Won O. Song

What do college students eat? Food selection and meal pattern

Abstract Data are limited on food selections of young adults. This study was undertaken to examine the eating practices of college students relevant to improving nutrition and health education programs. Dietary records (n=1912) were used to determine the frequency of meals skipped and specific foods selected by male and female students in different seasons between Fall 1990 and Summer 1991. Twenty-two percent, 8%, and 5% of the students skipped breakfast, lunch, and dinner, respectively; 80% of the students snacked at least once a day. There were no significant differences in frequency of meals skipped and snacks consumed among seasons, or between men and women. Forty foods consumed most frequently for meals and snacks included various carbonated beverages but few vegetables and fruits. Skimmed milk, 2% milk and chicken or turkey were among the top 40 foods selected by both genders whereas whole milk and higher-fat meats were not. Men consumed more high calorie and high fat foods, more fast foods but fewer vegetables than women. These findings suggest that health promotion for young adults in college should address importance of eating vegetables and fruits with less frequent consumption of carbonated beverages and high fat combination dishes. The message for men may need to differ for women.

Estimation of Antioxidant Intakes from Diet and Supplements in U.S. Adults

The importance of antioxidants in reducing risks of chronic diseases has been well established; however, antioxidant intakes by a free-living population have not yet been estimated adequately. In this study, we aimed to estimate total antioxidant intakes from diets and supplement sources in the U.S. population. The USDA Flavonoid Database, food consumption data, and dietary supplement use data of 8809 U.S. adults aged >/=19 y in NHANES 1999-2000 and 2001-2002 were used in this study. Daily total antioxidant intake was 208 mg vitamin C (46 and 54% from diets and supplements, respectively), 20 mg alpha-tocopherol (36 and 64), 223 mug retinol activity equivalents carotenes (86 and 14), 122 mug selenium (89 and 11), and 210 mg flavonoids (98 and 2). Antioxidant intakes differed among sociodemographic subgroups and lifestyle behaviors. Energy-adjusted dietary antioxidant intakes were higher in women, older adults, Caucasians, nonconsumers of alcohol (only for vitamin C and carotenes), nonsmokers (only for vitamin C, vitamin E, and carotenes), and in those with a higher income and exercise level (except for flavonoids) than in their counterparts (P < 0.05). Consumption of fruits, vegetables, and whole grains may be a good strategy to increase antioxidant intake. The possible association between antioxidant intake and the prevalence of chronic diseases should be investigated further.

Plasma and Dietary Antioxidant Status as Cardiovascular Disease Risk Factors: A Review of Human Studies

Extensive evidence has demonstrated that many antioxidants such as vitamin C, vitamin E, carotenoids and polyphenols have protective effects in preventing cardiovascular disease (CVD), a chronic disease that is mediated by oxidative stress and inflammation. This review focuses on evidence from prospective cohort studies and clinical trials in regard to the associations between plasma/dietary antioxidants and cardiovascular events. Long-term, large-scale, population-based cohort studies have found that higher levels of serum albumin, bilirubin, glutathione, vitamin E, vitamin C, and carotenoids were associated with a lower risk of CVD. Evidence from the cohort studies in regard to dietary antioxidants also supported the protective effects of dietary vitamin E, vitamin C, carotenoids, and polyphenols on CVD risk. However, results from large randomized controlled trials did not support long-term use of single antioxidant supplements for CVD prevention due to their null or even adverse effects on major cardiovascular events or cancer. Diet quality indexes that consider overall diet quality rather than single nutrients have been drawing increasing attention. Cohort studies and intervention studies that focused on diet patterns such as high total antioxidant capacity have documented protective effects on CVD risk. This review provides a perspective for future studies that investigate antioxidant intake and risk of CVD.

Estimation of Daily Proanthocyanidin Intake and Major Food Sources in the U.S. Diet

Proanthocyanidins (PA), the polymers of flavan-3-ols, have cardioprotective and cancer preventive properties as shown in clinical studies. The PA intake in a free-living population has not yet been reported, however. We aimed to estimate the dietary intake of PA and identify its major sources by combining the recently released and expanded USDA PA database with food consumption data of 8809 U.S. adults in the NHANES 1999-2002. U.S. adults over 19 y had a total PA intake of 95 mg/d, in the order of polymers (30%), monomers (22%), dimers (16%), 4-6 mers (15%), 7-10 mers (11%), and trimers (5%). When adjusted for energy intake, the total PA intake increased with age (P < 0.001), was higher in women than men (P < 0.01) and in alcohol consumers compared with nonconsumers (P < 0.05), and was lower in non-Hispanic blacks compared with other ethnicities (P < 0.001). Three major food sources, tea, legumes, and wines, contributed 45 mg (48%) of daily PA intake. The marked differences in PA intake among various sociodemographic subgroups need further investigation in relation to health disparities and chronic disease prevalence in the US.

