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We investigated the relative validity of an interview-administered FFQ to estimate phytoestrogen intake among South Asian women in the UK. A population-based sample of 108 healthy South Asian women completed random repeated monthly 24-h recalls [with a subsample (n = 58) also providing multiple plasma samples] over a period of 1 y followed by administration of the FFQ. The FFQ produced slightly higher estimates of phytoestrogen intake than the 24-h recalls, but the percentage of women classified into the same [+ or -] 1 quartile by the 2 methods was high for all phytoestrogens (from 81 to 94%) with only a small percentage (< 5%) being misclassified into extreme opposite quartiles. Energy-adjusted Spearman correlations coefficients between the estimates obtained by the FFQ and the 24-h recalls were 0.55 for genistein, 0.60 for daidzein, 0.70 for secoisolariciresinol, and 0.63 for matairesinol (all P < 0.001). Spearman correlation coefficients between the FFQ estimates and plasma levels were 0.21 (P = 0.12) for genistein, 0.32 (P = 0.02) for daidzein and 0.10 (P = 0.43) for enterolactone; the corresponding values for the 24-h recalls compared with plasma levels were 0.43 (P < 0.001), 0.40 (P = 0.002), and 0.08 (P = 0.50), respectively. The method of triads was used to estimate the validity coefficients (VCs) between the estimates provided by each assessment method and 'true intake.' The FFQ had the highest VC for lignans (0.91 vs. 0.73 for 24-h recalls and 0.11 for plasma samples) and satisfactory VCs for both genistein (0.46 vs. 0.95 and 0.45, respectively) and daidzein (0.67 vs. 0.83 and 0.45, respectively). This FFQ is thus a relatively valid tool with which to estimate phytoestrogen intake among South Asian women in the UK. KEY WORDS: * phytoestrogens * food frequency questionnaire * 24-h recalls * plasma phytoestrogens * validation

BACKGROUND: Phytoestrogens, naturally occurring hormones in plant food, may protect against hormone-related chronic diseases. South Asian migrants in the United Kingdom have a low incidence of hormone-related cancers, but the extent to which this may be due to phytoestrogen intake is not known. OBJECTIVE: Our objective was to compare habitual phytoestrogen intake in migrant first-generation South Asian women and native British women using multiple 24-h recalls, multiple plasma samples, and an enhanced phytoestrogen database. DESIGN: South Asian (n = 221) and native British women (n = 50) were recruited from general practitioners' lists. Subjects were asked to provide monthly 24-h recalls for 1 y. A phytoestrogen database was compiled using data from a literature search and from previously unpublished data. A subsample of South Asian women (n = 100) and the native British women (n = 40) also provided blood samples every 3 mo concurrently during the 1-y period. RESULTS: The median daily intakes ([micro]g/d) of isoflavones [184.2, interquartile (IQ) range 121.1-277.6, vs. 333.9, IQ range 227.0-448.7] and lignans (110.8, IQ range 76.8-182.4, vs. 148.8, IQ range 87.4-228.6) were significantly lower in South Asians than in the native British (P < 0.001 and P = 0.04, respectively). There were no significant differences in plasma isoflavone levels, but plasma enterolactone was significantly higher in the native British than in South Asians (28.5 [+ or -] 23.3 vs. 13.9 [+ or -] 17.5, P < 0.001). The main sources of phytoestrogens were bread and vegetables and vegetable dishes for both ethnic groups. CONCLUSIONS: Habitual phytoestrogen intake in South Asian and native British women was < 1 mg/d and was higher in the native British diet. This was reflected in both dietary intake data and plasma levels. This study, therefore, does not lend support to the protective role, at a population level, of phytoestrogens in hormone-related cancers. [Supported by Cancer Research Campaign (now Cancer Research UK); Grant SP2315.]

In South Asians (Indians, Pakistanis, and Bangladeshis) settled overseas, high rates of coronary disease and non-insulin-dependent diabetes occur in association with central obesity and insulin resistance. To examine whether these disturbances were related to diet, we measured 7-d weighed intakes in 173 South Asian and European men aged 40-69 y in London. In South Asians compared with Europeans, respectively, mean energy intake was lower (9.5 vs 10.8 MJ/day, P < 0.001), total fat intake was lower (36.5% vs 39.2% of energy intake, P = 0.007), stanch intake was higher (28.0% vs 21.5% of energy, P < 0.001), polyunsaturated fatty acid intake was higher (8.2% vs 7.0% of energy, P = 0.02), and dietary fiber intake was higher (3.2 vs 2.0 g/MJ, P < 0.001). Elevated serum insulin concentrations at 2 h postglucosc were associated positively with carbohydrate intake (P = 0.001) and inversely with alcohol intake (P = 0.006), but not with saturated fatty acid intake. The high coronary risk in South Asian people is not explained by any unfavorable characteristic of South Asian diets. [ABSTRACT FROM AUTHOR]

Diabetic foot disease is associated with a substantially reduced quality of life, a high mortality rate and a costly burden on the NHS. DSNs are best placed to educate people with diabetes about their foot status and refer appropriately to minimise amputation rates. Footcare networks support DSNs to establish best practice and implement national guidelines locally. [ABSTRACT FROM AUTHOR]