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The bioavailability and urinary excretion of three dietary flavonoids, quercetin, hesperetin and naringenin, were investigated. Ten healthy men were asked to consume a 'juice mix' containing equal amounts of the three flavonoids, and their urine and plasma samples were collected. The resulting mean plasma area under the curve (AUC)(0-48 h) and C(max) values for quercetin and hesperetin were similar, whereas the AUC(0-48 h) of naringenin and, thus, the relative bioavailability were higher after consumption of the same dose. The study consolidates a significantly lower urinary excretion of quercetin (1.5+/-1%) compared with hesperetin (14.2+/-9.1%) and naringenin (22.6+/-11.5%) and shows that this is not due to a lower bioavailability of quercetin, but rather reflects different clearance mechanisms.

Background/Aims: An adequate fruit and vegetable intake provides essential nutrients and nutritive compounds and is considered an important part of a healthy lifestyle. No simple instrument has been available for the assessment of fruit and vegetable intake as well as its determinants in school-aged children applicable in different European countries. Within the Pro Children Project, such an instrument has been developed. This paper describes the cross-sectional survey in 11-year-olds in 9 countries. Methods: The cross-sectional survey used nationally, and in 2 countries regionally, representative samples of schools and classes. The questionnaires, including a precoded 24-hour recall component and a food frequency part, were completed in the classroom. Data were treated using common syntax files for portion sizes and for merging of vegetable types into four subgroups. Results: The results show that the fruit and vegetable intake in amounts and choice were highly diverse in the 9 participating countries. Vegetable intake was in general lower than fruit intake, boys consumed less fruit and vegetables than girls did. The highest total intake according to the 24-hour recall was found in Austria and Portugal, the lowest in Spain and Iceland. Conclusion: The fruit and vegetable intake in 11-year-old children was in all countries far from reaching population goals and food-based dietary guidelines on national and international levels.

Objective: To describe and compare fruit and vegetable intakes of mothers of 11-year-old children across Europe. Methods: Cross-sectional surveys were carried out in 9 European countries in October/November 2003. Self-administered questionnaires assessing fruit and vegetable consumption were used for data collection. The current paper presents dietary intake data obtained by a precoded 24-hour recall and a food frequency questionnaire. Results: The consumption levels of fruit and vegetables (without fruit juice) were in line with World Health Organization recommendations of ≧400 g/day for only 27% of all participating mothers. Based on both instruments, the Pro Children results showed comparatively high average fruit intake levels in Portugal, Denmark and Sweden (211, 203 and 194 g/day) and the lowest intake in Iceland (97 g/day). High vegetable intake levels were found in Portugal and Belgium (169 and 150 g/day), the lowest in Spain (88 g/day). A south-north gradient could not be observed in the Pro Children study. Conclusion: Fruit and vegetable intakes are low in mothers of 11-year-olds across Europe. Especially vegetable consumption can be regarded as marginal in most of the studied European countries. A high percentage of mothers indicated to eat fruit and vegetables less than once a day. The results have shown that national and international interventions are necessary to promote fruit and especially vegetable consumption in the European population of mothers.

Epidemiological studies suggest that foods rich in flavonoids might reduce the risk of cardiovascular disease and cancer. The objective of the present study was to investigate the effect of green tea extract (GTE) used as a food antioxidant on markers of oxidative status after dietary depletion of flavonoids and catechins. The study was designed as a 2×3 weeks blinded human cross-over intervention study (eight smokers, eight non-smokers) with GTE corresponding to a daily intake of 18·6 mg catechins/d. The GTE was incorporated into meat patties and consumed with a strictly controlled diet otherwise low in flavonoids. GTE intervention increased plasma antioxidant capacity from 1·35 to 1·56 (P

Background/Aims: Validity and reproducibility were evaluated of a new questionnaire to assess fruit and vegetable intakes in 11- to 12-year-old children. Methods: The precoded teacher-assisted self-administered questionnaire included two sections: a 24-hour recall part and a food frequency part. Validity was tested in 4 countries (Denmark, Iceland, Norway, Portugal; n = 43–60 per country) using a 1-day weighed food record and 7-day food records as reference methods. Test-retest (7–12 days apart) reproducibility was assessed in 6 countries (Belgium, Denmark, Iceland, Norway, Portugal, Spain; n = 60–74 per country). Results: Spearman rank correlations for fruit and vegetable intake according to the frequency part and the 7-day food record ranged between r = 0.40–0.53. Between 25–50% were classified into the same quartile and 70–88% into the same or adjacent quartile. Test-retest Spearman rank correlations for the food frequency part were r = 0.47–0.84. Three countries showed no significant difference between fruit intake as assessed with the 24-hour recall part and the 1-day weighed food record, and 2 countries showed no significant difference for vegetables. In the other countries, the 24-hour recall part resulted in substantially higher mean intake levels. Conclusion: Validity and reproducibility as to ranking of subjects were regarded to be satisfactory in all countries. Group mean intake, based on the original 24-hour part, was valid for fruit in 3 countries and for vegetables in 2 countries, and this part was subsequently adjusted to avoid overestimation, before the questionnaire was used in the Pro Children study.

