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Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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Index

A

Absorption

arsenic, 391

calcium, 301, 312, 316, 317, 322, 349-351, 355, 359-360, 616, 667

cholesterol, 188-189, 201, 229, 657, 670

copper, 379

fats, 451

fiber's effect on, 6

food energy, 139

iron, 71, 77, 88, 92, 94, 301. 302, 368, 370, 517

phosphorus, 86

plant sterols, 201

trace element, 6, 368, 370

vitamin B12, 88

Acetaldehyde, 440, 441, 450

Acetylcholine, 217

Acne, 516

Acrylonitrile, 481-482, 662

Additives, food, see Food additives

Adenosine triphosphate (ADP), 143, 191, 419

Adipose tissue/adiposity

animals studies of, 148

blood flow and blood pressure in, 149

brown adipose tissue, 146-147, 436

carbohydrate intake and, 277

diabetes mellitus and, 123

distribution of, see Body fat distribution

energy intake and, 148

excess energy storage as, 139

fatty acids and, 28, 186, 193, 215

insulin resistance in, 149, 152

linoleic acid in, 203

lipoprotein lipase levels in, 143

norepinephrine and, 149

metabolism of, 147

obesity and, 147

osteoporosis and, 621

standards, 565-567

thermogenesis and, 152, 436

see also Obesity

Adrenal hyperfunction, 150

b-Adrenergic receptors, 152

Aflatoxins

carcinogenicity, 12, 264, 440, 490, 662, 665

liver cancer and, 119, 596-597, 601

protection against, 5, 478, 665

in trout, 490

see also Mycotoxins

Africa

cancer in, 117, 119, 120, 296, 334, 384, 386, 486-487

dental caries in, 127

diabetes in, 299, 333

gallstones in, 126, 301

serum cholesterol levels in, 166, 333

see also specific countries

Age

alcohol intake and, 61-62, 432, 451-452

atherosclerotic lesion characteristics and, 166

calcium intake and, 17, 69, 76, 264-265, 317, 347-351, 353, 354

body fat and, 139

bone mass and, 120-121, 264

breast cancer and, 119, 120, 207

CHD and, 101, 102, 165, 167, 445, 532

cholesterol intake and, 58, 161

dental caries and, 127, 128

diabetes mellitus and, 122, 123

eating patterns and, 75

energy expenditure and, 142, 146, 153

energy intake and, 52, 53, 59, 77-79, 89, 140-141, 146, 148, 153

fat intake and, 54-55, 161

fiber intake and, 294

gallbladder disease and gallstones and, 127, 218

hypertension and, 108, 109-110, 202, 416, 424, 660

intermittent claudication and, 107

lean body mass and, 147-148

liver cancer and, 119

lung cancer and, 119

mineral intake and, 69-74, 77-79, 81

obesity and overweight and, 90, 115

osteoporosis and, 69, 121-122, 316-318, 620

ovarian cancer and, 120

PAD and, 106, 107

plasma lipids and lipoproteins and, 224

prostate cancer and, 120

protein intake and, 16

renal function and, 265

serum cholesterol levels and, 163, 166

stomach cancer and, 117, 118

strokes and, 104

sugar intake and, 59

vitamin A status and, 51, 64, 312

vitamin D synthesis and, 312

vitamin intake and, 77-79, 81

Alabama, stroke rates in, 105

Alaska, arsenic contamination of well water in, 391

Alcohol and Health Practices Survey, 61

Alcohol consumption

age and, 61-52, 432, 451-452

animal studies of, 439-442

assessment of, 431, 436

atherosclerotic cardiovascular diseases and, 442-446

blood alcohol levels and, 431

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Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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blood pressure and, 415, 420, 442-443, 452

body weight and, 432, 436

cancer and, 10, 16, 334, 437-442, 444, 452, 660, 673

CHD and, 16, 444-446, 533, 660, 673, 695

cigarette smoking and, 10, 444, 660

cirrhosis and, 10, 33, 92; see also Alcoholic cirrhosis

clinical studies of, 436

coronary occlusion score and, 445

cultural aspects of, 433-435

data sources on, 47

diabetes mellitus and, 446

epidemiologic evidence on, 436, 437-439

ethnographic review of, 433-434

flushing of the skin and, 88, 93

gallbladder disease and. 127

glucose tolerance and, 446

historical perspective on, 433-435

hyperglycemia and, 446, 452

hyperlipidemia and, 443-444

hypertension and, 10, 16, 108, 415, 442-443, 660

hyperuricemia and, 447

hypoglycemia and, 446-447

insulin resistance and, 446

liver injury and, 10, 16, 33, 124-125, 447-449, 452, 673;

see also Alcoholic cirrhosis

for medicinal purposes, 434

metabolic disorders from, 446-449

neurological impairment and disorders and, 16, 431, 449-451, 452, 673

in nonliterate societies, 435

in non-Western literate societies, 435

nutritional disorders and, 10, 16, 434, 441-442, 448-449, 450-451, 634, 673

obesity and, 144, 436-437

osteoporosis and, 10, 619, 660

policy implications of, 451

during pregnancy, 10, 16, 452-453, 673, 681

recommended levels of, 16, 18, 451, 673, 675, 678-680, 682-683, 686-688

renal disease (chronic) and, 447, 452

reporting of, 25, 27, 60, 61, 81, 436, 442

safe levels of, 431, 432

sex differences in, 432-433, 452

stroke and, 105, 442-443, 452, 660

trace element intake from, 376

transcultural anthropological perspective on, 434

trends in, 60-61, 81, 431-433

vitamin deficiencies and, 335, 450-451, 452

in Western societies, 434-435

zinc and, 442, 450

see also Ethanol

Alcohol dehydrogenase, 88, 93, 440, 448

Alcoholic beverages

ale, 61

amount of ethanol in, 432

availability of, 47, 126

beer, 10, 16, 60, 61, 432-439, 441, 444, 445, 447, 451, 475, 660, 673

calories supplied by, 62, 140, 435-436

carbohydrate content of, 436

carcinogens in, 441, 452, 475, 480, 486

cognac, 436

80 proof, 432, 436, 438

86 proof, 443

gin, 434

monitoring status, 62, 81

rum, 434

sherry, 436, 441

vermouth, 441

vodka, 436

whiskey, 62, 393, 432, 434, 436, 437

wine, 16, 60, 61, 391, 392, 432-434, 436, 438, 439, 441, 444, 445, 673

see also Alcohol consumption: Ethanol: and specific alcoholic beverages

Alcoholic cardiomyopathy, 446

Alcoholic cirrhosis

age and, 125

animal studies of, 33

diagnosis of, 124

epidemiology of, 447-448

ethnic correlates of, 125

genetic and familial factors in, 92, 634

liver cancer and, 438-439

megaloblastic anemia and, 338

in migrants, 125

mortality rates, 125-126, 435, 447

nutritional factors in, 335, 336, 338, 448-449, 451, 634

population differences in frequency of, 125

prevalence of, 124, 447, 660

relation to alcoholism, 447-448, 660

sex differences in, 125, 447

socioeconomic status and, 125

time trends in morbidity and mortality, 125-126

see also Liver disease

Alcoholic dementia, 449

Alcoholic peripheral neuropathy, 449

Alcoholic polyneuritis, 334

Alcoholism and alcohol abuse

age and, 60-61, 432, 451-452

carcinogenic effects of dietary deficiencies associated with, 334, 441-442

defined, 431

electroencephalographic activity and, 93

family studies of, 92, 93

genetic and environmental factors in, 92-93, 433

liver damage from, 124-125, 334, 336, 338-340, 452, 660

male-limited susceptibility to, 93

markers of genetic susceptibility, 93

milieu-limited susceptibility to, 93

nutrient deficiencies from, 284, 334, 337-340, 357, 434, 450-452, 660

organ damage from, 92

prevalence of, 16, 433, 451, 673

racial and ethnic differences in, 443, 452

research needs on. 95, 453, 542, 556

symptoms of drunkenness, 431

twin studies of, 92, 93

Aldehyde dehydrogenase deficiency, 88, 93

Aldosterone, 418, 424

Alfalfa, 298, 490

Alginates, 74

Alkaline phosphatase, 302

Alkyl benzenes, 488

Allergic reactions, 478

Allyl isothiocyanate, 490

Aluminum

Alzheimer's disease and, 387-388, 395

animal studies of, 387, 388

cancer and, 387

clinical studies of, 387-388

dietary sources of, 387

epidemiologic studies of, 387-388

intake trends, 387

short-term tests of, 387

Alzheimer's disease

aluminum and, 387-388, 395

manganese and, 386

treatment of, 216

American Academy of Pediatric Dentistry, 17, 674

American Academy of Pediatrics, 17, 226, 674, 684-685

American Cancer Society, 676

American Dental Association, 17, 674

American Diabetes Association, 667, 676, 681

American Health Foundation, 685, 686

American Heart Association

dietary recommendations, 226, 667, 676, 677, 685, 686

risk calculations for coronary disease events, 108-109

American Indians, see Native Americans, and specific tribes

American Medical Association, 676

Ames test, see Mutagenicity tests

Amino acids

classification of, 259

data sources on availability of, 47

deficiencies, 262

glucogenesis from, 446

metabolism of, 337

requirement changes, 259

substitutions in apolipoproteins, 168

sulfur-containing, 423

supplements, 17, 448-449, 674

see also Essential amino acids; and specific amino acids

Aminoazobenzene, 28, 478

4-Aminobiphenyl, 478

2-Aminofluorene, 264, 381, 384, 440

Aminoimidazoquinoline, 485

Aminomethylimidazoquinoline, 485

Aminopolysaccharides, 291

Ammonia, 86

Amyotrophic lateral sclerosis, 387

Anagyrine, 490

Analytical methods

b-carotene, 313

dietary cholesterol, 199

fiber, 292-293

folacin in foods, 67

Anemia

copper deficiency and, 381, 517

hemolytic, 88, 320, 490

iron deficiency, 77, 88, 369-370, 395

megaloblastic, 338

microcytic, 373

monitoring children and pregnant women for, 44, 51

pernicious, 88

Aneurysms, 105, 333

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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Angina pectoris, 100, 107, 320, 444, 514, 530;

see also Coronary heart disease

Angiography, 106, 169

Aniline, 478

Animal fat

atherosclerotic cardiovascular diseases and, 15, 672

biologic marker of intake, 221

cancer and, 206, 209, 214, 229, 299

intake trends, 160, 179

cholesterol increases from, 179

SFAs in, 159

thrombotic brain infarction and, 194

Animal models

atherosclerosis, 33, 171, 200, 227, 228, 295, 532

cancer, 315, 393-394

cholelithiasis, 219-220, 229

dental caries, 280

diabetes mellitus, 150, 152, 276-278, 299

hypercholesterolemia, 33, 171, 228

hyperlipidemia, 200

hypertension, 33, 149, 204-205, 262, 281, 390, 417, 423

obesity, 91, 143, 145, 146, 221, 222, 277, 278, 281

osteoporosis, 33-34, 375

pellagra, 33

scurvy, 33

sexually dimorphic, 276

strike, 262

see also Laboratory animals

Animal protein

atherosclerotic lesions and, 193, 265, 533

cancer and, 15, 207, 263, 659, 673

CHD and, 15-16, 265, 673

fat association with, 16, 260, 659

food sources of, see Meats

gallstones and, 300

hypercholesterolemia and, 261, 265

intake trends, 9, 181, 259, 654

nutrients provided by, 16

recommended intakes of, 15-16, 17-18, 672-673, 675, 681, 682

serum cholesterol levels from, 9, 181, 261, 533

Animal studies

alcohol intake, 92, 439-442

aluminum, 387, 388

Alzheimer's disease, 388

arsenic, 392

aspartame, 473-474

atherosclerosis, 112-113, 161, 169, 176, 189, 196, 200

atherosclerotic cardiovascular diseases, 148-149, 151-152, 195-196, 200-201, 333-334, 376-377, 381, 382

BHA, 476-477

BHT, 477

biotin, 340

cadmium, 389, 390

calcium, 354, 356, 357, 603

cancer, 7, 8, 150-151, 153, 213-215, 264, 282-283, 297-298, 314, 315-316, 319-320, 321, 332-333, 335-340, 357, 368-369, 371-372, 378, 381-382, 384-387, 389, 391-394, 439-442, 468-469, 472, 473-474, 476-477, 576, 600-604:

see also specific cancer sites

carbohydrates, 276-277, 280-283, 601-602

b-carotene and other carotenoids, 314

CHD, 261, 295-296, 532-533

chromium, 382-383

coffee and tea, 468-469, 470-471

criteria used to assess, 34-35

copper, 380, 381

cyclamate, 473

dental caries, 280-281, 374, 641-642

design problems in, 150, 260, 378

diabetes mellitus, 149-150, 152, 153, 276-278, 299-300, 385-386, 629-630

dietary cholesterol, 8, 171, 200-201

dietary fats containing no cholesterol, 196

dose sizes in, 260, 378

endocrine disorders, 582

energy balance and body weight, 145

energy expenditure and chronic disease, 151-152, 153

energy expenditure-storage relationship, 145-146

energy intake, 148-151, 153

extrapolation of findings to humans, 4, 35, 37, 278, 653

fats and lipids, 7, 148-149, 171, 189, 204-205, 213-215, 221-222, 600-601

trans fatty acids, 8, 196

fiber, 295-296, 297-298, 299-300, 602

fluoride, 374, 375

folacin, 338

food colors, 478-479

gallbladder disease and gallstones, 219-220

generalizability of results from, 280

human studies compared to, 35-36

hypercholesterolemia, 161

hyperlipidemia, 295-296

hypertension, 262, 340, 356, 359, 375, 390, 394, 417-418, 553, 574-575

IDDM, 277-278

interpretation of results from, 34

interspecies variability in responses, 4, 33-34, 35, 200, 476, 653

iodine, 384, 603

iron, 368-369, 370

iron-deficiency anemia, 370

lead, 393-394, 395

liver disease, 335-336, 338, 340

magnesium, 359

manganese, 385-386

mercury, 391

methodological issues, 200-201

molybdenum, 386-387

mycotoxins, 487

niacin, 336

NIDDM, 276-277

nitrites, nitrates, and N-nitroso compounds, 475-476

nonnutritive dietary components, 603-604

nutrient levels in, 150

of obesity, 7, 91, 143, 145, 146-147, 221-222, 281-282, 574-575, 576, 577, 582

osteoporosis and osteomalacia, 317, 354, 619-620

pair feeding in, 145, 149, 153

pantothenic acid, 340

peanut oil, 196

plasma lipids and lipoproteins from fat intake, 189

polybrominated biphenyls, 480

polychlorinated biphenyls, 480

polyvinyl chloride, 481

potassium, 423

protein, 261, 262-263, 264, 265, 601

PUFAs, 8, 159, 187, 188, 195-196

w-3 PUFAs, 8, 159

renal disease (chronic), 265, 395

reproductive effects of nonnutrients, 470-471

retinol and other retinoids, 315-316, 602

riboflavin, 335-336

role in nutrition research, 33, 34, 35-36

saccharin, 472

SFAs, 195-196

selenium, 376-377, 378, 602

sex-specific responses to caloric intake, 145

sodium, 417-418, 421, 603

strengths and weaknesses of, 4, 33-34, 35

stroke, 262-263

triglycerides, 171

vitamin A, 314, 315-316, 602

vitamin B6, 337, 338

vitamin B12, 339

vitamin C, 332-334, 602

vitamin D, 317

vitamin E, 319-320, 602

vitamin K, 321, 602

weight gain and loss cycles, 577

weighting of evidence from, 4, 35, 37-38, 653

zinc, 371-372, 602-603

see also Experimental evidence; Laboratory methods

Anorexia nervosa, 358, 583-584

Antacids, 73, 355, 373, 388

Anthropomorphic measurements, 143, 450

Antibiotics, 322

Antocoagulants, 322

Antithrombotic agents, 191

a1,-Antitrypsin deficiency, 124

Apnea, prolonged, 88

Appalachia, CHD in, 102

Apolipoproteins

alcohol intake and, 443

Apo A, 88, 163, 169, 188, 223, 276, 277, 294, 443

Apo B, 89, 169, 171, 187, 199, 277, 294

Apo C, 163, 169

Apo D, 163

Apo E. 89, 163, 168, 169

atherosclerosis and, 168-169

carbohydrate intake and, 277

CHD and, 88, 168-171, 534, 536

diabetes mellitus and, 276

dietary cholesterol intake and, 199, 223

dietary responsiveness and, 169

familial combined hyperlipidemia and, 89

familial dysbetalipoproteinemia and, 168

families of, 163

functions of, 163, 168-170

(continued on next page)

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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genetic polymorphisms, 168-169

hyperlipidemia and, 168

interaction with dietary fats, 168

LDL cholesterol and, 168

peripheral vascular disease and, 169

predictive power of, 169-170

research needs on, 89

plasma cholesterol and, 168

PUFAs and, 187, 188

in vegetarians, 294

b-VLDL cholesterol and, 168

Apples, 73

Arabinogalactans, 300

Arachidonic acid

food sources of, 159

homeostatic actions of, 190

metabolism in humans, 177, 190, 191

structure of, 159

synthesis of, 159

see also w-6 Polyunsaturated fatty acids

Arginine, 261

Arsenic

absorption, retention, and excretion of, 391

animal studies of, 392

atherosclerotic cardiovascular diseases and, 391

biologic role of, 391

cancer and, 392, 395

dietary sources of, 391

epidemiologic studies of, 391, 392

occupational exposures to, 392

short-term tests of, 392

Arterial aneurysms, 105

Arteriosclerosis

defined, 161

diabetes mellitus and, 124

obliterans, 105

plaque formation, 105

see also Atherosclerosis

Arthritis

gouty, 337, 447

hemochromatosis and, 92

see also Osteoarthritis

Artificial sweeteners, taste of, 85;

see also specific sweeteners

b-Asarone, 488

Asbestos fibers, 441

Ascaris infection, 321

Ascorbic acid, see Vitamin C

Ashkenazi Jews, 94

Asia

alcoholic cirrhosis in, 447

cancer in, 117-120, 487

dental caries in, 127

diabetes mellitus in, 276

gallstones in, 126

serum cholesterol levels in, 166

see also specific countries

Asian Americans

alcohol intake by, 433

alcoholic cirrhosis in, 125

cancer incidence in, 118, 119

dental caries in, 128

diabetes mellitus in, 123

osteoporosis in, 122

Asian Indians, diabetes mellitus in, 123

Aspartame, 283, 471, 473-474;

see also Food additives

Aspirin, 190, 191

Association of Official Analytical Chemists, 293

Atherogenesis

apolipoproteins as predictors of, 169-170

endothelial injury and, 177

in vitro studies of, 176-177

LDLs and, 198

peanut oil and, 187, 196

triglyceride structure and, 196

VLDLs and, 170

Atherosclerosis

animal models and studies of, 33, 112-113, 161, 171, 176, 189, 200-201, 227, 228, 295, 333-334

apolipoproteins and, 168-169

autopsy data on, 165-166, 193

blood coagulation and, 190, 191

blood pressure and, 103

cerebral, 262

cholesterol intake and, 8, 161-162, 201, 657

childhood origin of, 222

cigarette smoking and, 103

in control subjects, 31

in diabetics, 275, 276

defined, 161

fat intake and, 162, 275, 655-656

trans fatty acids and, 193

fiber intake and, 295-296, 303

genetic factors in, 94, 668

HDL cholesterol and, 176

human studies of, 333

hydrogenated vegetable oils and, 195-196

hypercholesterolemia and, 176, 222

individual risk factors, 103, 167, 168

interventions for, 172, 191

LDL cholesterol and, 171, 172, 176

lesion characteristics in, 164, 529-530

lipoproteins and, 29, 168, 169

mortality rates, 103

myocardial infarction and, 161

pathogenesis of, 30, 33, 168, 175, 177, 529-530

platelet function and, 190

population differences in, 164

population risk of, 103

protective effects of nutrients for, 217, 303

w-3 PUFAs and, 191

sequelae, see Coronary heart disease; Peripheral vascular disease; Stroke

serum cholesterol and, 29, 103, 161, 162, 165-166, 227, 333

SFA intake and, 7-8, 195-196, 228, 656

stroke and, 104

subclinical detection of, 29-30

thrombosis and, 161

triglycerides and, 175

VLDLs and, 175

vitamin C and, 333-334

see also Arteriosclerosis

Atherosclerotic cardiovascular diseases

alcohol and, 442-446

animal studies of, 148-149, 151-152, 376-377, 380, 382, 392

arsenic and, 391

blood pressure and, 112-113

body fat distribution and, 114, 117

carbohydrates and, 278-279

chromium and, 381-382

clinical studies of, 148, 151, 198-200, 370, 376, 380, 381-382, 571-572

copper and, 380

dietary cholesterol and, 7, 15, 161-162, 178, 197-198, 656, 666, 670

energy expenditure and, 151-152

energy intake and, 148-149, 380

epidemiologic studies of, 148, 151, 163-171, 192-194, 197-198, 370, 376, 381-382, 391, 569-571

fats and, 6, 7, 15, 33, 161-201, 227-228, 655-656

fatty acids and, 192-196

fiber and, 15

HDL levels and, 117

historical background on, 161-162

hypertension and, 107

intermittent claudication in, 107

lead intake and, 392

lipoprotein levels and, 117, 163-178, 571-572, 670

obesity and, 117, 221, 569-572, 676

plant sterols and, 201

plasma lipid levels and, 163-178

prediction formulas for, 167

prospective studies of, 570-571

protective dietary components for, 6, 672

protein and, 15

retrospective life insurance studies of, 569-570

risk factors for, 6, 52, 107

selenium intake and, 376-377

serum cholesterol levels and, 32, 196, 670

SFAs and, 7, 656, 666, 670

triglycerides and, 170, 171

vitamin E and, 320

zinc and, 370

see also Coronary heart disease; Peripheral vascular diseases; Stroke

Atherosclerotic lesions

age and, 166, 530

animal protein intake and, 193

in animals, 200

aortic, 166, 177

apolipoproteins in, 169

characteristics of, 161, 165-167, 193, 530-531

in children, 222, 223-224

fat intake and, 193

malondialdehyde-LDL in, 177

plasma lipids and liproproteins and, 169, 223-224

progression of fatty streaks to fibrous plaques, 222, 529-530

serum cholesterol and, 166, 167

vegetable protein and starch intake and, 193

see also Plaque

Atherosclerotic occlusive disease, 333

Atherothrombotic disease, 175

Atractylosides, 467

Attention-deficit disorders, 283

Attributable risk, defined, 165

Australia

cancer in, 207-209, 297, 332, 356, 438

CHD in, 100-101, 102

dietary recommendations in, 682, 686

gallstones in, 126

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hypertension in, 108, 442

obesity and overweight in, 114-115

Austria, CHD in, 100-101

Autopsy data

accuracy of, 29

on alcoholic cirrhosis, 447

on atherosclerosis, 164, 165-166, 193, 262

on CHD, 102, 445, 446

disease incidence and prevalence assessment through, 29, 127

on gallstones, 127, 195, 218

on PAD, 106

to study early stages of disease, 29-30

Avidin, 340

Azobenzene, 478

Azoxymethane, 297-298

B

B vitamins, enrichment of foods with, 74; see also Biotin; Folacin; Niacin; Pantothenic acid; Riboflavin; Thiamin; Vitamin B6; Vitamin B12; Vitamins

Bacon, 72, 80, 475

Bakery products

carbohydrates supplied by, 15, 18, 60, 672

dough conditioners in, 74

enrichment of, 75

fats contributed by, 13, 15, 18, 56, 58, 670, 672

intake trends, 81

nitrites in, 475

recommended intakes of, 670, 675

see also specific bakery items

Baking powder, 73, 387

Baking soda, 72

Bananas, 66, 73, 280

Bangladesh, Vitamin A deficiency in, 316

Barbiturates, 322

Beans, 57, 70

Beef, 56-58, 63, 80, 160, 207, 208, 370, 654

Beef fat, 186, 204, 213, 298;

see also Animal fat

Beets, 208, 297

Behavior

alcohol intake and, 435, 446

carbohydrate intake and, 283

hypoglycemia and, 446

lead intake and, 395

Belgium

cancer in, 208, 282, 332, 356

CHD in, 100-101

hypertension in, 108, 358

Benign prostatic hypertrophy, 371, 389

Benzanthracene, 481

Benzanthrene, 441

Benzidine, 478

Benzo[a]pyrene, 314, 321, 333, 369, 440, 476, 477, 481

Benzpyrene, 440

Beriberi, 334, 450

Beverages

availability trends, 61

carbohydrates supplied by, 59, 60

carbonated, see Soft drinks

dry mixes, 476

fortification of, 75

intake trends, 60

nutrient contribution of, 59, 74

see also Alcohol consumption; Alcoholic beverages; Coffee: Tea: and specific beverages

BHA, see Butylated hydroxyanisole

BHT, see Butylated hydroxytoluene

Bias

confounding and, 30

in diagnosis of disease, 30

in dietary surveys, 25, 44-45, 46, 55, 161, 181

in food composition data, 48

interviewer, 25

nonresponse, 25, 44-45, 52

recall, 27, 207

sample selection, 29, 44

in survey questions, 55

systematic, 46, 55, 161, 163

see also Errors; Methodological issues

Bile acids, 125, 160, 162, 212-213, 215, 217-218, 219, 292, 296, 298, 301, 302, 320, 357, 440

Biliary tract lesions, 124

Binge eating, 25

Bioassays, see Laboratory methods

Bioelectric impedance analysis, 144

Biologic markers

accuracy of, 26, 28

alcoholism, 93

animal fat intake, 221

atherosclerosis, 29

carcinogen exposure, 51, 385

colorectal cancer, 212

energy intake, 28

fatty acids, 28

food intake, 26, 27

hemochromatosis, 92

hyperlipoproteinemia, 170

iron nutritional status, 50, 92

lead intake, 29

osteoporosis, 29

protein intake, 27, 28

selenium, 28

sodium or salt intake, 28, 414

value of, 28

validity checks against, 27, 28

see also Dietary data; Genetic markers

Biotin

animal studies of, 340

cancer and, 340

ESADD, 48

human studies of, 340

liver disease and, 340

safety index, 518

Blacks

adherence to dietary guidelines, 80

alcohol intake by, 61, 433, 434

atherosclerosis in, 166

blood pressure in, 95, 111

cancer incidence in, 118, 119, 120, 209, 212, 339, 475

CHD in, 102, 333, 532

cholesterol intake trends among, 58, 161

diabetes mellitus in, 123, 333

fat intake by, 224

hypertension in, 11, 89, 95, 109, 111-112, 394, 416-417, 419, 420, 660

hypolactasia in, 88

nutrient intakes by, 69, 70-71, 73

obesity and overweight in, 90, 115-116

osteoporosis in, 122

red-cell sodium/lithium countertransport in, 89

sickle-cell disease among, 94

stroke deaths and incidence in, 15, 104, 672

see also Race or ethnicity

Bladder cancer

cholesterol intake and, 210

cigarette smoking and, 599

coffee and tea and, 467, 599, 603

epidemiologic studies of, 467, 599

fat intake and, 599

food additives and, 476, 477

nitrates and, 475

nonnutritive sweeteners and, 471, 473, 599, 603

population differences in, 120, 599

protective dietary components for, 9, 377, 599

schistosomiasis and, 120

sex differences in, 120

trace element intake and, 387

vitamin A and, 313-315, 599, 602, 658

vitamin C and, 333

vitamin E and, 319

Blindness, 124, 316

Blood pressure

age and, 109-110, 416

amino acid deficiencies and, 262

alcohol intake and, 415, 420, 442-443, 452

arterial, 417

atherosclerotic cardiovascular diseases and, 103, 112-113, 148

body weight and, 10, 112, 117, 146, 148, 417, 420, 659

calcium intake and, 11, 17, 262-262, 355, 356, 515, 661

cerebral vascular accidents and, 113

CHD and, 103, 107, 112-113, 376, 382, 444, 535

classification of, 107, 549-550

congestive heart failure and, 113

energy intake and, 148

environmental factors in, 112

fat intake and, 202-205

genetic or familial factors in, 112, 418

hypertensive levels, 11, 107, 415;

see also Hypertension

intermittent claudication and, 107

kidney disease and, 107, 418

lead intake and, 394

linoleic acid intake and, 202, 204, 205

magnesium intake and, 358-359, 360

malnutrition and, 261

measurement of, 111

milk intake and, 262-262, 355

MUFA intake and, 204

myocardial infarction and, 148

normotension levels, 107, 414

obesity and, 112, 415, 420

population differences in, 108, 201-204, 550

potassium intake and, 11, 202, 203-204, 262-262, 355, 414, 416, 422, 424

protein intake and, 261, 262, 355

psychosocial stress and, 415, 417, 420

PUFA intake and, 204-205

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racial or ethnic differences in, 95, 111, 417

salt/sodium intake and, 11, 16-17, 89, 202-205, 414-417, 422-424, 660, 674

sex differentials in, 110-111, 442

SFA intake and, 203-205

stroke and, 11, 105, 107, 202, 442, 443

sucrose intake and, 149

survey data on, 550

trace element intake and, 375, 382, 386

tracking phenomenon, 110

variation in, 549

of vegetarians, 201, 202, 300, 302

see also Hypertension

Bloom's syndrome, 91

Body density measurement, 143

Body fat distribution

abdominal, 10, 16, 105, 144, 565, 659, 673

atherosclerotic cardiovascular diseases and, 114, 117, 148

body weight and, 565

cancer and, 16, 673

CHD and, 10, 16, 144, 659, 673

diabetes mellitus and, 10, 16, 114, 117, 123, 144, 659, 673

endometrial cancer and, 144

energy intake and, 144, 148

femoral, 10, 659, 673

gallbladder disease and, 16, 673

gluteal, 10, 144, 565, 659, 673

heritability of, 90

hypertension and, 10, 16, 144, 659, 673

measurement of, 114, 144, 565-567

obesity and, 578

osteoarthritis and, 16, 673

during pregnancy and lactation, 145

prospective epidemiologic studies of, 578

stability of, 566-567

standards for, 565

stroke and, 10, 105, 117, 144, 659

waist-hip ratios, 16, 114, 117, 144, 148, 565-567, 578

Body fat/fatness

age and, 139, 146

alcohol intake and, 450

blood pressure and, 112

body weight and, 139

carbohydrate and, 276

cardiovascular disease risk and, 148-149

energy balance and, 143-144, 153

energy intake and, 144-145, 281, 282

extreme leanness, 10, 659

heritability of, 117

measurement of, 114, 143-144

physical exercise and, 139, 144, 146, 151

stability of, 566-567

in twins, 90

see also Obesity; Triglycerides; Body fat distribution

Body mass index

atherosclerotic cardiovascular disease and, 148

carbohydrate intake and, 281

CHD and, 103

defined, 114

diabetes mellitus mortality and, 117

energy intake and, 144, 148, 221, 281

fat intake and, 221, 281

gallbladder mortality and, 117

mortality rates and, 569-570

obesity and, 90, 564-565, 566, 569-570

protein intake and, 281

skinfold measurements compared to, 114

trends, 16, 673

weight-height ratios and, 563-565, 673, 678

Body weight

age and, 115

alcohol intake and, 432, 436, 450

animal studies of, 145, 577

blood pressure and, 10, 112, 117, 148, 417, 420, 659

body fat and, 139, 565, 577

body mass index and, 564-565

cancer and, 10, 16, 659, 673

carbohydrate intake and, 276, 277

CHD and, 10, 16, 103, 659, 673

clinical data on, 144-145

cycles of loss and gain, 577, 659, 676

determinants of, 7, 52, 53

diabetes mellitus and, 10, 16, 149, 659, 673

energy balance and, 139, 144-145, 153

energy expenditure and, 142, 153

energy intake and, 7, 14, 52-53, 139, 144-145, 153, 282, 673

epidemiologic data on, 144, 153, 576-577

fat intake and, 7, 144, 202, 222, 656, 671

fluctuations in, 576-577

gains, 576-577

gallbladder disease and, 10, 16, 659, 673

glucose tolerance and, 10, 148, 659

HDL cholesterol and, 146, 148

hypertension and, 10, 16, 108, 112, 419, 420, 659, 673

insulin levels and, 148

intermittent claudication and, 107

LDL cholesterol and, 146

losses, 577, 659

obesity and, 144, 576-577, 659

osteoarthritis and, 16, 673

osteoporosis and, 69

physical activity and, 53, 146, 152, 673

plasma or serum lipids and, 10, 148, 659

plasma triglycerides and, 148

recommendations, 676, 686-688

relative, defined, 114

standards of, 114, 563-565

stroke and, 105

trends in, 16, 52, 77, 221

of vegetarians, 77

see also Overweight

Bone density losses

alcoholism and, 451

calcium supplementation for, 515

detection of, 29, 120-121

estrogen therapy for, 515

incidence indicators, 29

osteoporosis and, 350, 515

phosphorus and, 358

see also Osteoporosis

Bone fractures

age and, 121

alcoholism and, 451

calcium intake and, 11, 17, 353, 515

fluoride and, 373, 375, 619

osteoporotic, 29, 121, 316-319, 350, 353, 621

sex and, 121

vitamin D and, 316-318

Bone mass

age and, 120-121, 264

alcoholism and, 451

bone cell activities and, 349-350

calcium intake and, 349-353

estimation of, 351

hormonal status and, 121, 350

measurement of, 318

mineral balance and, 264, 349-350, 615

osteoporosis and, 350

sex and, 120

supplementation with calcium and, 352-353

vitamin D and, 316-318, 350, 353

Bosnia, CHD in, 164

Bowel, large, see Colon cancer

Bowel cancer, see Colon cancer

Bracken fern toxin, 489

Brain tumors, 211

Bran, 80, 278, 301;

see also specific brans

Brassicasterol, 201

Breads and rolls, 15, 18, 58, 62, 74, 76, 80, 81, 179, 279, 299, 302, 330, 672, 675

