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OBJECTIVES: Dietary berries, such as strawberries are rich in bioactive compounds and have been shown to lower cardiometabolic risks. We examined the dose-response effects of two dietary achievable doses of strawberries on glycemic control and lipid profiles in adults. METHODS: In this 14-week randomized controlled crossover study, adults with obesity and elevated serum LDL-cholesterol were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, one serving strawberries (low dose: 13 g powder/day), and 2.5 servings strawberries (high dose: 32 g powder/day). Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study. Blood samples and anthropometric measures were collected at baseline and at the end of each four-week phase of intervention. RESULTS: Thirty-three participants completed all three phases of the trial [(mean ± SD): Age: 53 ± 13 y; BMI: 33 ± 3.0 kg/m(2)). Outcome measures were analyzed using a mixed model analysis of variance with statistical significance set at P

Background and aims: Dietary berries, such as strawberries, are rich in bioactive compounds and have been shown to lower cardiometabolic risk. We examined the effects of two dietary achievable doses of strawberries on glycemic control and lipid profiles in obese adults with elevated serum LDL cholesterol (LDL-C). Methods: In this 14-week randomized controlled crossover study, participants were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, one serving (low dose: 13 g strawberry powder/day), or two-and-a -half servings (high dose: 32 g strawberry powder/day). Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study interval. Blood samples, anthropometric measures, blood pressure, and dietary and physical activity data were collected at baseline and at the end of each four-week phase of intervention. Results: In total, 33 participants completed all three phases of the trial [(mean ± SD): Age: 53 ± 13 y, BMI: 33 ± 3.0 kg/m2). Findings revealed significant reductions in fasting insulin (p = 0.0002) and homeostatic model of assessment of insulin resistance (p = 0.0003) following the high dose strawberry phase when compared to the low dose strawberry and control phases. Glucose and conventional lipid profiles did not differ among the phases. Nuclear magnetic resonance-determined particle concentrations of total VLDL and chylomicrons, small VLDL, and total and small LDL were significantly decreased after the high dose strawberry phase, compared to control and low dose phases (all p &lt, 0.0001). Among the biomarkers of inflammation and adipokines measured, only serum PAI-1 showed a decrease after the high dose strawberry phase (p = 0.002). Conclusions: These data suggest that consuming strawberries at two-and-a-half servings for four weeks significantly improves insulin resistance, lipid particle profiles, and serum PAI-1 in obese adults with elevated serum LDL-C.

OBJECTIVES: Dietary berries have been shown to lower cardio-metabolic risks in clinical trials. We examined the dose-response effects of two dietary achievable doses of strawberries on low-density lipoprotein cholesterol (LDL-C) and insulin resistance in adults with metabolic syndrome. METHODS: In this 14-week randomized controlled crossover study, adults with metabolic syndrome were assigned to one of the three arms for 4 weeks separated by a one-week washout period: control powder, one serving strawberries (13 g powder/day), and 2.5 servings strawberries (32 g powder/day). The freeze-dried powders were blended in water, and participants consumed half the daily dose in the morning and half in the evening. Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study. RESULTS: Thirty participants completed all three phases of the trial (baseline profiles: weight: 90.8 ± 22.4 kg, BMI: 33.1 ± 4.2 kg/m(2), waist circumference: 109 ± 12.5 cm, HbA(1c) : 5.8 ± 0.2%). Outcome measures were analyzed using a multivariate analysis of variance with statistical significance set at P

Objective: Knee osteoarthritis (OA) is increasingly prevalent in obese people, who often have high cardio-metabolic risk factors. Among the few available non-surgical approaches, nutraceuticals have gained popularity, and dietary berries have mitigated arthritis symptoms in observational and animal studies. Clinical studies in OA are sparse, but recently we reported that strawberry supplementation can mitigate pain and reduce inflammatory markers in adults with knee OA. This study extends those observations. Methods: We conducted a randomized cross-over double-blind placebo-controlled trial on the effects of dietary freeze-dried strawberries on obesity-related hormones, biomarkers of inflammation and lipid peroxidation. Seventeen subjects (4 men, 13 women; age 57 ± 3 year) were randomized to strawberry supplements (50 g day−1 for 12 weeks) vs. placebo (50 g day−1, matched for calories and fiber), for two 12-week intervention periods, separated by 2-week washout phase. Results: Among 24 biomarkers of inflammation examined (Bioplex-Pro human inflammation panel), 12 were detectable in all samples. Among these, high-sensitivity TNF-α (hs-TNF-α) and the soluble tumor necrosis factor receptor (sTNF-R2) were significantly decreased after strawberry consumption (p < 0.05). There were no changes in other biomarkers of the TNF super family, such as APRIL and BAFF. Among serum biomarkers of oxidative stress, 4-hydroxy-2-nonenal (4-HNE) and conjugated dienes were also reduced (p < 0.05). No changes were observed in body weight, serum obesity-related hormones, or osteocalcin. Conclusion: Strawberries lowered TNF-α, and lipid peroxidation products in obese adults with knee OA. Since, they also mitigate pain, these findings merit further investigation in larger trials.

Strawberries, a popularly consumed berry fruit, are rich in bioactive compounds with antioxidant effects. In this study, we examined the effects of two dietary achievable doses of strawberries on the antioxidant status and biomarkers of endothelial function in adults with features of metabolic syndrome and a confirmed low baseline of fruit and vegetable intake. In a 14-week randomized controlled crossover study, participants were assigned to one of three groups for four weeks separated by a one-week washout period: control powder, one serving (low dose: 13 g strawberry powder/day), or 2.5 servings (high dose: 32 g strawberry powder/day). Blood samples and health data were collected at baseline and at the end of each four-week phase of intervention. Thirty-three participants completed all three phases of the trial. Significant increases were observed in serum antioxidant capacity and superoxide dismutase activity as well as decreases in lipid peroxidation after both low and high dose strawberry phases when compared with the control phase. Significant decreases were also observed in soluble vascular cell adhesion molecule-1 and tumor necrosis factor-α with the high dose strawberry phase. These data confirm that consuming strawberries for four weeks significantly improves antioxidant status, endothelial function, and inflammation in adults with cardiometabolic risks.

