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Dietary intake and use of dietary supplements in relation to
demographic variables among pregnant Finnish women
Arkkola, T., Uusitalo, U., Pietikainen, M., Metsälä, J., Kronberg-Kippilä, C., Erkkola, M., Veijola, R., Knip, M., Virtanen, S. M. and Ovaskainen, M. L. British Journal of Nutrition. 2006; 96(5): 913-920. Article. IF 2.967 Proper nutrition during pregnancy may be important for maternal health and fetal growth and development. In Finland, targeted recommendations are given to guide pregnant women in their food choice and dietary supplement use so that they may obtain adequate nutritional status and meet the increased need for nutrients. The aims of the present study were to examine food choices, nutrient intake and dietary supplement use of pregnant Finnish women in association with demographic variables. One thousand and seventy-five families were invited to a birth cohort study during 1998-9. Mothers of 797 newborns completed a validated 181-item food-frequency questionnaire from which the food and nutrient intakes were calculated. The information about supplement use was collected concerning the whole pregnancy. The results of the present study suggest that healthy food choices are rather common among pregnant Finnish women and the choices are positively correlated with age and education. Nutrient supplements were used by 85 % of the women. Supplements were favoured by the older and well-educated women and by those who had normal weight before pregnancy. Of the women in the present study, 31 % received vitamin A-containing supplements, although it is not recommended during pregnancy. Taking food and supplementation into account, the intake of vitamin D did not meet the dietary recommendation and folic acid intake was below recommendation in 44 % of the women. Therefore there seemed to be unnecessary nutrient supplementation and at the same time lack of relevant supplementation among these pregnant women. Bergman, M., Huikko, S., Huovinen, P., Paakkari, P. and Seppälä, H. Antimicrobial Agents and Chemotherapy. 2006; 50(11): 3646-3650. Article. IF 4.379 The connection between regional rates of antimicrobial resistance in Streptococcus pneumoniae and regional antimicrobial use in Finland was investigated. During the 6-year study period of 1997 to 2002, a total of 31,609 S. pneumoniae isolates were tested for penicillin resistance and a total of 23,769 isolates were tested for macrolide resistance in 18 central hospital districts in Finland. The regional macrolide resistance rates were compared with the local use of (i) all macrolides pooled and (ii) azithromycin. The penicillin resistance levels were compared with the consumption data for (i) penicillins, (ii) cephalosporins, (iii) all beta-lactams pooled, and (iv) all macrolides pooled. A statistically significant association between macrolide resistance and total use of macrolides and the use of azithromycin was found. Moreover, total use of beta-lactams and total use of cephalosporins were significantly connected to low-level penicillin resistance. A statistically significant association between penicillin-nonsusceptible isolates and penicillin or total macrolide consumption was not found. In conclusion, total macrolide use and azithromycin use are associated with increased macrolide resistance, and beta-lactam use and cephalosporin use are connected to increased low-level penicillin resistance in S. pneumoniae. Unnecessary prescribing of macrolides and cephalosporins should be avoided. Boyd, J. J., Kyttä, J. V., Aittomäki, J. V., Rosenberg, P. H., Seppälä, T. A. and Randell, T. T. Acta Anaesthesiologica Scandinavica. 2006; 50(10): 1271-1276. Article. IF 1.837 Background: Naloxone is an opioid receptor antagonist. Even when used in modest doses, it has been associated with serious cardiopulmonary side-effects. In this experimental porcine study, we examined the cardiac effects of naloxone during an opioid overdose. Methods: Cardiac parameters, changes in the left ventricular compliance and the magnitude of catecholamine release were evaluated in eight spontaneously breathing piglets under propofol sedation. Cardiac parameters were recorded every 30 s and transthoracic echocardiography was used for the continuous assessment of cardiac performance. Respiratory arrest was induced by morphine (8 mg/kg). Ten minutes after morphine administration, naloxone (80 mu g/kg) was injected intravenously. Every 5 min, arterial blood gases were measured and, every 10 min, a sample