To study the association between alcohol consumption and risk of benign proliferative epithelial disorders (BPED) of the breast (conditions which are thought to have premalignant potential).

Case–cohort study.

The study was undertaken within the 56, 537 women in the Canadian National Breast Screening Study (NBSS) who completed self-administered dietary questionnaires. (The NBSS is a randomized controlled trial of screening for breast cancer in women aged 40–59 years at recruitment.)

The study subjects were the 657 women in the dietary cohort who were diagnosed with biopsy-confirmed incident BPED. For comparative purposes, a subcohort consisting of a random sample of 5681 women was selected from the full dietary cohort. After exclusions for various reasons, the analyses were based on 557 cases and 5028 non-cases.

When compared to non-drinkers, rate ratios (95%CI) for those consuming >0 and ≤10 g of ethanol day−1,>10 and≤20 g day−1, >20 and ≤30 g day1 and >30 g day1 were 0.35(0.27–0.45), 0.26(0.18–0.39), 0.29(0.18–0.48), and 0.23(0.13–0.40), respectively (the associated P value for the trend was 0.089). Similar findings were obtained from analyses conducted separately in the screened and control arms of the NBSS, in premenopausal and postmenopausal women, and for non-atypical and atypical forms of BPED, and there was little difference between the results for screen-detected and interval-detected BPED.

Alcohol consumption was associated with a non-dose-dependent reduction in risk of BPED

To determine the role of fruit and vegetable consumption and dietary intake of folic acid and related nutrients such as methionine, cysteine and alcohol in the aetiology of breast cancer.

Population based case-control study.

Part of the European Community Multicentre Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast (EURAMIC) in Berlin, Germany.

As part of the EURAMIC study, dietary intake data were collected in 43 postmenopausal women diagnosed with breast cancer between 191 and 1992 in Berlin, Germany, and compared to 106 population-based controls.

Odds ratios (ORs) adjusted for major risk factors of breast cancer but not for total energy intake showed a non-significant inverse association between a high intake of vegetables (OR=0.76, 95% CI=0.48–1.20) and fruits (OR=0.74, 95% CI=0.48–1.15) and breast cancer. Once results were adjusted for total energy intake the associations became much weaker (vegetables: OR=0.86, 95% CI=0.51–1.46; fruits: OR=0.82, 95% CI=0.51–1.32). For all nutrients, the effect of energy adjustment was more profound and the inverse associations disappeared when results were adjusted for energy intake (total folate—not energy adjusted: OR=0.79, 95% CI=O.51–1.21; energy adjusted: OR=1.14, 95% CI=0.73–1.79; folate equivalents-not energy adjusted: OR=0.81, 95% CI= 0.53–1.23; energy adjusted: OR=1.16, 95% CI=0.78–1.74; methionine—not energy adjusted: OR=0.60, 95% CI=0.35–1.03; energy adjusted: OR=1.29, 95% CI=0.76–2.19; cysteine—not energy adjusted: OR=0.52, 95% CI=0.29–0.94; energy adjusted: OR=1.22, 95% CI=0.75–1.97). Alcohol intake was inversely associated with breast cancer in a non-significant way, possibly due to the relatively low alcohol intake of the study population.

The results of this study do not provide firm evidence that a high intake of fruits and vegetables, folic acid, methionine or cysteine reduces the risk of getting breast cancer.

To examine the relationships between alcohol consumption and a range of nutrient intakes and blood status indices in older people.

National Diet and Nutrition Survey: cross-sectional survey of nationally representative sample of people aged 65 years or over.

Mainland Britain during 1994/5.

1198 people (623 males, 575 females) aged 65 years or over, of whom 925 were living in private households and 273 were living in institutions.

Intermediate alcohol consumption (particularly 0.1–14 units week−1; 1 unit = 8g) derived from a 4-day diet diary or a 12-month recall questionnaire, was associated with higher intakes of vitamins C, E, B1, iron, calcium, energy from food, carbohydrate and non-starch polysaccharides than heavy alcohol consumption (28 + units week−1) or abstinence, after adjustment for a number of factors (age, sex, domicile, social class, cigarette smoking, self-reported health, grip strength and total energy intake). Intermediate alcohol consumption was also associated with higher blood concentrations (independent of intake) of vitamin C, β-cryptoxanthin, lutein and calcium, with the lowest concentrations being found in heavy alcohol users. The lowest concentrations of serum ferritin were found in light drinkers and the highest levels in heavier alcohol drinkers. Alcohol consumption ranging from 0.1 to > 28 units week−1 was directly correlated with intakes of B vitamins, total energy and fat, with blood concentrations (independent of intake) of lycopene. high density lipoprotein (HDL)-cholesterol, plasma pyridoxal phosphate and retinol, and with blood pressure and grip strength.

