Early total enteral feeding in stable preterm infants a systematic review and...dineshdharel13
In conclusion, it seems feasible and safe to start total enteral feeding in stable VLBW infants born with birth weight greater than 1000–1200g. This approach can reduce the need of intravenous fluid or PN and its adverse consequences as well as decrease the length of hospital stay for these infants. A larger randomized trial is needed to ensure ETEF is not associated with increased risk of NEC in stable preterm infants with birth weight greater than 1000g and gestational age greater than 28 weeks. Furthermore, there is a need to explore whether ETEF regimen is feasible in extremely low birth weight infants.
Body mass-index-quality-of-life-and-migraine-in-studentsAnnex Publishers
Migraine is reported globally with a higher prevalence in students. The present study aims to evaluate the association between nutritional status, quality of life (QL) and characteristics of migraine.
A cross-sectional study. Headache characteristics, level of disability caused by migraine crises (Pediatric Migraine Disability Assessment - PedMIDAS) and QL (Pediatric Quality of Life Inventory- PedsQL) were assessed. Anthropometric variables were also measured.
Data were collected from 98 students with a mean age of 11.2 ± 1.7 years. Migraine had the highest prevalence (54.8%). The average Body Mass Index (BMI) of the total sample was 20.0 ± 3.8 kg/m2, and among students with migraine and students with tension headache, the average BMIs were 20.4 ± 4.0 and 19.5 ± 3.4 kg/m2, respectively (p = 0.264, Student's t-test). Around 47.5% from migraineurs were overweight or obese. Regarding QL, the average total score in students with migraine was 74.4 ± 12.4, with no differences observed among normal weight, overweight or obese students, and no correlation between the scores of the PedsQL and BMI (r = -0.182, p = 0.165, Pearson correlation coefficient) was observed. There was a high percentage of overweight students with migraine. Analyses show no associations between the nutritional status, frequency, severity, disability caused by crises, or QL.
Diet intake trends among pregnant women in rural area of rawalpindi, pakistanZubia Qureshi
Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and new-born. This study was designed to know the health status of pregnant women and new-born by determining food taking habits of pregnant women. Methods: A cross sectional study was conducted on pregnant women of 2nd and 3rd trimester in a rural area of district Rawalpindi. Food frequency questionnaire and 24 hours dietary recall methods were used to identify their food consumption practices. Analysis was done by SPSS, while Nutrisurvey software was used to check the presence of Vitamin A, C, and Iron in specific fruits or vegetables. Results: A total of 110 pregnant women participated in the study. Most of them were illiterate, had low household income, and unemployed. Intake of meal frequency was according to the standards of Institute of Medicine (IOM), but food group consumption was not according to the recommendations of the United State Department of Agriculture (USDA). Most participants 102 (93.2%) knew that food is important during pregnancy. However an increase in frequency intake was observed in 63 (57.3%); while, 19 (17.3%) reported no change in food intake practices. About 67 (61%) were taking some sort of dietary supplements. Avoidance of any food 24 (22%), intake of additional food 51 (46%), craving 86 (78%), and aversion to any sort of food 42 (38%) was also identified in the study sample. No significant association was found between food group consumption, food availability and accessibility. Dietary diversity score, calculated according to the Food and Agriculture Organization (FAO) guidelines, indicated that about half study participants were not consuming adequate food. Conclusion: Study results show that food intake practices of pregnant women in the study area were not satisfactory. The results suggest that pregnant women need nutrition counselling regarding food intake practices during pregnancy.
Keywords: food intake practices, diet consumption, pregnant women
This paper demonstrates knowledge of the indirect connection between diet and autism-related behaviors and the anatomical reasoning behind the position. I am studying to be a pediatric occupational therapist - a career field that often has patients with developmental abnormalities that can be treated with therapy and supplemented by diet.
Early total enteral feeding in stable preterm infants a systematic review and...dineshdharel13
In conclusion, it seems feasible and safe to start total enteral feeding in stable VLBW infants born with birth weight greater than 1000–1200g. This approach can reduce the need of intravenous fluid or PN and its adverse consequences as well as decrease the length of hospital stay for these infants. A larger randomized trial is needed to ensure ETEF is not associated with increased risk of NEC in stable preterm infants with birth weight greater than 1000g and gestational age greater than 28 weeks. Furthermore, there is a need to explore whether ETEF regimen is feasible in extremely low birth weight infants.
Body mass-index-quality-of-life-and-migraine-in-studentsAnnex Publishers
Migraine is reported globally with a higher prevalence in students. The present study aims to evaluate the association between nutritional status, quality of life (QL) and characteristics of migraine.
A cross-sectional study. Headache characteristics, level of disability caused by migraine crises (Pediatric Migraine Disability Assessment - PedMIDAS) and QL (Pediatric Quality of Life Inventory- PedsQL) were assessed. Anthropometric variables were also measured.
Data were collected from 98 students with a mean age of 11.2 ± 1.7 years. Migraine had the highest prevalence (54.8%). The average Body Mass Index (BMI) of the total sample was 20.0 ± 3.8 kg/m2, and among students with migraine and students with tension headache, the average BMIs were 20.4 ± 4.0 and 19.5 ± 3.4 kg/m2, respectively (p = 0.264, Student's t-test). Around 47.5% from migraineurs were overweight or obese. Regarding QL, the average total score in students with migraine was 74.4 ± 12.4, with no differences observed among normal weight, overweight or obese students, and no correlation between the scores of the PedsQL and BMI (r = -0.182, p = 0.165, Pearson correlation coefficient) was observed. There was a high percentage of overweight students with migraine. Analyses show no associations between the nutritional status, frequency, severity, disability caused by crises, or QL.
Diet intake trends among pregnant women in rural area of rawalpindi, pakistanZubia Qureshi
Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and new-born. This study was designed to know the health status of pregnant women and new-born by determining food taking habits of pregnant women. Methods: A cross sectional study was conducted on pregnant women of 2nd and 3rd trimester in a rural area of district Rawalpindi. Food frequency questionnaire and 24 hours dietary recall methods were used to identify their food consumption practices. Analysis was done by SPSS, while Nutrisurvey software was used to check the presence of Vitamin A, C, and Iron in specific fruits or vegetables. Results: A total of 110 pregnant women participated in the study. Most of them were illiterate, had low household income, and unemployed. Intake of meal frequency was according to the standards of Institute of Medicine (IOM), but food group consumption was not according to the recommendations of the United State Department of Agriculture (USDA). Most participants 102 (93.2%) knew that food is important during pregnancy. However an increase in frequency intake was observed in 63 (57.3%); while, 19 (17.3%) reported no change in food intake practices. About 67 (61%) were taking some sort of dietary supplements. Avoidance of any food 24 (22%), intake of additional food 51 (46%), craving 86 (78%), and aversion to any sort of food 42 (38%) was also identified in the study sample. No significant association was found between food group consumption, food availability and accessibility. Dietary diversity score, calculated according to the Food and Agriculture Organization (FAO) guidelines, indicated that about half study participants were not consuming adequate food. Conclusion: Study results show that food intake practices of pregnant women in the study area were not satisfactory. The results suggest that pregnant women need nutrition counselling regarding food intake practices during pregnancy.
