A Quality Management Framework to improve quality and harmonization of Total Diet Study practices in Europe was developed within the TDS-Exposure Project. Seventeen processes were identified and hazards, Critical Control Points and associated preventive and corrective measures described. The Total Diet Study process was summarized in a flowchart divided into planning and practical (sample collection, preparation and analysis; risk assessment analysis and publication) phases. Standard Operating Procedures were developed and implemented in pilot studies in five organizations. The flowchart was used to develop a quality framework for Total Diet Studies that could be included in formal quality management systems. Pilot studies operated by four project partners were visited by project assessors who reviewed implementation of the proposed framework and identified areas that could be improved. The quality framework developed can be the starting point for any Total Diet Study centre and can be used within existing formal quality management approaches.

• Klíčová slova
• Critical Control Points, Exposure Assessment, Quality Management Framework, Standard Operating Procedures, Total Diet Studies,
• MeSH
• dieta * MeSH
• hodnocení rizik MeSH
• lidé MeSH
• pilotní projekty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

PURPOSE: Mediterranean-type dietary pattern has been associated with lower risk of cardiovascular (CVD) and other chronic diseases, primarily in Southern European populations. We examined whether Mediterranean diet score (MDS) is associated with total, CVD, coronary heart disease (CHD) and stroke mortality in a prospective cohort study in three Eastern European populations. METHODS: A total of 19,333 male and female participants of the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study in the Czech Republic, Poland and the Russian Federation were included in the analysis. Diet was assessed by food frequency questionnaire, and MDS was derived from consumption of nine groups of food using absolute cut-offs. Mortality was ascertained by linkage with death registers. RESULTS: Over the median follow-up time of 7 years, 1314 participants died. The proportion of participants with high adherence to Mediterranean diet was low (25 %). One standard deviation (SD) increase in the MDS (equivalent to 2.2 point increase in the score) was found to be inversely associated with death from all causes (HR, 95 % CI 0.93, 0.88-0.98) and CVD (0.90, 0.81-0.99) even after multivariable adjustment. Inverse but statistically not significant link was found for CHD (0.90, 0.78-1.03) and stroke (0.87, 0.71-1.07). The MDS effects were similar in each country cohort. CONCLUSION: Higher adherence to the Mediterranean diet was associated with reduced risk of total and CVD deaths in these large Eastern European urban populations. The application of MDS with absolute cut-offs appears suitable for non-Mediterranean populations.

• Klíčová slova
• Diet, Eastern Europe, Mortality, Nutrition, Prevention,
• MeSH
• adherence pacienta MeSH
• chronická nemoc MeSH
• hodnocení stavu výživy MeSH
• kardiovaskulární nemoci mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• socioekonomické faktory MeSH
• strava středomořská * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Polsko epidemiologie   MeSH
• Rusko epidemiologie   MeSH

A total diet study (TDS) is a public health tool for determination of population dietary exposure to chemicals across the entire diet. TDSs have been performed in several countries but the comparability of data produced is limited. Harmonisation of the TDS methodology is therefore desirable and the development of comparable TDS food lists is considered essential to achieve the consistency between countries. The aim of this study is to develop and test the feasibility of a method for establishing harmonised TDS food and sample lists in five European countries with different consumption patterns (Czech Republic, Finland, Germany, Iceland and Portugal). The food lists were intended to be applicable for exposure assessment of wide range of chemical substances in adults (18-64 years) and the elderly (65-74 years). Food consumption data from recent dietary surveys measured on individuals served as the basis for this work. Since the national data from these five countries were not comparable, all foods were linked to the EFSA FoodEx2 classification and description system. The selection of foods for TDS was based on the weight of food consumed and was carried out separately for each FoodEx2 level 1 food group. Individual food approach was respected as much as possible when the TDS samples were defined. TDS food lists developed with this approach represented 94.7-98.7% of the national total diet weights. The overall number of TDS samples varied from 128 in Finland to 246 in Germany. The suggested method was successfully implemented in all five countries. Mapping of data to the EFSA FoodEx2 coding system was recognised as a crucial step in harmonisation of the developed TDS food lists.

