Development and validation of a short food list to assess the intake of total fat, saturated, mono-unsaturated, polyunsaturated fatty acids and cholesterol.

BACKGROUND: The aim of this study was the development and validation of a short list of food items to assess the intake of total fat, saturated, mono-unsaturated, polyunsaturated fatty acids, and cholesterol. The short list should be able to correctly classify persons according to their intake. METHODS: A short list of 20 food items was selected out of 1009 seven-day food records by means of the variance-based method Max_r. This list was validated using data from a further 479 persons who completed seven-day food records (validation sample 1, VS1) as well as a food frequency questionnaire (validation sample 2, VS2). The intake of total fat, different fatty acids, and cholesterol from the complete VS1 (VS1(complete)) and from the complete VS2 (VS2(complete)), respectively, was computed. Further, the intake in VS1 (VS1(short)) as well as in VS2 (VS2(short)) using only the 20 food items on the short list were calculated. RESULTS: Pearson correlation coefficients between the intake calculated from the items on the short list and the nutrient intake calculated from the full instrument in VS1 and VS2, respectively, were r = 0.81-0.91. In a quartile's cross-classification 53.4-64.1% of the participants were assigned to the same quartile. When comparing VS1(complete) with VS2(short), neither correlation coefficients nor the cross-classification differ much from the comparison of VS1(complete) with VS2(complete). CONCLUSIONS: The short list shows good results in both validation samples. Thus, the short list can assess the variability of fat intake and classify persons according to their intake.

Comparing the results of a cholesterol and saturated fat screener when using two different scores.

Screener are useful instruments for categorising individuals according to their nutrient intake. To accurately classify the individuals it is important to correctly analyse the screener. Therefore we compared a simple and a weighed score of a cholesterol and saturated fat (SF) screener with the cholesterol and SF intake, respectively, calculated from an extensive food frequency questionnaire. The validation results did not change when a weighed score was used instead of the simple one, indicating that a simple score does not introduce a higher amount of misclassification.

Neuroblastoma screening at one year of age.

BACKGROUND: Neuroblastoma is the second most common type of childhood tumor. It is not known whether screening for neuroblastoma at one year of age reduces the incidence of metastatic disease or mortality due to neuroblastoma. METHODS: We offered urine screening for neuroblastoma at approximately one year of age to 2,581,188 children in 6 of 16 German states from 1995 to 2000. A total of 2,117,600 eligible children in the remaining states served as controls. We compared the two groups in terms of the incidence of disseminated disease and mortality from neuroblastoma. RESULTS: A total of 1,475,773 children (61.2 percent of those who were born between July 1, 1994, and October 31, 1999) underwent screening. In this group, neuroblastoma was detected by screening in 149 children, of whom 3 have died. Fifty-five children who had negative screening tests were subsequently given a diagnosis of neuroblastoma; 14 of these children have died. The screened group and children in the control area had a similar incidence of stage 4 neuroblastoma (3.7 cases per 100,000 screened children [95 percent confidence interval, 2.7 to 4.7] and 3.8 per 100,000 controls [95 percent confidence interval, 2.9 to 4.6]) and a similar rate of death among children with neuroblastoma (1.3 deaths per 100,000 screened children [95 percent confidence interval, 0.7 to 1.8] and 1.2 per 100,000 controls [95 percent confidence interval, 0.7 to 1.7]). Comparison of the screened group and the children in the control area revealed substantial overdiagnosis in the former group (an estimated rate of 7 cases per 100,000 children [95 percent confidence interval, 4.6 to 9.2]); the overdiagnosis rate represents children who had neuroblastoma that was diagnosed by screening but who would not benefit from earlier diagnosis and treatment. CONCLUSIONS: The present findings do not support the usefulness of general screening for neuroblastoma at one year of age.