for the analysis of plasma catecholamines was drawn. Results: There were no statistically significant changes in left ventricular ejection fraction and no signs of pulmonary hypertension. There was a statistically significant increase in the mean arterial pressure immediately after naloxone administration and in norepinephrine concentration before naloxone administration. After naloxone administration, the plasma catecholamine levels decreased in all but one animal. Two animals developed cardiac arrest (pulseless electrical activity and ventricular fibrillation) shortly after receiving naloxone. Although they were both administered naloxone prematurely due to hypoxic bradycardia, naloxone could have contributed to the development of ventricular fibrillation. Conclusion: Naloxone did not cause changes in ejection fraction or mean pulmonary artery pressure in hypoxic and hypercarbic conditions. After naloxone administration, the plasma catecholamine levels returned to baseline in all but one animal, and two animals developed cardiac arrest. Eriksson, J. G. Int J Obes (Lond). 2006; 30 Suppl 4: S18-22. IF 4.482 Experiences during critical periods of development through the mechanisms of programming have consequences on later health outcomes. Observations worldwide linking a small body size at birth with adult health outcomes have greatly added to our understanding of the early origins of several non-communicable diseases like coronary heart disease (CHD) and type 2 diabetes. The pattern of growth predisposing to CHD is characterized by a small body size at birth and thinness through infancy up to 2 years of age, followed by accelerated gain in weight and body mass index (BMI) later in childhood. The early growth patterns of individuals who later develop type 2 diabetes very much resemble the growth patterns of CHD, that is, a small body size at birth and thinness at 1 year of age followed by higher body mass indices later in childhood. Numerous studies support the importance of events during critical periods of growth in the pathogenesis of many non-communicable diseases like CHD and type 2 diabetes. There are several possible mechanisms through which a non-optimal early growth associated with accelerated weight gain in childhood could lead to these diseases. To get a better understanding of the patterns of growth affecting adult health outcomes, a life-course approach to the development of chronic diseases needs to be taken.International Journal of Obesity (2006) 30, S18-S22. doi:10.1038/sj.ijo.0803515. Patterns of growth among children who later develop type 2 diabetes or its risk factors Eriksson, J. G., Osmond, C., Kajantie, E., Forsén, T. J. and Barker, D. J. P. Diabetologia. 2006; 49(12): 2853-2858. Article. IF 5.337 We studied fetal and childhood growth patterns that are associated with IGT and type 2 diabetes in adult life. We examined clinically 2,003 subjects born in Helsinki between 1934 and 1944. They had on average 11 measurements of height and weight between birth and 2 years of age, and seven measurements between 2 and 11 years of age. Glucose tolerance in adult life was assessed by a 75-g oral glucose tolerance test. We identified 311 subjects with type 2 diabetes and 496 with IGT. Both IGT and type 2 diabetes were associated with low birthweight (p < 0.0001 adjusting for current BMI). The risk of these conditions was increased by low weight gain between birth and 2 years. A 1 SD increase in weight at 2 years was associated with an odds ratio for either type 2 diabetes or IGT of 0.76 (95% CI 0.69-0.84). This effect was greatest in people who had low birthweight. Low growth in the first 6 months after birth was a critical period for the development of insulin resistance in later life; other critical periods were associated with slow fetal growth and rapid increase in BMI between age 2 and 11 years. Low weight gain during infancy increases the risk of IGT and type 2 diabetes. The effect is greater in people who had low birthweight. The first 6 months after birth may be the most critical period for growth, in relation to development of glucose intolerance. Gratz, S., Taubel, M., Juvonen, R. O., Viluksela, M., Turner, P. C., Mykkänen, H. and El-Nezami, H. Applied and Environmental Microbiology. 2006; 72(11): 7398-7400. Article. IF 3.818 In this study, the modulation of aflatoxin B-1 (AFB(1)) uptake in rats by administration of the probiotic Lactobacillus rhamnosus GG was demonstrated. Fecal AFB(1) excretion in GG-treated rats was increased via bacterial AFB(1) binding. Furthermore, AFB(1)-associated growth faltering and liver injury were alleviated with GG treatment. Hätönen, K. A., Similä, M. E., Virtamo, J. R., Eriksson, J. G., Hannila, M. L., Sinkko, H. K., Sundvall, J. E., Mykkänen, H. M. and Valsta, L. M. American Journal of Clinical Nutrition. 