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Victor Fulgoni 3rd,
Jill Nicholls,
Alan Reed,
Rita Buckley,
Karen Kafer,
Peter Huth,
Douglas Dirienzo,
Gregory D Miller
OBJECTIVE: To establish the first baseline of dairy and related nutrient intake in African Americans, an at-risk population of public health concern in the United States. To document dairy consumption in African Americans by age and sex during 1994-1998 and 1999-2000 and compare it with concomitant dairy, calcium, and related nutrient intakes in non-African-American adults and children. DESIGN: Duplicate and single 24-hour recalls were analyzed to determine dietary intake during the Continuing Survey of Food Intakes by Individuals 1994-1996, 1998 (CSFII), and the National Health and Nutrition Examination Survey 1999-2000 (NHANES), respectively. SUBJECTS: African Americans and non-African Americans of all ages who participated in CSFII 1994-1996, 1998, and in NHANES 1999-2000; both surveys are a stratified random sample of the total civilian, noninstitutionalized US population. STATISTICAL ANALYSIS: Dairy food and nutrient intake per day were quantified according to age, sex, and ethnicity/race from CSFII 1994-1996, 1998, and NHANES 1999-2000. For NHANES, mean intakes from 1-day food records were sample-weighted, and standard errors estimated by the Taylor linearization method of SUDAAN (version 9.0, 2004, RTI International, Research Triangle Park, NC). Usual daily intakes of calcium, magnesium, and phosphorus were based on 2-day intake data from CSFII 1994-1996, 1998, and calculated using Software for Intake Distribution from Iowa State University. The percentage of individuals categorized as not meeting the Estimated Average Requirement for magnesium and phosphorus were calculated in the same way. RESULTS: CSFII 1994-1996, 1998, and NHANES 1999-2000 data both show that African Americans in all age groups consume fewer mean servings per day of total dairy, milk, cheese, and yogurt than non-African Americans, and have lower mean intakes of calcium, magnesium, and phosphorus. Significant differences were seen for men and women. CONCLUSIONS: In this analysis, young African-American women did not meet Dietary Reference Intakes for phosphorus, and all African Americans did not meet Dietary Reference Intakes for calcium and magnesium. African Americans in all age groups did not meet dairy recommendations from the 2005 US Dietary Guidelines and the 2004 National Medical Association Consensus Report on the role of dairy and dairy nutrients in the diet of African Americans.
Latest citations:
1Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
BACKGROUND: Increased serum phosphate is associated with cardiovascular disease. Compared with whites, blacks have significantly higher serum phosphate and increased risk of hyperphosphataemia in health and chronic kidney disease (CKD). While population-based studies suggest that diminished urinary phosphorus excretion in blacks may explain these differences, few physiological studies explored the potential mechanisms. The aim of this study was to examine racial differences in postprandial urinary mineral ion excretion in health and in CKD. METHODS: Twenty-eight healthy (18 white and 10 black) and 19 CKD (9 white and 10 black) subjects consumed a standardized meal; after which, blood and urine samples were collected for 4 h for measurement of phosphate, calcium, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). RESULTS: Although serum phosphate did not differ by race, blacks had approximately 30% lower postprandial fractional excretion of phosphate than whites in health (P < 0.001) and CKD (P = 0.02). Similarly, blacks had approximately 35% lower fractional excretion of calcium in health (P = 0.02) and CKD (P = 0.3). Moreover, the postprandial response in serum calcium among CKD subjects differed by race (P = 0.03), with serum calcium significantly decreasing in whites but not blacks. CONCLUSIONS: Blacks had lower fractional excretion of phosphate than whites despite similar levels of PTH and FGF23 in health and in CKD, suggesting racial variability in renal sensitivity to phosphaturic hormones. Furthermore, blacks defend postprandial serum calcium more effectively than whites in CKD. Further studies are needed to define the mechanisms underlying these observations and evaluate whether racial differences in mineral ion handling may contribute to disparities in CKD outcomes.
Am J Hum Biol. 2010 Feb 12;:
20155844
Department of Anthropology, Indiana University, Bloomington, Indiana 47401.
