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.

Foi utilizado um Questionário Semi-quantitativo de Freqüência Alimentar (QSFA) anteriormente validado para obter dados de ingestão de macronutrientes e cálcio, agora para obtenção online de dados de ingestão de ferro e de cálcio. Para tanto, foram selecionadas mulheres de 19 a 59 anos de idade, que participaram espontaneamente de um evento do PRINUTHA (Projeto Integrado de Nutrição Humana Aplicada) no CEPE-USP (Centro de Práticas Esportivas da USP), para responderem a um Recordatório de 24 Horas (RH24). Nos quatro meses seguintes foram obtidos mais quatro RH24´s por telefone ou por e-mail. No mês seguinte as participantes preencheram o QSFA online. Este Questionário foi validado para ferro e para cálcio, uma vez que o coeficiente de correlação dos dados obtidos pelos RH24´s e pelo QSFA corrigidos pela energia resultaram em valores de rc = 0,402 para ferro e rc = 0,605 para cálcio. / A Semi-quantitative Food Frequency Questionnaire (QSFA), previously validated, was used to obtain the intake of energy, carbohydrates, proteins, fat and calcium, now to obtain the intake of iron and calcium online. Therefore, women between 19 and 59 years old, who participated from PRINUTHA (Integrated Project of Human Nutrition) at the CEPE-USP (USP´s Sport Practice Center) was selected to answer a 24 Hours Recall (RH24). At the next four months four more RH24´s was obtained per telephone ou e-mail. At the next month the participants full an online QSFA. This questionnaire was validated for iron and calcium, resulting in an energy adjusted correlation coefficient rc = 0,402 for iron and rc = 0,605 for calcium.

Introdução: O consumo alimentar inadequado é causa de deficiências nutricionais, especialmente na infância e adolescência, fases em que o organismo está em pleno crescimento e desenvolvimento. Portanto, é fundamental que sejam validados instrumentos que identifiquem o consumo alimentar de crianças e adolescentes e subsidiem o entendimento do processo saúde-doença. Objetivos: Avaliar a validade da estimativa do consumo de nutrientes e das pontuações total e por componentes do Índice de Qualidade da Dieta Revisado (IQD-R), ambas obtidas a partir de um Questionário Semiquantitativo de Frequência Alimentar (QSFA), utilizando biomarcadores dietéticos como métodos de referência, em crianças e adolescentes de 9 a 13 anos de idade do município de Ribeirão Preto - SP. Métodos: Estudo metodológico de validação. O consumo alimentar foi estimado por um QFSA e calculado no software Nutrition Data System for Research (NDSR) ®, sendo os seguintes nutrientes estimados: ácidos graxos mirístico (C14:0), palmítico (C16:0), margárico (C17:0), esteárico (C18:0), ?-linolênico (C18:3; ALA), eicosapentaenoico (C20:5 ; EPA) e docosahexaenóico (C22:6 ; DHA); ?- caroteno; retinol; ?-tocoferol e vitaminas D, B1, B2, B3, B5, B6, folato e B12. O consumo alimentar estimado pelo QSFA foi utilizado para calcular as pontuações do IQD-R. Além dos componentes originais do IQD-R, foram calculados os componentes modificados denominados Vegetais Totais sem Leguminosas (Vegetais Totais SL) e Vegetais Verde-Escuros e Alaranjados sem Leguminosas (Veveal SL), nos quais o excedente de leguminosas do Grupos Carnes, Ovos e Leguminosas não foi incluído. Os biomarcadores foram analisados em amostras de plasma: ?-caroteno, ?-caroteno/colesterol total (CT), retinol, ?-tocoferol, ?