An instrument to measure adherence to weight loss programs : the Compliance Praxis Survey-Diet (COMPASS-Diet)

Adherence to behavioral weight loss strategies is important for weight loss success. We aimed to examine the reliability and validity of a newly developed compliance praxis-diet (COMPASS-diet) survey with participants in a 10-week dietary intervention program. During the third of five sessions, participants of the “slim-without-diet” weight loss program (n = 253) completed the COMPASS-diet survey and provided data on demographic and clinical characteristics, and general self-efficacy. Group facilitators completed the COMPASS-diet-other scale estimating participants’ likely adherence from their perspective. We calculated internal consistency, convergent validity, and predictive value for objectively measured weight loss. Mean COMPASS-diet-self score was 82.4 (SD 14.2) and COMPASS-diet-other score 80.9 (SD 13.6) (possible range 12–108), with lowest scores in the normative behavior subscale. Cronbach alpha scores of the COMPASS-diet-self and -other scale were good (0.82 and 0.78, respectively). COMPASS-diet-self scores (r = 0.31) correlated more highly with general self-efficacy compared to COMPASS-diet-other scores (r = 0.04) providing evidence for validity. In multivariable analysis adjusted for age and gender, both the COMPASS-diet-self (F = 10.8, p < 0.001, r2 = 0.23) and other (F = 5.5, p < 0.001, r2 = 0.19) scales were significantly associated with weight loss achieved at program conclusion. COMPASS-diet surveys will allow group facilitators or trainers to identify patients who need additional support for optimal weight loss.

Consumers' readiness to eat a plant-based diet

Objective: The aim of this study was to examine consumers' readiness to change to a plant-based diet. Design: Mail survey that included questions on readiness to change, eating habits and perceived benefits and barriers to the consumption of a plant-based diet. Setting: Victoria, Australia. Subjects: A total of 415 randomly selected adults. Results: In terms of their readiness to eat a plant-based diet, the majority (58%) of participants were in the precontemplation stage of change, while 14% were in contemplation/preparation, and 28% in action/maintenance. Those in the action/maintenance stage ate more fruit, vegetables, nuts, seeds, whole-meal bread, and cooked cereals than those in earlier stages. There were statistically significant differences in age and vegetarian status between the stages of change, but not for other demographic variables. There were strong differences across the stages of change with regard to perceived benefits and barriers to plant-based diets. For example, those in action/maintenance scored highest for benefit factors associated with well-being, weight, health, convenience and finances, whereas those in the precontemplation stage did not recognise such benefits. Conclusions: These findings can be utilised to help provide appropriate nutrition education and advertising, targeted at specific stages of change. For example, education about how it is possible to obtain iron and protein from a plant-based diet and on the benefits of change, in addition to tips on how to make a gradual, easy transition to a plant-based diet, could help progress precontemplators to later stages.

Public views of the benefits and barriers to the consumption of a plant-based diet

Objective: The aim of this study was to examine consumers' perceived benefits and barriers to the consumption of a plant-based diet. Design: Mail survey that included questions on perceived benefits and barriers to the consumption of a plant-based diet. Setting: Victoria, Australia. Subjects: Four hundred and fifteen randomly selected Victorian adults. Results: The main perceived barrier to adoption of a plant-based diet was a lack of information about plant-based diets (42% agreement). Sex, age and education differences were present in over a quarter of the barrier items. For example, non-university-educated respondents and older people were less willing to change their current eating pattern than were university educated and younger respondents. The main benefits associated with plant-based diets were health benefits, particularly decreased saturated fat intake (79% agreement), increased fibre intake (76%), and disease prevention (70%). Age, sex and education differences with regard to benefits were apparent, although sex differences were more important than age or education differences. Conclusions: The majority of respondents perceived there to be health benefits associated with the consumption of a plant-based diet. Compared with the proportion of respondents who agreed that there were particular benefits of eating a plant-based diet, perceived barriers were relatively low. An understanding of the perceived benefits and barriers of consuming a plant-based diet will help formulate strategies that aim to influence beliefs about plant foods, plant food consumption, and, ultimately, public health.