Recent research supports a favorable role of cranberries on cardiometabolic health. Postprandial metabolism, especially hyperglycemia, has been shown to be an independent cardiovascular risk and few clinical studies have reported the role of berries in improving postprandial dysmetabolism. We investigated the postprandial effects of dried cranberries following a high-fat breakfast challenge in obese participants with type 2 diabetes (T2DM), in a randomized crossover trial. Blood draw and vascular measurements were conducted at fasting, 1, 2 and 4 hours (h), following the consumption of a fast-food style high-fat breakfast (70 g fat, 974 kcal) with or without cranberries (40 g). Analyses of our data (n = 25; BMI (kg m(−2)) (mean ± s.d.) = 39.5 ± 6.5; age (years) = 56 ± 6) revealed that postprandial increases in glucose were significantly lower in the cranberry vs. control at 2 & 4 h (p < 0.05). No significant differences were noted in insulin, insulin resistance evaluated by homeostasis model assessment, lipid profiles and blood pressure between the cranberry and control groups. Among the biomarkers of inflammation and oxidation, postprandial serum interleukin-18 and malondialdehyde were significantly lower at 4 h, and serum total nitrite was higher at 2 h in the cranberry vs. control group (all p < 0.05). No effects were noted on C-reactive protein or interlukin-6. Overall, dietary cranberries had notable effects in improving high-fat breakfast induced postprandial glucose and selected biomarkers of inflammation and oxidation in participants with T2DM. These findings provide evidence that adding whole cranberries to a high-fat meal may improve postprandial blood glucose management and warrant further investigation.

Investigate differences in familiarity of parents of school-aged children with school wellness polices (SWP) and perceptions of the problem of childhood obesity related to support for the SWP and school's role in providing a healthy environment.Descriptive, cross-sectional study using telephone surveys conducted in spring, 2016. T test statistics compared differences between parents with high vs low SWP familiarity and agreement vs disagreement of childhood obesity as problematic.Nearly half of parents (49.5%) had low familiarity with SWP. Overall, fewer parents agreed that obesity was a local school problem compared with a statewide problem (P.001). Differences in agreement about childhood obesity explained some differences in SWP support.Greater awareness is needed among parents of schoolchildren regarding the SWP as well as the prevalence of childhood obesity. This could be achieved through increased development, implementation, and evaluation of communication efforts between schools and families regarding health-promoting environments.

Background: Postprandial metabolic impairments in diabetes have been shown to play an important role in vascular complications. Dietary polyphenols and other bioactive compounds in berries have been shown to improve postprandial hyperglycemia and related metabolic impairments, but few clinical studies have been reported in diabetes. Objective: To examine the effects of daily dietary raspberries on postprandial and 4-week fasting glucose, lipids and biomarkers of inflammation in obese adults with type 2 diabetes. Design: This was a randomized crossover study with 2 different phases: a “postprandial phase” of acute raspberry supplementation (2 separate days at least 1 week apart), followed by a 1-week washout phase and then a 10-week “diet supplement phase”, with and without raspberry supplementation periods of 4 weeks each, separated by 2-week washout phase. Results: The postprandial phase revealed significantly lower levels of serum glucose at 2 and 4 h postprandial after raspberry versus control phase. In addition, among the serum biomarkers of inflammation, interleukin (IL)-6 and high-sensitivity tumor necrosis factor alpha (hsTNF-α) were also lower at 4 h postprandial following raspberry versus control meal (all p < 0.05). Finally, postprandial serum triglycerides showed a decreasing trend at 4 h in the raspberry versus control phase. Four-week daily raspberry supplementation continued to show a significant lowering effects on IL-6 and hsTNF-α versus control phase (all p < 0.05); systolic blood pressure revealed a decreasing trend after 4-week of raspberry supplementation. No effects were noted on fasting glucose and lipids, C-reactive protein and arterial elasticity. Conclusions: Thus, dietary raspberries, which are low in calories and high in polyphenols and other nutrients may lower postprandial hyperglycemia and inflammation, and in general exert selected anti-inflammatory effects in adults with diabetes. These findings deserve further investigation.

Background: Dietary cocoa is an important source of flavonoids and is associated with favorable cardiovascular disease effects, such as improvements in vascular function and lipid profiles, in nondiabetic adults. Type 2 diabetes (T2D) is associated with adverse effects on postprandial serum glucose, lipids, inflammation, and vascular function. Objective: We examined the hypothesis that cocoa reduces metabolic stress in obese T2D adults after a high-fat fast-food–style meal. Methods: Adults with T2D [n = 18; age (mean ± SE): 56 ± 3 y; BMI (in kg/m2): 35.3 ± 2.0; 14 women; 4 men] were randomly assigned to receive cocoa beverage (960 mg total polyphenols; 480 mg flavanols) or flavanol-free placebo (110 mg total polyphenols

Obesity is a global epidemic, yet successful interventions are rare. Up to 60% of people fail to achieve clinically meaningful, short-term weight loss (5–10% of start weight), whereas up to 72% are unsuccessful at achieving long-term weight loss (5–10% loss for ≥ 5 years). Understanding how biological, cognitive, and self-regulatory factors work together to promote or to impede weight loss is clearly needed to optimize obesity treatment. This paper describes the methodology of the Cognitive and Self-regulatory Mechanisms of Obesity Study (the COSMOS trial). COSMOS is the first randomized controlled trial to investigate how changes in multiple biopsychosocial and cognitive factors relate to weight loss and one another across two weight loss treatments. The specific aims are to: 1) Confirm that baseline obesity-related physiological dysregulation is linked to cognitive deficits and poorer self-regulation, 2) Evaluate pre- to post-treatment change across time to assess individual differences in biomarkers, cognition, and self-regulation, and 3) Evaluate whether the acceptance-based treatment (ABT) group has greater improvements in outcomes (e.g., greater weight loss and less weight regain, improvements in biomarkers, cognition, and self-regulation), than the standard behavioral treatment group (SBT) from pre- to post-treatment and 1-year follow-up. The results of COSMOS will provide critical information about how dysregulation in biomarkers, cognition, and/or self-regulation is related to weight loss and whether weight loss treatments are differentially associated with these factors. This information will be used to identify promising treatment targets that are informed by biological, cognitive, and self-regulatory factors in order to advance obesity treatment.

