Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / OBJECTIVE: The primary aim of the study was to determine the nutritional status of vegetarian and non-vegetarian students in relation to their dietary preferences and risk factors (dietary, physical inactivity and obesity) for CHD. DESIGN: Cross-sectional analytical study. Setting: The Adventist International Institute of Advanced Studies (AIIAS) situated in the province of Cavite, Philippines. METHODS: The sampling frame was all graduate students at AIIAS (n=203). Of these students 153 returned the distributed dietary questionnaires which determined dietary practices, thus yielding a stratified random sample of 70 registered students (≥20y and ≤50y) who met the inclusion criteria of the study. Three 24-hour recalls and a self-administered food frequency questionnaire assessed dietary practices. Lifestyle was assessed by means of questionnaires, which also included the socio-demographic characteristics of the subjects. Anthropometric measurements included height, weight and waist circumferences. RESULTS: Seventy subjects participated in the study [non-vegetarian (n=38) and vegetarian (n=32)]. The mean age of subjects was 33.3 [(SD) 1.6] and 38.4 (1.9) years for non-vegetarian and vegetarian males respectively, with the respective means for females being 35.7 (2.0) and 33.2 (2.1) years. The majority of the vegetarians’ income was insignificantly below $10.000 as compared with that of non-vegetarians’, in whom annual income earned was within the $10.000- $50.000 range per year. Variations in level of education between the dietary groups were small and inconsistent, most of whom were characterized by a high education level. Within this cohort, mean BMI and WC were insignificantly lower in the vegetarians when compared with the non-vegetarians. For males, the prevalence of overweight, pre-obese and obese (p>0.05) for non-vegetarians was insignificantly higher than vegetarians. Insignificantly, female vegetarians were more pre-obese than non-vegetarians. As far as waist circumference was concerned, the prevalence of subjects observed in the alerting (≥94cm) and action zone (≥102cm) (p≤0.05) was 21% and 4% for non-vegetarian males, while 0% and 6% for vegetarian males. For females, more vegetarians were insignificantly prevalent in the alerting zone (≥80cm) as compared to the nonvegetarians. Both dietary cohorts illustrated no considerable differences that exemplified moderate to a high level of physical activity. All subjects, regardless of dietary preference, were non-smokers and consumed no alcohol (p>0.05). Overall, mean daily nutrient intake met current recommendations and there was no statistically significant difference between the two cohorts, except for fat and saturated fatty acids (SFA), which was higher among the non-vegetarians. Carbohydrate and fiber consumption was greater in the vegetarians. According to the DRIs, there were no intakes above the UL, however inadequate intakes of calcium and zinc posed possible risk of deficiency for both dietary groups. CONCLUSIONS: A small percentage of subjects in both cohorts were at risk of CHD morbidity. Both groups followed good lifestyle habits with dietary choices being of greater concern among non-vegetarians.

Congenital Heart Disease (CHD) is one of the most common birth defects. It is the single most modifiable cause of infant mortality under one year of age. Therefore, the causes of CHD have been extensively researched in the past but the etiology remains largely unknown. Environmental risks, particularly maternal risk factors for congenital cardiac malformation have been evaluated in the original BWIS previously. However, in this research we examined one of the additional risk factors. We sought to determine whether maternal headache during six months prior to conception and throughout gestation until birth is a risk factor for CHD in the BWIS dataset. Among 3274 singleton cases and 3519 controls, a maternal report of headache was found to be associated with a nearly 20% increase in the risk of a congenital heart defect (OR= 1.2 p=0.001). Moreover, any medications use for headache 1-6 months prior to conception increased the risk of abnormal cardiac development by 1.3 fold (OR = 1.3, p=0.0004). Aspirin or aspirin containing analgesics were found to increase the risk for CHD at the defined risk period. According to subgroup analysis, aspirin or aspirin containing analgesics and acetaminophen or acetaminophen containing analgesics were found to be the risk factor for CTD i.e. Conotruncal defects. Furthermore, aspirin or aspirin containing analgesics increased the risk for PVSD i.e. Peri-membranous Ventricular Defect in offspring when the mother uses these drugs 1-6 months prior to conception. Additionally, the risk for CVD i.e. critical valve disease were found to be increased when women were exposed to aspirin or aspirin containing analgesics during third trimester after pregnancy. In conclusion, maternal headache increased the risk for CHD by 20% and the use of headache medications specifically pain relievers during 1-6 months prior to conception modulated type of defect was observed.