2006; 84(5): 1055-1061. Article. IF 5.853 Background: Methodologic choices affect measures of the glycemic index (GI). The effects on GI values of blood sampling site, reference food type, and the number of repeat tests have been insufficiently determined. Objective: The objective was to study the effect of methodologic choices on GI values. Comparisons were made between venous and capillary blood sampling and between glucose and white bread as the reference food. The number of tests needed for the reference food was assessed. Rye bread, oatmeal porridge, and instant mashed potato were used as the test foods. Design: Twelve healthy volunteers were served each test food once and both reference foods 3 times at 1-wk intervals in a random order after they had fasted overnight. Capillary and venous blood samples were drawn at intervals for 3 h after each study meal. Results: GIs and their CVs based on capillary samples were lower than those based on venous samples. Two tests of glucose solution as the reference provided stable capillary GIs for the test foods. The capillary GIs did not differ significantly when white bread was used as the reference 1, 2, or 3 times, but the variation was lower when tests were performed 2 and 3 times. Capillary GIs with white bread as the reference were 1.3 times as high as those with glucose as the reference. The capillary GIs of rye bread, oatmeal porridge, and mashed potato were 77, 74, and 80, respectively, with glucose as the reference. Conclusions: Capillary blood sampling should be used in the measurement of GI, and reference tests with glucose or white bread should be performed at least twice. Lehtinen, M., Kaasila, M., Pasanen, K., Patama, T., Palmroth, J., Laukkanen, P., Pukkala, E. and Koskela, P. International Journal of Cancer. 2006; 119(11): 2612-2619. Article. IF 4.700 Vaccines against high-risk (hr) human papillomaviruses (HPVs) causing cervical cancer may soon be licensed. Thus, nature of HPV epidemics needs to be studied now. Random sampling for studies on HPV epidemiology was done from all 230,998 women belonging to the population-based Finnish Maternity Cohort and having a minimum of 2 pregnancies between 1983 and 1994. First pregnancy serum specimens were retrieved for 7,805 subjects, and were analyzed for antibodies to HPV6/11, 16 and 18 with standard ELISAs. HPV16 seroprevalence almost doubled from the 1980s to the 1990s, and the epidemic spread to new areas in 23-31 year olds, i.e. the bulk of pregnant female population in the southwest part of the country. The HPV16 epidemic in the 14-22 year olds in 1983-1988 (1961-1974 birth cohorts) and in the 23-31 year olds in 1989-1994 (1958-1971 birth cohorts) overlapped with strong clustering of HPV16 and HPV18 infections in the latter (odds ratio 8.0, 95% confidence interval 6.6-9.7). Similar clustering of HPV16 and HPV6/11 infections was not found. The epidemic and the clustering may be due to high transmission probability of the hrHPV types and increase in sexual activity of the index birth cohorts. (c) 2006 Wiley-Liss, Inc. Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemio, K., Hämäläinen, H., Härkönen, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Mannelin, M., Paturi, M., Sundvall, J., Valle, T. T., Uusitupa, M. and Tuomilehto, J. Lancet. 2006; 368(9548): 1673-1679. Article. IF 23.878 Background Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, at least as long as the intervention continues. In the extended follow-up of the Finnish Diabetes Prevention Study, we assessed the extent to which the originally-achieved lifestyle changes and risk reduction remain after discontinuation of active counselling. Methods Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomly assigned to intensive lifestyle intervention or control group. After a median of 4 years of active intervention period, participants who were still free of diabetes were further followed up for a median of 3 years, with median total follow-up of 7 years. Diabetes incidence, bodyweight, physical activity and dietary intakes of fat, saturated fat, and fibre were measured. Findings During the total follow-up, the incidence of type 2 diabetes was 4.3 and 7.4 per 100 person-years in the intervention and control group, respectively (log-rank test p=0.0001), indicating 43% reduction in relative risk. The risk reduction was related to the success in achieving the intervention goals of weight loss, reduced intake of total and saturated fat and increased intake of dietary fibre, and increased physical activity. Beneficial lifestyle changes achieved by participants in the intervention group were maintained after the discontinuation of the intervention, and the corresponding incidence rates during the post-intervention follow-up were 4.6 and 7.2 (p=0.0401), indicating 36% reduction in relative risk. Interpretation Lifestyle intervention in people at high risk for type 2 diabetes resulted in sustained lifestyle changes and a reduction in diabetes incidence, which remained after the individual lifestyle counselling was stopped. Age is strongly associated with alexithymia in the general population Mattila, A. K., Salminen, J. K., Nummi, T. and Joukamaa, M. Journal of Psychosomatic Research. 2006; 61(5): 629-635. Article. IF 2.052 Objective: We studied the prevalence of alexithymia, its distribution in different age groups in a wide age range, its association with sociodemographic and health-related variables, and its co-occurrence with depression. Methods: The study forms part of the Health 2000 Study. The original sample comprised 8028 subjects representing the general adult population of Finland. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), and depression was measured with the 21-item Beck Depression Inventory. Altogether, 5454 participants filled in TAS-20 in their mother tongue. Results: The prevalence of alexithymia was 9.9%. Men (11.9%) were more commonly alexithymic than women (8.1%). Alexithymia was associated with mate gender, increasing age, low educational level, poor perceived health, and depression. Conclusions: The findings were in line with earlier population studies. For the first time, it was possible to analyze the prevalence of alexithymia in a wide age range (30-97 years). International comparative studies are needed. (c) 2006 Elsevier Inc. All rights reserved. Paldanius, M., Leinonen, M., Virkkunen, H., Tenkanen, L., Savykoski, T., Mänttäri, M. and Saikku, P. Diagnostic Microbiology and Infectious Disease. 2006; 56(3): 233-239. Article. IF 2.738 The lack of specific tests for the diagnosis of chronic Chlamydia pneumoniae infection has led to the use of enzyme immunoassay (EIA) instead of the gold standard, that is, microimmunofluorescence (MIF), in the measurement of C. pneumoniae antibodies. We assessed the predictive values of C. pneumoniae antibody levels and seroconversions measured by MIF and EIA for coronary events in the prospective Helsinki Heart Study. Sera from 239 cases with coronary events and 239 controls were available at the baseline and data from 210 cases and 211 controls before and, after the event. The agreement between MIF and EIA antibody levels was best in high antibody titers. In conditional logistic regression analysis, only high IgA MIF titers (>= 40) at the baseline predicted future coronary events, and the participants with MIF seroconversion between consecutive sera had a higher (nonsignificant) risk for coronary events than the controls. The difference in the kinetics of EIA and MIF antibodies demonstrated that MIF should remain the gold standard. (c) 2006 Elsevier Inc. All rights reserved. Treatment of anxiety disorders in the Finnish general population Sihvo, S., Hämäläinen, J., Kiviruusu, O., Pirkola, S. and Isometsä, E. Journal of Affective Disorders. 2006; 96(1-2): 31-38. Article. IF 3.078 Background: Treatments for anxiety disorders in the general population are not widely investigated. We determined the proportion, type and determinants of treatment in the Finnish general population. Methods: Within the Health 2000 Study, a representative sample (n = 6005) of adults (age > 30 years) were interviewed in 20002001 with the Composite International Diagnostic Interview (M-CIDI) to assess the presence of DSM-IV mental disorders during the preceding 12 months. Logistic regression models were used to examine factors influencing the type of treatment (phartnacotherapy and/or psychological treatment) and also the types of pharmacotherapy (antidepressants, anxiolytics, or sedatives and hypnotics) used for anxiety disorders. Results: For individuals with an anxiety disorder, 40% (95/229) currently used psychotropic medication, 23% (55/229) used antidepressants, 19% (44/229) anxiolytics and 17% (41/229) sedatives or hypnotics. Of those using health care services for