Dietary flavonoid intake, especially berry flavonoids, has been associated with reduced risks of cardiovascular disease (CVD) in large prospective cohorts. Few clinical studies have examined the effects of dietary berries on CVD risk factors. We examined the hypothesis that freeze-dried strawberries (FDS) improve lipid and lipoprotein profiles and lower biomarkers of inflammation and lipid oxidation in adults with abdominal adiposity and elevated serum lipids. In a randomized dose-response controlled trial, 60 volunteers [5 men and 55 women; aged 49 ± 10 y; BMI: 36 ± 5 kg/m(2) (means ± SDs)] were assigned to consume 1 of the following 4 beverages for 12 wk: 1) low-dose FDS (LD-FDS; 25 g/d); 2) low-dose control (LD-C); 3) high-dose FDS (HD-FDS; 50 g/d); and 4) high-dose control (HD-C). Control beverages were matched for calories and total fiber. Blood draws, anthropometrics, blood pressure, and dietary data were collected at screening (0 wk) and after 12-wk intervention. Dose-response analyses revealed significantly greater decreases in serum total and LDL cholesterol and nuclear magnetic resonance (NMR)-derived small LDL particle concentration in HD-FDS [33 ± 6 mg/dL, 28 ± 7 mg/dL, and 301 ± 78 nmol/L, respectively (means ± SEMs)] vs. LD-FDS (-3 ± 11 mg/dL, -3 ± 9 mg/dL, and -28 ± 124 nmol/L, respectively) over 12 wk (0-12 wk; all P < 0.05). Compared with controls, only the decreases in total and LDL cholesterol in HD-FDS remained significant vs. HD-C (0.7 ± 12 and 1.4 ± 9 mg/dL, respectively) over 12 wk (0-12 wk; all P < 0.05). Both doses of strawberries showed a similar decrease in serum malondialdehyde at 12 wk (LD-FDS: 1.3 ± 0.2 μmol/L; HD-FDS: 1.2 ± 0.1 μmol/L) vs. controls (LD-C: 2.1 ± 0.2 μmol/L; HD-C: 2.3 ± 0.2 μmol/L) (P < 0.05). In general, strawberry intervention did not affect any measures of adiposity, blood pressure, glycemia, and serum concentrations of HDL cholesterol and triglycerides, C-reactive protein, and adhesion molecules. Thus, HD-FDS exerted greater effects in lowering serum total and LDL cholesterol and NMR-derived small LDL particles vs. LD-FDS in the 12-wk study. These findings warrant additional investigation in larger trials. This trial was registered at clinicaltrials.gov as NCT01883401.

Emerging research provides substantial evidence to classify strawberries as a functional food with several preventive and therapeutic health benefits. Strawberries, a rich source of phytochemicals (ellagic acid, anthocyanins, quercetin, and catechin) and vitamins (ascorbic acid and folic acid), have been highly ranked among dietary sources of polyphenols and antioxidant capacity. It should however be noted that these bioactive factors can be significantly affected by differences in strawberry cultivars, agricultural practices, storage, and processing methods: freezing versus dry heat has been associated with maximum retention of strawberry bioactives in several studies. Nutritional epidemiology shows inverse association between strawberry consumption and incidence of hypertension or serum C-reactive protein; controlled feeding studies have identified the ability of strawberries to attenuate high-fat diet induced postprandial oxidative stress and inflammation, or postprandial hyperglycemia, or hyperlipidemia in subjects with cardiovascular risk factors. Mechanistic studies have elucidated specific biochemical pathways that might confer these protective effects of strawberries: upregulation of endothelial nitric oxide synthase (eNOS) activity, downregulation of NF-kB activity and subsequent inflammation, or inhibitions of carbohydrate digestive enzymes. These health effects may be attributed to the synergistic effects of nutrients and phytochemicals in strawberries. Further studies are needed to define the optimal dose and duration of strawberry intake in affecting levels of biomarkers or pathways related to chronic diseases.

Objective Green tea ( Camellia sinensis ) has shown to exert cardioprotective benefits in observational studies. The objective of this clinical trial was to assess the effects of green tea on features of metabolic syndrome and inflammation in obese subjects. Methods We conducted a randomized controlled trial in obese subjects with metabolic syndrome. Thirty-five subjects [(mean ± SE) age 42.5 ± 1.7 y, body mass index 36.1 ± 1.3 kg/m 2 ] completed the 8-wk study and were randomly assigned to receive green tea (4 cups/d), green tea extract (2 capsules and 4 cups water/d), or no treatment (4 cups water/d). Both the beverage and extract groups had similar dosing of epigallocatechin-3-gallate, the active green tea polyphenol. Fasting blood samples were collected at screening, 4 and 8 wk of the study. Results Green tea beverage or extract supplementation did not significantly alter features of metabolic syndrome or biomarkers of inflammation including adiponectin, C-reactive protein, interleukin-6, interleukin-1β, soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1, leptin, or leptin:adiponectin ratio. However, both green tea beverage and extracts significantly reduced plasma serum amyloid alpha versus no treatment ( P Conclusion This study suggests that the daily consumption of green tea beverage or extracts for 8 wk was well tolerated but did not affect the features of metabolic syndrome. However, green tea significantly reduced plasma serum amyloid alpha, an independent cardiovascular disease risk factor, in obese subjects with metabolic syndrome.

Among all fruits, berries have shown substantial cardio-protective benefits due to their high polyphenol content. However, investigation of their efficacy in improving features of metabolic syndrome and related cardiovascular risk factors in obesity is limited. We examined the effects of blueberry supplementation on features of metabolic syndrome, lipid peroxidation, and inflammation in obese men and women. Forty-eight participants with metabolic syndrome [4 males and 44 females; BMI: 37.8 ± 2.3 kg/m2; age: 50.0 ± 3.0 y (mean ± SE)] consumed freeze-dried blueberry beverage (50 g freeze-dried blueberries, #126 350 g fresh blueberries) or equivalent amounts of fluids (controls, 960 mL water) daily for 8 wk in a randomized controlled trial. Anthropometric and blood pressure measurements, assessment of dietary intakes, and fasting blood draws were conducted at screening and at wk 4 and 8 of the study. The decreases in systolic and diastolic blood pressures were greater in the blueberry-supplemented group (− 6 and − 4%, respectively) than in controls (− 1.5 and − 1.2%) (P lt 0.05), whereas the serum glucose concentration and lipid profiles were not affected. The decreases in plasma oxidized LDL and serum malondialdehyde and hydroxynonenal concentrations were greater in the blueberry group (− 28 and − 17%, respectively) than in the control group (− 9 and − 9%) (P lt 0.01). Our study shows blueberries may improve selected features of metabolic syndrome and related cardiovascular risk factors at dietary achievable doses.

