Bakgrund Frekvensenkät (FFQ) och kostregistrering är två vanliga kostundersökningsmetoder. För varje metod finns det felkällor och idag finns ingen fulländad kostundersökningsmetod. Genom att undersöka skillnader mellan kostundersökningsmetoder ökar förståelsen för att metoderna kan ge olika resultat. Vid kostundersökningar då näringsintag som t.ex. intag av vitamin D studeras, är det viktigt att ta hänsyn till energiintag. Detta för att ett missvisande energiintag kan ge ett felaktigt näringsintag. Syfte Syftet med studien var att jämföra eventuella skillnader mellan FFQ’s och kostregistreringar där barns intag av energi och vitamin D studerats. Metod FFQ där intaget av livsmedel uppskattades per månad, vecka eller dag och en vägd kostregistrering under tre dagar användes för att undersöka barns intag av energi och vitamin D. Barnen var mellan 5-8 år. Resultaten från de två metoderna jämfördes med varandra. Data analyserades i SPSS 22.0. Wilcoxon signed-rank test och correlate bivariate Spearman användes för att hitta skillnader respektive samband mellan resultaten från metoderna. Resultat Tjugosju FFQ’s jämfördes med 27 kostregistreringar. Medelåldern för barnen var 6 år och fyra månader. Det fanns en skillnad från uppskattningen av det totala intaget av vitamin D mellan de olika metoderna (p=0,001). Medelvärdet av intaget vitamin D från FFQ’s var 7,4 μg och 5,2 μg från kostregistreringarna. Enligt FFQ’s nådde sex barn det rekommenderade intaget (10 μg) av vitamin D. Inget barn nådde rekommendationen enligt kostregistreringarna. Intaget av fet fisk respektive intaget av mjölk 3% uppskattades i två fall lika mellan båda metoderna. Hos övriga deltagare skiljde sig intaget av alla livsmedel mellan kostundersökningsmetoderna. Slutsats Undersökningen visade signifikanta skillnader i resultaten av barns intag av vitamin D mellan FFQ’s och kostregistreringarna. Av den anledningen konkluderar vi att valet av kostundersökningsmetod påverkar resultatet. Eftersom FFQ´s visar ett medelintag över en längre tid kunde FFQ´s i den här studien med fördel använts som enda undersökningsmetod.

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Metabolic syndrome is a grouping of criteria that includes hypertension, glucose intolerance, truncal obesity and/or a high body mass index (BMI), insulin resistance, high very-low-density lipoproteins, high triglycerides, and low high-density lipoproteins. Metabolic syndrome is a problem in Hispanic children due to increasing obesity rates and a predisposition for insulin resistance in the Hispanic population. Omega-3 fatty acid supplementation has been shown to decrease triglycerides, body mass, insulin resistance, and hypertension while increasing HDL. Inflammatory markers are also reduced after omega-3 supplementation. More research is needed on the supplementation of omega-3 fatty acids in children before guidelines are written. Supplementation and overall intake levels of EPA and DHA can be determined through food frequency questionnaires. Research at this time indicates that supplementation with omega-3 fatty acids could be beneficial for Hispanic children who already partially met the criteria for metabolic syndrome, and is probably not harmful.

