Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: the Framingham Nutrition Studies.

BACKGROUND/OBJECTIVES: Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on the long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years, as well as the validity of the follow-up FNRS. SUBJECTS/METHODS: Framingham Offspring/Spouse Study women and men (n=1734) aged 22-76 years were evaluated over 8 years. Individuals' nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984-1988) and at follow-up (1992-1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated by Bland-Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using analysis of covariance. RESULTS: Modest changes from baseline (15%) were observed in nutrient intake. The stability coefficients for the FNRS (ICC: women, 0.49; men, 0.46; P<0.0001) and many nutrients (ICC 0.3) were moderate. Over half of the women and men (58%) remained in the same or contiguous baseline and follow-up quartile of the FNRS and few (3-4%) shifted >1 quartile. The FNRS was directly associated with body mass index in women (P<0.01) and high-density lipoprotein cholesterol among both women (P<0.001) and men (P<0.01). CONCLUSIONS: The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations.

Malaria prevalence and morbidity in relation to the use of permethrin-treated wall cloths in Kenya.

The effect of permethrin-treated wall cloths (Mbu cloth) on malaria parasitaemia prevalences and malaria morbidity, was evaluated in a population of over 10,000 for a period of three years in the Marigat area, Baringo District, Kenya. The use of the treated cloth in 2,000 houses resulted in significantly lower rates of malaria parasite prevalences with an overall reduction rate of 73% (P < 0.001) in the treated area. Control areas had an initial increase in rate of malaria parasite prevalence of 30% and later a reduction of 31%. There was a slight reduction in spleen rates in the control and treated areas but it was not significant for either between the surveys or among the villages.

PIP: The use of pyrethroid-treated fabrics against disease vectors is a well-accepted vector control strategy worldwide. Most studies have assessed the merits of using impregnated bednets, but this prevention strategy is inappropriate for many households in many communities due to incompatible cultural norms, high cost, the lack of conventional western style beds, sleeping arrangements which differ between cultures, and differences between housing construction styles in rural communities. The International Center of Insect Physiology and Ecology recently developed a technology using cotton wall cloth, Mbu cloth, to control vectors of malaria and leishmaniasis in rural communities in Kenya. Other fabrics such as polyester have even improved the technology by making the cloth lighter and cheaper. The authors evaluated the effect of permethrin-treated Mbu cloth on malaria parasitemia prevalences and malaria morbidity in a population of over 10,000 for a period of 3 years in the Marigat area of Baringo District, Kenya. 2000 houses were fitted with the cloth. The prevalence of malaria parasites was reduced an overall 73% in the treated area. Control areas saw a 30% initial increase in the rate of malaria parasite prevalence followed by a reduction of 31%. Slight reductions in spleen rates were also observed in the control and treated areas, but were insignificant between the surveys and among the villages.