Introduction: About 80% of those affected by osteoporosis are postmenopausal women. Therefore, identifying beneficial or harmful dietary factors for postmenopausal osteoporosis may have a significant public health impact. Objectives: The overall objective of this thesis was to examine the relations between various dietary factors and bone health in postmenopausal women aged ≥ 45 years using different analytical approaches. Methods: First, the associations between fruit and vegetables (F&V) intake and indicators of bone health were assessed using a systematic review approach. Electronic databases were searched and peer-reviewed observational and interventional studies published in English with F&V intake as a main dietary exposure were included. Data selection, extraction and evaluation of risk of bias were performed independently by two reviewers. Second, the associations between an overall diet quality index (HEI-2005) and its components with bone turnover markers (BTMs) were examined. Third, the relationships between alpha-tocopherol intake, serum alpha- and gamma-tocopherol, two concentration biomarkers of vitamin E intake, and their ratio and BTMs were assessed. For the second and third studies, cross-sectional data from the National Health and Nutrition Examination Survey 1999-2002 were used. Weighted multiple regression models with adjustments for relevant confounders were used to examine the relationship between exposures and serum bone-specific alkaline phosphatase (BAP), a biomarker of bone formation, and urinary N-Telopeptides/Creatinine (uNTx/Cr), a biomarker of bone resorption. Results: There was significant between-study heterogeneity in design, definition and amount of F&V intake, outcomes, analyses and reporting of results in the eight included studies. Overall, cross-sectional and case-control analyses reported protective associations between F&V intake and bone health, whereas interventional and prospective cohort analyses did not. There were no associations between total HEI-2005 scores and BTMs. However, the Milk Group component of HEI-2005 had a significant inverse relationship with uNTx/Cr. Higher serum gamma-tocopherol and lower ratio of serum alpha- to gamma-tocopherol were associated with higher BAP concentrations but had no associations with NTx/Cr concentrations. Conclusions: The results confirm the existing knowledge that a diet with adequate intake of dairy may reduce bone loss. Further research is needed to examine the potential anabolic effects of gamma-tocopherol on bone in postmenopausal women.

This methods-oriented dissertation focuses on the psychometric evaluation of the Feeding Your Preschooler Questionnaire (FYPQ) designed to assess the eating habits and diet quality of young children. Parental proxy reports (n=135) were obtained through pen and pencil administration of the FYPQ and an in-person interview using a 24- hour food recall (24HR).Test-retest reliability (n=82) was determined using a repeated measures design with Wilcoxon signed rank tests and Spearman correlations for the food frequency questionnaire (FFQ) portion of the survey, parental self-efficacy, parental role modeling, parental practices, and parental perception of child food preference regarding fruits and vegetables scales. Test-retest reliabilities ranged from r=.53 for water to r=.84 for vegetables for the FFQ and from r=.64 for role modeling to r=.71 for parental perception of child preference for the psychosocial measures. Concurrent construct validity (n=107) was examined with a cross-sectional study design using the Wilcoxon signed rank test, Spearman correlations, and cross-classification analysis into quartiles of food group intakes. Spearman’s correlations between the FFQ and the 24HR were .46 for milk, .22 for fruit, .22 for vegetables, .11 for grains and .07 for protein. Cross-classification analysis revealed that 29% of children were classified in the same quartile and 69% in the same or within one quartile, and gross misclassification ranged from 2% to 10%. Nomological validity was examined using weighted least squares regression. Two regression analyses with fruit and vegetable intake on first the FFQ and second the 24HR as the dependent variable examined the influences of psychosocial environmental predictors and food insecurity. The FFQ regression model explained 28% (p<.05) of the variance in fruit and vegetable intake, with the significant predictors of parental role modeling and food insecurity. The 24HR regression analysis predicting fruit and vegetable intake explained 11% (p<.05), with parental perception of child preference and parental role modeling as significant predictors. In summary, the FYPQ demonstrated good test-retest reliability. The study provides evidence of concurrent validity for the FFQ for assessment of milk consumption and fruit and vegetable variety in preschool children's diets and of nomological validity in the prediction of fruit and vegetable consumption. / text

