scholarly journals Lower nutritional status and higher food insufficiency in frail older US adults

2012 ◽  
Vol 110 (1) ◽  
pp. 172-178 ◽  
Author(s):  
Ellen Smit ◽  
Kerrie M. Winters-Stone ◽  
Paul D. Loprinzi ◽  
Alice M. Tang ◽  
Carlos J. Crespo
Keyword(s):  
Nutritional Status ◽  
Survey Design ◽  
Normal Weight ◽  
Food Insufficiency ◽  
Complex Survey ◽  
Adult Age ◽  
Dietary Recall ◽  
Targeted Interventions ◽  
Health And Nutrition ◽  
Complex Survey Design

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (n 4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses were adjusted for sex, race, age, smoking, education, income, BMI, other co-morbid conditions and complex survey design. Prevalence of frailty was highest among people who were obese (20·8 %), followed by overweight (18·4 %), normal weight (16·1 %) and lowest among people who were underweight (13·8 %). Independent of BMI, daily energy intake was lowest in people who were frail, followed by pre-frail and highest in people who were not frail (6648 (se 130), 6966 (se 79) and 7280 (se 84) kJ, respectively, P< 0·01). Energy-adjusted macronutrient intakes were similar in people with and without frailty. Frail (adjusted OR (AOR) 4·7; 95 % CI 1·7, 12·7) and pre-frail (AOR 2·1; 95 % CI 0·8, 5·8) people were more likely to report being food insufficient than not frail people. Serum albumin, carotenoids and Se levels were lower in frail adults than not frail adults. Research is needed on targeted interventions to improve nutritional status and food insufficiency among frail older adults, while not necessarily increasing BMI.

scholarly journals Association between alanine aminotransferase within the normal range and all-cause and cause-specific mortality: A nationwide cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242431
Author(s):  
Aayush Visaria ◽  
Suraj Pai ◽  
Alla Fayngersh ◽  
Neil Kothari
Keyword(s):  
Liver Dysfunction ◽  
Alanine Aminotransferase ◽  
Survey Design ◽  
Normal Range ◽  
Complex Survey ◽  
Health And Nutrition ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Complex Survey Design

Background and aim We sought to determine the association between alanine aminotransferase (ALT) in the normal range and mortality in the absence of liver dysfunction to better understand ALT’s clinical significance beyond liver injury and inflammation. Methods A cohort of 2,708 male and 3,461 female adults aged 20–75 years without liver dysfunction (ALT<30 in males & <19 in females, negative viral serologies, negative ultrasound-based steatosis, no excess alcohol consumption) from the National Health and Nutrition Examination Survey (NHANES)-III (1988–1994) were linked to the National Death Index through December 31, 2015. Serum ALT levels were categorized into sex-specific quartiles (Females: <9, 9–11, 11–14, ≥14 IU/L, Male: <12, 12–15, 15–20, ≥20 U/L). The primary outcome was all-cause mortality. Hazard ratios (HRs) were estimated, adjusting for covariates and accounting for the complex survey design. Results Relative to males in the lowest quartile (Q1), males in the highest quartile (Q4) had 44% decreased risk of all-cause mortality (aHR [95% CI]: 0.56 [0.42, 0.74]). Females in Q4 had 45% decreased risk of all-cause mortality (aHR [95% CI]: 0.55 [0.40, 0.77]). Males with BMI <25 kg/m2 in Q4 had significantly lower risk of all-cause mortality than Q1; however, this association did not exist in males with BMI ≥25 (BMI<25: 0.36 [0.20, 0.64], BMI≥25: 0.77 [0.49, 1.22]). Risk of all-cause mortality was lower in males ≥50 years than in males<50 (age≥50: 0.55 [0.39, 0.77], age<50: 0.81 [0.39, 1.69]). These age- and BMI-related differences were not seen in females. Conclusion ALT within the normal range was inversely associated with all-cause mortality in U.S. adults.

Reporting More but Moving Less? The Complex Relationship between Acculturation and Physical Activity Among US Adults

2017 ◽  
Vol 32 (2) ◽  
pp. 446-452
Author(s):  
Hua Zan ◽  
Jessie X. Fan
Keyword(s):  
Physical Activity ◽  
Leisure Time ◽  
Language Use ◽  
Survey Design ◽  
The United States ◽  
Complex Relationship ◽  
Cross Sectional ◽  
Complex Survey ◽  
Health And Nutrition ◽  
Complex Survey Design

Purpose: To investigate the association between acculturation and physical activity (PA). Design: Cross sectional. Setting: The National Health and Nutrition Examination Surveys (NHANES) 2003 to 2006. Subjects: A total of 4029 adults (aged 20-64), including 2063 men and 1966 women. Measures: The outcome measures included both self-reported PA and device-assessed PA. The acculturation measure was constructed based on nativity, language use at home, and length of residence in the United States. Analysis: Regressions with domain analysis were conducted to adjust for the influence of confounding factors and complex survey design. Results: For men, self-reported PA increased with acculturation, especially leisure-time PA. However, device-assessed PA decreased with acculturation. For women, the results were more mixed. Conclusion: All evidence considered, we concluded that PA decreased with acculturation for US men.

