Development and validation of a food frequency questionnaire for assessing nutrient intake during childhood in Jordan.

INTRODUCTION: Introduction: assessing the relationship between childhood diseases and nutrient intake is a crucial issue that requires valid and reliable dietary assessment tools in this period of physical and physiological development. Objective: the present study aimed to develop and validate a food frequency questionnaire (FFQ) to assess nutrient intake in Jordanian children. Methods: in this validation study, nutrient intake as obtained from a culturally sensitive quantitative FFQ was compared to nutrient intake as assessed by four 24-hour dietary recalls (24-HRs) between September 2017 and May 2018. One hundred and thirty-six children aged 6-18 years were enrolled from selected schools in Amman, Jordan. Children or their caregivers were asked to complete the FFQ during an initial face-to-face interview. Four 24-HRs were collected weekly over one month. Of these children, 50 also took part in the reproducibility phase, which involved a repeat completion of the FFQ within 1 month. Results: the intraclass correlation coefficients between the two FFQs ranged from 0.5 for trans-fats to 0.96 for calcium. Correlation coefficients between dietary intake estimates derived from the FFQ and 24-HRs were significant at p < 0.05. The highest correlation was detected for energy (0.8) while the lowest was identified for trans-fatty acids (0.04). For all nutrients, over 60 % of participants were classified into the same or adjacent quartile of crude and adjusted intake. Bland-Altman plots showed a satisfactory agreement between the two methods for energy and proteins. Conclusion: the FFQ showed a good reproducibility and a reasonable relative validity for most nutrients.

INTRODUCCIÓN: Introducción: evaluar la relación entre las enfermedades infantiles y la ingesta de nutrientes es un tema crucial que requiere herramientas de evaluación dietética válidas y confiables en este período de desarrollo físico y fisiológico. Objetivo: el presente estudio tuvo como objetivo desarrollar y validar un cuestionario de frecuencia de alimentos (FFQ) para evaluar la ingesta de nutrientes de los niños jordanos. Métodos: en este estudio de validación, la ingesta de nutrientes de un FFQ cuantitativo culturalmente sensible se comparó con la ingesta de nutrientes de cuatro recordatorios dietéticos de 24 horas (24-HR) entre septiembre de 2017 y mayo de 2018. Se reclutaron ciento treinta y seis niños y adolescentes de 6 a 18 años en escuelas seleccionadas de Amán, Jordania. Se pidió a los niños o sus cuidadores que completaran el FFQ en una entrevista inicial presencial. Se recogieron cuatro 24-HR semanalmente durante un mes. De estos niños, 50 también participaron en la fase de reproducibilidad, que involucró la repetición del FFQ en un plazo de 1 mes. Resultados: los coeficientes de correlación intraclase entre los dos FFQ oscilaron entre 0,5 para las grasas trans y 0,96 para el calcio. Los coeficientes de correlación entre las estimaciones de la ingesta alimentaria derivadas del FFQ y los 24-HR fueron significativas, con un valor p < 0,05. La correlación más alta se detectó para la energía (0,8) mientras que la más baja fue para los ácidos grasos trans (0,04). Para todos los nutrientes, más del 60 % de los participantes se clasificaron en el mismo cuartil o el adyacente de ingesta cruda y ajustada. Las gráficas de Bland-Altman mostraron un acuerdo satisfactorio entre los dos métodos en términos de energía y proteínas. Conclusión: el FFQ mostró una buena reproducibilidad y una validez relativa razonable para la mayoría de los nutrientes.

Reproducibility and construct validity of a food frequency questionnaire for assessing dietary intake in rural and urban Asian Indian adults.

BACKGROUND AND OBJECTIVES: To evaluate the reproducibility and construct validity of the Madras Diabetes Research Foundation FFQ (MDRF-FFQ) with biomarkers for its use in epidemiological settings in India. METHODS AND STUDY DESIGN: The MDRF-FFQ was administered to 500 participants representing rural and urban areas of 10 Indian states, twice at an interval of 12 months. Reproducibility was assessed using intra cluster correlation coefficients (ICC). Construct validity of carbohydrate and fat intake was assessed using baseline serum lipids by regression analysis. RESULTS: Reproducibility as measured by ICC was 0.50-0.77 for saturated fatty acids (SFA) and energy in urban and 0.61-0.72 for protein and SFA in rural areas. The ICC for food groups was 0.53-0.77 for whole grains, fruits and vegetables in urban and 0.50-0.89 for animal foods and whole grains in rural areas. After adjusting for potential confounders, carbohydrate intake was positively associated with serum triglycerides (TG) (ß [SE]: +2.3 [0.72] mg/dL; p=0.002) and inversely with high density lipoprotein cholesterol (HDL) (ß [SE]:-0.48 [0.12], p<0.001), while dietary fat and SFA (% Energy) were positively associated with HDL, low density lipoprotein (LDL) and total cholesterol and inversely with TG. CONCLUSIONS: The MDRF-FFQ can be considered as a reliable and valid tool to measure the long-term dietary exposure in respect of macronutrient intakes in Indian populations despite diverse dietary practices.

