS: Food intake of 502 individuals of both genders (mean age of 54 years, standard deviation of 10 years) was assessed in the city of Botucatu (SP) in 2006. Food intake was determined by the 24-hour recall and the reported foods were converted into portions according to the energy content and food groups of the Adapted Food Pyramid. Moreover, nutrients (cholesterol, total and saturated fat) and diet variety were also assessed. Descriptive statistical analysis was done and the intermediate values of the component scores were calculated by ratio and proportion. RESULTS: The number of food portions was modified according to the Adapted Food Pyramid, besides including the groups of legumes, sweets and sugars, oils and fats in the Adapted Healthy Eating Index score and excluding sodium. An intermediate score was established for nutrients and diet variety. The Adapted Healthy Eating Index scored a total of 12 components, classifying the diets as good quality (more than 100 points), needs improvement (from 71 to 100 points) and poor quality (under 71 points). The diet of 15% of the individuals was classified as good, 71% needed improvement and 14 percent was poor. CONCLUSION: The Adapted Healthy Eating Index is an instrument that can be used to assess population eating habits but it is specific for the adult Brazilian population. However, these indices need constant reviews and adaptations to new dietary recommendations.