Humans are unique among mammals in that many consume cow's milk or other dairy products well beyond the traditional age of weaning. Milk provides various nutrients and bioactive molecules to support growth and development, and the question arises as to whether this dietary behavior influences growth parameters. There is evidence that milk makes positive contributions to growth in height, but its associations with other aspects of body size, such as body mass index (BMI), are not well-established. National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and multivariate regression analysis were used to test the hypothesis that milk (g) or total dairy product consumption (kJ) is associated with higher BMI percentile among US White, Black, and Mexican-American children of age 2-4 years (n = 1,493) and 5-10 years (n = 2,526). Younger children in the highest quartile of dairy intake had higher BMIs (beta = 7.5-8.0; P < 0.01) than those in the lowest two quartiles. Controlling for energy intake eliminated differences between QIV and QI. Among children of 5-10 years of age dairy intake had no relationship to BMI. Young children in the highest quartile of milk intake had higher BMIs than all lower quartiles (beta = 7.1-12.8; beta = 6.3-11.8 in energy-controlled models; P < 0.05). Among children of 5-10 years of age, those in QIV for milk intake had higher BMIs than those in QII (beta = 8.3; beta = 7.1 in energy-controlled model; P < 0.01). Controlling for total protein or calcium did not change the results. Milk had more consistent positive associations with BMI than did dairy products, and these were strongest among children of 2-4 years of age. Am. J. Hum. Biol., 2010.(c) 2010 Wiley-Liss, Inc.
Am J Epidemiol. 2009 Dec 2;:
19955473
Rates of uterine leiomyomata are 2-3 times higher among black women than white women. Dietary factors that differ in prevalence between these populations that could contribute to the disparity include dairy intake. During 1997-2007, the authors followed 22,120 premenopausal US Black Women's Health Study participants to assess dairy intake in relation to uterine leiomyomata risk. Because soy may be substituted for dairy, the effect of soy intake was also evaluated. Diet was estimated by using food frequency questionnaires in 1995 and 2001. Incidence rate ratios and 95% confidence intervals were estimated with Cox regression. There were 5,871 incident cases of uterine leiomyomata diagnosed by ultrasound (n = 3,964) or surgery (n = 1,907). Multivariable incidence rate ratios comparing 1, 2, 3, and >/=4 servings/day with <1 serving/day of total dairy were 0.94 (95% confidence interval (CI): 0.88, 1.00), 0.87 (95% CI: 0.78, 0.98), 0.84 (95% CI: 0.70, 1.01), and 0.70 (95% CI: 0.58, 0.86), respectively (P-trend <0.001). Incidence rate ratios comparing the highest (>/=2 servings/day) with the lowest (<1 serving/week) intake categories were 0.81 (95% CI: 0.66, 0.99) for high-fat dairy, 0.80 (95% CI: 0.70, 0.91) for low-fat dairy, and 0.78 (95% CI: 0.68, 0.89) for milk. Soy intake was unrelated to uterine leiomyomata risk. This large prospective study of black women provides the first epidemiologic evidence of reduced uterine leiomyomata risk associated with dairy consumption.
Department of Family Medicine, Cleveland Clinic, OH 44111, USA. carl.tyler@fairviewhospital.org
INTRODUCTION: Inadequate calcium intake is more common among women belonging to racial and ethnic minorities. This study examined the patterns and characteristics associated with calcium supplement use or nonuse among African American women, and the potential impact of physician recommendation on calcium supplementation. METHODS: African American women aged 19 to 65, attending community outreach activities sponsored by a multispecialty academic medical center in northeastern Ohio, completed a calcium supplement survey. Survey items included demographic and bone health-related information, and rationale for calcium supplement use or nonuse. RESULTS: Of 160 respondents, 14% of women regularly took calcium supplements, 16% were former users, and 70% never used calcium supplements. Characteristics associated with calcium use status included age, multivitamin use, and marital status. Few African American women recall discussions with their doctors about calcium intake. Most who formerly took calcium supplements and most who had never taken them were willing to do so if recommended by their physician. DISCUSSION: Calcium supplement use among African American women in this study was low. However, many of the barriers to calcium supplement use by African American women appear remediable through brief calcium intake counseling by their physician.
Ann Hum Biol. 2009 Feb 25;:1-14
19241191
Department of Anthropology, Indiana University, Bloomington, IN, USA.
Background: Little is known about how cow's milk consumption affects growth of young children. Aim: The present study evaluated associations between milk consumption and height among preschool-age children in three ethnic groups in the USA. Subjects and methods: A sample of 1002 children aged 24-59 months from NHANES 1999-2002 was used. Multivariate regression tested for associations between milk consumption (milk kJ/total kJ from 24 h recall, daily vs less frequent intake over 30 days) and height, controlling for age, sex, ethnicity, birth weight, and energy intake. Results: Children in the highest quartile of milk intake (QIV) were taller (1.1-1.2 cm; p<0.01) than those in QII and QIII but not QI. Total calcium had a positive effect on height (p<0.01), but did not change the height differences among percentiles. Total protein was not associated with height and QIV children were taller (0.9-1.2 cm) than those in all other quartiles. Children who drank milk daily were taller (1.0 cm; p<0.02) than those with less frequent intake. Consumption of other dairy products (other dairy kJ/total kJ) had no association with height. Blacks were taller than Whites and Mexican-Americans; controlling for milk intake did not alter this pattern. Conclusion: Milk contributes positively to height among preschool children; this association was not found for non-milk dairy products.