Consumo de carnes por forma de preparo no Brasil.

A plausível associação entre o consumo de carnes e o desenvolvimento do câncer colorretal vem sendo em parte explicada pelo processo de formação de aminas heterocíclicas e hidrocarbonetos aromáticos durante a cocção. No Brasil este tipo de câncer encontra-se entre as três mais frequentes causas de óbito por câncer tanto em homens como em mulheres, sendo as regiões Sul e Sudeste as que apresentam as maiores taxas de mortalidade. Este estudo tem como objetivo estimar o consumo médio per capita e prevalência de carnes segundo formas de preparo no Brasil, com ênfase nas técnicas grelhado/brasa/churrasco e frito. Foram utilizados dados do Inquérito Nacional de Alimentação (INA) que faz parte da Pesquisa de Orçamentos Familiares (POF) realizado entre os anos de 2008 e 2009. Nesse inquérito foram analisadas informações referentes ao consumo alimentar de 34.003 indivíduos com dez anos de idade ou mais, contemplando questões a cerca da quantidade de alimentos consumidos em unidades de medidas caseiras, forma de preparo do alimento e local de consumo (alimentação dentro do domicílio ou quando o alimento foi preparado e consumido fora do domicílio). As medias de carnes em geral foram estratificadas por sexo, escolaridade, quarto de renda, grandes regiões geográficas, situação do domicílio (urbano/rural) e local de consumo (dentro/fora do lar). Para a extração dos valores médios per capita consumidos, foram utilizados os procedimentos survey para levar em consideração os efeitos do desenho amostral. Verificou-se que a maior média per capita de consumo em gramas ocorreu no grupo de carne bovina, e a forma de preparo frito apresentou a maior média per capita de ingestão (31 gramas/ dia). Agrupando-se todos os tipos de carnes em apenas uma classe, "carnes em geral", a forma de preparação frita permaneceu com média de consumo demasiadamente maior que a forma grelhado/brasa/churrasco em todas as variáveis analisadas. Quando desagregado pelas variáveis de interesse, a maior média de consumo per capita de carnes em geral ocorreu na mais alta categoria de escolaridade (21 gramas/ dia) para o tipo grelhado/brasa/churrasco e entre residentes da região Norte (111gramas/ dia) para o tipo frito. As menores médias per capita ocorreram entre os indivíduos no primeiro quarto de renda (1,96 gramas/ dia) para aqueles que consumiram grelhado/brasa/churrasco e para as carnes fritas a menor média foi observada fora do domicílio (20 gramas/ dia). Os achados indicam que existe uma acentuada diferença entre o consumo médio per capita de grelhado/brasa/churrasco e fritos entre as regiões brasileiras, sendo mais evidente quando desagregado por variáveis sócio demográficas.

The DietCompLyf study: A prospective cohort study of breast cancer survival and phytoestrogen consumption

DietCompLyf is a multi-centre prospective study designed to investigate associations between phytoestrogens - naturally occurring plant compounds with oestrogenic properties - and other diet and lifestyle factors with breast cancer recurrence and survival. 3159 women with grades I-III breast cancer were recruited 9-15 months post-diagnosis from 56 UK hospitals. Detailed information on clinico-pathological, diet, lifestyle and quality of life is collected annually up to 5 years. Biological samples have also been collected as a resource for subsequent evaluation. The characteristics of the patients and associations between pre-diagnosis intake of phytoestrogens (isoflavones and lignans; assessed using the EPIC-Norfolk UK 130 question food frequency questionnaire) and breast cancer (i) risk factors and (ii) prognostic factors are described for 1797 women who had complete data for all covariates and phytoestrogens of interest. Isoflavone intakes were higher in the patients who were younger at diagnosis, in the non-smokers, those who had breast-fed and those who took supplements. Lignan intakes were higher in patients with a higher age at diagnosis, in ex-smokers, those who had breast-fed, who took supplements, had a lower BMI at diagnosis, lower age at menarche and were nulliparous. No significant associations between pre-diagnosis phytoestrogen intake and factors associated with improved breast cancer prognosis were observed. The potential for further exploration of the relationship between phytoestrogens and breast cancer recurrence and survival, and for the establishment of evidence to improve dietary and lifestyle advice offered to patients following breast cancer diagnosis using DietCompLyf data is discussed.