mental health reasons (34%, 76/229), 80% (61/76) received pharmacotherapy. Only 45% (34/76) reported having psychological treatment, with few having more than 4 visits (27%, 20/76). Living in a semi-urban environment, retirement and high perceived disability increased the likelihood of pharmacotherapy-only treatment; higher education and comorbidity with mood disorders increased the likelihood of psychological treatment. General practitioners more often than psychiatrists provided pharmacotherapy treatment alone (67% vs. 34%, p < 0.05), particularly anxiolytics or sedatives. Limitations: Use of mental health services and psychological treatment were based on self-reports. No data on duration of pharmacotherapy was available. Conclusions: Anxiety disorders remain largely untreated in the general population. Among those seeking treatment, pharmacotherapy predominates, whereas even brief psychotherapies are rare. Contrary to clinical guidelines, anxiolytics and sedatives are commonly used instead of antidepressants. (c) 2006 Elsevier B.V. All rights reserved. Chemical composition and mass closure of particulate matter at six urban sites in Europe Sillanpää, M., Hillamo, R., Saarikoski, S., Frey, A., Pennanen, A., Makkonen, U., Spolnik, Z., Van Grieken, R., Branis, M., Brunekreef, B., Chalbot, M. C., Kuhlbusch, T., Sunyer, J., Kerminen, V. M., Kulmala, M. and Salonen, R. O. Atmospheric Environment. 2006; 40: S212-S223. Article. IF 2.724 The chemical composition of fine (PM2.5) and coarse (PM2.5-10) particulate matter was investigated in 7-week field campaigns of contrasting air pollution at six urban background sites in Europe. The campaigns were scheduled to include seasons of local public health concern due to high particulate concentrations or findings in previously conducted epidemiological studies. The sampling campaigns were carried out as follows: Duisburg/Germany October-November 2002 (autumn), Prague/Czech Republic November 2002-January 2003 (winter), Amsterdam/Netherlands January-March 2003 (winter), Helsinki/Finland March-May 2003 (spring), Barcelona/Spain March-May 2003 (spring) and Athens/ Greece June-July 2003 (summer). Aerosol samples were collected in 3 + 4-day periods per week (N = 14) using two identical virtual impactors (VI). All the filter samples were analysed with the same instruments to obtain particulate mass, inorganic ions, total and watersoluble elements, and elemental and organic carbon content. The campaign means Of PM2.5 and PM2.5-10 ranged from 8.3 to 30 and 5.4 to 29 mu g M-3, respectively. The "wet and cool" seasons favoured a low coarseto-fine particulate mass ratio (< 1), whereas the ratio was high (< 1) during the warmer and drier spring and summer campaigns. According to chemical mass closure, the major components in PM2.5 were carbonaceous compounds (organic matter+ elemental carbon), secondary inorganic ions and sea salt, whereas those in PM2.5-10 were soil-derived compounds, carbonaceous compounds, sea salt and nitrate. The major and minor components together accounted for 79-106% and 77-96% of the gravimetrically measured PM2.5 and PM2.5-10 mass, respectively. In conclusion, the measured PM2.5 and PM2.5-10 in the campaigns could be reconstructed to a large extent with the help of harmonized particulate sampling and analysis of the selected chemical constituents. The health significance of the observed differences in chemical composition and emission sources between the size-segregated particulate samples will be investigated in toxicological cell and animal studies. (c) 2006 Elsevier Ltd. All rights reserved. Cardiovascular risk in midlife and psychological well-being among older men Strandberg, T. E., Strandberg, A. Y., Pitkälä, K. H., Salomaa, V. V., Tilvis, R. S. and Miettinen, T. A. Archives of Internal Medicine. 2006; 166(20): 2266-2271. Article. IF 8.016 Background: Negative and positive affects influence the prognosis in the elderly, but underlying mechanisms are obscure. We investigated whether cardiovascular disease risk in midlife is related to psychological wellbeing in older men (aged 69-84 years old). Methods: A socioeconomically homogeneous volunteer sample of men, born from 1919 through 1934, was followed up for 29 years. At baseline in 1974, they were healthy but considered to be at low (n= 593) or high (n=610) risk of cardiovascular diseases (repeatedly 1 or more of classic cardiovascular risk factors). From November 1, 2002, through March 31, 2003, a mailed questionnaire was used to assess psychological well-being in older survivors. Mortality up to December 31, 2002, was retrieved from national registers. Results: During the entire follow-up, 303 men died, 127 ( 21.4%) and 176 (28.9%) in the low-and high-risk groups, respectively ( hazard ratio, 1.54; 95% confidence interval, 1.19-2.00; P=.001). From 2002 through 2003, the response rates were 73.7% (336/456) and 71.4% (297/416) in the low-and high-risk groups, respectively (P=.45), and the mean age was 76 years. The variables related to psychological well-being were consistently better in the low-risk than in the high-risk group as they became older. The differences were observed especially in life satisfaction (P=. 