Oxaliplatin-induced papilledema: Rare case report.

Papilledema is the presence of bilateral optic disc edema in the presence of raised intracranial pressure and often is symmetric. We report a case of a 70-year-old male with rectal carcinoma on chemotherapy presented with minimal drop in visual acuity. The patient has bilateral disc edema and investigations including computed tomography and cerebrospinal fluid opening pressure were normal and no evidence of brain metastasis has been found. The patient was on oxaliplatin regimen and literature search has shown very few cases of platinum chemotherapy agents-induced papilledema. So far to our knowledge, oxaliplatin-induced papilledema has not been reported and knowing this condition can be sight saving for ill patients.

Recurrent bilateral chorioretinitis with positive Lyme serology: a case report.

BACKGROUND: It has been disputed whether Lyme is a true causative agent in posterior uveitis or an incidental finding. CASE PRESENTATION: This report presents a case of a 33-year-old Caucasian female with a remote history of Lyme disease who presented with blurry vision in the right eye. Exam and imaging revealed a right active chorioretinitis and positive Lyme serology. The patient was systemically treated with prednisone and antibiotics. Symptoms initially improved, but she later developed a localized choriocapillaritis in the left eye. Steroids and antibiotics were restarted many times with fluctuating course of the disease. The patient was then started on chronic steroid-sparing immunosuppression, which has controlled the condition without recurrence. CONCLUSIONS: The current report presents a unique case of recurrent bilateral chorioretinitis with positive Lyme serology and raises the question of the existence of true Lyme-associated uveitis.

Presumed Choroidal Metastasis From Oncocytic Carcinoma of the Parotid Gland: A Case Report.

Purpose: This article reports a case of presumed choroidal metastasis from an oncocytic carcinoma of the parotid gland. Methods: A 70-year-old man with history of an oncocytic carcinoma of the parotid gland presented owing to a 1-month history of progressive blurred central vision shortly after metastatic surveillance workup revealed liver, lung, and spine metastases. Fundus examination of the right eye showed a yellow choroidal mass surrounding the optic nerve and extending inferonasally, which is associated with subretinal fluid involving the foveal center. A-scan and B-scan ultrasonography were remarkable for a dome-shaped choroidal mass with medium-to-high internal reflectivity. Fluorescein angiography revealed pinpoint foci of hyperfluorescence over the choroidal lesion with late leakage. Magnetic resonance imaging of the brain showed evidence of metastatic disease to the cerebellum. While the patient underwent systemic chemotherapy, external beam radiotherapy was used to treat the eye. Results: Four months later, visual acuity improved, the tumor reduced in size, and the subretinal fluid resolved. Systemic workup disclosed no new metastases. Conclusion: Oncocytic carcinoma of the parotid gland is a rare and aggressive malignant neoplasm with frequent recurrences and distant metastases. The current case suggests that oncocytic carcinoma can metastasize to the choroid and, consequently, ocular metastasis surveillance is advised in these patients.

Fruit, vegetable and vitamin C intakes and plasma vitamin C: cross-sectional associations with insulin resistance and glycaemia in 9-10 year-old children.

AIM: To examine whether low circulating vitamin C concentrations and low fruit and vegetable intakes were associated with insulin resistance and other Type 2 diabetes risk markers in childhood. METHODS: We conducted a cross-sectional, school-based study in 2025 UK children aged 9-10 years, predominantly of white European, South-Asian and black African origin. A 24-h dietary recall was used to assess fruit, vegetable and vitamin C intakes. Height, weight and fat mass were measured and a fasting blood sample collected to measure plasma vitamin C concentrations and Type 2 diabetes risk markers. RESULTS: In analyses adjusting for confounding variables (including socio-economic status), a one interquartile range higher plasma vitamin C concentration (30.9 µmol/l) was associated with a 9.6% (95% CI 6.5, 12.6%) lower homeostatic model assessment of insulin resistance value, 0.8% (95% CI 0.4, 1.2%) lower fasting glucose, 4.5% (95% CI 3.2, 5.9%) lower urate and 2.2% (95% CI 0.9, 3.4%) higher HDL cholesterol. HbA1c concentration was 0.6% (95% CI 0.2, 1.0%) higher. Dietary fruit, vegetable and total vitamin C intakes were not associated with any Type 2 diabetes risk markers. Lower plasma vitamin C concentrations in South-Asian and black African-Caribbean children could partly explain their higher insulin resistance. CONCLUSIONS: Lower plasma vitamin C concentrations are associated with insulin resistance and could partly explain ethnic differences in insulin resistance. Experimental studies are needed to establish whether increasing plasma vitamin C can help prevent Type 2 diabetes at an early stage.

