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To determine the prevalence of, and identify associated factors with, overweight and obesity in two samples of French children.
Design
We conducted two cross-sectional studies among two samples of children. Weight status, eating behaviour, sedentary activity, physical activity and parents’ socio-economic status (SES) were collected using questionnaires filled by doctors during school health check-ups. Overweight and obesity were defined according to the age- and sex-specific BMI cut-off points of the International Obesity Taskforce. Multivariate analysis (logistic regression) was used to identify independent factors associated with overweight including obesity and obesity alone.
Setting
Aquitaine region (south-west France).
Subjects
Analyses were conducted among children aged 5–7 years (n 4048) and 7–11 years (n 3619).
Results
Overweight prevalence was 9·5 % including 2·2 % of obesity in 5–7-year-old children and 15·6 % including 2·9 % of obesity in 7–11-year-old children. In both samples, overweight and obesity prevalence were higher in children whose parents had low or medium SES (P < 0·05). Factors associated significantly (P < 0·05) and independently with higher overweight or obesity prevalence were female gender, low or medium parental SES, never or sometimes having breakfast, never eating at the school canteen, never having a morning snack, never or sometimes having a light afternoon meal and having high sedentary activity.
Conclusions
Our data confirm that low SES, absence of breakfast and high sedentary activity are associated with a higher risk of being overweight or obese, but also highlight original potential protective factors such as eating at the canteen and high meal frequency.
To examine family- and school-based predictors of breakfast consumption, soft drink consumption and physical activity (PA) and moderating effects of gender and socio-economic status (SES).
Design
Longitudinal study (6-year follow-up), including a questionnaire about dietary and activity behaviour.
Setting
Fifty-nine Flemish elementary schools.
Subjects
Seven hundred and twenty-seven children (51·9 % girls, 51·9 % high SES, mean age 9·9 (sd 0·4) years at baseline).
Results
Having breakfast together with parents (P < 0·001) at age 10 years related to more days of eating breakfast at age 16 years. More parental soft drink consumption (P = 0·04), less soft drink availability at home (P < 0·001) and less parental permissiveness (children received soft drinks from their parents whenever they asked for it and children could take soft drinks whenever they wanted; P = 0·02 and P = 0·001, respectively) at age 10 years related to less soft drink consumption at age 16 years. A more positive parental attitude towards PA (P = 0·009), more parental encouragement (P = 0·002) and a higher rating of PA's benefit ‘relaxing’ (P < 0·001) at age 10 years related to more PA at age 16 years. Gender and SES did not significantly moderate any of the associations.
Conclusions
Only parental factors at age 10 years were associated with breakfast consumption, soft drink consumption and PA at age 16 years. An intervention programme at age 10 years with a strong focus on the modifiable parental factors might lead to healthy behaviour in the long term.
To examine the relationship between intake of whole grains and BMI Z-score in rural children.
Design
General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2–17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0–1·5 servings/d and >1·5 servings/d.
Setting
The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina.
Subjects
Seven hundred and ninety-two children attending 3rd–6th grade.
Results
After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations.
Conclusions
Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.
To assess the association between exclusive breast-feeding and childhood overweight.
Design
Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning.
Setting
Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain).
Subjects
The analysis included 14 726 children aged 2–9 years for whom early feeding practices were reported by parents in standardized questionnaires.
Results
After controlling for education, income and other potential confounders, breast-feeding exclusively for 4–6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR = 0·73; 95 % CI 0·63, 0·85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR = 0·71; 95 % CI 0·58, 0·85). The associations could not be explained by socio-economic characteristics or maternal overweight.
Conclusions
This multi-country investigation indicated that exclusive breast-feeding for 4–6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.
To determine the association of birth weight with obesity risk at first grade of high school in Chilean children after accounting for potential confounding factors.
Design
National non-concurrent cohort of newborns. Sociodemographic information, height, weight and anthropometric measurements at first grade of high school were analysed. Birth weight was classified as macrosomia (≥4000 g), by gestational age and by ponderal index. The relationship between birth weight and obesity at first grade of high school (BMI ≥ 95th percentile of the US Centers for Disease Control and Prevention's reference) was assessed using logistic regression models adjusted for sociodemographic information at delivery.
