The role of beta-carotene, alpha-tocopherol, and vitamin C in the prevention of cardiovascular diseases (CVD) is controversial. Prospective studies on gamma-tocopherol and carotenoids other than beta-carotene are sparse. We assessed relations between the intake of different carotenoids, alpha- and gamma-tocopherol, and vitamin C with 15-y CVD mortality in elderly men who participated in the Zutphen Elderly Study. Information on diet and potential confounding factors was collected in 1985, 1990, and 1995. In 1985, 559 men (mean age approximately 72 y) free of chronic diseases were included in the current analysis. After 15 y of follow-up, comprising 5744 person-years, 197 men had died from CVD. After adjustment for age, smoking, and other potential lifestyle and dietary confounders, relative risks (RR) (95% CI) of CVD death for a 1-SD increase in intake were 0.81 (0.66-0.99) for alpha-carotene and 0.80 (0.66-0.97) for beta-carotene. Carrots were the primary source of alpha- and beta-carotene and their consumption was related to a lower risk of death from CVD (adjusted RR, 0.83; 95% CI = 0.68-1.00). Intakes of carotenoids other than alpha- and beta-carotene were not associated with CVD mortality, nor were vitamin C and alpha- and gamma tocopherol. In conclusion, dietary intakes of alpha-carotene and beta-carotene are inversely associated with CVD mortality in elderly men. This study does not indicate an important role for other carotenoids, tocopherols, or vitamin C in lowering the risk of CVD death.

Objective: To evaluate the validity and reproducibility of a 122-item intervieweradministered quantitative FFQ developed to determine food and nutrient intakes of adults in Botswana. Design: Relative validity of the FFQ was evaluated by comparing nutrient and food group intakes against four non-consecutive 24 h recalls administered over 12 months. The FFQ was repeated after 1 year to assess reproducibility. Setting: Kanye, Botswana. Subjects: Seventy-nine adults aged 18-75 years. Results: Spearman correlation coefficients for the validity of energy-adjusted nutrients ranged from 0?42 (carbohydrate) to 0?49 (protein) for macronutrients and from 0?23 (Fe) to 0?44 (PUFA) for micronutrients. Exact agreement of quartile distribution for nutrients between the FFQ and recalls ranged from 27 % to 72 %. Weighted kappa values were lowest for retinol (0?13), Fe (0?22) and b-carotene (0?25) and ranged from 0?33 (SFA) to 0?59 (folate) for other nutrients (energy, carbohydrate, protein, fat, Ca and vitamin E). Spearman correlation coefficients between the recalls and FFQ for food groups ranged from 0?18 (dark green leafy and yellow vegetables) to 0?58 (poultry). Reproducibility correlation coefficients (energy-adjusted) varied between 0?39 for retinol and 0?66 for vitamin E, with most values falling between 0?50 and 0?60. Conclusions: The FFQ had good relative validity for estimating habitual food group and nutrient intakes, but was poor for some micronutrients (Fe, retinol and b-carotene) and foods (fruits and dark green leafy vegetables). Keywords Quantitative FFQ Adults Validity BotswanaBotswana has undergone a rapid epidemiological transition characterized by increased incidences of non-communicable diseases, namely CVD, diabetes and cancers (1) . Dietary intake is associated with morbidity and mortality from non-communicable diseases (2) . Assessment of the usual food intake of individuals and groups is central to the investigation of eating patterns, nutrient intakes and their relationship to health outcomes, but the measurement of food and nutrient intakes can be challenging. The FFQ is used to obtain estimates of habitual diet and in contrast to other methods, such as single 24 h recalls and food records which do not reflect past diet or usual intake, has been used in a variety of settings to measure intakes in epidemiological studies. The FFQ ranks individuals according to levels of consumption rather than providing estimates of absolute quantities of energy and nutrient intakes. In addition, the technique has the advantage of being relatively easy to administer and analyse, thereby incurring lower costs compared with other methods of dietary assessment (3) . The use and limitations of the FFQ have been extensively reviewed and the method can be prone to measurement errors; thus validation studies are an essential step in the development of new FFQ.Whereas FFQ have been developed and validated for many developed and developing economies, there are few published reports of validated instruments designed to mea...

No abstract

Dietary patterns and their association with general and central obesity among adult women were studied using a cross-sectional survey with multistage cluster sampling in urban and rural areas nationwide in Botswana. The participants in the study were adult women (N = 1019), 18–75 years old. The dietary patterns were identified using principal component analysis, and their associations with the body mass index and the weight-for-height ratio were examined. Factor analysis with varimax rotation was used to identify six dietary patterns (fast foods, refined carbohydrates, vegetables and fruits, fish and nuts, Botswana traditional foods, and organ and red meat dietary pattern). Overall, 24.5% of the women were overweight (BMI 25.0–29.99 kg/m2) and 24.5% were obese (BMI > 30 kg/m2). A waist-to-height ratio greater than 0.5 was observed for 42.2% of the women. With adjustment for age and education, individuals in the highest tertile of the Botswana traditional food pattern had a significantly higher risk of general obesity (RR = 1.40, 95% CI: 1.07–1.84) and central obesity (RR = 1.20, 95% CI: 0.97–1.48). With respect to the fish and nut pattern, a significant association was observed with central obesity only (RR = 1.43, 95% CI: 1.18–1.72). The Botswana traditional food pattern, characterised by a high carbohydrate intake, was found to be associated with a high risk of obesity in this study. However, more research is required to assess other factors contributing to obesity in women so that appropriate intervention programs can be put in place to help control this epidemic.

Background: Micronutrient deficiencies are common and compound the effects of human immunodeficiency virus (HIV) infection in Africa. Nutritional interventions, particularly vitamin A supplementation, may improve immune functioning and delay disease progression. Aim: To investigate the effect of fortified sorghum meal provided for 12 months on the immune status of adults with HIV. Methods: HIV-infected men and women were enrolled in a double-blind randomized placebo-controlled trial in Kanye, Botswana, to receive either sorghum meal fortified with micronutrients including vitamin A (n = 67) or control (n = 65). Serum retinol, iron, zinc, albumin, CD4 cell count and HIV viral load were assessed at baseline and every 3 months. Results: Baseline serum retinol levels were 1.6 µmol/l in both groups and no significant difference was observed at the end of the intervention (control group: 1.5 µmol/l; experimental group: 1.6 µmol/l). In addition, there was no significant difference in the mean (Q1, Q3) CD4 cell count; 348 (220, 456) cells/mm³ for the control group versus 338 (228, 426) cells/mm³ in the experimental group after intervention. Conclusion: In this study, fortified sorghum meal did not influence serum retinol, CD4 cell count and HIV viral load. Future intervention studies should carefully consider the composition and dosing of food supplements needed to improve immune status and delay disease progression.