During the past twenty years there has been a dramatic increase in obesity in the United States. An estimated thirty percent of adults in the US are obese; in , only fifteen percent were. The issue is gaining greater attention with the CDC and with the public health world in general.
This book will offer practical information about the methodology of epidemiologic studies of obesity, suitable for graduate students and researchers in epidemiology, and public health practitioners with an interest in the issue.
The book will be structured in four main sections, with the majority of chapters authored by Dr. Hu, and some authored by specialists in specific areas. The first section will consider issues surrounding the definition of obesity, measurement techniques, and the designs of epidemiologic studies. The second section will address the consequences of obesity, looking at epidemiologic studies that focus on cardio-vascular disease, diabetes, and cancer The third section will look at determinants obesity, reviewing a wide range of risk factors for obesity including diet, physical activity and sedentary behaviors, sleep disorders, psychosocial factors, physical environment, biochemical and genetic predictors, and intrauterine exposures.
In the final section, the author will discuss the analytical issues and challenges for epidemiologic studies of obesity. The world continues to lose more than a million lives each year to the HIV epidemic, and nearly two million individuals were infected with HIV in alone. Considerable emphasis on prevention of new infections and treatment of those living with HIV will be needed to make this goal achievable.
With nearly 37 million people now living with HIV, it is a communicable disease that behaves like a noncommunicable disease. Nutritional management is integral to comprehensive HIV care and treatment. A comprehensive approach that includes nutritional interventions is likely to maximize the benefit of antiretroviral therapy in preventing HIV disease progression and other adverse outcomes in HIV-infected men and women. While the primary focus for those infected should remain on antiretroviral treatment and increasing its availability and coverage, improvement of nutritional status plays a complementary role in the management of HIV infection.
The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research.
The book covers a broad range of concepts and methods, such as basic measures of disease frequency and associations, study design, field methods, threats to validity, and assessing precision. It also covers advanced topics in data analysis such as Bayesian analysis, bias analysis, and hierarchical regression. Chapters examine specific areas of research such as disease surveillance, ecologic studies, social epidemiology, infectious disease epidemiology, genetic and molecular epidemiology, nutritional epidemiology, environmental epidemiology, reproductive epidemiology, and clinical epidemiology.
Diet is a major factor in health and disease. Controlled, long-term studies in humans are impractical, and investigators have utilized long-term epidemiological investigations to study the contributions of diet to the human condition.
Such studies, while valuable, have often been limited by contradictory findings; a limitation secondary to systematic errors in traditional self-reported dietary assessment tools that limit the percentage of variances in diseases explained by diet. New approaches are available to help overcome these limitations, and Advances in the Assessment of Dietary Intake is focused on these advances in an effort to provide more accurate dietary data to understand human health.
Chapters cover the benefits and limitations of traditional self-report tools; strategies for improving the validity of dietary recall and food recording methods; objective methods to assess food and nutrient intake; assessment of timing and meal patterns using glucose sensors; and physical activity patterns using validated accelerometers.
Advances in the Assessment of Dietary Intake describes new avenues to investigate the role of diet in human health and serves as the most up-to-date reference and teaching tool for these methods that will improve the accuracy of dietary assessment and lay the ground work for future studies. Dr Campbell illuminates the connection between nutrition and these often fatal diseases and reveals the natural human diet. He also examines the source of nutritional confusion produced by powerful lobbies, government entities and opportunist scientists.
The Foundations of Epidemiology is an introductory level text intended for a broad range of courses in epidemiology, including those in medical schools, schools of public health, dental schools, schools of nursing, and other professional schools.
Minimal familiarity with statistics is assumed in the book, although the text is not intended as a primary introduction to statistics; an appendix provides the necessary overview of statistics necessary to understand epidemiologic concepts, including sampling, significance testing, confidence intervals, correlation and linear regression, relative risks and attributable fractions, the life table, and Cohen's Kappa statistic.