Strawberries have been reported to be potent antioxidants and reduce cardiovascular risk factors, such as elevated blood pressure, hyperglycemia, dyslipidemia, and inflammation in limited studies. We hypothesized that freeze-dried strawberry supplementation will improve blood pressure, impaired glucose, dyslipidemia, or circulating adhesion molecules in obese subjects with metabolic syndrome, thereby lowering cardiovascular risk factors in these subjects. Twenty-seven subjects with metabolic syndrome (2 males and 25 females; body mass index, 37.5 +/- 2.15 kg/m(2); age, 47.0 +/- 3.0 years [means +/- SE]) consumed 4 cups of freeze-dried strawberry beverage (50 g freeze-dried strawberries approximately 3 cups fresh strawberries) or equivalent amounts of fluids (controls, 4 cups of water) daily for 8 weeks in a randomized controlled trial. Anthropometrics and blood pressure measurements, assessment of dietary intakes, and fasting blood draws were conducted at screen and 8 weeks of the study. Strawberry supplementation significantly decreased total and low-density lipoprotein cholesterol (5.8 +/- 0.2 to 5.2 +/- 0.2 mmol/L and 3.5 +/- 0.2 to 3.1 +/- 0.1 mmol/L, respectively [means +/- SE], P < .05) and small low-density lipoprotein particles using nuclear magnetic resonance-determined lipoprotein subclass profile vs controls at 8 weeks (794.6 +/- 94.0 to 681.8 +/- 86.0 nmol/L [means +/- SE], P < .05). Strawberry supplementation further decreased circulating levels of vascular cell adhesion molecule-1 vs controls at 8 weeks (272.7 +/- 17.4 to 223.0 +/- 14.0 ng/mL [means +/- SE], P < .05). Serum glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and waist circumference were not affected. Thus, short-term freeze-dried strawberry supplementation improved selected atherosclerotic risk factors, including dyslipidemia and circulating adhesion molecules in subjects with metabolic syndrome, and these results need confirmation in future trials.

Background:Many wrestlers engage in chronic dieting and rapid “weight cutting” throughout the year to compete in a category below their natural weight. Such weightmanagement practices have a negative influence on their health and nutritional status, so the National Wrestling Coaches Association implemented a new weight-management program for high school wrestlers in 2006.Purpose:The purpose of this study was to determine whether seasonal changes in weight, body fat, and eating attitudes occur among high school wrestlers after the implementation of the new weight-management rule.Methods:Fifteen high school wrestlers participated in the study. Their weight, body composition, and eating attitudes were measured preseason, in-season, and off-season. Body fat was assessed using dual-energy X-ray absorptiometry. Attitudes toward dieting, food, and body weight were assessed using the Eating Attitude Test (EAT).Results:No significant changes in body fat were detected from preseason to off-season. Weight increased from preseason to in-season (p < .05) and off-season (p < .05). Although the EAT score did not change significantly from preseason to offseason, 60% reported “thinking about burning up calories when exercising” during preseason, and only 40% felt that way during the season (p < .05) and 47% during off-season (p < .05).Conclusions:The wrestlers experienced a significant weight gain from preseason to off-season with no significant changes in body fat. Their eating attitudes did not change significantly from preseason to off-season in this study, but further research using a large sample of high school wrestlers is warranted to confirm these findings.

Despite numerous anti-tobacco campaigns, smoking among adolescents continues to be a predominant public health issue. This report details the interrelationships between adolescence, smoking, and nutrition and health. Current data indicate that most smokers become nicotine-dependent as adolescents, which places them at risk for chronic diseases associated with continuous oxidative damage. Additionally, nicotine has antidepressant and hypermetabolic effects, which may be of particular importance during adolescence because nicotine use leads to increased dependence on tobacco, contributes to difficulty in smoking cessation, and promotes weight gain following smoking cessation.

Berries have shown several cardiovascular health benefits and have been associated with antioxidant functions in experimental models. Clinical studies are limited. We examined the antioxidant effects of freeze-dried strawberries (FDS) in adults [n=60; age:49±10years; BMI:36±5 kg/m2(mean ± SD)] with abdominal adiposity and elevated serum lipids. Participants were randomized to one of the following arms: low dose strawberry (25 g/day FDS), low dose control beverage (LD-C), high dose strawberry (50 g/d FDS), and high dose control beverage (HD-C) for 12 weeks. Control beverages were matched for calories and total fiber. Plasma antioxidant capacity, trace elements (copper, iron, selenium, and zinc), whole blood glutathione (GSH), and enzyme activity (catalase, glutathione peroxidase, and glutathione reductase) were examined at screening (0 week) and after 12 weeks’ intervention. At 12 weeks, plasma antioxidant capacity and glutathione levels were higher in the strawberry versus control groups (low and high dose FDS: 45% and 42% for plasma antioxidant capacity and 28% and 36% for glutathione, resp.); glutathione was higher in the high versus low dose strawberry group (allp<0.05). Serum catalase activity was higher in the low dose strawberry (43%) versus control group (p<0.01). No differences were noted in plasma trace elements and glutathione enzyme activity. Dietary strawberries may selectively increase plasma antioxidant biomarkers in obese adults with elevated lipids.

Background: Cranberries have been shown to lower risks of type 2 diabetes, and improve features of the metabolic syndrome, and lower postprandial glucose in a few clinical studies. Purpose: We inve...

Race-, gender- and age-specific differences in dietary micronutrient intakes of 1- to 10-year-old US children were evaluated. Three-day, dietary intakes from the US Department of Agriculture's Continuing Survey of Food Intakes by Individuals were evaluated. Data from 1895 children (967 males, 928 females; 1,540 Whites, 355 Blacks) who resided in the 48 conterminous states were analyzed. Micronutrient intakes, intakes as percent of the Recommended Dietary Allowance (RDA) and percent of children who consumed < or =67% of the RDA were computed. Black males compared with White males, Black females compared with White females and White females compared with White males had significantly lower dietary intakes for several micronutrients. More Black males than White males had intakes < or =67% of the RDA for vitamin E, calcium and zinc. Blacks and female children were at a greater risk for vitamin A, vitamin E, calcium, iron and zinc deficiency.

Osteoarthritis (OA), the most common form of arthritis, is a significant public health burden in U.S. adults. Among its many risk factors, obesity is a key player, causing inflammation, pain, impaired joint function, and reduced quality of life. Dietary polyphenols and other bioactive compounds in berries, curcumin, and tea have shown effects in ameliorating pain and inflammation in OA, but few clinical studies have been reported. The purpose of the present study was to examine the effects of dietary strawberries on pain, markers of inflammation, and quality of life indicators in obese adults with OA of the knee. In a randomized, double-blind cross-over trial, adults with radiographic evidence of knee OA (n = 17; body mass index (BMI): (mean ± SD) 39.1 ± 1.5; age (years): 57 ± 7) were randomized to a reconstituted freeze-dried strawberry beverage (50 g/day) or control beverage daily, each for 12 weeks, separated by a 2-week washout phase (total duration, 26 weeks). Blood draws and assessments of pain and quality of life indicators were conducted using the Visual Analog Scale for Pain (VAS Pain), Measures of Intermittent and Constant Osteoarthritis Pain (ICOAP), and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires, which were completed at baseline and at weeks 12, 14, and 26 of the study. Among the serum biomarkers of inflammation and cartilage degradation, interleukin (IL)-6, IL-1β, and matrix metalloproteinase (MMP)-3 were significantly decreased after strawberry vs. control treatment (all p < 0.05). Strawberry supplementation also significantly reduced constant, intermittent, and total pain as evaluated by the ICOAP questionnaire as well as the HAQ-DI scores (all p < 0.05). No effects of treatment were noted on serum C-reactive protein (CRP), nitrite, glucose, and lipid profiles. Dietary strawberries may have significant analgesic and anti-inflammatory effects in obese adults with established knee OA.

