Food consumption of Sri Lankan adults : an appraisal of serving characteristics

Objective The main aim of the present study was to identify food consumption in Sri Lankan adults based on serving characteristics. Design Cross-sectional study. Fruits, vegetables, starch, meat, pulses, dairy products and added sugars in the diet were assessed with portion sizes estimated using standard methods. Setting Twelve randomly selected clusters from the Sri Lanka Diabetes and Cardiovascular Study. Subjects Six hundred non-institutionalized adults. Results The daily intake of fruit (0·43), vegetable (1·73) and dairy (0·39) portions were well below national recommendations. Only 3·5 % of adults consumed the recommended 5 portions of fruits and vegetables/d; over a third of the population consumed no dairy products and fewer than 1 % of adults consumed 2 portions/d. In contrast, Sri Lankan adults consumed over 14 portions of starch and 3·5 portions of added sugars daily. Almost 70 % of those studied exceeded the upper limit of the recommendations for starch intake. The total daily number of meat and pulse portions was 2·78. Conclusions Dietary guidelines emphasize the importance of a balanced and varied diet; however, a substantial proportion of the Sri Lankan population studied failed to achieve such a recommendation. Nutrition-related diseases in the country may be closely correlated with unhealthy eating habits.

The contribution of psychosocial factors to socioeconomic differences in food purchasing

In developed countries the relationship between socioeconomic position (SEP) and health is unequivocal. Those who are socioeconomically disadvantaged are known to experience higher morbidity and mortality from a range of chronic diet-related conditions compared to those of higher SEP. Socioeconomic inequalities in diet are well established. Compared to their more advantaged counterparts, those of low SEP are consistently found to consume diets less consistent with dietary guidelines (i.e. higher in fat, salt and sugar and lower in fibre, fruit and vegetables). Although the reasons for dietary inequalities remain unclear, understanding how such differences arise is important for the development of strategies to reduce health inequalities. Both environmental (e.g. proximity of supermarkets, price, and availability of foods) and psychosocial (e.g. taste preference, nutrition knowledge) influences are proposed to account for inequalities in food choices. Although in the United States (US), United Kingdom (UK), and parts of Australia, environmental factors are associated with socioeconomic differences in food choices, these factors do not completely account for the observed inequalities. Internationally, this context has prompted calls for further exploration of the role of psychological and social factors in relation to inequalities in food choices. It is this task that forms the primary goal of this PhD research. In the small body of research examining the contribution of psychosocial factors to inequalities in food choices, studies have focussed on food cost concerns, nutrition knowledge or health concerns. These factors are generally found to be influential. However, since a range of psychosocial factors are known determinants of food choices in the general population, it is likely that a range of factors also contribute to inequalities in food choices. Identification of additional psychosocial factors of relevance to inequalities in food choices would provide new opportunities for health promotion, including the adaption of existing strategies. The methodological features of previous research have also hindered the advancement of knowledge in this area and a lack of qualitative studies has resulted in a dearth of descriptive information on this topic. This PhD investigation extends previous research by assessing a range of psychosocial factors in relation to inequalities in food choices using both quantitative and qualitative techniques. Secondary data analyses were undertaken using data obtained from two Brisbane-based studies, the Brisbane Food Study (N=1003, conducted in 2000), and the Sixty Families Study (N=60, conducted in 1998). Both studies involved main household food purchasers completing an interviewer-administered survey within