Sally Record

Demographic and dietary profiles of high and low fat consumers in Australia.

STUDY OBJECTIVE--To determine the socio-demographic, attitudinal, and dietary correlates of high and low fat consumption in the community. DESIGN--The study was undertaken using a postal survey format. A questionnaire was sent for self completion to a randomised sample of the adult population of two Australian states. PARTICIPANTS--Adult participants were selected randomly from the Electoral Rolls of the states of Victoria and South Australia. As voting at elections is compulsory in Australia, these rolls contain the names of all Australian citizens over the age of 18 years. Altogether 3209 respondents completed the survey giving a response rate of 67%. MAIN RESULTS--Lower than average fat consumption was more common in women. Age was a significant factor only in men. Occupation was not related to lower than average fat consumption but manual work and low occupational prestige were linked to higher than average consumption in men. People with a history of conditions related to heart disease were more likely to be low consumers but medical history did not distinguish high from average consumers. Low fat consumption was linked to higher refined and natural sugar consumption and higher alcohol consumption, but protein and complex carbohydrate consumption did not vary with fat consumption. Low fat diets also had higher densities of fibre and most vitamins and minerals, the exceptions being retinol, zinc, and vitamin B12, nutrients generally linked to meat and dairy consumption. Of the latter, only the low zinc concentrations, which are already borderline in the community, pose a potential nutritional problem. CONCLUSIONS--This study showed very strong links between dietary fat intake and the intake of nearly all other nutrients in the diet. The results highlight the need to consider relationships between nutrients not only for purposes of nutrition education but also in relation to nutritional epidemiology studies.

Repeatability of estimates of nutrient and energy intake: The quantitative food frequency approach

Abstract One aspect of the quality of a measurement is its repeatability. This study addresses the repeatability of estimates of nutrient and energy intake derived from a quantitative food frequency questionnaire. One hundred individuals who, as controls in case-control studies of breast disease, had completed food questionnaires relating to usual intake, completed a second such questionnaire on re-contact approximately one year later. While, in general, the estimates of nutrient and energy intake derived from the repeat questionnaires were lower than the earlier (original) estimates, the two estimates were moderately correlated, indicating some stability over a one year period in the ranking of individuals within a population with respect to dietary intake. When the repeat estimates, categorized into three levels, were compared with the original estimates, the minority of individuals who were not classified similarly on the two occasions were as likely to have repeat estimate higher as they were to have one lower than their original estimate, indicative of non-systematic misclassification. The results indicate that the food frequency questionnaire represents a convenient technique for the measurement of dietary intake in epidemiological studies.

Financial costs of healthful eating: A comparison of three different approaches

Abstract In the last decade, governments of most developed countries have established dietary guidelines for their populations in an effort to lower the incidence and prevalence of chronic diseases such as coronary heart disease, hypertension, certain cancers, and diabetes. However, although little quantitative analytical work has been undertaken, concern has been expressed about the potential increases in the financial costs of following a diet that complies with these dietary guidelines. To determine whether it is necessarily more expensive to follow a healthful diet, three pricing analyses were undertaken. An analysis of the potential cost of direct substitution of healthful alternatives for less healthful food choices (e.g., product-by-product substitution through the use of fat, fiber, or salt-modified alternatives, etc.) indicated that this approach would result in a more costly diet, while providing limited nutritional improvement at the population level. Pricing of self-selected diets of people whose diets currently comply with the dietary guidelines and targets for healthful eating showed that these people are currently paying more per megajoule for their diet. However, costing of diets that conformed to a new healthful eating plan, designed to produce eating patterns that meet both the dietary goals set for components of the food supply such as dietary fat, refined sugars or fiber, and the recommended daily intakes for energy, protein, vitamins, and minerals showed that healthful eating need not be more expensive and indeed, for most people, would bring cost savings. This study highlighted the need to consider the cost implications of recommendations made in nutrition education material and dietary guidelines, and to promote readjustment in the balance of foods in the diet rather than direct substitution of one particular food, or group of foods, by a “healthier” alternative.