Beverage intake and obesity in early childhood: evidence form primary health care clients in Northwest Argentina

2015 ◽  
Vol 7 (3) ◽  
pp. 244-252 ◽  
Author(s):  
E. Alderete ◽  
I. Bejarano ◽  
A. Rodríguez
Keyword(s):  
Public Health ◽  
Nutritional Status ◽  
Regression Models ◽  
Task Force ◽  
Normal Weight ◽  
The Body ◽  
Logistic Regression Models ◽  
Dietary Recall ◽  
Northwest Argentina ◽  
Artificial Fruit

Sugar sweetened beverages (SSB) are thought to play an important role in weight gain. We examined the relationship between the intake of caloric and noncaloric beverages (SSB and water) and the nutritional status of children. In 2014, we randomly selected 16 public health clinics in four cities of Northwest Argentina and conducted a survey among mothers of children 0–6 years of age. Children’s beverage intake was ascertained by 24-h dietary recall provided by the mothers. Children’s weight and height measures were obtained from clinic’s registries. We calculated the body mass index using the International Obesity Task Force standards. The analysis included 562 children 25 months to 6 years of age with normal or above normal nutritional status. Children’s beverage consumption was as follows, water 81.8%, carbonated soft drinks (CSD) 49.7%, coffee/tea/cocoa 44.0%, artificial fruit drinks 35.6%, flavored water 17.9%, natural fruit juice 14.5%. In multivariate logistic regression models the likelihood of being obese v. being overweight or having normal weight doubled with an intake of one to five glasses of CSD (OR=2.2) and increased by more than three-fold with an intake of more than five glasses (OR=3.5). Drinking more than five glasses of water decreased the likelihood of being obese by less than half (OR=0.3). The percentage of children drinking more than five glasses of other beverages was low (3.3–0.9%) and regression models did not yield significant results. The study contributed evidence for reducing children’s CSD intake and for promoting water consumption, together with the implementation of comprehensive regulatory public health policies.

scholarly journals Adherence to DASH Dietary Pattern Is Inversely Associated with Osteoarthritis in Americans (P18-012-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ellen Francis ◽  
Karen Kemper ◽  
Joel Williams ◽  
Liwei Chen
Keyword(s):  
Dietary Pattern ◽  
Survey Design ◽  
Dietary Factors ◽  
Common Disease ◽  
Dash Score ◽  
Complex Survey ◽  
Logistic Regression Models ◽  
Funding Sources ◽  
Lower Likelihood ◽  
Complex Survey Design

Abstract Objectives Osteoarthritis (OA) is a common disease which significantly contributes to disability among older adults. Dietary factors are suggested to play a role in preventing OA, however, studies in this area spare. The objective of this study was to assess the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) and OA in American adults. Methods This study included United States (US) adults (≥aged 20 years) who participated NHANES cycles 2007–2016. The Dietary Approaches to Stop Hypertension (DASH) score was calculated from nine food items with a higher DASH score indicating better adherence to the DASH dietary pattern. Multivariable logistic regression models adjusted for age, education, race/ethnicity, household income, smoking, alcohol consumption, and total energy intake were used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) of DASH with OA. All analyses accounted for the complex survey design. Results Among the 17,349 participants included in this study, 9.05% reported OA. The DASH score was inversely associated with OA. The aOR (95% CI) were 1.00 (ref), 0.09 (0.70, 1.16), and 0.74 (0.58, 0.94) (Ptrend = 0.01) across the DASH score tertiles. When analyses were stratified by BMI categories (normal, overweight, obese) the magnitude of the association was stronger and remained significant only among obese participants (i.e., BMI ≥ 30 kg/m2). Among participants with an obese BMI, participants with a DASH score in the highest tertile compared to participants with a DASH score in the lowest tertile had a 17% lower likelihood of having OA (P = 0.009). Conclusions In a representative sample of American adults, higher adherence to the DASH dietary pattern was associated with lower likelihood of having OA and this association was particularly evident among obese individuals. Funding Sources N/A. Supporting Tables, Images and/or Graphs

scholarly journals The impact of complex survey design on prevalence estimates of intakes of food groups in the Australian National Children's Nutrition and Physical Activity Survey