Breakfast cereals, 42, 64, 74, 75, 80, 279-280, 311, 330, 668

Breast cancer

age and, 119, 120, 299

alcohol and, 10, 439, 598, 660

animal studies of, 150, 151, 213, 214

anthropomorphic measures and, 598

carbohydrates and, 282, 598

caloric intake and, 150, 151, 598

coffee and tea and, 468

dietary cholesterol and, 210, 439

early diagnosis of, 120

ecogenetic factors in, 91

endocrine-related, 204, 210

energy expenditure and, 152

epidemiologic studies of, 207-208, 210, 215, 229, 263, 299, 468, 598

fat intake and, 7, 14, 30, 31, 77, 205-208, 210, 214, 215, 229, 263, 282, 439, 598, 656, 671

fiber and, 77, 207, 263, 299, 302, 598, 659

folacin and, 338

genetic and familial factors in, 119-120, 439

genetic markers of, 120

incidence of, 593

hormonal status and, 117, 207, 214, 575, 598

mortality rates, 120, 439, 598, 655

nonnutritional risk factors, 439

obesity and, 117, 575, 598, 659

other cancers associated with, 118, 120

physical exercise and, 153

population differences in, 119, 206, 207

postmenopausal, 117

prevention of, 19

protective dietary components for, 9, 207, 213, 313, 332, 377

protein and, 9, 207, 263, 598

(continued on next page)

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public information programs on, 77, 120

racial, ethnic, and migrant differences in, 119, 207, 208, 598

riboflavin and, 335

sex differential in, 119-120

SFAs and, 8, 206, 207, 210, 215, 439, 598, 656

socioeconomic status and, 119

trace elements and, 380, 383-384, 389

vitamin A and, 313, 315, 439, 658

vitamin B6 and, 337

vitamin B12and, 339, 341

vitamin E and, 318, 319, 322, 439

Breast milk, 222, 223

Brewer's yeast, 76, 381

Broca Index, 114

Broccoli, 69, 73, 81, 329, 488, 654;

see also Cruciferous vegetables

Brussels sprouts. 80, 81, 297. 488,

see also Cruciferous vegetables

Bulgaria, CHD death rates in, 100-101

Bulimia, 583, 584-585

Burke, Bertha, 24

Butter, 10, 57, 80, 160, 179, 186, 187, 207, 213, 220, 311, 312, 315, 480, 654

Butterfat, 159, 186, 189

n-Butyl-n-(4-hydroxybutyl)-nitrosamine, 333

Butylated hydroxyanisole (BHA), 476-477, 662

Butylated hydroxytoluene (BHT), 12, 441, 476, 477-478, 662

C

Cabbage, 80, 81, 208, 297, 329, 433, 488, 657

Cadmium, 379, 388-390, 394

Caffeine

cancer and, 468

hazards of, 5, 655

intake trends, 466

mutagenicity of, 469

sources of, 466

teratogenicity of, 470-471

Cafestol palmitate, 467

Cakes, 56, 58, 73, 81

Calcitonin, 355

Calcitriol, 355

Calcium

absorption of, 301, 312, 316, 317, 322, 349-351, 355, 359-360, 616, 667

age and intake of, 17, 69, 76, 264-265, 317, 347-351, 353, 354, 616, 617

alcoholism and, 450-452

animal studies of, 354, 356, 357

availability trends, 53, 69

balance, 16, 264-265, 317, 349-350, 355, 616, 659

bone fracture and, 11, 17, 353, 616-617

bone mass and, 349-353, 517, 616-617

biologic role of, 17, 316, 347, 360, 661

blood pressure and, 11, 17, 261-262, 355, 356, 515, 553, 661

cancer and, 11, 356-357, 514, 661

CHD and, 515, 666

clinical studies of, 351-354, 355-356, 616-617

dental caries and, 281, 642

drug interaction with, 355

epidemiologic studies of, 351-352, 355, 356-357, 616-617, 654

estimation of intake, 351

estrogen status and, 354, 360, 617

fiber intake and, 301, 302, 354-355

food composition data availability on, 46-48

food sources of, 5, 17, 18, 69, 74, 92, 349, 666, 667, 674, 675

hyperparathyroidism and, 616, 619

hypertension and, 17, 355-356, 360, 415, 417

intake trends, 41, 69, 75, 77-79, 81, 348-349

magnesium and, 517

monitoring status, 69, 74, 81, 349

nutritional status, 69, 75, 81, 349

osteoporosis and, 5, 11, 17, 33, 264, 317, 318, 349-355, 359, 375, 515, 616-617, 619, 654, 659, 661, 666, 674

phosphorus and, 265, 354, 357-358, 360, 617-618

populations at risk of deficiencies in, 17, 76, 671, 674

protective effects of, 11, 261, 281, 357, 515

protein intake and, 354, 517, 659, 673

RDA, 48, 69, 348, 350, 360

recommended intake of, 17, 666, 674, 678, 680, 681

safety index, 518

serum cholesterol and, 261

standards for, 48

supplementation, 11, 17, 352-354, 356, 360, 514, 515, 517, 518, 553, 617, 661, 674, 680

from tap water, 25

toxicity, 517, 518

vitamin D and, 312, 316, 322, 353, 356, 616

California

cancer in, 118, 119, 210, 297

CHD in, 102, 164, 445

hypertension in, 355

obesity and overweight in, 114-115

PAD in, 106

serum cholesterol levels in, 163

stroke in, 104-105

Calories

alcoholic beverages, 436

fat, 14, 671

snack foods, 76

sources of, 15, 54, 56, 59, 62, 62, 80, 654, 672

see also Energy balance; Energy expenditure; Energy intake; Energy stores/storage; Food energy; Low-calorie diets

Calorimetry, 141

Cameroon, dental caries in, 127

Campesterol, 201

Canada

alcoholic cirrhosis in, 125

cancer in, 207, 282, 297, 299, 331, 388, 437, 467-468, 471-472, 475, 489, 699

CHD in, 100-101

dietary intake trends in, 224

dietary recommendations in, 682, 686-688

hypertension in, 442

obesity and overweight in, 114-115

Cancer

acrylonitrile and, 481-482

aflatoxins and, 486-487

alcohol intake and, 16, 437-442, 673

aluminum and, 387

animal studies of, 8, 150-151, 153, 213-215, 282-283, 314, 315-316, 319-320, 321, 332-333, 335-340, 357, 368-369, 371-372, 378, 381-387, 389, 391, 392, 394-395, 468-469, 472, 473-474, 476-477, 483-484. 576, 600-604

arsenic and, 392

aspartame and, 473-474

BHA and, 12, 476-477, 662

BHT and, 12, 477-478, 662

biotin and, 340

cadmium and, 388-389

calcium and, 356-357, 514, 603

caloric intake and, 150-151

carbohydrates and, 282, 336, 601-602, 657-658

b-carotene/carotenoids and, 15, 313-314, 658

chromium and, 382-383

cigarette smoking and, 91

classification of, 117

clinical and metabolic studies of, 211-213, 282, 321, 368, 370-371, 380-381, 385, 576

coffee and tea consumption and, 12, 467-469, 662

copper and, 380-381

country differences in occurrence of, 117;

see also specific countries

cyclamate and, 472-473

defined, 117

detection of, 29

diagnosis of, 117

dietary cholesterol and, 210

dietary data for studies of, 24

dietary guidelines for prevention of, 676, 679, 688

dietary modification and, 699-701

dietary supplementation and, 514

diethylstilbestrol and, 482

DNA repair mechanisms and, 91

ecogenetic factors in, 91

energy expenditure and, 152-153

energy intake and, 150-151, 153

environmental factors in, 12, 19, 91

epidemiologic studies of, 150, 152-153, 206-210, 263-264, 282, 313, 315, 318-319, 331-332, 356-357, 368, 370-371, 374, 377-378, 382, 383-384, 386, 387, 389-391, 392, 394, 437-439, 467-468, 471-473, 483, 575-576, 594-600, 689

ethyl carbamate and, 486

fats and, 6-8, 13-14, 54, 153, 205-210, 225-226, 228-229, 600-601, 656, 666, 668, 670, 671

fiber and, 6, 15, 80, 296-299, 303, 602, 658

fluoride and, 11, 17, 374-375

folacin and, 338, 658

food colors and, 478-479

food storage and preparation and, 51

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genetic and familial factors in, 91, 94, 211

human studies of, 334-340

in vitro assays, 314, 316

iodine and, 383-384, 603

iron and, 368-369, 603

latency periods, 12, 51, 662

lead and, 393-394

linoleic acid and, 208, 213, 227

manganese and, 385

mechanisms of action in, 441

mercury and, 390-391

metastasis, 213, 333, 372

molybdenum and, 386-387, 603

mortality rates, 6, 654, 700

naturally occurring toxicants and, 12, 486-490, 662

nitrates, nitrites, and N-nitroso compounds and, 474

nonnutritive dietary components and, 603-604, 662

niacin and, 336

obesity and, 117, 221, 575-576, 676

pantothenic acid and, 340

PBBs and, 480

PCBs and, 479-480

pesticides and, 12, 43, 483-484, 662

plant food intake and, 8

polycyclic aromatic hydrocarbons and, 481

polyvinyl chloride and, 480-481

protective effects of foods and nutrients for, 6, 8, 11, 15, 488, 657-658, 666, 672

prevention of, 19, 699-701

protein and, 15-16, 263-264, 601

public perceptions of risk factors for, 80

PUFAs and, 8, 14, 174, 194, 229, 657, 672

research objectives and priorities, 21, 51, 230, 284, 322-323, 341, 395-396, 492-493, 604-605

retinol and other retinoids and, 315-316, 658

riboflavin and, 334-335, 658

saccharin and, 12, 471-472, 662

salt and, 17, 603

selenium and, 11, 319, 377-378, 602, 661

serum cholesterol and, 14, 174, 210-211, 229, 671, 692-693, 689

short-term tests for, 369, 372, 374-375, 378, 383, 385, 387, 389, 391, 392, 394, 469, 472, 473-474, 477-478

thiamin and, 334

trace elements and, 6, 395, 602-603, 666;

see also specific trace elements

tryptophan and, 486

in United States, 117-120, 593-594

vitamin A and, 51, 313-314, 315-316, 514, 516, 602, 658

vitamin B6 and, 337

vitamin B12 and, 339, 658

vitamin C and, 331-333, 514, 602, 658

vitamin E and, 318-320, 602, 658

vitamin K and, 321, 602

zinc and, 370-372, 514, 602-603

see also specific cancer sites

Canavanine, 490

Candies, 58, 74

Canola oil, 13, 671

Canthaxanthin, 314

Carbohydrates

in alcoholic beverages, 436

animal studies of, 276-278, 280-283

apolipoprotein levels and, 276, 277

atherosclerotic cardiovascular diseases and, 278-279, 532-533, 672

attention-deficit disorders and, 283

availability trends, 53, 58-59, 80, 274, 654

blood pressure and, 203

body fat and, 282

body mass index and, 281

body weight and, 277, 282

calories from, 59, 80, 140, 654

cancer and, 282-283, 284, 336, 657, 658, 672, 695

categories of, 58

CHD and, 278-279, 284, 657

clinical studies of, 275-276, 277, 279-282

complex, defined, 273

criminality and, 283, 284

data sources on availability of, 47

dental caries and, 9, 127, 279-281, 284, 658, 672

energy expenditure for storage as fat, 140, 151, 221

energy intake from, 139-140

epidemiologic evidence on, 274-275, 279, 281, 282

food sources of, 14, 55, 59-60, 76, 273-274, 654, 671, 672, 675

gallstones and, 300

glucose tolerance and, 9, 274, 277, 284, 385, 657, 658

glycemic index, see Glucose tolerance

glycosuria and, 277

HDL cholesterol and, 276, 278-279

hyperactivity and, 283, 284

hypercholesterolemia and, 275

hyperglycemia and, 275-277, 283, 284

hyperlipidemia and, 277

hypertriglyceridemia and, 275, 276, 278

IDDM and, 277-278

indigestible, see Fiber

insulin levels and, 9, 149, 275, 277, 284, 385, 658

intake trends, 15, 54, 59, 76, 142, 273-274

interactions with other dietary constituents, 281, 330

lactose intolerance and, 283-284

LDL cholesterol and, 13, 276, 278, 671

metabolism of, 59

monitoring status, 81

NIDDM and, 9, 274-277, 284, 299, 658

obesity and, 9, 221, 277, 281-282, 284

protective effects of, 281

recommended intake of, 14, 15, 17, 18, 669-670, 671, 672, 675, 677-680, 682-683, 686

refined, 127

renal disease and, 277-278

retinopathy and, 277

serum cholesterol and, 261, 276-278

simple, defined, 273

triglyceride levels and, 275, 277, 278, 658

VLDL levels and, 275

see also Fiber; Sugars; and specific carbohydrates

Carcinogenesis

animal studies of, 33, 153, 213-215

caloric intake and, 150-151, 215

dietary fat and, 213-215

dose-response relationships in, 36

mechanisms of action in, 320, 335, 378-379, 477-478

nutritional deficiencies and, 441-442

short-term tests for, 34, 369, 372, 374-375, 378, 383, 385, 387, 389, 391, 392, 394

see also Cancer; Carcinogens

Carcinogens

biologic markers of exposure to, 51

epigenetic, 34

ethanol activation of, 440

metabolism of, 91

mutagenic action of, 91

produced in cooked foods, 481, 485-486

see also Cancer; Carcinogenesis; and specific carcinogens

Cardiac function, obesity and, 578-579

Cardiac hypertrophy, 29

Cardiovascular diseases

body weight and, 10, 659

in children, 222

dietary cholesterol and, 6, 196-201

magnesium intake and, 359

mortality rates from, 162

phospholipids and, 217

w-3 PUFAs and, 11-90

see also Atherosclerotic cardiovascular diseases

Cardiovascular function, physical exercise and, 151-152

b-Carotenes and other carotenoids

animal studies of, 314

antioxidant effects of, 314

cancer and, 9, 207, 313-314, 318, 322, 334, 341, 488, 658, 672, 695

data sources on availability of, 47-48

food sources of, 64, 311, 654

human studies of, 313-314

hypercarotenemia and, 314

in vitro studies of, 314

intake trends, 64, 82, 311, 312

mechanisms of action, 15, 314

protective effects of, 9, 15, 207, 302, 314, 322, 341, 488, 658, 672

see also Vitamin A

Carotenodermia, 314

Carotenoids with no vitamin A activity

cancer and, 314

inclusion in dietary surveys, 51

Carrageenan, 291

Carrots, 64, 73, 82, 279, 311, 654

Case-comparison studies

cancer, 313, 315, 514

CHD, 444, 445

stroke, 443

Case-control studies

alcohol intake, 437-439, 446

cancer, 153, 207-211, 263, 264, 282, 297-299, 302, 331-332, 356, 371, 377, 387-389, 437-439, 467, 471, 472, 488, 489, 514

cigarette smoking, 437

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dietary intake assessment methods in, 24-25, 27, 208

dietary supplements, 514

hypertension, 358

methodological considerations in, 31, 193, 470, 653

myocardial infarction, 162

PAD, 175

reliability of, 31

strengths and weaknesses of, 31, 193, 208

weight of evidence for causation, 4. 35, 37, 653

see also Epidemiologic evidence, studies, and cohorts

Casein, 261, 281, 295

Catechol, 490

Catecholamines, 142

Cauliflower, 80, 81, 297, 654

Celery, 489

Celiac disease, 321

Cell cultures

barking deer fibroblasts, 478

Chinese hamster cells, 385, 391, 394, 461, 477, 478, 480, 485

cholesterol autooxidation products and, 201

hamster embryo, 374-375, 383, 385, 482, 485

HeLa cells, 482

human fetal lung fibroblasts, 476

human lymphocytes, 389, 480

mouse lymphoma cells, 383, 482

Novikoff ascite hepatoma cells, 383

rat alveolar macrophages, 387

Syrian hamster cells, 389, 392, 394, 482

trace element carcinogenicity, 374-375, 383, 387

see also In vitro studies and methods; Mutagenicity tests; Short-term tests and studies

Cellulose, 291-293, 295, 298-302

Centers for Disease Control, nutrition monitoring by, 44

Central America, alcohol intake in, 433

Central nervous system

genetic variation in, 88

hypertension and, 418

nutrient roles in functions of, 159

Cereal grains and cereal grain products

BHA and BHT in, 476

enrichment of, 66, 74, 75, 368

intake trends, 41, 59-60, 76, 80, 260, 293, 654

malted, 273

in meat mixtures, 75

nitrites in, 475

nutrient contribution of, 43, 62, 66, 259, 260, 273, 293, 312, 349, 370, 373, 385

nutrient losses during refining, 70

protective effects of, 8, 295, 296, 302, 666

recommended intake of, 13-15, 18, 670, 671, 672, 675

see also Breakfast cereals; Grains and grain products; Whole grains and whole-grain products

Cerebral hemorrhage, 103, 104, 105, 176, 194, 442, 531;

see also Stroke

Cerebral infarction, 103, 104, 105, 113, 423, 442, 443, 530-531:

see also Stroke

Cerebral thrombosis, 176, 442

Cerebral vascular accidents, 113

Cerebrovascular disease

diabetes mellitus and, 124

intermittent claudication and, 175

w-3 PUFAs and, 192

see also Stroke

Cervical cancer, 313, 338, 377, 380, 575

Cervical dysplasia, 332, 338

Chaconine, 489

CHD, see Coronary heart disease

Cheese, 18, 56, 57, 66, 69, 71, 72, 160, 179, 194, 207, 209, 280, 281, 370, 387, 654, 675

Cheeseburgers, 56

Chicken, 73;

see also Poultry

Children, see Infants and children

Chile

alcohol-related deficiencies in, 451

cancer in, 421, 475

peripheral vascular disease in, 391

China

arteriosclerosis in, 162

atherosclerotic cardiovascular diseases in, 376

cancer in, 118, 313, 315, 334, 341, 371, 386, 475, 487

gallbladder disease and gallstones in, 126

hyperlipidemia in, 443

hypertension in, 108, 415

vitamin deficiencies in, 334, 341

Chinese hamster ovary, see Cell cultures: Mutagenicity tests

Chloride, 48, 423-424

Chlorogenic acid, 467

Chlorophyll, 70

Chocolate, 280, 466

Cholcalciferol, see Vitamin D

Cholecystitis, 125

Cholelithiasis

bile composition and, 219, 220

cholecystitis and, 125

clinical/metabolic studies of, 218-219

ecogenetic factors in, 219

incidence of, 29, 127

nutritional factors in, 124, 195, 218, 220, 229

see also Gallbladder disease and gallstones

Cholestane triol, 201

Cholesterol, see Dietary cholesterol; HDL cholesterol; LDL cholesterol; Serum or plasma cholesterol

Cholesteryl esters, 162, 169, 176-177

Cholestyramine, 167

Choline, 160, 216-217, 338, 339, 448, 449

Chromium

animal studies of, 382-383

atherosclerotic cardiovascular diseases and, 381-382

biologic role of, 381

cancer and, 382, 395

CHD and, 515

clinical studies of, 381-382, 383

data sources on availability in food supply, 47

diabetes and, 383

epidemiologic studies of, 381-382

ESADDI, 48

food sources of, 381

glucose metabolism and, 381, 382, 515

intake trends, 381

protective of, 277

serum cholesterol and, 515

short-term tests of, 383

supplementation, 382, 515

Chrysene, 441

Chylomicrons, 162-163, 177, 296, 443

Cigarette smoking

alcohol consumption and, 10, 437, 444, 445

cancer and, 10, 91, 210, 322, 368, 389, 437-438, 467, 660

cerebral infarction and, 105

CHD and, 101, 103, 151, 195, 444, 445, 531, 535

gallbladder disease and, 127

intermittent claudication and, 106, 107

myocardial infarction and, 148

osteoporosis and, 621

PAD and, 106, 107, 531

stroke and, 105, 443

trace element intake from, 376, 389, 390, 392

vitamin C deficiencies and, 68

Cirrhosis of the liver

alcohol intake and, 633-634;

see also Alcoholic cirrhosis

biliary, 320

causes of, 124, 320, 321, 633

childhood, 381

classification of, 124

definition, 124

diagnosis of, 124

essential features of, 124, 633

incidence indicators, 29

morbidity and mortality, 125, 633

niacin and, 336

vitamin B6 and, 337-338

vitamin B12 and, 339

vitamin K and, 321

Citric acid cycle, 448

Citrus fruits, 9, 15, 18, 60, 61, 67, 293, 298, 329, 331, 654, 657, 672, 675

Clinical studies and trials

alcohol intake and chronic disease, 448

aluminum intake and chronic disease, 387-388

Alzheimer's disease, 387-388

angiographic end points, 171-172

atherosclerotic cardiovascular diseases, 148, 151, 198-200, 376, 380, 381-382, 571-572

body weight fluctuations, 577 ,

calcium intake and chronic disease, 351-352, 355-357, 654

calcium supplementation, 352-354

cancer, 211-213, 282, 321, 356-357, 368, 370-371, 380-381, 385, 576

carbohydrates, 275-276, 277-278, 279-280, 281, 282, 638-640

CHD, 171-175, 193, 194-195, 260-261, 295, 534-535

cholelithiasis, 219

chromium intake and chronic disease, 381-382, 383

copper intake and chronic disease, 380-381

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crossover, 203

dental caries, 279-280, 638-641

design of, 32-33

diabetes mellitus, 149, 152, 153, 299, 372, 383, 385, 573-574, 628-629

dietary cholesterol and chronic disease, 198-199, 218

diverticulosis, 300

double-blind, 32-33, 173, 203, 216, 320

endocrine disorders, 581-582

energy balance and body weight, 144-145

energy expenditure and chronic disease, 151, 152

energy expenditure-storage relationship, 145-146

energy intake and chronic disease, 148, 149, 153, 219

exposure duration in, 32

fat or lipid intake, 7, 201-204, 218-219, 221

trans fatty acids and, 193

fiber intake and chronic disease, 295, 299, 300, 301

fluoride intake and chronic disease, 375, 640-641

gallbladder disease and gallstones, 218-219, 301, 575

hematologic responses to chronic disease, 579-580

hyperlipidemia, 295

hypertension, 202-204, 262, 300, 355-356, 394, 417

IDDM, 277

immunologic responses to chronic disease, 579-580

iron intake and chronic disease, 368

large-scale preventive trials, 172-175

lead intake and chronic disease, 394-395

liver disease, 448

manganese intake and chronic disease, 385

metabolic studies, 33, 35, 140-141, 143, 182-189, 193, 198, 211-213, 275, 277, 448

MUFA intake and chronic disease, 184

NIDDM, 273-274

Nurses' Health Study, 221

obesity, 7, 221, 281, 573-574, 575, 576, 577, 579-580, 581-582

osteoarthritis, 580

osteoporosis and osteomalacia, 264-265, 316-317, 351-352, 372, 375, 654

physical activity and chronic disease, 153

protein intake and chronic disease, 260-261, 262, 264-265

PUFA intake and chronic disease, 184-186, 218-219

randomized, 194-195, 203, 261, 320

renal disease (chronic), 265, 394-395

response to serum cholesterol, 198

selenium intake and chronic disease, 376

SFA intake and chronic disease, 182-184

small-scale, 171-172, 653

sodium intake and chronic disease, 417-418

strengths and weaknesses of, 4, 32-33, 653

uses, 32

vitamin D intake and chronic disease, 316-317

vitamin E intake and chronic disease, 320

vitamin K intake and chronic disease, 321

weight of evidence for causation, 35

zinc intake and chronic disease, 370-371, 372-373

see also Intervention trials; Randomized clinical studies

Cobalamin, see Vitamin B12

Cocarcinogens, activation of, 440;

see also Ethanol

Cocoa, 281

Cocoa butter, 183

Coconut oil, 13, 159, 182, 183, 184, 186, 187, 189, 196, 204, 205, 213, 220, 223, 670

Cod liver oil, 191

Coenzyme Q, 320

Coffee and tea

animal studies of, 468-469, 470-471

availability trends, 60, 61

cancer and, 12, 467-469, 662

CHD and. 11-12, 192, 469-470, 662

decaffeinated coffee, 60, 466, 469

epidemiologic studies of, 11-12, 467-468, 469-470

fluoride in tea, 74

intake patterns, 60, 76, 466-467

reproductive effects of, 470-471

serum cholesterol and, 11, 469, 533, 662

short-term tests of, 469

see also Caffeine

Cognitive development and function, 395, 449

Cohort studies, see Epidemiologic evidence, studies, and cohorts; Longitudinal (cohort) studies

Collagen, 191

Collard greens, 69, 349

Colles' fracture, 121

Colombia, cancer in, 384, 475

Colon cancer

adenomatous polyps and, 211

animal studies of, 151, 213, 297-298, 600

biologic markers of, 212

calcium and. 11, 356, 514, 661

caloric intake and. 151, 263, 595-596

carbohydrates and, 282

b-carotene and, 314

cholesterol intake and, 174, 210

clinical studies of, 212

coffee and tea and, 467-468

Dukes' A and B, 211

ecogenetic factors in, 91

epidemiologic studies of, 153, 211, 263, 296-297, 467-468

familial polyposis and, 91

fat intake and, 14, 205, 209, 282, 357, 600-601, 656, 671, 693

trans fatty acids and, 213, 600-601

fiber and, 6, 9, 210, 212, 296-298, 302, 303, 357, 602, 658, 666

folacin and, 338

food additives and, 476-477

genetic and familial factors in, 91, 118

mortality rates, 690-691

MUFAs and, 601

obesity and, 575

pantothenic acid and, 340

physical activity and, 153

population differences in, 212, 296

prevention of, 6, 19

protective dietary components for, 8, 11, 15, 303, 315, 322, 341, 377, 488, 672

protein and, 9, 263, 659

PUFAs and, 213, 600

serum cholesterol and, 14, 206, 210, 211, 671. 692-693

sex differences in, 118

SFAs and, 8, 174, 215, 656, 692-693

trace elements and, 368, 377, 380, 385, 393

vitamin B12 and, 339, 341

vitamin C and, 332, 333, 341

vitamin E and, 319, 322

Colorectal cancer

alcohol intake and, 438, 596

calcium and, 356, 357, 360, 596

carbohydrates and, 208

dietary cholesterol and, 210, 596

endocrine-related, 210

epidemiologic studies of, 152-153, 208-209, 282, 284, 438, 595-596, 654, 657

fat intake and, 7, 77, 206, 208-209, 215, 595

fiber and, 77, 208, 296, 297, 302, 488, 596

incidence and mortality from, 118-119

linoleic acid and, 208

other cancers associated with, 118, 120, 595

meats and, 208, 596

MUFAs and, 596

physical activity and, 152-153

protective dietary components for, 208, 314, 596

protein and, 208, 598-599

public information programs on, 77

racial, ethnic, and migrant differences in, 118

sex differences in, 118, 119, 208

SFAs and, 208, 692-693

U.S. rates of, 118, 593

vitamin A and, 314, 658, 596

vitamin C and, 332, 514, 596

Coloring dyes, 74

Community trials

Busselton Community Study, 210

hypertension, 202, 693

Computed tomography, 104, 144, 175, 351-353

Condiment sauces, 72

Conference of Health Effects of Blood Liproproteins, 164

Confounding/confounders

in case-comparison studies, 443

in CHD studies, 284

in cross-sectional comparisons, 24, 204, 228

defined, 30

in dietary intake data, 185, 194, 197. 274, 284

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in obesity studies, 114

in temporal relationships, 30-31

Congeners, 441

Congenital malformations, 124

Congestive heart failure, 29, 113, 124, 175

Connecticut

cancer in, 467

CHD in, 102

Constipation, 302, 354

Contaminants, environmental

carcinogenicity of, 12, 662

naturally occurring, 12, 486-490

survey data on, 51

see also Aflatoxins; Pesticides; and other specific contaminants

Continuing Surveys of Food Intakes of Individuals (CSFII)

bias in, 55, 161

corrections to data base, 46

dietary intake data reported by, 53-55, 62-67, 69, 70-73, 160-161, 274, 293, 312, 329-331, 348, 368, 466, 509, 511

methods in, 42, 45-46

nutrients and food constituents reported in, 47, 62-74, 312

populations represented by, 44-45, 49

Cookies, 18, 58, 81, 675

Coordinated State Surveillance System, 44

Copper

absorption, 379

anemia and, 381

animal studies of, 380, 381

atherosclerotic cardiovascular diseases and, 370, 380, 395

biologic role of, 379

cancer and, 380-381

cirrhosis and, 381

clinical studies of, 380-381

in contraceptive devices, 381

coronary arrhythmias and, 380

data sources on availability of, 47-48, 51

environmental sources of, 381

epidemiologic studies of, 380-381

ESADDI, 48, 72, 379

excess intake of, 381

fiber and, 301

food sources of, 72

hypertension and, 390

intake trends, 72, 379

interaction with other trace elements, 370, 373, 379, 380, 386, 390, 395, 517

metabolic disorders from, 124

safety index, 518

supplementation, 380

Corn bran, 299

Corn oil, 64, 159, 183, 184, 186, 187, 189, 204, 205, 213, 214, 220, 223, 261, 277, 671