La pobreza como determinante de la calidad alimentaria en Argentina. Resultados del Estudio Argentino de Nutrición y Salud (EANS) / Poverty as a determinant of food quality in Argentina. Results of the Argentine Study of Nutrition and Health (EANS)

Introducción: las diferencias socioeconómicas acarrean desigualdades alimentarias y nutricionales. La dieta es un factor de riesgo modificable con acciones de salud pública, camino a la prevención de enfermedades crónicas no transmisibles. Objetivo: estimar las desigualdades alimentarias en Argentina en función del nivel socioeconómico de la población, analizando el consumo de distintos grupos de alimentos. Métodos: datos argentinos del Estudio Latinoamericano de Nutrición y Salud. Muestra: 1266 individuos estratificados por género, nivel socioeconómico y región geográfica. Ingesta: 2 recordatorios de 24 horas con técnica de pasos múltiples. Análisis: con el NDS Software se analizaron los valores medios de consumo de 11 grupos de alimentos por nivel socioeconómico y región del país. Resultados: la población con menor nivel socioeconómico consume significativamente menos frutas, verduras y lácteos que la población de nivel medio y alto. Frutas: 59 vs. 79,1 y 106,3 g/d, respectivamente; p = 0,000. Verduras: 82,3 vs. 112 y 118 g/d; p = 0,000. Lácteos: 114 vs. 165 y 137 g/d; p = 0,000). Por el contrario, consume un mayor volumen de refrescos y jugos industriales (680 ml/d vs. 527 y 590 ml/d, respectivamente; p = 0,000), infusiones con azúcar agregada (568 ml/d vs. 385 y 309 ml/d; p = 0,000), pan (85 g/d vs. 75,5 y 66,7 g/d; p = 0,012) y bollería (159 g/d vs. 147 y 122 g/d; p = 0,008). Conclusiones: la vulnerabilidad social es un determinante importante de la calidad de la dieta. Intervenciones diseñadas para reducir las desigualdades sociales vinculadas a la nutrición y la salud resultan imprescindibles

Introduction: socio-economic differences lead to food and nutritional inequalities. Diet is a modifiable risk factor by public health activities, on the way to the prevention of chronic non-communicable diseases. Objective: to estimate food inequalities in Argentina based on the socioeconomic level of the population, analyzing the consumption of different food groups. Methods: Argentine data from the Latin American Study of Nutrition and Health. Sample: 1,266 individuals stratified by gender, socioeconomic level and geographic region. Intake: 2 24-hour reminders with the multi-step technique. Analysis: with the NDS Software average consumption values of 11 food groups were analyzed by socioeconomic level and country region. Results: the population with lower socioeconomic status consumes significantly less fruits, vegetables and dairy products than the population with medium to high socioeconomic level. Fruits: 59 vs. 79.1 and 106.3 g/d, respectively; p = 0.000. Vegetables: 82.3 g/d vs. 112 and 118 g/d; p = 0.000. Dairy products: 114 g/d vs. 165 and 137 g/d; p = 0.000). On the contrary, it consumes a greater volume of soft drinks and industrial juices (680 mL/d vs. 527 and 590 mL/d, respectively; p = 0.000), infusions with added sugar (568 mL/d vs. 385 and 309 mL/d; p = 0.000), bread (85 g/d vs. 75.5 and 66.7 g/d; p = 0.012) and pastries (159 g/d vs. 147 and 122 g/d; p = 0.008). Conclusions: Social vulnerability is an important determinant for diet quality. Interventions designed to reduce social inequalities as linked to nutrition and health are essential

Validation of a Complementary Food Frequency Questionnaire to assess infant nutrient intake.

Dietary assessment in infants is challenging but necessary to understand the relationship between nutrition and growth and development. Currently no simple, validated methods exist to assess nutrient intake in New Zealand (NZ) infants. Therefore, this study aimed to assess the relative validity and reproducibility of a Complementary Food Frequency Questionnaire (CFFQ) to determine nutrient intakes of NZ infants. Ninety-five parent-infant pairs (infant age 10 ± 1 months) completed the CFFQ twice (CFFQ-1 and CFFQ-2), 4 weeks apart (to assess reproducibility). A 4-day weighed food record (4dWFR) was collected between CFFQ administrations (to assess validity). Validity and reproducibility were assessed for intakes of energy and 18 nutrients using Bland-Altman analysis, Pearson's correlation coefficients, cross-classification, and weighted Kappa (κ). The CFFQ showed acceptable validity: Nutrients from the CFFQ were comparable with the 4dWFR (bias, 9-28%), correlation between methods ranged from r = .18 (saturated fat) to r = .81 (iron; mean r = .52), 54% (mean) of participants were correctly classified (range 39% to 67%), and 7.1% (mean) misclassified into opposite tertiles (range 2.1% to 14.7%). There was acceptable agreement between the CFFQ and 4dWFR (κ = 0.20-0.60). The CFFQ showed good reproducibility: Correlations ranged from r = .34 (folate) to r = .80 (zinc); for 16 nutrients, >50% of participants were correctly classified, and for all nutrients, <10% of participants were grossly misclassified. All nutrients showed acceptable to good agreement (κ > 0.20). The CFFQ has acceptable relative validity and good reproducibility for assessing nutrient intake in NZ infants aged 9-12 months, making it a useful tool for use in future research.

