Calcaneal bone mineral density and dietary calcium intake in healthy adults from eastern Croatia: what difference do gender and age make?

AIM: Adequate nutrition supports optimal bone development and prevents later metabolic bone diseases. The aim of this study was to assess calcium dietary intake and measure calcaneal bone mineral density and based on the obtained values to evaluate gender and age impact on the values itself as well as on their correlation. METHODS: Subjects recruited for this study were 120 healthy adults. Calcaneal bone mineral density was measured by quantitative ultrasound and expressed as estimated bone mineral density (eBMD). Calcium intake was assessed using ten 24-hours recalls. RESULTS: Values were compared between age and gender based sub-groups. The average value of eBMD of the study group was 0.543 g/cm2. There was no difference between females and males in eBMD. The average daily dietary intake of calcium was low (661 mg/day), and males had statistically significantly higher daily dietary intake than females (805 mg/day and 599 mg/day, respectively). The younger group had higher average value for eBMD (0.560 g/cm2), and higher dietary intake of calcium (10.5 mg/kg of body weight) than the older group (eBMD=0.527 g/cm2; calcium intake=9.4 mg/kg of body weight), but the difference was not significant. CONCLUSION: Lack of statistically significant difference in eBMD values between two observed study subgroups based on the years of age, and low eBMD value itself, are obvious evidence of the compromised bone health status within the study population as well as the need for preventive actions.

[Croatian guidelines for nutrition in the elderly, part I]. / Hrvatske smjernice za prehranu osoba starije dobi, dio I.

Aging produces numerous physical and physiologic changes, which in turn alter nutritional requirements and affect nutritional status. The presence of chronic disease, and/or medications can enhance potential disparities between nutrient needs and dietary intake, leading to malnutrition. Indeed, research suggests that malnutrition is a common condition among the elderly. Therefore, regular nutritional assessment should be done as an integral part of healthcare for elderly. Also, it is important to take in consideration all determinants of geroanthropometry. The physiologic changes associated with aging affect requirement for several essential nutrients. In general, the requirement for many nutrients decreases, concomitant with the decrease in energy needs. However, some nutrients are needed in higher amounts. Additionally, various psychosocial and socioeconomic changes that often attend aging may also alter dietary intake. Dietary planning is important part of nutritional care in the elderly. Also, some elderly persons can benefit with dietary supplements and oral nutritional supplements (enteral formulas) which can be prescribed by diagnosed or threatening malnutrition. Croatian guidelines for nutrition in the elderly have been developed by interdisciplinary expert group of Croatian clinicians, gerontologists, anthropologists, nutritionists and other professionals involved with care for elderly population. The guidelines are based on evidence from relevant medical literature and clinical experience of working group.

[Using of household budget survey data for public health monitoring of dietary habits in Croatia--DAFNE initiative]. / Javnozdravstveni aspekt pracenja prehrambenih navika temeljem istrazivanja potrosnje u kucanstvima--inicijativa DAFNE.

AIM: The aim of the study was to determine mean food availability based on the data of national Household Budget Surveys (HBS) provided for the years 1999 and 2004, and also to identify the trends in dietary patterns of the Croatian population according to the Data Food Networking (DAFNE) procedure. SUBJECTS AND METHODS: The Croatian National Statistics Bureau conducted the first HBS survey in 1999 on the sample of 2937 households and the second in 2004 on 2847 households, respectively. Those two raw data sets together with the data on relevant socio-demographic characteristics: household locality, number of household members, education and occupation of the household head were sent to the DAFNE coordinating centre in Athens. A post-harmonisation of the raw data was performed according to DAFNE procedure. Further, data were statistically analysed and integrated into the DAFNE databank (DafneSoft). RESULTS: Average daily food availability per person/day for both surveyed years seems to be satisfying. However, a dietary pattern showed discrepancies between proposed dietary guidelines and consumption of some food items. In comparison with proposed daily intake of 400 grams or more of fruits and vegetables, an average availability is lower and accounts 343 grams in 1999 and 314 grams in 2004. Availability of fish and seafood is low (23-27 g) but in the same time daily availability of meat and meat products is high (181-186 g), especially regarding red meat. During the five year period a decreasing trend is evident for availability of most food items, including lipids and sugar products. The availability has increased only for nuts, fruit and vegetable juices. The differences in availability of certain food groups are evident amongst some socio-economic categories of households. In urban households the availability of milk products, fish, vegetables, fruit and fruit juices is higher than in rural households, as it is in households with higher educated in comparison to low educated household heads. The highest food availability is registered in households with one person. However, there is a general trend that the food quantities are lowering in households with a growing number of persons. CONCLUSION: The data of HBS harmonised and statistically analysed according to DAFNE methodology offers the possibility to monitor and compare dietary habits and trends in food availability on national level as well as across European countries. If the HBS data are properly expanded and exploited they could become valuable tool for planning national food and nutrition policy, development of national dietary guidelines, promotion of healthy eating, planning and implementation of public health interventions, and for many other positive features.

[Reason for dietary salt reduction and potential effect on population health--WHO recommendation]. / Razlozi za smanjenje soli u prehrani i potencijalni ucinak na zdravlje populacije--preporuke Svjetske zdravstvene organizacije.