Kidney Int. 2008 Feb 6;:
18256597
Cit:11
1Department of Medicine, Renal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Disorders of mineral metabolism develop early in chronic kidney disease, but it appears that Blacks with stage-5 disease have more severe secondary hyperparathyroidism than other races. We measured levels of parathyroid hormone, calcium, phosphorus, 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) in 227 Black and 1633 non-Black participants in the SEEK study, a multi-center cohort of patients with early chronic kidney disease. Overall, Blacks had similar 1,25D levels compared with non-Blacks, but significantly lower levels of 25D with higher levels of calcium, phosphorus, and parathyroid hormone, and were significantly more likely to have hyperphosphatemia than non-Blacks. In multivariable analyses adjusted for age, gender, estimated glomerular filtration rate, body mass index, and diabetes, Blacks had significantly lower 25D and higher parathyroid hormone levels than non-Blacks, with the latter parameter remaining significant after further adjustment for calcium, phosphorus, 25D, and 1,25D. The association between Black race and secondary hyperparathyroidism, independent of known risk factors, suggests that novel mechanisms contribute to secondary hyperparathyroidism in Blacks with chronic kidney disease.Kidney International advance online publication, 6 February 2008; doi:10.1038/ki.2008.4.
Other papers by authors:
Director, Nutrition and Scientific Affairs, National Dairy Council, Rosemont, IL.
Carla R McGill,
Victor L Fulgoni 3rd,
Douglas DiRienzo,
Peter J Huth,
Anne C Kurilich,
Gregory D Miller
Healthy Science Communications, LLC, 7059 Strand Circle, Bradenton, FL 34203, USA. Cmcgill644@aol.com
OBJECTIVE: Adequate dietary potassium intake is associated with a reduced risk of cardiovascular and other chronic diseases. The Dietary Guidelines for Americans 2005 identifies milk and milk products as a major contributor of dietary potassium and lists dairy products, along with fruits and vegetables, as food groups to encourage. This paper further examines the impact of dairy consumption on the potassium intake of the United States (US) population. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 we determined potassium intakes for various age groups of individuals who met the recommended number of dairy servings compared to those who did not. We also examined the impact of dairy servings consumed on mean and median potassium intakes and compared intakes to the age-appropriate Adequate Intakes (AI). RESULTS: For all age groups, mean and median potassium intakes did not meet the respective AI. Mean potassium intakes were significantly greater in those subjects who met dairy intake recommendations compared to those who did not for all age groups. Mean and median potassium intakes increased with increasing dairy intake but were below current intake recommendations for all age groups analyzed. For adults age 19 to 50, 16.1% consumed the recommended number of dairy servings per day. For those 51 and older, 10.7% met current dairy intake recommendations. CONCLUSIONS: Consumption of dairy products is below current recommendations which contributes in part to suboptimal dietary potassium intakes among a large proportion of the US population. Since adequate potassium intake is associated with decreased risk of chronic disease, consumption of a variety of potassium-rich foods, including fruits, vegetables and low-fat and fat free dairy products, should continue to be encouraged.
Department of Foods and Nutrition, Purdue University, 700 West State Street, West Lafayette, IN 47907, USA. armobley@purdue.edu
With approximately 2 out of 3 Americans currently overweight or obese, many continue to come up short on recommendations for certain nutrients such as calcium, magnesium, potassium, vitamin A, vitamin C, vitamin E, and fiber in their diet. Numerous attempts have been made to provide consumers with nutrient-profiling tools, such as manufacturer-specific symbols, to improve dietary selections, but many of the tools have focused on assisting consumers in making single food selections and do not provide guidance about planning total diets. In response to the 2005 Dietary Guidelines Advisory Committee's recommendation for research to define nutrient density, the Nutrient Rich Foods Coalition (NRFC) embarked on the development of a scientifically valid definition of nutrient density and consumer-driven educational tools to communicate the concept of nutrient-rich foods (NRF) to consumers. The science-based, consumer-driven NRF approach to eating may help Americans make multiple small changes in their diet that ultimately lead to better diet quality and significant improvements in public health.