Demographic and nutritional profiles of people consuming varying levels of added sugars

Abstract Sociodemographic characteristics and dietary intake of high and low consumers of added sugars, was assessed on a random sample of the Australian adult population using a postal, quantified food frequency approach. People with a higher percentage of energy coming from added sugars in their diet had higher energy and fibre intakes, but lower % energy from fat, complex carbohydrates, protein and alcohol. They also had lower intakes of a range of micronutrients despite having a higher energy intake. However, the form of the relationship between % added sugars and micronutrient intake varied. For some there was a strong linear trend across deciles of added sugars intake with vitamin B6, beta-carotene, folate and magnesium showing the strongest inverse linear trends in both men and women. In women, there was also a strong trend for niacin and weaker but still significant inverse linear trends for retinol, vitamin C, vitamin B12, potassium and zinc. In men, weaker trends were evident for vitamin B12, sodium, calcium and zinc. There were no significant linear trends for thiamine, riboflavin or iron in either sex, nor for retinol, vitamin C or potassium in men and sodium and calcium in women. For some of the micronutrients however, the relationship between % added sugars and micronutrient intake was not strictly linear, with lower nutrient intakes occurring at either end of the % added sugars intake range. High consumers of added sugars were found in all sociodemographic sectors but more particularly so in men and amongst smokers. For women, younger respondents and those in the paid workforce were more likely to be high consumers and, for men, consumption was more likely to be high in those who had never married.

Zinc and magnesium status of australian adults

Abstract A national random survey of Australian adults showed that the daily intakes ofzinc and magnesium in the population were marginal with the diets of 67% of men and 85% of women being below the RDA for zinc, and those of 50% of men and 39% of women, below the RDA for magnesium. There were few differences across state of residence, metropolitan or country, age gender or occupational status and where such differences did exist, these were related almost entirely to differences in total food or energy intake. The major source of zinc in the diets of participants were steak, bread, milk, cheeses, minced meat and breakfast cereals and, for magnesium, bread, milk, breakfast cereals, bananas and beer (in men). Biochemical assessments were also made on a random sample of the South Australian population whose sociodemographic and dietary profile matched closely that of the national sample. Measures of plasma and urinary zinc and magnesium, appeared to confirm a high level of risk for magnesium but not for zinc. Interpretation of these data are however difficult because of uncertainty about plasma magnesium standards and, for zinc, the ability of plasma measures, alone, to detect marginal deficiencies.

The development of a simple dietary assessment and education tool for use by individuals and nutrition educators

Abstract Many of the major food guidance systems in use in western countries are based primarily on minimal nutrient requirement standards. In the last decade, increasing knowledge about the nutritional correlates of chronic disease have refocussed the nutrition debate to include concerns related to dietary excesses. The purpose of the research outlined in this paper was to develop a quantified and nutritionally-assessed food guidance system that was in line not only with current recommended minimal intake standards but also with the more recently developed national dietary guidelines designed to improve chronic disease risk profile. The system was devised using a computer simulation and analysis process. Foods and portion sizes used in modeling the diets were based on extensive nutrient intake data sets from random samples of the population. The system has been termed the 12345(+) nutrition plan, the numeric descriptor refering to the recommended servings or portions per day from the various food groups. The system is adaptable to varying energy and nutrient needs, and educational materials are being developed to detail its use in individual counselling and group settings with subjects of varying social and ethnic backgrounds.

Repeatability of interview-derived socio-demographic and medical information

In this report, the repeatability of socio-demographic and medical information elicited by means of an interviewer-administered questionnaire is examined. One hundred and seven women who were controls in case-control studies of breast disease were re-interviewed approximately one year after initial interview. Both interviews addressed the same time period, namely that which preceded the first interview. For most of the quantitative variables studied, at least 70% of individuals provided two estimates (original and repeat) which were within one unit of each other. Also, comparison of the categorization of individuals on repeated measurements of qualitative variables (reports of events, operations and habits) revealed that most individuals were categorized consistently. This strong agreement between the original and repeat estimates was also reflected in the relatively high values of the summary measures of agreement (the intraclass correlation coefficient for quantitative variables and the Kappa statistic for qualitative variables) for most of the variables studied. The results of the present study on repeatability complement the results of previous research into the criterion validity of questionnaire-derived information and, taken together, suggest that information of relatively high quality may be obtained from such sources.