-tocoferol/CT, 25-hidroxivitamina D3 [25(OH)D3], tiamina, riboflavina, nicotinamida, nudifloramida, ácido pantotênico, piridoxamina 5-fosfato (PMP), piridoxal, piridoxal 5-fosfato (PLP), 5- metiltetrahidrofolato (5-MTHF), folato, vitamina B12, creatina; ou eritrócitos: C14:0, ácido pentadecanóico (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. As associações da estimativa do consumo de nutrientes e das pontuações do IQD-R com as concentrações de biomarcadores foram analisadas por correlação de Spearman e correlação parcial ajustada para energia, sexo, idade e escore-z de índice de massa corporal para idade. Todos os indivíduos foram classificados em quartis de acordo com a estimativa do consumo de nutrientes, as pontuações do IQD-R e os biomarcadores e os dados foram analisados para concordância entre quartis de biomarcadores vs. consumo, diferença das médias dos biomarcadores entre o primeiro e o último quartil de consumo e análise de tendência das médias dos biomarcadores entre os quartis de consumo. As análises estatísticas foram realizadas no software Statistical Package for the Social Sciences (SPSS) ®, versão 20.0, com nível de significância de 5%. Resultados: A amostra foi constituída de 177 indivíduos com média de 11,5 (DP 1,1) anos de idade, sendo 52,0% do sexo feminino. Os biomarcadores ?-caroteno (r=0,168), ?-caroteno/CT (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211) e EPA (r=0,166) apresentaram correlações ajustadas com os respectivos consumos estimados pelo QSFA. Após ajuste para variáveis de confusão, o biomarcador DHA apresentou correlação com o consumo estimado de DHA apenas no sexo feminino (r=0,280). Quanto ao IQD-R, os componentes de vegetais foram correlacionados aos biomarcadores de ?-caroteno e ?-caroteno/CT (r = 0,230 a 0,340), enquanto os componentes modificados Vegetais Totais SL e Veveal SL foram correlacionados aos biomarcadores vitamina B12 (r=0,194) e 5-MTHF (r=0,201), respectivamente. Todos os componentes ricos em proteínas de origem vegetal (leguminosas) e animal (carnes e ovos) foram correlacionados à creatina plasmática (r=0,205 a 0,327). O componente Leite e Derivados foi correlacionado aos biomarcadores C14:0 (r=0,169), ácido pantotênico (r=0,233), PLP (r=0,283) e vitamina B12 (r=0,265). Biomarcadores de vitaminas do complexo B foram inversamente correlacionados aos componentes Cereais Totais; Carnes, Ovos e Leguminosas e Gordura Saturada (r= -0,178 a -0,282). Não houve correlações entre biomarcadores e a pontuação total do IQD-R. As associações entre biomarcadores e os nutrientes estimados pelo QSFA e os componentes Vegetais Totais SL, Veveal SL, Leite e Derivados e Gordura Saturada foram corroboradas por concordância entre quartis >70%, diferença de média de biomarcador entre primeiro e último quartil de consumo e tendência de média biomarcador entre quartis de consumo. Conclusão: A estimativa de nutrientes e os componentes do IQD-R, ambos obtidos por meio do QSFA, foram validados conforme as associações acima descritas e podem ser utilizados em estudos clínicos e epidemiológicos que investiguem a associação entre desfechos em saúde e consumo alimentar de crianças e adolescentes de 9 a 13 anos da região de Ribeirão Preto, SP. / Introduction: Inadequate dietary intake is a cause of nutritional deficiencies, especially in childhood and adolescence, when the body is experiencing rapid growth and development. Therefore, it is fundamental to validate instruments that identify the dietary intake of children and adolescents and support the understanding of the health-disease process. Objectives: To assess the validity of nutrient intake estimate and total and component scores from Brazilian Healthy Eating Index - Revised (BHEI-R), both obtained from a semiquantitative food frequency questionnaire (SFFQ), using dietetic biomarkers as a reference method, in children and adolescents aged 9 to 13 years in Ribeirão Preto - SP. Method: Methodological and validation study. Dietary intake was estimated by a SFFQ and calculated using the software Nutrition Data System for Research (NDSR) ®, and the following nutrients were estimated: myristic acid (C14:0), palmitic acid (C16:0), margaric acid (C17:0), stearic acid (C18:0), ?