Gotowa bibliografia na temat „Kuwait National Diet and Nutrition Survey”

Background Nutrition transition towards a Western diet is happening in parallel with the rapidly increasing rates of cardiovascular disease and its risk factors in Kuwait. The cardiometabolic deaths attributable to poor diet have not been quantified among Kuwaiti adults. Methods Using a Comparative Risk Assessment model that incorporated dietary intake data from Kuwait’s first national nutrition survey, number of cardiometabolic deaths from the World Health Organization, and estimated associations of diet with cardiometabolic deaths from the Global Burden of Disease project, we estimated the number and proportion of cardiometabolic deaths attributable to suboptimal intake of 10 dietary factors among Kuwaiti adults ages 25+ years, and by population subgroups. Findings An estimated 1,308 (95% uncertainty interval [UI] = 1,228–1,485) cardiometabolic deaths were attributed to suboptimal diet, accounting for 64.7% (95% UI = 60.7%-73.4%) of all cardiometabolic deaths in Kuwait in 2009. The low intake of nuts/seeds was associated with the highest estimated number and proportion of cardiometabolic deaths (n = 380, 18.8%), followed by high intake of sodium (n = 256, 12.6%), low intake of fruits (n = 250, 12.4%), low intake of vegetables (n = 236, 11.7%), low intake of whole grains (n = 201, 9.9%), and high intake of sugar-sweetened beverages (n = 201, 9.9%). The estimated proportions of cardiometabolic deaths attributable to suboptimal diet were higher in men (67.7%) than women (57.8%) and in younger adults aged 25–34 years (84.5%) than older adults aged ≥55 years (55.6%). Conclusion Suboptimal dietary intake was associated with a very substantial proportion of cardiometabolic deaths among Kuwaiti adults in 2009, with young adults and men experiencing the largest proportion of diet-associated cardiometabolic deaths in Kuwait.

AbstractObjectiveThe objective of the present study was to determine whether nutrition knowledge differs between male and female physicians working in Kuwait City, Kuwait.DesignThe study employed a cross-sectional analysis of physician's nutrition knowledge by using a sixteen-item multiple-choice questionnaire.SettingGovernmental hospitals in Kuwait City, Kuwait.SubjectsOne hundred Kuwaiti physicians (fifty males; fifty females) working in Kuwait City, Kuwait.ResultsA response rate of 73 % was achieved (forty males; thirty-three females). The mean percentage of correctly answered questions was 60 %. The male and female physicians averaged 56 % and 65 % of correct responses, respectively (P = 0·042). However, only for two questions did male and female physicians’ scores differ significantly (P < 0·05). The two age groups (<40 years; ≥40 years) had equal mean total correct scores (60 %, P = 0·935). Physicians’ knowledge was greatest for topics that have received a great deal of media coverage in Kuwait. Most (70 %) of the physicians described their nutrition knowledge as ‘moderate’.ConclusionsPhysicians in Kuwait gave inaccurate information regarding common problems in Kuwaitis such as obesity, hypertension and osteoporosis. In view of the public's perception of the role of the physician in providing nutrition advice, it is imperative that nutrition and diet training be part of continuing medical education to bridge these deficiencies in physicians’ knowledge.

The National Diet and Nutrition Survey (NDNS) of adults aged 19–64 years, carried out in 2000–1, is part of the NDNS programme, a series of cross-sectional surveys aiming to provide detailed quantitative information on the diet, nutritional status and related characteristics of the British population. The programme is split into four surveys of different population age-groups, conducted at approximately three-yearly intervals. In the survey of adults food consumption data were collected from 1724 respondents using a 7 d weighed-intake dietary record. Other components included: height, weight, waist and hip circumference and blood pressure measurements; a 24 h urine sample; a blood sample; a record of physical activity. Results have been published in four volumes covering food consumption, energy and macronutrient intakes, micronutrient intakes and nutritional status, including physical measurements and physical activity. The results have shown that, based on a comparison of nutrient intakes with the UK dietary reference values, adults in Britain are generally getting sufficient nutrients from their diets. However, younger adults (particularly women) and those in lower socio-economic groups are more likely to have low micronutrient intakes and lower levels of some nutritional status indices. The proportion of food energy derived from total fat has fallen since the last survey of this age-group in 1986–7 and is close to the dietary reference value, while the proportion of energy derived from saturated fatty acids and non-milk extrinsic sugars exceeds the dietary reference values. The prevalence of overweight and obesity has increased since 1986–7 and physical activity levels are low.

