Objective: To illustrate the impact of intake-related bias in FFQ and 24 h recall (24hR), and correlated errors between these methods, on intake-health associations. Design: Dietary intake was assessed by a 180-item semi-quantitative FFQ and two 24hR. Urinary N and urinary K were estimated from two 24 h urine samples. We compared four scenarios to correct associations for errors in an FFQ estimating protein and K intakes. Setting: Wageningen, The Netherlands. Subjects: Fifty-nine men and fifty-eight women aged 45-65 years. Results: For this FFQ, measurement error weakened a true relative risk of 2?0 to 1?4 for protein and 1?5 for K. As compared with calibration to duplicate recovery biomarkers (i.e. the preferred scenario 1), estimating a validity coefficient using this duplicate biomarker resulted in overcorrected associations, caused by intakerelated bias in the FFQ (scenario 2). The correction factor based on a triad using biomarkers and 24hR was hampered by this intake-related bias and by correlated errors between FFQ and 24hR, and in this population resulted in a nearly perfect correction for protein but an overcorrection for K (scenario 3). When the 24hR was used for calibration, only a small correction was done, due to correlated errors between the methods and intake-related bias in the 24hR (scenario 4). Conclusions: Calibration to a gold standard reference method is the preferred approach to correct intake-health associations for FFQ measurement error. If it is not possible to do so, using the 24hR as reference method only partly removes the errors, but may result in improved intake-health associations.
Nutritional genomics, or nutrigenomics, can be considered as the combination of molecular nutrition and genomics. Students who attend courses in nutrigenomics differ with respect to their prior knowledge. This study describes digital nutrigenomics learning material suitable for students from various backgrounds and provides design guidelines for the development of the learning material. These design guidelines, derived from theories on cognitive science and instructional design, describe the selection of interaction types for learning tasks and the timing of information presentation. The learning material supports two learning goals: 1) the formulation of meaningful research questions in the field of nutrigenomics and 2) the development of feasible experiments to answer these questions. The learning material consists of two cases built around important nutrigenomics topics: 1) personalized diets and 2) the role of free fatty acids in the regulation of hepatic gene transcription. Each case consists of several activities to promote active learning by the student. Evaluation of the cases in a realistic academic educational setting indicates that the cases were useful.
This study used a sequential set-up to investigate the consecutive effects of timing of supportive information presentation (information before vs. information during the learning task clusters) in interactive digital learning materials (IDLMs) and type of collaboration (personal discussion vs. online discussion) in computer-supported collaborative learning (CSCL) on student knowledge construction. Students (N = 87) were first randomly assigned to the two information presentation conditions to work individually on a case-based assignment in IDLM. Students who received information during learning task clusters tended to show better results on knowledge construction than those who received information only before each cluster. The students within the two separate information presentation conditions were then randomly assigned to pairs to discuss the outcomes of their assignments under either the personal discussion or online discussion condition in CSCL. When supportive information had been presented before each learning task cluster, online discussion led to better results than personal discussion. When supportive information had been presented during the learning task clusters, however, the online and personal discussion conditions had no differential effect on knowledge construction. Online discussion in CSCL appeared to compensate for suboptimal timing of presentation of supportive information before the learning task clusters in IDLM.
Background Population-based studies generally show neutral associations between dairy consumption and ischemic heart disease (IHD) mortality, whereas weak inverse associations were found for cardiovascular disease (CVD) and stroke mortality. Whether dairy consumption affects long-term survival after myocardial infarction (MI) is unknown. Objectives We studied types of dairy and long-term mortality risk in drug-treated post-MI patients. Methods We included 4365 Dutch patients from the Alpha Omega Cohort aged 60–80 y (21% women) with an MI ≤10 y before enrollment. Dietary data were collected at baseline (2002–2006) using a 203-item FFQ and patients were followed for cause-specific mortality through December 2018. HRs of CVD, IHD, stroke, and all-cause mortality for types of dairy were obtained from Cox models, adjusting for age, sex, energy intake, physical activity, smoking, alcohol intake, diabetes, obesity, and dietary factors. Results Most patients were Dutch, 24% were obese, 20% had diabetes, and 97% used cardiovascular medication. Median intakes were 39 g/d for plain yogurt, 88 g/d for total nonfermented milk, and 17 g/d for hard cheeses. Of the cohort, 10% consumed high-fat milk. During ∼12 y of follow-up (48,473 person-years) 2035 deaths occurred, including 903 from CVD, 558 from IHD, and 170 from stroke. Yogurt was linearly inversely associated with CVD mortality (HR: 0.96; 95% CI: 0.93, 0.99; per 25 g/d) and nonlinearly inversely associated with all-cause mortality. Milk was not associated with any of the outcomes (HRs: ∼1.0 per 100 g/d), except for a higher mortality risk in high-fat milk consumers (HR: 1.30; 95% CI: 1.13, 1.49). Other dairy groups were not associated with mortality risk. Conclusions In Dutch post-MI patients, yogurt consumption was inversely associated with CVD mortality and all-cause mortality. Associations for milk and other dairy products were neutral or inconsistent. This trial was registered at clinicaltrials.gov as NCT03192410.
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