Patrones alimentarios de adultos mayores en una región argentina y su relación con factores socioeconómicos / Dietary patterns of older adults in an Argentine region and their relationship with socioeconomic factors

RESUMEN Objetivos Estudiar los patrones de consumo de alimentos en adultos mayores de la provincia de Buenos Aires (Argentina) y relacionarlos con factores socioeconómicos. Métodos A partir de la Encuesta Nacional de Gasto de los Hogares (2012-2013) se efectúa un análisis de componentes principales para encontrar y describir patrones alimentarios adoptados por hogares de la provincia de Buenos Aires habitados por adultos mayores. Mediante pruebas de diferencia de media y proporciones, se establecen relaciones entre el puntaje de los hogares en cada patrón alimentario, el ingreso promedio y la condición de vivir solo o sola. Resultados En función de las cargas factoriales asociadas a cada grupo alimentario, los patrones que, en conjunto, explican el 44,6% de la varianza total son: i) dieta variada tradicional, ii) dieta antiproteica, iii) dieta vegetariana y iv) dieta de hidratos de carbono. Se encuentra que el nivel de ingreso y la condición de vivir solo(a) son factores que podrían estar asociados a la adopción (o no) de la dieta variada tradicional, patrón alimentario recomendado por las guías alimentarias para la población argentina. Discusión La menor frecuencia de hogares habitados por adultos mayores solos y el menor nivel de ingreso promedio de los hogares que presentan un elevado puntaje en la dieta variada tradicional, podría ser utilizada por las autoridades sanitarias a la hora de tomar medidas tendientes a mejorar los patrones alimentarios de los adultos mayores que viven solos y cobran la pensión mínima.(AU)

ABSTRACT Objectives To study the patterns of food consumption in older adults in the province of Buenos Aires (Argentina) and relate them to socioeconomic factors. Methods Based on the National Household Expenditure Survey (2012-2013), an analysis of main components is carried out to find and describe dietary patterns adopted by households in the province of Buenos Aires habited by older adults. Through tests of mean difference and proportions, relationships between household scores in each food pattern, average income and living alone or alone are established. Results Depending on the factor loads associated with each food group, the patterns that together explain 44.6% of the total variance are: i) traditional varied diet, ii) anti-protein diet, iii) vegetarian diet and iv) carbohydrate diet. It is found that the level of income and the condition of living alone are factors that could be associated with the adoption (or not) of the traditional varied diet, food pattern recommended by the dietary guidelines for the Argentine population. Discussion The lower frequency of households habited by older adults alone and the lower average income level of households that have a high score in the traditional varied diet, could be used by health authorities when taking measures to improve the eating patterns of older adults who live alone and receive the minimum pension.(AU)

Inadequate daily intakes of n-3 polyunsaturated fatty acids (PUFA) in the general French population of children (3-10 years) and adolescents (11-17 years): the INCA2 survey.

PURPOSE: This paper deals with the dietary daily intakes of main polyunsaturated fatty acids (PUFA) in French children and adolescents. METHODS: Dietary intakes of main PUFA were determined from a general French population of 1500 children (3-10 years) and adolescents (11-17 years) by using the most recent set of national robust data on food (National Survey INCA 2 performed in 2006 and 2007). RESULTS: Main results showed that mean daily intakes of total fat and n-6 PUFA linoleic acid (LA, 18:2n-6) were close to current recommended values for children and adolescent populations. However, 80% (children) to 90% (adolescents) of our French populations not only ingested low quantities of n-3 long-chain PUFA (docosahexaenoic (22:6n-3) and eicosapentaenoic (20:5n-3) acids) but also very low quantities of alpha-linolenic acid (ALA, 18:3n-3) at the origin of a non-balanced n-6/n-3 ratio. Inadequate consumption of EPA + DHA was also observed in subgroups of infants and adolescent who consumed more than two servings/week of fish. CONCLUSIONS: Such disequilibrium in PUFA dietary intakes in favor of n-6 PUFA could have adverse impact on cell membrane incorporation of long-chain n-3 PUFA and deleterious impacts on the health of children and adolescents. Promoting the consumption of both vegetable oils and margarines rich in ALA, and oily fish rich in long-chain n-3 PUFA might improve such PUFA disequilibrium.

Rapid Eating Assessment for Participants [shortened version] scores are associated with Healthy Eating Index-2010 scores and other indices of diet quality in healthy adult omnivores and vegetarians.

The Healthy Eating Index-2010 is a measure of diet quality as portrayed by the Dietary Guidelines for Americans; however, computing the Healthy Eating Index score is time consuming and requires trained personnel. The Rapid Eating Assessment for Participants [shortened version] is a simple measure that quickly, in less than 10 min, assesses diet quality in a clinical or research setting. This research evaluated the degree of correlation between these two methods of scoring diet quality, as well as between these methods and other indicators of diet quality, including the nutrient density of the diet, the dietary potential renal acid load, urine pH, and plasma vitamin C concentrations. The research design was a secondary data analysis, and participants were healthy adults (n = 81) self-classified as omnivorous, vegetarian, or vegan. Confounding variables were identified and controlled using partial correlations. The two methods of scoring diet quality were significantly correlated (r = 0.227, p = 0.047). Both the Healthy Eating Index and the Rapid Eating Assessment for Participants scoring methods were correlated to nutrient density of the diets (r = 0.474 and r = 0.472 respectively, p < 0.001) as well as to the dietary potential renal acid load and urinary pH (r ranging from 0.304-0.341, p ≤ 0.002). The Rapid Eating Assessment for Participants, but not the Healthy Eating Index, was significantly correlated to plasma vitamin C concentrations (r = 0.500, p < 0.001 and 0.192, p = 0.095 respectively). These results in combination with ease of use and low cost suggest that the Rapid Eating Assessment for Participants measure is a useful tool for assessing diet quality.

Feasibility of a commercial smartphone application for dietary assessment in epidemiological research and comparison with 24-h dietary recalls.

