Associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders: an analysis of data from the 2008/09 New Zealand Adult Nutrition Survey.

PURPOSE: To investigate associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders. METHODS: Dietary patterns were identified using factor analysis in adults 15 years plus (n = 4657) using 24-h diet recall data from the 2008/09 New Zealand Adult Nutrition Survey. Multivariate regression was used to investigate associations between dietary patterns and age, gender and ethnicity. After controlling for demographic factors, associations between dietary patterns and food insecurity, deprivation, education, and smoking were investigated. Associations between dietary patterns and body mass index and waist circumference were examined adjusting for demographic factors, smoking and energy intake. RESULTS: Two dietary patterns were identified. 'Healthy' was characterised by breakfast cereal, low fat milk, soy and rice milk, soup and stock, yoghurt, bananas, apples, other fruit and tea, and low intakes of pies and pastries, potato chips, white bread, takeaway foods, soft drinks, beer and wine. 'Traditional' was characterised by beef, starchy vegetables, green vegetables, carrots, tomatoes, savoury sauces, regular milk, cream, sugar, tea and coffee, and was low in takeaway foods. The 'healthy' pattern was positively associated with age, female gender, New Zealand European or other ethnicity, and a secondary school qualification, and inversely associated with smoking, food insecurity, area deprivation, BMI and waist circumference. The 'traditional' pattern was positively associated with age, male gender, smoking, food insecurity and inversely associated with a secondary school qualification. CONCLUSIONS: A 'Healthy' dietary pattern was associated with higher socio-economic status and reduced adiposity, while the 'traditional' pattern was associated with lower socio-economic status.

Predictors of vitamin D status in New Zealand preschool children.

Vitamin D deficiency has adverse health effects in young children. Our aims were to determine predictors of vitamin D status and then to use these factors to develop a practical tool to predict low 25(OH)D concentrations in preschool New Zealand children. A cross-sectional sample of 1329 children aged 2 to <5 years were enrolled from throughout New Zealand in late-winter to spring 2012. 25-Hydroxyvitamin D (25(OH)D) was measured on dried blood spot (DBS) samples collected using finger-prick sampling. Caregivers completed a questionnaire. Mean (SD) DBS 25(OH)D concentration was 52(19)nmol/L. 25(OH)D < 25 nmol/L was present in 86(7%), 25(OH)D < 50 nmol/L in 642(48%), 25(OH)D 50- < 75 nmol/L in 541(41%) and 25(OH)D > 75 nmol/L in 146(11%) of children. Factors independently associated with the risk of 25(OH)D < 25 nmol/L were female gender (OR 1.92,95%CI 1.17-3.14), other non-European ethnicities (not including Maori or Pacific) (3.51,1.89-6.50), had olive-dark skin colour (4.52,2.22-9.16), did not take vitamin D supplements (2.56,1.06-6.18), had mothers with less than secondary-school qualifications (5.00,2.44-10.21) and lived in more deprived households (1.27,1.06-1.53). Children who drank toddler milk (vitamin D fortified cow's milk formula marketed to young children) had a zero risk of 25(OH)D < 25 nmol/L. The predictive tool identified children at risk of 25(OH)D < 25 nmol/L with sensitivity 42%, specificity 97% and ROC area-under-curve 0.76(95%CI 0.67-0.86, p < 0.001). Predictors of low vitamin D status were consistent with those identified in previous studies of New Zealand children. The tool had insufficient predictive ability for use in clinical situations, and suggests a need to promote safe, inexpensive testing to determine vitamin D status in preschool children.

The effect of monthly 50,000 IU or 100,000 IU vitamin D supplements on vitamin D status in premenopausal Middle Eastern women living in Auckland.