Corn products, 57

Corn sweeteners, 58, 60

Corn syrups, 273, 274, 281, 654

Cornstarch, 277, 278, 281

Coronary artery disease, 190, 192, 278, 333, 376, 659;

see also Coronary heart disease; Peripheral arterial disease; Stroke

Coronary heart disease (CHD)

age and, 101, 102, 167, 445, 532

alcohol intake and, 16, 444-446, 533, 660, 673, 695

animal studies of, 261, 295-296, 532-533

apolipoproteins and, 88, 168-171, 534, 536

blood pressure and, 103, 107, 112-113, 376, 382, 535

body fat distribution and, 16, 144, 659

body mass index and, 103

body weight and, 16, 103, 673

calcium and, 515, 666

carbohydrates and, 8, 278-279, 284, 533, 657-658

case fatalities, 102

in children, 222, 225

cholesterol intake and, 8, 14, 31, 33, 58, 77, 80, 103, 161, 197-198, 228, 534-536, 657, 668, 670, 694

cigarette smoking and, 101, 151, 195, 444, 445, 534, 535, 571

clinical trials of, 11-12, 171-175, 194-195, 218, 260-261, 295, 534-535

coffee and tea and, 11-12, 469-470, 533, 534, 662

commonality of risk and protective factors for, 693

coronary-prone behavior and personality and, 103, 537

country differences in incidence of, 31, 100-101, 104

diabetes mellitus and, 103, 124, 171

diet trial feasibility for, 32

eating patterns and, 103

end points, 172-175

energy intake and, 148, 534, 536-537

epidemiologic evidence on, 102, 163-171, 197-198, 260, 294-295, 369, 469-470, 533-534

ethnic, racial, and migrant differences in, 102, 149, 178

fat intake and, 5, 7, 31, 33, 54, 77, 80, 93, 102, 161, 278, 656

fiber and, 9, 294-296, 302, 303, 533, 534, 658

fish consumption and, 8, 13, 185, 192, 193, 657, 671

foods correlated with, 192

gallbladder disease and, 127

genetic and familial factors in, 86, 88-89, 93, 103, 171, 224, 536

HDL cholesterol and, 151, 166-168, 171, 376, 533-536

HDLs and, 88, 444

hypercholesterolemia and, 86, 88, 171, 172, 534, 536

hyperlipidemia and, 6, 171, 533

hypertension and, 101, 107, 535

individual risk of, 164-165, 166-168, 170

LDL cholesterol and, 166-168, 171, 178, 227, 228, 532-533, 536

LDLs and, 86, 88, 168, 444

lipids and, 88-89, 93, 177

manganese and, 386

morbidity, 100

mortality rates, 6, 89, 100-102, 151, 164-165, 167, 197, 445, 531-532, 572, 655, 690-691

MUFAs and, 54

nephrotic syndrome and, 171

obesity and, 376, 535, 569-570, 659

observational studies of, 533-534

occupational factors and, 102-103, 537

pathogenesis of, 99-100, 168, 175, 530

peripheral vascular disease and, 175

physical activity and, 16, 103, 151, 153, 534, 536-537

population differences in rates, 100-101, 113, 164, 168, 170, 177, 227, 532

population risk of, 103, 166

premature, 171, 227, 536

prevention of, 113, 167, 172-175, 185, 192, 193, 194-195, 227, 679, 686-687

protective dietary components for, 8, 227, 295, 533, 534, 657-658

protein and, 9, 15-16, 260-261

psychosocial factors in, 103, 537

public information programs on, 77

public perceptions of risk for, 80

PUFAs and, 54, 193, 227-228, 533-534, 657

renal disease and, 171

risk factors for, 77, 88, 101, 102-103, 113, 171, 532-537

serum cholesterol and, 6, 86, 88, 93, 101, 102, 103, 161-164, 167, 172-175, 177-178, 195, 222, 225, 227, 228, 376, 445-446, 532, 533-534, 668, 671, 692, 697-699, 700-701

sex differences in, 100, 102, 167, 369, 536

SFAs and, 7-8, 14, 54, 77, 102, 103, 193, 228, 532-535, 656, 666, 668, 671, 694

socioeconomic factors and, 101, 102-103, 275, 532

stroke and, 105

supplement use and, 514-515

time trends in, 101-102, 196

trace elements and, 369, 370, 376, 380, 515, 382

triglycerides and, 170-171

in the United States, 101, 531-532

in vegetarians, 278-279

vitamin C and, 33, 515

vitamin E and, 514-515

VLDL cholesterol and, 170-171

Corpus uteri, see Uterine cancer

Correlation analysis studies, 275, 332, 352

Cottonseed oil, 64, 184, 186, 490

Coumarin, 322, 490

Crab meat, 72

Crackers, 58

Cream, 203, 207

Creatinine, 28

Creatinuria, 320

Criminality, and carbohydrate intake, 283, 284

Croatia, CHD in, 164

Cross-sectional studies

blood pressure, 202, 204, 415, 442

confounding in, 24, 204, 228

dental caries, 279

energy intakes by elderly people, 147-147

glucose tolerance, 274

hyperlipidemia, 443

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interindividual variability in, 199

overweight subjects, 144, 153

peak bone mass, 350

serum cholesterol determinants, 181, 197, 198

serum lipids and lipoproteins in children, 225

suitability for studying causal relationships, 81, 197, 654

see also Epidemiologic evidence, studies, and cohorts

Croton oil, 320

Cruciferous vegetables, intake trends, 80, 81;

see also Broccoli: Brussels sprouts, Cabbage; Cauliflower: Vegetables

Cucumbers, 297

Cured foods, see Salt-cured (salt-pickled) foods

Cutin, 291

Cycad nuts, 489

Cycasin, 489-490

Cyclamate, 471, 472-473

Cyclohexylamine, 473

Cyclophosphamide, 333

Cystic fibrosis, 223, 320, 321

Czechoslovakia

alcoholic cirrhosis in, 125

CHD in, 100-101

D

Dairy products

availability trends, 57, 80

cancer risk from, 207

fat intake from, 13, 160

intake trends, 41, 260, 348, 654

iodine in, 74

nutrient contribution of, 5, 13, 14, 18, 56, 58, 62, 63, 70, 74, 260, 312, 348, 666, 667, 671, 675

recommended intake of, 13, 17, 666, 670, 674, 675

see also Milk and Milk products; and specific dairy products

Danish adoption registry, 90

Deaths, diet-associated causes of, 99;

see also Mortality rates

Death certificates

accuracy of data in, 30, 104

CHD coding, 100

coding of diseases, 100, 109

as disease incidence/prevalence measures, 29, 30, 43, 100

stroke data on, 104

7-Dehydrocholesterol, 64, 160, 312

Delaney Clause, see Food, Drug, and Cosmetic Act

Delaware, CHD in, 102

Demographic characteristics, see Age; Race or ethnicity; Sex differentials; and other specific characteristics

Denmark

bone fracture in, 121

cancer in, 212, 296, 437, 438, 467, 575

CHD in, 100-101

dental caries in, 127

see also Danish adoption registry

Dental caries age and, 17, 127, 128, 279

animal studies of, 280-281, 374, 641-642

B vitamins and, 642

buccal decay, 280, 641

calcium and, 281, 642

carbohydrates and, 9, 279-281, 284, 637, 638-642, 658

clinical studies, 279-280, 638-641

consistency/texture of food and, 9, 639, 658

coronal, 128, 637

defined, 127

dmft values, 127, 637

DMFT values, 127, 279, 637, 638, 640

eating patterns and, 639

enamel erosion and, 638

epidemiologic studies, 127, 128, 279, 373-374, 638-641

fluoride and, 11, 17, 74, 94, 128, 280, 373-374, 387, 395, 638, 640-641, 661, 668, 674

fructose and, 638, 641

genetic and familial factors in, 128, 280, 643

historical evidence on, 637-638

molybdenum and, 387

oral microflora and, 280, 642, 643

phosphates and, 281

prevalence of, 127, 279, 637, 655

protective dietary components for, 280, 281, 639-641

protein and, 642

racial and ethnic differences in, 128

root surface, 128, 637

saliva composition and flow and, 638, 643

sex and, 127, 128

socioeconomic status and, 128

sucrose (sugar), 15, 280, 281, 284, 638-642, 672, 685

sulcal decay, 280

time trends in, 127-128

vitamin D and, 639-640, 642

xylitol and, 638, 639

Deoxycorticosterone, 205, 418, 423, 424

Dextrin, 282

Dextrose, 280, 282

Diabetes mellitus

age and, 123, 627

alcohol intake and, 446, 628

animal models of, 150, 629

animal studies of, 149-150, 152, 153, 299-300, 385-386, 574, 629-630

atherosclerosis and, 275, 531

body fat distribution and, 114, 117, 123, 144, 627-628

body mass index and, 117

body weight and, 149

carbohydrates and, 628, 629

cardiovascular complications in, 4, 124

CHD and, 103, 124

chromium and, 383, 628

clinical/metabolic studies of, 149, 152, 153, 299, 372, 383, 385, 573-574, 628-629

defined, 122

diagnosis of, 122, 627

dietary management of, 264, 628-629

epidemiologic studies of, 149, 152, 153, 299, 372, 573, 628-629

energy expenditure and, 152, 153

energy intake and, 149-150, 153, 629

fat intake and, 628

fiber and, 9, 299-300, 301, 302, 628, 629, 658

forms, see Insulin-dependent diabetes mellitus; Noninsulin-dependent diabetes mellitus

genetic factors in, 89, 628

glucose intolerance and, 106, 122, 153, 628, 629

genetic and familial factors in, 123

hemochromatosis and, 92

hypertension and, 629

intermittent claudication and, 106

manganese and, 385-386

in migrants, 123, 149, 628

mortality rates, 117, 149

myocardial infarction and, 148

nutritional management of, 90

obesity and, 117, 573-574

PAD and, 106, 124

physical exercise and, 152, 153

population differences in, 122-123, 274-275, 627

racial and ethnic differences in, 123

renal disease, 629

as a risk ractor for other chronic diseases, 123-124, 274

sex differences and, 123, 627

socioeconomic status and, 123, 628

stroke and, 105, 124

sugar and, 629

time trends in, 123

triglycerides and, 171, 275, 276

zinc metabolism and, 372

Diagnosis of disease

anorexia nervosa, 584

bulimia, 584-585

cirrhosis of the liver, 124

diabetes mellitus, 122

familial dysbetalipoproteinemia, 168

gallstones, 126

hypertension, 107

local biases in, 30

PAD, 105-106

pancreatic cancer, 119

stroke, 104, 175-176

Dibenz[a,h]anthracene, 481

3, 4, 9, 10-Dibenzpyrene, 319

Diet, definition of, 99

Dietary cholesterol

animal studies of, 33, 161, 200, 228

atherosclerosis and, 6-8, 13, 15, 161, 196-201, 228, 656, 657, 666, 670

autooxidation products, 201

availability trends, 53, 58, 160

biologic role of, 160, 225-226

cancer and, 174, 206, 210, 214

CHD and, 8, 14, 31, 33, 58, 77, 80, 103, 197-198, 228, 657, 668, 670-672, 694

clinical/metabolic studies of, 218

data sources on availability of, 47-48

dietary fat intake and, 222-223

food sources of, 13, 16, 58, 160, 161, 222-223, 670-671

gallbladder disease and gallstones and, 125, 127, 218, 220

hormonal status and, 210

hypercholesterolemia and, 201, 228

infant intake of, 222-223

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intake trends, 41, 58, 160, 161, 654

interactions with other nutrients, 200

intestinal absorption of, 201, 657, 670

LDL cholesterol and, 201, 657, 670

lipoprotein metabolism and, 199-200

measurement of intake, 198, 199

monitoring status, 81

plant sterols and, 201

plasma lipids and, 197

predictive equations for, 198-199, 533

prevention of absorption of, 201

racial and ethnic differences in, 161

recommended intake of, 13, 14, 17, 226, 670, 671, 675, 677-680, 682-683, 685-687

serum cholesterol and, 8, 180, 197-199, 201, 228, 657, 670

SFAs and, 200

socioeconomic status and, 58, 161

structure of, 160

variability of human response to, 8, 182-183, 197, 199, 201, 228

see also Fats; Lipids and lipoproteins; Serum or plasma cholesterol

Dietary data

accuracy of, 24, 25-27, 28, 80, 652

biologic markers, 26, 27, 28

diet histories, 24, 27, 297

dietary recalls, 24, 25

food composition tables, 23, 24, 25, 27-28, 652

food disappearance data, 24, 80

food frequency questionnaires, 24, 27, 207, 208

food models, 24

food records, 24, 26, 27

on groups, 23-24, 26, 27, 46

household food inventories, 24

on individuals, 24-25

per-capita intake, 24

24-hour recall, 24, 25, 26-27, 45, 46, 49, 50, 52, 53, 55, 61, 63, 140, 180, 208, 261, 264, 295

volume models, 24

see also Dietary intake

Dietary guidelines and recommendations

cancer prevention, 676, 679

criteria and processes for formulation of, 5-6, 18-20, 652, 665-669, 670

diabetes management, 680

implementation of, 20, 667, 669, 701-703

implications for food choices, 674-675

general health maintenance, 675, 676, 678-679

heart disease, 676, 679

osteoporosis, 680

by other expert groups, 667, 675-690

populations versus individuals, 93-94, 652, 667-670

potential adverse consequences of, 690-691

public health impacts of, 697-701

quantitative versus qualitative, 667, 670

see also specific foods and specific nutrients

Dietary intake

by age-sex groups, 24, 161

by children, 224, 225

correlation with biochemical indicators of nutritional status, 50

criteria for assessing adequacy of, 49-50

cutoff points, 27, 49-50, 52

day-to-day variation in, 12, 25, 26, 27, 45, 49, 50, 653

educational status and, 80, 81

errors in reporting, 25, 26, 27, 46, 80

genetic factors in, 88

methods for assessing, 23-28, 45-46, 50-51, 652

national surveys of. 42-52; see also Continuing Surveys of Food Intakes of Individuals; Hispanic Health and Nutrition Examination Survey; National Health and Nutrition Examination Surveys; Nationwide Food Consumption Surveys; Total Diet Study

nutritional status and, 41-82

observational studies of, 225

physical activity and, 140-141

plasma/serum lipids and lipoproteins and, 224, 225

public information programs and, 80

socioeconomic status and, 41, 80, 81

strengths and weaknesses of assessment methods, 26-28, 29, 46

temporal relationship to disease pathogenesis, 30-32

underreporting of, 26, 53

see also specific foods and specific nutrients

Dietary patterns, see Diets; Eating habits and patterns

Dietary supplements/supplementation

by adults, 509-511, 513

algae, 518

amino acids, 17, 447-448, 513, 674

B complex, 509-511

bioavailability of nutrients in, 518-519

bone fracture and, 353

bone mass and, 352-353

calcium, 11, 17, 352-354, 509, 511, 514, 515, 517, 518, 661, 674

cancer and, 514

CHD, 515

by children, 511-512, 513-514

chromium, 382, 383, 515

clinical studies on, 352-354

for colds, 515

complicating effects of, in diagnosis of disease, 517

contaminants in, 517-518

copper, 380

definition of, 509

by elderly people, 511, 513

failure to meet advertised claims, 11, 518-519, 661

fiber, 15, 17, 295, 302, 672, 674

fish oils, 13-14, 190, 518, 671

folacin, 338

by health professionals, 512-513

inclusion in dietary intake assessments, 46

interactions with other nutrients, 517

iodine, 384

iron, 369, 511, 512

lecithin, 17, 216, 674

legal status of, 519

liver preparations, 315, 514

magnesium, 335

management of metabolic disorders with, 86

manganese, 386

market shares, 509

molybdenum, 335

multivitamins, 509-512, 674

niacin, 335

nutrient adequacy and, 513-514

one-a-day, 11, 509, 662, 674

osteoporosis and, 11, 515

phosphate, 281

potassium, 15, 511, 672

w-3 PUFAs, 191

protein powders, 17, 674

recommendations on use of, 15, 17, 518, 519-520, 671, 672, 674, 679, 684

Red Dye No. 3 in, 74

riboflavin, 335

safety of, 11, 353-354

selenium, 11, 335, 518

thiamin, 449

toxicities, 11, 515-517, 518

use trends, 509-513

vitamin A, 315, 514, 516, 662

vitamin B, 516

vitamin C, 509-512, 514, 515

vitamin E, 319, 320, 509-512, 514-515, 516-517

zinc. 335, 370, 514, 515, 517

Dietary surveys, 23, 42-52, 140, 160-161; see also Continuing Surveys of Food Intakes of Individuals; Hispanic Health and Nutrition Examination Survey; National Health and Nutrition Examination Surveys; Nationwide Food Consumption Surveys; Total Diet Study

Diethylnitrosamine, 282, 333, 338, 339, 392, 439-440

Diethylstilbestrol (DES), 482

Diets

formulated meal replacements, 75

of Paleolithic hunter-gatherers, 41, 413, 431

technological changes to facilitate changes in, 5

see also Low-calorie diets; Weight-reduction dieting

3, 2'-Dimethyl-4-aminobiphenyl, 298

Diglyceride, 215

Diketopiperazine, 474

Dimethylaminoazobenzene, 335, 340

Dimethylbenzanthracene, 153, 214, 264, 282, 314, 319-320, 333, 369, 378, 379, 384, 387, 439, 477

Dimethylbenzhydrazine, 264

Dimethylbenzylamine, 371

Dimethylhydrazines, 297, 333, 368, 440

Dimethylnitrosamines, 381, 387, 440, 441

Dinitropyrenes, 485

Dioxin, 483

1, 3-Diphenyltriazine, 478

Disaccharides, 58, 208, 273, 282;

see also Lactose; Maltose; Sucrose

Disease prevention, defined, 99

Distilled liquor, see Alcoholic beverages

Diuretics, 417

Diverticulitis, 296

Diverticulosis, 9, 300, 302, 658

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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DNA

metabolism, ethanol effects on, 440-441

mutations, detection of, 87

noncoding, 85

repair mechanisms, and cancer, 91

variants as genetic markers of disease, 87

see also Genetic and familial associations

Docosahexaenoic acid, 159, 190, 191

Dose-response relationships

aflatoxins and cancer, 487

alcohol and cancer, 437-439

alcohol and CHD, 444

alcohol and stroke, 443

carbohydrates and dental caries, 280

coffee and cancer, 467, 468

in human studies compared to animal studies, 35

fluoride and cancer, 374

and inferences of causality, 36, 38

mono- and disaccharides and cancer, 208

nonnutritive sweeteners and cancer, 472

potassium and stroke, 11

SFAs and cancer, 207, 209

threshold, 36

upper limit in, 36

Dough conditioners, 74, 383

Dried beans, peas, nuts, and soybeans

availability trends, 57

nutrient contribution, 65, 67, 70, 71

see also Legumes

Drinking water

aluminum in, 387

arsenic in, 393, 392

cadmium in, 388

calcium in, 25

carcinogens in, 480

chromium in, 381-382

data sources on availability of, 47

fluoride in, 11, 74, 373, 374, 661, 668

intake trends, 62

lead in, 393-395

nitrates and nitrites in, 475

sodium in, 73

Drug reactions, from defective acetylation of drugs, 88

Dysbetalipoproteinemia. familial, 168, 171, 177

E

Eating disorders

anorexia nervosa, 583-584

bulimia, 584-585

diagnosis of, 584, 585

prevalence of, 584-585

Eating habits and patterns

alternative diets, 76-79;

see also Vegetarians and vegetarianism

away from home, 75-76, 82

caloric need and, 53

changes in, 75-79, 82

CHD and, 103

dental caries and, 280-281

diabetes mellitus and, 275, 276

dieting, 76, 82,

see also Low-calorie diets: Weight-reduction diets

modified gorging, 53, 275

number of occasions, 18, 75

reporting of, 25

serving size, 15, 18, 672

snacking, 75, 76, 82

see also Dietary data

Ecogenetics

cancer and, 91

CHD and, 89

hypertension and, 89

nutrition and, 88

obesity and, 90, 117

research needs in, 95

Ecological correlations and studies

advantages of, 31

averaging across individuals in, 31

bias in, 30

confounding in, 30

discrepancies between individual correlations and, 31

food frequency assessment method in, 27

interpretation problems in, 30, 37

misclassification effects in, 30

of plasma lipids and lipoproteins in children, 224

weight of evidence for causation, 35, 37

see also Population differences

Educational attainment

body mass index and, 103

CHD and, 101, 103

dietary intake and, 80, 81, 103

hypertension and, 112

physical activity levels and, 103

serum cholesterol levels and, 103

Eggs

atherosclerosis and, 161

availability trends, 57, 80

cancer and, 209, 315

CHD and, 192

cholelithiasis and, 218, 219

intake trends, 54, 80

ischemic heart disease and, 197

nutrient contribution of, 13, 58, 62, 64, 67, 74, 160, 161, 259, 260, 311, 312, 370, 469, 670

recommended intake of, 13, 18, 670, 696

stroke and, 194

Eicosapentaenoic acid (EPA)

blood pressure and, 204

endothelial cell metabolism of, 191

human metabolism of, 191

short-term studies of, 191

structure of, 159

Elderly people

alcohol intake by, 432, 445, 451

CHD in, 445, 532

dietary intake and nutrition surveys of, 42

energy balance in, 147-148

fiber intakes, 294

protein intake by, 16, 264-265

stroke in, 15, 672

supplement use by, 511, 513

vitamin D intake by, 312, 317

see also Age

Electroencephalographic activity, and alcoholism, 93

Electrolytes, see Potassium: Sodium

Embolism, 104

Emulsifiers, 73

Encephalomalacia, 320

Endemic goiter, 383, 384-385, 395

Endometrial cancer

body fat distribution and, 16, 144

body weight and, 10, 16, 575, 659

Endocrine-related, 210

epidemiologic studies of, 264, 299, 598-599

fat intake and, 206, 209, 210

fiber intake and, 299, 302, 599

hormonal status and, 120, 576, 598-599

hypertension and, 598-599

mortality rates, 120, 655

NIDDM and, 598-599

obesity and, 10, 117, 575, 598-599, 659

other cancers associated with, 118, 120, 598

population differences in, 120, 598

prevention of, 19

protein intake and, 264

socioeconomic status and, 120

trace elements and, 380

in the United States, 120

vitamin B6 and, 337

Endothelial cells, eicosapentanoic acid

metabolism in, 191

Energy

availability trends, 140

defined, 139

measures of, 139

needs, estimation of, 142

see also Calories: Food energy

Energy balance

animal studies of, 145, 146-147

body fat and, 153

body weight and, 139, 144-145, 153

clinical data on, 144-145, 146

defined, 139

in elderly people, 147-148

energy expenditure-storage relationship, 145-147, 153

epidemiologic data on, 144, 145-146, 153

measurement of body fat and, 143-144

metabolic mechanisms in, 143

obesity and, 10, 567-568, 655, 659

during pregnancy and lactation, 139, 147

in rapid growth periods, 147

Energy expenditure

age and, 146

animal studies of, 143, 146-147, 151-152, 153

atherosclerotic cardiovascular diseases and, 151-152

cancer and, 152-153

for carbohydrate storage as fat, 140, 151, 221

CHD and, 10, 153, 659

clinical data on, 146, 151, 152

components of, 141-142

diabetes mellitus and, 152, 153

energy intake and, 140

epidemiologic data on, 145-146, 151, 152-153

factors influencing, 142-143, 153

for fat storage, 140, 151, 221, 671

historical trends in, 142

measurement of, 141, 142

net energy stores and, 145-147

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obesity and, 10, 142-143, 221, 567-568, 659

physical activity and, 142-143, 153

for protein storage as fat, 140, 151

resting, 142

Energy intake

age and, 140, 146, 148, 153

animal studies of, 145, 148-151, 153

atherosclerotic cardiovascular diseases and, 148-149

biologic markers of, 28

blood pressure and, 148

body fat and, 144-145, 148, 281

body mass index and, 144, 148, 281

body weight and, 7, 10, 52, 144-145

cancer and, 150-151, 153

from carbohydrates, 139-140

CHD and, 148

clinical studies of, 144-145, 148, 149, 153, 219

data sources on, 47, 81

diabetes mellitus and, 149-150, 153

energy expenditure and, 140

energy stores and, 144-145, 153

epidemiologic studies of, 144, 148, 149, 150

from ethanol, 436, 451

factors influencing, 140-141, 153, 294

from fats, 7, 139-140, 148, 215

food records of, 26

gallstones and, 127, 219

glucose tolerance and, 149

historical trends in, 140, 142

hypertension and, 149

malnutrition and, 139

myocardial infarction and, 148

obesity and, 10, 149, 220, 281, 284, 567-568

from protein, 139-140

recommended levels of, 17, 18, 226, 675

resting metabolic rate and, 146

serum cholesterol and, 180

serum triglycerides and, 148

sex and, 53, 59, 77-79, 81, 140, 145, 148

stroke and, 148

surveys of, 140

temperature (ambient) and, 140-141

trends in, 16, 52-54, 76-79, 142, 148, 180, 180, 220-221

Energy stores/storage

animal studies of, 145, 146-147

body weight and, 144-145

caloric intake and, 144-145

clinical data on, 144-145, 146

energy expenditure and, 145-147

epidemiologic data on, 144, 145-146

England/Wales

cancer in, 296, 380, 387, 467, 471, 475

CHD in, 100-101, 103, 164

diabetes in, 299

hypertension in, 108

see also United Kingdom

Enrichment, see Fortification and enrichment

Environmental factors

in cancer, 19, 91

gallbladder disease and gallstones, 126

hypertension, 88, 89, 111-112

interaction of genetics with, 87, 94, 95:

see also Ecogenetics

in stroke, 104-105

serum cholesterol levels and, 164

see also Migrants

Enzymes

for detoxification of ammonia, 86

genetic variability in activities of, 85-87, 93

see also specific enzymes

Epidemiologic evidence, studies, and cohorts

Albany Study of New York civil servants, 444

alcohol consumption, 436, 437-439

aluminum, 387-388

Alzheimer's disease, 387-388

arsenic, 391, 392

Ashkenazi Jews, 94

atherosclerotic cardiovascular diseases, 148, 151, 163-171, 192-194, 197-198, 227, 370, 376, 380, 381-382, 391, 422-423, 569-571

Benedictine and Trappist monks, 202

body fat distribution, 578

body weight fluctuations, 576-577

Bogalusa Heart Study, 111, 166, 223, 224, 512

British civil servants, 151, 152, 165, 444

British Regional Heart Study, 167, 444, 445

Busselton Study, 444

cadmium, 388-390

calcium, 351-352, 355, 356-357

cancer, 7, 150, 152-153, 205-210, 215, 228-229, 263-264, 282, 296-297, 299, 313-314, 315, 331-332, 334-335, 356-357, 368, 370-371, 374, 377-378, 380-381, 382, 383-384, 386, 387, 388-389, 391-392, 393, 437-439, 467-468, 471-472, 575-576, 598-599, 654;

see also specific cancer sites

Cape Town, South Africa, cohort, 179

carbohydrates, 274-275, 279, 281, 282, 638-640

b-carotenes, 313-314

CHD, 163-171, 197-198, 227, 260, 295-296, 369, 469-470

Chicago Heart Association Detection Project in Industry, 692

Chicago Gas and Electric Study, 577, 692

Chicago Stroke Study, 105, 175, 540

chromium, 381-382

coffee and tea and, 467-468, 469-470

copper, 380-381

criteria for evaluating, 28-29

cyclamate, 472

Danish brewery workers, 437, 438

dental caries, 127, 128, 279, 373-374, 638-641

diabetes mellitus, 122, 149, 152, 153, 299, 372, 573, 628-629

dietary cholesterol, 197-198

diverticulosis, 300

endemic goiter, 384-385

endocrine disorders, 581

energy balance and body weight, 144, 153

energy expenditure and chronic disease, 151, 152-153

energy expenditure-storage relationship, 145-146

energy intake, 148, 149, 150

Evans County Study, 111, 112, 315, 689

Faribault Study, 200

fats, 7, 178-181, 192-194, 201-205, 206-210, 220-221

fiber, 294-295, 296-297, 298-299, 300-301

Finnish alcoholics, 438

fluoride, 373-374, 375, 640-641

Four European Communities Study, 166

gallbladder disease and gallstones, 218, 300-301, 575

Göteborg studies, 105, 148, 578, 693

Greenland Eskimos, 185, 190, 192

Harvard University alumni, 151

Hiroshima Adult Health Study, 165

historical food supply data in, 42

Honolulu Heart Program, 165, 175, 193, 197, 202, 210, 319, 442-445, 534

Honolulu Heart Study, 29, 105, 148, 165, 170, 260, 535, 540, 577, 578, 689

hyperlipidemia, 294-295

hypertension, 201-204, 261-262, 300, 355, 358-359, 389-390, 394

immunologic consequences of disease, 579

International Atherosclerosis Project, 164

iodine, 383-385

Iranian cohort, 118

Ireland-Boston Diet-Heart Study, 102, 115, 181, 193, 197, 294-295, 534

iron, 368, 369-370

iron-deficiency anemia, 369-370

Israel Ischemic Heart Disease Study (civil servants), 122, 163, 164-165, 166, 167, 179, 193, 274, 692