BACKGROUND: Dietary assessment methods that can provide high quality data while limiting participant burden and resource requirements in epidemiological research are highly sought after and continue to evolve. The use of mobile phone technology in research has increased rapidly over the last decade and offers multiple advantages to the researcher over traditional data collection methods. This study tested the acceptability and relative validity of a commercial smart phone application (app) for use as an epidemiological dietary assessment tool, compared with a traditional dietary assessment method. METHODS: Study participants completed a 4-d food diary using a modified version of the Easy Diet Diary app and two 24-h dietary recalls during the same week, for comparison. At the end of data collection, participants completed a questionnaire on their experience with both methods. Average proportions of energy from macronutrients and fibre, iron, and calcium densities from the app and 24-h recalls were compared after log transformation, by calculating mean agreement, limits of agreement (LOA), and Pearson's correlations. The prevalence of dietary under-reporting was compared in each method using the Goldberg method. RESULTS: A total of 50 adults (82% women) provided data for analysis (mean age, 31 y; mean BMI, 22.4 kg/m2; 14% overweight or obese). Participant feedback showed high levels of acceptance of the app; 83% preferred using the app to completing 24-h dietary recalls. The average difference in energy intake (mean agreement) between methods was 268 kJ/d. For all intakes except alcohol, the average difference between methods was not significantly different from zero. Most limits of agreement were within an acceptable range. The prevalence of dietary misreporting was similar in both methods. CONCLUSIONS: These findings demonstrate good feasibility for applying this commercially-developed smartphone app in epidemiological research.

Avaliação de modelos avançados de espectroscopia de bioimpedância para medir a composição do corpo em adultos saudáveis (NHANES 1999-2004) e aqueles que sofrem perda de peso em massa após a cirurgia de bypass gástrico Roux-en-Y / Evaluation of Advanced Bioimpedance Spectroscopy Models for Measuring Body Composition in Healthy Adults (NHANES 19992004) and Those Undergoing Massive Weight Loss Following Roux-en-Y Gastric Bypass Surgery

Introduction: Bioimpedance spectroscopy (BIS) devices utilize biophysical modeling to generate body composition data. The addition of body mass index (BMI) to modified Xitron-Hanai-based mixture equations improved BIS estimates of intracellular water (ICW), particularly at the extremes of BMI. A 3-compartment model for distinguishing excess fluid (ExF) from normally hydrated lean (NHLT) and adipose tissue may further improve BIS estimates. Objective:We aimed to validate a BIS approach based on the Chamney model for determining fat mass (FM) in healthy individuals (NHANES) and for measuring FM changes in individuals undergoing massive weight loss. Methods: Using adult NHANES 1999-2004 (2821 female, 3063 male) and longitudinal pre-topost-RYGB (15F) data, we compared dual-energy-X-ray absorptiometry (DXA) and BIS for FM. We applied BIS adiposity-corrected values to Chamney equations for normally hydrated lean and adipose tissue (NHLT, NHAT) and FM. Method agreement was evaluated by correlations, paired t-tests, root mean square error (RMSE), BlandAltman (B-A) analysis, and concordance correlation coefficients (CCC). Results: Method agreement between BIS and DXAFM was good in healthy adults (r=0.96, CCC=0.93, p<.0001), and pre-to-post-RYGB (r=0.93-0.98, CCC=0.81-0.86, p<.001). Although cross-sectional FM measures differed, FM change measures post-RYGB did not (35.6±8.9 vs. 35.2±9.2 kg, BIS vs. DXA) and agreed well (r=0.84, p<.0001). The 15 subjects with follow-up measurements at 1 year lost 11.5±9.8 kg FFM by DXA, but only 1.3±2.5 kg of NHLT by BIS, suggesting that the FFM loss may have been mostly adipose tissue water. Conclusions: Incorporation of the Chamney model into BIS algorithms is a major conceptual advancement for assessing and monitoring body composition. Its ability to differentiate ICW and extracellular water (ECW) in NHLT and NHAT, as well as excess ECW is promising, and would facilitate lean tissue monitoring in obesity and acute/chronic disease.(AU)

Introdução: Os dispositivos de espectroscopia de bioimpedância (DEB) utilizam modelagem biofísica para gerar dados de composição corporal. A adição do índice de massa corporal (IMC) às equações de mistura modificadas com Xitron-Hanai modificadas melhorou as estimativas de DEB de água intracelular (AI), particularmente nos casos extremos do IMC. Um modelo de 3 compartimentos para distinguir o excesso de fluido (ExF) de magro normalmente hidratado (NHLT) e tecido adiposo pode ainda melhorar as estimativas do DEB. Objetivo: Pretendemos validar uma abordagem do DEB com base no modelo de Chamney para determinar a massa de gordura (MG) em indivíduos saudáveis (NHANES) e para medir mudanças de MG em indivíduos submetidos à perda de peso maciça. Método: Usando o NHANES adulto 1999-2004 (2821 mulheres, 3063 homens) e dados longitudinais pré-pós-RYGB (15 F), comparamos a absorção de raios-X de dupla energia (DXA) e DEB para MG. Aplicamos os valores corrigidos de adiposidade do BIS às equações de Chamney para tecidos magros e adiposos normalmente hidratados (NHLT, NHAT) e FM. O acordo de método foi avaliado por correlações, testes t pareados, erro quadrado médio (EQM), análise Bland-Altman (B-A) e coeficientes de correlação de concordância (CCC). Resultados: O acordo de método entre DEB e DXA MG foi bom em adultos saudáveis (r=0,96, CCC=0,93, p<.0001) e pré-pós-RYGB (r=0,93-0,98, CCC=0,81-0,86, p<0,001). Embora as medidas de MG transversais diferissem, as medidas de mudança de MG pós-RYGB não (35,6±8,9 vs. 35,2±9,2 kg, DEBvs. DXA) e concordaram bem (r=0,84, p<.0001). Os 15 sujeitos com medidas de seguimento ao 1 ano perderam 11,5±9,8 kg FFM por DXA, mas apenas 1,3±2,5 kg de NHLT pelo DEB, sugerindo que a perda de FFM pode ter sido principalmente água do tecido adiposo. Conclusões: A incorporação do modelo de Chamney em algoritmos DEB é um grande avanço conceitual para avaliar e monitorar a composição corporal. A sua capacidade de diferenciar AI e água extracelular (AE) no NHLT e NHAT, bem como o excesso de AE é promissor e facilitará a monitorização do tecido magro na obesidade e doença aguda/crônica.(AU)

