To evaluate the utility of the Mini-Nutritional Assessment (MNA) in assessing nutritional, physical and psychosocial functions in community-living elderly individuals.

A cross-sectional study of elderly individuals investigated in August 2007 and August–September 2008. Nutritional status was assessed using serum biomarkers, anthropometric measurements and the MNA. Physical function was assessed by measuring grip strength and both usual and maximum walking speeds. The Geriatric Depression Scale (GDS) was used to measure the individual's depressive state.

Elder-care facilities in Tokyo, Japan.

Community-living elderly individuals aged ≥65 years (n 130).

The MNA evaluation classified twenty-seven (20·8 %) individuals as being at risk for malnutrition (MNA score ≤23·5); these at-risk individuals included a high proportion of the elderly aged ≥75 years. MNA scores correlated with nutritional biomarkers (total protein, albumin, cholinesterase, Hb) and anthropometric measurements (triceps skinfold, subscapular skinfold, mid-arm muscle area) and exhibited a strong correlation with grip strength and GDS score. Multivariate analysis revealed that grip strength, GDS score, marital status and maximum walking speed are strong predictors of MNA score.

The MNA is considerably useful in providing a comprehensive assessment of nutritional status in elderly, community-living Japanese. However, larger-scale epidemiological studies are needed to determine the utility and the appropriate cut-off point of the MNA as a screen for risk of malnutrition.

Low bone mass often leads to osteoporosis and increased risk of bone fractures. Soda consumption may contribute to imbalances that lead to decreased bone mineral density (BMD) and general bone health. We examined the relationship between soda consumption and osteoporosis risk in postmenopausal American-Indian women, an at-risk population because of nutritional and other lifestyle-related factors.

Cross-sectional analysis using logistic regression to examine associations between soda consumption and osteoporosis, and linear regression to examine the association between soda consumption and BMD, with and without adjustment for demographic and lifestyle factors. Quantitative ultrasound of the heel was performed to estimate BMD (g/cm2).

American-Indian communities in the Northern Plains and Southwestern USA.

A total of 438 postmenopausal American-Indian women.

Women with osteoporosis were significantly older and had lower BMI, average daily soda intakes, BMD levels and use of hormones than women without osteoporosis (P < 0·05). Soda consumption was not associated with increased odds of osteoporosis in either unadjusted or adjusted models (P > 0·05), although age (increased), BMI (decreased) and past hormone use (decreased) were all significantly associated with osteoporosis risk (P < 0·05).

Although the present study did not find associations between soda consumption and osteoporosis risk in postmenopausal American-Indian women, analyses did confirm confounding between soda consumption and age and BMI. This suggests that any potential effects of soda consumption on bone health are largely mediated through these factors.

The influence of moderate alcohol consumption on renal function is not clear in elderly people. The aim of the present study was to investigate the relationship between alcohol consumption and renal function, expressed as serum creatinine levels and glomerular filtration rates (GFR), in an elderly population.

Perspective cohort study.

Population-based study on an elderly Italian population.

A sample of 3404 Italian people (1619 women and 1785 men), aged 65–84 years, from the Italian Longitudinal Study on Aging (ILSA).

Prevalence and cumulative risk of impaired renal function (defined as GFR ≤ 60 ml/min) were estimated by sex and alcohol consumption groups. Logistic regression analysis adjusting for confounders (age, education, smoking, BMI and medications) and intermediate factors (blood cholesterol and fibrinogen, systolic hypertension and diabetes) showed that alcohol consumption level was not significantly related to the prevalence of mild renal impairment in elderly women. In men, both prevalence and incidence results seemed to suggest an inverse linear relationship between moderate alcohol consumption and the risk of mild renal impairment. A U-shaped association was shown for women at the incidence phase, suggesting a higher risk of developing renal impairment for women who drink more than 24 g alcohol/d.

Our results suggest that, in accordance with the recommendations on alcohol consumption in the elderly, moderate quantities of alcohol are not injurious to renal function in elderly men.

To examine absolute socio-economic differences in food habits and their changes over time.

A longitudinal study using the cohort baseline mail surveys conducted in 2000–2002 (n 8960, response rate 67 %) and the follow-up in 2007 (n 7332, response rate 83 %), including data on seven food habits recommended in the national dietary guidelines, as well as socio-economic and sociodemographic variables.