Nutrient deprived diets are major contributors to the development of childhood obesity and metabolic diseases. Total and site-specific adiposity, such as visceral and skeletal muscle fat, have been associated with an increased risk of metabolic syndrome, insulin resistance, and other cardiometabolic risk factors in youths. C-reactive protein (CRP), a circulating inflammatory biomarker, is an established risk factor for cardiovascular disease and is associated with adiposity even at a young age. Diet quality indexes have been developed for use in adolescents and have evaluated the relationships between diet quality and selected health outcomes. Studies that assess relationships between diet quality, adiposity measured using direct methods, and metabolic risk are lacking in youth, particularly Hispanic Americans. Therefore, the objective of this dissertation was to evaluate the relationships between diet quality, assessed by the Youth Healthy Eating Index (YHEI), measures of total and site-specific adiposity, by dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), and inflammation, assessed by high-sensitivity CRP (hs-CRP) in a cross-sectional study at baseline of 576 healthy Hispanic American and non-Hispanic girls aged 8-13 years. Diet was assessed using the validated semi-quantitative Harvard Youth/Adolescent Food Frequency Questionnaire (YAQ). Diet quality was assessed from the YHEI, developed based on the YAQ. Muscle density (mg/cm³), a surrogate for fat infiltration, was measured at tibial and femoral sites using pQCT. Total body and android fat (surrogate for visceral fat) were measured by DXA. Serum hs-CRP concentrations were measured by nephelometry. Multiple linear and logistic regression analyses were employed to assess these relationships. Total YHEI score was inversely associated with total body fat percent (p= 0.01) and android percent fat (p= 0.02), but not body mass index (BMI) or muscle density. Lower "margarine and butter use" and higher "meat ratio" were associated with higher leg muscle density. Higher "meat ratio" was inversely associated with BMI and greater "multivitamin use" was inversely associated with visceral adiposity. In a subsample of 113 Hispanic girls, over 50% of study participants demonstrated non-detectable serum hs-CRP levels. In adjusted models, there was no significant relationship between overall YHEI score and hs-CRP in this sample of adolescent girls. For every 1-unit increase in "whole grains" score there was a 44% increase in odds of being in the "high" category compared to the "undetectable" category of hs-CRP, after adjusting for maturity offset, PYPAQ score, total energy intake, total body fat, and all other individual YHEI components (OR: 1.44, 95% CI: 1.06, 1.97). The odds of being in the "high" category of hs-CRP were 38% higher compared to those with "non-detectable" hs-CRP for every 1-kg/m² increase in BMI (OR: 1.33, 95% CI 1.16, 1.53, p<0.0001). The odds of being in the "high" hs-CRP category increased with every 5 percent unit increase in total body percent fat (OR: 2.38, 95% CI 1.58, 3.58, p<0.0001) and android percent fat (OR: 1.89, 95% CI 1.39, 2.57, p<0.0001), compared to those with "non-detectable" concentrations. Calf muscle density was associated with lower odds of elevated hs-CRP compared to the "non-detectable" group (OR: 0.58, 95% CI 0.35, 0.75, p<0.001). The findings suggest that higher diet quality scores are associated with lower total and visceral body fat in adolescent girls. While greater total and regional adiposity are associated with increased inflammation, independent of biological and lifestyle factors, diet quality is not significantly associated with inflammation, as assessed by concentrations of hs-CRP, in Hispanic American girls.

A paradox exists between food insecurity and obesity. Childhood obesity has tripled in the past three decades. This study aimed to understand the relationships between food insecurity, poverty income ratio, food stamps usage, perceived diet quality, and weight status in children. A child’s weight status is determined by many different factors and this study investigated several of these aspects. It was found that the family’s poverty index ratio had the greatest effect on a child’s BMI, but household food security status, ethnicity, and the perceived inability to serve balanced meals were all found to be statistically significant when considering a child’s BMI.