Eating habits of preschool children with high migrant status in Switzerland according to a new food frequency questionnaire.

Assessment of eating habits in young children from multicultural backgrounds has seldom been conducted. Our objectives were to study the reproducibility and the results of a food frequency questionnaire (FFQ) developed to assess changes in eating habits of preschool children with a high migrant population, in the context of a multidisciplinary multilevel lifestyle intervention. Three kindergarten classes (53% from migrant backgrounds) in French-speaking Switzerland were randomly selected and included 16 girls and 28 boys (mean age +/- SD, 5.4 +/- 0.7 years). The FFQ was filled out twice within a 4-week interval by the parents. Spearman rank correlations between the first and the second FFQ for the 39 items of the food questions were as follows: low (r < 0.50) for 8 (7 P < .05 and 1 nonsignificant), moderate (0.50 <or= r < 0.70) for 22 (all P < .01), and high (r >or= 0.70) for 9 (all P < .01). In addition, 28 of 39 intraclass correlation coefficients were high (>0.50, all P < .01). Eighty-six percent of the children ate breakfast at home daily, but only 67% had lunch at home. The percentages of children eating at least once a week in front of the TV were as follows: 50% for breakfast, 33% for lunch, 38% for dinner, and 48% for snacks. Forty percent of children asked their parents to buy food previously seen in advertisements and ate fast food between once a week and once a month. Children generally consumed foods with a high-energy content. The FFQ yielded good test-retest reproducibility for most items of the food questions and gave relevant findings about the eating habits of preschool children in areas with a high migrant population.

Avaliação da ingestão dietética de cálcio em indivíduos adultos portadores de hipertensão arterial idiopática

Foi estudada a relação entre a ingestão dietética de cálcio e os demais parâmetros alimentares e antropométricos em 60 indivíduos adultos, portadores de hipertensão arterial idiopática (10 homens e 50 mulheres), com média etária de 48,6 anos, seguidos no Centro de Hipertensão Arterial do Hospital das Clínicas da Faculdade de Medicina de Botucatu (SP), Brasil. Foram utilizados três métodos diferentes de inquérito aumentar em três diferentes ocasiões: recordatório de 24h, questionário de freqüência alimentar, dirigido para ingestão de cálcio, e registro alimentar de 3 dias. As médias de ingestão de cálcio, extraídas desses inquéritos, foram semelhantes, mostrando que, em relação á ingestão de cálcio, esses métodos de inquérito alimentar podem ser utilizados indistintamente com o objetivo de se mensurar à ingestão de cálcio de um grupo de indivíduos. Além da ingestão de cálcio, foi avaliada a ingestão protéico-calórica e de diversos outros nutrientes, assim como realizada a antropometria desse grupo de hipertensos em três ocasiões diferentes, com intervalos variando de duas semanas a 15 meses. Quando comparado a um grupo de referência local, constituído de indivíduos sadios, com média etária semelhante, o grupo de hipertensos mostrou ter menor ingestão média de cálcio. Comparados por sexo, os homens dos dois grupos exibiram perfis nutricional e antropométrico semelhantes. em relação às mulheres, houve diferenças quanto à ingestão protéico-calórica, o que se supõe ser devido à ingestão menor do leite e derivados entre as hipertensas. Estas estavam mais pesadas que as mulheres do grupo de referências, à custa de maior massa muscular, provavelmente devido a maior atividade física. Concluiu-se que o cálcio dietético foi o principal item alimentar que distinguiu hipertensos de normotensos. Como existem estudos clínicos comprovando o efeito benéfico da suplementação de cálcio na redução dos níveis pressóricos de indivíduos hipertensos, sugere-se a repetição deste tipo de trabalho, em outros locais, visando ao embasamento de programa nacional de suplementação de cálcio dietético entre indivíduos hipertensos idiopáticos.