Data from the Helsinki Health Study survey, followed up for 5–7 years.

Municipal employees of the City of Helsinki, Finland.

Apart from fish and vegetable-based margarine on bread, the proportions of the recommended food items were higher for women than for men. The consumption of the recommended food items either increased or remained stable over the follow-up period. On the basis of the slope index of inequality (SII) it was observed that socio-economic differences widened with regard to the consumption of fresh vegetables and fish and use of vegetable-based margarine or oil in cooking, with the upper classes consuming these foods more often. The largest differences were observed in the consumption of fresh vegetables, for which the SII value among women was 2·38 (95 % CI 1·93, 2·95) at baseline and 2·47 (95 % CI 2·01, 3·03) at follow-up, and 3·36 (95 % CI 1·80, 6·28) and 3·47 (95 % CI 1·95, 6·19) for men, respectively. Socio-economic differences were non-existent for milk, and the reverse was observed for dark bread and vegetable-based margarine on bread.

Consumption of the recommended food items increased in the examined cohort over time. This increase was mostly similar throughout the socio-economic groups and thus the socio-economic differences remained stable. The upper classes followed the guidelines better with regard to the consumption of vegetables and fish and in the use of vegetable-based margarine or oil in cooking.

To build a comprehensive overview of the potential role of fish in improving nutrition with respect to certain micronutrient deficiencies in developing countries.

A comprehensive literature review was completed. For this the electronic library databases ASFA, CABD and Scopus were systematically searched and relevant references cited in these sources were carefully analysed. The search terms used were ‘fish’, ‘small fish species’, ‘micronutrients’, ‘food-based strategies’, ‘fish consumption’ and ‘developing countries’. The quality of data on nutritional analyses was carefully reviewed and data that lacked proper information on methods, units and samples were excluded.

The evidence collected confirmed the high levels of vitamin A, Fe and Zn in some of the small fish species in developing countries. These small fish are reported to be more affordable and accessible than the larger fish and other usual animal-source foods and vegetables. Evidence suggests that these locally available small fish have considerable potential as cost-effective food-based strategies to enhance micronutrient intakes or as a complementary food for undernourished children. However, the present review shows that only a few studies have been able to rigorously assess the impact of fish consumption on improved nutritional status in developing countries.

Further research is required in areas such as determination of fish consumption patterns of poor households, the nutritional value of local fish and other aquatic animals and the impact of fish intake on improved nutritional status in developing countries where undernutrition is a major public health problem.

To determine the dietary patterns of a national sample of 2–8-year-old Australian children and to establish whether breast-feeding is associated with dietary patterns in this age group.

Cross-sectional study using 24 h recall data from the 2007 Australian National Children's Nutrition and Physical Activity Survey.

Australia.

A total of 2287 children aged 2–8 years.

Principal component factor analysis identified three distinct patterns. The ‘Non-core food groups’ pattern included food groups such as whole-fat dairy products, cheese, medium–high sugar-sweetened breakfast cereals and sweet biscuits, no fruit, reduced/low-fat dairy products and wholegrain bread/rolls. The ‘Healthy, meat and vegetable’ pattern included vegetables, red meat, fruit and wholegrain bread/rolls and was inversely associated with take-away foods and carbonated sugar-sweetened beverages. The ‘Combination’ pattern contained many food groups including candy (not chocolate based), pasta/rice products, nuts/seeds, cakes and chocolate, but no fruit or vegetables. Of the 2287 children, 2064 (89·3 %) had been breast-fed. A positive association was found between breast-feeding and the healthy, meat and vegetable pattern (r = 0·267) but not with the other two patterns. Higher scores on this pattern were also associated with younger age, lower BMI, higher birth weight, high likelihood of being in the less-disadvantaged Socio-economic Indexes for Areas category and less likelihood of the child's parents having a lower educational level.

These results provide suggestive evidence that breast-feeding during infancy is associated with a healthy dietary pattern in childhood and offers a likely pathway to explain the previously reported association between breast-feeding and chronic disease.

Intake of nutrients may influence the risk of endometrial cancer (EC). We aimed to estimate the association of intake of individual nutrients from food and from food plus supplements with EC occurrence.