Food Matrix Affecting Anthocyanin Bioavailability: Review

Anthocyanins, abundant in deep-colored fruits and vegetables, have received considerable attention due to their potential health benefits. However, the bioavailability of anthocyanins is relatively low compared to that of other flavonoids. While previous reviews focused on the absorption, metabolism and excretion of anthocyanins, little information is available on the effects of food matrix on anthocyanin bioavailability, particularly food matrices of the usual diet. The present review includes the recent studies on interactive effects of anthocyanins and certain food components. Evidence suggests that the bioavailability of anthocyanins varies markedly depending on food matrices, including other antioxidants and macronutrients present in foods consumed, which consequently affects the absorption and antioxidant capacity of anthocyanins. Further studies are needed to gain insight into the mechanisms underlying the interactive effects of anthocyanins and food components in their bioavailability and antioxidant capacity of anthocyanins at the physiological level.

Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis

Importance Body mass index (BMI) and gestational weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with theIOM guidelines and pregnancy outcomes is unclear. Objective To perform a systematic review, meta-analysis, and metaregression to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 12.5-18 kg for underweight women [BMI <18.5]; 11.5-16 kg for normal-weight women [BMI 18.5-24.9]; 7-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes. Data Sources and Study Selection Search of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies stratified by prepregnancy BMI category and total gestational weight gain. Data Extraction and Synthesis Data were extracted by 2 independent reviewers. Odds ratios (ORs) and absolute risk differences (ARDs) per live birth were calculated using a random-effects model based on a subset of studies with available data. Main Outcomes and Measures Primary outcomes were small for gestational age (SGA), preterm birth, and large for gestational age (LGA). Secondary outcomes were macrosomia, cesarean delivery, and gestational diabetes mellitus. Results Of 5354 identified studies, 23 (n = 1 309 136 women) met inclusion criteria. Gestational weight gain was below or above guidelines in 23% and 47% of pregnancies, respectively. Gestational weight gain below the recommendations was associated with higher risk of SGA (OR, 1.53 [95% CI, 1.44-1.64]; ARD, 5% [95% CI, 4%-6%]) and preterm birth (OR, 1.70 [1.32-2.20]; ARD, 5% [3%-8%]) and lower risk of LGA (OR, 0.59 [0.55-0.64]; ARD, −2% [−10% to −6%]) and macrosomia (OR, 0.60 [0.52-0.68]; ARD, −2% [−3% to −1%]); cesarean delivery showed no significant difference (OR, 0.98 [0.96-1.02]; ARD, 0% [−2% to 1%]). Gestational weight gain above the recommendations was associated with lower risk of SGA (OR, 0.66 [0.63-0.69]; ARD, −3%; [−4% to −2%]) and preterm birth (OR, 0.77 [0.69-0.86]; ARD, −2% [−2% to −1%]) and higher risk of LGA (OR, 1.85 [1.76-1.95]; ARD, 4% [2%-5%]), macrosomia (OR, 1.95 [1.79-2.11]; ARD, 6% [4%-9%]), and cesarean delivery (OR, 1.30 [1.25-1.35]; ARD, 4% [3%-6%]). Gestational diabetes mellitus could not be evaluated because of the nature of available data. Conclusions and Relevance In this systematic review and meta-analysis of more than 1 million pregnant women, 47% had gestational weight gain greater than IOM recommendations and 23% had gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes.

Carbohydrate Intake Is Associated with Diet Quality and Risk Factors for Cardiovascular Disease in U.S. Adults: NHANES III

Objectives: To determine if carbohydrate intake, as a % of energy, was related to diet quality and risk factors for cardiovascular disease (CVD) in adults in a cross-sectional and population-based study in the U.S. Methods: Data from the third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) were utilized. The nationally representative sample of the U.S. population (3,754 men, 4,074 women, ages 25 to 64 years) was divided into quintiles of carbohydrate intake (% of energy), which was examined in relation to risk factors for CVD: systolic blood pressure, body mass index (BMI), and concentrations of serum triglyceride, serum total and HDL cholesterol and plasma glucose. Results: When covariates (age, ethnicity, smoking, alcohol intake and total energy intake) were adjusted in multivariate analyses, carbohydrate intakes (% of energy) were inversely associated with BMI and serum total cholesterol concentration in men and BMI in women and positively associated with serum triglyceride concentration in women. When total sugar intake (% of energy) was further controlled as a step to understand the quality of carbohydrate, carbohydrate intakes (% of energy) was a stronger predictor of BMI and plasma glucose in men and BMI in women. A high carbohydrate diet (>57.4% of energy in men and >59.1% of energy in women) was associated with a low serum HDL-cholesterol concentration in men and high serum triglyceride in women. Conclusion: Moderately high carbohydrate (50% to 55% of energy) diets were associated with low CVD risks with favorable lipid profiles.