Keywords: food intake practices, diet consumption, pregnant women
This paper demonstrates knowledge of the indirect connection between diet and autism-related behaviors and the anatomical reasoning behind the position. I am studying to be a pediatric occupational therapist - a career field that often has patients with developmental abnormalities that can be treated with therapy and supplemented by diet.
Local Determinants of Malnutrition: An Expanded Positive Deviance Studyjehill3
Local Determinants of Malnutrition: An Expanded Positive Deviance Study
Julie Hettinger, Food for the Hungry
Nutrition Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Can the management of blood sugar levels in
gestational diabetes mellitus cases be an indicator
of maternal and fetal outcomes? The results of a
prospective cohort study from India
Nutritional Status of School Age Children in Private Elementary Schools: Basi...IJAEMSJORNAL
Department of Education (DepEd) organizes nutritional programs to improve the health status of children in public schools. Likewise, the researcher believes that health awareness must be raised in private schools as well. This study aimed to affect the community to be aware and more knowledgeable about nutrition. Specifically, this study focused on the nutritional status of school age children in private elementary schools in Santa Rosa, Nueva Ecija. It sought to determine the profile of the learners, anthropometrics, clinical data and the knowledge of the learners as to dietary and the significant relationship between the profile of the learners and the nutritional status of the school aged children. With all the data gathered a meal management program was proposed. The study employed the quantitative description design. The study manifests that majority of the respondents were not yet aware of what they eat. In addition, age, greatly affects the respondent’s anthropometrics as to height. More so, age, number of siblings and family income, greatly affect the respondents’ anthropometrics as to weight. The researcher adopted the Nutritional Guidelines for Filipino program that was developed by the DOST- FNRI.
Nutritional Rehabilitation for Eating DisordersDavid Garner
This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. Our approach to meal planning has been referred to as “mechanical eating” and consists of a structured eating program in which quantity of food consumed, type of food consumed and spacing of meals, are all specified in advance. This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. We have anticipated potential criticisms of this
approach and have provided the theoretical and practical basis for our model.
Effect of Nesting on Posture Discomfort and Physiological Parameters of Low B...iosrjce
A study was conducted to determine the effectiveness of “nesting” among low birth weight infants in
NICU of selected government hospital of Delhi. An experimental study was conducted in which low birth weight
infants (birth weight 1.00-2.5kg) were stratified into three groups based on their birth weight (1.0-1.5kg, 1.5-
2.0kg, 2.0-2.5kg). The samples consisted of 60 low birth weight infants; 30 in experimental group and 30 in
control group. Pre-test Post-test control group design was used in which nesting was provided in experimental
group 9 hours per day for 5 days. Posture, comfort and physiological parameters were assessed before and
during administration of nesting. A significant improvement in posture (t=12.64) was observed in experimental
group during application of nesting. A significant reduction in the discomfort was observed in experimental
group as compared to control group (t=10.65).Low birth weight infants exhibit comparatively stable
physiological parameters during the period of nesting.
Does physical-activity-and-sport-practice-lead-to-a-healthier-lifestyle-and-e...Annex Publishers
The prevalence of childhood obesity has been increasing rapidly and there is general consensus that good nutritional practices and physical activity should be encouraged as early as possible in life. The aim of this study was to describe and to compare the current lifestyle and dietary pattern of normal weight (NW) and overweight + obese (OW+OB) male adolescents who are physically active.
Methods: This observational and retrospective study was based on clinical records analysis of male adolescents aged 11-18 years who had undergone a medical evaluation at a Medical Sport Centre (Pavia, Italy) during 2009, and had filled in a self-administered life style questionnaire.
Results: The results showed that out of 1423 clinical records 23.0% of subjects were OW, 5.4% OB and 71.6% NW. We invited all the overweight and obese subjects to participate in the study, 308 of them (75.8%) agreed. Then we randomly enrolled an equivalent number of NW participants (n=308) in the medical evaluation at the sports center with similar characteristics as for socio-economic status, physical activity and age for a whole sample of 616 subjects. We handled them a validated lifestyle questionnaire. The questionnaire analysis was used to compare OW+OB and NW participants, as far as eating habits, sedentary activities and time spent in sports. All the subjects frequently skipped breakfast, did not consume fruit and vegetables daily and had a high soft drinks intake. Inverse correlations were found between weight and physical activity (p=0.01). Sedentary activities were preferred by about 25% and 66 % of the NW and OW+OB groups respectively. The percentage of smokers was similar within the two groups (14%).
Conclusions: Adolescents eating habits are incorrect, despite BMI and sports practice. Sports practice seems contributing to lower spare time physical inactivity, but does not improve eating habits. Public health interventions should focus on the reinforcement of leisure time physical activity, besides nutrition education and behavioral education programs in order to prevent obesity in the adulthood.
To study the knowledge, beliefs and practices of mothers, in relation to initiation, duration and type of breastfeeding, introduction and type of complementary food and other infant feeding practices.
The Eating Attitudes Test (EAT-26) is probably the most widely used and cited standardized measure of symptoms and concerns characteristic of eating disorders . The original EAT appeared as a Current Contents Citation Classic in 1993. The 26-item version is highly reliable and valid according to Wikipedia. Many studies have used the EAT-26 as an economical first step in a two-stage screening process.