A population-based case–control study conducted in Canada (2002–2006).

Nutrient intakes from food and supplements were assessed using an FFQ. Logistic regression was used to estimate EC risk within quartile levels of nutrient intakes.

Incident EC cases (n 506) were identified from the Alberta Cancer Registry, and population controls were frequency- and age-matched to cases (n 981).

There existed little evidence of an association with EC for the majority of macronutrients and micronutrients examined. We observed a statistically significant increased risk associated with the highest, compared with the lowest, quartile of intake of dietary cholesterol (multivariable-adjusted OR = 1·51, 95 % CI 1·08, 2·11; P for trend = 0·02). Age-adjusted risk at the highest level of intake was significantly reduced for Ca from food sources (OR = 0·73, 95 % CI 0·54, 0·99) but was attenuated in the multivariable model (OR = 0·82, 95 % CI 0·59, 1·13). When intake from supplements was included in Ca intake, risk was significantly reduced by 28 % with higher Ca (multivariable-adjusted OR = 0·72, 95 % CI 0·51, 0·99, P for trend = 0·04). We also observed unexpected increased risks at limited levels of intakes of dietary soluble fibre, vitamin C, thiamin, vitamin B6 and lutein/zeaxanthin, with no evidence for linear trend.

The results of our study suggest a positive association between dietary cholesterol and EC risk and an inverse association with Ca intake from food sources and from food plus supplements.

Little is known of the beverage intake patterns of Canadian children or of characteristics within these patterns. The objective was to determine beverage intake patterns among Canadian children and compare intakes of fourteen types of beverages, along with intakes of vitamin C and Ca, and sociodemographic factors across clusters.

Dietary information was collected using one 24 h recall. Sociodemographic data were collected by interview. Cluster analysis was used to determine beverage intake patterns. Pearson's χ2 and 95 % CI were used to test differences across clusters.

Data from the Canadian Community Health Survey Cycle 2·2.

Children aged 2–18 years with plausible energy intake and complete sociodemographic data (n 10 038) were grouped into the following categories: 2–5-year-old boys and girls, 6–11-year-old girls, 6–11-year-old boys, 12–18-year-old girls and 12–18-year-old boys.

Five beverage clusters emerged for children aged 2–5 years, six clusters for children aged 6–11 years (both sexes) and four clusters for those aged 12–18 years (both sexes). Sweetened beverage clusters appeared in all age–sex groups. Intakes of sweetened beverages ranged from 553 to 1059 g/d and contributed between 2 % and 18 % of total energy intake. Girls 6–11 years of age in the ‘soft drink’ cluster had lower Ca intake compared with other clusters in that age–sex group. Age and ethnicity differed across clusters for most age–sex groups. Differences for household food security status and income were found; however, no pattern emerged.

Patterns in beverage intake among Canadian children include beverages that are predominantly sugar sweetened. Public health nutrition professionals can use knowledge about beverage patterns among children, as well as the characteristics of these groups, in the development of nutritional programmes and policies.

To identify food sources of nutrients in adolescents’ diets and to identify differences in food sources according to individual characteristics.

A cross-sectional evaluation was carried out in the 2003/2004 school year. Self-administered questionnaires were used and a physical examination was performed. Diet was evaluated using an FFQ.

Public and private schools in Porto, Portugal.

Adolescents aged 13 years (n 1522) enrolled at school.

The main sources of energy were starchy foods (26·5 %), dairy (12·5 %) and meat (12·0 %). The major contributors to carbohydrate intake were starchy foods (38·2 %) and fruit (13·8 %) and to protein intake were meat (28·0 %), dairy products (20·3 %), starchy foods (15·3 %) and seafood (13·6 %). The main sources of total fat were meat (22·0 %), starchy foods (13·4 %) and dairy products (12·7 %). Sweets and pastries presented important contributions to energy (11·1 %), carbohydrate (12·4 %), total fat (13·3 %) and saturated fat (16·6 %) intakes. Parental education was inversely associated with the contribution of sweets and pastries to energy, carbohydrate and fat intakes and it was positively associated with the seafood contribution to protein intake.