Diet is an important factor in disease prevention and health promotion. According to Global Health, in 2006 four of the top five leading causes of death in Ecuador were heart disease, cerebrovascular diseases, diabetes mellitus and hypertensive diseases which are all associated with dietary intake. Knowledge of eating patterns enables the formulation of public policies directed toward health promotion and disease prevention. Studies using indices that measure dietary quality and summarize the main characteristics of healthful eating habits enables the evaluation of possible associations between health determinants and health indicators. Most studies using score-based approaches have generally shown more varied and healthful diets to be associated with higher income, higher education, lower obesity rates and reduced cardiovascular disease mortality. The purpose of this research was to characterize the health practices and diet quality of a low-income population in Quito, Ecuador. A diet quality index (MyPyramid Index) was developed to calculate diet scores for subjects and results show that the mean MPI was 34.1 out of a possible score of 70. Body Mass Index (BMI) was calculated using heights and weights recorded. The mean BMI was 27.2 which would indicate that this sample is categorized as being overweight.

Food insecurity and diet quality are concerns in low-income populations, contributing to high rates of obesity. Food management skills may enable low-income populations to obtain a healthy food supply rather than relying on less expensive and less nutritious foods to fill their diets. The purpose of this study was to assess the relationship between food management practices and diet quality in SNAP-ED/EFNEP participants. This study examines the association between food management behaviors and dietary outcomes (Healthy Eating Index totals, total calories, carbohydrates, protein, fat, and fiber, and servings of fruits, vegetables, milk, and meats/beans) as measured by the Behavior Checklist and diet information collected by Extension Program assistants for 1,585 participants in Kentucky counties (n=57) during 2010-2011. The results of the cross-sectional analysis suggest that food management practices can help low-income SNAP-ED and EFNEP participants obtain more food for their families. However, diet quality was only improved for the variable ‘healthy foods,’ (participants who responded that they thought about healthy foods when deciding what to feed their families). It was concluded that an integrated approach of food management practices and nutrition education is needed to improve diet quality for low-income populations.

OBJECTIVES: This dissertation was divided into two studies. The aim of the first study was to investigate whether there is an association between diet quality of preschool children and their caregivers. The aim of the second study was to examine the relationship of children diet quality and dental caries risk. METHODS: The study utilized a longitudinal population-based data of a representative sample of low-income African American families in Detroit, Michigan. Analyses were limited to 522 children aged 3-5 years old and their primary caregivers. For caregivers, dietary histories were obtained at wave I using the Block 98.2 food frequency questionnaire. For children, dietary histories were obtained at wave I and wave II using the Block Kids Food Questionnaire. Healthy Eating Index-2005 was used to evaluate overall diet quality. Dental caries in primary teeth were measured by the ICDAS criteria. The mean number of decayed surfaces (noncavitated and cavitated), missing, and filled surfaces for each child was estimated. Statistical analyses were conducted using SAS 9.4 and STATA 14 to account for the complex sampling design. RESULTS: The first study found that the mean total HEI-2005 scores were 57.47 for caregivers at wave I, 56.04 for children at wave I, and 57.39 for children at wave II indicating that the diet quality of this population needs improvement. Significant, positive relationship was found between caregivers-child overall diet quality at wave I (β=0.35; p <0.0001) and wave II (β=0.31; p <0.0001). The second study found that children who had high diet quality or improved their diet quality throughout the study period had significantly lower dental caries incidence compared to those with low diet quality scores (IRR = 0.59 and 0.55, respectively) (CI = 0.36-0.96 and 0.35-0.86 , respectively). CONCLUSION: Our findings suggest that caregiver’s and children’s diet quality are associated. Therefore, caregiver’s diet quality should be considered in efforts to improve diets of their children. Additionally, preschooler children in our study with improved diet quality showed lower caries incidence. These results suggest that strategies and intervention to prevent dental caries among children should focus on improving overall diet quality. / 2018-09-28T00:00:00Z