their own home. Data pertaining to food-purchasing, and psychosocial, socioeconomic and demographic characteristics were collected in each study. The mutual goals of both the qualitative and quantitative phases of this investigation were to assess socioeconomic differences in food purchasing and to identify psychosocial factors relevant to any observed differences. The quantitative methods then additionally considered whether the associations examined differed according to the socioeconomic indicator used (i.e. income or education). The qualitative analyses made a unique contribution to this project by generating detailed descriptions of socioeconomic differences in psychosocial factors. Those with lower levels of income and education were found to make food purchasing choices less consistent with dietary guidelines compared to those of high SEP. The psychosocial factors identified as relevant to food-purchasing inequalities were: taste preferences, health concerns, health beliefs, nutrition knowledge, nutrition concerns, weight concerns, nutrition label use, and several other values and beliefs unique to particular socioeconomic groups. Factors more tenuously or inconsistently related to socioeconomic differences in food purchasing were cost concerns, and perceived adequacy of the family diet. Evidence was displayed in both the quantitative and qualitative analyses to suggest that psychosocial factors contribute to inequalities in food purchasing in a collective manner. The quantitative analyses revealed that considerable overlap in the socioeconomic variation in food purchasing was accounted for by key psychosocial factors of importance, including taste preference, nutrition concerns, nutrition knowledge, and health concerns. Consistent with these findings, the qualitative transcripts demonstrated the interplay between such influential psychosocial factors in determining food-purchasing choices. The qualitative analyses found socioeconomic differences in the prioritisation of psychosocial factors in relation to food choices. This is suggestive of complex cultural factors that distinguish advantaged and disadvantaged groups and result in socioeconomically distinct schemas related to health and food choices. Compared to those of high SEP, those of lower SEP were less likely to indicate that health concerns, nutrition concerns, or food labels influenced food choices, and exhibited lower levels of nutrition knowledge. In the absence of health or nutrition-related concerns, taste preferences tended to dominate the food purchasing choices of those of low SEP. Overall, while cost concerns did not appear to be a main determinant of socioeconomic differences in food purchasing, this factor had a dominant influence on the food choices of some of the most disadvantaged respondents included in this research. The findings of this study have several implications for health promotion. The integrated operation of psychosocial factors on food purchasing inequalities indicates that multiple psychosocial factors may be appropriate to target in health promotion. It also seems possible that the inter-relatedness of psychosocial factors would allow health promotion targeting a single psychosocial factor to have a flow-on affect in terms of altering other influential psychosocial factors. This research also suggests that current mass marketing approaches to health promotion may not be effective across all socioeconomic groups due to differences in the priorities and main factors of influence in food purchasing decisions across groups. In addition to the practical recommendations for health promotion, this investigation, through the critique of previous research, and through the substantive study findings, has highlighted important methodological considerations for future research. Of particular note are the recommendations pertaining to the selection of socioeconomic indicators, measurement of relevant constructs, consideration of confounders, and development of an analytical approach. Addressing inequalities in health has been noted as a main objective by many health authorities and governments internationally. It is envisaged that the substantive and methodological findings of this thesis will make a useful contribution towards this important goal.