- linolenic acid (C18:3 ; ALA), eicosapentaenoic acid (C20:5 ; EPA), docosahexaenoic acid (C22 : 6; DHA), ?-carotene, retinol, ?-tocopherol, and vitamins D, B1, B2, B3, B5, B6, folate, and B12. The dietary intake estimated by SFFQ was used to generate the BHEI-R scores. In addition to the original components of the BHEI-R, the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were calculated, in which the excess legumes from Meat, Eggs and Legumes component was not included. Biomarkers were analyzed in plasma: ?-carotene, ?-caroteno/total cholesterol (TC), retinol, ?- tocopherol, ?-tocopherol/TC, 25-hydroxyvitamin D3 [25(OH)D3], thiamine, riboflavin, nicotinamide, nudifloramide, pantothenic acid, pyridoxamine 5-phosphate (PMP), pyridoxal 5-phosphate (PLP), 5-methyltetrahydrofolate (5-MTHF), folate, vitamin B12, and creatine; or erythrocytes samples: C14:0, pentadecanoic acid (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. The associations of the nutrient intake estimate and BHEI-R scores with biomarkers concentrations were analyzed by Spearman correlation and partial correlation adjusted for energy, sex, age, and z-score for body mass index-for-age. Subjects were classified into quartiles according to nutrient intake estimates, BHEI-R scores and biomarkers and data were analyzed for quartile agreement between biomarkers vs. intake, comparison of biomarkers averages between the first and last intake quartiles, and trend analysis of biomarkers averages among the intake quartiles. Statistical analyzes were performed in software Statistical Package for Social Sciences (SPSS) ®, version 20.0, with a significance level of 5%. Results: The sample was composed of 177 subjects, the mean age was 11.5 (SD 1.1) years old and 52% were female. The biomarkers ?- carotene (r=0,168), ?-carotene/TC (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211), and EPA (r=0,166) showed positive adjusted correlations with their respective intakes estimated by SFFQ. After adjusting for confounding variables, DHA showed correlation only in females (r=0,280). Regarding BHEI-R, vegetable components were correlated with biomarkers ?- carotene and ?-carotene/TC, while the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were correlated with the biomarkers vitamin B12 (r=0,194) and 5-MTHF (r=0,201), respectively. All components rich in vegetable (legumes) and animal protein (meat, eggs) were correlated with plasma creatine (r=0,205 a 0,327). The component Milk was correlated with biomarkers C14:0 (r = 0,169), pantothenic acid (r = 0,233), PLP (r = 0,283), and vitamin B12 (r = 0265). Biomarkers of Bcomplex vitamins were inversely correlated with the components Whole Grains; Meat, Eggs and Legumes; and Saturated Fat (r= -0,178 a -0,282). There was no correlation between biomarkers and total IQD-R score. The associations between the biomarkers and the nutrients estimated by the SFFQ and the components Total Vegetables without Legumes, Dark Green and Orange Vegetables without Legumes, Milk, and Saturated Fat were confirmed by quartiles agreement >70%, difference between biomarker average between first and last quartile of intake and trend of biomarker average among quartiles of intake. Conclusion: The nutrient estimates and the BHEI-R components, both obtained through the SFFQ, were validated according to the associations described above and can be used in clinical and epidemiological studies investigating the association between health outcomes and dietary intake of children and adolescents age 9 to 13 years in Ribeirão Preto - SP.

