Until such time, rigorous quality control using protein analysis methods such as qPCR or enzyme linked immunosorbent assay remains a sensitive method to confirm such contaminants are not detected in therapeutic diets fed for the purpose of the clinical diagnosis of CAFR. This remains the industry standard for quality control of commercially produced diets, including extensively hydrolyzed diets. In conclusion, this study confirms that commercial RMBD should not be considered appropriate for selection as ED in the diagnosis of CAFR as a result of their tendency to include unlisted protein ingredients, which can differ from batch to batch. A clinician should use caution when interpreting the results of an owner-directed ED trial using RMBD to exclude CAFR as a cause of their pet’s pruritic dermatopathy, and veterinarian-guided elimination diet oversight is still recommended. Until further evidence is presented, an elimination diet and provocation trial with a patient-appropriate prescription-based diet subjected to applicable quality control or a home-prepared novel protein diet remain the current diagnostic standard for CAFR.The CDPS is nationally recognized as the oldest, state-specific tracking survey for fruit and vegetable intake in the country. In 2005, it will represent sixteen years of bi-annual survey data using a modified 24-hour recall telephone interview methodology. Before this study, the examination of trends over time, especially for the race/ethnic groups of interest and for their low-income cohort, could not rule out seasonal effects. Because the CDPS has not always spanned the exact same months,plastic planters wholesale although generally it covers July through October, seasonal issues concerning the race/ethnic samples have been suspect.
The results of this study enhance both the interpretative dimensions of past and future CDPS findings. This study set out to achieve four objectives that are intended to illuminate and augment observations and methodological issues related to the California Dietary Practices Surveyin tracking fruit and vegetable consumption in the California population. The first and primary objective is to explore whether seasonal variation exists during the months of the year. The second is to quantify differences among, and seasonality effects as it relates to, the race/ethnic groups tracked by the CDPS, specifically Whites, Latinos, and African Americans. The third objective is to see if Latino acculturation plays a role in seasonal differences. And fourth, nested within this study is the calibration of a short form version of the CDPS dietary collection method. This study assesses this short form as a possible low-cost substitute data collection tool for tracking fruit and vegetable intake. Using identical CDPS methods, 8,543 telephone interviews were collected between November 2000 and October 2002. Sample sizes for each month of the year were approximately equal and included over-samples of low-income persons in the three race/ethnic groups of interest and of African Americans and Latinos in general. Interviews were conducted in both English and Spanish, and Latinos were further categorized into highand low-acculturation segments. Half of the overall sample was randomly assigned to answering three questions directly asking for the number of servings of fruit, fruit juice, and vegetables consumed on the previous day. These were asked ahead of the more extensive and detailed CDPS questions in order to avoid positive recall bias. Findings indicate that seasonality is not a factor in California for the adult population for the total number of servings of fruit and vegetables consumed, or separately for servings of fruit or servings of vegetables.
For the race ethnic groups in this study, this finding is the same for Whites and for Latinos. Additionally, no seasonality effects are seen for high-acculturation Latinos, however, results for low-acculturation Latinos are inconclusive. African Americans do have significant variation among months, mostly attributed to the month of December where there are large and significant intakes of servings of total fruit and vegetables and of servings of vegetables. However, since December is excluded from the usual CDPS data collection period, this finding is not a factor in interpreting CDPS data. For African Americans, although there appears to be some variation, there are no significant differences observed across the months of July through November, the months when CDPS African American samples and over-samples have been collected in the past. The overall conclusion is that there are no major month-to-month seasonality effects during the usual period of data collection for the CDPS for all adults, or specifically for Whites, African Americans, Latinos, and the low-income segments of these three race/ethnic groups. A noteworthy caveat is that these findings suggest, somewhat surprisingly, that the monthly patterns may be different from year to year. There is no explanation for this. Since this study only included two years of data, there is insufficient evidence to confirm this finding. Interpretation of CDPS trend data since 1989 can eliminate seasonality as an explanatory factor if patterns of monthly variation from July though October are assumed to be the same from year to year. This study suggests that this is the case.