Local Determinants of Malnutrition: An Expanded Positive Deviance Studyjehill3
Local Determinants of Malnutrition: An Expanded Positive Deviance Study
Julie Hettinger, Food for the Hungry
Nutrition Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Can the management of blood sugar levels in
gestational diabetes mellitus cases be an indicator
of maternal and fetal outcomes? The results of a
prospective cohort study from India
Nutritional Status of School Age Children in Private Elementary Schools: Basi...IJAEMSJORNAL
Department of Education (DepEd) organizes nutritional programs to improve the health status of children in public schools. Likewise, the researcher believes that health awareness must be raised in private schools as well. This study aimed to affect the community to be aware and more knowledgeable about nutrition. Specifically, this study focused on the nutritional status of school age children in private elementary schools in Santa Rosa, Nueva Ecija. It sought to determine the profile of the learners, anthropometrics, clinical data and the knowledge of the learners as to dietary and the significant relationship between the profile of the learners and the nutritional status of the school aged children. With all the data gathered a meal management program was proposed. The study employed the quantitative description design. The study manifests that majority of the respondents were not yet aware of what they eat. In addition, age, greatly affects the respondent’s anthropometrics as to height. More so, age, number of siblings and family income, greatly affect the respondents’ anthropometrics as to weight. The researcher adopted the Nutritional Guidelines for Filipino program that was developed by the DOST- FNRI.
Nutritional Rehabilitation for Eating DisordersDavid Garner
This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. Our approach to meal planning has been referred to as “mechanical eating” and consists of a structured eating program in which quantity of food consumed, type of food consumed and spacing of meals, are all specified in advance. This report describes our approach in sufficient detail to allow our outcomes to be replicated and compared with other programs. We have anticipated potential criticisms of this
approach and have provided the theoretical and practical basis for our model.
Effect of Nesting on Posture Discomfort and Physiological Parameters of Low B...iosrjce
A study was conducted to determine the effectiveness of “nesting” among low birth weight infants in
NICU of selected government hospital of Delhi. An experimental study was conducted in which low birth weight
infants (birth weight 1.00-2.5kg) were stratified into three groups based on their birth weight (1.0-1.5kg, 1.5-
2.0kg, 2.0-2.5kg). The samples consisted of 60 low birth weight infants; 30 in experimental group and 30 in
control group. Pre-test Post-test control group design was used in which nesting was provided in experimental
group 9 hours per day for 5 days. Posture, comfort and physiological parameters were assessed before and
during administration of nesting. A significant improvement in posture (t=12.64) was observed in experimental
group during application of nesting. A significant reduction in the discomfort was observed in experimental
group as compared to control group (t=10.65).Low birth weight infants exhibit comparatively stable
physiological parameters during the period of nesting.
Does physical-activity-and-sport-practice-lead-to-a-healthier-lifestyle-and-e...Annex Publishers
The prevalence of childhood obesity has been increasing rapidly and there is general consensus that good nutritional practices and physical activity should be encouraged as early as possible in life. The aim of this study was to describe and to compare the current lifestyle and dietary pattern of normal weight (NW) and overweight + obese (OW+OB) male adolescents who are physically active.
Methods: This observational and retrospective study was based on clinical records analysis of male adolescents aged 11-18 years who had undergone a medical evaluation at a Medical Sport Centre (Pavia, Italy) during 2009, and had filled in a self-administered life style questionnaire.
Results: The results showed that out of 1423 clinical records 23.0% of subjects were OW, 5.4% OB and 71.6% NW. We invited all the overweight and obese subjects to participate in the study, 308 of them (75.8%) agreed. Then we randomly enrolled an equivalent number of NW participants (n=308) in the medical evaluation at the sports center with similar characteristics as for socio-economic status, physical activity and age for a whole sample of 616 subjects. We handled them a validated lifestyle questionnaire. The questionnaire analysis was used to compare OW+OB and NW participants, as far as eating habits, sedentary activities and time spent in sports. All the subjects frequently skipped breakfast, did not consume fruit and vegetables daily and had a high soft drinks intake. Inverse correlations were found between weight and physical activity (p=0.01). Sedentary activities were preferred by about 25% and 66 % of the NW and OW+OB groups respectively. The percentage of smokers was similar within the two groups (14%).
Conclusions: Adolescents eating habits are incorrect, despite BMI and sports practice. Sports practice seems contributing to lower spare time physical inactivity, but does not improve eating habits. Public health interventions should focus on the reinforcement of leisure time physical activity, besides nutrition education and behavioral education programs in order to prevent obesity in the adulthood.
To study the knowledge, beliefs and practices of mothers, in relation to initiation, duration and type of breastfeeding, introduction and type of complementary food and other infant feeding practices.
The Eating Attitudes Test (EAT-26) is probably the most widely used and cited standardized measure of symptoms and concerns characteristic of eating disorders . The original EAT appeared as a Current Contents Citation Classic in 1993. The 26-item version is highly reliable and valid according to Wikipedia. Many studies have used the EAT-26 as an economical first step in a two-stage screening process.
NCCR 2020: Conference Of Very Important Disease (COVID-19) | 24 - 26 August 2020
Young Investigator Awards Presentation
Mohammad Hasnan Ahmad
Nutritionist
Principal Investigator
Centre for Nutrition Epidemiology Research
Institute for Public Health
National Institutes of Health
Ministry of Health Malaysia
https://doi.org/10.5281/zenodo.4004505
Methods of Determining Nutritional Status in IndiaAkash Dass
India is a developing country where the percentage of malnutrition and undernutrition is higher than that of developed countries. Nutritional status is such a state of health of a person, which is affected by the usefulness of food elements.
Objective: Food habits may be associated with inflammation, but there is little information about processed and ultra-processed foods in children. Thus, our aim was to investigate the relationship between processed and ultra-processed foods, energy intake, total fat and saturated fats intake and high sensitivity C - reactive protein levels (hs - CRP) in children.
Design: A cross-sectional study with a population-based cluster sample.
Globally 165 million children under-five
years of age are stunted. Hence development of local
therapeutic nutritional intervention is recommended by WHO.