The aim of this paper is to describe innovations taking place in national nutrition surveys in the UK and the challenges of undertaking innovations in such settings. National nutrition surveys must be representative of the overall population in characteristics such as socio-economic circumstances, age, sex and region. High response rates are critical. Dietary assessment innovations must therefore be suitable for all types of individuals, from the very young to the very old, for variable literacy and/or technical skills, different ethnic backgrounds and life circumstances, such as multiple carers and frequent travel. At the same time, national surveys need details on foods consumed. Current advances in dietary assessment use either technological innovations or simplified methods; neither lend themselves to national surveys. The National Diet and Nutrition Survey (NDNS) rolling programme, and the Diet and Nutrition Survey of Infants and Young Children (DNSIYC), currently use the 4-d estimated diary, a compromise for detail and respondent burden. Collection of food packaging enables identification of specific products. Providing space for location of eating, others eating, the television being on and eating at a table, adds to eating context information. Disaggregation of mixed dishes enables determination of true intakes of meat and fruit and vegetables. Measurement of nutritional status requires blood sampling and processing in DNSIYC clinics throughout the country and mobile units were used to optimise response. Hence, innovations in national surveys can and are being made but must take into account the paramount concerns of detail and response rate.

AbstractObjectiveThe National Diet and Nutrition Surveys (NDNS) are a series of government-funded surveys of food intake, nutrient intake and nutritional status of individuals, undertaken to support nutritional policy and risk assessment. This paper summarises a review that considered the extent to which NDNS met the needs of users and suggested options for the future. The Food Standards Agency has since progressed favoured options. This paper aims to help others wishing to obtain this type of information within their own populations.DesignA detailed questionnaire was used to probe use of data and gather opinions from users, producers and managers of the NDNS. It asked about general information needs from NDNS and changes that might be made. This was followed by a two-day workshop which included discussion of the main issues and the generation of 19 possible future options for consideration by the Agency.ResultsOptions to improve effectiveness included methods to prioritise breadth and depth of coverage and possible ways of improving response and compliance. Strategies to make surveys more efficient and timely, such as adopting a rolling programme, disaggregating survey components, integrating with other studies and improving data access, were also suggested. A rolling programme, in which data are collected continuously, was the favoured option to address some of the concerns and a strategy is now in place to achieve this.ConclusionsThere is widespread support for the NDNS from its users. There is no alternative source for such high-quality data on food and nutrient consumption and nutritional status and physical measurements in the same individuals. Useful information, such as the potential value of using a rolling programme from the outset, can be gained from this British experience by others wishing to measure food and nutrient intakes and status in their own populations.

Breakfast is considered to be one of the most important meals of the day. Its omission has been reported to be associated with increased disease risk, such as obesity, diabetes, and coronary heart disease, as well as unhealthy lifestyle and lower dietary quality. Using data from the National Adult Nutrition Survey (NANS)—a food consumption survey conducted among 1500 Irish men and women over 18 years of age, residing in the Republic of Ireland at the time the survey was conducted—we aimed to characterize breakfast regularity, identify dietary patterns associated with regular breakfast consumption, and assess the nutritional quality of such dietary patterns, using the nutrient-rich food index score NRF9.3. We determined two breakfast regularity categories and assessed dietary quality, by means of adherence to the principal component analysis derived dietary patterns and the NRF9.3 dietary index. Regular breakfast consumers were identified as those who consumed breakfast 3–4 times out of the 4 days of the collection period; such consumers comprised the majority of the population (94.4%). They had the highest adherence to healthier dietary patterns, namely, the “vegetarian” (odds ratio (OR): 2.59: 95% Confidence Interval (CI): 1.40, 4.77), “fish and vegetables” (OR: 2.88: 95% CI: 1.63, 5.10), and “breakfast cereals” (OR: 4.62: 95% CI: 2.43, 8.79) dietary patterns. Breakfast significantly contributed to the daily micronutrient intake by providing, on average, 24% of dietary fiber, 32% of iron, 30% of calcium, 32% of folate, and 37% of riboflavin. The importance of regular breakfast consumption on those who skip breakfast should be highlighted, in order to improve compliance with nutritional recommendations and adherence to a healthy lifestyle.

AbstractObjectiveTo compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality.DesignCross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested usingpost hocWald tests andztests.SettingThe National Health and Nutrition Examination Survey (NHANES), 2007–2012.SubjectsThe sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual.ResultsNon-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (P<0·05). Among non-meat eaters, mean consumption across HEI-2010 quintiles demonstrated different (P<0·05) amounts of empty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (P<0·05) amounts of nuts and legumes, vegetables and PUFA.ConclusionsPublic health messages targeted at vegetarians and others who may choose to eat meat-free on certain days should emphasize decreased consumption of empty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

This study investigated Kuwait food system. Firstly the current dietary consumption of a representative sample of the Kuwaiti population was assessed. Secondly the effects of the 1990 Gulf war on Kuwait's food and nutrition system were investigated. The major part of this study was a National Diet and Nutrition Survey of people aged 20 to 65 years, which is the largest and most detailed survey ever undertaken of the diet and nutritional status of adult people in Kuwait. A food frequency questionnaire was delivered to 491 subjects (response rate 81.8%, 278 female and 213 male). In addition, a sample of 383 (response rate 207 female and 176 male) were interviewed using a 24 hour recall method. This study aimed to provide a comprehensive cross-sectional picture of the dietary habits and nutritional status of the population of Kuwait. The energy and nutrient intakes in the survey were compared with the US RDA.

