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To examine the hypothesis that there is sufficient agreement between percentage of households purchasing selected foods using household budget surveys and percentage of individuals consuming these foods as determined in individual-based surveys to allow the former to act as a surrogate for the latter when estimating food chemical intakes using household budget data.
Databases from Sweden, The Netherlands, Ireland and the UK.
319 foods (Sweden n=60, The Netherlands n=80, Ireland n=90, UK n=89).
Pearson correlations demonstrated a high degree of linear association between % households purchasing and % consumers (r=0.86). Regression analysis defined a close positive relationship between the two datasets (slope 0.95, intercept +2.74). Across countries, using the regression equation, the % households predicted % consumers to within 5% of the true value for between 33 and 48% of foods and to within 10% for between 53 and 78% of foods.
Values for % households can be used as a crude surrogate for % consumers and can thus play a role in improving estimates of food additive intake.
Menstrual disorders are common in young women, and heavy menstrual blood losses (MBL) are an important cause of anaemia. Menstrual morbidity normally goes untreated in developing countries where cultural barriers also serve to mask the problems. We investigated the prevalence of menstrual morbidity, and measured MBL and its relationship to iron deficiency in a rural adolescent population. The rationale was to assess whether or not reducing heavy MBL could be part of a strategy to reduce iron deficiency anaemia.
Rural village in south-east Nigeria.
The study included all non-pregnant, unmarried nulliparous girls (< 20 years) who had menstruated, and who lived in K'Dere village.
A field worker allocated to each girl completed a questionnaire, and supervised recovery and collection of soiled pads and ensured blood sampling. MBL was measured using the standard alkaline haematin method. Haemoglobin (Hb), serum iron, transferrin saturation and protoporphyrin levels (ZPP) were also measured.
307 girls completed MBL measurements; 11.9% refused to participate. 12.1% had menorrhagia (> 80 ml); median MBL was 33.1 ml. Menorrhagia was more frequent in girls who had menstruated for > 2 years (P = 0.048), and had longer duration of menses (P < 0.001). Iron status as measured by haematocrit, serum iron, transferrin saturation and ZPP values was inversely related to MBL. Neither height nor body mass index for age was associated with current iron status.
The level of menorrhagia detected (12%) may be an ‘expected’ level for a condition which often has no underlying pathology. Heavy MBL is one of the most important factors contributing to iron deficiency anaemia. Measures are needed to alleviate menstrual disorders, and improve iron status. Oral contraceptives can be part of a strategy to reduce anaemia, particularly for adolescents at high risk of unwanted pregnancies.
To assess the nutritional status of older people in an unstable situation.
Anthropometric and socioeconomic data were collected cross-sectionally. Body mass index (BMI), arm muscle area (AMA) and arm fat area (AFA) were calculated to evaluate nutritional status. For 41 subjects with kyphosis, height was estimated from arm span using sex-specific regression equations from the non-kyphotic group.
The study was carried out in the post-emergency phase in a Rwandan refugee camp in Karagwe district, north-west Tanzania.
Measurements were obtained from 413 men and 415 women aged 50–92 years.
The prevalence of undernutrition (BMI < 18.5) was 19.5% in men and 13.1% in women and was higher above age 60 years in both sexes: in men the prevalences were 23.2% and 15.0% (P < 0.05) and in women 15.1% and 10.9% for the older and younger age groups respectively. AMA, which is important in relation to the ability to remain active and independent, was also significantly lower in older age groups. No difference was found in AFA. The proportion with low BMI was much higher in the group with kyphosis.
Even in this population of older Rwandans who managed to reach the camp and survive in exile for more than a year, undernutrition does occur and is more prevalent at an advanced age. The higher prevalence of undernutrition in kyphotic people illustrates the importance of including this group in nutritional status assessments.
To review and categorize the problems associated with undertaking physical activity validation studies and to construct a checklist against which any study could be compared.
The studies reviewed demonstrated problems in defining the dimension of physical activity that is of interest and in the selection of an appropriate comparison technique. Ideally this should be closely related to the true exposure of interest and assess that exposure objectively and without correlated error from the study instrument in question. In many studies inappropriate comparison methods have been chosen which do not measure the true underlying exposure and which are likely to have correlated error. The choice of study populations, the frame of reference of the exposure measurement and the use of appropriate statistical methods are also problematic areas.
There is no ideal measurement instrument or validation study design that is suitable for all situations. However, the checklist in this paper provides a means whereby the appropriateness of studies already undertaken or at the planning stage can be assessed.
To evaluate the effect of a dietary treatment programme on blood cholesterol concentration in hypercholesterolaemic patients in general practice and to analyse subjectively experienced side-effects.
A 1-year parallel trial comparing a new treatment programme with conventional treatment.
General practitioners in Roskilde county, Denmark.
355 men and women, aged 20–60 years, with a persistent blood cholesterol concentration above age- and gender-specific cut-off points (265 in an intervention group and 90 in a control group).
A treatment strategy based on collaboration between doctor and dietitian using individual dietary advice and feedback from measured biological parameters.
Main outcome measures:
Serum lipids, body weight, blood pressure, dietary behaviour, health parameters, quality of life parameters and acceptance by patients and general practitioners.
Total blood cholesterol concentration decreased by 14% (1.07 mmol l−1, P < 0.0001) in 159 patients in the intervention group, not having any lipid altering drug during treatment, in addition to 3% from screening to start of treatment. In 65 patients in the control group, without any lipid altering drug, the reduction of cholesterol concentration was 4% (0.27 mmol l−1, P < 0.01; intervention vs. control P < 0.001). In the intervention group overweight subjects (body mass index > 30) reduced body weight by 6% (P < 0.0001). Systolic blood pressure was reduced by 11% (P < 0.0001) and diastolic blood pressure by 10% (P < 0.0001) and 19% (P < 0.003) for intervals 90–110 mmHg and > 110 mmHg, respectively. Risk score decreased and self-assessed health, physical and psychological well-being improved.
The treatment strategy tested proved to be efficient, without side-effects and well accepted by patients and general practitioners. The results strongly suggest that hypercholesterolaemia can efficiently be treated non-pharmacologically in general practice.