Objectively measured physical activity and longitudinal changes in adolescent body fatness: an observational cohort study.

BACKGROUND: The data regarding prospective associations between physical activity (PA) and adiposity in youth are inconsistent. OBJECTIVE: The objective of this study was to investigate associations between baseline levels of objectively measured PA and changes in adiposity over 2.5 years from mid-to-late adolescence. METHODS: This was an observational cohort study in 728 school students (43% boys) from Cambridgeshire, United Kingdom. Fat mass index (FMI, kg m(-2) ) was estimated at baseline (mean ± standard deviation age: 15 ± 0.3 years) and follow-up (17.5 ± 0.3 years) by anthropometry and bioelectrical impedance. Habitual PA was assessed at baseline by ≥3 d combined heart rate and movement sensing. Average daily PA energy expenditure (PAEE) and the time (min d(-1) ) spent in light, moderate and vigorous intensity PA (LPA, MPA and VPA, respectively) was estimated. Multilevel models were used to investigate associations between baseline PA and change in FMI (ΔFMI). Adjustment for baseline age, sex, follow-up duration, area-level socioeconomic status, season of PA assessment, sedentary time, energy intake and sleep duration was made; baseline FMI was also added in a second model. RESULTS: FMI increased significantly over follow-up (0.6 ± 1.2 kg m(-2) , P < 0.001). Baseline PAEE and LPA positively predicted ΔFMI in overfat participants (P ≤ 0.030), as did VPA in initially normal fat participants (P ≤ 0.044). There were further positive associations between PAEE and ΔFMI in normal fat participants, and between MPA and ΔFMI in both fat groups, when adjusted for baseline FMI (P ≤ 0.024). CONCLUSIONS: Baseline PAEE and its subcomponents were positively associated with small and unlikely clinically relevant increases in ΔFMI. These counter-intuitive findings may be explained by behavioural changes during the course of study follow-up.

Trends in food consumption over 30 years: evidence from a British birth cohort.

BACKGROUND/OBJECTIVES: As populations are ageing, more emphasis is placed on healthy ageing. Over the past decades, food consumption patterns and food availability have also changed drastically, and therefore this study aimed to describe these changes in an ageing population. SUBJECTS/METHODS: Food consumption of participants from the Medical Research Council National Survey on Health and Development, a British birth cohort study, was assessed using a 5-day estimated food records at 60-64 years (2006-11), 53 years (1999), 43 years (1989) and 36 years (1982). Only those who recorded ⩾3 days at all four time points were included in the analyses, n=989 (n=438 men and n=551 women); trends were tested using the Friedman test. RESULTS: Consumption of white bread, whole milk, fats and oils, meat and meat products, alcoholic drinks, coffee, sugar, preserves and confectionery decreased (P<0.001), whereas consumption of wholemeal and granary bread, semi-skimmed milk, fish and fruit and vegetables increased (P<0.001) over time. These observed changes in food consumption reflect a healthier diet, for example, replacement of white bread by granary and wholemeal bread, lower consumption of red and processed meats, somewhat higher consumption of fish, higher consumption of vegetables and lower consumption of coffee. This could partly be because of ageing of the cohort or compliance with dietary recommendations, facilitated by greater availability of healthier foods, such as semi-skimmed milk and wholegrain bread, in the UK. CONCLUSIONS: The changes in food consumption in this British birth cohort over the past three decades are encouraging and reflect a healthier diet in the later years.

Silicone oil microbubble found in failed full-thickness macular hole closure.

PURPOSE: To describe a case of failed macular hole closure after vitrectomy with silicone oil tamponade because of a silicone oil microbubble. METHODS: This is a retrospective case review of a single patient's clinical course. RESULTS: Because of the inability of the patient to assume a prone position after vitrectomy for full-thickness macular hole, 1000-centistoke silicone oil tamponade was used at the initial repair. Optical coherence tomography showed persistent full-thickness macular hole with evidence of a silicone oil microbubble within the macular hole. Subsequent vitrectomy with the removal of silicone oil and exchange for 25% sulfur hexafluoride (SF6) gas with attempted prone positioning failed to provide hole closure. Successful hole closure was accomplished after tamponade with 5000-centistoke silicone oil, without prone positioning. No recurrence of the full-thickness defect was seen after the eventual removal of 5000-centistoke silicone oil. CONCLUSION: It is possible that the silicone oil microbubble formation and migration within a full-thickness macular hole defect may contribute to surgical failure.

