Search

Excessive consumption of free sugars, defined as any sugars that are added to foods and beverages by the manufacturer, and sugars in fruit juices, honey, and syrups, is associated with increased risk of obesity. Low-calorie sweeteners (LCS) reduce free sugar content of foods, whilst maintaining diet palatability. As studies generally use low-calorie sweetened beverage (LCSB) consumption as a proxy measurement, potential health benefits are not currently established. Therefore, a urinary biomarker approach that accurately determines short-term exposure of five commonly consumed LCS was previously developed, and this project developed a food-frequency questionnaire (FFQ) to assess habitual exposure. The FFQ and biomarker assessed the relationship between LCS exposure, weight status, dietary intakes, and food-related cognition, finding no clear relationships. The FFQ and biomarker both estimated LCS exposure as widespread (≥89%; Chapter 3, 4 & 5). Chapter 4 indicated that adults with a high saccharin exposure had 5% higher total energy intake (TEI) from sugar than those with medium exposure. Conversely, pregnant women with high acesulfame-k exposure had a 4% lower %TEI from carbohydrates than those with medium exposure (Chapter 5). Chapter 3 indicated that high exposure to LCS-sweetened foods (LCSF) may be related to a lower ability to recognise sweet taste. The medium LCSB exposure grouping reported higher sweet-food preferences, compared to the no/low grouping. The included systematic review investigating the effectiveness of LCS as diabetes management tools also indicated that LCSB may increase blood glucose, whereas LCSF showed reductions in glucose concentrations, when compared to controls. Although studies were observational and included small sample sizes, lack of clear relationships indicate that LCS are seemingly inert compounds. As the potential differences between individual LCS and delivery vehicles demonstrate the limitation in using LCSB as a proxy measurement, a multi-factorial approach utilising the FFQ and biomarker is optimal in similar future studies.

Abstract Background & aims: To our knowledge the association between dietary advanced glycation end-products (dAGEs) and cardiometabolic disease is limited. Our aim was to examine the association between dAGEs and serum concentration of carboxymethyl-lysine (CML) or soluble receptor advanced glycation end-products (sRAGEs), and to assess the difference on dAGEs and circulating AGEs according to lifestyle and biochemical measures. Methods and results: 52 overweight or obese adults diagnosed with type 2 diabetes were included in this cross-sectional analysis. dAGEs were estimated from a Food Frequency Questionnaire (FFQ) or from a FFQ þ Home Cooking Frequency Questionnaire (HCFQ). Serum concentrations of CML and sRAGEs were measured by ELISA. Correlation tests were used to analyze the association between dAGEs derived from the FFQ or FFQ þ HCFQ and concentrations of CML or sRAGEs. Demographic characteristics, lifestyle factors and biochemical measures were analyzed according to sRAGEs and dAGEs using student t-test and ANCOVA. A significant inverse association was found between serum sRAGEs and dAGEs estimated using the FFQ þ HCFQ (r Z 0.36, p Z 0.010), whereas no association was found for dAGEs derived from the FFQ alone. No association was observed between CML and dAGEs. dAGEs intake estimated from the FFQ þ HCFQ was significantly higher among younger and male participants, and in those with higher BMI, higher Hb1Ac levels, longer time with type 2 diabetes, lower adherence to Mediterranean diet, and higher use of culinary techniques that generate more AGEs (all p values p < 0.05). Conclusions: These results show knowledge on culinary techniques is relevant to derive the association between dAGEs intake and cardiometabolic risk factors.

Introducción: es importante determinar si los cuestionarios de frecuencia de consumo de alimentos (CFCA) son herramientas válidas para recopilar información sobre la dieta habitual en los niños. Objetivo: evaluar la reproducibilidad y validez del CFCA semi-cuantitativo de una cohorte española de niños de 4 a 7 años. Métodos: en total se estudiaron 67 (para reproducibilidad) y 37 (para validez) niños de 4 a 7 años de edad del estudio piloto del proyecto SENDO. Para explorar la reproducibilidad, los padres cumplimentaron el CFCA basalmente (CFCA-0) y al año (CFCA-1). Para explorar la validez, el CFCA-1 se comparó con cuatro registros dietéticos (DR) pesados de 3 días. Calculamos coeficientes de correlación de Pearson desatenuados para corregir la variabilidad inter-estacional, y el índice de Bland-Altman. El índice kappa ponderado permitió evaluar la clasificación errónea de los participantes entre quintiles. Resultados: respecto a la reproducibilidad, encontramos índices promedio de Bland-Altman de 0-10,45 % para los nutrientes y de 1,49-10,45 % para los alimentos. La r ajustada varió entre 0,29 y 0,71, y entre 0,27 y 0,74 para nutrientes y alimentos, respectivamente. En cuanto a la validez, encontramos índices promedio de Bland-Altman de 0-16,22 % y 0-10,81 % para nutrientes y alimentos, respectivamente. La r desatenuada osciló entre 0,38 y 0,81 para los nutrientes y entre 0,53 y 0,68 para los alimentos. El índice kappa ponderado para el acuerdo entre quintiles varió entre 54,1 y 85,1 para los nutrientes y entre 55,4 y 78,4 para los grupos de alimentos. Conclusiones: nuestros resultados mostraron niveles aceptables tanto de reproducibilidad como de validez. El FFQ desarrollado ad hoc es una herramienta válida para evaluar nutrientes y alimentos en preescolares españoles.