Compared with abstinence and heavy drinking, light to moderate alcohol consumption in older people is associated with higher intakes of certain nutrients, and higher blood concentrations (independent of intake) of some micronutrient status indices, including antioxidants. The explanation for the latter associations remains unclear and further investigation is recommended. Heavier alcohol consumption is associated with both beneficial and adverse effects with respect to nutrient intakes and health status.

To describe the distribution of plasma fibrinogen and relationships with other risk factors for coronary heart disease (CHD) and stroke in the black population of the Cape Peninsula.

A cross-sectional survey of a stratified proportional sample of randomly selected black men and women.

Households in Gugulethu, Langa, Nyanga, New Crossroads, KTC, Old Crossroads and Khayelitsha in the Cape Peninsula, South Africa.

One subject per household (352 men and 447 women), aged 15–64 years, voluntarily participated. Visitors, pregnant, lactating, ill, mentally retarded and intoxicated subjects were excluded.

Mean fibrinogen (thrombin time coagulation method) of men and women were higher than published data for Europeans but slightly lower than values of black Americans. Women aged 45–54 years had the highest level (3.13 ± 0.89g1−1) and men aged 15–24 years had the lowest (2.13 ± 0.88g1−1). Fifteen per cent of the men and 12% of the women had a level greater than 1 standard deviation of the mean for their age group. Univariate and multivariate analyses revealed significant (P< 0.05) positive correlations of fibrinogen with smoking habit, age, body mass index (BMI), total and low-density lipoprotein (LDL) cholesterol, triglycerides, blood pressure and white blood cell count, and significant negative correlations with high-density lipoprotein (HDL) cholesterol, gamma glutamyl transferase (GGT), serum iron and ferritin. The correlations with BMI, serum lipoproteins, iron, ferritin, and GGT suggest that nutritional status and therefore diet influences plasma fibrinogen.

Relatively high fibrinogen levels, tending to cluster with other, including diet-related, risk factors for CHD and stroke, were observed in black South Africans. It is suggested that fibrinogen may contribute to the high stroke incidence of this population group.

We examined whether or not the effect of elevated blood lead levels on children's psychomotor development was modified by their nutritional status.

Anthropometry, developmental quotients (DQs), blood lead levels and haemoglobin were measured in lead exposed and unexposed children with different levels of nutritional status. Social background and maternal height and verbal intelligence were also measured. Testers, anthropometrists and interviewers established reliabilities with a trainer before the study began.

Children were from two suburban areas in Kingston, Jamaica. All measurements on the children were carried out at a research unit. Social background and maternal measurements were carried out at the children's homes.

The exposed group comprised 58 children (3–6 years) attending the same preschool which was situated in a lead contaminated environment. The unexposed group comprised 53 children attending a nearby preschool without lead contamination.

The exposed children had significantly higher blood lead levels and lower DQs, and their homes had poorer facilities than the unexposed children. The deficit in DQ was greater (10.6 points) among children with weight for height less than –1 SD (National Center for Health Statistics references) than among better nourished Children (2 points).

Undernourished children exposed to lead may have more serious developmental deficits than better nourished children.

Qualitative case study and mathematical model.

Belgium.

To evaluate the correlation between the polyamine mean concentration of the milk drunk during the first postnatal month and the appearance of allergy in children who drank this milk.

A model that describes the dependence of the allergy appearance with the spermine mean concentration of milk drunk during the first postnatal month was established.

This model shows that 5.02 nmol ml−1 of spermine is a critical value to prevent the appearance of allergy.

Dietary surveys are a valuable tool in nutrition surveillance programmes to monitor the nutritional status of a group or population of a country. The objective of this study was to assess the food consumption pattern in the adult population of the Basque Country (Spain).

A cross-sectional nutritional survey was carried out in 1990. Dietary habits were assessed by means of ‘24-h recall’ during 3 non-consecutive days and a food frequency questionnaire.

Population survey in the Basque Country (Spain).

Random sample of the adult population (25–60 years) in the Basque Country (n=2348).

Results draw a food pattern characterized by a high consumption of meat, 163±3.04 g day−1 (mean±SEM), supplied mainly by poultry, butchery products, veal and fish (88±2.68 g day−1). The average consumption of milk and dairy products was 359±5.19 g day−1, although 39% of the sample did consume less than 2 portions from this group of foods daily. Olive oil was the most widely used fat for cooking (4i%), followed by sunflower seed oil (30%). Cereals supplied 21.5% of the average energy intake and the consumption of vegetables and garden products was 159±3.13 g day−1. Only 29% of the group usually had 2 or more portions of vegetables per day. Women consumed higher amounts of chocolate, cookies, sweets and coffee (P < 0.01) than men. Younger adults consumed more meat (P < 0.01), while the older community consumed more fish, vegetables and fruit (P < 0.01). More highly educated people consumed more dairy products, vegetables and butter (P < 0.01). Conversely, less educated people consumed higher amounts of olive oil, pulses and bread (P < 0.01).