Submitted by Claudia Rocha (claudia.rocha@udesc.br) on 2018-03-15T16:44:00Z No. of bitstreams: 1 PGCA17MA212.pdf: 755428 bytes, checksum: 72b64e835e22e9356f3dea7f2684090f (MD5) / Made available in DSpace on 2018-03-15T16:44:00Z (GMT). No. of bitstreams: 1 PGCA17MA212.pdf: 755428 bytes, checksum: 72b64e835e22e9356f3dea7f2684090f (MD5) Previous issue date: 2016-12-15 / Studies aiming at the characterization of the carcass and meat of cattle fed on grazing and feedlot systems used in the Santa Catarina State Region contribute to the characterization of the production and to the comparison of carcasses and meat from finished and grazing animals. The objective of this study was to evaluate the effect of bovine termination systems on pasture in comparison to feedlot, on animal performance and carcass and meat quality of castrated Angus males on Planalto Catarinense. The work was carried out in the period from 12/10/2015 to 04/26/2016. One group of animals was finished under confinement for a period of 82 days, and the other group was finished in summer pasture consisting of millet (Pennisetum glaucum) for a period of 138 days. Twenty male Aberdeen Angus bulls were weaned and castrated at approximately seven months of age, divided into two uniform batches, based on paternal origin and live weight (mean ± 331 kg), distributed in a completely randomized experimental design . The animals of the experiment were weighed on a digital scale every 28 days to control weight gain. For weighing the animals were kept in water fasting and solids for an average of 12 hours, and measurements were performed early in the morning. At the beginning of treatments and before slaughter, the thickness of the subcutaneous fat between the 12 th and 13 th ribs (EGS) and the subcutaneous fat thickness in the picanha (EGP) were measured by means of ultrasonography in live animals. The groups were slaughtered when they reached minimum weight of 420kg and minimum EGS of 3mm. The time required for the animals to reach the goal of live weight and EGS for slaughter was 56 days higher in the pasture termination system when compared to the feedlot termination system. The animals in feedlot obtained a mean of 4.4 mm of subcutaneous fat and 6.3 mm of fat in the rumpcap in 82 days of feedlot, while the animals in pasture required 138 days of pasture finishing to obtain 3 and 4,3 mm Of subcutaneous fat and on picanha, respectively. The warm carcass weight (PCQ) and hot carcass pH (pHCQ) were similar between pasture and feedlot treatments, with averages of 232 kg and 6.72, respectively. The subcutaneous fat thickness in the carcass (EGSC) (+ 0.71 mm) and the depth of the muscle (PM) longissimus dorsis, (+ 0.85 cm) were higher in the animals finishing in feedlot when compared to the animals finished in grass, But the length area of the muscle (CM) longissimus dorsis (+ 1.5 cm) was higher in the pasture-terminated animals when compared to the other group. In relation to the softness, the confined animals had inferior values in comparison to the animals finished to grass (4,5 and 6,3 kgF / cm² respectively). Both groups reached similar weights but in different periods. Greater attention should be given to animals finishing the pasture to obtain an adequate carcass finish. Termination with annual summer pasture allows final live weight and carcass yields similar to animals finished in feedlot / Trabalhos que visam a caracterização da carcaça e da carne de bovinos terminados em sistemas a pasto quanto em confinamento utilizados na Região Serrana Catarinense, contribuem para caracterização da produção e para a comparação das carcaças e carne de animais terminados a pasto e em confinamento. Objetivou-se avaliar o efeito de sistemas de terminação bovina a pasto em comparação ao confinamento, sobre o desempenho animal e a qualidade de carcaça e carne de machos castrados da raça Angus no Planalto Catarinense. O trabalho foi realizado no período de 10/12/2015 a 26/04/2016. Um grupo de animais foi terminado sob regime de confinamento por um período de 82 dias, e o outro grupo foi terminado em pastagem de verão constituída por milheto (Pennisetum glaucum) por um período de 138 dias. Foram utilizados 20 bovinos, machos, da raça Aberdeen Angus, desmamados e castrados com aproximadamente sete meses de idade, divididos em dois lotes uniformes, em função da origem paterna e do peso vivo (média ± 331 kg), distribuídos num delineamento experimental inteiramente casualizado. Os animais do experimento foram pesados em balança digital a cada 28 dias para controle do ganho de peso. Para as pesagens os animais eram mantidos em jejum hídrico e de sólidos por, em média, 12 horas, e as medidas eram realizadas no início da manhã. No início dos tratamentos e antes do abate, foram medidas a espessura de gordura subcutânea entre a 12ª e 13ª costela de (EGS) e