Dietary patterns derived with multiple methods from food diaries and breast cancer risk in the UK Dietary Cohort Consortium.

BACKGROUND/OBJECTIVES: In spite of several studies relating dietary patterns to breast cancer risk, evidence so far remains inconsistent. This study aimed to investigate associations of dietary patterns derived with three different methods with breast cancer risk. SUBJECTS/METHODS: The Mediterranean Diet Score (MDS), principal components analyses (PCA) and reduced rank regression (RRR) were used to derive dietary patterns in a case-control study of 610 breast cancer cases and 1891 matched controls within four UK cohort studies. Dietary intakes were collected prospectively using 4- to 7-day food diaries and resulting food consumption data were grouped into 42 food groups. Conditional logistic regression models were used to estimate odds ratios (ORs) for associations between pattern scores and breast cancer risk adjusting for relevant covariates. A separate model was fitted for post-menopausal women only. RESULTS: The MDS was not associated with breast cancer risk (OR comparing first tertile with third 1.20 (95% CI 0.92; 1.56)), nor the first PCA-derived dietary pattern, explaining 2.7% of variation of diet and characterized by cheese, crisps and savoury snacks, legumes, nuts and seeds (OR 1.18 (95% CI 0.91; 1.53)). The first RRR-derived pattern, a 'high-alcohol' pattern, was associated with a higher risk of breast cancer (OR 1.27; 95% CI 1.00; 1.62), which was most pronounced in post-menopausal women (OR 1.46 (95% CI 1.08; 1.98)). CONCLUSIONS: A 'high-alcohol' dietary pattern derived with RRR was associated with an increased breast cancer risk; no evidence of associations of other dietary patterns with breast cancer risk was observed in this study.

Irregular consumption of energy intake in meals is associated with a higher cardiometabolic risk in adults of a British birth cohort.

BACKGROUND/OBJECTIVES: A potential risk factor for cardiometabolic diseases is irregular or inconsistent eating, however, research on this topic is scarce. We aimed to study associations between irregular consumption of energy intake in meals and cardiometabolic risk factors. SUBJECT AND METHODS: Dietary intake data were derived from 5-day estimated diet diaries of 1768 participants of the National Survey of Health and Development. Energy intakes during predefined meals (breakfast, lunch, dinner, between meals) and daily totals were analyzed using a score for irregularity based on the deviation from the 5-day mean energy intake. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for having the metabolic syndrome or one of its components. Models were adjusted for sex, physical activity, socioeconomic status, marital status and smoking. RESULTS: Irregularity scores of energy intake ranged from 0-160 and were highest for between meals. An increased risk of the metabolic syndrome was associated with more irregular energy intake during breakfast (OR=1.34 (0.99, 1.81); P trend=0.04) and between meals (OR=1.36 (1.01, 1.85); P trend=0.04). Moreover, increased waist circumference was associated with irregular energy intake during breakfast (OR=1.90 (1.47, 2.45); P trend <0.01), evening meal (OR=1.36 (1.06, 1.75); P trend=0.02) and daily total (OR=1.34 (1.04, 1.72); P trend=0.01). No significant associations were found for the other components of the metabolic syndrome. CONCLUSIONS: Individuals with a more irregular intake of energy, especially during breakfast and between meals, appeared to have an increased cardiometabolic risk.

Biomarkers of diabetes risk in the National Diet and Nutrition Survey rolling programme (2008-2011).