The major sources of carbohydrates were starchy foods, which also accounted for a quarter of energy intake. Dairy products plus meat accounted for another quarter of energy. Meat was a major source of protein and fats. Sweets and pastries contributed more than 10 % to energy, carbohydrates, total and saturated fat. Parental education was the strongest determinant of food sources and was positively associated with a healthier contribution of food groups.

To examine the accuracy of maternal ability to classify their children's weight status correctly using a verbal and a visual classification instrument and to detect significant correlates of maternal misperceptions.

Cross-sectional study.

Primary schools in four counties from north, west, central and south Greece.

A representative sample of 1858 primary-school children aged 9–13 years was examined. Two different instruments to assess maternal perceptions of their children's weight status, i.e. a verbal and a visual one, were used.

Verbal and visual maternal underestimation rates of children's weight status were 15·0 % and 41·3 %, respectively. The frequency of underestimation was much higher among overweight and obese children for both instruments. The highest underestimation rates of 87·9 % and 82·1 % in overweight and obese boys, respectively, were obtained with the visual instrument. Multiple logistic regression modelling revealed that the likelihood of both verbal and visual maternal underestimation of their children's weight status was significantly higher for overweight mothers and for those with a lower educational level. Furthermore, children's male gender and a nanny or someone other than the mother as the child's primary caregiver were found to increase the odds of visual and verbal maternal underestimation of children's weight status, respectively.

The present study showed that the verbal instrument used to assess maternal perceptions of their children's weight status was more accurate compared with the visual one. However, both instruments showed that a considerable number of overweight and obese boys had their weight status underestimated by their mothers. Educating mothers to classify their children's weight status correctly might be a key factor for the implementation of successful childhood obesity prevention initiatives.

To assess race-specific validity of food and food group intakes measured using an FFQ.

Calibration study participants were randomly selected from the Adventist Health Study-2 (AHS-2) cohort by church, and then by subject-within-church. Intakes of forty-seven foods and food groups were assessed using an FFQ and then compared with intake estimates measured using six 24 h dietary recalls (24HDR). We used two approaches to assess the validity of the questionnaire: (i) cross-classification by quartile and (ii) de-attenuated correlation coefficients.

Seventh-day Adventist church members geographically spread throughout the USA and Canada.

Members of the AHS-2 calibration study (550 whites and 461 blacks).

The proportion of participants with exact quartile agreement in the FFQ and 24HDR averaged 46 % (range: 29–87 %) in whites and 44 % (range: 25–88 %) in blacks. The proportion of quartile gross misclassification ranged from 1 % to 11 % in whites and from 1 % to 15 % in blacks. De-attenuated validity correlations averaged 0·59 in whites and 0·48 in blacks. Of the forty-seven foods and food groups, forty-three in whites and thirty-three in blacks had validity correlations >0·4.

The AHS-2 questionnaire has good validity for most foods in both races; however, validity correlations tend to be higher in whites than in blacks.

To describe the development of the Oxford WebQ, a web-based 24 h dietary assessment tool developed for repeated administration in large prospective studies; and to report the preliminary assessment of its performance for estimating nutrient intakes.

We developed the Oxford WebQ by repeated testing until it was sufficiently comprehensive and easy to use. For the latest version, we compared nutrient intakes from volunteers who completed both the Oxford WebQ and an interviewer-administered 24 h dietary recall on the same day.

Oxford, UK.

A total of 116 men and women.

The WebQ took a median of 12·5 (interquartile range: 10·8–16·3) min to self-complete and nutrient intakes were estimated automatically. By contrast, the interviewer-administered 24 h dietary recall took 30 min to complete and 30 min to code. Compared with the 24 h dietary recall, the mean Spearman's correlation for the 21 nutrients obtained from the WebQ was 0·6, with the majority between 0·5 and 0·9. The mean differences in intake were less than ±10 % for all nutrients except for carotene and vitamins B12 and D. On rare occasions a food item was reported in only one assessment method, but this was not more frequent or systematically different between the methods.

Compared with an interviewer-based 24 h dietary recall, the WebQ captures similar food items and estimates similar nutrient intakes for a single day's dietary intake. The WebQ is self-administered and nutrients are estimated automatically, providing a low-cost method for measuring dietary intake in large-scale studies.

