Sujata L. Archer

Association of Dietary Fish and n-3 Fatty Acid Intake With Hemostatic Factors in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Hemostatic factors play an important role in the complications of ischemic heart and vessel disease. Dietary fats such as n-3 fatty acids have been shown to possibly influence hemostatic factors. However, most studies reporting an inverse association between cardiovascular disease and fish and n-3 fatty acid consumption used supplemental doses of fish oil or intakes exceeding the typical amount consumed by the US population. This report examined the associations of usual intakes of fish, linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid with fibrinogen, factor VII, factor VIII, and von Willebrand factor in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The analyses reported here included 1672 black and white men and women aged 24 to 42 years in 1992 to 1993. After adjustment for age, body mass index, diabetes, number of cigarettes smoked per day, race, and energy and alcohol consumption, no significant associations were observed between those who consumed no fish versus those who consumed the highest level of dietary fish with respect to fibrinogen, factor VIII, or von Willebrand factor for any race-sex group. Comparisons of tertile 1 versus tertile 3 for dietary linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid were also not significantly associated with fibrinogen, factor VII, factor VIII, or von Willebrand factor for any race-sex group. These data suggest that customary intakes of fish and n-3 fatty acids in populations that generally do not consume large amounts of these food items are not associated with these hemostatic factors.

RELATIONSHIP BETWEEN CHANGES IN DIETARY SUCROSE AND HIGH DENSITY LIPOPROTEIN CHOLESTEROL : THE CARDIA STUDY

Abstract PURPOSE: Cross-sectional data from several observational studies have suggested that dietary sucrose may be inversely associated with high density lipoprotein cholesterol (HDL-C). This study examined associations between energy from dietary sucrose and HDL-C at baseline, year 7 and longitudinally (year 7 minus baseline) in a cohort of young black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS: The sample included 4734 black men, black women, white men and white women, ages 18–30 years, in 1985–86 (baseline); 3513 at year 7; and 3335 for longitudinal analyses. Multivariate analyses was used with adjustment for age, BMI, cigarettes smoked per day, physical activity score, and alcohol intake. RESULTS: Multivariate analyses indicated that energy intake from sucrose was inversely associated with HDL-C for each race-gender group at baseline, year 7, and longitudinally from baseline to year 7. This association was significant at baseline for black men, and white men and women ( p p p CONCLUSIONS: The consistent inverse associations between energy from dietary sucrose and HDL-C observed in both cross-sectional and longitudinal analyses, and in different race and gender groups in CARDIA suggest that lowering dietary sucrose intake may be beneficial for those who may have low HDL-C.

Publishing Nutrition Research: A Review of Sampling, Sample Size, Statistical Analysis, and Other Key Elements of Manuscript Preparation, Part 2

Members of the Board of Editors recognize the importance of providing a resource for researchers to insure quality and accuracy of reporting in the Journal. This second monograph of a periodic series focuses on study sample selection, sample size, and common statistical procedures using parametric methods, and the presentation of statistical methods and results. Attention to sample selection and sample size is critical to avoid study bias. When outcome variables adhere to a normal distribution, then parametric procedures can be used for statistical inference. Documentation that clearly outlines the steps used in the research process will advance the science of evidence-based practice in nutrition and dietetics. Real examples from problem sets and published literature are provided, as well as reference to books and online resources.

Publishing Nutrition Research: A Review of Nonparametric Methods, Part 3

This is the third article in a periodic five-part series on publishing nutrition research. These monographs are designed to assist in the interpretation of the Journal of the American Dietetic Association author guidelines and provide guidance in publishing and interpreting nutrition-related research articles. This installment focuses on the use of nonparametric statistical methods. The rationale for their use, their advantages and disadvantages, nonparametric alternatives to parametric tests, nonparametric statistical analysis, examples of their use, and helpful resources for further study are topics and issues addressed in this article.

Differences in food habits and cardiovascular disease risk factors among Native Americans with and without diabetes: the Inter-Tribal Heart Project

OBJECTIVE To examine differences in food habits among Native Americans with and without diabetes. DESIGN A cross-sectional epidemiological study in which participants underwent a physical examination and answered an extensive interviewer-administered questionnaire to assess differences in food servings, preparation and eating habits. SETTING/PARTICIPANTS Participants aged >/=25 years were randomly selected from three reservations in Minnesota and Wisconsin. There were 990 persons without diabetes, 294 with a prior diagnosis of diabetes, and 80 with fasting glucose >125 mg dl(-1) but no prior diabetes diagnosis. RESULTS Persons with prior diabetes diagnosis were less likely than those without diabetes to report eating fast-food meals two or more times per week, eat visible fat on meat or the skin on poultry, eat fried chicken or fried fish, to add fat to cooked vegetables and drink whole milk. Persons with previously undiagnosed diabetes were more likely than previously diagnosed persons to report eating fast-food meals two or more times per week, eat visible fat on meat and the skin on poultry, drink whole milk and eat fried fish, but were less likely to drink low-fat milk. Previously undiagnosed persons were more likely than either diagnosed persons or persons without diabetes to consume lard from cooked foods and use it when cooking. CONCLUSION Persons with diagnosed diabetes showed healthier eating patterns than those without diabetes, while undiagnosed persons showed some less favourable patterns. Because virtually all persons with diabetes in these communities receive nutrition education, the results suggest that nutrition education programmes for diabetics may be associated with healthier eating patterns.