Basic epidemiologic concepts, such as rates and ratios, age adjustment, incubation periods, investigation of an outbreak time-place-and person, agent-value, inter- and intra-observer variability, odds ratios, randomized trials, and cohort and case-control study designs are illustrated using examples from a variety of conditions, including asthma, food poisoning, coronary heart disease, measles, stroke, lung cancer, ovarian cancer, breast cancer, venous thrombosis, histoplasmosis, lyme disease, and AIDS.
The text consists of 13 chapters, each of which includes study problems and solutions. A discussion of the uses of epidemiology in clinical settings includes a guide to the critical review of medical and related literature.
This newly revised edition contains updated versions of all of the topics that were in the first edition and has been substantially expanded with an additional 5 chapters. Each chapter includes information from the most up-to-date research on how nutritional factors can affect bone health, written with an evidence-based focus and complete with comprehensive references for each subject. Nutrition and Bone Health, second edition covers all aspects of nutrition and the skeleton, from the history and fundamentals, to the effects of macronutrients, minerals, vitamins, and supplements, and even covers the effects of lifestyle, the different life stages, and nutrition-related disorders and secondary osteoporosis.
Nutrition and Bone Health, second edition is a necessary resource for health care professionals, medical students, graduate students, dietitians, and nutritionists who are interested in how nutrition affects bone health during all stages of life. Nutritional oncology is an increasingly active interdisciplinary field where cancer is investigated as both a systemic and local disease originating with the changes in the genome and progressing through a multi-step process which may be influenced at many points in its natural history by nutritional factors that could impact the prevention of cancer, the quality of life of cancer patients, and the risk of cancer recurrence in the rapidly increasing population of cancer survivors.
This broad concept can now be investigated within a basic and clinical research context for specific types of cancer. This book attempts to cover the current available knowledge in this new field of nutritional oncology written by invited experts. Because of their cost and complexity, the demanding duplicate portion method and the dietary diaries are less often used in large-scale epidemiologic investigations of diet—disease associations.
Methods of recall include dietary histories, food frequency questionnaires FFQs , and single or multiple daily recalls hour dietary recalls [HDRs]. In the vast majority of the nutritional epidemiology literature, two dietary assessment methods prevail: the FFQs, mainly in studies assessing diet and disease associations, and the HDRs, mostly in nutrition surveillance studies, which monitor the populations usual intake and can help identify subpopulations in need of dietary guidance.
The FFQ relies on the principles of the diet history method. It records the frequency by which an individual consumes foods and beverages—listed either collectively e. The FFQ may or may not include questions on the usual quantity consumed semi-quantitative, quantitative or non-quantitative FFQs, respectively ; information on quantities is often collected with the use of photographs of various portions and household or standard units.
The questionnaire can be administered by an interviewer or filled in directly by the participant, who is usually asked to indicate the frequency of consumption through pre-determined options. A short FFQ may underestimate the true variation in dietary intake, but a very long and detailed one can be time and resource consuming and the burden on the responder may jeopardize data quality. In a HDR, participants are asked to recall and describe in detail and in an open-ended manner the foods and beverages consumed over one day, preferably the day before.
Data collection can be either interviewer- or self-administered and it often follows the psychometric principles of structured, multi-faceted interviews that facilitate participants in their descriptions. The use of technology further allows the integration of databases assisting the recording of the type and quantity of foods consumed. Both are prone to recall bias, particularly FFQs, since individuals are asked to report their intake retrospectively and usually refer to prolonged periods of time.
Other errors in the assessment of diet through FFQs and HDRs can be introduced via the use of food composition databases to calculate energy, nutrient, and alcohol intake; natural variations or limited information regarding the composition of processed and packaged products as well as foods prepared out of home are the main culprits.
A biomarker is a biological specimen that serves as an indicator of intake or metabolism of dietary constituents or an indicator of nutritional status ,. A classification distinguishes biomarkers into recovery, concentration, replacement, and predictive biomarkers, although some biomarkers can fall into more than one of these categories.
Recovery biomarkers are based on precise and quantitative knowledge of the physiological balance between intake and output and can provide a dose—response relationship with intake.