To examine the relationship between dietary patterns, as measured by the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index (AHEI), and 10-year predicted CHD risk in Cuban Americans with and without type 2 diabetes (T2D).

In a cross-sectional study participants were selected from two randomly generated mailing lists of individuals with and without T2D. HEI and AHEI scores were calculated from a self-reported FFQ. CHD risk was determined using the 10-year CHD risk calculator of the Adult Treatment Panel III.

Miami Dade and Broward Counties, FL, USA.

Cuban Americans (n 358) aged ≥30 years.

Participants with T2D had a higher waist circumference (P = 0·001) and 10-year CHD risk score (P = 0·008) compared with those without T2D. Participants without T2D had a higher energy intake (P = 0·034), total blood cholesterol (P = 0·007), HDL cholesterol (P = 0·001) and HEI score (P = 0·006) compared with participants with T2D. AHEI score was a significant predictor of 10-year CHD risk (F(1,351) = 4·44, P = 0·036). An association between AHEI and 10-year CHD risk was found only for participants with T2D (β = −0·244, se = 0·049, P = 0·001).

The present study showed that only participants with T2D with significantly higher AHEI scores had lower scores for 10-year predicted CHD risk. No association was found between HEI score and CHD risk among Cuban Americans. Individuals with T2D are advised to follow the AHEI dietary pattern.

The aim of the present study was to assess the concurrent and construct validity of two diet-quality indices, a modified Mediterranean diet score (mMDS) and a Mediterranean-like diet score (MLDS) additionally incorporating unhealthy food choices, as determined by an FFQ.

A validation study assessing FFQ intake estimates compared with ten or more unannounced 24 h recalls. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Bland–Altman plots and the limits of agreement method were used to assess the between-method agreement of scores. Construct validity was shown using associations between nutrient intakes derived from multiple 24 h recalls and the mMDS and MLDS derived from the FFQ.

Gerona, Spain.

A total of 107 consecutively selected participants from a population-based cross-sectional survey.

Pearson's correlations for the energy-adjusted mMDS and MLDS compared with multiple recalls were 0·48 and 0·62, respectively. The average FFQ energy-adjusted mMDS and MLDS were 102 % and 98 % of the recall-based mMDS and MLDS estimates, respectively. The FFQ under- and overestimated dietary recall estimates of the energy-adjusted MLDS by 28 % and 25 %, respectively, with slightly wider boundaries for the mMDS (31 % and 34 %). The ICC, which assesses absolute agreement, was similar to Pearson's correlations (mMDS = 0·48 and MLDS = 0·61). The mean differences between methods were similar across the range of average ratings for both scores, indicating the absence of bias. The FFQ-derived mMDS and MLDS correlated in the anticipated directions with intakes of eleven (73·3 %) and thirteen of fifteen nutrients (86·7 %), respectively.

The FFQ provides valid estimates of diet quality as assessed by the mMDS and MLDS.

To assess folic acid supplementation rates and validate the self-reporting of folic acid supplement use among pregnant women in a multiethnic cohort.

Secondary analysis of a prospective cohort study.

Self-reported folic acid supplement use in the Amsterdam Born Children and their Development study cohort was compared with serum folate concentrations using non-parametric trend analysis and linear and logistic regression.

A total of 4234 pregnant women of various ethnic backgrounds.

Serum folate levels showed a significant positive linear trend as reported use of folic acid increased (P < 0·001), which was supported by linear regression (r = 0·49). Odds of having low serum folate concentration decreased with reported early start of folic acid intake. Young, multiparous or non-Western women reported less pre-conception folic acid intake. Non-Western women showed lower serum folate concentrations. The overall rate of over-reporting, i.e. serum folate concentrations ≤20 nmol/l while reporting the use of folic acid supplements, was 20·7 %. Women of Surinamese and Moroccan ancestry had higher odds of over-reporting (OR = 2·3; 95 % CI 1·5, 3·5 and OR = 2·3; 95 % CI 1·3, 4·0, respectively). The odds for Surinamese women remained significant after adjusting for the onset of supplement use, parity and age (OR = 1·7; 95 % CI 1·1, 2·6).

