Differences in nutrient composition and choice of side dishes between red meat and fish dinners in Norwegian adults.

BACKGROUND: Food-based dietary guidelines often recommend increased consumption of fish and reduced intake of red and processed meat. However, little is known about how changing the main protein source from red meat to fish may influence the choice of side dishes. OBJECTIVE: To investigate whether side dish choices differed between red meat and fish dinners. Moreover, to compare intakes of macronutrients and selected micronutrients in red meat and fish dinners and to see whether whole-day intakes of these nutrients differed between days with red meat dinners and days with fish dinners. DESIGN: Data were collected in a cross-sectional nationwide Norwegian dietary survey using two non-consecutive telephone-administered 24-h recalls. The recalls were conducted approximately 4 weeks apart. In total, 2,277 dinners from 1,517 participants aged 18-70 were included in the analyses. RESULTS: Fish dinners were more likely to include potatoes and carrots than red meat dinners, whereas red meat dinners more often contained bread, tomato sauce, and cheese. Red meat dinners contained more energy and iron; had higher percentages of energy (E%) from fat, saturated fat, and monounsaturated fat; and a lower E% from protein and polyunsaturated fat than fish dinners. Fish dinners contained more vitamin D, ß-carotene, and folate than red meat dinners. Similar differences were found when comparing whole-day intakes of the same nutrients on days with red meat versus fish dinners. CONCLUSION: Fish dinners were accompanied by different side dishes than red meat dinners. With regard to nutrient content, fish dinners generally had a healthier profile than red meat dinners. However, iron intake was higher for red meat dinners. Information about associated foods will be useful both for developing public health guidelines and when studying associations between dietary factors and health outcomes.

Nutritional Consequences of Adhering to a Low Phenylalanine Diet for Late-Treated Adults with PKU : Low Phe Diet for Adults with PKU.

BACKGROUND: The main treatment for phenylketonuria (PKU) is a low phenylalanine (Phe) diet, phenylalanine-free protein substitute and low-protein special foods. This study describes dietary composition and nutritional status in late-diagnosed adult patients adhering to a PKU diet. METHODS: Nineteen patients, followed at Oslo University Hospital in Norway, participated; median age was 48 years (range 26-66). Subjects were mild to severely mentally retarded. Food intake, clinical data and blood analyses relevant for nutritional status were assessed. RESULTS: Median energy intake was 2,091 kcal/day (range 1,537-3,277 kcal/day). Carbohydrates constituted 59% (range 53-70%) of the total energy, including 15% from added sugar; 26% was from fat. The total protein intake was 1.02 g/kg/day (range 0.32-1.36 g/kg/day), including 0.74 g/kg/day (range 0.13-1.07 g/kg/day) from protein substitutes. Median dietary Phe intake was 746 mg/day (range 370-1,370 mg/day). Median serum Phe was 542 µmol/L (range 146-1,310 mg/day). Fortified protein substitutes supplied the main source of micronutrients. Iron intake was 39.5 mg/day (range 24.6-57 mg/day), exceeding the upper safe intake level. Intake of folate and folic acid, calculated as dietary folate equivalents, was 1,370 µg/day (range 347-1744 µg/day), and resulted in high blood folate concentrations. Median intake of vitamin B(12) was 7.0 µg/day (range 0.9-15.1 µg/day). CONCLUSIONS: The diet supplied adequate protein and energy. Fortification of the protein substitutes resulted in excess intake of micronutrients. The protein substitutes may require adjustment to meet nutritional recommendations for adults with PKU.

Do patients with lymphoedema cholestasis syndrome 1/Aagenaes syndrome need dietary counselling outside cholestatic episodes?

BACKGROUND & AIMS: Patients with lymphoedema cholestasis syndrome 1/Aagenaes Syndrome need a fat reduced diet when cholestatic. We wanted to assess the need for dietary counselling outside cholestatic episodes, and hypothetized that no counselling was needed. METHODS: Fifteen patients above 10 years of age without symptoms of cholestasis were compared with a sex and age matched control group. Diet from a four-day weighed record and blood samples were compared between the two groups and with general Norwegian recommendations. RESULTS: The patients had a similar diet to the healthy controls, except for statistically significant lower intake of energy from total fat (p=0.04) and saturated fat (0.02), and fish (0.05). The patients met the dietary recommendations for macronutrients, except for saturated fat, monounsaturated fat, refined sugar and fibre. Supplements were needed to meet the micronutrient recommendations. Patients had a significantly lower serum level of alpha-tocopherol (0.01) compared with the control group, and the serum 25-OH D level was below reference ranges. CONCLUSIONS: The patients would benefit from counselling on fat quality, carbohydrates including fibre intake, and individual needs for vitamins D and E. To secure serum 25-OH D and alpha-tocopherol levels within reference ranges, regular examinations to determine the need for supplementary vitamins D and E are recommended.