The prevalence of children and adolescents who are considered overweight or obese has grown drastically in the United States. Childhood overweight and obesity is associated with serious long-term health consequences, including an increased risk for cardiovascular disease, type 2 diabetes, strokes, and different types of cancers. Added sugar intake (AS), in the form of sugar-sweetened beverages (SSB), may contribute to weight gain and obesity development in children and adolescents. Due to the negative health implications of SSB consumption, a valid and reliable brief beverage intake assessment tool is needed for children and adolescents to advance research in this area. The BEVQ-15 food frequency questionnaire has been validated as a tool to assess habitual beverage intake in adults. By validating this tool in youth, there will be a rapid, feasibly administered method to assess beverage intake in children and adolescents. The purpose of this investigation was to determine the comparative validity and test-retest reliability of the BEVQ-15 for assessing usual beverage intake in children and adolescents. Participants (n=326) completed four laboratory sessions, which included providing demographic information, assessment of height/weight, and four record-assisted 24 hour dietary recalls (24HR) from January 2014-September 2015. The BEVQ was completed at 2 sessions (BEVQ1, BEVQ2). Validity was assessed by comparing beverage intake from dietary recalls (24HR) to the BEVQ1; reliability was assessed by comparing BEVQ responses at two sessions (BEVQ1, BEVQ2). Data analysis included descriptive statistics, paired sample t-tests, independent sample t-tests, and chi-squared test, and one-way ANOVA tests. Comparisons of validity and reliability were also made within two subsets; children (aged 6-11) and adolescents (aged 12-18). In the full sample, self-reported water and total sugar-sweetened beverage intake (in fl oz and kcal) were not different between BEVQ1 and 24HR. Responses between BEVQ1 and BEVQ2 were not different in intake (fl oz) or energy (kcal) for water, milk, and total sugar-sweetened beverages. In children, milk and energy (kcal) for total beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 across beverage categories. In adolescents, water and energy (kcal) for total-sugar sweetened beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 with the exception of sweetened juice drinks and total beverages. Overall, these results demonstrate that the BEVQ-15 appears to be a valid and reliable tool to assess habitual water and total SSB intake in children and adolescents. This tool could further epidemiological and clinical research examining the impact of SSB intake, as well as intake of other beverages, on health.

Manganese (Mn) is an essential nutrient to humans. While Mn deficiency is extremely rare in humans, toxicity due to overexposure is more prevalent and potentially harmful. Toxicity occurs almost exclusively from excessive environmental exposure in water or air. When studying Mn toxicity, it is important to account for that portion of Mn which is acquired from food sources. Assessing dietary Mn intake in a systematic and accurate way is vital to the scientific identification of pediatric (and adult) populations at risk. Given that the majority of Mn exposure for a typical population comes from diet, it is important to develop a reliable tool to measure dietary Mn intake. To date, no assessment tool has been validated against a Mn biological marker. The main purpose of this study was to develop and validate a Food Frequency Questionnaire (FFQ) to measure dietary Mn intake in a pediatric Appalachian population by comparing the estimated intakes of Mn with corresponding measures of Mn in blood and hair. The FFQ was developed to capture the diverse diet of the Appalachian pediatric population with emphasis on foods rich in Mn. The FFQ was constructed after the Dietary Guidelines for Americans published by the U.S. Government in 2005. A cover page of the FFQ contained detailed instructions on how to complete the questionnaires. The FFQ listed 115 food items, 3 portion sizes, and 6 frequencies of intake. Data were collected between 2009 and 2012 from children ages 7 to 9 years who participated in the Communities Actively Researching Exposure Study (CARES). CARES recruited 404 children. Accurate FFQ data was collected on 375 children. Hair samples were analyzed for Mn and blood samples was analyzed for Mn and serum ferritin concentrations. Nutritional data obtained from the FFQ was restricted to energy and selected nutrients of interest.Pearson’s correlation coefficients matrix were used to investigate the association between dietary and biological data. Results showed that dietary Mn was not correlated with either blood or hair Mn; however, dietary Mn and serum ferritin were significantly and inversely correlated with correlation coefficient of -0.51, P=0.001. Moreover, dietary iron (Fe) and serum ferritin were significantly correlated with a correlation coefficient of 0.51, P=0.001.The proposed FFQ is valid due to the strong association between dietary Fe and Fe measures. Given the small number of subjects in this validation study, further development of the FFQ would likely improve its use in larger studies. Specific recommendations for future research improvement are summarized for upcoming studies utilizing this Mn FFQ.