J Nutr. 2009 Apr 1;:
19339707
National Dairy Council, Rosemont, IL 60018.
The consumption of nutrient-dense foods and beverages, which would ultimately be identified by a scientifically validated nutrient density profiling system, should be instituted as a nutrition platform in the Dietary Guidelines as a part of a larger educational effort to help people choose more nutrient-dense foods and as the guiding principle for consumers to plan healthful diets. By consciously choosing more nutrient-dense foods and beverages, Americans will be in a better position to meet their nutrient requirements without overconsuming energy. An objective, science-based, and validated nutrient density profiling system is needed to characterize foods based on their nutrient composition and this concept should be integrated into the Dietary Guidelines. This article sets forth guiding principles for the development and implementation of a nutrient density profiling system based on the current knowledge of diet and health and recommends that the development of a nutrient density profiling system include testing for effectiveness against accepted measures of diet quality, such as the Healthy Eating Index, and measurable public health markers, such as blood lipids and blood pressure.
From Nutrition Impact, LLC, Battle Creek, MI.
The annual American Society for Nutrition Public Information Committee symposium for 2007 titled "High Fructose Corn Syrup (HFCS): Everything You Wanted to Know, But Were Afraid to Ask" served as a platform to address the controversy surrounding HFCS. Speakers from academia and industry came together to provide up-to-date information on this food ingredient. The proceedings from the symposium covered 1) considerable background on what HFCS is and why it is used as a food ingredient, 2) the contribution HFCS makes to consumers' diets, and 3) the latest research on the metabolic effects of HFCS. The data presented indicated that HFCS is very similar to sucrose, being about 55% fructose and 45% glucose, and thus, not surprisingly, few metabolic differences were found comparing HFCS and sucrose. That said, HFCS does contribute to added sugars and calories, and those concerned with managing their weight should be concerned about calories from beverages and other foods, regardless of HFCS content.
Nutr Rev. 2008 Jan ;66 (1):23-39
18254882
Cit:5
Center for Public Health Nutrition at the University of Washington, Seattle, Washington, USA.
Nutrient profiling of foods, described as the science of ranking foods based on their nutrient content, is fast becoming the basis for regulating nutrition labels, health claims, and marketing and advertising to children. A number of nutrient profile models have now been developed by research scientists, regulatory agencies, and by the food industry. Whereas some of these models have focused on nutrients to limit, others have emphasized nutrients known to be beneficial to health, or some combination of both. Although nutrient profile models are often tailored to specific goals, the development process ought to follow the same science-driven rules. These include the selection of index nutrients and reference amounts, the development of an appropriate algorithm for calculating nutrient density, and the validation of the chosen nutrient profile model against healthy diets. It is extremely important that nutrient profiles be validated rather than merely compared to prevailing public opinion. Regulatory agencies should act only when they are satisfied that the scientific process has been followed, that the algorithms are transparent, and that the profile model has been validated with respect to objective measures of a healthy diet.
Shiro Fujita,
Takahisa Fujikawa,
Shugo Mizuno,
Alan Reed,
Robin Kim,
Richard Howard,
Roberto Firpi,
David Nelson,
Alan Hemming
BACKGROUND.: While the main effect of hepatitis C virus (HCV) is hepatitis, HCV is also known to cause a variety of systemic immunologic inflammatory abnormalities. The effect of HCV infection on the biliary tract after liver transplantation (LT) is not well understood. The aim of the current study is to determine if recurrence of hepatitis C affects biliary complications after LT, with special reference to late biliary anastomotic strictures (LBAS). METHODS.: A total of 688 consecutive adult LT recipients with a choledochocholedochostomy without T-tube placement between 1990 and 2005 were reviewed. Biliary anastomotic stricture was confirmed by endoscopic retrograde cholangiopancreatography. LBAS was defined as stricture that occurred 30 days or more after LT. Early HCV recurrence was defined as recurrence within 6 months after LT. RESULTS.: LBAS occurred in 55 patients (8% of total). Patients with HCV infection had a higher occurrence of LBAS than non-HCV patients (11% vs. 5%, P=0.0093). Among HCV patients, those with early HCV recurrence had an exceedingly high rate of LBAS (16%). In multivariate analyses, early recurrence of hepatitis C (P<0.0001), as well as occurrence of hepatic artery thrombosis (P=0.0018) and prolonged cold ischemic time (P=0.034), were independent risk factors affecting LBAS. Among HCV patients, those with LBAS had a significantly higher hepatitis activity index score (3.1 vs. 1.4, P<0.0001) and fibrosis stage (0.9 vs. 0.4, P<0.0001) as compared to patients without LBAS. CONCLUSION.: Patients with early recurrence of HCV have increased occurrence of late biliary anastomotic stricture after liver transplantation.