Present study was designed to find the efficacy of the
nutritional intervention for the recovery of impaired lipid
metabolism and correlation of weight for height% with
cholesterol, triglyceride in malnourished children. 105 test and
100 control SAM children without infection, of 1 to 5 years of
age and either sex were enrolled. Test group was given
treatment of nutritional intervention therapy, providing 2.5 to
3gm Protein and 90-100 kcal /kg body Weight/day, for the
three months. Their Anthropometric, and Biochemical
parameters were measured before and after the nutritional
therapy. Before the nutritional intervention treatment P values
for Serum Total cholesterol, Triglyceride, Weight for height
%, were insignificant suggestive of similar baseline
characteristics at enrollment. After nutritional intervention
treatment P values for Serum Total cholesterol, Triglyceride,
Weight for height % were highly significant. The r value of
Pearson correlation coefficient for triglycerides in the study
group and its ANOVA model was very significant, showing
poor positive correlation with weight for height % while for
total cholesterol it was found to be insignificant. Depending on
results we conclude that it is the most effective food supplement
for the speedy recovery of the impaired lipid metabolism in
SAM children and the use of weight for height % as a
anthropometric marker for the pre-indication of fatty liver in
malnourished children
An assessment of adolescent eating habits in public schools of chak shahzad, ...Zubia Qureshi
Abstract: Eating patterns influence the nutritional status, health, learning process and academic performance of the school children. This study was conducted to explore the food availability at school canteens and food intake by adolescents in break period. A cross sectional study was conducted on 290 adolescents (145 were girls and 145 boys) of 6th, 7th and 8th grade from public schools of Chak Shahzad, Islamabad. Pre-structured questionnaire was used for data collection. Chi square / fisher exact test was done by using SPSS to check the association. The mean age of adolescents was 12.6 ± 1.33 years. They were reported normal, underweight, overweight and obese as 176 (60.7%), 79 (27.2%), 27 (9.3%) and 9 (2.8%) respectively. Nutritional status was significantly related with gender, age and grade of adolescents with p-value <0.05. Response showed that 199 (68.6%) adolescents prefer canteen food during break time, and 66 (22.8%) give preference to homemade lunch. Few of them 25 (8.6%) take fruits in school break time. About (24.8%) took drink with lunch which were juices 30 (10.3%), milk/milk shake 14 (5.9%), carbonated drinks 6 (2.1%), and tea/coffee 13 (4.5%). Consumption of carbohydrates, protein, fruits, vegetables, and dairy products was found as 64 (22.1%), 26 (0.9%), 32 (11%), 4 (1.4%) and 1 (0.3%) respectively in adolescents who brought their lunch from home. Around 49% of students were not satisfied with food provided on their school canteens. Availability of food items on school canteens and overall eating pattern of adolescents is not satisfactory. There is a need of school canteen guidelines/policy and nutritional education to canteen staff and pupils.
Keywords: School Canteen, Pakistan, Eating Habits, Adolescents
Nutritional status of Girls through Anthropometric and Dietary Assessmentiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Cheap vs healthy: Analyzing McDonald’s menu using linear programmingjournalBEEI
The factors that influence food choices nowadays are time, cost and deliciousness. An obvious example is fast food. Although consumers are aware that fast food is not a healthy choice, many still chooses fast food because it is convenient. Therefore in this paper, by using linear programming, we analyzed McDonald’s Malaysia menu in order to find the cheapest menu and the ‘healthiest’ menu. We developed a linear programming model for McDonald’s Malaysia menu which adheres to Malaysia Recommended Nutrient Intake 2017 (RNI 2017). Then we solved the model and proposed the cheapest menu and also the ‘healthiest’ menu that meets the nutrient requirement based on RNI 2017. The result showed that price for the cheapest palatable menu is RM21.69 a day. For set menu, we found that no menu meets this requirement, suggesting that McDonald’s set menu should not be taken three times a day. The price for the ‘healthiest’ McDonald’s menu with the least total of fat, sugar and salt that meets the nutrient requirement is RM42.99 a day.
"OptiFood - Future Approach to Improve Nutrition Programme Planning and Policy Decisions in SE Asia" from the Regional Conference on Micronutrient Fortification of Foods 2013 (10 ~ 11 October 2013 in Bangkok, Thailand)
Every Civilization having its own culture of treating diseases
260 AD around establishment of Jund-i-Shapur
Initially Prisoners from Roman Empire
After Roman Empire cracked down on Scientific Centers and Intellectuals
The AYUSH system of medicine mostly relies on
prevention of disease. The Unani System of Medicine has much more to
offer for prevention of the disease.
Six essentials of life which form the basics of the Unani
Preventive measures are:
•Air-----Quality of air
•Food and Drinks (Ma’akool wa Mashroob)---Dietary habits,
balanced diet etc
•Physical Rest and Movement (Harkat wa Sakoon Badni)….Exercise
etc
•Mental Rest and Movement (Harkat wa Sakoon Nafsani) ….
Thinking, stress etc
•Sleep and awakeness (Naum wa Yagza)----Sleep time, good sleep
•Retention and Evacuation (Ehtibas and Estefaragh)….What is to be
retained and evacuated from the body.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Performance of short food questions to assess aspects of the dietary intake of australian children
1. Nutrients 2013, 5, 4822-4835; doi:10.3390/nu5124822
OPEN ACCESS
nutrients
ISSN 2072-6643
www.mdpi.com/journal/nutrients
Article
Performance of Short Food Questions to Assess Aspects of the
Dietary Intake of Australian Children
Gilly A. Hendrie * and Malcolm D. Riley
Commonwealth Scientific Industrial Research Organisation (CSIRO), PO BOX 10041 Adelaide South
Australia 5000, Australia; E-Mail: malcolm.riley@csiro.au
* Author to whom correspondence should be addressed; E-Mail: gilly.hendrie@csiro.au;
Tel.: +61-8-8305-0662; Fax: +61-8-8303-8899.
Received: 2 July 2013; in revised form: 12 September 2013 / Accepted: 28 October 2013 /
Published: 26 November 2013
Abstract: Single dietary questions are used as a rapid method of monitoring diet. The aim
of this investigation was to assess the performance of questions to measure population
group intake compared to the mean of two 24-h recalls. Data from the Australian National
Children’s Nutrition and Physical Activity Survey 2007 was used (n = 4487). Children
reported their intake on three questions relating to usual serves of fruit, vegetables and type
of milk. Age, gender and body weight status were assessed as modifiers of the relationship
between methods. There was a stepwise increase in fruit and vegetable intake (p < 0.001)
measured by recall when grouped by response category of the short question. By recall,
fruit consumption decreased with age (F = 12.92, p < 0.001) but this trend was not
detectable from the short question (F = 2.31, p = 0.075). The difference in fruit intake
between methods was greatest for obese children. Almost 85% of children who consumed
whole milk by short question consumed mainly whole fat milk by recall, but agreement
was lower for other milk types. Saturated fat and volume of milk was highest in whole
milk consumers. Ease of administration suggests that short questions, at least for some
aspects of diet, are a useful method to monitor population intakes for children.