a espessura de gordura subcutânea na picanha (EGP) realizadas por meio de ultrassonografia, nos animais vivos. Os grupos foram abatidos quando atingiram peso mínimo de 420kg e EGS mínima de 3mm. O período necessário para os animais atingirem a meta de peso vivo e EGS para o abate foi 56 dias superior no sistema de terminação a pasto quando comparado ao sistema de terminação em confinamento. Os animais em confinamento obtiveram em média 4,4 mm de gordura subcutânea e 6,3 mm de gordura na picanha em 82 dias de confinamento, enquanto os animais em pasto precisaram de 138 dias de terminação a pasto para obterem 3 e 4,3 mm de gordura subcutânea e na picanha, respectivamente. O peso de carcaça quente (PCQ) e o pH da carcaça quente (pHCQ) foram similares entre os tratamentos a pasto e confinamento, com médias de 232 kg e 6,72, respectivamente. A espessura de gordura subcutânea na carcaça (EGSC) (+ 0,71 mm) e a profundidade do músculo (PM) longissimus dorsis, (+ 0,85 cm) foram superiores nos animais terminados em confinamento quando comparados aos animais terminados em pasto, mas o comprimento área do músculo (CM) longissimus dorsis (+ 1,5 cm) foi superior nos animais terminados a pasto quando comparados ao outro grupo. Em relação à maciez, os animais confinados apresentaram valores inferiores em comparação aos animais terminados a pasto (4,5 e 6,3 kgF/cm² respectivamente). Ambos os grupos atingiram pesos semelhantes mas em diferentes períodos. Maior atenção deve ser dada a animais terminados a pasto para que obtenham adequado acabamento de carcaça. A terminação com pastagem anual de verão permite peso vivo final e rendimentos de carcaça semelhantes aos animais terminados em confinamento

Adjust and apply the Revised Children s Diet Quality Index (RC-DQI) to evaluate the quality of pre-school student s diet in Aracaju /SE. Cross-sectional ) study with 910 pre-school students of both genders with age between 2 years and 6 years and 11 months, registered in municipal schools of Aracaju/SE. The charactheristics of the population were obtained through questionaries and food consumption was determined by 24 hours recording method. The diet quality was evaluated by an adjusted RC-DQI. The statistical test of Kolmogorov-Smirnov verified the normal distribution of variables, and the Pearson correlation checked the relation between the components of RC-DQI and the nutrient ingestion and the Kruskal Wallis verified the difference between the quartile. The statistical significance stabilished was of p <0,05. The RC-DQI average was of 58,95 points. The quartiles with best diet quality presented the higher ingestion of nutrients. A minimal score was found for fruits (61,2%), vegetables (75,1%) and children that were older and had more individuals per family presented the lowest diet quality. Families with higher incomes presented higher diet quality. The index showed that the diet quality needs enhancements (total score 58,95) and also showed a correlation between family income, structure, children s age and number of individuals in the same family. / O presente trabalho tem por objetivo adaptar e aplicar o Revised Children's Diet Quality Index (RC-DQI) para avaliar a qualidade da dieta de pré-escolares do município de Aracaju/SE. Estudo transversal de uma amostra de 910 pré-escolares, de ambos os gêneros com idade de dois a seis anos e onze meses, matriculados nas escolas da rede municipal de Aracaju-SE. As informações sobre as características da população de pré-escolares foram obtidas através de questionário e o consumo alimentar pelo método recordatório de 24h. A qualidade da dieta foi avaliada através RC-DQI adaptado. Foi utilizado o teste estatístico de Kolmogorov-Smirnov para verificar o grau de aderência da distribuição das variáveis à distribuição normal. Apenas a variável do RC-DQI apresentou distribuição normal. Para verificar correlação entre os componentes do RC-DQI e ingestão de alguns nutrientes foi utilizado correlação de Pearson e teste Kruskal Wallis para verificar a diferença entre os quartis. A significância estatística foi estabelecida em p < 0,05. Encontrou-se consumo inadequado (zero porções) de frutas em 35,6% da população, de legumes e verduras em 45,7% e consumo insuficiente (zero porções) de leite e derivados e alimentos fontes de ferro em 15,7% e 5,49% respectivamente. Além disso, observou-se também que as crianças apresentaram consumo excessivo de açúcar e suco, principalmente artificial e que as mesmas eram sedentárias. Foi verificado que as crianças com maior idade, inseridas em família de menor renda e com maior número de pessoas, apresentaram pior qualidade da dieta. O índice dietético identificou que a qualidade da dieta dos pré-escolares necessita de melhoras e as crianças que apresentaram dietas de melhor qualidade foram aquelas cujas famílias possuíam maior renda, menor número de pessoas e as crianças mais jovens.