Background: Prostate cancer remains the second most common cause of cancer-related death in men in the United States (Siegel et al. 2017). Observational studies of patients with prostate cancer have found associations between diet and prostate cancer severity, but the evidence is inconsistent or inconclusive. The purpose of this thesis is to implement a validated international healthy diet score and evaluate whether or not it is associated with prostate cancer severity. Objective: The objectives of this thesis were: Chapter 1: examine whether an association exists between diet quality, using the validated Healthy Diet Score, and the severity of prostate cancer, and Chapter 2: examine the agreement between two methods of dietary data collection (an abridged FFQ and a longer previously validated FFQ) with respect to macronutrients and main food groups. Methods: We used observational data from the Randomized Intervention for Cardiovascular and Lifestyle Risk Factors in Prostate Cancer Patients (RADICAL PC), a multi-centre Canadian prospective cohort study into which men with a new diagnosis of prostate cancer or who were being treated with androgen deprivation therapy were enrolled. To complete objective 1 (Chapter 1) of this dissertation, a cross-sectional analysis was completed using baseline data collected in the RADICAL PC study. In order to evaluate the association of diet with prostate cancer severity, the relationship between the Healthy Diet Score and prostate cancer severity (stage and grade) was assessed. The second objective (Chapter 2) is a comparability sub-study comparing an abridged FFQ with a long, validated FFQ in a subgroup of participant (N=130) enrolled in the RADICAL PC study. Results: Chapter 1: In the cross-sectional analysis of baseline data collected in RADICAL PC, a higher diet score was not significantly associated with prostate cancer severity. An association between age and the high-risk prostate cancer category was found to be statistically significant (OR: 1.04, 95%CI 1.02-1.05, p<0.00). Chapter 2: There was good agreement between the abridged FFQ and long FFQ for carbohydrates, proteins, whole wheat, refined grains, fish, dairy, potatoes, fruits, nuts, and soft drinks (Spearman rank correlation >0.5). Food groups including fried foods, processed meats, vegetables and total fats (nutrients) were found to have moderate correlation (Spearman rank correlation between 0.3-0.5). There was low correlation for legumes, sugars and oils. Bland-Altman plots showed good absolute agreements between the two methods, and reliability test using Spearman’s correlation showed moderate to good correlation (0.45 to 0.75 among most food groups. Conclusion: There was no clear association between a healthier diet and prostate cancer severity in men with newly diagnosed prostate cancer. There was adequate agreement between the abridged SFFQ and the long FFQ of the expected food groups, and thus the SFFQ can be considered an appropriate tool to use for measuring diet among prostate cancer patients for some food groups and nutrients. / Thesis / Master of Health Sciences (MSc)

Yes / Food Involvement reflects the bond between consumer and food, and serves as a means of expression, identity and social recognition. Yet no existing scales are able to assess the complex psychological nature of Food Involvement. To fill this gap, this study developed and validated a Psychological Food Involvement Scale (PFIS). Data were collected by an online self-report questionnaire, involving 476 Italians aged 20-72 years (M = 48.13, SD = 13.18). The structure and psychometric properties of PFIS were examined through an exploratory and a confirmatory factor analysis, and construct validity was assessed by correlating it with Food Involvement Scale, Food Variety Seeking Scale and the General Health Interest Scale. As a behavioural indicator of validity, food and drink consumption was assessed using the Dietary Habits and Nutrition Beliefs Questionnaire. Factor analysis indicated that the PFIS comprised 19 items grouped in four stable dimensions: Emotional Balance; Self-Realization; Social Affirmation; Social Bonding. People more psychologically involved in food were more interested in healthy eating and more likely to vary their diet. The PFIS discriminated between dietary patterns. Higher PFIS scores were associated with frequent consumption of meat/fish and wholegrains/legumes. Frequent intake of meat/fish and snacks was associated with Social Bonding and meat/fish with Emotional Balance. The PFIS also explained consumption of vegetable drinks and lactose-free milk indicating the symbolic value ascribed to them related to self-expression, acceptance by others, and emotions. This implies potential for the PFIS for use in research to understand food choice and promote healthy eating. / This work was supported by the Fondazione Cariplo and Regione Lombardia within the CRAFT (Cremona Agri-Food Technologies) project ID 2018/2757.

Univerzita Karlova v Praze 1. lékařská fakulta Studijní program: Specializace ve zdravotnictví Obor: Adiktologie Bc. et Bc. Kristýna Kopecká Nutriční návyky pacientů léčících se ze závislosti na alkoholu ve vybraných psychiatrických nemocnicích The Nutritional habits of Pacients Recovering From Alcohol Addiction in Selected Psychiatric Hospitals Diplomová práce Vedoucí práce: PhDr. Lenka Čablová PRAHA 2016 Abstract Introduction: Nutritional habits significantly affect the health and quality of life and they are an important part of a healthy lifestyle. Following nutritional recommendations is very important for the general population as well as for people recovering from alcohol dependence. One of the goals of treatment is improving the quality of life and well-balanced diet can actually help. Goals: The main objective of the research is to determine what are the eating habits of people recovering from alcohol dependence during their stay in selected psychiatric hospitals. Another objective is to determine the difference in eating habits of respondents before entering treatment and after entering treatment. The aim is also to describe the relationship between dietary habits and socio-demographic data. It is set as a sub-goal to also map the results of the YFAS questionnaire. Methods and sample: A tool...