The dietary pattern observed in the Basque Country, although in keeping with its traditions, is in harmony with the actual dietary trends in Mediterranean countries. In order to satisfy the dietary guidelines suggested by the Spanish Society of Community Nutrition, it would be desirable to gradually increase the consumption of vegetables, fresh garden produce, fruit and cereals. At the same time, it would be advisable to decrease the consumption of animal products (whole fat dairy products, meat, added fats) so the proportion of energy intake from fat can be reduced by 5% (3% from saturated fatty acids).

This study explores the factors that influence eating patterns in a nationally representative sample of the English population.

Subjects were interviewed in 1993; questions covered basic demographic details, attitudes about nutrition, and they completed a short food frequency questionnaire that had previously been validated. Cluster analysis was used to summarize dietary intake into more or less healthy clusters.

A random sample ofthe English population.

A cross-sectional survey of 5553 men and women (response rate 70%) aged between 16 and 74 years.

As defined from the cluster analysis about half the sample were currently reporting a more healthy diet; respondents in the better educated middle-aged demographic cluster were more likely to report eating a more healthy diet than respondents in the younger lower-income family cluster. About three-quarters of all respondents believed that they either already ate a healthy diet or had changed to a healthy diet in the last 3 years. For those respondents who said they were eating a healthy diet about half of them were eating a more healthy diet. Respondents who had not changed their diet were more likely than those who had to believe that healthy foods were just another fashion (men 34% v. 13%; women 30% v. 12%). or expensive (men 50% v. 35%; women 53% v. 40%); they were less likely to care about what they ate (men 45% v. 13%; women 27% v. 7%). Nearly three-quarters of all respondents agreed that experts never agree about what foods are good for you. Younger, low-income families, and those who smoked, were the group least likely to be eating a more healthy diet.

The results of this study suggest that about half of the population has reported a change to a healthier diet over the last 3 years and that overall about half of the population report eating a healthy diet. Those who had not made any change and were currently reporting a less healthy diet were more likely to smoke and come from the 'worse off' group in the survey; they were also more likely to hold negative attitudes about healthy eating. A more focused and integrated approach to promoting Dietary change healthy lifestyle in general is required, while at the same time ensuring that there is healthy eating continued support for the majority of the population who have made healthy dietary Cluster analysis changes.

To validate a dietary assessment method, a 4-day food record together with a duplicate portion technique, with biological markers for food intake.

Four days of duplicate portions were collected in parallel with food recording. A 24-h urine sample and the faeces corresponding to the food intake (using a coloured marker) were collected. Completeness of urine and faeces collections was assessed using para-aminobenzoic acid (PABA) in urine and cadmium in faeces, respectively. Biomarkers of food intake (energy, protein, fibre, sodium, potassium, calcium) were measured in urine and faeces.

Swedish west coast.

Non-smoking Swedish women, 20–50 years of age, consuming a mixed diet (n=34), a mixed diet rich in shellfish (n=17) or a vegetarian/high-fibre diet (n=23).

The average ratio (food intake according to the dietary assessment methods/biological marker) for protein, sodium, potassium and calcium was 0.86. This indicates an underestimation of the food intake by approximately 15%. The ratio of stated fibre intake to biological marker was 1.20 for the mixed diet and the vegetarian diet group, indicating an overestimation by approximately 20%.

The underestimation of the intake of protein, sodium, potassium and calcium by all three groups and the overestimation of the fibre intake by two groups indicate that underreporting is selective to certain nutrients and foods and to various groups of people. The two dependent dietary assessment methods were equally good in measuring protein intake, which indicates that the women recorded what they actually duplicated.

In the vast majority of surveys and research in humans, dietary data are obtained from self-reports: recalls; records; or historical methods, usually food frequency questionnaires (FFQ). This study provides a rare opportunity to compare data derived from all three methods.

A crossover study of dietary fat in which data were collected using an average of 11.4 food records and 11.7 24-h diet recalls. Using simple subtraction and correlation, energy and nutrient intakes derived from the three methods were compared to each other and with those derived from a single FFQ. Analysis of variance was used to evaluate sources of variability in nutrient intakes estimated from the individual days of records and recalls.

An independent, free-standing medical research institute.

13 men who were compliant with study procedures.

FFQ-derived estimates of energy and nutrient intake were highest (e.g. 1967 kcal versus 1858 kcal and 1936 kcal for the records and recalls, respectively). Mean differences in energy and nutrient intakes and their variances were lowest and correlation coefficients highest in comparing the records and recalls (e.g. for fat the mean difference was 5.0 g, and r=0.85). Analysis of variance of individual days of record- and recall-derived datd (n=300) revealed that there was no effect due to either method (record or recall) or the sequence of administration.

Results of this study indicate that the FFQ overestimated dietary intake. Energy and nutrient results obtained from the records and recalls were interchangeable. However, based on smaller SDs around the means, it appears that the recalls may perform slightly better in estimating dietary intake in groups such as these well-educated, highly compliant men.