Publishing Nutrition Research: A Review of Epidemiologic Methods

The use of epidemiologic research designs and analytical methods is common in dietetics research. Food and nutrition professionals who seek to perform evidence-based practice or participate in research design, analysis, and communication need skills in the essentials of epidemiology. This is one of a series of monographs on research methodology that addresses these needs and supports the goals of the Board of Editors of the Journal of the American Dietetic Association to further enhance competency and skills. This monograph focuses on statistical approaches for univariate analyses used with the primary observational study designs associated with epidemiology. Tables illustrating the presentation and interpretation of these results are included.

Association of education with dietary intake among young adults in the bi-ethnic Coronary Artery Risk Development in Young Adults (CARDIA) cohort

OBJECTIVE To examine associations of changes in dietary intake with education in young black and white men and women. DESIGN The Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-centre population-based prospective study. Dietary intake data at baseline and year 7 were obtained from an extensive nutritionist-administered diet history questionnaire with 700 items developed for CARDIA. SETTING Participants were recruited in 1985-1986 from four sites: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. SUBJECTS Participants were from a general community sample of 703 black men (BM), 1006 black women (BW), 963 white men (WM) and 1054 white women (WW) who were aged 18-30 years at baseline. Analyses here include data for baseline (1985-1986) and year 7 (1992-1993). RESULTS Most changes in dietary intake were observed among those with high education (>or=12 years) at both examinations. There was a significant decrease in intake of energy from saturated fat and cholesterol and a significant increase in energy from starch for each race-gender group (P<0.001). Regardless of education, taste was considered an important influence on food choice. CONCLUSION The inverse relationship of education with changes in saturated fat and cholesterol intakes suggests that national public health campaigns may have a greater impact among those with more education.

CHAPTER 19 – Other Dietary Components and Cardiovascular Risk

The purpose of this chapter is to summarize current knowledge regarding these dietary factors and their impact on blood lipids and cardiovascular risk. Most national dietary guidelines aimed at reducing cardiovascular risk are based on reductions in saturated fat, dietary cholesterol, and weight loss for those patients who are overweight. Recent studies have reaffirmed the primary focus on reduced saturated fat and dietary cholesterol intake, but there is also mounting evidence that other dietary factors beyond fat may play a significant supporting role in prevention of heart disease. Dietary fiber, soy, antioxidant vitamins, decreased plasma homocystine levels, phytochemicals, and flavonoids appear to offer advantages that enhance and complement the lipidmodified aspect of the anthiatherogenic diet. Fruits, vegetables, and whole grains are major contributors of these dietary factors and can safely be recommended for other health promoting attributes as well. Future studies will help quantify and validate these associations and also provide evidence of possible long-term benefits.

Comparison of a Food Frequency Questionnaire To 3–24 Hour Recalls in Young Women

Abstract Food frequency questionnaires (FFQs) are popular for use in nutrition research because they are less burdensome than other dietary assessment methods. FFQs are especially suitable for group comparisons because they capture habitual intake over a given period, e.g., a month or a year. They provide reasonable estimates of average energy and nutrient intake. The FFQ can be used as a screening tool to estimate baseline levels of nutrients relevant to eligibility for participation in research. The Diet and Hormone Study (DHS) excluded participants with a total fat intake less than 27.5% kcal/day. DHS is studying the impact of a diet low in total fat and high in fruits, vegetables and fiber on serum hormones and other potential biomarkers of breast cancer risk in women ages 20 to 40. DHS utilized the Block FFQ to determine entry level fat intake. Within 4 to 6 weeks, at baseline, three 24 hour recalls were collected from 168 women and analyzed using the Nutrient Data System (NDS) of the Nutrition Coordinating Center (NCC), University of Minnesota. Differences in the NDS minus FFQ results for energy, absolute fat (gm) and percent fat intake were 116.12±641.14, −3.35±31.04 and −4.32±6.69 respectively. Pearson correlation coefficients were 0.22, 0.27 and 0.50 respectively. In all participants, regardless of age or body mass index, the FFQ overestimated total fat and underestimated energy intake despite relatively high correlations with recalls. The FFQ achieved the purpose of establishing eligibility for DHS but researchers should exercise caution and allow margins for error when determining specific eligibility cut points.