Vitamin D, not iron, is the main nutrient deficiency in pre-school and school-aged children in Mexico City: a cross-sectional study / La vitamina D, y no el hierro, es la principal deficiencia nutricional en niños preescolares y escolares en la ciudad de México: un estudio transversal

Introduction: In 2012, the Mexican National Health Survey (ENSANUT 2012) showed a moderate prevalence rate of vitamin D deficiency, around 16%, in a national representative sample of children. A decreasing prevalence of anemia during the last 15 years has been observed in Mexico. The aim of this study was to determine the levels of vitamin D in children 3-8 years old in four different locations within the metropolitan area of Mexico City and to compare them to levels of iron and zinc as references of nutritional status. Methods: One hundred and seventeen healthy children aged 3-8 years attending four hospitals in Mexico City were invited to participate. All children received medical and nutritional evaluation, and blood samples were obtained. Results: Children were selected in four hospitals between April and August 2008. More than half (51.3%) were boys; their average age was 5.5 ± 1.6 years. The prevalence of subjects with deficient levels of 25-OH-vitamin D (< 50 nmol/L) was 24.77%. None of the children had haemoglobin levels below the anaemia threshold, and zinc determination revealed 8.26% of individuals with deficient levels (< 65 μg/dL). These data confirm the findings reported in ENSANUT about the sustained reduction of anaemia prevalence among preschool and schoolchildren and the rising rates of vitamin D deficiency in the same population. Similar to other studies, we found a link between socioeconomic status and micronutrient deficiency, these being markers of better nutrition, and vitamin D is remarkably related to the quality of the diet. This finding has not been considered in our population before. Conclusions: There is evidence of a sustained decrease of anaemia in Mexican children due to general enrichment of foods and focus on vulnerable populations, while vitamin D deficiency seems to have increased. More studies are needed to obtain more information on vitamin D levels at different ages and definition of susceptible groups in order to investigate the possibility of general population measures such as enrichment, which have proven to be effective (AU)

Introducción: en 2012 la Encuesta Nacional de Salud y Nutrición (ENSANUT) mostró una prevalencia moderada de deficiencia de vitamina D, alrededor del 16%, en una muestra de niños representativa del país. A su vez, la anemia carencial ha disminuido durante los últimos 15 años en México. El objetivo del presente estudio fue determinar los niveles de vitamina D en niños de 3 a 8 años de edad en cuatro diferentes regiones dentro del área metropolitana de la Ciudad de México y compararlos con los niveles de hierro y zinc como referentes del estado nutricional. Métodos: ciento diecisiete niños sanos de 3 a 8 años de edad que regularmente asisten a cuatro diferentes hospitales en la Ciudad de México fueron invitados a participar. Todos los niños recibieron una evaluación médica y nutricional, y se obtuvieron muestras de sangre. Resultados: se reclutaron niños en los cuatro hospitales entre abril y agosto del 2008. Más de la mitad (51,3% fueron niños, su edad promedio fue de 5,5 ± 1,6 años. La prevalencia de sujetos con niveles deficientes de 25-OH-vitamina D (< 50 nmol/l) fue de 24,77%. Ninguno de los niños tuvo niveles de hemoglobina por debajo del umbral de la anemia y la determinación de zinc reveló que 8,26% de los individuos tenían niveles deficientes (< 65 μg/dl). Estos datos confirman los hallazgos reportados en el ENSANUT acerca de la reducción sostenida en la prevalencia de anemia en escolares y preescolares, pero también muestran que se eleva la de deficiencia de vitamina D en esta población. De forma similar a otros estudios, encontramos un vínculo entre el estatus socioeconómico y la deficiencia de micronutrimentos en tanto que estos son marcadores de mejor estado nutricional y la vitamina D se relaciona notablemente con la calidad de la dieta. Estos hallazgos no se han considerado previamente en nuestra población. Conclusiones: existen datos que sugieren una disminución progresiva de la anemia en niños mexicanos debido a una fortificación general de los alimentos y el enfoque en población vulnerable, mientras que la deficiencia de vitamina D parece haber incrementado. Se requieren más estudios para obtener más información acerca de los niveles de vitamina D en distintos grupos de edad y definir a los grupos susceptibles para investigar la posibilidad de llevar a cabo medidas de impacto en la población general como enriquecimiento de alimentos, que ha probado ser efectiva en otros nutrimentos (AU)

Perfil nutricional e uso de suplementação entre praticantes de musculação e atletas de judô em academias de Campo Grande, MS / Nutritional profile and use of supplementation by bodybuilders and judo athletes in gyms of Campo Grande, MS