Estudo antropométrico e dietético de nadadores competitivos de áreas metropolitanas da região sudeste do Brasil

Com o objetivo de caracterizar os ábitos alimentares de nadadores competitivos de dois clubes das cidades do Rio de Janeiro e de São Paulo, foram estudados atletas, 30 homens e 37 mulheres pertencentes às equipes juvenil (15-17 anos) e seniors (18-25 anos). Concomitantemente à avaliação antropométrica, foi feito o inquérito alimentar mediante os métodos de registro alimentar, recordatório de 24 horas e freqüência de consumo alimentar. Os resultados mostraram semelhança antropométrica entre as duas faixas etárias para cada um dos sexos, semelhança dos alimentos prevalentemente ingeridos com aqueles referidos pela população da área metropolitana das duas cidades e semelhança entre os suplementos alimentares ingeridos pelos atletas dos dois clubes. A ingestão calórica observada foi quase o dobro da referida para a população daquelas localidades, mas equivalente à descrita para nadadores de outros países. Os lanches, entre refeições, contribuíram com 25-28% da ingestão calórica global e a maior contribuição energética alimentar foi dada pelo grupo de cereais. Apesar de contribuir com quase 50% do aporte calórico diário, a ingestão glicídica foi menor que a recomendada para atletas competitivos (55-60%). A ingestão protéica de 2,5-3,0 g/kg/dia superou em 100% o valor recomendado para atletas e ultrapassou os 15% na participação calórica diária. A ingestão lipídica foi considerada elevada, particularmente a de gordura saturada. O aporte de micronutrientes foi acima do referido para as populações locais em função da ingestão calórica elevada, mas mostrou-se relativamente inadequado em magnésio, ferro e vitaminas A e D. Conclui-se que o padrão alimentar dos nadadores estudados não difere, muito, do da população local, distinguindo-se pelo elevado e freqüente consumo de alimentos energéticos, maior no sexo masculino que no feminino.

Regional and socioeconomic distribution of household food availability in Brazil, in 2008-2009

OBJECTIVE: To describe the regional and socioeconomic distribution of household food availability in Brazil. METHODS: Data from the 2008-2009 Household Budget Survey on food and beverage acquisition for household consumption, conducted by the Instituto Brasileiro de Geografia e Estatistica (Brazilian Institute of Geography and Statistics), were analyzed. The amounts of foods, recorded during seven consecutive days in the 55,970 sample households, were converted into calories and nutrients. Food quality indicators were constructed and analyzed according to the regional and socioeconomic strata of the Brazilian population. RESULTS: The amount of energy from protein was adequate in all regional and socioeconomic strata. On the other hand, an excess of free sugars and fats was observed in all regions of the country, especially in the Southern and Southeastern regions. The proportion of saturated fats was high in urban areas and consistent with the greater contribution of animal-derived products. Limited availability of fruits and vegetables was found in all regions. An increase in the fat content and reduction in carbohydrate content of the diet were observed with the increase in income. CONCLUSIONS: The negative characteristics of the Brazilian diet observed at the end of the first decade of the 21(st) century indicate the need to prioritize public policies for the promotion of healthy eating.