Linking food literacy to nutrition

“Food literacy” is an emerging term used to describe the relative ability to understand the nature of food and how it is important. It also describes the ability to gather, process, analyse and act upon information about food and to apply it in individual settings. A Delphi study of 43 Australian food experts from diverse sectors and settings in all states and territories explored the meaning of food literacy, its constitutive components and how they relate to nutrition. The three-round Delphi began with a semi-structured telephone interview and was followed by two online surveys. Grounded theory was used to develop a conceptual model of the relationship between food literacy and nutrition. It is proposed that food literacy influences nutrition through three related mechanisms of security, choice and pleasure. These mechanisms will be mediated by the local food supply and individual values. The relative importance of components of food literacy will depend upon these mediators. The level of nutrition outcome being sought (for example, dietary guidelines versus food group serves) will also influence the relative importance of these components. This model will be useful in informing program planning and evaluation and will be tested and refined following a phenomenological study of consumers.

The contribution of three components of nutrition knowledge to socio-economic differences in food purchasing choices

Objectives: To assess socio-economic differences in three components of nutrition knowledge, i.e. knowledge of (i) the relationship between diet and disease, (ii) the nutrient content of foods and (iii) dietary guideline recommendations; furthermore, to determine if socio-economic differences in nutrition knowledge contribute to inequalities in food purchasing choices. Design: The cross-sectional study considered household food purchasing,nutrition knowledge, socio-economic and demographic information. Household food purchasing choices were summarised by three indices, based on self-reported purchasing of sixteen groceries, nineteen fruits and twenty-one vegetables. Socio-economic position (SEP) was measured by household income and education. Associations between SEP, nutrition knowledge and food purchasing were examined using general linear models adjusted for age, gender, household type and household size. Setting: Brisbane, Australia in 2000. Subjects: Main household food shoppers (n 1003, response rate 66?4 %), located in fifty small areas (Census Collectors Districts). Results: Shoppers in households of low SEP made food purchasing choices that were less consistent with dietary guideline recommendations: they were more likely to purchase grocery foods comparatively higher in salt, sugar and fat, and lower in fibre, and they purchased a narrower range of fruits and vegetables. Those of higher SEP had greater nutrition knowledge and this factor attenuated most associations between SEP and food purchasing choices. Among nutrition knowledge factors, knowledge of the relationship between diet and disease made the greatest and most consistent contribution to explaining socio-economic differences in food purchasing. Conclusions: Addressing inequalities in nutrition knowledge is likely to reduce socio-economic differences in compliance with dietary guidelines. Improving knowledge of the relationship between diet and disease appears to be a particularly relevant focus for health promotion aimed to reduce socio-economic differences in diet and related health inequalities.

Estimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000

OBJECTIVES To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. DESIGN The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 microg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. SETTING South Africa. SUBJECTS Children under 5 years and pregnant women 15 - 49 years. OUTCOME MEASURES Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9 - 12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174,976 (95% uncertainty interval 150,344 - 203,961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. CONCLUSIONS This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.

Vegetables containing phytochemicals with potential anti-obesity properties: A review

The incidence of obesity is rising worldwide at an alarming rate and is becoming a major public health concern with incalculable social and economic costs. Studies have exposed the relationship between the adiposity, inflammation and the development of other metabolic disorders, so dietary factors that influence some or all of these are of interest. Dietary phytochemicals appear to be able to target different stages of the adipocyte (fat cell) lifecycle. For example, several classes of polyphenols have been implicated in suppressing the growth of adipose tissue through modifying the adipocyte lifecycle. Many dietary phytochemicals also have strong anti-inflammatory activity, but the amount present in plants varies and may be affected by processing. In this review we summarise the likely mechanisms of action of plant phytochemicals. We highlight the major vegetable sources of polyphenols, including those with possible synergistic attributes, discuss the variation in polyphenol levels and their distribution in cultivars and outline the effects of food processing. The identification and characterisation of the anti-obesogenic properties of phytochemicals in vegetables, as well as an appreciation of the effect of cooking on phytochemical content provide significant new information supporting dietary guidelines that encourage vegetable consumption for the prevention and management of lifestyle related disease.

The role of added sugar in a healthy diet and implications for health inequalities

The role of added sugar in a healthy diet and implications for health inequalities Sugars provide a readily available, inexpensive source of energy, can increase palatability and help preserve some foods. However added sugars also dilute the nutrient density of the diet. Further, consumption of sugar-sweetened beverages is associated with increased risk of weight gain and reduced bone strength, and high or frequent consumption of added sugars is associated with increased risk of dental caries, particularly in infants and young children. The products of the 2013 NHMRC Dietary Guidelines work program at www.eatforhealth.gov.au include the comprehensive evidence base about food, diet and health relationships and the dietary modeling used to inform recommendations. This presentation will detail the scientific evidence underpinning the revised dietary recommendations on consumption of foods and drinks containing added sugar and compare recommendations with the most recently available relevant Australian dietary intake and trend data. Differences in intakes of relevant food and drinks across quintiles of social disadvantage and in particular between Aboriginal and Torres Strait Islander groups and non-Indigenous Australians will also be explored.

Survey of the fatty acid composition of Canadian beef: Backfat and longissimus lumborum muscle

[EN]A survey of Canadian retail beef was undertaken with emphasis on the trans fatty acid (TFA) and conjugated linoleic acid (CLA) isomers, and compared with current health recommendations. Thirty striploin steaks were collected in the winter and summer from major grocery stores in Calgary (Alberta, Canada). Steak fatty acid compositions (backfat and longissimus lumborum muscle analysed separately) showed minor seasonal differences with lower total saturates (PB0.05) and higher total monounsaturates (PB 0.01) in winter, but no differences in total polyunsaturated fatty acids. The ratio of n-6 and n-3 polyunsaturated fatty acid in longissimus lumborum averaged 5.8. The average TFA content in longissimus lumborum was 0.128 g 100 g_1 serving size, and 10t-18:1 was found to be the predominant isomer (32% of total trans), while vaccenic acid was second most abundant (15% of total trans). The CLA content in longissimus lumborum was similar to that of backfat, ranging from 0.43 to 0.60% of total fatty acids and rumenic acid represented 60% of total isomers. Overall, there is still room for improvement in the saturated, mono- and polyunsaturated fatty acid composition of Canadian beef to meet general dietary guidelines for human consumption and additional targets should include reducing 10t-18:1 while increasing both rumenic and vaccenic acids.