They are sensitive and time-dependent and are not substantially affected by inter-individual differences in metabolism. They are often used as reference measures to validate self-reported intakes. Only a few recovery biomarkers are currently known, the best examples being doubly labeled water DLW , which is used to measure total energy expenditure, and urinary nitrogen and potassium, which are used to estimate total daily protein and potassium intake, respectively.
Therefore, they cannot be considered as surrogate measures of absolute intake and are less suitable than are recovery biomarkers for assessing the relative validity of dietary questionnaires, although they have been used in this context. Concentration biomarkers can be used in studies of association with disease risk. Examples of concentration biomarkers are fatty acids measured in adipose tissue or vitamins in blood, including carotenoids. Replacement biomarkers are similar to the concentration biomarkers but refer to compounds with limited information in food composition databases, or biomarkers of metabolic response to a dietary stimulus.
Examples include aflatoxins and some phytoestrogens. Predictive biomarkers resemble the recovery biomarkers, as they are sensitive to intake in a dose—response manner, but their overall recovery is lower. The hour urinary fructose and sucrose fall into this category. Hence, in the context of genomics, polymorphisms in the lactase gene, for instance, can be used to reflect milk consumption in Mendelian randomization analyses these analyses rely on the assumption that genotype distribution is unrelated to confounders and use variation in genes of known function to examine the effect of a modifiable exposure on disease.
Similarly, in epigenomics, we can examine if the epigenetic regulation of specific genes can be affected by food intake; in transcriptomics, we can compare differences in the gene expression profile among individuals following different dietary patterns; and in lipidomics, proteomics, and metabolomics, we can compare differences or changes in the respective profiles cross-sectionally or following particular dietary interventions.
The use of dietary biomarkers is often recommended to overcome the errors of self-reported dietary intake and the bias introduced by the use of food composition tables. Nevertheless, using biomarkers to assess dietary intake also has its limitations.
Several inter-individual factors can operate and generate variation in biomarker levels, which does not reflect solely differences in dietary intake.
Furthermore, interactions between dietary components, the type and handling of the biological samples e. For these reasons, the use of a biomarker in nutritional epidemiology should be preceded by an assessment of its validity, reproducibility, ability to detect changes, and suitability for the population under study.
According to recent reviews , , however, the majority of studies concentrate on the validity of biomarkers, whereas much less attention has been paid to the evaluation of their reproducibility and sensitivity in detecting changes in intakes and over time.
This program aims to harmonize aspects related to dietary biomarkers and provide advice to researchers, clinicians, and policy makers on the process of making decisions about their best use in individual situations.
Well-designed studies on diet—disease associations often provide inconsistent findings. Over the years, the discussion has evolved on whether this could also, at least partially, reflect limitations of the dietary assessment methods that generate measurement error of different magnitude. Kipnis and colleagues described two potential components of the dietary measurement error.
Measurement error can be systematic or random. Systematic errors reflect methodological weaknesses, appear at the group level, and generate differential misclassification. Random errors occur at the individual level, generate non-differential misclassification, and generally attenuate relative risk estimates and reduce statistical power to detect them. That said, even random measurement error can lead to biases towards or away from the null depending on multiple factors ,.
According to their results, underreporting of energy was greater than that of protein, possibly indicating a preferential underreporting of fat, carbohydrate, and alcohol. The extent of underreporting was positively associated with intake and higher in the second administration of methods, reflecting probably the gradual loss of commitment after multiple administrations of time-demanding questionnaires.
Underreporting, when present, affected all food groups, but the magnitude of underreporting varied between foods. It focuses specifically on the relationship between disease and nutrition, an area of ever increasing interest and concern as health care costs and availability continue to be an issue worldwide. Now reaching beyond just the individual healthcare concern, the potential for nutritional interventions to improve health status is also of heightened interest to public health professionals who are faced with an aging, obese, at-risk-of-diabetes population who may or may not have access to insurance.
This textbook is the foundation of understanding how nutrition can be used to improve health status. Nutrition plays a key role in many areas of public health such as pre-term delivery, cancer, obesity, diabetes, and cardiovascular and renal diseases.