Cette thèse étudie les conditions de taxation indirecte optimale qui permettent d'améliorer l'adéquation de la ration alimentaire des ménages français aux recommandations nutritionnelles. L'approche adoptée exige d'estimer un système complet de demande alimentaire afin de mettre à jour les élasticités-prix. Les comportements de consommation alimentaire des ménages sont décrits par une forme fonctionnelle AI (Deaton et Muellbauer, 1980). Deux spécifications quadratique et dynamique autorisant, respectivement, de possibles non-linéarités des courbes d'Engel et la persistance d'habitudes de consommation sont testées. L'estimation se fait par les moindres carrés linéaires itérés (Blundell et Robin, 1999) sur données de pseudo-panel. Une base de données s'étalant sur 156 périodes de 4 semaines, de 1996 à 2007, a été constituée par l'aggrégation en 8 cohortes de ménages et le regroupement de coupes transversales issues de TNS Worldpanel. Dans la lignée des mécanismes théoriques de taxation optimale initiée par Ramsey (1927), un application à un objectif de politique nutritionnelle permet de dériver les variations de prix, ou taux de taxe, optimales. Chacune apparait comme une fonction des élasticités-prix, directes et croisées, de la demande et d'indicateurs d'adéquation aux recommandations. L'impact des variations de prix sur l'adéquation aux recommandations nutritionnelles du panier alimentaire, ainsi les taux de taxation de produits optimaux sont estimés. L'incidence de ces scénarios de politique sur le bien-être des ménages et les inégalités nutritionnelles est abordée dans un dernier chapitre. / This thesis aims at simulating optimal prices satisfying public health recommendations in terms of nutrient adequacy. This implies to estimate a complete food demand system in order to compute price elasticities. Food consumption behaviors are described by an AI functional form (Deaton and Muellbauer, 1980). The demand system is estimated using the Iterated Least Square Estimator developed by Blundell and Robin (1999). Augmented specifications to control for, respectively, non-linearities in expenditure patterns and habit persistence are tested. We use French household expenditure data drawn from TNS Worldpanel covering 156 periods of 4 weeks from 1996 to 2007. Given the nature of our data, households are split into 8 cohorts. Issues afferent to pseudo-panel data are presented. Nutrient adequacy is defined using three nutrient only-based indicators: the MAR (Mean Adequacy Ratio), the LIM (Score des Composés à Limiter) and the SAIN (Score d'Adéquation Individuel aux recommandations Nutritionnelles). Optimal prices are derived following Ramsey's approach to optimal taxation; Maximizing social welfare under nutritional constraints results in optimal price variations or tax rates, each defined as a function of all direct and cross price elasticities and the above mentioned indicator for all food groups. Further developments allow to estimate the impacts of price variations on nutrient adequacy. Incidence on social welfare and nutritional inequalities is assessed in a last chapter.