Results comparing the SF3 with the CDPS method in measuring the number of servings of total fruit and vegetables show that the SF3 correlates positively and somewhat strongly . However, the SF3 was found to overestimate the number of servings of total fruit and vegetables by a little more than one-third of a serving . Among the three race ethnic groups studied, that overestimation is only slightly higher for African Americans . Since few surveys have sample sizes that can statistically differentiate groups at a level below half a serving, the SF3 appears to be a very good approximation of the number of servings of fruit and vegetables for population estimates in relation to the CDPS method. The conclusion is similar for estimating the number of servings of fruit. The degree of overestimation of the number of servings of fruit for all adults is higher than that for total fruit and vegetables, however, it is still less than half a serving . In estimating the number of servings of vegetables, the SF3 performed best in that there is no significant difference from estimates made using the CDPS method either for all adults or for any of the race/ethnic groups measured. The correlation is also good , although not as strong as that observed for fruit or for total fruit and vegetables. Although the point estimate for servings of vegetables in this study was not statistically different from the CDPS estimate, the lower correlation suggests the SF3 vegetable estimate will not track as well over time as the estimates for fruit alone or for total fruit and vegetables, both of which have relatively stronger correlations with the CDPS estimates. However, compared to dietary studies in general, all these correlations are still very good. In place of the CDPS method, the SF3 is a very good and potentially cost efficient way to obtain population estimates of the number of servings of fruit and vegetables. It should work well to track intake over time, but would likely produce a slightly higher estimate than that produced by the CDPS method. It is a good estimator of the number of servings of fruit. Estimates of the number of servings of vegetables,plastic plant pot although not as strongly correlated, should not be very different than those produced using the CDPS method. The California Dietary Practices Survey is conducted by the Cancer Prevention and Nutrition Section of the California Department of Health Services and the Public Health Institute to measure and track fruit and vegetable intake in the California population. Since its inception in 1989, the CDPS has been carried out every other year. From 1993 onward, an over-sample of Latino adults has been included, and since 1995, over-samples of low-income persons and low-income African Americans have been conducted. The CDPS is nationally recognized as the oldest, state-specific tracking survey for fruit and vegetable intake in the country.
In 2005 it will represent sixteen years of bi-annual survey data using a modified 24-hour recall telephone interview methodology. The results of this California Fruit and Vegetable Intake Calibration Study will enhance both the interpretative dimensions of past and future CDPS findings. Trends among White, Latino, and African-American groups have been a major focus of the CDPS.1 Between 1989 and 2001, the trend for the overall state estimates was relatively stable, starting at 3.8 servings in 1989 to 3.9 in 2001 . The highest estimate was 4.1 servings for 1995, dropping back to 3.8 in 1997 and 1999 and 3.9 in 2001. Among the majority White population, the trend mirrors the statewide trend. After an initial increase from 3.7 to 4.0 in 1991, the estimate has remained relatively flat at 3.9 servings per day, going to 4.0 in 2001. A much more pronounced increase has been observed among California’s Latino population. Starting relatively high at 3.9 servings in 1989 that increased to 4.7 in 1995 then fell almost a full serving to 3.8 in 1997 and returning to 3.9 in 2001. The trend among African Americans evokes even more concern because of its seemingly clear negative direction for a number of years. After an initial increase from 4.0 servings to 4.3 in 1991, each subsequent estimate has been lower. After a drop to 3.7 in 1993 it remained stable and lower at around 3.1 or 3.2 since 1997. A simple linear regression line fitted to these estimates for each race/ethnic group appears slightly positive for Whites and for Latinos, and negative for African Americans . However, the actual trend line or slope for Whites and for Latinos is technically flat, i.e., not statistically different from zero. The slope or trend line for African Americans is significantly negative . For a reasonable scientist, these observations also raise the question of a possible methodological or measurement flaw in the CDPS design. If only the statewide general population estimates were being made, the trend line appears believable even if discouraging when measured against the more than 10 years of effort by the 5 a Day—for Better Health! campaign. The race/ethnic subgroups, however, suggest another story. The question remains, how believable are these trends? Are there some critical adjustments not being made to these important data? If there is a race/ethnic difference, can a more precise difference be quantified? How much is the limited sample size of past surveys a contributor to these observations? Are the implementation methods suspect with regard to seasonal timing? One issue of possible measurement error may exist from the inherent logistic difficulties in obtaining past over-samples of Latino, African American, and low-income persons. To the best possible extent, the CDPS has been conducted mostly during the same months of the year, generally between July and October. Although conducting the survey in the same window of time each year is the operative objective, for a variety of funding-related administrative reasons, this has not always been possible. The actual data collection periods for the past seven surveys have been somewhat different. The 1989 survey occurred the earliest , while the 1993 survey ended the latest . Four surveys covered similar periods starting sometime in July-August and ending in September-October. This is also true for CDPS VI, because it finished data collection on November 2, 2001, making the effect of any cases in November negligible . The question arises whether or not there is a dimension of seasonal variation not accounted for in the CDPS estimates, especially in CDPS I and III. Equally important to acknowledge is that the more time consuming, “more difficult to reach” over-samples extended their data collection as much as four to six weeks beyond the end month for the general population shown in Exhibit 3 for CDPS III-VII. This places the Latino and much of the low-income African American data collection far outside the California “summer” period. These groupshave had their data collected well into the month of November when perhaps fruit and vegetable intake may be seasonally lower. Although fruits and vegetables are available throughout the year in the California, their cost is seasonally affected. This research examines if any seasonal variation exists for each of the racial/ethnic groups, both generally and for their low-income cohort. Seasonal variability in dietary intake has been recognized and measured using intake instruments other than the CDPS telephone interview method, but not for California alone.This study also measures seasonal differences among California’s Latino population based on different levels of acculturation.