• Klíčová slova
• FoodEx2, TDS samples, Total diet study, dietary exposure, food list, harmonisation,
• MeSH
• bezpečnost potravin * MeSH
• dieta - přehledy * MeSH
• dieta * MeSH
• dietní záznamy MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kontaminace potravin analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• potraviny * MeSH
• senioři MeSH
• vystavení vlivu životního prostředí * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH
• Finsko MeSH
• Island MeSH
• Německo MeSH
• Portugalsko MeSH

The usual dietary intake of vitamin D was studied in 10 subgroups of the Czech population. Food consumption data was collected using repeated 24 h recall in a national cross-sectional survey (the Study of Individual Food Consumption, SISP04), and the vitamin D content in marketed foods was quantified within the national Total Diet Study (2014⁻2015). The Monte Carlo Risk Assessment computational model (version MCRA 8.2) was used to assess usual intake. The median vitamin D intakes for the Czech population (aged 4⁻90 years, both genders) were within a range of 2.5⁻5.1 μg/day. The highest median intake, excluding dietary supplements, was observed in men aged 18⁻64, and the lowest was observed in children aged 4⁻6 and girls aged 11⁻17. The main sources in the diet were hen eggs (21⁻28% of usual dietary intake), fine bakery wares (11⁻19%), cow's milk and dairy products (7⁻23%), meat and meat products (4⁻12%), fish (6⁻20%), and margarines (7⁻18%). The dietary intake of vitamin D for more than 95% of the Czech population was below the recommended Dietary Reference Values (DRVs). These findings should encourage public health authorities to support interventions and education and implement new regulatory measures for improving intake.

• Klíčová slova
• Czech population, dietary intake, dietary sources, micronutrient adequacy, total diet study, vitamin D,
• MeSH
• dieta - přehledy MeSH
• dieta * MeSH
• dietní záznamy MeSH
• dítě MeSH
• dospělí MeSH
• hodnocení stavu výživy MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• skot MeSH
• stravovací zvyklosti * MeSH
• věkové faktory MeSH
• vitamin D aplikace a dávkování   MeSH
• výživové doporučené dávky MeSH
• zvířata MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• skot MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• vitamin D MeSH

A Total Diet Study (TDS) consists of selecting, collecting and analysing commonly consumed foods to obtain concentration data of different chemical compounds in foods as eaten. A TDS food list summarises the most consumed foods and represents the dietary habits of the general population of the country under study. The work reported here investigated whether TDS food lists that were initially designed for the whole population of the country under study also sufficiently cover the dietary pattern of specific subpopulations that are extra vulnerable for certain contaminants. The work was performed using data of three European countries: the Czech Republic, France and the UK. Each national food consumption database was combined with the corresponding national TDS food list (containing 336, 212 and 119 food items for the Czech Republic, France and the UK, respectively). The data were aggregated on the highest level of hierarchy of FoodEx-1, a pan-European food classification system, including 20 main FoodEx-1 groups. For the group 'milk and dairy products', the coverage of the consumption by the food list was investigated for more refined subgroups. For each food group or subgroup and country, the average percentage of coverage of the diet by the national TDS food list was calculated for different subpopulations, including children versus adults, women versus men, vegetarians versus non-vegetarians, and women of child-bearing age versus older women. The average diet of the different subpopulations was sufficiently covered by the food list of the Czech Republic and France. For the UK the average coverage was low due to a different food-coding approach and because food lists were not derived directly from national food consumption data. At the level of the 20 main food groups, differences between the subpopulations with respect to the average coverage of consumption by the TDS food list were minimal. The differences were more pronounced when looking in detail at the coverage of the dairy consumption. TDS food lists based on the mean consumption of the general population are also applicable to study the chemical exposure of different subpopulations, e.g. children, women of child-bearing age and vegetarians. This lowers the effort when performing a TDS.