Introdução: Avaliar o perfil nutricional e o uso de suplementação entre praticantes de musculação e atletas de judô em academias de Campo Grande, MS. Método: Estudo transversal descritivo com 50 participantes, de ambos os gêneros, entre 18 e 35 anos. Para avaliação do consumo alimentar, foram aplicados inquéritos dietéticos, medindo-se consumo energético e de macronutrientes. Foram realizadas medidas de peso, estatura, pregas cutâneas e circunferência. Para cálculo do percentual de gordura, foi utilizado somatório de três pregas cutâneas. O uso de suplemento foi avaliado por meio de aplicação de questionário. A análise estatística foi realizada com o software SPSS, considerando p<0,05. Resultados: A média de energia consumida pelos praticantes de musculação foi 1768,4 kcal/dia e a média dos valores das necessidades estimadas de energia foi 2445,6 kcal/dia; entre os atletas de judô, foi 1851,1 kcal/dia e 2800,1 kcal/dia, respectivamente. O consumo de carboidratos, proteínas e lipídios foi 50,49%, 20,44% e 29,06% entre os praticantes de musculação e 45,06%, 23,31% e 31,61% entre os judocas, respectivamente. Houve diferença significativa na composição corporal entre os participantes nas variáveis índice de massa corporal, circunferência da cintura, massa magra e massa gorda. A utilização de suplementos ocorreu em 26% dos participantes. Conclusões: A quantidade de energia consumida foi menor do que a necessidade estimada de energia em ambos os grupos e os valores de macronutrientes estavam inadequados. Houve diferença significativa na composição corporal dos participantes, destacando- se percentual elevado de gordura em ambos os grupos. Não houve diferença significativa entre o uso de suplementos entre os grupos.(AU)

Introduction: To evaluate the nutritional status and the use of supplementation by bodybuilders and judo athletes in gyms of Campo Grande, MS. Methods: A descriptive cross-sectional study with 50 participants, of both genders, between 18 and 35 years. Dietary surveys were applied to assess food consumption, evaluating energy consumption and macronutrients. Measures of weight, height, skin folds and circumference were performed. To calculate the percentage of fat was used sum of three skinfolds. The use of supplementation was assessed by questionnaire. Statistical analysis was performed using SPSS software, considering p<0.05. Results: The average power consumed by bodybuilders was 1768.4 kcal/day and the average value of the estimated energy needs was 2445.6 kcal/day; among the judo athletes was 1851.1 kcal/day and 2800.1 kcal/day, respectively. The consumption of carbohydrates, proteins and lipids was 50.49%, 20.44% and 29.06% among bodybuilders and 45.06%, 23.31% and 31.61% among judokas, respectively. There were significant differences in body composition between the participants in variables body mass index, waist circumference, fat mass and lean mass. The use of supplements occurred in 26% of participants. Conclusions: The amount of energy consumed was lower than the estimated energy requirements in both groups and macronutrient values were inadequate. There were significant differences in body composition of the participants, highlighting high percentage of fat in both groups. There was no significant difference between the use of supplements between groups.(AU)

8º Encuesta antropométrica a menores de 6 años: Noviembre 2016 / 8th anthropometric survey of the population under 6 years old: November 2016

La encuesta antropométrica a menores de 6 años constituye un estudio de tipo transversal que permite conocer el estado nutricional de los niños y niñas que concurren a los efectores públicos del primer nivel de atención de la Ciudad de Buenos Aires.Es la octava oportunidad en que se realiza esta encuesta, habiéndose realizado la primera en 1995. Esta secuencia de estudios forma parte de las actividades de monitoreo de la situación nutricional de la población materno-infanto-juvenil que lleva adelante el Programa Nutricional. (AU)

Misreporting in nutritional surveys: methodological implications / Infradeclaración en las encuestas alimentarias: implicaciones metodológicas

The reliability of the information collected in dietary assessment can be affected by different factors. One of the main sources of error in dietary assessment is misreporting which encompass under- and overreporting. Underreporting of food intake is one of the major problems in the assessment of habitual dietary intake. Physical and psychosocial characteristics that are related to energy underreporting include sex, age, weight, BMI, fear of negative evaluation and dieting among others. At present, diverse reference methods are employed to verify the results of dietary assessment and double labelled water is used as the gold standard method. Underreporting affects the estimation of nutrient intake and also alters associations between diet and disease assessed in epidemiological studies. Therefore, underreporting has to be considered and addressed by researchers through development and improvement of dietary intake adjustment methods, and taking advantage of the new technologies for assessing dietary intake in order to minimize underreporting bias (AU)

La fiabilidad de la información recogida en la evaluación dietética puede verse afectada por diferentes factores. Una de las principales fuentes de error en la evaluación de la dieta es la declaración errónea de consumo de alimentos, que abarca la infradeclaración y sobredeclaración de la dieta. La infradeclaración de la ingesta de alimentos es uno de los principales problemas en la evaluación de la ingesta dietética habitual. Las características físicas y psicosociales que están relacionadas con la infradeclaración de energía incluyen el sexo, edad, peso, índice de masa corporal, el miedo a la evaluación negativa y estar bajo un régimen de dieta, entre otros. En la actualidad, se emplean diversos métodos de referencia para verificar los resultados de la evaluación dietética, no obstante, el método estándar es el agua doblemente marcada. La infradeclaración afecta a la estimación de la ingesta de nutrientes y también altera las asociaciones entre dieta y enfermedades en estudios epidemiológicos. Por lo tanto, la infradeclaración tiene que ser considerada y abordada por los investigadores a través del desarrollo y la mejora de los métodos de ajuste de la dieta y el aprovechamiento de las nuevas tecnologías para la evaluación de la ingesta dietética con el fin de minimizar el sesgo ocasionado por la infradeclaración (AU)