Alan Reed,
Jill Boylston Herndon,
Nail Ersoz,
Takahisa Fujikawa,
Denise Schain,
Paul Lipori,
Alan Hemming,
Qin Li,
Elizabeth Shenkman,
Bruce Vogel
We sought to determine whether the prophylactic use of amphotericin B products (conventional amphotericin B and liposomal amphotericin B) reduces the incidence of fungal infections in high-risk liver transplant recipients, and if so, whether this lowers the cost of care. The study sample comprised 232 adult orthotopic liver transplants performed from 1994 to 2005 at a single center for patients classified as being at high risk for fungal infections. High-risk patients who received transplants with a prophylaxis regimen of amphotericin B (n = 58 transplants) were compared with high-risk patients who received no prophylaxis (n = 174 transplants). Fungal infections occurred in 3 transplants (5.17%) of those who received amphotericin B and 28 transplants (16.09%) in those without prophylaxis (P = 0.0432). Regression models were used to analyze fungal infection and costs for the 232 high-risk transplants. Failure to offer prophylaxis conferred a 4-fold greater risk of fungal infection (P = 0.046) compared with those who received amphotericin B. A fungal infection in a high-risk recipient increased mean costs by 46.48%. The indirect effect of prophylaxis (operating through infection reduction) is estimated to reduce overall costs in high-risk patients by 8.73%. Liver Transpl 13: 1743-1750, 2007.(c) 2007 AASLD.
Little is known about the financial impact of transplantation on patients and families. We interviewed 333 liver transplant (LT) and 318 kidney transplant (KT) recipients who were at least 1 year posttransplant. Patients were asked whether transplantation caused financial problems, whether income had changed since transplantation, what resources they used to pay for transplant-related expenses, and what their out-of-pocket monthly expenses were. Descriptive and comparative statistics, measures of association, and logistic regression analyses were calculated. Many patients reported financial problems secondary to transplantation (40.6%) and less monthly income now than in the year preceding transplantation (46.5%). Average monthly out-of-pocket expense was $476.60. LT recipients had higher out-of-pocket expenses than KT recipients (t=2.46, P=0.015). Patients used personal savings (53.9%) and credit cards (25.0%) to help offset these expenses, among other strategies. For both LT and KT recipients, older age, nonworking status before transplantation, and current nonworking status predicted greater financial impact, whereas younger age and current nonworking status predicted higher monthly out-of-pocket expenses. These findings highlight the potential financial impact of transplantation on patients and families, and they have implications for assisting patients in managing out-of-pocket expenses after transplantation.
Clin Transpl. 2005 ;:101-9
17424728
Cit:6
David P Foley,
Pamela R Patton,
Herwig-Ulf Meier-Kriesche,
Qin Li,
Betsy Shenkman,
Shiro Fujita,
Alan Reed,
Alan W Hemming,
Robin D Kim,
Richard J Howard
Department of Surgery, University of Florida, Gainesville, FL, USA.
As the population ages, the transplant community will continue to see "elderly" patients with end-stage kidney disease who are seeking transplantation. In this report we describe long-term outcomes of 315 primary kidney transplants performed at the University of Florida in recipients aged > or = 60 years and compare them to results from 3 younger recipient cohorts. Among recipients > or = 60 years, patient survival was significantly worse than for younger recipients but no differences in graft or death-censored graft survival were seen. We suspect that although patient survival was worst in the oldest group, there were likely other causes of graft loss within the younger groups that balanced the effects of death on graft survival in the oldest group. Among recipients aged > or = 60 years, patient survival at 10 years was 55% for living-donor kidney recipients and 46% for deceased-donor kidney recipients. African-American recipients had a higher risk of mortality and graft loss in all age groups after deceased donor kidney transplantation but not after living donor transplantation. Delayed graft function negatively impacted outcomes among all recipients and the adverse effects were greater after deceased donor than living donor transplantation. These effects were also seen within the oldest recipient age group. Increased donor age was a significant risk factor for death and graft loss among all age groups after deceased donor kidney transplantation but not among living-donor kidney recipients. More specifically, recipients aged > or = 60 years who received kidneys from donors > or = 60 years demonstrated significantly worse outcomes when compared to those receiving donor kidneys < 60 years. The presence of diabetes mellitus in recipients > or = 60 years was not a significant risk factor for mortality or graft loss after transplantation. Acceptable results can be obtained after kidney transplantation in recipients aged > or = 60 years. Future investigations should focus on improving recipient selection in the elderly population, identifying strategies to minimize DGF in deceased donor kidneys, understanding all variables involved in the risk associated with recipient race, and increasing living donor transplantation across all age groups.