BACKGROUND/OBJECTIVES: Middle Eastern female immigrants are at an increased risk of vitamin D deficiency and their response to prescribed vitamin D dosages may not be adequate and affected by other factors. The objectives were to determine vitamin D deficiency and its determinants in Middle Eastern women living in Auckland, New Zealand (Part-I), and to determine serum 25-hydroxyvitamin D (serum-25(OH)D) response to two prescribed vitamin D dosages (Part-II) in this population. PARTICIPANTS/METHODS: Women aged ⩾20 (n=43) participated in a cross-sectional pilot study during winter (Part-I). In Part-II, women aged 20-50 years (n=62) participated in a randomised, double-blind placebo-controlled trial consuming monthly either 50,000, 100,000 IU vitamin D3 or placebo for 6 months (winter to summer). RESULTS: All women in Part-I and 60% women in Part-II had serum-25(OH)D<50 nmol/l. Serum-25(OH)D was higher in prescribed vitamin D users than nonusers (P=0.001) and in Iranians than Arab women (P=0.001; Part-I). Mean (s.d.) serum-25(OH)D increased in all groups (time effect, P<0.001) and differed between groups (time × dosage interaction, P<0.001; 50,000 IU: from 44.0±16.0 to 70.0±15.0 nmol/l; 100,000 IU: 48.0±11.0 to 82.0±17.0 nmol/l; placebo: 45.0±18.0 to 54.0±18.0 nmol/l). Only 32% and 67% achieved serum-25(OH)D⩾75 nmol/l with 50,000 and 100,000 IU/month, respectively. Predictors of 6-month change in serum-25(OH)D were dose (B-coefficient±s.e.; 14.1±2.4, P<0.001), baseline serum-25(OH)D (-0.6±0.1, P<0.001) and body fat percentage (-0.7±0.3, P=0.01). CONCLUSIONS: Vitamin D deficiency/insufficiency is highly prevalent in this population. Monthly 100,000 IU vitamin D for 6 months is more effective than 50,000 IU in achieving serum-25(OH)D ⩾75 nmol/l; however, a third of women still did not achieve these levels.

Inflammatory status modulates plasma lipid and inflammatory marker responses to kiwifruit consumption in hypercholesterolaemic men.

BACKGROUND AND AIMS: Kiwifruit has the potential to improve markers of metabolic dysfunction, but the response may be influenced by inflammatory state. We aimed to investigate whether inflammatory state would modulate the effect of consuming two green kiwifruit daily on plasma lipids and markers of inflammation. METHODS AND RESULTS: Eighty-five hypercholesterolaemic men completed a 4-week healthy diet run-in, before randomisation to a controlled cross-over study of two 4-week interventions of two green kiwifruit/day plus healthy diet (intervention) or healthy diet alone (control). Anthropometric measures and fasting blood samples (plasma lipids, serum apolipoproteins A1 and B, high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6, tumour necrosis factor-alpha (TNF-α) and IL-10) were taken at baseline, 4 and 8 weeks. Subjects were divided into low and medium inflammatory groups, using pre-intervention hs-CRP concentrations (hs-CRP <1 and 1-3 mg/L, respectively). In the medium inflammatory group the kiwifruit intervention resulted in significant improvements in plasma high-density lipoprotein cholesterol (HDL-C) (mean difference 0.08 [95% CI: 0.03, 0.12] mmol/L [P < 0.001]), total cholesterol (TC)/HDL-C ratio (-0.29 [-0.45, -0.14] mmol/L [P = 0.001]), plasma hs-CRP (-22.1 [-33.6, -4.97]% [P = 0.01]) and IL-6 (-43.7 [-63.0, -14.1]% [P = 0.01]) compared to control treatment. No effects were seen in the low inflammatory group. There were significant between inflammation group differences for TC/HDL-C (P = 0.02), triglyceride (TG)/HDL-C (P = 0.05), and plasma IL-6 (P = 0.04). CONCLUSIONS: Inflammatory state modulated responses to the kiwifruit intervention by improving inflammatory markers and lipid profiles in subjects with modestly elevated CRP, suggesting this group may particularly benefit from the regular consumption of green kiwifruit. Registered 16th March 2010, Australian New Zealand Clinical Trials Registry (no. ACTRN12610000213044), www.ANZCTR.org.au.

Vitamin D supplementation suppresses age-induced bone turnover in older women who are vitamin D deficient.

There is a lack of evidence that improving vitamin D status, without changing calcium intake, has a positive effect on bone turnover as indicated by bone marker changes. The objective was to measure the effect of vitamin D supplementation, in vitamin D deficient women (25(OH)D concentration<50 nmol/L), on osteocalcin (OC) and C-telopeptide (CTX). The study design was a randomised controlled intervention administering 4000 IU vitamin D3 or placebo daily for 6 months to South Asian women, aged>20 years. Subjects were stratified by age and menopausal status. Median (25th, 75th percentile) serum 25(OH)D increased significantly from 21 (11, 40) to 75 (55, 84) nmol/L with supplementation. In women>49 years or postmenopausal (n=26), who were not supplemented (n=13), CTX and OC levels increased (P=0.001, P=0.004 respectively), indicating an increased rate of bone turnover. With supplementation CTX decreased (P=0.012) and there was no significant change in OC. In women who were under 49 years and premenopausal (n=55; 29 supplemented), there was no significant response to supplementation in either CTX or OC. We conclude that correcting vitamin D deficiency in older women suppresses the age-induced increase in bone turnover and reduces bone resorption which would normally be exacerbated in conditions of low serum 25(OH)D.