Background: Cigarette smoking is a major risk factor for several chronic oxidative diseases that can be ameliorated by antioxidants. Objectives: This study identified the typical dietary intakes and the major food group contributors of the antioxidants β-carotene, vitamin C, and vitamin E by smoking status. Design: The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the current sample (n = 6749), who were categorized as non- (n = 3231), former (n = 1684), and current (n = 1834) smokers. In the CSFII, individuals' food intakes were estimated with two 24-h dietary recalls. Data were analyzed by using a chi-square test with a simultaneous Fisher's z test, analysis of variance with Scheffe's test, multivariate analysis of covariance, and analysis of covariance with Bonferroni adjustment for multiple comparisons. Results: The sample consisted of 3707 men and 3042 women. Current smokers tended to be younger with less education and lower incomes than nonsmokers and former smokers. The average body mass index (in kg/m 2 ) of current smokers was 25.8, the lowest of the 3 groups. Current smokers had the lowest dietary antioxidant intake. Fatty foods such as luncheon meats, condiments and salad dressings, and ground beef contributed more to the antioxidant intakes of current smokers than to those of the other 2 groups, whereas fruit and vegetables contributed less. Current smokers consumed the fewest numbers of servings of all nutrient-bearing groups in the food guide pyramid, except the meat group. Conclusion: Future interventions should target the clustering of cigarette smoking and other unhealthy lifestyle habits, eg, an imprudent diet.

Objective To determine children's sources of dietary fiber and to identify the food group choices made by those who met the "age+5" rule, which recommends that children daily consume an amount of fiber that is equal to their age plus an additional 5g fiber. Design This study used 24-hour dietary recalls and 1-day food records to assess the nutrient intake and food group choices of children who did and did not meet the recommendations of the age+5 rule. Subjects The 1989-1991 US Department of Agriculture Continuing Survey of Food Intakes by Individuals provided the study sample of 603 children between the ages of 4 and 6 years and 782 children between the ages of 7 and 10 years. Statistical analyses Differences in nutrient and food group intakes between age categories were determined by t tests. Results Only 45% of 4- to 6-year-olds and 32% of 7- to 10-year-olds consumed adequate fiber to meet the age+5 rule. Those who met the age+5 rule did so by consuming significantly more high- and low-fiber breads and cereals, fruits, vegetables, legumes, nuts, and seeds. Children with low fiber intakes had significantly higher energy-adjusted intakes of fat and cholesterol, whereas those who met the age+5 rule had significantly higher energy-adjusted intakes of dietary fiber, vitamins A and E, folate, magnesium, and iron. Applications The majority of the children had low intakes of dietary fiber, suggesting that they are at risk for future chronic disease. Parents and school foodservice personnel should strive to offer fiber-rich foods to children so their acceptance and consumption of them will be increased. J Am Diet Assoc. 1998;98:1418-1423.

Objectives Health-related characteristics and habits and food choices of young adults were compared for three groups: college students, college graduates, and nonstudents. Design Subjects completed a mailed survey that included questions about demographics, attitudes, and behaviors and a food frequency questionnaire. Main outcome measures were health-related characteristics and habits and food choices. Subjects Female (n=758) and male (n=580) 18- to 24-year-olds in nine states who were selected randomly by zip code in each state. The response rate averaged 43% for all states. Statistical analyses performed Analysis of variance or χ 2 tests were applied to health-related personal characteristic variables and the Kruskal-Wallis analysis of variance was applied to food consumption variables for women and men separately. Results According to self-reported heights and weights, female nonstudents were more often overweight than female students or graduates. Nonstudents of both genders reported smoking more often than students or graduates. College students and graduates ate more grain foods high in dietary fiber, more fruits and dark-green vegetables, and more lower-fat milk and meats than non students. Conclusions/applications Non students were at greater health risk for some chronic illnesses, because of poorer health habits and food choices, than were college students and graduates. The behavior of nonstudents implies weaker response to messages promoting weight control, smoking cessation, and observance of the Dietary Guidelines for Americans than behavior exhibited by students or college graduates. Health promotion efforts could be enhanced by identifying demographic, educational, situational, and formative influences on positive health and dietary behaviors of young adults.

To identify the ways in which 18 to 24 year olds view foods, a mail survey was constructed that included demographics, opinion items, a repertory grid rating foods against factors thought to influence food intake, and a food frequency. Of the 1475 respondents, 736 were college students (students), 237 were college graduates (graduates), and 328 were high school graduates not attending school (nonstudents). Factor analysis for the total group and for each subgroup examined underlying views held by the respondents. Findings showed that the respondents viewed foods in terms of physical/social aspects, whether they were health-promoting or fattening, importance of nutrition with adequacy of money and food shopping/preparation skills, and adequacy of stores and cooking facilities. For students, importance of nutrition disappeared as a perception while convenience emerged. For graduates, adequacy of money disappeared while importance of nutrition appeared as a strong perception. The nonstudents showed a fifth factor identifying satiety value of food as a strong perception while importance of nutrition disappeared. Habit was the individual variable showing the highest correlation with frequency of consumption of selected foods. The results suggest that respondents viewed foods differently based on ’whether or not they were students. Nutrition messages may need to focus on the different ways in which foods are viewed to be effective.

Health experts recommend merging a healthy diet and adequate physical activity into one behavior. This study compared attitudes about foods, recent dietary changes, and food choices of 319 18- to 24-year-olds, who defined themselves as exercisers or nonexercisers. Subjects were recruited by telephone and were mailed questionnaires that asked about factors influencing food selection and changes in intake of high-fat foods. Exercisers considered it more important to eat nutritious foods; ate more nutrient-dense, low-fat foods; and more frequently met the Food Guide Pyramid recommended grain and fruit intakes than nonexercisers. Female exercisers more often perceived foods high in calcium to be fattening and not healthful, and they reported decreasing their intake of high-fat foods more than did female nonexercisers. Some merging of healthy diet and exercise behavior is evident among the young adult exercisers in this study. Nutrition and exercise messages targeted to young women should emphasize low-calorie calcium sources.