Israeli Heart Study, 149

Jerusalem Lipid Research Clinics Prevalence Study, 163, 166

lead, 393, 394-395

Lipid Research Clinics Prevalence Study, 140, 442, 444

lipoprotein levels, 163-171, 178-181

London Busmen Study, 444

longshoremen, 151, 152-153

magnesium, 358-359

Mayo Clinic series, 106, 353

mercury, 390-391, 392

metabolic, 203

methodological issues, 197

Minamata disease, 391

Minneapolis businessmen, 167

molybdenum, 386

mycotoxins, 486-487

National Diet-Heart Study, 32

Nauruans (South Pacific), 103, 123

New Zealand Maoris, 211, 296, 689

Ni-Hon-San study, 102, 104-105, 114-115, 163, 164, 180

NIDDM, 274-275

nitrites, nitrates, and N-nitroso compounds, 475

nurse cohort, 27, 207, 210, 439, 512, 575

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Nutrition Canada Survey, 445

obesity, 90, 144, 220-221, 281, 569-571, 573, 575-578, 579, 580, 581

osteoarthritis, 580

osteoporosis and osteomalacia, 264-265, 316-317, 351-352, 372-373, 375

Paris Study, 577, 578, 689

physical activity and chronic disease, 153

plasma lipid levels, 163-171, 178-181

population studies, 178-181

polybrominated biphenyls, 480

polychlorinated biphenyls, 479-480

polyvinyl chloride, 480-481

potassium, 422-423

protein, 260, 261-262, 263-265

Puerto Rico Heart Health Program, 29, 440, 689

Puerto Rico Heart Study, 166, 170, 193, 260

renal disease (chronic), 265, 394-395

Ranch Hand Study, 483

reproductive effects, 470

Rochester, Minnesota, cohort, 102-106, 123, 539, 584

selenium, 376, 377-378

serum cholesterol, 163-164

Seven Countries Study, 100, 163, 164, 166, 178, 192, 211, 445, 446, 535, 537, 693, 698

sodium, 415-417

stomach cancer, 264, 298-299

strengths and weaknesses of, 4

stroke, 262, 422-423

Swedish copper smelter workers, 391

Tecumseh study, 152, 653

Third National Cancer Survey, 439

Tromsö Heart Study, 167, 168-169

U.S. Pooling Project, 164, 165, 692

vegetarians/vegetarianism, 201, 260, 262

Vipeholm mental patients, 279, 280

vitamin A, 313-314, 315

vitamin C, 331-332, 333

vitamin D, 316-317

Western Electric Study, 193, 197, 444, 445, 534, 577, 692

Whitehall study (British civil servants), 151, 152, 165, 444, 445, 689

Yugoslavia Cardiovascular Disease Study, 444, 445, 692

zinc, 370-371, 372-373

Zutphen Study, 144, 193, 197, 534

see also Case-control studies; Cross-sectional studies; Human studies; Framingham Study; Longitudinal (cohort) studies; Prospective studies and specific ethnic groups and countries

Ergocalciferol, see Vitamin D

Errors

in day-to-day dietary variability, 25, 27

in food composition tables, 25

measurement, 52, 208

from misuse of RDAs, 49

reporting, 25, 26, 27, 46

sampling, 25

systematic, 27

see also Misclassification

Erythremic myelosis, 339

ESADDI, see Estimated Safe and Adequate Daily Dietary Intakes

Eskimos

Greenland, 185, 190, 192

North Alaskan, 264

Esophageal cancer

alcohol intake and, 10, 437-441, 594, 660

bracken fern and, 489

calcium and, 357, 594

cigarette smoking and, 437-438, 576, 594

country differences in incidence, 118

epidemiologic studies, 594

folacin and, 338

iron and, 368

magnesium and, 334-336, 594

niacin and, 334-336, 594

N-nitroso compounds and, 475, 594, 602

protective dietary components for, 8, 9, 313, 331-332, 341, 377, 594, 657

racial, ethnic, and migrant differences in, 118

riboflavin and, 334, 335, 341, 371, 594, 602

mortality rates, 118

trace elements and, 334-337, 371, 377, 386, 442, 594, 602

U.S. incidence rates, 118

vitamin A and, 313, 315, 331-332, 334, 371, 594, 658

vitamin C and, 331-332, 341, 357, 594

Essential amino acids

animal studies of, 33

blocked catabolic pathway of, 86

dietary sources of, 15, 62, 259, 672

see also Protein; and specific amino acids

Essential element, survey of intakes of, 43;

see also Trace elements; and specific elements

Essential fatty acids

deficiencies in, 220

defined, 159

sources of, 159, 226

see also Lineolic acid

Essential nutrients

cholesterol as, 225-226

choline, 216

see also other specific nutrients

Estimated Safe and Adequate Daily Dietary Intakes (ESADDI)

biotin, 48

copper, 72, 379

manganese, 48, 385

molybdenum, 48, 386

potassium, 73

selenium, 48, 74, 375

sodium, 72

use in national surveys, 48

vitamin K, 312

Estragole, 488, 489

Estrogen

cancer and, 120, 214, 384

osteoporosis and, 354, 317-318, 352-353, 360, 515, 620

see also Hormonal status

Ethanol

amounts in alcoholic beverages, 432

cocarcinogenic effects of, 440

effects on DNA metabolism, 440-441

energy intake from, 436, 448, 451

hormonal status and response to, 442

local effects on cancer induction, 441

metabolization of, 436, 442

mutagenicity of, 440

neurological effects of, 434

occupational exposures to, 437, 438

see also Alcohol consumption; Alcoholic beverages

Ethnic groups, see Race and ethnicity; and specific ethnic groups

Ethnographic review of alcohol use, 433-434

Ethoxyquin, 441

Ethyl carbamate, 486

Ethylene dibromide, 482, 484

2-(Ethylnitrosoamino)ethanol, 394

Ethylnitrosourea, 393

Europe

alcohol intake in, 433-434

alcoholic cirrhosis in, 447

bone fracture in, 121

cancer incidence, in, 118, 119

dental caries in, 127

dietary recommendations in, 688

gallstones in, 126

hypertension in, 108

salt intake in, 414

see also specific countries

Event-related potentials, 93

Evolution (human), nutritional factors in, 85;

see also Genetic or familial associations

Excretion

cholesterol, 261

fecal steroid, 212, 213, 296

salt, 414

sterol, 188

uric acid, 447

urinary lignans, 299

see also Bile acids

Experimental evidence, criteria for evaluating, 5-6, 29, 652-654;

see also Animal experiments; Cell cultures; In vitro studies and methods; Mutagenicity tests; Short-term tests and studies

Exposure, duration of, in intervention studies, 32;

see also Dose-response relationships; Occupational factors and exposures

F

Familial associations of disease, see Genetic and familial associations

Familial combined hyperlipidemia, 89, 171

Familial dysbetalipoproteinemia, 168, 171, 177

Familial hypercholesterolemia

atherosclerosis and, 171, 222

CHD and, 171, 222, 227

in children, 222

defined, 86

genetic transmission of, 88, 171

homozygous, 222

incidence of, 86, 87

serum cholesterol levels and, 103

treatment of, 217

Familial polyposis, 91, 118

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Fast foods, 74, 75

Fat. see Body fat distribution; Body fat/fatness; Body mass index; Body weight

Fat cells, 146, 566

Fat substitute, 479

Fat-soluble vitamins

evidence of association with chronic disease, 313-322

sources of, 159

see also Vitamin A Vitamin D; Vitamin E; Vitamin K

Fats (dietary)

animal studies of, 7, 189, 213-215, 221-222, 600-601

atherosclerotic cardiovascular diseases and, 5-7, 33, 161-162, 163-178, 192-196, 227-228, 275, 655-656, 666

availability trends, 53, 57, 80, 140. 160, 654

biologic contributions of, 159

body mass index and, 221, 281

body weight and, 7, 14, 144, 202, 222, 656, 671

breast cancer and, 7, 30, 31, 77, 207-208, 215, 263, 656, 671

cancer and, 5, 7, 13, 54, 77, 153, 205-210, 215, 228-229, 600-601, 666, 668, 670, 671, 673, 693

CHD and, 5, 7, 31, 33, 54, 77, 80, 93, 102, 161, 278, 656, 668, 673

cholesterol intake from, 58, 222-223

clinical/metabolic studies of, 182-189, 211-213, 221

colorectal cancer and, 7, 77, 205, 206, 208-209, 215, 303, 357, 656, 671

defined, 159

eicosanoid metabolism and, 190-192

energy expenditure in storage as triglycerides, 140, 221

energy intake from, 14, 139-140, 671

epidemiologic evidence on, 7, 178-181, 192-194, 206-210, 220-221

fiber and, 77, 294

food composition data on, 27-28, 47-48

food sources of, 16, 18, 41, 55-58, 76, 160, 672

in foods eaten out, 76

gallbladder disease and, 7, 127, 217-220, 229, 300, 656

glucose tolerance and, 274

hemostasis and, 190-192

hydrogenation of, 57

hypertension and, 201-205

intake by children, health effects of, 14, 204, 222-227, 685

lipoprotein levels from, 178-192

liver disease and, 448

malabsorption of, 451

in meats from wild game, 41

mechanism of action of, 214

mineral contribution of, 74

monitoring status, 81

noncholesterol-containing, 128

obesity and, 7, 13, 14, 54, 144, 220-222, 229, 655, 656, 670, 671

plasma lipid and liproprotein levels from, 178-192

population differences in, 192

prostate cancer and, 7, 209, 656, 671

recommended levels of, 13, 14, 17-18, 81, 226, 669, 670-672, 675, 677-679, 682-683, 685, 686-688, 692-693

serum cholesterol levels and, 7, 178-192, 228, 656

serum triglycerides and, 148, 448

stroke and, 202

trends in, 15, 41, 54-55, 57, 81, 142, 160-161, 180, 208

see also Dietary cholesterol; Lipids and lipoproteins; and specific fats

Fatty acids

animal studies of, 159, 196

availability trends, 54, 57-58, 80, 160

biologic marker of intake of, 28

biologic roles of, 159

cardiovascular disease and, 192-196, 227

cyclopropenoid, 490

epidemiologic evidence on effects of, 192-194

food sources of, 57-58, 159, 160

intake trends, 58

cis isomers, 8, 57, 159-160, 657

trans isomers, 8, 57-58, 160, 193, 196, 213, 657

metabolism, 331

structure of, 159

transport of, 162

see also Essential fatty acids; Lineolic acid; Oleic acid; Monounsaturated fatty acids; Polyunsaturated fatty acids; Saturated fatty acids; Unsaturated fatty acids

Fava beans, 490

FD&C Blue No. 2, 478

FD&C Red No. 3, 74, 478

FD&C Yellow No. 5, 478-479

FD&C Yellow No. 6, 478, 479

Federal Republic of Germany

cancer in, 118, 332, 368, 392

CHD in, 100-101

dietary recommendations in, 683, 686

hypertension in, 442

Federation of American Societies for Experimental Biology, 57, 291, 368

Feed additives, for dairy cows, 74

Fetal alcohol syndrome, 10, 449-450, 660

Fiber

alcohol intake and, 450

adverse effects of, 301-303, 652

analysis of, 292-293

animal studies of, 295, 297-298, 299-300

atherosclerosis and, 295-296, 672

calcium balance and, 354-355

cancer and, 6, 9, 77, 80, 207, 208, 210, 212, 263, 296-299, 357, 488, 666;

see also specific sites

categories of, 291-292

CHD and, 9, 15, 294-295

clinical and metabolic studies of, 295, 299, 300, 618-619

composition of, 291-292, 293

crude, 62, 293, 294

diabetes mellitus and, 9, 299-300

digestibility, 9, 62

diverticulosis and, 9, 300

edible, 291

epidemiologic studies of, 294-295, 296-297, 298-299, 300, 618-619

food composition data on, 28. 47-48, 62, 293

food sources of, 15, 62, 261, 278, 292-293, 295

gallstones and, 9, 300-301

hypertension and, 9, 300

insoluble fraction, 9, 622-78, 292, 293, 299, 658

intake trends, 41, 80, 81, 293-294

ischemic heart disease and, 295

lipid metabolism and, 77, 294-295

mechanisms of action, 296

methodological problems in assessing disease relationships, 294

mineral bioavailability and, 301, 354-355, 652, 666

osteoporosis and, 354-355, 618-619

physiological effects of, 292

properties of, 292

protective effects of, 9, 15, 208, 263, 294-296, 298, 331, 658, 666, 672

recommended intake of, 677, 683, 686-688, 696

research needs on, 81, 303, 360, 622, 630

serum cholesterol and, 295-296

soluble fraction, 9, 62, 278, 292, 293, 295, 298, 302, 658

supplements, 15, 17, 295, 302, 672, 674

trace element absorption and, 6, 368, 370

see also specific fibers

Fiddlehead greens, 489

Figs, 489

Filipino betel nut chewers, 514

Finland

alcohol-related diseases in, 438

cancer in, 212, 296, 298, 315, 319, 357, 377, 438

CHD in, 100-101, 164, 376, 386, 445

dental caries in, 127

dietary recommendations in, 686-687

hypertension in, 202, 394, 442

osteoporosis in, 352

serum cholesterol levels in, 163

Fish

availability trends, 57, 80

cancer and, 264, 421

CHD and, 8, 13-14, 191, 192, 657, 671

contaminants in, 479

dried, 421

in frozen and canned entrees and dinners, 72

intake trends, 63, 80

mackerel, 13, 191, 671

nutrients supplied by, 13, 62, 64, 65, 67, 73, 671

recommended intake of, 13-14, 15, 670, 672, 675, 678, 681

salmon, 13, 191, 671

see also Meat, poultry, and fish group; Seafood

Fish liver oils, 64

Fish oils, 8, 64, 159, 185, 191, 192, 205, 206, 213, 214, 227-228, 229, 518, 671;

see also w-3 Polyunsaturated fatty acids

Fish protein, 262

Flavonoid glycosides, 488

Flavor, 159

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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Flour, 62, 65, 66, 70, 74-76, 92, 192, 282, 299, 348, 368, 413, 489, 654

Fluoranthrene, 441

2-Fluorenylacetamide, 477

Fluoride

animal studies of, 374, 375

bioavailability of, 373

biologic role of, 373

blood pressure and, 375

cancer and, 374-375

cardiac function and, 375

clinical studies, 375, 619

dental caries and, 11, 17, 74, 94, 128, 280, 373-374, 387, 395, 640-641, 661, 668, 674

in drinking water, 11, 17, 74, 373, 374, 395, 661, 668, 678-679

epidemiologic studies of, 373-374, 375, 619

ESADDI, 48

food sources of, 74, 373

hypertension and, 375

interactions with other dietary constituents, 373, 375

monitoring status, 74, 81

mutagenicity of, 374

osteoporosis and, 373, 375, 619

recommended intake of, 17, 674, 678-679

safety index for, 518

short-term tests of, 374-375

toxicity of, 373, 518

N-(4'-Fluoro-4-biphenyl)acetamide, 394

5-Fluorouracil, 321

Foam cells, 176-177

Folacin

alcoholism and, 450

analytical methods for, 67

animal studies of, 338

availability trends, 67

bioavailability, 67

biologic role of, 331

cancer and, 338, 339, 658

data sources on availability of, 47-48, 51

food sources of, 67, 331

human studies of, 338-339

intake trends, 67, 81, 331

liver disease and, 338-339

populations at risk of deficiencies in, 67, 331

processing losses, 67

RDA, 48, 67, 331

research needs on, 67, 81

safety index, 518

supplements, 338

Folate, see Folacin

Folic acid, see Folacin

Food additives

avoidance of, through dietary practices, 76, 678, 688

cancer from, 12

nutrients provided by, 70

sodium in, 73

see also Federal Food, Drug, and Cosmetic Act; and specific food additives

Food and Drug Administration

fortification and enrichment standards, 74

guidelines for fortification of foods, 74-75

Market basket surveys, 388, 482

opinion surveys on health and diet, 80

regulation of nonnutritive dietary components, 465-466

Sugars Task Force, 59, 278

survey of diet supplement use, 510

see also Total Diet Study

Food and Nutrition Board general health maintenance recommendations, 476

Subcommittee on Criteria for Dietary Evaluation, 49, 50-51

see also National Research Council

Food choices

factors governing, 77, 85

genetic basis for, 85

implications of dietary recommendations for, 674-675

Food colors, 478-479

Food composition data

accuracy of, 23, 25, 27-28, 48

availability of, 81

limitations of, 27-28, 46-48, 293, 652

nutrients and other food constituents reported by, 47, 62

preparation/processing losses or modifications and, 46

uses, 24, 42

see also specific foods and nutrients

Food constituents

factors affecting, 48

reported by national studies, 47

see also specific foods and nutrients

Food disappearance data

in cancer mortality studies, 210, 388

energy availability from, 140

estimation of, 23-24

in USDA food supply surveys, 42, 53, 80, 140, 160

Food, Drug. and Cosmetic Act

Color Additive Amendment, 466

Food Additive Amendment (Delaney Clause), 465-466

Miller Pesticide Amendment, 465

Food energy

absorption differences, 139

availability trends, 53, 140

monitoring status, 81

RDA, 148

sources of, 18, 53-55, 139, 159

standard energy output equations of, 28

standards for, 52

storage of excess, 139

uses in the body, 139

see also Calories; and Energy topics

Food groups, defined, 55;

see also specific food groups

Food Label and Package Survey, 43

Food manufacturers, response to consumer demands, 80

Food Marketing Institute, 43

Food models, 46

Food packaging, contamination of foods through, 43, 476, 479-481, 662

Food preparation and processing browning products, 291

innovations in. and food supply trends, 42

mutagens and carcinogens produced during cooking, 18, 485-486

nutrients inadvertently added during, 25, 381, 387

nutrient losses during, 18, 70, 329, 348, 413

recommendations on, 688

salt added during, 414

sugar added during, 273

Food safety laws, 465-466, 476, 519

Food supply

eating patterns and, 75-76

estimates of nutrient availability, 654

historical changes in, 41, 80-81

monitoring by USDA, 24, 80

trends in food availability, 57, 63-74, 654-655

see also Historical food supply; and specific dietary components and foods

Food use trends, estimation of, 24

Foods

see also Carcinogens; Contaminants, environmental; Food additives: Nonnutrients; Nutrients; and specific foods and food groups

Formulated meal replacements, 75

Fortification and enrichment of foods

with B vitamins, 74

defined, 74

FDA guidelines for, 74-75

flour and grain products, 70, 74, 75, 368

fruit drinks, 67

with iron, 70, 74, 75

margarine, 74

milk, 64, 74, 312

nutritional status and, 75

public policy issues in, 94

purpose of, 75

standards for, 74

with vitamin A, 74, 75, 311

with vitamin C, 67, 75, 329, 654

with vitamin D, 64, 74, 312

Fowler's solution, 392

Framingham Offspring Study, 442

Framingham studies

blood pressure data from, 109-110, 113

body fat distributions in, 578

cancer and serum cholesterol, 689, 692

CHD incidence in, 164, 165

CHD predictors in, 162, 166, 167, 170-171, 175, 279, 444, 445

congestive heart failure in, 113

coronary atherosclerosis in, 166

design of, 32

gallbladder disease incidence in, 127

hypertension risk factors in, 113, 442

intermittent claudication in, 175, 446

obesity and cancer in, 575

PAD findings in, 106, 107, 113, 170

representativeness of data from, 692-693

serum cholesterol levels in, 163, 165-167, 175

sex differences in disease incidence in, 166

stroke incidence in, 104, 105, 113, 175, 442-443

triglyceride levels in, 170-171

weight of evidence from, 653

France

(continued on next page)

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(continued from previous page)

alcohol intake in, 433, 437, 438

alcoholic cirrhosis in, 125, 126

cancer in, 118, 207, 208, 297, 332, 356, 392, 437-439

CHD in, 100-101, 102, 164

dietary recommendations in, 682

fetal alcohol syndrome in, 449

hyperlipidemia in, 443

hypertension in, 442

Frankfurters, 72

French fries, 56

Fried foods, 13, 18, 670, 675

Friedreich's ataxia, 217

Frostings, 58

Frozen entrees and dinners, 72

Fructose, 59, 60, 273, 274, 277-280, 282, 283;

see also High-fructose corn syrups

Fruit ades and drinks, 60, 67

Fruit juices, 60, 466

Fruits

availability trends, 57, 80

cancer and, 15, 80

dried, 76

fresh, 57

intake trends, 54, 76, 81, 260

nutrient contribution of, 15, 18, 48, 60, 62, 64, 66, 70, 72-74, 260, 273, 295, 301, 311, 331, 332, 341

processed, 57

protective effects of, 8, 15, 341, 488

recommended intake of, 13-15, 18, 226, 670-672, 675, 679, 688

yellow, 64

see also Citrus fruits; and specific fruits

Furocoumarins, 489

Furosemide, 419

G

Galactomannans, 300

Galactose, 273, 283, 446

Gallbladder disease

age and, 127

animal studies of, 219-220

body fat distribution and, 16, 673

body mass index and, 117

body weight and, 10, 16, 575, 659, 673

caloric intake and, 219

clinical and metabolic studies of, 218-219, 575

dietary cholesterol and, 218

epidemiologic studies of, 575

in migrants, 126

mortality rates, 117

obesity and, 7, 117, 127, 229, 575, 656, 659

pathophysiology of, 217-218

population differences in frequency of, 126

pregnancy and, 127

PUFAs and, 218-219

sex differences and, 127

subclinical detection of, 30

time trends in morbidity and mortality, 126-127

Gallstones

age and, 218

body weight and, 575

caloric intake and, 127

cholesterol, 125, 218, 229;

see also Gallbladder disease

clinical studies on, 301

composition of, 125, 217, 634

diagnosis of, 126

epidemiologic evidence on, 300-301

fat intake and, 127, 634

fiber and, 9, 127, 300-301, 302, 658

formation of, 125, 217-218, 634

genetic factors in, 635

obesity and, 218, 219

pigment, 218

population differences in, 218, 219, 300-301, 634

pregnancy and, 218

radiopacity, 125

sex differences in, 126, 218

see also Cholelithiasis

Gambia, The osteoporosis in, 352, 617

Gangrene, 531

Gardner's syndrome, 118

Gas chromatographic analysis, of foods, 58

Gastric cancer, see Stomach cancer

Gastric intrinsic factor, absence of, 88

Gastritis, 11, 421, 424, 661

Gastrointestinal diseases

lactose malabsorption and, 88, 91-92, 284

vitamin K malabsorption and, 321

Gastrointestinal tract cancer

dietary cholesterol and, 214

and dietary intake assessment, 27

fat intake and, 206, 229

lead and, 393

protective dietary components for, 215

trace elements and, 377, 378, 380-382

vitamin A and, 315

vitamin E and, 318-319

Gene pools, 87

Gene product variation, and nutrition, 85-86

Genetic or familial associations

alcoholism, 92-93, 433, 634

atherosclerosis, 668

breast cancer, 119-120

CHD, 86, 88-89, 93, 103, 168, 171, 536

cirrhosis of the liver, 634

colorectal cancer, 118

dental caries, 128, 643

diabetes mellitus, 123

energy expenditures, 142

environmental interactions with, 87, 88, 90;

see also Ecogenetics

family studies of, 87, 89, 92

heterozygosity, 86-87

homozygosity, 86

hyperlipidemia, 86, 88-89, 93, 94, 168, 668

hypertension, 16, 112, 415, 416-418, 420, 424, 554, 660, 668, 674

obesity and overweight, 116-117, 568-569, 659

osteoporosis, 122, 620

ovarian cancer, 120

of plasma lipids and lipoproteins in children, 224

policy implications of, 93-94

proof of, 87, 90

race/ethnicity and, 88

research needs on, 95

resting metabolic rate, 153

stroke, 105

sucrose intolerance, 284

twin studies, 87, 89, 90, 92, 116-117

see also Metabolic disorders; and specific diseases

Genetic markers

alcoholism, 93

cancer, 120, 514

CHD, 89

DNA variants as, 87, 89

hyperlipidemia, 89

hypertension, 418, 419, 424

linkage analysis of, 87

Genetics

medical, research methods in, 87-88

nutrition and, 85-95

osteoporosis and, 69

reverse, 87

see also Ecogenetics; Genetic or familial associations; Pharmacogenetics

Geographical differences

CHD frequency and death rates, 100-101

cholesterol intake, 58

dietary fat and cancer, 209

fiber intake, 62

mineral intakes, 69-70

vitamin intakes, 64-68

see also Population differences; and specific countries and U.S. states

Glucose

alcohol intake and formation of, 446

behavioral change and, 283

cariogenicity of, 280

food sources of, 273, 283

obesity and, 282

triglyceride levels and, 278

Glucose-galactose malabsorption, 86

Glucose-6-phosphate dehydrogenase deficiency, 88

Glucose tolerance

age and, 122

alcohol intake and, 446

body weight and, 148

carbohydrate intake and, 9, 274-277, 284, 385, 657, 658

diabetes and, 106, 122, 277, 284

energy intake and, 149

fat intake and, 274

fiber intake and, 9, 292, 299

food intake and, 148, 149

intermittent claudication and, 107

obesity and, 277

PAD and, 106, 107

physical activity and, 146, 151, 152, 153

protein intake and, 274

trace element intake and, 381-383, 385-386, 515

Glutamic-6-pyruvate transaminase, 120

Glutathione peroxidase, 375-376

Glycine, 261, 331, 423

Glycoalkaloids, 489

Glycogen, 273, 446;

see also Starches

Glycosuria, 149-150, 277, 372

Gossypol, 490

Gout, 386, 580;

see also Arthritis

Grains and grain products

availability trends, 57, 81

contamination of, 665

(continued on next page)

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(continued from previous page)

intake trends, 54, 80, 63-66, 69-71, 348, 654

enriched, 65, 66, 70, 75

nutrients provided by, 56, 58, 59-60, 63-66, 69-71, 74, 75, 161, 273, 330, 331, 348, 349, 413

protective effects of, 295, 299

see also Cereal grains and cereal grain products; Whole grains and whole-grain products; and specific grains

Grapefruit, 73

Grape juice, 433

Grapes, 392

GRAS (Generally Recognized as Safe) substances, 466

Greece and Greek Islands

cancer in, 207, 208, 297, 467, 468

CHD in, 100, 164, 445

serum cholesterol levels in, 163

Green peppers, 329

Groundnut oil, 202

Growth

coffee and, 470

energy balance during periods of, 147

Growth disorders

choline deficiency and, 216

in diabetics, 372

monitoring of children for, 44

Guanine, 441

Guanosine 5'-diphosphate, 146

Guar gum, 295, 298, 299, 301, 302

Gums, 62, 295;

see also specific gums

H

Ham, 56, 72, 421, 475

Hamburgers, 56

Hawaii

cancer in, 119, 207, 209, 212, 313, 332, 384, 438, 467

CHD in, 102, 164, 279

dental caries in, 128

diabetes mellitus in, 123, 149, 276

gallbladder disease and gallstones in, 126

hypertension in, 355

obesity and overweight in, 114-115, 149

serum cholesterol levels in, 163

stroke in, 104-105, 262

HDL, see High-density lipoproteins

HDL cholesterol

alcohol intake and, 443

atherosclerotic cardiovascular disease and, 117

at birth, 224

body weight and, 146, 148

carbohydrates and, 276, 278

CHD risk and, 151, 166-168, 169, 177-178, 224, 376

cholesterol intake and, 199-200, 223

fiber and, 294, 295, 300, 302

food sources of, 187

individual differences in, 166-168

lecithin and, 217

MUFAs and, 8, 184, 228, 657

obesity and, 146

population differences in, 166, 177-178

PUFAs and, 8, 188, 189, 227, 657

serum cholesterol and, 181, 185, 198

SFAs and, 189

stroke and, 175

trace elements and, 370, 382, 383, 515

triglyceride levels and, 170

Health and Nutrition Examination Survey, 45;

see also National Health and Nutrition Examination Surveys

Health foods, 76

Health professionals, dietary supplement use by, 512-513

Health promotion, defined, 99

Heart diseases, see Cardiovascular diseases; Coronary heart disease

Heart rate, energy expenditure and, 141;

see also Cardiac function

Heat exhaustion, 414

Height

trends in, 52, 77

of vegetarians, 77

Hemicellulose, 291-293, 300

Hemochromatosis, 88, 92, 94, 95, 124, 368, 668

Hematopoietic cancers, 393

Hemoglobin

intermittent claudication and, 107

as iron nutritional status indicator, 50

obesity and, 579

Hemostasis

atherosclerosis and, 190

fish oils and, 185-186

Hepatic cancer, see Liver cancer

Hepatitis

aflatoxins and, 487

alcoholic, 10, 124, 660

liver cancer and, 438-439, 441, 487

viral, 119, 124, 339, 438-439, 441, 487

Hepatobiliary disease, 124-125, 676;

see also Alcoholic cirrhosis; Cirrhosis of the liver; Gallbladder disease; Gallstones; Liver disease

