Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries.

BACKGROUND: Malnutrition linked to noncommunicable diseases presents major health problems across Europe. The World Health Organisation encourages countries to conduct national dietary surveys to obtain data to inform public health policies designed to prevent noncommunicable diseases. METHODS: Data on 27334 participants aged 19-64y were harmonised and pooled across national dietary survey datasets from 12 countries across the WHO European Region. Weighted mean nutrient intakes were age-standardised using the Eurostat 2013 European Standard Population. Associations between country-level Gross Domestic Product (GDP) and key nutrients and nutrient densities were investigated using linear regression. The potential mitigating influence of participant-level educational status was explored. FINDINGS: Higher GDP was positively associated with total sugar intake (5·0% energy for each 10% increase in GDP, 95% CI 0·6, 9·3). Scandinavian countries had the highest vitamin D intakes. Participants with higher educational status had better nutritional intakes, particularly within lower GDP countries. A 10% higher GDP was associated with lower total fat intakes (-0·2% energy, 95% CI -0·3, -0·1) and higher daily total folate intakes (14µg, 95% CI 12, 16) in higher educated individuals. INTERPRETATION: Lower income countries and lower education groups had poorer diet, particularly for micronutrients. We demonstrate for the first time that higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. It illustrates the feasibility and value of harmonising national dietary survey data to inform European policy regarding access to healthy diets, particularly in disadvantaged groups. It specifically highlights the need for strong policies supporting nutritional intakes, prioritising lower education groups and lower income countries.

Maternal diet during pregnancy and lactation and cow's milk allergy in offspring.

BACKGROUND/OBJECTIVES: Diet during pregnancy and lactation may have a role in the development of allergic diseases. There are few human studies on the topic, especially focusing on food allergies. We sought to study the associations between maternal diet during pregnancy and lactation and cow's milk allergy (CMA) in offspring. SUBJECTS/METHODS: A population-based birth cohort with human leukocyte antigen-conferred susceptibility to type 1 diabetes was recruited in Finland between 1997 and 2004 (n=6288). Maternal diet during pregnancy and lactation was assessed by a validated, 181-item semi-quantitative food frequency questionnaire. Register-based information on diagnosed CMA was obtained from the Social Insurance Institution and completed with parental reports. The associations between maternal food consumption and CMA were assessed using logistic regression, comparing the highest and the lowest quarters to the middle half of consumption. RESULTS: Consumption of milk products in the highest quarter during pregnancy was associated with a lower risk of CMA in offspring (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.37-0.86; P<0.01). When stratified by maternal allergic rhinitis and asthma, there was evidence of an inverse association between high use of milk products and CMA in offspring of non-allergic mothers (OR 0.30, 95% CI 0.13-0.69, P<0.001). Cord blood IgA correlated positively with the consumption of milk products during pregnancy, indicating exposure to CMA and activation of antigen-specific immunity in the infant during pregnancy. CONCLUSIONS: High maternal consumption of milk products during pregnancy may protect children from developing CMA, especially in offspring of non-allergic mothers.

Maternal dietary fat and fatty acid intake during lactation and the risk of asthma in the offspring.

AIM: To explore the association between maternal dietary fat and fatty acid (FA) intake during lactation, and the risk of asthma in the offspring by the age of 5 years. METHODS: The subjects comprised 1798 mother-child pairs from the Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Dietary intake was assessed by a validated 181-item food frequency questionnaire, which covered the third month of lactation. The cumulative incidence of asthma was assessed at the age of 5 years with a questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC). Cox proportional hazards regression was used for statistical analysis. RESULTS: The maternal use of margarines during lactation was associated with a marginally increased risk of asthma [hazard ratio (HR) for user vs. nonuser 1.96, 95% confidence interval (CI) 1.01-3.82, p = 0.047] after adjusting for putative confounders. The maternal intakes of n-3 polyunsaturated FA (PUFA) and fish during lactation were not associated with the risk of asthma. CONCLUSION: Maternal use of margarines during lactation was weakly associated with an increased risk of asthma in the offspring at the age of 5 years. Other fats or FAs during lactation were not associated with the risk of asthma. However, the nonadherence to dietary recommendations regarding especially fats of our study population may restrict the generalizability of our results.

Dietary acrylamide exposure among Finnish adults and children: the potential effect of reduction measures.