Background: Studies have consistently found a high prevalence of vitamin D deficiency in adolescents. Few validated dietary intake assessment tools for vitamin D exist for adolescents. Objective: The aim of this study was to determine if a short food frequency questionnaire (SFFQ) can be used to effectively assess vitamin D intake in adolescents compared to a previously validated long food frequency questionnaire (LFFQ). Participants/setting: 140 healthy 6-12 year old (male n=81) Caucasian and African American (n=94) children from Pittsburgh, Pennsylvania completed a SFFQ and LFFQ at two time points 6 months apart. Main outcome measures: Reliability and validity of a SFFQ by comparison with a previously validated LFFQ for children and adolescents. Statistical analysis: Reliability, validity, sensitivity, specificity, positive, and negative predictive values were assessed using Pearson correlation coefficients. Results: Mean vitamin D intake from the SFFQ (range, 434 to 485 IU) was higher than the LFFQ (range, 320 to 378 IU). Overall association between the SFFQ and the LFFQ for vitamin D intake was modest (r=0.36, P

Objectives. To determine if an omega-3 food frequency questionnaire (FFQ) will provide a valid estimate of omega-3 fatty acid intake in overweight and obese pregnant women when compared to biomarker values.Design. Cross-sectional validation studySubjects. Twenty-seven overweight and obese pregnant women (pre-pregnant BMI > 25) between 18 and 40 years old were recruited from the greater Cincinnati area.Methods. An omega-3 FFQ was administered, and a fasting venous blood sample was collected to assess erythrocyte fatty acid levels in 27 pregnant women in the last trimester of pregnancy. Average intake for total omega-3 fatty acids, alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) were calculated and compared to erythrocyte concentrations of the same fatty acids. The mean intake of DHA was also calculated and compared to the recommended intake levels for pregnant women. Results. Dietary DHA intake was significantly correlated with both total omega-3 (r = +0.491, p < 0.01) and DHA (r = +0.438, p < 0.05) in the red blood cell. There was no significant correlation between dietary intake of total omega-3 fatty acids, ALA, or EPA and erythrocyte concentrations of the same. Mean DHA intake levels for this sample were 75 mg/day, significantly lower than the recommended level of 200 mg/day.Conclusion. The omega-3 FFQ was a valid tool for assessing DHA status in overweight and obese pregnant women.Acknowedgements. Supported in part by USPHS Grant #UL1 RR026314 from the National Center for Research Resources, NIH and NIH, R21 HL093532-0231.

Type 2 Diabetes (T2D) has been steadily rising in the United States. The condition is characterized by elevated blood glucose levels and is preceded by insulin resistance. Before the onset of T2D patients go through a state of pre-diabetes. To be tested for pre-diabetes and diabetes, either a Fasting Plasma Glucose test or an Oral Glucose Tolerance Test may be used. While an estimated 24 million Americans have T2D, another 57 million Americans are estimated to be in a state of pre-diabetes. There are many risk factors that may contribute to the development of T2D including obesity, a high calorie diet, lack of physical activity, genetic factors and aging. The complications associated with T2D may affect the kidney, nerves, eyes and feet. The prevalence of T2D continues to increase in the US and around the world including the developing world. Lifestyle interventions have been shown to be an effective way of treating and delaying T2D. There is a need for an effective intervention to reduce the rising incidence of T2D.

Objective: To assess the validity and reliability of an omega-3 fatty acid (FA) food frequency questionnaire (FFQ) and the quantity of omega-3 FA intakes in obese, pregnant women.Study design: Cross-sectional study.Subjects: 36 obese (Pre-pregnant BMI ≥ 30), pregnant women were recruited between 24 and 26 weeks gestation from the Greater Cincinnati region.Methods: We adapted the FFQ developed and evaluated by Ritter-Gooder et al. by adding pictures of portion sizes. To determine the validity, the FFQ was administered by study staff in the clinic or via mail to 36 women. To determine the reliability, a second FFQ was collected from 10 of 36 women two weeks later. The reference method was a 24-hour dietary recall using the standardized interview in Nutrition Data System for Research software obtained from 22 of 36 women. Pearson correlation was used to determined agreement for daily intakes of omega-3 FAs collected from the first administration of FFQ and 24-hour dietary recall. Pearson correlation was also used to assess the test-retest reliability of the FFQ using the two administrations of FFQ.Results: The mean age of the women was 28 ± 4.8 years. Mean intakes of total omega-3 FAs estimated by the first FFQ and 24-hour dietary recall were 0.98 ± 0.70 g/day and 2.35 ± 1.11 g/day, respectively. The correlation of daily omega-3 FA intakes using the first administration of FFQ and 24-hour dietary recall was r = +0.225 (P > 0.05). The test-retest reliability of the two administrations of FFQ was r = +0.97 (P < 0.01). Fats/oils and nuts/seeds were the top two food sources of omega-3 FAs in this population and provided nearly 40% of omega-3 FA intakes. Forty-two food items contributed 90% of omega-3 FA intakes.Conclusion: The FFQ yielded excellent reliability, but inadequate validity in obese, pregnant women. Further modification of the FFQ should be made to increase its validity. Both the FFQ and 24-hour food recall showed low intakes of omega-3 FAs in obese, pregnant women. Therefore, this population should increase their consumption of foods rich in omega-3 FAs, especially fish, fish oil supplements or fortified foods rich in eicosapentaenoic Acid (EPA) and docosahexaenoic Acid (DHA).