Government nutrition policy, therefore, bears a huge influence on the nation's biggest health concerns. There is a clear need for information on this topic that unarguably holds the key to the primar. This graduate-level community nutrition textbook presents a conceptual framework for understanding the course of health and disease and matching community nutrition or applied nutrition epidemiology to the model.
Featuring articles from the prestigious Encyclopedia of Biostatistics, many of which have been revised and updated to include recent developments, the Encyclopedia of Epidemiologic Methods also includes newly commissioned articles reflecting the latest thinking in Cancer Registries Birth Defect Registries Meta Analysis of Epidemiologic Studies Epidemiology Overview Sample Size Sex Ratio at Birth Software Design and Analysis Featuring contributions from leading experts in academia, government and industry, the Encyclopedia of Epidemiologic Methods has been designed to complement existing texts on the subject by providing further extensive, up-to-date coverage of specialised topics and by introducing the reader to the research literature.
Offering a wealth of information in a single resource, the Encyclopedia of Epidemiologic Methods Offers an excellent introduction to a vast array of specialised topics Includes in-depth coverage of the statistical underpinnings of contemporary epidemiologic methods Provides concise definitions and introductions to numerous concepts found in the current literature Uses extensive cross-references, helping to facilitate further research, and enabling the reader to locate definitions and related concepts In addition to featuring extensive articles in the areas of descriptive and analytic epidemiology, the Encyclopedia also provides the reader with articles on case-control design and offers substantial coverage of allied statistical methods.
This is a comprehensive text on the methods - dietary, anthropometric, laboratory and clinical - of assessing the nutritional status of populations and of individuals in the hospital or the community. This Second Edition incorporates recent data from national nutritional surveys in the US and Europe; the flood of new information about iron, vitamin A and iodine; the role of folate in preventing neural tube defects; the use of HPLC techniques and enzyme assays; improvements in data handling; and many other developments.
A paperback edition of this book is available to readers living outside of North America and Europe. Following up on the success of its highly-regarded predecessor, the Second Edition covers the most important topics pertinent to the world of clinical nutrition.
It emphasizes the importance of nutrition to medicine and allied health sciences, and how the principles of good nutrition can enhance day-to-day clinical practice and profiles real clinical cases to facilitate the understanding and application of nutrition principles. This new edition features new chapters and fully updated material on nutraceuticals, alternative medicine and nutritional supplements, nutritional epidemiology, gene-nutrient interaction, and helps the reader understand why each nutrient is required for good health.
Compatible with any devices. Teaching epidemiology requires skill and knowledge, combined with a clear teaching strategy and good pedagogic skills. The general advice is simple: if you are not an expert on a topic, try to enrich your background knowledge before you start teaching. Teaching Epidemiology, third edition helps you to do this, and by providing the world-expert teacher's advice on how best to structure teaching gives a unique insight in to what has worked in their hands.
The book will help you plan your own tailored teaching program. The book is a guide to new teachers in the field at two levels; those teaching basic courses for undergraduates, and those teaching more advanced courses for students at postgraduate level.
Each chapter provides key concepts and a list of key references. Subject specific methodology and disease specific issues from cancer to genetic epidemiology are dealt with in details. There is also a focused chapter on the principles and practice of computer-assisted learning. Nutritional oncology is an increasingly active interdisciplinary field where cancer is investigated as both a systemic and local disease originating with the changes in the genome and progressing through a multi-step process which may be influenced at many points in its natural history by nutritional factors that could impact the prevention of cancer, the quality of life of cancer patients, and the risk of cancer recurrence in the rapidly increasing population of cancer survivors.
This broad concept can now be investigated within a basic and clinical research context for specific types of cancer. This book attempts to cover the current available knowledge in this new field of nutritional oncology written by invited experts. This book attempts to provide not only the theoretical and research basis for nutritional oncology, but will offer the medical oncologist and other members of multidisciplinary groups treating cancer patients practical information on nutrition assessment and nutritional regimens, including micronutrient and phytochemical supplementation.
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