Latest similar papers:
Am J Clin Nutr. 2010 Aug 4;:
20685949
Department of Family, Nutrition, and Exercise Sciences, Queens College of the City University of New York, Flushing, NY, and the Division of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
BACKGROUND: Little is known about the association of contributors of total water intake with dietary characteristics in US children. OBJECTIVE: We examined intakes of total water and its contributors and their associations with diet and meal reporting in children and adolescents. DESIGN: Dietary data for children 2-19 y of age (n = 3978) from the National Health and Nutrition Examination Survey 2005-2006 were used to compute usual intake of total water. The association of total water and its contributors with sociodemographic characteristics and dietary and meal attributes was examined by using multiple regression analysis. RESULTS: The adjusted mean intakes of total water in Americans aged 2-5, 6-11, and 12-19 y were 1.4, 1.6, and 2.4 L, respectively. The mean usual intake of total water was generally less than the Adequate Intake; overall, more boys reported intakes of at least the Adequate Intake. The percentage of total water intake from plain water increased with age. Plain water intake was inversely associated with the intake of beverage moisture and the energy density of foods; conversely, beverage moisture was positively associated with dietary energy, fat, and the energy density of foods. Associations of water contributors with meal patterns (number of eating occasions, reporting of breakfast or snack) were inconsistent across age groups. Nearly 80% of food moisture, gt 66% of beverage moisture, and ap 30% of plain water were reported with main meals. CONCLUSIONS: Intake of total water over 24 h from different contributors varied by age. Qualitative differences in dietary intake in association with the amount of plain water and beverage moisture in the recalls were observed. American children and adolescents consumed more than two-thirds of their daily beverages with main meals.
Ear Hear. 2010 Jul 28;:
20683190
1Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland; 2Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at San Antonio, Texas; and 3Hearing Loss Prevention Team, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.
OBJECTIVES::(1) To present hearing threshold data from a recent nationally representative survey in the United States (National Health and Nutrition Examination Survey, 1999-2004) in a distributional format that might be appropriate to replace Annex B in international (ISO-1999) and national (ANSI S3.44) standards and (2) to compare these recent data with older survey data (National Health Examination Survey I, 1959-1962) on which the current Annex B is based. DESIGN:: Better-ear threshold distributions (selected percentiles and their confidence intervals) were estimated using linear interpolation. The 95% confidence intervals for the medians for the two surveys were compared graphically for each of the four age groups and for both men and women. In addition, we calculated odds ratios comparing the prevalences of better-ear hearing impairment (thresholds > 25 dB HL) between the two surveys, for 500, 1000, 2000, and 4000 Hz, and for their four-frequency average. RESULTS:: Across age and sex groups, median thresholds were lower (better) in the 1999-2004 survey at 500, 3000, 4000, and 6000 Hz (8000 Hz was not tested in the 1959-1962 survey). For both men and women, the prevalence of hearing impairment was significantly lower in 1999-2004 at 500, 2000, and 4000 Hz, but not at 1000 Hz. CONCLUSIONS:: For men and women of a specific age, high-frequency hearing thresholds were lower (better) in 1999-2004 than in 1959-1962. The prevalences of hearing impairment were also lower in the recent survey. Differences seen at 500 Hz may be attributable at least in part to changes in standards for ambient noise in audiometry. The National Health and Nutrition Examination Survey 1999-2004 distributions are offered as a possible replacement for Annex B in ISO-1999 and ANSI S3.44.
Priya R Deshmukh-Taskar,
Theresa A Nicklas,
Carol E O'Neil,
Debra R Keast,
John D Radcliffe,
Susan Cho
BACKGROUND: National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. OBJECTIVE: To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. SUBJECTS: Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339). DESIGN: Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006. METHODS: Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers. RESULTS: Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index >/=95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05). CONCLUSIONS: RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.
Abt Associates Inc., Durham, NC.