Hepatorenal syndrome, 447;

see also Liver disease; Renal disease

Heterocyclic amines, 485-486

Heterozygosity

in familial hypercholesterolemia, 86

in hemochromatosis, 92

possible effects of, in metabolic disorders, 86-87, 94, 95

High blood pressure, see Blood pressure; Hypertension

High-density lipoproteins (HDL)

alcohol intake and, 443, 444

carbohydrates and, 278-279

CHD and, 88, 107, 168

composition of, 163

PAD and, 107, 175

physical exercise and, 146, 443

PUFA effects on, 188

triglyceride levels and, 170

see also HDL cholesterol

High-fructose corn syrup (HFCS), 58, 59, 273, 274, 654

Hispanic Health and Nutrition Examination Survey, dental caries, data from, 128

Hispanics

alcoholic cirrhosis in, 125

cancer incidence among, 119

dental caries in, 128

diabetes mellitus in, 123

gallstones in, 126

Histidine, 259, 331

Historical food supply (USDA)

data gathering for, 42

nutrients and food constituents reported in, 47, 273-274, 347-348

nutritive value calculations, 42

per-capita use estimation, 42

uses of data from, 44

HLA, see Tissue histocompatability antigen

Hodgkin's disease, 337, 377, 483

Homeostasis, dietary fat intake and, 8, 190-192

Honey, 76

Hong Kong, cancer in, 212

Hopi Indians, 435

Hormonal status

bone mass and, 121, 350

breast cancer risk and, 117, 153, 207, 210, 214, 384

CHD and, 102

endometrial cancer and, 120

energy expenditure and, 142, 153

osteoporosis and, 69, 264, 316-318, 350, 354, 620

and responses to ethanol intake, 442

serum lipid and lipoprotein levels and, 185, 224

stroke and, 104

Hot dogs, 56

Human studies

animal studies compared to, 35-36

atherosclerosis, 333

biotin, 340

cancer, 334-340

CHD, 333, 533-534

evaluation of evidence from, 652-653

folacin, 338-339

hyperlipidemia, 533

hypertension, 340, 550-552

liver disease, 334-336, 337-340

niacin, 336

pantothenic acid, 340

problems in weighting of, 4, 35

PUFA effects on HDL levels, 188

riboflavin, 334-335

sodium sensitivity, 420

stomach cancer, 420-421

thiamin, 334

vitamin B6, 337-338

vitamin B12, 339-340

vitamin C, 331-332, 333, 334

see also Case-control studies; Clinical studies and trials; Community trials; Cross-sectional studies; Dietary data; Epidemiologic evidence, studies, and cohorts; Intervention studies; Longitudinal (cohort) studies; Observational studies

Hungary, CHD in, 100-101

Hycanthone, 477

Hydrazines in mushrooms, 12, 487, 662

Hydrogenation of oils

atherosclerosis and, 195-196

CHD and, 193

essential fatty acid content, 187

trans fatty acid formation during, 57, 160, 186

product labeling for, 58

purpose, 186

serum cholesterol and, 186, 189

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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25-Hydroxycholesterol, 201

5-Hydroxyeicosapentaenoic acid, 190

5-Hydroxyeicosatetraenoic acid, 190

1-Hydroxymethyl-1, 2-dehydropyrrolizine, 488-489

Hypercalcemia, 354, 355, 360

Hypercalciuria, 355

Hypercarotenemia, 314

Hypercholesterolemia

animal studies of, 33, 161, 171, 189, 201, 228

atherosclerosis and, 176

carbohydrates and, 275

cholesterol intake and, 176, 189, 197, 201, 228

clinical studies of, 195, 197

complications of, 176

CHD and, 88, 167, 172

cross-sectional studies of, 181

fiber and, 295, 296

genetic disorders of lipoprotein metabolism, 171

hydrogenated vegetable oils and, 296

liver cholesterol content in, 188

protein and, 260, 261, 265

serum cholesterol and, 195, 197, 217, 260

SFAs and, 176, 183

sterol excretion and, 188

trace elements and, 380

treatment of, 217

see also Familial hypercholesterolemia

Hyperglycemia, 149-150, 275-277, 299-300, 382, 383, 446

Hyperinsulinemia, 277, 300

Hyperkeratosis, 335

Hyperlipidemia

alcohol intake and, 443-444

animal studies of, 295-296

carbohydrates and, 277

clinical and metabolic studies of, 295, 533

CHD and, 6, 171, 533

dietary cholesterol and, 200

epidemiologic studies of, 294-295

fiber intake and, 294-296

genetic and familial factors in, 86, 88-89, 93, 94, 168, 668

postprandial, 443

triglyceride levels and, 171, 443

see also Familial combined hyperlipidemia

Hyperlipoproteinemia, biologic markers for, 170

Hyperparathyroidism, 354, 355, 358, 360

Hyperphagia, 145, 221-222, 276

Hyperactivity, carbohydrates and, 283

Hypertension

age and, 108, 109-111, 202, 660

alcohol intake and, 10, 16, 108, 415, 420, 442-443, 552, 660, 673, 681

angiotensin-salt, 418

animal studies of, 33, 204-205, 262, 340, 356, 359, 375, 390, 394, 417-418, 553

atherosclerosis and, 176

atherosclerotic cardiovascular diseases and, 107, 112-113, 415, 549

blood pressure levels, 107, 415

body fat distribution and, 16, 144, 659

body weight and, 10, 16, 108, 112. 420, 550, 659, 673

borderline, 107, 415, 417, 549

cadmium and, 389-390, 515, 552, 553

calcium and, 17, 355-356, 360, 553, 685

cerebral hemorrhage and, 194

CHD and, 101, 107, 535

chloride and, 423-424

choline deficiency and, 216, 217

classifications, 107, 549-550

clinical studies of, 10-11, 262, 300, 355-356, 394, 417

complications of, 107

country differences in prevalence of, 104, 108

deaths, 107, 109, 112-113

defined, 107, 414-415, 549-550

detection and control of, 29, 108, 109

diabetes mellitus and, 124

diagnosis of, 107

energy intake and, 149

environmental factors in, 88, 89, 111-112, 554

epidemiologic evidence on, 109, 261-262, 300, 355, 358-359, 389-390, 394, 415-417, 422-423

fat/lipid intake and, 201-205

fiber and, 9, 300, 302, 552, 658

genetic and familial factors in, 11, 16, 88, 89, 94, 95, 112, 415, 416-418, 420, 424, 554, 660, 668, 674, 681

genetic marker for, 419, 424

glomerular capillary, 265

human studies of, 201-204, 340, 550-552

incidence measures, 29

intermittent claudication and, 107

isolated systolic, 105, 549

kidney disease and, 107, 418, 422

lead and, 394, 395, 552, 553

magnesium and, 358-359, 552

mechanisms for development of, 262, 418-420

obesity and, 108, 117, 149, 415, 420, 550, 572-573, 659, 676

occupational factors in, 112

PAD and, 107, 113, 538

pantothenic acid and, 340, 552, 553

pediatric antecedents to, 555

physical activity and, 108, 112, 555, 673

population-attributable fraction of cases, 109

population differences in, 108, 414

potassium and, 202, 415, 416, 418-419, 422-423, 424, 551, 553-555, 685

protein and, 9, 261-262, 659

psychosocial factors in, 112, 420, 554-555

public information programs on, 77

PUFAs and, 552

racial, ethnic, and migrant differences in, 11, 89, 95, 105, 111-112, 149, 394, 419, 420, 554-555, 660

risk factors for, 108, 109-112

salt/sodium and, 10-11, 16-17, 33, 77, 80, 89, 95, 108, 112, 202, 204-205, 414-420, 423, 551, 553-555, 660, 668, 674, 681, 685

sequelae, 29, 655

serum cholesterol and, 18, 194, 693-694

severe, 107

sex differentials in, 110-111, 442

SFAs and, 552

socioeconomic status and, 112, 555

stroke and, 104, 105, 107, 113, 415, 539-540, 693-694

time trends in frequency and mortality, 108-109

trace elements and, 370, 375, 390, 552, 553

treatment of, 420, 660

U.S. prevalence of, 105, 414

vegetable intake and, 203

see also Blood pressure

Hypertensive heart disease, 107

Hyperuricemia, 447

Hypertriglyceridemia

borderline, 170

carbohydrates and, 274, 276, 278

fish oils and, 185

low-fat, high-carbohydrate diets and, 185, 275-276

pancreatitis and, 170

peripheral vascular diseases and, 175

PUFAs and, 218

sterol excretion, 188

Hyperzincuria, 372, 451

Hypocholesterolemia, 182, 185

Hypoglycemia, 283, 284, 446-447, 448

Hypolactasia, 88, 91-92

Hypolipidemia, 443

Hypomagnesemia, 358

Hypophosphatemia, 86, 357

Hypothrombinemia, 321

Hypothyroidism, 384

I

Ice cream, 18, 675

Iceland, cancer in, 384, 421

IDDM, see Insulin-dependent diabetes mellitus

Ileitis, 321

Illinois, CHD mortality rates, 102

Imaging techniques, 144

Immune system responses

alcohol intake and, 441

obesity and, 579-580

PUFA effects on, 215

and somatic mutations in, 85

trace elements and, 372, 389, 395

vitamin B6 and, 441

vitamin E and, 320

In vitro studies and methods of atherogenesis, 176-177

avian myeloblastosis virus, 389

cancer, 314, 316, 374

b-carotene and other carotenoids, 314

cholesterol esterification, 169

cholesterol measurement, 188

for eicosanoid metabolism, 191

fluoride and dental caries, 374

foam cell formation, 177

N-nitroso compounds, 476

nonnutritive sweeteners, 473

retinol and other retinoids, 316

see also Cell cultures; Mutagenicity tests: Organ cultures; Short-term studies and studies

Incidence of disease

cardiovascular disease, 113

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CHD, 100-101, 102, 113, 164-165

colorectal cancer, 118-119

endometrial cancer, 120

esophageal cancer, 118

hemochromatosis, 92

inborn errors of metabolism, 86

measures of, 29-30, 113

NIDDM, 122-123

ovarian cancer, 120

pancreatic cancer, 119

problems in assessment of, 29-30

prostate cancer, 120

stomach cancer, 118

stroke, 104

see also Epidemiologic evidence, studies, and cohorts: Population differences; and specific groups

India

alcohol intake in, 435

cancer in, 212, 296

hypertension in, 416

nutrient deficiency diseases in, 316, 381

Indonesia

CHD in, 161

vitamin A deficiency in, 316

Industrial chemicals

cleaners and disinfectants, 74

survey of exposures to, 43

see also specific chemicals

Infant formulas, 75, 223, 417

Infants and children

alcohol consumption and health effects in, 442

arterial lesions in, 222, 223-224

atherosclerosis in, 222

behavioral and learning deficits, 283, 395

blood pressure in, 204, 442

caffeine intake by, 466

caloric intake trends for, 53, 76

cancer in, 117-118

carbohydrate intake, 59, 274

cardiovascular diseases in, 222

CHD in, 222

dental caries in, 17, 127-128, 279, 685

dietary cholesterol as an essential nutrient, 225-226

dietary intakes by, 224

eating patterns of, 75-76, 685, 690

familial hypercholesterolemia in, 222

fat intake by, 14, 55, 161, 204, 222-227

fat requirements of, 226, 671

fiber intake, 62, 293, 302

hypertension antecedents in, 555

hypoglycemia in, 283, 446

lead exposure, chronic effects in, 393, 395

mineral intake trends, 69-74

obesity in, 90, 116, 685

observational studies of, 225, 226

plasma cholesterol in infants, 222-223

plasma lipids and lipoproteins in, 223-224

RDAs for, 64-73, 312

recommended dietary modifications for, 4, 226-227, 671, 678, 684-685, 690

safety of fat-modified diets for, 225-226

salt/sodium intake by, 416, 417

serum cholesterol in children, 164, 685

serum lipids and lipoproteins in, 225

sugar intake by, 59

supplement use by, 511-512

tracking of, 224-225

vitamin D deficiency in, 302, 327

vitamin E deficiency in, 320

vitamin intake trends, 64-68

see also Pediatric population

Infections, 124

Inositol, 217

Insulin-dependent diabetes mellitus (IDDM)

animal studies of, 277-278

caloric intake and, 149, 277-278

carbohydrates and, 277-278

cause, 122

clinical studies of, 277

complications of, 124

fiber and, 299, 301

genetic factors in, 89, 122

sex differences in, 123

trace elements and, 386

see also Diabetes mellitus; Noninsulin-dependent diabetes mellitus

Insulin metabolism

adiposity and, 143, 149, 152

alcohol intake and, 446

body weight and, 148, 150, 152

carbohydrate intake and, 9, 149, 275, 277, 284, 657, 658

energy expenditure and, 142, 143

energy intake and, 150

fiber intake and, 292, 299, 302

food intake and, 148, 149, 276

physical exercise and, 146, 151, 152

trace element intake and, 382, 383, 386

Inter-Society Commission for Heart Disease Resources, 676, 684, 687

Intermittent claudication

age and, 106, 107

alcohol intake and, 446

angina pectoris and, 107

atherosclerotic cardiovascular diseases and, 107, 320

blood sugar and, 106

body weight and, 107

cerebrovascular disease and, 107

characteristics of, 105

cigarette smoking and, 106, 107

congestive heart failure and, 107

diabetes and, 106

glucose tolerance and, 107

hemoglobin and, 107

hypertension and, 107

physical activity and, 107

relative risk of, 107

risk factors for, 106-107

serum cholesterol and, 107, 175

sex differentials in, 106, 107

systolic blood pressure and, 107

urinary sugar and, 106

vitamin E and, 320

International Classification of Disease

angina pectoris, 100

cancer, 117-120

myocardial infarction, 100

International Coffee Organization, 406

Intervention studies and trials

b-carotene, 314

CHD, 194, 195, 218

Cholesterol Lowering Atherosclerosis Study, 167

Coronary Drug Project, 167

experimental design, 32, 194

exposure duration in, 4, 32

Finnish Mental Hospital Study, 172-174, 195

Göteborg Multifactor Trial, 172-174, 195

Helsinki Heart Study, 167, 172-173

hypertension, 203

Hypertension Detection and Follow-Up Program, 111, 210, 318, 420

large-scale, 195

Lipid Research Clinics Coronary Primary Prevention Trial, 167, 172-173, 183, 185, 197, 198, 224

Los Angeles Veterans Administration Domiciliary Study, 172-174, 194-195

Malmo Prevention Program, 210

Multiple Risk Factor Intervention Trial (MRFIT), 165, 166-167, 173-174, 176, 194, 195, 211, 693-694

Oslo Study, 166, 167, 173-174, 195

problems common to, 4, 32-33, 37

weight of evidence from, 653

World Health Organization Clofibrate Trial, 173-174, 692

World Health Organization Multifactor Trial, 172-174, 195

see also Clinical studies and trials; Community trials

Intestinal cancer, see Colon cancer; Colorectal cancer; Gastrointestinal tract cancer; Rectal cancer

Intracerebral hemmorhage, 103, 104

Iodine

animal studies of, 384

availability in food supply, 43, 47

bioavailability of, 74

biologic role of, 383

cancer and, 383-384

endemic goiter and, 384-385, 395

epidemiologic studies of, 383-385

food sources of, 74, 383

intake trends, 74

RDA, 48

safety index for, 518

sources, 43, 74

supplements, 384

Iodophors, 74

Iran

cancer in, 118, 332, 334, 475

hypertension in, 416

Ireland

cancer in, 118, 438

CHD in, 100-101, 102

dietary recommendations in, 681, 683

obesity and overweight in, 115

plasma lipids/lipoproteins and fat intake in, 181

Iron

absorption of, 71, 77, 88, 92, 94, 301, 302, 368, 370;

see also Hemochromatosis

alcoholism and, 450

animal studies of, 368-369, 370

availability trends, 53, 70, 75, 368

biologic role of, 367

cancer and, 368-369

CHD and, 369

clinical studies of, 368

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from cooking utensils, 25

data sources on availability of, 47-48, 51, 81

enrichment of foods with, 70, 74, 75, 92, 668

epidemiologic studies of, 368, 369-370

food sources of, 70-71, 74, 77, 360

intake trends, 71, 77-79, 81

interaction with other trace elements, 379

iron-deficiency anemia and, 369-370, 668

monitoring status, 71, 74, 81

nutritional status, 50, 368

RDA, 48, 70-71, 77, 367

recommended intake of, 681, 696

safety index, 518

short-term tests of, 369

vitamin C and, 71, 77, 367, 368, 370

Iron-deficiency anemia, 77, 88, 369-370, 395

Iroquois Indians, 435

Ischemic heart disease, 197, 295, 359, 469, 690

Isoleucine, 259

Isoniazid, 88

Isosafrole, 488

Isothiocyanates, 667

Israel

cancer in, 207, 297, 298-299, 313, 468, 469

CHD in, 100-101, 164

diabetes mellitus in, 122, 123

serum cholesterol in, 469

Italy

alcoholic cirrhosis in, 125

cancer in, 118, 207, 313, 468, 480

CHD in, 100-101, 164

hypertension in, 442

plasma lipid/lipoproteins and fat intake levels in, 179-180

serum cholesterol levels in, 163

J

Jamaica, osteoporosis in, 352

Japan

alcoholic cirrhosis in, 125

cancer in, 118, 212, 263, 313, 389, 392, 421, 438, 467, 475, 488, 489

CHD in, 100-101, 102, 104, 164, 445

dental caries in, 127, 279

dietary recommendations in, 683, 687-688

diabetes mellitus in, 123, 149, 276

diverticulosis in, 300

gallbladder disease and gallstones in, 126, 127, 218, 300

hyperlipidemia in, 443

hypertension in, 104, 108, 340, 389

Minamata disease in, 391

neurological disorders in, 387

obesity and overweight in, 114-115, 149

osteoporosis in, 352

plasma lipid/lipoproteins and fat intake levels in, 180

serum cholesterol levels in, 163, 166

stroke in, 103, 104, 105

Jaundice, 320, 339

Joint Nutrition Monitoring Evaluation Committee, 44, 62, 64-68, 81, 107, 329, 331, 667

K

Kaempferol glycosides, 469, 488

Kentucky, CHD in, 102

Keshan disease, 376

Ketoacidosis, 124

Kidney disease, see Renal disease

Know Your Body Program, 225

Korea, hypertension in, 108, 416

Kahweal palmitate, 467

L

Laboratory animals

ACI rats, 489

action of dietary fat in, 214-215

African green monkeys, 220

albino iron-deficient rats, 369, 370

albino mice, 380

baboons, 188, 189, 196, 200, 216, 220, 223, 227, 261, 335, 337, 441, 448, 449, 532

Balb/c mice, 333, 368-369, 372, 477, 485

B6C3F1, mice, 477, 484

cats, 354, 388

CD/I mice, 470

cebus monkeys, 189, 220, 320

CF/I mice, 476

Charles River mice, 473-474, 485

Charles River rats, 472, 478

chickens, 200, 216, 295, 322, 418, 484

cows, 374, 375

cynomolgus monkeys, 196, 200, 320, 532

Dahl rats, 204, 417, 418, 423, 424

desert sand rat, 150, 152, 276, 386

diabetic mice, 152, 277, 278, 574

dogs, 33, 152, 176, 200, 216, 219, 354, 375, 398, 392, 418, 474, 484, 486, 532

ducks, 487

Fischer 344

rats, 333, 336, 476, 484, 487

genetically obese rodents, 143, 146, 277

goats, 200

ground squirrels, 220

guinea pigs, 33, 200, 333, 385, 532

hamsters, 171, 187, 216, 219, 319-320, 333, 371, 440, 472, 476, 477, 481, 482, 484, 487

Holtzman albino rats, 336

horses, 390

macaques, 449

mice, 91, 150, 152, 200, 216, 219, 220, 276, 277, 282, 299-300, 314, 317, 319-321, 332, 336-338, 340, 354, 378, 387, 391, 392, 421, 439, 440, 469, 472, 473, 478, 482, 484, 487

obese, glucose-intolerant rodents, 152

obese monkeys, 152

Okamoto-Aoki spontaneously hypertensive rats, 204

Osborne-Mendel rats, 470, 471, 484

prairie dogs, 219-220

prediabetic rats, 276

primates (nonhuman), 33, 152, 159, 176, 188, 189, 196, 200, 219, 220, 223, 227, 228, 375, 382, 418, 424, 448, 532

quail, 484

rabbits, 33, 161, 171, 177, 189, 196, 200, 204, 205, 217, 219, 261, 295, 333-334, 369, 382, 388, 423, 532

rats, 33, 91, 145, 146, 149, 150, 152, 176, 196, 200, 204, 213, 216, 217, 221-222, 223, 262, 264, 265, 276, 280, 296, 298, 300, 317, 319, 335-340, 354, 359, 368, 370, 374, 376, 378, 379, 381, 382, 384, 386-392, 395, 421, 424, 436, 439-443, 447, 448, 468, 472, 473, 476, 481-484, 487, 489, 532,

rhesus monkeys, 171, 189, 196, 200, 354, 385, 449, 472, 532, 641

riboflavin-deficient mice, 441

Sherman rats, 480

Sprague-Dawley rats, 204, 205, 222, 278, 386, 387, 423, 470, 472, 474, 484

spiny mouse, 150, 276

spontaneously hypertensive rat, 149, 204, 205, 262, 281, 356, 359, 418, 423, 424

spontaneously obese rodents, 145, 574

squirrel monkeys, 188, 189, 200, 220

streptozotocin-diabetic rats, 277, 278, 300

stroke-prone rats, 423

swine, 33, 90, 150, 200, 216, 223, 276, 418, 424, 532

Swiss mice, 391, 393, 394, 472, 484

trout, 487, 490

vervet monkeys, 189, 196, 200, 295, 532

Watanabe heritable hyperlipidemic rabbit, 171, 177

while leghorn cockerels, 389

Wistar rats, 152, 153, 222, 276, 277, 333, 359, 369, 389, 393, 468, 474, 477, 484, 574

Wistar-Kyoto rats, 204, 205, 356, 418

Wistar-Schonwalde rats, 204

Yucatan miniature swine, 150, 276

see also Animal models; Animal studies

Laboratory experiments, see Animal studies: Cell cultures; In vitro studies and methods; Mutagenicity tests; Short-term tests and studies

Lactase deficiency, 284

Lactose, 273

Lactose intolerance/malabsorption

ecogenetic nature of, 88, 92

carbohydrate intake and, 283-284

defined, 86

pathophysiology of, 91

policy implications of, 92

Laennec's cirrhosis, see Alcoholic cirrhosis

Lamb, 208

Lard and beef tallow, 57, 160, 214

Lauric acid, 13, 183, 184, 189, 227, 670

Laryngeal cancer, 10, 313, 332, 333, 437, 660

LDL. see Low-density lipoproteins

LDL cholesterol

apolipoproteins and, 168

atherosclerosis and, 171, 172, 223-224, 657

body weight and, 146

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carbohydrates and, 276, 278, 671

CHD and, 166-168, 171, 172, 178, 657

cholesterol intake and, 8, 13, 171, 199, 228, 657, 670

coffee and, 469, 470

familial hypercholesterolemia and, 171, 217, 260

fiber and, 295-296, 302

food sources of, 187

individual differences in, 166-168

intrinsic and extrinsic determinants of, 181

lecithin and, 217

lipid intake and, 181

MUFAs and, 8, 13, 184, 189, 228, 657, 671

population differences in, 166

protein and, 260

PUFAs and, 8, 182, 185, 189, 227, 657, 671

serum cholesterol and, 179, 181, 182, 183, 197, 199, 201, 227

SFAs and, 7-8, 13, 171, 183, 189, 227, 228, 656, 670

stroke and, 175

vegetarianism and, 8, 658

Lead

animal studies of, 393-394, 395

atherosclerotic cardiovascular diseases and, 393

biologic markers of intake, 29

biologic role of, 392-393

cancer and, 393-394

chronic effects in children, 393, 395

clinical studies of, 394-395

epidemiologic studies of, 393, 394-395

hypertension and, 394, 395

permissible levels of, 393, 395

renal diseases and, 394-395

short-term tests of, 394

sources of exposure to, 393

Lecithin, 160, 216, 217, 261

Lectin, 196, 291, 674

Legumes, 8, 13-15, 18, 54, 62, 65, 66, 72, 74, 259, 260, 273, 293, 295, 370, 490, 670-672, 678;

see also Dried beans, peas, nuts, and soybeans

Lettuce, 208, 297, 490

Leucine, 259

Leucotrienes, 214

Leukemias, 117-118, 150

Leukopenia, 315

Lignin, 291-293, 301

Linoleic acid

in adipose tissue, 203

availability trends, 54, 55, 654

blood pressure and, 202, 204, 205

cancer and, 208, 213, 227

data sources on availability of, 47

food sources of, 55, 56, 184, 213-214, 223

hydrogenation of, 186

infant requirements for, 226

intake trends, 56, 160

trans isomers of, 187

protective effects of, 208, 227-228

recommended intake of, 672

structure of, 159, 184

see also w-6 Polyunsaturated fatty acids

a-Linolenic acid, 159, 204

Linseed oil, 204

Lipids and lipoproteins (dietary) atherosclerosis, 29, 169, 200

atherosclerotic cardiovascular diseases and, 6, 33, 42, 161-201

availability trends, 160

apolipoproteins and, 162

characteristics of, 159, 162, 163, 200

CHD and, 86, 88-89, 93, 103, 571-572

classes of lipoproteins, 162;

see also Chylomicrons; High-density lipoproteins; Low-density lipoproteins; Very-low-density lipoproteins

clinical and metabolic studies of, 182-189

data sources on availability of, 47

dietary cholesterol and, 199-200

fiber intake and, 294

intermediate density, 168

metabolism of, 199-200, 571-572

MUFA intake and, 184

nutrition-gene interactions, 89, 93, 95

obesity and, 571-572

peripheral vascular diseases and, 175

postprandial, 200

protein intake and, 261

PUFA intake and, 184-186

research needs on, 95

SFA intake and, 182-184

stroke and, 175-176

surveys of intake, 160-161

see also Dietary cholesterol; Fats; Fatty acids; Oils; Phospholipids; Serum or plasma lipids; Serum or plasma cholesterol; Triglycerides

a-Lipoprotein cholesterol, see HDL cholesterol

b-Lipoprotein cholesterol, see LDL cholesterol

Lipoprotein lipase, 143, 163

Liquor, see also Alcohol consumption; Alcoholic beverages; Alcoholism and alcohol abuse