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Background and objective: Researchers have been looking for a way to predict future emission rates, and come up with explanations on how to tackle the issue of global warming through changes in individual behavior for decades. The focus of these studies have, on the other hand, focused more on nutritional bases rather than cultural. This study’s objective is to provide a method, as a useful tool in further analysis on GHG-emission based on cultural behavioral factors such as socio-economic status as well as age, sex, etc. with diet as emission prediction factor. This could be a stepping stone toward future research on Co2e related to e.g. physiological factors such as BMI, blood pressure and diseases. Method: With the use of data obtained from the FFQ questionnaire within the VIP-program, combined with estimates of greenhouse gas-emission (Co2e) attributed to specific diets obtained from Röös, estimations of individual Co2e emission-levels were calculated using the software “R”. The dataset contained 159 687 observations and 152 different variables. The data was obtained from the Department of Public Health and Clinical Medicine at Umeå University. Portions sizes were mainly collected from the Swedish Food Composition Database. Box-plots and regression analysis were made to illustrate the main findings. Result: The result was a new dataset that could be applied to any population to estimate Co2e-emission on individual level based on an FFQ, given that the FFQ have the same structure as the one in the VIP. The variables that contributed to the highest amount of Co2e were animal products i.e. butter, milk and meat. Chicken, pork and fish were not nearly as Co2e heavy as the meat products containing beef such as “steak”, “minced meat” and “hamburgers”. The regression analysis showed that higher age had a positive effect on reducing emission, as well as being a woman. Education showed an increase in Co2e for higher education. There were some small differences among municipalities. Marital status gave a slight decrease in the regression, meaning married couples emits more than singles. Exercise showed an increase in Co2e for active individuals in the regression analysis. However, the most noticeable result were sex, yielding a relatively big decrease in Co2e-emission for women compared to men. Conclusion: People at younger ages, within the observed age groups 40-60, seemed to reduce their carbon footprint more in relation to the higher age groups over the last 20 years. Overall, the general diet-based carbon footprint in Västerbotten seems to have increased slightly during the last 17 years. A remarkable dip were noticed in 2003, however this might not have been due to any behavioral changes, since the trend broke in 2006 and instantly receded back to the normal levels. This study confirms the fact that meat and dairy products are responsible for a significant amount of the diet-based emission. This topic needs to be studied more, and with this method of applying GHG-emission measures to individual diet-based data, a gate has been opened for a new field of research.

Introdução: Epilepsia é uma desordem cerebral caracterizada predominantemente pela interrupção paroxística do funcionamento normal do cérebro causada por crises epilépticas que ocorrem de maneira recorrente e imprevisível. Aproximadamente 50% dos adultos com epilepsia têm ao menos uma comorbidade médica associada, e algumas condições apresentam uma prevalência maior quando comparados à população em geral. Entre elas podemos citar as comorbidades psiquiátricas e as alterações nutricionais. Objetivos: O presente estudo avaliou o consumo alimentar de pacientes portadores de epilepsia, e de forma mais específica, o consumo dos ácidos graxos poli-insaturados (PUFAS), e a sua relação com a presença de transtornos neuropsiquiátricos. Métodos: Foi realizado um estudo transversal onde o consumo alimentar de paciente com epilepsia do lobo temporal foi avaliado por um questionário de frequência alimentar (QFA) validado para a população de Porto Alegre –RS. Também foi avaliado a presença de transtornos psiquiátricos e sintomas de ansiedade através dos questionários estruturados, SCID, BAI e Escala de Hamilton. Resultados: Pacientes com diagnóstico de transtornos psiquiátricos avaliado por SCID apresentaram menor consumo de ácidos graxos omega-3, (0,53 ± 0,34g vs 0,84 ± 0,58g; p=0,047) e (0,21g ± 0,13g/1000kcal vs 