This study describes the distribution of glycosylated haemoglobin (Hb(A1c)) and glucose concentrations in the combined year 1 (2008-2009), year 2 (2009-2010) and year 3 (2010-2011) of the National Diet and Nutrition Survey (NDNS) rolling programme. The NDNS rolling programme is a nationally representative survey of food consumption, nutrient intakes and nutritional status of people aged 1.5 years and over living in England, Wales, Scotland and Northern Ireland. The study population comprised survey members who completed three or four days of dietary recording and who provided a blood sample. After excluding survey members with self-reported diabetes (n=25), there were 1016 results for HbA1c and 942 for glucose (not the same individuals in each case). Around 5.4% of men and 1.7% of women aged 19-64 years, and 5.1% of men and 5.9% of women aged ≥65 years had impaired fasting glucose (glucose concentrations 6.1-6.9 mmol/L). Over 20% of men aged ≥65 years had fasting glucose concentrations above the clinical cut-off for diabetes (≥7 mmol/L) compared to 2.1% of women of similar age (p=0.007). Similarly, 16.4% of men had Hb(A1c) concentrations ≥6.5%, compared to 1.5% of women (p=0.003). Children and teenagers had fasting glucose and Hb(A1c) values largely within the normal range. To conclude, this is the first study to provide data on the distribution of HbA1c and glucose concentrations in a nationally representative sample of the British population. The high prevalence of men aged ≥65 years with Hb(A1c) and glucose concentrations above the clinical cut-off of diabetes warrants further attention.

Diurnal eating rhythms: association with long-term development of diabetes in the 1946 British birth cohort.

BACKGROUND AND AIMS: Few studies have described the association between time-of-day of macronutrient intake and diabetes. This study examined the prospective association between time-of-day and nutrient composition of eating occasions in relation to diabetes incidence in the 1946 British birth cohort. METHODS AND RESULTS: The study included 1618 survey members who completed dietary assessment at age 43 (1989) and for whom data on glycosylated haemoglobin at age 53 years (1999) were available. Diet was assessed using 5d estimated diaries, divided into seven meal slots: breakfast, mid-morning, lunch, mid-afternoon, dinner, late evening and extras. Diabetes was defined by glycosylated haemoglobin (HbA1c) ≥ 6.5% or diabetes medication use. The association between time-of-day of macronutrient intake at age 43 years and diabetes at age 53 years was assessed using logistic multivariate nutrient density models after adjustment for potential confounders. There were 66 cases of diabetes at age 53 years. Survey members with diabetes obtained 50.4% of their energy from carbohydrate at breakfast compared to 55.9% in survey members without diabetes (P = 0.001). Increasing carbohydrate intake at breakfast at the expense of fat was related to lower odds ratio (OR) of diabetes (OR = 0.86; 95%CI = 0.79-0.93; P < 0.001). This relationship was attenuated after adjustment for body mass index and waist circumference. CONCLUSION: Increasing energy intake from carbohydrate at the expense of fat at breakfast is inversely associated with 10-year diabetes incidence. However, further studies are required to elucidate whether the type or source of carbohydrates or fat influences the above association.

Mapping low intake of micronutrients across Europe.

Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B1, B2, B6, B12, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

Time-of-day and nutrient composition of eating occasions: prospective association with the metabolic syndrome in the 1946 British birth cohort.

BACKGROUND: Diet is a key modifiable factor in the prevention and treatment of the metabolic syndrome. However, few studies have examined the prospective association between time-of-day of nutrient intake and the metabolic syndrome. OBJECTIVE: To examine the association between time-of-day and nutrient composition of eating occasions and the long-term development of metabolic syndrome in the Medical Research Council (MRC) National Survey of Health and Development (NSHD; 1946 British birth cohort). METHODS: The analysis comprised 1488 survey members who completed at least 3 days of estimated diet records at age 43 years (1989) and for whom data on metabolic syndrome at age 53 years (1999) were available. Dietary records were divided into seven meal slots: breakfast, mid-morning, lunch, mid-afternoon, dinner, late evening and extras. Metabolic syndrome was defined by the criteria of the adult treatment panel (ATPIII8), and was modified to include glycosylated haemoglobin instead of fasting glucose. Associations between time-of-day of nutrient intake at age 43 years and prevalence of metabolic syndrome at age 53 years were assessed using multivariate nutrient density logistic models after adjustment for sex, social class, smoking status, region, alcohol intake and recreational physical activity. RESULTS: There were 390 cases of metabolic syndrome at age 53 years. Substituting 5% of energy from carbohydrate for a similar amount of energy from fat at breakfast (odds ratio=0.93; 95% confidence interval=0.89-0.98; P=0.002) and mid-morning at age 43 years (odds ratio=0.96; 95% confidence interval=0.93-0.99; P=0.011) was associated with lower odds of the metabolic syndrome at age 53 years. Carbohydrate intake at breakfast or mid-morning was particularly protective against abdominal obesity (P0.001). Increasing carbohydrate intake at breakfast while simultaneously decreasing fat intake was also negatively related to triacylglycerols (P0.001). CONCLUSIONS: Increasing carbohydrate intake in the morning while simultaneously reducing fat intake could be protective against long-term development of the metabolic syndrome and its components.