Liver (food), 64, 65, 67, 70, 160, 311, 312, 315, 330, 381, 388

Liver cancer

aflatoxins and, 119, 596-597, 601

age and, 119

alcohol and, 10, 438-439, 440, 441, 597

animal studies of, 150

arsenic and, 392

bracken fern toxins and, 489

caloric intake and, 150

carbohydrates and, 282-283

cirrhosis of the liver and, 438-439, 597

coffee and tea and, 468-469

cycasin and, 489, 596

epidemiologic studies of, 596-597

folacin and, 338

food additives and, 476, 477

hepatitis B infection and, 119, 438-439, 441, 596-597

incidence of, 119, 593, 596-597

PCBs and, 479-480

phospholipid deficiencies and, 216

pyrrolizidine alkaloids and, 488-489, 596

safrole and, 596

sex differences in, 119

socioeconomic status and, 119

trace elements and, 377, 381

vitamin B6 and, 337

vitamin B12 and, 339

vitamin C and, 352

Liver disease

alcohol intake and, 16, 124-125, 447-448, 660, 673;

see also Alcoholic cirrhosis

animal studies of, 335-336, 338, 340

biotin and, 340

causes of, 124

cell regeneration and, 124

fatty liver, 10, 124, 216, 340, 448-449, 660

folacin and, 338

HDL levels and, 443-444

human studies of, 321, 334-336, 337-340, 448

hypolipidemia and, 443-444

niacin and, 336

nutritional factors in, 216, 446-447

pantothenic acid and, 340

parenchymal, 321

riboflavin and, 335-336

thiamin and, 334

vitamin B6 and, 337, 341

vitamin B12 and, 339-341

vitamin E and, 321

vitamin K and, 321

see also Cirrhosis of the liver

Locust bean gum, 291

Longitudinal (cohort) studies

calcium intake and bone mass, 352

cancer, 207, 211, 439, 467

CHD, 102, 192

cholelithiasis, 218

dietary cholesterol and serum cholesterol, 197

dietary intake assessment for, 27, 208, 224

energy intake and body weight, 144

H. J. Heinz Company, 224

methodology, 32

multiphasic health examination program, 439

renal disease and, 447

strengths and weaknesses of, 32, 81, 208

weight of evidence for causation, 35, 52

Los Angeles, lung cancer in, 119

Louisiana, cancer in, 475

Low-calorie diets

life-span effects of, 583

nutrient levels in, 52

Low-density lipoproteins (LDLs)

alcohol intake and, 444

atherosclerosis and, 176, 198

in atherosclerotic lesions, 169

carbohydrates and, 278-279

CHD and, 86, 88, 107, 168, 444

colon cancer and, 211

composition of, 163

endothelial cell injury from, 177

foam cell formation and, 176-177

hepatic receptor activity, 189

measurement of, 198

PAD and, 107

physical characteristics and properties of, 176, 187

receptor activity of, 176, 177, 187-189, 199

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receptor defects in, 86, 88-89, 171

serum cholesterol and, 185

see also LDL cholesterol; Plasma or serum lipids and lipoproteins

Low-fat diets

cancer risk and, 6

hypertension and, 203

protective effects of, 8-9

safety of, for children, 225

serum cholesterol concentrations, 32

see also Diets

Low-income populations

dietary intake and nutrition surveys of, 42, 44, 293;

see also National Health and Nutrition Examination Surveys

fiber intake of, 293

meat intake by, 63

see also Socioeconomic status

Luncheon meats, 56, 72, 80

Lung cancer

age and, 119

arsenic and, 392, 395

b-carotene and, 9, 313, 314, 322, 488, 514, 658

cholesterol intake and, 210, 598

cigarette smoking and, 322, 576, 593, 597-598

fat intake and, 598

food additives and, 476

human studies of, 153, 211, 313, 597-598

incidence of, 29, 119

lead and, 393

mercury and, 391

mortality rates, 119, 211, 655, 691

niacin and, 336

occupational exposures and, 381, 598-599

population differences in, 119, 598

prevention of, 19

protective dietary components for, 8, 9, 15, 313-316, 322, 377, 488, 657, 672, 598-599

racial and ethnic differences in, 119

serum cholesterol and, 211

sex differences in, 119, 598

socioeconomic status and, 119

trace elements and, 368, 377, 378, 380-381, 387, 389, 395

vitamin A and, 313, 315-316, 322, 488, 514, 598

vitamin B12 and, 339

vitamin C and, 332, 341, 598

vitamin E and, 318, 319, 322

Lupus erythematosus, 490

Lycasin, 281

Lymphoma, 318

Lysine, 259, 261

M

Macrophages

cholesteryl ester production by, 169, 176

cultured, 176, 177, 387

foam cell, 176, 177

mouse peritoneal, 169

plasma lipoprotein interaction with, 176

Magnesium

alcoholism and, 451

animal studies of, 359

availability trends, 53, 70, 347-348

biologic role of, 347, 349, 358, 661

blood pressure and, 360

cancer and, 334-336, 380

CHD and, 359

data sources on availability of, 47-48

epidemiologic studies of, 358-359

fiber and, 301

food sources of, 70, 74, 349

hypertension and, 358-359

hypomagnesemia and, 358

intake trends, 70, 77-79, 81, 349, 359

RDA, 48, 70

safety index, 518

Maize, 280

Malnutrition

alcoholism and 448, 450

blood pressure and, 261

energy intake and, 139

liver disease and, 448

see also Nutritional inadequacies and deficiencies

Malonaldehyde, 378

Malondialdehyde, 177, 190

Maltose, 273

Manganese

Alzheimer's disease and, 386

animal studies of, 385-386

biologic role of, 385, 386

cancer and, 380, 381, 385

CHD and, 386

clinical studies of, 385

data sources on availability in food supply, 47

diabetes and, 385-386

epidemiologic studies of, 385

ESADDI, 48, 385

food sources of, 385

mutagenicity of, 385

nutritional status, 74

short-term tests of, 385

toxicity, 385

Mania, 217-218

Maple syrup, 273

Margarine, 55-58, 64, 74, 75, 80, 160, 186, 187, 196, 480

Market Research Corporation of America, 466

Maryland

cancer in, 313

CHD in, 102

Massachusetts

cancer in, 313

CHD in, 102, 445

obesity and overweight in, 115

see also Framingham Study

Mayonnaise, 56, 58

Meat loaf, 56

Meat, poultry, and fish group

availability trends, 57

intake trends, 54, 65-66, 654

nutrient contribution of, 54, 56, 58, 63, 65-66, 70, 71, 74, 160, 260, 330, 331, 349, 368

recommended intakes of, 18, 670

Meats and meat products

atherosclerosis and, 161, 658-659

cancer and, 208, 209, 263, 264, 303, 659, 673

cholesterol intake from, 161

CHD and, 15-16, 192, 673

contaminants in, 391

creatinine excretion, 28

cured, 72, 475

fat content of, 13, 16, 41, 56, 159, 161, 179, 671

fortification of, 75

in frozen and canned entrees and dinners, 72

intake trends, 76

mineral content of, 14, 70, 71, 77

processed, 76

protein intake from, 15-16, 41, 62, 259

recommended intakes of, 13, 16, 18, 670, 675, 681

soybean analogs of, 42

stroke and, 193

vitamin content of, 65, 331

wild game, 41

see also Meat. poultry, and fish group; Red meats; and specific meats

Melons, 329

Memory impairment, 216

Menhadden oil, 213

Mercury, 390-391, 518

Metabolic disorders

alcoholism and, 93, 446-449

carrier heterozygotes for, 86-87, 94

nutritional management of, 86

research needs on, 87, 95

uric acid, 447

see also specific disorders

Metabolic efficiency

ethanol intake and, 436

mechanisms for, 143

in obesity, 10, 568, 659

during pregnancy, 147

thermogenesis and, 152

Metabolism

of brown adipose tissue, 147

of carcinogens, 91

DNA, ethanol and, 440-441

eicosanoid, 190-192

energy balance and, 143

fatty acid, 331

food intake and, 149

genetic determinants of, 142

inborn errors of, 85-87, 93, 94, 95;

see also Metabolic disorders

lipoprotein, 185

of minerals for bone formation, 615

rate measurement, 141

retinoic acid, 451

Methionine, 216, 259, 261, 331, 338, 339, 448

Methodological considerations

accuracy, 25-26

animal studies, 4, 35, 37, 150, 200-201, 260, 278, 280, 378

in assessing dietary intake, 21, 23-28, 29, 181, 197, 198, 205, 207, 208, 264, 295, 330, 351, 378, 652

averaging across subjects in individual correlations, 31

biologic plausibility of causal association, 37

case-control studies, 31, 193, 470, 653

clinical investigations, 32-33, 174-175

combining information from separate studies, 28

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committee criteria for evaluating studies, 4-5, 28, 36-37, 652-654

comparing studies of different size, 163

confounding/confounders, 30-31, 172, 185, 186, 192, 194, 197, 204, 205, 224, 228, 274, 656

consistency of association across studies, 37

cross-sectional studies, 181, 204, 228, 415

discrepancies between ecological and individual correlations, 31

epidemiologic studies, 197

evaluating evidence, 23-38, 652-653

experimental design, 32, 378

exposure duration, 32

fiber-disease studies, 294, 295

individual correlations, 31, 37

inferring causality, 5, 34-37, 38, 652

intercorrelation among dietary variables, 263, 656

intervention studies, 32-33, 653

laboratory experiments, 4, 33-34, 36

lipoprotein cholesterol measurement, 166, 200

longitudinal (cohort) studies, 32, 193, 653

medical genetics research, 87-88

misclassification, 21, 27, 30-32, 193, 652

reliability, 26, 31, 197

reproducibility, 27, 67

responsiveness to dietary components, 199

sample size, 26, 163, 178

single-study evaluations, 28-34, 652

specificity of association across studies, 37

strength-of-association assessments, 36, 38

temporal relationships, 30-32, 36-37, 577

weight studies over time, 577

see also Dietary data; Dose-response relationships; Epidemiologic evidence, studies, and cohorts

Methotrexate, 321

Methyl cellulose, 291

Methyl mercury, 390

3'-Methylaminoazobenzene, 283

MethylbenzyInitrosamine, 387, 442

Methylcholanthrene, 264, 319, 332, 333, 369, 383, 477

Methylcyclopentadienyl manganese tricarbonyl, 385

Methylene cholesterol, 201

Methyleugenol, 488, 489

Methylglyoxal, 467

O6-Methylguanine transferase, 440-441

Methylnitrosourea, 298, 333, 384, 387, 472, 473, 477

4-Methylpyrazole, 447

Metronidazole, 477

Metropolitan Life Insurance Tables, 114

Metropolitan Relative Weights, 114

Mexican-Americans

dental caries in, 128

gallstones in, 126

obesity in, 90

Mexico

alcohol intake in, 433

HDL cholesterol levels in, 166

peripheral vascular disease in, 391

Microsomal monoxygenase activity, 302

Migrants

alcoholic cirrhosis in, 125

cancer in, 118, 119, 207, 208, 212

CHD in, 102, 149, 178

diabetes mellitus in, 123, 149

gallbladder disease and gallstones in, 126

hypertension in, 89, 105, 111-112, 149

obesity and overweight in, 114-115, 149

physical activity in, 149

plasma lipids/lipoproteins and fat intake by, 179-181

serum cholesterol levels in, 163, 164, 178, 180, 181

strokes in, 104-105

see also Population differences

Milk and milk products

atherosclerosis and, 161

availability trends, 57, 60, 61, 69, 160

blood pressure and, 261, 355

CHD and, 192

contamination of, 392, 479, 489, 665

fortification of, 64, 74, 75, 312

intake trends, 54, 56, 60, 80, 466, 564

lactose malabsorption from, 91-92

low-fat, 18, 56, 57, 69, 160

malted milk, 273

nutrient contribution of, 18, 43, 57, 64, 65, 67, 69, 70, 73, 74, 92, 159, 161, 223, 259, 273, 311, 330, 331, 349, 357, 370, 417, 675

powdered, 392

recommended intake of, 670, 675

skim milk, 18, 69, 160, 299, 311, 675

stroke and, 194

whole milk, 18, 56, 57, 61, 64, 80, 160, 207, 311, 654, 670, 675

see also Dairy products; Infant formulas

Milk fat, 159

Minerals, dietary fiber and bioavailability of, 301;

see also specific minerals

Minnesota

cancer in, 297, 313

diabetes mellitus in, 123

hypertension in, 109

PAD in, 106

stroke in, 103, 104

Misclassification

in case-control studies, 31, 193

of disease severity, 193

of exposure, 30, 31, 32, 193

in longitudinal (cohort) studies, 32, 193

in observational studies, effects, 30, 31, 32

of respondents in dietary recall methods, 27

systematic, 30

Mississippi, CHD in, 102

Mitomycin E, 333

Mitrifonate, 477

Molasses, 273

Molybdenum

animal studies of, 386-397

biologic role of, 386

cancer and, 335, 386-387

dental caries and, 387

epidemiologic studies of, 386

ESADDI, 48, 386

excess intakes of, 386

interaction with other trace elements, 386

supplementation, 386

Monitoring priorities, 62, 63;

see also specific dietary components

Monosaccharides, 58, 208, 273, 282;

see also Fructose; Glucose

Monounsaturated fatty acids (MUFA)

availability trends, 80, 654

blood pressure and, 204

CHD and, 54

clinical and metabolic studies of, 8, 184

data sources on availability of, 47

food sources of, 13, 213, 223, 671

intake trends, 55, 161, 178

lipoprotein levels and, 184, 657, 671

protective effects of, 204, 671, 694-695

serum or plasma cholesterol and, 8, 13, 178, 184, 189, 228, 657

structure of, 159

see also Oleic acid

Mormons

cancer in, 437

reproductive effects of coffee in, 470

Mortality rates

alcoholic cirrhosis, 125-126, 435, 447

cancer, 6, 118-120, 173-174, 194, 439, 655

CHD, 6, 100-102, 151, 164-165, 173, 197, 445, 655, 690, 691

clofibrate treatment and, 173-174

diabetes mellitus, 117, 123, 149, 655

hypertension, 108-109

as indicator of disease incidence, 29

PAD, 106

patterns of, for major chronic diseases, 690-691

stroke, 103, 104, 125, 655

MUFA, see Monounsaturated fatty acids

Muffins, 73

Multiple myeloma, 339

Muscle meats, 67

Mushrooms, 12, 487, 662

Mustard greens, 69, 329, 349

Mutagenicity

aflatoxins, 487

arsenic, 392

cadmium, 389

carcinogenicity and, 12, 34, 91, 662

coffee, 469

cycasin, 489

ethanol, 440

food colors, 478-479

hydrazines, 487

lead, 394

mercury, 391

nonnutritive sweeteners, 472, 473

pesticides, 483

polychlorinated biphenyls, 480

polyvinyl chloride, 481

pyrrolizidine alkaloids, 489

salt, 421

trace elements, 369, 372, 374-375, 378, 383, 385

see also Mutagens

Mutagenicity tests

Ames Salmonella assay, 378, 392, 394, 476-478, 480, 481, 486, 487, 489

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Bacillus subtilis rec assay, 389, 392, 394, 478, 487

Drosophila melanogaster, 473, 476, 481

Escherichia coli assay, 383, 385, 389, 392, 394, 469, 478, 481

host-mediated assay, 486

limitations of, 473

platelet incorporation and fluctuation assays, 383

Saccharomyces cerevisiae assay, 394

Salmonella typhimurium assay, 369, 383, 389, 440, 469, 485, 486, 487

Schizosaccharomyces pombé assay, 481

see also Cell cultures; In vitro tests and studies; Organ cultures

Mutagens

produced in cooked foods, 485-486, 662

see also specific mutagens

Mutations

carriers of, 86-87

detection of, 87

immune system, 85

LDL receptor, 86

somatic, 85, 91

Mycotoxins, 486-487

Myocardial infarction

alcohol intake and, 444

atherosclerosis and, 161

CHD and, 164, 444

death certification classification, 100

energy intake and, 148

familial hypercholesterolemia and, 171, 176, 195

incidence of, 29, 102, 164

niacin and, 337

nonfatal, 101, 102

risk factors for, 148

serum cholesterol and, 148, 162, 165

see also Coronary heart disease

Myristic acid, 13, 184, 186, 189, 227, 670

Myricetin, 469

N

Nasopharyngeal cancer, 440

National Cancer Institute

dietary guidelines, 676, 688

public information programs, 77

National Center for Health Statistics, energy intake data from, 140;

see also Hispanic Health and Nutrition Examination Survey; National Health and Nutrition Examination Surveys

National Cholesterol Education Program, 77, 167-168, 676

National Health and Nutrition Examination Surveys

advance notification of survey, 45

bias in, 44-45, 52, 55

biochemical data collected by, 44, 51, 52, 71, 72, 108, 369, 394

body weight trends in, 115

comparability of NFCS data with, 45-48, 56, 81

description of, 42, 43, 51, 81

diet-disease studies using data from, 51-52

dietary intake data, 52, 54-56, 61-62, 64, 65, 73, 161, 223, 293-294, 312, 329, 331, 348, 368, 370, 510, 513

energy intake trends in, 148

food composition data in, 46-48

limitations of, 44-51, 52, 81

methods of assessing dietary intake, 27, 45-46, 50

missing data in, 45

nutrients and food constituents reported in, 47, 51, 63-74

populations represented by, 44-45, 49, 51, 223

problems in assessing nutritional status, 49-51, 81

standards of dietary adequacy used in, 48-49

use of data in other studies and surveys, 43, 44, 80, 202, 207, 351, 355, 394

see also Continuing Surveys of Food Intakes of Individuals; Hispanic Health and Nutrition Examination Survey; National Health and Nutrition Examination Surveys

National Health Examination Survey, blood pressure data from, 108

National Health Interview Survey, 61, 512

National Health Survey, dental caries data from, 127, 128

National Heart, Lung, and Blood Institute, public education programs, 77

National High Blood Pressure Education Program, 77

National Institute on Alcohol Abuse and Alcoholism, 431

National Institutes of Health

dietary recommendations, 676, 677, 685, 687

Consensus Conference on Cholesterol, 226, 676

Consensus Conference on Osteoporosis, 681

Consensus Conference on Treatment of Hypertriglyceridemia, 170

opinion surveys on health and diet, 80

National Nutrition Monitoring System, 44

National Research Council

Committee on Diet, Nutrition, and Cancer, 666, 676, 688

Committee on Nitrite and Alternative Curing Agents in Foods, 475

cyclamate reviews, 473

pesticide studies, 43

Nationwide Food Consumption Survey (NFCS)

bias in, 44, 46, 55

comparability of NHANES data with, 45-48, 56, 81

description of, 81

dietary intake data from, 52-56, 59, 60-73, 75-76, 140-141, 161, 260, 274, 293, 311-312, 329, 330, 348, 368, 370, 466, 696

energy intake data from, 148

fat intake data from, 160, 161

food composition data in, 46-48

limitations of, 44-51, 81

methods of assessing dietary intake, 45-46, 75

nutrients and food constituents reported in, 47, 62-74

populations represented by, 44-45, 81

problems in assessing nutritional status, 49-51, 81

response rates, 45

standards of dietary adequacy used in, 48-49, 52, 81

use of data in other surveys/studies, 43, 44, 75

Native Americans

alcohol intake by, 433-435

diabetes mellitus in, 123

fetal alcohol syndrome in, 449

gallstones in, 126, 218

obesity in, 90

see also specific tribes

Navaho Indians, 435

Nephrolithiasis, 354

Nephrotic syndrome, 171

Nervous system diseases and disorders

alcohol intake and, 16, 449-451, 673

aluminum and, 387-388

cancer and, 282

lead and, 395

mercury and, 391

nutritional deficiencies and, 450-451

phospholipids for treatment of, 116-117

testing of pesticides for contribution to, 43

vitamin B6 deficiency and, 516

see also specific disorders

Netherlands

cancer in, 377

CHD in, 100-101, 164, 295, 376, 445

dietary recommendations in, 681, 686, 693

energy expenditure during preganancy in, 147

hypertension in, 355

obesity and overweight in, 114-115

serum cholesterol levels in, 163, 199

Neuropathy, 124

Nevada, CHD in, 102

New Jersey, cancer in, 313

New Mexico, cancer in, 313

New York

alcoholic cirrhosis in, 447

cancer in 296-298, 357

New Zealand

bone fracture in, 121

cancer in, 119, 296, 483

dietary recommendations in, 681, 686

CHD in, 100-101, 102

hypertension in, 442

NFCS, see Nationwide Food Consumption Survey

NHANES, see National Health and Nutrition Examination Surveys

Niacin

animal studies of, 336

availability trends, 53, 66, 75

cancer and, 334-336

biologic role of, 330

data sources on availability of, 47-48

food sources of, 66, 330

fortification of foods with, 75

human studies of, 336

intake trends, 66, 77-79, 81, 330

liver disease and, 336

monitoring status, 63, 66, 81, 331

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NE, 68

pellagra and, 33

RDA, 48, 66

safety index, 518

toxicity of, 336-337, 518

Nickel, 381, 393

Nicotinamide, see Niacin

Nicotinic acid, see Niacin

NIDDM, see Noninsulin-dependent diabetes mellitus

Nitrates, nitrites, and N-nitroso compounds

animal studies of, 475-476

carcinogenicity of, 12, 331, 334-336, 339, 386, 421, 474-475, 662

in coffee, 468-469

epidemiologic studies of, 475

formation in the stomach, 474-475

mutagenicity of, 476

niacin and, 336

occurrence of and exposure to, 474-475

riboflavin and, 334

short-term tests of, 476

vitamin B12 and, 339

vitamin C and, 331, 332

Nitrogen, see Protein

Nitropyrenes, 485

Nitrosamides, 320

Nitrosamines, 9, 320, 441, 468, 474, 475, 658

Nitrosoalkylamides, 476

N-Nitrosodimethylamine, 477

Nitrosometbylbenzylamine, 371

Nitrosomorpholin, 440

Nitrosopyrrolidine, 440, 475

N-Nitrososarcosine, ethyl ester, 386

Nondairy creamers, 56, 58

Noninsulin-dependent diabetes mellitus (NIDDM)

adiposity and, 122, 123

age and, 122, 123

animal models for, 152, 276-277

animal studies of, 149, 152, 276-277

atherosclerosis and, 276, 277

body fat distribution and, 123, 659, 673

body weight and, 10, 16, 659, 673

carbohydrates and, 9, 274-277, 284, 658

clinical studies of, 275-276

complications of, 124

country differences in incidence, 122

dietary management of, 275, 676, 680

eating patterns and, 275, 276

energy intake and, 149

epidemiologic studies of, 274-275

fiber and, 299

genetic and familial factors in, 86, 89-90, 122, 123

hypercholesterolemia and, 275

hyperglycemia and, 275, 276

hypertriglyceridemia and, 275, 276

insulin resistance and, 122, 276, 277

marker for, 122

in migrants, 123, 276

mortality rates, 123

obesity and, 9, 10, 277, 655, 659, 676

physical exercise and, 152

population differences in, 276

racial and ethnic differences in, 123

research needs on, 95, 303, 630

as a risk factor for other diseases, 123

sex differences in, 123

socioeconomic status and, 123

thermogenesis and, 152

time trends in incidence of, 123, 655

U.S. incidence of, 122

see also Diabetes mellitus; Insulin-dependent diabetes mellitus

Nonnutritive dietary components, food safety laws for, 465-466;

see also Coffee and tea; Food additives; Nonnutritive sweeteners; and other specific nonnutritive substances

Nonnutritive sweeteners

animal studies of, 472, 473-474

aspartame, 473-474

cancer and, 471-474

cyclamate, 472-473

epidemiologic studies of, 471-472

evidence of chronic disease from, 471-474

occurrence of and exposure to, 471

phenylketonuria and, 474

recommended intakes of, 680

reproductive effects of, 473

saccharin, 471-472

short-term studies of, 472, 473-474

weight reduction with, 474

Noodle dishes, 72-73

Norepinephrine, 149

North Carolina, calcium intake and bone mass in, 352

Norway

cancer in, 118, 313, 438, 467, 468

CHD in, 100-101, 164

dietary recommendations in, 682, 686

hyperlipidemia in, 443

Nuclear magnetic resonance spectroscopy, 144

Nutrient densities

expression of, 148

foods eaten away from home, 75-76

SFAs, 208

vegetarian diets, 76-77, 78

Nutrient labeling, 43, 474

Nutrients

added during food preparation, 25

analytical data available for, 48

determinants of physiological requirements for, 4

genetic variability and responsiveness to, 95

individual differences in requirements for, 49

interactions of, 6

reported by national studies, 47

see also specific nutrients

Nutrition

biologic processes in, 85, 86, 94;

see also Absorption; Excretion; Metabolism; Receptor action

factors influencing, 31, 94

gene product variation and, 85-86, 93, 94

Nutrition monitoring

Coordinated State Surveillance System, 44

National Nutrition Monitoring System, 44

see also National Health and Nutrition Examination Surveys; Nationwide Food Consumption Surveys

Nutrition research

animal studies in, 33-34

controlling diet in, 32

links to agricultural research, 28

see also specific studies

Nutritional inadequacies and deficiencies alcohol intake and, 10, 16, 434, 441-442, 448-449, 450-451, 634, 660, 673

carcinogenic effects of, 441

in children, 225

groups at risk of, 81

liver injury and, 448-449

nervous system disorders and, 450-451

pattern of development, 49

impact of dietary recommendations on, 695-696

sample size needed for detection in populations, 49

see also specific nutrients

Nutritional status

age and, 51

biochemical assessment of, 50, 51

defined, 49

dietary intake trends and, 41-82

dietary supplementation and, 513-514

energy expenditure and, 153

food fortification and, 74-75

national surveys of dietary intake and, 42-52, 75

problems in assessing, 49-51, 81

supplement use and, 513-514

see also specific nutrients

Nuts

availability trends, 57

intake trends, 54, 76

nutrients in, 62, 64, 66, 67, 70-72, 259, 312, 370, 381

O

Oat bran, 278, 292, 295, 658

Oat gum, 295, 302

Oatmeal, cooked, 73

Obesity

age and, 115, 116, 144

alcohol intake and, 144, 436-437

animal models of, 276-277

animal studies of, 7, 91, 143, 145, 146-147, 221-222, 281-282, 574, 576, 577, 582

atherosclerotic cardiovascular diseases and, 10, 117, 221, 569-572, 676

blood pressure and, 112, 415, 420, 577

body fat distribution and, 565, 566, 568, 577, 578, 676

body mass index and, 90, 114, 564-566, 569, 570

body weight and, 144, 146, 567, 5755end577, 659

bone, joint, and skin disorders, 580, 659

brown adipose tissue and, 147

cancer and, 10, 117, 221, 571, 575-576, 659, 676

carbohydrates and, 9, 277, 281-282, 284, 567, 658

cardiac function and, 569, 578-579

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CHD and, 376, 535, 569-571, 578, 659

childhood adiposity and, 566, 685

clinical studies of, 7, 221, 281, 571-572, 573-574, 575, 576, 577, 579-580, 581-582

country differences in, 114-115

defined, 114, 563

diabetes mellitus and, 9, 10, 117, 276, 571, 573-574, 655, 659, 676

dietary management of, 474, 673, 676

endocrine disorders and, 581-582

energy balance and, 153, 567-568, 655, 659

energy expenditure and, 142-143, 567-568, 659

energy intake and, 9, 10, 16, 149, 220, 281, 284, 567-568, 577

energy transfer efficiency and, 143

environmental factors in, 90, 568

epidemiologic studies of, 90, 144, 220-221, 281, 569-571, 573, 575-577, 578, 579, 581

fat cell size and number and, 583

fat intake and, 7, 13, 14, 54, 144, 220-222, 229, 567, 655, 656, 670, 671

fiber and, 300

gallbladder disease and gallstones and, 7, 10, 117, 127, 218, 219, 229, 575, 656, 659, 676

genetic and familial factors in, 10, 16, 86, 87, 90-91, 94, 116-117, 415, 568-569, 659, 668

HDL cholesterol levels, 117, 146, 571

hematologic and immunologic consequences of, 579-580

hypercellular and hypertrophic, 566

hyperphagia and, 145, 568, 583

hypertension and, 10, 108, 117, 149, 415, 572-573, 659, 676

hypertrophic, 146

hypoglycemia and, 447

lipid metabolism and, 571-572, 676

measurement of, 114

metabolic efficiency and, 10, 568, 577, 659

misconceptions about, 582-583

myocardial infarction and, 148

PAD and, 107

physical activity and, 10, 140-141, 142, 144, 146, 281, 659

population differences in frequency, 114-114

pregnancy and, 580-581

prevention of, 16, 93

prospective studies of, 569-570, 578

psychosocial factors in, 116

pulmonary function and, 579

racial, ethnic, and migrant differences in, 88, 90, 114-115, 116, 149

research needs on, 95

retrospective life insurance studies of, 569-570

as a risk factor for chronic diseases, 117

risk factors for, 115-117

sex differences in, 115-116, 144

SFA intake and, 144, 567

socioeconomic status and, 116

stroke and, 578

subclinical detection of, 30

thermogenesis and, 143, 146

time trends in frequency of, 115

in the United States, 114

see also Adipose tissue/adiposity; Body fat/fatness; Body weight; Overweight

Observational studies

blood pressure, 201-202

cancer, 210

of children, 225

CHD, 533-534

compared to experimental studies, 36

criteria for evaluating, 28-29

disease incidence and prevalence assessment in, 29-30

misclassification in, 29, 30

problems common to, 29-32

serum or plasma lipids/lipoproteins, 188, 210, 225, 533-534

weight given to, 36

see also Case-control studies; Dietary intake; Longitudinal (cohort) studies

Obstructive atherothrombotic disease, 106

Occupational factors and exposures

in cancer, 12, 368, 371, 380-381, 382, 389, 391-393, 479-480, 483-484

in CHD, 102-103

environmental contaminants, 479-480

ethanol, 437

in hypertension, 112, 394

pesticides, 483-484

trace element toxicity and, 385, 388, 389, 390

trans-Octadecanoic acid, 58

Oils

availability trends, 57, 80

cholesterol intake from, 58

nutrient contributions of, 64, 159, 160

hydrogenation of, 57, 58, 160

recommended intake of, 13, 18, 670

vitamin composition of, 64

see also Salad and cooking oils; Vegetables fats and oils; and specific oils

Oklahoma, CHD in, 102

Oleic acid

availability trends, 54, 654

cancer and, 207, 209, 213

data sources on availability of, 47

food sources of, 55, 184, 213

hydrogenation of oils rich in, 186

intake trends, 56

serum cholesterol-lowering poperties, 184, 228

structure of, 159

Olive oil, 13, 179, 182, 184, 213, 214, 671

Olives, 72

Onions, 297

Oranges, 73

Oregon, arsenic contamination of well water in, 391

Orientals, skin reaction to alcohol, 88, 93;

see also Asian Americans; Asian Indians

Organ culture, hamster tracheal system, 316

Organ meats, 13, 388, 671

Ornithine transcarbamylase deficiency, 86

Oropharyngeal cancer, 10, 313, 319, 334, 377, 441, 437, 660

Osteoarthritis, 16, 373, 580, 659, 673

Osteoporosis and osteomalacia

age and, 121-122, 316-318, 616, 620

alcohol intake and, 10, 619, 660

animal studies of, 317, 354, 375, 619-620

biologic marker, 29

bone loss and, 350, 515. 619

bone mass and, 349-350

cadmium intake and, 17, 390

calcium and, 5, 11, 33, 317, 318, 349-355, 359, 375, 515, 616-617, 619, 654, 659, 661, 666, 674

characteristics of, 349, 615

cigarette smoking and, 621

clinical studies of, 264-265, 316-317, 351-352, 372-373, 375

diabetes and, 621

diagnosis of, 121

dietary modifications to prevent, 676, 680

drug intake and, 355

epidemiologic studies of, 264-265, 316-317, 351-352, 372-373, 375, 616-619

estrogen status and, 354, 515, 617, 620, 621

fiber intake and, 354-355, 618-619

fluoride intake and, 375, 619

genetic and familial factors in, 122, 620

hormonal status and, 69, 264, 316-317, 350, 354, 617, 620

mechanisms of action and interactions in, 317-318

medical conditions aggravating, 621-622

obesity and, 621

pathophysiological relationships in, 349-351

phosphorus and, 354, 375, 617-618, 619

previous fractures and, 621

population differences in frequency, 121, 615

protein intake and, 9, 264-265, 354, 618, 659

racial/ethnic differences in, 95, 122, 615, 620

reproductive history and, 621

research needs on, 95

risk factors for, 69, 121-122

sex and, 121-122, 615, 620

socioeconomic status and, 122

subclinical detection of, 29-30

supplementation with calcium and, 352-354, 515

syndromes, 121-122

time trends in frequency of, 121

U.S. incidence of, 121, 655

vitamin D and, 316-318, 616, 618

zinc intake and, 372-373

see also Bone density losses

Ovarian cancer

age and, 120

carbohydrates and, 282

characteristics of, 120

coffee and tea and, 468, 599

contraceptive use and, 599

defining, 120

endocrine-related, 210

epidemiologic studies of, 209, 299, 468, 599

fat intake and, 209, 210, 599

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fiber intake and, 299, 302

incidence of, 599

genetic or familial factors in, 120

obesity and, 117, 575

other cancers associated with, 118, 120, 599

population differences in, 120, 599

protein and, 264

socioeconomic status and, 120, 599

trace elements and, 377, 380

vitamin B12 and, 339

Overweight

atherosclerotic cardiovascular diseases, 117

body fat and, 146

among children, 44

clinical studies of, 152

cross-sectional studies of, 144

defined, 114

food intake and, 144

glucose tolerance and, 152

other cancers associated with, 120

physical exercise and, 16, 146, 152

prevalence of, 114, 655

sex differences in, 144

see also Obesity

Oxyphenbutazone, 322

Oysters, 71, 370

P

Pacific Islanders

cancer in, 119

CHD in, 102

diabetes in, 299

neurological disorders in, 387

obesity in, 90

PAD, see Peripheral arterial disease

Palatibility, 159, 186

Palm oils, 13, 159, 184, 205, 670

Palmitic acid, 13, 183, 184, 186, 189, 227, 670

Pancreatic cancer

alcohol intake and, 10, 438, 597, 660

carbohydrates and, 282

cigarette smoking and, 597

coffee and tea and, 468, 597

diagnosis of, 119

epidemiologic studies of, 263-264, 438, 468

fat intake and, 213, 229, 600

incidence, 597

meat consumption and, 597

niacin and, 336

population differences in, 119

protective dietary components for, 9, 215, 315, 322, 377

protein intake and, 263-264

race differences in, 119

sex differences in, 119

socioeconomic status and, 119

trace elements and, 368, 380

U.S. incidence of, 119

vitamin A and, 315, 322, 658

vitamin B12 and, 339

Pancreatitis, 170

Pantothenic acid

animal studies of, 340

cancer and, 340

data sources on availability of, 47

ESADDI, 48

human studies of, 340

hypertension and, 340

liver disease and, 340

safety index, 518

Parathyroid hormone, 316, 318, 350-351, 353, 355, 356, 360

Parkinsonian dementia, 387

Parsley, 489

Parsnips, 489

Pasta, 60, 72, 179

Pastries, 18, 56, 675

Peaches, 73, 293

Peanut oil, 187, 196

Peanuts, 67

Pears, 73, 280, 293

Peas, 57

Pectin, 62, 291, 292, 295, 298-302, 658

Pediatric population, nutrition monitoring of, 44;