Objectives of this study were to estimate mean daily intake of copper for eight age subgroups of each gender, to examine consumption patterns of chocolate foods in the U.S., and to determine amounts of copper provided by the consumption of chocolate foods by analyzing 3-day dietary records reported by individuals in the 1987–1988 Nationwide Food Consumption Survey. Mean daily copper intake for all age/gender groups of infants and children reached the lower value of the Estimated Safe and Adequate Daily Dietary Intake (ESADDI) range. However, the mean daily copper intake of all age/gender groups of adolescents and adults was below the ESADDI of 1.5 to 3.0 mg/day. Chocolate cookies were most frequently consumed among chocolate foods. Dark chocolate/candy made the highest contribution to mean daily copper intake (22.1% of ESADDI). Other major contributors to the daily copper intake were chocolate pie (17.8% of ESADDI), chocolate milk (13.3%), chocolate topping/syrup/icing (12.0%), milk chocolate/candy (11.3%), and chocolate cake/muffin (11.2%). The total dietary copper intake by males and females was positively associated (p

Green tea, a popular polyphenol-containing beverage, has been shown to alleviate clinical features of the metabolic syndrome. However, its effects in endogenous antioxidant biomarkers are not clearly understood. Thus, we tested the hypothesis that green tea supplementation will up-regulate antioxidant parameters (enzymatic and non-enzymatic) in adults with the metabolic syndrome. Thirty-five obese participants with the metabolic syndrome were randomly assigned to receive one of the following for 8 weeks: green tea (4 cups/day), control (4 cups water/day), or green tea extract (2 capsules and 4 cups water/day). Blood samples and dietary information were collected at baseline (0 week) and 8 weeks of the study. Circulating carotenoids (alpha-, beta-carotene, lycopene) and tocopherols (alpha-, gamma-tocopherols), and trace elements were measured using high performance liquid chromatography (HPLC) and inductively-coupled plasma mass spectroscopy (ICP-MS), respectively. Serum antioxidant enzymes (glutathione peroxidase, glutathione, catalase) and plasma antioxidant capacity were measured spectrophotometrically. Green tea beverage and green tea extract significantly increased plasma antioxidant capacity (1.5μmol/L to 2.3μmol/L and 1.2μmol/L to 2.5μmol/L respectively, p

The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards.Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May 2010.Participants completed anthropometric measurements and dietary assessment using a 3-day food record, a 24-hour recall, and a nutrition questionnaire.t tests indicated the energy and carbohydrate intakes were below the minimum recommended amount (p.001), with only 9% of the participants meeting their energy needs. Seventy-five percent of the participants failed to consume the minimum amount of carbohydrates that is required to support training. The majority of the participants reported no regular breakfast, 36% consumed5 meals/day, and only 16% monitored their hydration status.Effective nutrition interventions are needed to improve dietary intakes and eating habits of female college athletes.

Aims. To examine the antioxidant and anti-inflammatory effects of pomegranate polyphenols in obese patients with type 2 diabetes (T2DM) (n=8) and in healthy nondiabetic controls (n=9).Methods. Participants received 2 capsules of pomegranate polyphenols (POMx, 1 capsule = 753 mg polyphenols) daily for 4 weeks. Blood draws and anthropometrics were performed at baseline and at 4 weeks of the study.Results. Pomegranate polyphenols in healthy controls and in T2DM patients did not significantly affect body weight and blood pressure, glucose and lipids. Among clinical safety profiles, serum electrolytes, renal function tests, and hematological profiles were not significantly affected by POMx supplementation. However, aspartate aminotransferase (AST) showed a significant increase in healthy controls, while alanine aminotransferase (ALT) was significantly decreased in T2DM patients at 4 weeks (P<0.05), though values remained within the normal ranges. Among the biomarkers of lipid oxidation and inflammation, oxidized LDL and serum C-reactive protein (CRP) did not differ at 4 weeks in either group, while pomegranate polyphenols significantly decreased malondialdehyde (MDA) and hydroxynonenal (HNE) only in the diabetic group versus baseline (P<0.05).Conclusions. POMx reduces lipid peroxidation in patients with T2DM, but with no effects in healthy controls, and specifically modulates liver enzymes in diabetic and nondiabetic subjects. Larger clinical trials are merited.

The 3-day food intake data from 1987–1988 Nationwide Food Consumption Survey (NFCS) was used to evaluate the nutrient intakes of 1–3, 4–6 and 7–10 year old American children. Nutrient intakes were compared with 1989 Recommended Dietary Allowances (RDA) and percent RDAs were computed. On average, the children consumed 35 to 37% of their energy from fat, 49 to 51% of energy from carbohydrate, 15% of energy from protein, 13 to 14% of energy from saturated fat and 142 to 148 mg of cholesterol/1000 calories. Intakes of total fat, saturated fat and cholesterol were higher, while intakes of polyunsaturated fat and ratio of polyunsaturated to saturated fat were lower than the expert recommendations. Mean intakes of vitamins and minerals were adequate except for vitamin E and zinc for all age groups. Calcium and iron intakes were below the RDA (84% of RDA) only in the 1–3 year age group. Although dietary intake patterns observed in this study were in agreement with other survey results, caution should be used in applying these results to general the US population because of possible bias introduced by survey low-response.

One problem encountered by many who work with nutrition and health education programs is the lack of curricular and instructional materials appropriate for adults with low literacy skills. In their seminal work, Doak et al. (1) clearly demonstrated the breadth and depth of this problem in patient education. Systematic methods for determining appropriate written materials for adults with low literacy skills are badly needed. A method that holds promise for identifYing and developing instructional materials for adults with low literacy skills is the Critical Incident Technique (CIT). Studies have shown the CIT to be a powerful approach to identifYing specific behaviors associated with effective and ineffective performance (2). This technique has been adopted by various professions as a strategy for developing educational and training programs. Few studies, however, have used the cq for groups with low levels of literacy. In addition, its application to the development of instructional materials remains unexplored. The purposes of this paper are to provide an overview of the CIT and to report on the use of the CIT in the development of nutrition information materials for adults with low literacy skills.

The purpose of this project was to develop nutrition materials based on bulletins HG 232(1–11), “The Dietary Guidelines and Your Diet”, for use by adults with low literacy skills. A booklet testing at the fifth grade level was designed and tested using qualitative research methods. Participants included 131 women and 21 men, 16 to 60 years of age (mean age 30 years). Sixteen percent were African American, 3% were Native American, 1% were Hispanic, and the remaining 80% were Caucasians. All possessed reading skills from the third to eighth grade levels, and years of education completed ranged from sixth grade to high school graduate (mean of tenth grade). Two sets of interviews were conducted. The booklet was revised based upon results from the first set of interviews. Participants were especially interested in “how to” and “did you know” information, and calorie and nutrient contents of food. Topics of interest included, “Tips on Feeding Young Children”, “Eat Less Fat”, and “Watch Your Weight”. Findings from the interviews provide evidence of the need for nutrition information among these low Uterate adults. Further research with low literate adults is needed to define typical dietary practices, beliefs and perceptions, and barriers to change.