Background/Aims: The Pro Children Project was designed to assess fruit and vegetable consumption in European schoolchildren and their parents, as well as determinants of the children’s consumption patterns. A second objective was to develop and test strategies, applicable across Europe, for promoting consumption of fruits and vegetables among schoolchildren and their parents. In this paper, the rationale, theoretical background, overall design and implementation of the project is presented. Methods: Surveys of national, representative samples of 11-year-old schoolchildren and their parents were conducted in 9 countries, i.e. in Austria, Belgium, Denmark, Iceland, the Netherlands, Norway, Portugal, Spain and Sweden. Comprehensive school-based educational programmes have been developed and tested in three settings, i.e. in Spain, the Netherlands and in Norway. A precoded 24-hour recall form combined with a set of food frequency questions assessing regular intake were used to assess fruit and vegetable consumption. Determinants were assessed employing a comprehensive theoretical framework including personal, social and environmental factors related to fruit and vegetable consumption. The intervention programmes have been tested employing a group-randomized trial design where schools have been randomly allocated to an intervention arm and a delayed intervention arm. Surveys among all participating children and their parents were conducted prior to the initiation of the intervention, immediately after the end of the intervention and at the end of the subsequent school year. Conclusion: The project is expected to provide new information of great importance for improving our understanding of consumption patterns of fruits and vegetables and for guiding future efforts to promote increased consumption patterns across Europe.

Objectives:To describe the use of dietary supplements in a group of Danish adults and to investigate the differences between users and non-users with respect to age, gender, health and lifestyle factors.Design:Cross-sectional study in two Danish cities.Setting:The Danish Investigation on Iodine Intake and Thyroid Diseases, 1997–1998.Subjects:Participants were 3707 women (selected age groups between 18 and 65 years) and 942 men (60–65 years). Participation rate was 50%. Supplement data were collected in a personal interview. Data on education, smoking, alcohol intake, physical activity, use of medication and self-perceived health were derived from a self-administered questionnaire. Multiple logistic regression was used for the statistical analysis.Results:Participants were asked about all kinds of supplements, ranging from products containing vitamins and minerals, to fish oils and products of herbal origin. On average 59% reported use of some kind of dietary supplement. Most common were combined multivitamin/mineral products (48%) followed by single vitamin C products (10%). Twelve per cent used three or more different supplements. Supplement use was strongly associated with age and gender, being highest among elderly women (78%). Ex-smokers were more likely to use supplements than subjects who had never smoked (odds ratio (OR) 1.36, 95% confidence interval (CI) 1.09–1.76). Supplement use was more likely among subjects who had many days of illness (OR = 1.37, 95% CI 1.12–1.66) and among users of medication (OR = 1.22, 95% CI 1.04–1.42). Subjects who perceived their health as poor were more likely to use supplements other than just a multivitamin/mineral tablet (OR = 2.2, 95% CI 1.31–3.77).Conclusions:Use of dietary supplements was related to age, gender and smoking, but also to poor self-perceived health status and absence from work. This indicates that a group of people use supplements as a form of self-medication.