A deterministic exposure assessment using the Nusser method that adjusts for within-subject variation and for nuisance effects among Finnish children and adults was carried out. The food consumption data covered 2038 adults (25-74 years old) and 1514 children of 1, 3 and 6 years of age, with the data on foods' acrylamide content obtained from published Finnish studies. We found that acrylamide exposure was highest among the 3-year-old children (median = 1.01 µg kg(-1) bw day(-1), 97.5th percentile = 1.95 µg kg(-1) bw day(-1)) and lowest among 65-74-year-old women (median = 0.31 µg kg(-1) bw day(-1), 97.5th percentile = 0.69 µg kg(-1) bw day(-1)). Among adults, the most important source of acrylamide exposure was coffee, followed by casseroles rich in starch, then rye bread. Among children, the most important sources were casseroles rich in starch and then biscuits and, finally, chips and other fried potatoes. Replacing lightly roasted coffee with dark-roasted, swapping sweet wheat buns for biscuits, and decreasing the acrylamide content of starch-based casseroles and rye bread by 50% would result in a 50% decrease in acrylamide exposure in adults. Among children, substituting boiled potatoes for chips and other friend potatoes and replacing biscuits with sweet wheat buns while lowering the acrylamide content of starch-based casseroles by 50% would lead to acrylamide exposure that is only half of the original exposure. In conclusions, dietary modifications could have a large impact in decreasing acrylamide exposure.

Snacks as an element of energy intake and food consumption.

BACKGROUND: An increasing frequency of snacks has been observed in meal pattern studies. Snacks can alter the diet because of their high-energy density and low-nutrient content or on the contrary. OBJECTIVE: The prominence of snacks in energy intake and food consumption was assessed. DESIGN: Dietary data were collected for 2007 adults by using a computer-assisted 48-h dietary recall in the national FINDIET 2002 survey. Energy intakes and food consumption were aggregated for snacks and for main meals. RESULTS: Daily energy was mostly derived from main meals comprising traditional mixed dishes, milk and bread. However, a snack-dominating meal pattern was observed in 19% of men and 24% of women. This meal pattern was associated with urbanization in both genders and with physical work in men. Higher sucrose intake and lower intake of micronutrients were typical of the snack-dominating meal pattern compared to the others. CONCLUSIONS: As snacks appear to have a higher energy density and a lower content of micronutrients than main meals, a snack-dominating meal pattern is inadvisable. However, further studies are needed to examine the association between meal pattern and health status.

Meat fats in nutrition.

This article reviews the fat content and fatty acid composition of meats in the human diet and discusses nutritional facts related to meat, meat products and other meat-containing foods as sources of dietary fats. Meat is an increasingly important source of high-value animal protein worldwide. Meat fat comprises mostly monounsaturated and saturated fatty acids, with oleic (C18:1), palmitic (C16:0), and stearic acid (C18:0) being the most ubiquitous. Meat and meat products are considerable sources of cholesterol in the diet. In most industrialized countries, a high meat intake contributes to a higher than recommended total and saturated fat and cholesterol intake. Another concern is that meat may replace sources of other important nutrients in the diet. Therefore, the advice to consumers is to prefer lean meats and low-fat meat products and use meat in moderation only.

Determinants of serum enterolactone concentration.

BACKGROUND: The lignan enterolactone, which is produced by the intestinal microflora from dietary precursors, may protect against hormone-dependent cancers and cardiovascular diseases. OBJECTIVE: We examined the cross-sectional associations between the serum enterolactone concentration and variables related to diet and health in Finnish adults. DESIGN: Serum enterolactone was measured by using time-resolved fluoroimmunoassay in 2380 Finnish men and women aged 25-64 y who were participating in a cross-sectional national survey in 1997. Background information was collected with self-administered questionnaires and the diet was assessed with a food-frequency questionnaire. RESULTS: The median serum enterolactone concentration was 13.8 nmol/L (range: 0-95.6 nmol/L) in men and 16.6 nmol/L (range: 0-182.6 nmol/L) in women. Multiple regression analyses showed positive associations in men between the serum enterolactone concentration and constipation, consumption of whole-grain products, and intake of fruit and berries. In women, the serum enterolactone concentration was positively and independently associated with consumption of vegetables, subject age, and constipation and was negatively associated with smoking. Furthermore, female subjects of normal weight had significantly higher serum enterolactone concentrations than did their underweight or obese peers. CONCLUSIONS: The serum enterolactone concentration varies widely in the population. Of the variables we examined, the most important determinants of the serum enterolactone concentration were consumption of lignan-containing foods and constipation; however, these appeared to explain only a small part of the variation. Therefore, the role of gut microflora in the metabolism of lignans might be very important. Further studies will also be needed to determine the bioavailability and absorption rate of lignans.