0,32±0,21g/1000kcal; p=0,049). Pacientes com maiores níveis de ansiedade avaliados pelo BAI também apresentaram menor ingestão de PUFAS n-3 (9,14 ± 3,65g vs 12,82 ± 4,84g; p=0,011 e 3,41 ± 1,21% vs 4,14 ± 1,05% do VET; p=0,04). A Escala de Hamilton apresentou correlação inversa ao consumo de PUFAS n-3 (-0,306; p=0,041). Conclusão: Foi identificada uma associação entre o consumo de PUFAS n-3 e a presença de transtornos psiquiátricos e níveis mais altos de ansiedade em pacientes com epilepsia do lobo temporal. Ainda que o nosso estudo não pode determinar uma relação de cause efeito entre alterações neuropsiquiátricas e consumo de PUFAS é possível que um consumo de alimentos ricos em Omega-3 possa ser uma estratégica terapêutica a fim de melhorar anormalidades neuropsiquiátricas nesses pacientes. Essa é uma interessante questão que necessita ser melhor avaliada no futuro. / Background: Epilepsy is a brain disorder characterized by recurrent and unpredictable interruptions of normal brain function. About 50% of the adults patients with epilepsy have one or more coexisting medical conditions. Among the comorbidities, we highlight nutritional problems as well psychiatric disorders, which have a significant impact in the life quality of this patient. Aims: The aim of this study is to evaluate the nutritional intake of lobe temporal epilepsy patients and investigate its relation with psychiatric disorders diagnosis. Patients and Methods: we performed a cross-sectional study with 45 temporal lobe epilepsy patients and applied a food frequency questionary (FFQ), comparing the results with psychiatric diagnosis assessed by SCID to any disorders and depression by BAI and Hamilton Scale for anxiety. Results: All patients had a higher consumption of calories (38,89 ± 15,44). than the preconized for people in general and a lower intake of PUFAS than the recommended for cardiovascular protection. Patients identified with any psychiatric disorder by SCID had a lower intake of PUFAS n-3 (0,53 ± 0,34g vs 0,84 ± 0,58g; p=0,047 and 0,21g ± 0,13g/1000kcal vs 0,32±0,21g/1000kcal; p=0,049 than those free of diagnosis. Patients with high levels of anxiety also had also had a lower consumption of PUFAS n-3 (9.14 ± 3.65g vs 12.82 ± 4,84g; p=0.011). The Hamilton Scale had a negative correlation with PUFAS n-3 intake (0,306; p=0,041). Conclusion: We found a negative relation between the diagnosis of psychitric disorders and anxiety as assessed by SCID and BAI respectively. It’s not possible to determine a cause and effect relationship in this association, but we can consider the omega-3 fat acid and PUFAS n-3 rich food might be potentially therapeutic in patients with temporal lobe epilepsy. This question might deserve further studies.

Evidências indicam a relação entre o consumo excessivo de açúcar pela população mundial e o desenvolvimento de doenças crônicas como cárie, obesidade, diabetes e câncer. Para verificar a relação entre dieta e processo saúde-doença, estudos epidemiológicos utilizam instrumentos válidos, reprodutíveis e confiáveis, sendo o mais utilizado o questionário de frequência alimentar (QFA). Este estudo tratou de desenvolver, reproduzir e validar um instrumento de pesquisa (QFA-açúcar) que permita quantificar em gramas o consumo de açúcar em amostra da população adulta de Porto Alegre/RS. Para a determinação da lista de alimentos e do modelo de registro do QFA-açúcar, foi realizada a abordagem de pesquisa qualitativa denominada grupo focal, baseada na adaptação do QFA desenvolvido para a população adolescente, adulta e idosa de Porto Alegre (QFA-Porto Alegre). A quantificação do açúcar dos alimentos seguiu o método físico-químico de análise de alimentos de Fehling, ou a leitura da tabela de composição de alimentos do Departamento de Agricultura dos Estados Unidos (USDA). O QFA-açúcar foi avaliado por juízes com experiência na elaboração e aplicação de QFA. O resultado final desta etapa apresenta o QFA-açúcar com 94 itens. Para testar a reprodutibilidade e medir a validade do QFA-açúcar, foi empregada a abordagem quantitativa de pesquisa, utilizando uma amostra de 81 indivíduos, residentes em Porto Alegre, com idade entre 18 e 60 anos, selecionada através da amostragem por estágios múltiplos. O estudo aconteceu de julho a novembro de 2011 e os participantes responderam dois inquéritos recordatórios de 24 horas e 2 QFA-açúcar, num intervalo de 15 a 30 dias. A reprodutibilidade foi testada através do coeficiente de correlação intraclasse