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      Is childhood meat eating associated with better later adulthood cognition in a developing population?

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          Abstract

          Inadequate childhood nutrition is associated with poor short-term academic and cognitive outcomes. Dietary supplementation with meat is associated with better cognitive outcome in children. Whether childhood nutrition has life long effects on cognitive function is unclear. We examined the association of childhood meat eating with adulthood cognitive function in southern China where the older population lived through significant hardship during their early years. Multivariable linear regression was used in a cross-sectional study of 20,086 Chinese men and women aged ≥ 50 years from the Guangzhou Biobank Cohort Study (phases 2 and 3) 2005–8. We assessed the association of childhood meat eating with delayed 10-word and immediate recall score. Adjusted for age, sex, education, childhood and adulthood socio-economic position and current physical activity, childhood meat eating almost daily, when compared to yearly or never childhood meat eating, was positively associated with delayed recall score (additional number of words recalled out of 10 = 0.22 [95% confidence interval = 0.11–0.31]). Similarly adjusted, childhood meat eating about once a month, about once a week and almost daily were positively associated with immediate recall score (additional number of words recalled out of 30 = 0.38 [0.23–0.54], 0.73 [0.56–0.89] and 0.76 [0.55–0.98] respectively). More frequent childhood meat eating was associated with better cognition through to old age. If confirmed, these results highlight the importance of adequate childhood nutrition and they also emphasise the childhood and adolescent antecedents of adult disease, with corresponding public health implications for healthy aging.

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          Dementia diagnosis in developing countries: a cross-cultural validation study.

          Research into dementia is needed in developing countries. Assessment of variations in disease frequency between regions might enhance our understanding of the disease, but methodological difficulties need to be addressed. We aimed to develop and test a culturally and educationally unbiased diagnostic instrument for dementia. In a multicentre study, the 10/66 Dementia Research Group interviewed 2885 people aged 60 years and older in 25 centres, most in Universities, in India, China and southeast Asia, Latin America and the Caribbean, and Africa. 729 had dementia and three groups were free of dementia: 702 had depression, 694 had high education (as defined by each centre), and 760 had low education (as defined by each centre). Local clinicians diagnosed dementia and depression. An interviewer, masked to dementia diagnosis, administered the geriatric mental state, the community screening instrument for dementia, and the modified Consortium to Establish a Registry of Alzheimer's Disease (CERAD) ten-word list-learning task. Each measure independently predicted a diagnosis of dementia. In an analysis of half the sample, an algorithm derived from all three measures gave better results than any individual measure. Applied to the other half of the sample, this algorithm identified 94% of dementia cases with false-positive rates of 15%, 3%, and 6% in the depression, high education, and low education groups, respectively. Our algorithm is a sound basis for culturally and educationally sensitive dementia diagnosis in clinical and population-based research, supported by translations of its constituent measures into most languages used in the developing world.
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            Bias in dietary-report instruments and its implications for nutritional epidemiology.

            To evaluate measurement error structure in dietary assessment instruments and to investigate its implications for nutritional studies, using urinary nitrogen excretion as a reference biomarker for protein intake. The dietary assessment methods included different food-frequency questionnaires (FFQs) and such conventional dietary-report reference instruments as a series of 24-hour recalls, 4-day weighed food records or 7-day diaries. Six original pilot validation studies within the European Prospective Investigation of Cancer (EPIC), and two validation studies conducted by the British Medical Research Council (MRC) within the Norfolk cohort that later joined as a collaborative component cohort of EPIC. A sample of approximately 100 to 200 women and men, aged 35-74 years, from each of eight validation studies. In assessing protein intake, all conventional dietary-report reference methods violated the critical requirements for a valid reference instrument for evaluating, and adjusting for, dietary measurement error in an FFQ. They displayed systematic bias that depended partly on true intake and partly was person-specific, correlated with person-specific bias in the FFQ. Using the dietary-report methods as reference instruments produced substantial overestimation (up to 230%) of the FFQ correlation with true usual intake and serious underestimation (up to 240%) of the degree of attenuation of FFQ-based log relative risks. The impact of measurement error in dietary assessment instruments on the design, analysis and interpretation of nutritional studies may be much greater than has been previously estimated, at least regarding protein intake.
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              Proper interpretation of non-differential misclassification effects: expectations vs observations.

              Many investigators write as if non-differential exposure misclassification inevitably leads to a reduction in the strength of an estimated exposure-disease association. Unfortunately, non-differentiality alone is insufficient to guarantee bias towards the null. Furthermore, because bias refers to the average estimate across study repetitions rather than the result of a single study, bias towards the null is insufficient to guarantee that an observed estimate will be an underestimate. Thus, as noted before, exposure misclassification can spuriously increase the observed strength of an association even when the misclassification process is non-differential and the bias it produced is towards the null. We present additional results on this topic, including a simulation study of how often an observed relative risk is an overestimate of the true relative risk when the bias is towards the null. The frequency of overestimation depends on many factors: the value of the true relative risk, exposure prevalence, baseline (unexposed) risk, misclassification rates, and other factors that influence bias and random error. Non-differentiality of exposure misclassification does not justify claims that the observed estimate must be an underestimate; further conditions must hold to get bias towards the null, and even when they do hold the observed estimate may by chance be an overestimate.
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                Author and article information

                Contributors
                +852-39062032 , +852-2855 9528 , cms1@hkucc.hku.hk
                Journal
                Eur J Epidemiol
                European Journal of Epidemiology
                Springer Netherlands (Dordrecht )
                0393-2990
                1573-7284
                6 June 2010
                6 June 2010
                July 2010
                : 25
                : 7
                : 507-516
                Affiliations
                [1 ]Department of Community Medicine, and School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
                [2 ]Guangzhou Occupational Diseases Prevention and Treatment Centre, Guangzhou Number 12 Hospital, Guangzhou, China
                [3 ]Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
                Article
                9466
                10.1007/s10654-010-9466-0
                2903695
                20526800
                f6ad849f-0b43-4a50-95a6-bb452172039b
                © The Author(s) 2010
                History
                : 6 July 2009
                : 18 May 2010
                Categories
                Neuro-Epidemiology
                Custom metadata
                © Springer Science+Business Media B.V. 2010

                Public health
                cognition,dementia,china,nutrition,cross-sectional studies,childhood,aged
                Public health
                cognition, dementia, china, nutrition, cross-sectional studies, childhood, aged

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