02), feeling of happiness (P=. 001), positive life orientation as a whole (P=. 04), and the Zung depression score (P=. 007). The difference in the feeling of happiness between the groups prevailed (P=. 01) after adjustments, including the feeling of depression. Conclusion: Low cardiovascular risk in midlife was associated not only with better survival but also with better psychological well-being in the elderly. Tiittanen, M., Huupponen, J. T., Knip, M. and Vaarala, O. Diabetes. 2006; 55(12): 3446-54. IF 8.848 Patients with type 1 diabetes are treated with daily injections of human insulin, an autoantigen expressed in thymus. Natural CD4+CD25(high) regulatory T-cells are derived from thymus, and accordingly human insulin-specific regulatory T-cells should exist. We had a chance to study peripheral blood mononuclear cells (PBMCs) from children with type 1 diabetes both before and after starting insulin treatment, and thus we could analyze the effects of insulin treatment on regulatory T-cells in children with type 1 diabetes. PBMCs were stimulated for 72 h with bovine/human insulin. The mRNA expression of regulatory T-cell markers (transforming growth factor-beta, Foxp3, cytotoxic T-lymphocyte antigen-4 [CTLA-4], and inducible co-stimulator [ICOS]) or cytokines (gamma-interferon [IFN-gamma], interleukin [IL]-5, IL-4) was measured by quantitative RT-PCR. The secretion of IFN-gamma, IL-2, IL-4, IL-5, and IL-10 was also studied. The expression of Foxp3, CTLA-4, and ICOS mRNAs in PBMCs stimulated with bovine or human insulin was higher in patients on insulin treatment than in patients studied before starting insulin treatment. The insulin-induced Foxp3 protein expression in CD4+CD25(high) cells was detectable in flow cytometry. No differences were seen in cytokine activation between the patient groups. Insulin stimulation in vitro induced increased expression of regulatory T-cell markers, Foxp3, CTLA-4, and ICOS only in patients treated with insulin, suggesting that treatment with human insulin activates insulin-specific regulatory T-cells in children with newly diagnosed type 1 diabetes. This effect of the exogenous autoantigen could explain the difficulties to detect in vitro T-cell proliferation responses to insulin in newly diagnosed patients. Furthermore, autoantigen treatment-induced activation of regulatory T-cells may contribute to the clinical remission of the disease. Vaarala, O. Ann N Y Acad Sci. 2006; 1079: 350-9. IF 1.971 In humans the primary trigger of insulin-specific immunity is a modified self-antigen, that is, dietary bovine insulin, which breaks neonatal tolerance to self-insulin. The immune response induced by bovine insulin spreads to react with human insulin. This primary immune response induced in the gut immune system is regulated by the mechanisms of oral tolerance. Genetic factors and environmental factors, such as the gut microflora, breast milk-derived factors, and enteral infections, control the development of oral tolerance. The age of host modifies the immune response to oral antigens because the permeability of the gut decreases with age and mucosal immune response, such as IgA response, develops with age. The factors that control the function of the gut immune system may either be protective from autoimmunity by supporting tolerance, or they may induce autoimmunity by abating tolerance to dietary insulin. There is accumulating evidence that the intestinal immune system is aberrant in children with type 1 diabetes (T1D). Intestinal immune activation and increased gut permeability are associated with T1D. These aberrancies may be responsible for the impaired control of tolerance to dietary insulin. Later in life, factors that activate insulin-specific immune cells derived from the gut may switch the response toward cytotoxic immunity. Viruses, which infect beta cells, may release autoantigens and potentiate their