Setting
First grade of public high school of low and middle socio-economic status in the whole country (about 77 % of Chilean children in this age group).
Subjects
Newborns (n 119 070) and the same number of high-school students.
Results
A positive relationship of high ponderal index (OR = 1·86, 95 % CI 1·69, 2·03), birth weight ≥4000 g (OR = 1·66, 95 % CI 1·54, 1·78) and large for gestational age (OR = 1·69, 95 % CI 1·58, 1·81) with obesity at adolescence (P < 0·001) was found. Macrosomic children had a higher risk of being obese at first grade of high school after controlling for prenatal confounding variables (OR = 1·63, 95 % CI 1·52, 1·76; P < 0·001).
Conclusions
A direct relationship between high birth weight and obesity at first grade of high school was observed in this group of Chilean children. The results highlight the significance of birth weight as a simple tool to be used as an indicator of obesity risk for children by health-care providers.
To investigate the association of family income at birth with BMI among young adults who have been followed since birth.
Design
A birth cohort study.
Setting
In 1982, all children born in Pelotas, southern Brazil, were included in a perinatal survey and visited at ages 1, 2, 4, 15, 18–19 and 23 years.
Subjects
Cohort members (n 4297) were traced and interviewed in 2004–2005. In all follow-ups, participants were weighed and measured, and BMI and prevalence of obesity were calculated for each age. Family income was obtained in minimum wages in 1982 and as a continuous variable, in reais, in later follow-ups. Skin colour was self-reported in 2004–2005.
Results
Mean BMI and prevalence of obesity differed between males and females. In males, a direct relationship was found throughout life and among females this relationship was modified by age. During childhood, BMI was higher among girls from higher income groups and this association was inversed at age 23 years. At this same age, mean BMI among black women was 1·3 kg/m2 higher than among white women, even after adjustment for current family income.
Conclusions
The findings show in men that the relationship between income and BMI is similar to that seen in less developed areas, whereas among adult women the relationship is similar to that observed in developed countries. In addition to the effect of socio-economic status, skin colour also has an influence on the BMI of adult women.
Given the rapid increase in the prevalence of childhood obesity, identifying the sociodemographic influences on obesity status is important for planning and implementing effective prevention initiatives. However, this type of data is limited for Greek children. Therefore the aim of the present study was to identify possible sociodemographic factors associated with childhood obesity at the national level.
Design
Cross-sectional, population-based survey, carried out from October to May 2009.
Setting
Under the context of the GRECO (Greek Childhood Obesity) study, a nationwide sample of 2315 primary-school children.
Subjects
Children aged 10–12 years and their parents were voluntarily enrolled. Direct anthropometric measurements of the children were obtained and information on sociodemographic characteristics of the parents, as well as their self-reported values of body weight and height, were collected.
Results
Overweight and obesity prevalence was 29·5 % and 13·1 %, respectively, among boys; 29·5 % and 9·0 %, respectively, among girls. Multiple logistic regression analysis revealed that the most important sociodemographic predictors of childhood obesity were mother's age, parental BMI classification and father's type of occupation. More specifically, increased mother's age and normal BMI status of the parents seemed to have a protective effect on the likelihood of having an overweight/obese child. Additionally, the odds of a female child of being overweight/obese were reduced when the father's type of occupation tended to be less manual.
Conclusions
Anti-obesity health policy interventions have to address to the parents and promote their active involvement, to effectively confront the alarming magnitude of the paediatric obesity problem in Greece.
To compare BMI with abdominal skinfold thickness (ASF), waist circumference and waist-to-height ratio in the prediction of insulin resistance (IR) in prepubertal Colombian children.
Design
We calculated age- and sex-specific Z-scores for BMI, ASF, waist circumference, waist-to-height ratio and three other skinfold-thickness sites. Logistic regression with stepwise selection (P = 0·80 for entry and P = 0·05 for retention) was performed to identify predictors of IR and extreme IR, which were determined by age- and sex-specific Z-scores to identify the ≥ 90th and ≥ 95th percentile of homeostasis model assessment (HOMAIR), respectively. We used receiver operating characteristic curves to compare the area under the curve between models.