por ponto e por intervalo de 95% de confiança, por meio do teste das diferenças das médias pareadas (t-student) e pelo coeficiente alfa de Cronbach. A validade foi medida através dos coeficientes de correlação de Pearson e Spearman brutos e deatenuados e da classificação dos indivíduos segundo suas distribuições em quartos de consumo de sacarose de cada método. Os resultados apontaram que, para a reprodutibilidade, o teste t-student indicou que não há diferença significativa entre os dois questionários (p>0,01). O valor obtido para o coeficiente de alfa de Cronbach foi 0,903. Quanto à validade, diversamente do QFA-açúcar2, o teste t pareado entre o QFA-açúcar1 e a média dos dois IR24h mostrou diferença estatisticamente significativa para a ingestão de sacarose (p<0,05). Os coeficientes de correlação de Pearson e Spearman deatenuados para o QFA-açúcar 1 foram de 0,18 e 0,21 e para o QFA-açúcar2 de 0,36 e 0,44. A concordância exata média entre os QFA-açúcar1 e 2 foi de 30,25% e o percentual médio de indivíduos classificados em quartos adjacentes foi 61,11%. Concluindo, o QFA-açúcar possui relevâncias e limitações, contudo pode ser aprimorado. Mostrou reprodutibilidade e validade satisfatórias e poderá ser utilizado em estudos epidemiológicos para investigar a associação entre consumo de açúcar, doenças crônicas não-transmissíveis e cárie na população adulta de Porto Alegre. / Evidence indicates the relationship between excessive consumption of sugar by the population and the development of non communicable chronic diseases such as caries, obesity, diabetes and cancer. To investigate the relationship between diet and health-disease process, epidemiological studies use valid and reproducible instruments, and the most widely used is the Food Frequency Questionnaire (FFQ). The objective of this study was to develop, reproduce and validate a survey instrument (FFQ-sugar) to quantify in grams the sugar consumption in a sample of the adult population from Porto Alegre / RS. To determine the list of foods and the model's log of the FFQ-sugar, was carried out a qualitative research approach called focus group. It was based on the adaptation of the FFQ developed for adolescents, adults and elderly from Porto Alegre (FFQ-Porto Alegre). The food sugar quantification followed the Fehling method of food physical-chemical analysis or the reading of the food composition table from the American United States Department of Agriculture (USDA). The FFQ-sugar was evaluated by judges with experience in FFQ developing and implementing. The final result of this step shows the FFQ sugar with 94 items. To test the reproducibility and to measure the validity of the FFQ-sugar, was used the quantitative research approach. A sample of 81 individuals living in Porto Alegre, from 18 and 60 years of age were selected by multistage sampling. The study happened from July to November of 2011. The participants answered two 24-hour dietary recall questionnaire and two FFQ-sugar, in a interval of 15 to 30 days. The reproducibility was tested by the intra-class correlation coefficient by point and 95% confidence interval, through the test of paired differences of means (student-t test) and by the Cronbach's alpha. The validity was measured by the brute and de-attenuated correlation coefficients of Pearson and Spearman and by the classification of the individuals according to their distributions in sucrose consumption quartile of each method. The results showed that, for the reproducibility, the student-t test indicated that there is no significant difference between the two questionnaires (p> 0,01). The value of the coefficient of Cronbach's alpha was 0.903. As for validity, unlike the FFQ-açúcar2, the student-t test between the FFQ-açúcar1 and the two IR24h average demonstrated statistically significant difference for sucrose intake (p <0,05). The de-attenuated correlation coefficients of Pearson and Spearman for the FFQ-sugar1 were 0,18 and 0,21 and for the FFQ-sugar2 were 0,36 and 0,44. The exact average concordance between the FFQ- sugar 1 and 2 was 30,25% and the the average percentage of individuals classified in adjacent quartiles was 61,11%. The FFQ-sugar has relevance and limitations, but can be improved. It showed reasonable reproducibility and validity. As such, it may be used in epidemiological studies to investigate the association between sugar consumption, non communicable chronic diseases and dental caries in the adult population from Porto Alegre.