Keywords: diet; food habits; children; nutrition survey
2. Nutrients 2013, 5
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1. Introduction
There is a recognised need for brief methods to measure aspects of dietary intake that combine a
low subject burden with the capacity for rapid reporting of population dietary intake, and to monitor
population dietary change [1,2]. Short measurement tools are not expected to provide the richness of
information that is achievable using more detailed dietary measurement methods, however they are
likely to be useful in circumstances where efficient monitoring of key indicators of dietary intake is
required. Intake of fruit and vegetables is generally lower than recommended [3], and programs to
promote their consumption [4–6] are supported by monitoring population intake. While dairy foods are
also under consumed by Australians [7], the common short question utilised in surveys seeks to
determine the usual type of milk consumed. Australian dietary guidelines recommend the use of mainly
reduced fat milk for children above the age of two years [8], and the type of milk used has been shown to
indicate the percentage of total dietary energy intake contributed by saturated fat in children [2].
Short dietary questions used with children pose particular difficulties because food intake patterns
and portion sizes generally differs between age groups, and the cognitive processes required to respond
to dietary questions may also vary with age. An assessment of the validity of three short dietary
questions applied to children in a national survey of Australian children [9] was recently reported by
the Australian Institute of Health and Welfare [2]. Children’s response to short questions about usual
fruit and vegetable intake, and milk type, were compared to estimates from 24-h recalls. However, it
may be unrealistic to expect the same short question to perform equally well across the population;
therefore, a more detailed investigation is warranted to provide further insight into the performance of
the questions.
The aim of this investigation is to extend the evaluation of the three short dietary questions by
considering how the question response is influenced by the frequency of intake and the stated serve
size, and whether the performance of the question differs by children’s gender, age and weight status.
2. Experimental Section
The Australian National Children’s Nutrition and Physical Activity Survey 2007 included measurement
of weight, height and food intakes in a nationally representative sample of 4487 children aged 2–16
years. A household quota sampling scheme from random clusters of postcodes resulted in children
being selected proportional to the age and sex structure in each state or territory. The final response
rate was 40%. A detailed description of the sample characteristics are presented elsewhere [9].
2.1. Dietary Intake Assessment Methods
Detailed dietary intake information was obtained on two days for each child using a three pass 24-h
dietary recall administered by computer assisted personal interview (CAPI) followed by computer
assisted telephone interview (CATI) between 7 and 21 days later. The main care giver was the primary
source of dietary intake information if children were aged 2–8 years, and children aged 9–16 years
reported their own intake. Food intake data were converted to nutrient intakes using an Australian food
composition database (AUSNUT 2007).
3. Nutrients 2013, 5
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Participants also responded to short dietary questions as part of the CAPI. The wording of the three
short questions is shown in Table 1. Interviewers had the option to show a half cup measure to describe
a serve of fruit and vegetables if necessary. Responses to the short questions were compared to
grouped intake data from the dietary recalls. Responses to the fruit and vegetable short questions were
recorded as zero for “doesn’t eat” fruit/vegetables, 0.5 serves for “less than one serve”, six for “six or
more”, and all other values were as reported.
Table 1. Short questions used in the 2007 Australian National Children’s Nutrition and
Physical Activity Survey and their response categories.
Short question
1. How many serves of fruit do (you/your child) usually eat
each day? One serve is equal to half a cup.
INTERVIEWER NOTE: Show food prompt if necessary 1.
2. How many serves of vegetables do [you/your child]
usually eat each day? One serve is equal to half a cup.
INTERVIEWER NOTE: Show food prompt if necessary 1.
3. What is the main type of milk that (you/your child)
usually use?
1
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Response category
Doesn’t eat fruit
Less than one serve
One serve
Two serves
Three serves
Four serves
Five serves
Six or more serves
Doesn’t eat vegetables
Less than one serve
One serve
Two serves
Three serves
Four serves
Five serves
Six or more serves
Whole/full cream
Low/reduced fat
Skim
Evaporated or sweetened condensed
Soy milk
None of the above
Does not drink milk
Don’t know
Interviewer instruction manual states “Show the 1/2 cup measure to describe serve if necessary”.
2.2. Statistical Analysis
Foods included in the fruit (±juice) and vegetables food groups were extracted from the 24-h recall
data based on the 5 digit level codes (minor food group) and where necessary the 8 digit level
(representing individual foods). The amounts of fruit and vegetables (in grams) were converted to 75 g
serves based on the description given in the short question. The intake of fruit was also calculated as
150 g serves because this is consistent with the suggested serve size in the national food based
recommendations for Australians (The Australian Guide to Healthy Eating [10]). The mean of two
days of intake was calculated.
4. Nutrients 2013, 5
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The mean frequency of fruit and vegetable consumption from the dietary recalls was also calculated
by summing the entries for fruit or vegetables for each day.
Responses to short questions were plotted against mean grouped intake data from the dietary
recalls, and compared using analysis of variance. Mean population intake and frequency of intake of
fruit, fruit and 100% juice and vegetables (in serves) were calculated as the mean of two days from the
24-h recalls. The difference in estimated intake between the short question and 24-h recall was
calculated for each individual with a positive difference value representing a higher estimation of
intake by the short question.
The main type of milk used was derived from the recall data for each individual as the type of milk
that contributed the greatest percentage of the total volume consumed, and as the highest contributor to
the total occasions of milk consumed. Both methods of determining “main type of milk” from the
dietary recall were compared to the grouped response from the short question on milk type.
Children’s gender, age and body weight status were assessed as potential modifiers of the
relationship between the measurement methods. For children, BMI (body mass index) was converted
to a z-score and adjusted for age and sex by using the least mean squares method [11]. Because of the
lack of Australian data, calculations were based on the US Centres for Disease Control reference data
provided as a computer program [11]. Children’s BMI z-score was classified by using the International
Obesity Task Force definition [12].
Differences between gender, age, and weight status subgroups of the population were assessed
using analysis of variance, and the mean difference between dietary measurement methods estimated
using paired sample t-tests. Population weights were applied to all analyses to account for the
non-proportional sampling scheme of the survey. These weights were based on the age, gender and
region distributions of the 2006 Census of Population and Housing. The population weights were
rescaled to the size of the sample for inferential statistics and to calculate 95% confidence limits for the
mean estimates. Statistical significance was taken to be p < 0.05. All analyses were conducted using
IBM SPSS Statistics 20 (SPSS Inc., Chicago, IL, USA).
3. Results
There was a stepwise increase in the mean fruit (p < 0.001, Figure 1) and vegetables (p < 0.001,
Figure 2) intake measured by dietary recall when grouped by response category of the respective
short question.
Frequency of consumption closely tracked the average number of serves of fruit and vegetables
consumed when a 75 g serve size was used for vegetables and a 150 g serve size used for fruit.
The short question provided a markedly higher estimate of fruit and vegetable intake than
the grouped recall data when the response for fruit intake was four serves a day or more, and
for vegetables intake, was three serves a day or more. This accounted for 18.8% and 38.4% of
responses, respectively.
Mean consumption of 100% fruit juice did not vary across levels of reported fruit intake by short
question (average = 112 mL, F = 0.605, p = 0.752), including the “does not eat fruit” category. When
measured by dietary recalls, mean fruit intake decreased with age group for both boys and girls
(Table 2, linear trend F = 12.92, p < 0.001), while vegetable intake increased with age group (linear
5. Nutrients 2013, 5
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trend F = 20.61, p < 0.001). The same trend was not detectable when fruit intake was measured by
short question (F = 2.31, p = 0.075), but the trend was observed for vegetable intake measured by short
question (F = 72.91, p < 0.001).
Figure 1. Estimated fruit intake from the 24-h recalls by reported intake on the
short question.
Serves of fruit (75g)
Serves of fruit (150g)
Frequency of fruit
Line of perfect fit
Mean of two 24-hour recalls (serves)
6.0
5.0
4.0
3.0
2.0
1.0
0.0
Doesn't eat
(0.5%)
Less than
one (6.9%)
One
(19.6%)
Two
(34.2%)
Three
(20.2%)
Four
(11.9%)
Five
(4.3%)
Six +
(2.6%)
Short question response in serves (% of sample)
Figure 2. Estimated vegetable intake from the 24-h recalls by reported intake on the
short question.
Serves of vegetables (75g)
Frequency of vegetables
Line of perfect fit
6.0
Mean of two 24-hour recalls (serves)
5.0
4.0
3.0
2.0
1.0
0.0
Doesn’t eat Less than
(0.3%)
one (7.7%)
One
(21.8%)
Two
(31.8%)
Three
(21.2%)
Four
(11.2%)
Short question response (% of sample)
Five
(3.6%)
Six +
(2.4%)
6. Nutrients 2013, 5
4827
Table 2. Estimated mean intakes of fruit, fruit and juice, and vegetables (in serves) from the short questions and mean of two 24-h recalls, by
gender and age group 1.
n
Short question
Fruit
Mean (95% CI)
550
613
525
561
2.4 (2.3–2.5)
2.4 (2.3–2.5)
2.4 (2.3–2.5)
2.2 (2.0–2.3)
2.4 (2.2–2.6)
2.5 (2.4–2.6)
2.0 (1.9–2.2)
1.7 (1.5–1.9)
3.6 (3.3–3.9)
4.1 (3.9–4.3)
3.7 (3.4–3.9)
3.5 (3.1–3.8)
1.6 (1.5–1.7)
2.1 (2.0–2.1)
2.5 (2.4–2.6)
2.8 (2.7–3.0)
1.4 (1.2–1.5)
1.7 (1.6–1.8)
2.1 (2.0–2.2)
2.4 (2.2–2.7)
521
603
585
529
2.3 (2.2–2.4)
2.4 (2.3–2.5)
2.4 (2.3–2.5)
2.3 (2.1–2.4)
2.3 (2.1–2.5)
2.4 (2.3–2.5)
2.1 (1.9–2.2)
1.8 (1.6–1.9)
3.3 (3.1–3.6)
3.6 (3.4–3.7)
3.5 (3.4–3.7)
3.5 (3.3–3.8)
1.6 (1.5–1.7)
2.0 (2.0–2.1)
2.5 (2.4–2.6)
2.8 (2.7–2.9)
1.5 (1.3–1.6)
1.7 (1.6–1.9)
2.2 (2.0–2.4)
2.3 (2.1–2.5)
Gender/age group
Males
2–3 years
4–8 years
9–13 years
14–16 years
Females
2–3 years
4–8 years
9–13 years
14–16 years
1
Mean of two 24-h recalls
Fruit
Fruit and juice 2
Mean (95% CI)
Mean (95% CI)
Short question
Vegetables 3
Mean (95% CI)
Mean of two 24-h recalls
Vegetables
Mean (95% CI)
Population weighting applied. 2 A serve of fruit is equal to 75 g. “Fruit and juice” includes 100% fruit juice and no maximum limit on juice consumption. 3 A serve of
vegetables is equal to 75 g. Vegetables includes potatoes and legumes, but not fried potato foods (chips or crisps).
7. Nutrients 2013, 5
4828
Estimated fruit intakes were similar between methods for males and females aged 2–8 years,
however for children in age groups 9–13 years and 14–16 years significantly higher intakes were
reported by the short question compared to the dietary recalls (0.3–0.5 serves, p < 0.001 Table 3).
Table 3. Difference in reported fruit and vegetables intake (in serves)
question and mean of two 24-h recalls, by age group and child gender 2,3.
1
between short
Child gender
Fruit
2–3 years
4–8 years
9–13 years
14–16 years
Difference between age groups 4
Vegetables
2–3 years
4–8 years
9–13 years
14–16 years
Difference between age groups 4
Male
Female 3
Mean (95%CI)
Age group
Mean (95%CI)
−0.01 (−0.18–0.15) a
−0.09 (−0.20–0.02) a
0.32 (0.19–0.45)
0.48 (0.32–0.64)
<0.001
0.00 (−0.18–0.17) a
0.04 (−0.07–0.15) a
0.36 (0.23–0.48)
0.51 (0.36–0.66)
<0.001
0.18 (0.05–0.32)
0.39 (0.29–0.50)
0.40 (0.27–0.54)
0.38 (0.16–0.59)
ns
0.12 (−0.03–0.27) b
0.29 (0.18–0.40)
0.34 (0.19–0.49)
0.49 (0.31–0.67)
0.047
1
For fruit and vegetables a serve is equal to 75 g. 2 Adjusted population weight for inferential statistics
applied. 3 Positive values represent higher reported intake by short question compared to 24-h recalls.
4
Difference between males and females were statistically non significant. 5 One Way Analysis of Variance.
a
significantly different to 9–13 years and 14–16 years, b significantly different to 14–16 years.
Overestimation of vegetable intake by the short question compared to 24-h recall was apparent for
all age groups except females aged 2–3 years. The difference in estimates of fruit and vegetable intake
between methods was similar for males and females, increased with age for fruit intake (p < 0.001) but
the age group trend for vegetable intake was not consistent between males and females (Table 3).
Overall, obese children (n = 247, 5.5% of the sample) reported a lower mean fruit intake compared
to normal weight children (n = 3267, 72.8%) in response to the short question (−0.26 serves,
p = 0.012) and by 24-h recall (−0.60 serves, p < 0.001). The difference in estimate of intake between
methods differed significantly by children’s weight status for fruit (F = 3.34, p = 0.018) but not
vegetable intake. The difference in estimated fruit intake between methods was greater for obese
children (0.5 serves greater by short question) than normal weight children (0.2 serves, p = 0.010).
Almost 85% of children who reported their main milk type was whole milk by the short question
consumed mostly whole milk as evidenced by the recalls, but the agreement was significantly lower
for those who responded that low/reduced fat milk was their usual type (71.0%, p < 0.001) or that skim
milk was their usual type (53.9%, p < 0.001). Agreement was similar when usual milk type by recall
was calculated using frequency of consumption rather than volume of consumption, but slightly lower
for cow’s milk categories when flavoured milk was included (Table 4).
8. Nutrients 2013, 5
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Table 4. Main type of milk usually used: percent agreement (%) of short question response with two 24-h recalls, and percentage of energy
from saturated fat (%) and volume consumed (mL) by short question response.
Whole/full cream
(n = 2842, 63.3%)
By dominant proportion of
volume—plain white milk only 2
By dominant proportion of
volume—plain and flavoured milk 2
By highest frequency of use
Didn’t drink any milk on either day
of the survey 2
Overall
Child aged 2–8 years
Child aged 9–16 years
Plain milk
Plain and flavoured milk
1
Low/reduced fat
(n = 1143, 25.5%)
84.8
71.0
83.5
Short question response 1
Skim
(n = 244, 5.4%)
Percentage agreement
Soy milk
(n = 117, 2.6%)
Does not drink milk
(n = 75, 1.7%)
53.9
63.6
66.7
66.7
45.7
72.2
63.0
81.4
71.5
53.6
64.1
66.7
9.8
12.3
16.6
18.8
66.7
14.3 (14.2–14.5)
14.6 (14.5–14.8)
14.1 (13.9–14.2)
635.5 (618.2–652.7)
704.1 (685.6–722.6)
Mean (95% Confidence interval)
12.7 (12.6–12.9)
12.6 (12.1–13.1)
12.5 (12.3–12.8)
12.4 (11.5–13.4)
12.9 (12.6–13.1)
12.6 (12.1–13.2)
542.0 (518.7–565.3)
451.5 (398.8–504.1)
611.5 (587.0–636.1)
560.0 (500.3–619.6)
10.5 (9.8–11.1)
10.1 (9.3–11.0)
10.8 (9.8–11.8)
517.6 (433.6–601.5)
592.3 (512.5–672.0)
“None of the above” accounted for 1.4% (n = 64) of the sample and “don’t know” for n = 2. All analyses are population weighted.
proportion was 50:50, e.g., had 50% full cream and 50% reduced fat (n = 32 for plain milk and n = 27 for plain and flavoured milk).
2
12.4 (11.5–13.2)
11.8 (10.5–13.0)
13.0 (10.5–13.0)
227.5 (95.9–359.0)
281.0 (151.6–410.4)
Data excludes children whose
9. Nutrients 2013, 5
4830
Saturated fat content of the total diet, as a percentage of energy, was highest for those who reported
whole milk as their main milk type (14.3%) and lowest for those who reported soy milk as their main
milk type (10.5%). Saturated fat intake was similar for children who reported their main milk type was
low/reduced fat (12.7%) or skim milk (12.6%), and for those who reported they did not consume milk
(12.4%). The mean volume of milk consumed (±flavoured milk) decreased as children reported lower
fat milk choices as their main milk type by short question (p < 0.001). Those who reported they did not
consume milk by the short question consumed a daily average of 227 mL in the recalls, with one third
consuming some milk (Table 4).
4. Discussion
Short survey instruments measuring fruit and vegetable intake typically use between six and
16 questions [13]; however, single item questions to measure fruit intake or vegetable intake have also
been used [14,15]. The standard short questions on usual fruit intake, usual vegetable intake and usual
milk type used in the 2007 Australian National Children’s Nutrition and Physical Activity Survey
showed acceptable validity for groups of Australian children compared to information from 24-h
dietary recalls.
As is generally recommended [16], parents were the primary reporters of young children’s intake in
this survey, and in these age groups estimation of the mean fruit intake using the short question was
similar to estimation using two detailed 24-h dietary recalls. Relatively good validity has also been
shown with Australian parents reporting their pre-school aged (2–5 years) children’s usual intake on
single item questions for fruit and vegetables compared to three-day food records [17]. In groups aged
between nine and 16 years, estimation of fruit intake using the short question was higher by less than
half of a serve (75 g) compared to estimation from the recalls. Children reporting high fruit intake by
short question (4, 5, or 6+ serves a day) markedly overestimated their fruit intake compared to 24-h
recall, however, this was <20% of the sample.
Estimation of mean vegetable intake of groups aged four years and older using the short question
was also higher by less than half a serve (75 g) compared to estimation using recalls. Again, children
reporting higher vegetable intake by short question substantially overestimated their vegetable intake.
A modest decrease in fruit intake with age group was detectable using the 24-h dietary recall data, but
not in the data from the short questions. However, an increase in mean vegetable intake with age group
was detectable using both methods. While the differences in the group mean estimates of intake
between the short questions and 24-h recalls may appear minor, less than one half of a 75 g serve, this
represents up to 20%–30% of children’s intake (depending on age).
Consumption data from two 24-h dietary recalls was consistent with the response provided by short
question regarding the main type of milk usually used. Agreement between methods was similar when
frequency rather than volume of milk consumption was used, but was slightly lower when flavoured
milk was included. The reason for this maybe because children who consume flavoured milk tend to
consume whole flavoured milk (79.4% of flavoured milk consumers) regardless of the type of milk
they report as their main milk type. Importantly, milk type used also appeared to be related to milk
volume consumed. There was an association between main type of milk and the percentage of total
dietary energy contributed by saturated fat, with the small number of children who respond soy milk
10. Nutrients 2013, 5
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(~3%) having the lowest percentage energy from saturated fat and the large number of children
(~65%) who respond whole milk having the highest percentage energy from saturated fat. Usual type
of milk reported has also been shown to relate to saturated fat intake in adults [1].
The short questions about usual fruit and vegetable intake required a response in “serves”, and a
reference serve size in a household measure (half a cup in each case) was provided. The reference
serve size only provides a guide because fruit and vegetables are not necessarily eaten or easily
conceived in “half cup” multiples. Furthermore, portion size differs across age groups. We considered
whether subjects responded after taking into account the reference serve size provided, or responded
according to the number of occasions (frequency) they usually consumed a food. For fruit intake, the
mean frequency of fruit intake by 24-h recall for each short question response category was
substantially less than the reported intake of 75 g serves from the short question, but rather paralleled
the intake of 150 g serves. We interpret this as evidence that the average serve size of fruit consumed
by children was close to 150 g but that subjects provided a response to the short question that
incorporated the reference serve size provided in the question. Researchers in the US have shown that
the inclusion of a reference serve size description in a short question makes a large difference to the
group response given [18].