Methods for monitoring the functional status of the circadian system in dietary surveys studies: application criteria and interpretation of results

To evaluate the circadian system status of the subject may be of special interest in nutrition. Particularly for those studies related to the assessment of diseases related to malnutrition, as it is the case of most of the degenerative diseases such as obesity, cancer, or cardiovascular diseases. For this purpose, one of the approaches consists to measure a) the external synchronizers of the internal clock, such as light intensity, and changes from fasting to eating and from resting to activity. Indeed, "chronodisruptors" have been defined as "exogenous and endogenous exposures or effectors which are chronobiologically active and can thus disrupt the timing and order". Another approach to assess the circadian system health is to measure the b) outputs of the internal clock (circadian marker rhythms). Among such outputs, the rhythm of body temperature, motor activity, melatonin, cortisol and clock gene expression are the most commonly used. From the genetic perspective, we are now able to measure failures in the internal clock, in order to assess c) the genetics of the molecular clock. Indeed, new nutrigenetics techniques are giving us the opportunity to measure the association between different genetic variants of our clock genes and several illnesses such as obesity, cardiovascular diseases, diabetes or cancer. In addition to these techniques, self-reported questionnaires based in the morning-evening preferences have been developed as complementary procedures to assess human chronotypes (AU)

Evaluar el estado del sistema circadiano del sujeto puede ser de especial interés en la nutrición. En particular, para los estudios relativos a la evaluación de las enfermedades relacionadas con la malnutrición como es el caso de la mayoría de las enfermedades degenerativas tales como la obesidad, cáncer, o enfermedades cardiovasculares. Para este propósito, uno de los enfoques consiste en medir a) los sincronizadores externos del reloj interno, tales como intensidad de la luz, y los cambios de ayuno/ingesta y de reposo/actividad. De hecho, se ha definido el término de "cronodisruptor" que se refiere a "exposiciones o efectores exógenos y endógenos que son cronobiológicamente activos y que por lo tanto pueden interrumpir el tiempo". Otro enfoque para evaluar la salud del sistema circadiano es medir b) las salidas del reloj interno (ritmos circadianos). Entre ellos las más utilizadas son la medición del ritmo de la temperatura corporal, la actividad motora, la melatonina, el cortisol y la expresión de genes reloj. Desde el punto de vista genético, ahora somos capaces de medir c) las alteraciones del reloj interno, con el fin de evaluar la genética del reloj molecular. De hecho, las nuevas técnicas de nutrigenética nos están dando la oportunidad de medir la asociación entre las diferentes variantes genéticas de nuestros genes reloj y varias enfermedades como la obesidad, las enfermedades cardiovasculares, la diabetes o el cáncer. Además de estas técnicas, se han desarrollado cuestionarios basados en las preferencias de mañana-tarde como procedimientos complementarios para evaluar cronotipos humanos (AU)

Uses and applications of the results from food surveys, physical activity estimates and other lifestyle related surveys at a population leve

The results and conclusions of well design nutrition studies, using the appropriate methods to achieve the intended aims with the best validity and precision possible are of great value for nutritional, food and toxicological surveillance systems; also in the planning, follow-up and evaluation of nutrition and health policies and providing high value information for the formulation of recommended reference intakes, nutritional objectives and food based dietary guidelines (AU)

Los resultados y las conclusiones de los estudios nutricionales bien diseñados, utilizando la metodología adecuada para lograr los objetivos planteados, con la mayor validez y precisión posible, son de gran utilidad en los sistemas de vigilancia nutricional, alimentaria y toxicológica, en la planificación, seguimiento y evaluación de políticas nutricionales y proporcionan información de gran interés en el planteamiento de ingestas de referencia, objetivos nutricionales y guías alimentarias (AU)

Sesgos y ajustes en la valoración nutricional de las encuestas alimentarias / Biases and adjustments in nutritional assessments from dietary questionnaires

En epidemiología nutricional es fundamental una correcta valoración del consumo alimentario de los individuos y grupos de población. Esta estimación debe hacerse con la mayor calidad posible, evitando las fuentes de error y confusión en su estimación. Las cualidades que otorgan calidad a un método de medida son la validez y la precisión, siendo la validez la principal característica. La falta de validez produce sesgos o errores sistemáticos, los cuales pueden aparecer en el proceso de selección de los sujetos o en el proceso de obtención de la información; y la falta de precisión produce los errores aleatorios. Para muchos nutrientes, las variaciones intra-individuales, debidas a muchos factores como el día de la semana o la estación del año valorada, podrían crear problemas en el análisis e interpretación de los resultados. Para minimizar estas fuentes de error se deben utilizar los métodos de ajustes en el proceso de análisis de datos. Los factores de confusión pueden exagerar o subestimar la verdadera magnitud de la asociación o incluso alterar su dirección. El consumo total de energía puede ser una variable de confusión en el estudio de la relación entre la ingesta de un nutriente y el riesgo de enfermedad. Para controlar este efecto se proponen varias aproximaciones: la densidad de nutrientes, el modelo multivariado estándar y el modelo residual de nutrientes (AU)

In nutritional epidemiology, it is essential to use Food Consumption Assessment Methods that have been validated and accepted by the international community for estimating food consumption of individuals and populations. This assessment must be made with the highest quality possible so as to avoid, as far as possible, sources of error and confusion in the processes. The qualities that are required in a measurement method are validity and accuracy; validity being the main factor. Lack of validity produces biases, or systematic errors. These can reside in the process of subject selection, or processes of information gathering where the lack of accuracy produces random errors. For many nutrients, the intra-individual variances are due to many factors such as day-of-the-week or season, and could create problems in the data analyses. Adjustments are needed to minimize these effects. Confounding factors may over- or under-state the real magnitude of the observed association, or even alter the direction of the real association. Total energy intake can be a confounding variable when studying a relationship between nutrient intake and disease risk. To control for this effect several approximations are proposed such as nutrient densities, standard multivariate models and thenutrient residual model (AU)

Reliability and validity of a short FFQ for assessing the dietary habits of 2-5-year-old children, Sydney, Australia.