Mudanças no consumo alimentar e atividade física de escolares de Florianópolis, SC, 2002 - 2007

OBJETIVO: Avaliar a mudança em cinco anos do consumo alimentar e nível de atividade física em escolares. MÉTODOS: Estudo com amostra representativa (n = 4.168) de escolares de sete a dez anos de idade de Florianópolis, SC. Medidas do consumo alimentar e atividade física foram realizadas em dois estudos de base escolar em 2002 (n = 2.936; 51% meninos; idade média = 8,5 anos) e 2007 (n = 1.232; 50,7% meninos; idade média = 8,6 anos), utilizando questionários ilustrados. O teste do qui-quadrado foi utilizado para avaliar a mudança no consumo de oito alimentos/grupos de alimentos, no atendimento às recomendações do Guia Alimentar para a População Brasileira e no nível de atividade física (avaliado segundo os terços de distribuição do escore e o tipo de deslocamento para a escola). As análises foram realizadas segundo a rede de ensino. RESULTADOS: Houve redução da proporção de crianças que relatou o consumo de frutas, verduras e legumes, feijão, carnes, guloseimas, pizza, batata frita e refrigerantes. Maior proporção de escolares da rede privada atendeu às recomendações de restrição de consumo de refrigerantes, pizzas e batata frita, e de maior consumo de frutas, verduras e legumes, em ambos os estudos. Por outro lado, maior proporção de escolares da rede pública atendeu às recomendações para o consumo de carnes em 2007. Os valores medianos do escore de atividade física diminuíram em 2007. Em ambos os anos escolares da rede privada foram mais ativos. A proporção de escolares que se deslocou ativamente para a escola reduziu de 49% para 41% (p < 0,01). CONCLUSÕES: Houve redução no consumo de alimentos marcadores de dieta saudável (feijão, carnes/peixes, frutas, legumes e verduras) e de alimentos de alta densidade energética e baixo valor nutricional (refrigerantes, guloseimas e pizza/batatas fritas). Também houve decréscimo da proporção de escolares que relataram deslocamento ativo para a escola.

Asociación entre la dieta y la presencia de sobrepeso y obesidad: método de evaluación dietética de la Encuesta Nacional de Salud Española 2006

Introducción: analizar la asociación entre la frecuencia de consumo de alimentos y la presencia de sobrepeso-obesidad a partir de datos de la Encuesta Nacional de Salud Española 2006 (ENS-06). Material y métodos: estudio transversal retrospectivo de fuentes secundarias de la ENS-06. Se seleccionaron 29.321 individuos que respondieron el Cuestionario de Frecuencia de Consumo de Alimentos, compuesto por una lista de 12 grupos, sobre los que se preguntaba su frecuencia de consumo en 5 opciones de respuesta y que se categorizaron en 3 para el análisis (consumo diario, semanal y ocasional). Se realizó un análisis descriptivo del consumo de grupos de alimentos categorizados por frecuencia de consumo, y calculando la diferencia (brecha) entre hombres y mujeres. La asociación entre frecuencia de consumo de alimentos y sobrepeso-obesidad se realizó mediante regresión logística. Resultados: el 40,7% de la población consume a diario verduras-hortalizas y el 65,2% consume frutas a diario. El 69,8%, y el 46,3% de las mujeres cumplen las recomendaciones de consumo de frutas (brecha -7,2), y de verduras-hortalizas (brecha -14,0) respectivamente. Consumir fruta ocasionalmente, disminuye la probabilidad de padecer obesidad (OR=0,72 IC95%: 0,63-0,82), frente a consumirla a diario. Consumir embutidos a diario, disminuye la probabilidad de padecer obesidad (OR=0,75 IC95%: 0,68-0,83), frente a un consumo ocasional. Conclusiones: Los resultados muestran contradicciones científicas por la presencia de sesgos en el instrumento utilizado en la recogida de la información, sugiriendo la necesidad de que la ENS incluya un método de recogida de información dietética-nutricional validado y adoptado, que permita mediciones de mayor calidad y exactitud.

Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases : design and methods for nation-wide surveys

Introduction: 

Monitoring and benchmarking population diet quality globally : a step-wise approach

INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support) aims to monitor and benchmark the healthiness of food environments globally. In order to assess the impact of food environments on population diets, it is necessary to monitor population diet quality between countries and over time. This paper reviews existing data sources suitable for monitoring population diet quality, and assesses their strengths and limitations. A step-wise framework is then proposed for monitoring population diet quality. Food balance sheets (FBaS), household budget and expenditure surveys (HBES) and food intake surveys are all suitable methods for assessing population diet quality. In the proposed ‘minimal’ approach, national trends of food and energy availability can be explored using FBaS. In the ‘expanded’ and ‘optimal’ approaches, the dietary share of ultra-processed products is measured as an indicator of energy-dense, nutrient-poor diets using HBES and food intake surveys, respectively. In addition, it is proposed that pre-defined diet quality indices are used to score diets, and some of those have been designed for application within all three monitoring approaches. However, in order to enhance the value of global efforts to monitor diet quality, data collection methods and diet quality indicators need further development work.

Diet composition and prey selection of the introduced grouper species peacock hind (Cephalopholis argus) in Hawaii

The introduced grouper species peacock hind (Cephalopholis argus), was the dominant large-body piscivore on the Main Hawaiian Island (MHI) reefs assessed by underwater visual surveys in this study. However, published data on C. argus feeding ecology are scarce, and the role of this species in Hawaiian reef ecosystems is presently not well understood. Here we provide the first comprehensive assessment of the diet composition, prey electivity (dietary importance of prey taxa compared to their availability on reefs), and size selectivity (prey sizes in the diet compared to sizes on reefs) of this important predator in the MHI. Diet consisted 97.7% of fishes and was characterized by a wide taxonomic breadth. Surprisingly, feeding was not opportunistic, as indicated by a strongly divergent electivity for different prey fishes. In addition, whereas some families of large-body species were represented in the diet exclusively by recruit-size individuals (e.g., Aulostomidae), several families of smaller-body species were also represented by juveniles or adults (e.g., Chaetodontidae). Both the strength and mechanisms of the effects of C. argus predation are therefore likely to differ among prey families. This study provides the basis for a quantitative estimate of prey consumption by C. argus, which would further increase understanding of impacts of this species on native fishes in Hawaii.

Diet of Bottlenose Dolphins Tursiops truncatus in the Northwest Panhandle and Foraging Behavior Near Savannah, Georgia

The foraging ecology of bottlenose dolphins Tursiops truncatus in the Northwest Florida Panhandle and estuaries in northern Georgia was determined using diet analysis and behavioral surveys. Stomach content analysis was completed on bottlenose dolphins(N = 25) that stranded in the Northwest Florida Panhandle from November 2006 to March 2009. The most abundant prey species were spot Leiostomus xanthurus (20.4%), squid (10.9%), pinfish Lagodon rhombiodes (10.3%), and Atlantic croaker Micropogonias undulatus (8.5%). Dolphins that stranded during months with a red tide Karenia brevis bloom consumed more pinfish, and spot; whereas dolphins that stranded in non-bloom months consumed more squid, Atlantic croaker, and silver perch Bairdiella chrysoura. Differences in diet were also identified for dolphins that stranded inside bays/sound and dolphin that stranded outside of bays along the coast, and male and female dolphins. Surveys were conducted from south of the Savannah River to north of Ossabaw Sound in Georgia where foraging behaviors were classified. Multivariate Generalized Additive Models were used to test correlations of behaviors to dolphin group size, depth, salinity, temperature, creek width, and tide. Sightings with headstands (p = 0.009), hard stops (p = 0.019), chasing (p = 0.004), mudbank whacking (p < 0.001), herding/circling (p = 0.024), and strand feeding (p = 0.006) were correlated with shallow water or small creeks. Sightings with kerplunking (p = 0.031), mudbank whacking (p = 0.001), strand feeding (p = 0.003), and herding/circling (p = 0.026) were significantly correlated with low tide. The results of the Savannah, Georgia study were the first to characterize foraging behaviors in this area and demonstrate how bottlenose dolphins utilize the salt marsh estuary in terms of foraging. Studies like these are important to determine how dolphins forage efficiently and to provide background information on diet and foraging behavior for use in monitoring future impacts to dolphins in the Northwest Florida Panhandle and near Savannah, Georgia.