Setting
Bucaramanga, Colombia.
Subjects
Children (n 1261) aged 6–10 years in Tanner stage 1 from a population-based study.
Results
A total of 127 children (seventy girls and fifty-seven boys) were classified with IR, including sixty-three children (thirty-three girls and thirty boys) classified with extreme IR. Only ASF and BMI Z-scores were retained as predictors of IR by stepwise selection. Adding ASF Z-score to BMI Z-score improved the area under the curve from 0·794 (95 % CI 0·752, 0·837) to 0·811 (95 % CI 0·770, 0·851; P for contrast = 0·01). In predicting extreme IR, the addition of ASF Z-score to BMI Z-score improved the area under the curve from 0·837 (95 % CI 0·790, 0·884) to 0·864 (95 % CI 0·823, 0·905; P for contrast = 0·01).
Conclusions
ASF Z-score predicted IR independent of BMI Z-score in our population of prepubertal children. ASF and BMI Z-scores together improved IR risk stratification compared with BMI Z-score alone, opening new perspectives in the prediction of cardiometabolic risk in prepubertal children.
Measurement errors in dietary data lead to attenuated estimates of associations between dietary exposures and health outcomes. The present study aimed to compare and evaluate different approaches of handling implausible reports by exemplary analysis of the association between dietary intakes (total energy, soft drinks, fruits/vegetables) and overweight/obesity in children.
Design
Cross-sectional multicentre study.
Setting
Kindergartens/schools from eight European countries participating in the IDEFICS Study.
Subjects
Children (n 5357) aged 2–9 years who provided one 24 h dietary recall and complete covariate information.
Results
The 24 h recalls were classified into three reporting groups according to adapted Goldberg cut-offs: under-report, plausible report or over-report. In the basic logistic multilevel model (adjusted for age and sex, including study centre as random effect), the dietary exposures showed no significant association with overweight/obesity (energy intake: OR=0·996 (95 % CI 0·983, 1·010); soft drinks: OR = 0·999 (95 % CI 0·986, 1·013)) and revealed even a positive association for fruits/vegetables (OR = 1·009 (95 % CI 1·001, 1·018)). When adding the reporting group (dummy variables) and a propensity score for misreporting as adjustment terms, associations became significant for energy intake as well as soft drinks (energy: OR = 1·074 (95 % CI 1·053, 1·096); soft drinks: OR = 1·015 (95 % CI 1·000, 1·031)) and the association between fruits/vegetables and overweight/obesity pointed to the reverse direction compared with the basic model (OR = 0·993 (95 % CI 0·984, 1·002)).
Conclusions
Associations between dietary exposures and health outcomes are strongly affected or even masked by measurement errors. In the present analysis consideration of the reporting group and inclusion of a propensity score for misreporting turned out to be useful tools to counteract attenuation of effect estimates.
Nutritional interventions to decrease energy intake, aimed at portion sizes and front-of-package labelling, are effective only if people do not compensate for their reduced energy intake. Since several observational studies indicate that these interventions could prompt compensation behaviour, it is important to assess underlying beliefs. Therefore, the purpose of the two studies reported here was to develop a Diet-related Compensatory Health Beliefs Scale (Diet-CHBS).
Design
Cross-sectional surveys were conducted for the scale development. Study 1 provided data on the factor analysis and convergent validity, while Study 2 assessed the Diet-CHBS’ test–retest reliability.
Settings
VU University Amsterdam (Study 1) and twenty-five worksite cafeterias in the Netherlands (Study 2).
Subjects
Study 1 was conducted among 179 students and their parents; Study 2 was conducted among 119 worksite cafeteria visitors.