see also Infants and children

Pellagra, 33

Peripheral arterial disease (PAD)

age and, 106

angina pectoris and, 107

atherosclerotic cardiovascular diseases and, 107

blood pressure and, 107, 538

body weight and, 107, 538

CHD and, 103, 107, 170

cigarette smoking and, 106, 107, 538

clinical syndromes, 105, 537-538

data scarcity on, 106

diabetes and, 106, 107, 538

diagnosis of, 105-106, 538

familial associations in, 106

glucose tolerance and, 106, 107, 538

hypertension and, 107, 113, 538

large-vessel, 107

lipoprotein levels and, 107, 538

obesity and, 107, 538

pathogenesis of, 175, 531

physical activity and, 107

risk factors for, 106-107, 538-539

serum cholesterol and, 107, 538

sex and, 105

small-vessel, 107

stroke and, 103, 105, 113

triglycerides and, 107, 175, 538-539

in the United States, 537-538

see also Intermittent claudication

Peripheral vascular diseases

in animals, 200

arsenic and, 391

blood lipids and lipoproteins and, 175

diabetes mellitus and, 124

rates of, 194

Pesticides

carcinogenicity of, 12, 43, 381, 392, 482-483, 662, 695

on fruits and vegetables, 18, 675

limitations of laboratory methods for, 43

nervous system damage from, 43

occurrence of and exposure to, 18, 392, 482, 695

public beliefs about exposures to, 43

regulation of, 43

reproductive effects in laboratory animals, 484-485

residue in foods, 391

survey of exposures to, 43

teratogenicity of, 43

testing of, 43

Phenanthrene, 441

Pharmacogenetics, 88

Phenobarbital, 440

Phenolic antioxidants, see Butylated Hydroxyanisole: Butylated hydroxytoluene

Phenylalanine, 259, 474

Phenylketonuria, 86, 474

Phenylthiocarbamide, 85

Philippines

cancer in, 487, 489

energy expenditure during preganancy in, 147

vitamin A deficiency in, 316

Phorbol ester, 215, 316

Phosphate, 70, 281, 301

Phosphatidylcholine, 191, 216-217

Phosphatidylethanolamine, 191

Phosphatidylglycerol, 160

Phosphatidylinositol, 160, 191

Phosphatidylserine, 191

Phosphoenolpyruvate carboxykinase, 386

Phosphoinositides, 217

Phospholipids, 125, 160, 216-217

Phosphorus

alcoholism and, 451

availability trends, 53, 70

biologic role of, 347, 349, 357, 661

calcium balance and, 265, 354, 357-358, 617-618

data sources on availability of, 47-48

excesses of, 357-358

fiber intake and, 301

food sources of, 70, 74, 349

hypophosphatemia and, 357

impaired absorption of, 86

intake trends, 70, 77-79, 81, 349

monitoring status, 81

nutritional status, 70, 349

osteoporosis and, 354, 617-618

RDA, 48, 70

safety index, 518

vitamin D and, 312, 316

Photosensitivity, 314

Physical activity/exercise

aerobic, 151

body fat and, 139, 144, 146, 151

body weight and, 146, 151, 152, 436, 673

bursts of, 151

cancer and, 152-153

cardiovascular function and, 151-152

CHD risk and, 16, 103, 151, 153, 536-537

diaries of, 141

energy intake and, 146, 675

food intake and, 140-141, 673

gallbladder disease and, 127

glucose tolerance and, 146, 151, 152, 153

HDL levels and, 443

hypertension and, 108, 112, 555

insulin metabolism and, 146, 151, 152

intermittent claudication and, 107

myocardial infarction and, 148

NIDDM and, 152

obesity and, 140-141, 142, 144, 281, 659

osteoporosis and, 69, 375, 621

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recommendations for, 16-18, 675, 678-680, 682-683, 696

resting metabolic rate and, 146

trace element levels and, 381

vitamin requirements and, 330

see also Energy expenditure

Phytates, 291, 368, 370

Phytoene, 314

Phytosterolemia, 201

Pickles, 72, 387, 421

Pies, 18, 56, 675

Pima Indians

gallstones in, 126, 219

diabetes mellitus in, 123

energy expenditures by, 143

obesity in, 88

Pituitary hypofunction, 150

Plains Indians, 274

Plant constituents and metabolites. toxic, 488-490

Plant foods

intake trends, 41

protective effects of, 9-10, 672

see also specific vegetables and fruits

Plant protein, 18, 259, 260-261, 262:

see also Soy protein

Plant sterols, 160, 201

Plaque, atherosclerotic

aortic, 106

creation of, 529

intermittent claudication and, 172

progression of fatty streaks to, 222, 529-530

qualitative changes with age, 530

thrombosis and, 530-531

see also Atherosclerotic lesions

Plaque, dental, 279, 280

Plasma cholesterol, see Serum or plasma cholesterol

Plasma lipids and lipoproteins, see Serum or plasma lipids and lipoproteins

Platelet function

atherosclerosis and, 190

docosahexaenoic acid and, 191

eicosahexaenoic acid and, 191

endothelial injury and, 177

hyperreactivity, 190

w-3 PUFA role in, 190-191

w-6 PUFA role in, 190

Plummer-Vinson disease, 334, 368, 441

Poland

cancer in, 118

CHD in, 100-101

Polybrominated biphenyls (PBBs), 480

Polychlorinated biphenyls (PCBs), 12, 43, 479-480, 662

Polycose, 281

Polycyclic aromatic hydrocarbons (PAHs), 12, 36, 368, 387, 421, 441, 481, 485, 662

Polycythemia vera, 339

Polynesians, pancreatic cancer in, 119

Polyneuropathy, 450

Polysaccharides, 58, 273, 291, 292, 295;

see also Fiber; Starches

Polyunsaturated fats and fatty acids (PUFAs)

animal studies of, 8, 189, 195-196, 204, 213

atherosclerosis and, 195-196

availability trends, 80, 654

cancer and, 8, 14, 174, 205, 213-214, 229, 672, 694

CHD and, 8, 54, 192

clinical and metabolic studies of, 8, 184-188, 218-219

data sources on availability of, 47

food sources of, 159, 223, 261, 672

gallbladder disease and gallstones and, 218-219

HDL cholesterol levels and, 8, 188

hydrogenated, 186

hypertension and, 204, 415

hypocholesterolemia and, 182

intake trends, 41, 55, 161, 180, 181

LDL cholesterol levels and, 8, 183, 189

lipoprotein levels from, 184-188

mechanisms of action, 187-188

obesity and, 221

plasma lipids and lipoproteins and, 189

recommended intakes of, 14-15, 185, 671-672, 675, 677-680, 682-683, 685-687

serum cholesterol and, 8, 162, 177-178, 179, 183-189, 225, 261

structure of, 159

triglycerides and, 8, 188

see also Arachidonic acid; Linoleic acid; w-3 Polyunsaturated fatty acids: w-6 Polyunsaturated fatty acids; w-9 Polyunsaturated fatty acids

w-3 Polyunsaturated fatty acids (w-3 PUFAs)

biologic role of, 159

blood pressure and, 205

cancer and, 8, 206, 213-215, 229, 657

clinical and metabolic studies of, 185-185

eicosanoid metabolism and, 190

food sources of, 8, 13, 15, 159, 192, 205, 206, 213, 227-228, 671

homeostasis and, 8, 190

lipoprotein levels and, 185-186

serum or plasma cholesterol and, 185-186, 671

serum or plasma triglycerides and, 8, 13, 657, 671

platelet function and, 191

protective effects of, 192, 206, 213, 214, 227-228, 229, 657, 671

see also Docosahexaenoic acid; Eicosapentaenoic acid

w-6 Polyunsaturated fatty acids (w-6 PUFAs)

animal studies of, 8, 205

blood pressure and, 205

cancer and, 8, 206, 213-215, 229

clinical and metabolic studies of, 184-185

food sources of, 13, 205, 213, 671

HDL cholesterol and, 8, 189, 657

LDL cholesterol and, 8, 13, 189, 657, 671

liproprotein levels and, 184-186

serum or plasma cholesterol and, 8, 184-186, 227, 657

recommended intake of, 14-15, 672

structure, 159

see also Arachidonic acid: Linoleic acid

w-9 Polyunsaturated fatty acids. see Oleic acid

Polyvinyl chloride (PVC), 480-481, 662

Population differences

alcoholic cirrhosis, 125

atherosclerosis, 164

blood pressure, 108

cancer occurrence, 117-120, 207, 209, 212

cardiovascular disease, 192-193, 197

CHD rates and risk, 100-101, 113, 164, 166, 168, 170

among/within countries, see specific countries

dental caries, 127

diabetes mellitus, 274-275, 276

dietary cholesterol intake, 197

fat intake and chronic disease, 192-193

gallbladder disease and gallstones, 126

genetic traits, 87-88

HDL cholesterol, 166

hypertension, 108

LDL cholesterol, 166

obesity, 114-115

osteoporosis, 121

plasma lipid and lipoprotein levels from fat intake, 178-181

serum cholesterol, 163-164

stroke frequency, 103-104

triglycerides, 170

VLDL cholesterol, 170

see also Epidemiologic evidence. studies, cohorts: Race or ethnicity: and specific countries

Pork, 56, 57, 63, 65, 160

Portal cirrhosis, see Alcoholic cirrhosis

Portugal

alcoholic cirrhosis in, 125

cancer in, 384, 421

Potassium

animal studies, 423

biologic role of, 421

blood pressure and, 202, 261, 355, 415, 418-419, 422-423, 424

CHD and, 422-423

data sources on availability in food supply, 47-48

epidemiologic studies, 422-423

ESADDI, 48, 73

food sources of, 15, 73, 672

hypertension and, 202, 415, 418-419, 422-423, 424

intake trends, 73, 421-422

magnesium deficiency and, 358

nutritional status, 73

protective effects of, 422, 424

recommended intakes of, 681

stroke and, 11, 15, 422-242, 660-661, 672

Potatoes

availability trends, 81

cancer and, 282, 296

fresh, 57

fried, 56

intake trends, 56, 57, 58, 293, 654

nutrient contribution of, 62, 67, 73, 259, 273

recommended intakes of, 675

processed, 57, 73, 476

starch in, 261

sweet, 82, 654

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teratogens in, 489

white, 57

Poultry

availability trends, 57, 80, 160

fat intake from, 56, 161

fortification of, 75

intake trends, 80, 63, 161

nutrients provided by, 62, 65, 71, 160, 370

recommended intake of, 13, 18, 670, 675, 681

skin, 13, 18, 160, 670, 675

Praziquantel, 477

Pregnancy and lactation

alcohol intake during, 10, 16, 449-450, 451, 660, 673, 381

body fat distribution during, 145

carbohydrate intake during, 276

coffee intake during, 470

diabetes mellitus during, 134

energy balance during, 139, 141, 147

energy expenditure during, 142, 147

food intake during, 145

gallbladder disease and, 127

metabolic efficiency during, 145

nutrient requirements during, 81

nutrition monitoring during, 44

obesity and, 580-581

osteoporosis and, 621

RDAs for, 64-73

vitamin A toxicity during, 516

vitamin requirements for, 330

Premature coronary arteriosclerosis, 86

Premenstrual syndrome, 516

Prepared foods, nutrient labeling survey of, 43

Prevalence of disease

alcoholism and alcohol abuse, 431

anorexia nervosa, 584

atherosclerotic cardiovascular diseases and, 178

bulimia, 584-585

CHD, 102

dental caries, 279

diabetes mellitus, 123

fetal alcohol syndrome, 449-450

gallbladder disease and gallstones, 126-127

hypertension, 108

iron-deficiency anemia, 369

measures of, 29-30

monitoring of, 44

obesity, 114-116

problems in assessment of, 29-30

stroke, 103-104

see also specific countries and U.S. states

Prevention

CHD, 172-175, 194-195

cholesterol absorption, 201, 229

dental caries, 280-281

large-scale trials, 172-175, 194-195

public health approach to, 6, 19, 229, 701-702

see also Dietary guidelines and recommendations; Protective effects

Prevention paradox, 93, 94

Probucol, 177

Processed foods, intake trends, 76

Prolactin, 214

Propylgallate, 441

Prospective cohort studies

cancer, 263, 313, 315, 368

CHD incidence and mortality, 164, 279, 570-571

diseases with long latency, 30

hypertension, 442

lead exposure, 395

obesity, 570-571

weight of evidence for causation, 4, 37, 653

Prostacyclin, 190

Prostaglandins, 190, 205, 214, 215

Prostate cancer

age and, 120

calcium supplementation and, 353

carbohydrates and, 282

coffee and tea and, 468

early detection of, 120

endocrine-related, 210

epidemiologic studies of, 7, 152, 153, 209, 229, 264, 468, 599-600

fat intake and, 7, 14, 206, 209, 210, 215, 600, 656, 671

hormonal status and, 600

incidence of, 593, 599-600

mortality rates, 120

obesity and, 117, 575, 600

oleic acid and, 209

other cancers associated with, 118, 600

physical activity and, 152

population differences in, 120, 600

protein intake and, 209, 264

racial or ethnic differences in, 120, 599-600

SFAs and, 8, 209, 210, 215, 229, 656

trace elements and, 371, 380, 388, 389, 514, 600

vitamin A and, 313-314, 315, 318, 600

vitamin B12 and, 339

vitamin C and, 332

vitamin E and, 318

Protective effects

BHA, 477

BHT, 441

calcium, 281, 356-357

b-carotenes and carotenoids, 15, 207, 314, 322, 332, 341, 488

cereals, 295

chromium, 277

cocoa, 281

dairy products, 207, 280, 281

fiber, 208, 295-297, 299, 302, 202, 331

fruits, 341, 488

linoleic acid, 208, 227-228

lycasin, 281

phosphate, 281

plant sterols, 201

protein, 281

w-3 PUFAs, 206, 213, 214, 215, 227-228, 229

retinoids, 315

saccharin, 281

selenium, 11, 277, 371-372, 377, 661

vegetables, 15, 207, 208, 297, 298, 341, 488

vitamin A, 488

vitamin C, 331, 341, 658

vitamin E, 332, 341, 441

xylitol, 281

Protein

age and, 16

alcohol intake and, 448, 450

animal studies of, 33, 261, 262, 264, 265

atherosclerosis and, 261, 262, 265, 658-659, 672

availability trends, 53, 80, 259-260, 654

biologic marker of, 27, 28

biologic role of, 259

blood pressure and, 261-262, 355

body mass index and, 281

calcium balance and, 9, 16, 264-265, 354, 659, 673

cancer and, 9, 108, 109, 263-264, 299, 336, 659, 673

CHD and, 9, 15-16, 260-261, 673

clinical studies of, 260-261, 262, 264-265, 618

composition of, 15, 259, 672

correlation with fat intake, 260, 263, 673

data sources on availability of, 27-28, 46-48, 51, 81, 259-260

dental caries and, 281

energy expenditure for storage as fat, 140, 151

energy intake from, 139-140

epidemiologic studies of, 260, 261-262, 263-265, 618

food sources of, 9, 18, 41, 55, 62-63, 76, 92, 259-260, 672, 675, 696

gallbladder disease and, 127

glucose tolerance and, 274

hormonal status and, 264

hypercholesterolemia and, 261, 265

hypertension and, 261-262, 659

intake trends, 15, 41, 54, 62-63, 76-79, 81, 142, 259-260, 673, 696

lipoprotein levels and, 260-261

malnutrition, 450

monitoring status, 81

nutritional value of, 259

osteoporosis and, 9, 264-265, 354, 618, 659

protective effects of, 281

RDA, 15, 62

recommended intakes of, 15-16, 17-18, 672-673, 675, 679, 680

renal disease (chronic), and 265

renal toxicity of, 264

serum cholesterol and, 260-261, 265, 659

sex differences in, 16, 62-63

stroke and, 262

vegetarian intakes of, 260, 262, 265

see also Animal protein; Plant protein

Protein kinase C, 215

Proteinuria, 276

Prunes, 73

Pseudocholinesterase variation, 88

Psoralens, 489

Psychosocial factors

CHD and, 101, 103, 537

dietary intake and, 80, 81

hypertension and, 112, 415, 420, 554-555

obesity and overweight and, 116

see also Stress

Public information programs

breast cancer, 120

dietary fat, fiber, and cancer, 77

dietary fat/saturated fat, cholesterol, and heart disease, 77

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effectiveness of, 5, 80

sodium and hypertension, 77, 80

Public opinion surveys on diet and health, 80

Puddings, 58

Puerto Rico

alcohol intake and, 437

cancer in, 297, 437

CHD in, 164, 279

hypertension in, 355

PUFAs, see Polyunsaturated fatty acids

Pulmonary function, obesity and, 579

Purine, 331

Pyridoxamine, see Vitamin B6

Pyridoxine, see Vitamin B6

Pyrrolizidine alkaloids, 488-489

Q

Quercetin, 469, 488, 489

Quetelet Index, 114, 204, 209

Quinones, 489-490

R

Race or ethnicity

adherence to dietary guidelines, 80

alcohol intake and, 61, 434-435

alcoholic cirrhosis and, 125

cancer and, 118, 119, 206

CHD and, 102

cholesterol intake and, 161

dental caries and, 128

fetal alcohol syndrome and, 449-450

gallstones and, 218

genetic predisposition to disease, 87, 88, 94, 95

hypertension and, 11, 89, 95, 105, 109, 111-112, 149, 394, 419, 420, 554

nutrient intakes by, 70-71

obesity and overweight and, 88, 90, 115-116

osteoporosis and, 620

policy implications of, 88, 93

population studies of, 87-88

strokes and, 104

see also Asians; Blacks; Hispanics; Orientals

Radionuclides, survey of exposures to, 43

Randomized clinical studies

blood pressure in vegetarians, 262

strengths of, 30-31

weight of evidence for causation, 35

see also Clinical studies and trials; Intervention studies and trials

RDA, see Recommended Dietary Allowances

Receptor action

for LDL removal, 86, 88-89, 103

model for, 86

Recommended Dietary Allowances

adequacy of intakes below, 73, 81, 348

calcium, 48, 69, 348, 350, 360

cutoff points, 49

defined, 49

energy, 148

folacin, 48, 67, 331

iodine, 48

iron, 48, 70-71, 367

magnesium, 48, 70, 349

niacin, 48, 66, 330

phosphorus, 48, 70, 357

protein, 15, 62

riboflavin, 48. 65, 330

thiamin, 48, 65, 330

use in national surveys, 48-49, 81

vitamin A, 48, 64, 311

vitamin B6, 48, 66, 330, 331

vitamin B12, 48, 67, 331

vitamin C, 67-68, 329

vitamin D, 48, 64, 312

vitamin E, 48, 64-65, 312

zinc, 48, 370

Recommended Energy Intakes, 52

Rectal cancer

alcohol intake and, 10, 438, 440, 660

carbohydrates and, 282

epidemiologic studies of, 152

fat intake and, 282

physical activity and, 152

sex differences in rates of, 118

vitamin C and, 332, 341

vitamin E and, 319

see also Colorectal cancer

Red meats, 70, 80, 160, 370, 678

Reliability, of case-control studies, 31

Religious groups, see specific groups

Renal cancer, 206, 264, 282, 333, 336, 388-389, 391, 393-394

Renal disease (chronic)

alcohol intake and, 447

animal studies of, 265

cadmium and, 390

choline deficiency and, 216

clinical studies of, 265, 394-395

diabetes mellitus and, 124

epidemiologic studies of, 265, 394-395

glomerular sclerosis, 265, 277-278

high blood pressure and, 107, 418

lead and, 394-395

protein intake and, 265

triglycerides and, 171

vitamin D and, 318

Renin-angiotensin system, 205, 447

Reproductive effects

coffee and tea, 470-471

cyclamate, 473

pesticides, 484-485

see also Pregnancy and lactation

Research needs

alcohol and alcoholism, 95, 447, 453, 542, 556, 704, 705, 706

alcoholic cirrhosis, 635

amino acids, 266, 705

animal studies, 303, 541

apolipoproteins, 89

atherosclerosis, 541-542, 703, 705

atherosclerotic cardiovascular disease, 229-230, 303, 360, 395, 541-542, 705

B vitamins, 341, 705

biologic markers of exposure, 21, 704-705, 706

blood pressure, 95, 360, 424-425, 556, 704

body mass determinants, 154, 703

BHA and BHT, 492

breast cancer, 703, 705, 706

calcium, 360, 556, 622, 704, 705

cancer, 21, 230, 284, 322-323, 341, 395-396, 492-493, 604-605, 703, 704, 705, 706

carbohydrates, 154, 284, 303, 542, 630, 644, 703, 704, 705

carcinogens, 492-493, 704, 705

b-carotene and carotenoids, 322-323, 704, 706

CHD, 284, 541-542, 630, 703, 705

children, 425

chloride, 425, 704, 705

clinical and metabolic studies, 21, 303, 322-323, 360, 541-542

coffee, 492, 704

colon cancer, 303, 705, 706

colorectal cancer, 284

competing risks, 21, 705

cooking/processing effects on foods, 493, 704

copper, 72, 396, 705

dental caries, 284, 644, 704, 705

diabetes, 284, 395, 630, 703, 705

dietary cholesterol, 541, 630

dietary fat, 154, 541-542, 703, 705, 706

dietary surveys, 21, 492, 704

dose-response relationships, 21, 705

ecogenetics, 95, 703, 704

elderly people, 154, 303

energy balance, 154, 542, 703

environmental factors in nutrition and disease, 425, 630, 703, 704, 706

epidemiologic studies, 303, 341, 360, 493, 704

fetal energy needs, 154

fiber, 81, 303, 360, 622, 630, 703, 705

fluoride, 284, 644, 704

folacin, 67, 81

food additives, 492, 706

gallstones, 220, 230-231, 635, 703, 705

genetic factors in disease and nutrition, 95, 154, 424-425, 453, 556, 605, 630, 644, 703, 705

genetic markers, 425, 453, 556, 705

HDL cholesterol, 154, 541, 703

hemochromatosis, 95

hypertension, 95, 420, 425, 556, 703, 704, 705

immune system, 396

interactions among nutrients, 21, 341, 395, 425, 705, 706

intervention studies, 21, 303, 425, 604-605, 706

lactose malabsorption, 92

lipids, 95, 541-542, 556, 703

lipoproteins, 284, 541-542, 703

liver disease, 341, 705

magnesium, 70, 74, 81, 360

metabolic disorders, 87, 95, 153, 284

methodologies, 21, 396, 604, 704

molecular and cellular nutrition, 21-22, 706

MUFAs, 541, 703

mutagens, 492-493, 704, 705

NIDDM, 95, 303, 630, 703, 705

nitrosamines, 492, 704

nonnutritive dietary constituents, 492-493, 704

nutritional requirements, 396, 705-706

obesity, 95, 230, 425, 630, 703, 705, 706

osteoporosis, 95, 360, 622, 704

PAD, 541

pancreatic cancer, 303, 705

pediatric antecedents of disease, 556

potassium, 425, 704, 706

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phosphorus, 360, 622

physical activity, 154, 706

protein, 265-266, 360, 542, 556, 622, 630, 703, 705

public health program design, 21, 706

w-3 PUFAs (fish oils), 542, 703, 705

w-6 PUFAs, 541, 703

quantitative relationships, 605, 705-706

racial/ethnic differences in disease frequency, 95, 556, 706

renal disease, 266, 447, 630, 705

responsiveness to nutrients, 95, 705

resting metabolic rate, 154

risk-altering dietary constituents, 20-21, 703-704

salt sensitivity, 95, 420, 425

SFAs, 541, 630

selenium, 323, 396, 705

serum cholesterol, 492

social and behavioral, 21, 703, 706

sodium, 424-425, 556, 704, 705, 706

stomach cancer, 303, 704, 705, 706

supplementation, 360, 520, 706

sweeteners, 81, 704

taste and olfaction, 95

thermogenesis, 146

a-tocopherol, 323, 704

trace elements, 395-396, 705

vitamin B6, 63, 66, 81, 331

vitamin C, 341, 704, 705

vitamin D, 704

vitamin E, 323, 704, 705

zinc, 72, 74, 81, 396, 705

Respiratory tract cancer. see Lung cancer; and other specific cancers

Resting metabolic rate, 141, 142, 146, 153;

see also Energy expenditure; Energy intake

Retinol and other retinoids

alcohol intake and, 441, 451

animal studies of, 315-316

cancer and, 9, 315-316, 319, 322, 334, 377, 441, 658

deficiency diseases, 316

human studies of, 315

in vitro assays, 316

mechanisms of action, 316

protective effects of, 9

toxicity, 516

see also Vitamin A

Retinopathy, 277

Retrolental fibroplasia, 320

Retrospective life insurance studies, 569-570

Rhubarb, 489-490

Riboflavin

alcohol intake and, 335, 441, 450

animal studies of, 335-336

availability trends, 53, 65, 75

biologic roles of, 330

cancer and, 334, 335, 336, 341, 371, 441, 658

data sources on availability of, 47-48

deficiency, 334, 336

food sources of, 65, 92, 330

fortification of foods with, 75

human studies of, 334-335

intake trends, 65, 77-79, 81, 330

liver disease and, 335-336

mechanisms of action in disease, 335

monitoring status, 63, 65, 81, 331

RDA, 48, 65, 330

safety index, 518

Rice, 76, 279, 300, 420

Rickets, 86, 302

Risk

CHD, 103, 165, 166-168, 170, 697-699

of excess nutrient intake, 51

of heterozygotes for nutritional disorders, 86-87, 92

of inadequate nutrient intake, 51

inferences of causality, 36

relative, defined, 36, 165

stroke, 105

Risk assessment

for body fat distribution, 144

from dietary lipid profiles, 698

for formulating dietary recommendations, 5-6, 666-667

interchangeability of methods, 26

population-attributable fraction in, 109, 697

from short-term tests, 34

Risk reduction

calculation of, 19, 109

for cancer, 699-700

for CHD, 19, 697-699

from cholesterol lowering, 19, 89, 697-699

defined, 4

for hypertension, 89, 109

population versus individuals, 6-7, 93, 652

from salt restriction, 89

Roughage, 80

Roumania, CHD in, 100-101

Rural populations

cancer in, 117, 212

CHD in, 445

hypertension in, 108, 203

serum cholesterol in, 445

S

Saccharin, 12, 281, 283, 471-472

Safflower oil, 159, 182, 184, 186, 187, 202, 203, 205, 223, 671

Safrole, 488, 489

Salad and cooking oils, 18, 55, 57, 58, 64, 160, 186, 654, 675

Salad dressings, 18, 56, 58, 675

Salami, 421

Salt

appetite centers, 413

atrophic gastritis and, 11

blood pressure and, 10, 16-17, 89, 202-205, 415-417, 422, 424, 660, 674

conversion to mg sodium, 72

depletion, 414

discretionary addition of, 414

estimation of intake of, 415, 421

excretion, 414

historical uses of, 413

hypertension and, 10-11, 16, 33, 77, 80, 89, 95, 108, 202, 203, 417-418, 420, 660, 668, 674, 681

iodized, 74, 384

preservation of foods with, 18, 421, 413

public information programs on, 77, 80

recommended intake of, 16-17, 18, 660-661, 673-674, 678-681, 686-688, 696

restricted intake, and blood pressure, 89

sensitivity, 415, 674;

see also Hypertension

stomach cancer and, 11, 17, 420-421, 674, 675, 681, 682-683

stroke and, 421

substitutes, 424

supplements, 423-424

Salt-cured (salt-pickled) foods, 11, 16, 17, 72, 421, 424, 475, 660-661, 673, 674, 675, 681, 695

San Francisco Bay Area, cancer in, 118

Satiation, 88, 159, 292

Saturated fats and fatty acids (SFAs)

animal studies of, 288

atherosclerosis and, 7, 23, 103, 195-196, 228, 656

atherosclerotic cardiovascular diseases and, 7, 13, 196, 656, 666, 670

animal studies of, 189, 195-196

availability trends, 54, 80, 564

blood pressure and, 201, 203-205

body mass index and, 221

body weight and, 144

cancer and, 5, 7, 8, 14, 174, 206-210, 215, 229, 263, 656, 671

CHD and, 5, 6, 7-8, 14, 54, 77, 93, 102, 192, 228, 656, 666, 668, 671, 694, 698-699

data sources on availability of, 47

dietary cholesterol and, 200

food sources of, 13, 16, 18, 56, 159, 204. 205. 222, 223, 670, 675

intake trends, 41, 55, 56, 81, 160, 161, 180

LDL cholesterol and, 7-8, 13, 227, 228, 656, 670

lipoproteins and, 182-184

mechanisms of action, 187-188

monitoring status, 81

nutrient densities of, 208

plasma lipids and lipoproteins and, 7, 189

recommended intakes of, 13, 14, 17-18, 226, 229, 666, 669, 670, 671, 675, 677-680, 682-683, 685-688, 692-693

serum or plasma cholesterol and, 7-8, 13, 162, 178-180, 182-189, 195, 225, 227, 228, 656, 666, 669, 670

structure of, 159

see also specific fatty acids

Saudi Arabia, alcohol intake in, 435

Sausage, 72, 421, 475

Schistosomiasis, 120

Scotland

cancer in, 384

CHD in, 100-101

energy expenditure during preganancy in, 147

hypertension in, 391

Scurvy, 33, 329, 434

Seafood, 74, 388, 391, 392

Second National Health and Nutrition Examination Survey, see National Health and Nutrition Examination Surveys