Quantitative Use of the Food Guide Pyramid to Evaluate Dietary Intake of College Students

OBJECTIVES To evaluate the usefulness of the Food Guide Pyramid as a quantitative tool for assessing nutritional adequacy and quality. DESIGN One-day food records (n = 2,489) were assigned food group scores (1 through 5) by two systems. System 1 recorded the number of food groups on a given record that included the minimum number of servings suggested by the Food Guide Pyramid. System 2 recorded the number of food groups in the Food Guide Pyramid for which at least one serving was included. The food records were further evaluated by mean adequacy ratio (MAR) for iron, calcium, magnesium, vitamin A, and vitamin B-6 (MAR-5 score) and percentage of energy contributed by fat and sugar. Sensitivity and specificity of the food group scores to predict nutritional inadequacy were determined. SUBJECTS College students (n = 2,489) attending introductory nutrition, foods, and health-related courses at a mid-western university. STATISTICAL ANALYSES Students t test, chi2 test, Dunnetts multiple mean comparison test. RESULTS A food group score of 5 was given to 11% and 35% of the diet records by systems 1 and 2, respectively; MAR-5 scores of 75 or greater were given to 70% of the records. Only 4% of the diets contained both 30% or less and 10% or less of energy from fat and sugar, respectively. Both scoring systems can be used as a quantitative tool for screening nutritional inadequacy with high sensitivity (correctly classifying nutritionally inadequate diets) but with a moderate to low specificity (correctly classifying nutritionally adequate diets).

Reliability and Validity of Nutrition Knowledge, Social-Psychological Factors, and Food Label Use Scales from the 1995 Diet and Health Knowledge Survey

OBJECTIVE To test the reliability and validity of scales on nutrition knowledge, social-psychological factors, and use of food labels developed from the 1995 Diet and Health Knowledge Survey (DHKS) questions. DESIGN The 1995 DHKS questions within a section were pooled together as a scale and their reliability and validity were examined. PARTICIPANTS US adults (> or =20 years) in the 1995 DHKS who responded to questions selected for this study (n = 1196). VARIABLES Nutrition knowledge about the diet-disease relationship and nutrient content of products, perceived barriers and benefits of food labels, perceived ease of understanding food labels, food label use, and importance of healthful eating. ANALYSIS Scales validity, Cronbach alpha, item total correlation, alpha if the item was deleted, and discriminant, convergence, and correspondence validity. RESULTS Scales on perceived ease of understanding the food label, benefits of using food labels, food label use, and importance of healthful eating were reliable (Cronbach alpha =.78,.82,.91, and.82, respectively) and valid. CONCLUSION AND IMPLICATIONS Accurate findings and interpretation of survey data depend on the use of reliable and valid instruments. This study identified the scales in the DHKS that can substantiate the conclusion on which effective nutrition education strategies should be established.

Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants

Abstract Objective: We examined if prepregnancy body mass index (BMI) is a risk factor for gestational hypertension, gestational diabetes, preterm labor, and small-for-gestational-age (SGA) and large-for-gestational-age (LGA) infants with consideration of gestational weight gain, to document the importance of preconception versus prenatal stage. Methods: We used the data of 219 868 women from 2004 to 2011 Pregnancy Risk Assessment Monitoring System (PRAMS). Multivariate logistic regression analyses were performed to examine the effect of prepregnancy BMI for gestational hypertension, gestational diabetes, preterm labor, and SGA and LGA infants with consideration of gestational weight gain. Results: Regardless of gestational weight gain, women with obese prepregnancy BMI (≥30 kg/m2) had increased odds of gestational hypertension (adjusted odds ratios (AOR) = 2.91; 95% CI = 2.76–3.07), gestational diabetes (2.78; 2.60–2.96), and LGA (1.87; 1.76–1.99) compared to women with normal prepregnancy BMI (18.5–24.9 kg/m2). Women with underweight prepregnancy BMI (<18.5 kg/m2) had increased odds of preterm labor (1.25; 1.16–1.36) and SGA infants (1.36; 1.25–1.49), but decreased odds of LGA infants (0.72; 0.61–0.85) in reference to women with normal prepregnancy BMI (18.5–24.9 kg/m2). Conclusions: Regardless of adequacy of gestational weight gain, the risk of gestational hypertension, gestational diabetes, and LGA infants increases with obese prepregnancy BMI, whereas that of preterm labor and SGA infants increases with underweight prepregnancy BMI. Preconception care of reproductive aged women is as important as prenatal care to lower the risk of gestational hypertension, gestational diabetes, preterm labor, and SGA and LGA infants.