• Klíčová slova
• Total Diet Studies (TDS), dietary exposure, food consumption, food contaminants, food intake, food list,
• MeSH
• dieta statistika a číselné údaje   MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• potraviny klasifikace   statistika a číselné údaje   MeSH
• přijímání potravy etnologie   fyziologie   psychologie   MeSH
• senioři MeSH
• sexuální faktory MeSH
• stravovací zvyklosti etnologie   fyziologie   psychologie   MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Francie MeSH
• Spojené království MeSH

BACKGROUND: Our study is designed to establish whether supplementation with erythropoietin (EPO) exerts additional beneficial metabolic effects in patients with chronic renal failure (CRF) treated with keto acids (KAs) on a low-protein diet (LPD). METHODS: A long-term, prospective, randomized study was designed to use three therapeutic protocols: (A) EPO plus KAs plus LPD (group I), (B) EPO plus LPD (group II), and (C) LPD (group III). One hundred eighty-six randomly selected patients (90 men, 96 women; age, 22 to 78 years) with a creatinine clearance of 22 to 36 mL/min were monitored at the beginning and at every 6 months for 3 years. RESULTS: During the study period, glomerular filtration rate measured as inulin clearance decreased slightly (from 26.2 +/- 3.4 to 23.4 +/- 4.1 mL/min in group I), 27.4 +/- 4.8 to 20.2 +/- 4.4 mL/min in group II, and 26.8 +/- 3.6 to 17.4 +/- 4.1 mL/min in group III; P < 0.01). Serum urea levels also declined (P < 0.01), more pronouncedly in group I (P < 0.025). In group I, there was a significant increase in levels of leucine (P < 0.01) and albumin (P < 0.01) and a decrease in proteinuria (P < 0.01). Analysis of the lipid spectrum showed a mild, yet significant, decrease in total cholesterol and low-density lipoprotein cholesterol levels (P < 0.025), more pronounced in group I. In group I, there was a decrease in plasma triglyceride levels (from 362.85 +/- 115.05 mg/dL [4.1 +/- 1.3 mmol/L] to values as low as 203.55 +/- 70.80 mg/dL [2.3 +/- 0.8 mmol/L]; P < 0.01), whereas high-density lipoprotein cholesterol levels increased (from 34.75 +/- 7.72 mg/dL [0.9 +/- 0.2 mmol/L] to 46.33 +/- 7.72 mg/dL [1.2 +/- 0.2 mmol/L]; P < 0.025). Mean arterial blood pressure was stable. CONCLUSION: EPO supplementation in patients with CRF administered KAs potentiates the beneficial effects on metabolism of proteins, amino acids, and lipids. Long-term coadministration of EPO, KA, and LPD was associated with a delay in progression of renal failure and reduction in proteinuria.

• MeSH
• chronické selhání ledvin krev   dietoterapie   farmakoterapie   metabolismus   MeSH
• dospělí MeSH
• erythropoetin farmakologie   terapeutické užití   MeSH
• hodnoty glomerulární filtrace účinky léků   MeSH
• ketokyseliny farmakologie   terapeutické užití   MeSH
• krevní proteiny metabolismus   MeSH
• krevní tlak účinky léků   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy krev   MeSH
• nízkoproteinová dieta metody   MeSH
• prospektivní studie MeSH
• rekombinantní proteiny MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• erythropoetin MeSH
• ketokyseliny MeSH
• krevní proteiny MeSH
• lipidy MeSH
• rekombinantní proteiny MeSH

A Total Diet Study (TDS) consists of selecting, collecting and preparing commonly consumed foods purchased at retail level and analysing them for harmful and/or beneficial chemical substances. A food classification system is needed to link food consumption data with the contaminant concentration data obtained in the TDS for the exposure assessment. In this study a comparison was made between the use of a national food classification systems and the use of FoodEx-1, developed and recommended by the European Food Safety Authority (EFSA). The work was performed using data of six European countries: Belgium, Czech Republic, France, The Netherlands, Spain and the UK. For each population, exposure to contaminant A (organic compounds) and/or contaminant B (inorganic compound) was assessed by the Monte Carlo Risk Assessment (MCRA) software using the national classification system and FoodEx-1 for food consumption data and for TDS laboratory results. Minimal differences between both approaches were observed. This observation applied for both contaminant A and contaminant B. In general risk assessment will be similar for both approaches; however, this is not guaranteed. FoodEx-1 proved to be a valuable hierarchic classification system in order to harmonise exposure assessment based on existing TDS results throughout Europe.