It is well known that reduction of salt results in lowering blood pressure and cardiovascular incidents. Daily salt is double the recommended daily quantity and mainly comes from processed food. The assessment of daily salt intake for Croatia is 12 g/day (WHO recommendation is <5 g/day). The main source of sodium is processed food and food prepared in restaurants (77%), natural content of sodium in food (12%), added salt at table (6%) and prepared meals at home (5%). Reduction of salt by 50% would save nearly 180,000 lives per year in Europe. It is necessary to establish better collaboration with food manufacturers in order to reduce the content of salt in processed food and to achieve appropriate salt intake per day in accordance with the WHO recommendation. Further, it is necessary to encourage food manufacturers to produce food and meals with low or reduced salt content (shops, catering, changes in recipes, offer salt substitutions). This kind of collaboration is based on bilateral interests that can result in positive health effects. One of the most important public health tasks is to educate consumers and to give them choice when buying food. This can be achieved by effective campaigns and social marketing, by ensuring a declaration of salt content on the product, or specially designed signs for food products with low or reduced salt content.

[Less salt--more health. Croatian action on salt and health (CRASH)]. / Manje soli--vise zdravlja. Hrvatska inicijativa za smanjenje prekomjernog unosa kuhinjske soli (CRASH).

Developed part of the world has realized that excessive salt intake is harmful for humans' health. Several countries have their own national programmes for reducing salt intake, and the most successful are Finland, Japan and Great Britain. National programme that was launched in Great Britain several decades ago (CASH) achieved most and should serve as an example and model for others. In 2005 this programme evolved into the World action on salt and health (WASH). According to the EU plan, salt intake should be also cut down, and salt content should be labelled on all food articles. In 2006, the First Croatian Congress on Hypertension announced Declaration of salt reducing programme in Croatia, and in 2007 at the 6th Croatian Congress on Atherosclerosis Croatian action on salt and health (CRASH), and national programme for reducing salt intake were launched. In 2008 we have started with mapping of sodium intake (determined from urine sodium excretion), and CRASH has organized several educational activities for general population, but also for physicians and nurses. CRASH and national programme are organized by Croatian Academy of Medical Science, Croatian Society of Hypertension, Croatian Atherosclerosis Society, Croatian Cardiac Society, and School of Medicine, University of Zagreb. Associations of nurses are involved in all activities, as well as students and patients. Negotiations with food industry have started. Croatian Food Agency and companies for public relations and collaboration with media are included in this important programme. Croatian Ministry of Health and Social Care supports these activities, and CRASH is included in the action of the World Health Organization on mapping sodium intake in European countries. CRASHjoins WASH and will organize several activities for the World Salt Awareness Week, which is in 2009 focused on salt eaten outside the home. We hope that Croatia will soon follow countries who have already achieved success in this struggle for reducing salt intake. Our motto is Less salt-more health, and one of our principles is based on an old proverb Firstly sweep around your own front door Thus all physicians and nurses are invited to be health enlightened and permanently active.

[Dietary habits: Croatian health survey]. / Prehrambene navike--hrvatska zdravstvena anketa.

OBJECTIVE: To examine dietary habits and to determine the presence of possible regional differences in Croatia. SUBJECTS AND METHODS: Survey was performed during 2003 by means of modified food frequency questionnaire. Survey included randomly selected 9070 adult examinees at the age of 18 and above in the whole Croatia. The SPSS program using weighted database was used for statistical analysis. RESULTS: Obtained data indicate existing significant differences in dietary habits at county and regional level in nutrition of the Croatian population. There is a tendency toward grouping as much unhealthy dietary habits as healthy by certain counties, respectively regions. Population of the Eastern and Northern regions (except of the Medjimurska County) living in the counties of Vukovarsko-srijemska, Koprivnicko-krizevacka, Pozesko-slavonska and Viroviticko-podravska in comparison to population of other counties, respectively regions, significantly more often use animal fats, add salt to foods, consume less fruit and vegetables, eat more cakes, sweets and cured meat products. The observed characteristics are considered risk factors for development of cardiovascular diseases and other chronic non-communicable diseases. Population of the Southern and Western regions, in the counties of Primorsko-goranska, Istarska, Zadarska, Dubrovacko-neretvanska, but also in Medjimurska County, significantly more often use vegetable oils; they also on daily basis consume more often fruit and vegetables, less frequent or rarely add salt and consume sweets and cakes. Differences are also observed in dietary habits between genders, but also within the same sex in certain counties. CONCLUSIONS: Indicators of the present nutrition of the population show regional dietary differences. It is important to point out a need for broader education of general public regarding the impact of diet on health, principles of healthy nutrition, and promotion of comparative advantages of the Mediterranean diet as a prototype of healthy nutrition.

Dietary habits and folate status in women of childbearing age in Croatia.

Folic acid and folates have an important role in prevention of neural tube defect that appears in the first weeks of pregnancy, when women are still not aware of their pregnancy, especially when pregnancy is not planned. Since ensuring sufficient quantities of folates and folic acid in this period is essential, dietary habits of childbearing age women are very important. In line with that the intake of folates and folic acid in nutrition of women age group 20-30 years is examined, as well as the frequency of consumption of foodstuffs rich in vitamins and folic acid supplements. Values of folates in serum are presented, dependent on their nutritional habits. Obtained results indicate that in spite of inadequate intake of folates and folic acid from foodstuffs, clinical deficit is not recorded, which is the result of frequent consumption of dietary supplements. In accordance with these dietary habits, differences in the folates status of examinees were observed.