Cranberries, high in polyphenols, have been associated with several cardiovascular health benefits, although limited clinical trials have been reported to validate these findings. We tested the hypothesis that commercially available low-energy cranberry juice (Ocean Spray Cranberries, Inc, Lakeville-Middleboro, Mass) will decrease surrogate risk factors of cardiovascular disease, such as lipid oxidation, inflammation, and dyslipidemia, in subjects with metabolic syndrome. In a randomized, double-blind, placebo-controlled trial, participants identified with metabolic syndrome (n = 15-16/group) were assigned to 1 of 2 groups: cranberry juice (480 mL/day) or placebo (480 mL/day) for 8 weeks. Anthropometrics, blood pressure measurements, dietary analyses, and fasting blood draws were conducted at screen and 8 weeks of the study. Cranberry juice significantly increased plasma antioxidant capacity (1.5 ± 0.6 to 2.2 ± 0.4 μmol/L [means ± SD], P < .05) and decreased oxidized low-density lipoprotein and malondialdehyde (120.4 ± 31.0 to 80.4 ± 34.6 U/L and 3.4 ± 1.1 to 1.7 ± 0.7 μmol/L, respectively [means ± SD], P < .05) at 8 weeks vs placebo. However, cranberry juice consumption caused no significant improvements in blood pressure, glucose and lipid profiles, C-reactive protein, and interleukin-6. No changes in these parameters were noted in the placebo group. In conclusion, low-energy cranberry juice (2 cups/day) significantly reduces lipid oxidation and increases plasma antioxidant capacity in women with metabolic syndrome.

To compare the effects of supplementation of green tea beverage or green tea extracts with controls on body weight, glucose and lipid profile, biomarkers of oxidative stress, and safety parameters in obese subjects with metabolic syndrome.Randomized, controlled prospective trial.General Clinical Research Center (GCRC) at University of Oklahoma Health Sciences Center (OUHSC).Thirty-five subjects with obesity and metabolic syndrome were recruited in age- and gender-matched trios and were randomly assigned to the control (4 cups water/d), green tea (4 cups/d), or green tea extract (2 capsules and 4 cups water/d) group for 8 weeks. The tea and extract groups had similar dosing of epiogallocatechin-3-gallate (EGCG), the active compound in green tea.Anthropometrics, blood pressure, fasting glucose and lipids, nuclear magnetic resonance (NMR)-based lipid particle size, safety parameters, biomarkers of oxidative stress (oxidized low-density lipoprotein [LDL], myeloperoxidase [MPO], malondialdehyde and hydroxynonenals [MDA and HNE]), and free catechins were analyzed at screen and at 4 and 8 weeks of the study.Pairwise comparisons showed green tea beverage and green tea extracts caused a significant decrease in body weight and body mass index (BMI) versus controls at 8 weeks (-2.5 +/- 0.7 kg, p0.01, and -1.9 +/- 0.6, p0.05, respectively). Green tea beverage showed a decreasing trend in LDL-cholesterol and LDL/high-density lipoprotein (HDL) versus controls (p0.1). Green tea beverage also significantly decreased MDA and HNE (-0.39 +/- 0.06 microM, p0.0001) versus controls. Plasma free catechins were detectable in both beverage and extract groups versus controls at screen and at 8 weeks, indicating compliance and bioavailability of green tea catechins.Green tea beverage consumption (4 cups/d) or extract supplementation (2 capsules/d) for 8 weeks significantly decreased body weight and BMI. Green tea beverage further lowered lipid peroxidation versus age- and gender-matched controls, suggesting the role of green tea flavonoids in improving features of metabolic syndrome in obese patients.

Background Strawberry flavonoids are potent antioxidants and anti-inflammatory agents that have been shown to reduce cardiovascular disease risk factors in prospective cohort studies. Effects of strawberry supplementation on metabolic risk factors have not been studied in obese populations. We tested the hypothesis that freeze-dried strawberry powder (FSP) will lower fasting lipids and biomarkers of oxidative stress and inflammation at four weeks compared to baseline. We also tested the tolerability and safety of FSP in subjects with metabolic syndrome. FSP is a concentrated source of polyphenolic flavonoids, fiber and phytosterols. Methods Females (n = 16) with 3 features of metabolic syndrome (waist circumference >35 inches, triglycerides > 150 mg/dL, fasting glucose > 100 mg/dL and < 126 mg/dL, HDL 130/85 mm Hg) were enrolled in the study. Subjects consumed two cups of the strawberry drink daily for four weeks. Each cup had 25 g FSP blended in water. Fasting blood draws, anthropometrics, dietary analyses, and blood pressure measurements were done at baseline and 4 weeks. Biomarkers of oxidative stress and inflammation were measured using ELISA techniques. Plasma ellagic acid was measured using HPLC-UV techniques. Results Total cholesterol and LDL-cholesterol levels were significantly lower at 4 weeks versus baseline (-5% and -6%, respectively, p < 0.05), as was lipid peroxidation in the form of malondialdehyde and hydroxynonenal (-14%, p < 0.01). Oxidized-LDL showed a decreasing trend at 4 weeks (p = 0.123). No effects were noted on markers of inflammation including C-reactive protein and adiponectin. A significant number of subjects (13/16) showed an increase in plasma ellagic acid at four weeks versus baseline, while no significant differences were noted in dietary intakes at four weeks versus baseline. Thus, short-term supplementation of freeze-dried strawberries appeared to exert hypocholesterolemic effects and decrease lipid peroxidation in women with metabolic syndrome.

In early spring of 1988, questionnaires were mailed to 4,000 Midwestern physicians to survey their attitudes and practices regarding elevated serum cholesterol and their use of referrals for nutrition counseling; 633 physicians responded. Sixty-eight percent of the physicians thought that reducing high serum cholesterol levels would substantially affect heart disease; however, physicians attributed considerably less preventive value to reducing the cholesterol level than to reducing blood pressure (80.3%) or ceasing smoking (90.0%). The range of serum cholesterol for which diet therapy was most frequently initiated was 5.70 to 6.20 mmol/L. The most frequent range for initiation of drug therapy was 7.80 to 8.25 mmol/L. The physicians reported that although their medical school training did not prepare them adequately for providing diet counseling, they did feel prepared to provide, and were successful in, counseling on diet modifications for reducing serum cholesterol. Few (10%) of the total sample reported having registered dietitians available for dietary counseling, and most (88.8%) believed that it is the physician’s responsibility to provide such counseling. Although the low response rate limits the conclusions of the survey, it is likely that those physicians most interested in the topic responded. We conclude that registered dietitians should explore the need for their special services further. More aggressive marketing of dietetic services could benefit both physicians and patients in the campaign to reduce serum cholesterol.