• Klíčová slova
• Dietary exposure, Exposure assessment, Food consumption, Food contaminants, FoodEx-1, Total diet studies (TDS),
• MeSH
• bezpečnost potravin MeSH
• databáze faktografické MeSH
• dieta - přehledy MeSH
• dieta normy   MeSH
• dítě MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kojenec MeSH
• kontaminace potravin analýza   MeSH
• látky znečišťující životní prostředí toxicita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vystavení vlivu životního prostředí analýza   normy   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Francie MeSH
• Nizozemsko MeSH
• Španělsko MeSH
• Spojené království MeSH
• Názvy látek
• látky znečišťující životní prostředí MeSH

AIMS/HYPOTHESIS: The proportion of children with type 1 diabetes (T1D) who have experience with low-carbohydrate diet (LCD) is unknown. Our goal was to map the frequency of LCD among children with T1D and to describe their clinical and laboratory data. METHODS: Caregivers of 1040 children with T1D from three centers were addressed with a structured questionnaire regarding the children's carbohydrate intake and experience with LCD (daily energy intake from carbohydrates below 26% of age-recommended values). The subjects currently on LCD were compared to a group of non-LCD respondents matched to age, T1D duration, sex, type and center of treatment. RESULTS: A total of 624/1040 (60%) of the subjects completed the survey. A total of 242/624 (39%) subjects reported experience with voluntary carbohydrate restriction with 36/624 (5.8%) subjects currently following the LCD. The LCD group had similar HbA1c (45 vs. 49.5, p = 0.11), lower average glycemia (7.0 vs. 7.9, p = 0.02), higher time in range (74 vs. 67%, p = 0.02), lower time in hyperglycemia >10 mmol/L (17 vs. 20%, p = 0.04), tendency to more time in hypoglycemia <3.9 mmol/L(8 vs. 5%, p = 0.05) and lower systolic blood pressure percentile (43 vs. 74, p = 0.03). The groups did not differ in their lipid profile nor in current body height, weight or BMI. The LCD was mostly initiated by the parents or the subjects themselves and only 39% of the families consulted their decision with the diabetologist. CONCLUSIONS/INTERPRETATION: Low carbohydrate diet is not scarce in children with T1D and is associated with modestly better disease control. At the same time, caution should be applied as it showed a tendency toward more frequent hypoglycemia.

• Klíčová slova
• low-carbohydrate diet, time in range, type 1 diabetes,
• MeSH
• diabetes mellitus 1. typu dietoterapie   metabolismus   MeSH
• dieta s omezením sacharidů * škodlivé účinky   statistika a číselné údaje   MeSH
• dítě MeSH
• glykovaný hemoglobin analýza   MeSH
• index tělesné hmotnosti MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• lipidy krev   MeSH
• průzkumy a dotazníky MeSH
• tělesná hmotnost MeSH
• tělesná výška MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• krevní glukóza MeSH
• lipidy MeSH