Other state-based Australian surveys [15,19–21] have used the recommended serve size in the
Australian Guide to Healthy Eating [10], however, short questions with a half cup reference serve size
have also been used internationally [18,22]. For Australian children, the mean consumed portion size
of fruits varies from 92 g to 141 g, and for vegetables from 41 g to 80 g for 2–3 year olds and
14–16 year olds, respectively [3]. Selection of a reference size in a single question is important but will
not be consistent with consumed portion size for all age groups.
The short questions about fruit and vegetable intake did not specify what foods to include. For the
present analysis, potato crisps and other fried potato foods were excluded from the vegetable group for
estimating intake from the 24-h recall data; however, some subjects may have included these foods in
their short question response. Data from the 24-h recalls suggests that vegetable intake increased with
age, and the discrepancy between the estimates from the recalls and the response on the short question
increased with intake. As a single category, potato accounts for 18%–22% of children’s total vegetable
consumption depending on age, and up to 40% if fried potato products are included. Also, the amount
of potato reported per eating occasion is almost double that of other vegetables whereas for other
vegetables it is less than one serve (110 g vs. 65 g on average across all age groups). So, as total
vegetable intake increases, potatoes account for a relatively smaller proportion of total intake. This
may partially explain the increasing discrepancy between methods as intake increases.
When 100% fruit juice was included into the estimation of total fruit intake by dietary recall, we
found that a similar amount was consumed regardless of the short fruit question response given.
Furthermore, inclusion of 100% fruit juice implied a substantial under estimation of fruit intake by the
short question. Subjects probably do not include fruit juice when answering the current question. The
Australian Guide to Healthy Eating states that half a cup of 100% fruit juice is an alternative to one
piece of fresh fruit [10], therefore measuring intake is of interest. However, inclusion of 100% fruit
juice in a short question is not necessarily straightforward, with a study in U.S. adults suggesting that
the term “100% fruit juice” was not appropriately understood and adults included fruit drink in this
category, inflating their estimated fruit intake [23]. Further work is required to develop either a single
11. Nutrients 2013, 5
4832
short question to include 100% fruit juice in fruit intake, or to develop a separate question about 100%
fruit juice intake.
Almost one quarter of Australian children are overweight or obese [24,25], so it is relevant to
understand how weight status might potentially influence dietary intake estimates in population
surveys. While fruit intake was higher by short question than by 24-h recall for all children, for obese
children the difference was more than twice as much as normal weight or overweight children.
Children with higher BMIs are more likely to under report their energy intake in 24-h recalls compared
to individuals with lower BMIs [26], and also parents of obese children are more likely to under report
their children’s intake more than parents of normal weight children [27]. In this analysis, the larger
difference between methods in fruit intake for obese children may actually be due to a more accurate
estimate of fruit intake by short question. However, a Canadian study [28] using a six item
questionnaire to measure fruit and vegetable intake over the previous seven days found little difference
between obese and non-obese individuals, and there was no difference by weight status in short
question performance for vegetable intake. Other individual characteristics not explored in this
analysis may also influence the performance of short dietary questions. For example, a short question
about fruit intake has been shown to perform better in non-Indigenous Australian children than in
Aboriginal and Torres Strait Islander children. The question was able to detect an increasing trend in
intake (relative to three dietary recalls) in the non-Indigenous children; however, this trend was not
evident in the Aboriginal and Torres Strait Islander children [29].
Type of milk used was dominated by children who stated they usually had whole milk (~65%).
More than 80% of these children did have mostly whole milk by volume, and most often had whole
milk by frequency, based on two days of dietary recall. This underestimates the true level of agreement
because two days of recall does not necessarily confirm the main type of milk used. In particular,
between 10% and 19% of children could not be assigned a “main type of milk” because they did not
consume milk on the days of the dietary recall. The small percentage of children (~5%) who responded
that their usual type of milk was skim milk were less likely to have consumed milk, and almost a third
mostly consumed another type of milk on the days of recall. A small percentage of children (<2%)
reported that they did not use milk; however, about one third of these were found to consume milk by
dietary recall. Milk has many different dietary usages and respondents may only consider a particular
milk usage in their response to the short question.
Short dietary questions are useful in monitoring population intakes when they accurately reflect true
differences or changes in intake between relevant population groups. Responses to single short
questions on fruit and vegetable intake were compared directly to food intake from recalls and not
nutrient intakes (sometimes referred to as indirect validity). Responses on short questions on fruit and
vegetables have also been shown to correlate to biomarkers such as serum B-carotene, red cell
folate [30,31], serum vitamin C and urinary potassium [30] for fruit intake, and serum B-carotene and
red cell folate for vegetable intake [31] in Australian and UK adult samples, which provides support
for their validity. Ideally short questions would accurately reflect true intake differences between
relevant population groups. In our analyses, a short question on fruit intake was not sensitive enough to
show the small decrease in fruit intake with age.
This study utilises data from a nationally representative sample of Australian children where
response to short dietary questions was collected prior to collection of two 24-h dietary recalls. The
12. Nutrients 2013, 5
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fruit intake estimate would benefit by the inclusion of a further question on intake of 100% fruit juice
(which is not captured by the current question).
5. Conclusions
Even single short questions provide reasonable estimates of fruit and vegetable intake compared to
detailed 24-h dietary recalls. A short question about milk type is a crude surrogate for percentage of
total dietary energy contributed by saturated fat. Ease of administration and data processing suggest
that short dietary questions, at least for some aspects of dietary intake, are a useful method to monitor
population dietary intake of children, and to assess the impact of programs between the administrations
of more detailed surveys.
Implications
•
•
At the group level, single questions provide reasonable estimates of children’s fruit and
vegetable intake compared to detailed 24-h dietary recalls, and milk type is a crude surrogate
for percentage of total dietary energy contributed by saturated fat.
The accuracy of reporting intake using a single question can vary by children’s age, gender and
weight status. In addition, the wording of questions to measure intake can also vary between
surveys. These variations need to be considered in the interpretation of eating habits data from
population surveys using single questions.
Conflicts of Interest
The authors declare no conflict of interest.
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