Gentofte Hospital, Niels Andersensvej 65, DK-2900Hellerup, Copenhagen, DenmarkSubmitted 5 January 2001: Accepted 26 March 2001AbstractObjectives: To monitor trends in Danish food habits with respect to selected keyelements, from 1995 to 1998, and to evaluate the appropriateness of the methoddeveloped for that purpose.Design and method: Two cross-sectional population surveys, in 1995 and 1998. Datacollection by computer-assisted telephone interviews including 10 food-frequencyquestions,questionsontypeoffatusedon sandwichesanddrinkingmilk,andcheckquestions on theprevious day. Reproducibility was tested ina subgroup –n ‹222ƒinthe 1998 survey.Setting: The Danish Nutrition Council initiated the survey.Subjects: Men and women aged 15–90 years, 1007 in 1995 and 1024 in 1998. Samplesof private telephone numbers were drawn from regional telephone registers,geographically stratified. Participation rates were 62%.Results: Significant differences were observed between 1995 and 1998, some of thesein accordance with dietary guidelines (decreased use of whole milk and fat spreadon bread, increased use of skimmed milk, salad vegetables, rice/pasta and fish).Other changes were opposite to dietary guidelines (increased use of soft butter,decreased use of soft margarine and low-fat spreads, potatoes, and fresh fruit).Differences in average consumption frequency amounted to 4–13%. Several resultswere confirmed by comparison with other data, and the reproducibility of themethod was acceptable. Data were suitable for analysis of food use patterns, arelevant approach when assessing food habits in a lifestyle context.Conclusions: The changes observed illustrate the dynamics of food habits and theneed for frequent monitoring. This simple telephone method may be a valuable toolfor that purpose, as a supplement to national dietary surveys, also in a public healthcontext.KeywordsFood habitsDietary changesTelephone interviewsFood frequenciesPopulation surveillanceDietary habits are in a constant process of change. Publichealth authorities, food authorities, the food industry andothers working within this field need up-to-date data onthe dietary habits of the population as a basis for theirinitiatives. Up until now the availability of such data hasbeen limited in Denmark. Only two national dietarysurveys have been carried out, in 1985 and 1995

Background Epidemiologic studies suggest that foods rich in flavonoids might reduce the risk of cardiovascular disease. Objective Our objective was to investigate the effect of intake of flavonoid-containing black currant and apple juice on urinary excretion of quercetin and on markers of oxidative status. Design This was a crossover study with 3 doses of juice (750, 1000, and 1500 mL) consumed for 1 wk by 4 women and 1 man corresponding to an intake of 4.8, 6.4, and 9.6 mg quercetin/d. Results Urinary excretion of quercetin increased significantly with dose and with time. The fraction excreted in urine was 0.29-0.47%. Plasma quercetin did not change with juice intervention. Plasma ascorbate increased during intervention because of the ascorbate in the juice. Total plasma malondialdehyde decreased with time during the 1500-mL juice intervention, indicating reduced lipid oxidation in plasma. Plasma 2-amino-adipic semialdehyde residues increased with time and dose, indicating a prooxidant effect of the juice, whereas erythrocyte 2-aminoadipic semialdehyde and gamma-glutamyl semialdehyde concentrations, Trolox-equivalent antioxidant capacity, and ferric reducing ability of plasma did not change. Glutathione peroxidase activity increased significantly with juice dose. Conclusions Urinary excretion of quercetin seemed to be a small but constant function of quercetin intake. Short-term, high intake of black currant and apple juices had a prooxidant effect on plasma proteins and increased glutathione peroxidase activity, whereas lipid oxidation in plasma seemed to decrease. These effects might be related to several components of the juice and cannot be attributed solely to its quercetin content.

Objectives: To investigate whether a modest number of food frequency questions are sufficient to describe sociodemographic differences in dietary habits, and to identify sociodemographic characteristics of subjects adhering to food-based dietary guidelines operationalised in a ‘healthy-diet index’. Design: Cross-sectional population survey. Subjects: A total of 480 men, 515 women, aged 15–90 y. Random sample of private telephone numbers drawn from regional telephone records, geographically stratified. Participation rate 62%. Methods: Computer-assisted telephone interviews, including six food frequency questions, a question on type of fat spreads used on bread, questions on seven sociodemographic variables. Results: The summary of the healthy-diet index showed that the subjects who adhered to food-based dietary guidelines (top quintile) compared to those who did not (bottom quintile) were most often women (odds ratio (OR)=6.07; confidence interval (CI): 3.91–9.43, women vs men), of older age (OR=9.72; CI: 3.02–31.31, old age vs young), highly educated (OR=3.69; CI: 1.53–8.92, high education vs low) and living in multiperson households including children (OR=4.66; CI: 2.47–8.80, multiperson household vs single household). The results also showed that gender difference in dietary habits is associated with other sociodemographic variables. Conclusions: The selected food frequency questions proved sufficient to describe sociodemographic differences in dietary habits, and this method may be a valuable supplement to traditional quantitative dietary surveys in monitoring sociodemographic changes in eating patterns. The results also underline the influence of sociodemographic status on dietary habits. Sponsorship: The Danish Nutrition Council funded the study.