In the Institute of Medicine (IOM) macronutrient report the Committee recommended a maximal intake of </= 25% of energy from added sugars. The primary objectives of this study were to utilize National Health and Nutrition Examination Survey (NHANES) to update the reference table data on intake of added sugars from the IOM report and compute food sources of added sugars. We combined data from NHANES with the United States Department of Agriculture (USDA) MyPyramid Equivalents Database (MPED) and calculated individual added sugars intake as percent of total energy then classified individuals into 8 added sugars percent energy categories, calculated usual intake with the National Cancer Institute (NCI) method, and compared intakes to the Dietary Reference Intakes (DRIs). Nutrients at most risk for inadequacy based on the Estimated Average Requirements (EARs) were vitamins E, A, C, and magnesium. Nutrient intake was less with each 5% increase in added sugars intake above 5-10%. Thirteen percent of the population had added sugars intake > 25%. The mean g-eq added sugars intake of 83.1 g-eq/day and added sugars food sources were comparable to the mid-1990s. Higher added sugars intakes were associated with higher proportions of individuals with nutrient intakes below the EAR, but the overall high calorie and the low quality of the U.S. diet remained the predominant issue. With over 80% of the population at risk for select nutrient inadequacy, guidance may need to focus on targeted healthful diet communication to reach the highest risk demographic groups for specific life stage nutrient inadequacies.
Center for Agricultural and RuralDevelopment, Department of Economics, Iowa State University, Ames, IA 50011-1070, USA.
BACKGROUND: Little is known about rice consumption, related food intake patterns, and the nutritional contribution that rice provides in the diets of Americans. OBJECTIVE: To provide information about rice consumption in the United States and the diets of rice consumers. DESIGN: Data come from the Continuing Survey of Food Intakes by Individuals (1994-1996) and the National Health and Nutrition Examination Survey (2001-2002). Respondents report 24-hour recall dietary intakes. The amount of rice available in foods is estimated using the Food Commodity Intake Database. Consumers are classified based on the amount of rice they consume in foods. SUBJECTS: The analysis includes information from adult individuals: 9,318 from the Continuing Survey of Food Intakes by Individuals and 4,744 from National Health and Nutrition Examination Survey. STATISTICS: Weighted percentages and mean values show the food and nutrient intake amounts. Logistic regression analysis is used to examine relationships among economic, social, and demographic factors that affect rice consumption. RESULTS: Rice is consumed by a significant portion of the US adult population. Compared with others who did not consume rice, rice consumers consumed a smaller share of energy per day from fat and saturated fat; more iron and potassium; and more dietary fiber, meat, vegetables, and grains. Race/ethnicity and education are determinants of the probability of consuming rice, and more so than low-income status. CONCLUSIONS: Rice consumers choose a diet that includes more vegetables, a smaller share of energy from fat and saturated fat, more dietary fiber and more iron than those who do not consume rice; the differences have remained relatively stable over the last decade. Accounting for race/ethnicity and income levels is important for better understanding of factors that affect food choices and for effective design of dietary interventions.
NCHS Data Brief. 2008 Apr ;(5):1-8
19389319
Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA.
KEY FINDINGS: Data from the National Health and Nutrition Examination Surveys. The percentage of infants who were ever breastfed increased from 60% among infants who were born in 1993-1994 to 77% among infants who were born in 2005-2006. Breastfeeding rates increased significantly among non-Hispanic black women from 36% in 1993-1994 to 65% in 2005-2006. Breastfeeding rates in 1999-2006 were significantly higher among those with higher income (74%) compared with those who had lower income (57%). Breastfeeding rates among mothers 30 years and older were significantly higher than those of younger mothers. There was no significant change in the rate of breast-feeding at 6 months of age for infants born between 1993 and 2004. Human milk is the ideal food for most infants. Breastfeeding benefits infants and their mothers. Breastfed infants receive anti-bodies from breast milk, which protect against infection in the early postpartum period, and breastfeeding is less expensive than formula feeding. This report summarizes information on breastfeeding rates in the United States based on data from the 1999-2006 National Health and Nutrition Examination Surveys (NHANES). Results are reported for the total U.S. population and three race-ethnic groups by birth year cohort.
OBJECTIVE: To compare reported dairy/calcium intake with intake recommendations and examination of food sources and fat levels of dairy intake in the National Health and Nutrition Examination Survey 1999-2002. STUDY DESIGN: Dietary, anthropometric, and sociodemographic data for 2- to 18-year-olds (n = 7716) were evaluated to compare intakes of dairy (MyPyramid) and calcium (Adequate Intake [AI]) recommendations. US Department of Agriculture food codes were used to identify mutually exclusive food groups of dairy-contributing foods, which were ranked in descending order proportional to total intake. Complex sample survey Student t tests were used to determine statistical significance among intakes in 4 age groups and between reported and recommended intakes. RESULTS: Dairy consumption was not significantly different among age groups, but only 2- to 3-year-olds met the MyPyramid recommendation. Calcium intake was significantly different among age groups, and 2- to 8-year-olds met the AI. Intake of flavored milk ranged from 9% to 18%. More than half of the milk consumed by 2- to 3-year-olds was whole milk, and, with the exception of yogurt consumption in 2- to 3-year-olds, children choose to consume more of the highest-fat varieties of cheese, yogurt, ice cream, and dairy-based toppings. CONCLUSIONS: Dairy and calcium intakes are inadequate in 4- to 18-year-olds. Most children consume the high-fat varieties of milk and dairy products. Focusing nutrition guidance efforts on increasing the intake of the low-fat dairy products, with special emphasis on increasing calcium intake in school-age children and adolescents through flavored low-fat milk products, may be beneficial.