BACKGROUND: There is accumulating evidence suggesting that diet may play a role in preventing or delaying cognitive decline and dementia, but the underlying biological mechanisms are not well understood. OBJECTIVES: To examine the cross-sectional associations of the Mediterranean diet (MeDi) and its components with 11C-PiB-PET scan measures of amyloid-β (Aβ) deposition. METHODS: The study consisted of 278 Mayo Clinic Study of Aging participants 70+ years old, who were cognitively unimpaired (CU) at the time of completion of the Food Frequency Questionnaire (FFQ) and when they underwent PET imaging. Adherence to the MeDi was assessed by computing the MeDi score for each participant. All scans were performed after the FFQ completion; median [IQR] time between FFQ and Aβ PET was 3.5 (1.4) years. Z-scores were created for component, macro- and micronutrients measured. Linear and logistic regression models were adjusted for age, sex, education, apolipoprotein E (APOE) ɛ4 allele carrier status, time interval between the FFQ completion and PET scan, and total energy intake. RESULTS: Participants' median age at FFQ was 77.7 years (55.8% men; 26.6% with an APOE ɛ4 allele). Higher MeDi score (linear regression slope (beta):-0.035, p = 0.012; per standard deviation increase), vegetable intake (beta:-0.043, p = 0.002), intake of vitamin A (beta:-0.041, p = 0.003) or β-carotene (beta: -0.039, p = 0.005) from food sources and moderate alcohol consumption (beta: -0.074, p = 0.03) were associated with lower 11C-PiB standardized uptake value ratio. CONCLUSION: Findings are consistent with previous studies suggesting that higher adherence to a MeDi pattern and higher vegetable consumption are associated with better neuroimaging biomarker profile. Prospective studies are needed to validate current findings.

• Klíčová slova
• Amyloid, Mediterranean diet, cross-sectional study, vegetables,
• MeSH
• amyloid metabolismus   MeSH
• aniliny farmakokinetika   MeSH
• demence epidemiologie   prevence a kontrola   MeSH
• kognitivní dysfunkce diagnostické zobrazování   epidemiologie   prevence a kontrola   MeSH
• kohortové studie MeSH
• lidé MeSH
• mozek diagnostické zobrazování   účinky léků   MeSH
• neuropsychologické testy MeSH
• pozitronová emisní tomografie MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• psychiatrické posuzovací škály MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• strava středomořská * MeSH
• thiazoly farmakokinetika   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• 2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole MeSH Prohlížeč
• amyloid MeSH
• aniliny MeSH
• thiazoly MeSH

To update the clinical practice guidelines for nutrition therapy of the European Association for the Study of Diabetes, we conducted a systematic review and meta-analysis of prospective cohort studies and randomized clinical trials (RCTs) to evaluate the effect of the Mediterranean diet (MedDiet) on the prevention of cardiovascular disease (CVD) incidence and mortality. We searched Medline, EMBASE (through April 20, 2018) and Cochrane (through May 7, 2018) databases. Pooled relative risks (RRs) and 95% confidence interval (CI) were calculated by the generic inverse variance method. A total of 41 reports (3 RCTs and 38 cohorts) were included. Meta-analyses of RCTs revealed a beneficial effect of the MedDiet on total CVD incidence (RR: 0.62; 95% CI: 0.50, 0.78) and total myocardial infarction (MI) incidence (RR: 0.65; 95% CI: 0.49, 0.88). Meta-analyses of prospective cohort studies, which compared the highest versus lowest categories of MedDiet adherence, revealed an inverse association with total CVD mortality (RR: 0.79; 95% CI: 0.77, 0.82), coronary heart disease (CHD) incidence (RR: 0.73; 95% CI: 0.62, 0.86), CHD mortality (RR: 0.83; 95% CI: 0.75, 0.92), stroke incidence (RR: 0.80; 95% CI: 0.71, 0.90), stroke mortality (RR: 0.87; 95% CI: 0.80, 0.96) and MI incidence (RR: 0.73; 95% CI: 0.61, 0.88). The present study suggests that MedDiet has a beneficial role on CVD prevention in populations inclusive of individuals with diabetes.

• Klíčová slova
• Mediterranean diet, cardiovascular disease, cardiovascular mortality, diabetes, meta-analysis,
• MeSH
• diabetes mellitus epidemiologie   MeSH
• kardiovaskulární nemoci mortalita   prevence a kontrola   MeSH
• kohortové studie MeSH
• lidé MeSH
• randomizované kontrolované studie jako téma MeSH
• strava středomořská statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH