02217nas a2200301 4500008004100000022001400041245005400055210005200109260001300161300001600174490000700190520146000197653000901657653002101666653000901687653001101696653000901707653001101716653000901727653002501736653003101761100002001792700001501812700001701827700001401844700002101858856003601879 1997 eng d a0002-916500aDietary assessment using a picture-sort approach.0 aDietary assessment using a picturesort approach c1997 Apr a1123S-1129S0 v653 a

Food-frequency questionnaires are usually administered as a list of foods to be checked off by the respondent or interviewer. Techniques in which participants sort into categories cards on which names or pictures of foods are printed can also be used to assess food intake. Food-frequency scores were obtained from a five-category picture sort administered to 4643 men and women aged > or = 65 y in the Cardiovascular Health Study (CHS). This one-step (qualitative) assessment yielded significant associations in expected directions between frequency scores and sex, age, race or ethnicity, body mass index, and use of a special diet. In the two-step (semiquantitative) version of this instrument, an interviewer documented specific frequencies and portion-size information for the foods in each sorting category. A substudy of the two-step version with 96 CHS participants indicated relative validity similar to that of conventionally administered food-frequency questionnaires. The one-step version may be broadly applicable to situations in which general food-pattern data can be informative and cost and time limitations are great. When it is feasible, the two-step picture sort may offer certain methodologic advantages because respondents have a chance to change their responses and the format may simplify the cognitive-response task. Sorting or picture-sort procedures deserve systematic attention in research on dietary assessment methods.

10aAged10aAudiovisual Aids10aDiet10aFemale10aFood10aHumans10aMale10aNutrition Assessment10aSurveys and Questionnaires1 aKumanyika, S, K1 aTell, G, S1 aShemanski, L1 aMartel, J1 aChinchilli, V, M uhttps://chs-nhlbi.org/node/147803409nas a2200349 4500008004100000022001400041245010900055210006900164260001600233300001200249490000800261520242900269653000902698653002802707653001802735653001702753653001102770653001002781653001102791653000902802653002502811653002402836653000902860653001502869100002502884700002602909700002402935700001902959700002202978700002403000856003503024 2003 eng d a0098-748400aCereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals.0 aCereal fruit and vegetable fiber intake and the risk of cardiova c2003 Apr 02 a1659-660 v2893 a

CONTEXT: People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population.

OBJECTIVE: To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons.

DESIGN: Prospective cohort study conducted from 1989 to June 2000.

SETTING AND PARTICIPANTS: Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire.

MAIN OUTCOME MEASURE: Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction).

RESULTS: During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend =.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend =.98) nor vegetable fiber intake (P for trend =.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources.

CONCLUSIONS: Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber.

10aAged10aCardiovascular Diseases10aDietary Fiber10aEdible Grain10aFemale10aFruit10aHumans10aMale10aNutrition Assessment10aProspective Studies10aRisk10aVegetables1 aMozaffarian, Dariush1 aKumanyika, Shiriki, K1 aLemaitre, Rozenn, N1 aOlson, Jean, L1 aBurke, Gregory, L1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/731