Vitamin C intake from diary recordings and risk of breast cancer in the UK Dietary Cohort Consortium.

BACKGROUND/OBJECTIVES: Vitamin C intake has been inversely associated with breast cancer risk in case-control studies, but not in meta-analyses of cohort studies using Food Frequency Questionnaires, which can over-report fruit and vegetable intake, the main source of vitamin C. This is the first study to investigate associations between vitamin C intake and breast cancer risk using food diaries. SUBJECTS/METHODS: Estimated dietary vitamin C intake was derived from 4-7 day food diaries pooled from five prospective studies in the UK Dietary Cohort Consortium. This nested case-control study of 707 incident breast cancer cases and 2144 matched controls examined breast cancer risk in relation to dietary vitamin C intake using conditional logistic regression adjusting for relevant covariates. Additionally, total vitamin C intake from supplements and diet was analysed in three cohorts. RESULTS: No evidence of associations was observed between breast cancer risk and vitamin C intake analysed for dietary vitamin C intake (odds ratios (OR)=0.98 per 60 mg/day, 95% confidence interval (CI): 0.88-1.09, P (trend)=0.7), dietary vitamin C density (OR=0.97 per 60 mg/day, 95% CI: 0.87-1.07, P (trend)=0.5 ) or total vitamin C intake (OR=1.01 per 60 mg/day, 95% CI: 0.99-1.03, P (trend)=0.3). Additionally, there was no significant association for post-menopausal women (OR=1.02 per 60 mg/day, 95% CI: 0.99-1.05, P (trend)=0.3). CONCLUSIONS: This pooled analysis of individual UK women found no evidence of significant associations between breast cancer incidence and dietary or total vitamin C intake derived uniquely from detailed diary recordings.

Daily profiles of energy and nutrient intakes: are eating profiles changing over time?

BACKGROUND/OBJECTIVES: Associations between timing of eating occasions and their nutrient composition and health have been described in interventional and cross-sectional studies. However, data from longitudinal data are limited. This study examined 17-year changes in energy and macronutrient intake across eating occasions in the 1946 British birth cohort. SUBJECTS/METHODS: Data were obtained from the 1946 British birth cohort. Cohort members completed 5d-estimated diaries at ages 36 (1982), 43 (1989) and 53 years (1999). Data from subjects who provided dietary data at all three time points were analysed (n = 1253). Repeated-measures analysis of variance with post hoc Bonferroni's adjustment was used to examine changes in energy and macronutrient at breakfast, mid-morning, lunch, mid-afternoon, evening and extra meal slots between 1982 and 1999. Analyses were stratified by sex and social class. RESULTS: The proportion of energy and macronutrients consumed at lunch declined between 1982 and 1999, which was compensated by a greater intake in the mid-afternoon and evening. This trend was seen across sex and social class, although women and adults with a non-manual occupation reported greater energy, carbohydrate and non-starch polysaccharide intake at breakfast in 1982 and had a higher protein intake in the evening compared with men and adults with a manual occupation. CONCLUSIONS: The timing of energy and nutrient intake has shifted slightly over time, with a greater proportion of intake later in the day. The association between the observed sex and occupational social class differences in eating profiles and chronic disease warrants investigation.

Breakfast consumption and physical activity in British adolescents.

