Method to develop a regional guide for the allergenic potential of tree pollen.

Allergic rhinitis, caused by airborne pollen, is a common disease with a great impact on the quality of life for patients and high costs for society. Prevention of high pollen concentrations in the air is relevant for creating a safe environment for allergic patients. Due to climate change, the heat in cities during the summer is a recurring problem. The local climate can be improved by using the cooling properties of trees, providing shade and cooling by evapotranspiration. When deciding which tree species will be planted, it is important to take into account the allergenicity of the pollen that the tree produces. Available guides, used all over the world, on the allergenicity of pollen are very divers in content and interpretation and not applicable for the Netherlands. In this study a method is described to develop a guide for the allergenic potential of tree pollen in a region, in this case the Netherlands. For the most common tree species in the Netherlands the scientific knowledge on the allergenicity of the pollen was collected, followed by an inventory on regional pollen abundance. Subsequently, the sensitization pattern in a patient group with possible inhalation allergy was analyzed. Based on these data allergenicity of the tree pollen was classified into five classes. Eight tree species/genera of the 61 most planted tree species in the Netherlands are considered to have a very strong to moderate allergenic potential. We propose to use this methodology to develop regional-specific guides classifying the allergenic potential of tree pollen.

Development and validation of a food use checklist for evaluation of community nutrition interventions.

We developed a new dietary assessment instrument, the Food Behavior Checklist (FBC), which measures food use related to adopting lower-fat and higher-fiber diets. The FBC is a simplification of the 24-hour diet recall that consists of 19 simple yes/no questions about foods consumed during the previous day. To develop the FBC, an expert committee generated a list of foods based on our intervention program, and we used focus groups and random-digit dialing pretests to refine the format and clarify items. To validate the FBC, we compared responses of 96 women on the FBC to information collected during a professionally administered 24-hour diet recall. For most items, agreement between the FBC and 24-hour recall, based on the kappa statistic, was good to excellent. Agreement was poor for items requiring detailed knowledge about food composition (e.g. high-fiber cereal). There was a trend to over-report general food categories (e.g. luncheon meats) but not specific food items (e.g. ice cream). In an embedded randomized study, we found that a set of introductory items designed to serve as a memory retrieval cue did not improve agreement between the FBC and 24-hour recall. These data provide preliminary evidence supporting the use of short checklist questionnaires on the previous day's food use as a means to assess diet at the group or community level. This relatively inexpensive and rapid measure can be used to inform the design of public health nutrition programs and as an evaluation tool in intervention research.

Patterns of dietary behavior associated with selecting diets low in fat: reliability and validity of a behavioral approach to dietary assessment.

This report describes the development and evaluation of a behavioral measure of dietary patterns related to selecting low-fat diets. An 18-item questionnaire, based on an anthropological theory of dietary change, was developed to assess four relevant dimensions of dietary behavior: (a) excluding high-fat ingredients and preparation techniques, (b) modifying high-fat foods, (c) substituting specially manufactured low-fat foods for their higher-fat counterparts, and (d) replacing high-fat foods with low-fat alternatives. In this study, 99 women completed the diet behavior questionnaire twice and, to characterize precisely their dietary fat intake, also completed two 4-day food records and a food frequency questionnaire. Participants were aged 45 to 59 years and were selected to have a wide range of fat intakes (19.4% to 49.4% of calories from fat). Confirmatory factor analysis identified five scales that corresponded to those hypothesized, except for exclusion, which split into avoiding meat and avoiding fat as a seasoning. The scales had high test-retest and internal consistency reliabilities, and correlations with percent of calories from fat ranged from 0.34 to 0.57 (p less than .01). The correlation of the sum of the five scales (18 items) with percent of calories from fat was 0.68 (p less than .001) and, in multiple regression models, the multiple R2 using all factors to predict percent of calories from fat was 0.47. Overall, these findings supported the validity of the theoretical model of dietary patterns related to selecting diets low in fat. We conclude that a standardized, behavioral approach to measuring fat-related dietary behavior may be useful for designing and evaluating nutrition intervention programs.

Rapid assessment of dietary intake of fat, fiber, and saturated fat: validity of an instrument suitable for community intervention research and nutritional surveillance.