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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Seeds

intake trends, 54, 76

nutrients in, 62, 66, 70, 72, 292, 312, 349

Segregation analysis, 87

Selenium

alcohol consumption and, 376

animal studies of, 376-377, 378

atherosclerotic cardiovascular diseases and, 376-377

biologic marker of intake, 28

biologic role of, 375-376

cancer and, 11, 318-319, 322, 335, 371-372, 377-379, 602, 661, 667

cigarette smoking and, 376

clinical studies of, 376

data sources on availability in food supply, 47

epidemiologic studies of, 376, 377-378

ESADDI, 48, 74, 375

fiber intake and, 301

hypertension and, 390

intake trends, 74

interactions with other elements, 376, 390

mechanisms of action in cancer, 378-379

mutagenicity of, 378

protective effects of, 11, 277, 371-372, 378-379, 395, 661, 667

safety index for, 518

short-term tests of, 378

toxicity of, 11, 518, 661

Selenodiglutathione, 379

Serbia, CHD in, 164

Serine, 331

Serum or plasma cholesterol absorption, synthesis, and excretion of, 188-189

action of dietary components that raise, 171, 187, 195

age and, 163, 164, 177, 224

alcohol intake and, 443

apo E and, 168

atherosclerosis and, 23, 103

biologic role of, 162

body weight and, 10, 659

cancer and, 14, 18, 174, 206, 210-211, 229, 671, 692-693

carbohydrates and, 276-278

carriers of, 160

cerebral hemorrhage and, 194

CHD risk and, 6, 7, 13, 14, 19, 32, 86, 88-89, 93, 101, 102, 103, 107, 163-165, 167, 170, 172, 174, 175, 178, 195, 224, 225, 227, 228, 376, 444, 533-534, 671, 697-699, 700-701

clinical and metabolic studies of, 174, 182-189

coffee intake and, 11, 469, 662

dietary cholesterol intake and, 8, 13, 178, 189, 195, 197, 198-199, 201, 228, 357, 670

extrinsic factors in, 181-182

familial hypercholesterolemia and, 103, 171

fat intake and, 7, 178-188

trans fatty acids and, 187

fiber intake and, 9, 292, 294, 295-296, 302, 659

food intake and, 148

gallbladder disease and, 127, 217-218

hydrogenated vegetable oils and, 186, 189

intermittent claudication and, 107, 175

interventions for lowering, 172-174, 178, 182;

see also Clinical studies/trials

LDL cholesterol and, 179, 181-183, 197, 199, 201

low-fat diets and, 32

lowering effects of nutrients and foods, 8, 162, 182, 184-186, 194, 195, 217, 227, 260-261, 265

measurement of, 188

in migrants, 163, 178-181

MUFA intake and, 8, 184, 189, 229, 357

myocardial infarction and, 148, 162, 165

observational studies of, 533-534

peanut oil and, 187

population differences in, 163-164, 178-181, 195, 445

predictive equations for, 180, 182, 184, 198-199, 533

protein intake and, 260, 261, 265

PUFA intake and, 18, 184-186, 194, 195

SFA intake and, 7-8, 13, 162, 178-179, 182-187, 195, 225, 227, 228, 656, 666, 670

stroke and, 18, 175, 693-694

trace elements and, 370, 382, 515

transport of, 162

vegetarianism and, 8, 264, 294

vitamin C and, 333, 515

see also Dietary cholesterol; HDL cholesterol; LDL cholesterol

Serum or plasma lipids and lipoproteins

age and, 224

animal studies of, 189

apolipoproteins and, 168

atherosclerotic cardiovascular diseases and, 163-178, 223-224

body weight and, 148

cell receptors for, 103

childhood arterial lesions and, 223-224

in children, 223-225

dietary cholesterol and, 197

dietary intakes and, 224, 225;

see also specific foods and nutrients

dietary phospholipids and transport of, 217

ecological associations, 224

familial associations, 224

fat intake and, 93, 178-192

fish oils and, 185

functions and transport mechanisms, 160, 162-163, 217

lowering of, 172

macrophage interaction with, 176

observational studies of diet and, 225

peripheral vascular diseases and, 175

sex and, 224

stroke and, 175-176

trace element intake and, 515

tracking of, 224-225

Sesquiterpene lactone, 490

Seventh-Day Adventists

cancer in, 209, 210, 212, 263, 437, 467, 445, 446, 693, 695

CHD in, 193, 445, 446

stroke in, 194

Sex differentials

in adherence to dietary guidelines, 80

alcoholic cirrhosis, 125, 447

alcohol intake, 61, 432-433

bladder cancer, 120

blood pressure, 110-111, 442

body weight, 52

breast cancer, 119-120

carbohydrate intake, 59

CHD, 100, 102, 167, 369

cholesterol intake, 161

colorectal cancer, 118, 119, 208, 297, 438

dental caries, 127, 128

eating patterns, 75

energy expenditures, 142, 153

energy intake, 53, 59, 77-79, 81, 140, 148, 153

esophageal cancer, 118

fat intake, 54, 161

fiber intake, 62, 293-294

gallbladder disease and gallstones and, 127, 218

hemochromatosis, 92

hypertension, 110-111, 442

liver cancer, 119

lung cancer, 119

mineral intakes, 69-74, 77-79, 81

obesity and overweight, 90, 114, 115-116

osteoporosis, 121-122, 620

PAD, 106, 107

pancreatic cancer, 119

plasma lipids and lipoproteins, 224

prostate cancer, 120

protein intake, 16, 62-63, 77-79

RDAs, 64-73

stomach cancer, 118

strokes, 104

sugar intake, 59

vitamin intakes, 64-68, 77-79, 81

SFA, see Saturated fats and fatty acids

Shellfish, 13, 18, 71, 73, 370, 671, 675,

see also Seafood; and specific shellfish

Short-bowel syndrome, 321

Short-term tests and studies

advantages and disadvantages in nutrition research, 34

arsenic, 392

aspartame, 473-474

BHA, 477

BHT, 477-478

cadmium, 389

carbohydrates, 278

chromium, 383

coffee and tea, 469

cyclamate, 473

eicosanoid effect on platelet function, 191

fluoride, 374-375

food colors, 478-479

iron, 369

lead, 394

manganese, 385

mercury, 391

molybdenum, 387

mycotoxins, 487

need for, 51

(continued on next page)

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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(continued from previous page)

nitrites, nitrates, and N-nitroso compounds, 476

pesticides, 483-484

polybrominated biphenyls, 480

polychlorinated biphenyls, 480

polyvinyl chloride, 481

saccharin, 472

salt, 421

selenium, 378

uses, 34, 51

zinc, 372

see also Cell cultures; In vitro tests and studies: Mutagenicity tests: and specific tests

Shortening, 55, 57, 160, 186, 476

Sickle-cell disease, 94

Silicon, 291

Singapore, cancer in, 438

Sitosterol, 160

Skin cancer, 9, 150, 314, 315, 318, 319, 320, 332, 378, 380, 392, 395, 441, 469, 658

Skinfold measurements, 114, 143, 180, 450

Snack foods

carbohydrates in, 76

dental caries and, 280

fats in, 76

fortification of, 74

intake trends, 76

introduction of, 42

protein in, 76

sodium in, 73

Socioeconomic status

alcohol intake and, 62

alcoholic cirrhosis and, 125

cancer and, 118-120

carbohydrate intake and, 59, 274, 275

cholesterol intake and, 58, 161

CHD and, 101, 102-103

dental caries and, 128

diabetes mellitus and, 123, 275

dietary intake and, 41, 80, 81, 180-181

endometrial cancer and, 120

fetal alcohol syndrome and, 449

hypertension and, 112, 555

LDL cholesterol and, 224

meat intake and, 63

mineral intake and, 70-71

obesity and, 90, 116

osteoporosis and, 122

serum cholesterol levels and, 179, 180-181

vitamin intake and, 64-69, 312, 331

Sodium

alcohol intake and, 447

animal studies on, 417-418, 421

availability trends, 72

biologic markers of intake, 28

biologic role of, 413

cancer and, 333, 420-421

conversion to mg of salt, 72

data sources on availability in food supply, 47-48

ESADDI, 48, 72

food sources of, 72-73

hereditary factors interacting with, 418

human studies of, 415-417, 420-421

hypertension and, 77, 80, 89, 112, 414-420

intake trends, 41, 72-73, 413

monitoring status, 73, 74, 81

physiologic requirements for, 414

public information programs on, 77, 80

sensitivity in humans, 420

transport mechanisms, 418-419

see also Salt

Sodium bicarbonate, 414

Sodium chloride, see Salt

Sodium citrate, 414, 423

Sodium glutamate, 414

Sodium a-methylpanthothenate, 340

Soft drinks, 58, 60, 61, 74, 76, 81, 274, 466, 468, 470, 471

Solanine, 489

Soups, 72

Sour cream, 315

South Africa

cancer in, 212, 339

dental caries in, 127

diverticulitis in, 300

hypertension in, 442

plasma lipid/lipoproteins and fat intake levels in, 179

South African Bantu, 121, 164

South America

alcohol consumption in, 433

alcoholic cirrhosis in, 447

Southeast Asians, thalassemia among, 93

Soviet Union

cancer in, 118

CHD in, 167

gout in, 386

Soy protein, 260, 261, 22-65

Soy sauce, 392, 421

Soybean oil, 13, 64, 159, 184, 186, 223, 319, 671

Soybeans, 42, 57, 299, 300

Special Supplemental Food Program for Women, Infants, and Children, 224

Spinach, 208, 297, 329, 667

Spinocerebellar degeneration, 217

Sprue, 321

Squash, winter, 82

Starches

availability trends, 58, 274

cancer and, 282

CHD and, 279

dental caries and, 279

food sources of, 60, 261, 273

linoleic acid from, 202

resistant, 291

wheat, 281

Starvation, alcohol-related, 447

Stearic acid, 184

Steroid hormones, 160, 162

Stigmasterol, 201

Stomach cancer

age and, 117, 118

alcohol intake and, 437-438, 595

animal studies of, 420-421

carbohydrates and, 282, 595, 657

copper and, 380

ecogenetic factors in, 91

epidemiologic studies of, 264, 298-299, 420-421, 438, 594-595

fat intake and, 595

fiber and, 298-299, 595

incidence and mortality rates of, 118, 593, 594, 655

iron and, 368

lead and, 393

mechanisms of action in, 421

in migrants, 118, 594

nitrates, nitrites, and N-nitroso compounds and, 475, 595

prevention of, 19

protective dietary components for, 8, 9, 15, 488, 595, 672

protein intake and, 264

regional differences in, 118

salt or sodium and, 11, 17, 420-421, 424, 475, 594-595, 603, 674, 681

selenium and, 377

sex differences in, 118

socioeconomic status and, 118

vitamin A and, 313, 314

vitamin B12, and, 339, 341

vitamin C and, 9, 332, 341, 488, 595, 658

vitamin E and, 319

Strawberries, 293, 329

Stress (psychosocial), 381, 415, 417, 451

Stroke

age and, 15, 104, 105, 540, 672

alcohol intake and, 10, 105, 442-443, 660

animal studies of, 262-263

blood lipids and lipoproteins and, 175-176

body fat distribution and, 105, 117, 144, 540, 659

body weight and, 105

causes, 103, 104, 539

CHD and, 105

cigarette smoking and, 105, 443

clinical syndromes, 539

country differences in, 103-104

diabetes and, 105

diagnosis of, 104

environmental factors in, 104-105, 540

epidemiologic studies of, 202, 262, 422-423

fat intake and, 202, 540

frequency in U.S., 104, 539

genetic and familial differences in, 105

habitual diet and, 105

HDL cholesterol and, 539-540

hemorrhagic, 202, 442, 443, 539

hypertension and, 10, 104, 105, 107, 113, 539, 540, 693-694

mortality rates, 103, 104, 125, 655

PAD and, 103, 105

pathogenesis, 103, 530-531

population differences in frequency, 103-104, 539

potassium and, 11, 15, 422-423, 660-661, 672

protein intake and, 9, 262-263, 659

racial, ethnic, and migrant differences in, 5, 104-105, 540, 672

residual damage from, 104

risk factors for, 29, 104-105, 194, 202, 539-540, 693-694

serum cholesterol and, 18, 104, 105, 539, 693-694

sex differences in, 104, 442-443

SFAs and, 540

sodium and, 11

thromboembolic, 202, 442, 443, 539

time trends in mortality and morbidity, 104

see also Cardiovascular diseases; Transient ischemic attacks

Suggested Citation:"Index." National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: The National Academies Press. doi: 10.17226/1222.
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Subarachnoid hemorrhage, 103, 104

Sucrose

availability trends, 58, 274

blood pressure and, 149

cancer and, 282

cariogenicity, 9, 279, 281, 284

diabetes mellitus and, 275, 277

food sources of, 273

hyperglycemia and, 277

hypoglycemia and, 283

intake trends, 59, 60, 654

intolerance, 284

obesity and, 277, 281

renal disease and, 278

triglyceride levels and, 278

see also Sugars

Sucrose polyester, 221, 479

Sugars

added during food processing, 273

availability trends, 57, 58, 80, 274, 654

cancer and, 282

CHD and, 192, 278, 279

data sources on availability of, 47

dental caries and, 15, 280, 284, 672, 685

form of, 279, 280

fortification of, 74

intake trends, 58-60, 76, 80, 274

invert, 280

recommended intake of, 15, 17, 18, 672, 675, 677-680, 682-683, 686-687

refined, 76

see also Fructose; Nonnutrititive sweeteners; Sucrose

Sunflower seed oil, 64, 204, 205, 261, 671

Supplements, see Dietary supplements/supplementation

Surveys, see Dietary surveys

Sweden

cancer in, 118, 480, 483

CHD in, 100-101

dietary guidelines in, 682, 686

Swedish Cancer Registry, 211

Swedish Twin Registry, 90

Sweeteners

availability trends, 80-81

research needs on, 81

artificial, see Aspartame; Cyclamates; Saccharin

see also Sugars; and other specific sweeteners

Sweets

intake trends, 54

mineral contribution of, 74

Switzerland

alcoholic cirrhosis in, 125

cancer in, 319, 384

CHD in, 100-101

dental caries in, 127

Sympathetic nervous system

caloric intake effects on, 149

cardiovascular function, 152

fat intake effects on, 149

Syrups, 57, 58

T

Taiwan

cancer in, 368

peripheral vascular disease in, 391

Tannins and tannic acid, 468-469, 490

Tarahumara Indians, cholesterol levels in, 166

Tardive dyskinesia, 216

Taste and olfaction

food choices and, 85, 88

obesity and, 281

research needs on, 95

Tay-Sachs disease, 94

Tea, see Coffee and tea

Temperature (ambient)

energy intake and, 153

obesity and response to, 146

Tendon xanthomas, 171

Tennessee. CHD in, 102

Ten-State Nutrition Survey, 42-43, 90, 264, 351

Teratogenicity

pesticides, 43

vitamin A, 516

Testicular cancer, 206, 282, 593, 603

Thailand

cancer in, 487

energy expenditure during preganancy in, 147

hypertension in, 416

Thalassemia, 94

Thermogenesis (diet-induced)

adaptive, 141-142

adiposity and, 152

alcohol intake and, 436

of carbohydrates, fats, and protein, 141, 143

defined, 141

food intake and, 146

metabolic efficiency and, 152

NIDDM and, 152

Thiamin

alcoholism and, 334, 449, 450

availability trends, 53, 65, 75

biologic role of, 329-330

cancer and, 334

data sources on availability of, 47-48

deficiency, 334, 449

food sources of, 65, 330

fortification of foods with, 75

human studies of, 334

intake trends, 65, 77-79, 81, 330

monitoring status, 63, 65, 81, 331

RDA, 48, 65, 330

safety index, 518

supplementation, 449

Third World countries, dental caries in, 127

Threonine, 259

Thrombosis, 104, 105, 161, 190

Thromboxane, 190, 214, 376

Thymidine, 337

Thymidylate, 331

Thyroid cancer, 380, 383-384, 477

Thyroxin, 142, 384

Tissue histocompatability antigen (HLA), 85, 89, 122

a-Tocopherol, see Vitamin E

Tocotrienols, 296, 312

Tomatoes, 57, 67, 73, 297, 329

Total Diet Study

description of, 43

nutrients and food constituents reported in, 47, 63, 71, 72, 74, 348

Toxic substances

naturally occurring, 486-490

plant constituents and metabolites, 488-490

survey of exposures to, 43, 51

see also specific substances

Toxicity

from blocked catabolic pathway of essential amino acid, 86

of cholesterol derivatives, 201

iron, 92,

see Hemochromatosis

nutrient, and supplementation, 11, 515-517

see also specific dietary constituents

Trace elements, 6. 51;

see also specific elements

Trace minerals, food composition data on, 28;

see also specific minerals

Tracheal cancer, 333

Transient ischemic attacks, defined, 103

Triglycerides

alcohol intake and, 443, 448

body weight and, 148, 221

carbohydrate intake and, 275, 277, 278

characteristics of, 162-163

CHD and, 170-171, 224

energy expenditure of storing dietary fats as, 140

fat intake and, 148, 221, 448

fiber intake and. 295, 300

fish oils and, 185

food intake and, 148

individual differences in, 170

myocardial infarction and, 148

PAD and, 107

population differences in, 170

PUFA intake and, 8, 13, 227, 657, 671

transport of, 162-163

VLDLs and, 185, 443

vitamin E and, 320

1, 3, 7-Trimethylxanthine, 466

Tryptophan, 66, 259, 262, 330, 337, 440, 486

Tuberous xanthomas, 171

Tumorigenesis/tumors

caloric intake and, 150-151, 153

fiber intake and, 9

protein intake and, 264

PUFA intake and, 205, 213

see also Cancer; Carcinogenesis; and specific nutrient or nonnutritive component

Tungsten, 386-387

Turkey, 73

Turnip greens, 69, 329, 349

Tyrosine, 262

U

Ulcerative colitis, 321

Ultrasound, 106, 144

Ultraviolet light

cancer and, 91, 314, 320, 332, 378

mutagenicity of, 385

Vitamin D from, 64, 312

Uganda, cancer in, 212

Underweight, among children, 44

trans-Unsaturated octadecanoic acid, 186-187

Urine, 28,

see also Excretion

United Kingdom

alcoholic cirrhosis in, 125

cancer in, 313, 319, 389, 439, 467

(continued on next page)

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(continued from previous page)

CHD in, 100-101, 102, 103, 693

dental caries in, 127

dietary recommendations in, 683, 686-687

hypertension, 389, 442

ischemic heart disease in, 197

obesity and overweight in, 114-115

osteoporosis in, 121, 317

stroke in, 103

United States

alcohol intake patterns in, 431-433, 451-452

alcoholic cirrhosis in, 125, 447

bone fracture in, 121

cancer in, 117-120, 212, 313, 377, 384, 386, 388, 437, 439, 467, 468, 593-594

CHD in, 100-101, 102, 103, 164, 445, 469-470, 531-532

dental caries in, 127

diabetes mellitus in, 122

diverticulosis in, 300

fetal alcohol syndrome in, 449

gallbladder disease and gallstones in, 126, 218

hyperlipidemia in, 443

hypertension in, 105, 108, 394, 414, 442

malnutrition related to alcoholism in, 450

nitrosamines intake in, 475

salt intake in, 414

obesity and overweight in, 114-115

osteoporosis in, 121

PAD in, 537-538

protein intake patterns in, 259-260

serum cholesterol levels in, 163

stroke in, 104, 539

temporal trends in CHD in, 101-102

see also specific states

Urethane, 476, 477, 486

Urinary tract infections, 475

U.S. Department of Agriculture (USDA) Beltsville Human Nutrition Research Center, 53

dietary recommendations, 676

food supply monitoring, 24, 259-260

fortification standards, 75

Human Nutrition Information Service, 42

joint nutrition monitoring activities with DHHS, 44, 676

Nutrient Data Bank, 46, 311

national surveys of dietary intake and nutritional status. 42;

see also Historical Food Supply; Nationwide Food Consumption Surveys

Primary Data Set, 48

U.S. Department of Health and Human Services

dietary recommendations, 676

joint nutrition monitoring activities with USDA, 44, 676

Office of Disease Prevention and Health Promotion, 99

surveys of food intake and nutritional status, 24, 42-43, 61;

see also Hispanic Health and Nutrition Examination Survey; National Health and Nutrition Examination Surveys; Total Diet Study

U.S. Surgeon General, 434, 667, 676, 681

Utah, cancer in, 296

Uterine cancer, 206, 282

V

Valine, 259

Veal, 63

Vegans, 76;

see also Vegetarians and vegetarianism

Vegetable fats and oils

cancer and, 8, 206, 214, 229

food sources of, 160

hydrogenated, 57, 186

intake trends, 160

nutrient contribution of, 312

SFAs in, 13, 159

see also Polyunsaturated fats and fatty acids; Salad and cooking oils; and specific fats and oils

Vegetables

availability trends, 57, 80

cancer and, 6, 15, 80, 207, 296, 297, 303, 332, 488, 666

canned, 73

contaminants in, 391, 675;

see also Pesticides

dark green leafy, 17, 67, 69, 71, 311, 312, 329, 330, 674

fresh, 57

frozen with sauces, 73

green and yellow, 15, 18, 57, 64, 65, 70, 313, 488, 657-658, 672, 675

intake trends, 54, 76, 81, 260, 654

nitrates in, 475

nutrient contribution of, 15, 18, 48, 60, 62, 64-66, 72-74, 260, 293, 301, 311, 331, 349, 672

protective effects of, 8, 9, 15, 203, 207, 208, 296, 297, 303, 313, 332, 488, 657-658, 666, 672

processed, 57

raw, 488

recommended intakes of, 13-15, 18, 226, 670-672, 675, 679

vitamin content, 66

see also specific vegetables

Vegetarians and vegetarianism

alcohol intake and, 443

blood pressure and, 201, 262, 300, 302

cancer and, 210, 212

CHD and, 278-279, 295

defined, 76

historical trends, 76

lacto-ovo, 8-9, 76, 210, 212, 260, 262, 263, 294, 658

mineral status, 301

nutrient intakes, 8-9, 76-77, 78, 201, 260, 260, 278, 294, 295, 658

osteoporosis and, 264, 317

supplement use by, 515

total, 76, 260

serum cholesterol and triglyceride levels in, 8-9, 265, 294, 302, 658

Very-low-density lipoproteins (VLDLs)

carbohydrate intake and, 275, 278

composition of, 162-163

dietary cholesterol intake and, 199, 200

fatty acid effects on, 188

function of, 163

PAD and, 107

see also VLDL cholesterol

Vinyl chloride, 440

Vitamin A

alcohol intake and, 441, 450-451, 452

availability trends, 53, 64, 75, 311, 654

biologic role of, 311, 315

cancer and, 9, 51, 313-314, 315-316, 322, 331, 334, 371, 441, 488, 514, 516, 658

data sources on availability of, 47-48, 51, 81

fortification of foods with, 74, 75, 311

food records of intake of, 26

food sources of, 64, 311, 654

hypercarotenemia and, 314

intake trends, 64, 76-79, 80, 81, 311-312

international units, 47, 311

monitoring status, 63, 64, 81

nutritional status, 64, 76

populations at risk of deficiencies in, 76

protective effects of, 488

RDA, 48, 64, 311

retinol equivalents, 47, 64, 68, 311

safety index, 518

supplements use, 315, 514, 516

toxicity, 11, 516

see also b-Carotenes and other carotenoids; Retinol and other retinoids

Vitamin B1, see Thiamin

Vitamin B2,see Riboflavin

Vitamin B6,

alcohol intake and, 441, 450

animal studies of, 337, 338

availability trends, 53, 66

biologic role of, 330, 337, 441

cancer and, 337, 441

data sources on availability of, 47-48

food sources of, 66, 331

human studies of, 337-338

intake trends, 66, 76-79, 81, 330-331

liver disease and, 337

nutritional status, 76, 331

populations at risk of deficiencies in, 76, 331

RDA, 48, 66, 330

research needs on, 63, 66, 81

safety index, 518

toxicity, 516, 518

Vitamin B12

availability trends, 53, 67

biologic role of, 216, 331

cancer and, 338, 341, 358

data sources on availability of, 47-48

defective absorption of, 88

deficiencies, 216

food sources of, 67, 331

intake trends, 67, 77-79, 81, 331

monitoring status, 81

nutritional status, 67

RDA, 48, 67

Vitamin C (ascorbic acid)

alcoholism and, 332, 450

animal studies of, 332-334

atherosclerosis and, 333-334

availability trends, 53, 67, 75, 654

biologic role of, 329

cancer and, 9, 331-333, 338, 341, 488, 514, 658

CHD and, 333-334, 515

colds and, 517

(continued on next page)

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(continued from previous page)

data sources on availability of, 47-48, 51, 81

food sources of, 9, 67-68, 329, 341, 654, 658

fortification of foods with, 67, 75, 329, 654

human studies of, 331-332, 333

intake trends, 41, 67-68, 76-79, 81, 329

iron absorption and, 71, 77, 367, 368, 517

monitoring status, 63, 68, 81, 329, 331

nitrosamines and, 475, 476

nutritional status, 68, 76, 81, 329

populations at risk of deficiencies in, 68, 76

protective effects of, 9, 331-332, 341, 476, 488, 514, 515, 658

RDA, 67-68, 329

safety index, 518

scurvy, 33, 329

serum cholesterol and, 515

supplements, 514, 515, 518

Vitamin D

aging and, 312, 318, 322

alcoholism and, 451

animal studies of, 33, 317

availability trends, 312

biologic role of, 312, 316

cancer and, 356

D2 (ergocalciferol), 312, 317

D3 (cholcalciferol), 312, 317

data availability on intakes, 64

1, 25-dihydroxycholcalciferol, 312, 316, 317, 318, 356, 390

fiber intake and, 302

food sources of, 64, 312

fortification of foods with, 74, 312

human studies of, 316-317

hydroxycholecalciferols, 317, 318

intake trends, 312

mechanisms of action and interactions, 317-318, 357-358, 360

osteoporosis/osteomalacia and, 316-318, 322, 350, 353, 618

RDA, 48, 64, 312

recommended intakes of, 680

renal disease and, 318

safety index, 518

skin synthesis of, 160

supplementation, 353

Vitamin E

alcohol intake and, 441, 451

animal studies of, 319-320

atherosclerotic cardiovascular disease and, 320, 376

availability trends, 53, 64, 312, 654

biologic role of, 312, 320

cancer and, 318-320, 377, 379, 443, 658

CHD and, 514-515

data sources on availability of, 47-48

deficiency diseases, 320-321

food sources of, 64, 312,

human studies of, 318-319

interaction with vitamin K, 321

intake trends, 65, 81, 312

mechanisms of action, 320

protective effects of, 441, 476

RDA, 48, 64-65, 312

safety index, 518

sucrose polyester and, 479

a-tocopherol, 68, 476

toxicity of, 321, 516-517, 518

Vitamin K

animal studies of, 321

availability trends, 312

biologic role of, 312

cancer and, 321

deficiency, 321-322

ESADDI, 48, 312

food sources of, 312

human studies of, 321

interaction of vitamin E with, 322

K1 (phylloquinone), 312, 321, 322

K2 (menoquinone), 312, 322

K3 (menadione), 321, 322

liver disease and, 321-322

malabsorption of, 321-322

toxicity, 321

Vitamins, food sources of, 28, 63;

see also specific vitamins

VLDL, see Very-low-density lipoproteins

VLDL cholesterol

apolipoproteins and, 168

carbohydrate intake and, 278

CHD and, 170-171

individual differences in, 170

lecithin and, 217

population differences in, 170

W

Waffles, 73

Warfarin, 321, 322

Washington

cancer in, 483

CHD in, 102

Water, softened, 73;

see also Drinking water

Water-soluble vitamins, see Biotin; Folacin; Niacin; Pantothenic acid; Riboflavin; Thiamin; Vitamin B6; Vitamin B12; Vitamin C

Weight, see Body weight

Weight-reduction dieting

age-sex trends in, 76

prevalence of, 82

Wernicke-Korsakoff's syndrome, 92, 334, 449, 450

Wheat bran, 278, 292, 298, 299, 301, 302

Wheat germ, 67

Wheat gluten, 42

Wheat products, 57, 301, 302

Wheat starch, 280

Wheat straw, 295

Whole grains and whole-grain products, 8, 14, 18, 62, 64-67, 70, 71, 76, 80, 293, 301, 302, 312, 370, 381, 671, 675, 679;

see also Cereal grains and cereal grain products

Wilms's tumor, 393

Wilson's disease, 124

Women

CHD in, 445

dietary recommendations for, 671

fat intake trends, 54-55

nutrient deficiencies from alcoholism, 450

see also Sex differentials

World Health Organization

definitions of health and disease prevention, 99

dietary recommendations, 686

hypertension classifications, 107, 550

cirrhosis definition, 124

Global Oral Epidemiology Bank, 127

X

Xanthomas, 171, 201

Xeroderma pigmentosum, 91

Xerophthalmia, 316, 451

Xylitol, 279

Y

Yanomami Indians, 414, 415

Yeast, 476

Yemenite Jews

diabetes mellitus in, 123

plasma lipids/lipoproteins and fat intake by, 180-181

Yogurt, 18, 69, 76, 207, 370, 675

Yugoslavia

bone fracture in, 351-352

cancer in, 421

CHD in, 100-101

serum cholesterol levels in, 163

Yusho disease, 479

Z

Zambia, dental caries in, 127

Zinc

alcohol intake and, 442, 450, 451

animal studies, 371-372

atherosclerotic cardiovascular diseases and, 370

availability trends, 53, 71

bioavailability of, 71-72, 301, 301, 370

biologic role of, 370

cancer and, 334-336, 370-372, 380, 442, 514

CHD and, 370, 380, 515

clinical studies, 370-371

data sources on availability, 47-48, 51

deficiency, 336, 450

diabetes mellitus and, 372

epidemiologic studies, 370-371

food sources of, 71-72, 370

HDL cholesterol and, 370

hypertension and, 370, 390, 394

immunocompetence and, 372, 395, 517

intake trends, 71-72, 81

interaction with other trace elements, 370, 371, 373, 379, 380, 390, 515

mutagenicity, 372

nutritional status, 72, 370

occupational exposures, 371

osteoarthritis and, 373

osteoporosis and, 372-373

RDA, 48, 71, 370

safety index, 518

serum cholesterol and, 261, 370, 515

short-term tests of, 372

supplements, 370, 373, 514, 515

toxicity, 517, 518

Zucchini, 297

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Diet and Health examines the many complex issues concerning diet and its role in increasing or decreasing the risk of chronic disease. It proposes dietary recommendations for reducing the risk of the major diseases and causes of death today: atherosclerotic cardiovascular diseases (including heart attack and stroke), cancer, high blood pressure, obesity, osteoporosis, diabetes mellitus, liver disease, and dental caries.

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