Studies show an inverse relationship between breakfast frequency and weight gain. This may reflect poor eating habits generally and associated low physical activity (PA) or direct impacts of breakfast on mechanisms leading to lethargy and reduced PA. The relationship between breakfast frequency and PA is inconclusive. We aimed to determine whether breakfast frequency is associated with PA levels in British adolescents independent of body composition and socio-economic status (SES). Habitual breakfast frequency (self-report questionnaire) was assessed in 877 adolescents (43% male, age 14·5 (SD 0·5) years old). PA was measured over 5 d (accelerometry, average counts/ min; cpm). Associations between daily PA and breakfast frequency were assessed using linear regression adjusted for body fat percentage and SES. Effect modification by sex and associations with PA during the morning (06.00-12.00 hours) were explored. For boys, there were no significant associations between breakfast frequency and PA. For girls, less frequent breakfast consumption was significantly associated with lower PA (cpm) during the morning (occasional v. frequent b - 6·1 (95% CI - 11·1, -1·1), P = 0·017) when adjusted for body fat percentage and SES. There were no associations between PA and breakfast consumption over the whole day; however, for girls, less frequent breakfast consumption may be associated with lower PA levels during the morning, suggesting that breakfast consumption should perhaps be taken into consideration when aiming to promote PA in adolescent girls.

Disaggregating composite food codes in the UK National Diet and Nutrition Survey food composition databank.

OBJECTIVE: To disaggregate composite food codes used in the UK National Diet and Nutrition Survey (NDNS) into their individual food components in order to provide a more complete estimate of intake at the individual food level. METHODS: A total of 3216 composite food codes from the NDNS food composition databank were subject to disaggregation. The main food components used were meat, fish, fruit, vegetables and cheese, which were further divided into 26 subcategories. RESULTS: It was shown that previous determination of meat containing composite food codes provided an overestimate of meat intake and underestimate of additional components such as fruit and vegetables. CONCLUSIONS: By incorporating disaggregated data into NDNS, variations will be seen in consumption of some main food groups, but these variations may be also attributable to trends in consumption.

Alcohol intake and risk of colorectal cancer: results from the UK Dietary Cohort Consortium.

BACKGROUND: Epidemiological studies have suggested that excessive alcohol intake increases colorectal cancer (CRC) risk. However, findings regarding tumour subsites and sex differences have been inconsistent. METHODS: We investigated the prospective associations between alcohol intake on overall and site- and sex-specific CRC risk. Analyses were conducted on 579 CRC cases and 1996 matched controls nested within the UK Dietary Cohort Consortium using standardised data obtained from food diaries as a main nutritional method and repeated using data from food frequency questionnaire (FFQ). RESULTS: Compared with individuals in the lightest category of drinkers (>0-<5 g per day), the multivariable odds ratios of CRC were 1.16 (95% confidence interval (95% CI): 0.88, 1.53) for non-drinkers, 0.91 (95% CI: 0.67, 1.24) for drinkers with 5-<15 g per day, 0.90 (95% CI: 0.65, 1.25) for drinkers with 15-<30 g per day, 1.02 (95% CI: 0.66, 1.58) for drinkers with 30-<45 g per day and 1.19 (95% CI: 0.75, 1.91) for drinkers with >or=45 g per day. No clear associations were observed between site-specific CRC risk and alcohol intake in either sex. Analyses using FFQ showed similar results. CONCLUSION: We found no significantly increased risk of CRC up to 30 g per day of alcohol intake within the UK Dietary Cohort Consortium.

Nutritional composition of the diets of South Asian, black African-Caribbean and white European children in the United Kingdom: the Child Heart and Health Study in England (CHASE).

In the UK, South Asian adults have increased risks of CHD, type 2 diabetes and central obesity. Black African-Caribbeans, in contrast, have increased risks of type 2 diabetes and general obesity but lower CHD risk. There is growing evidence that these risk differences emerge in early life and that nutritional factors may be important. We have therefore examined the variations in nutritional composition of the diets of South Asian, black African-Caribbean and white European children, using 24 h recalls of dietary intake collected during a cross-sectional survey of cardiovascular health in eighty-five primary schools in London, Birmingham and Leicester. In all, 2209 children aged 9-10 years took part, including 558 of South Asian, 560 of black African-Caribbean and 543 of white European ethnicity. Compared with white Europeans, South Asian children reported higher mean total energy intake; their intakes of total fat, polyunsaturated fat and protein (both absolute and as proportions of total energy intake) were higher and their intakes of carbohydrate as a proportion of energy (particularly sugars), vitamin C and D, Ca and haem Fe were lower. These differences were especially marked for Bangladeshi children. Black African-Caribbean children had lower intakes of total and saturated fat (both absolute and as proportions of energy intake), NSP, vitamin D and Ca. The lower total and saturated fat intakes were particularly marked among black African children. Appreciable ethnic differences exist in the nutritional composition of children's diets, which may contribute to future differences in chronic disease risk.