J Pediatr. 2007 Oct ;151 (4):374-7
17889072
Cit:3
Fujie Xu,
Francis K Lee,
Rhoda A Morrow,
Maya R Sternberg,
Kristina E Luther,
Gary Dubin,
Lauri E Markowitz
OBJECTIVES: To describe HSV-1 seroprevalence in children in the United States and to examine factors associated with herpes simplex virus type 1 (HSV-1) infection in children. STUDY DESIGN: Sera samples available from 2989 children age 6 to 13 years who participated in the National Health and Nutrition Examination Surveys (NHANES) 1999-2002 were tested for HSV-1 antibodies using a type-specific immunodot assay. HSV-1 seroprevalence in children age 12 to 13 years was compared with that reported in an earlier survey (NHANES 1988-1994). RESULTS: Overall, HSV-1 seroprevalence in children age 6 to 13 years was 31.1%(95% confidence interval [CI], 28.6% to 33.9%). Seroprevalence increased with age, from 26.3% in 6- to 7-year-olds to 36.1% in 12-to 13-year-olds, and varied by race/ethnicity, birthplace, and poverty level. Among US-born children age 12 to 13 years, the point estimate of HSV-1 seroprevalence was lower in NHANES 1999-2002 than in NHANES 1988-1994 (34.3% vs 38.1%), but the differences were not statistically significant. CONCLUSIONS: HSV-1 is a common infection in US children, with more than 25% infected by age 7. Race/ethnicity, birthplace, and poverty level are predictors for HSV-1 infection in children.
National efforts directed toward improving our understanding of the epidemiology of periodontal disease began nearly a half century ago following the development of Russell's periodontal index (PI). United States Public Health Service agencies began national surveillance activities for periodontal disease with the first National Health Examination Survey in 1960 to 1962, and this continued periodically through 2004 in the National Health and Nutrition Examination Survey (NHANES). Periodontal disease status was assessed by using the PI in the earlier national health surveys, but beginning in the 1980s, direct measures for clinical attachment loss were made in national health surveys and continued through 2004 in NHANES. This article provides a general history of the development and implementation of national surveillance efforts for periodontal disease from the mid-1950s to 2005. It also provides brief background information on the factors that have influenced these national surveillance efforts.
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, and the Department of Medical Genetics, University of British Columbia, Vancouver, Canada.
BACKGROUND: Neural tube defects are serious birth defects of the brain and spinal cord. Up to 70% of neural tube defects can be prevented by the consumption of folic acid by women before and early during pregnancy. OBJECTIVE: The objective was to examine folic acid intake in women of childbearing age in the United States. DESIGN: We analyzed nutrient intake data reported by 1685 nonpregnant women aged 15-49 y who participated in the National Health and Nutritional Examination Survey, 2001-2002. RESULTS: The adjusted geometric mean consumption of folic acid from fortified foods was 128 mug/d (95% CI: 123, 134 mug/d) in nonpregnant women. Eight percent (95% CI: 5.8%, 11.0%) of nonpregnant women reported consuming >/=400 mug folic acid/d from fortified foods. This proportion was lower among non-Hispanic black women (5.0%) than among non-Hispanic white (8.9%) or Hispanic (6.8%) women. A smaller percentage of non-Hispanic black (19.1%) and Hispanic (21%) women than of non-Hispanic white women (40.5%) consumed >/=400 mug folic acid from supplements, fortified foods, or both, in addition to food folate, as recommended by the Institute of Medicine to reduce the frequency of neural tube defects. CONCLUSIONS: Most nonpregnant women of childbearing age in the United States reported consuming less than the recommended amount of folic acid. The proportion with low daily folic acid intake was significantly higher in non-Hispanic black and Hispanic women than in non-Hispanic white women. At the present level of folic acid fortification, most women need to take a folic acid-containing dietary supplement to achieve the Institute of Medicine recommendation.