This study investigated Kuwait food system. Firstly the current dietary consumption of a representative sample of the Kuwaiti population was assessed. Secondly the effects of the 1990 Gulf war on Kuwait's food and nutrition system were investigated. The major part of this study was a National Diet and Nutrition Survey of people aged 20 to 65 years, which is the largest and most detailed survey ever undertaken of the diet and nutritional status of adult people in Kuwait. A food frequency questionnaire was delivered to 491 subjects (response rate 81.8%, 278 female and 213 male). In addition, a sample of 383 (response rate 207 female and 176 male) were interviewed using a 24 hour recall method. This study aimed to provide a comprehensive cross-sectional picture of the dietary habits and nutritional status of the population of Kuwait. The energy and nutrient intakes in the survey were compared with the US RDA.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
Full Text

Background: The consequences of poor nutrition are well known and of wide concern. Governments and public health agencies utilise food and diet surveillance data to make decisions that lead to improvements in nutrition. These surveys often utilise complex sample designs for efficient data collection. There are several challenges in the statistical analysis of dietary intake data collected using complex survey designs, which have not been fully addressed by current methods. Firstly, the shape of the distribution of intake can be highly skewed due to the presence of outlier observations and a large proportion of zero observations arising from the inability of the food diary to capture consumption within the period of observation. Secondly, dietary data is subject to variability arising from day-to-day individual variation in food consumption and measurement error, to be accounted for in the estimation procedure for correct inferences. Thirdly, the complex sample design needs to be incorporated into the estimation procedure to allow extrapolation of results into the target population. This thesis aims to develop novel statistical methods to address these challenges, applied to the analysis of iron intake data from the UK National Diet and Nutrition Survey Rolling Programme (NDNS RP) and UK national prescription data of iron deficiency medication. Methods: 1) To assess the nutritional status of particular population groups a two-part model with a generalised gamma (GG) distribution was developed for intakes that show high frequencies of zero observations. The two-part model accommodated the sources of data variation of dietary intake with a random intercept in each component, which could be correlated to allow a correlation between the probability of consuming and the amount consumed. 2) To identify population groups at risk of low nutrient intakes, a linear quantile mixed-effects model was developed to model quantiles of the distribution of intake as a function of explanatory variables. The proposed approach was illustrated by comparing the quantiles of iron intake with Lower Reference Nutrient Intakes (LRNI) recommendations using NDNS RP. This thesis extended the estimation procedures of both the two-part model with GG distribution and the linear quantile mixed-effects model to incorporate the complex sample design in three steps: the likelihood function was multiplied by the sample weightings; bootstrap methods for the estimation of the variance and finally, the variance estimation of the model parameters was stratified by the survey strata. 3) To evaluate the allocation of resources to alleviate nutritional deficiencies, a quantile linear mixed-effects model was used to analyse the distribution of expenditure on iron deficiency medication across health boards in the UK. Expenditure is likely to depend on the iron status of the region; therefore, for a fair comparison among health boards, iron status was estimated using the method developed in objective 2) and used in the specification of the median amount spent. Each health board is formed by a set of general practices (GPs), therefore, a random intercept was used to induce correlation between expenditure from two GPs from the same health board. Finally, the approaches in objectives 1) and 2) were compared with the traditional approach based on weighted linear regression modelling used in the NDNS RP reports. All analyses were implemented using SAS and R. Results: The two-part model with GG distribution fitted to amount of iron consumed from selected episodically food, showed that females tended to have greater odds of consuming iron from foods but consumed smaller amounts. As age groups increased, consumption tended to increase relative to the reference group though odds of consumption varied. Iron consumption also appeared to be dependent on National Statistics Socio-Economic Classification (NSSEC) group with lower social groups consuming less, in general. The quantiles of iron intake estimated using the linear quantile mixed-effects model showed that more than 25% of females aged 11-50y are below the LRNI, and that 11-18y girls are the group at highest of deficiency in the UK. Predictions of spending on iron medication in the UK based on the linear quantile mixed-effects model showed areas of higher iron intake resulted in lower spending on treating iron deficiency. In a geographical display of expenditure, Northern Ireland featured the lowest amount spent. Comparing the results from the methods proposed here showed that using the traditional approach based on weighted regression analysis could result in spurious associations. Discussion: This thesis developed novel approaches to the analysis of dietary complex survey data to address three important objectives of diet surveillance, namely the mean estimation of food intake by population groups, identification of groups at high risk of nutrient deficiency and allocation of resources to alleviate nutrient deficiencies. The methods provided models of good fit to dietary data, accounted for the sources of data variability and extended the estimation procedures to incorporate the complex sample survey design. The use of a GG distribution for modelling intake is an important improvement over existing methods, as it includes many distributions with different shapes and its domain takes non-negative values. The two-part model accommodated the sources of data variation of dietary intake with a random intercept in each component, which could be correlated to allow a correlation between the probability of consuming and the amount consumed. This also improves existing approaches that assume a zero correlation. The linear quantile mixed-effects model utilises the asymmetric Laplace distribution which can also accommodate many different distributional shapes, and likelihood-based estimation is robust to model misspecification. This method is an important improvement over existing methods used in nutritional research as it explicitly models the quantiles in terms of explanatory variables using a novel quantile regression model with random effects. The application of these models to UK national data confirmed the association of poorer diets and lower social class, identified the group of 11-50y females as a group at high risk of iron deficiency, and highlighted Northern Ireland as the region with the lowest expenditure on iron prescriptions.

Background: Over the long term, unhealthy lifestyles can lead to many health problems, especially type 2 diabetes (T2D). The aim of the present study was to determine associations between lifestyle factors (smoking, alcohol consumption, physical activity, and diet) and T2D in American adults (aged ≥20 years) in a nationally representative sample. Methods: Data for 12 987 American adults participating in the National Health and Nutrition Examination Survey 2005–2014 were evaluated. Weighted multiple logistic regression models were used to examine associations between the four lifestyle factors and T2D after adjusting for demographics and socioeconomic status (SES). Prevalence trends for T2D were examined using Cochran–Armitage tests. Results: There was a significant increasing prevalence trend for T2D among American adults. Smokers and individuals consuming >12 alcoholic drinks in the past year were less likely to report having T2D than non‐smokers (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.35–0.48) and those consuming(OR 0.46; 95% CI 0.39–0.55). Participants with light physical activity have a greater likelihood of having T2D than those engaging in vigorous physical activity (OR 5.72; 95% CI 4.30–7.60). Individuals consuming a poor diet were more likely to report having T2D than those eating an excellent diet (OR 1.18; 95% CI 1.02–1.41). All these relationships remained significant after adjustment for demographics and SES. Conclusion: All four lifestyle factors were significantly associated with T2D among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications.

Background Over the long term, unhealthy lifestyles can lead to many health problems, especially type 2 diabetes (T2D). The aim of the present study was to determine associations between lifestyle factors (smoking, alcohol consumption, physical activity, and diet) and T2D in American adults (aged ≥20 years) in a nationally representative sample. Methods Data for 12 987 American adults participating in the National Health and Nutrition Examination Survey 2005–2014 were evaluated. Weighted multiple logistic regression models were used to examine associations between the four lifestyle factors and T2D after adjusting for demographics and socioeconomic status (SES). Prevalence trends for T2D were examined using Cochran–Armitage tests. Results There was a significant increasing prevalence trend for T2D among American adults. Smokers and individuals consuming >12 alcoholic drinks in the past year were less likely to report having T2D than non-smokers (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.35–0.48) and those consuming Conclusion All four lifestyle factors were significantly associated with T2D among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications.

BACKGROUND: The effects of pro-inflammatory diets, as measured by the Dietary Inflammatory Index (DII), on periodontal disease among Americans have not been evaluated. OBJECTIVE: This study examines whether the DII is associated with periodontitis in U.S. adults participating in the National Health and Nutrition Examination Surveys (NHANES) 2009-2014. In particular, it evaluates whether an anti-inflammatory dietary pattern is associated with lower prevalence of periodontitis in NHANES and lower severity of periodontitis. METHODS: Dietary Inflammatory Index score was derived from taking the mean of two 24-hour dietary recall interviews. The sample population included 7,480 subjects (3,628 men and 3,852 women), who were 30-80 years old from all racial/ethnic groups. The exclusion criteria were incomplete or missing data regarding clinical periodontal and dental examinations. In addition, participants were also excluded who had diabetes, cancer, pregnancy or breastfeeding status, unreliable dietary information, or elevated alcohol intake. The DII score was classified as Low DII/anti-inflammatory (DII: -5.16≤DII≤0.54) and High DII/pro-inflammatory (DII: 0.54