Enhancing data on nutrient composition of foods eaten by participants in the INTERMAP study in China, Japan, the United Kingdom, and the United States.

The International Study of Macronutrients and Blood Pressure (INTERMAP) is a four-country study investigating relationships between individual dietary intakes and blood pressure. Dietary intake patterns of individuals were estimated for macronutrients (proteins, lipids, carbohydrates, alcohol) and their components (amino acids, fatty acids, starch), as well as minerals, vitamins, caffeine, and dietary fiber. The dietary assessment phase of the study involved collection of four 24-h recalls and two 24-h urine specimens from each of 4680 adults, ages 40-59, at 16 centers located in the People's Republic of China, Japan, the United Kingdom and the United States.

Development and reproducibility of a brief food frequency questionnaire for assessing the fat, fiber, and fruit and vegetable intakes of rural adolescents.

Objective: To describe the systematic development and reproducibility of a food frequency questionnaire (FFQ) designed to meet the specific research requirements of the Goals for Health cancer prevention intervention program for rural middle school children.

Design: A 4-step process was used to develop a brief FFQ for scoring intakes of total fat, fiber, and fruits and vegetables. The resulting questionnaire consisted of 25 food frequency items and 10 supplemental questions.

Methods of dietary and nutritional assessment and intervention and other methods in the Multiple Risk Factor Intervention Trial.

Various dietary assessment instruments were used in the Multiple Risk Factor Intervention Trial (MRFIT), either to assist with the special intervention program or to assess trial outcomes. For the latter purpose, the 24-h recall was the main method and was selected with the understanding that the single recall collected at baseline and at most annual visits--considered by itself--would be useful mainly for assessing groups rather than individuals. Major components of the data collection and analysis system developed for the 24-h recall included central training and certification of nutritionists, a central nutrient coding system, and a food grouping system to assist interventionists in using recall data for counseling.

Monitoring dietary change in a low-fat diet intervention study: advantages of using 24-hour dietary recalls vs food records.

Objective: The purpose of the study was to evaluate two methods of dietary assessment for monitoring change in fat intake in a low-fat diet intervention study.

Design: The two dietary assessment methods were a 4-day food record (4DFR) and an unannounced 24-hour dietary recall conducted by telephone interview (referred to as a telephone recall [TR]). Subjects were assigned randomly to either a low-fat diet intervention group or a control group that received no counseling about fat intake.

A food frequency questionnaire can detect pregnancy-related changes in diet.

Objective: To determine whether a food frequency questionnaire (FFQ) can detect changes in dietary intake before pregnancy to mid-pregnancy relative to a 4-day food record.

Design: FFQs and 4-day, weighed food records (4DRs) were completed during similar time intervals before pregnancy and again near mid-pregnancy by women served by a large health maintenance organization in the Minneapolis-St Paul, Minn, area. The outcome of interest was change in the intake of energy and 16 nutrients.

Reproducibility of a comprehensive diet history in the Diabetes Control and Complications Trial. The DCCT Research Group.

Objective: To evaluate the reproducibility of a modified Burke-type diet history within the context of a long-term, randomized, 29-center clinical diabetes study.

Design: Diet histories were collected by trained interviewers at the end of years 1 and 2 after subjects were randomly assigned to the intensive treatment group or the conventional treatment group. Mean daily intakes of energy, protein, carbohydrate, total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol, and dietary fiber were calculated for each treatment group at each time period.

Research priorities and recommendations for dietary assessment methodology. First International Conference on Dietary Assessment Methods.

A list of research priorities related to dietary assessment methodology is presented. The priorities are based on a consensus of opinion by a multidisciplinary international group of experts who participated in the First International Conference on Dietary Assessment Methods. These experts included researchers in dietary assessment methodology, major users of dietary assessment methods, and policymakers involved in setting food and nutrition policies.

Rationale for an international conference series on dietary assessment methods.

The rationale for establishing an international conference series on dietary assessment methods is based on the needs expressed by numerous national and international organizations for better methods of collecting and analyzing dietary data. Dietary assessment is essential for investigating diet-health relationships, formulating policies to reduce health risks, predicting the adequacy of the food supply, and monitoring trends in food use, exposure to contaminants, and compliance with dietary guidelines. The conference rationale is discussed with respect to 1) the need for improved methods to enhance our understanding of diet-health relationships, 2) the need for better methods to facilitate development and monitoring of nutrition-related health objectives, and 3) the importance of international participation.

Adherence to a dietary fat intake reduction program in postmenopausal women receiving therapy for early breast cancer. The Women's Intervention Nutrition Study.

Purpose: To evaluate the feasibility of integrating a program based on dietary fat intake reduction into adjuvant treatment strategies for postmenopausal women receiving therapy for early breast cancer.

Patients And Methods: Two hundred ninety postmenopausal women with localized (stage I to IIIa) breast cancer receiving conventional systemic therapy provided informed consent and were randomized in a multicenter trial to either a dietary intervention group receiving a program of individualized instruction for reducing total fat intake or a dietary control group with minimal dietary counseling.

Results: Significantly reduced (P < .

The effects of a low-fat dietary intervention and tamoxifen adjuvant therapy on the serum estrogen and sex hormone-binding globulin concentrations of postmenopausal breast cancer patients.

The purpose of the study was to determine the effect of a low-fat dietary intervention, with or without concomitant tamoxifen adjuvant therapy, on serum estrogen and sex hormone-binding globulin (SHBG) levels in postmenopausal patients with resected breast cancer. Ninety-three patients were randomized to either reduce their fat intake to 15-20% of total calories, or to a dietary control group. Serum estradiol, estrone, estrone sulfate, and SHBG concentrations were assayed at baseline, and at 6, 12, and 18 months thereafter.