OBJECTIVE: A simple FFQ which ranks young children's dietary habits is necessary for population-based monitoring and intervention programmes. The aim of the present study was to determine the reliability and validity of a short FFQ to assess the dietary habits of young children aged 2-5 years. DESIGN: Parents completed a seventeen-item FFQ for their children by telephone on two occasions, two weeks apart. Sixty-four parents also completed 3 d food records for their children. The FFQ included daily servings of fruit and vegetables, frequency of eating lean meat, processed meats, take-away food, snack foods (biscuits, cakes, doughnuts, muesli bars), potato crisps and confectionery, and cups of soft drinks/cordials, juice, milk and water. Weighted kappa and intra-class correlation coefficients were used to assess FFQ reliability and the Bland-Altman method was used to assess validity of the FFQ compared with the 3 d food record. SETTING: Seven pre-school centres in metropolitan Sydney, Australia. SUBJECTS: Seventy-seven children aged 2-5 years. RESULTS: The majority of questions had moderate to good reliability: κ w ranged from 0·37 (lean meat) to 0·85 (take-away food consumption). Validity analysis showed a significant increase in mean values from the food record with increasing ordered categories from the FFQ for servings of vegetables and fruit and cups of drinks (all trend P ≤ 0·01). Spearman rank correlation coefficient was >0·5 for vegetables, fruit, diet soft drinks and fruit juice. CONCLUSIONS: The FFQ provides reliable and moderately valid information about the dietary intakes and habits of children aged 2-5 years, in particular for fruit, vegetables and beverages.

Measuring food and nutrition security: tools and considerations for use among people living with HIV.

As an increasing number of countries implement integrated food and nutrition security (FNS) and HIV programs, global stakeholders need clarity on how to best measure FNS at the individual and household level. This paper reviews prominent FNS measurement tools, and describes considerations for interpretation in the context of HIV. There exist a range of FNS measurement tools and many have been adapted for use in HIV-endemic settings. Considerations in selecting appropriate tools include sub-types (food sufficiency, dietary diversity and food safety); scope/level of application; and available resources. Tools need to reflect both the needs of PLHIV and affected households and FNS program objectives. Generalized food sufficiency and dietary diversity tools may provide adequate measures of FNS in PLHIV for programmatic applications. Food consumption measurement tools provide further data for clinical or research applications. Measurement of food safety is an important, but underdeveloped aspect of assessment, especially for PLHIV.

7º Encuesta antropométrica a la población menor de 6 años: Noviembre 2013 / 7th anthropometric survey of the population under 6 years old: November 2013

La encuesta antropométrica a menores de 6 años constituye un estudio de tipo transversal que permite conocer el estado nutricional de los niños y niñas que concurren a los efectores públicos del primer nivel de atención de la Ciudad de Buenos Aires. Es la séptima oportunidad en que se realiza esta encuesta, habiéndose realizado la primera en 1995. Esta secuencia de estudios forma parte de las actividades de monitoreo de la situación nutricional de la población materno-infanto-juvenil que lleva adelante el Programa Nutricional. El presente informe tiene como principal objetivo devolver la información consolidada a los equipos de salud y difundir los datos obtenidos a todos/as aquellos/as interesados/as en la temática. (AU)

Validation of a dietary vitamin D questionnaire using multiple diet records and the block 98 health habits and history questionnaire in healthy postmenopausal women in northern California.

Vitamin D deficiency is common in older women and can negatively impact bone status. A simple method by which clinicians and researchers can evaluate a patient's vitamin D dietary intake could help identify individuals at risk for vitamin D deficiency. This study was done to validate a short dietary vitamin D questionnaire. Postmenopausal women (n=122), with a mean age of 63.9 ± 7.8 years, completed a Brief Vitamin D Questionnaire (BVDQ), the Block Health History and Habits Questionnaire 1998 (BHHHQ98), a 3-day food record, and an evaluation of serum 25 hydroxyvitamin D (25[OH]D) levels. Data were analyzed using Pearson correlation coefficients, Wilcoxon signed ranks tests, and Bland-Altman analyses to compare the performance of the BVDQ to the BHHHQ98 and to the diet record. As assessed by the BVDQ, vitamin D intake averaged 178.7 ± 112.3 IU per day, correlating well with the Block HHHQ98 (r=0.51, P<0.001) and the 3-day food record (r=0.43, P<0.001). Compared with the food record, both the BVDQ and the BHHHQ98 overestimated dietary vitamin D intake by less than 100 IU/day. The two questionnaires performed nearly identically at all levels of vitamin D intake. Serum 25(OH)D was not related to vitamin D intake as measured by either the BVDQ or the BHHHQ98, but did correlate weakly with vitamin D intake from the 3-day diet record (r=0.20, P=0.04). The Brief Vitamin D Questionnaire correlated well with the longer and more intense dietary assessment methods, making it a simple and accurate instrument for assessing vitamin D intake.