presentation by an infection-associated "danger signal." This kind of secondary immunization may cause functional changes in the dietary insulin primed immune cells, and lead to the infiltration of insulin-reactive T cells to the pancreatic islets. Webb, K. L., Lahti-Koski, M., Rutishauser, I., Hector, D. J., Knezevic, N., Gill, T., Peat, J. K. and Leeder, S. R. Public Health Nutr. 2006; 9(8): 1035-44. IF 1.918 Objective: This study evaluates the contribution of energy-dense, nutrient-poor 'extra' foods to the diets of 16-24-month-old children from western Sydney, Australia. Design: An analysis of cross-sectional data collected on participants in the Childhood Asthma Prevention Study (CAPS), a randomised trial investigating the primary prevention of asthma from birth to 5 years. We collected 3-day weighed food records, calculated nutrient intakes, classified recorded foods into major food groups, and further classified foods as either 'core' or 'extras' according to the Australian Guide to Healthy Eating. Setting: Pregnant women, whose unborn child was at risk of developing asthma because of a family history, were recruited from all six hospitals in western Sydney, Australia. Data for this study were collected in clinic visits and at participants' homes at the 18-month assessment. Participants: Four hundred and twenty-nine children participating in the CAPS study; 80% of the total cohort. Results: The mean consumption of 'extra' foods was approximately 150 g day(-1) and contributed 25-30% of the total energy, fat, carbohydrate and sodium to the diets of the study children. 'Extra' foods also contributed around 20% of fibre, 10% of protein and zinc, and about 5% of calcium. Children in the highest quintile of 'extra' foods intake had a slightly higher but not significantly different intake of energy from those in the lowest quintile. However, significant differences were evident for the percentage of energy provided by carbohydrate and sugars (higher) and protein and saturated fat (lower). The intake of most micronutrients was also significantly lower among children in the highest quintile of consumption. The intake of 'extra' foods was inversely associated with the intake of core foods. Conclusions: The high percentage of energy contributed by 'extra' foods and their negative association with nutrient density emphasise the need for dietary guidance for parents of children aged 1-2 years. These preliminary data on commonly consumed 'extra' foods and portion sizes may inform age-specific dietary assessment methods. Wright, M. E., Lawson, K. A., Weinstein, S. J., Pietinen, P., Taylor, P. R., Virtamo, J. and Albanes, D. American Journal of Clinical Nutrition. 2006; 84(5): 1200-1207. Article. IF 5.853 Background: A meta-analysis of 19 trials suggested a small increase in the risk of all-cause mortality with high-dose vitamin E supplementation. Little is known, however, about the relation between mortality and circulating concentrations of vitamin E resulting from dietary intake, low-dose supplementation, or both. Objective: We examined whether baseline serum a-tocopherol concentrations are associated with total and cause-specific mortality. Design: A prospective cohort study of 29 092 Finnish male smokers aged 50-69 y who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study was carried out. Fasting serum a-tocopherol was measured at baseline by using HPLC. Only 10% of participants reported vitamin E supplement use at baseline, and thus serum concentrations of vitamin E mainly reflected dietary intake and other host factors. Risks of total and cause-specific mortality were estimated by using proportional hazards models. Results: During up to 19 y of follow-up, 13 380 deaths (including 4518 and 5776 due to cancer and cardiovascular disease, respectively) were identified. Men in the higher quintiles of serum a-tocopherol had significantly lower risks of total and cause-specific mortality than did those in the lowest quintile [relative risk (RR) = 0.82 (95% CI: 0.78, 0.86) for total mortality and 0.79 (0.72, 0.86), 0.81 (0.75, 0.88), and 0.70 (0.63, 0.79) for deaths due to cancer, cardiovascular disease, and other causes, respectively; P for trend for all < 0.0001]. Cubic regression spline analysis of continuous serum a-tocopherol values indicated greater risk reductions with increasing concentrations up to approximate to 13-14 mg/L, after which no further benefit was noted. Conclusion: Higher circulating concentrations of a-tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers. |