Calidad de la dieta, sobrepeso y obesidad en estudiantes universitarios

Este trabajo se encuentra bajo la licencia Creative Commons Attribution 3.0.

Avaliação da Ingestão Alimentar de Idosos em Hemodiálise.

O número de pacientes idosos iniciando tratamento dialítico aumentou de maneira importante nas últimas duas décadas. Por esse motivo, é importante conhecer sobre aspectos nutricionais desse segmento de pacientes. Poucos trabalhos até o momento investigaram a ingestão alimentar de pacientes idosos em hemodiálise (HD) com foco na qualidade da dieta. Dessa forma, o objetivo deste estudo é investigar o padrão alimentar de idosos em HD, verificar se o dia de tratamento dialítico pode alterar o padrão alimentar, avaliar se o padrão alimentar se associa com marcadores do estado nutricional e averiguar se o padrão alimentar de pacientes idosos em HD difere do de idosos sem doença renal crônica (DRC). Métodos: Este trabalho tem desenho observacional e transversal. Foram avaliados 153 pacientes idosos (> 60 anos) em tratamento crônico de HD (Grupo Estudo: 70,8 7,2 anos) e 47 idosos sem DRC (Grupo Controle: 73,2 7,9 anos). A avaliação do estado nutricional, no Grupo Estudo, foi feita por medidas antropométricas, impedância bioelétrica, força de preensão manual, albumina sérica e avaliação subjetiva global de 7 pontos. O consumo alimentar foi avaliado a partir do registro alimentar de 3 dias, sendo 1 dia do final de semana sem diálise (FS), 1 dia da semana com diálise (HD) e 1 dia da semana sem diálise (SHD) para o Grupo Estudo; e 1 dia do final de semana (FS) e um dia da semana (dia 1) para o Grupo Controle. O padrão alimentar foi avaliado pelo índice de qualidade da dieta revisado (IQD-R), com 12 componentes e pontuação máxima de 100 pontos, indicando melhor qualidade da dieta. Para avaliar o consumo de alimentos ultraprocessados, os alimentos foram categorizados em três grupos (in natura, ingredientes de adição e ultraprocessados). Resultados: Não houve diferença estatística na pontuação total do IQD-R entre os três dias avaliados no Grupo Estudo. No entanto, observou-se diferença quando avaliado os componentes do IQD-R. Notou-se menor consumo de frutas integrais (2,66 0,18 vs. 3,28 0,18 pontos), vegetais verde-escuros e alaranjados (2,99 0,19 vs. 3,55 0,16 pontos) no dia HD comparado ao dia SHD, respectivamente. Quanto ao consumo de alimentos ultraprocessados, apenas no dia HD a contribuição energética desse grupo alimentar (41,6 17,6%) foi similar à de alimentos in natura (41,7 15,9%), enquanto nos dias FS e SHD a contribuição de alimentos in natura foi maior. Não foram observadas associações clinicamente significantes entre a pontuação total do IQD-R e parâmetros nutricionais no Grupo Estudo. Ao comparar o Grupo Estudo com o Grupo Controle, notou-se que a pontuação total do IQD-R foi menor no Grupo Estudo em todos os três dias avaliados e as maiores diferenças foram encontradas no dia HD. O mesmo se repete quanto à contribuição energética dos alimentos ultraprocessados, que foi maior no dia HD (41,6 17,6%) quando comparado ao dia 1 do Grupo Controle (33,4 15,9%). Essa diferença não foi observada quando o dia 1 do Grupo Controle foi comparado ao dia SHD. Conclusão: Pacientes idosos em HD apresentam pior padrão alimentar no dia HD e pior do que de idosos sem DRC. Fica clara a importância de rever as orientações alimentares voltadas a esse grupo de pacientes, de forma a favorecer um padrão alimentar compatível com uma boa saúde.