Foi utilizado um Questionário Semi-quantitativo de Freqüência Alimentar (QSFA) anteriormente validado para obter dados de ingestão de macronutrientes e cálcio, agora para obtenção online de dados de ingestão de ferro e de cálcio. Para tanto, foram selecionadas mulheres de 19 a 59 anos de idade, que participaram espontaneamente de um evento do PRINUTHA (Projeto Integrado de Nutrição Humana Aplicada) no CEPE-USP (Centro de Práticas Esportivas da USP), para responderem a um Recordatório de 24 Horas (RH24). Nos quatro meses seguintes foram obtidos mais quatro RH24´s por telefone ou por e-mail. No mês seguinte as participantes preencheram o QSFA online. Este Questionário foi validado para ferro e para cálcio, uma vez que o coeficiente de correlação dos dados obtidos pelos RH24´s e pelo QSFA corrigidos pela energia resultaram em valores de rc = 0,402 para ferro e rc = 0,605 para cálcio. / A Semi-quantitative Food Frequency Questionnaire (QSFA), previously validated, was used to obtain the intake of energy, carbohydrates, proteins, fat and calcium, now to obtain the intake of iron and calcium online. Therefore, women between 19 and 59 years old, who participated from PRINUTHA (Integrated Project of Human Nutrition) at the CEPE-USP (USP´s Sport Practice Center) was selected to answer a 24 Hours Recall (RH24). At the next four months four more RH24´s was obtained per telephone ou e-mail. At the next month the participants full an online QSFA. This questionnaire was validated for iron and calcium, resulting in an energy adjusted correlation coefficient rc = 0,402 for iron and rc = 0,605 for calcium.

The effect of fish consumption on the risk of cardiovascular disease has been extensively studied. Omega-3 fatty acids present in fish, namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been found to have beneficial effects through several mechanisms. In addition, selenium, an antioxidant, may be protective. Fish also represents the main human exposure source to the pollutant methylmercury (MeHg), which is associated with elevated cardiovascular risk in previous studies. The aim of this thesis was to evaluate whether MeHg is associated with the risk of myocardial infarction (MI) or stroke, whether EPA+DHA or selenium (Se) have protective associations, and if the overall association between fish consumption and risk of stroke or MI is detrimental or protective. A prospective incident case-control study design was used to study effects on stroke or MI. Three hundred and sixty-nine cases with twice as many matched controls were included in the study on stroke, while 431 cases with 499 controls participated in the MI study, all from the Northern Sweden Health and Disease Study. The data was collected from health examinations of the population from 1986 until 1999. Also, time trends in burdens of mercury (Hg), lead (Pb) and cadmium (Cd) in erythrocytes (Ery) from 1990 to 1999 were examined. The food frequency questionnaire (FFQ) used in the case-control studies was correlated with measurements of fatty acids in erythrocyte membranes as biomarkers of intake. In this northern Swedish population, levels of Ery-Hg and Ery-Pb decreased during the 1990´s, but Ery-Cd decreased only in smoking men. No significant associations were found between Ery-Hg or levels of EPA+DHA and the risk of stroke. Men reporting fish consumption >3 meals/week had an elevated risk of stroke. In the MI study, higher levels of Ery-Hg were associated with lower risk of MI. No clear associations were found for reported fish consumption, levels of EPA+DHA or Ery-Se. The validated FFQ has a fair reliability in estimating intake of fatty acids EPA and DHA. However, the low variation in fish consumption in the general population in combination with different versions of the FFQ (with pre-defined, multiple choice alternatives) decreased the reliability of self-reported fish consumption in the case-control studies on risk of stroke or MI. In conclusion, MeHg has no harmful association regarding the risk of stroke or MI in this population with generally low exposure levels. The protective association regarding risk of MI is probably due to Ery-Hg being a biomarker for consumption of fish, a source of other beneficial nutrients. Thus, in this population the benefits of the nutrients in fish appear to overcome the potential harm of MeHg. The finding of elevated stroke risk related to high fish consumption in men will be investigated further. / PHIME; Public health impact of long-term, low-level mixed element exposure in susceptible population strata

Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response is a result of both the type and amount of carbohydrate foods consumed and is commonly measured as the glycemic index (GI) or glycemic load (GL), where the GI is a ranking in comparison to glucose and the GL is an absolute value encompassing both the GI and amount of carbohydrate consumed. Evidence from controlled trials in rat models suggests that glycemic intake has a role in development of insulin resistance, however trials and observational studies of humans have produced conflicting results. As insulin resistance is a precursor to type 2 diabetes mellitus, lifestyle factors that could prevent development of this condition have important public health implications. Previous observational studies have used food frequency questionnaires to assess usual diet, which could have resulted in a lack of precision in assessment of individual serve sizes, and have been limited to daily measures of glycemic intake. Daily measures do not take fluctuations in glycemic intake on a per meal basis into account, which may be a more relevant measure for investigation in relation to disease outcomes. This PhD research was conducted in a group of Brisbane women aged 42 to 81 years participating in the multidisciplinary Brisbane Longitudinal Assessment of Ageing in Women (LAW study). Older women may be at particular risk of insulin resistance due to age, hormonal changes, and increases in abdominal obesity associated with menopause, and the LAW study provided an ideal opportunity to study the relationship between diet and insulin resistance. Using the diet history tool, we aimed to assess the glycemic intake of the population and hypothesised that daily GI and daily GL would be significantly positively associated with increased odds of insulin resistant status. We also hypothesised that a new glycemic measure representing peaks in GL at different meals would be a stronger predictor of insulin resistant status than daily measures, and that a specially designed questionnaire would be an accurate and repeatable dietary tool for assessment of glycemic intake. To address these hypotheses, we conducted a series of studies. To assess glycemic intake, information on usual diet was obtained by detailed diet history interview and analysed using Foodworks and the Australian Food and Nutrient (AUSNUT) database, combined with a customised GI database. Mean ± SD intakes were 55.6 ± 4.4% for daily GI and 115 ± 25 for daily GL (n=470), with intake higher amoung younger participants. Bread was the largest contributor to intakes of daily GI and GL (17.1% and 20.8%, respectively), followed by fruit (15.5% and 14.2%, respectively). To determine whether daily GI and GL were significantly associated with insulin resistance, the homeostasis model assessment of insulin resistance (HOMA) was used to assess insulin resistant status. Daily GL was significantly higher in subjects who were insulin resistant compared to those who were not (134 ± 33 versus 114 ± 24 respectively, P<0.001) (n=329); the odds of subjects in the highest tertile of GL intake being insulin resistant were 12.7 times higher when compared with the lowest tertile of GL (95% CI 1.6-100.1, P=0.02). Daily GI was not significantly different in subjects who were insulin resistant compared to those who were not (56.0 ± 3.3% versus 55.7 ± 4.5%, P=0.69). To evaluate whether a new glycemic measure representing fluctuations in daily glycemic intake would be a stronger predictor of insulin resistant status than other glycemic intake measures, the GL peak score was developed to express in a single value the magnitude of GL peaks during an average day. Although a significant relationship was seen between insulin resistant status and GL peak score (Nagelkerke’s R2=0.568, P=0.039), other glycemic intake measures of daily GL (R2=0.671, P<0.001) and daily GL per megajoule (R2=0.674, P<0.001) were stronger predictors of insulin resistant status. To develop an accurate and repeatable self-administered tool for assessment of glycemic intake, two sub-samples of women (n=44 for the validation study and n=52 for the reproducibility study) completed a semi-quantitative questionnaire that contained 23 food groupings selected to include the top 100 carbohydrate foods consumed by the study population. While there were significant correlations between the glycemic intake questionnaire and the diet history for GL (r=0.54, P<0.01), carbohydrate (r=0.57, P<0.01) and GI (r=0.40, P<0.01), Bland-Altman plots showed an unacceptable difference between individual intakes in 34% of subjects for daily GL and carbohydrate, and 41% for daily GI. Reproducibility results showed significant correlations for daily GL (r=0.73, P<0.001), carbohydrate (r=0.76, P<0.001) and daily GI (r=0.64, P<0.001), but an unacceptable difference between individual intakes in 25% of subjects for daily GL and carbohydrate, and 27% for daily GI. In summary, our findings show that a significant association was observed between daily glycemic load and insulin resistant status in a group of older women, using a diet history interview to obtain precise estimation of individual carbohydrate intake. Both the type and quantity of carbohydrate are important to consider when investigating relationships between diet and insulin resistance, although our results suggest the association is more closely related to overall daily glycemic intake than individual meal intake variations. A dietary tool that permits precise estimation of carbohydrate intake is essential when evaluating possible associations between glycemic intake and individual risk of chronic diseases such as insulin resistance. Our results also suggest that studies using questionnaires to estimate glycemic intake should state degree of agreement as well as correlation coefficients when evaluating validity, as imprecise estimates of carbohydrate at an individual level may have contributed to the conflicting findings reported in previous studies.

Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

Estudo de caso-controle conduzido na cidade de Porto Alegre, com o objetivo de avaliar a associação do consumo de gorduras saturadas com sobrepeso e obesidade. Foram incluídas 52 crianças e adolescentes com idades entre seis e 19 anos, sendo 26 eutróficos e 26 com sobrepeso ou obesidade. Todos responderam a um questionário que contemplava história familiar, atividade física e hábitos alimentares. O consumo diário de alimentos ricos em ácidos graxos saturados no grupo de casos e controles foi, em média, de 31,63 mg e 23,18 mg, respectivamente (p<0,05). Quando a ingestão foi avaliada pelo questionário de freqüência alimentar, os casos apresentaram consumo mais freqüente de produtos lácteos e carne de gado. Este estudo demonstrou que fatores relacionados a história familiar de obesidade, hábitos alimentares inadequados e sedentarismo influenciam no desenvolvimento da obesidade desde a infância, e que a intervenção nutricional precoce torna-se necessária para prevenção de fatores de risco associados ao desenvolvimento desta patologia. / A case-control study was conducted in Porto Alegre, south Brazil, with the aim of evaluating the association of consumption of saturated fat with overweight or obesity. It was included 52 children and adolescents aged between 6 and 19 years old, being 26 eutrophic people and 26 overweight or obese people. All of them answered a questionnaire that contemplated family history, physical activity and feeding habits. The daily consumption of food rich in saturated fatty acid in the group of cases and controls were in average 31,63 mg and 23,18 mg, respectively (p< 0.05). There was a variation according to the type of food when ingestion was evaluated through the questionnaire of feeding frequency. This study showed that the factors related to family history of obesity, inadequate feeding habits and sedentariness influenced upon the development of obesity since childhood, and that precocious nutritional intervention is necessary to the prevention of risk factors associated to the development of this pathology.

O presente estudo teve como objetivo identificar um ou mais padrões de dieta e verificar sua associação com excesso de peso em uma amostra de indivíduos adultos de Porto Alegre. Para avaliar a dieta, desenvolveu-se um questionário de freqüência alimentar (QFA) composto por 135 itens alimentares. A validade relativa do questionário foi verificada comparando-o à média de dois inquéritos recordatórios de 24 horas. A comparação entre os métodos foi realizada através dos coeficientes de correlação de Pearson e da classificação dos indivíduos segundo as distribuições em quartis de energia e nutrientes de cada método. Após ajuste para energia total e deatenuação, a correlação média entre os métodos foi 0,43. Em média, 76% dos participantes foram classificados no mesmo quartil ou quartis adjacentes; e somente 4% foram classificados em quartis opostos. Com base nas informações obtidas com o QFA, realizou-se análise exploratória de fatores para identificar padrões alimentares. A associação entre os padrões e excesso de peso foi testada utilizando-se análise de regressão de Poisson modificada, ajustando-se para variáveis de confundimento. Seis padrões foram derivados e explicaram 40,2% da variância total na ingestão de alimentos. Os rótulos atribuídos foram de acordo com os alimentos que mais contribuíram para o padrão: “Fast-food”, “Alimentos light/diet”, “Vegetais e frutas”, “Carnes e vísceras”, “Camarão e oleaginosas” e “Feijão e arroz”. O ajuste na análise para fatores de confusão mostrou que o aumento de uma unidade no escore do padrão “Carnes e Vísceras” elevou em 24% a prevalência de excesso de peso. Adicionalmente, houve tendência à redução nesta taxa entre aqueles que seguiam os padrões “Camarão e Oleaginosas” e “Feijão e Arroz”. Concluindo, o QFA apresentou validade razoável, o padrão “Carnes e vísceras” foi preditor de excesso de peso, enquanto os padrões “Camarão e oleaginosas” e “Feijão e arroz” mostraram tendência à