Results
The results of Study 1 showed that the scale consisted of the hypothesized factors of compensation beliefs with regard to portion sizes (α = 0·73), front-of-package health logos (α = 0·77) and exercise (α = 0·75). The scale's overall Cronbach's α was 0·82. The Diet-CHBS had a Pearson correlation of 0·32 with a general health compensatory beliefs scale, signifying satisfactory convergent validity. Study 2 showed that the intra-class correlation coefficient between T1 and T2 was 0·69, indicating adequate test–retest reliability.
Conclusion
The Diet-CHBS is a valid and reliable instrument for assessing diet-related compensatory health beliefs in response to nutritional interventions. It is important to take such beliefs into account in further intervention studies aimed at preventing overweight and obesity.
To investigate which anthropometric measure of overweight status, BMI or waist-to-height ratio (WHtR), is most closely associated with parents’ perception of their child's overweight status.
Design
The sensitivity and specificity of parental perception against child-specific BMI and WHtR definitions of overweight were tested.
Setting
Primary schools in Queensland, Australia.
Subjects
Boys and girls aged 9·00–11·99 years (n 1431).
Results
Of the 138 boys and 202 girls who were classified as overweight according to BMI, only 27·5 % (boys) and 22·7 % (girls) were also perceived as overweight by their parents. Using WHtR, 206 boys and 333 girls were classified as overweight, of whom only 21·9 % and 13·8 %, respectively, were perceived as overweight. Perception of overweight was underestimated in approximately 15 % of boys and 21 % of girls when compared with BMI. Underestimation was higher when compared with WHtR: 25 % (boys) and 39 % (girls). Overweight prevalence was significantly lower according to perception than according to BMI or WHtR. Mother's education level was significantly associated with accurate perception of overweight status (P < 0·001).
Conclusions
The sensitivity of parental perception of child overweight was higher when BMI was used. However, emphasis needs to be placed on using WHtR as an actual measure of overweight because high central adiposity is associated with increased risk of CVD. The combined use of WHtR, body-shape images rather than word responses regarding perception and public health messages that educate parents and children about body shape and associated health risks may be the best combination in improving parents’ perception of their child's overweight status.
It is not clear whether measuring waist circumference in clinical practice is problematic because the measurement error is unclear, as well as what constitutes a clinically relevant change. The present study aimed to summarize what is known from state-of-the-art research.
Design
To identify the magnitude of the measurement error of waist circumference measurements from the literature, a search was conducted in PubMed from 1975 to February 2011.
Results
The measurement error may vary between 0·7 cm and 15 cm. Taking a realistic range of measurable waist circumference into account (60–135 cm), we argue that a short-term clinically relevant change in waist circumference of 5 % may lie between 3·0 and 6·8 cm and a maintained clinically relevant change of 3 % between 1·8 and 4·1 cm.
Conclusions
Based on these results, we conclude it may be difficult to distinguish clinically relevant change from measurement error in individual subjects, due to the large measurement error and unclear definition of clinically relevant change. More research is needed to address these gaps in knowledge. To minimize measurement error, we recommend using a uniform measurement protocol, training and repeated measurements.
To assess the association of the acute-phase protein biomarkers, C-reactive protein (CRP) and α1-acid glycoprotein (AGP), with anaemia in children aged 6–59·9 months in Papua New Guinea.
Design
A nationally representative household-based cross-sectional survey of children aged 6–59·9 months was used to assess the relationships between various combinations of elevated CRP (>5 mg/l) and AGP (>1·2 g/l) with anaemia. Logistic regression was used to determine if other factors, such as age, sex, measures of anthropometry, region, urban/rural residence and household size, modified or confounded the acute-phase protein–anaemia association.
Setting
Papua New Guinea.
Subjects
A total of 870 children aged 6–59·9 months from the 2005 Papua New Guinea National Micronutrient Survey were assessed.
Results
The following prevalence estimates were found: anaemia 48 %; elevated CRP 32 %; and elevated AGP 33 %. Children with elevated CRP had a prevalence of anaemia of 66 % compared with children with normal CRP who had a prevalence of 40 %. Corresponding estimates for AGP were 61 % and 42 %, respectively. Similar results were found with combinations of elevated CRP and AGP. The higher prevalence of anaemia in children with elevated CRP and/or AGP was still present after controlling for confounders.