Adjuvant dietary fat intake reduction in postmenopausal breast cancer patient management. The Women's Intervention Nutrition Study (WINS).

Management of localized breast cancer now commonly involves a breast-sparing approach combined with systemic adjuvant therapy resulting in improved cosmetic results and patient survival. Reducing dietary fat intake represents a conceptually new approach to further improve outcome of patients with resected breast cancer. The rationale supporting evaluation of dietary fat reduction in the management of patients with localized breast cancer is based on: (1) epidemiologic observations (along with biochemical and hormonal correlates) of major differences in stage-by-stage survival of patients with localized breast cancer comparing outcome in countries with low fat (Japan) versus high fat (U.

Considerations for selecting nutrient-calculation software: evaluation of the nutrient database.

With the growing number of nutrient-calculation software packages on the market, potential users are faced with the increasingly difficult task of determining which system best meets their needs. Most published reviews of nutrient-calculation software focus on program features rather than on the quality of the nutrient database on which all calculations are based. This is unfortunate because program features are of little consequence if the nutrients calculated are not of acceptable quality.

Videotape dietary assessment: validity, reliability, and comparison of results with 24-hour dietary recalls from elderly women in a retirement home.

The validity and reliability of a videotape method for quantifying food intake were tested, and results of the method were compared with results obtained from 24-hour dietary recalls. Participants were 37 elderly Catholic nuns (aged 81.8 +/- 4.

Diet intervention methods to reduce fat intake: nutrient and food group composition of self-selected low-fat diets.

A multicentered pilot study was conducted to test an intervention protocol designed to reduce fat intake to 15% of energy intake. Eligible subjects were postmenopausal women with stage II breast cancer whose baseline fat intake was more than 30% of energy intake. The low-fat diet intervention protocol consisted of bi-weekly individual counseling sessions with emphasis on substitution of lower-fat foods for high-fat foods and maintenance of nutritional adequacy.

Unpublished Data Summaries and the design and conduct of clinical trials. The Nutrition Adjuvant Study experience and commentary.

A trend in cancer clinical investigation has been the application of new analytic techniques and reporting forums to summarize developing trial results. Examples include: Consensus Conferences, Meta-Analyses, and most recently (in the breast cancer area), the "Clinical Alert." These Unpublished Data Summaries have been widely disseminated in lay and scientific communities and have frequently engendered debate conducted in the absence of primary information.

Maintenance of a nutrient database for clinical trials.

Maintenance of a nutrient database for use in dietary analysis for clinical trials and other medical research studies is described. The database, maintained at the University of Minnesota's Nutrition Coordinating Center (NCC), has been used to calculate dietary intake data for a wide range of diet-disease related investigations including studies on cardiovascular disease, hypertension, cancer, gastroenterology, and osteoporosis. Potential sources of error associated with nutrient databases are identified.

Computerized collection and analysis of dietary intake information.

A computer system has been developed which facilitates standardized and in-depth collection and analysis of dietary intake information required for nutritional research. The system uses a hierarchically arranged database of food descriptions. A user identifies a consumed food by traversing a hierarchy and reaching a leaf node food item via a succession of selections from menu displays.

Sources of data for developing and maintaining a nutrient database.

A nutrient database that contains current, reliable data is a prerequisite for accurate calculation of dietary intakes. Most nutrient databases are expanded from data supplied by the U.S.

Comparison of a computerized and a manual method of food coding for nutrient intake studies.

The Dietary Data Collection (DDC) microcomputer system is currently being developed as a tool for the standardized and detailed collection of dietary intake data for human nutrition research studies. The system operates interactively, soliciting all necessary information on menu selection screens to ensure user entry of complete food descriptions and quantity information. The descriptive data are then automatically converted to food codes and gram weights for subsequent calculation of nutrient content.

A breast cancer Nutrition Adjuvant Study (NAS): protocol design and initial patient adherence.

To evaluate the feasibility of using a reduction in dietary fat intake as a component of treatment regimens for patients with resected breast cancer, a multi-disciplinary cooperative group protocol was developed. Females 50 to 75 years of age with stage II breast cancer who completed primary local therapy were eligible for randomization to a Control Dietary Group in which dietary fat intake was to remain unchanged from baseline level (at approximately 38% of calories derived from fat) and an Intensive Intervention Dietary Group designed to reduce dietary fat intake. Both Dietary Groups were given tamoxifen 20 mg/day.

Birth weight and placental proximity in like-sexed twins.

In addition to zygosity, the type of placentation has proven to be an important variable in twin studies. A number of quantitative traits in human twins have been found to be influenced by chorion type. Our study confirms an earlier finding that there is larger within-pair birth weight variability in dichorionic twins with fused placentas than in those with separate placentas.

Effect of dietary eggs and ascorbic acid on plasma lipid and lipoprotein cholesterol levels in healthy young men.

The effects on plasma lipid levels of increased ingestion of whole eggs and of ascorbic acid (AA) were investigated in 40 healthy, free-living men, aged 21 to 35 yr. Ten subjects were assigned to each of four groups which included the following regimens in combination with the usual daily diet: EGGS group, 3 eggs + placebo; AA group, 2 g ascorbic acid; EG AA group, 3 eggs + 2 g ascorbic acid; CONTROL group, placebo only. Fasting blood was sampled at 2-wk intervals during a 6-wk experimental period and during a 4-wk postexperimental period.