proteção. / The objective of this study was to identify one or more eating patterns and to evaluate the association between these patterns with excess of weight in a sample of adult from Porto Alegre. A food frequency questionnaire (FFQ), covering 135 food items, was developed to assess diet patterns. Relative validity of the FFQ was verified by comparison with the average of two 24-hour dietary recalls. The comparison between the two methods was carried out using Pearson correlation coefficient and cross-classification of individuals according to the quartile energy and nutrients distributions in each method. After adjustment for total energy intake and de-attenuation, the average correlation between the two methods was 0.43. On average, 76% of the participants were classified in the same quartile or in the adjacent quartiles; and only 4% were misclassified into the opposite quartiles. Based on of the information obtained from the FFQ, an exploratory analysis of factors was carried out to identify eating patterns. The association between eating patterns and overweight was tested using modified Poisson models, adjusting for confounding variables. Six patterns were derived and accounted for 40.2% of the total variance in food intake. These were labeled according to the food types that contributed most to the pattern: “Fast-food”, “Light/Diet Foods”, “Fruit and Vegetables”, “Meat and Animal products”; “Shrimp and Oily foods” and “Beans and Rice”. The analysis adjusting for confounding factors showed that the increase of one unit in the “Meat and Animal Products” pattern raised by 24% the prevalence of overweight. In addition, there was a trend to reduce overweight rate for those who had the “Shrimp and Oily Foods” and “Beans and Rice” patterns. In conclusion, the FFQ showed reasonable validity, the “Meat and Animal Products” pattern was a predictor of overweight, while the “Shrimp and Oily foods” and “Beans and Rice” patterns showed a trend to protect against excess of weight.

Estudo de caso-controle conduzido na cidade de Porto Alegre, com o objetivo de avaliar a associação do consumo de gorduras saturadas com sobrepeso e obesidade. Foram incluídas 52 crianças e adolescentes com idades entre seis e 19 anos, sendo 26 eutróficos e 26 com sobrepeso ou obesidade. Todos responderam a um questionário que contemplava história familiar, atividade física e hábitos alimentares. O consumo diário de alimentos ricos em ácidos graxos saturados no grupo de casos e controles foi, em média, de 31,63 mg e 23,18 mg, respectivamente (p<0,05). Quando a ingestão foi avaliada pelo questionário de freqüência alimentar, os casos apresentaram consumo mais freqüente de produtos lácteos e carne de gado. Este estudo demonstrou que fatores relacionados a história familiar de obesidade, hábitos alimentares inadequados e sedentarismo influenciam no desenvolvimento da obesidade desde a infância, e que a intervenção nutricional precoce torna-se necessária para prevenção de fatores de risco associados ao desenvolvimento desta patologia. / A case-control study was conducted in Porto Alegre, south Brazil, with the aim of evaluating the association of consumption of saturated fat with overweight or obesity. It was included 52 children and adolescents aged between 6 and 19 years old, being 26 eutrophic people and 26 overweight or obese people. All of them answered a questionnaire that contemplated family history, physical activity and feeding habits. The daily consumption of food rich in saturated fatty acid in the group of cases and controls were in average 31,63 mg and 23,18 mg, respectively (p< 0.05). There was a variation according to the type of food when ingestion was evaluated through the questionnaire of feeding frequency. This study showed that the factors related to family history of obesity, inadequate feeding habits and sedentariness influenced upon the development of obesity since childhood, and that precocious nutritional intervention is necessary to the prevention of risk factors associated to the development of this pathology.