[Growth and dietary intake among children with previous cow's milk allergy]. / Vekstutvikling og kosthold hos barn som har hatt kumelkallergi.

BACKGROUND: Approximately 2-3% of children develop allergy or intolerance to cow's milk and many of them go on a milk-free diet for a long time. Few studies have been done on growth and dietary intake among these children. MATERIAL AND METHODS: 28 children aged 6-10 who had recovered from cow's milk allergy, divided into groups "low-milk" and "ad lib milk", were compared with a control group of 32 children of same age. Growth rates from age one and dietary intake at present age based on four days weighed dietary assessment were used. RESULTS: Among the allergic children at ages 6-10, 50% had developed tolerance to cow's milk protein, while 35% used some dairy products. A totally milk-free diet was kept by 15%; these children were excluded from the study. The children with allergy had low body weight and height at ages one, two and four and at the present age compared with the controls. The energy intake was the same in both groups. The total sample had higher intake of sugar and lower intake of vitamin D than the recommended values. The 35% of children with restricted intake of cow's milk had lower intake of calcium, riboflavin and protein. The 50% of children with ad lib intake of milk products had a diet that differed little from that of the non-allergic children. INTERPRETATION: There is a need for further studies on growth, dietary intake and development of tolerance that could give health workers better knowledge for dealing with this group of children.

[Effects of public initiatives aimed at reducing neural tube defects with folic acid supplementation]. / Effekt av offentlige tiltak for å forebygge nevralrørsdefekter med folat.

BACKGROUND: In order to prevent neural tube defects, a daily supplement of 400 microg (microgram) folic acid has been recommended in Norway since 1998, during the last month before conception and the first two or three months of pregnancy. Compliance with and effects of this recommendation has recently been evaluated in Norway in a report to the Directorate of Health and Social Welfare. MATERIAL AND METHODS: Reports published on periconceptional folic acid intake in Norway and some other countries from 1998 to autumn 2003 have been evaluated. RESULTS: In spite of several information activities, few Norwegian women start folic acid supplementation before verified pregnancy. The supplementation is started too late for the prevention of neural tube defects. A reduction is not observed in Norway. Internationally, information has not proven effective either, whereas compulsory fortification of foods with folic acid has been associated with reduced incidence. Information about periconceptional folic acid intake should be intensified. Compulsory fortification of foods with folic acid will affect the whole population, not only the target group of fertile women. If ongoing large intervention studies show improved clinical prognosis for patients with cardiovascular disease, this will be an additional argument for fortification of foods.

[Does folic acid have effects on other health problems than neural tube defects?]. / Effekt av folat på andre helseproblemer enn nevralrørsdefekter?

BACKGROUND: While it is widely accepted that periconceptional supplement of 400 microg (microgram) folic acid reduces the risk of neural tube defects in pregnancy, it remains to be established whether folic acid has other beneficial effects on larger population groups. Evidence concerning effect of increased intake on cardiovascular disease, cancer and other diseases has recently been evaluated in a report to the Directorate of Health and Social Welfare in Norway. MATERIAL AND METHODS: Research reports published mainly from 1998 to 2003 on folic acid intake and disease have been evaluated. RESULTS: Sufficient evidence that increased folic acid intake may prevent cancer or cardiovascular diseases is not yet available, hence at present there is no indication for recommending augmented intake for other groups than fertile women. However, several intervention studies with folic acid supplementation are in progress to establish its effect on cardiovascular mortality and morbidity. INTERPRETATION: If the ongoing intervention studies show a beneficial clinical effect on cardiovascular disease, it would be a further argument for fortification of foods, in addition to reducing the risk of neural tube defects in pregnancy.