Although self-reporting is a valid method for assessing folic acid supplement use in a multiethnic population, some participants do over-report. Surinamese and possibly Moroccan women appear to over-report more often. Rates of supplementation are low, especially in non-Western women. This suggests the need for intensifying current campaigns or perhaps even additional advice to start or continue to use folic acid post-conceptionally.

To identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health.

Background interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were conducted in Amharic and translated into English.

Kossoye, a rural Amhara village with high prevalence rates of stunting: inappropriate neonatal feeding is thought to be a factor.

Women (20–60 years of age) reporting at least one live birth (range: 1–8, mean: ∼4).

Colostrum (inger) and breast milk (yetut wotet) were seen as different substances. Colostrum was said to cause abdominal problems, but discarding a portion was sufficient to mitigate this effect. Almost all (nineteen of twenty) women breast-fed and twelve (63 %) reported ritual prelacteal feeding. A majority (fifteen of nineteen, 79 %) reported discarding colostrum and breast-feeding within 24 h of birth. Prelacteal feeding emerged as an additional factor to be targeted through educational intervention.

To maximize neonatal health and growth, we recommend culturally tailored education delivered by community health advocates and traditional health practitioners that promotes immediate colostrum feeding and discourages prelacteal feeding.

To examine the associations between maternal education level and diet in 10-year-old children.

Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal–Wallis test used for food consumption.

Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.

Children (n 7474) who provided dietary data at age 10 years.

A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P < 0·001; sausages, burgers and kebabs P < 0·001).

The quality of children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.

Dietary n-3 (omega-3) and n-6 (omega-6) PUFA have significant implications in health and disease prevention. Marine life is rich in long-chain n-3 PUFA. Children and adults in North America are reluctant fish eaters; canned tuna is a common fish in children's diets. Although a multitude of tuna products are available, their respective PUFA contents have not been well described. The aim of the present study was to compare the fatty acid (FA) profiles of different commercially available US tuna products.

Fat and FA composition of eight products randomly selected from two US suppliers were analysed with capillary GC after lipid extraction.

Large north-eastern US grocery store chain.

Canned tuna.

Energy from fat varied from 3 to 33 % and the essential FA (EFA) linoleic acid (18 : 2n-6) and α-linolenic acid (18 : 3n-3) varied tenfold. DHA varied between 90 and 770 mg/serving. The n-6:n-3 ratio was 3:1–4:1 in oil-packaged products, 2:1–7:1 in packaged tuna salads and 1:3–1:7 in water-packaged products. A similar magnitude of differences was seen in the ratio between arachidonic acid (20 : 4n-6) and DHA.

Light tuna canned in water may be a better choice of providing n-3 PUFA to individuals in a healthy population, whereas oil-packaged products may be preferable for those individuals with a need for increased EFA, such as for patients with cystic fibrosis. Awareness regarding PUFA content may aid in consumer product choices and health-care provider advice.

To investigate the association of antioxidant intakes from diet and supplements with elevated blood C-reactive protein (CRP) and homocysteine (Hcy) concentrations.

A cross-sectional study. The main exposures were vitamins C and E, carotene, flavonoid and Se intakes from diet and supplements. Elevated blood CRP and Hcy concentrations were the outcome measures.

The US population and its subgroups.

We included 8335 US adults aged ≥19 years from the National Health and Nutrition Examination Survey 1999–2002.

In this US population, the mean serum CRP concentration was 4·14 (95 % CI 3·91, 4·37) mg/l. Intakes of vitamins C and E and carotene were inversely associated with the probability of having serum CRP concentrations >3 mg/l in multivariate logistic regression models. Flavonoid and Se intakes were not associated with the odds of elevated serum CRP concentrations. The mean plasma Hcy concentration was 8·61 (95 % CI 8·48, 8·74) μmol/l. Intakes of vitamins C, E, carotenes and Se were inversely associated with the odds of plasma Hcy concentrations >13 μmol/l after adjusting for covariates. Flavonoid intake was not associated with the chance of elevated plasma Hcy concentrations.

These results suggest that high antioxidant intake is associated with lower blood concentrations of CRP and Hcy. These inverse associations may be among the potential mechanisms for the beneficial effect of antioxidant intake on CVD risk mediators in observational studies.