The use of focus group interviews as a qualitative research method has grown in popularity. This paper was written to provide ideas on how to determine if publication of focus group-based research should be pursued. Included are viewpoints on methodological, design, analysis, and reporting issues. In addition, a list of suggested readings is provided.

The purpose of this study was to evaluate the acceptability of stage-tailored newsletters as a communication means for promoting fruit and vegetable intake by young adults. Qualitative interviews were conducted to gather young adults' likes and dislikes about stage-tailored newsletters on fruits and vegetables. A total of 246 interviews were completed by young adults between the ages of 18 and 24 years for focus group and/or in-depth interviews. Prototype newsletters containing stage-matched messages were designed to increase motivational readiness to increase fruit and vegetable intake based on the Transtheoretical Model. Transcripts were grouped by stage of change and examined to identify major themes or topics. Results showed that young adults in each of the three stages responded positively to the tailored newsletters. Subjects provided feedback on newsletter likes/dislikes, benefits/barriers to eating fruits and vegetables, and strategies for promoting change. This study provides an example of the incorporation of key concepts from the Transtheoretical Model in development of stage-tailored newsletters for young adults.

Adequate fruit and vegetable intake is strongly associated with a reduced risk for various chronic diseases. US national surveys show that 18- to-24-year-olds are not consuming enough of these foods. Theory-based nutrition interventions, e.g. stage-tailored education programs, are needed for promoting fruit and vegetable consumption in this age group. Accurate stage assignment is the basis for developing effective stage-tailored interventions. In the current study, three different methods were compared for assigning stages of change in fruit and vegetable intakes by young adults. Significant differences in food intake, decisional balance and self-efficacy were found between respondents with concordant responses to the traditional stage algorithm and the food-frequency questionnaire (FFQ) and those with discordant responses. The stage assignment method that combined the staging algorithm and FFQ identified a distinct stage, labeled 'non-reflective action', in addition to the traditional five stages of change. This stage lay between the preparation and action stages with regard to food intake and psychosocial variables. Implications of the findings were discussed for future intervention programs that attempt to promote fruit and vegetable intake.

Purpose.To examine the appropriateness of the five-stage schema developed for addictive behaviors when applied to nonaddictive behaviors such as fruit and vegetable consumption.Design.A cross-sectional mail survey was conducted.Setting.Self-administered questionnaires were mailed to the home addresses of respondents recruited in 10 states and returned upon completion.Subjects.In all, 116 male and 185 female young adults (response rate = 70%) completed the questionnaires. Most respondents were Caucasian (74.4%) and college students (62.2%).Measures.Statistical analyses included analysis of variance with Scheffe's test, Pearson correlation and Cronbach's a coefficients, factor analysis, and cluster analysis.Results.Staging algorithms for fruits and vegetables were developed according to the five-stage schema, and their construct validity was verified by the incremental trend of food intakes. The algorithms identified more than 80% of the subjects as precontemplators, preparers, or maintainers for both food groups. This distribution pattern agreed well with the three-factor solution generated from the stages of change questionnaire, for which internal reliability and validity were confirmed. Seven cluster profiles of the respondents were derived based on the three generated factors and appeared to represent stage subgroupings of those factors. The two food groups shared marked similarities regarding the profiling of the clusters, which was validated by comparing food intake. The results, however, cannot be generalized because of limitations involved in the current sample.Conclusions.The original five stages of change and traditional staging measures may need to be adapted and/or extended for dietary change.

Purpose. To examine relationships between cigarette smoking, alcohol use, and dietary intake. Design. Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals, a nationwide probability sample conducted from January 1994 through January 1997 (n = 23,602; response rate = 80%), were selected. Adults ages 19 years and older were grouped according to their smoking and drinking habits. Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared. Setting. In-home interviews were conducted in the 50 states and the District of Columbia. Subjects. The selected sample (n = 6745) included 3229 nonsmokers, 1701 former smokers, and 1808 current smokers, and 2284 abstainers, 2713 occasional drinkers, 1000 moderate drinkers, and 748 liberal drinkers. Measures. Responses to standard questionnaires were examined by Student's t-test, χ2, one-way analysis of variance, and univariate and multivariate analyses of covariance. Results. Men were more likely than women to be current smokers and liberal drinkers (64% vs. 40% and 62%) vs. 38%). For both, the use of cigarettes and alcohol was closely related. An additive relationship was observed between smoking/drinking classification and lower food group servings and nutrient intakes. Although cigarette and alcohol use may have been underreported, these findings support previous ones showing poor food choices along with lower nutrient intakes as smoking and drinking increase. Conclusions. Smoking and drinking habits may alter individuals' food selections and nutrient intakes. Future interventions for health promotion may achieve greater success by targeting multiple risk factors simultaneously or sequentially.

Zinc and copper are two trace minerals essential for important biochemical functions and necessary for maintaining health throughout life. Several national food surveys revealed marginally to moderately low contents of both nutrients in the typical American diet. Using data from the respondents >/= 60 y old in the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII), we examined average dietary intakes of zinc, copper and relevant dietary factors; primary dietary contributors of zinc and copper; and Zn:Cu ratios of the primary dietary contributors. Data were analyzed with the use of a chi(2) test, Student's t test and multivariate analysis of covariance with Bonferroni correction. The daily zinc intake was 12 +/- 6.4 mg for men and 8.0 +/- 4.0 mg for women (P < 0.05); the daily copper intake was 1.3 +/- 0.7 mg for men and 1.0 +/- 0.5 mg for women (P < 0.05). Foods such as beef, ground beef, legumes, poultry, ready-to-eat and hot cereals, and pork constituted the major sources of zinc. Copper consumption was contributed mainly by legumes, potato and potato products, nuts and seeds, and beef. The less-than-recommended intakes of zinc and copper by the elderly were likely associated with age, low income and less education. The intakes of zinc and copper could be improved by more frequent consumption of food sources rich in these minerals. An inherent limitation of this study was the use of the 24-h dietary recall method, which may underestimate usual dietary intakes. Nonetheless, this study affirms the need for assessment of zinc and copper nutriture in the elderly.