Effect of storage on physical-chemical properties and phenolics of sweet cherry from São Julião region.

Effect of storage on physical-chemical properties and phenolics of sweet cherry from São Julião region. A.C. Agulheiro-Santos1, F. Vieira1, D. Gonzalez2, M. Lozano2, V. Palma1, A.E. Rato1 1Universidade de Évora. Instituto de Ciências Agrárias e Ambientais Mediterrânica (ICAAM). 7000 Évora, Portugal. 2Centro de Investigaciones Científicas y Tecnológicas de Extremadura (CICYTEX). Ctra. San Vicente. Finca Santa Engracia. 06071 Badajoz, Spain. Worldwide the consumption of fruit and vegetables is increasing due to the dietary guidelines recommended by nutritionist. Because of their high content on phenols, vitamins, mineral and antioxidants, berry fruits are consumed not only in fresh forms but also as processed and derivative products such as juices, yogurts, jellies and dried fruits. As a high consumed red fruit, sweet cherry has been the focus on some studies, mainly regarding bioactive compounds content. “Sweetheart” cherries from São Julião region (Alentejo, Portugal) from two different production campaigns were kept in different storage conditions in order to evaluate both the environmental and storage effect on some physical-chemical properties and phenolics. Cold conditions - Cold (1 ºC, 95% RH) and modified atmosphere - MA (1 ºC, 95% RH with micro-perforated bags of Pplus®, Sidlaw Packaging, Bristol, UK) were tested. In order to establish the appropriate storage conditions, individual phenolic acids and physical-chemical properties were analysed during two consecutive years. Results show a general decrease on phenolic compounds content between cherries from both years. It is also observed that MA conditions do not affect significantly both phenolics and physical-chemical parameters when compared with Cold conditions. Additionally, it is observed similar behaviour on Cold and MA sweet cherries regarding its pH, total soluble solids content (TSS), titratable acidity (TA) and colour and individual phenols during storage time. Concluding, these results show, as expected, changes between cultivars which may be correlated with the environmental conditions on different years. Keywords: sweet cherry, postharvest, phenols, physical-chemical, storage conditions.

The nutritional significance of cheese in the UK diet

Cheese currently suffers from an adverse nutritional image largely due to a perceived association between saturated fatty acid, cholesterol and the salt content of cheese with cardiovascular disease. However, cheese is also a rich source of essential nutrients such as, proteins, lipids, vitamins and minerals that play an integral part of a healthy diet. This review outlines the composition, structure and physiological characteristics of the nutritionally significant components of cheese, whilst presenting some of the controversies that surround the role of cheese in dietary guidelines and the potential cheese has to improve health in the UK population.

Attitudinal and demographic determinants of diet quality and implications for policy targeting

Background:  Poor diet quality is a major public health concern that has prompted governments to introduce a range of measures to promote healthy eating. For these measures to be effective, they should target segments of the population with messages relevant to their needs, aspirations and circumstances. The present study investigates the extent to which attitudes and constraints influence healthy eating, as well as how these vary by demographic characteristics of the UK population. It further considers how such information may be used in segmented diet and health policy messages. Methods:  A survey of 250 UK adults elicited information on conformity to dietary guidelines, attitudes towards healthy eating, constraints to healthy eating and demographic characteristics. Ordered logit regressions were estimated to determine the importance of attitudes and constraints in determining how closely respondents follow healthy eating guidelines. Further regressions explored the demographic characteristics associated with the attitudinal and constraint variables. Results:  People who attach high importance to their own health and appearance eat more healthily than those who do not. Risk-averse people and those able to resist temptation also eat more healthily. Shortage of time is considered an important barrier to healthy eating, although the cost of a healthy diet is not. These variables are associated with a number of demographic characteristics of the population; for example, young adults are more motivated to eat healthily by concerns over their appearance than their health. Conclusions:  The approach employed in the present study could be used to inform future healthy eating campaigns. For example, messages to encourage the young to eat more healthily could focus on the impact of diets on their appearance rather than health.