2011 ◽  
Vol 15 (8) ◽  
pp. 1362-1372 ◽  
Author(s):  
Sandy Burden ◽  
Yasmine Probst ◽  
David Steel ◽  
Linda Tapsell
Keyword(s):  
Physical Activity ◽  
Survey Design ◽  
Food Groups ◽  
Sample Design ◽  
Complex Survey ◽  
Children's Nutrition ◽  
Prevalence Estimates ◽  
Complex Survey Design ◽  
Activity Survey ◽  
The Impact

AbstractObjectiveTo assess the impact of the complex survey design used in the 2007 Australian National Children's Nutrition and Physical Activity Survey (ANCNPAS07) on prevalence estimates for intakes of groups of foods in the population of children.DesignThe impacts on prevalence estimates were determined by calculating design effects for values for food group consumption. The implications of ignoring elements of the sample design including stratification, clustering and weighting are discussed.SettingThe ANCNPAS07 used a complex sample design involving stratification, a high degree of clustering and estimation weights.SubjectsAustralian children aged 2–16 years.ResultsDesign effects ranging from <1 to 5 were found for the values of mean consumption and proportion of the population consuming the food groups. When survey weights were ignored, prevalence estimates were also biased.ConclusionsIgnoring the complex survey design used in the ANCNPAS07 could result in underestimating the width of confidence intervals, higher mean square errors and biased estimators. The magnitude of these effects depends on both the parameter under consideration and the chosen estimator.

scholarly journals Brazilians’ experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy

2016 ◽  
Vol 20 (2) ◽  
pp. 363-370 ◽  
Author(s):  
Diva Aliete dos Santos Vieira ◽  
Josiane Steluti ◽  
Eliseu Verly-Jr ◽  
Dirce Maria Marchioni ◽  
Regina Mara Fisberg
Keyword(s):  
Survey Design ◽  
Age Groups ◽  
Substantial Reduction ◽  
Population Based ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Complex Survey ◽  
Before And After ◽  
Complex Survey Design ◽  
Fortified Flour

AbstractObjectiveTo assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe.DesignTwo cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design.SettingSão Paulo, Brazil.SubjectsAdolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661).ResultsThe Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19–50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors.ConclusionsThe mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.

scholarly journals Physical violence and violent threats reported by Aboriginal and Torres Strait Islander people with a disability: cross sectional evidence from a nationally representative survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeromey B. Temple ◽  
Heather Wong ◽  
Angeline Ferdinand ◽  
Scott Avery ◽  
Yin Paradies ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Physical Violence ◽  
Survey Design ◽  
Exposure To Violence ◽  
Royal Commission ◽  
Torres Strait Islander People ◽  
Cross Sectional ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Torres Strait

Abstract Background A recent Royal Commission into the treatment of Australians living with disabilities has underscored the considerable exposure to violence and harm in this population. Yet, little is known about exposure to violence among Aboriginal and Torres Strait Islander people living with disabilities. The objective of this paper was to examine the prevalence, disability correlates and aspects of violence and threats reported by Aboriginal and Torres Strait Islander people living with disabilities. Methods Data from the 2014–15 National Aboriginal and Torres Strait Islander Social Survey were used to measure physical violence, violent threats and disability. Multivariable logistic and ordinal logistic regression models adjusted for complex survey design were used to examine the association between measures of disability and exposure to violence and violent threats. Results In 2014–15, 17% of Aboriginal and Torres Strait Islander people aged 15–64 with disability experienced an instance of physical violence compared with 13% of those with no disability. Approximately 22% of those with a profound or severe disability reported experiencing the threat of physical violence. After adjusting for a comprehensive set of confounding factors and accounting for complex survey design, presence of a disability was associated with a 1.5 odds increase in exposure to physical violence (OR = 1.54 p < 0.001), violence with harm (OR = 1.55 p < 0.001), more frequent experience of violence (OR = 1.55 p < 0.001) and a 2.1 odds increase (OR = 2.13 p < 0.001) in exposure to violent threats. Severity of disability, higher numbers of disabling conditions as well as specific disability types (e.g., psychological or intellectual) were associated with increased odds of both physical violence and threats beyond this level. Independent of these effects, removal from one’s natural family was strongly associated with experiences of physical violence and violent threats. Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report partner or family violence, whereas men were more likely to report violence from other known individuals. Conclusion Aboriginal and Torres Strait Islander people with disability are at heightened risk of physical violence and threats compared to Aboriginal and Torres Strait Islander people without disability, with increased exposure for people with multiple, severe or specific disabilities.

scholarly journals The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia

2018 ◽  
Vol 15 (11) ◽  
pp. 2333 ◽  
Author(s):  
Jeromey Temple
Keyword(s):  
Food Insecurity ◽  
Stressful Life Events ◽  
Survey Design ◽  
General Social Survey ◽  
Stressful Events ◽  
Economic Policies ◽  
Cross Sectional ◽  
Complex Survey ◽  
Complex Survey Design ◽  
Nationally Representative

A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.

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