Abstract Traditional methods to assess changes in dietary intake, for example food frequency questionnaires or 24-hour dietary recalls, are often not practical: they are lengthy, expensive, and unsuitable for telephone administration. This article describes the development and evaluation of an approach to the rapid assessment of the dietary intake of nutrients of most interest in health promotion research; total fat, saturated fat, dietary fiber, and percent of calories from fat. In this validation study on 97 women, short dietary questionnaires were compared to two criterion measures of usual dietary intake, a food frequency questionnaire and the mean of two four-day diet records. Correlations between self-administered short questionnaires and four-day diet records were 0.52, 0.53, 0.61, and 0.40 for total fat, percent of calories from fat, saturated fat, and dietary fiber, respectively. These correlations are similar to those observed between food frequency questionnaires and four-day diet records, which suggests that this approach to developing and administering short dietary questionnaires may be useful in situations where more expensive and time-consuming methods of dietary assessment are not practical.

Increasing calcium intake lowers blood pressure: the literature reviewed.

Evidence to support an association between dietary calcium and blood pressure is presented in this article. Epidemiological surveys, animal experiments, and clinical trials support an inverse relationship between calcium and blood pressure. Several independent diet surveys have reported reduced consumption of calcium by individuals with hypertension. Animal experiments demonstrate an inverse correlation between calcium intake and blood pressure and reveal disturbances in calcium metabolism in hypertensive animals. Similar metabolic disturbances, including lower serum ionized calcium, elevated parathyroid hormone values, and increased urinary calcium excretion, have been reported in human hypertensives compared with normotensives. In addition, three recent experimental trials using 1 gm calcium carbonate supplements demonstrated that increasing calcium intake may reduce blood pressure in some human beings. Further clinical investigations are necessary to define the subset of patients who will respond to calcium therapy. Dietary sources of calcium to provide at least the RDA are recommended. Dairy products are suggested because in addition to calcium, they are valuable sources of potassium and magnesium, which may also lower blood pressure. If a patient cannot tolerate dairy products, oral calcium supplements are indicated.

Blood pressure and nutrient intake in the United States.

A data base of the National Center for Health Statistics, Health and Nutrition Examination Survey I (HANES I), was used to perform a computer-assisted, comprehensive analysis of the relation of 17 nutrients to the blood pressure profile of adult Americans. Subjects were 10,372 individuals, 18 to 74 years of age, who denied a history of hypertension and intentional modification of their diet. Significant decreases in the consumption of calcium, potassium, vitamin A, and vitamin C were identified as the nutritional factors that distinguished hypertensive from normotensive subjects. Lower calcium intake was the most consistent factor in hypertensive individuals. Across the population, higher intakes of calcium, potassium, and sodium were associated with lower mean systolic blood pressure and lower absolute risk of hypertension. Increments of dietary calcium were also negatively correlated with body mass. Even though these correlations cannot be accepted as proof of causation, they have implications for future studies of the association of nutritional factors and dietary patterns with hypertension in America.

Human nutrition and blood pressure regulation: an integrated approach.

This review highlights the complex interactions that constitute the disciplines of nutrition and cardiovascular physiology. Nutritional factors have long been considered as critical in the pathogenesis of human hypertension. Theoretical and established contributions of various nutrients to blood pressure regulation are presented. A brief historical perspective of sodium's dominance in this area is provided. "Accepted" principles of nutrient interaction are then applied to cardiovascular research. First, the interrelationships among all macronutrients and diet composition, nutrient absorption, renal elimination, and ultimate bioavailability to the vascular tissue are assessed. An analysis of dietary recall data from human studies is provided to illustrate such nutrient interaction. Second, associated factors that influence nutrition are considered in relation to both human and animal investigations of blood pressure regulation. Finally, the development and interpretation of future studies are assessed in light of these principles. Examples from both the human and animal investigations of blood pressure regulation. Finally, the development and interpretation of future studies are assessed in light of these principles. Examples from both the human and animal literature are provided to show why it is necessary to incorporate fully the established principles of nutrition into our current concepts of the pathogenesis of hypertension. Future progress in terms of nutrition, food, and health will be dependent upon such an integrated approach.