Conclusions
Elevated levels of CRP and AGP were significantly associated with a higher prevalence of anaemia in the children surveyed. There are no expert group recommendations on whether to or how to account for markers of inflammation in presenting results on anaemia prevalence. Additional research would be helpful to clarify this issue.
To assess the most important sociodemographic determinants of age at introduction of complementary foods in infancy.
Design
A prospective birth cohort with increased risk of type 1 diabetes, recruited between 1996 and 2004. The families completed at home a follow-up form on the age at introduction of new foods and, for each clinic visit, a structured dietary questionnaire with 3 d food records.
Setting
Data from the Type 1 Diabetes Prediction and Prevention (DIPP) Project, Finland.
Subjects
A cohort of 5991 infants (77 % of those invited) belonging to the DIPP Nutrition Study.
Results
Sixty-three per cent of the infants were introduced to complementary foods, including infant formula, before the age of 4 months. The median age at introduction of infant formula was 1·5 months (range 0–18 months) and that of the first other complementary food 3·5 months (range 0·7–8 months). All sociodemographic and lifestyle factors studied were associated with the age at introduction of infant formula and/or first other complementary food. Female sex of the infant, being born in the southern region of Finland, living in a rural municipality, the presence of siblings, the mother or the father being a high-school graduate, high maternal professional education and maternal non-smoking during pregnancy predicted later introduction of complementary foods.
Conclusions
Compliance was relatively poor with the current recommendations for the age of introducing complementary foods. Small-sized young families with less well-educated parents were most prone to introduce complementary foods early.
To assess the prevalence and geographic distribution of major cardiovascular risk factors in a large community-wide sample of the Italian population.
Design
A cross-sectional survey. Standardized methods were used to collect and measure cardiovascular risk factors. Data were adjusted for survey weightings. Qualitative and quantitative variables were compared with parametric and non-parametric tests, as appropriate.
Setting
Towns (n 193) across different Italian regions.
Subjects
Unselected adults (n 24 213; 12 626 men; 11 587 women) aged 18–98 years (mean age 56·9 (sd 15·3) years), who volunteered to participate in a community-wide screening programme over a 2 d period in 2007.
Results
Overall, the prevalence of major cardiovascular risk factors was: obesity, 22·7 % (women 18·9 %, men 26·1 %); overweight, 44·7 % (women 31·6 %, men 56·7 %); hypertension, 59·6 % (women 48·3 %, men 70·0 %); dyslipidaemia, 59·1 % (women 57·7 %, men 60·3 %); diabetes, 15·3 % (women 11·2 %, men 19·0 %) and smoking, 19·8 % (women 14·0 %, men 25·2 %). We found a high prevalence of unhealthy eating habits; fruit and vegetable consumption was below the recommended range in 60 % of the study population. Ninety per cent of the study population had more than one cardiovascular risk factor and 84 % had between two and five cardiovascular risk factors. There were differences among Italian macro-areas mainly for obesity, hypertension, dyslipidaemia and diabetes.
Conclusions
The study provides alarming evidence on current prevalence data for major cardiovascular risk factors in a large sample of the Italian population. Particularly, obesity and hypertension represent a relevant public health problem. There is a pressing need for effective preventive health measures which must also take into account the differences among Italian macro-areas.
To identify correlates of anaemia during the first trimester of pregnancy among 366 urban South Indian pregnant women.
Design
Cross-sectional study evaluating demographic, socio-economic, anthropometric and dietary intake data on haematological outcomes.
Setting
A government maternity health-care centre catering predominantly to the needs of pregnant women from the lower socio-economic strata of urban Bangalore.
Subjects
Pregnant women (n 366) aged ≥18 and ≤40 years, who registered for antenatal screening at ≤14 weeks of gestation.
Results
Mean age was 22·6 (sd 3·4) years, mean BMI was 20·4 (sd 3·3) kg/m2 and 236 (64·5 %) of the pregnant women were primiparous. The prevalence of anaemia (Hb <11·0 g/dl) was 30·3 % and of microcytic anaemia (anaemia with mean corpuscular volume <80 fl) 20·2 %. Mean dietary intakes of energy, Ca, Fe and folate were well below the Indian RDA. In multivariable log-binomial regression analysis, anaemia was independently associated with high dietary intakes of Ca (relative risk; 95 % CI: 1·79; 1·16, 2·76) and P (1·96; 1·31, 2·96) and high intake of meat, fish and poultry (1·94; 1·29, 2·91).
Conclusions
Low dietary intake of multiple micronutrients, but higher intakes of nutrients that inhibit Fe absorption such as Ca and P, may help explain high rates of maternal anaemia in India.
Pregnancy is one of the most critical periods for iodine deficiency. The aim of the present study was to assess the iodine status and dietary intake of pregnant women in a population changing from high to lower consumption of milk and fish.
Design
Cross-sectional observational study. Urine samples were collected for measuring urinary iodine concentration (UIC) and creatinine, and blood samples for measuring serum thyroid-stimulating hormone (TSH). Frequency of consumption of selected food and beverages was obtained through a semi-quantitative validated FFQ. The difference in the distribution of UIC, ratio of iodine to creatinine (I:Cr) and TSH between groups following recommendations on fish and dairy product intake or not (fish ≥2 times/week as a main meal, diary products ≥2 portions/d) was assessed.
Setting
Primary Health Care of the Capital Area, Reykjavik, Iceland.
Subjects
Randomly selected pregnant women (19–43 years old, n 162).
Results
The median UIC was 180 μg/l, I:Cr 173 μg/g and TSH 1·5 mmol/l. Women who did not consume fish ≥2 times/week and also did not consume dairy products in line with the recommended intake level of ≥2 portions/d had median UIC of 160 μg/l (I:Cr 149 μg/g) compared with 220 μg/l (I:Cr 190 μg/g) in the group following both the recommendations for fish and those for dairy products. Use of dietary supplements in the two groups was similar.
Conclusions
Iodine status in the population studied was within the optimal range (150–249 μg/d) defined by the WHO.
To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese.
Design
A retrospective cohort study, with a follow-up of 2 years (2003–2005). Intakes of dietary antioxidants (vitamin C, vitamin E, α-carotene and β-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3 mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression.
Setting
Niigata City (Japan).
Subjects
Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264).
Results
A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1·00, 0·76 (95 % CI 0·60, 0·97) and 0·72 (95 % CI 0·56, 0·93) for vitamin C; 1·00, 0·79 (95 % CI 0·62, 0·99) and 0·55 (95 % CI 0·42, 0·72), for vitamin E; and 1·00, 1·02 (95 % CI 0·81, 1·29) and 0·73 (95 % CI 0·56, 0·95) for β-carotene.
Conclusions
The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.
Several studies have suggested that dairy food may reduce the risk of obesity and metabolic abnormalities but few have been able to conclusively demonstrate that it reduces the risk of diabetes. The aim of the present analysis was to investigate if dairy food intake independently reduces the risk of diabetes.
Design
The Australian Diabetes Obesity and Lifestyle Study (AusDiab) is a national, population-based, prospective survey conducted over 5 years. Baseline measurements included a 121-item FFQ, anthropometrics and an oral glucose tolerance test.
Setting
Forty-two randomly selected clusters across Australia.
Subjects
Adults aged ≥25 years who participated in the baseline survey and returned to follow-up 5 years later.
Results
A total of 5582 participants with complete data were eligible for analysis, 209 of whom had incident diabetes. Compared with men in the first tertile of dairy food intake, men in the third tertile had a significantly reduced risk of developing diabetes after adjustment for age, sex, total energy intake, family history of diabetes, education, physical activity, smoking status, fasting serum TAG and HDL cholesterol, systolic blood pressure, waist circumference and hip circumference (OR = 0·53, 95 % CI 0·29, 0·96; P = 0·033). A similar non-significant association was observed in women.
Conclusions
Dietary patterns that incorporate high intakes of dairy food may reduce the risk of diabetes among men. Further investigation into the relationship between dairy food intake and diabetes needs to be undertaken to fully understand the potential mechanism of this observation.